Overview of Services:

For mood and anxiety disorders, I typically adhere to a Cognitive Behavioral approach. Cognitive Behavioral Therapy (including branches of CBT like Dialectical Behavior Therapy and Exposure Response Prevention Therapy) is one of the most effective forms of therapy for these disorders. However, depending on the needs and circumstances of the individual I am working with, other modalities such as Motivational Interviewing, Behavioral Therapy, trauma focused treatment, attachment based treatment, among others, can also be utilized. Play is often combined depending on the age and need of the child.

Treatments and Interventions Offered:

Trauma:

Trauma Focused Cognitive Behavioral Therapy (TF-CBT)

TF-CBT is an evidenced based therapy for children who have experienced trauma. It focuses on helping children who have varying degrees of Posttraumatic Stress Disorder, as well as their parent(s) or caregiver(s). It has been found to be effective with children as young as 3 years old to an 18 year old adolescent. TF-CBT addresses biopsychosocial needs of children with therapy that combines cognitive behavioral therapy and trauma informed interventions. Children and parents are provided education and skills related to trauma. Although originally developed for victims of sexual abuse, there is evidence that it is effective with a variety of traumas, such as physical and verbal abuse, domestic violence, terrorism, natural disasters, car accidents, bullying, community violence, traumatic grief, and multiple traumatic events. It is considered more short term, with the typical length of treatment being between 12 and 20 weeks, with up to 30 weeks for those with more complicated trauma. Find out more on the TF-CBT website.

Child Parent Psychotherapy (CPP)

CPP is an evidence-based therapeutic intervention designed to treat young children (0-6 years old), who have experienced trauma. Originally developed for children who had been exposed to domestic violence, it has also been found to be effective for children exposed to a variety of child maltreatment types as well as those children without trauma who are still struggling with behavior problem. The therapy focuses on strengthening the parent-child relationship as a means of healing. It is rooted in attachment theory and developmental psychology, recognizing the crucial role of early relationships in shaping a child’s emotional and psychological well-being.

During sessions, the therapist works with both the child and parent to address trauma-related symptoms, such as anxiety, aggression, or withdrawal. Through play, dialogue, and direct interaction, the therapy helps the child process traumatic experiences and fosters a sense of safety and trust between the child and parent. The parent is also supported in understanding their child’s emotional needs and improving their own responses. CPP aims to enhance the child’s overall functioning and promote healthier family dynamics. It is particularly effective in addressing the effects of domestic violence, abuse, and other significant stressors on young children. This therapy typically lasts about a year and has been found to be very effective. Find out more on the Child Parent Psychotherapy website.

Dialectical Behavior Therapy Prolonged Exposure (DBT PE)

DBT PE is a specialized treatment created by Dr. Melanie Harned in order to provide trauma focused treatment to those individuals who also struggle with suicidal and self-injurious symptoms. This treatment can be utilized with both adolescents and adults. Prolonged Exposure (PE) has been utilized in trauma treatment since the 1980’s when Dr. Edna Foa first created it. Both PE and DBT PE have been substantially researched and viewed as highly effective treatments for Posttraumatic Stress Disorder (PTSD).

DBT-PE helps clients confront and process traumatic memories through structured exposure techniques, which include revisiting the trauma in a controlled, therapeutic environment (imaginal exposure) and gradually facing real-life situations they avoid due to trauma (in vivo exposure). The therapy aims to reduce PTSD symptoms like flashbacks, hypervigilance, and avoidance while maintaining the emotional regulation strategies taught in standard DBT. Clients also continue to work on mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills. The core of the treatment focuses on using imaginal and in vivo (real life) exposure followed by processing. This treatment can “comprehensively address the full range of problems experienced by high-risk, severe, and complex clients with PTSD.” (DBT PE website)

The goal of DBT-PE is to help clients achieve a sense of safety and emotional stability, allowing them to lead a more fulfilling and balanced life. This approach is evidence-based and has been shown to be effective in treating complex trauma and co-occurring disorders.

You can learn more about Dr. Harned and DBT PE, the most up to date research about it and training at the DBT PE website.

Cognitive Processing Therapy (CPT)

Cognitive Processing Therapy (CPT) is an evidence-based treatment for Post-Traumatic Stress Disorder (PTSD) that focuses on helping individuals reframe and challenge unhelpful beliefs related to their trauma. CPT’s approach stems directly from Cognitive Behavioral Therapy and can be used with individuals 12 years old to 120 years old. It involves structured sessions where clients explore the impact of trauma on their thoughts and feelings, aiming to reduce symptoms by modifying maladaptive thinking patterns. CPT typically includes cognitive restructuring, where clients learn to identify and dispute distorted cognitions, and it emphasizes the role of trauma in shaping these beliefs. CPT heavily emphasizes the role of traumatic events in shaping distorted cognitions, focusing on themes such as safety, trust, power, control, esteem, and intimacy. CBT, while also addressing cognition, includes a broader range of interventions that address a wider array of dysfunctional thinking and behavior patterns.

The therapy can be delivered in individual or group settings and usually spans 12 sessions. CPT can be used with individuals who are dealing with suicidal ideation (excluding imminent risk), have been diagnosed with personality disorders, and substance use disorders (excluding those who still need detox support). CPT has been proven effective in reducing PTSD symptoms and improving overall functioning. Check out more about CPT on the website here.

How is CPT different from CBT? CPT is specifically designed to address trauma-related symptoms, particularly PTSD. It centers on the impact of trauma on thoughts and beliefs, helping clients process and reframe these to reduce distress. CBT, on the other hand, is a broader therapeutic approach used to treat a variety of mental health issues, including anxiety, depression, and phobias, by targeting maladaptive thoughts and behaviors in general.

Mood Disorders, Anxiety Disorders, Behavioral Difficulties:

Dialectical Behavior Therapy (DBT) and Dialectical Behavior Therapy for Adolescents (DBT-A)

DBT was originally developed for adult women who suffered from self-injurious or suicidal behaviors. However, it has increasingly been researched and found to be effective for a variety of other populations, including teenagers experiencing bipolar disorder, depression, Posttraumatic Stress Disorder, conduct disorders, substance abuse issues, self-injurious behaviors, suicidality, parent/child issues, and others. DBT usually involves a more intensive approach that includes weekly individual sessions, group skills classes, and as appropriate, between session coaching calls. DBT-A is similar except parents are often expected to be consistently involved. This can mean parent/family sessions, weekly DBT skills group for the parent and teen, etc. This treatment approach is very skills based. Groups typically last about 20-24 sessions, with individual therapy lasting as long as needed. Find out more about DBT from its source at the Behavioral Tech website.

Status of the DBT skills group for adults: ongoing

Status of the DBT skills group for adolescents: paused

To find out more, feel free to contact us!

Collaborative Assessment and Management of Suicide (CAMS)

CAMS is an evidence-based therapeutic framework designed to assess and intervene in suicidal crises effectively. Developed by David Jobes, PhD, CAMS emphasizes a collaborative approach between the therapist and the client, focusing on understanding the client’s unique experiences and developing tailored treatment plans. Key elements include a detailed assessment of suicidal thoughts and behaviors, the creation of personalized safety plan, and ongoing monitoring and suicidal risk factors (“drivers”). CAMS is notable for its structured yet flexible nature, aiming to empower clients and enhance theri sense of control over their suicidal thoughts through a supportive therapeutic alliance. The CAMS is “nondenominational” in that it can be utilized as an intervention in conjunction with many different treatments (such as DBT, ACT, CBT, and many others).

For more information about CAMS, please visit their website.

Exposure and Response Prevention (ERP)

ERP is derived from Cognitive Behavioral Therapy (CBT) and is the gold standard for treatment Obsessive Compulsive Disorder (OCD). In particular, ERP exposes an individual to the thoughts, images, objects, and situations that cause anxiety and activate the obsessions, and then purposefully restricting any attached compulsions. This is completed using a hierarchy specifically targeting the irrational fears that have become so overdeveloped that they impact functioning. There are also types of OCD where the compulsions are not obvious, as they are completed internally (i.e. saying a religious prayer after a “bad thought”). Depending, these are sometimes called “Pure O” OCD. For more information about OCD, the different types, and how ERP can work, check out the International OCD Foundation here.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is a structured, time-limited psychotherapy that focuses on identifying and changing negative thought patterns and behaviors. CBT is widely used to treat a variety of mental health conditions, including depression, anxiety, PTSD, obsessive-compulsive disorder (OCD), phobias, alcohol and drug use, marital issues, eating disorders, among others. It is based on the premise that our thoughts, feelings, and behaviors are interconnected, and by altering one, we can influence the others. CBT is goal-oriented and involves active collaboration between the therapist and client, where they work together to develop coping strategies for dealing with problematic thoughts and behaviors.

The therapy typically involves homework assignments, such as journaling or practicing new skills, to reinforce what is learned during sessions. The therapy often includes techniques such as cognitive restructuring, exposure therapy, and behavioral activation. It is supported by a strong evidence base and is considered one of the most effective forms of psychotherapy. CBT helps clients develop a more realistic and balanced way of thinking, which can lead to lasting improvements in their emotional well-being. Sessions usually last between 12 to 20 weeks, depending on the client’s needs and goals.

Overall, CBT empowers individuals to take control of their mental health by providing them with practical tools to manage their thoughts and behaviors. For more information, you can check out the American Psychological Association’s brief article about CBT here.

Parenting Programs and Curricula:

Safe Care

Safe Care is an evidence-based curriculum that provides training for parents who are at risk for child maltreatment and have a child under the age of 5 years old. It is designed to be provided within the home environment of the client, with weekly sessions. This is not therapy, but instead an instructional tool aimed at supporting parents. Typical duration is between 18 to 20 weeks. Check out the National Safecare Training and Research Center website.

Circle of Security

The Circle of Security is an evidence based 8 week program that offers caregivers an understanding of attachment and how this impacts interactions between children and their caregivers. Applying The Circle to interactions helps increased understanding that undesired behaviors are communication of a need on the Circle. If you want to change the behavior, caregivers learn how to meet the need behind the behaviors. This increases caregivers confidence and increases cooperative and compliant behaviors in children. For more information, check out The Circle of Security website!

Looking for Consultation or Supervision?

Qualified Supervisor

Meghan is certified as a Qualified Supervisor for Licensed Clinical Professional Counselors in the state of Idaho and Florida.

Meghan also provides consultation to individuals and clinics specific to learning and implementing evidence based treatments with children, adolescents, and families.

Looking for Training?

Meghan is passionate about providing quality training in a variety of topics, and has done so since working at the University of Colorado Medical School, providing Grand Rounds presentations to other faculty and staff, as well as workshops, trainings, and presentations to organizations and clinics throughout the United States. Some topics Meghan has provided trainings and presentations on include: Evidence Based Treatment for Children Who Have Experienced Trauma; How Trauma Impacts Neurological Development in Children; Utilizing TF-CBT with Complex PTSD; Overview of the CAMS; Boundaries and Burnout for Therapists; Ethical Standards of Reporting Child Maltreatment; Overview of Implementing Dialectical Behavior Therapy with Suicidal Adolescents; Preventing Burn Out and Supporting Trauma Therapists. If you are interested in having Meghan present, please reach out to us! We would love to discuss your training needs and how Meghan can help!