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by Michael Stein, PsyD

If you have made the wise decision that it is time to get help, first of all: good for you. Treatment for anxiety disorders requires a significant investment of time, energy, and effort. If you are going to invest so much, there are a few key things you can do to maximize your chances that your recovery from your anxiety disorder will be successful.

First and foremost, you need to choose a good therapist who specializes in treating anxiety. That starts by making sure your therapist practices evidence-based treatment (treatment methods that have demonstrated their effectiveness in research studies). For anxiety, this practically always means some form of cognitive behavioral therapy (CBT), most often with an emphasis on Exposure Therapy, a form of CBT that has been shown to be particularly effective for anxiety disorders. 

You should ask prospective therapists about their treatment methods, what percentage of their caseload is anxiety cases (most therapists treat anxiety but only a specialist spends most or all of their time on it) and whether they feel they are typically successful in treating anxiety (the answer should be a confident "yes").   The "Find a Therapist Directory" on this website is a good place to start looking for a qualified anxiety specialist.

Once you have found a good therapist, the most important thing you can do is quite simple: trust them.

Therapy for anxiety requires you to face your fears and do things that may feel risky and anxiety-provoking. It also requires you to practice new skills (like acceptance, tolerance of uncertainty, and mindfulness) that may feel unnatural to you at first. When your therapist suggests these things, your first reaction may be skepticism: "I can't do that", "That's too scary", and "That might work for other people but not for me" are common thoughts that people have when they first learn some of the strategies that work for anxiety. 

It's understandable and valid to be skeptical and scared, but look at it this way: if you don't trust your therapist, there is no chance that the therapy can work. If you trust your therapist, even if you're skeptical that it will work, there is at least the chance that the therapist's ideas are correct and that it will work.  So trusting your therapist is the only option you have that allows the possibility for success. And it's actually quite a good possibility for success; research shows that CBT/exposure therapy for anxiety is effective for most people who try it.

The importance of trusting your therapist ties into what I have found to be the biggest factor that determines clients' success in therapy for anxiety: doing your therapy homework. 

While therapy is a place to learn and practice the skills that are effective for anxiety, change doesn't actually happen during your therapy sessions. What really counts is you taking the things you've learned in therapy and applying them outside of sessions on your own. 

In my experience with both my own clients and the clients of all the students I've supervised, clients who do their therapy homework get better and clients who do not do their therapy homework do not get better.

Following through on therapy homework often requires taking risks and doing things that seem counter-intuitive. Clients who are successful in therapy typically approach it with a willingness to experience the discomfort brought about by therapy homework in the short-term, knowing that this will lead to relief of their anxiety in the long-term. 

For example, a client with contamination OCD (fears of germs) would be asked to touch things that they perceive to be dirty (e.g. door handles, floors, toilets, trash cans) and then not wash their hands, even though that feels like they are risking getting sick. Or a client with anxiety about losing a relationship might be asked to stop seeking reassurance from their relationship partner even though the uncertainty feels intolerable and reassurance feels good. 

There's no way around it: for anxiety to get better, you must go through the anxiety in the short-term. Generally speaking, clients who are willing to push through short-term anxiety get better and clients who are not willing to do this do not get better.

I hope these tips are helpful as you start your journey into treating your anxiety. It may feel daunting at first, but rest assured, you will be successful if you put the work in!


About the Author

Dr. Michael Stein is a licensed clinical psychologist who has spent 13 years specializing in the treatment of anxiety disorders and OCD using Exposure Therapy and other evidence-based behavioral interventions. He is the founder and owner of Anxiety Solutions, a group private practice that serves clients with anxiety and OCD both online and at its offices in Denver, CO and Reno, NV. He sees clients, teaches, and supervises other therapists from Anxiety Solutions' Denver office. He is passionate about both helping his own clients overcome anxiety and OCD and expanding access to quality care for these problems. 

The article is spot on and has proven true in my own experience. Thank you for all your work Dr. Stein. It's made a huge impact in my life.