Anxiety Treatment
Evidence-based Cognitive Behavioral Therapy (CBT) for generalized anxiety, panic attacks, social anxiety and specific phobias. In-person sessions in downtown Santa Cruz and online throughout Bolivia.
Sessions are held in Spanish. Therapy in English is available with psychologist Jazmín Villazón.
Spanish original clinically reviewed by Junisse Montaño, MSc, Clinical Psychologist · College of Psychologists No. JMP-1004-25 · Last reviewed:
What is anxiety, clinically speaking?
Anxiety is the body's and the mind's natural response to situations perceived as threatening. Up to a point it is adaptive: it helps us prepare for an exam, stay alert before an important interview and act quickly in the face of real danger. The problem appears when that response is triggered disproportionately, persistently or in situations that objectively pose no threat.
In its clinical form, anxiety includes disorders such as generalized anxiety (chronic worry that is hard to control), panic disorder (sudden attacks of intense fear with physical symptoms), social anxiety (disproportionate fear of being evaluated by others) and specific phobias. Although they present differently, they share a common core: the body's alarm system goes off too often or too intensely, and it interferes with work, relationships or everyday well-being.
Signs that may point to clinical anxiety
Not all worry is clinical anxiety. The difference lies in the intensity, the frequency and how much it affects your life. These are the most common signs we see in our practice:
- Constant worry about different things (work, health, money, relationships) that shows up several times a day and is hard to stop.
- Persistent physical symptoms: muscle tension, headaches, trouble falling asleep, a racing heart, pressure in the chest, digestive problems.
- Panic attacks: sudden episodes of intense fear with palpitations, shortness of breath, a sense of unreality or fear of dying.
- Avoidance: no longer doing things you used to do because they cause anxiety (driving, going to meetings, speaking in public, traveling).
- Catastrophic anticipation: repeatedly imagining the worst-case scenarios even when they are unlikely.
- Irritability and difficulty concentrating: your mind is busy with worry, and nothing is left for anything else.
- Chronic tiredness that rest does not resolve.
How we approach anxiety in therapy (CBT)
Cognitive Behavioral Therapy (CBT) is the psychotherapeutic approach with the strongest evidence for anxiety disorders. We do not try to "eliminate" anxiety: that is neither possible nor desirable, because anxiety serves important functions. The goal is for it to become proportionate to the context again and stop running your life.
The typical process has three phases. First, psychoeducation: understanding what happens in your body and mind when anxiety is triggered, identifying your specific triggers and defusing the "anxiety about anxiety". Second, concrete tools: physiological regulation techniques (diaphragmatic breathing, sensory grounding), cognitive restructuring (identifying and changing catastrophic thoughts) and gradual exposure to situations you have been avoiding. Third, relapse prevention: consolidating the changes and building a personal map to recover quickly if anxiety rises again.
A CBT process for moderate anxiety usually takes between 12 and 20 sessions (3 to 5 months, meeting weekly). This is an approximate range, not a prognosis for your case: it is discussed in the first session and reviewed as you go. In more severe presentations or with comorbidity (associated depression, underlying trauma) it can take longer, but always with a plan that has an end point.
What sessions are like: in person in Santa Cruz or online
The first session is an assessment: together we review what is happening to you, since when, in which situations the anxiety is triggered and what you have tried so far. You leave it with a concrete goal and a work plan. You do not need to arrive with a diagnosis or prepare anything; if you have previous reports or take medication, it is helpful to mention it.
Each session lasts 60 minutes and costs 190 Bs. At first the recommended frequency is weekly, because regulation techniques and gradual exposure are learned by practicing between sessions; later, sessions are spaced out according to your progress. Between one session and the next there are short, concrete assignments, agreed with you.
You can choose in-person sessions at our office in downtown Santa Cruz de la Sierra (Calle Pari, Edificio Don Alcides, two blocks from Plaza 24 de Septiembre) or online sessions by video call from any city in Bolivia. Both follow the same process; for intense panic attacks or agoraphobia we usually recommend starting in person, as explained in the frequently asked questions.
When is it time to seek professional help?
Seeking therapy does not require being in crisis. Ideally, the sooner the better: untreated anxiety tends to settle into avoidance patterns that become harder to reverse over time.
There are clear signs that the time has come: when anxiety affects your work or studies; when you start avoiding places, people or activities you used to enjoy; when physical symptoms become chronic and have no medical explanation; when you are turning to alcohol, non-prescribed medication or binge eating to regulate how you feel; when the people close to you tell you that you seem different.
If there is suicidal ideation, panic attacks that paralyze your daily life, or intrusive thoughts of harming yourself, it is important to act soon and, if necessary, to complement psychotherapy with a psychiatric evaluation. We work in coordination with trusted psychiatrists when a case requires it.
Specialist in anxiety
Junisse Montaño
Clinical psychologist with outstanding training in Bolivia and Spain. Master's degree in Clinical and Health Psychology from ISEP Barcelona. My practice is grounded in Cognitive Behavioral Therapy, offering practical, evidence-based tools to overcome anxiety, depression and life crises. My office is a safe, judgment-free space where we work together so you can regain your emotional well-being and build the life you want.
College of Psychologists No. JMP-1004-25Colegio de Psicólogos de Santa Cruz (Santa Cruz College of Psychologists)View full profile →
Cost of therapy: 190 Bs per session (60 min). A 4-session package is 650 Bs and a 10-session package is 1,500 Bs. Sessions are available in person in Santa Cruz and online throughout Bolivia. See all fees.
Frequently asked questions about anxiety
Answers to the questions we hear most often in our practice.
How long does CBT take to show results for anxiety?
Most patients with moderate anxiety notice their symptoms easing between sessions 4 and 8: that means roughly 4 to 8 weeks of weekly work. Fully consolidating the process usually takes between 12 and 20 sessions. CBT is one of the approaches with the strongest evidence precisely because of its limited duration and its focus on practical tools.
Do I need medication in addition to therapy?
It depends on the severity. Many anxiety presentations respond well to psychotherapy alone. In severe presentations, with frequent panic attacks or associated depression, combining CBT + medication prescribed by a psychiatrist usually gives better results than either one on its own. The decision is made by the psychiatrist who evaluates your case. From our practice we refer to trusted colleagues when needed.
Do you treat social anxiety specifically?
Yes. Social anxiety has a well-established CBT protocol that combines cognitive restructuring with gradual exposure to feared social situations. We work in stages, without pushing you to "jump into the deep end": each step is planned with you and reviewed before moving on to the next one.
Does online therapy work for anxiety?
For mild to moderate anxiety, yes: online therapy has evidence equivalent to in-person therapy. For severe panic attacks or active agoraphobia, we recommend at least the first 4-6 sessions in person: the therapist's physical presence is an important regulator in that phase. Afterwards you can continue online if that is more convenient for you.
What if panic attacks happen between sessions?
In the first sessions we put together an "emergency kit" with you: breathing techniques, sensory grounding and quick restructuring that you can use when an attack comes. It is not magic: it requires practicing the techniques when you are well so that they are available when you need them. As the process moves forward, the attacks become less frequent and more manageable.
How much does anxiety treatment cost?
An individual session costs 190 Bs (60 minutes). To keep up the weekly frequency recommended in the first weeks, we offer a 4-session package for 650 Bs (you save 110 Bs compared with paying for each session separately) or a 10-session package for 1,500 Bs. All the information on fees and formats is on the individual therapy page.
Is it stress or anxiety? How can I tell them apart?
Stress usually has an identifiable cause (a workload, an exam, a specific problem) and eases when that cause is resolved. Anxiety can persist without a clear reason, show up in anticipation and come with physical symptoms and avoidance. In practice they overlap, and sustained stress can turn into anxiety. The initial assessment exists precisely to tell them apart and choose the right tools.
Can anxiety and depression be treated at the same time?
Yes. They often appear together, and CBT has protocols for both. In the assessment we define which one weighs more right now and where to start; often, reducing anxiety also improves mood, and vice versa. If there are significant depressive symptoms, a complementary psychiatric evaluation may be needed, which we coordinate from our practice.
What happens in the first session?
It is a 60-minute assessment session: we talk about what is happening to you, when it started and how it affects your day-to-day life, and we agree on a goal and a work plan. You do not need to bring a diagnosis or prepare anything. If you have previous reports or take medication, it is helpful to mention it.
Should I start with a psychologist or a psychiatrist?
For most anxiety presentations, psychotherapy is the recommended first step, and many people do not need medication. Psychiatry is added when the symptoms are very intense, or when there are frequent panic attacks or associated depression; in that case we work in coordination. If you are unsure, start with the psychological assessment: that is where we evaluate whether a referral makes sense.
Sources and references
This page draws on leading health organizations and clinical guidelines. The links open in a new tab.
- Anxiety disordersWorld Health Organization (WHO)
- AnxietyMedlinePlus · U.S. National Library of Medicine
- Generalised anxiety disorder and panic disorder in adults: management (CG113)NICE · National Institute for Health and Care Excellence (UK)
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