What theories or techniques do you use in counseling?

My practice centers around several theories: Cognitive Behavioral Therapy, Dialectical Behavior Therapy, and Polyvagal Theory. I am a person-centered therapist, meaning that I view our therapeutic relationship as a collaborative journey, and that I will adjust my approach based on what works best for you. Therapy will not be a passive process. You will define your goals, as you are the expert on you. I will help you to break down your goals into smaller steps and I will suggest clinical interventions that may help you reach those goals.

Keep in mind that therapy typically happens 1 time per week, so I may recommend work to be completed in between sessions. While “homework” is not required, it can greatly enhance your progress and improve your results.

What is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy (CBT) is based on the premise that a person’s cognitions, emotions and behaviors all interact. Our thoughts influence how we feel and what we do.

Imagine you are born with a pair of glasses or lenses over your eyes, and that everything you experience throughout your life shapes those lenses. After a while, your lenses will be shaped differently than another person’s lenses based on what you both experience during your lifetimes. This means you will see the world differently than others because you’ve had a unique set of experiences. CBT views human behavior this way. Your actions, your emotions, your thoughts—they are a product of what you have seen, heard and experienced in the past. The good news is this: We can change how we think, how we feel and how we behave because we can learn. In counseling sessions, CBT therapists teach clients how the brain works and how to re-shape their patterns through cognitive behavioral interventions.

What is Dialectical Behavior Therapy?

Dialectical Behavior Therapy (DBT) is a type of cognitive behavioral therapy developed by Marsha Linehan at the University of Washington. Initially developed for the treatment of Borderline Personality Disorder, DBT has since been studied and adapted for use with a multitude of disorders including anxiety, depression, eating disorders, bipolar disorder, PTSD, and substance use disorders.

DBT is about learning and practicing 4 types of skills: Mindfulness, Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness. After learning the skills during counseling sessions, you will attempt to practice the skills between sessions and report back about how it went. DBT skills help clients manage painful emotions and decrease conflict in relationships with others.

In DBT, we assume that sometimes our circumstances are changeable and sometimes they are not. When you cannot change the situation you’re in, you can learn how to cope with your specific set of circumstances.

The cornerstone of DBT is practicing mindfulness, which focuses on your ability to accept and be fully present in the current moment. While DBT is most often practiced in a group counseling format, many clients have found success in learning DBT through individual counseling sessions.

What is Polyvagal Theory?

Polyvagal Theory, developed by Dr. Stephen Porges, provides a map of the human nervous system and a new understanding of the way our nervous system shapes our experience. The function of the vagus nerve is a cornerstone of the theory. Beginning in the brainstem and wandering through the body, the vagus nerve is responsible for the regulation of internal processes including digestion, heart rate and respiratory rate.

A person’s ability to respond to and recover from the challenges of life depends on the actions of their autonomic nervous system (ANS). The ANS is heavily shaped by a person’s early experiences in life, and it continues to be re-shaped over time by ongoing experiences. It is possible to interrupt the habitual responses of the autonomic nervous system, learn new responses, and change the way we cope as a result.

Trauma/PTSD

Many patients come to me because they are suffering from a compromised ability to regulate autonomic responses. They may have suffered trauma early in life, and/or are suffering from ongoing symptoms of Posttraumatic Stress Disorder (PTSD). PTSD can happen as the result of a traumatic experience of any kind, and what is traumatic to one person may not be traumatic to another. PTSD is often associated with military personnel returning from war. The reality is that many people are suffering from PTSD (1 in 11 people) as a result of witnessing or experiencing a traumatic event such as physical abuse, emotional abuse, sexual abuse, a natural disaster, a car accident, a serious medical issue, crime, terrorism and a variety of other events. Many counselors, social workers, physicians, nurses, environmental workers, veterinarians, and other helping professionals suffer from symptoms of PTSD due to their exposure to the trauma of those they are helping.

If you believe you may be suffering from PTSD, one of the best things you can do for yourself is to find a therapist you trust and begin the work of healing. Some symptoms of PTSD include:

• Involuntary memories or “flashbacks” of the trauma—feeling like you are re-living the traumatic experience

• Nightmares

• Avoiding people, places and things that trigger memories of the trauma

• Resisting talking about or thinking about the traumatic event

• Inability to remember important aspects of the event

• Distorted beliefs about oneself, others, or the world (“I’m a bad person,” “I can’t trust anyone,” “The world is a terrible place,” “All men/women are bad”)

• Ongoing fear, horror, anger, guilt or shame related to the trauma

• Not feeling interested in doing the things you once enjoyed

• Feeling detached from others

• Inability to experience positive emotions or feeling “empty/flat”

• Irritability and/or angry outbursts

• Doing things that are reckless or self-destructive

• Difficulty concentrating

• Difficulty sleeping

• Being easily startled or feeling constantly watchful of your surroundings, like you can never put your guard down

What is Telehealth or Teletherapy?

Telehealth or Teletherapy is the provision of medical or counseling services via video conferencing software. Should you prefer this mode of therapy, you will be provided with a link via email that you can click on to join your counseling sessions. I use a video conferencing software through Simple Practice. If there are connection problems during your session, you may be asked to try logging in again or we may try a different video conferencing software.

Will my counseling sessions be kept confidential?

Pacific Coast Mental Health follows the professional and ethical guidelines of the American Counseling Association and NAADAC. Information about your counseling sessions or information disclosed during your counseling sessions will not be shared with anyone without written permission from you. There are some exceptions to confidentiality. Counselors in Washington State must report to proper authorities when a client poses a danger to themselves or others as well as suspected abuse or neglect of a child or vulnerable adult.

How long will I be in counseling?

Since your counseling experience is driven by your personal goals, the time in counseling varies. As we discuss your goals, we will get a better idea of the number of counseling sessions you’ll need. Some clients will come to counseling with a very specific problem and goal in mind, and they will find that a few sessions is sufficient. Others may benefit from the ongoing support of weekly counseling for a number of months, or even a year or more. Ultimately the decision is yours and depends on what you want to accomplish. The idea, however, is not to remain in counseling forever. As problems resolve and you find new ways of engaging and coping, you will find that you no longer need ongoing support in the form of counseling.

Can you treat my addiction?

I am a Substance Use Disorder Professional (SUDP), and I can talk with you about addiction, your concerns about a potential addiction, or the addictions of loved ones and how to cope. I can also provide ongoing support for those in recovery. I cannot provide Drug and Alcohol Assessments for entrance to treatment or for court/DUI cases. I also cannot replace good inpatient services, detox services, or intensive outpatient treatment for addiction. If we are working together and it becomes clear that you need a higher level of care, I can help you find the appropriate level of care and refer you to an addiction treatment agency. I have extensive experience treating addictions both mild and severe, and I understand the need for a non-confrontational, non-judgmental approach. Your care will always be in your hands when you work with me.