Treatments

Rationale, Approach, & Levels of Care

TREATMENT RATIONALE

Dr. Curiel strongly believes in providing gold-standard, evidence-based treatments (EBTs) for the scope of disorders she has chosen to treat (all of which have symptoms that closely relate and/or require treatments with similar interventions).  This means that she strives to abide by approaches that research says are the most effective.  EBTs increase the chances of optimal symptom relief, a successful treatment outcome, a shorter treatment duration, and lower costs over time.  Dr. Curiel maintains her knowledge of the latest developments in research via literature review and trainings/conferences provided by renowned experts in their respective fields.  


Because many of these conditions are neurobehavioral, where the brain involuntarily "fires" false alarm signals of discomfort, intolerance, or danger, it would be unhelpful to treat symptoms with therapy that emphasizes searching for a hidden cause or larger meaning.  Simply exploring or trying to "reason" through symptoms typically causes the individual to remain stuck, particularly if they know their fears are irrational (or that their tics are disruptive) and they are capable of the same methods of logic independently.  Similarly, traditional play therapy will often not yield the same outcomes as the treatments listed below.  CBT and Exposure Therapies emphasize education on the mechanisms that allow the condition to thrive and changing mental and behavioral responses to the brain's "firings."  Imaginal and in-vivo exposures are completed in the office and in natural settings to generalize results to real-life settings.  When games are utilized, they are tailored to precisely target the maladaptive mental and behavioral responses.


TREATMENT APPROACHES

The Cognitive-Behavioral approaches utilized are supported by research as the gold-standard treatments for OCRDs, TDs, and Anxiety Disorders.

  • Cognitive-Behavioral Therapy
  • Exposure (and Response Prevention)
  • Habit Reversal
  • Comprehensive Behavioral Intervention for Tics
  • Comprehensive Behavioral Model 

LEVELS OF CARE

Traditional Outpatient - one individual therapy session per week

Informal Intensive Outpatient - two or more individual sessions per week are offered within a private practice setting (as opposed to a formal IOP program).  Intensive group therapy is not provided; however, a referral for local IOP group therapy can be provided if an individual needs more support and containment.

One-time Skills Consultation

  • Typically reserved for those in rural settings where access to care is limited and a home visit is beneficial (e.g. hoarding)
  • This service is NOT psychotherapy (explained in consent form), rather synonymous with an interactive class that entails education and time-limited practice (e.g. diet and insulin classes for diabetes)

CBT Rationale for Anxiety Disorders

Rethinking anxiety: Learning to face fear | Dawn Huebner