Matthew Sexton, LCSW, offers weekly telehealth therapy for adults with high-functioning anxiety: over-preparing, scanning for what could go wrong, and rarely looking anxious from the outside. A webpage cannot diagnose you or decide what treatment you need. Sessions are 50 minutes, $225 self-pay, or in-network through Alma with Aetna, Cigna, UnitedHealthcare (including Optum, Oxford, UMR, Surest), and Anthem Blue Cross Blue Shield. A free 15-minute fit conversation comes first; it is not a session.
What is high-functioning anxiety?
High-functioning anxiety describes anxiety that is hard for other people to see because the work gets finished and the responsibilities stay covered.
This part of my practice makes room for anxiety that is difficult for other people to see. The work gets finished, the responsibilities stay covered, and the preparation may even be praised. I want to hear about the experience of getting there: what occupies your attention and what it costs to keep anticipating the next problem.
I write about over-preparation, perfectionism and the constant scanning for what could go wrong. If those descriptions are familiar, an initial conversation can start with one ordinary example from your week. A label on a website does not have to capture your whole experience for you to ask about therapy.
Call (917) 432-9580 or request a free 15-minute fit conversation. It is not therapy.
What does this practice do?
This practice offers weekly, 50-minute individual telehealth therapy for adults with Matthew Sexton, LCSW, where high-functioning anxiety can be talked through collaboratively and at an agreed pace.
We can look at what the preparation is protecting against, what happens when a task is unfinished, and what it means to you to be the person who catches everything. The question is also about the rules you have learned to live by: what counts as enough, whose reaction matters, and whether your own limits have a place in the decision.
Another part of the conversation is the connection between worth and output. We can trace where that connection came from and how it appears now, including the internal criticism that continues even when things are going well. There is room to talk about the goals you care about alongside the pressure you experience around them.
You do not need to demonstrate that you have stopped functioning before describing distress. In our conversation, we can consider both what is working and what feels costly. You can ask how I would approach that tension, what working together might involve, and how we would discuss the fit as the work develops.
Practical fit at a glance
- Sessions
- Weekly, 50-minute individual therapy for adults, by telehealth.
- Fee
- $225 per session, self-pay. Monthly superbills provided for out-of-network reimbursement.
- Insurance
- Currently in-network through Alma with Aetna, Cigna, UnitedHealthcare (including Optum, Oxford, UMR, Surest), and Anthem Blue Cross Blue Shield. Confirm your plan during the fit conversation.
- First step
- A free, 15-minute fit conversation by phone or video. It is not therapy; it is for fit and logistics.
- Cancellation
- 24 hours’ notice; otherwise the full session fee applies.
- Reply time
- Within one business day.
What does a webpage not decide?
A webpage cannot diagnose you or decide what treatment you need. Reading about a pattern here is a starting point for a conversation, not an assessment, and it does not establish a therapist-client relationship.
How does the first conversation work?
The first step is a free, 15-minute fit conversation by phone or video, and it is not therapy. You can ask how Matthew works, describe what you are looking for in broad terms, and confirm location, scheduling, fees, and whether your plan applies. Replies come within one business day.
Closest patterns
Ask about high-functioning anxiety.
You do not need the whole story ready. A broad starting point and your location are enough for the initial inquiry. Keep clinical detail out of email and voicemail.
Call (917) 432-9580 or request a free 15-minute fit conversation. It is not therapy.
Request a fit conversation · Fees, insurance, and cancellation