Counseling Methods

Think of positive psychology as the activation of your psychological immune system. Positive psychology emphasizes flourishing, wellbeing, resilience, and hope. It is a research-supported strength-based approach.  Hope theory and choice theory are part of the positive psychology family of modalities, and I incorporate their teachings in my work.

Positive psychology is about finding meaning and satisfaction in life by focusing on what's right with you instead of focusing only on what's wrong with you. We do not discount what you feel is wrong in your life or what feels wrong in your spirit. Instead, we look at the inherent capabilities you have forgotten or may not realize you have. We don't just solve problems or repair damage - we identify your talents and capabilities and build solutions that support your pursuit of joy, self-efficacy, and fulfillment.

With a positive psychology framework, we work on creating the nurturing life that you deserve by recognizing your agency - the amount of personal control you believe you can exert over your life. 

There’s some psychoeducation involved. I’ll give you readings, videos, and worksheets to help you explore your values, your abilities, and your wishes for yourself.

Cognitive behavioral therapy, or CBT for short, focuses on problems stemming from your thought and behavior patterns and helps you identify and implement solutions you are willing to use. That’s the key for me - solutions you are willing to use. 

Some of the areas we focus on in CBT work include problem solving, cognitive restructuring, communication, setting goals, facing fears, and managing yourself through healthy habits and positive activities.

In exploring the problems that brought you to therapy, I lean full-in on building your confidence and resilience. Even with a modality like CBT in which we examine the patterns that are causing you problems, I approach those patterns from a strength-based perspective.  With CBT, we spend some time reviewing the past - not to assign blame or make you feel like crap about yourself, but as a source of information. 

Information is power. Information arms you to make decisions that serve you instead of hurting you. Self-awareness gives you the gift of choice, and there’s nothing more empowering than choice.

If you aren’t open to a particular strategy, it’s not going to work for you, and it’s my job to help you find a different one. Sometimes it’s the willingness itself we need to work on first, starting with your self-talk. How we talk to ourselves is a key feature of CBT work.

Dialectical Behavior Therapy, known as DBT, is an evidence-based, skills-based model of therapy. What DBT means is that we learn how to live with dialectics in a way that helps us cope with all the stress and anxiety that we encounter both in our heads and in our environments.

The term dialectics as it is used today originated with Georg Wilhelm Friedrich Hegel in the 19th century. Dialectics refers to the presence of opposing forces or constructs. A popular example is that we can love someone and also have powerfully negative feelings toward them. Another example is that we can acknowledge that at any moment, there are things over which we are powerless, but there are also things over which we have power. That juxtaposition in our lives creates a dialectic in our emotional state. 

DBT has four modules: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. All four modules help you cope with stress, anxiety, cravings, obsessions, conflicts, and unanticipated problems. 

DBT includes psychoeducation, discussion, and worksheets. Phone coaching is a useful component of DBT in that it reinforces skills practice when you are confronted with real-life situations in which you need to use the skills. As a concierge therapist who schedules remote sessions seven days a week, I can offer that support.

DBT was initially developed to treat borderline personality disorder, self-destructive behavior, and suicidality, but research has shown it to be effective in treating anxiety, stress, low self-esteem, trauma, substance use, and impulse control. If you find yourself wanting to escape from your life, DBT will help you surmount that feeling.  

Some of the goals of DBT are to equip you with coping skills, give you more control over your choices, and improve your quality of life. In this way, DBT works in tandem with the other modalities I use.  

You may have had a therapist or two tell you, “I accept you where you’re at, but the purpose of therapy is working toward change.” Accept/change, power/powerlessness, distress/calm - these are dialectics, and I’m going to help you learn how to persevere with these conflicts inside you. To that end, we’ll work on self-acceptance and acceptance of others. I know you are doing your best, but I also know that learning new skills and behaviors will help you create a life that you will consider worth living.

DBT is typically delivered in group format in a specific order over two six-month cycles. Because I’m working with you individually, I vary the order of the modules based on what’s useful for you at the time. 

If you know what active addiction or borderline personality disorder look like from personal experience, then you know how hard it is to calm your racing thoughts, self-doubts, high-tension emotions, and resentments toward life's inequities. It’s challenging to learn how to balance opposing forces in your head and heart, and it’s challenging to master interpersonal skills when you feel like your emotions are controlling you instead of the other way around. DBT therapy validates your frustrations and helps you see how to manage that balancing act.

The concept of humans having personal agency refers to our ability to exercise control over our lives - our thoughts, actions, environments, and choices. Agency speaks to the heart of being human, in that choice is the foundation of empowerment.

Personal agency is prominent in hope theory, a member of the positive psychology family of theories. Hope theory asserts that agency is motivated by internal factors. According to hope theory, your belief in yourself grows from success at attempting and reaching your goals. The more your actions lead to the results you want, the more you believe in your capacity to succeed. Research shows that higher hope and belief in our capabilities strengthens our self-esteem, decreases anxiety, lessens chronic pain, increases energy, and leads to a greater sense of well-being.

Here’s how it works. From the time we are born, our agency is shaped by what we observe - first in our environment, and eventually in ourselves. Alfred Badura, the originator of social learning theory, contributed greatly to the field of psychology and the literature on human agency.

According to social learning theory, agency stems from external influences. Because we are social creatures, we learn from watching others. It’s common to hear a person in recovery talk about a mentor or sponsor who helped them. “I listen to what they tell me and I take their suggestions, because I want what they have.” Think for a moment about the people who have what you want: appealing qualities, personal traits, lifestyles, capabilities.

One of the exercises I ask you to do in therapy is to identify your personal heroes - people who model the kind of person you would like to be. Sometimes those heroes are famous people, and sometimes they are people we interact with in our everyday lives. As an example, Fred Rogers (aka Mister Rogers) is one of my heroes because he exemplifies values I find admirable.

Using the models we identify as our heroes motivates us to emulate the qualities we find attractive in others, qualities that lead others to respect and appreciate us for the valuable individuals we are. Practicing those values in your actions gives you control over who you are because it helps you define who you are. In therapy, we will work a lot on values and identity.

As you can imagine, both self and environment play key roles in your sense of personal agency. When you lack control, whether over minor or major issues, you feel trapped. Human agency allows you to develop resilience, self-awareness, and self-efficacy, leading to a greater sense of control over yourself, your relationships, your environment, and your choices.

The power threat meaning framework (PTMF) was developed by psychiatrists in the United Kingdom. It is a conceptual perspective rather than a clinical model. It represents an approach to therapy that steers away from the traditional medical model that depends heavily on diagnoses.

Instead, the PTMF views mental health issues as threat responses and considers symptoms of mental health issues to be

• our reactions to our experiences.

• the adaptations we’ve made to survive the things we’ve been through that threatened our sense of self-worth and our understanding of personal power.

We will use the power threat meaning framework to identify areas where you’ve developed coping strategies that have gotten you stuck in behavior or relationships patterns that don’t feel right to you. As a strength-based therapist, I focus on nurturing the qualities that serve you and support your wellbeing. We’ll take the coping strategies you’ve developed and figure out how to use them in healthy ways that provide you with a sense of safety, serenity, and confidence.

If it’s one of your goals to be seen as a person who’s reacted to experiences instead of being seen as a person whose entire being can be encapsulated by a label, then I hear you, and I will support you through the lens of this framework.

You may meet the criteria for a mental health diagnosis and you may not. It’s common for active addiction to mimic the symptoms of a variety of mental health diagnoses such as bipolar disorders, mood disorders, personality disorders, anxiety disorders, obsessive-compulsive disorders, and impulse control disorders. As your therapist, it is my responsibility to recognize when you meet the criteria for a diagnosis and when you don’t. The power threat meaning framework helps us to look at your symptoms in the context of your environment so we get a full picture.

I am not anti-diagnosis. I am against premature diagnosis or diagnosis for the sake of insurance reimbursement. That’s one of the reasons I’m a private pay practice; insurance companies require an immediate diagnosis to reimburse you for claims. If you’re here, you’ve got issues you’re looking to work on, but that doesn't necessarily mean you’re ill or that there’s something wrong with you. Diagnoses are useful when your symptoms meet the criteria.

A clear diagnosis gives us language for describing what’s going on with you, and that can make it easier for you to communicate your struggles to me and your loved ones . Plus, if you and I agree that you meet the criteria for a particular diagnosis, that knowledge directs us to a large body of reliable, evidenced-based treatments that we know we can count on to help you with your symptoms. But I believe strongly in confirming the presence of a diagnosis before saddling you with a label that will follow your medical records for the rest of your life, and that is why I incorporate this framework into my clinical practice.

I will carefully assess and evaluate your symptoms over time, so we can get a clear and accurate picture of where you are at, compare it to where you want to be, and provide you with the tools to move forward.