Through large‐scale clinical trials, the implantable cardioverter defibrillator (ICD) has been established as the treatment of choice for primary and secondary prevention of sudden cardiac death. Although the ICD offers a confirmed mortality benefit, it may incite psychological adjustment issues within recipients. The most predominant form of psychological morbidity for ICD patients is anxiety. The prevalence of anxiety is well documented within the context of cardiac patients; however, ICD recipients often present with device‐specific concerns, including shock and death anxiety. Therefore, the interventions for these patients must be tailored to their unique concerns. This article will discuss forms and manifestations of anxiety within the ICD patient population, followed by an exploration of the components of psychosocial interventions found to be effective with these patients. Copyright © 2008 John Wiley & Sons, Ltd.