Anxiety, Stress, & Trauma Clinic — Pediatrics and Adults

Although anxiety disorders are the most common type of mental health problem (affecting nearly 40 million adults in the United States alone), most people who suffer from anxiety do not receive treatment. Of those who do, many do not receive the treatments that have been proven to be the most effective. At PBH, we strive to provide anxiety treatments that have the most solid research support and do so in a flexible way that meets the needs of our individual clients. We are passionate about treating anxiety in all of its forms and strive to provide the best care possible to our clients.

PTSD can develop after individuals experience events that involve actual or threatened serious injury, death, or sexual violence. Symptoms of PTSD can develop related to these experiences if individuals have experienced them directly, witnessed these events happening to others, learned about these events happening to loved ones, or had repeated exposure to the details of these types of events (i.e., first responders, police officers). Common types of traumas that are linked to PTSD symptoms include serious accidents, physical assault or abuse, military combat, natural disasters, terrorist incidents, and sexual assault or abuse.

Therapists at the PBH specialize in several evidence based interventions including cognitive-behavioral therapy (CBT), exposure-based interventions, habit reversal training, prolonged exposure, and EMDR, which have been found to be the most effective psychological treatments for anxiety-related problems and PTSD. We also use mindfulness and acceptance-based interventions when appropriate given the increasing research support for these types of interventions for treating anxiety symptoms.

Our team meets bi-weekly to collaborate and ensure high-quality care. We also work closely with medical providers and psychiatrists to provide coordinated, comprehensive treatment.

How we address anxiety-based problems

CBT for Anxiety & Stress

Emphasizes the connections between thoughts, physical sensations, and behaviors in the maintenance of anxiety-related problems
Teaches individuals how to examine and challenge unhelpful thought patterns
Introduces more effective and accurate thoughts to successfully guide healthy behaviors
Focuses on changing unhelpful behavior patterns that can maintain problems over time
Deceases avoidance behaviors, compulsions/rituals, repetitive behaviors, unhelpful coping strategies

Exposure Response/Ritual Prevention (ERP) for OCD,
Panic Disorder, and Agoraphobia,

Gold standard treatment for phobias, social anxiety, OCD, PTSD, OCD, GAD, panic, agoraphobia, health anxiety
Teaches people how to face their fears and decrease patterns of avoidance and safety behaviors/rituals that maintain anxiety problems over time
Helps people see the role that avoidance of triggers/situations that cause anxiety plays in keeping anxiety symptoms going
Learn new skills leading to new and more adaptive ways of responding to these situations
Includes relaxation and breathing strategies
Can include biofeedback with body sensations

Habit Reversal Training (HRT), Stimulus Control, and ComB for Picking, Pulling, Repetitive Behaviors

Evidence-based treatments for body-focused repetitive behaviors (i.e., hair pulling, skin picking, nail biting), as well as tic disorders
Identify and implement behaviors and strategies that make it more difficult to do the target behaviors (i.e., pulling hair, picking skin, motor/vocal tic)
Make changes to the environment to reduce the likelihood that these behaviors will occur.
Includes relaxation skills, strategies for managing strong emotions, cognitive therapy skills

Mindfulness -Based Stress Reduction (MBSR) & Acceptance Commitment Therapy (ACT)

Teaches the individuals how to tolerate distress
Focuses on accepting thoughts and emotions AND committing to more effective actions that align with long-term goals
Learn to step back to observe thoughts and experiences (diffusion), stay in the present moment, and understand you are not your thoughts
Learn to observe, describe, be aware, fully participate in life, and let go of judgments about self and others to be fully present
Increase stress tolerance through mindfulness, relaxation, & deep breathing techniques

EMDR for PTSD

Interactive therapy designed to integrate basic exposure techniques with bilateral stimulation
Bilateral stimulation can be achieved via side-to-side movements, hand tapping, or audio tones
Promotes reprocessing of stored memories to decrease the emotional intensity of these memories
Active ingredients of exposure and processing of trauma remain present
Bilateral movements require working memory activation and allows individuals to relax to process trauma information via exposure
Bilateral stimulation can be effectively implemented in person or via telehealth with a light bar
EMDR should not be used for cPTSD
Considerations for using hand tapping or audio tones should be observed for those with seizures or other neurological coniditons

Cognitive Processing Therapy & Narrative Development for PTSD

Focuses on the connections between thoughts, feelings, behavior, and bodily sensations with a particular emphasis on identifying how traumatic experiences change thoughts and beliefs, and how these thoughts influence current feelings and behaviors
Identify and change "stuck" points related to fear, guilt, shame, and anger
Develop a healthy understanding of the trauma you experienced, understand the fragmented memories you have, and let go of defining your life based on that trauma
Process memories and move from reactive fear state to an integrated identity
Explore avoided behaviors and experiences to develop a life worth living

DBT for complexPTSD (cPTSD)

Comprehensive integration of multiple treatments to address different facets of complex PTSD
Focus on skills acquisition around mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance
Targets cognitive & emotional stabilization, processing of thoughts and emotions, and behavioral coaching
Combines somatic experiencing/processing, exposure, skills acquisition, behavioral activation, functional analysis, and behavior modification strategies
Examines and promotes healthy attachment, relational patterns
Targets identity integration, internal value development, development of internal validation and awareness, and promotion of value-based behaviors

Prolonged Exposure and Stimulus Control for PTSD

Gold-standard treatment for PTSD
Primary goal of PE is to gradually approach feelings, situations, and memories that have been avoided since the traumatic event
Thoughts and emotions about the trauma changes as one learns to shift from a fear/flight/fight response
Increase tolerance for internal body sensations and emotions
Avoidance behaviors around the trauma decreases and are replaced with healthy coping strategies
Develop understanding of how trauma has increased reaction to fear or anxiety cues
Learn to regulate body sensations associated with thoughts and emotions and learn to approach experiences again for a higher quality of life