What can I expect during a session? We will co-create the structure of the session together, based on treatment goals.

What to do in case of emergency? If we are in session, we will do whatever we can to keep you safe. https://dbhds.virginia.gov/contact/need-help/ call 988 and tell them your location

What is informed consent? Informed consent is an ongoing conversation between therapist and client so the client truly understands the process, including all the limitations, risks, benefits and alternatives. Per National Library of Medicine, informed consent is the process in which a health care provider educates a patient about the risks, benefits, and alternatives of a given procedure or intervention. The patient must be competent to make a voluntary decision about whether to undergo the procedure or intervention. Informed consent is both an ethical and legal obligation of medical practitioners in the US and originates from the patient's right to direct what happens to their body. Implicit in providing informed consent is an assessment of the patient's understanding, rendering an actual recommendation, and documentation of the process.

Emotional Support Animal Accommodation Guidance. I will follow the guidance of the U.S. Dept of Housing and Urban Development (HUD) when crafting a letter regarding the necessity of an Emotional Support Animal. My recommendation will be based on an assessment of what mental health disorders you may be experiencing, and how an animal can decrease the severity of the symptoms and improve your functioning. Below is information on this process directly from HUD. Information Confirming Disability-Related Need for an Assistance Animal: • Reasonably supporting information often consists of information from a licensed health care professional – e.g., physician, optometrist, psychiatrist, psychologist, physician’s assistant, nurse practitioner, or nurse – general to the condition but specific as to the individual with a disability and the assistance or therapeutic emotional support provided by the animal. • A relationship or connection between the disability and the need for the assistance animal must be provided. This is particularly the case where the disability is non-observable, and/or the animal provides therapeutic emotional support. • For non-observable disabilities and animals that provide therapeutic emotional support, a housing provider may ask for information that is consistent with that identified in Guidance on Documenting an Individual’s Need for Assistance Animals in Housing in order to conduct an individualized assessment of whether it must provide the accommodation under the Fair Housing Act. The lack of such documentation in many cases may be reasonable grounds for denying a requested accommodation. more info: https://www.hud.gov/sites/dfiles/PA/documents/HUDAsstAnimalNC1-28-2020.pdf

What is EMDR and how does it treat trauma? The limbic system is the part of the brain that processes and stores trauma, controls learning, motivation, the stress response, and the immune system. When someone experiences trauma, the amygdala, which is part of the limbic system, imprints the memory and holds the emotional significance of the event as well.  When feeling triggered, the rational, thinking part of your brain can’t control the emotional part of your brain. This is why you can’t think straight and feel overwhelmed. Traumatic memories are “stuck” in the amygdala-hippocampal complex and when triggered, they seem to occur in the present, as this area becomes overstimulated by the trigger.  “Stuck” memories are thought to be unprocessed memories. During sleep, we process and consolidate memories from the hippocampus to the neocortex. Normal, less traumatic memories, don’t become “stuck”, because at night when we dream (Rapid Eye Movement or REM phase), these are moved out of the amygdala-hippocampal complex and processed by the rest of the brain. This is one of the reasons a good night's sleep is so refreshing! EMDR (eye movement desensitization reprocessing) uses bilateral stimulation (BLS) to alternately engage both sides of the brain in action, while you focus on a fragmented memory or emotion. Bilateral stimulation (BLS) is a technique that involves alternatingly stimulating the left and right sides of the brain. It's a key component of EMDR therapy, which aims to help people process and recover from traumatic events. BLS can include a variety of activities that use sight, sound, or touch to cross the body in a rhythmic pattern.  Originally this was done by having a person follow a therapist’s finger back and forth, in front of their field of vision, which is similar to your eye movement when dreaming.  EEG tracings show that the eye movements (much like in REM sleep) elicit a synchronisation of all cortical activity at a frequency in the delta range like slow-wave sleep. EMDR temporarily slows your over-stimulated amygdala down and synchronises your brain waves helping you process the traumatic memory. This bilateral movement causes the traumatic memory that is looping in the emotional side of the brain to integrate with the cognitive part of the brain. The eye and brain movement increases the ability of the prefrontal cortex to “get online” or find rationality in the traumatic event, and release it's grip on the present.  In other words, the bilateral movements used in EMDR rapidly allow the brain to process stuck, traumatic memories as we would normally do with less traumatic memories during REM sleep. Our brains, nervous system, and bodies naturally trend toward health and recovery, and I am excited to accompany you on that journey. more info: https://www.phoenix-society.org/resources/calming-trauma https://mysydneypsychologist.com.au/how-does-emdr-work-a-neuroscience-explanation/

What is Gender Affirming Care? The mission of the World Professional Association for Transgender Health (WPATH) is to promote evidence-based care, education, research, public policy, and respect in transgender health. We envision a world wherein people of all gender identities and gender expressions have access to evidence-based healthcare, social services, justice, and equality. https://www.tandfonline.com/doi/pdf/10.1080/26895269.2022.2100644