Therapy For Anxiety Options

Medically reviewed by Laura Angers Maddox, NCC, LPC
Updated April 26, 2024by BetterHelp Editorial Team
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There are many types of therapy that can treat anxiety

Many people do not realize just how many treatment options there are when it comes to therapy for anxiety and anxious feelings. Anxiety is a very treatable condition with psychotherapy for anxiety. There are a variety of different therapeutic techniques and psychological treatments that are used for treating anxiety disorders that can affect one’s mental and physical health. 

This article examines how anxiety therapy works, what types of therapies might be included in a treatment plan aimed at reducing anxiety symptoms, and how you can find a mental health specialist trained in treating mental disorders. 

About therapy for anxiety symptoms 

According to the American Psychiatric Association, “Anxiety is a normal reaction to stress. . . Anxiety disorders differ from normal feelings of nervousness or anxiousness and involve excessive fear or anxiety. Anxiety disorders are the most common of mental disorders. They affect nearly 30% of adults at some point in their lives. However, anxiety disorders are treatable with a number of psychotherapeutic treatments. Treatment helps most people lead normal productive lives.”

Additionally, the Anxiety and Depression Association of America states that “anxiety disorders are the most common and pervasive mental disorders in the United States.”

According to the Diagnostic and Statistical Manual of Mental Health Conditions (DSM-V), generalized anxiety disorder is diagnosed based on the following criteria

  • Excessive anxiety and worry 

  • Difficulty controlling worry 

  • Anxiety and worry are associated with at least three of the following: 

    • Restlessness

    • Being easily fatigued 

    • Difficulty concentrating 

    • Irritability 

    • Muscle tension 

    • Sleep disturbance 

  • Symptoms cause significant distress or impairment in daily functioning 

  • Disturbance is not better explained by a substance or another mental health condition 

There are several ways to treat anxiety disorders and similar mental health conditions. With a trained mental health professional by your side, you can explore a range of treatment options and combinations, including anti-anxiety medication. 

A meta-analysis review published by International Clinical Psychopharmacology found that medications, online therapy, in-person therapy, eye movement desensitization and reprocessing (EMDR) therapy, and group CBT therapy can all have benefits for people living with anxiety disorders and related psychiatric disorders. Which anxiety therapy works best for you can depend on several factors. And consulting with a trained professional is often the best way to get recommendations for treating specific symptoms. 

Not every type of psychotherapy works for every person. Every patient and every presentation of anxiety can be different. You may need to try several different types of therapy for anxiety disorders before you find the one that lessens feelings related to the condition(s) for you.

For example, some individuals with anxiety disorder might benefit from interpersonal therapy while others might do best with psychodynamic therapy or psychoanalytic therapy. The National Institute of Mental Health lists several types of treatments which may be viable. 

Some people may benefit from a combination of different types of therapy for anxiety or other mental health needs. Many types of therapy for anxiety can be used in conjunction with one another to treat symptoms while addressing the underlying cause(s) of the anxiety or other co-occurring conditions, such as panic disorder, social anxiety disorder, obsessive-compulsive disorder and others.

Mindfulness-based therapy

Mindfulness-based therapy is a type of therapy that many believe was originally developed for the prevention and reduction of anxiety and depression. Mindfulness-Based Therapy has been found to have positive effects in the treatment of anxiety as well. This is a variation of cognitive therapy and is often referred to as MBCT, or Mindful Based Cognitive Therapy.

Several studies have shown that mindfulness-based therapy can reduce symptoms of anxiety in a way that is comparable to other behavioral therapy options (such as cognitive behavioral therapy). However, many agree that more research needs to be conducted to examine the effectiveness of this treatment modality in treating anxiety symptoms.

Mindfulness-based therapy is similar to cognitive behavioral therapy (CBT) in that it generally focuses on changing the way you think, and it focuses on the link between your thoughts and feelings. Some of the techniques you will learn in mindfulness-based therapy are mindful meditation and breathing exercises. Sessions are usually done in a group setting, but can also be conducted individually. 

Cognitive therapy

Cognitive therapy is generally based on research that shows that there is a definite link between the way you think and the way you feel. Many people who experience anxiety have thoughts that things will go wrong, they tend to worry and have bouts of fear. Learning how to control those thoughts and changing the way you think can reduce your anxiety or eliminate it completely. The process of identifying negative thinking patterns (cognitive distortions) and replacing them with more rational and positive thoughts is called “cognitive restructuring”. Clinical neuroscience experts have found evidence that cognitive therapy is an effective way to restructure automatic thinking patterns

In cognitive therapy, your thoughts and views on yourself and the world are challenged. It can be very uncomfortable at first. Many people instinctively resist the process this treatment method entails, therefore, trusting the process and the therapist and completing homework assignments as suggested, are key to successful outcomes. It can be extremely effective, but you have to put in the effort to make it work. 

Virtual reality exposure therapy

Some specific causes of anxiety or phobias can be treated with exposure therapy. Virtual reality exposure therapy is a new way to facilitate change using old theories. The idea is to gradually or abruptly instigate exposure to what it is that is making you anxious. Repeated exposure can help desensitize you to the stimuli that are causing your anxiety.

Virtual reality exposure therapy is becoming a preferred method of exposure therapy because it can take place entirely in the presence of the therapist. The therapist can be there to make sure that the situation does not get out of control, and they can stop the treatment if it becomes too stressful.

Therapeutic techniques using VR technology could enable clients to face their fears in a safe environment, but the effectiveness of virtual reality exposure therapy is not yet well-researched. Some studies suggest that it can decrease symptoms of anxiety. However, more research is needed as to how well virtual reality works to decrease or eliminate anxiety.

Cognitive behavioral therapy

Cognitive behavioral therapy, or CBT, is a very common and well-researched form of psychotherapy that has been found to be extremely effective in the treatment of anxiety and other psychological disorders. The basis for cognitive behavioral therapy is that anxiety is based all or in part on unhelpful ways of thinking or behaving. The theory is that these thoughts and actions are frequently learned, and they can be unlearned or replaced with more helpful thoughts and behaviors.

Cognitive behavioral therapy has been well-researched over the years and there is evidence that it can be an effective form of therapy for anxiety disorders and related disorders whether it is online or in person therapy.  A randomized controlled trial from 2020 surveying the effects of online cognitive therapy for patients with clinical anxiety found that engaging in digital CBT could effectively improve:

  • Depressive symptoms

  • Insomnia

  • Nervousness

  • Well-being 

  • Quality of life 

Cognitive behavioral therapy may focus on learning to recognize your unhelpful thoughts and actions and making a conscious effort to change those thoughts and behaviors. One of the goals of CBT is to give you confidence that you can make positive changes in your life. Cognitive behavioral therapy may use some tools to help you on this journey.

Cognitive behavioral therapy (CBT) is one of the most widely used therapy techniques and many other types of therapy use CBT methods. Like other types of therapy, you will frequently have homework from your therapist when you are going through the process of cognitive behavioral therapy. It is important to do all of the work assigned to you because the sessions themselves can only teach you the tools. You have to use the tools in your everyday life for a change to occur.

Dialectical behavior therapy (DBT) 

Dialectical behavior therapy (DBT) is similar to CBT, but it focuses more on teaching coping skills related to behavior. It is a form of talk therapy that is popular for people with borderline personality disorder, but it can also be effective for other types of mental illness such as anxiety. DBT is specifically adapted for treating patients who experience intense emotions. 

“Dialectical” means to combine opposites. In DBT therapy, the patient learns how to accept the reality of experiencing strong negative emotions while also changing their unhelpful behaviors. It focuses on teaching coping skills to help individuals navigate intense emotions in a healthy way and improve interpersonal relationships. The distress tolerance skills taught in DBT therapy can be beneficial for reducing anxiety levels. 

Dialectical behavioral therapy is also used to treat borderline personality disorder, major depression, and specific phobias. It may also help individuals who have gone through traumatic experiences. 

Family therapy

A research study published in The American Journal of Psychiatry found that family therapy can prevent the spread of anxiety disorders from parents to their children. Experts in adolescent psychiatry theorize that children may be susceptible to developing high anxiety levels and anxiety disorders from close family members. Family therapists specialize in working with multiple family members and understanding how family dynamics can impact mental health and behavior. Family therapy may be the most effective when every family member chooses to actively participate. 

Animal-assisted therapy

Studies have shown that animal-assisted therapy is extremely effective in reducing symptoms of anxiety. Animal-assisted therapy may involve a trained animal, its handler, and a therapist using the animal's behaviors and interactions with the patient to work towards achieving the therapeutic goals that were agreed upon with the patient.

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The research done on animal-assisted therapy has also led to the common practice of emotional support animals as a method of therapy at home. Trained emotional support animals can greatly reduce symptoms of anxiety when you are not with your therapist or a trained handler and their animal. Of course, there are places where you cannot take an emotional support animal, and getting a trained animal for this purpose can be costly and difficult.

Acceptance and commitment therapy

Acceptance and commitment therapy is a fairly new kind of psychotherapy that is based on relational frame theory and philosophical and psychological research and analysis. In this type of therapy, the patient is led to examine and accept things in their past or present that relate to their anxiety. Once the patient reaches acceptance, they commit to change or maintain a behavior that meets their goals.

Many exercises are used in acceptance and commitment therapy. These may include metaphor, paradox, or experiential exercises. You will learn to make healthy contact with your thoughts, feelings, and experiences, and acknowledge and accept them in the present. You will then commit to making changes in thoughts or behavior to better meet your overall goals.

Some initial studies on acceptance and commitment therapy indicate that it can be as effective as cognitive therapy, although it works in a much different way. The studies have shown that although the mechanisms are different, overall outcomes are similar.

Massage therapy

Massage therapy is not a treatment for anxiety per se. However, it can be helpful in the treatment of symptoms of anxiety while you are working with other methods to decrease or eliminate the anxiety. Stress can make anxiety worse; stress management like massage therapy, walking outside, yoga, and meditation can be beneficial during the treatment process and reduce the physical effects of anxiety such as muscle tension. 

Studies have shown that massage therapy decreases nervousness not just during the massage, but lasting for some time after the massage, especially when the massage therapy is repeated throughout the week for several weeks in a row.

Meditation therapy

Meditation can also be used to reduce the symptoms of anxiety. Transcendental meditation specifically has been shown to reduce the effects of anxiety greatly. However, this should not be used as your sole method for combatting anxiety. It is important to make use of psychotherapy to address the core problem of the anxiety rather than simply trying to cope by reducing the anxiety through meditation.

Muscle relaxation therapy

Muscle relaxation therapy is another way that you can reduce anxiety on an ongoing basis while undergoing other treatments to address the core problem of anxiety. Muscle relaxation therapy is most frequently done through progressive muscle relaxation, which can be described as a relaxation technique similar to body scan meditation, that can be done on your own or with the direction of a therapist. Anxiety can have physical effects on the body such as muscle pains and aches, but relaxation techniques like muscle relaxation therapy can help. 

Exposure therapy

Some anxiety disorders are characterized by an irrational fear or excessive worrying about a feared outcome. Exposure therapy is one of the most effective ways to treat situational anxiety or phobias. Through exposure therapy, you are exposed to the stimuli that are causing your anxiety. The idea is to desensitize you to the stimuli so that you are no longer worried about or afraid of it.

The biggest downfall of exposure therapy is that some phobias or situations that cause anxiety cannot be duplicated in the therapist's office. Often exposure therapy is done by the therapist helping you to evaluate your feelings about the stimuli, and then assigning homework to expose yourself to the stimulus outside of their office, reporting back at the next session to discuss and evaluate results.

Exposure therapy might be immediate where you are exposed fully to your fears all at once, or they can be gradual. Therapists generally prefer a gradual approach because it allows for a much more controlled and learned response. 

One approach to exposure therapy is a process referred to as “systematic desensitization”. Systematic desensitization involves pairing relaxation techniques with exposure to the phobia or fear in order to rewire the brain’s connections to not have a fear reaction to that stimuli. For example, practicing relieving muscle tension with progressive muscle relaxation techniques while thinking about the fear. Other relaxation techniques used in systematic desensitization therapy include deep breathing, visualization, and meditation.

Support groups

Going to an anxiety support group may be a more affordable option than traditional therapy for some people. Other benefits of attending a support group include having social support during treatment and learning from the other members. There are different types of support groups you can attend, but they generally include 5-10 members and one or more therapists or other mental health professionals. The effectiveness of peer support groups for people with anxiety has been studied and there is evidence that it can be highly beneficial for treatment. 

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There are many types of therapy that can treat anxiety

Creative arts therapy 

There is a range of complementary therapies for anxiety that can be combined with the main form of treatment for anxiety. Complementary therapies include things like art therapy and pet therapy. Creative arts therapy alone may not be enough to treat clinical anxiety, but it is a helpful tool to use during treatment. 

Creative or expressive arts therapy includes things like painting, dancing, writing, and drawing. Art therapists teach individuals how to express their emotions through various creative outlets. Creative arts can help people build self-esteem, control emotions, and relieve stress. A research study on the effects of art therapy on adult women with anxiety found that art therapy reduced anxiety symptoms and improved quality of life by teaching acceptance of emotions and improving goal-oriented action.

Finding therapy for anxiety disorders

Now that you have an idea of the many different types of therapy for anxiety, your next step is to contact a therapist to get started. A good therapist, such as those available through BetterHelp, will be familiar with all of these therapies and will be able to help you determine what might work best for you. If one therapy is not helpful after several weeks, another therapy can be tried. Remember that everyone is different, and this is your journey.

An excellent option for those with anxiety is online therapy. Online therapy through services like BetterHelp has been found to have just as much positive effect as its traditional in-person counterpart at a significantly more affordable price point. It’s often more convenient for those with anxiety, as meeting in the comfort of their own home can avoid unnecessary stressors. 

Takeaway

There is a wide range of therapy options available for those who live with anxiety. Each has its unique set of benefits for overcoming the symptoms of anxiety and allowing you to regain control over your recovery.
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