Anxiety & panic

Who this is for

You might be here because anxiety has started to shape your days, racing thoughts, tight chest, avoiding situations, or checking and reassurance-seeking that never quite settles the fear. Perhaps you have had panic attacks and now live carefully, trying not to trigger the next one.

Many people wait until anxiety affects work, relationships, or sleep before seeking help. You do not need a formal diagnosis to begin. If worry or panic is costing you freedom, that is reason enough.

Common experiences we work with

• Generalised worry and "what if" thinking that is hard to switch off
• Panic attacks or fear of panic in public, travel, or meetings
• Social anxiety and fear of judgment
• Health anxiety and repeated checking
• Performance anxiety at work or in exams
• Anxiety linked to a recent life event or transition

How brief therapy can help

At Door to Therapy, we work collaboratively and practically. Rather than spending months mapping your entire history, we clarify what you want to be different, what triggers and maintains the anxiety, and which tools will help you most, often in a focused number of sessions.

Cognitive and behavioural approaches help you test unhelpful predictions, reduce avoidance, and build tolerance for uncertainty. Solution-focused work keeps us oriented toward your preferred future, not only the problem.

Research on brief interventions for anxiety shows that focused therapy can produce meaningful change; many clients notice shifts within the first few sessions when work is goal-directed and actively practiced between meetings.

Signs it may be time to seek help

Anxiety becomes worth treating when fear is out of proportion to the situation, persists, and starts to limit work, relationships, sleep, or daily freedom. NICE (the UK's National Institute for Health and Care Excellence) recommends psychological therapy as a first-line treatment for generalised anxiety disorder and panic disorder for many adults, often alongside or before medication depending on severity.

You do not need every symptom on a checklist. If worry or panic is frequent, exhausting, or steering your choices, that is enough to speak to a professional.

• Worry on most days for several weeks, difficult to control
• Unexpected panic attacks or intense fear of having another attack
• Avoiding travel, meetings, social situations, or health checks because of anxiety
• Sleep disrupted by rumination, muscle tension, or restlessness
• Anxiety continuing long after a stressful period has passed
• Relying on alcohol, reassurance, or checking rituals to feel safe

What the evidence suggests

Decades of research support cognitive and behavioural therapies for anxiety. Meta-analyses show that CBT and related structured approaches reduce anxiety symptoms with benefits that often last beyond the end of treatment. Brief, goal-directed formats can work well when sessions focus on maintaining patterns such as avoidance, catastrophic predictions, and safety behaviours, with practice between meetings.

For panic disorder, reducing fear of bodily sensations and stopping avoidance of situations where panic occurred are among the most evidence-backed ingredients. For generalised anxiety, techniques that limit worry time and test "what if" thoughts are well supported. At Door to Therapy we draw on these methods pragmatically rather than following a rigid manual, so the fit is personal as well as evidence-based.

What a session looks like

Your first session is a 50-minute assessment: we explore what you are experiencing, what you want to achieve, and what approach fits best. From there, sessions are structured but warm, a mix of understanding, skill-building, and planning concrete steps for the week ahead.

You leave with clarity on what we are working on and why. Between sessions, small experiments (behavioural tasks, thought records, grounding practices) help translate insight into change.

Accessing therapy at Door to Therapy

Anxiety and panic are among the most evidence-supported areas of psychological therapy. Door to Therapy offers brief CBT and solution-focused work with Dr. Santiago de Ossorno, HCPC-registered counselling psychologist, online across the UK and Spain and in London.

A free 15-minute consultation helps you decide on fit and format. If panic is severe or you avoid essential medical care, we may coordinate with your GP while working psychologically.

Standard sessions are £80. Many anxiety presentations respond in a focused number of sessions when homework and exposure are part of the plan.

What progress can look like

Progress might mean fewer panic attacks, shorter worry episodes, or doing something you avoided (travel, health appointment, presentation) with manageable anxiety. We track specific targets each session.

The goal is not zero anxiety, which is unrealistic, but anxiety that no longer runs your choices. Clients often notice the first shifts within two to four sessions when practice is consistent.

Anxiety, panic, and the brain

Panic disorder involves misinterpretation of bodily sensations (heart rate, breathlessness) as catastrophic. CBT targets those misinterpretations and gradually reduces safety behaviours (sitting near exits, carrying water, constant checking).

Generalised anxiety involves intolerance of uncertainty: the mind treats "not knowing" as danger. Worry can feel like problem-solving but often avoids emotion or action. Therapy distinguishes productive planning from repetitive rumination.

NICE recommends psychological therapy as a core treatment for panic disorder and GAD. Medication can help some people; therapy adds durable skills. Many clients use both under GP guidance.

Your first appointment

Book a free 15-minute consultation if you want to discuss panic, worry, or both before committing to a full session. We cover fees, online versus London in-person, and what brief CBT-style work involves.

The 50-minute assessment maps triggers, avoidance, safety behaviours, and your goals. Many clients leave with a first experiment to try (for example a small exposure step or a worry-time plan).

If panic mimics medical symptoms, we encourage GP review to rule out physical causes. Therapy and medical care can run in parallel.

Related resources

• Thought Mastery self-help programme →

  CBT techniques for testing anxious thoughts, to complement therapy, not a substitute for live support

Approaches we use

Where we work

Frequently asked questions

Can therapy help if I only have panic attacks occasionally?

Yes. Even occasional panic can lead to avoidance and hypervigilance. Brief therapy can address both the attacks themselves and the patterns that maintain fear of future episodes.

How many sessions will I need for anxiety?

It varies. Many mild-to-moderate anxiety presentations respond well in 1–6 sessions of focused work. We review progress together and you decide whether to continue.

Do you offer online therapy for anxiety across the UK?

Yes. Online sessions are available throughout the UK and Spain. In-person sessions are available in London (Queen's Park area) by arrangement.

Is CBT the only approach you use for anxiety?

CBT is a core method, but I also draw on solution-focused, person-centred, and brief strategic approaches depending on what fits you best.

When is anxiety severe enough to need therapy?

There is no single threshold. If anxiety is frequent, distressing, or limiting your life, NICE guidelines support accessing psychological help. A free 15-minute consultation can help you decide whether therapy here is the right next step.

Does online CBT work as well as in-person?

Research comparing guided and supported online CBT with face-to-face formats for anxiety has generally found similar outcomes when the therapy is structured and actively engaged with. Many clients prefer online for flexibility and for practising exposure in their own environment.

What is the difference between anxiety and stress on your site?

Stress pages emphasise overload and life pressure; anxiety pages emphasise fear, worry, and panic mechanisms. Many people fit both; we choose a starting focus in assessment rather than forcing one label.