# Therapy for anxiety: when to see a psychologist and what works for each type of anxiety > Your stomach has been in knots for months and you wonder whether a psychologist could help. Which therapy works for each type of anxiety, how long it takes and how to choose well. *https://mypsicotest.com/en/blog/therapy-for-anxiety/ · Published: 2026-10-06 · 8 min read · MyPsicoTest team* You wake up with your heart racing before the alarm goes off. You run through everything that could go wrong that day, your stomach is in knots and for weeks you have not been able to switch off properly. You have tried exercising, sleeping more, not thinking about it. Some of it helps, but the anxiety comes back. If you are looking for **therapy for anxiety**, you are in good company. According to the [World Health Organization](https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders), anxiety disorders are the most common mental health conditions in the world: 470 million people had one in 2023. And although highly effective treatments exist, only about one in four people receive any. This guide explains when it is worth seeking help, which therapy clinical guidelines recommend for each type of anxiety, how many sessions it usually takes, what role medication plays and how to choose a professional. ## When to see a psychologist for anxiety Everyone feels anxious sometimes, and in reasonable doses anxiety helps you prepare for what is coming. The WHO explains that in anxiety disorders, fear and worry are intense and excessive, hard to control and very distressing; they usually last for months and lead people to avoid the situations that trigger them. It is worth seeking help if: - The worry or fear has lasted for months and is not easing. - You are starting to avoid places, people or situations because of how you might feel. - Working, studying, sleeping or enjoying your free time is getting harder. - Physical symptoms such as palpitations, tension, sweating, trembling or stomach problems come up often. - You turn to alcohol or other substances to calm down. That last sign matters more than it seems: according to the WHO, anxiety disorders increase the risk of depression, of problems with alcohol and other substances and of suicidal thoughts. If you ever think about harming yourself, do not wait: in immediate danger, call **112** or your local emergency number, and in Spain the **024 line** is free and available at any time. If you are not sure whether what you are going through is anxiety, the [Anxiety Test](https://mypsicotest.com/en/anxiety-test/) can help you put a name to it before your appointment. ## Which therapy works for anxiety There is no single therapy for anxiety: it depends on the type. The WHO points out that the psychological interventions with the most evidence behind them are based on **cognitive behavioural therapy** (CBT), including exposure therapy, in which people learn to face their fears. The UK's NICE guidelines set out what to offer in each case, and for phobias the best summary is a meta-analysis of 33 trials: | Type of anxiety | Recommended therapy | Usual length | |---|---|---| | Generalised anxiety | CBT or applied relaxation | 12 to 15 weekly one-hour sessions | | Panic disorder | CBT | 7 to 14 hours in total, in weekly sessions of 1 to 2 hours, within 4 months at most | | Social anxiety | Individual CBT designed for social anxiety | Up to 14 sessions of 90 minutes over about 4 months | | Specific phobias | Exposure-based treatments | Varies; multi-session treatments do slightly better than single-session ones | ### Generalised anxiety This is constant worry about many things at once: work, health, family, money. The [NICE guideline on generalised anxiety disorder and panic disorder](https://www.nice.org.uk/guidance/cg113/chapter/Recommendations) follows a stepped-care model. First, information about the problem and monitoring. If that is not enough, low-intensity interventions such as guided self-help or psychoeducational groups. And if the anxiety does not improve or seriously interferes with life, a high-intensity psychological intervention or medication, chosen according to the person's preference, because there is no evidence that either option is better. That high-intensity intervention can be CBT or **applied relaxation**, a cognitive behavioural technique in which you learn, step by step, to relax within seconds and to do so as soon as the first signs of tension appear in everyday life. For both, the guideline describes 12 to 15 weekly one-hour sessions, fewer if the person recovers sooner and more if needed. ### Panic attacks A single panic attack is not panic disorder, NICE points out. It becomes a disorder when the attacks keep coming back and you live in fear of the next one. For mild to moderate panic disorder, the guideline suggests starting with self-help, with or without support from a professional. For moderate to severe panic disorder, CBT, or an antidepressant if the problem is long-standing or therapy has not worked or is not wanted. It also advises against benzodiazepines for panic disorder, because they are linked to worse outcomes in the long term. We explain what happens in the body during an attack in [Panic attack: what it is, why it feels like a heart attack and what to do](https://mypsicotest.com/en/blog/panic-attack/). ### Social anxiety For an intense fear of being judged, NICE recommends individual CBT developed specifically for social anxiety, such as the Clark and Wells model: up to 14 sessions of 90 minutes over about four months. It includes behavioural experiments, exercises to stop focusing attention on yourself and video feedback to correct the negative image people have of how others see them. The guideline does not recommend offering group CBT in preference to individual CBT. ### Specific phobias For an intense fear of something specific, such as flying, heights, dogs or needles, exposure is the treatment with the strongest evidence. A meta-analysis by Wolitzky-Taylor and colleagues, covering 33 trials, found that exposure-based treatments had large effects compared with no treatment and outperformed placebo and other psychotherapies. Multi-session treatments did slightly better than single-session ones, and more sessions were generally linked to better outcomes. ## What therapy for anxiety is like The first session is about understanding what is happening to you: when the anxiety appears, what triggers it, what you do to calm it and what it is costing you. From there, a plan is put together. In CBT, the work usually involves learning how anxiety works, reviewing the thoughts that feed it, gradually facing what you avoid and practising between sessions. We explain it step by step in [Cognitive behavioural therapy: what it is, how it works and what it treats](https://mypsicotest.com/en/blog/cognitive-behavioural-therapy/). ![Person on a video call at their kitchen table, looking worried, as in an online therapy session for anxiety](https://mypsicotest.com/assets/img/blog-terapia-online-ansiedad-1200.webp) Guidelines also ask for progress to be measured. NICE recommends that practitioners use questionnaires in sessions to track outcomes and involve the person in reviewing whether the treatment is working. It is a good sign if your psychologist does this. ## What about medication? Psychiatric medication is prescribed by a doctor, not a psychologist. For generalised anxiety, NICE suggests an antidepressant from the SSRI group as the first drug option and advises against benzodiazepines except as a short-term measure during a crisis. The WHO takes the same line: they are generally not recommended for anxiety disorders, because of their high potential for dependence and their limited long-term effectiveness. We compare the two options in more detail in [Anxiety medication or therapy: what works better for anxiety](https://mypsicotest.com/en/blog/anxiety-medication-or-therapy/). ## Does online therapy work for anxiety? There is evidence to support it. A [systematic review by Berryhill and colleagues](https://pubmed.ncbi.nlm.nih.gov/30188992/) brought together 21 studies of psychological therapy by video call for anxiety, mostly CBT, in people with panic disorder, generalised anxiety, social anxiety or health anxiety. Fourteen found significant improvements, and none of the controlled studies found any difference between video call and face-to-face therapy. The authors call for more rigorous research, but the result is promising. Another meta-analysis, by Carlbring and colleagues, covering 20 studies and more than 1,400 participants, found equivalent effects for therapist-guided internet CBT and face-to-face CBT across different conditions. ## How to choose a psychologist for anxiety These checks help you choose well: - **Licensing and registration.** That comes first, whatever the approach. - **Experience with anxiety.** Ask how they work with your particular type of anxiety. - **Evidence-based therapies.** CBT with exposure, applied relaxation for generalised anxiety or CBT designed for social anxiety. - **A clear plan.** They should explain what you will work on and roughly how many sessions they expect. - **Reviewing progress.** Measuring how you are doing makes it possible to adjust therapy in time. - **Coordination with your doctor** if you take or plan to take medication. ## A psychologist for anxiety At MyPsicoTest we recommend [Xènia Capel Salcedo](https://psicologaigualada.es/en/therapist-psychologist-igualada/), a licensed clinical psychologist (COPC 14982) with a master's degree in Clinical Psychology and Psychotherapy. Anxiety and depression are among the services at her practice in Igualada and in her [online therapy](https://psicologaigualada.es/en/online-therapy-online-therapist/), which she describes as the treatment of anxiety disorders, depression and other emotional difficulties that affect daily quality of life. She works from an integrative, evidence-based approach, adapting tools and techniques to each person and to their pace. Sessions last about 60 minutes, are available in English, Spanish or Catalan and end with small steps agreed for everyday life. On how long therapy lasts, she explains that it depends on each person: some need only a few sessions for a specific issue, while others choose to do deeper work. The first contact is a free, no-commitment information session by phone, and she herself points out that in a serious crisis or psychiatric emergency, immediate in-person care is what is needed. ## Frequently asked questions ### When should I see a psychologist for anxiety? When worry or fear has lasted for months, you cannot control it, it makes you avoid situations or it interferes with work, sleep or relationships. There is no need to wait until things get very bad: anxiety has effective treatments. ### What is the best therapy for anxiety? The therapies with the most evidence are based on cognitive behavioural therapy, including exposure. Guidelines are specific about each type: CBT or applied relaxation for generalised anxiety, CBT for panic disorder, CBT designed for social anxiety and exposure for phobias. ### How many therapy sessions does anxiety take? It depends on the type of anxiety and the person. As a guide, NICE describes 12 to 15 weekly sessions for generalised anxiety, 7 to 14 hours of CBT for panic disorder and up to 14 sessions of 90 minutes for social anxiety. ### Can anxiety be treated without medication? Yes. For generalised anxiety, guidelines offer either psychological therapy or medication and ask for the decision to follow the person's preference, because there is no evidence that either is better. Benzodiazepines are not recommended except as a short-term measure during a crisis. ### Does online therapy work for anxiety? Yes. A review of 21 studies of video-call therapy for anxiety found improvements and no difference from face-to-face therapy in the controlled studies. In a serious crisis, in-person care is what is needed. ### What does a psychologist do in the first session for anxiety? They get to understand what is happening to you: when the anxiety appears, what triggers it, what you do to calm it and how it affects your life. From there, they agree a plan of work with you. ### Is a panic attack the same as panic disorder? No. A single panic attack is not a disorder. Panic disorder is diagnosed when the attacks keep coming back and you live in constant fear of having another one.