I-CBT

stands for Inference-based Cognitive-Behavioral Therapy, and it helps people understand the inferential confusion that makes them doubt so much in the first place, and re-learn how to use their senses (including common sense and sense of self). It has a lot of metaphors and visuals to help you become better able to recognize when your OCD is showing up, but also help you see why your rituals are unnecessary. <—this is for OCD

ACT / ERP

stands for Acceptance and Commitment Therapy / Exposure and Response Prevention. ACT also has a bunch of visuals and metaphors, but it emphasizes accepting thoughts and feelings, even if they’re uncomfortable, and not trying to ‘solve’ them. In ERP, we’re similarly focused on exposing ourselves to uncomfortable experiences, and reducing rituals. But by integrating ACT concepts, the experiences that we are exposing ourselves to are always values-congruent - meaning they are things we want to do that are in line with our values. For example, if you have harm OCD, we might work on ‘exposing’ you to an experience that you think might cause harm (like going to a farmer’s market, because you are currently convinced that you might snap and throw a watermelon at someone and they could get hurt), but I wouldn’t actually ask you to go out and throw (whole) watermelons at people. The exposure is to a wanted activity (procuring vegetables and whatnot), not to an unwanted activity (hurting people). <—this can be for OCD and BDD (body dysmorphic disorder), but also anxiety, panic, and phobias

OLD (which is really the “RP” part of ERP, and is probably more important than the “E” part)

is a mnemonic for Obstruct, Limit, and Delay. It comes in handy when we’re figuring out ways to reduce checking behaviors and other compulsions related to BDD (body dsymorphic disorder), OCD, and BFRBs like skin-picking, hair-pulling, etc.

DBT

stands for Dialectical Behavior Therapy, and it makes up for its lack of visuals with a treasure trove of acronyms. Jargon aside, it is super helpful at teaching mindfulness, emotion regulation, and interpersonal communication skills. If you get overwhelmed easily, this is likely what we’ll look to - it will help you learn ways to ground and tolerate distress short-term so that you can work long-term towards a life worth living. <—this is mostly for anxiety and eating disorders, but sometimes we use it for other things adjunctively

HRT/ComB

stands for Habit Reversal Training/Combined Behavioral treatment, and it’s the go-to therapy for skin-picking, hair-pulling, nail-biting, and other body-focused repetitive behaviors (BFRBs). In it, you’ll develop more compassionate self-talk, explore some environmental changes to reduce the frequency & impact of cues to pick/pull, and find strategies to prevent, reduce, and pause unwanted behaviors. <—this is for BFRBs

SPACE

stands for Supportive Parenting of Anxious Childhood Emotions, and it was created by a team of researchers at Yale (fancy). It targets family accommodation, aka, all the ways that family members who are trying to be helpful end up reinforcing their kids’ anxieties. If you have a family member who won’t go to therapy themselves, but asks you to alleviate their anxiety (like always being home when they are home, cleaning/showering much more than is necessary or helpful, providing reassurance repeatedly), we might look at how you could

1. use language that acknowledges your loved one’s challenges, but does not contribute to a story that they need you to do rituals for or with them;

2. evaluate your participation in rituals that maintain your loved one’s distress;

3. slowly reduce the amount of time you spend managing your loved one’s feelings, and communicate these changes to your loved one.

<— this is for OCD, anxiety, and panic

OHIO

stands for Only Handle It Once, and it comes in handy when we’re working on improving Executive Function and attention skills. We might figure out how can you automate more tasks so that you only have to handle them once, rather than forgetting and trying to remember to do them x1000. <— this is for ADHD

CBT-I

is a special Cognitive-behavioral protocol for insomnia. When people typically (more than 3x/wk, for more than 1 month) have trouble falling asleep, sleeping through the night, and/or getting up in the morning, and don’t feel rested, they tend to struggle with focus, irritability, and/or anxiety.

I am trained in helping people change their behaviors to help improve sleep efficiency (aka how much of your Time In Bed is spent sleeping). Learning the tools of CBT-I can take 6-8 weekly sessions, and improving sleep consolidation (how much REM sleep you get because you can sleep better for more hours in a row) can have a markedly positive effect on improving other conditions.