Individual & Couples Counseling
What is your approach to treatment?
I have a very relaxed and open style, whether in-person or virtual. One very important thing to know about me is that I’m not just an active listener. I believe in the power of dialogue and use Trauma-Informed CBT, DBT, and ACT as my primary therapeutic modalities. These modalities work together and were all developed from the same thought and behavior-based approach. Trauma-Informed CBT is still CBT, with an additional emphasis on diffusing trauma both in session and through specific homework exercises that identify triggers, process trauma in real time, identifying the mind/body connection regarding trauma, participating in a somatic-based practice to rid trauma from the body (such as yoga), and create symbolic closure. CBT also includes analyzing the thoughts and thought-life through interventions such as cognitive reframing, restructuring, and challenging. With CBT, there is a greater emphasis on identifying toxic thought patterns or cognitive distortions with an inherent intent to change toxic thoughts through interventions such as thought-stopping, thought-switching, or validity testing. Other clients may benefit more from an approach more heavily DBT-related. DBT is an offshoot of CBT, but rather than focusing on thought-stopping or changing, DBT focuses more on developing radical acceptance of thoughts or feelings (often times with some clients, toxic thoughts will dissolve faster if the client just chooses to accept them as they are and move on, as this tends to take the power away from the thought. Another DBT focus is the separating of “you” from the thoughts you think, as you are not just the sum of you thoughts! Thought watching is also used to develop awareness and eliminate cognitive dissonance (it’s possible to observe thoughts without “buying in” to them, and it is also possible for two opposing thoughts to exist at the same time). In my practice, I have found that developing the skill of mindfulness, or becoming present-oriented and grounding down (out of your brain and into your body) is helpful in almost all clients, as is distress tolerance, emotional regulation, and interpersonal effectiveness training. Clients are also empowered by learning how to clearly articulate their needs with no guilt, shame, or accompanying negative emotion. During this process, clients learn how to develop healthy boundaries and discover the power of their agency by committing to action, regardless of thoughts or emotions. Techniques of ACT include taking a step back from emotions or emotionally-charged events, often gives clients the space they need to untangle and make sense of what they are feeling and why they’re feeling it. All sessions will include homework, because pen to paper work is 50% of why CBT works. When we write, our “emotional brain” lights up brighter than in any other modality (talk therapy, body work, etc.) Specific, directed journal activities including letter writing, listing, and emotional brain release will be give at almost every session. These exercises will be personalized to your specific situation, they typically take anywhere from 5-12 days to complete, and one may run as a theme throughout our work until the client has achieved radical acceptance (at which time we will symbolically close the event.) Both CBT and DBT are geared towards developing various coping mechanisms, from learning how to live in the present in your body by “getting out of your head,” to identifying unique core values, If a client has been struggling with stress and takes it out on other members of the home, we would switch the toxic coping mechanism with radical acceptance and engaging in activities the client likes to do; ultimately, the focus would be on creating boundaries to protect the client from reaching the point where stress is interfering with their every day life. Solid boundaries and assertiveness training (learning to speak your truth unapologetically and ask for help when you need it) are 2 very important parts of the therapeutic process. New coping and self-soothing skills will be established if the client feels out of control and to help ground the patient. Trauma will be processed primarily through bodywork (trauma settles in the body). Processing any type of abuses they client may have faced, dialoguing and journaling on the grief/shame components of abuse will be covered, the we will work as a team to deliberately begin to curate your life. One goal of my approach for all of my clients is for them to experience living their best and highest unapologetically deliberate, authentic, transparent, and curated life based on their individual needs, wants, and interests. I believe that therapy should be more proactive than reactive, so while we will probably start in a reactive state, I believe that a proactive, mental health preventative approach is equally as important as preventative physical health approaches! Additional exercises used include yoga, breathing exercises, and formal meditation as they have all now been reliably tested and are evidence-based practice to decrease anxiety, PTSD, prevent/stop oncoming panic spirals, and improve regulation of the nervous system.
For my couples, I use the Gottman Method to assess the relationship and integrate research-based interventions based on the Sound Relationship House Theory. This modality includes assessing and improving the seven principals for making marriage work including getting to know each other better by creating love maps, nurturing the fondness and admiration of each other, turning toward each other instead of away, letting each member of the couple influence the other, solving solvable problems, overcoming gridlock, and creating a shared sense of meaning. The goals of couples therapy are personalized, but typically include disarming conflicting verbal communication, increasing intimacy/respect/affection; removing barriers that create a feeling of stagnancy, and creating a heightened sense of empathy/understanding within the context of the relationship. Ultimately, the big picture of couple’s therapy is learning to radically accept, reframe, or change the dynamics of the couple as a system.
60 minutes = $100
Insurances- Although I am paneled with most insurances at this point, I am in school full-time right now so I’m not able to take the time to bill insurance, but I did lower my rate as the average cost of one therapy session, particularly if you are a specialist and a strong generalist, is $150.
What are your virtual and in-office times?
I’m only doing virtual sessions while in school to save time and increase the number of people I can help. If you think we might be a good fit but you’re leery of telehealth, I would suggest that you just give it a try. It’s not the same kind of experience that people had during Covid, when everyone was using Better Help and they got a different therapist each time and their were all kinds of glitches. This is not that at all! True story: Even when I’m not in school, I only saw clients in my office once a week, usually just the first time, because once they tried telehealth, I never saw them in person again! It dawned upon them, “I’m getting the same quality care, at home, on my bed, in my pjs, and I didn’t have to drive anywhere and deal with Nashville traffic, this is a W all the way around!” (actual client quote)
What is your primary specialty?
I specialize in Covert Narcissistic Abuse, a specialty that is evidently very difficult to find, even within each state. I am open-minded and would never diagnose NPD in a client I have not formally worked with and assessed. I am aware that Narcissism itself exists on a continuum, with some level of Narcissism being healthy as it propels you forward in life and helps you advocate for yourself. I work with many survivors of Narcisistic Abuse, and this work is a specialty regardless of whether the perpetrator fully met criteria for NPD or whether a lesser trait-based profile is described to me; either way, Narcissism, if too high on the continuum towards pathology, can result in its own unique brand of psychological abuse and indoctrination that typically includes both verbal and emotional abuse. I am also a lifecoach in order to help those who are outside the state of TN. Please note: I cannot engage in therapy with anyone outside the state of TN; however, I do help clients outside of the state in the capacity of a life coach, utilizing the modality of trauma-informed practical application and pulling from all various life and education experiences. For me, every woman I work with who manages to break free and stay free from a covert or overt narcissist is true fulfillment and the reason why I do what I do. Freedom from a narcissist is absolutely invaluable in being the healthiest version of yourself that you can be.
Although Narcissistic Abuse is my primary specialty, this specialty has far-reaching mental and emotional consequences and has led to me becoming well-versed in treating most mental/emotional/psychological pathologies. I’ve worked extensively with anxiety and depressive disorders, and I also did a 2-year residency in addiction, which is much like trauma bonding. Most clients who are survivors of Narcissistic Abuse typically have at least 2 additional mental health diagnoses, whether it be depression, anxiety, grief/loss, stress/coping, adjustment disorder, substance abuse, etc. By specializing in Narcissistic Abuse, I have become a strong generalist and am competent and willing to help most all mental health conditions.
I also specialize in helping victims who share children with a covert or overt. There are specific techniques that help diffuse the situation and create emotional distance even while co-parenting. I do need to emphasize that Narcissists in general do not do much of the heavy lifting when it comes to parenting, so the primary caregiver is and always will be the victim. This is even more of a reason why it’s important to set healthy boundaries when co-parenting with a Narcissist.
Lastly, I always have a few clients who have decided to stay in the relationship with the covert for personal reasons. In this case, I am still able to treat any abuse that has or is occurring while offering techniques and support to help the victim curate, develop, and find fulfillment through friends, career, hobbies that can lead to passions, and many other areas of their life beyond their relationship with the covert. Training clients in “deliberate living” is balanced with diffusion techniques such as “not taking the bait,” “grey-rocking,” and others to create as much emotional safety as possible and navigate the high-conflict nature of the relationship. Some of these techniques include learning how to live proactively and deliberately rather than just letting life “happen.”
Do you ever see men?
I do actually work with some men who are victims of narcissistic abuse, particularly if they are willing to primarily do virtual statements. While narcissistic personality disorder is a majority male disorder, there are absolutely female narcissists or females with traits that exist high on the narcissistic continuum. In this case, I will definitely treat anyone, women or men, who are victims of narcissistic abuse.
Where are your intake forms located?
To create an account and fill out your paperwork, simply go to the teletherapy io link on my site, click on create new profile, and you will see the intake paperwork! If you are in the state of TN and are seeing me for therapy, you only need to fill out the therapy paperwork. Since you will be seeing me virtually, I will need you to fill out the telehealth consent to treat. I tried to keep the paperwork to a minimum! Once you’re finished, simply submit them to the portal and you’re good to go!
How often would I see you?
It’s really dependent on the client’s specific situation. I will say, most of my clients see me every other week, as there is usually some journaling homework as well as physical “body” homework and thought-watching or mindfulness work. Some of the most important work is done outside of session. The key to seeing these elements come together and result in healing is cumulative and based on the competency of the therapist, the level of involvement/vulnerability of the client in session, and the consistency and thoroughness of performing the work outside of session. Most of these exercises will not just be done to check off a box, but rather will represent a both processing and letting go of what brought you to me while simultaneously introducing new elements that will result in increased self-care and a preventative mental health lifestyle. If a client feels she needs weekly sessions for extra support or accountability, I totally support that. In all, how often a client comes to therapy is dependent upon their individual pace to complete the homework thoroughly and their emotional brain’s speed to fully process as we integrate new coping skills and techniques, get any potential trauma or anxiety moving, and begin to symbolically close specific anxieties or traumas. I consider every other week (unless a specific situation calls for it) within the confines of “best practice” along with the specific homework.
Do you do sliding scale?
I’m not able to do sliding scale at this time, but the customary rate of $125-$150 didn’t feel right to me either. I will take insurance again once I am out of school.
What is your cancellation policy?
I have a 24 hour cancellation policy. If clients cancel after the 24 hour window it may result in a charge. A first time warning will be issued.
Do you communicate with clients outside of session?
Yes. One of the unique things about my practice is that for increased continuity of care. Since I don’t see my clients as often, all of my clients have access to my email and I encourage them to reach out to me if they need support, if they have a question, or even if they just wanted to talk! Please know that I will do my best to respond within a few hours! I am much better with text, but I have stopped texting for now as the board does not look friendly upon it. I will also check in between session weeks for continuity of care and to strengthen the therapeutic relationship if the client is okay with these methods of communication. That being said, it’s important to note that communications like email aren’t always HIPPA compliant. This is an important thing to think about in making the decision to participate in communication outside of confines of a session; however, as long as you feel comfortable with communication using email, I’ll always try my best to help you or answer any question without costing you the fee of a session! I absolutely want all clients to feel comfortable reaching out to me and if I can send back a response that will bring them clarity, offer additional reading materials, or answer a quick question without it costing them a session I’m happy to do so.
Additionally, if a client communicates with me that they need to be seen asap I can usually find them a virtual session right away.
If I sound like a good fit for you, don’t hesitate to reach out to me and let’s schedule an appointment to work together soon! I truly feel like therapy/mental health is my purpose work and I’m grateful that you took the time to even scan this looong document lol!
Thank you again for checking out my site!
Anna LPC-MHSP, FNP-C, PMHNP-to-be