Abstract: This project provided real-world conditions with a national sample that allowed us to empirically investigate the role of anxiety among employee assistance program (EAP) users. This study is based on 20,725 clients who used a national EAP service during parts of 2022 and 2023 for mental health counseling (96%) or coaching (4%). All clients had completed a standardized measure for anxiety risk (GAD-2), depression disorder (PHQ-2), the extent of hazardous alcohol use (AUDIT-C), and two aspects of employee work performance (WOS absenteeism and presenteeism). The primary finding was 42% of EAP clients had a clinical level of anxiety symptoms at the start of use. This is about four times higher than the typical working adult in the United States. In addition, 30% had a clinical level of depression, and there was substantial comorbidity between anxiety and depression (r = .54). Only 13% of clients had alcohol misuse as a clinical problem and it had little overlap with anxiety (r = .10). Thus, anxiety is one of the most common psychiatric disorders among users of counseling and coaching services. Only 14% of clients contacted the EAP specifically for assistance with an anxiety related issue.