Therapy Modalities I use in therapy

ACT is a trans-diagnostic treatment, meaning it has been found to be helpful across a variety of diagnoses and shares roots with Cognitive Behavior Therapy (CBT).
The Acceptance part of ACT is based on the idea that negative experiences are inevitable, and that trying to change or suppress those experiences cause unnecessary suffering.
Acceptance is NOT about giving up or giving in, but instead about learning how to drop the struggle with things we cannot control. This saves our time, energy, and attention, allowing us to respond and take care of ourselves through these negative experiences.
Commitment is about getting in touch with what it means to live a rich and meaningful life for you, and taking steps that help move you towards that. These “toward moves” aren’t easy, but we know that things that are worthwhile aren’t always easy.
ACT and ERP work really well together. ERP is a tool for learning how to move toward what’s important to you, but has been difficult due to the rules and distress created by OCD. When practicing exposures I always make sure my clients know and are keeping in mind the bigger “why” of doing these hard things and taking risks.

ERP is an evidence-based treatment for OCD and anxiety disorders. It is considered the gold standard treatment for OCD recovery. IOCDF.org is a great resource to learn more about OCD and ERP.
ERP is the practice of gradually and intentionally facing the thoughts, images, objects, memories or situations that trigger fear (exposure) while resisting the urge to perform behaviors that would ordinarily offer temporary relief (response prevention). We call this "leaning in" to anxiety.
ERP is a gradual and collaborative process. If people are pushed to do things they are not ready not only is it not helpful, in fact it can be counterproductive. I will collaborate on exposure plans with you based on your willingness, checking that we are in the growth zone as we do exposures together, with a healthy dose of compassion to hold you through any discomfort.
Over and over my clients tell me that through exposure practice they have learned how to handle the difficult sensations that come from their emotions, that their anxiety overpredicts problems and underpredicts their ability to cope, and that they are better at having the difficult emotions that come in life.
In fact, many of my clients have told me that after their OCD treatment, they felt better prepared for life in general, with all the twists and turns and challenges that may come.

Unlike other modalities, the treatment focus of SPACE is on changing parent and caregiver behaviors in order to affect their child’s anxiety. SPACE can be used with parents and caregivers of young children, teens, or adults with anxiety disorders, including OCD.
The goals of this parent focused treatment are:
- to learn how to respond supportively to the child instead of responding reactively to anxiety
- to build a child’s autonomy
- to improve collaboration and communication in the family
- to reduce accommodations which exhaust caregivers and contribute to the child’s anxiety cycle
One advantage of SPACE is that the child does not need to participate in order for change to happen in the family and in the child. This is especially useful if the child is unwilling to participate in their own therapy, if the child has difficulty attending sessions (such as inattention, or lack of availability in their area), or has any other barriers to therapy.
SPACE has been tested and found to be as effective in treating child anxiety as direct individual treatment.
In my own practice I have found SPACE to be so effective that I do not work with children unless their primary caregivers are also willing to participate in this coaching.

CFT is also a behavioral form of psychotherapy based in evolutionary science and eastern philosophies. The primary aim of CFT is to use compassionate mind training to counteract individuals with high levels of self-criticism and feelings of guilt or shame (low self-esteem).
Compassion is not self-indulgence, a common belief I hear. Instead, compassion is about understanding, bravery, and strength in flexibility. The example I give is that compassion is the same stance you might have while holding a child or pet while getting medical treatment. You would hold it firmly enough so that it doesn’t fall or get hurt, flexible enough to move as you need to catch it’s wiggling protests. You would speak to it gently, you want it to feel loved and cared for and soothed. You would want it to know it’s heard and understood (not minimized or demeaned), and you want it to know it will get through this. This is the stance of compassion.
I incorporate self-compassion work into all of my work. I have found that guilt and shame and self-criticism are incredibly common to co-occur with anxiety disorders. By adding in compassionate mind training I see improvements in mood, motivation, and willingness in treatment.

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