Anxiety Therapy in New Jersey
Colleen Makowsky offers anxiety therapy for adults across New Jersey — practical, evidence-based, by secure video.
Anxiety therapy at Colleen Makowsky LPC can help clients experiencing worry, tension, or avoidance. Whether it’s generalized anxiety, social anxiety, health anxiety, or panic, therapy aims to target the cause — and reduce the symptoms.
Colleen Makowsky offers anxiety therapy in New Jersey
Most people dealing with anxiety are functioning, sometimes well. But the worry doesn’t stop, the body stays braced, and quiet moments become ruminations about what could go wrong. Anxiety therapy is about learning how to stop the overthinking, and live in the present.
Generalized anxiety — the always-on worry loop
Chronic worry across topics — work, health, relationships, money — when one thing resolves the worry just migrates. Body tension, sleep disruption, difficulty concentrating. CBT’s cognitive restructuring can help: testing the prediction against what actually happens, identifying the catastrophic loop, and building practical skills you can use mid-spiral.
Social anxiety — when other people are the trigger
Anticipatory dread before meetings, calls, parties, dates. Replay-spiral after — what they thought, what you should have said, what they’re telling someone else right now. The work blends ACT values clarification with graded behavioral steps — choosing the actions that match what you actually care about even when anxiety shows up.
Panic — anxiety in the body before it’s in the thoughts
Racing heart, chest tightness, dizziness, derealization, the fear-of-the-attack-itself loop. CBT for panic addresses the body cycle directly — noticing cues, understanding what the system is doing, breaking the catastrophic interpretation. You leave with skills you can use mid-episode, not just an explanation.
OCD-adjacent rumination — the loop that asks for certainty
Recurring thoughts you can’t shake, mental checking, intrusive content that feels at odds with who you are. This is not formal OCD treatment (ERP) — if your diagnosis is OCD or your clinician has recommended ERP, Colleen will refer you to a colleague who specializes in that work. For OCD-adjacent rumination patterns, CBT and ACT both help break unwanted repetitive thoughts and behaviors.
Health anxiety — when every sensation reads as evidence
Body-scanning, googling symptoms, reassurance-seeking from doctors or partners, doctor hopping. The reassurance feels like it should help and it doesn’t — the relief lasts hours, then the cycle restarts. CBT cognitive work + reducing the reassurance cycle can help. Exploration on medical rule out vs. what the anxiety is amplifying.
Situational anxiety — when life pressure is the cause
Anxiety tied to a specific event or chapter — career pivot, health diagnosis, relationship change, parenting transition, immigration stress. The anxiety is the system saying “this is bigger than I expected.” SFBT’s next-step framing helps here — mapping the next concrete move when the whole picture is overwhelming.
Three approaches to reduce anxiety
Anxiety responds differently depending on whether it lives in the thoughts, in the body, or in avoidance. The three approaches below can help.
Cognitive Behavioral Therapy (CBT)
For the thought loops and the worst-case spiral. CBT untangles the cognitive pattern feeding the anxious thought — testing the prediction against what actually happens, noticing the loop’s hooks, and building practical responses you can use mid-spiral. Strongest evidence base for generalized anxiety, social anxiety, panic, and health anxiety.
Acceptance and Commitment Therapy (ACT)
For when the anxiety doesn’t go away just by reasoning with it. ACT works on changing your relationship with the anxious thought instead of fighting it — naming the values underneath the avoidance, taking small actions in their direction even when anxious. Helps with social anxiety, life-transition anxiety, and chronic rumination.
Solution-Focused Brief Therapy (SFBT)
Used when you need a concrete next step, not a deep-dive. SFBT can help you combat anxiety in the moment, and identify a small move that makes the next 24 hours easier. Clients continue to build coping strategies. SFBT is used for situational anxiety, work pressure, and the in-between moments when relief is needed.
Anxiety and depression often travel together; if you’re working through both, we’ll start with the most severe symptoms. If trauma is underneath the anxiety, visit the trauma therapy page — including information on Colleen’s training and credentials.
Colleen uses evidence based anxiety treatment
See the information below about evidence based anxiety treatment
CBT is the most-studied anxiety intervention we have
APA Division 12 lists CBT as the first-line evidence-based treatment for generalized anxiety disorder, social anxiety disorder, and panic disorder. Decades of randomized trials, replicated across populations and presentations.
Evidence-based isn’t a marketing word. It means there are studies, replicated, with outcomes that hold up.
Anxiety lives in the body — not just the thoughts
Interoceptive-exposure-adjacent work within CBT addresses panic and health anxiety — the racing heart, the breath, the body’s alarm system. Identifying the automatic body response reduces its grip; challenging the worst case scenario often helps. Clients explore the cognitive layer, the somatic layer, or both depending on the symptoms.
When anxiety is in the body, talking about it from the neck up doesn’t help. You have to address where it actually lives.
Short-term focus, ongoing flexibility
Most anxiety therapy spans three to twelve months. Some clients stay in therapy longer for relapse prevention or to address additional symptoms. Clients leave with coping skills they can keep using.
Good therapy is practical. You should leave each session with something you can use — not just insight that stays in the room.
How we start — your first three steps
Reach out
Open the secure intake form or call (917) 519-8447. It takes about a minute, and we’ll set up your free 15-minute consultation from there.
15-minute call (free)
We meet for a 15 minute video/phone consulation. You tell me what brings you to therapy. I tell you how I can help. We decide if we are a good fit. No charge. No pressure.
First session, then ongoing work
Sessions run 38 to 53 minutes, by secure video, weekly. Most anxiety therapy spans three to twelve months — varies by client. You’ll likely notice change after three or four sessions.
WHAT A SESSION LOOKS LIKE
What an anxiety therapy session actually looks like
Practical sessions, by secure video. Here’s what an anxiety session actually covers — and what you leave with.
About anxiety
Anxiety often has roots — sometimes recent, sometimes from the past, sometimes both at once. Naming the root pattern doesn’t eliminate the anxiety, but it changes how you experience it. Below: five ways anxiety often develops.
Family-of-origin patterns — what was rewarded growing up
Anxious vigilance is often learned in childhood as adaptive — in a chaotic household, in a high-pressure home, in a family that withdrew love when you weren’t producing. The pattern outlasts its usefulness. The anxiety that kept you safe at eight is the same anxiety that’s keeping you from getting a good night’s sleep at thirty-five.
A specific event the body never finished processing
Sometimes anxiety is unprocessed activation from a past moment — an accident, a medical scare, a loss, an assault. Trauma-informed care (CCTP credential) is used to treat anxiety and PTSD. If trauma is present, view the trauma therapy page — including information on Colleen’s training and credentials.
Chronic stress
Long stretches of pressure — caregiving, career, financial uncertainty, illness — can turn on the alarm system. Anxiety here is a signal, not a malfunction — though the signal is always loud. Colleen helps clients direct their attention to the signal and use coping skills/make changes to relieve stress.
Cognitive habits that weigh you down
Catastrophic thinking, mental rehearsal, certainty-seeking — these habits are exhausting. They’re patterns that were reinforced because they sometimes worked. CBT can help facilitate change by learning to identify patterns; and then choose healthier responses in real time.
Life-transition pressure
Career pivot, identity shift, role change, geographic move, parenting transition, perimenopause. Sometimes anxiety is the system saying “this is too much!” SFBT can help clients gain skills to take incremental steps when the whole picture is overwhelming.
It might be time to reach out if…
Most people struggle too long — partly because they believe they should be able to handle this alone. The signs that indicate counseling can help usually look like this.
If you experience two or three of these scenarios, schedule a 15-minute consultation to see if Colleen can help.
Colleen Makowsky offers anxiety therapy across New Jersey
Colleen Makowsky
MA · LPC · NCC · CCTP · CAIMHP
Licensed counselor in Fort Lee, NJ. Adults and couples across all of New Jersey by secure video.
MA in Community Counseling, Montclair State University.
Trauma-informed (CCTP) · CBT · ACT · SFBT for anxiety work.
OUR LOCATION
Online counseling across New Jersey
I’m a service-area provider — I work with adults and couples statewide by secure video. My base is Fort Lee, NJ (Bergen County), but you can see me from anywhere in New Jersey.
Hours
By appointment
Weekdays and weekends
Morning, afternoon, evening
Phone
(917) 519-8447
EXPLORE OTHER SERVICES
Types of therapy
Depression Therapy · Trauma Therapy · Grief & Loss Counseling · Anger & Emotion Regulation · Individual Therapy
Anxiety therapy FAQ
What does insurance cover?
Colleen accepts Aetna, Cigna/Evernorth, Optum/UnitedHealthcare/Oxford, Horizon BCBS NJ, Oscar, Medicare, and most EAPs. Out-of-network superbill available on request. Medicaid is not accepted. See the insurance and cost page for carrier-by-carrier specifics.
How long are sessions?
Sessions run 38 to 53 minutes, occasionally 60 minutes if needed.
How long does anxiety therapy take?
Three to twelve months is the standard frame, it varies by individual need. Some clients find short term therapy with a developed tool kit they can keep using is sufficient. Others stay longer for relapse prevention or to further address what’s underneath the anxiety.
I have anxiety AND depression — do I have to pick which to work on?
No. Anxiety and depression often travel together. We address the symptoms that are most pressing first; we map the pattern that’s most interfering with daily life and start there.
Is this CBT or talk therapy?
Both. CBT is one of the treatment modalities Colleen uses — it’s the strongest evidence base for generalized anxiety, social anxiety, panic, and health anxiety. Acceptance and Commitment Therapy and Solution-Focused Brief Therapy are also used. The blend depends on your individual needs.
What if I’ve tried therapy before and it didn’t work?
That’s common — and worth talking about on the free 15-minute call. Maybe the fit was off, maybe the modality wasn’t right, maybe it was not the right time. Colleen asks what you’ve tried to avoid repetition.
Do you work with panic attacks?
Yes — panic is one of the most common anxiety presentations Colleen encounters. CBT for panic addresses the body cycle (interoceptive cues, the fear-of-the-attack-itself loop) and gives you a set of coping skills you can use mid-episode. If panic is the main presentation, expect direct work on it from session one.
What about OCD — can you treat that?
Not formally. Colleen does not provide ERP (Exposure and Response Prevention) — the evidence-based treatment for OCD. For OCD-adjacent rumination patterns, CBT and ACT both help. If your diagnosis is OCD or your clinician has recommended ERP, Colleen can refer you to a colleague who specializes in that work.
RELATED SPECIALTIES
Depression Therapy in NJ · Trauma Therapy in NJ · Anger & Emotion Regulation in NJ
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If anxiety has been weighing on you long enough that you searched for this page, that’s already worth a 15-minute conversation. No commitment.