Contact Us

We offer both in person services based in Mission Valley as well as telehealth services via video-conferencing platforms to patients located in California.

We do not accept walk-ins. You must contact our Clinic Coordinator at 858-354-4077 or info@csamsandiego.com before visiting us on site.

CONTACT US

IF YOU WOULD LIKE TO INQUIRE ABOUT TREATMENT AT CSAM, PLEASE FILL OUT THE FORM AND A THERAPIST WILL CONTACT YOU TO MAKE AN APPOINTMENT.

You may also contact us via phone or email:

Phone: 858-354-4077

Email: info@csamsandiego.com

7860 Mission Center Ct, Suite 209
San Diego, CA, 92108

858.354.4077

At The Center for Stress and Anxiety Management, our psychologists have years of experience. Unlike many other providers, our clinicians truly specialize in the diagnosis and treatment of anxiety and related problems. Our mission is to apply only the most effective short-term psychological treatments supported by extensive scientific research. We are located in Rancho Bernardo, Carlsbad, and Mission Valley.

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Blog

Read our award-winning blogs for useful information and tips about anxiety, stress, and related disorders.

 

Mental Health, & Stigma as a Barrier to Social Support

Jill Stoddard

In honor of the National Alliance on Mental Illness (NAMI) San Diego's Mental Health Awareness Walk, this blog delves into the importance of social support for those with mental illness, and how stigma may become a barrier to the support that is needed by so many.

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Righting Your Relationship With You: Part Two ~ Self-Validation, Self-Compassion, Radical Self-Acceptance, and Authenticity

Jill Stoddard

Recently, the relationship that we have with ourselves has been the subject of growing interest. Psychologists (along with many others!) have begun to more openly and honestly explore why it is so common to have a harsh relationship with ourselves, and what we can do to shift into a more authentic, resilient, strong, and nourishing relationship with ourselves. This part of our blog series explores and ties together some of the recent theories that clue us in about how to cultivate a radically different relationship with the real YOU.

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Righting Your Relationship With You: Part One ~ Stop Hiding, and Start Embracing All of Yourself

Jill Stoddard

Take a moment to pause and reflect on the relationship that you have with yourself. What is it like?  Recently, the relationship that we have with ourselves has been the subject of growing interest. Learn why it is so common to have a harsh relationship with ourselves, and what we can do to shift into a more authentic, resilient, strong, and nourishing relationship with ourselves. 

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Anxiety in Children

Jill Stoddard

 

Have you noticed that your child seems to be experiencing a significant amount of anxiety? Learn more about the anxiety disorders that can develop at a young age and the support that is available. If you would like to seek the help of a professional, contact us to schedule an appointment with our child anxiety specialist now.

 

Childhood Anxiety Disorders

 

Generalized Anxiety Disorder

Learn more about GAD.

Things to look out for:

·      Excessive worry about a variety of things in your child’s life

·      Perfectionism and self-criticism

·      Constant need for approval or reassurance

 

Obsessive-Compulsive Disorder (OCD)

Learn more about OCD.

Things to look out for:

·      Obsessions: Experiencing unwanted and intrusive thoughts

·      Compulsions: Repeatedly perform rituals and/or routines in order to ward off anxious feelings

 

Panic Disorder

Learn more about panic disorder and panic attacks.

Things to look out for:

·      Panic/anxiety attacks that come on for no reason or out of the blue

·      If your child is concerned about or afraid of having another panic attack in the future

 

Posttraumatic Stress Disorder (PTSD)

Learn more about PTSD.

Things to look out for:

·      Experiencing or witnessing a traumatic or life-threatening event

·      Intense fear/anxiety

·      Emotional numbness

·      Easily irritable

·      Avoidance of places, people or activities

 

 

Separation Anxiety Disorder

Learn more about separation anxiety disorder here.

Things to look out for:

·      Your child is slightly older (common in ages seven to nine)

·      Unable to be separated from loved ones or takes significantly longer to calm down compared to other children

·      Experiences extreme homesickness/misery at being separated from loved ones

 

Social Anxiety Disorder

Learn more about social anxiety disorder.

Things to look out for:

·      Intense fear or anxiety related to social interactions

·      Anxiety about performance and activities

·      Extreme shyness or inhibition

·      Difficulty making new friends or speaking with peers

 

Selective Mutism

Visit online: Selective Mutism Group

Things to look out for:

·      Refusing to speak in situations that make your child anxious

·      Standing motionless/expressionless

·      Avoiding eye contact, chewing/twirling hair, turning heads

 

Specific Phobias

Learn more about phobias.

Things to look out for:

·      Intense irrational fear of a specific object or situation (such as animals, storms, blood, needles, medical procedures, etc.)

 

 

Treatments Offered at CSAM

 

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is an empirically supported treatment that focuses on modifying problematic thoughts & behaviors that contribute to & maintain emotional problems like anxiety, stress, & depression. Like traditional forms of therapy, CBT emphasizes a warm, safe, & empathic therapeutic environment. CBT is different from some approaches in that it focuses on present-day problems & learning skills to overcome symptoms. It teaches children to identify thoughts & behaviors that are keeping your child stuck, so your child may develop more adaptive ways for navigating life.

 

Acceptance and Commitment Therapy (ACT)

Acceptance and commitment therapy is an empirically supported treatment that focuses on reducing experiential avoidance and accepting internal experiences (thoughts and feelings) in the service of living a valued, vital, meaningful existence.  Mindfulness, metaphors, and experiential exercises play a central role in ACT.

 

Biofeedback

Biofeedback is an empirically supported treatment that focuses on balancing the nervous system. Biofeedback is shown to be extremely effective at helping patients reduce anxiety and stress, lower blood pressure, reduce chronic pain (including migraines), increase focus and attention, and reduce hyper-vigilance commonly experienced after trauma.

 

How Can I Respond to My Child?

 

ADAA provides the following suggestions in their article “Tips for Parents and Caregivers”

Source: http://www.adaa.org/living-with-anxiety/children/tips-parents-and-caregivers

 

Here are things you can do at home to help your child manage his or her anxiety disorder:

 

Pay attention to your child’s feelings.

Stay calm when your child becomes anxious about a situation or event.

Recognize and praise small accomplishments.

Don’t punish mistakes or lack of progress.

Be flexible and try to maintain a normal routine.

Modify expectations during stressful periods.

Plan for transitions (For example, allow extra time in the morning if getting to school is difficult).

Keep in mind that your child’s anxiety disorder diagnosis is not a sign of poor parenting. It may add stress to family life, however. It is helpful to build a support network of relatives and friends

Resources:

The Anxiety and Depression Association of America, ADAA

www.ADAA.org

 



Are you interested in scheduling an appointment with our child specialist? If you'd like to speak with a professional at the Center for Stress and Anxiety Management for help with anxiety, please click here.

Follow us! Subscribe to the CSAM RSS feed, and follow us on Facebook or Twitter (@CSAMSanDiego).

Exposure Therapy Basics: What It Is & Why It Works

Jill Stoddard

Written by Lauren Helm, M.A.

 

 

 

“Face your fears.” The wisdom of this adage is built into exposure therapy, an intervention that has been extensively researched and shown to be very effective in treating various anxiety disorders. What is exposure therapy? We break it down here.

 

Anxiety disorders are usually characterized by excessive and debilitating fear or anxiety. The anxiety may become so powerful that it can feel as though it has taken on a life of its own, domineering a person’s relationships, work, and quality of life.  Though fear and anxiety are normal emotional responses to a threat (they motivate us to avoid potentially harmful situations), those with anxiety disorders often experience debilitating anxiety even when a truly dangerous threat is not present.  Despite the absence of something that may cause physical harm, the brain’s fear centers are fully activated, and for someone with anxiety, it strongly feels as though something bad will happen. It is proposed that anxiety disorders in part develop as a result of both classical and operant conditioning, two important psychological concepts that inform and guide exposure therapy.

 

Basically, fear and anxiety are actually reinforced and strengthened when we avoid whatever causes it (whether it be a person, place, thing, thought, memory, emotion, or physical sensation that acts as a trigger). When we avoid or escape something that makes us feel afraid, it’s like our brain sends us a message that says, “Thank goodness I got away from that scary thing! It must have been truly dangerous. I am safe now that I am not longer in contact with the threat. If I get close to it again, I better make sure to get far away again!” A cycle is created. The next time we encounter the feared stimulus (i.e. whatever it is that triggered our anxiety), the more likely we are to experience a heightened fearful or anxious response, and to have stronger urges to avoid or escape.

 

In exposure therapy, the therapist leads her client through a set of experiences intended to elicit the very fear that the person has been avoided. Though this may seem counter-intuitive, it is an extremely effective behavioral approach that helps the client free themselves from the cycle of anxiety and avoidance. Essentially, avoidance is “blocked;” the client begins learning how to face his or her fears, and in doing so, experiences habituation. Habituation is like desensitization. When someone is exposed to something repeatedly, it begins to lose potency. Anxiety and fear naturally drop off, and with repeated exposures, become less intense and long-lasting. Additionally, when avoidance is prevented, the fear/anxiety response is no longer reinforced and strengthened. This leads to an extinguishing of the fear response. In other words, a fearful or anxious response is “extinguished” and fades away over time.


Most people have trepidation about starting exposure therapy. It is admittedly uncomfortable, at least in the short-term. However, the long-term benefits far outweigh the discomfort that may occur along with exposure therapy. Usually, it turns out that we hold beliefs about emotions (especially fear and anxiety) that interfere with our willingness to effectively face our fears.


Common myths about emotion typically include beliefs that:

  • Fear or anxiety will continue to escalate (without a ceiling effect or peaking) indefinitely until the person gets away from whatever is causing them anxiety
  • Fear or anxiety will become so intense that it will cause physical harm or death
  • Fear or anxiety will become so intense that it will cause psychological damage, insanity, a loss of control, etc.


These beliefs often reflect a fear of emotions stemming from a commonly-held belief that emotions are dangerous. In and of themselves, emotions are not dangerous – they are physiological sensations (along with thought & urges). The sensations are designed to motivate us to act. The feelings that come along with emotions may be experienced as overwhelming (especially when we don’t understand them or it feels as though they can do us harm), but they will not hurt you (and it is not physically possible for them to intensify beyond a certain point). Frequently, exposure therapy results in the added benefit of being able to tolerate intense emotions, and learn that it is safe to fully feel your emotions. It’s what you do with your emotions that count – how we ACT can have a beneficial or detrimental effect on our lives and well-being. Therapists help you to learn how to effectively respond to your emotions, so that they don’t restrict your way of life. Your CSAM therapist is well-trained in exposure therapy principles and will explain in more detail why it is not the case that intense, acute emotional experiences cause harm. In fact, one of the principles of exposure therapy is to ensure that individuals are absolutely not caused harm – otherwise that would defeat the point! Exposure therapy is all about learning that despite the anxiety, there is no danger, but rather, safety. Once this is sufficiently experientially learned and processed (not just known intellectually), dramatic change begins to occur.


Don’t worry – your therapist will collaborate with you to figure out the best pace of treatment. Depending on your needs, you may opt to participate in flooding (which essentially means that you face some of your most intense fears right away), or the more commonly used approach, gradual exposure (you work your way up an exposurehierarchy, starting with mild-moderate fears). Both approaches have been found to be equally effective, but differ in the length of time that they may take to complete, and in the likelihood of premature drop-out. Remember, exposure requires repeated practice facing your fears until a re-learning occurs. Sticking with exposure therapy until anxiety has naturally begun to dissipate (or tolerance of anxiety has increased) is essential for success.

Are you interested in using exposure therapy to tackle your fears? Our CSAM therapists are trained in exposure therapy and can help you effectively respond to anxiety using evidence-based methods. If you'd like to speak with a professional at the Center for Stress and Anxiety Management for help with anxiety, please click here.

Follow us! Subscribe to the CSAM RSS feed, and follow us on Facebook or Twitter (@CSAMSanDiego).


References



Barlow, D. H., Craske, M. G., Cerny, J. A., & Klosko, J. S. (1989). Behavioral treatment of panic disorder. Behavior Therapy20(2), 261-282.


Barlow, D. H., Rapee, R. M., & Brown, T. A. (1992). Behavioral treatment of generalized anxiety disorder. Behavior Therapy23(4), 551-570.

Feeny, N. C., Hembree, E. A., & Zoellner, L. A. (2004). Myths regarding exposure therapy for PTSD. Cognitive and Behavioral Practice10(1), 85-90.


Foa, E., Hembree, E., & Rothbaum, B. O. (2007). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences therapist guide. Oxford University Press.


Hofmann, S. G. (2008). Cognitive processes during fear acquisition and extinction in animals and humans: Implications for exposure therapy of anxiety disorders. Clinical psychology review28(2), 199-210.

The Benefits of Group Therapy

Jill Stoddard

Written by Lauren Helm

The Benefits of Group Therapy

 

Image source: www.mental-illness-resources.com

Though it may be intimidating to envision sharing your path of recovery and well-being with a group of others (who are admittedly, at least initially, strangers), group therapy may be a worthwhile alternative to pursuing individual psychotherapy. It is often more cost-effective than individual therapy, and yet can be just as efficacious as therapy provided one-on-one.

 At CSAM, we offer evidence-based group therapy treatments that are structured in approach, but also allow you to connect with others while you learn more effective ways of responding to anxiety or other related disorders. The therapist both teaches and guides group members through exercises geared towards helping each person make significant changes in their lives.

 Our CSAM therapist, Dr. Michelle Lopez, regularly leads a cutting-edge cognitive behavioral group, called the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders. The group helps you to understand the nature of our thoughts, emotions, and behaviors, the role they play in the development and maintenance of anxiety disorders and depression, and how to begin reclaiming your life. If you’d like to learn more about these groups, feel free to reach out to us!

Above and beyond the useful informational content that the group offers, there are added benefits to receiving therapy in a group setting. Here we briefly review a few (though not all) of Yalom’s therapeutic factors that may occur in group therapy: 

Universality

When you participate in a group and share your experiences with others, you may become more and more aware of the shared nature of human experiencing (including pain and joy), thus creating a sense of universality, and reducing feelings of isolation or aloneness. FYI, a sense of common humanity is connected to self-compassion and optimal well-being!

Altruism

Group therapy offers opportunities to practice compassion and other altruistic behaviors towards one another, enhancing a sense of connection to others as well as your connection to yourself. You can also be a role model for others: Studies find that kindness breeds kindness.

Instillation of hope

Each of us is resilient in our own way, and we can share with others how we have persevered despite extreme difficulty, offering hope and inspiration to one another.

Imparting information

Often, we have learned very practical information about how to navigate various aspects of life that others may benefit from. Imparting information is also a form of social support, which can positively impact our physical and emotional health.

Development of socializing techniques & Interpersonal learning

A group setting may allow members to practice new social and communication skills in a safe environment with the support of the therapist. This may lead to more satisfying interpersonal relationships.

 

These are but a few of the benefits that may be experienced as a result of participating in group therapy. If you’d like to learn more about the group therapy that CSAM offers, click here. You can also call our clinic to see if any groups will be offered in the near future so that you can experience the benefits of group therapy for yourself!

 

  

If you'd like to speak with a professional at the Center for Stress and Anxiety Management for help with anxiety, please click here.

Follow us! Subscribe to the CSAM RSS feed, and follow us on Facebook or Twitter (@CSAMSanDiego)

 

 

References

Barlow, D. H., Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Allen, L. B., & May, J. T. E. (2010). Unified protocol for transdiagnostic treatment of emotional disorders: Therapist guide. Oxford University Press.

Ellard, K. K., Fairholme, C. P., Boisseau, C. L., Farchione, T. J., & Barlow, D. H. (2010). Unified protocol for the transdiagnostic treatment of emotional disorders: Protocol development and initial outcome data. Cognitive and Behavioral Practice17(1), 88-101.

Ellis, A. (1992). Group rational-emotive and cognitive-behavioral therapy.International journal of group psychotherapy.

Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Thompson-Hollands, J., Carl, J. R., ... & Barlow, D. H. (2012). Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial.Behavior therapy43(3), 666-678.

Yalom and Leszcz (2005) The Theory and Practice of Group Psychotherapy, 5th edition, Basic Books p. 272