Anxiety Therapy in New Jersey
Colleen Makowsky, LPC offers anxiety therapy for adults across New Jersey — generalized, social, panic, and the kind that just won’t quiet down.
If anxiety is running your day — the spiral at 3am, the chest-tight before meetings, the rumination loop that won’t shut off — there’s practical work that helps. Online, NJ statewide. Adults only. CBT, ACT, and Solution-Focused Brief Therapy.
Colleen Makowsky offers anxiety therapy in New Jersey for the way it actually shows up
Most couples who reach out aren’t in a single big crisis. They’re in a slow accumulation — small disagreements that didn’t resolve, communication patterns that became defaults, distance that crept in without anyone naming it. Marriage counseling is for naming that out loud, in a room where both people get heard.
Generalized anxiety — the always-on worry loop
Chronic worry across topics — work, health, relationships, money — that doesn’t settle when one thing resolves because the worry just migrates. Body tension, sleep disruption, difficulty concentrating. CBT’s cognitive restructuring is the strongest entry point here: testing the prediction against what actually happens, naming the catastrophic loop, and building practical responses 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 — not exposure-by-protocol, but choosing the actions that match what you actually care about even when the anxiety shows up too.
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 — interoceptive cues, naming what the system is doing, breaking the catastrophic interpretation. You leave with moves 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 page 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.
Health anxiety — when every sensation reads as evidence
Body-scanning, googling symptoms, reassurance-seeking from doctors or partners, GP-hopping. The reassurance feels like it should help and it doesn’t — the relief lasts hours, then the loop restarts. CBT cognitive work + reducing the reassurance cycle is the entry point. Honest framing on what medical workup is appropriate 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 you’ve named.” SFBT’s next-step framing fits here — mapping the next concrete move when the whole picture is too big to hold.
Three approaches that match how anxiety actually behaves
Anxiety responds differently depending on whether it lives in the thoughts, in the body, or in the actions you’ve been avoiding. The three approaches below pick up where each shows up. Colleen blends them session-to-session based on what your anxiety is actually doing.
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 anxiety shows up too. Good fit for social anxiety, life-transition anxiety, and chronic rumination.
Solution-Focused Brief Therapy (SFBT)
For when you need a concrete next step, not a deep-dive. SFBT maps where you’re stuck right now, finds the small move that makes the next 24 hours easier, and builds from there. Good fit for situational anxiety, work pressure, and the in-between moments when the bigger work feels like too much.
Anxiety and depression often travel together; if you’re working through both, we’ll address whichever is louder first. If trauma is underneath the anxiety, the trauma therapy page goes deeper — including an honest note on what Colleen is and isn’t trained in.
Colleen’s anxiety work is grounded in what actually moves the needle
Anxiety responds to method. The three claims below aren’t a sales pitch — they’re what the evidence base actually says about what helps, paired with Colleen’s honest hedge on what she does and doesn’t promise.
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. Colleen leads with CBT for anxiety presentations that respond to it — especially when the cognitive loop is the loudest part of what’s happening.
Evidence-based isn’t a marketing word. It means there are studies, replicated, with outcomes that hold up.
Anxiety lives in the body too — not just the thoughts
Interoceptive-exposure-adjacent work within CBT addresses panic and health anxiety where they actually fire — the racing heart, the breath, the body’s alarm system. Naming the body loop reduces its grip; reasoning with it from the neck up usually doesn’t. The work moves between the cognitive layer and the somatic layer depending on what’s loud that session.
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 work runs three to twelve months. Some clients land in four months with a tool kit they can keep using. Others stay longer for relapse prevention or to address what’s underneath the anxiety. Colleen hedges honestly — she doesn’t quote session counts, because anxiety doesn’t honor session counts.
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
Send a quick note through the contact form or call (551) 305-3742. The form is two fields — name and best way to reach you. Don’t include health details; we’ll talk through what’s going on verbally on the call.
15-minute call (free)
We get on the phone for fifteen minutes. You tell me what’s bringing you in, what you’ve tried before, and whether what I do is a fit. If it’s not, I’ll point you in a useful direction. No charge. No pressure either direction.
First session, then ongoing work
Sessions run 38 to 53 minutes, by secure video, weekly to start. Most anxiety work runs three to twelve months — varies by client. You’ll know inside three or four sessions whether the fit is right.
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.
Colleen’s view of where anxiety often comes from
Anxiety isn’t random. It has roots — sometimes recent, sometimes old, sometimes both at once. Naming the root pattern doesn’t eliminate the anxiety, but it changes how you work with it. Below: five places anxiety often comes from in the adults Colleen sees.
Family-of-origin patterns — what got 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 up at thirty-five.
A specific event the body never finished processing
Sometimes anxiety is unprocessed activation from a discrete moment — an accident, a medical scare, a loss, an assault. Trauma-informed (CCTP) framing applies even when there’s no formal PTSD diagnosis. If this is the root, the trauma therapy page goes deeper — including an honest note on what Colleen is and isn’t trained in.
Chronic stress the system never got to step down from
Long stretches of pressure — caregiving, career, financial precarity, illness — can leave the alarm system stuck on. Reducing the input matters; teaching the system to step down matters more. Anxiety here is a signal, not a malfunction — though the signal’s been on too long.
Cognitive habits that feel like personality
Catastrophic thinking, mental rehearsal, certainty-seeking — these aren’t who you are. They’re patterns that got reinforced because they sometimes worked. They respond to CBT. The first move is making the pattern visible; the second is choosing a different response 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 bigger than you’ve named.” SFBT helps map the next concrete step when the whole picture is too big to hold at once.
It might be time to reach out if…
Most people wait too long — partly because anxiety convinces you that you should be able to handle this alone. The signs you’re past the “I’ll just deal with it” line usually look like this.
If two or three of these are landing, that’s usually a signal it’s worth a 15-minute conversation. Not a commitment — just a way to figure out if we’re a fit.
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
Mon–Fri by appointment
Sat & Sun: Closed
Phone
(551) 305-3742
EXPLORE OTHER SERVICES
Other ways Colleen works
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. The range reflects what the work actually looks like — not the insurance-billing default of 50 minutes. Weekly to start; cadence is reviewed together once the work is underway.
How long does anxiety therapy take?
Three to twelve months is the standard frame, varies by client. Some people land in four months with a tool kit they can keep using. Others stay longer for relapse prevention or to address what’s underneath the anxiety. Colleen hedges honestly — she doesn’t quote session counts.
I have anxiety AND depression — do I have to pick which to work on?
No. Anxiety and depression often travel together. We address whichever is louder first; the other usually starts to shift as we work. If both are showing up equally, 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 tools Colleen uses — strongest evidence base for generalized anxiety, social anxiety, panic, and health anxiety. ACT and Solution-Focused Brief Therapy fill in where CBT doesn’t reach. The blend depends on what your anxiety looks like.
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. Sometimes the fit was off, sometimes the modality didn’t match the anxiety presentation, sometimes the timing wasn’t right. Colleen asks what you’ve tried so she’s not running the same play twice.
Do you work with panic attacks?
Yes — panic is one of the most common anxiety presentations Colleen sees. CBT for panic addresses the body cycle (interoceptive cues, the fear-of-the-attack-itself loop) and gives you a set of moves 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.