Anxiety and stress
When worry runs the day, counseling gives you a way to take it back.
Anxiety is more than feeling nervous. It is the mind scanning for threats that never arrive, the body tensing for a fight that is not coming, and the sleep that will not settle because tomorrow is already being rehearsed. Many people carry it for years while looking fine from the outside.
Cognitive behavioral counseling treats anxiety at the level where it lives: the automatic thoughts, the avoidance, and the physical habits that keep the alarm ringing. Brett has worked with anxious adults for more than two decades, in the emergency department and in private practice, and the work is practical from the first session.
What it can look like
- Worry that jumps from topic to topic and is hard to switch off
- Trouble falling or staying asleep, or waking already tense
- Racing heart, tight chest, stomach trouble, or restlessness with no medical cause
- Avoiding calls, meetings, driving, or social plans because of what might go wrong
- Irritability and difficulty concentrating at work or at home
- Panic attacks, or the fear of having another one
How counseling helps
Counseling starts by mapping how your anxiety actually works: what sets it off, what you tell yourself in the moment, and what you do to feel safe again. That map is the foundation for everything that follows.
From there the work is cognitive behavioral therapy (CBT). You learn to catch anxious predictions and test them against evidence, to calm the body with breathing and grounding skills you can use anywhere, and to face avoided situations gradually so they lose their power. Between sessions you practice; in sessions you review what happened and adjust.
The goal is not to never feel anxious. It is to have anxiety stop making the decisions.
Three steps, and the first one is free
- 01
Free 10-minute call
You describe what is happening. Brett tells you honestly whether counseling is a good fit and answers questions about fees and insurance.
- 02
Initial assessment
A full first session to understand your history, your current symptoms, and what a good outcome looks like for you. You leave with a plan.
- 03
Weekly sessions and practice
Fifty-minute sessions, usually weekly at first, by secure video or in the Clifton Avenue office. Skills are practiced between sessions so change shows up in real life.
How long it takes
Many people notice relief within the first several sessions once they have concrete tools. A typical course of CBT for anxiety runs a few months, then tapers as you take over. Your pace is set together, and you are never locked in.
Counseling is a good fit if
- Worry or panic is interfering with sleep, work, or relationships
- You have tried to think your way out of it and it keeps coming back
- You want practical skills, not just a place to vent
- You would like to understand the pattern, not only manage the symptom
Before the first call
Anything not answered here is a good question for the free call. All FAQs →
Do I need a diagnosis before I start?
No. The initial assessment is where we sort out what is going on. If a formal diagnosis is useful for insurance or your own clarity, Brett will explain it plainly.
Can anxiety be treated over video?
Yes. CBT for anxiety translates well to secure video, and practicing skills in your own home is often an advantage. In-person sessions in Cincinnati are available if you prefer.
What about medication?
Brett does not prescribe. Many clients do well with counseling alone; others combine it with medication from their physician. If medication seems worth discussing, Brett will say so and coordinate with your prescriber if you wish.
How much does it cost?
An initial assessment is $175 and individual sessions are $150. UnitedHealthcare, Optum, Anthem, and CareSource are in network. Private pay is welcome.
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