Understanding the anxiety cycle. Clients learn how anxious thoughts, bodily sensations, and avoidance feed one another, which makes anxiety feel more predictable and less overwhelming.

Challenging anxious thinking and facing fears gradually. Clients test worry-driven predictions against evidence, then approach feared situations, sensations, or thoughts step by step, learning that anxiety rises and falls and that they can cope.

Building skills and practicing between sessions. Clients learn to tolerate uncertainty, reduce reassurance-seeking and safety seeking behaviors, and use relaxation tools such as paced breathing, applying them through homework so gains carry over into daily life.

Psycho-education about the cycle of how intrusive thoughts develop into OCD. Clients learn that their responses to intrusive thoughts in the form of reassurance and safety seeking crystalize into OCD and the role of accepting uncertainty.

Exposure. Gradually and collaboratively, you approach the thoughts and behaviors you would otherwise avoid and stop engaging in neutralizing behaviors that provide short term help but maintain the OCD.

Response prevention. While facing the trigger, you practice resisting the urge to perform compulsions, whether checking, washing, seeking reassurance, or mental reviewing/checking.

Learning through experience. Over time, you discover that anxiety rises and falls on its own, that feared outcomes are less likely than they feel, and that you can tolerate uncertainty without rituals.

Understanding the cycle of panic. Understanding about where panic attacks begin and how to cycle develops.

Cognitive reframing. You identify catastrophic interpretations of bodily sensations ("I'm going to collapse") and the tendency to overestimate danger, then practice evaluating them against evidence and developing more accurate perspectives.

Interoceptive exposure. In a guided, gradual way, you deliberately bring on harmless physical sensations similar to panic, such as a racing heart, dizziness, or breathlessness, so you learn that these sensations are tolerable, not dangerous and fade on their own.

Situational (in vivo) exposure. You gradually return to places and activities you have been avoiding, building confidence step by step.

Task initiation. Treatment teaches you how to create a sense of urgency when it is not externally created like someone else’s deadline.

Organizational skills and time management. CBT teaches you skills to work on “time blindness,” how to break down tasks into manageable bites and get things done more efficiently.

Change the negative thoughts that hold you back. CBT helps you examine self-critical thoughts like “I’m lazy” or “I can’t get it together,” which often fuel anxiety, avoidance, and low confidence.

Practical, structured, and built for real life. Sessions are goal-focused and time-limited, with tools and between-session practice that you can use at work, at home, and in your relationships.

Self-monitoring. Tracking eating, hunger, and mood to identify patterns and triggers.

Changing unhelpful thoughts. Challenging all-or-nothing thinking, harsh self-criticism, and “I blew it” reactions that lead to giving up.

Managing emotional eating and urges. Learning alternative ways to cope with stress, boredom, and difficult emotions.

Planning and problem-solving. Building realistic routines for meals, activity, and high-risk situations such as holidays, travel, and social events.

Relapse prevention. Preparing for setbacks so small slips don’t turn into regaining weight, which supports long-term maintenance.

Behavioral activation. Together, you gradually schedule meaningful, rewarding, and manageable activities, starting small. Plan activities and do not wait for motivation to come and instead work on building momentum.

Cognitive restructuring. You learn to notice self-critical and hopeless thoughts, examine the evidence for and against them, and develop more balanced perspectives.

Reducing rumination and avoidance. You build skills to step out of repetitive negative thinking and re-engage with the things you have been avoiding.

Problem-solving. You break overwhelming problems into manageable steps and practice acting on them.

Strengthening relationships and routines. You work on reconnecting with others and building consistent sleep, activity, and daily structure.

Identify perfectionist beliefs and rules. CBT for perfectionism helps you spot rigid “shoulds” and all-or-nothing thinking.

Cognitive restructuring. Replaces harsh self-criticism with balanced, more realistic thoughts.

Behavioral experiments. Test your fears with small, safe mistakes to see what actually happens.

Reduce perfectionist behaviors. Scale back over-checking, over-preparing, and avoidance.

Build self-compassion. Respond to setbacks with kindness while keeping high standards.

Regular, balanced eating. We establish a steady pattern of meals and snacks, which reduces the hunger and restriction that often lead to binges.

Understanding your triggers. You’ll learn to identify the thoughts, emotions, and situations that lead to binge episodes, so you can respond differently in the moment.

Changing unhelpful thoughts. We work on the rigid food rules, all-or-nothing thinking, and self-criticism that keep the cycle going.

Develop and strengthen other parts of your identity. During treatment, we will work on building up more meaning and sense of identity outside of body image/appearance.

Sleep tracking. Start keeping a log about sleep including various habits around sleep.

Sleep scheduling (sleep restriction). Time in bed is temporarily matched more closely to the time you are actually sleeping, then gradually adjusted. This builds sleep drive and consolidates sleep.

Sleep education and sleep habits. You learn how your sleep works and adjust routines which support it.

Cognitive restructuring. You examine unhelpful beliefs about sleep and its consequences and replace them with more balanced, realistic ones, reducing nighttime worry.

Relaxation and wind-down skills. You practice techniques that lower physical and mental arousal before bed.

Identify and reframe anxious thoughts. Learn to spot the negative automatic thoughts that fuel social anxiety, like “everyone will notice I’m nervous” or “I’ll say something stupid.”

Test your fears against reality: Examine the evidence for and against anxious beliefs, and replace harsh self-judgment with more balanced, realistic thinking.

Gradually face feared situations. Practice step by step, from easier situations (like a short chat) to harder ones (like speaking up in a meeting), so avoidance loses its grip and confidence builds.

Shift your focus outward. Reduce self-monitoring and over-analysis during interactions so you can be more present with the people around you.