--- title: "Anxiety Therapist in San Francisco, CA · Online Therapy for Tech & Startup Workers" description: "Online therapy for San Francisco tech and startup professionals — imposter syndrome, performance dread, equity-cliff burnout. 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I try to hold evening slots because the reality of a tech calendar is not a mystery to me." } }, { "@type": "Question", "name": "I've done therapy through my employer's EAP and it felt shallow. How is this different?", "acceptedAnswer": { "@type": "Answer", "text": "EAP is short-term by design. This is depth work — meant to touch the pattern under the symptom, not manage the crisis of the week. It's a different kind of container." } }, { "@type": "Question", "name": "What if I'm in crisis outside a session?", "acceptedAnswer": { "@type": "Answer", "text": "Call or text 988, or SF Suicide Prevention at 415-781-0500. Between-session emergencies are not a burden — they're a signal, and we build a plan for them." } } ] } ] --- [Skip to content](#main) [](/) [About](/about)[Approach](/approach) [Services](/services) [Who I work with](/who-i-work-with) [Insights](/insights)[Español](/es)[Contact](/contact) [Book a free call](/book) ![Coastal Monterey cypress trees bent by wind on a foggy Bay Area headland](/assets/nature-san-francisco-DpzA7ugt.jpg) [← California online therapy](/california-online-therapy) San Francisco County · Telehealth across California # Anxiety therapist for San Francisco professionals You are a senior anything in a company where the seniority came fast and the vocabulary for what you're actually feeling never quite arrived. On paper, this is what you moved here for. Inside, you have been running on caffeine, adrenaline, and the quiet fear that someone in the next all-hands is finally going to say the thing you already secretly believe about yourself. [Book your free 15-min call ](/contact) The specifics ## What lives in a San Francisco week The people I see from San Francisco rarely arrive saying they have anxiety. They arrive saying they're behind — even when the calendar, the comp letter, and the last review say the opposite. The anxiety is the fuel that got them here, and now the fuel is eating them. Startup culture rewards a very specific nervous system: someone who can absorb a re-org on Slack at 9pm, treat a founder's mood swing as a leadership event, and internalize a missed quarter as a personal failing. That nervous system does not turn off when the laptop closes. It runs errands. It has a face for the partner. It wakes up at 3am. The most honest conversations happen around the edges — the return-to-office memo that reshuffled a life, the equity that vested into a company that changed underneath you, the identity collapse when 'I'm at \[company\]' stops meaning what it used to mean. This is the layer we work on. Not the productivity system. The person underneath it. Sound familiar? ## You might recognize — - You perform in meetings and dissociate immediately after - Sunday-night dread that starts on Saturday morning - Every review — even good ones — leaves you convinced you're one quarter from being managed out - Your identity and your employer's name have quietly fused, and you're afraid of what's left if the company goes away - You've optimized sleep, meditation, and cold plunges and you still can't feel your own life How telehealth actually works ## No commute. No waiting room. No one sees you walk in. You will not sit in a waiting room in SoMa where three coworkers might see you walk in. Sessions happen from your apartment, a booked focus room, a car parked near Crissy Field — anywhere in California with a door that closes and a decent signal. I keep evening availability that respects the fact your Wednesday calendar is not yours. I am a Licensed Clinical Social Worker in California (LCSW #121584). I do not have a physical office. Sessions run by secure video and are confidential under California law and HIPAA. You can be anywhere in the state. Where San Francisco clients usually start ## Services that fit this work . [ Specialization Burnout & high-achiever therapy For people who look fine on paper and are quietly running on empty. Read more ](/services/burnout-therapy)[ Primary focus Anxiety & chronic stress Primary focus. EMDR, DBT, and CBT for the version of you that looks fine and feels wrecked. Read more ](/services/anxiety-therapy)[ Modality EMDR therapy EMDR helps your brain reprocess experiences that got stuck — the memories, images, or feelings that still fire even when you know, on paper, they shouldn't. We don't rush it. We move at your pace, build the resources you need first, and work toward those old moments losing their grip on the present. Read more ](/services/emdr-therapy) FAQ ## Questions people in San Francisco actually ask. Do you have an office in San Francisco? No. My practice is telehealth-only, statewide across California. We meet by secure video from wherever you are. Can we do sessions during the workday between meetings? Yes. Many of my SF clients book at the edges of the workday, over a long lunch, or after 5. I try to hold evening slots because the reality of a tech calendar is not a mystery to me. I've done therapy through my employer's EAP and it felt shallow. How is this different? EAP is short-term by design. This is depth work — meant to touch the pattern under the symptom, not manage the crisis of the week. It's a different kind of container. What if I'm in crisis outside a session? Call or text 988, or SF Suicide Prevention at 415-781-0500. Between-session emergencies are not a burden — they're a signal, and we build a plan for them. If it's an emergency ## Local and California crisis resources. If you or someone you love is in immediate danger, call 911. Otherwise, these lines are free, confidential, and answered by trained humans. San Francisco Suicide Prevention 24-hour crisis line staffed locally in San Francisco since 1962. [415-781-0500](tel:4157810500)[Visit site](https://www.sfsuicide.org) SF Behavioral Health Access Line San Francisco Department of Public Health — treatment access and referrals. [415-255-3737](tel:4152553737)[Visit site](https://www.sf.gov/departments/department-public-health/behavioral-health-services) 988 Suicide & Crisis Lifeline Call or text 988 — free, confidential, 24/7, English & Español. [988](tel:988)[Visit site](https://988lifeline.org) Crisis Text Line Text HOME to 741741 for free, 24/7 crisis support by text. [741741](tel:741741)[Visit site](https://www.crisistextline.org) California Peer-Run Warm Line Non-crisis peer support for anyone in California. 24/7. [855-845-7415](tel:8558457415)[Visit site](https://www.mentalhealthsf.org/peer-run-warmline/) ## Ready to do the work from San Francisco? [Book your free 15-min call ](/contact) With Love Wellness Center Depth-oriented therapy across California. Sessions in English & Español. Telehealth-only practice. Begin [Book your free 15-min call](/contact) In a crisis or emergency, call or text [988](tel:988) or [911](tel:911). Services - [All services](/services) - [EMDR therapy](/services/emdr-therapy) - [Anxiety & chronic stress](/services/anxiety-therapy) - [Trauma & PTSD](/services/trauma-ptsd-therapy) - [Relationship & attachment patterns](/services/relationship-therapy) - [Depression](/services/depression-therapy) - [Substance use, recovery & codependency](/services/substance-use-therapy) - [Burnout & high-achiever therapy](/services/burnout-therapy) - [Life transitions](/services/life-transitions-therapy) - [Grief & loss](/services/grief-therapy) - [Men's issues](/services/mens-therapy) Who I work with - [Overview](/who-i-work-with) - [Latino/a/x adults](/who-i-work-with/latino-therapy) - [LGBTQ+ adults](/who-i-work-with/lgbtq-therapy) - [Veterans & first responders](/who-i-work-with/veterans-therapy) - [High achievers](/who-i-work-with/high-achievers) Serving California - [California online therapy](/california-online-therapy) - [Los Angeles](/california/los-angeles) - [Orange County](/california/orange-county) - [San Diego](/california/san-diego) - [San Francisco](/california/san-francisco) - [San Jose](/california/san-jose) - [Sacramento](/california/sacramento) Insights - [All insights](/insights) - [High-functioning anxiety](/insights/high-functioning-anxiety) - [When therapy didn't work](/insights/when-therapy-didnt-work) - [Are my problems bad enough?](/insights/are-my-problems-bad-enough) - [Perfectionism & anxiety](/insights/perfectionism-and-anxiety) - [Can't think your way out](/insights/why-you-cant-think-your-way-out) Practice - [About Joshua](/about) - [Approach](/approach) - [Rates & insurance](/rates) - [Reviews](/reviews) - [Contact](/contact) En Español - [Inicio](/es) - [Sobre mí](/es/sobre-mi) - [Terapia de ansiedad](/es/terapia-de-ansiedad) - [Terapia de trauma](/es/terapia-de-trauma) - [Contacto](/es/contacto) With Love Wellness Center · Telehealth across California · sessions in English & Español. Individual results vary; therapy outcomes are not guaranteed. This website is for informational purposes only and is not a substitute for clinical care. Website by [Automaus.ai](https://automaus.ai) © 2026 With Love Wellness Center · Joshua Acosta-Duque, LCSW · CA LCSW #121584