Mental Health Therapy

From your first contact with my practice, you will experience a welcoming and accepting atmosphere. I have the deepest faith in the power of a trusting and collaborative therapeutic relationship, where your voice is heard and your experiences are validated. Together, we will develop strategies and pathways that bring you to the top of "wellness mountain" - (one of my many metaphors).

My core focus is on connecting the Mind and Body together for holistic healing. I recognize that chronic medical conditions and emotional distress are closely related. This approach is anchored in two complementary methodologies: Dialectical Behavior Therapy (DBT) and Compassionate Inquiry (CI). I view healing not just as symptom reduction, but as a deep connection that resolves emotional and physical pain to create a "life worth living."

• Importance of integrating the Mind and Body 

  • I often work with individuals who were referred to me by their medical provider. If a client is interested, I often collaborate with other providers who offer wellness practices like integrative medicine, yoga, acupuncture, physical activity, chiropractic medicine, massage therapy and other wellness options.

• Mind (Cognitive/Behavioral): I use the evidence-based structure of DBT to teach concrete skills—like Mindfulness, Emotion Regulation, Interpersonal Effectiveness and Distress Tolerance—to change the emotional and behavioral patterns that exacerbate suffering.

• Body (Somatic, Emotional & Physiological): I integrate the principles of Compassionate Inquiry to explore the profound link between unprocessed emotions, past trauma and present-day bodily sensations or chronic pain. This somatic approach uses curiosity and compassion to gently access the body's wisdom.

• Wisdom (Acceptance & Meaning): The foundation of this process is curiosity, compassion, validation and acceptance. Our inner wisdom guides us in ways to integrate experiences, find answers we've been seeking, and reconnect with our authentic self.

DBT Foundation: My core training is rooted in Dialectical Behavior Therapy (DBT), providing concrete, evidence-based skills in Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness. We focus on acceptance and change through proven behavioral strategies.

Integrating Compassionate Principles: My practice is adapted to integrate principles of Compassionate Inquiry (CI), developed by Gabor Mate and Sat Dharam Kaur. This approach emphasizes:

• Curiosity and Compassion: Nurturing a wholesome relationship with your emotional and physical symptoms with compassionate curiosity rather than self-criticism.

• Somatic Awareness: Guidance in gently exploring the link between past emotional history, repressed emotional pain and present bodily sensations or chronic pain.

At Create Meaning, I provide the Behavioral Tech Model that adheres to the original treatment protocols and methods developed by Dr. Marsha Linehan. This model emphasizes fidelity to the core principles and practices of DBT to ensure clients receive the most effective and evidence-based treatment. I have over 5 years experience providing this treatment. 

• Dialectical Behavior Therapy (DBT) is structured into four stages, each with specific goals to help individuals progress toward their life worth living. These stages are defined by the severity of a client's behaviors and emotional state. While they are often presented sequentially, clients may enter at different points or revisit stages as needed. 

• At my practice, I offer a unique approach of 4-Month commitments. 

  • What happens is we agree to an initial 4 month commitment to participate in therapy at any DBT Stage. After the initial 4 months, we evaluate whether to continue for another 4 months at the same or the next stage. This helps us choose which stage best meets your needs and measures your growth.

  • In addition, the DBT therapist participates in a weekly consultation meeting with other DBT therapists to provide high quality care. 

Stage 1: Achieving Behavioral Control (Moving from Out of Control to In Control)

• • Services Provided: 

    1. Weekly Individual Therapy (including an individualized diary card)

    2. Weekly Telehealth Skills Group (Tuesdays 5:00-6:30pm). This is a skills focused, educational group.

    3. 24/7 Phone coaching access to the therapist.

  • Focus: This initial stage addresses behavior stabilization where there is consistent emotional suffering, problematic behaviors and important areas of life are impacted. This can include life-threatening behaviors and behaviors that reduce or destroy quality of life 

  • Goal: To help gain behavioral control, stabilize situations, and move forward effectively. Emphasis is placed on breaking old chains of behavior and immediately improving quality of life.

  • Behavior Patterns and Skills: Clients understand patterns of behavior and foundational DBT skills: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.

Stage 2: Addressing Quiet Desperation (Moving from Quiet Desperation to Full Emotional Experiencing)

• • Focus: Once behavioral control is established, clients may still suffer in silence, often due to past trauma or chronic emotional suffering. Their outward behavior might be improving, but their internal emotional world remains difficult.

  • Services Provided: 

    1. Weekly Individual Therapy (including individualized diary card) targeting emotions and full experiencing of them.

    2. (Optional) The DBT Skills Group is up to you and your preferences. 

    3. Trauma specific treatment as needed, specifically DBT-Prolonged Exposure.

  • Goal: To help clients move from a state of "quiet desperation" to experiencing the full range of emotions without becoming overwhelmed or losing control. This stage often involves addressing emotions relating to trauma, post-traumatic stress and other underlying patterns.

Stage 3: Learning to Live (Moving from Ordinary Problems in Living to a Life of Ordinary Happiness and Unhappiness)

• • Focus: With behavioral control and emotional experiencing in place, this stage focuses on building a meaningful life. Clients learn to cope with the everyday ups and downs that life presents.

  • Goal: To help clients define life goals, build self-respect, develop a stronger sense of self-identity, and find peace and happiness in their daily lives. The aim is to achieve a life of "ordinary happiness and unhappiness," where clients can manage life's challenges effectively.

  • Structure: Discussing self-identity, developing healthy relationships, and pursuing personal aspirations. It's about maintaining gains and proactively building a meaningful existence.

Stage 4: Finding Deeper Meaning (Moving from a Sense of Incompleteness to a Connection with a Greater Whole)

• • Focus: This final stage is for clients who, even after achieving a life of ordinary happiness, seek a deeper sense of meaning, purpose, or spiritual fulfillment.

  • Goal: To help clients achieve a sense of connectedness, joy, and freedom, moving beyond merely coping to truly experiencing a life of fulfillment and purpose. This stage addresses a sense of incompleteness and helps individuals find a greater connection to themselves and the world around them.

  • Structure: This stage is highly individualized and might involve further exploration of values, spirituality, or community engagement, often in a less intensive therapeutic format or as a maintenance phase.

At Create Meaning, I provide the above DBT program and can also include a specific focus on reducing or quitting substance use. This treatment is ideal for individuals who find themselves using alcohol or drugs to cope with difficult situations, emotional pain, and intense physical sensations. This focus of treatment is typically a 4 to 12 month commitment.

DBT Prolonged Exposure (DBT PE) developed by Dr. Melanie Harned as a specialized therapy that combines the core principles of Dialectical Behavior Therapy with a trauma-focused approach called Prolonged Exposure (PE). It's designed to help people who have experienced trauma and are also struggling with intense emotions, self-harm or suicidal thoughts. In addition, this treatment can be beneficial for those who have experienced Traumatic Invalidation or who have compulsive behaviors.

Key features:

• Targets PTSD: DBT PE specifically addresses emotions related to past traumatic events and post-traumatic stress disorder (PTSD) symptoms.

• Two-pronged approach:

  • DBT skills: Provides a foundation of skills for managing emotions, tolerating distress, and improving relationships.

  • Prolonged Exposure: Gradually confronts trauma-related memories and situations to reduce their power over time.

• Safety first: DBT PE prioritizes creating a safe environment and equipping individuals with coping skills before directly addressing trauma.

• Effective for complex cases: It's particularly helpful for people who haven't responded well to other treatments or who have multiple mental health conditions.

If you are interested in participating in the DBT skills group only, this is an option at my practice. 

• Targeted Audience: Ideal for individuals seeking effective coping skills for managing chronic medical conditions, chronic pain, health anxiety, or general emotion dysregulation.

• Commitment: 4-Month Cycle (Condensed Curriculum). Clients commit to a single cycle focused on acquiring core skills without the requirement for concurrent individual therapy.

• Skills Acquired: Clients are taught core skills from the four DBT modules: Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness.

• Tools for Self-Management: Includes the use of the Individualized Diary Card for daily self-monitoring, tracking the correlation between skill use, emotional states, and physical symptoms (e.g., pain, fatigue).

• Goal: To enhance self-efficacy, reduce psychological suffering associated with illness, and improve overall quality of life by providing a powerful, actionable set of coping skills.

• Note on Scope: This service is DBT-Informed Skills Training Only and is not the comprehensive, four-mode DBT treatment required for high-risk behaviors.