Frequently Asked Questions About Therapy
I’m new to therapy, what can I expect in my first session?
All first sessions are get-to-know-you sessions. I encourage all clients to attend weekly sessions at the beginning of our time with each other.
Pre-Teens + Teens
First sessions for pre-teens and teens typically include the pre-teen/teen and any parents/guardians. In sessions after that first one, I typically only meet with the pre-teen/teen for session, except for coaching or check-in sessions with the parents and/or guardians.
In our first session, we will talk about parent/guardian involvement; safety, privacy, and confidentiality; and any questions y’all have for me. We will talk about goals, growing up, and any challenges you are a having. We might do an activity together to help you get comfortable!
Adults
With individual adults, our first session will consist of discussing any questions you have about the intake paperwork, your personal life story, the community that you live in, who you are and who you want to be, and any issues that you are wanting to work on and heal. Sometimes we don’t get to everything in one session, so we work through the next few sessions to build a therapeutic relationship where you feel comfortable sharing your innermost self. As the therapist, I will go at your pace when we are first meeting each other and share what kinds of therapies I can tailor to your needs that may work best for you.
Relationships + Families
For the first four sessions, I prefer and encourage all direct family or partners to join. Family and relationship therapy works better if all members who are involved in the challenges or issues show up to do the work on a regular basis.
Over the course of the initial four sessions, we will discuss any questions you have about the intake paperwork, how you met and/or how you formed your family, your family elders and ancestors, your family legacy, who you are as individuals within the family context, and the issues or challenges you are wanting to change and heal. Throughout the first month of sessions, I will slowly introduce how I, as the therapist, can best work with your relationship and family to tailor the healing experience to y’alls needs.
A Note About Virtual Sessions
If you are accessing therapy sessions through the HIPAA-compliant Zoom platform, please log in from a private space with no other adults or children over the age of 6 months present. Pets are always welcome! At the beginning of each session I will ask for you to share your location and address or cross-streets for your safety and in case of an emergency. If you are logging into your session from a car, please have the car parked and do not drive during the session. If you are in a space that isn’t conducive to holding a private therapy session, we may need to cancel and reschedule the appointment.
What is your talk therapy style?
Individual Talk Therapy
I use an eclectic approach that mixes relational-cultural, intersectional feminist, and narrative therapies. These three therapies have much in common and also include complementary elements that work well together.
Relational-Cultural Therapy: I believe that the cultures and contexts that we find ourselves in affect our relationship with ourself and others. I work with you to build a genuine sense of self and a feeling of agency over your own life. I use aspects of this therapy to help you build patience with and trust in others. We’ll explore patience, trust, boundaries, and compromise to maintain a healthy balance in relationship with you and others.
Intersectional Feminist Theory informs my beliefs that mental health issues are a consequence of social, political, financial, racial, and disability stereotyping. In short, the personal is political. We are often isolated in our journey of healing - in part due to these systems. I help you find your community, authenticity, empathy, and confidence to help you heal. We are meant to heal in community, not alone.
Narrative Therapy: I believe all identities are shaped by the stories we develop about ourselves, based on sociopolitical stories that also influence us. Change happens when we separate the authentic you from the challenges you are facing. We work together to create a new story for yourself that emphasizes your strengths and control over the direction of your life within the sociopolitical context.
Relationship and Family Systems Therapies
I have completed Level 1 Training in Gottman Method Couples Therapy. I also work using sex therapy theories with clients navigating adult relationships. With families of any type, I use an eclectic array of family systems therapies.
The Gottman Method was created by Drs. John and Julie Gottman based on extensive consensual couples research. My goals in using aspects of this therapy with clients is to help you increase relational closeness, learn how to address conflict in a productive and more communicative way, and help you build a shared life of meaning together. This method has been proven to work with most intimate partnerships where there is an overload of fighting, high emotions, criticism, contempt, defensiveness, and stonewalling.
Sex Therapy consists of talk therapy online or in a therapist’s office and does not include any sexual acts by either the intimate partner(s) or the therapist. I work with you and your partner (or you by yourself) to understand and help reintroduce positive elements into your intimate emotional, physical, and mental interactions with yourself and others. Often I see clients who have had inadequate sex education about the act and how our body responds to the act, harmful attitudes around sex, systemic factors that lead to a lack of desire or sexual confidence, and/or a history of sexual trauma. We work together to reduce anxiety, enhance you relationships, and find out who you are as a sexual (or asexual/nonsexual) being. If needed, there may be exercises for you and your partner(s) to complete with each other at home.
Family Systems Therapy: When you come to see me for family therapy or relational work, the client I’m working with is your family/relationship. I believe that when something affects one person, it also affects every other family/relationship member. I believe that the strength and stability of a healthy family unit provides help to family members who need support. Through this type of therapy, I work to help explore intergenerational, sociopolitical, community, and cultural factors that contribute to the context of your family/relationship. This work with you and your family helps us collaboratively build healthy boundaries within and without the family, increase positive relationships, integrate healthy communication patterns, and improve your family’s overall functioning and cohesiveness.
Trauma Therapies
Many people think trauma therapy is only for the big traumas, such as abuse, assault, violence, or car crashes. While trauma therapy can definitely help address symptoms arising from these issues, it is also a great healing tool for other life events, environmental events, or world events that have caused emotional hurt, shame, guilt, physical wounds, sleep difficulties, depression, and suicidal ideation. Below are the three evidenced-based trauma-informed therapies that I am either trained or certified in and may provide if together we find you might be a good fit.
See below for more information on Eye Movement Desensitization and Reprocessing (EMDR), Cognitive Processing Therapy (CPT), and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT).
What trauma therapies do you provide?
Eye Movement Desensitization and Reprocessing (EMDR)
The theory: When a trauma occurs, it seems to get locked in the brain with the original images, sounds, thoughts, feelings, and sensations. This “locked information” is what often gets triggered by something the person hears, smells, or sees that might remind them of the trauma. The locked information is often responsible for feelings of anxiety, helplessness, hopelessness, fear, anger, and other strong emotions. The locked information may be inappropriately coloring their perceptions and actions in similar present circumstances. They may react negatively to certain places, activities, authority, groups, new learning experiences, or whatever aspects are evident in that memory. These are really the emotions connected with the old experience that are being triggered.
The goal is to process the sensory information and locked information and to unlock it. The goals are to have you remember the distressing memory or trauma but not experience the old emotions or sensations in the present. The person can be informed by their memories, but not controlled by them.
The process: Adults -Before beginning EMDR, I will teach you some calming and grounding techniques that we can use together when the therapy gets too intense, or when we are closing a sessions. In EMDR we use eye movements or tapping, called bilateral stimulation, to unlock the system and allow the brain to process the experience and unconscious beliefs or thoughts. We are sitting with the sensory images and exploring how it feels in the person’s body and what emotions are coming up for them. It is not required to talk about the details of the traumatic events. Your brain is doing the healing work through the bilateral stimulation. In session, we work to help you to notice the effects of the trauma as if you are a passenger on a train through your memories and are merely looking through the windows of the scenery, instead of reliving the memory and stopping the train and getting immersed in the scenery.
Pre-teens/Teens - Using EMDR with your pre-teen/teen is based on the original EMDR theory, goal, process, and risks. However, when I work with kiddos, I include expressive arts and movement along with bilateral stimulation. For example, instead of tapping or eye movements, pre-teens/teens may prefer to use a drum that they can play, or instead of of the kiddo telling me their body sensations or emotions they experienced, I will have them draw both those things out with crayons on paper.
Risks: In between sessions, your brain is still processing in the background. Memories – the same or different - may come up as triggers. Feelings may become more intense and depressive or PTSD symptoms might increase a little bit. When the memory is processed either outside of or inside of session, these symptoms will decrease, especially those associated to the original memory that was being processed. EMDR may trigger you and your body in session when intense memories show up. We can stop the eye movements or tapping at any time to use on of these techniques. The important thing to remember about this therapy is that you are always in control. I am just guiding you through the process.
Watch the EMDRIA video on how EMDR therapy works, what it is like, and how widely it is recognized.
EMDR Therapy sounds familiar; how does it work?
Cognitive Processing Therapy (CPT)
CPT teaches you how to evaluate and change the upsetting thoughts you have had since your trauma. By changing your thoughts, you can change how you feel.
The theory: Trauma can change the way you think about yourself and the world. You may believe you are to blame for what happened or that the world is a dangerous place. These kinds of thoughts keep you stuck in your PTSD and cause you to miss out on things you used to enjoy.
The goal: CPT teaches you a new way to handle these upsetting thoughts. In CPT, you will learn skills that can help you decide whether there are more helpful ways to think about your trauma. You will learn how to examine whether the facts support your thought or do not support your thought. And ultimately, you can decide whether or not it makes sense to take a new perspective.
The process: CPT is a 12-session short-term therapy, typically provided over 12 weeks. Sessions range from 50-80 minutes each. If needed, we may decide together to break up session into two or more appointments with me. Sometimes, we may also need fewer than the 12 sessions. I will start off by giving you an overview of the treatment. Together, you and I will review some information about PTSD to help you better understand your symptoms. Your provider will ask about the type of trauma you experienced, but you will not need to go into great detail right away. I will also ask you to do some writing about how your trauma has affected you. You will not need to talk about the specific details of your trauma, but you will be asked to talk about your beliefs and feelings related to the trauma. You can choose to do a type of CPT that involves writing about the details of the trauma, but this is optional.
Over the next several sessions, you will talk about any negative or unhelpful thoughts you have been having about the trauma, and you will work together to consider other ways of thinking about the situation. You will use worksheets in session and for homework that help you learn this strategy. CPT can also include writing about the details of your trauma, if you and your provider decide this is right for you. Towards the end of therapy, you and your provider will focus on some specific areas of your life that may have been affected by the trauma, including your sense of safety, trust, control, self-esteem, and intimacy.
Risks: It may be difficult to talk or write about trauma-related memories or beliefs, especially at first. These feelings are usually brief and people tend to feel better as they keep doing CPT. Most people who complete CPT find that the benefits outweigh any initial discomfort.
Watch the Veterans Health Administration’s video introducing CPT for PTSD.
What is Cognitive Processing Therapy?
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
The theories: TF-CBT is designed to reduce negative emotional and behavioral responses following child sexual abuse, domestic violence, traumatic loss, and other traumatic events. It is based on several theories: Cognitive Therapy, Behavioral Therapy, Family Therapy, and Attachment Therapy. TF-CBT adresses your pre-teen/teen’s negative beliefs and sensations related to the abuse and provides a supportive environment where your kiddo is encouraged to talk about their traumatic experience. TF-CBT also helps you, as the caregiver(s) who were not abusive to cope effectively with your own emotional distress and develop skills that support your pre-teen/teen. Based on research, I believe it is very important for caregivers to be involved and supportive, and that your kiddo’s trauma symptoms need to be addressed as early as possible to prevent any long-term effects.
The goal of TF-CBT is to achieve the following for both the caregiver(s) and the pre-teen/teen: increase knowledge about trauma and common reactions; help with parenting and behavior problems; increase Relaxation/Stress Management; increase knowledge about feelings and ways to express them; increase knowledge about our thoughts, feelings, and actions; develop creative ways for your kiddo to tell their stories about what happened; learn and practice safety skills; change any unhelpful thoughts about the trauma; and help the family talk together about the trauma.
The process: TF-CBT is a structured, short-term therapy (4–6 months) for kiddos I will meet with your pre-teen/teen and you, as the caregiver(s) separately once per week. Sometimes I will meet with both your kiddo and you together for a family session.
Pre-teen/teen sessions include helping your kiddo learn how to express and talk about the trauma through expressive arts and creating a written/verbal trauma narrative about the trauma that happened to them in their own words. I tailor each TF-CBT session to you and your kiddo, sometimes using workbooks, journals, collage, poetry, developmentally appropriate books, and other methods of helping your child feel safer and brave in thinking and talking about what happened to them.
Risks: TF-CBT can be a time-consuming treatment. The treatment can take several months to complete (4-12), and it requires the participation of both your pre-teen/teen and you, as the caregiver(s). TF-CBT can be emotionally challenging for both you and your pre-teen/teen. Your kiddo may need to talk about difficult and painful memories during treatment. You, as the caregiver, may also need to talk about your reaction to your kiddo’s trauma. Because of this, I recommend caregivers find their own individual therapist, along with the parent sessions I will provide as part of your pre-teen/teen’s treatment.
Watch the video by the Texas Children’s Advocacy Centers of Texas on how TF-CBT works.
