Trisha B

Exposure Response Prevention (ERP)

You may see me use Exposure and Response Prevention (ERP) to help you confront fears, intrusive thoughts, or distressing situations in a structured and supportive way. Together, we identify the specific triggers that fuel anxiety and gradually expose you to them at a pace that feels manageable for you. As you face these challenges, I guide you in resisting compulsions or avoidance so your brain can learn that anxiety naturally rises and falls without needing a ritual. Over time, you build confidence, increase your tolerance for uncertainty, and break out of the loops that keep you stuck. In ERP, you and I may build a step‑by‑step exposure together and practice it right in session. For example, if you’re working on contamination fears, you might touch a moderately triggering surface and then sit with the anxiety without washing. I help you ride out the urge to ritualize, notice how the discomfort shifts, and experience firsthand that you can handle the moment without relying on compulsions. ********************************************************************** You may also see me use Habit Reversal Training (HRT) to help you reduce body‑focused repetitive behaviors like hair‑pulling, skin‑picking, or nail‑biting. Together, we identify the specific urges, sensations, and situations that trigger the behavior, and then build alternative responses that give you more control. In HRT, you and I may practice a competing response right in session. For example, if you feel the urge to pick or pull, I might guide you to clench your fists, press your palms together, or engage your hands in a neutral movement until the urge passes. We also work on increasing awareness of the moments leading up to the behavior so you can interrupt the cycle earlier and with more confidence.

Acceptance and commitment (ACT)

You may see me incorporate Acceptance and Commitment Therapy (ACT) to help you build psychological flexibility—the ability to stay present, make room for difficult thoughts and emotions, and take action guided by your values. Instead of trying to eliminate uncomfortable thoughts or feelings, ACT helps you change your relationship with them so they no longer dictate your choices. Together, we explore mindfulness strategies, acceptance skills, and values‑based goal setting to help you step out of unhelpful patterns. Through ACT, you can learn to navigate discomfort, increase resilience, and build a life driven by purpose and authenticity rather than fear or avoidance. In ACT, you and I may practice defusion right in session. For example, if a painful thought shows up—like “I can’t handle this”—I might invite you to slow it down, repeat it in a different tone, or label it as a thought. This helps you create space from it so you can choose a values‑aligned action, even while the discomfort is still there.

Cognitive Behavioral (CBT)

You may see me use Cognitive‑Behavioral Therapy (CBT) to help you identify and shift unhelpful thought patterns and behaviors that contribute to emotional distress. CBT is a structured, evidence‑based approach that focuses on how your thoughts, feelings, and actions influence one another. By noticing negative thinking patterns and learning practical coping strategies, you can develop healthier responses to life’s challenges. Together, we’ll build skills to manage anxiety, depression, stress, and other concerns. Through CBT, you can increase self‑awareness, strengthen problem‑solving abilities, and create lasting, meaningful change in your daily life. In CBT, you and I may work through a thought‑reframing exercise right in session. For example, if you’re feeling overwhelmed by a situation, we might identify the automatic thought driving the distress, examine the evidence for and against it, and develop a more balanced, grounded alternative. You then practice responding to the situation from this new perspective, helping you feel more in control and less pulled around by old patterns.

Motivational Interviewing

You may see me use Motivational Interviewing (MI) to help you explore ambivalence and build motivation for meaningful change. This collaborative, client‑centered approach focuses on your values, strengths, and personal reasons for change—without pressure or judgment. Through open‑ended questions, reflective listening, and gentle curiosity, we work together to uncover barriers, resolve uncertainty, and strengthen your confidence in taking action. In MI, you and I may map out the “pulls” in both directions when you’re feeling stuck. For example, if part of you wants to make a change and another part feels unsure, I might guide you through a decisional balance exercise where you name what each side is trying to protect. I reflect your language back to you, highlight the strengths you’re already using, and help you identify one small, values‑aligned next step that feels doable and self‑directed

Eclectic

You may notice that I take an eclectic approach, meaning I draw from multiple evidence‑based therapies and tailor them to what you need in the moment. Instead of forcing you into one rigid model, I integrate tools from ERP, ACT, CBT, MI, and HRT so your treatment feels responsive, flexible, and aligned with your goals. In an eclectic session, you and I may blend approaches in real time. For example, if you’re working through an OCD trigger, we might start with an ERP exposure, then use ACT defusion to help you sit with the discomfort, and finish with a CBT reframing exercise to help you understand the thought pattern that showed up. This allows you to build skills across multiple domains while staying grounded in what works best for you.