Prior to beginning treatment, we conduct initial consultation sessions, the aim of which is to assess the difficulties leading clients to seek treatment, as well as goals they would like to reach in therapy. During this session, we ask specific questions about the nature and history of clients' difficulties, and about personal background information relevant to these difficulties. The aim of this type of session is to specify and define what would be addressed in therapy and to formulate initial treatment recommendations. This session also allows for clients to ask questions about our approach and practice. This session is typically 90 minutes.
Cognitive Behavioral Therapy:
Cognitive Behavior Therapy (CBT) is an evidenced-based treatment that is based upon the assumption that there are reciprocal links between our emotions, thoughts, physiological sensations and behaviors. Using CBT, emotions and situations that have become difficult or painful are evaluated with respect any unhelpful thinking and/or behavioral responses that undermine effective coping and exaggerate distress. CBT is a goal-oriented, solution-focused, and collaborative process whereby clients are taught a range of coping skills to develop new patterns of thinking, behaving and responding to emotions. Sessions also focus upon how clients can generalize these skills to other and/or new distressful emotions and situations, with the aim of enhancing general life satisfaction. CBT has been shown in research to be effective for a range of problems and diagnoses in children, adolescents, and adults. Treatment is time-limited, varies in length depending on the presenting problem, and can involve one or more of the following modalities: individual therapy, family therapy, group therapy, and/or parent training. Sessions are typically 45-minutes per week, 1-2 times per week. We provide individual CBT to adolescents and adults for the treatment of trauma, anxiety, depression and instability of mood, anger, stress management, and difficulties adjusting to major life stressors and changes. We also use CBT for the treatment of couples, parents and families having relationship and communication problems.
We incorporate the teaching and practice of mindfulness in both CBT and DBT. Mindfulness is an evidence-based treatment component for many emotional difficulties, including anxiety, depression, anger, relationship difficulties, difficulties with stress management, self-destructive and impulsive behaviors and general difficulties regulating intense emotions. Mindfulness aims to help clients increase their focus and attention to the present moment, by way of developing awareness and understanding of their own thoughts and feelings.
Dialectical Behavioral Therapy:
Dialectical Behavior Therapy (DBT) is an evidenced-based and specific type of cognitive behavioral treatment that was initially developed by Marsha Linehan, Ph.D., for the treatment of suicidal and self-injurious individuals diagnosed with Borderline Personality Disorder (BPD). It has since been modified and widely adopted for adolescents and individuals with other psychological problems, such as eating disorders, substance use, and anger management, and there is a large body of evidence supporting its use for both adolescents and adults. Most broadly, DBT is designed to help people who have difficulty managing particularly intense emotions. Difficulties managing intense emotions are often related to difficulties understanding oneself and meeting personal life goals, impulsive and/or self-destructive behaviors, and conflict in interpersonal relationships. DBT is a comprehensive treatment that includes both individual therapy, skills training and between-session phone coaching to address all of these difficulties. It is both compassionate and change-focused, with an overall goal of helping clients who are experiencing significant pain, to create a life worth living.
In DBT, each client participates in three modalities of treatment: 1) individual therapy (typically 45-minute sessions, 1 or 2 times per week), 2) skills training groups (once weekly), and 3) telephone coaching, as needed. When DBT is provided to adolescents, the skill groups include both the adolescent and his/her caregivers. Many times, DBT with adolescents also includes parenting sessions. Colleen provides individual therapy and skills coaching with adults and adolescents, and provides referral(s) for skills groups run by clinicians with whom she can closely collaborate. We also all see parents whose young adult and adolescent children are being seen by other clinicians for individual DBT and themselves want added support around use of parenting skills.
Parents of children who are having emotional and behavioral difficulties, often experience significant distress themselves and have difficulty figuring out the most effective ways to communicate, set limits and support their child. Parenting work can be an important adjunct or component to children’s treatment, in both CBT and DBT. In our work with parents, the goals are to increase parent’s satisfaction and comfort in their relationship with their child(ren) and to teach them skills that help increase or support their child(ren)’s best behavior. These skills may include behavior modification, contingency management problem-solving, and communication strategies as well as strategies that help parents increase mindfulness and regulate their own emotions in the context of parenting. Parenting sessions are typically 45 minutes, once weekly or twice monthly.
Professional Consultation And Trainings:
Many times, other professionals practicing therapy seek support and feedback in implementing CBT, DBT and mindfulness in their own practice. Colleen provides individual professional consultation, as well as trainings on a variety of topics related to CBT and DBT to schools and other agencies. If you are a professional seeking consultation or to coordinate a training for your school or agency, Colleen would be very happy to discuss your interests and needs.