What I do is have a tutor on italki for specifically conversation practice, and I talk to them for an hour twice a week.
I’d say I’ve noticed some improvement after a couple months already. I also find it helps highlight your weaknesses in the language in general.
I’d say my speaking ability before I started doing that was by far the lowest compared to reading/writing/listening. Over time I find it’s starting to get closer to my listening ability. I’m generally better at reading/writing.
As far as speaking anxiety goes, I’d say the more stock phrases/speaking patterns you pick up over time either by hearing people you talk to use them or developing them on your own, the less anxious you tend to be.
I’d say it went down for me a fair bit when I could clearly communicate that I didn’t quite get something or could ask them to repeat something or when I got into the habit of explaining in simple terms a word that doesn’t come to mind rn etc.
Doing that and realizing that being stuck on something doesn’t mean that your conversation is joever and that you can just communicate it, clarify it, and then keep on going helps a lot. Over time it becomes second nature and everything goes smoother.