What kind of counseling do you do?

I use Cognitive Behavior Therapy (CBT), Inference Based Cognitive Behavior Therapy (I-CBT), Rational Emotive Behavior Therapy (REBT), as well as elements of mindfulness and (Dialectical Behavior Therapy) DBT. When working with kids, I incorporate play into the therapy. This can be done even with teletherapy, however, I have a complete set-up of therapeutic toys for kids and sandtray therapy with a wide array of miniatures (for all ages). There is a fidget basket of sensory toys and art supplies for anyone's use during their session if desired. 

My style can be very active, informative, teaching-oriented, and "toolsy" or warm and supportive. It depends on what the client needs and what they bring to therapy. Each client and each session are different. Therapy is something that is co-created between a client and a therapist who together create something unique. Instead of therapy being something that is "done" to you, therapy is very much a collaboration. 

Sometimes results are fast and immediately noticeable. Sometimes the benefits are more subtle. In any case, think of therapy less like a surgery that is done to you and more like taking vitamins or doing exercises.  

Do you do ERP (Exposure Response Prevention)?

This is a great question, and one that could be discussed for quite awhile! ERP has been used to treat OCD for many years and it can be very helpful when applied intelligently, and as it makes sense to do so. However, it is a tool that is often misapplied which can be ineffective at worst, and do great psychological harm at worst. Newer theories and methods that involve meta-cognition are gaining popularity for their effectiveness without being as distressing to the client.  One of these theories is called Inference Based Cognitive Behavior Therapy or I-CBT and I am using this with clients as a first line of treatment.

ERP stands for Exposure and Response Prevention, meaning someone is exposed to their stressful trigger (such as a door knob) and the response prevention is basically not doing the compulsion that usually follows the trigger (washing hands). The fact is most people are regularly exposed to their triggers, whatever they may be, and we do want to eventually eliminate the compulsions. The difference is in how we get there. With traditional ERP you do intentional exposures and response prevention until you "habituate" or "get used to" the trigger. The problem is there are some types of OCD where this is not feasible at all! There are some things you will never get used to, nor should you! Should you get used to door knobs? Yes! Should you get used to and be OK with other types of OCD symptoms? Not always. I will explain this more for clients who work with me and we will choose your treatment together based on what will be the most helpful for you. Sometimes that will involve a creative combination of methods, skillfully applied, rather than just one approach. That is why it is important to choose someone who specializes in OCD.  

If you are seeking therapy for OCD, please choose someone who has expertise in successfully treating this disorder, and specializes in helping people who have it. OCD really is a specialty and is misunderstood by many people, unfortunately, including therapists who mean well. I think we might have spent two hours at the most on this disorder in graduate school. That did not prepare me to treat anyone with this disorder, but I have since attended many of the top conferences on the topic over many years and continue to do so, as well as participate in professional forums and case consultations. Two excellent resources to look for therapists are the International OCD Foundation, www.iocdf.org, and www.icbt.online.     

If a therapist lists OCD as something they treat but they also have 18 other items listed, buyer beware. No one can specialize in everything. There are even subspecialties within OCD that I do not have expertise in. These include Body Dysmorphic Disorder, Body Focused Repetitive Behaviors, and Hoarding Disorder. The types of OCD I do specialize in include intrusive thoughts (ROCD, POCD, SO-OCD to name a few), doubting and checking, order/symmetry, and contamination type. 

How do I know if this is a good fit? 

The things to ask yourself when choosing a counselor are: Does this person specialize in the topics I need help with? Do the payment/insurance/finances work? Does the scheduling line up? Is the person available at times that work for me or can I make myself available during their availability? Is the location convenient or if telehealth, am I OK with that? Do I accept their office policies?  If the answer to those questions is yes, then it is very likely a good fit, at least good enough to have a first session or two.  Other qualities such as warmth and style can only be assessed after you start working with someone. 

If a person finds himself or herself overanalyzing fit, doing a lot of "shopping" and trying to find "the just right therapist" this could be a symptom of OCD interfering with their treatment, the result of a previous bad experience, or an indicator that there is a lot of anxiety and resistance toward therapy, and maybe the person is not ready yet. 

My indicators that it is not a good fit:

There is nothing wrong with the following treatment needs, however, these are issues that are outside the scope of my practice. These include couples counseling, severe trauma, severe depression, addictions (including video games, porn, drugs, alcohol), anger management, court cases, high conflict divorce, or personality disorders.  Many of these issues are best served by a therapist who specializes in those issues and for some of these, a larger practice with a support staff to field crisis calls, records requests, and follow up on billing issues. 

My indicators of a good fit:

My best fit clients are seeking help in the areas I specialize in, or at least treat. Our days/times of availability match up. (I work some evenings and most Saturdays, so it should be pretty easy to find something that works with your schedule). They may be in a severe crisis due to OCD or panic attacks but are not frequently suicidal or severely depressed. My best fit clients understand that I do not have an office staff to follow up on their insurance for them and are willing/able to do this for themselves.  Someone once summed up my best fit clients as "Geeks with anxiety." I think that is a fair description, and now we talk more in terms of clients who are neurodivergent.  

Also, my ideal clients value the exchange of services for money and have integrity, responsibility, kindness, and fairness in dealing with others financially.