Clinical Psychologist
Treating Anxiety Disorders
Certified Clinical Anxiety Treatment Professional (CCATP)
Treatment Modalities
An African proverb teaches us, "If you want to go fast, go alone. If you want to go far, go together". Everyone needs support from time to time to get through the difficulties life can throw. You might feel frustrated, overwhelmed and even hopeless. Change is hard and it's important to balance it with self-acceptance and a non-judgmental stance.
Whether you're seeking support for yourself or your family, counseling can be very helpful in reconnecting to ourselves, repairing relationships, managing stress, problem-solving, and learning coping skills. Together, in a non-judgmental and supportive environment, I can help you find your wise mind, adapt new coping skills, make decisions informed by your core values, and find your path to a more resilient you. Whatever might bring you to therapy, how ever vulnerable or stuck you might feel, asking for help is an act of courage, and together we will work to assess your needs and set goals for your treatment, so you can regain hope and feel effective again. You can be the author of your next chapter.
I utilize a unique integrative and individualized therapeutic approach to best address each individuals and families specific needs. I incorporate a variety of treatment approaches and modalities, some are listed below.
Starting or returning to therapy can be one of the most positive and rewarding decisions you can make, and feeling comfortable in the therapeutic relationship is important. Therefore, I invite you to schedule a free 15 mins. consultation to discuss your areas of concern, explore your options, and ask questions.
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Dialectical Behavior Therapy (DBT)
Dialectical Behavior Therapy (DBT) is an evidence-based therapy designed to help people change patterns of behavior that are unhelpful. If you or your teen is struggling with any of the following, DBT can help:
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depression
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anxiety/panic
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self-harm
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suicidal thoughts
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excessive worrying
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negative judgments of self
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impulsivity
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emotion regulation
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attention problems
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relationship problems (peers and family)
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The basic premise behind DBT is to live a life worth living by gaining the skills addressed in each of the four DBT modules:
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Core Mindfulness - The skills learned in this module encourage your teen to be more mindful in daily life. They will learn the difference between their Emotion Mind and their Reasonable Mind, and be able to balance the two to operate more from their Wise Mind. They will also become more in touch with their emotions, thoughts, and body sensations, and be able to identify when they are using judgments and how to reframe them.
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Distress Tolerance - These skills are designed to teach your teen how to tolerate a stressful moment, soothe him or her self, and be able to accept the moment nonjudgmentally without making the situation worse.
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Emotion Regulation - These skills will help your teen decrease their negative emotions, increase their positive emotions, and understand the relationship between their thoughts, emotions, and behaviors.
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Interpersonal Effectiveness - These skills will help your teen identify how thoughts and emotions can get in the way of effectively communicating with others, and are designed to teach your teen how to both be assertive and increase his or her chances of more positive communication.
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The treatment uses chain analysis, role playing, and ​problem solving techniques among others, in session, and incorporates in between sessions homework assignments.
Cognitive Behavioral Therapy (CBT)
CBT is a form of psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders and severe mental illness.
CBT is based on several core principles, including:
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Psychological problems are based, in part, on faulty or unhelpful ways of thinking.
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Psychological problems are based, in part, on learned patterns of unhelpful behavior.
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People suffering from psychological problems can learn better ways of coping with them, thereby relieving their symptoms and becoming more effective in their lives.
CBT treatment usually involves efforts to change thinking patterns. These strategies might include:
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Learning to recognize one's distortions in thinking that are creating problems, and then to reevaluate them in light of reality.
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Gaining a better understanding of the behavior and motivation of others.
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Using problem-solving skills to cope with difficult situations.
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Learning to develop a greater sense of confidence is one's own abilities.
CBT treatment also usually involves efforts to change behavioral patterns. These strategies might include:
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Facing one's fears instead of avoiding them.
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Using role playing to prepare for potentially problematic interactions with others.
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Learning to calm one's mind and relax one's body.
Not every CBT treatment will use all of these strategies. Rather, we will work together, in a collaborative fashion, to develop an understanding of the problem and to develop a treatment strategy.
Through exercises in the session as well as “homework" outside of sessions, clients are helped to develop coping skills, whereby they can learn to change their own thinking, problematic emotions and behavior.
CBT therapists emphasize what is going on in the person's current life, rather than what has led up to their difficulties. A certain amount of information about one's history is needed, but the focus is primarily on moving forward in time to develop more effective ways of coping with life.
Prolonged Exposure for PTSD
Any event or experience that shatters your sense of security, leaves you feeling confused, sad, shocked and sometimes feeling powerless to prevent it can be considered traumatic.
The stress accompanying traumatic events demands coping strategies of the individual that far exceed their capabilities. They may develop protective psychological mechanisms to help them deal with the stress, but this comes with a price. Over time, even after the trauma may be long past, the mind has not been able to reconcile the trauma with the sense of self.
Without professional treatment, such individuals eventually become unable to function well, as they find themselves reliving the trauma over and over again. PTSD Treatment can be a helpful in processing the traumatic event so that you can move forward.
Exposure is an intervention strategy commonly used in cognitive behavioral therapy to help individuals confront fears. Prolonged exposure is a specific type of cognitive behavioral therapy that teaches individuals to gradually approach trauma-related memories, feelings and situations.
Most people want to avoid anything that reminds them of the trauma they experienced, but doing so reinforces their fear. By facing what has been avoided, a person can decrease symptoms of PTSD by actively learning that the trauma-related memories and cues are not dangerous and do not need to be avoided.
This treatment is strongly recommended for the treatment of PTSD.
Prolonged exposure is typically provided over a period of about three months with weekly individual sessions, resulting in eight to 15 sessions overall. 60 to 120-minute sessions are usually needed in order for the individual to engage in exposure and sufficiently process the experience.
Therapists begin with an overview of treatment and understanding the patient’s past experiences. Therapists continue with psychoeducation and then will generally teach a breathing technique to manage anxiety.
Generally, after the assessment and initial session, exposure begins. As this is very anxiety-provoking for most patients, the therapist works to ensure that the therapy relationship is perceived to be a safe space for encountering very scary stimuli. Both imaginal and in vivo exposure are utilized with the pace dictated by the patient.
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Imaginal exposure occurs in session with the patient describing the event in detail in the present tense with guidance from the therapist. Together, patient and therapist discuss and process the emotion raised by the imaginal exposure in session. The patient is recorded while describing the event so that she or he can listen to the recording between sessions, further process the emotions and practice the breathing techniques.
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In vivo exposure, that is confronting feared stimuli outside of therapy, is assigned as homework. The therapist and patient together identify a range of possible stimuli and situations connected to the traumatic fear, such as specific places or people. They agree on which stimuli to confront as part of in vivo exposure and devise a plan to do so between sessions. The patient is encouraged to challenge him or herself but to do so in a graduated fashion so as to experience success in confronting feared stimuli and coping with the associated emotion.
Exposure & Response Prevention (ERP)
OCD is a form of Anxiety Disorder, that can affect people of all ages and walks of life, and occurs when a person gets caught in a cycle of obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, images, or urges that trigger intensely distressing feelings. Compulsions are behaviors an individual engages in to attempt to get rid of the obsessions and/or decrease his or her distress. In order for a diagnosis of OCD to be made, this cycle of obsessions and compulsions becomes so extreme that it consumes a lot of time and gets in the way of important activities that the person values. Only trained therapists can diagnose OCD.
The most effective treatment for anxiety disorders, and especially for OCD, is a sub-type of CBT called Exposure and Response Prevention (ERP) combined with medications.
The Exposure in ERP refers to gradually exposing yourself to the thoughts, images, objects and situations that make you anxious and/or start your obsessions. While the Response Prevention part of ERP, refers to making a choice not to do a compulsive behavior once the anxiety or obsessions have been “triggered.” This is done at the client's pace, along with the guidance of a therapist.
For those who may be resistant to jumping right into real world situations, imaginal exposure (IE), sometimes referred to as Visualization, can be a helpful way to alleviate enough anxiety to move willingly to ERP. With visualization, we create a scenario that elicits the anxiety you might experience in real situations. As you habituate to the discomfort, with decreased anxiety over time, you are gradually desensitized, making you more willing to move the process to real life, and engage in the next step of treatment, ERP.
ACT (Acceptance & Commitment Therapy)
A unique empirically based psychological intervention that uses acceptance and mindfulness strategies, together with commitment and behavior change strategies, to increase psychological flexibility. Psychological flexibility means contacting the present moment fully as a conscious human being, and based on what the situation affords, changing or persisting in behavior in the service of chosen values.
Based on Relational Frame Theory, ACT illuminates the ways that language entangles clients into futile attempts to wage war against their own inner lives. Through metaphor, paradox, and experiential exercises clients learn how to make healthy contact with thoughts, feelings, memories, and physical sensations that have been feared and avoided. Clients gain the skills to recontextualize and accept these private events, develop greater clarity about personal values, and commit to needed behavior change.
​Mindfulness
Mindfulness, from a therapeutic perspective, is a conscious awareness to the present moment. This includes openness and non-judgment about the experience. It is often coupled with other types of therapy, such as Cognitive-based Therapy (CBT), Dialectical Behavior Therapy (DBT), or Acceptance and Commitment Therapy (ACT).
Mindfulness therapy is not concerned with relaxation, though that might be a result of certain practices. The focus is on increasing our awareness of the thoughts, feelings, and actions that hinder our progress. When we are better able to do that, we can engage with those aspects of ourselves, learn to tweak our language, and choose how to respond effectively.