Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is a therapeutic approach that deals with our perceptions and behaviors. It explains how our thoughts influence the way we behave and how our emotions influence the way we think. We all have distorted thoughts, negative thoughts that have no base in reality. They could be about ourselves, about other people, or generalized about the world. Distorted thoughts include all or nothing thinking, magnifying or minimizing, overgeneralizing, blaming oneself or blaming others, doweling on the negative, and more. The cognitive-behavioral approach guides you through a realistic examination of these distorted thoughts, altering the way we feel, think, and behave. It consists of tools that would help you feel good, empowered, and believe in yourself. CBT is used with children, adults, and couples, and is the most evidence-based therapy available in the mental health field.

 
Depression

Depression has many faces and although it is generally characterized by a low negative mood and irritability, there are many more specifications to consider. Depression should not be taken lightly. In a good case depression could diminish the quality of your life and in the worst case can be life-threatening. Depression could emerge due to various factors like genetics and brain chemistry, environmental factors affected by levels of stress we are exposed to at home, school/work, or both. Studies show that the most efficient treatment for depression consists of Cognitive Behavioral Therapy (CBT) in conjunction with medication. The depressed mind is preoccupied with negative thoughts. These negative thoughts are distorted, not rooted in reality, but they feel real and are therefore hard to get rid of. CBT provides very helpful techniques to manage depression and at times for eradicating it. This process takes time and effort, but it is life-changing for you and your loved ones. If you are depressed or know someone who is, I cordially recommend getting professional help. Lifeline https://suicidepreventionlifeline.org/chat/  and 

I am a live https://www.imalive.org/  provide a hotline and chat for emotional support and suicide prevention.

 
Anxiety

Anxiety disorders pertain to a ​variety of symptoms triggered by fear. Whether the source of fear is real or not, the symptoms tend to be rather extreme and often lead to the fear of fear itself. Anxiety based disorders include panic attacks, phobias, Obsessive-Compulsive Disorder (OCD), Trichotillomania (hair-pulling), social anxiety, Generalized Anxiety Disorder (GAD), and more. The symptoms of anxiety trigger a flight or fight response that generates physiological responses like cold sweat, heart palpitations, shortness of breath, or feeling faint. Racing thoughts is another common feature of anxiety, telling you that you are going crazy or that something bad is about to happen. Little anxiety is normal, but anxiety becomes a problem when it interferes with your daily functions, like work or school performance and socializing. The causes of anxiety are both biological and environmental. Cognitive Behavioral Therapy for anxiety is the most recommended treatment, and medication is most effective while in conjunction with CBT treatment. Note that when anxiety becomes prominent in your life after an upsetting or a traumatic event, you are likely to be facing post-traumatic stress.

 
Trauma

Trauma is an emotional and psychological response to a distressing event that is life-threatening or could cause serious injury, like exposure to violence that is physical, emotional, or sexual. Trauma can affect individuals or groups and can take effect immediately after the traumatic event, or have a delayed onset. Whether the traumatic event is light of profound, Post Traumatic Stress Disorder (PTSD) is highly distressing and can include flashbacks of the traumatic event, upsetting dreams, sleeplessness, and the attempt to avoid memories, feelings, and places associated with the trauma. It can evoke a negative emotional state, often companied with guilt and regret. Cognitive Behavioral Therapy for the treatment of trauma involves working with the distorted cognitions developed as a result of the trauma like: "This is my fault," "I am defective," or " I am not good enough." It further entails building safety networks in and outside the therapy as a foundation for exposure therapy. 

 
Obsessive Compulsive Disorder  (OCD)

OCD is an anxiety-related disorder. Individuals who are struggling with OCD face invasive thoughts causing them to develop a set of ritualistic behaviors (compulsions) as an attempt to reduce or avoid the anxiety caused by those thoughts. At times the rituals remain mental (like counting) and without physical display of rituals, OCD is regarded as pure "O" alluding to the obsessions as they appear without the compulsions. OCD can get rather debilitating and time-consuming. Children with OCD often delegate the rituals to their parents, like straightening the bedsheets tight before they go to bed or set their plate just right or they refused to eat. The Yale-Brown Obsessive Compulsive Scale provides Symptoms checklist of the obsessions and compulsions commonly found in OCD. Pharmaceutically, OCD is usually treated with SSRI (Serotonin Selective Reuptake Inhibitor). The most efficient approach for treating OCD is ERP (Exposure Response Prevention). The client is exposed to the fear stimulus while preventing the compulsive reaction. Acceptance Commitment Therapy (ACT) can also be used in conjunction with ERP. In children, a sudden and acute flair of OCD is likely indicative of PANDAS, a Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. This calls for pediatrician attention and is usually treated with antibiotics or anti-inflammatories. ​

 
Couples Therapy

Our need to feel connected and loved is most innate and natural. We experience void when we don't feel connected and grief when we lose connection with a loved one. Couples therapy includes marital and pre-marital counseling. Couples may experience various struggles like relationship dissatisfaction, barriers in communication, conflicting parenting styles, infidelity, sexual issues, or merely daily stress in balancing work and family life. Many couples struggle due to anxiety, depression, or inadequate coping skills used by one of the partners. I use TEAM-CBT to help couples foster safe and effective communication. Couples therapy may call for one or both partners to pursue individual therapy to enhance treatment efficiency.

 
Children and Adolescent Therapy

Like adults, children can also experience anxiety and depression, though they express it differently. Children might experience irritability, restlessness, and worry. They worry about school achievement, their social life, and the well-being of their family and loved ones. Children thrive in a stable environment and therefore do well with routines. Change is constant for children as their bodies and brain are constantly changing as part of their development. Predictability provides children with safety during the time of rapid change. As a child psychologist, I work with children as young as 6 years old and use an integrated approach, including CBT (Cognitive Behavioral Therapy) and Play Therapy. Parents take an essential part in the treatment and are invited for coaching sessions with me to address the child's behavior at home and school.

Contact Me

Due to COVID-19, all services are via Video Therapy.

Therapy is a commitment, and ​before we start working together, I'd like to offer you a 20 min' free consultation, where you can ask me questions and explain why you are seeking my services at this point in your life.

Please contact me to schedule a FREE consultation.

Be aware that the use of email could compromise your privacy. Please keep your email succinct and minimize identifying information. 

Keren Shemesh, PhD

1061 El Monte Ave, suite B

Mountain View, CA 94040

 

650-283-3542

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