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Common Questions about Therapy for Anxiety

What if I'm feeling ambivalent about working on my anxiety?

Chances are you're going to keep feeling ambivalent if you don't take that first step. The best way to get things moving is to make an appointment with a therapist and start figuring out why you're stuck. Talking to someone may be just what you need to find your motivation and start taking the small steps towards feeling better.

What if my child doesn't want to go to therapy?

Therapy involves making changes, and that can be scary for anyone. This is especially true when you throw anxiety into the mix. From my experience, the best way to ease children into therapy is to 1) make sure that they feel like they have some control over the process and 2) let them know they won't be forced to make changes that they are not ready to make. This is often all that's needed to get things started. Of course for some kids this may still not be enough to help them overcome their discomfort. In cases where children absolutely refuse to engage in treatment, I can start by working with parents and then developing a strategy to bring the child into the process.

How long will treatment last?

In general the form of therapy that I provide (CBT) is considered a short-term treatment. The goal is to develop skills, practice them in the therapy office, and move towards managing your symptoms independently. For many of my clients, particularly those who are motivated and have mild to moderate symptoms, this can happen in as few as 8-10 weekly sessions. For others, treatment can take significantly longer. Beginning with the initial intake appointment we will be identifying your goals and proceeding at a pace and time frame that works for you.

How difficult is therapy?

Starting therapy is a big commitment. Real success can only happen if our therapy sessions are part of a plan that includes working on things every day outside of the therapy office. At the same time, we will identify the resources you have at your disposal to make the process manageable. Utilizing your coping skills and social supports, as well as finding ways to celebrate your small successes, will be an essential part of the process.

I've been diagnosed with an anxiety disorder. Will I have these symptoms forever?

If you are an anxious person, like so many of us, you probably won't ever become a non-anxious person, and really, who would ever want to completely change that about you? However, anxiety disorders are absolutely treatable. The symptoms that have been causing you distress and interfering with your life - the worries, the avoidance, the obsessions, the rituals, the inability to concentrate - can be significantly improved.

Will I relapse after treatment?

Living with mental health issues tends to be an up and down wave over the lifespan. You will inevitably have good and bad periods. But with proper treatment, the good periods will become even better and last longer, and the bad periods will be less bad and shorter in duration. Oftentimes, clients who have experienced improvements in their anxiety will continue with symptom maintenance plans that involve less frequent appointments (once a month, for example) to have a little support as they move forward through life.

I've heard that ERP is the most effective treatment for OCD. Does it really work?

Exposure and Response Prevention (ERP) therapy is the most effective treatment for OCD. If you are struggling with OCD, you have probably noticed that having others try and "talk you out of" your fears and worries hasn't resulted in any long term results. The only way to increase your tolerance of the things you are currently avoiding, and to truly begin to understand that you are safe, is to have actual therapeutic "experiences." This means purposely exposing yourself to your triggers, and resisting your usual rituals (or avoidance strategies). This may sound like the last thing you want to do, but when done gradually, this approach not only works, but can be a rewarding experience. ERP is often used in conjunction with medication for maximum impact.

Can you prescribe medication?

As a licensed mental health professional, I am trained to provide psychotherapy. However, I am not qualified to prescribe medication (only physicians and some nurses can do that). I also understand that medication is a critical component of treatment for most of my clients. If you are already being prescribed medication, I will work with your prescriber to ensure that your medication and therapy are complimenting one another. If you are not currently taking medication, but would like to do so, I can also provide referrals for trusted physicians. For general questions, the IOCDF has a page on medications for OCD: https://iocdf.org/about-ocd/treatment/meds/.

Do you treat PANDAS/PANS?

PANDAS/PANS are very rare disorders characterized by a sudden rapid onset of OCD symptoms that is triggered by an infection such as Streptococcus (Strep throat). In true PANDAS/PANS, a physician familiar with the disorder will medically treat the infection. In some cases this will be all that's needed for the OCD symptoms to subside. In cases where OCD symptoms remain after the infection is managed, they are treated just as typical OCD symptoms would be treated; through a combination of ERP therapy and medication. A good overview of PANDAS/PANS can be found on the International OCD Foundation website https://kids.iocdf.org/what-is-ocd/pandas/.

Can you help with my child falling behind in school?

Yes. Sometimes school personnel need help from a mental health professional to develop an approach to working with a child's anxiety symptoms. This can be as simple as providing the school with some education about your child's symptoms or, in more severe cases, include implementing formal accommodations through a 504 plan or an IEP plan. From my experience, schools are typically very understanding and accommodating when it comes to helping children who are experiencing mental health issues. In cases where a specific school is having trouble understanding or being empathic towards a child's struggles, we will work with a combination of persistence and patience in improving the learning environment for your child.

Do you work with couples and families?

Yes. I provide family and couples therapy in addition to individual therapy. Whether this is to get help with addressing an individual in the family who is struggling with anxiety, or to simply improve communication patterns, meeting with all involved in the situation is often the most effective way to address the issue.

Michael Parker, LCSW   |   2526 Monroeville Blvd #208, Monroeville, PA 15146   |   412.256.8256   |   Treatment for OCD and Anxiety in Pittsburgh, PA

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