Therapy Services

I have expertise treating the following:

  • Anxiety (Social Anxiety Disorder, Panic Disorder, Generalized Anxiety Disorder, Phobias, and others). 
  • Depression
  • Obsessive-Compulsive Disorder (OCD) (i.e., intrusive, unwanted thoughts and compulsive mental acts or behaviors)
  • Adult Attention-Deficit Hyperactivity Disorder (ADHD)
  • Relationships (improving communication and intimacy, resolving trauma, divorce, creating safety, etc) 

Also:

  • Work stress and work/life balance
  • Life Transitions (adjusting between jobs, cities, relationships, lifestyle)
  • Millennial generational challenges
  • Navigating political realities
  • Chronic Pain or Illness
  • Bipolar Disorder
  • Anger Management
  • Eating Disorders
  • Sexual Compulsivity
  • Cognitive changes due to brain injury or stroke
  • Schizophrenia and other psychotic disorders
  • Post-Traumatic Stress Disorder (PTSD)
  • Substance Abuse
  • Sleeping Problems (e.g., Insomnia, Sleep Apnea)
  • GLBTQ Issues
  • Grief

My Practice

My practice consists of adults (ages 18+). I work with some teens and families, but in most cases for child, teen, or family therapy I provide referrals to other providers.

I help my clients to make positive changes and live within their values. Therapy is tailored to fit your specific needs. I use techniques from evidenced-based treatments such as Mindfulness-Based Cognitive-Behavioral Therapy (MCBT), Exposure with Response Prevention (ERP), Dialectical Behavior Therapy (DBT), Psychodynamic Theory, and Emotion-Focused Therapy (EFT). These are evidence-based approaches that have positive clinical outcomes. I also approach therapy in the following ways:

  • Relationship- The most important healing occurs in the context of the relationship between the client and therapist. An objective perspective in an atmosphere of trust, free of judgment is an essential foundation for therapy.
  • Insight- Understanding how present feelings and actions relate to past events and relationships offers valuable understanding of recurrent behaviors.
  • Education and Skills Training – New information to inspire problem solving skills and strategies can be integral to change.
  • Exercise and Nutrition- Physical health and balancing body chemistry, specifically brain chemistry, is fundamental to a sense of well being.

Services are provided in my office or as needed via teletherapy visits (i.e., video over the internet). For specific cases I offer out-of-office visits for an additional fee.

Individual Psychotherapy – One on one 50 minute sessions.

Couple’s Counseling – Couple’s sessions are 50 or 90 minute duration, depending on prior agreement.

Group Psychotherapy – This is a weekly interpersonal process group (also knowing as a personal growth/self-exploration group). Maximum of eight people for 90 minutes. – Currently inactive. 

Click For More Information on Group Psychotherapy

Personal Growth/Self-Exploration Group: 

  • Prospective members desire self-exploration and personal growth in a safe environment.
  • Members are encouraged to explore life transitions, careers, self-care, finances, family issues, and intimacy issues.
  • Members increase their awareness of ineffective interpersonal patterns and explore new ways to create satisfying relationships.
  • This group also helps to overcome social fears, cultivate mindfulness, and develops emotional intelligence.

This is a long-term, on-going group that meets weekly on Wednesdays from 5:30-7pm in NE Portland.

Group is a safe place to: 

  • Learn to identify and satisfy your wants and needs in relationships.
  • Improve your confidence and self-esteem.
  • Discover the gift of compassion for yourself.
  • Improve your communication skills.

My co-leader Elizabeth Cloud and I (Click here to learn more about her) believe that individual screening and preparation makes groups more effective.

  • We carefully screen and prepare people for the group.
  • It helps to meet with Elizabeth or myself at least twice, sometimes more, before the group.
  • The first appointment allows us to see whether we are a good match and feel we can work well together. We also determine whether he or she would benefit from and contribute to the group. We use a collaborative approach to clarify the individual’s goals for the group experience.

For billing and rates questions please click here to read the FAQ.

Therapy works best when there is a good match between the therapist and client. This allows a sense of safety, which allows the client to be more fully honest about his or her issues. Throughout our work together, I encourage clients to let me know what is and isn’t working in therapy so we can do our best work together.

Feel free to call me at 503-660-8549 to answer any questions you have about whether my approach to therapy might feel like a good “fit.” I’m here to help, even if that means you might work better with another professional.


Individual Therapy Specialties


Relationships

Support for those seeking to create, maintain, or leave a relationship(s).
Common issues addressed:

        • Infidelity         • Grief
        • Dating Advice and Etiquette         • Codependency
        • Premarital Counseling         • Separation or Divorce
       • Improving Communication Skills         • Balancing work and family life
       • Improving Physical and Emotional Intimacy         • How to set effective boundaries


Anxiety Disorders

I specialize in the treatment of anxiety disorders. I typically approach treatment for anxiety using Mindfulness-Based Cognitive-Behavioral Therapy (MCBT) and/or exposure therapy. I provide education about why you have anxiety and how it happens, skills to manage it, and support for long-term benefits. As needed, I offer treatment outside of the office (e.g., in-home or in public) to help people address certain kinds of anxiety that cannot be treated in the office alone (e.g., some phobias, social anxiety).

You may have anxiety if you often feel overwhelmed, have difficulty feeling calm, have problems controlling worry, or have feelings of dread or apprehension. Other, less discussed problems associated with anxiety are many physical conditions (e.g., Irritable Bowel Syndrome, Crohn’s Disease, heart palpitations, high blood pressure, etc).

Whether your stress comes from work, relationships, physical conditions, a difficult life history (including trauma), and/or a very busy lifestyle, I have extensive experience treating a variety of anxiety disorders including Panic Disorder, Social Anxiety Disorder, Generalized Anxiety Disorder, Agoraphobia, Hypochondriasis, and Phobias.

For More Information

Anxiety is both a physical and emotional experience. It can be generalized or specific to fear of objects or situations (e.g., fear of being in enclosed spaces, or social anxiety). The most severe form of anxiety is a Panic Attack. Here are typical symptoms:

• Physical symptoms can include tightness in the chest or stomach, a sensation of choking, muscle tension, rapid heart rate, sweating, stomach upset and bloating, dizziness, shortness of breath, tremors or twitching, headaches, frequent urination, diarrhea, fatigue, and insomnia.

• Emotional symptoms can include feelings of apprehension or dread, trouble concentrating, feeling tense or jittery, anticipating the worst, restlessness, looking for signs of danger, and feeling like the mind has gone blank.


Depression

Depression is one of the most debilitating mental health conditions that affects the entire mind and body. Not many people understand what it feels like having a dark cloud over your life. Or that getting out of bed to boil water for tea might as well be like trying to run a marathon. And that you can’t just “will” your way out of depression. Many people with depression struggle everyday trying to wear a mask of normalcy, and wearing this mask is exhausting.

As with many other mental health conditions, the stigma of depression is real. Whether you have experienced depression for years or have fallen into a funk and just can’t seem to break out, know that there are effective treatments for depression. Treatment approaches differ depending on the depression profile, but I typically use MCBT to alleviate symptoms, and relationship-focused interventions if the quality of a person’s relationships are a factor.

For More Information

Depression takes many forms and affects both the mind and body. Everyone experiences depression differently, and understanding how depression affects you guides treatment interventions. Here are some typical symptoms:

•        Feelings of sadness, emptiness, or blue mood

•       Feelings of hopelessness, helplessness, worthlessness, or feeling excessive guilt

•       Low energy, fatigue, or difficulty motivating oneself

•       Irritability, restlessness

•        Difficulty enjoying previously pleasurable activities

•        Changes in appetite (i.e., overeating or undereating)

•        Difficulty concentrating, remembering details, or making decisions

•        Sleep is often affected, with early-morning wakefulness or excessive sleeping

•       Thoughts of suicide, or suicide attempts


Attention-Deficit Hyperactivity Disorder (ADHD)

For many people they know they are bright, capable, and creative, yet have difficulty with focus on certain tasks, or have difficulty following through and completing their goals despite best intentions. People with ADHD often struggle with feeling easily distracted, their mind feels “busy,” as if a hundred interesting post-it notes are floating through the air and each one begs to be read and understood. Maybe their loved ones get angry and feel they don’t listen, or are careless, or just plain forget things too often. Perhaps they feel they never fit into a “box,” were different from others, yet always found a means to the end – even if that meant not following the traditional path.

Having assessed and treated hundreds of people with ADHD, I employ a comprehensive strategy to assess, educate, coach, and help people develop skills to manage symptoms of ADHD. If you or your loved ones suspect you may have ADHD, an accurate diagnosis and subsequent treatment can be absolutely life-changing. Treatment does not have to include medication, but for many it does help.

For More Information

ADHD is a neurodevelopmental disorder of attention and executive functioning that begins in childhood and persists throughout the lifespan. I believe it is a misnomer to call it a disorder; however, because fundamentally ADHD is a difference in neurological wiring that affects specific brain functions. People have different “profiles” of ADHD and common patterns/symptoms may include the following:

•       Problems with focus/concentration

•       Difficulty organizing thoughts and behavior

•        Problems following through on tasks

•        Forgetfulness in daily activities

•       Poor listening skills

•       Extreme distractibility, bouncing between irrelevant sights or sounds

•        Chronic tardiness

•        Irritability or angry outbursts

•        Becomes bored quickly

•       Sense of underachievement

•        Sensitivity to criticism

•       low self-esteem or sense of insecurity


Obsessive-Compulsive Disorder (OCD)

OCD is a condition characterized by intrusive and distressing thoughts or images that create anxiety (obsessions), and compulsive behaviors or mental acts that are performed to reduce that anxiety (compulsions).

I have specialty training in the treatment of OCD as certified by the International OCD Foundation (IOCDF) and provided by the Behavior Therapy Training Institute (BTTI).

Outcome studies show the most effective treatment for OCD is Exposure with Response Prevention, or ERP, and this is the treatment I provide for OCD. Treatment for OCD is typically provided in my office; however, because many OCD symptoms only occur in specific situations, and the office environment is not always appropriate to elicit OCD triggers, I offer in-home or out-of-office visits on as as needed basis for an additional fee.

For More Information

OCD is defined by recurring and distressing thoughts or images that create anxiety, which lead to compulsive behaviors or mental acts (i.e., rituals or routines) to reduce the anxiety. Here are a few common forms of OCD (there are many more):

·         Checking behaviors occur in many forms; here are just a few: checking the door, locks, or gate to make sure no one will break in. While driving, may feel a bump and turn around multiple times to check that no one was injured. People may also review multiple times for mistakes in homework or on the job. Checking the body for signs of disease or illness.

·         Contamination fears, often with the compulsion being hand washing or excessive cleaning.

·         Ordering and Arranging (making sure things look or feel “just right”)

·         Morality or intrusive religious blasphemous thoughts (“scrupulosity”)

·         Compulsive counting, often having a significant number to avoid to reach. Often associated with some form of ritual (e.g., tapping or moving in a specific way).

·         Mental Rituals (say special words, images, or numbers to neutralize “bad” thoughts, or mental reviewing of conversations or actions and attempting to “fix” or “erase” them).

·         Sexual Orientation Obsessions include fear that one is of a particular sexual orientation despite not feeling an attraction that way.

People with OCD can often relate to the following:

Imagine that your mind got stuck on a certain thought or image. Then this thought or image got replayed in your mind over and over again. No matter what you did the thoughts kept coming. You don’t want these thoughts nor the anxiety that comes with them. Because the anxiety feels like you’re in danger it means you have to do something. It may be a ritual or routine. It may be a mental act. It may just be avoidance. But doing whatever you believe will help only helps for a little bit, before the thoughts and behavior returns. On one hand, you might recognize the fear doesn’t make sense, doesn’t seem reasonable, yet it still feels very real, very intense, and true.

Why would your brain lie? Why would these feelings exist if they weren’t true? Unfortunately, if you have OCD, your brain creates thoughts that are not an accurate representation of reality, and the anxiety that follows is a false alarm. People who have OCD have brain scans that are different than people who do not have OCD.