Therapist in her office

Specialist anxiety therapists vs general therapists

The fastest way to reduce your anxiety is with one-to-one private therapy. But, if you do want to go down this route, who should you use? Do you want an anxiety specialist or a general mental health therapist? This article will discuss the pros and cons of both options.


One area that shouldn't make much of a difference is the level of experience. Whether you get a specialist or a generalist, you should expect them to have a relevant qualification, be registered with your country's governing body for therapists, and have several years of experience.

Counsellor, therapist, or psychologist

There is a lot of different terms for how therapists may describe themselves and, for the most part, these are irrelevant here. Counsellor and therapist are interchangeable. Psychologist typically indicates a stronger academic background and less hands-on experience (unless they are a clinical or counselling psychologist) and psychiatrist is someone with medical training (a doctor) who has then specialised in mental health.

Transferable skills

One advantage that a generalist has over a specialist is that they will have a broader range of experiences to draw from. It's true that treating schizophrenia or bipolar won't help most of the time. However, there could be occasions when having that knowledge is helpful in finding novel solutions.

This comes down to an individual therapist's experience. For example, a therapist may have started out as a generalist and then specialised in anxiety. This is ideal as it means they will have a wide range of experience to draw upon but still have the specialist knowledge as well.

Also, anxiety is often co-morbid with other conditions such as depression, so someone who specialises in anxiety is likely to have experience dealing with related conditions alongside anxiety.

Subject knowledge

A specialist should have an unrivalled knowledge of anxiety, including the types, symptoms, treatments and medications.

For example, if you have social phobia, you don't want to have to spend time explaining the differences between generalised anxiety disorder. Or, if you're taking fluoxetine, you don't want to have to spend your session time waiting for them to remind themselves that it is an SSRI and not an SNRI.

Treatment plans

With anxiety, there are well-defined treatment plans for each of the different types of anxiety disorders. Often therapists will tailor these plans rather than following them to the letter. However, you want a therapist that has an understanding of what the plans are so that they can develop your customised plan quickly.

Building your customised plan from a proven plan also means your treatment has a higher chance of success because it is built from an evidence-based solution.

Treatment barriers

One of the biggest difficulties for generalists is understanding the unique barriers to treatment that anxiety causes. When severe, anxiety causes us to avoid doing things, including engaging with treatment. Metacognitive beliefs may lead us to think our anxiety is useful and vital for keeping us safe.

Unless your therapist understands these barriers to treatment, they are unlikely to be able to provide a plan that mitigates these and therefore the chance of success is significantly reduced.

For example, sometimes your therapist will set you homework. And sometimes, you won't complete it. The reasons that someone with depression may not complete their homework, such as low energy, are different from the reasons that someone with anxiety may not complete their homework, such as chronic avoidance or it triggering a panic attack.

A generalist would hopefully understand these differences, but a specialist certainly would.

Availability and location

One of the biggest factors in deciding on the best anxiety therapist for you may simply be who is available in your local area.

Here in Leeds, for example, we're lucky enough to have the Leeds Anxiety Clinic, but for many people, it may be a case that there are only generalists available where they live.

One way around this would be to consider online therapy, such as Skype counselling. This would mean that as long as you had an internet connection, you could access treatment no matter where you live.


Seeking therapy is a positive step to reducing your anxiety. So, if you're planning to, or already have, then great job; you're already one step ahead of a lot of people.

If you want to make the most amount of process, then a therapist who specialises in anxiety is going to provide that. So, they should be your number one choice.

However, a generalist brings a lot of experience and transferable skills to the table, so if you can't find a specialist, don't worry, as any therapist should be able to provide valuable and effective support.

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Published 30 July 2018. Written by Chris Worfolk.

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