Our Clinical Approaches

We are here to provide collaborative care throughout the counseling relationship in a way that cultivates insight, change, and growth in your life. This can range from building skills to help manage emotions in daily life while processing the impact of events, relationships, and/or traumas in your life that have impacted daily living. Working and processing through these life challenges builds resiliency and can lead to a newfound sense of freedom.

As you work with your therapist, they will collaborate with you around techniques and modalities that are tailored to meet your unique needs and goals.

We are here to provide you with personalized care and support, and the use of various counseling techniques can help you move towards the healing and freedom that is needed to shift from surviving to living.

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Acceptance and Commitment Therapy (ACT)

Acceptance and Commitment Therapy is a mindfulness-based-cognitive behavioral therapy, intended to alleviate suffering by optimizing cognitive flexibility and reducing avoidant behaviors. ACT is beneficial for chronic pain, addiction, anxiety, obsessive-compulsive disorder, depression, and psychosis. 

*ACT identifies six core processes:

1. Acceptance – allowing space for your emotions, impulses, and feelings creates the freedom to accept your thoughts without distraction or rumination. Strategies include identifying emotional avoidance, conscious suppression, and self-reflection.    

2. Cognitive Defusion – mindfulness skills help distance yourself from painful thoughts, such as harsh self-criticism or catastrophizing. Guided meditations and scripts provide opportunities to recognize your experiences objectively, rather than as perceived threats or realities.

3. Self as Context – observing your emotions, sensations, and thoughts as transient, helps to transcend memories, emotions, or personal experiences you feel preoccupied with. As you watch, listen, and simply notice experiences, you’ll see observer Self is not defined by the roles you play daily.

4. Values Clarification – exploring what is personally meaningful helps prioritize the most important areas of life so that you find direction and motivation. Ranking values and finding your deviation score are examples of how to clarify values and create a rich life.

5. Committed Action – goal setting removes obstacles to attaining goals and helps you commit to strategic plans for overcoming them. Identifying possible roadblocks and coming up with alternative pathways you are willing to commit to, takes you closer to achieving goals and maintaining motivation over time. 

6.Contact with the Present Moment – appreciating what’s right here, right now strengthens your ability to accept and overcome struggles. Mindfulness exercises such as anchored breathing, grounding, and experiencing the five senses, bring awareness to the present moment.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy helps to identify connections between how you feel, think, and act. The key principle behind CBT is that your though patterns affect your emotions, which can affect your behaviors. CBT is utilized to treat depression, bipolar disorders, eating disorders, anxiety, panic, personality disorders, OCD and PTSD. CBT can help with chronic stress, fear, low self-esteem, and other emotional struggles.

*CBT utilizes two separate techniques:

1. Cognitive Therapy – identifying irrational thoughts that reinforce negative thinking patterns (cognitive distortions), learning how to problem-solve and develop more positive thought patterns. Some techniques include: Cognitive Restructuring, Exposure therapy, Problem-Solving, Guided Discovery, Journaling and thought records, Self-Management and Recovery Training.

2. Behavioral Therapy – identifying patterns in behavior that may be worsening your problem’s, then changing these behaviors and replacing them with healthier habits. Some techniques include: Behavioral Assignments, Activity Scheduling, Behavior activation, Meditation, Mindfulness, Relaxation and Stress Reduction. 

Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy, a type of CBT, focuses on teaching skills used to cope with stressful situations, to “create a life worth living.” Aimed to treat overwhelming emotions and self-harm, suicidal ideation, eating disorders, and substance abuse, as well as Borderline Personality Disorder. DBT helps decrease conflict in relationship, improving one’s ability to stay in the present, and handle distress without losing control or acting destructively. Core beliefs in DBT are, “I am doing the best that I can,” and “I need to learn new ways to do better and try harder.” Primary DBT thoughts include, everything in life is connected, and change is unavoidable.

*DBT identifies four modules

1. Mindfulness – “What” skills teach what you’re focusing on, for example: a) awareness in the present, b) emotions, thoughts, and sensations, c) separating emotions and sensations from thoughts. “How” skills teach how to be more mindful by: a) balancing rational thoughts with emotions, b) radical acceptance, c) mindfulness.

2. Distress Tolerance – distraction techniques are useful until you’re calm enough to deal with the situation or emotion at hand; these may include: self-soothe by relaxing, and find ways to improve the moment despite difficulty.

3. Interpersonal Effectiveness – listening skills, social skills, and assertiveness training helps you learn how to change situations while remaining true to values. Examples include, learning how to ask for what you want and taking steps to get it, and learning how to work through conflict and challenges in relationships.

4. Emotion Regulation – help to cope with primary emotional reactions before they lead to a chain of distressing secondary reactions. This includes learning how to handle negative and overwhelming emotions, overcoming barriers to emotions that have positive effects, and reducing vulnerability. Goals are: Understanding Emotions, Reducing Emotional Vulnerability (i.e. PLEASE MASTER), and Decreasing Emotional Suffering (i.e. Letting Go, Taking Opposite Action). 

Eye Movement Desensitization and Reprocessing (EMDR)

Eye Movement Desensitization and Reprocessing therapy considers symptoms of PTSD and other disorders to result from past disturbing experiences that continue to cause distress because the memory was not adequately processed. EMDR focuses directly on the memory and is intended to change the way that memory is stored in the brain via bilateral stimulation (ie. moving the eyes rhythmically from left to right). Sessions are typically delivered 1-2x/wk for a total of 6-12 sessions.

*EMDR uses a structured eight-phase approach:

• Phase 1: History-taking. Client and therapist work together to develop a treatment plan that targets specific memories or incidents.

• Phase 2: Preparation. Safe/calm place exercises (deep breathing, guided imagery, progressive muscle relaxation) are resourced for grounding and affect management, to improve your ability to cope with emotional distress.

• Phase 3: Assessing the target memory, a) activation of memory with a vivid mental image, b) a negative belief, and c) related emotions/body sensations. 

• Phases 4-7: Processing the memory to adaptive resolution. 4). Desensitization. Bilateral stimulation (e.g., eye movements, tactile taps, or auditory tones. 5). Installation. 6). Body scan, 7). Closure.

• Phase 8: Evaluating treatment results. 

Internal Family Systems (IFS)

Internal Family Systems is used to treat a wide variety of mental health conditions and psychological wounds: trauma, physical, emotional, sexual abuse, compulsive behaviors, depression, bipolar, body image issues, anxiety, phobias, substance dependency. The theory is that individuals cannot be fully understood in isolation from the family unit. By learning how all aspects of the Self function as a system, and how the overall system reacts to other systems, healing can be achieved by identifying the roots of conflict through reintegration.  

*Common techniques and exercises include:

1. Keeping a journal

2. Using diagrams to illustrate relationships

3. The room technique

4. Mountain or path exercise

5. Getting to know who’s there

6. Feeling one’s heart

Angela counseling

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