Anxiety therapy online across New Zealand

What is an anxiety disorder?

An anxiety disorder is when fear or worry becomes persistent, feels out of proportion to the actual situation, and gets in the way of work, sleep, relationships or everyday life. Generalised anxiety disorder, panic disorder, social anxiety, specific phobias and health anxiety are the main forms. Cognitive behavioural therapy is the first-line psychological treatment recommended by clinical guidelines.

Worry that has stopped being useful

Everyone knows the feeling before a job interview or a hard conversation. Anxiety is the body's alarm system, and in short bursts it is useful. It becomes a problem when the alarm keeps going off without a clear reason, fires at the wrong things, or will not switch off once the moment has passed.

Generalised anxiety disorder (GAD) is the pattern we see most often. The worry moves from topic to topic: the kids, money, a comment a colleague made, whether you locked the back door, whether the tiredness means something is wrong with you. Each worry feels urgent and reasonable at the time. Put together, they fill most of the day and leave very little room for anything else.

People usually describe worry as something they cannot stop rather than something they choose. Many also quietly believe it serves a purpose, that worrying keeps them prepared or shows they care. Therapy takes those beliefs seriously, because they are part of what keeps the cycle going.

Overthinking: when your mind won't switch off

Overthinking is one of the most common reasons people look for help, and it usually takes one of two shapes. Worry runs forward ("what if the scan shows something?"). Rumination runs backward ("why did I say that in the meeting?"). Both feel like problem-solving, which is why they are so hard to put down, yet going round the same loop rarely produces an answer and keeps your body on alert.

What helps is less about stopping thoughts and more about changing how you respond to them:

• Sort the problem. If there is something you can act on, decide the next step and write it down. If it is a "what if" with nothing to do, treat it as a worry, not a task.
• Postpone it. Set a short worry period later in the day and park worries until then. By the time it arrives, many have lost their urgency.
• Notice the loop and step out of it. Naming it ("I'm going round in circles again") and bringing your attention back to what is in front of you is a skill that strengthens with practice.
• Question the belief that worry helps. Therapy that targets beliefs about worry itself, as metacognitive therapy does, has good evidence from controlled trials for anxiety and depression.

If overthinking is costing you sleep, concentration or patience most days, it is often part of generalised anxiety, and the CBT described below is built for it.

How anxiety shows up in the body

Anxiety is as much a physical experience as a mental one. When your brain decides something is a threat it releases adrenaline, speeds up your heart and breathing, and sends blood to your large muscles. That is the fight-or-flight response, and it works the same way whether the threat is a car swerving towards you or a thought about an email you have not answered.

A system stuck in that gear for weeks or months produces symptoms that do not obviously look like anxiety:

• Tension and pain: tight shoulders, a clenched jaw, headaches, a sore back or stomach.
• Gut symptoms: nausea, churning, needing the toilet before anything important.
• Sleep: lying awake at 2am running through tomorrow, or waking early with a sense of dread.
• Exhaustion and poor concentration: being "on" all day is tiring, and worry uses up attention you need for work or conversation.
• Irritability: snapping at your partner or kids over small things, then feeling guilty about it.

Because these symptoms are real and physical, many people see their GP more than once before anxiety is named. That is sensible; new or unexplained physical symptoms should be checked. Once they have been, understanding them as part of anxiety is often a relief in itself, and it becomes something therapy can work with directly.

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Generalised anxiety, or something more specific?

Anxiety disorders overlap, and having more than one is common. A psychologist will explore questions like these in your first sessions. They are not a test with a score; they help work out what is driving your anxiety and where treatment should focus:

• Does the worry roam across many areas of life, or does it centre on one thing?
• Do you get sudden surges of intense fear that peak within minutes? That points towards panic attacks.
• Is the fear mainly about being judged, embarrassed or watched? See social anxiety.
• Does it attach to your body and health, with checking, searching symptoms online or seeking reassurance from doctors? See health anxiety.
• Is it a strong fear of one particular thing, such as flying, needles, dogs or vomiting? See specific phobias.
• Are there intrusive thoughts, and rituals or mental checking to neutralise them? That may be OCD, which is treated differently (see OCD vs anxiety).

The distinction matters because the techniques differ. Worry work for GAD is not the same as interoceptive exposure for panic or behavioural experiments for social anxiety. Getting the formulation right early saves time and sessions.

What CBT for anxiety involves, step by step

Cognitive behavioural therapy (CBT) is the psychological treatment recommended by clinical guidelines for generalised anxiety and panic disorder, and the most researched therapy for anxiety overall. In a meta-analysis of 41 placebo-controlled trials, CBT produced moderate effects across the anxiety disorders and large effects for GAD in particular. It is structured, practical and time-limited: NICE guidance describes a typical course for GAD as around 12 to 15 weekly sessions, though your plan is agreed with you and adjusted as you go.

In practice, CBT for anxiety usually moves through these stages:

1. Mapping the cycle. You and your psychologist work out what triggers your anxiety, what goes through your mind, what your body does and what you do in response (avoid, over-prepare, check, seek reassurance). Seeing the whole loop on one page is often the first turning point.
2. Understanding worry. For GAD this means looking at how you handle uncertainty, the beliefs that keep worry going ("if I stop worrying I'll be caught out"), and the difference between a problem you can act on today and a hypothetical "what if".
3. Working with anxious thinking. Not forcing yourself to think positively, but learning to notice predictions ("I'll make a fool of myself", "they're about to make me redundant"), test them against what actually happens, and hold them more lightly.
4. Changing what you do. Avoidance and safety behaviours feel protective but teach your brain that the danger was real. Behavioural experiments and graded exposure let you find out what really happens when you stop. This is where most of the change comes from.
5. Keeping the gains. The final sessions turn what you have learned into a written plan for setbacks, because anxiety will spike again at some point and that does not mean the work has failed.

Between sessions you will practise. Fifty minutes a week is a small slice of your life; the exercises you do on a Tuesday night or during the school run are where the learning sticks.

Where Acceptance and Commitment Therapy fits

Acceptance and Commitment Therapy (ACT) comes at anxiety from a different angle. Rather than trying to reduce anxious thoughts, it works on changing your relationship with them, so they take up less room and have less say over what you do. ACT uses mindfulness skills, values work and a willingness to feel uncomfortable in the service of things that matter to you.

For someone who has spent years arguing with their worry, this can be freeing. It is often blended with CBT: a psychologist might use CBT to understand and test anxious predictions, and ACT to help you act on your values even when the anxiety has not fully settled. Meta-analyses of randomised trials show ACT performs better than waiting lists and usual care, and about as well as CBT, for anxiety and related problems. There is more on our ACT page.

Facing what you avoid

Most anxiety treatment involves some form of exposure: deliberately approaching the situations, sensations or thoughts you have been steering around. It is rarely as frightening as people expect, because it is planned together, starts where you can manage, and builds from there.

Current thinking about exposure, sometimes called the inhibitory learning approach, is less about waiting for fear to drop and more about learning something new: that the feared outcome did not happen, or that you coped when it did. So the person who avoids the motorway because they fear losing control might start with a short stretch at a quiet time of day, deliberately noticing that their hands are shaking and the car is still in its lane. Someone who re-reads every email three times to check the tone might send one once and sit with the uncertainty.

Online sessions suit this well. Your psychologist plans an exposure with you, you carry it out in your actual life between sessions, and you review it together the following week, instead of rehearsing in a clinic room that has nothing to do with where your anxiety shows up.

Does online therapy work for anxiety?

Yes, and the evidence is reasonably strong. A 2021 meta-analysis of live video psychotherapy found outcomes comparable to in-person sessions, with CBT showing particularly large effects when delivered by video. A systematic review focused specifically on anxiety disorders found telehealth and face-to-face treatment produced similar results for anxiety symptoms, day-to-day functioning and the working relationship with the therapist. Therapist-supported online CBT more broadly has been directly compared with face-to-face CBT in dozens of randomised trials, with no meaningful difference in outcomes.

In practice there are some advantages. You do not need to find parking in a city you avoid, sit in a waiting room, or take half a day off work for a 50-minute appointment. Someone in Gisborne, Westport or Kaitaia can see the same psychologist as someone in Auckland. And you are already in the environment where your anxiety lives, which makes between-session practice easier to plan. Read more in our guide Is online therapy effective?

Getting help for anxiety in New Zealand

Anxiety is one of the most common mental health difficulties in Aotearoa New Zealand. Healthify, New Zealand's consumer health information site, notes that around 1 in 4 New Zealanders will be affected by an anxiety disorder at some stage in their lives. The 2024/25 New Zealand Health Survey found that about 1 in 10 adults wanted professional help for their mental health or substance use in the previous year and did not receive it.

There is more than one way to get support, and it is worth knowing your options:

• Your GP can rule out physical causes, discuss medication if that is relevant for you, and refer you to local services. Many practices now have Health Improvement Practitioners offering free, short appointments through the Access and Choice programme.
• Just a Thought (justathought.co.nz) offers a free online CBT course for generalised anxiety, with separate courses for panic, social anxiety and health anxiety.
• Anxiety NZ runs a free 24/7 helpline on 0800 ANXIETY (0800 269 4389).
• 1737 is free to call or text at any time to talk with a trained counsellor.
• Private psychologists, including Mindwell's team, which you can book directly without a referral. Sessions are self-funded; if you have health insurance, check whether your policy includes psychologist cover (see our insurance guide).

Mindwell is not an ACC provider. If your anxiety relates to an injury covered by ACC, including a sensitive claim, an ACC-registered provider is the right pathway.

What to expect when you book with Mindwell

You can book online at any time and either choose a psychologist or take the first available appointment. First sessions are typically available within 7 days, and no GP referral is needed. Once you have booked, you receive a confirmation email with your video link and a calendar invite, then a separate email with a short intake form (consent and a brief questionnaire, about five minutes).

Sessions are 50 minutes over secure video through Carepatron, which runs in your browser with nothing to download. Your first session is mostly about understanding your anxiety: when it started, what it looks like now, what you have already tried, and what you want to be different. From there you and your psychologist agree a plan, usually weekly or fortnightly sessions.

The fee is $199 + GST per session ($228.85 including GST), paid at booking, with a receipt you can submit to your health insurer. You can read about how it works and what happens in a first session.

All of our psychologists work with anxiety: Sandy Laurenson (CBT, ACT and ERP), Jeremy Mason (CBT, ACT and DBT), Katherine Lee (CBT, ACT and schema therapy), Jake Meads (practical and skills-focused, drawing on Māori frameworks such as Te Whare Tapa Whā), Inge Prince (CBT, ACT and mindfulness-based therapy), Candice van der Merwe (CBT and ERP, alongside DBT and ACT), Jezebel Machado (relational and attachment-based therapy, drawing on CBT where it fits) and Dan Kerr (EMDR, CBT and ACT). They work with adults 18 and over, anywhere in New Zealand.

Mindwell is online-only, so anxiety therapy with a registered psychologist is available to adults anywhere in New Zealand, from Auckland, Wellington and Christchurch to Hamilton, Tauranga, Dunedin and rural areas, without travel or a local waiting list.

Related support: Panic attacks · Social anxiety · Health anxiety · OCD treatment

Updated October 2026 · How we write our information