Anxiety Therapists in Columbia County, WA

Photo of Nathan Franklin, MA, LMHC, Counselor
Nathan Franklin
Counselor, MA, LMHC
Verified Verified
Dayton, WA 99328
I have over twenty two years experience working with adults, adolescents, and families in behavioral and community mental health. However, the last thirteen years have been the most gratifying as I have had the privilege to practice directly as a mental health therapist. My approach focuses on working collaboratively with clients to find the change, growth, peace of mind, and general sense of well being they seek, as well as to help work through the challenges that life can present.
I have over twenty two years experience working with adults, adolescents, and families in behavioral and community mental health. However, the last thirteen years have been the most gratifying as I have had the privilege to practice directly as a mental health therapist. My approach focuses on working collaboratively with clients to find the change, growth, peace of mind, and general sense of well being they seek, as well as to help work through the challenges that life can present.
(509) 563-7328 View (509) 563-7328

Online Therapists

Photo of Bonnie St George, LMHC, Counselor
Bonnie St George
Counselor, LMHC
Verified Verified
Prosser, WA 99350  (Online Only)
Hello and welcome! My name is Bonnie St George-Ayotte, Licensed Mental Health Counselor 60996772 in the state of Washington. I specialize in trauma-informed, person-centered care for those struggling with anxiety, depression, and other performance impairments, and PSTD. Clients come to me from a variety of backgrounds and strengths. I love to hear people's stories and have a geeky sense of humor.
Hello and welcome! My name is Bonnie St George-Ayotte, Licensed Mental Health Counselor 60996772 in the state of Washington. I specialize in trauma-informed, person-centered care for those struggling with anxiety, depression, and other performance impairments, and PSTD. Clients come to me from a variety of backgrounds and strengths. I love to hear people's stories and have a geeky sense of humor.
(323) 643-8569 View (323) 643-8569
Photo of Shawna Hopple, BS, EMDR , ART, Pre-Licensed Professional
Shawna Hopple
Pre-Licensed Professional, BS, EMDR , ART
Verified Verified
1 Endorsed
Spokane, WA 99201
I work with individuals ages 16 and older struggling with a variety of concerns including stress management, depression, anxiety, trauma, prenatal and postpartum challenges, substance abuse and relationship distress.
I strive to create a space where you have the ability to heal from your past and the freedom to pursue a life worth living. As a counselor in training, I want to help you explore the connection between your emotions, thoughts and behaviors. Whether in person or video therapy, we will work together to help you achieve your goals. Through compassion, encouragement, honesty, and humor, we will collaborate to find tools, techniques and skills to help you foster new growth in your life.
I work with individuals ages 16 and older struggling with a variety of concerns including stress management, depression, anxiety, trauma, prenatal and postpartum challenges, substance abuse and relationship distress.
I strive to create a space where you have the ability to heal from your past and the freedom to pursue a life worth living. As a counselor in training, I want to help you explore the connection between your emotions, thoughts and behaviors. Whether in person or video therapy, we will work together to help you achieve your goals. Through compassion, encouragement, honesty, and humor, we will collaborate to find tools, techniques and skills to help you foster new growth in your life.
(509) 557-7739 View (509) 557-7739
Photo of Taylor Svetlichny, MA, LMFT, Marriage & Family Therapist
Taylor Svetlichny
Marriage & Family Therapist, MA, LMFT
Verified Verified
Spokane, WA 99202  (Online Only)
You are constantly questioning yourself, relying on validation from other people to feel good enough. Sometimes, you don’t know who you are, and you find yourself thinking about others and their needs before your own. Your mind races with thoughts about what others might think of you or how they might react, which leaves you wondering, “Why do I feel this way? I’m just not enough.” You sense yourself shutting down with feelings of fear, anxiety, worry, and dread… It might be time to take the next steps to discover how you can more fully engage in your life and the lives of others with greater ease and with greater joy.
You are constantly questioning yourself, relying on validation from other people to feel good enough. Sometimes, you don’t know who you are, and you find yourself thinking about others and their needs before your own. Your mind races with thoughts about what others might think of you or how they might react, which leaves you wondering, “Why do I feel this way? I’m just not enough.” You sense yourself shutting down with feelings of fear, anxiety, worry, and dread… It might be time to take the next steps to discover how you can more fully engage in your life and the lives of others with greater ease and with greater joy.
(509) 253-1181 View (509) 253-1181
Photo of Chris Gravett, LCSW, LICSW, Clinical Social Work/Therapist
Chris Gravett
Clinical Social Work/Therapist, LCSW, LICSW
Verified Verified
1 Endorsed
Spokane, WA 99202  (Online Only)
Some of the most significant are those who have overcome significant trauma, PTSD, and anxiety.
I like to work with people who want to change something in their life but may not know what or how to start. I believe that the desire to change, or try something different is the beginning of significant life changes! I can help you figure out what needs to change and begin this process.
Some of the most significant are those who have overcome significant trauma, PTSD, and anxiety.
I like to work with people who want to change something in their life but may not know what or how to start. I believe that the desire to change, or try something different is the beginning of significant life changes! I can help you figure out what needs to change and begin this process.
(435) 466-2335 View (435) 466-2335
Photo of Heather Stiles, MA, LMHC, NCC, Counselor
Heather Stiles
Counselor, MA, LMHC, NCC
Verified Verified
1 Endorsed
Spokane, WA 99202
I work with a variety of issues including, but not limited to, anxiety, depression, past trauma, conflict, communication, boundary setting, parenting, etc.
Looking for increased energy, motivation, happiness? Stressors, life changes, or past trauma can hold you back from being at peace in the present moment. I work individually with children, adolescents and adults on a variety of stressors. Sessions can include, emotional release techniques, shifting ways of thinking that get in the way, and practices of learning how to live in the present moment. I also work with families and couples on goals such as, but not limited to: conflict, communication, parenting or intimacy. I assess the family's relational dynamics, and come up with a plan to move the couple/family toward their goals.
I work with a variety of issues including, but not limited to, anxiety, depression, past trauma, conflict, communication, boundary setting, parenting, etc.
Looking for increased energy, motivation, happiness? Stressors, life changes, or past trauma can hold you back from being at peace in the present moment. I work individually with children, adolescents and adults on a variety of stressors. Sessions can include, emotional release techniques, shifting ways of thinking that get in the way, and practices of learning how to live in the present moment. I also work with families and couples on goals such as, but not limited to: conflict, communication, parenting or intimacy. I assess the family's relational dynamics, and come up with a plan to move the couple/family toward their goals.
(509) 956-4005 View (509) 956-4005
Photo of Andrew Paves, LCP, Counselor
Andrew Paves
Counselor, LCP
Verified Verified
Pasco, WA 99301  (Online Only)
I’m Dr. Andrew Paves (feel free to call me Andy), a licensed clinical psychologist passionate about racial identity development, intergenerational trauma, and enhancing motivation to change behaviors. Throughout my graduate training and professional career, I have worked with a variety of clients across the lifespan including individuals affected by trauma, depression, anxiety, chronic medical conditions, alcohol and substance use, as well as individuals from underrepresented backgrounds.
I’m Dr. Andrew Paves (feel free to call me Andy), a licensed clinical psychologist passionate about racial identity development, intergenerational trauma, and enhancing motivation to change behaviors. Throughout my graduate training and professional career, I have worked with a variety of clients across the lifespan including individuals affected by trauma, depression, anxiety, chronic medical conditions, alcohol and substance use, as well as individuals from underrepresented backgrounds.
(323) 643-8569 View (323) 643-8569
Photo of Colleen D. Taylor, MS, LMHC-A, Counselor
Colleen D. Taylor
Counselor, MS, LMHC-A
Verified Verified
Spokane, WA 99201  (Online Only)
I have worked with diverse adult populations, addressing issues such as anxiety, depression, trauma, substance use, and life transitions.
You’ve taken an important step in caring for your mental health, and I’m here to support you. In our sessions, we’ll work together to tap into your strengths and explore your needs. I like to use a combination of education—providing handouts to explain how thoughts and feelings work—and open conversations where we can dive deeper into what’s important to you. Whether you’re navigating past trauma, questioning your identity, or working on sobriety, I offer a safe space for you to explore what matters most.
I have worked with diverse adult populations, addressing issues such as anxiety, depression, trauma, substance use, and life transitions.
You’ve taken an important step in caring for your mental health, and I’m here to support you. In our sessions, we’ll work together to tap into your strengths and explore your needs. I like to use a combination of education—providing handouts to explain how thoughts and feelings work—and open conversations where we can dive deeper into what’s important to you. Whether you’re navigating past trauma, questioning your identity, or working on sobriety, I offer a safe space for you to explore what matters most.
(509) 550-7638 View (509) 550-7638
Photo of Myrlanda Lafortune, LMHCA, Counselor
Myrlanda Lafortune
Counselor, LMHCA
Verified Verified
Spokane, WA 99201  (Online Only)
I provide individual therapeutic services to adults and young adults who are dealing with unresolved loss, anxiety, depression, trauma symptoms, post-traumatic stress disorder, autism, and relationship issues.
If you are struggling with depression, anxiety, domestic violence, or going through significant life changes, I am here to help you. I can assist you in developing coping skills, practicing mindfulness, and utilizing tools to manage your mental health effectively. I believe that healing occurs within the therapeutic relationship. I aim to work with clients who are willing to help themselves and are open to the therapeutic process.
I provide individual therapeutic services to adults and young adults who are dealing with unresolved loss, anxiety, depression, trauma symptoms, post-traumatic stress disorder, autism, and relationship issues.
If you are struggling with depression, anxiety, domestic violence, or going through significant life changes, I am here to help you. I can assist you in developing coping skills, practicing mindfulness, and utilizing tools to manage your mental health effectively. I believe that healing occurs within the therapeutic relationship. I aim to work with clients who are willing to help themselves and are open to the therapeutic process.
(509) 715-6612 View (509) 715-6612
Photo of Averi Basso, Pre-Licensed Professional
Averi Basso
Pre-Licensed Professional
Verified Verified
1 Endorsed
Spokane, WA 99218
I specialize in working with high achievers struggling with feelings of anxiety, self-critical talk, burnout, and feeling overwhelmed, among other struggles.
You're someone who is a high achiever, but still find yourself overwhelmed, feeling anxious, and highly self-critical. It can feel difficult to move out of these feelings and achieve what you work so hard for. But you're ready to make a change. You're ready to ease those feelings and work through your anxiety. You're ready to break free from your critical thoughts. Most of all, you're ready to make a positive, lasting change to your quality of life! I want to help you get there.
I specialize in working with high achievers struggling with feelings of anxiety, self-critical talk, burnout, and feeling overwhelmed, among other struggles.
You're someone who is a high achiever, but still find yourself overwhelmed, feeling anxious, and highly self-critical. It can feel difficult to move out of these feelings and achieve what you work so hard for. But you're ready to make a change. You're ready to ease those feelings and work through your anxiety. You're ready to break free from your critical thoughts. Most of all, you're ready to make a positive, lasting change to your quality of life! I want to help you get there.
(509) 519-4098 View (509) 519-4098
Photo of Amie Peterson - Thin Line Therapy 206, PLLC - Amie M. Peterson, MHA, MS, LPCC-MN, LPCC-ND, LMHC-WA, Counselor
Thin Line Therapy 206, PLLC - Amie M. Peterson
Counselor, MHA, MS, LPCC-MN, LPCC-ND, LMHC-WA
Verified Verified
1 Endorsed
Walla Walla, WA 99362  (Online Only)
Are you a First Responder, Healthcare Professional, Therapist, or in a High Stress Occupation who struggles with stress or trauma related to your career? Are you a spouse or family member who is struggling with the grief of a Line of Duty Death or a Suicide of your loved one? Now more than ever the stress within these careers continues to grow, and not taking the time for yourself can lead to long-term issues for your mind and body. I'm a trained EMDR therapist and I have over a decade of experience working with those who have endured trauma, substance use, depression, anxiety, compassion fatigue, and other mental health concerns.
Are you a First Responder, Healthcare Professional, Therapist, or in a High Stress Occupation who struggles with stress or trauma related to your career? Are you a spouse or family member who is struggling with the grief of a Line of Duty Death or a Suicide of your loved one? Now more than ever the stress within these careers continues to grow, and not taking the time for yourself can lead to long-term issues for your mind and body. I'm a trained EMDR therapist and I have over a decade of experience working with those who have endured trauma, substance use, depression, anxiety, compassion fatigue, and other mental health concerns.
(509) 955-7147 View (509) 955-7147
Photo of Adriana Vargas, LMHCA
Adriana Vargas
Mental Health Counselor Associate, LMHCA
Verified Verified
Spokane, WA 99201
I specialize in working with women and men who struggle with complex trauma, anxiety, depression, grief, relationship/family issues, sexual abuse, and PTSD.
Meaning of life is different for everyone and everyone has their own mission that permits one a great sense of fulfillment in their lives. We are unique when dealing with challenges in life, and at times might need support in finding a purpose that promotes inner growth and self-awareness. Finding solutions can become challenging at times but with an engaging therapeutic relationship, one's challenges become meaningful and solvable feats. . How can we make sense of obstacles that damp many of our dreams and plans for life? How do we confront difficulties with curiosity and self-awareness
I specialize in working with women and men who struggle with complex trauma, anxiety, depression, grief, relationship/family issues, sexual abuse, and PTSD.
Meaning of life is different for everyone and everyone has their own mission that permits one a great sense of fulfillment in their lives. We are unique when dealing with challenges in life, and at times might need support in finding a purpose that promotes inner growth and self-awareness. Finding solutions can become challenging at times but with an engaging therapeutic relationship, one's challenges become meaningful and solvable feats. . How can we make sense of obstacles that damp many of our dreams and plans for life? How do we confront difficulties with curiosity and self-awareness
(509) 383-8689 View (509) 383-8689
Photo of Sarah M. Parks - Accepting Always PLLC, MA, LMHCA, SUDPT, Counselor
Accepting Always PLLC
Counselor, MA, LMHCA, SUDPT
Verified Verified
1 Endorsed
Pullman, WA 99164  (Online Only)
I work with individuals & couples in exploring childhood messages, disconnection and current life circumstances as well as anxiety.
We are not individuals who are broken that need to be fixed, we are humans having a human experience and we are constantly in a state of change and transitions that have sometimes served us and sometimes not. People who seem to work well with me are ones that are motivated to make changes and comfortable with awareness of self. I work from a developmental trauma, attachment theory and shame basis of therapy including meeting and nurturing your inner child. It is easiest to reach me by email or visit my website linked on this page.
I work with individuals & couples in exploring childhood messages, disconnection and current life circumstances as well as anxiety.
We are not individuals who are broken that need to be fixed, we are humans having a human experience and we are constantly in a state of change and transitions that have sometimes served us and sometimes not. People who seem to work well with me are ones that are motivated to make changes and comfortable with awareness of self. I work from a developmental trauma, attachment theory and shame basis of therapy including meeting and nurturing your inner child. It is easiest to reach me by email or visit my website linked on this page.
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Photo of Maegan McClanahan, MA, LMHC, Counselor
Maegan McClanahan
Counselor, MA, LMHC
Verified Verified
4 Endorsed
Spokane, WA 99203  (Online Only)
We all seek help for different reasons. I see my job as a therapist to help guide you towards the life you wish to live. To do this, together we will develop a personalized treatment plan to help you realign with your values and progress towards your goals, whether this is in the context of relationships, new transitions, or difficult periods of time. I work with a wide variety of issues, including depression, anxiety, adjustment disorders, PTSD, attachment issues, marital conflict, and many more.
We all seek help for different reasons. I see my job as a therapist to help guide you towards the life you wish to live. To do this, together we will develop a personalized treatment plan to help you realign with your values and progress towards your goals, whether this is in the context of relationships, new transitions, or difficult periods of time. I work with a wide variety of issues, including depression, anxiety, adjustment disorders, PTSD, attachment issues, marital conflict, and many more.
(509) 265-6016 View (509) 265-6016
Photo of Allison Sande, LMHC, Counselor
Allison Sande
Counselor, LMHC
Verified Verified
Pasco, WA 99301  (Online Only)
As a DBT-informed therapist, I work with adolescents, teens, and emerging adults, helping them navigate the challenges of anxiety, depression, and mood disorders.
Hello! My name is Allison Sande, I am a licensed mental health counselor. I am deeply committed to guiding individuals in uncovering their authentic selves and building lasting self-esteem. By integrating mindfulness, emotional regulation, and compassionate support, I help my clients navigate life’s challenges while empowering them to embrace their truth and live with greater confidence and fulfillment. Dialectical Behavior Therapy (DBT) is a type of cognitive-behavioral therapy designed to help individuals manage intense emotions, improve relationships, and build a life worth living.
As a DBT-informed therapist, I work with adolescents, teens, and emerging adults, helping them navigate the challenges of anxiety, depression, and mood disorders.
Hello! My name is Allison Sande, I am a licensed mental health counselor. I am deeply committed to guiding individuals in uncovering their authentic selves and building lasting self-esteem. By integrating mindfulness, emotional regulation, and compassionate support, I help my clients navigate life’s challenges while empowering them to embrace their truth and live with greater confidence and fulfillment. Dialectical Behavior Therapy (DBT) is a type of cognitive-behavioral therapy designed to help individuals manage intense emotions, improve relationships, and build a life worth living.
(323) 643-8569 View (323) 643-8569
Photo of Victoria Howells, MA, LMHC, LCPC, Counselor
Victoria Howells
Counselor, MA, LMHC, LCPC
Verified Verified
Pullman, WA 99163  (Online Only)
I work with anxiety, depression, trauma, chronic pain, stress, limiting beliefs, and other mental health concerns.
Welcome to my practice! I am a licensed mental health therapist in both Washington and Idaho state and a certified EMDR practitioner. I provide high quality virtual EMDR therapy as well as provide EMDR consultant services to other mental health professionals. I am a LGBTQIA+ ally and pride myself on offering a warm, non-judgmental, accepting environment.
I work with anxiety, depression, trauma, chronic pain, stress, limiting beliefs, and other mental health concerns.
Welcome to my practice! I am a licensed mental health therapist in both Washington and Idaho state and a certified EMDR practitioner. I provide high quality virtual EMDR therapy as well as provide EMDR consultant services to other mental health professionals. I am a LGBTQIA+ ally and pride myself on offering a warm, non-judgmental, accepting environment.
(509) 631-9751 View (509) 631-9751
Photo of Lauren Kohler, LSWAIC, Clinical Social Work/Therapist
Lauren Kohler
Clinical Social Work/Therapist, LSWAIC
Verified Verified
Spokane, WA 99201
Women and teens experiencing depression, anxiety, stress, trauma, relationship struggles, etc are my focus.
Welcome! Reaching out for help takes courage, and you are taking a courageous step towards healing. Perhaps you are here because each day is a struggle, like trudging through deep waters, each step feeling like it is too much. Maybe the thought of going through your day makes your heart race and your head spin. Or do you live with painful memories and intrusive thoughts from your past? It is possible to feel light and joy in your life again. Therapy can help you rediscover yourself - work towards a happier, healthier, more functional you - in a safe space free of judgment or fear.
Women and teens experiencing depression, anxiety, stress, trauma, relationship struggles, etc are my focus.
Welcome! Reaching out for help takes courage, and you are taking a courageous step towards healing. Perhaps you are here because each day is a struggle, like trudging through deep waters, each step feeling like it is too much. Maybe the thought of going through your day makes your heart race and your head spin. Or do you live with painful memories and intrusive thoughts from your past? It is possible to feel light and joy in your life again. Therapy can help you rediscover yourself - work towards a happier, healthier, more functional you - in a safe space free of judgment or fear.
(509) 519-3828 View (509) 519-3828
Photo of Jayne Helle, PhD, CHT, LMHC
Jayne Helle
PhD, CHT, LMHC
Verified Verified
Spokane, WA 99204
Hello! Everyone experiences anxiety from time to time, but for some people, it can interfere with everyday life. Do you find it difficult to concentrate or often feel overwhelmed? Do you experience a racing heart or lightheadedness? Are you finding yourself putting things off or avoiding social activities? Whether you know what triggers your anxiety or not, I can help you navigate through the stress without emotional turmoil by helping you let go of the past, have a fresh start, and create more happiness and well-being in your life. Together, we can move past what you have been struggling with and create the best version of you.
Hello! Everyone experiences anxiety from time to time, but for some people, it can interfere with everyday life. Do you find it difficult to concentrate or often feel overwhelmed? Do you experience a racing heart or lightheadedness? Are you finding yourself putting things off or avoiding social activities? Whether you know what triggers your anxiety or not, I can help you navigate through the stress without emotional turmoil by helping you let go of the past, have a fresh start, and create more happiness and well-being in your life. Together, we can move past what you have been struggling with and create the best version of you.
(509) 517-6191 View (509) 517-6191
Photo of Dr. Jeanette Perales Notturno, PhD, LMHC, LPC, NCC, Counselor
Dr. Jeanette Perales Notturno
Counselor, PhD, LMHC, LPC, NCC
Verified Verified
Walla Walla, WA 99362  (Online Only)
There are several reasons why you may seek a counselor. You may be dealing with relationship issues, anxiety, depression, OCD, trauma, and more. There is a lot on everyone’s plate and I aim to support and guide you to feel some relief. As a counselor, I have the honor and privilege to meet so many wonderful humans and witness their potential; Because of this, I treat each counseling session as sacred work. I hope to form a collaborative relationship where I guide and empower you to get closer to your goals. This collaborative relationship can foster confidence in you to conquer your goals.
There are several reasons why you may seek a counselor. You may be dealing with relationship issues, anxiety, depression, OCD, trauma, and more. There is a lot on everyone’s plate and I aim to support and guide you to feel some relief. As a counselor, I have the honor and privilege to meet so many wonderful humans and witness their potential; Because of this, I treat each counseling session as sacred work. I hope to form a collaborative relationship where I guide and empower you to get closer to your goals. This collaborative relationship can foster confidence in you to conquer your goals.
(509) 204-1689 View (509) 204-1689
Photo of Christina Jean Bailey, LSWAIC, MHP, CMHS, Clinical Social Work/Therapist
Christina Jean Bailey
Clinical Social Work/Therapist, LSWAIC, MHP, CMHS
Verified Verified
2 Endorsed
Richland, WA 99352  (Online Only)
They need a support person who has the clinical knowledge and experience to walk alongside them as they heal, find new ways to cope with their stress and anxiety, and explore what they want to do with their life.
Are you someone who has difficulty feeling connected with others, or have you noticed your teen is struggling to connect with you, their friends, family, and even with themselves? Maybe you’re concerned they’re harming themselves, using drugs, or engaging in risky behaviors. They may seem like they don’t have any hope or goals and have low self-confidence. There may be worries about what the future may hold. Maybe you are worried about having difficulties of your own.
They need a support person who has the clinical knowledge and experience to walk alongside them as they heal, find new ways to cope with their stress and anxiety, and explore what they want to do with their life.
Are you someone who has difficulty feeling connected with others, or have you noticed your teen is struggling to connect with you, their friends, family, and even with themselves? Maybe you’re concerned they’re harming themselves, using drugs, or engaging in risky behaviors. They may seem like they don’t have any hope or goals and have low self-confidence. There may be worries about what the future may hold. Maybe you are worried about having difficulties of your own.
(509) 612-7478 View (509) 612-7478

See more therapy options for Columbia County

Anxiety Therapists

What are the most common treatments for anxiety?

Talk therapy, particularly cognitive behavioral therapy, is the most common treatment for anxiety. Studies have shown it is equally effective as medication. Other popular forms of therapy are popular, depending on a patient’s experience. Exposure therapy, for instance, can be useful for people dealing with fears and phobias, or who have experienced traumatic events. Dialectical Behavioral Therapy may be useful for patients who need help with emotion regulation. Anxiolytic medications, like benzodiazepines, can also help with calming a person enough to focus on the skills they’ve learned, and physical exercise has been shown to help symptoms of anxiety across the board.

How long does therapy for anxiety take to work?

The amount of time needed to alleviate symptoms depends on the severity of a person’s condition. Some therapies may take 5-20 weekly sessions to show results. Anti-depressant medications typically take two to four weeks before a benefit is felt. Anti-anxiety medications are felt typically within 20-30 minutes. Medications are best used to offer a patient a better headspace in which to work on techniques learned in therapy. Exercise, improved sleep habits, and meditation are effective, but takes weeks or months to show results.

When should I seek treatment for anxiety?

Everyone feels anxious at times, but when anxiety causes disruption to your daily life, it may be time to seek help. Such disruption can be mental, physical, or both: having fear dominate your thoughts, avoiding situations or objects that bring on feelings of anxiety, or experiencing shortness of breath, sweating, dizziness, or panic attacks. When these symptoms are recurrent and distressing, it may be time to talk to someone.

How effective is treatment for anxiety?

Treatment for anxiety has been shown to be moderately to highly effective, according to a large body of psychology studies and analyses. For some people, treatment using CBT or exposure therapy alone is effective. Others respond best to a combination of medication and therapy.