Our therapists offer counseling for anxiety & depression in Greensboro, NC

I gravitate towards an integrative approach utilizing psychodynamic therapy, DBT, CBT, psychoeducation, and mindfulness-based practices. I find the strongest efficacy in psychoeducation because the more clients understand their anxiety, the better equipped they are in dealing/managing their anxiety.

My go-to approach for treating anxiety is Cognitive Behavioral Therapy (CBT), which focuses on identifying and challenging anxious thoughts while introducing healthier thinking patterns and behaviors. I find the best benefit in combining cognitive restructuring with exposure therapy because it addresses both the mental and behavioral aspects of anxiety. Exposure therapy helps clients gradually confront their fears in a controlled and safe environment, reducing avoidance behaviors. I also incorporate mindfulness and relaxation techniques, like deep breathing or progressive muscle relaxation, to help manage anxiety in real-time. This approach provides both immediate relief and long-term strategies for managing anxiety.

I reference polyvagal theory frequently to explain our body's natural response to things that cause anxiety or fear. I provide psychoeducation of the tools they can learn and practice for anxiety management. (These tools are also pulled from polyvagal theory and understanding the function of the nervous system. For example, teaching clients to use cold temperature as a resource for reducing anxiety).

I teach the following tools in anxiety therapy:

• Cognitive Restructuring: Helps clients identify and challenge irrational or negative thoughts, replacing them with more balanced and realistic thinking patterns.
• Exposure Therapy: Gradually exposes clients to anxiety-provoking situations in a controlled way, helping them build tolerance and reduce avoidance behaviors over time.
• Mindfulness: Teaches clients to stay present and observe their thoughts and feelings without judgment, helping to reduce anxious thinking and rumination.
• Deep Breathing Exercises: Guides clients in using slow, deep breaths to calm their nervous system and reduce physical symptoms of anxiety, such as a racing heart or shortness of breath.
• Progressive Muscle Relaxation: Involves tensing and relaxing different muscle groups to release tension and promote physical relaxation, which can ease anxiety.
• Grounding Techniques: Helps clients focus on the present moment, using the five senses to anchor themselves and reduce overwhelming anxious thoughts.
• Problem-Solving Skills: Teaches structured ways to approach and solve stressful situations, reducing feelings of helplessness and anxiety.
• Self-Monitoring: Encourages clients to track their anxiety levels, triggers, and coping strategies, promoting greater awareness of patterns and progress.

I notice a client is making progress when they talk about their anxiety as separate from themselves. I believe a major component of psychotherapy is helping the client recognize that they are not their condition, so when separating themselves from their anxiety, they can distinguish between their beliefs and “anxiety thoughts,” allowing the client to reclaim control over their anxiety—something that is integral for progress.

I know a client is making meaningful progress in anxiety therapy when they begin to recognize and challenge their anxious thoughts more independently, rather than automatically reacting to them. Progress is also evident when they start to face anxiety-provoking situations with less avoidance, using exposure techniques or coping strategies effectively. Clients often report feeling more in control of their anxiety, with physical symptoms (such as racing heart or shortness of breath) occurring less frequently or intensely. Additionally, meaningful progress is seen when clients demonstrate improved emotional regulation, use relaxation techniques in moments of anxiety, and experience an overall reduction in the impact anxiety has on their daily life and relationships.

Outside of sessions, clients can identify mindfulness-based activities that personally resonate with them. For example, if a client enjoys art, they can draw, paint, doodle to clear their mind of anxious thoughts. If a client enjoys physical activity, they can utilize music and movement to release emotions related to anxiety.

Clients can supplement their time in anxiety therapy with the following activities:

• Practicing Mindfulness: Engaging in daily mindfulness exercises, such as meditation or mindful breathing, can help clients stay grounded and reduce anxious thoughts.
• Using Cognitive Restructuring: Actively challenging and reframing anxious thoughts outside of therapy reinforces cognitive skills and helps reduce automatic negative thinking.
• Applying Exposure Techniques: Gradually exposing themselves to anxiety-provoking situations in small, manageable steps can build tolerance and reduce avoidance behaviors.
• Keeping a Thought Journal: Writing down anxious thoughts and tracking emotional responses helps clients recognize patterns and apply coping strategies learned in therapy.
• Engaging in Relaxation Techniques: Regular use of deep breathing, progressive muscle relaxation, or guided imagery can reduce the physical symptoms of anxiety and provide immediate relief.
• Maintaining Physical Activity: Exercise, such as walking, yoga, or other activities, helps reduce overall stress levels and improves mood, which can help manage anxiety.
• Improving Sleep Hygiene: Establishing a regular sleep routine, limiting screen time before bed, and creating a calming environment can improve sleep quality, which is crucial for anxiety management.
• Limiting Caffeine and Stimulants: Reducing or avoiding caffeine and other stimulants can help prevent the physical symptoms of anxiety from being triggered or worsened.

To prepare for your first anxiety therapy session, you can reflect on specific situations or triggers that cause anxiety, noting when and how your symptoms appear. It may be helpful to write down recent experiences where anxiety felt overwhelming, as well as any physical symptoms you’ve noticed, such as racing heart or difficulty breathing. Think about your goals for therapy, such as reducing avoidance behaviors or learning to manage anxious thoughts. Coming with an open mind and a willingness to explore new techniques is important, as therapy may introduce tools and strategies you haven’t tried before. Additionally, consider asking any questions you have about the therapy process to feel more comfortable and informed during the session.