A two-minute check: the GAD-7

The GAD-7 is the seven-question screen clinicians across Virginia use to gauge how much anxiety someone is carrying. It is scored here, in your browser; your answers are not sent anywhere. A score is a screening aid — it says how much worry is present, not what is causing it, and it is not a diagnosis. Whatever number you get, the useful next step is a conversation with a clinician, for example one of ours.

How anxiety is treated here

The backbone is cognitive behavioral therapy: finding the specific predictions your anxiety makes — the meeting will go badly, the night will be ruined, the feeling means danger — testing them against what actually happens, and changing the avoidance that keeps them unexamined. Around that backbone our Virginia clinicians draw on what their training supports: mindfulness practice for the body that wakes before the mind; solution-focused work when the worry is attached to a real problem that needs a plan; motivational interviewing when part of you is not sure it wants to change; and, with some clinicians, dialectical behavior therapy skills for the anxiety that arrives as a wave, or Internal Family Systems for the version that argues with itself.

Where sleep has been pulled into it — and it usually has — the CBT-I protocol is built into the same course of treatment: a sleep window from your diary, rules for the hours you are awake in bed, and cognitive work aimed squarely at the 3 am track. The practical effect is that you learn to bring the night-time worry into daylight, where it can be worked on, instead of doing your thinking in the dark.

How do I know whether I have anxiety or insomnia?

Often you have both, and the order does not matter much for treatment. If the worry is there in the daytime too — at work, in the car, on a Sunday afternoon — anxiety is likely the main problem and the bad nights are one of its symptoms. If the daytime is mostly fine and the dread only arrives at bedtime, the sleep problem has probably become its own engine. Your clinician sorts this out in the first session, and both are treated by the same person.

How many sessions does anxiety therapy take?

Most of our Virginia patients work with a clinician weekly for somewhere between two and four months, and many feel a difference well before that. Anxiety therapy has a beginning and an end: you learn a set of skills, practise them in your own week, and stop when they are yours. If sleep is part of the picture the CBT-I work is folded into that span rather than added on top.

Do you prescribe medication for anxiety?

No. Our clinicians are licensed therapists — social workers, professional counselors, marriage and family therapists and psychologists — and the treatment here is talk therapy. If you already take something for anxiety you keep taking it, and if medication ever seems worth discussing your clinician will say so and coordinate with your prescriber rather than around them.

Can I see someone in person in Northern Virginia?

We see most patients via telehealth with Virginia-licensed clinicians, and a limited number of clinicians also see patients in person. Tell us when you book if meeting face to face matters to you and we will say what is possible; most Arlington, Alexandria and Fairfax patients choose video once they see how the sessions run.

Does online anxiety therapy work as well as sitting in a room?

For cognitive and behavioral therapy the research comparing video with in-person sessions finds similar results, and anxiety is the condition where that has been studied most. Some parts of the work go better from home: practising a calming skill in the room where the 3 am worry actually happens is more useful than practising it in an office.