Therapy for Anxiety. What to Expect and How It Works.
Understanding anxiety
Anxiety is a normal human response. Your brain is trying to keep you safe. A little anxiety can help you prepare for a test, drive carefully in a snowstorm, or protect your kids. It becomes a problem when the alarm stays on most of the time, shows up even when you are not in real danger, or starts to control your choices.
You might notice constant worry and overthinking, panic attacks, trouble breathing, intrusive thoughts that feel disturbing or “not me,” checking or googling for reassurance, avoiding people, places, driving, school, or certain tasks, and feeling “high functioning” on the outside but tightly wound inside.
If anxiety is starting to run your day, therapy for anxiety can help you feel safer in your own body and get your life back.
What therapy for anxiety actually looks like
A lot of people imagine therapy as “just talking about your feelings.” Good anxiety therapy is more focused than that. In anxiety therapy, you and your therapist: Map out how anxiety shows up in your thoughts, body, and habits Learn skills to calm your nervous system Understand what keeps anxiety going Practice new ways of responding, not just talking about them You are not a passive patient. You are a teammate in the process.
The first few sessions
In the beginning, your therapist will usually: Ask what brought you in and what feels hardest right now Ask about your history with anxiety, mood, trauma, and health Get curious about your relationships, work or school, and support system Help you name clear goals, like “drive on the highway again” or “sleep without checking the baby monitor every 10 minutes” Share how they treat anxiety and what a plan might look like You can also share what has and has not helped before and any fears you have about therapy itself.
What happens in ongoing sessions
After those first meetings, sessions usually follow a simple rhythm: Check in What went well, what felt hard, how anxiety showed up this week. Learn or practice a skill A thinking tool, a body calming tool, a boundary script, or a small exposure step. Plan real life practice How you will use that skill between sessions in your actual routines. Adjust the plan If something is not working, you talk about it and tweak it together. You leave with something concrete to try, not just insight.
Core types of anxiety therapy we use
Most people do not need the technical names of every therapy. What helps is knowing what we actually do together. At Emberly Counseling, we mainly use cognitive behavioral therapy, exposure based work, acceptance and commitment therapy, interpersonal work, and trauma informed approaches like EMDR when needed.
Cognitive behavioral therapy (CBT) for anxiety
Cognitive behavioral therapy looks at two things: The thoughts running through your mind The things you do when you feel anxious CBT helps you see how: Thoughts like “I will definitely mess this up” or “Everyone will judge me” spike anxiety Behaviors like avoiding, checking, and reassurance seeking keep anxiety strong Then we work together to change those patterns.
Types of negative thinking
Common thinking habits that fuel anxiety include: Catastrophizing “If I make one mistake at work, I will get fired and lose everything.” Mind reading “They think I am annoying. I just know it.” Overgeneralizing “Last presentation went badly. I will always fail at public speaking.” All or nothing thinking “If I am not the best parent, I am a terrible parent.” These are called cognitive distortions. They are very convincing in the moment and they keep your nervous system on high alert.
Example: a friend invites you to a big party
Same invitation, three different inner stories: “I am tired, but it might be fun to see people.” “It is fine either way.” “If I go, I will say something weird, everyone will notice, and I will never live it down.” CBT for anxiety helps you move from that third story to something more balanced, like: “I will probably feel awkward at first, but that is normal. Most people are focused on themselves. I can leave early if I need to.”
Thought challenging in CBT
Thought challenging is a simple but powerful process: Catch the thought “If I have a panic attack in public, everyone will think I am crazy.” Check the facts Has that actually happened before? What did people really do? How often does your feared outcome occur? Notice the distortion Are you catastrophizing, mind reading, or ignoring other possible outcomes? Create a more realistic thought “Panic attacks feel awful, but they pass. Most people either do not notice or are worried for me, not judging me. I have gotten through this before.” Practice it in real life You use that new thought during the week when anxiety spikes. This is not about pretending everything is fine. It is about telling yourself the full story, not only the worst case version.
Exposure therapy for anxiety
Avoidance is one of anxiety’s favorite tools. It makes you feel better in the short term and more trapped in the long term. Exposure therapy reverses that pattern in a careful way. You and your therapist: List the things you fear and avoid Rank them from “uncomfortable” to “terrifying” Practice facing them in steps, with support Over time, your brain learns that the situation is not as dangerous as it feels, or that you can handle the feelings that come with it.
Systematic desensitization and a fear of flying
For example, if you have a fear of flying, you might: Start by looking at photos of planes Then watch a video of a plane taking off Then drive past the airport Then sit in the airport without boarding Then take a short flight with support At each step, you use skills like breathing and thought challenging. You stay with the step until your anxiety drops. Then you move up to the next step. You are never forced to jump straight into your worst fear with no warning. Good exposure therapy is planned, collaborative, and at your pace.
Acceptance and commitment therapy (ACT)
Some people feel more stuck when they fight their anxiety all day. Acceptance and commitment therapy can help. ACT focuses on: Noticing anxious thoughts and feelings without getting swept away Seeing thoughts as “stories” your brain tells, not as facts you must obey Getting clear on your values, like being a present parent or a kind friend Taking small steps toward those values, even when anxiety is along for the ride The goal is not to erase anxiety. The goal is to give anxiety less power over your choices.
Interpersonal and trauma focused work
For many people, anxiety is tied to: Conflict with a partner or family People pleasing and thin boundaries Old attachment wounds and trauma Major life shifts, like becoming a parent or going through a breakup Interpersonal therapy and trauma informed work help you: Understand patterns in your relationships Practice clearer communication and boundaries Process past experiences that keep your nervous system on edge At Emberly Counseling, we are EMDR trained and trauma informed. That means safety and pacing come first, especially if trauma and anxiety are tangled together.
How therapy and medication fit together
Medication and therapy for anxiety can both be helpful. They just do different things. Medication can: Take the edge off panic or intense physical symptoms Help with sleep and appetite Create enough space so you can use therapy skills Therapy can: Teach you how anxiety works in your brain and body Change the thinking and behavior patterns that keep anxiety going Give you tools you can use long after medication is finished Sometimes they are used together, especially when: Anxiety is severe and you can barely function There is also major depression, bipolar disorder, or PTSD Your body is so activated that it is hard to sit through a session At Emberly Counseling, we do not prescribe medication, but we are happy to collaborate with your doctor or psychiatrist so you feel supported on all sides.
## How long anxiety therapy takes and how you know it is working
There is no one timeline, but research and lived experience tell us a few things.
Typical length and early changes
Structured anxiety therapies, like CBT and exposure, often run 8 to 20 sessions. Some people need less, some need more, especially when there is trauma, OCD, or long term avoidance. People often notice early shifts like: Feeling less alone and more hopeful Understanding what is happening instead of feeling broken Having one or two tools that actually help in the moment
Signs that anxiety therapy is helping
You might notice that: Your spirals are shorter or less intense You can do things you used to avoid, even if you still feel nervous You need a bit less reassurance from others You are more present with your kids, partner, or friends Sleep or appetite start to settle Your therapist will also keep an eye on progress by asking about: How often panic attacks happen How often you check, google, or avoid What you can do now that you could not do a month or two ago We look for trends, not perfection.
How long results last
Skills from therapy for anxiety are meant to be portable. They can last a long time, especially if you: Keep using them Catch avoidance early when it creeps back in Come in for a tune up when life gets extra hard Big stressors, like a new baby, a loss, or a major change, can wake up old patterns. That is normal. It is not a failure. It just means you may need some extra support for a season.
Making anxiety therapy work for you
Therapy works best when it is a real partnership. A few things that help: Be as honest as you can, even if you feel embarrassed Show up, especially on the days you want to cancel Try the homework, even if it feels awkward at first Tell your therapist what is and is not helping Notice small wins, like answering one email or saying no one time You do not have to impress your therapist. You are there to practice, not perform.
Getting started with anxiety therapy at Emberly Counseling
Emberly Counseling serves teens and adults in Pennsylvania who are living with: Anxiety and high functioning anxiety OCD and intrusive thoughts Trauma and PTSD Depression and burnout Relationship strain, people pleasing, and boundary issues Pregnancy and postpartum anxiety, including scary thoughts and birth trauma Our approach is: Evidence based and practical Relational and down to earth Tailored to you, not one size fits all We want you to feel safe, seen, and supported. You set the pace. We bring the plan and the tools. If you are curious about therapy for anxiety, you can reach out for a free consultation and see if we feel like a good fit. If we are not the right match, we will do our best to point you toward other options.
FAQ: Therapy for Anxiety At Emberly Counseling
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Therapy for anxiety is a series of guided conversations and exercises that teach you how anxiety works, help you face the things you fear in safe steps, and give you tools to handle worry, panic, and intrusive thoughts in daily life.
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For many people, yes. Research supports therapies like cognitive behavioral therapy and exposure therapy for panic, social anxiety, OCD, phobias, and more. No approach helps everyone, but anxiety therapy is one of the most studied and effective types of therapy we have.
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We work with people who live in Pennsylvania. For current information about online and in person options, you can check our site or contact us directly, and we will help you figure out what format makes sense for you.
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Most people start with weekly therapy for anxiety so skills can build steadily. As you feel more stable and confident, we may move to every other week or use occasional booster sessions. We will decide this together.
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You are not the only one and you are not “too much.” Shame and silence keep people stuck. At Emberly Counseling, our goal is to offer steady support, clear information, and practical tools, so you can move out of hiding and into a life that feels more honest and livable.
