Are there specific requirements for us to work together? Yes! You must meet all of the following criteria in order for us to work together: 1. You are located Arizona, New York, or a Foreign Country If not, you are not eligible for remote treatment. Due to the way that the process of psychology is regulated, I can only offer remote treatment in states where I am licensed to practice (i.e., Arizona and New York). This is true even for video-conference-based services, such as online OCD therapy. If you are located in Arizona, New York, or a foreign country, you may be eligible for online OCD therapy or another other type of remote treatment. Keep reading to see if you meet the remaining criteria… 2. Your symptoms be addressed appropriately via remote treatment Not all symptoms can be addressed appropriately via online therapy. For example, if you are in a crisis, if you are abusing drugs or alcohol, if you are thinking of harming yourself or others, online therapy is not the best fit for you. Online therapy allows me to easily do some types of treatment but not others, which may limit my ability to help you. Thus, if your treatment is likely to require a significant portion in-person, face-to-face interaction that cannot be replicated via online/telephone-based options, you are not eligible for remote treatment. If your symptoms would be expected to respond to remote treatment, you may be eligible for online OCD therapy or another other type of remote treatment. Keep reading to see if you meet the final criterion… 3. You are not involved in any legal, custody, or court-ordered proceedings I do not provide treatment to anyone actively involved in divorce or custody proceedings. I do not provide court-ordered treatment or evaluation. 4. I feel that I can provide you with the best treatment possible for your concerns and that it is in your best interest to receive services remotely Every situation is different, and sometimes I feel that it is in a patient’s best interest to work with a local provider (even if that provider is not a specialist). As such, eligibility for for online OCD therapy or another other type of remote service is ultimately at my discretion. 5. You have access to a computer with a webcam, ipad or tablet, or a smartphone and you have internet access fast enough to stream Netflix or Hulu. One of the wonderful things about online therapy is that you are able to participate in your therapy session wherever you feel comfortable and free of distractions or interruptions. As long as you have an internet connection, and a computer, smartphone, or tablet, you're all set! I always encourage people to think about their own privacy and confidentiality when choosing when and where to hold sessions, so keep that in mind when you're making that decision.
What is Cognitive-Behavioral Therapy? Cognitive-behavior therapy (CBT) is based upon the idea that OCD and anxiety symptoms represent unhealthy and unworkable beliefs about possible dangers that result in habitual responses that can, with proper effort, be unlearned. Exposure and response prevention (ERP) is the specific method of helping patients confront obsessively feared situations, and at the same learn new, more appropriate responses in those situations. ERP conducted by a skilled and experienced therapist is a powerful tool for helping sufferers overcome their fears and live normal, productive lives. CBT is an active, symptom-focused treatment often brings about more rapid results in much shorter time than more traditional “talk” therapy, which could drag on for years with little improvement.
As almost any person who has recovered from the grips of OCD and anxiety disorders will attest, the choice of doctor/therapist is a crucial, often making the difference between recovery and disability. Seeing a specialist in OCD and anxiety treatment is crucial. Considered the “gold standard” of treatment for OCD, exposure and response prevention (ERP), is not widely available as it requires specialized training and experience to implement effectively. It is said that most persons with OCD and anxiety disorders typically will see between 5-10 practitioners before finding the right help. I am a nationally recognized expert in the use of ERP and exposure-based therapies for the variety of OCD and anxiety disorders. As such, I am committed to the highest quality of compassionate care.
Who can benefit from Cognitive-Behavioral Therapy? Patients with a wide range of mental disorders, including OCD, OCD spectrum disorders (such as Trichotillomania and body-dysmorphic disorder, as well as anxiety disorders such as panic disorder, agoraphobia, social anxiety disorder, phobias and PTSD (post-traumatic stress disorder), both in adults and children, can benefit from cognitive-behavior therapy. Research studies consistently confirm that cognitive-behavior therapy is, for many patients, an essential component for recovery from OCD and anxiety disorders. While not a cure all, CBT offers the patient tools necessary to successfully manage the disorder and live a fuller, more productive life. To be effective, the patient benefits most when they choose to be an active participant in treatment, during which time they will be actively mastering previously feared situations, and learning more appropriate ways of handling them rather than using repetitive, compulsive behaviors.
What is Involved in CBT Treatment for OCD and Anxiety? After the initial evaluation, the patient, with the guidance of the therapist, becomes engaged in a process of gaining awareness of how his/her automatic, beliefs and habitual actions perpetuate the situation he/she so desperately wishes to gain relief from. An individually tailored cognitive-behavioral treatment regimen geared to helping control his/her obsessions by gradual exposure and habituation to feared situations. During this time, the patient is helped to resist engaging in compulsive rituals. Considerable home practice is often needed. Not infrequently, a home visit may be required to assist the client to carry out the cognitive-behavioral procedures at home. Gradually, the patient learns to master formerly feared situations without the need to ritualize, avoid, or escape.
How successful is Cognitive-Behavior Therapy (CBT)? Does it Really Work? Studies conducted with thousands of OCD patients at leading research centers nationwide indicate that patients who undergo exposure and response prevention treatment have demonstrated success rates as high as 90%. It is widely considered the most effective treatment method for OCD available. However, many factors may affect ones individual progress, including motivation, compliance to treatment procedures, general health, the presence of other psychological conditions (such as substance abuse), and the social/familial environment in which the patient lives. All can have an impact upon the rate and degree of any individual’s progress with CBT for OCD or anxiety disorder.
What if I am unsure about starting treatment? The decision to enter into therapy may be somewhat anxiety provoking. I understand your concerns and seek to create as comfortable and safe of an environment as is possible. Many people have had negative or unhelpful experiences in the past due to poor fit, unreadiness, a therapist's lack of expertise, etc. I will work with you collaboratively to determine your treatment goals, questions and concerns. Most people likely know after the initial evaluation whether or not they feel that treatment with me is a good fit.
How long does treatment last?How long are sessions? How many times per week? I feel that the effective management of OCD and anxiety disorders requires that each patient is to be viewed as unique in terms of their level of impairment, their previous treatment encounters, their personal strengths and weaknesses, environmental forces and personal attributes that both impede and propel the recovery process. Therefore, I offer a variety of levels of care, each tailored specifically to the needs of the individual patient. Unique to my approach is my willingness to work with patients in the very situations where the fear is triggered, be it in the home, in a mall, in a hospital waiting room, restaurant, elevator, or commercial airline. E-therapy makes all of this possible no matter where you live. This “exposure in vivo” (in the very situation where the anxiety occurs) is a uniquely powerful tool, often bringing about extremely rapid progress in conditions previously considered resistant or untreatable. Please feel free to explore my website to discover out how our unique treatment services can benefit you or a family member/loved one.
Generally, most individual sessions run for 45-50 minutes or 50-60 minutes (1 hr). Sometimes a patient determines that a longer session is required (e.g. Exposure, Intensive CBT, etc.). In this case, sessions may run 80-85 minutes (1.5 hrs) or 110-115 minutes (2 hrs). Patients are usually seen 1-3 times per week in the initial stages of treatment and come less frequently as they begin to see their progress. The more time you put in between sessions, the more benefit you will see. When are your office hours? My hours are variable depending on time zone and are flexible due to the fact that all appointments are currently provided by phone and video conferencing. I offer several options outside of regular business hours, such as evening and weekend appointments. Please be aware that afternoon, evening, and weekend appointments are highly sought after and these appointments can be booked several weeks to months in advance. You may request to be put on a wait list in case of cancellations. How will you determine what is the best treatment and number of sessions for me? After the initial assessment, I will discuss your treatment plan and share a timeline for therapy. Generally, I will prefer to meet with you more often in the beginning of treatment and will taper off as skills are acquired and momentum is gained. Treatment planning is a collaborative process so you will be offered multiple opportunities for input.
Are you available between sessions? I am not on call outside of office hours and do not provide emergency crisis services. In non-urgent situations, I encourage patients to contact me by email for brief questions and you may also provide updates and journal entries on the secure patient portal. Email is considered a courtesy and is not the preferred means of contact for urgent matters.