Email: Briana@BrianaEvansLCSW.com

Phone: 858.449.2563

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My Services

I provide a variety of services to best meet the needs of my clients.

The Location: In person at my office or Teletherapy via Zoom.  (For teletherapy sessions, I utilize a HIPAA compliant Zoom platform.)

Off-Site: When clinically beneficial I may meet clients at an alternate location or at their home to complete therapeutic strategies. This is often helpful when treating OCD, BDD and other anxiety disorders.

Initial Comprehensive Assessment
In Office or Teletherapy
45-50 min: $250
60 min: $275

Individual Therapy
In Office or Teletherapy
45-50 minutes: $200
60 minutes: $225

Couples Therapy
In Office or Teletherapy
45-50 minutes $225

Family Therapy
In Office or Teletherapy
45-50 minutes $225

Off-Site or Home Visits
Length of session varies
Additional Charges Apply
Please inquire regarding these services

Cognitive Therapy (CBT)

CBT is a large category that encompasses many types of therapies. I utilize some form of CBT with most clients. The specific type of CBT depends on the symptoms and goals of the client. The following treatment modalities are included under the umbrella of CBT:

Cognitive Therapy:

I typically utilize cognitive techniques in conjunction with other therapeutic techniques. Cognitive therapy helps a person to identify and potentially change their thought patterns. This is important as our thoughts, feelings and behaviors all impact one another. Negative thinking patterns have been shown to contribute to decreased motivation, low self-esteem, increased stress, problems in interpersonal relationships, and increased anxiety and depression. By identifying and changing these negative thought patterns, clients develop healthier patterns of thinking that lead to better coping and well-being.

Behavioral Therapy

The basics of Behavioral therapy are included in almost all the therapies listed here. The basic premise of behavioral therapy is that we can learn to change or decrease undesired behaviors and increase the desired ones by using operant or classical behavioral techniques. An example of two types include: we can engage in pleasant or relaxing behaviors while facing a feared object to teach our brain not to be afraid of the feared stimulus.

Alternatively, if we want to increase a behavior, we can reward ourselves while or immediately after engaging in that behavior- which will teach our brain to engage in that behavior with greater ease or frequency.

Types of Treatment Modalities

No matter what type of treatment modality I use, I first seek to connect with each client and provide a safe place to share their experience. Through listening and helping individuals share and process their thoughts and feelings I can better understand each person’s experience and how I can best help.

I utilize different types of evidence backed treatment approaches depending on the needs of the client. The modalities I use include, but are not limited to the following:

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Exposure and Response Prevention (ERP)

ERP is the gold standard treatment of choice when treating Obsessive Compulsive Disorder (OCD) and is an integral part of treatment for Body Dysmorphic Disorder (BDD). The treatment includes identifying a person’s obsessions and compulsions and then “mapping” the way in which the obsessions and compulsions are impacting a person’s life. Clients are also taught how to create exposures (tasks in which a person faces their fear and then resists completing their compulsion). Once rated, the tasks create a hierarchy which the client will use to address their OCD symptoms. Easier exposures are usually worked on first. As someone successfully completes exposures, a process of “habituation” occurs in which the fear/obsession becomes less anxiety provoking and therefore less dependency or need to complete the compulsion. Over time with consistent work on exposures, the obsessions and compulsions decrease and shrink the OCD in a person’s life.
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Habit Reversal Therapy (HRT)

HRT is used to treat Body Focused Repetitive Disorders (BFRDs) such as nail biting, skin picking and hair-pulling, as well as tics (see paragraph below). When treating BFRDs, this therapy retrains the brain to ignore/tolerate the urge to pick/pull/bite and instead utilize relaxing techniques to manage any distressing feelings. Clients are also taught to engage in healthier substitute behaviors (competing responses) that are less disruptive or destructive than the picking/pulling/biting. With practice the original triggers for the picking/pulling/biting (whether they be environmental or internal such as feeling states) become less distressing and better managed, and the previous behavioral habits (picking, pulling biting) ultimately reduces in frequency and severity.

Comprehensive Behavioral Intervention for TICS (CBIT)

CBIT includes providing education on tics in general, increasing a person’s awareness of their tics (when they typically do/don’t occur, what the common triggers are, any other patterns to the tics), as well as the premonitory urge that occurs just prior to the tic. Clients then participate in HRT (see description above) and learn to tolerate the urge to tic through practicing relaxation techniques and utilizing a chosen competing response.

Competing responses are typically less distracting, more socially acceptable behavioral responses that a client chooses to engage in that “compete with” and are incompatible with performing the tic. Over time, by practicing relaxation and competing response behaviors until the urge to tic passes, tic severity and frequency decrease.

Acceptance and Commitment Therapy (ACT):

ACT has been shown to be helpful for a range of disorders including OCD, BDD, Panic, Anxiety, and Depression. The goal of ACT is to increase a person’s awareness and non-judgmental acceptance of all their thoughts and feelings while remaining committed to taking actions that are value and goal oriented. ACT also incorporates mindfulness techniques to help someone remain grounded in the moment. Thus a person is better able take action steps toward meeting their value-based goals regardless of what their thoughts or feelings may be.

Dialectical Behavior Therapy (DBT):

DBT was initially created to help people learn how to better modulate and manage strong emotions, engage in healthy coping methods rather than self destructive ones, and improve interpersonal relationships. It builds on many aspects of cognitive and behavioral methods, and adds mindfulness, acceptance work, distress tolerance strategies, and interpersonal skills such as effectively communicating ones needs and setting boundaries when needed.