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Types of Anxiety Treatment: Therapy, Medication, and Levels of Care

Everyone with anxiety is unique. People have different anxiety triggers. What helps one person might not be the right approach for another. Thankfully, there are many types of anxiety treatment. Learning about anxiety treatment options can help you get an idea as to which one(s) could be right for you. We’ll start with the two foundational pillars of anxiety treatment. Then, we’ll go over therapies, medication, and levels of care.

The Two Pillars of Anxiety Treatment

Therapy and medication are the evidence-based foundations of anxiety treatment. Both can produce benefits on their own. However, combining medication and therapy for anxiety is often the most effective approach. This is especially true for people with moderate to severe symptoms or for those who do not respond to therapy alone.

Lifestyle factors like sleep, movement, and nutrition can support the treatment process and are important for overall health. They don’t replace treatment for clinical and ongoing anxiety disorders.

Therapy for Anxiety

Multiple types of therapy can be used for anxiety. Here are some of the most prevalent.

Cognitive Behavioral Therapy (CBT)

CBT is the gold standard treatment for anxiety disorders such as generalized anxiety disorder, social anxiety disorder, and panic disorder. It focuses on the relationship between thoughts and behaviors. Therapists who use CBT for anxiety will often use techniques such as:

Thought records (where you write down, examine, and challenge negative thoughts)
Exposure hierarchies (creating a list of anxiety-inducing situations and ranking them from the most to least distressing).
Behavioral experiments (participating in safe, real-life situations that help you challenge anxious thoughts and beliefs).

Typically, CBT takes around 12-20 sessions total. Most people get CBT once weekly for about 3-5 months. This can vary.

Exposure and Response Prevention (ERP)

ERP is a type of CBT. It’s also called CBT with ERP. This treatment is an ideal fit for people with obsessive-compulsive disorder (OCD) and phobias. There are some important differences between ERP and typical CBT. The main distinction is that ERP does not focus on analyzing or debating thoughts. Instead, ERP is designed to help people break cycles.

ERP works by helping you face triggers, mental images, or obsessive thoughts safely and gradually. Starting with the least distressing challenges, your therapist will help you refrain from compulsions or avoidance behaviors. With repetition, this teaches your brain that anxious thoughts and urges will fade and don’t need to be acted on.

Acceptance and Commitment Therapy (ACT)

A lot of people with anxiety disorders struggle with fighting their symptoms. This can actually be counterproductive. Attempting to fight your symptoms or wishing that they would just go away can often make anxiety feel bigger and cause more distress. Acceptance and Commitment Therapy aims to help people change their relationship with anxious thoughts and physical sensations. The goal is to stop them from ruling your life and behavior.

In ACT, you’ll work on letting feelings and urges exist without pushing them away. Your therapist will help you see these as harmless mental events that can pass rather than as a threat or a fact. You’ll focus on staying present in the moment and cultivating an observing self that notices thoughts and emotions without necessarily judging or acting on them. They will also help you define your personal values and commit to actions guided by your values and desires, even when anxiety is present.

EMDR

Many people with anxiety disorders have a history of trauma. When anxiety has a trauma component, it means that a real-life event affects your symptoms in some way. For example, you might avoid people, places, or things if they remind you of an adverse event or how you felt during it. You may know that what you’re avoiding is not a real threat, but your nervous system might not. That’s where treatments like EMDR therapy come in.

EMDR is short for “eye movement desensitization and reprocessing.” EMDR works by helping you reprocess traumatic events so that your body and mind start to understand that things are not as threatening as they feel. The therapist will use left-to-right sensory input (called bilateral stimulation) to engage both sides of your brain as you hold a distressing memory and install a more peaceful, positive belief.

Before you start this process, the therapist will learn about your history, help you prepare for treatment by arming you with coping skills and calming techniques, and ask you to rate your current subjective distress related to memories. You will work with your therapist to reprocess the least distressing memories first.

Medication for Anxiety

Like types of therapy, there are many different medication options for people with anxiety disorders. The medication your psychiatrist recommends to you should be based on your specific symptoms, personal history, and, if applicable, concerns about side effects.

SSRIs and SNRIs

In most instances, selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs) are the first anxiety medication types a provider will recommend. Some of the most common SSRIs and SNRIs used for anxiety include:

Lexapro (escitalopram)
Zoloft (sertraline)
Effexor (venlafaxine)
Cymbalta (duloxetine)
Prozac (fluoxetine)
Celexa (citalopram)

These medications take about 4-6 weeks to work. Understanding why that’s the case can help people with anxiety disorders get more comfortable with treatment, especially in the early stages. SSRIs work by stopping rapid reabsorption of serotonin; SNRIs work by stopping the rapid reabsorption of both serotonin and norepinephrine.

At first, your brain might try to reduce serotonin production to combat the increased availability. It takes time for receptors to re-adjust. Additionally, it takes until about week 4-6 for the medication to start helping your brain form new neural pathways that’ll ultimately help you better combat negative or anxious thoughts.

Buspirone

Buspirone is a non-habit-forming medication. It is primarily used for generalized anxiety disorder (GAD), which it is FDA-approved to treat. While it can be a first-line treatment, it can also be an alternative to SSRIs and SNRIs.

Beta-blockers

Beta blockers can be a good fit for people with situational anxiety. Specifically, they’re often used for performance anxiety. These are prescribed as-needed (not for daily use). For this reason, they are not a good fit for people who need daily relief, such as those with persistent GAD symptoms.

Benzodiazepines

Benzodiazepines have a time and place, but they’re prescribed with caution. They are habit-forming and can lead to dependence quickly. Since they’re not typically recommended for long-term use, they’re most ideally prescribed for short-term, infrequent situations that cause acute anxiety. For example, the specific phobia of flying.

Since you can develop a tolerance to benzodiazepines within weeks and they have a potential for abuse, they aren’t generally used for people with substance use disorders, save for short-term, monitored situations like alcohol detox. People with a history of substance abuse can be more likely to abuse benzodiazepines.

SPRAVATO (esketamine)

SPRAVATO (esketamine) is a newer treatment option. While it is FDA-approved for depression, it can be an option for people with anxiety in some cases. It is most often used for:

Those who do not respond to first-line treatments like medication and therapy alone.
People experiencing acute suicidal thoughts or behaviors.
People with co-occurring anxiety and depression.

Since it’s a newer treatment option, SPRAVATO can be hard to find. People often have an even harder time finding it at clinics that accept their insurance. Sanford Behavioral Health offers a variety of treatments so that people can get the kind of mental health treatment that works for them. Ask for a consultation. We can tell you if it’s a good fit for you.

Levels of Care - Matching Treatment to Your Needs

Some people wonder when to go to treatment for anxiety. Understanding the levels of care for anxiety can help you match treatment to your needs.

Outpatient (OP)

Outpatient anxiety treatment is best for people with mild to moderate symptoms. It usually involves attending once-weekly therapy, but some go biweekly. Appointments with a psychiatrist are often monthly, though they can be more or less frequent if needed.

If you function well in daily life (e.g., work, school, caring for your family) with minimal disruption, this is likely a good fit. If your symptoms improve with therapy or a combination of medication and weekly therapy, it’s unlikely that a higher level of care is needed.

Intensive Outpatient (IOP)

If your anxiety disrupts your routine and still affects your quality of life despite ongoing weekly therapy, it may be time to try an IOP. This can feel like a big step, but it can provide great relief. IOP is best for those who do not need 24/7 support. It’s also ideal for those who need to and can go to work or school outside of sessions.

Our IOP meets three days per week. Sessions last for a few hours per day. The total time commitment is about ten hours per week. Sanford offers multiple IOP treatment schedules. You can choose morning or evening IOP to accommodate your needs.

IOP clients can expect to participate in a combination of group therapy and individual therapy sessions. Other treatments (e.g., medication management sessions) can be added to your personalized care plan as needed.

Partial Hospitalization (PHP)

PHP is ideal for people with moderate to severe symptoms, those who experience acute distress regularly, and those who have found that standard outpatient treatment does not work. Partial hospitalization programs for anxiety are a great fit for people who need a structured therapy schedule and help building new, healthy routines, but who can sleep and live at home and remain physically and emotionally safe.

During PHP, you’ll participate in therapy at our center for most of the day, multiple days per week. Since you will spend your evenings at home, a stable living environment and the ability to stay safe outside of treatment hours is important.

Residential

Residential inpatient treatment is generally for people with severe anxiety, complex co-occurring conditions (e.g., eating disorders, substance use disorders), or who need close supervision for safety. It may be an ideal fit for you if you need a higher level of care than an outpatient program can provide and have found that your symptoms aren’t managed stably outside of outpatient treatment hours.

A typical day in residential mental health treatment with us involves following a structured, but not rigid, therapy schedule. This includes group therapy, individual therapy, meals, wellness activities (such as art, yoga, and supervised outdoor excursions), and medication management or check-ins as needed.

Medical Detox

If substance use (e.g., benzo or alcohol dependence) complicates or co-occurs with anxiety, medical detox must precede treatment. Stopping substances abruptly can be dangerous after prolonged use. People often experience increased anxiety during discontinuation. Medical detox helps keep you safe at this time and can reduce the severity of these symptoms.

A typical day in medical detox involves vital sign monitoring, supportive treatments (e.g., hydration support), meals, and medication management, including short-term medications that are meant to alleviate withdrawal symptom severity. It is short-lived and usually lasts around 1-2 weeks.

How to Know Which Level of Care Is Right

How do you know which level of care is right for you? Here’s a quick general guide.

Anxiety is manageable, but persistent → Outpatient
Symptoms still disrupt daily life, but you are safe and (if applicable) need to and can work or go to school while in treatment → Intensive outpatient
Therapy and medication haven’t helped; highly structured, daily therapy seems like an ideal match → Partial hospitalization
You are in crisis, have co-occurring conditions, would benefit from living on-site at a treatment center, or need 24/7 supervision → Residential

Still not sure which level of care is best for you? During the intake process, we’ll ask about your current symptoms, personal history, and treatment needs. This will help our team make a recommendation. Call 616.202.3326 for a free assessment or contact us online.

Frequently Asked Questions

What is the most effective treatment for anxiety?

Generally, a combination of therapy and medication is the most effective treatment for anxiety. While recommendations can vary based on diagnosis and other factors, providers often suggest CBT for anxiety and medications like SSRIs and SNRIs first because of their efficacy.

What are the different levels of care for anxiety treatment?

Outpatient therapy, intensive outpatient programs, partial hospitalization programs, and inpatient programs are the main levels of care used for anxiety. One may need to undergo medical detox first if they have a co-occurring substance use disorder.

How long does anxiety treatment take?

How long anxiety treatment takes depends entirely on the person. Mild anxiety usually improves within 1-3 months. Severe, chronic anxiety treatment can take 6-12 months or longer and may require ongoing management for sustained relief and support. Step-down approaches can be helpful.

Can anxiety be treated without medication?

It depends. Some people with anxiety, specifically those with mild symptoms and/or who respond to therapy alone, may not need medication for successful treatment. Medications like SSRIs and SNRIs are often very effective treatments, especially when combined with therapy, for people with symptoms that affect their daily life despite standalone therapy.