TREATMENT APPROACH

Obsessive Compulsive Disorder

Over the years, my primary approach for treating OCD has been integrating exposure with response prevention (ERP) with mindfulness and motivational strategies.  In ERP, clients are guided in systematically facing avoided triggering situations while resisting counterproductive safety-seeking behaviors.   I use a 12-session protocol that is extremely effective for clients who are able to participate.  However, ERP is not appropriate for all clients.  For example, if people are in a fragile state due to having multiple co-occurring diagnoses and life stressors, ERP could be overwhelming and counterproductive.  For these clients, it can be more effective to implement new research-based innovations in the field  or to creatively tailor treatment to their unique psychological constitution and needs.

One research-proven, effective treatment for OCD and related conditions is Inference-Based CBT (ICBT).  ICBT focuses on why people with OCD experience the specific obsessional doubts they do (vs. the world of other things they could worry about) and how these obsessions form.  By identifying and slowing down the process that forms obsessional doubts, people with OCD can then resolve them.  This then leads to reduction in anxiety, renders compulsions unnecessary and increases quality of life.  There have been several well-constructed research studies that found ICBT to be highly effective.

Clients with Post-Traumatic Stress Disorder (PTSD) or Co-Occurring PTSD and OCD

Another approach I've been using is a break-through treatment is called the  Reconsolidating of Traumatic Memories (RTM) protocol (see https://thertmprotocol.com). 

It was designed to treat PTSD and is highly effective and extremely rapid in doing so. In several research studies with combat veterans, 6 sessions resulted in loss of PTSD diagnosis for approximately 90% of clients.  In RTM, the therapist guides clients in visualization procedures that change the traumatic memory format so that the memory no longer feels real or like a current danger.   RTM can be effective for clients having co-occurring PTSD and OCD.  Moreover, for OCD clients who do not have a trauma history, I have made modifications to the RTM protocol.  Although there have been no research studies on RTM for OCD thus far, I've seen remarkable effects for clients who seem to be a good fit for it.

Other Anxiety Disorders

Although my primary focus in recent years has been OCD and PTSD, I have extensive experience using Cognitive-Behavioral Therapy to treat various other anxiety disorders, including Panic–for which I use an ultra-brief treatment that I developed, Agoraphobia, Health Anxiety, Social Anxiety Disorder and Generalized Anxiety Disorder.

Short-Term Focus

Although long-term therapy can be helpful and may actually be necessary for some clients (and there are many therapists who offer this), I am committed to time-limited, brief, research-informed and highly effective treatments. I want my clients to be able to have full lives as quickly as possible and to learn skills, change perspectives, and/or change their reactions to situations so that they don't need ongoing therapy. That being said, after the completion of active treatment, it is often useful to have some follow up visits over time.  Specially, it is typically beneficial to increase time between sessions as opposed to abruptly stopping; for example, weekly  to monthly to quarterly sessions. This approach allows people to experience more of life while applying therapy skills and approaches and perspectives, encourages accountability and keeps the door open for contact to address issues when they arise.

Thank you for reading this long description of my approaches and perspectives. I am excited to work with new clients who are want brief, research-supported, effective treatments!