Questions and Answers

Who are we?

Barbara lives in Seattle, Washington, with her husband and kids, as well as an energetic beagle and a fluffy silver tabby kitty. She is neurodivergent herself, having been diagnosed with ADHD as a young child, and she fully embraces her quirky, black sheep self. She loves nature walks, cooking, baking, puzzles, word games, road trips, reading, gentle yoga, trying to meditate, movies, theater, concerts, listening to music (especially vinyl records!), museums, urban exploring, lounging with a triple espresso and the New York Times, and traveling the world. Also, just because she CAN'T sing, doesn't mean she WON'T sing. 

Rachel is a dedicated therapist, a busy parent of four, and a proud hobby farmer. Juggling the demands of a career, a lively family, and tending to a gazillion fruit trees and three enormous dogs, she has mastered the art (mostly) of balancing work, family, and fun. When she is not immersed in daily life, she finds personal joy in creating interesting gardens, socializing, and simply enjoying the peace and quiet of country life. With a heart full of empathy and a spirit for hard working adventure, Rachel cherishes the beauty of both the human mind and the natural world. 

Why see us for therapy?

People come to see us for therapy for various reasons, including but not limited to:

• • Dealing with emotional difficulties (e.g., anxiety, depression, mood swings, anger issues)

  • Managing stress or life transitions (e.g. parenthood, career, aging)

  • Learning strategies to improve executive functioning, motivation, and focus

  • Understanding your differences and channeling your strengths as a neurodivergent person

  • Building healthier habits, like improving sleep and increasing activity

  • Developing coping skills to manage addictive behaviors

  • Improving relationships and communicating better

  • Coping with trauma or past experiences

  • Enhancing self-esteem and personal growth

Are we the right therapists for you?

Finding the right therapist involves considering factors such as expertise, therapeutic approach, and personality. Therapy with us involves humor and warmth, and a casual, conversational style. We very much believe in meeting you where you are in the moment, and making a human connection. Sessions are dynamic and can change focus according to your needs. Sometimes you might want some structured exercises to work on skill-building, other times you might need to explore, process, or even vent! 

How long does therapy typically last?

The duration of therapy varies based on your individual needs and goals. Some people may benefit from short-term therapy (a few sessions), while others may engage in longer-term therapy, spanning several months or even years.

Is therapy confidential?

Yes, therapy is generally confidential. We are bound by ethical and legal guidelines to protect your privacy. However, there are exceptions, such as if there is a risk of harm to yourself or others.

What should you expect in the first therapy session?

The first session we will complete an intake, which involves discussing your reasons for seeking therapy, sharing relevant personal history, and establishing goals.

Can people bring up anything in therapy?

Absolutely! We want to provide a safe and non-judgmental space to discuss any thoughts, feelings, or experiences you choose. 

How do you know if therapy is working?

Progress in therapy varies, but positive signs may include improved coping skills, increased self-awareness, and better overall functioning. We will regularly assess your goals and discuss your progress.

The Tricky Triad

What is the tricky triad?

The convergence of ADHD, anxiety, and depression forms what we've come to call the “tricky triad.” This constellation of conditions often presents a complex interplay that can confound both the individual experiencing them and the clinician striving to provide effective care. ADHD, characterized by difficulties in attention regulation, hyperactivity, and impulsivity, frequently coexists with anxiety and depression. The relentless racing thoughts and restlessness of ADHD can fuel anxiety, while the chronic struggles with focus and organization can sow the seeds of despair, leading to depression. Conversely, the constant worry and self-doubt of anxiety, or the pervasive sadness and lack of energy of depression, can exacerbate the core symptoms of ADHD, creating a vicious cycle of impairment.

Why is it so tricky?

Diagnosing and treating these conditions individually can already be challenging, but when they co-occur, the task becomes even more daunting. Clinicians often encounter the dilemma of determining whether certain symptoms are attributable to one condition, another, or all of them simultaneously. Misdiagnoses are common, with ADHD being mistaken for anxiety-driven distractibility or depression-induced apathy, and vice versa. This diagnostic confusion can delay appropriate treatment and exacerbate distress.

What can help?

A multimodal approach is key. Interventions should address the specific symptoms of each condition and their interconnectedness. For example, cognitive behavioral therapy (CBT) can help you develop coping strategies for managing both ADHD-related impulsivity and anxiety-driven rumination. Mindfulness-based interventions can help you cultivate greater awareness and acceptance of thoughts and emotions, reducing the grip of depression and anxiety while enhancing attentional control. Medication management, when appropriate, can target the neurochemical imbalances underlying these conditions, offering symptomatic relief and improving overall functioning. Ultimately, fostering a collaborative and empathetic therapeutic alliance is paramount. By working closely with you to understand your unique experiences and tailor interventions to your individual needs, we can help navigate the complexities of the tricky triad with compassion and effectiveness.