Dr. LaFleur brings active listening, collaboration, and warmth to evidence-based, goal-oriented treatment that leads to lasting change. She takes seriously that patients seek treatment to live more meaningfully and to show up more often as the person they want to be. Once she has an understanding of a patient’s goals and perspectives, she works collaboratively and with researched strategies to explore and change patterns, build skills for living more intentionally, and develop confidence for managing the discomfort that comes with growth.

Patients may be seeking support to manage:

• Anxiety (including generalized anxiety, social anxiety, performance anxiety, fears/phobias, panic attacks, and separation anxiety)
• Obsessive-compulsive disorder (OCD)
• Shyness
• High stress
• Perfectionism
• Challenges with body image and self-esteem
• Uncontrollable, distressing thoughts or feelings
• Avoidance of activities or low motivation
• Navigating life transitions, new responsibilities, conflicts, and burnout
• Sadness and/or feelings of emptiness or hopelessness
• Irritability 
• Inflexibility
• Relationship concerns
• Challenging life transitions
• School concerns
• Body-focused repetitive behaviors (including skin picking, hair pulling, and tics)

For children ages 7-12, Dr. LaFleur may use an individual, family, or hybrid approach. Children often enjoy having the involvement of their parent(s) as it brings a further understanding of what they are experiencing, increases the liveliness and focus of appointments, and facilitates parent-child conversations and interactions that reinforce therapy frameworks and more regular practice of therapy skills. Dr. LaFleur has observed (as have some researchers), that family-based telehealth approaches can facilitate children’s access to highly specialized services. In addition, at every step of the way, she is careful to consider whether a child is a good fit for telehealth.

Dr. LaFleur draws from cognitive behavioral and behavioral approaches, such as:

• Acceptance and Commitment Therapy (ACT)
  • Dr. LaFleur typically grounds treatment in ACT, though she often folds in other treatments as appropriate. ACT helps in gaining a sense of direction for navigating life or certain aspects of it, while also exploring and learning to cope with the challenging thoughts, feelings, and experiences that show up when living meaningfully and purposefully.
• Cognitive Behavioral Therapy (CBT)
  • Dr. LaFleur’s clinical practice is consistent with a CBT approach, and she often draws from CBT. In addition, ACT is has a lot in common with CBT, and studies comparing CBT to ACT demonstrate that they are typically equally effective. Both ACT and CBT focus on exploring and shifting the patterns around cognitions and behavior. And both pair well with other treatment techniques, such as ERP or HRT.
• 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.
• Inference-Based Cognitive Behavioral Therapy (I-CBT or IBT) 
  • I-CBT is a fairly new treatment that addresses the obsessional doubt and faulty reasoning processes that drive OCD. I-CBT does not involve a systematic exposure process.
• Habit Reversal Training (HRT), Comprehensive Behavioral Treatment (ComB), and Comprehensive Behavioral Intervention for Tics (CBIT)
  • HRT and ComB are treatments that help grow awareness of habits and then understand and change the patterns that sustain them. They are commonly used to treat body-focused repetitive behaviors, such as skin picking, hair pulling, or tics. Dr. LaFleur also offers CBIT, which is specifically designed for treating tics. 
• Behavioral Parent Training
  • The younger the child, the more likely Dr. LaFleur is to include behavioral parent training treatment components. Behavioral parent training can involve (1) teaching parents tools for increasing child motivation for practicing therapy skills and/or (2) exploring and shifting parent-child interaction patterns that developed from and inadvertently maintain child symptomology.