Anxiety treatment serving Fort Lauderdale — exposure-based CBT, in-house psychiatry.

RECO Health is a 40-minute drive up I-95 from Las Olas, Victoria Park, and Coral Ridge — close enough to attend PHP without relocating, far enough for genuine separation from the avoidance patterns that maintain anxiety. Care is disorder-specific: GAD-7, PDSS, LSAS, and Y-BOCS scoring at intake, SSRI dosing at anxiety-effective ranges, and ERP or interoceptive exposure delivered by therapists trained in the protocols. Benzodiazepines are avoided in clients with any substance use history; buspirone, hydroxyzine, or low-dose aripiprazole are used when augmentation is indicated.

Fort Lauderdale sits 26 miles south of RECO Health’s Delray Beach campus — a 40-minute run up I-95 from Las Olas, Victoria Park, or Coral Ridge. That distance is deliberate: clients from Rio Vista or Wilton Manors can commute to partial hospitalization without uprooting jobs or custody arrangements, while gaining meaningful separation from the neighborhoods, bars, and social circles that reinforce anxious avoidance and, in many cases, active addiction. For clients who need a higher level of containment, residential and detox beds are on the same Delray campus.

Disorder-specific assessment before treatment starts

“Anxiety” is a presenting symptom, not a diagnosis. RECO’s psychiatric intake begins with structured diagnostic differentiation because the DSM-5-TR anxiety disorders — generalized anxiety disorder, panic disorder, social anxiety disorder — and the closely related obsessive-compulsive disorder each demand a different exposure architecture. Running an OCD client through a generic “anxiety group” produces stagnation at best and iatrogenic worsening at worst.

Every client is scored at baseline on the instrument matched to their working diagnosis: GAD-7 for generalized anxiety severity, PDSS for panic frequency and functional impairment, LSAS for social anxiety, and Y-BOCS for obsessive-compulsive symptom burden. PHQ-9 tracks comorbid depression, which is present in roughly half of anxiety presentations. When substance use is in the picture, ASAM Criteria dimensions guide the level-of-care decision, and CIWA or COWS protocols run in parallel if withdrawal management is needed before psychiatric stabilization can proceed.

The treatment plan that leaves intake names the primary DSM-5-TR diagnosis, the outcome measure the team will track, and the target score at 30, 60, and 90 days. Vague plans produce vague outcomes.

SSRI pharmacotherapy at anxiety-appropriate doses

First-line pharmacotherapy for every anxiety disorder is an SSRI, and the dosing is where community prescribers most often fall short. Anxiety-effective sertraline typically sits at 150–200 mg, escitalopram at 20 mg, paroxetine at 40–60 mg, and fluoxetine at 40–80 mg. Starting doses are deliberately low — sertraline 25 mg, escitalopram 5 mg — with slow titration over two to four weeks to avoid the paradoxical activation that drives early discontinuation.

Augmentation and adjuncts are used judiciously. Buspirone at 20–30 mg per day augments SSRIs in generalized anxiety without dependence risk. Hydroxyzine 25–50 mg is available for as-needed acute anxiety when a non-controlled option is clinically appropriate. Propranolol 10–40 mg has a defined role in situational performance anxiety and adrenergic symptoms. Gabapentin can bridge sleep and somatic anxiety in appropriate cases. For OCD specifically, target SSRI doses run higher still, and low-dose aripiprazole (2–5 mg) is a common augmentation strategy when Y-BOCS scores plateau.

Exposure-based CBT is the therapy that works

The evidence base across every anxiety disorder points to exposure-based cognitive behavioral therapy, not supportive talk therapy or generic coping-skills groups. For OCD, that means Exposure and Response Prevention (ERP): a therapist-guided, hierarchical program in which the client confronts obsessional triggers and withholds the compulsive response until the anxiety extinguishes on its own. For panic disorder, interoceptive exposure — deliberately provoking the feared bodily sensations of hyperventilation, dizziness, or tachycardia — teaches the nervous system that the sensations are not dangerous.

Social anxiety disorder is treated with graded in-vivo exposures paired with cognitive restructuring targeting overestimated social cost. Generalized anxiety responds to worry exposure, applied relaxation, and behavioral experiments that test catastrophic predictions against actual outcomes. Acceptance and Commitment Therapy (ACT) is layered in when experiential avoidance is the dominant maintaining factor, and DBT skills — distress tolerance, opposite action — are drawn on when emotion dysregulation complicates the picture.

RECO’s PHP and IOP schedules are built so that individual exposure work drives the plan and group programming reinforces it. Group is not a substitute for the ERP hierarchy; it is the container that makes the between-session exposures survivable.

Why we don’t lean on benzodiazepines

Alprazolam, clonazepam, and lorazepam relieve acute anxiety within minutes, which is precisely the problem. Fast relief before an exposure trial blunts the extinction learning that makes CBT work — the client learns that the medication made the panic stop, not that the panic would have stopped on its own. Meta-analyses consistently show worse long-term outcomes when benzodiazepines are combined with exposure therapy.

The risk profile is also incompatible with a meaningful share of RECO’s population. A significant share of clients present with a co-occurring substance use disorder, and benzodiazepines carry documented cross-addiction potential with alcohol and opioids, plus a withdrawal syndrome that can be medically dangerous. In clients with any substance use history, benzodiazepines are avoided. In clients without that history, they are used sparingly, briefly, and with a documented taper plan.

When a fast-acting bridge is genuinely warranted — a phobic dental procedure, an unavoidable flight during the SSRI titration window — hydroxyzine, gabapentin, or a low-dose beta-blocker covers most clinical needs without the dependence trajectory.

Adjunctive services when standard care stalls

A subset of clients — treatment-resistant OCD, severe comorbid depression, panic that has not remitted after adequate SSRI and CBT trials — benefit from the interventional psychiatry services on the Delray campus. rTMS is FDA-cleared for OCD using a deep-coil protocol delivering approximately 3,000 pulses per session at 120% of motor threshold over six weeks. Ketamine and esketamine (Spravato) are considered for severe treatment-resistant depression that frequently sits underneath chronic anxiety.

These are not first-line treatments and are never marketed as such. They are offered when the standard SSRI-plus-exposure protocol has been given an adequate trial and outcome measures have not moved.

What to expect on your first visit

Intake begins with a 60–90 minute psychiatric evaluation covering DSM-5-TR differential, medical and medication history, substance use screening, trauma history, and family psychiatric history. The scored measures (GAD-7, PDSS, LSAS, Y-BOCS, PHQ-9, ASRS when ADHD is suspected) are completed the same day. A licensed therapist completes the psychosocial assessment in parallel. By day two, the client leaves with a written plan naming diagnosis, level of care (PHP or IOP), pharmacologic starting point, therapy protocol, and the outcome measure and target. Anything less specific is not a treatment plan.

Insurance and admissions from Fort Lauderdale

RECO Health is in-network with most major commercial carriers serving Broward County, including Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and Blue Cross Blue Shield. Admissions verifies benefits within an hour of a call. For Fort Lauderdale clients, PHP is typically five days per week for four to six weeks, transitioning to three-day IOP; the 40-minute I-95 commute is workable for both. Transportation assistance is available for clients whose driving is restricted during initial medication titration.

Serving residents of: Las Olas, Victoria Park, Coral Ridge, Rio Vista, Wilton Manors.