Anxiety Therapy for Adults in Sacramento & Online Across California

You are an adult whose anxiety is running more of your day than you want it to. You may have ADHD as well, you may suspect you do, or you may have anxiety and no ADHD at all. Brilla Counseling provides anxiety therapy for all three, in person at our office in Sacramento, CA and online for anyone located in California. Sessions are 50 minutes, weekly to start, and built on Acceptance and Commitment Therapy (ACT).

You do not need an ADHD diagnosis, a referral, or a name for what is wrong before you begin. Request a free 20-minute consultation and we will tell you plainly whether we are a fit.

Reviewed by Lauren Dibble, LMFT (License #123427), Owner and Clinical Director, Brilla Counseling, Sacramento, California. Last reviewed October 2026.

Is this the kind of anxiety we treat?

Most likely, yes. Adults contact us when anxiety has started making their decisions for them. You may see yourself in some of these.

• Your mind rehearses. Conversations, emails, and worst cases get run through hours before they happen, and again afterward.
• You avoid, then pay for it. The phone call, the appointment, the inbox, the hard conversation. Putting it off buys an hour of relief and a week of dread.
• Your body is involved. A tight chest, a clenched jaw, a stomach that reacts before you have had a thought, sleep that will not come or will not stay.
• You function well and it costs too much. Work gets done and people rely on you. Nobody sees the checking and over-preparing that make it possible.
• You have tried arguing with your thoughts. You know the worry is out of proportion. Knowing has not made it quieter.
• You have ADHD and cannot tell which is which. Anxiety may be how you have kept deadlines and details from slipping, and you are tired of running on it.
• You do not have ADHD and wonder whether an ADHD practice is the right place. It is. Our full name is Brilla Counseling for ADHD & Anxiety, and anxiety on its own is a reason to be here.

If two or three of those describe your week, that is enough to start a conversation. Reach out for a free 20-minute consultation.

What is ACT for anxiety, and what do we do in session?

Skills practice, guided weekly. Acceptance and Commitment Therapy is an evidence-based behavioral therapy. Your clinician does not try to talk you out of anxious thoughts. She or he teaches you to notice them, loosen their hold, and do what matters to you while they are still there. In a controlled trial, ACT performed comparably to cognitive behavioral therapy for adults with anxiety disorders (Arch et al., 2012).

In session, the work looks like this:

• Mapping avoidance. You and your clinician list the specific situations anxiety has taken off the table and what each one is costing you.
• Stepping back from thoughts. You practice skills for seeing a worry as a thought your mind produced, so it has less say over what you do next.
• Making room for the physical part. You learn to let a racing heart or a tight chest be there without treating it as an emergency.
• Naming what matters. You get specific about the relationships, work, and daily life you want, so there is a reason to do the hard thing.
• One step between sessions. Each week ends with one concrete action you chose, small enough to do and uncomfortable enough to count.

How does Brilla run the first sessions?

History first, then a plan. Session one is your history with anxiety: when it shows up, what it has cost you, what you have already tried, and what "better" would look like in an ordinary week. Over the first few sessions, you and your clinician have agreed on a working plan that names the situations you want back and the skills you will practice to get there.

There are things we do not do. We do not prescribe, so medication questions go to your prescribing provider, and with your written permission we will coordinate with that provider. We do not evaluate you for ADHD unless you ask us to. We do not promise that anxiety disappears. The aim is that it stops deciding what you do.

What happens after you contact us?

Five steps, no surprises.

1. Contact form. You fill out a short form on our contact page. Our intake coordinator replies to set up a call.
2. Free 20-minute consultation. This is a phone call with the intake coordinator. You will be asked what is going on, whether you want in-person or online sessions, and what your schedule allows. The call is informational and is not a clinical assessment.
3. Matching. Using what you shared, you are matched with a clinician whose training, schedule, and rate fit. You can also ask for a specific clinician.
4. First session. You complete consent forms through the client portal ahead of time, then meet your clinician for an intake session.
5. Weekly to start. Sessions are weekly at first. You and your clinician adjust the frequency as things progress.

The consultation call is where you find out who you would see and what it would cost, before you commit to anything. Reach out for a free 20-minute consultation.

What if you have both ADHD and anxiety?

One clinician treats both. At Brilla Counseling, an adult with co-occurring ADHD and anxiety works on the two in the same sessions with the same clinician. You are not asked to resolve one before starting on the other, and you do not need an ADHD diagnosis for your clinician to take attention and follow-through into account.

The first sessions sort out which anxiety is which. Some worry is attached to things that keep going wrong: the late bill, the unanswered text, the deadline met at 2 a.m. That worry has real material, and it eases when the ADHD is better supported, so your clinician builds executive function strategies for those spots. Other anxiety stays put even when things are going fine, and it gets the ACT skills work. Most adults have some of each.

The order matters. If anxiety is what has been getting you out the door on time, lowering it first can let things drop. Your clinician puts a replacement in place, such as external reminders and routines, before or alongside the anxiety work. Questions about how ADHD medication affects your anxiety go to your prescribing provider.

For the explanation of why the two so often show up in the same person, read ADHD and Anxiety: Why Worry Was Never the Whole Story.

Who provides anxiety therapy at Brilla?

Four clinicians who see adults.

Lauren Dibble, LMFT (License #123427), Owner and Clinical Director. Lauren is trained in ACT and executive function work and supervises the practice's associate clinicians. Read Lauren's bio.

Joseph Boyle, LPCC (License #21262). Joe works with adults through life transitions, including career and relationship changes, and draws on parts work and Gestalt therapy. Read Joe's bio.

Andrea Valle, ASW (Registration #131274), supervised by Lauren Dibble, LMFT #123427. Andrea uses ACT, motivational interviewing, and behavioral activation with adults. Read Andrea's bio.

Mary Rose Bernal, ASW (Registration #140803), supervised by Lauren Dibble, LMFT #123427. Mary Rose uses ACT, motivational interviewing, and DBT skills with adults, is based in San Diego, and sees clients online only. Read Mary Rose's bio.

How much does anxiety therapy cost?

$150 to $275 per session. Brilla Counseling is private pay. The rate for a 50-minute session depends on the clinician's tier: $150 for an Associate Clinician, $180 for an Advanced Associate Clinician, $200 for a Licensed Clinician, $225 for an Advanced Licensed Clinician, and $275 for the Founder and Clinical Director.

We are not in-network with any insurance plan. We provide superbills you can submit to your insurer for out-of-network reimbursement. Whether and how much you are reimbursed depends on your plan, and we cannot guarantee it. You have the right to a Good Faith Estimate of your expected costs and can ask for one at any time. Full details are on the rates and insurance page.

Can you do anxiety therapy online?

Yes, anywhere in California. Online sessions are available to any adult who is physically in California at the time of the session. In-person sessions take place at our office at 924 57th Street in East Sacramento. The method and the 50-minute session length are the same in both formats, and many clients choose based on commute and schedule. Learn more about online therapy throughout California.

Frequently asked questions

Do I need an ADHD diagnosis to start anxiety therapy at Brilla?

No, none is needed. Brilla Counseling sees adults for anxiety whether or not they have ADHD. You do not need a diagnosis of any kind, a referral, or prior therapy to begin. If you have anxiety and no ADHD, your sessions focus on anxiety, and nobody will evaluate you for ADHD unless you ask.

Does Brilla take insurance for anxiety therapy?

No, Brilla is private pay. Brilla Counseling is not in-network with any insurance plan. Clients receive superbills they can submit to their insurer for out-of-network reimbursement. Reimbursement depends on the individual plan and is not guaranteed.

Can Brilla prescribe anxiety medication?

No, we do not prescribe. Brilla Counseling's clinicians are therapists, and medication decisions belong with your prescribing provider. If you take medication or are considering it, your clinician can coordinate with your prescriber with your written permission.

How long does anxiety therapy take?

It varies by person. Sessions at Brilla Counseling are weekly to start, and there is no fixed number of sessions. You and your clinician review progress together and reduce the frequency as the situations you had been avoiding come back into your life.

How is ACT different from CBT for anxiety?

They differ in aim. Cognitive behavioral therapy teaches you to examine anxious thoughts and replace them with more accurate ones. Acceptance and Commitment Therapy teaches you to let the thought be there and act on what matters to you regardless. Adults who found that arguing with their thoughts did not help often prefer ACT.

What if I think I might also have ADHD?

Tell your clinician. Brilla Counseling's clinicians work with adult ADHD every week and can help you decide whether an assessment is worth pursuing. Anxiety therapy does not have to wait for that answer, and the plan can be adjusted if ADHD turns out to be part of the picture.

Is weekly therapy the right help in a crisis?

No, use crisis services. Weekly therapy is not emergency care. If you are in immediate danger or thinking about ending your life, call or text 988 to reach the Suicide and Crisis Lifeline, or call 911.

Keep reading

• ADHD and Anxiety: Why Worry Was Never the Whole Story, for how the two interact
• Why CBT Doesn't Work for a Lot of Women with ADHD, if thought-challenging has not helped you
• ADHD and Sleep, if the worry is loudest at 1 a.m.
• ACT therapy at Brilla, for more on the method
• Therapy for adults, for the other services we offer adults

You do not have to be sure this is the right place before you call. Twenty minutes with our intake coordinator will answer that. Schedule your free consultation.