What does therapy with you look like?

My biggest hope is that you feel a sense of safety in and outside of the therapy office. I approach each session based on what you need, while always checking in on things like safety, how your experience is showing up in your body, and what is currently impacting you most. I hope to help you tune into yourself, notice patterns and receive the support you need to make meaningful change. Sessions may feel like they are moving at a slower pace than traditional talk therapy, and this is intentional. My hope is that our time together will support healthy rhythms for your nervous system.

What therapeutic modality do you use?

I am what is considered “eclectic,” with areas of specialty that we draw upon. Sometimes sessions look like teaching skills to manage overwhelm, others it’s traditional “talk therapy” and occasionally, it’s breaking down different therapeutic ideas so you can understand how they apply to your life. Often, it’s a combination of many different interventions. Depending on what you’re working on, we may use tools from different therapeutic approaches, including Somatic Experiencing (SE), Inner Relationship Focusing (IRF), Exposure-Response Prevention Therapy (ERP), Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), mindfulness, and more. Of all these approaches, I default to SE and IRF (parts work) in each session. Because of this, you can expect a slower pace to sessions than you may be used to. I will check in with you regularly to see what is working and what isn’t—therapy is your space and your time, and it’s my goal to give you the support you want and need as you learn to trust yourself in working through challenges.

What is Somatic Experiencing for Trauma?

Trauma is, unfortunately, a universal experience. Our bodies and nervous systems have an amazing capacity to heal and regulate themselves. Sometimes, the trauma we experience overwhelms our systems and we feel frozen in time—stuck in the same fight/flight/freeze process as if we were reliving the trauma in our bodies today. Somatic Experiencing is a body-based approach that supports your nervous system to process the “residue” trauma has left in our bodies. Instead of traditional talk therapy that asks that you tell and process the narrative of your trauma, Somatic Experiencing helps your body find a deep sense of safety by resolving its activated (fight/flight) or deactivated (freeze) states so that you can get back to the natural rhythms of nervous system regulation—protecting you when necessary, and enjoying both activity and rest when not. Somatic Experiencing is a gentle and supportive approach to resolving the activation in our bodies leftover from the challenges of life. If you’d like to learn more, please go here.

**Please note, Kara is currently at the Advanced level in the certification process to become a Somatic Experiencing Practitioner.

What is Exposure and Response Prevention for OCD?

Exposure and Response Prevention (ERP) is the “gold standard” of treatment options for Obsessive Compulsive Disorder. If you suffer with obsessive thoughts and compulsive behaviors, you know that no amount of reframing, affirmation, insight building or replacement behaviors help. In fact, compulsions are an attempt to get relief from your intrusive thoughts, but they often make obsessions and the fears underneath them even louder by unintentionally telling our minds that we are right to fear our triggers. It’s a vicious cycle that is strengthened every time we give energy to our obsessions. With ERP, we interrupt the cycle. Instead of acting on compulsive behaviors for relief, we learn to tolerate the thing we fear. We learn to accept that thoughts can be scary, but also have only the meaning we give them. We learn that by exposing ourselves to what we fear and not seeking the quick fix of a compulsive behavior, we can sit with our anxiety and distress until it naturally decreases and our fears aren’t quite so loud. ERP is difficult, but incredibly effective and supportive for the treatment of OCD. And, much less difficult than paying the cost of your compulsions over the course of your life. If you’d like to learn more, please feel free to contact me or read more here.

How long should I expect to work with you?

Therapy is different for everyone. Some folks need a few sessions to learn new skills, while others will need more long-term support to work through complex trauma or challenging relational dynamics. There is no “good” or “bad” timeline for “finishing” therapy—it takes the time that it takes. As your capacity for managing your experiences increases, you may need less and less therapeutic support. That said, my hope is to support you moving through the therapeutic process at a pace that works for you. I am here for as long as you need!

I want to work with you but I’m not in san diego. What are my options?

COVID-19 changed the way we do therapy, making virtual sessions more available. Virtual therapy is an option, as long as you reside in the state of California. If you live outside of California, I would love to refer you to a provider in your area, when possible. If you are in San Diego but need a virtual session, you can “opt in” to virtual sessions at any time. Some clients are always virtual. In both situations, a HIPAA-compliant video link is sent for all sessions. To receive virtual treatment, you must reside in the state of California, where I am licensed. If you prefer to be in-person, great! For in-person sessions, my only ask is that you don’t come to session while sick!

Therapy is expensive! What options do I have?

It’s true, therapy is expensive, and it’s definitely worth the investment. Therapy has been shown to improve overall quality of life and relationship satisfaction, as well as decrease risk factors for medical issues such as high blood pressure, sleep issues, and the overall impact of stress on the body. It’s a short-term expense for a long-term payoff. I offer sliding scale payment on a case-by-case basis. If you are interested in this, please do let me know. And while I’m not “in-network” with insurance companies, we do have the ability to have a “single case agreement” with your insurance provider. Please contact me with questions about this process, as it varies between clients and insurance providers.

What if I need to cancel?

I get it—things come up! Whether you’re sick, have a scheduling conflict or need to cancel for any other reason, just let me know! I have a 36-hour notice policy: there is no fee if you cancel your session within 36 hours. If you let me know after the 36 hour marker, I do charge a “late cancellation” fee, which is the full fee for the session. While not ideal, please keep in mind, I have reserved this time in our schedule for you and without enough notice, often aren’t able to fill that space to provide a service to someone else. If you need to cancel within 36 hours but are able to reschedule within the same week, there is no late cancellation fee.

How do I receive a “Good Faith Estimate” for my time with you?

In California, you have the right to receive a “Good Faith Estimate” as a rough estimate how much your mental health care will cost. You can ask for a Good Faith Estimate before you schedule a service, or any time during our therapeutic relationship. For more questions or more informations regarding your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.