Therapists for anxiety employ various approaches to help clients manage their symptoms and improve their well-being. While some approaches focus on addressing the root causes of anxiety, others concentrate on teaching clients coping strategies and changing their relationship with their anxious thoughts and feelings.
Here’s a breakdown of what therapists might do, drawing on different methods and principles:
- Assessment and Diagnosis: Therapists may start by assessing the client’s symptoms, including physical sensations, cognitive patterns, and behaviours, in order to understand the nature and severity of their anxiety. They might use lay descriptions of major anxiety disorders, rather than medical labels, to discuss these issues with the client. They may explore how much the anxiety interferes with the client’s life.
- Education About Anxiety: A therapist may provide education about the nature of anxiety, including its purpose and function as a normal human experience. They may explain the difference between fear (an immediate response to a present danger) and anxiety (worry about the future). A therapist may explore how normal anxiety can become problematic or disordered, and work with clients to understand their own experience. Therapists may explain to clients that anxiety is a normal part of life, and not something to be “gotten rid of”. They may also work to dispel common misconceptions about anxiety.
- Identifying Avoidance Patterns: Therapists often help clients identify patterns of avoidance, and how these patterns narrow the client’s life space. They might explore behaviours the client uses to manage or control their anxiety, including physical escape and cognitive strategies such as reassurance seeking. By helping clients understand how these strategies work in the short and long term, therapists may help clients see that their coping methods may be part of the problem.
- Exploring Past Coping Strategies: Therapists often review past attempts to control anxiety, such as relaxing, distraction, reassurance or taking medication. By identifying what the client has already tried, therapists can help clients determine if these strategies have been helpful, and also avoid repeating past ineffective treatments.
- Shifting Focus from Control to Acceptance: Many approaches, particularly Acceptance and Commitment Therapy (ACT), encourage clients to shift their focus from controlling or eliminating anxiety to accepting and moving with it. This involves recognising that trying to suppress unwanted thoughts and feelings can be counterproductive. Therapists may help clients to recognise what they can and cannot control and to distinguish one from the other.
- Mindfulness and Defusion Techniques: Therapists may utilise mindfulness exercises and techniques that promote a non-evaluative stance toward thoughts and feelings. This can include mindful breathing exercises that are used to help clients experience their experience fully, without trying to change it. Therapists may use defusion techniques to help clients recognise that their thoughts are not facts and weaken the fusion of language and experience. They may encourage clients to observe their thoughts and feelings rather than reacting to them.
- Values-Based Approach: Some therapies, such as ACT, encourage clients to identify their values and goals in life and to take actions that align with those values, even when experiencing anxiety. The therapist may encourage the client to connect with what they want their life to be about, beyond managing anxiety. This can involve helping clients to clarify what is important to them and to commit to making choices that are consistent with those values.
- Exposure Therapy: Some therapists use exposure therapy to help clients gradually face their fears and reduce avoidance behaviours. This could involve working through exercises that help clients experience what they are avoiding, in order to show them that these things are not actually harmful. Therapists may help clients create a list of high risk situations to approach.
- Identifying Triggers: Therapists may work with clients to identify specific triggers for their anxiety. This process helps to determine specific situations or thoughts that provoke anxiety, in order to address the triggers directly.
- Promoting Self-Compassion: Therapists may encourage clients to be kind and understanding towards themselves when experiencing anxiety. They help clients to become aware of and reduce their secondary emotions about their emotions such as anger, frustration or despair.
- Focus on the Present Moment: Therapists may guide clients toward being more aware of the present moment and focusing less on future worries. By helping clients stay grounded in the present, they may reduce overthinking or worry about the future.
- Developing New Coping Strategies: Therapists work with clients to develop new, flexible ways of responding to anxiety, rather than relying on old patterns of avoidance and control. This might include teaching relaxation techniques, self-talk strategies, or other tools to manage symptoms. A therapist may suggest self-talk strategies that activate imagery or internal dialogue.
- Emphasis on Action and Behavioural Change: Rather than focusing on managing or eliminating anxiety as a goal, therapists may help clients to focus on behavioural changes and action steps. By encouraging clients to do what matters to them, and live a richer and more meaningful life, a therapist may help them to move beyond their anxiety, even when it is present.
- Working with Setbacks: Therapists may help clients to prepare for and respond to setbacks in their recovery process by using mindful observation practices and drawing on skills they have learned. This is to help clients understand that anxiety is part of life and that they can use the skills they have developed to navigate these situations.
It’s important to note that the specific approach a therapist uses will depend on their training and the client’s individual needs. Some therapists might draw on a combination of techniques or work within a specific framework, such as ACT or SFBT. They may also encourage clients to seek support from other sources, such as friends, family, support groups or self-help resources. Overall, the goal is to empower clients to manage their anxiety effectively and live full and meaningful lives.