Anxiety Therapist in Los Angeles, CA
Casen Psychology | Sara Casen, PhD
Many of my clients come to therapy because …
They are still functioning well on the outside. They continue meeting deadlines, showing up for school or work, maintaining relationships, and doing what is expected of them.
At the same time, they may describe a persistent internal strain. Their mind keeps anticipating what could go wrong. They prepare extensively but rarely feel completely ready. Rest can be difficult because there always seems to be another problem to solve, decision to reconsider, or responsibility to manage.
I provide anxiety, depression, and life transitions therapy for college and graduate students, recent graduates, and young professionals, primarily in their 20s and 30s. Sessions are available in person in West Los Angeles and through telehealth across California and New York.
My training, which includes a doctorate from Fordham University, helps provide effective therapy for the issues you're experiencing. My work typically draws from CBT and psychodynamic psychotherapy, with goals developed collaboratively based on what each client is experiencing.
What can anxiety look like in high-achieving adults?
Anxiety does not always prevent someone from functioning.
Some people continue performing well while using a great deal of mental and emotional energy to maintain that performance.
Clients may describe:
Replaying conversations or decisions long after they happen
Preparing much more than a situation realistically requires
Difficulty sleeping because their mind continues working through possible problems
Feeling tense even when there is no immediate crisis
Struggling to enjoy accomplishments because attention quickly moves to the next responsibility
Worry about making mistakes or disappointing other people
Feeling exhausted by the effort required to keep everything moving
These experiences can occur for many reasons, and having one or several of them does not automatically indicate a particular diagnosis.
Therapy gives us an opportunity to understand the pattern more carefully and consider what may be maintaining it.
Is it anxiety, depression, or both?
Anxiety and depressive symptoms can overlap, and some people experience elements of both.
Someone who has been anxious for a long time may also begin to feel emotionally depleted, disconnected, or less interested in activities they previously enjoyed. Others come to therapy because they are feeling depressed without understanding why, even though their life appears relatively stable from the outside.
Rather than deciding from a list of symptoms what must be happening, early therapy sessions allow us to look at the larger picture.
We may consider stress, transitions, relationships, work or academic demands, longstanding emotional patterns, sleep, and other factors that seem relevant.
How can CBT help with anxiety?
CBT can help us examine the thoughts and behaviors that accompany anxiety.
For example, we may notice patterns of anticipating worst-case outcomes, excessive preparation, avoidance, perfectionism, or repeated reassurance-seeking.
The goal is not simply to tell yourself to stop worrying. Instead, CBT provides a structured way of examining the patterns that may be maintaining anxiety and experimenting with different responses.
When useful, I may incorporate psychoeducation, reflection exercises, or practical strategies that extend the work between sessions.
How does psychodynamic therapy fit in?
Psychodynamic work allows us to ask different questions.
Where might certain expectations have developed? Are there longstanding pressures or beliefs that continue to influence how you respond to achievement, uncertainty, relationships, or mistakes?
Sometimes anxiety is connected to experiences or emotional expectations that have developed gradually over many years. Sometimes, current life situations are more influential.
Rather than assuming the cause in advance, we explore what appears most relevant for you.
Using CBT and psychodynamic approaches together allows therapy to address both present-day patterns and the broader context in which those patterns developed.
Anxiety during school, work, and major transitions
My practice includes many college students, graduate students, recent graduates, and professionals working in demanding environments.
Transitions within these stages can bring uncertainty even when the change is wanted.
Graduating, beginning graduate school, starting a demanding position, changing careers, ending a relationship, or reconsidering the direction of your life can create emotional strain without fitting neatly into a single category.
Therapy can provide space to understand the transition, identify what is making it difficult, and consider how you want to move through it.
My education and clinical training, including my doctorate from Fordham University and experience in college counselling and other clinical settings, inform my work with people navigating these periods of increased pressure and change.
What happens in the first sessions?
The first sessions help me understand what has been happening and what you would like therapy to address.
We may discuss current anxiety, previous experiences, relationships, academic or professional demands, important transitions, and any patterns you have already noticed.
We then identify goals together and continue reflecting on those goals as therapy progresses.
There is no requirement that you arrive knowing exactly why you feel anxious.
Understanding the pattern can be part of the therapeutic process.
What should I know before booking anxiety therapy in Los Angeles?
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Therapy is suitable when stress or anxiety is persistent and affecting your life. People often reach out when stress or anxiety has become persistent, is affecting important areas of their life, or is something they would like to understand more clearly.
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Yes. People also seek therapy to understand and navigate changes such as graduation, career shifts, relationship changes, relocation, or other important transitions. A diagnosis is not required in order to explore how a transition is affecting you.
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We can discuss what your previous therapy experience was like, what felt helpful or unhelpful, and what you would like to be different this time. That information can help guide our work together.
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Yes. I offer in-person sessions in West Los Angeles and telehealth for clients located in California and New York. We can discuss which format seems to fit your circumstances.
Finding the right support is a journey.
If any of this resonated, a consultation call is a low-pressure way to continue to explore if my approach feels like the right fit for you.