Anxiety Therapy in San Diego: How to Find the Right Therapist
Finding the right Anxiety therapist in San Diego for you
You have finally arrived at: maybe it’s time I talk to someone about how much I’m struggling. Amazing! Congratulations on getting to this point. This is huge. So you walk to the edge of the pier, look out at the ocean, and there's a sea of therapists. Hundreds, maybe even thousands, all seemingly well-qualified, kind, and helpful. But gosh, where do you even start? This feels overwhelming, and if you're already struggling with anxiety, which probably means you're caught up in your head and overthinking, this feels like another daunting task. But it doesn't have to be. The purpose of this article is to simplify things, so you have a place to start.
The right therapist for you may not be the person with the most experience or have extensive certifications. The right therapist for you will be the one who you feel heard and seen by. And they have the right tools for the job. This article is intended to offer information so you can make an informed and connected choice on who you’d like to do this important work with. You will learn where to look, what to look for, and what questions to ask in your quest for the right anxiety therapist.
What Anxiety Can Look Like in Everyday Life
What is anxiety? According to the DSM-5-TR (Diagnostic and Statistical Manual, 5th Edition, Revised in 2022), anxiety is excessive and uncontrollable worry more days than not for an extended period of time which negatively impacts both mental and biological functioning. Okay, great, thanks for the clinical jargon, but what does that really mean?
The Mental and Emotional Side
It means you're experiencing constant worry and overthinking, usually about a variety of topics, though it could be a fixation on one or two things in particular. You may have difficulty relaxing, which can look like trouble sleeping, a general sense of overwhelm, and irritability. Oftentimes, people who struggle with anxiety also wrestle with perfectionism, including negative beliefs that you're supposed to be perfect and do things "correctly," which often leads to avoidance. The thought sounds like, "If I can't do it right, I'm not even going to try."
The Physical Side
Anxiety shows up in the body too. You may experience a racing heart, heart palpitations, sore muscles and muscle tension, tummy troubles, general GI issues, headaches, and fatigue.
The Bigger Picture
This is not merely "I'm stressed about an upcoming event." This is a pervasive pattern that impacts all of your relationships, including your relationship with yourself. You may notice a decline in your work capabilities and not feeling joy from activities that used to make you happy. Self doubt and constant questioning permeates throughout most your decisions, and it becomes hard to operate the way you used to. Anxiety steals the joy out of life and leaves you feeling disconnected. It's not the quality of life you want to be living.
How Anxiety Therapy Can Help
One common misconception is that therapy is just sitting there and talking about your problems. While talking can be supportive, therapy goes much further than that. It's about learning practical skills to manage anxiety, uncovering your patterns of behavior, and understanding what activates anxiety for you. You may discover that these patterns are old, connected to the way you were raised or to difficult life events. Your therapist will help you develop a different way of relating to your thoughts and emotions.
Learning to Put on the Brakes
It's quite possible you're not even aware of how much your mind is running. It just goes and goes and goes, no breaks. Therapy is about learning how to slow that down and take back control so that you're in the driver's seat of your own life.
Regulating Your Nervous System
Therapy also offers skills for regulating your nervous system through somatic-based techniques that help you feel safe and calm in your body. This is so important. You can't think your way out of these patterns alone. Safety and connection have to be created in the physical body, which then supports the mind. It's all connected.
Doing the Work
Think of therapy like going to the gym. It's a muscle, and practice is your training. You're not going to see results overnight. The work you do inside the therapy room helps remove barriers so you can show up in your life the way you want to. The goal is to build your confidence and your resiliency toward negative thoughts when they show up, which sometimes looks like meeting them with compassion and acceptance. Your therapist may also challenge you to move toward your anxiety to decrease avoidance patterns and reclaim what anxiety has taken from you.
Types of Anxiety Therapy
Here is a rundown of some common approaches therapists use in treating anxiety.
Cognitive Behavioral Therapy (CBT)
One of the most well-known and well-researched approaches is cognitive behavioral therapy. Your therapist supports you in identifying unhelpful and distorted thought patterns, and together you work to create more balanced, realistic ones. The underlying principle: the way you think about the world creates your reality. I don't know who said it, but I often use this quote when explaining CBT: "Change your thinking, change your life." You'll learn coping tools to practice these new thought patterns, and CBT therapists often use educational materials and worksheets to reinforce the principles. CBT has decades of strong research behind it as an effective treatment for anxiety.
Eye Movement Desensitization and Reprocessing (EMDR)
Anxiety and other dysfunctional behavior patterns are often connected to unresolved, challenging life experiences. This could be the way you were raised, your family system, exposure to ongoing difficulty, single trauma events, neglect, or abuse. These experiences impact the way you think and the way your nervous system functions. Think: getting stuck in fight or flight and responding to old things as if they're happening right now.
EMDR allows your brain to process events from the past that may be “stuck “in the present. Often times our experience of present anxiety is actually rooted in old traumas or difficult experiences. EMDR gets to the root of anxiety and helps the mind and body rewire for safety. EMDR is supported in the research literature as an effective treatment for anxiety disorders. Clinical trials show positive outcomes for phobias, social anxiety, generalized anxiety, and panic disorders.
Psychodynamic Therapy
Psychodynamic therapy uses a variety of techniques to help you increase your insight around emotional and behavioral patterns. It is more along the lines of "traditional talk therapy," where you and your therapist explore the meaning behind your thoughts and actions, with the goal of creating insight that promotes behavior change and empowerment. The focus is on understanding how the past creates the present. This is a strong fit for people who really want to understand "where is this coming from?" or "why am I like this?"
Mindfulness-Based Approaches
Mindfulness-based approaches help you connect to yourself in the present moment. You'll learn how to slow down and respond with curiosity and acceptance instead of reacting with judgment. Your therapist will teach your real-life tools to help you stay present throughout your daily life. Practicing your skills outside of session is highly encouraged. Common mindfulness techniques include: meditation, deep breathing, yoga, intuitive body movement, vagus nerve exercises, and other somatic-based practices.
Where Do I Find a Therapist?
There are more options than ever when it comes to finding a therapist, which is great news. The challenge is figuring out where to start. Here are some of the most common (and effective) ways to find an anxiety therapist in San Diego.
Psychology Today
One of the most popular therapist directories is Psychology Today. Therapists create profiles to showcase their clinical speciality, treatment approaches, who they work best with, if they accept insurance, which will allow you to get a feel for who they are. Therapist often include their photo, a short video clip, a link to their website and endorsements from colleagues. You can reach out to them directly.
You can filter your search to bring up specifics that you are searching for. ie., specialty, insurance, zip code, gender, etc. .The directory will then show therapists who meet those criteria.
EMDRIA
If you are searching for an EMDR therapist, the EMDR International Association (EMDRIA) has a therapist directory that allows you to search for EMDRIA-certified clinicians (advanced clinical training in EMDR).
While certification isn't the only measure of quality, therapists listed through EMDRIA have completed extensive EMDR training and consultation requirements.
Word of Mouth
One of my favorite ways to find a therapist is through referrals.
Talk to your friends and family: who’s got an awesome therapist? Hearing firsthand that someone felt supported and helped can provide a level of confidence that online profiles simply can't.
Now, if seeing the same therapist as a friend feels uncomfortable, that's completely valid. In that case, ask the therapist for recommendations. Most great therapists know other great therapists. Personally, if someone reaches out and we're not the right fit, I'm usually able to connect them with someone from my trusted referral network.
Therapists refer to each other all the time, and those referrals are often some of the strongest you'll find.
Contact Your Insurance Company
If you're planning to use insurance, you can contact your insurance provider directly and ask for a list of in-network therapists.
This is often the recommendation you'll receive from your primary care physician or insurance company. Just keep in mind that insurance directories are not always up to date. Therapists regularly join or leave insurance panels, so a provider listed today may no longer be accepting that insurance.
If your insurance company offers an online directory, it is often more accurate than a printed list, but it's still a good idea to verify coverage directly with the therapist before scheduling.
Ask Your Trusted Providers
Whether it's your primary care doctor, your nurse practitioner, your psychiatrist, or your midwife, asking them is a great place to start. These folks generally have mental health therapists they refer to because they respect them and can vouch for the work they're doing out in the community. That can be a wonderful place to get a solid referral from somewhere that already feels good for you.
Open Path Collective
If you don't have insurance coverage for therapy and private-pay rates feel out of reach, I often recommend looking into Open Path Collective.
Open Path is a nonprofit organization that helps connect people with affordable therapy. After paying a one-time membership fee, members gain access to therapists who offer sessions at significantly reduced sliding-scale rates.
Therapists will often join Open Path because they want to increase access to quality mental health care. Clients who cannot afford the going market rate for therapy ($150-250 per 50 min session here in Southern California) can pay a sliding-scale rate ($40-70 per session). A fantastic option, because we know that cost is one of the biggest barriers keeping folks from getting the support they need.
What to Look for in an Anxiety Therapist
Their Speciality
You'll want a therapist who clearly and confidently states their speciality. For Anxiety Therapy in San Diego look for someone who can speak to their experience working with people who have panic attacks, generalized anxiety, social anxiety, phobias, and trauma-related anxiety.
Training and Credentials
Verify that the therapist is licensed in California. The BBS (Board of Behavioral Sciences) oversees mental health licensures in the state. You can ask for their license number and verify it is active. You may also want to ask about specialized trainings or certifications relevant to anxiety, such as EMDR, trauma-informed credentials, or exposure and response prevention training.
Their Approach
Know what you're looking for. If you want EMDR, make sure your therapist is trained in it and actively using it with comfort and regularity.
What does your intuition say?
In your initial consultation, use your intuition. Do you feel understood? Do you feel safe? Are they answering your questions directly?
There may also be identity and lifestyle factors to consider. Are you part of a community where shared lived experience matters to you? Do you want a therapist who is comfortable working with trans folks, or one who shares your cultural or ethnic background? Does your therapist's gender matter to you? Who would you feel safest with? These are all valid and important considerations. Take a moment, close your eyes, take a deep breath, and ask yourself: what does your ideal therapist look like?
Trust Is Everything
Research shows, over and over again, that trusting your therapist is more important than what modality they use, how many years they've been in the field, or what credentials they have. Do you feel safe enough to talk about the things you need to talk about to heal and grow? Can you have hard conversations with them?
Trust is the single strongest factor in determining positive outcomes in therapy. It can be hard to measure that in a 15 or 20 minute consultation, and that's okay. Give yourself two or three sessions to really feel it out. If it's not there, let's keep it moving. There is nothing wrong with being assertive about your needs, and what you need in therapy is to trust your therapist. That is it.
In my own personal journey, I was once matched with a therapist through insurance with no consultation, and after that first session I was like, nope. Hard no. Something just didn't feel right, whether it was their approach, their mannerisms, or possibly the two Red Bulls they drank during session and the jittery, frantic energy that came with it. I kept going until I found someone who was a good fit. So if you know immediately after a first session that it's not working, trust that. If you're on the fence, give it two or three sessions and then make your decision. You are in charge here. You are not stuck.
Questions to Ask During a Consultation
What experience do you have treating anxiety?
What is your therapeutic approach?
What types of anxiety do you treat? Do you have a specialty?
Do you have training in EMDR or trauma-informed approaches?
How do I know if therapy is working?
What should I expect when starting therapy with you? (therapy process overall?)
Take a moment to save these questions somewhere accessible so you have them ready during your consults.
Red Flags to Watch For
If a therapist is promising you a specific outcome or a guarantee, that's a concern. Human beings are complex and unpredictable, and guaranteeing results is a little sketchy. Watch out for definitive and absolute language.
If you feel rushed, dismissed, pressured, judged, or like the consultation is a sales pitch, back away slowly. This is a personal decision that deserves care and diligence, which is clearly something you care about if you've made it this far.
If the therapist lacks clear boundaries or is not being professional, that's a red flag. Safety in the therapeutic relationship comes largely from clear and consistent boundaries. If things feel too loose and informal, that's not good.
If the therapist cannot explain or articulate their treatment approach with confidence, that is also a red flag.
Online vs. In-Person Anxiety Therapy in San Diego
In-Person Therapy
In-person therapy gives you a dedicated, safe space that contains your sessions. It can be really grounding to walk into that same safe environment each week, free from the distractions of home or the office. There is also something meaningful about face-to-face connection. We are social creatures, and our biology is wired for in-person connection. We pick up on nuances in body language, facial expressions, and energy that do not fully translate through a screen.
Online Therapy
Online therapy is convenient, and let's be real, gas prices are scary right now. Skipping the commute will likely save you money and time. You also get greater scheduling flexibility and access to specialized providers throughout all of California. That unicorn therapist in Redding? You can see them. Per the research, and there was tons of research conducted during and post-COVID to measure the effectiveness of online treatments, virtual therapy is just as effective as in-person therapy for anxiety treatment. At the end of the day, the best option is the one that actually works for you and your lifestyle.
How To Know If Therapy Is Working?
Therapy can be pretty activating. I tell my clients: you are not always going to leave here feeling sunshine and rainbows. We are going to talk about hard stuff, and sometimes you might leave feeling like crap, just to keep it real. It’s the idea that you have to go through it to get to the other side. And your right therapist will be there with you to guide you in a way that feels safe.
Progress Is Not Linear
It looks like a graph that is all over the place, ups and downs, peaks and valleys. But generally, it should be trending upward. You should be having regular outcomes conversations with your therapist, connected to the goals you set early on in treatment. The main questions being: what do you want to achieve, and how do you want to measure success?
Signs That Therapy Is Working
A gradual reduction in the intensity of your anxiety
Less time recovering after stressful events
Avoiding things less
Improved sleep
Feeling more confident, kinder and accepting
You may not even notice these shifts until your therapist reflects them back to you.
Therapy is not about getting rid of anxiety. Anxiety is inherent in the human condition. Therapy is about shifting your relationship to it.
If It Is Not Working
If you are not seeing a change in your symptoms or are not reaching your goals, I encourage you to have that coversation directly with your therapist. They need to know, and frankly, they want to know stuff like that! A good therapist will appreciate your honesty and use it as an opportunity to make adjustments in treatment. Here’s a beautiful opportunity for you to practice direct, assertive communication and derail patterns of avoidance often experienced by anxious folks.
Finding the Right Anxiety Therapist in San Diego
Your right therapist should specialize in treating your concern, be able to communicate a clear treatment path and rationale, and feel safe. I encourage you to schedule a consult with more than one therapist. You are interviewing them for the job to be your therapist! We want goodness of fit to go both ways.
Anxiety is totally treatable, even when it is rooted in old, stuck patterns from childhood. Folks who come to therapy often experience real relief from overthinking and system overload. My hope for you is that you walk away from your consultations feeling clear, knowing that you trusted your gut and can move forward with an informed decision. This is the beginning of the path towards a calmer, freer self where you can show up in your life authentically, in your relationships, and in the way you move through the world.
About the Author
Alexa Hall, LCSW, is a San Diego anxiety therapist and owner of Trailstone Therapy. Alexa helps anxious women who struggle with self-doubt, perfectionism, overthinking, chronic stress, nervous system dysregulation, and trauma-related symptoms through Eye Movement Desensitization and Reprocessing (EMDR), Cognitive Behavioral Therapy (CBT), and somatic techniques. To support clients in moving out of survival mode and into calm, confidence, and safety, she offers both in-person therapy in San Diego and online therapy throughout California.