Anxiety and OCD can feel like dread, panic, a sense of not being on solid ground, or a feeling that if precautions aren’t taken, everything will fall apart. This can be exhausting, and some people share that they have lost parts of themselves or their lives as more and more of their time is invested in anticipating, white-knuckling through, replaying, analyzing, and recovering from the situations that overwhelm or haunt them.

Whether you or your child is new to experiencing anxiety or OCD or has been receiving care for some time and looking to make additional progress, Dr. LaFleur is eager to help.

She is drawn to the treatment of anxiety and OCD because effective treatment requires experience, creativity, and attunement with the changing landscape of research and clinical practice. She takes care to explain the treatments available and works closely with her patients and families to build a tailored program that adapts based on preferences and treatment response. 

Progress Matters

Dr. LaFleur understands that hope and progress are important. If she’s not observing the momentum in treatment she would expect, she may collaboratively and carefully adjust:

• The type of treatments being used
• Approach to homework, including increasing the level of structure
• Change agents, such as by including family members in aspects of treatment, or in the case of children and teens, engaging parents as primary change agents
• Case conceptualization, including whether there is a missed factor or diagnosis related to the presenting concerns

Treatments Available

Anxiety and OCD

• Acceptance and Commitment Therapy (ACT).  ACT helps individuals gain a sense of direction for navigating life or specific aspects of it, while also exploring and learning to cope with the challenging thoughts, feelings, and experiences that arise when living meaningfully and purposefully.
• Exposure and Response Prevention (ERP). ERP is about facing discomfort, often in the service of doing what matters. If this sounds like ACT based on the description above, that makes sense as these treatments pair well with one another. ERP is a process of transforming one’s relationship with discomfort and avoidance. It can be done very systematically or more organically, and ACT helps dive deeper into managing the thoughts and feelings that show up.

OCD Only

• Inference-Based Cognitive Behavioral Therapy (I-CBT). I-CBT is a fairly new treatment that addresses the obsessional doubt and faulty reasoning processes that drive OCD. I-CBT isn’t about facing threats. Rather, it’s about learning that the threat does not exist and understanding why it has still felt so real. I-CBT does not involve a systematic exposure process. Dr. LaFleur has been offering I-CBT since 2022 and provides both consultation and training to other mental health professionals.

Body-Focused Repetitive Behaviors & Tics

• Habit Reversal Training (HRT), Comprehensive Behavioral Treatment (ComB), and Comprehensive Behavioral Intervention for Tics (CBIT). These treatments help address habits by growing awareness of and changing the patterns that sustain them. Body-focused repetitive behaviors commonly co-occur with anxiety and OCD, and these include skin picking and hair pulling.

Treatments Involving Family or Loved Ones

• Addressing Family Accommodation. Research suggests that anxiety and OCD often recruit family members and loved ones to fuel and maintain them. Dr. LaFleur offers tailored solutions to address. Available research suggests that for children and teens, reducing family accommodation may be at least as effective as individually-focused CBT treatment for reducing anxiety and OCD symptoms. One treatment developed specifically to reduce family accommodation is called Supportive Parenting for Anxious Childhood Emotions (SPACE).
• Parent-Facilitated ERP. Some children and teens are not ready to lead their ERP treatment independently. Studies suggest that parent-facilitated ERP is an important tool for facilitating change. 
• Other Behavioral Parent Training Interventions. Dr. LaFleur utilizes a variety of additional treatments, which can help parents address common concerns that co-occur with anxiety or OCD or pose challenges for treating it. For example, some children engage in power struggles when their parents seek to promote their bravery. Additionally, some children have sleep, toileting, or other concerns that may be related to their anxiety or OCD, but require a specialist with a skillset that extends to these specific concerns. 
• Developmentally-Appropriate Treatment for Young Children. Dr. LaFleur commonly draws from Parent-Child Interaction Therapy (PCIT), which has researched adaptations for treating anxiety. PCIT and its adaptations can be delivered very effectively by telehealth. PCIT involves using the parent-child relationship to facilitate child bravery.