Effective Interventions for Anxiety: A Clinician’s Guide

In a clinical setting, rapid coping skills for anxiety focus on calming the body and mind within minutes so clients can regain a sense of control. Effective options include diaphragmatic breathing (slow, deep breaths to reduce physiological arousal), grounding techniques (such as the 5-4-3-2-1 sensory method to shift focus away from anxious thoughts), and progressive muscle relaxation to release tension. Some clients respond well to guided imagery or visualization exercises that evoke calming mental scenes. Affirmations and positive self-talk can help challenge intrusive worries in the moment, while mindful body scans promote nonjudgmental awareness of sensations. These skills work best when practiced regularly in session so clients can use them confidently during acute anxiety episodes outside the therapy room.

When anxiety does not respond to standard interventions, clinicians should first reassess the diagnosis, ruling out underlying medical conditions, substance use, or co-occurring disorders that may be contributing to symptoms. A comprehensive case review can help identify overlooked factors such as trauma history, environmental stressors, or lifestyle contributors. In these cases, consider stepping outside a single therapeutic model—for example, integrating Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT) skills, somatic therapies, or neurofeedback. Collaboration with other providers, such as psychiatrists for medication evaluation, can also be beneficial. For treatment-resistant anxiety, slower-paced, relationship-focused work may help build trust and open the door to progress, especially when symptoms are rooted in complex trauma. Above all, maintaining flexibility, curiosity, and a willingness to tailor and adapt interventions is key to finding an approach that resonates with the client.

Clinicians should approach discussions about supplements for anxiety with a balanced, evidence-informed perspective. While compounds like ashwagandha, L-theanine, magnesium, and omega-3 fatty acids have some research suggesting potential benefits for mild to moderate anxiety, results are mixed and often based on small studies. Guidance should include reminding clients that supplements are not a replacement for evidence-based therapy or prescribed medications, and quality, purity, and dosage can vary widely between products. Clinicians can encourage clients to:

• Consult their primary care provider or psychiatrist before starting any supplement, especially if they take other medications, are pregnant, or have medical conditions.

• Choose reputable brands with third-party testing for safety and quality.

• Monitor for side effects and track symptom changes over time.

Positioning supplements as a possible adjunct—rather than a stand-alone solution—helps clients make informed choices while prioritizing safety and effectiveness.

Sensory grounding techniques can be highly effective during acute anxiety episodes because they redirect attention away from racing thoughts and anchor clients in the present moment. One widely used method is the 5-4-3-2-1 technique, where clients identify five things they see, four they can touch, three they can hear, two they can smell, and one they can taste. Other options include holding a textured object (like a stress ball or piece of fabric), splashing cool water on the face, savoring a strong flavor such as peppermint, or listening closely to ambient sounds. Clinicians can guide clients to practice these skills in session so they become second nature, allowing the brain and body to shift from a state of threat to a state of regulation more quickly during real-life anxiety spikes.

Personalizing anxiety interventions for clients with comorbid conditions starts with a thorough assessment to understand how each condition influences symptoms and functioning. For example, when anxiety co-occurs with ADHD, interventions may emphasize brief, structured coping tools, visual reminders, and behavioral strategies that accommodate attention challenges. With depression, treatment may begin with behavioral activation and small, achievable goals to help improve mood and energy before tackling anxiety exposure work. Clinicians can also adapt pacing, language, and skill complexity to match the client’s cognitive and emotional capacity. Collaboration with other providers is essential when medication management or medical oversight is needed. Above all, interventions should be integrated and flexible, addressing overlapping symptoms (like sleep issues or rumination) while ensuring the treatment plan reflects the client’s priorities, strengths, and readiness for change.