How does Cognitive Behavior Therapy (CBT) work?

Dr. Esther Lapite-Garrett is a licensed psychologist and the founder of Alafiora, a premium private practice offering depth-oriented, attachment-centered care for individuals navigating complex sexual trauma and the relational patterns that form in its aftermath. The clients Dr. Lapite-Garrett works with include survivors of rape, incest, sex trafficking, intimate partner sexual violence, and childhood sexual abuse. What followed that history is the center of her clinical practice: the love obsession, limerence, compulsive sexual behavior, hypersexuality, and emotional dysregulation that form in the aftermath of sexual harm, and that most generalist approaches were never quite equipped to treat. Alafiora is one of a small number of practices equipped to work with the full spectrum of how these patterns express themselves in contemporary life, including the migration of erotic and romantic attachment into AI companionship, parasocial bonds, fantasy-based intimacy systems, and the accelerating escalation that occurs when real-world connection no longer feels safe, satisfying, or possible. The clients who carry these presentations arrive having spent considerable financial, emotional, and psychological resources on experiences that brought temporary relief and deepening shame in equal measure. The clients Dr. Lapite-Garrett works with are not struggling with a lack of insight. They have read the books, tried the prior therapy, and understand their patterns with a clarity that has not been enough to stop them. They wake at 3am with a body that will not settle. They reach for sex or connection not from desire but from the need to feel something, or to feel nothing at all. They love with an intensity that outlasts what the relationship warrants, cycling through obsessive thought long after every rational part of them knows the situation has ended. They make choices in moments of emotional flooding that they do not recognize as their own afterward. They experience behavior escalation, spending elevations, and deepening secrecy. Even still, they find that the pattern repeats, each time carrying a little more shame and a little more distance from the person they understood themselves to be. What years of prior effort could not move, the work at Alafiora finally does. What changes in our work is structural. The clients who engage fully describe experiencing more than symptom management but a fundamental shift in the organizing patterns that formed them, patterns that prior treatment approaches could not reach. Alafiora is a private-pay practice offering sessions virtually, in person, and on location across multiple states. The practice maintains a small, intentionally limited caseload to ensure each client receives the full depth of care their history requires. Visit https://www.alafiora.com to learn more or inquire confidentially.

I’m a board-certified Psychiatric Mental Health Nurse Practitioner dedicated to helping individuals improve their mental health and overall well-being. I work with adolescents and adults experiencing concerns such as anxiety, depression, ADHD, and feeling overwhelmed by life’s stressors. My approach is compassionate, collaborative, and personalized. I believe that mental health care should feel supportive and non-judgmental, and I strive to create a space where you feel comfortable sharing your concerns. Together, we will work to better understand what you’re experiencing and develop a treatment plan that may include medication management and practical strategies to support your daily life. My goal is to help you feel more balanced, supported, and empowered in your mental health journey.

I am a physician assistant with a background in endocrinology and psychiatry, specializing in the intersection of mental health and metabolic health. My clinical focus is on understanding how hormones, sleep, and metabolic imbalances contribute to conditions like depression, anxiety, fatigue, and brain fog. At MetaBridge Health & Wellness in Atlanta, I provide integrative and metabolic psychiatric care with an emphasis on hormone optimization, circadian health for shift workers, and personalized treatment plans guided by advanced lab testing. My approach is evidence-based and patient-centered, designed for individuals who are functioning but still struggling with energy, mood, or focus. I believe in going beyond symptom management to address the root causes of health challenges, creating lasting solutions that support both mind and body.

Are you finding it difficult to form or maintain meaningful relationships? Struggling with self-esteem, anxiety, or feeling like you're not “enough” no matter how much you achieve? Perhaps you appear successful on the outside, but inside, you're overwhelmed, emotionally drained, or simply not feeling like yourself. You’re not alone and you don’t have to navigate this alone either. You may have tried to manage things on your own, ignoring the signs, pushing through, hoping things will get better. But if you're reading this, something inside you knows it's time for a different approach. Therapy can be that turning point. Together, we’ll work to understand what's beneath the surface and begin to build a more empowered, fulfilling life. As an immigrant from Central America, I deeply understand the cultural pressures, generational expectations, and identity struggles that can weigh heavily on us. I also know the courage it takes, especially in communities where therapy is often stigmatized to ask for help. There is nothing weak about seeking support. In fact, it’s one of the bravest things you can do for yourself. I provide a warm, non-judgmental space where your lived experiences are acknowledged and honored. My trauma-informed, culturally responsive approach ensures that therapy isn’t one-size-fits-all. Your story is unique, and the healing process should reflect that. I work with adults navigating: Anxiety, depression, and emotional overwhelm Relationship and attachment challenges Grief, loss, and life transitions First-generation identity struggles and intergenerational trauma Immigration-related stress and cultural adjustment Burnout, perfectionism, and low self-worth, even in high-achieving individuals The emotional impact of racism and systemic oppression on BIPOC communities Whether you're seeking clarity, connection, or peace of mind, we’ll co-create a path that aligns with your values and goals.

Hey there! I’m Ragnar Scott, a Board-Certified Psychiatric Mental Health Nurse Practitioner (PMHNP) specializing in substance use disorder (SUD) treatment and holistic mental health care. As the Associate Medical Director at Rose City Detox and the owner of LiveWell, LLC in Ridgefield, WA, I’m committed to delivering compassionate, patient-centered care that meets you where you are. My experience spans psychiatric, neurological, and substance use disorders, with a career path that has taken me to hospitals and healthcare settings across Oregon, Washington, Illinois, Georgia, Alabama, and Massachusetts. I’ve had the privilege of leading and educating healthcare teams in diverse environments, building a foundation of collaboration and support. If you're between 15 and 55 and facing challenges like ADHD, anxiety, depression, or life transitions, I’m here to help. I understand how overwhelming it can feel when you're balancing work, school, or relationships. My goal is to offer practical, no-nonsense strategies that make life feel more manageable, while helping you regain control of your well-being. My approach is straightforward, transparent, and supportive. I believe in fostering a welcoming environment where you feel safe to express your thoughts and concerns without the pressure of medical jargon. With telehealth as a core part of my practice, I make it convenient to connect when you need it most. Outside of work, you might find me enjoying the great outdoors with my loyal (and occasionally grumpy) German Shorthair, Buddy. I’m passionate about creating a balance between professional dedication and personal fulfillment, and I bring that philosophy into my practice. If you're looking for a down-to-earth approach to mental health and recovery, let's chat. Treatment Philosophy: I believe in providing compassionate, patient-centered care tailored to each individual. At LiveWell, I focus on holistic wellness, addressing mental health and substance use disorders with empathy and understanding. My approach emphasizes open communication and collaboration, fostering a trusting environment where you feel supported. Whether it’s recovery or maintaining well-being, I strive to empower you with practical, effective strategies for lasting wellness. Specialties & Conditions: • Mental Health • Psychiatry • Child Psychiatry • Psychotherapy • Addiction Medicine • Depression • Anxiety • Bipolar Disorders • ADHD • Addiction • PTSD • Insomnia • Relationship Issues • Mood Disorders • Panic Attacks • Substance Abuse • Pediatric Psychiatry • Substance Use Disorder • Grief and Loss • Counseling • Anxiety Disorders • Behavioral Issues • Substance Abuse Evaluation • Opioid Addiction • Alcohol Dependency • Detoxification Management • Behavioral Therapy • Prescription Drug Misuse • Relapse Prevention • Addiction Counseling • Withdrawal Symptoms • Co-occurring Disorders Treatment approach: • Existential • Substance Use Disorder Treatment • Cognitive Behavioral Therapy • Mindfulness-Based Techniques • Patient-Centered Care • Integrative Health Approaches In-network Insurance company: • Anthem • Aetna • Cigna • Blue Cross Blue Shield • Quest • Carelon

As a Psychiatry Provider, I am honored to play a central role in delivering thoughtful, patient-centered care within a supportive and nonjudgmental environment. I employ a professional and compassionate approach, collaborating closely with each individual to understand their unique experiences and objectives. My focus is on cultivating trust, promoting open communication, and developing treatment plans that are both evidence-based and tailored to each patient's specific needs.

I am a licensed clinical social worker with over 20 years of experience working with adult population with issues of decreased motivation and anxiety. It is my thinking that everyone should have someone to speak to about things on their minds, both good and not great, and I will provide a confidential and safe space for this. I use various types of therapeutic interventions while engaging my clients in conversation and helping them see how they can improve in their life choices and to feel better about themselves. As humans, we all make mistakes and in making these mistake, we learn to improve ourselves. I work with Cognitive Behavioral therapeutic techniques as the way we think about things affects how we feel, which in turn affects our behaviors. I urge for self care and help my clients with feelings of low confidence. My focus is in the areas of depression and anxiety and I use a blend of evidence based techniques to make my clients feel happier with their lives and their choices. I have experience with group work and with individual therapy and will help you find what works for you throughout our time together.

South Asian therapist specializing in working with life changes, family relationship issues, an

Rebuilding Mental Health is a leading mental health center, mental health clinic, and behavioral health facility dedicated to compassionate, evidence-based care. We offer partial hospitalization programs and intensive outpatient programs as levels of support. These programs integrate proven therapies such as cognitive-behavioral therapy, dialectical behavior therapy, trauma therapy, narrative therapy, and experiential therapy. As a trusted psychiatric center, we empower individuals to regain control of their lives, build resilience, and achieve long-term wellness in a supportive environment.

My passion is rooted in working with individuals who may find themselves faced with challenges such as depression, anxiety, life transitions, as well as racial trauma. Additionally, I enjoy working with clients within the Black and POC community to help address and decrease the stigma and barriers associated with receiving mental health treatment. *in person appointments available on Tuesdays only