Anxiety therapy onlineFind calm and control again.

Stress is a state of worry or mental tension caused by a difficult situation; it is a natural response that helps us deal with challenges and threats, and everyone experiences it to some degree⁵. It usually has a clear cause and eases when the pressure lifts.

Anxiety is a feeling of fear or unease that everyone has at times⁶. It becomes a problem when it is intense, frequent or out of proportion to the situation, or when it lingers long after the trigger has passed. Anxiety can take several forms:

Most anxiety follows a recognisable cycle. A trigger leads to a threatening thought ("I'll make a fool of myself", "something is wrong with my heart"); the body responds with alarm; and we do something to feel safer, such as leaving, avoiding, checking or seeking reassurance. The relief is real but short-lived, and it teaches the brain that the situation really was dangerous, so the next time anxiety arrives sooner and stronger.

Therapy works by helping you see this cycle clearly and then loosening it at several points: noticing and questioning catastrophic thoughts, calming the body's alarm, and gradually approaching what you have been avoiding so that your brain can learn, through experience, that you can cope.

Our therapists work in an integrative, evidence-informed way. For anxiety, this commonly includes:

• Understanding your pattern: what triggers your anxiety, what you tell yourself, what you do to cope and what that costs you.
• Techniques from cognitive behavioural therapy, where helpful, to notice and test anxious predictions rather than accept them as facts. A meta-analysis of placebo-controlled trials found that CBT had moderate effects on anxiety-related disorders, with large effects for generalised anxiety disorder².
• Gradual exposure: planned, step-by-step approach to avoided situations, at a pace you agree with your therapist.
• Working with the body: breathing and relaxation skills to bring the nervous system down when it is on high alert. The NHS describes simple breathing exercises for stress that many people find helpful⁷.
• Emotions and context: what the anxiety might be protecting you from, and pressures in your work, relationships or history that feed it.

Clinical guidance follows a similar logic. For generalised anxiety disorder, the NICE guideline recommends a stepped approach in which education and self-help come first and, if anxiety persists or significantly affects daily life, a high-intensity psychological intervention such as CBT or applied relaxation, or medication, is offered³.

For many people with anxiety, online sessions remove barriers such as travelling to an unfamiliar place or sitting in a waiting room. A 2021 meta-analysis found that video therapy produced large improvements, with anxiety among the targets showing effect sizes near 1.0, and negligible differences from in-person therapy⁴. Your therapist can also use the online format creatively, for example by practising a feared phone call or video meeting during the session.

Consider therapy if anxiety or stress:

• has lasted several weeks or keeps returning;
• leads you to avoid work, social events, travel or other things that matter;
• is affecting your sleep, relationships or health;
• comes with panic attacks;
• is leading you to rely on alcohol, sleeping tablets or other substances.

Some physical conditions can cause anxiety-like symptoms. If you experience chest pain, breathlessness or palpitations for the first time, or symptoms that feel different from usual, seek medical help first; in an emergency call 112. We are happy to work alongside your doctor or psychiatrist where that helps.