Use the menu at the top to learn more about the evidence-based therapies offered at DSE.

I have been working at the VA for over 7 years and have had the opportunity to learn a few things.

Evidence-Based Therapy

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Accepting new patients, several insurances, VA referrals, and private pay clients.

As a Veteran of the Marine Corps and Army, with combat deployments to Desert Storm, Kosovo and Operation Iraqi Freedom, treating Veterans is dear to my heart. This is why I have worked at the VA and the Army for many years.
I do accept referrals from the VA. Ask me for details.

"But those who wait on the Lord
Shall renew their strength;
They shall mount up with wings like eagles,
They shall run and not be weary,
They shall walk and not faint."

Isaiah 40:31

Cognitive Processing Therapy (CPT)

CPT is used to treat Post Traumatic Stress Disorder and associated traumas.

What is Cognitive Processing Therapy?
• Short-term therapy in an individual (50 minutes) setting occurring weekly or twice weekly.
Cognitive Processing Therapy (CPT) looks at the impact a traumatic event has had on one’s life and helps examine and change unhelpful thoughts and feelings related to the event, one’s self, others, and the world. An important part of treatment is addressing ways of thinking that might keep an individual “stuck” and get in the way of recovery from symptoms of PTSD and other problems.
CPT is effective in treating PTSD across a variety of populations and types of trauma. CPT has worked well for individuals who have experienced combat, sexual, or childhood trauma, as well as other types of traumatic events.

Cognitive Behavioral Therapy for Attention Deficit/Hyperactivity Disorder (CBT-ADHD)

ADHD is often misunderstood as laziness, bad parenting, or excessive screen time. These myths ignore the scientific evidence and can prevent people from getting proper support.
ADHD is real. It is neurobioligical in nature where brain imaging actually shows structural differences, especially in the prefrontal cortex.
About 60% of children with ADHD continue to experience symptoms as adults.
Many adults with ADHD find medication insufficient, and even those with symptom relief often lack practical coping skills. CBT-ADHD addresses this gap by integrating updated insights into adult ADHD and proven behavioral strategies..
Not all who have ADHD need medications, and there are other medications that are not stimulants. Even if you don’t need medications, you can benefit from the skills taught here.CBT-ADHD includes three main modules:
●Psychoeducation, organizing, and planning. You will learn that ADHD is a neurobiological disorder, a valid
diagnosis, and not related to laziness or a lack of intelligence. They also learn that the cognitive behavioral treatment approach they’re embarking upon can significantly alleviate challenges associated with ADHD. Participants also learn how to effectively use a calendar and task list systems for filing papers, among other organizational and problem solving strategies.
●Coping with distractibility. You will learn to stay focused on lengthy, uninteresting tasks learn how to break these tasks down into smaller chunks. You also learn how to use timers, cues, and other strategies to override distractibility problems.
●Cognitive restructuring, or adaptive thinking. You will learn positive self-coaching strategies as well as how to look at situations more rationally, and how to dispute negative or other unhelpful thoughts.

Cognitive Behavioral Therapy for Insomnia (CBT-I)

CBT-I is recommended above medications for insomnia treatment.

CBT-I is highly recommended as a first-line treatment for insomnia.
What is Insomnia?
People with insomnia may have a hard time falling asleep, staying asleep, or may wake up too early. They also usually experience effects of poor sleep during the daytime, such as:
• Feeling tired
• Having low energy
• Trouble with attention, concentration, and memory
• Becoming easily irritated
• Having difficulty at work or school without sacrificing their own well-being.The “cognitive” part of CBT-I focuses on your thoughts, feelings, and expectations about sleep and insomnia that may affect how well you sleep.
The “behavioral” part of CBT-I helps you develop proven sleep habits, based on the science of sleep that will help you sleep better.
What are the goals of CBT-I?
The goals of CBT-I are to help you fall asleep, stay asleep, and improve your daytime functioning and quality of life as a result of better sleep at night.
Does CBT for Insomnia work?
CBT-I is one of the most studied and effective therapies.How long does CBT-I last?
CBT for insomnia usually requires only 6 sessions to be effective. In some cases, extra sessions may be needed, but your insomnia may also get better in fewer than 6 sessions

Dialectical Behavioral Therapy (DBT)

DBT is a powerful and proven therapy helpful across a wide range of conditions. It assists in managing Anxiety and Depression by helping you become aware of and change negative thought patterns, focusing instead on positive activities that promote health. For those struggling with Substance Abuse, DBT provides skills to reduce cravings, avoid high-risk situations, and find healthier alternatives for managing stress. If you have ADHD, DBT skills improve impulse control and help you develop necessary life organizational strategies. It is particularly effective for Borderline Personality Disorder (BPD), helping to moderate excessive emotions, increase tolerance for high stress and triggers, and address issues like problem relationships and impulsivity. Furthermore, DBT is useful for Post-Traumatic Stress Disorder (PTSD), assisting in trauma processing and providing essential grounding techniques. Finally, for Anger Management, DBT helps you quickly recognize your emotional triggers and offers tools to reduce intense feelings without resorting to aggressive behavior.How Does DBT Help? (The Core Skills)
DBT is a comprehensive approach built around four core skill areas that together teach you how to build a life worth living. First, Emotional Regulation teaches you practical skills to identify, understand, and manage intense emotions, reducing emotional overwhelm and impulsivity so you can cope independently. Second, Mindfulness is the foundational skill of staying present and observing your thoughts and feelings without judgment, which significantly reduces anxiety and helps you respond thoughtfully instead of reacting impulsively. Third, Distress Tolerance provides you with essential tools to tolerate and survive emotional crises without resorting to destructive behaviors like self-harm or emotional shutdown, using techniques such as distraction and radical acceptance. Finally, Interpersonal Effectiveness teaches you crucial communication, assertiveness, and boundary-setting skills, enabling you to build healthier relationships, express your needs clearly, and resolve conflicts while maintaining your self-respect

Cognitive Behavioral Therapy for Chronic Pain (CBT-CP)

CBT-CPis a specialized, evidence-based program that offers proven tools for managing persistent pain, even when the sensation itself cannot be fully eliminated. This therapy recognizes that pain is a complex experience shaped as much by your thoughts, feelings, and behaviors as by physical sensations. CBT-CP empowers you to shift your focus from seeking a cure to significantly improving your quality of life and daily functionality.How CBT-CP Works for Healing
CBT-CP is a structured, skill-based program focused on teaching you practical ways to interrupt the chronic pain cycle. Over several sessions, we work together to understand how stress, worry, and avoidance actually intensify your pain and limit your life. We then focus on two key areas: Cognitive Restructuring, which means identifying and challenging unhelpful thoughts—like feeling that all pain equals harm—that fuel your distress; and Pacing and Activity Scheduling, where you learn to intentionally schedule activities consistently to safely increase your stamina, breaking the exhausting "boom-bust" cycle of overdoing it and then crashing.The Benefits of Choosing CBT-CP
The goal of CBT-CP is to dramatically decrease the disability and suffering associated with chronic pain. By changing your mental and behavioral responses, you gain practical skills to effectively dial down the associated distress. This leads to profound improvements, including better sleep quality, a reduction in fear of pain, and a safe, sustained increase in your overall functionality and engagement in the activities that matter most to you. CBT-CP ultimately shifts your power away from the pain itself and puts you back in charge of your life.

Written Exposure Therapy (WET)

WET is a highly efficient and evidence-based psychotherapy designed to reduce or eliminate the overwhelming symptoms of Post-Traumatic Stress Disorder (PTSD). It is a recognized and recommended treatment by leading organizations like the VA and DoD. This treatment is distinguished by being brief and highly focused, providing a clear path to healing in a short timeframe.
How WET Works for Healing
The entire WET process is typically completed in just five structured sessions. The core of the treatment is dedicated writing about your traumatic experience. You are guided to detail the event while focusing specifically on the thoughts and emotions you experienced at that time. By safely engaging with the memory repeatedly, you teach your mind and body new, corrective lessons: that the memory itself is not dangerous, and that the powerful distress you feel is temporary and manageable. This repeated, safe exposure helps your system learn to neutralize the trauma's power, allowing chronic symptoms like flashbacks and avoidance to fade. WET empowers you to take control of your memories, offering you a fast track to freedom and peace of mind.

Cognitive Behavioral Therapy for Nightmares (CBT-N)

CBT for Nightmares is an evidence-based, short-term, multi-component, behavioral treatment for chronic nightmares.

CBT-N, primarily using a technique called Imagery Rehearsal Therapy (IRT), is a powerful, non-medication approach designed to help you regain control over those distressing, recurring dreams. It's completely understandable if you feel helpless against your nightmares; they often lead to poor sleep, anxiety, and avoidance during the day. This therapy operates on the principle that nightmares are often a learned pattern, and just like any habit, your brain can be trained to unlearn them. The core benefit of this process is that it will give you a structured, step-by-step method to safely confront the dream and permanently alter its content, effectively turning a terrifying experience into something neutral or even positive.The most rewarding benefits of engaging in this therapy are the lasting, positive changes you'll see in both your sleep and your waking life. You will work on "rescripting" your nightmare—changing its plot and outcome—and then you will practice rehearsing that new, safer ending in your mind while you're awake. This simple, focused practice creates a new, less frightening pathway for your brain to follow during sleep. As you continue, you will notice a significant drop in the frequency and intensity of your chronic nightmares. This, in turn, leads to better quality sleep and a reduction in related symptoms like fatigue, anxiety, and hypervigilance. By successfully tackling your nightmares with this method, you'll build confidence and a powerful sense of mastery, proving to yourself that you can change the narrative and reclaim your peace of mind and your rest.

Guided Imagery

Guided Imagery is a practical, mind-body approach that uses your imagination—the same internal process you use every day—to promote profound healing and well-being. This technique has been utilized throughout history to positively influence not just thoughts and behaviors, but also physiological functions within the body. It is a powerful, yet gentle way to communicate with your mind and empower your body's natural ability to heal, reduce stress, and manage discomfort.How Guided Imagery Works
The process typically begins with a relaxation exercise to help you enter a calm state. From there, we work together to explore positive visual images. This might involve visiting a beautiful, safe place that you create in your mind, or visualizing a specific positive outcome you wish to achieve. As you engage with the image, you will be encouraged to use all your senses—what do you see, hear, smell, and feel? This deep engagement promotes an altered state of awareness, which is key to its effectiveness. By working with imagery, you can distract your mind from sensations like pain, induce deep relaxation, and affect major physical systems in the body, including your heart rate, blood pressure, and stress hormone levels.The Benefits of Using Imagery
A key benefit of Guided Imagery is the sense of mastery and control it provides, which fuels self-directed change. It is a versatile tool that can be taught one-on-one or used through recordings for repeated practice at home. Guided Imagery is particularly beneficial for reducing anxiety, improving sleep quality, helping to manage chronic pain, and coping more effectively with stress. By training your mind to focus on healing, comfort, and positive outcomes, you actively support your body's ability to maintain balance and enhance your overall well-being.

Biofeedback using Heart Rate Variability

What is Heart Coherence?
The science-based practice of synchronizing your heart and brain

Heart Rate Variability Coherence
This is the foundation of HeartMath's science. Heart Rate Variability (HRV) is the pattern of the time interval between heartbeats, which reflects your emotional and physiological state. Coherence is the optimal state where the heart rhythms are smooth, like a sine wave, indicating synchronization between the heart, brain, and the Autonomic Nervous System (ANS). Achieving coherence restores physiological balance and optimizes nervous system function.The Heart-Brain Connection
Research shows the heart, often called the "heart-brain," sends signals that significantly influence the cranial brain. Stressful emotions create incoherent, erratic heart rhythms that impair mental clarity and performance. In contrast, regenerative emotions (like appreciation) create smooth, coherent rhythms that facilitate brain function, enhancing decision-making and intuition. By intentionally shifting your heart rhythms, you quickly improve both your emotional state and cognitive processes.HeartMath Technology and Techniques
HeartMath combines simple self-regulation techniques (e.g., Heart-Focused Breathing™) with patented technology (e.g., the Inner Balance™ sensor). The technology measures your HRV in real-time, providing coherence feedback. This visual feedback allows you to immediately see your heart rhythms and learn to successfully shift yourself into the coherent state, training you to maintain balance and emotional composure daily.Evidence-Based Benefits
Supported by over 500 peer-reviewed studies, consistent use of HeartMath leads to significant improvements in just 6-9 weeks. Benefits include substantial increases in Psychological Well-being (e.g., drops in anxiety and depression) and Cognitive Function (e.g., improved focus and mental clarity). It also promotes better Physical Health by reducing stress and enhancing resilience, leading to Optimized Performance across physical and relational activities.

Motivational Interviewing (MI)/ Motivational Enhancement Therapy (MET)

MI and MET are compassionate, collaborative approaches designed to help you explore and resolve mixed feelings about making a life change. These therapies respect your right to self-determination and focus entirely on your reasons and your commitment to change, rather than pressure or confrontation.Motivational Interviewing (MI): Exploring Healthier Habits
MI is a versatile therapy that can help you develop healthier habits across many areas of your life, including substance use, smoking, nutrition, exercise, and managing chronic health problems. Typically lasting between one to four sessions, MI focuses on exploring your personal values and goals for change. By speaking openly with your therapist about any mixed feelings you have, you increase your awareness of your reasons for change and your commitment to new behaviors. This therapy helps you set healthier choices and commit to follow-up care if needed to support your goals.Motivational Enhancement Therapy (MET): Focusing on Substance Use
MET is a specialized, brief intervention, usually lasting three to four sessions, often used for individuals who are contemplating changing their use of alcohol or drugs. You will complete an assessment to help explore your personal reasons for changing substance use, which you then review with your therapist to identify and strengthen your motivations. Through this focused work, you can develop healthier substance use habits, reduce engagement in risky behaviors (like unsafe drug use or gambling), and increase your overall commitment to a plan that works best for you. MET can serve as a powerful first step or be used on its own to support your path toward recovery.

What are Evidence-Based Therapies (EBT)?

EBTs are important because they provide treatments that are scientifically proven to work, maximizing the likelihood of a positive outcome. They ensure clients receive reliable, effective care that is backed by the best available research, setting a standard for quality in mental health.

Evidence-Based Therapies (EBTs) are mental health treatments that have been thoroughly investigated in scientific studies, such as Randomized Controlled Trials (RCTs), and proven to be effective and reliable for specific conditions. This means that a large body of research supports the therapy's ability to produce positive change and consistent results for patients. EBTs, which often include approaches like Cognitive Behavioral Therapy (CBT), Exposure Therapy, and others you utilize in your practice, rely on the integration of the best available research with your clinical expertise and the client's values and unique circumstances, ensuring the care provided meets the highest standards of safety and efficacy.