Do I need a referral from a doctor?

No. Therapy with a Registered Psychotherapist or Registered Psychologist in Ontario does not require a physician referral. You can book directly. Some extended health insurance plans require a doctor’s note for reimbursement, however — it’s worth checking your plan’s wording before your first session.

Belleisle

Online Anxiety Therapy in Ontario

Evidence-based therapy for anxiety, delivered online by registered psychotherapists and psychologists across Ontario.

Sessions in French or English · Confidential, secure, PIPEDA-compliant · First appointment usually within days. If anxiety has started shaping your decisions — what you do, what you avoid, how well you sleep, how much energy you have left for the rest of your life — it may be time to work with someone. Belleisle Clinics connects you with registered psychotherapists (CRPO) and registered psychologists (CPBAO) in our network who provide online therapy for anxiety across Ontario, using evidence-based approaches. Sessions are confidential, secure, and available in French or English. Most clients are matched with a clinician and have their first session within a week.

Reviewed by Dr. Marie Paquette, C.Psych. (CPBAO #7136). Written and edited by the Belleisle Clinics care team. Last updated: June 2026.

Anxiety is more than feeling worried

Everyone feels anxious sometimes — before a job interview, during a difficult conversation, in the hours after a hard email lands in the inbox. That kind of anxiety has a job: it focuses attention, mobilizes energy, and usually fades once the situation resolves.

Anxiety becomes a clinical concern when it stops being situational. When the worry is constant rather than tied to a specific event. When the body stays in alert mode — racing heart, tight chest, shallow breathing — long after the trigger is gone. When avoidance starts narrowing what you do and where you go. When sleep, concentration, appetite, or relationships start to suffer.

Anxiety also wears many different faces. The patterns we most commonly work with include:

GENERALIZED ANXIETY

Persistent worry that moves from one topic to the next — work, health, money, family, the news — with physical signs like muscle tension, fatigue, irritability, and disrupted sleep.

PANIC AND PANIC ATTACKS

Sudden surges of intense fear with strong physical symptoms (chest pain, dizziness, shortness of breath, a sense that something terrible is about to happen), often followed by a fear of having another attack.

SOCIAL ANXIETY

Intense self-consciousness in social or performance situations, with avoidance of the situations themselves — meetings, presentations, parties, dating, sometimes even routine interactions.

HEALTH ANXIETY

Recurrent worry about having or developing a serious illness, often despite reassurance from doctors. Frequently involves repeated symptom-checking, online searching, or avoidance of medical settings.

PHOBIAS AND SPECIFIC ANXIETIES

Intense fear of a specific object or situation — flying, driving, needles, enclosed spaces, heights — strong enough to interfere with daily life.

ANXIETY WITH DEPRESSION

Anxiety and depression frequently appear together. Treating one often helps the other; understanding how they interact in your situation is part of the work.

You do not need a formal diagnosis to start therapy. If anxiety is shaping more of your life than you want it to, that is reason enough to talk to someone.

What online anxiety therapy looks like

Online therapy is not a workaround for in-person therapy. It is a complete therapeutic format, supported by a strong evidence base, and — for many people with anxiety — a better fit than in-person sessions.

The session itself

Sessions are conducted over a secure, encrypted video platform that meets PIPEDA standards for personal health information. You join from a quiet, private space of your choice — your home, a parked car, an office with a closed door. Your clinician joins from theirs. The work that happens is the same work that would happen in a consulting room: a structured conversation, with the same depth and the same clinical training behind it.

Why online often works particularly well for anxiety

Three reasons online sessions are often a strong fit for anxiety specifically:

Reduced barriers to access. If anxiety includes avoidance of driving, public transit, waiting rooms, or unfamiliar buildings, the in-person logistics of therapy can themselves be a barrier. Removing them lets the work start sooner.
Practicing in the environment where anxiety lives. Anxiety doesn’t happen in a consulting room — it happens at your desk, in your kitchen, on your commute. Doing the work from where you actually live and work makes the strategies more applicable on the spot.
Schedule flexibility. Online sessions slot more easily into a working day, which matters when avoidance has built up around taking time off, asking colleagues for cover, or explaining absences.

What the work typically involves

Anxiety therapy is structured. After an initial assessment, you and your clinician set goals: what you want to be different in three months, six months, a year. The sessions then combine:

Understanding what is happening. Mapping the triggers, thoughts, physical responses, and behaviours that keep anxiety active. Many clients say this stage alone is a relief — the experience starts making sense.
Building practical strategies. Tools you can use in the moment when anxiety spikes, plus longer-term strategies for changing the patterns that fuel it.
Practice between sessions. The strongest evidence-based treatments for anxiety involve doing things differently between sessions — not just talking about it. Your clinician will work with you to design realistic, paced steps.
Adjusting as you go. Therapy is collaborative. What works, you keep. What doesn’t, you change.

Evidence-based approaches for anxiety

Anxiety is one of the most extensively researched areas of psychotherapy. Several approaches have strong empirical support, and our clinicians draw on the ones that fit each client’s situation.

COGNITIVE BEHAVIOURAL THERAPY (CBT)

CBT is the most studied approach for anxiety and has the strongest evidence base. It is structured, present-focused, and works on the connections between thoughts, feelings, physical sensations, and behaviours. For anxiety specifically, CBT typically includes identifying the thinking patterns that fuel worry, working with the physical aspects of anxiety, and gradually facing avoided situations in a paced way. Many clients see meaningful change within 12 to 20 sessions.

ACCEPTANCE AND COMMITMENT THERAPY (ACT)

ACT focuses less on changing anxious thoughts and more on changing your relationship to them. The work is to recognize that anxious thoughts are mental events — not commands or predictions — and to keep moving toward what matters to you even when anxiety shows up. ACT is particularly useful when anxiety has been around for a long time and previous attempts to argue with or suppress it have backfired.

MINDFULNESS-BASED APPROACHES

Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) train present-moment awareness as a way of working with anxiety. Strong evidence base for generalized anxiety, stress-related conditions, and preventing relapse.

EXPOSURE-BASED WORK

For phobias, panic, social anxiety, and certain types of obsessive-compulsive presentations, gradually and safely confronting feared situations is among the most effective interventions available. Online sessions are particularly well-suited to designing exposure work that fits your actual life.

EMOTION-FOCUSED THERAPY (EFT)

Useful when anxiety is closely tied to unresolved emotional experiences, relationship patterns, or grief. Often used in combination with other approaches.

PSYCHODYNAMIC THERAPY

Longer-term exploration of anxiety as it connects to early experiences, attachment patterns, and unconscious dynamics. A good fit when anxiety is part of a longer-standing pattern that hasn’t responded to shorter-term approaches.

Our intake team helps match you with a clinician whose primary approach fits both the type of anxiety you’re experiencing and what you’re looking for in the work.

Who you’ll work with

The professionals in the Belleisle network who provide anxiety therapy are independent, regulated professionals — Registered Psychotherapists (CRPO) and Registered Psychologists (CPBAO) — each working within their own areas of competence. Both can provide effective, evidence-based care for anxiety, and for the most common forms — generalized anxiety, panic, social anxiety, phobias — a Registered Psychotherapist can be just as effective as a psychologist. The two professions differ mainly in depth of training — a master's-level qualification for psychotherapists, a doctoral degree (PhD or PsyD) for psychologists — and in scope, since only a psychologist can carry out formal psychological assessment or diagnosis, which matters most for complex or co-occurring conditions.

For a full comparison and help choosing, see our guide, Psychologist vs. Psychotherapist in Ontario. Our intake team helps you make this choice with you, based on your situation, your preferences, and practical considerations like fees and availability.

Evaluation

Fees and insurance

Fees in Ontario depend on the type of regulated professional you work with. Because rates vary and can change, we don’t publish set figures here — your intake team confirms the specific fee with you before your first session, based on the clinician you’re matched with. As a general pattern, sessions with a Registered Psychotherapist (CRPO) are usually more accessible than sessions with a Registered Psychologist (CPBAO), reflecting the difference in training.

Most extended health benefits plans cover online therapy with both RPs and psychologists. Common patterns:

Reimbursement: often a portion of the session fee, up to an annual maximum that varies widely from one plan to another.
Both professions usually covered. Some plans cover one but not the other — check the wording. Plans that cover “Registered Psychotherapist” generally also cover sessions with an RP (Qualifying).
Tax credit: sessions with either profession qualify as a medical expense for the federal Medical Expense Tax Credit. Keep your receipts.
Disclaimer: these figures may evolve over time — confirm specific coverage and reimbursement limits with your insurer.

Evaluation

How To Start

Tell us briefly what brings you in

Fill out our short online form. No referral required. Your request is reviewed by our intake team, not a chatbot.

We match you with the right clinician

Based on your concern, your language preference, your schedule, and your budget, our intake team identifies the clinician in our network whose expertise and approach best fit. If you’d like to ask questions before booking, our intake team is available by phone.

Begin your first session

Your matched clinician contacts you to confirm a time. Sessions take place over a secure video platform. From there, the pace is whatever fits the work and your life.

BOOK YOUR FIRST SESSION

Frequently Asked Questions

For most forms of anxiety, the research is clear: online therapy delivered by a qualified clinician produces outcomes comparable to in-person therapy. Multiple meta-analyses, including ones focused specifically on anxiety, have found no significant difference in effectiveness. For some clients — particularly those whose anxiety includes avoidance of leaving home, public transit, or unfamiliar settings — online is actually a better fit because it removes barriers that would otherwise interfere with consistent attendance.

It depends on the type of anxiety and how long it has been present. Many clients with focused presentations — panic, specific phobias, social anxiety — see meaningful change within 12 to 20 sessions of an evidence-based approach like CBT. Longer-standing or more complex anxiety, especially when intertwined with depression, trauma, or relationship patterns, often benefits from longer work. Your clinician will discuss expected timelines with you in your first sessions and adjust as you go.

Therapy and medication are different paths, and many people choose one without the other. For some conditions — particularly more severe anxiety, anxiety with significant depression, or anxiety that has not responded to therapy alone — the combination is often more effective than either on its own. Medication is prescribed by physicians or psychiatrists, not by psychotherapists or psychologists. If you and your clinician think a medication conversation makes sense, they will help you think it through and coordinate with your family doctor or a psychiatrist.

That depends on your situation. For most common forms of anxiety, a Registered Psychotherapist is a strong fit — often with faster availability and more accessible fees. If your situation involves a need for formal psychological assessment, complex co-occurring conditions, or a clinical presentation that is harder to characterize, a Registered Psychologist may be the right match. Our intake team works through this with you, not for you.

Yes. Sessions are governed by strict professional confidentiality rules set by each clinician’s regulatory college, plus Ontario’s health privacy legislation (PHIPA) and federal privacy law (PIPEDA). The video platform we use is encrypted and PIPEDA-compliant. There are narrow legal exceptions to confidentiality — risk of serious harm to self or others, suspected abuse of a minor or vulnerable adult, court-ordered disclosure, and reportable abuse by a regulated health professional. Your clinician will explain these in your first session.

Our online psychotherapy is available across all of Ontario — Ottawa, Toronto, Hamilton, London, Kingston, Sudbury, Thunder Bay, and everywhere in between. The only requirement is that the client is physically located in Ontario at the time of the session, since that’s where our clinicians are licensed to practise. For clients in Quebec, our network includes clinicians registered with the Ordre des psychologues du Québec (OPQ).

Online psychotherapy is suitable for ongoing support and structured treatment — it is not designed for crisis intervention. If you are in crisis or experiencing thoughts of self-harm, please call or text 9-8-8 (Suicide Crisis Helpline, available 24/7 across Canada), call 9-1-1, or go to your nearest emergency department. Once the crisis has stabilized, online therapy can be part of ongoing care.

Sources

The statements on this page about the effectiveness of online and in-person therapy, and about what predicts good outcomes, are supported by peer-reviewed research, including:

Carlbring, P., Andersson, G., Cuijpers, P., Riper, H., & Hedman-Lagerlöf, E. (2018). Internet-based vs. face-to-face cognitive behaviour therapy for psychiatric and somatic disorders: an updated systematic review and meta-analysis. *Cognitive Behaviour Therapy, 47*(1), 1–18. (20 studies, 1,418 participants; the two formats were found to be equally effective.)
Zhang, A., et al. (2022). Comparative efficacy of face-to-face and internet-based cognitive behaviour therapy for generalized anxiety disorder: a meta-analysis of randomized controlled trials. *Frontiers in Psychiatry, 13*. (26 trials, 1,687 participants; internet-based CBT achieved a similar therapeutic effect to in-person CBT for GAD.)
Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: a meta-analytic synthesis. *Psychotherapy, 55*(4), 316–340. (295 studies, more than 30,000 patients; the therapeutic alliance is among the most robust predictors of outcome, across both in-person and internet-based therapy.)

The information on this page is for general educational purposes and does not constitute medical, psychological, or therapeutic advice. It does not replace consultation with a qualified mental health professional. If you are in crisis or experiencing thoughts of self-harm, please contact 9-8-8 (Suicide Crisis Helpline), call 9-1-1, or visit your nearest emergency department.

Ready to talk to someone?

Anxiety responds to treatment. The strongest predictor of progress is starting — finding a clinician you can work with, and beginning the work. Booking takes a few minutes; a first session does not commit you to anything beyond it.

BOOK YOUR FIRST ONLINE SESSION