Cora Keene Cora Keene

2022 Wrap Up & Exciting News for 2023

We've had an eventful year at Respire with some highlights including:

  • Welcoming 2 new Associates - Srijana and Erica!

  • Expanding our reach to support clients with Nepali and Hindi language capacity

  • Offering services to victims of violence through California Victims Compensation program

  • Website refresh to better reflect the growing practice

As we wrap up the year and look to 2023 we have some exciting new updates!

We are pleased to welcome Krista Gaston, LMFT to provide clinical supervision and join Respire as a licensed clinician serving adults, couples and families. Krista is a trauma informed systems specialist with experience working with children, adults, families and couples in a variety of settings including community based care. Krista also is a certified Eco-Therapist bringing an ecological paradigm to her therapy work. Welcome Krista!!

We look forward to continuing to serve our community supporting mental health and wellness in 2023!

Wishing everyone a healthy, joyous close to the year!

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Cora Keene Cora Keene

Getting to Know Respire: CFT

Compassion Focused Therapy or CFT is an integrative approach to therapy that holds a practice of compassion central to the healing process.

What: Developed by Dr. Paul Gilbert, CFT utilizes techniques to help clients challenge critical, negative, and unhelpful thought processes and build internal self-compassion and compassion for others while learning techniques to self-soothe integrated from CBT (check back next month for more on CBT) interventions and mindfulness practice. CFT is rooted in evolutionary psychology and neuroscience, using what we know about how our body and brain works to develop skills and promote healing.

How I use it: At Respire CFT is integrated with our Trauma Informed approach (see last month’s blog) to build safety and support clients from a welcoming, compassionate lens. CFT informed by cross-disciplinary research helps integrate and makes sense of what we know works for clients and the “Why” it works. I support clients in learning skills for self- and external compassion and self-soothing to support their goals.

Application: I find CFT particularly useful for client’s struggling with anxiety and toxic perfectionism that no longer serves their goals and well-being. Supporting clients in challenging -often long standing - beliefs and relational patterns with a compassionate lens can shift how people interact with and show up in their lives for the better. This might mean addressing burn out in the work place, conflict in relationships, chronic depression and anxiety. CFT focuses on exploring causality but just as importantly, building skills for changing the way one thinks and behaves to better align with who they are or who they want to be.

Training: I was introduced to Compassion Focused Therapy while involved with Stanford’s CCARE program (Center for Compassion and Altruism Research and Education) and supporting Dr. Philip Zimbardo while teaching his course for PsyD students at Palo Alto University. Dr. Gilbert was invited to provide a training that I was honored to attend. I subsequently read his book the Compassionate Mind and have sought additional training on integrating this model into my work. As a Supervisor, I support clinicians in learning this modality and integrating compassion into their approach with clients.

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Getting to Know Respire: Trauma Informed Care

Trauma informed therapy is an approach to care that incorporates the effects of trauma on our lives including systemic and generational trauma such as racial violence and genocide. 

What: Trauma informed clinicians seek to understand “what happened to you” as opposed to “what is wrong with you.” Trauma informed therapy holds several key principles: safety, transparency and trust, peer support, collaboration, empowerment, and cultural/historical and gender awareness. 

How I use it: At Respire, trauma informed therapy is a mindset - how we approach everything. We integrate trauma informed principles into every step including the website, scheduling and fee process. We want to be transparent, safe, and collaborative from the moment we make contact throughout your therapy experience.

Application:  In sessions this means allowing clients to make decisions about their own care, support them in creating relationships and accessing their community support, addressing relationship issues in therapy with compassion and non-judgement, and genuinely holding space for clients to process and explore the areas most important to their life. We work collaboratively to create a plan of care that helps you meet your goals including discussing appropriate frequency of meetings and offering flexible scheduling when available. We understand at the core that safety and relationship are the path to healing.

Training: I was introduced to trauma informed therapy while in graduate school and applied those principles while working with youth in a pediatric clinic. I received supervised training and experience while working at San Francisco's YMCA Urban Services providing support to youth with severe chronic truancy issues and then further experience while working with detained youth at San Francisco Juvenile Hall. I currently also work within the SFDPH system of care and receive regular training and experience working with folks impacted by trauma including community based and domestic violence. In 2019/2020 I pursued certification as a clinical trauma professional and maintain the certification through continuing education and experience annually. As a clinical supervisor I support my Associates in learning and applying these principles as clinicians and also seek to provide trauma informed clinical supervision, knowing many of our clinicians have experienced trauma themselves.

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Getting to Know Respire and Evidenced Based Care

When searching for a therapist, you might notice an abundance of acronyms - CBT, LPCC, LMFT,  DBT, EFT, IFS, RO-DBT, MBCT, etc.*

Some acronyms refer to a clinician’s training and license and then others refer to a treatment modality - or how a clinician works and applies theory to practice.

You might find yourself googling or asking someone in the field what does it mean and how do I find someone that can help me?

Just as your concerns and reasons for seeking therapy are personal and individualized, so can be the therapist and the way they apply theory. How a clinician approaches the therapeutic relationship can have a big impact on whether therapy with that clinician will be successful for you.

With Respire clinicians, we hope to demystify and support clients in engaging with the therapist that is right for them. In this monthly series we will explore some of the modalities and techniques we use in therapy and how they might be applied from a clinician’s perspective. We will start off this year exploring a broader concept EBT’s or Evidence Based Treatment.

EBT’s - Evidenced Based Treatment

What are EBT’s? 

EBT’s refers to utilizing treatment approaches that have been validated and studied in research. EBT’s generally are developed over the course of many years and based in well-established psychological principles. EBT might also refer to an individual clinician utilizing assessment and outcomes measures to help guide treatment and determine efficacy.

There are many EBT’s and what is considered an EBT changes with the research. CBT and DBT are two of the more well-known EBT’s utilized in mental health care - stay tuned for more on these in a later blog - but there are many. EBT’s can be a manualized approach, aka step by step, or psychodynamic meaning focused more on therapeutic relationship and experience approaches, among others. There are theories related to EBT’s including Common Factors model that looks more at how to determine efficacy and what are the key pieces in effective therapy.

How We Use It

We use EBTs throughout the course treatment starting from the first appointment utilizing bio-psycho-social assessment and standardized assessment measures to guide treatment planning. Our clinicians are trained in a variety of EBT modalities most commonly CBT, DBT, IFS, Mindfulness and Somatic Experiencing which we employ during session to support clients in their treatment goals.

Application

EBT’s really are applied across the therapeutic experience. One example of utilizing an EBT is working with a client experiencing anxiety with CBT thought stopping techniques to help manage the distressing experience of ruminative or intrusive thoughts.

Training

EBT’s are generally the primary focus of a clinician’s graduate education with different programs focusing on different EBT’s. Clinicians are also required to engage in continuing education which often involves training and learning about EBT’s and keeping updated on the research. During supervision, we discuss application of EBT’s and explore further educational experiences to enhance a clinician’s depth and breadth of knowledge about the EFT’s they utilize.


(* CBT- Cognitive Behavioral Therapy, LPCC - Licensed Professional Clinical Counselor, LMFT - Licensed Marriage and Family Therapist, DBT - Dialectical Behavior Therapy, IFS - Internal Family Systems, RO-DBT - Radically Open Dialectical Behavior Therapy, MBCT - Mindfulness Based Cognitive Therapy)


Written by Cora Keene, LMFT CCTP

Founder of Respire Therapy

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