Anxiety Therapist NYC: Online Therapy for High-Functioning Professionals
Online across New York State · Schema Therapy, CBT, ACT & exposure work · Three licensed clinicians
The pitch landed. Your client signed. Everyone in the conference room forty floors above Midtown saw someone composed and in command. At 2:14 a.m., you are awake anyway, replaying one sentence you wish you had phrased differently while your chest tightens around a fear you cannot name.
If you are searching for an anxiety therapist in NYC because previous treatment brought insight without lasting relief, the issue is not your effort. It is the approach. New York Therapy treats persistent anxiety in high-achieving professionals with Schema Therapy, cognitive behavioral therapy (CBT), Acceptance and Commitment Therapy (ACT), and exposure-based methods, online across New York State.
Anxiety that outlasts standard therapy usually runs on early beliefs called schemas, so we treat the wound at its source while using well-established symptom tools to bring relief early.
High achievers tend to manage fear with control: more preparation, more checking, more reassurance. Each round works for a night and strengthens the anxiety over time.
Several early maladaptive schemas can drive anxiety. One of them is the vulnerability to harm schema, a learned conviction that catastrophe is coming and you will not cope.
At New York Therapy, founder Travis Atkinson and our clinicians use CBT, ACT, and exposure work to bring relief quickly, and Schema Therapy to close the wound driving it. Validated measures track both.
Key Takeaways
Anxiety that survives previous therapy usually has roots in early patterns, not weak coping skills.
Vulnerability to harm is one of several schemas that drive anxiety, alongside unrelenting standards, mistrust, and others.
CBT, ACT, and exposure work bring relief early; Schema Therapy closes the wound underneath so the relief holds.
Online sessions deliver full clinical rigor, and validated measures keep progress visible.
Why Anxiety Persists in High-Functioning Professionals
Anxiety persists in high achievers because they treat it with the same tool that built their careers: control. The tool works. That is the problem.
Each round of over-preparation quiets the fear for a night, then teaches your nervous system the threat was real, making the next wave stronger.
The strategy that runs your career is the engine of your anxiety.
In a city that rewards the strategy with promotions, the feedback loop is nearly airtight.
Anxiety disorders are also the most common mental health conditions in the United States. The Anxiety and Depression Association of America counts roughly 15 million adults with social anxiety disorder and 6.8 million with generalized anxiety disorder. Most cope silently until anxiety erodes work performance, relationships, and sleep.
~15 million
U.S. adults live with social anxiety disorder
~6.8 million
U.S. adults live with generalized anxiety disorder
Anxiety and Depression Association of America. Anxiety disorders are the most common mental health conditions in the United States.
Coping Skills Manage the Alarm, Not the Belief
Coping skills fail on their own because they manage the alarm without touching the belief that sets it off. Standard talk therapy often reinforces the loop by handing you more techniques to control your thoughts. You gain insight. The pattern does not move.
When excessive worry, panic attacks, or social anxiety disorder persist after competent treatment, one or more early maladaptive schemas are often holding the pattern in place. In Dr. Jeffrey Young’s model, a schema is not just a thought. It is a full-body theme woven from memories, emotions, beliefs, and physical sensations, formed when a core childhood need went chronically unmet, then elaborated across a lifetime. Unrelenting standards whispers “whatever I achieve, the bar moves higher.” Vulnerability to harm insists “catastrophe could strike at any moment.”
One point matters for skeptics: you do not need a dramatic childhood to carry a strong schema. Temperament research shows that sensitive children absorb more from ordinary family pressure than their siblings do. So one accomplished adult can carry deep anxiety out of a household that looked fine from the outside.
Schemas do not respond to relaxation exercises. They respond to Schema Therapy and related methods that reach them directly.
A managing director comes in after two prior therapists. He can name his cognitive distortions fluently, yet still checks his phone at 3 a.m., convinced a missed email from Hong Kong will end his career. The turning point is tracing that dread to a childhood where love arrived only with achievement, then dismantling the belief at its source. Within months the checking stops, and his GAD-7 scores confirm it.
Treating the Symptom and Treating the Source Are Different Jobs
We are not against symptom relief. Someone who cannot sleep, cannot board a plane, or cannot get through a Monday leadership meeting needs help fast, and CBT, exposure work, and mindfulness techniques deliver it. Withholding those tools in the name of depth would be poor care, so we start using them in the first weeks.
Stopping there is the problem. Symptom tools work like a clean dressing on a wound nobody has closed. Change the dressing often enough and life stays manageable, which is why capable people remain in that arrangement for years and call it recovery. Lift the dressing and the wound is unchanged, so the fear returns with the next real stressor.
Our anxiety treatment runs both jobs at once. Practical tools lower the daily noise while the schema work targets the belief that made the alarm so loud in the first place: that catastrophe is coming and you cannot cope with it. Relief arrives early. Durability comes from the deeper layer, and clients feel the difference when a stressor that would once have cost them a week passes in an afternoon.
Which Schemas Show Up in Anxiety?
Vulnerability to harm is one driver among several. Schema Therapy describes 18 early maladaptive schemas, and the five below are examples where anxiety tends to be a core part of the emotional picture rather than a side effect. Most people carry more than one, and the combination shapes both how the anxiety feels and how we treat it.
Vulnerability to Harm
“Catastrophe is coming, and I will not be able to handle it.”A deep conviction that catastrophe is close and that you would not have the resources to survive it. It shows up as health scanning, travel dread, or financial worry that no balance sheet quiets. Explored in depth below.
Unrelenting Standards
“Whatever I achieve, the bar moves higher.”A frequent companion to vulnerability among high achievers, and often the trait that built the career. Rest registers as risk. The finish line relocates the moment you reach it, so the tension never fully releases.
Abandonment and Instability
“The people I love will leave, and I will be left alone.”Fear aimed at connection rather than catastrophe. An unanswered text, a distant partner, or a short trip can trigger a reaction that feels wildly out of proportion. Many clients function beautifully at work and fall apart over a delayed reply.
Mistrust and Abuse
“People will use me, so I stay ready.”Fear of harm from others, which registers as vigilance instead of worry. You read motives and search for the angle behind a kindness. The exhaustion comes from scanning that does not stop when you leave the office.
Subjugation
“If I say what I want, there will be a cost.”Fear of the consequences of speaking up, which is why the dread arrives before conflict rather than before performance. You rehearse how to raise something for days, then soften it into nothing. Anger leaks out sideways.
Schemas that look like anxiety but run on a different feeling Defectiveness and failure run largely on shame. Self-sacrifice runs on guilt. Emotional deprivation runs more on sadness than fear. All of them can produce anxious symptoms, though the anxiety is usually anticipatory: dread of being seen accurately, of the guilt that follows saying no, or of carrying something alone again. The distinction matters because shame, guilt, and sadness do not respond to the same methods that resolve fear. Sorting out which feeling sits underneath is part of what a first session is for.
One clinical caution Anxiety also has causes that are not schemas at all: thyroid and other medical conditions, medication effects, stimulant or alcohol use, chronic sleep loss, and genuine current crisis. A thorough assessment rules those in or out before schema work begins. Treating a schema that is not there wastes your time and misses what is.
What Is the Vulnerability to Harm Schema?
The vulnerability to harm schema is a deep conviction that catastrophe is about to strike and that you lack the resources to survive it. Its distortion is two-pronged: you exaggerate the odds of disaster while discounting your own capacity to cope. In our work at New York Therapy, it is one of the patterns we look for first when intelligent, disciplined professionals cannot think their way out of chronic fear. It is not the only one, as the section above shows, but it is common enough among the professionals we see to be worth walking through in depth.
Dr. Young’s work describes four faces the schema wears, and you can carry more than one:
Health: scanning your body for the sensation that finally means something is seriously wrong, despite clean physicals
Danger: a mind that runs disaster drills on flights, in elevators, on the walk from the subway
Money: dread of losing everything that no balance sheet ever quiets
Losing control: fear of breaking down or unraveling in front of people who respect you
If the schema is active, some of these will read like your own diary:
A background sense that something bad is about to happen, even on good days
Worry about a serious illness no physician has found
Unease on planes, trains, or elevators that you manage but never mention
Monitoring physical sensations and wondering what they mean
Money fear that persists at income levels most people would envy
Three or more of these, felt strongly, usually means the schema deserves a clinical look.
How the Schema Runs Your Life Right Now
The schema runs your present life through three channels: what you feel, what you refuse, and what you ask of the people who love you.
Start with what you feel. The tell is the gap between felt odds and real odds. At the JFK gate before a client trip, a crash feels like a coin flip; the actual figure sits near one in a million. That same distortion drives the fear of going crazy during a panic attack, an outcome so rare the clinical literature has essentially never recorded it.
What you refuse is quieter. Safety outweighs gain in every decision, which is how the dull, secure role beats the ambitious one year after year. A Park Slope physician turns down the department chair position twice. Eleven years into a firm she stopped finding interesting, a Tribeca attorney still has not moved, because known misery outranks the unknown. Even good moments get filtered: you sit through your daughter’s recital at the Brooklyn school auditorium doing threat math instead of listening.
Then there is what you ask of others. Reassurance cannot close the felt-odds gap; it works like a bottomless pit. Each answer soothes for an hour and deepens the need for the next one. Over time the people closest to you get recruited as bodyguards, a role that exhausts them and confirms your fragility to you both. When the schema runs unchecked, life stops being a pursuit of what you want and becomes a project of containing danger.
The costs compound quietly. Chronic vigilance leaks into the body as tension, stomach trouble, and stress-prone health, and it often gets managed with the nightly drink or the sleep aid. Left alone long enough, it also teaches your children the same odds you learned. For many of our clients, that last one is the reason they finally book.
Where the Vulnerability Schema Comes From
The schema usually forms in childhood through one of five doorways, and the most common is a parent who carried the same fear.
A frightened parent as teacher. You absorbed vulnerability by watching it: a mother who found a symptom in every ache, a father who read danger into every plan. Children learn odds from the adults in the room.
Overprotection. Constant warnings taught two lessons at once: the world is dangerous, and you are too fragile to handle it.
Underprotection. No one shielded you, and home never felt physically, emotionally, or financially safe.
Early catastrophe. A serious childhood illness or accident proved that disaster does not only happen to other people.
A parent’s catastrophe. You grew up inside the aftermath of a tragedy, sometimes one that struck before you were born, and inherited its vigilance.
Here is a piece of candor most therapy pages skip: for this particular schema, insight is the starting point, not the cure. Understanding where the fear came from rarely dissolves it. Change comes from what you do next, which is why our treatment moves quickly from history to action.
Three Ways People Cope, and Why Each One Feeds It
People manage this schema in three recognizable styles, and every one of them ultimately feeds it.
Surrender means living as if the danger were confirmed. Think of checking the locks or the stove a fixed number of times, holding every kind of insurance, or keeping a standing reassurance line open to your partner or your doctor.
Avoidance means shrinking the map: routes redrawn around elevators, invitations declined, the checkup never booked, the offer never pursued.
Overcompensation is the professional’s signature, and it is the one Manhattan rewards. Master every variable and ask no one for help. The fear stays silent right up until something appears that preparation cannot cover: the diagnosis, the market, the partner who says they are unhappy.
Each style solved a real problem once, usually in childhood. Now every round quietly confirms both the danger and your narrow escape. So willpower has not fixed this, and the smartest people often build the most elaborate versions.
How Do We Go Beyond Symptom Reduction?
Symptom reduction is the first job, not the whole job. CBT, exposure work, and ACT bring the alarm down, and we start them early because relief matters. Going beyond that means changing the belief the alarm is defending, so the relief does not depend on maintaining the strategy that produced the anxiety. The work follows a deliberate arc.
Map the pattern
First we map it precisely: your specific fears, what you avoid, how you protect yourself, and who protects you. Most clients have never seen the full architecture laid out, and putting it on one page is often the first crack in it.
Recalibrate the odds
We test felt probability against real probability using your own data, then build portable tools you can reach for when the pattern flares mid-flight or mid-meeting.
Do the experiential work
Schema Therapy frames the fear as a vulnerable child mode, the part of you still bracing for catastrophe. The goal is a healthy adult mode strong enough to reassure that part from the inside. In imagery, the adult you have become enters the scenes where the fear was learned. There, that younger self receives what no one provided: protection, calm, and a sense of proportion.
Chair work gives the same conversation a voice. The frightened part, the controlling part, and the healthy adult finally speak to one another. This is where the conviction starts to bend.
Practice without the rituals
Graduated practice means facing feared situations first in imagery, then in real life, while the safety rituals get retired one by one. Exposure with the rituals intact changes very little.
Bring in the people around you
Partners join the work too. The reassurance role gets phased out gently, and in our experience the person who has been playing bodyguard is usually relieved to hand in the badge.
Progress registers on the GAD-7 and schema measures. Clients often say the strangest part is the quiet: the first flight, or elevator, or unread inbox that produces nothing at all.
What the research shows, including the limits
Two studies speak directly to the idea that symptom change and schema change move together. A 2023 uncontrolled pilot in Behavioural and Cognitive Psychotherapy followed 27 patients with treatment-resistant anxiety disorders or OCD through a combined schema therapy and CBT day program. Symptom improvement correlated strongly with improvement in early maladaptive schemas and modes, and stronger schemas at intake did not prevent people from improving. A 2021 study in the British Journal of Clinical Psychology combined schema therapy with exposure and response prevention for patients with chronic anxiety who had not responded to guideline CBT. Distress and maladaptive modes both fell, and the two moved together. Neither study included a control group.
The most rigorous comparison available is more sobering, and worth stating plainly. A 2024 randomized controlled trial in the Journal of Anxiety Disorders assigned 154 patients with social anxiety disorder and comorbid avoidant personality disorder to group schema therapy or group CBT. Both produced substantial improvement, and neither outperformed the other at three months or at one-year follow-up. Significantly more patients finished the schema therapy course than the CBT course. The authors read that higher retention as a sign that schema therapy was more acceptable to this group, not that it worked better.
The honest summary: schema therapy for anxiety is promising, and in at least one head-to-head trial more people stayed with it through to the end, but the evidence base is still small and much of it uncontrolled. That is why we pair it with CBT, ACT, and exposure work, which carry stronger evidence for symptom relief, rather than using it on its own.
Why Do NYC Professionals Choose New York Therapy for Anxiety Treatment?
A search for an anxiety therapist NYC professionals can trust returns hundreds of listings. What separates New York Therapy is clinical depth with persistent, treatment-resistant anxiety disorders in high-achieving adults.
In-network anxiety care is often competent and, for a first episode, frequently enough. Panel practice also carries real constraints: large caseloads, generalist training spread across many presentations, and utilisation rules that favour short, symptom-focused courses. That structure suits a straightforward first round of CBT. It suits treatment-resistant anxiety poorly, because the deeper work takes time the model is not built to give.
- Three New York State licensed clinicians, led by a founder who trained directly with the creator of Schema Therapy starting in 1994.
- A fully licensed online practice serving all of New York State, with HIPAA-compliant encrypted video sessions that protect your privacy in high-visibility roles.
- Validated outcome measures, including the GAD-7 and schema assessments, at intake and throughout treatment. You see quantified progress, not impressions.
- A specialization in anxiety that persists despite previous therapy. Our anxiety therapists work with professionals who have already tried standard treatment without lasting relief.
The research base supports this approach. A 2022 systematic review in the British Journal of Clinical Psychology pooled six studies covering 316 patients with anxiety, OCD, or PTSD. It found Schema Therapy produced beneficial effects on both disorder-specific symptoms and early maladaptive schemas, while noting the evidence base remains small.
Evidence-based behavioral treatment also travels well online. A 2023 meta-analysis in World Psychiatry found therapist-supported internet-based CBT yields effects similar to face-to-face therapy. You lose the commute, not the rigor.
Who You Will Work With
New York Therapy is a small practice by design: three licensed clinicians who go deep rather than a roster that treats everything. Here is who we are, and what each of us tends to be matched with.
Travis Atkinson, LCSW, LICSW, Founder and Clinical Director
Travis began training with Dr. Jeffrey Young, the creator of Schema Therapy, in 1994, and has spent the three decades since working with patterns that survive ordinary treatment. He co-developed Schema Therapy for Couples with Dr. Young and holds Honorary Lifetime Membership in the International Society of Schema Therapy. As founder and director of the Schema Therapy Training Center, he trains other clinicians in these methods, and he is certified in Schema Therapy, Emotionally Focused Therapy, and the Gottman Method. His training with Dr. Sue Johnson in Emotionally Focused Therapy began in 2006, followed by advanced work with Dr. Daniel Siegel in interpersonal neurobiology. He has also authored and contributed to leading clinical texts in psychotherapy. Clients usually reach Travis when anxiety has outlasted two or three prior therapists, when the presentation is complex, or when the fear has become tangled up with a marriage.
Paul Chiariello, LMSW
Paul holds advanced training in Schema Therapy for individuals and Schema Therapy for couples, together with advanced training in Emotionally Focused Therapy for couples. He also practices ACT and cognitive behavioral therapy, an integration that suits anxiety particularly well: ACT loosens the avoidance, CBT dismantles the daily worry cycle, and schema work reaches the belief underneath both. Certification as a Trauma Professional and advanced CBT training through New York University round out that foundation.
Before clinical practice, Paul worked in sociology research, conflict resolution, and curriculum development, including work with humanitarian organizations and research institutions in Uganda, Bosnia, and India. That path followed a Fulbright in Indonesia and a Master of Science in Sociology of Education from Oxford, and it preceded his Master of Social Work at Columbia University. The experience shaped how he works with identity, belief systems, and resilience, and it lands especially well with first-generation professionals and expats.
Paul works particularly well with men’s issues, and he leads three men’s therapy groups that pair well with individual treatment. His approach suits clients whose anxiety runs on avoidance rather than rumination, and men who were never really invited into the emotional side of this work.
Tiffany Goldberg, LMSW
Tiffany holds advanced training in Schema Therapy for individuals and couples, so clients who start with her get schema-level work from the first phase rather than after a detour through symptom management. She works especially well with women, and particularly with self-sacrificers and high achievers, the two patterns that surface most often when an accomplished woman arrives exhausted and cannot quite say why.
A clinical social worker trained at Columbia University, Tiffany worked with survivors of the World Trade Center attacks after September 11th and facilitated groups for widows and widowers, then provided trauma-informed services in the women’s facility at Rikers Island. Several years in substance use treatment followed, in both clinical and senior administrative roles, which deepened her understanding of recovery, relapse patterns, family systems, and long-term behavior change. That steadiness matters most when worry is entangled with family obligation.
Unsure who fits? Book any opening. We sort it out in the first session, and we will move you to a colleague if that is the better match.
What Types of Anxiety Disorders Do We Treat?
We treat the full range of anxiety disorders in professionals, and we match each presentation to the clinical approach research supports most strongly. Social anxiety is the presentation we see most often in high-visibility roles. The four sections below cover most of what our clients bring.
Cognitive Behavioral Therapy (CBT) for Generalized Anxiety and Constant Worry
We treat generalized anxiety disorder by pairing cognitive behavioral therapy (CBT) for the worry cycle with Schema Therapy for the beliefs beneath it. Generalized anxiety involves excessive worry about daily life, including finances, career, health, and relationships, that persists when no proportional threat exists.
Signs of chronic worry in professionals:
Worry that jumps from one topic to the next without resolution
Decisions delayed by endless research and reassurance-seeking
Tension headaches or jaw clenching that never fully release
Sleep that breaks in the early hours with racing thoughts
Cognitive behavioral therapy identifies and changes the unhelpful thought patterns driving the worry cycle. Schema Therapy goes deeper, addressing the underlying causes, such as vulnerability to harm or unrelenting standards, that keep the worry locked in place after previous treatment. Many clients notice improvement within 8 to 12 sessions of CBT, while schema-focused work may extend to 20 or more.
Constant worry is exhausting in a particular way, because it feels productive. Cognitive behavioral therapy (CBT) interrupts that by separating the problems you can act on from the ones your mind is only rehearsing, and by testing the belief that worry itself is what keeps you safe. Schema work then addresses the underlying causes that keep constant worry running long after the presenting problem is solved.
Treating Panic Attacks and Panic Disorder With Exposure Therapy
We treat panic with structured exposure therapy and panic-specific CBT, which reduce both the attacks and the avoidance that grows around them. Panic disorder brings episodes of intense fear with physical symptoms: chest tightness, shortness of breath, heart palpitations, dizziness.
Anticipatory anxiety about the next attack often follows, and avoidance progressively narrows your life. First the 4/5 at rush hour, so you car service it instead. Then the elevator to the 40th floor, so you take meetings downstairs. Eventually the client trip you keep handing to a colleague.
The physiology of a panic attack burns itself out within a minute or two. What stretches it into twenty is catastrophic interpretation, the “what if” that turns a racing heart into evidence of dying or losing control. Treatment targets that interpretation directly.
Signs of panic disorder in professionals:
A racing heart or shortness of breath with no medical cause
Fear of the next attack quietly shaping your schedule
Avoiding trains, elevators, flights, or crowded rooms
Scanning your body for the first hint of symptoms
Exposure and Response Prevention (ERP) systematically reverses the avoidance dynamic. Panic also responds well to virtual therapy, because exposure practice happens in the settings where attacks actually occur.
Treating Social Anxiety, Social Phobia, and Performance Anxiety
We pair structured exposure work with Schema Therapy targeting the beliefs beneath social phobia: social inhibition, defectiveness, or fear of judgment. Social anxiety disorder produces fear of embarrassment in social interactions: networking events, team meetings, client presentations, public speaking.
Social anxiety rarely travels alone. Beneath it we usually find the social isolation schema, a conviction that you are fundamentally different from everyone in the room and will never quite belong to it. That belief does not announce itself. It shows up as the founder who runs a company of two hundred people and eats lunch alone, or the physician who is respected on every ward and has not accepted a social invitation in a year.
The social isolation schema and social anxiety feed each other. The schema predicts rejection, so you avoid situations where rejection is possible, and every declined evening confirms the prediction. Social situations then carry more weight than they should, because you have had less recent practice in them than your peers have. People experiencing anxiety of this kind often describe a private sense that everyone else received a manual they never got.
For high achievers the pattern hides well. Work supplies structured contact that feels like connection without requiring any, so social anxiety can run for a decade inside a calendar that looks full. What surfaces instead is exhaustion, low-grade depression, and a slow narrowing of life outside the office.
For executives, founders, physicians, and creatives in high-visibility roles, social anxiety can be professionally costly even while it stays invisible to colleagues. It shows up as the partner who lets an associate run the pitch. Or the founder who skips the demo day afterparty where the actual introductions happen, and the attending who dreads grand rounds more than the surgery.
Signs of social anxiety disorder in professionals:
Rehearsing conversations hours before they happen
Dread before presentations that colleagues never see
Replaying social interactions for days afterward
Declining visibility that could advance your career
Performance anxiety responds to the same mechanisms: cognitive behavioral therapy to challenge catastrophic predictions, graded exposure, and mindfulness techniques that reduce avoidance. Imagery adds a bridge, because mentally rehearsing the dreaded presentation in calm, specific detail lowers anxiety and builds self-efficacy before live practice in real social interactions begins.
We treat social anxiety on both levels at once. Exposure and behavioral practice reduce anxiety in the social situations you currently avoid, while schema work addresses the social isolation schema and the social inhibition that grows out of it. Unwanted thoughts about how you came across get examined rather than suppressed, because suppression reliably makes unwanted thoughts louder. Clients who feel stuck after earlier therapy for anxiety usually did the first half of this work and never the second.
Evidence based treatment for social anxiety is well established. Exposure-based cognitive behavioral therapy has the strongest trial record for social anxiety, and schema-focused work extends it for people whose social anxiety has run continuously since adolescence.
Progress in social anxiety is measurable in ordinary terms. Clients tell us they stopped rehearsing before a standing meeting, accepted a dinner they would have declined, or noticed that a social situation ended without a two-day post-mortem. Those changes usually arrive before the feelings catch up, which is normal and worth expecting rather than treating as failure.
What Is High-Achiever Anxiety, and How Does Acceptance and Commitment Therapy Treat It?
High-achiever anxiety is the trap of perfectionism, overwork, and dread that never quite meets criteria for a textbook diagnosis. We treat it with Schema Therapy targeting schemas like unrelenting standards and self-sacrifice, combined with Acceptance and Commitment Therapy (ACT), which builds psychological flexibility in place of avoidance-driven striving.
Your career looks successful from the outside. Inside, fear of failure drives you more than genuine motivation, and thoughts about inadequacy compete with evidence of your competence.
Schema Therapy calls these driven states coping modes. Here is the reframe that lands with our clients: a coping mode is a genuine strength taken past the point of awareness. The vigilance that spots every risk, the perfectionism that ships flawless work, and the stamina that outlasts everyone in the room all began as protection. On autopilot, they run you instead.
Signs of high-achiever anxiety:
Success that never feels safe for long
Rest that feels like falling behind
Praise discounted, criticism memorized
Imposter syndrome despite a strong track record
Anxiety therapy at this level sustains performance without the cost of burnout. If burnout is your primary concern, see our page on work stress and burnout therapy.
How Does Online Anxiety Therapy Work at New York Therapy?
Online anxiety therapy here moves through three phases: a thorough first-session assessment, active evidence-based treatment, and maintenance planning that makes change last. Every session runs on HIPAA-compliant telehealth platforms. Sessions fit around trading hours, hospital rotations, and court calendars. That flexibility is often the difference between starting treatment and postponing it another year.
What Happens in Your First Session?
Your first session is a comprehensive assessment for anxiety disorders using validated measures, not a casual intake. We review your therapy history: what you tried, what helped partially, and what did not hold.
Careful assessment also separates schema from circumstance. A spike of dread during a funding crunch or a health scare is situational anxiety. It calls for different work than a schema that has hummed in the background since childhood. Getting that distinction right at the start keeps treatment efficient.
Fit gets decided in that first hour, not guessed at beforehand. Every clinician holds a New York State license, and your anxiety type, history, and goals determine which one you work with. If you have already read about one of us and want to request them, that works too.
What Does Evidence-Based Treatment Look Like Week to Week?
Treatment consists of weekly 45 or 60-minute encrypted video sessions. Your anxiety therapist integrates the latest evidence-based treatments as clinically indicated: Schema Therapy, cognitive behavioral therapy, exposure work, ACT, Mindsight, or individually focused EFT.
Schema-level change relies on experiential methods, not discussion alone. In imagery rescripting, one of the most researched tools in Schema Therapy, we revisit the formative memory beneath a fear and change its meaning from the inside. The approach carries published support for social anxiety, OCD, and post-traumatic stress. Clients often describe the session where the old scene finally shifts as the moment the 3 a.m. checking loses its grip.
Sessions also provide a supportive space to explore anxiety symptoms while delivering practical tools you can apply before stressful situations at work. Your treatment plan evolves as we learn which methods produce the strongest response, and psychodynamic elements enter when early experiences and relationships sit at the center of your anxiety.
Progress gets measured at regular intervals rather than assumed, so you can see the change in numbers as well as in how your week feels.
How Does Psychotherapy Compare With Medication for Anxiety Treatment?
Many clients ask about medication before they ask about anything else. Psychotherapy and medication are not competitors, and plenty of people use both. We are a psychotherapy practice and do not prescribe, so what follows is orientation rather than advice, and decisions about medication belong with your physician or psychiatrist.
The more useful distinction is not psychotherapy against medication. Evidence-based behavioral treatments are better for anxiety than general talk therapy, and that gap is the one that decides outcomes. Cognitive behavioral therapy and Schema Therapy both target a mechanism. Supportive counselling offers a safe space to talk without a model of what maintains the problem, which is why so many of our clients arrive having gained insight while their anxiety symptoms stayed exactly where they were.
Where medication helps, it often lowers baseline arousal enough that exposure work becomes tolerable. Where medication alone falls short is durability, because it does not teach your nervous system anything new, and symptoms frequently return when it stops. Evidence based therapy that changes the beliefs underneath tends to hold after treatment ends.
Psychodynamic therapy sits between the two approaches. It explores early relationships and unconscious conflict, and there is reasonable evidence for psychodynamic therapy in anxiety disorders and depression. It shares that developmental interest but adds structure, measurement, and experiential technique, which is why we lean on it.
One finding cuts across every model of psychotherapy: the therapeutic relationship is a key predictor of successful treatment. That is worth holding in mind while you compare treatment options, because fit with your therapist is not a soft variable. It is part of the evidence based care itself.
How Does Anxiety Therapy Work for Couples and Groups?
Anxiety rarely stays inside one person. It reorganizes a relationship around reassurance, and it isolates people who look well connected from the outside, so we treat it in couples therapy and group formats as well as individually.
In couples sessions the reassurance cycle changes on both sides at once. The partner who has been playing bodyguard hands back a role that was exhausting, and the anxious partner practices tolerating uncertainty with the person it matters most with. Travis Atkinson co-developed Schema Therapy for Couples, and Paul Chiariello and Tiffany Goldberg both hold advanced training in Schema Therapy for individuals and couples, with Paul adding advanced training in Emotionally Focused Therapy for couples.
Groups meet weekly for 90 minutes by secure video with six to eight members, and every prospective member completes a screening consultation and an orientation first. The model is group Schema Therapy, developed by Joan Farrell and Ida Shaw. Paul leads three men’s therapy groups, which fit professionals who can name a pattern in individual sessions and still cannot catch it in the moment it happens.
How Do We Reduce Anxiety Symptoms So Change Lasts?
The goal is not temporary symptom relief. It is measurable reduction in anxiety symptoms, improved functioning at work and in relationships, and the unwinding of avoidance habits. CBT provides practical tools for managing anxiety long after treatment ends.
Relapse prevention planning belongs to the final phase, and booster sessions remain available before high-stakes professional transitions. For many clients the shift is from managing anxiety to a more fulfilling life no longer organized around fear.
A more fulfilling life is a vague goal, so we make it concrete at the start. For one client a more fulfilling life meant flying to see family again. For another it meant leaving a job held purely because it felt safe. Behavior usually changes first, then feelings follow some weeks later, and the background stress that had become normal finally lifts. Where anxiety and depression travelled together, both tend to improve, because avoidance feeds each of them.
Is New York Therapy the Right Fit for You?
New York Therapy fits adults who want serious, structured, evidence-based work. Our clients come from the professional cultures that define this city: Big Law and finance, medicine and academic hospitals, media and fashion, plus founders and creatives who keep unusual hours by choice. They expect depth and measurable progress, and they have usually already tried the reasonable thing first.
That range includes first-generation professionals weighing their own ambition against family expectation, expats and international assignees living across time zones, and LGBTQ+ and intercultural couples who would rather not spend the first three sessions supplying context. The same care extends to our individual therapy and men’s therapy groups.
We work with people experiencing anxiety severe enough to shape their decisions, and we treat anxiety as one part of overall mental health rather than a symptom to be silenced. Where anxiety sits alongside depression, work stress, or relationship strain, those threads get worked together rather than referred out.
We are not a crisis service, and we are not the right fit if you want occasional venting or quick tips. If you are in immediate crisis, call or text 988 or go to your nearest emergency room.
Where We Serve Clients Across New York
New York Therapy is a fully online practice serving clients physically located anywhere in New York State during their sessions. Most of our clients live in New York City, and the practice grew out of a Park Avenue South office in Manhattan. Two markets make up most of our caseload.
Manhattan. Midtown and the Financial District bring us attorneys, bankers, and consultants whose anxiety tracks the deal calendar. The Upper East and Upper West Sides bring physicians and academics, plus parents running school admissions like a merger. Tribeca and Chelsea bring founders and creative directors.
Brooklyn. Park Slope, Brooklyn Heights, Fort Greene, and Cobble Hill send us a different profile: professionals who traded the Manhattan commute for a neighborhood. Many have young children, and quiet worry about passing the anxiety on comes up early in the work. Sessions often happen after bedtime.
We also work with clients throughout Queens, the Bronx, and Staten Island. Coverage extends to Westchester and the Hudson Valley, Nassau and Suffolk Counties, and upstate in Albany, Buffalo, Rochester, and Syracuse.
Online delivery also changes the maths of access. A New York City professional keeps the same clinician through a move upstate, and someone living hours from New York City reaches the specialists New York City residents have long taken for granted.
To meet licensure requirements, you must be physically located in New York State during your session. Clients join from a home office, a parked car between meetings, or an empty conference room.
Frequently Asked Questions
How is this different from previous therapy I’ve tried?
Most standard anxiety treatment focuses on symptom management: relaxation and basic cognitive restructuring. If that had worked for you, you would not be reading this page.
Our primary lens is Schema Therapy, which targets the early maladaptive schemas that keep anxiety locked in place after surface symptoms improve. From there, our anxiety therapists integrate CBT, ACT, exposure therapy, and EFT based on what your history requires. Obsessive-compulsive disorder calls for specialized ERP interventions, and ACT works especially well when avoidance is a primary driver.
Self-management differs in the same way. You have probably already tried handling this alone, with intelligence and discipline, and the 2:14 a.m. wake-ups continue, because self-management strengthens the very control strategies that feed professional anxiety. A trained clinician also sees the avoidance you stopped noticing years ago.
How do I choose the right anxiety therapist in NYC?
Look for a licensed clinical social worker, psychologist, or other licensed mental health professional trained specifically in anxiety disorders. Ask which evidence based treatment they use, how they measure progress, and what happens if the first approach does not work. A qualified mental health professional answers all three without hesitation, and anyone with anxiety that survived previous treatment should also ask how they handle treatment-resistant presentations.
New York City has thousands of therapists and most are generalists. Anxiety therapists who specialise will name the protocol they run and say why. A clinical social worker with advanced training in schema therapy and CBT will treat anxiety differently from therapists offering general supportive counselling, and that difference shows up in outcomes rather than in the credentials listed on a website. Ask prospective therapists how many clients with your presentation they see in a typical month.
Can therapy for anxiety help social anxiety if I already function well socially?
Yes, and social anxiety is one of the most common presentations we treat. Social anxiety disorder is not shyness and it does not require visible awkwardness. Many people with social anxiety perform capably in social situations and pay for it afterward in exhaustion, rumination, and unwanted thoughts about how they came across. Treatment reduces the anticipatory dread and the post-event replay, and it addresses the social isolation schema underneath when one is present.
What if I feel hesitant about starting therapy?
Ambivalence is normal, especially for people used to solving problems themselves. Many of our clients arrive skeptical after earlier therapy that stalled. Bring the skepticism to your first session; it makes for a sharper assessment, and you will know quickly whether the approach fits.
Do you take insurance, and is out-of-network care worth the difference?
We provide documentation for out-of-network reimbursement, and many clients with PPO plans receive partial reimbursement from their insurance provider. The proportion depends entirely on your policy, your deductible, and how your plan treats behavioral health. Our fee schedule is transparent before you begin treatment. For details, see our fees and insurance page.
Whether the difference is worth it comes down to what the money buys. A repeated course of symptom-focused treatment costs little per session and a great deal across a decade, measured in postponed decisions, narrowed travel, strain at home, and career moves never made. Paying a low copay for a fourth round of an approach that already failed to hold is not the economical choice.
Here you get a clinician with advanced training in Schema Therapy and CBT, a plan designed for anxiety that survived earlier treatment, and validated measures showing whether it is working. Should those measures fail to move, we change the plan or help you find someone better suited. That accountability is part of what you are paying for.
How long does anxiety treatment take?
It depends on the type and severity of your anxiety and your treatment history. For generalized anxiety, structured cognitive behavioral therapy (CBT) protocols run 8 to 16 weekly sessions. With panic disorder and exposure work, many clients notice improvement in 8 to 12 sessions.
Deeper Schema Therapy work addressing lifelong anxiety may require 20 to 40 sessions or more. Progress stays measurable throughout, so you and your therapist can adjust the plan as the work unfolds.
Can a schema formed in childhood really change in adulthood?
Yes. A schema is a learned pattern held in memory, emotion, and the body, and what was learned can be relearned. Experiential methods like imagery rescripting exist precisely because talking about a schema rarely shifts it. The change shows up in measurable terms, so you are not asked to take it on faith.
Can online therapy be as effective as in-person therapy for anxiety?
Yes, for the large majority of anxiety presentations. Randomized trials comparing therapist-guided online CBT with face-to-face CBT find equivalent effects, a conclusion reached by an updated meta-analysis in Cognitive Behaviour Therapy across psychiatric and somatic conditions.
Virtual therapy removes commute time and offers privacy many NYC professionals value, with the same clinical protocols you would receive in a traditional office.
What types of anxiety do you treat?
We treat generalized anxiety disorder, panic disorder, social anxiety disorder and social phobia, performance anxiety, obsessive compulsive disorder and related disorders, phobias, post-traumatic stress disorder, and high-achiever presentations including perfectionism and imposter syndrome.
Social anxiety and performance anxiety account for a large share of our caseload, and social anxiety in particular is often what brings people to us after individual therapy elsewhere reached a ceiling. If you are unsure whether your symptoms fit, your first session includes a thorough assessment. To learn more about the clinicians who provide this work, visit our clinicians page.
Do you offer group therapy or couples therapy for anxiety?
Yes. Anxiety rarely stays contained to one person; it shapes marriages, parenting, and friendships. We offer couples therapy when anxiety strains a relationship, and Paul Chiariello runs three men’s therapy groups for professionals who benefit from structured peer work. Group members complete a screening consultation first, because composition is what makes a group work.
What Is the Next Step?
If your anxiety has persisted despite previous therapy, the missing element is unlikely to be effort. You have applied plenty of that. It is treatment that reaches the roots. Your first session begins with a thorough assessment of your history, your patterns, and the approach that fits you best. It can happen from your apartment, your office after hours, or wherever you are in New York State this week.
Reviewed by Travis Atkinson, LCSW, LICSW, founder and clinical director of New York Therapy. Last reviewed August 2026. Learn more about our clinicians.
Client examples in this article are composites drawn from common presentations. They do not describe individual clients.
New York Therapy | newyorktherapy.com | Online anxiety therapy across New York State