If someone asked you not to think for 10 minutes how hard would that be? Is overthinking about the “What Ifs” driving you to relentlessly check things over and over again? Are you determined to find certainty in an uncertain world? Do you frequently ask others repeatedly if something or someone is going to be OK? No matter how much you do a task or say a particular thing does peace of mind elude you? Does the compulsion to handwash, re-read, double check, pray, or re-arrange items never provide lasting relief? Do you find yourself burdened by intrusive thoughts that strike against your will and preoccupy your mind for hours a day? OCD is characterized by unabating obsessions matched with intense mental or behavioral rituals to relieve the anxiety provoked. It is not treated by “talk therapy” but with Exposure and Response Prevention (ERP). Through customized gradual exposures, ERP is an evidence-based method of intervention to reduce the severity of OCD symptoms. ERP is a collaborative and creative approach to learning new skills and strategies to become comfortable with uncertainty and more confident in your ability to handle life’s unexpected challenges. My style is compassionate, client centered, and culturally sensitive. What to do if you’re nervous about sharing your thoughts with me in therapy? If you're too embarrassed to share something, you can write it down, you can use visuals, you can type it. We can work around this to find other ways that you can deliver the communication. I am a Licensed Marriage and Family Therapist in California, Hawaii, Indiana, Massachusetts, Nevada and Virginia. Registered Out-of-State Telehealth Provider in Florida, South Carolina, and Vermont. My treatment focus is on neurodivergent issues, gifted learners, managing life transitions, women’s mental health issues around shifting roles in family and career, and immigration/re-entry adjustment stressors.
What can clients expect to take away from sessions with you?
My therapeutic style is collaborative, client-centered, and multiculturally sensitive. I focus on supporting neurodivergent and gifted learners with healthy adaptive coping tools to develop resilience in an uncertain world. Interventions used in my practice are evidenced and strength based. You are the expert on you. My role is to facilitate and support an awareness of how to implement changes to overcome unhelpful patterns in thinking and decision making. I strive to see the whole person not just a list of symptoms. Understanding your unique background is key because therapy is not a cookie cutter approach.
Explain to clients what areas you feel are your biggest strengths.
This is not a cookie-cutter approach. You will not be treated like a textbook case. Therapy is unique to each person, and treatment is very collaborative. It's more of a partnership. You're the expert on you. We will follow a process and a protocol, but you will be very involved in the treatment, not passive As a therapist, I like to learn a lot about what's happening in your life now. How does your OCD manifest in daily life? What are you doing now that isn't working for you? I also like to get background stories to determine perhaps why some of these anxieties exist. I like to look at biopsychosocial history—like birth order or your school experience—which is often relevant.
About Maria Rheba Estante
Maria Rheba Estante offers therapy covered by Blue Shield of California - Medi-Cal, Blue Shield of California Promise Health Plan (Medi-Cal), Central California Alliance for Health (Medi-Cal), Gold Coast Health Plan (Medi-Cal), Kern Family Health Care - Medi-Cal, L.A. Care Health Plan (Medi-Cal), Orange County Mental Health Plan (Medi-Cal), Partnership HealthPlan of California (Medi-Cal) and San Francisco Health Plan (Medi-Cal) in California.
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Exposure Response Prevention (ERP)
Specialized training in Exposure and Response Prevention (ERP) for OCD, Habit Reversal Training (HRT) for Excoriation Disorder or Trichotillomania and Flash technique/EMDR for PTSD. EMDR (Basic 1 and 2) trained Clinician (EMDRIA).
EMDR
According to current research, approximately 40 to 60 percent of OCD has a trauma onset. Unresolved trauma may cause a person's nervous system to be already elevated on a daily basis. For individuals who experience both PTSD and OCD symptoms, resolving traumatic memories often takes priority in treatment. The Cleveland Clinic explains EMDR as follows: Eye movement desensitization and reprocessing (EMDR) therapy is a mental health treatment technique. This method involves moving your eyes a specific way while you process traumatic memories. EMDR’s goal is to help you heal from trauma or other distressing life experiences. The first clinical trial investigating EMDR was in 1989. EMDR is an evidence-based modality that has been used by organizations such as the VA to treat symptoms of PTSD.
Emotionally Focused Therapy (EFT)
Emotionally Focused Individual Therapy (EFIT) is a groundbreaking therapeutic model that facilitates emotional processing and the creation of secure relationships with self and others. EFIT focuses on facilitating reparative experiences in connection with self and others to develop secure emotionally safe connections.
Acceptance and commitment (ACT)
ACT is geared towards developing emotional and psychological flexibility. It is comprised of 6 processes and integrates well with ERP for the treatment of OCD, Anxiety, Phobias, and Panic Attacks. The six core processes that promote psychological flexibility are: 1. Acceptance Acceptance involves acknowledging and embracing the full range of your thoughts and emotions rather than trying to avoid, deny, or alter them. 2. Cognitive Defusion Cognitive defusion involves distancing yourself from and changing the way you react to distressing thoughts and feelings, which will mitigate their harmful effects. Techniques for cognitive defusion include observing a thought without judgment, singing the thought, and labeling the automatic response that you have. 3. Being Present Being present involves being mindful in the present moment and observing your thoughts and feelings without judging them or trying to change them; experiencing events clearly and directly can help promote behavior change. 4. Self as Context Self as context is an idea that expands the notion of self and identity; it purports that people are more than their thoughts, feelings, and experiences. 5. Values Values encompass choosing personal values in different domains and striving to live according to those principles. This stands in contrast to actions driven by the desire to avoid distress or adhere to other people’s expectations, for example. 6. Committed Action Committed action involves taking concrete steps to incorporate changes that will align with your values and lead to positive change. This may involve goal setting, exposure to difficult thoughts or experiences, and skill development.
Cognitive Processing (CPT)
CPT focuses on how your thinking has been impacted by the trauma and teaches you to take a look at your thoughts and help you progress toward recovery. CPT, EMDR, and the Flash Technique are utilized in my practice for the treatment of trauma.