Our first contact will likely be by phone. During this initial phone contact, I will be most interested in what you are wanting some help with and why now. Of course, I’ll also be happy to answer any questions you may have about my practice, and I’ll give you my initial impression of whether what you are wanting to work on is within my area of practice. Then you can decide if you’d like to schedule an initial consultation with me. Our first meeting will last 60 to 70 minutes. My agenda for this meeting is to learn about your current life situation, especially the issues that brought you in to see me, and your goals for treatment. As time permits, I’ll ask for additional information about your life history, and we’ll discuss a plan for how to help you meet your treatment goals and/or discuss a referral if appropriate. You also have an important job during out first meeting; specifically, you’ll want to begin deciding whether or not I’m someone you will likely feel comfortable working with. Choosing the right therapist—one you feel at ease with and “click” with—is very important. This often is a gut feeling that may take more than one meeting for you to determine. It’s important to pay attention to this process. Research says that "goodness of fit" between a client and therapist predicts positive therapy outcomes.
After the initial evaluation, I usually meet with clients for a 55-minute session once a week or every other week and then progress to less frequent visits as appropriate. The length of therapy varies from person to person, depending on various factors including the type of problem being worked on, the amount of between-session effort a client puts into therapy, and the complexity and number of problems being tackled.
My Style and Approach
You should know that my style as a therapist is generally collaborative and direct rather than neutral. This doesn't mean I will push my views on you or try to make decisions for you. In fact, I'm a strong believer in the idea that what works for one person won't necessarily work for another person and that a person generally knows what is best for him- or herself, even if he or she isn't aware of it at the time. It's my job to help you explore and make decisions within this discovery and change process. I also want you to know that I view therapy as a partnership between us. Psychotherapy is not like visiting a medical doctor. It requires a very active effort on your part both during and between our sessions. This means that for therapy to be successful you have to be open to discussing important experiences, thoughts, behaviors, and feelings you have as well as practicing new skills and working towards goals between our sessions. Change will sometimes be easy and quick, but more often it will be slow and frustrating and you'll have to keep working on the things we talk about in session. The good news is that you can learn new, more effective, ways of looking at and responding to the problems you are dealing with.
My general approach to therapy involves helping a person identify the symptoms, patterns, problems, or areas in their life that are causing them distress or that they are dissatisfied with and working together to develop a plan of action for how to best address these issues, all the while keeping in mind the person’s unique life goals and approach to life. The most central ideas in my work are: (1) change is possible; (2) prior difficult experiences (memories) are often the source of current difficulties and thus may need to be revisited; (3) getting “unstuck” often involves examining and/or changing how we think and behave in response to past or current events in our lives; (4) feelings are a natural and normal part of the human experience that provide us with important information and require our undivided attention at times; and (5) people can learn skills that help them to be more effective in coping with stress, responding to life’s inevitable hurdles, and obtaining desired outcomes.
I use a variety of techniques to help my clients meet their goals, and I tailor my treatment approach to suit the needs of my clients. I also emphasize treatment methods that are supported by the latest research findings, as appropriate. While the specific techniques I use in therapy vary with the needs of my client, I primarily use a combination of cognitive-behavioral, EMDR, and interpersonal therapeutic interventions. I’ve summarized these below to give you a better sense of what this means in case you're interested. I might also at times suggest an equine-assisted psychotherapy session(s) with one of the other psychologists at the Ranch (more on this approach below too). Some people opt not to include this as a part of their therapy experience while others decide to take full advantage of what the horses have to offer them in reaching their treatment goals. As the client, it’s your choice.
Eye Movement Desensitization and Reprocessing (EMDR)
I am certified in EMDR Therapy by the EMDR International Association (basic EMDR trained in 2014; certified in 2017). Since my original training, I have discovered the power of this therapy and have actively pursued advanced trainings in this modality including:
Eye Movement Desensitization and Reprocessing (EMDR Therapy) is a comprehensive method of psychotherapy that enables people to recover from the emotional pain and symptoms that are caused by disturbing life experiences. It has been extensively researched and is recognized worldwide by such organizations as the American Psychiatric Association, the World Health Organization, Veterans Health Administration, and the Department of Defense as an effective form of treatment for trauma and other upsetting life events. Since its development in 1987, millions of people have been successfully treated with EMDR Therapy for many types of psychological stress. EMDR is considered one of the 'gold standard' treatments for PTSD.
EMDR Therapy combines dual attention to a disturbing memory with a bilateral stimulus (e.g., back and forth eye movements, alternating vibrations) in conjunction with a set of standardized protocols. This unique combination of methods in EMDR therapy appears to stimulate an intrinsic capacity of the human brain to heal itself (like the body heals physical wounds) by "reprocessing" disturbing memories, resolving emotional disturbance, and facilitating adaptive insights in a manner similar to what occurs spontaneously during rapid eye movement sleep (dreaming) .
In short, you identify the upsetting memory you want to focus on, including any negative thoughts, feelings and bodily sensations related to the memory. You hold the memory in your mind while also paying attention to a back-and-forth stimulus. This process is done in short sets (about 30 seconds each) until the memory is processed by the brain, the way you experience the memory shifts, and distress resolves. In most cases, you will not be asked to talk about your trauma in detail, although you will be asked to call your trauma to mind in session.
For more information on this wonderful and exciting therapy please visit the following websites:
Watch these short videos to learn about PTSD and effective treatments:
https://www.emdria.org/page/what_is_emdr_therapy (EMDRIA webpage explaining EMDR Therapy)
More EMDR specific:
https://www.youtube.com/watch?v=6niU2ldpJjU (Combat Vet, Dateline, 13 min video on EMDR)
https://www.youtube.com/watch?v=IigQZKLXIck (Dr. Shapiro discussing EMDR, 11 min, 20/20)
https://www.youtube.com/watch?v=zBtqWrs2-K0 (EMDR and PTSD, 6 min video, Ch 2 News)
https://www.youtube.com/watch?v=QWnj9QQbD8c (Vet and Workplace Shooting, 4 min video)
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (aka CBT) is action-oriented, practical, and helps a client gain independence and effectiveness in dealing with real-life issues. It is based on the idea that our thoughts are a primary cause of our feelings and behaviors. In other words, it is not so much the events or circumstances that occur in life that most strongly determines how we think, feel and behave, but the meaning or way we interpret what happens to us that determines how we feel about ourself, our future and the world around us. The truth is that ALL humans have biased, unhelpful, and inaccurate ways of looking at the world at times (myself included), and there’s no shame in this. It’s just part of how our brain processes information. The great thing about this is that it lends us a degree of control in how we live our life. We can learn to change ways of thinking that cause us problems and interfere in our life.
So in working together, one of our jobs is to determine how you are seeing things and what you are saying to yourself, examine the degree to which it is balanced and accurate, and then teach you some strategies for challenging problematic ways of interpreting things around you. To be clear, this technique is not simply “positive thinking,” and the goal is not to get you to see everything in a rosy, optimistic and hopeful manner. That would be an unrealistic view of how things work in this world of ours. Rather, the goal is to help you view your experience in a more balanced and accurate manner.
Of course there are other things we might include in our work as part of CBT. We will also look at behaviors that are interfering with your attainment of life goals and recovery. For example, we may identify things (emotions, activities, situations, objects, experiences) you have avoided as a means of self-protection and, as appropriate, begin to have you gradually and safely face these things. We may also have you try out new ways of behaving and reacting that are consistent with desired outcomes, or we may have you learn or expand life skills (e.g., problem-solving, relaxation, distress tolerance, etc.) that would contribute to your growth or recovery.
As mentioned above, Interpersonal Psychotherapy (IPT) also influences my therapeutic approach. IPT focuses on problems in a person’s relationships that are creating distress and negatively impacting quality of life and psychological well-being. So what this means is that problematic patterns in your current relationships may be explored. Interactional desired outcomes may be identified and planned for. Awareness of specific consequences of your interpersonal behavior may be enhanced, and new ways of dealing with people and situations may be identified and developed through skills training (e.g., communication skills, assertiveness, social skills).