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# CBT Worcester

Helen Turano, LICSW  508-735-4468

## Sitemaps

- [XML Sitemap](https://cognitivetherapyworcester.com/sitemap.xml): Contains all public & indexable URLs for this website.

## Posts

- [Blog](https://cognitivetherapyworcester.com/blog/)
- [Obsessive Compulsive Disorder Treatment with ERP](https://cognitivetherapyworcester.com/obsessive-compulsive-disorder-treatment-with-erp.html/) - Many, probably most, clients who have OCD are initially ambivalent about getting treatment. If they have heard about Exposure and Response Prevention, the "gold standard" treatment for OCD, they know that more than talking is involved. What's "response prevention"? It sounds pretty scary. To understand ERP, it's important to learn to distinguish between obsessions and
- [Obsessive Compulsive Disorder Treatment with ACT](https://cognitivetherapyworcester.com/obsessive-compulsive-disorder-treatment-with-act.html/) - Exposure, facing what you fear the most, in a gradual, supported way, is the key treatment for OCD. It may involve writing scripts about feared outcomes and rereading them repeatedly, or tolerating an environment that feels disorganized in some profoundly disturbing way. Always it is specifically tailored to your particular anxiety. A trained therapist helps
- [Obsessive Compulsive Disorder Treatment - "Just So" OCD](https://cognitivetherapyworcester.com/just-so-ocd.html/) - Recently, I've been reading a very interesting discussion on one of the professional listservs I've joined. One writer cited the concept that the "core belief" of people with OCD is that they are "bad people". This is true of many clients, I believe, but not all. We know that OCD attaches itself to areas
- [Attention Deficit Disorder and Internet/Screen Addiction.](https://cognitivetherapyworcester.com/internet-addiction-and-adhd.html/) - Internet Addiction is a growing problem in our society, and people with attention and other "executive functioning" difficulties may be particularly vulnerable. These are some of the brain functions which we call "Executive Functioning": Attention Working memory (keeping what you need to remember in mind) Organization skills Controlling impulses to act (also controlling impulsive "jumping
- [Trichotillomania Treatment with COMB](https://cognitivetherapyworcester.com/hair-pulling-skin-picking-and-other-body-focused-repetitive-behaviors-part-2.html/) - Therapy for Body Focused Repetitive Behaviors (like Trich. and skin picking) has changed a lot in the last several years.There is now a new therapy called COMB which helps the therapist and client pinpoint which strategies to manage pulling and picking are likely to help the most. COMB was developed by Dr Charles Mansueto and
- [Trichotillomania Symptoms](https://cognitivetherapyworcester.com/hair-pulling-skin-picking-and-other-body-focused-repetitive-behaviors-part-1.html/) - People with Body Focused Repetitive Behaviors like trichotillomania (hair pulling) or dermatillomania (skin picking) are often afraid that others will think they are "weird". They feel ashamed and keep the behavior a secret. The Trichotillomania Learning Center is breaking silence about these problems. Their website, www.bfrb.org , is full of helpful information. It's
- [OCD and "Passengers on the Bus"](https://cognitivetherapyworcester.com/ocd-and-the-whos-driving-your-bus-game.html/) - This week I am writing about a game I played with a young client who has quite severe OCD. We are working on getting her ready for exposure treatment at a residential program by playing a role-playing game. This game is based on "Passengers on the Bus" a great Acceptance and Commitment Therapy video by
- [OCD and the family](https://cognitivetherapyworcester.com/ocd-and-the-family.html/) - Family members of people with OCD are frequently puzzled and distressed because they don't know how to help. Those who feel most powerless are often the parents or partners of adults who refuse to get treatment. Their own lives may be severely disrupted. They may not realize that help is available. Dr Alec Pollard has
- [ADHD- How to help your kid.](https://cognitivetherapyworcester.com/executive-functioning-how-to-help-your-kid.html/) - This week we talking about managing the return to school. Today's schools demand a high level of self-management from kids. When children and teens have difficulty with ADHD or "executive functioning" - managing their emotions, attention, and time, learning to set priorities, remember, start tasks and persist with them - it can be very stressful
- [Acceptance and Commitment Therapy and being mindful: Just looking](https://cognitivetherapyworcester.com/act-and-being-mindful-just-looking.html/) - This week I am thinking about Acceptance and Commitment Therapy and being present. My favorite way of not being present is reading. Of course, I have been incredibly educated, enriched and inspired by what I have read. It's hard for me to imagine who I would have become without access to books. Nonetheless, it's clear
- [CBT and Anger Management, part 2](https://cognitivetherapyworcester.com/anger-management-and-act.html/) - In the last post, we talked about how "standard" CBT links angry outbursts and aggressive behavior with excessive expectations of others. Angry people also become very tense physically. CBT treatment helps clients to challenge their thinking patterns and learn skills that help them to relax, so that physical tension and angry thinking don't interact and
- [CBT and Anger Management, part 1](https://cognitivetherapyworcester.com/cbt-and-anger-management-part-1.html/) - This week we will look at "standard" CBT approaches to anger management problems. In the next blog, we'll add to this by talking about the mindfulness-based/Acceptance and Commitment Therapy approach also. People who have difficulty in managing anger can damage relationships with loved ones, lose friendships and career opportunities, even if they "only"
- [Acceptance and Commitment Therapy and  Anxiety](https://cognitivetherapyworcester.com/acceptance-and-commitment-therapy-and-anxiety.html/) - This week I'm thinking about anxiety as a disorder, and anxiety as part of being human. It's part of the human condition that can never be 100% sure of anything. We can't know that our loved ones to whom we said goodbye five minutes ago are safe. We can't know whether we will have
- [Obsessive Compulsive Disorder Symptoms](https://cognitivetherapyworcester.com/ocd-erp-and-act-part-1.html/) - There are many different ways that OCD can show up in people's lives. Imagine that you had to live with one or more of these fears:- That you were alone with the fear that you might molest, or had molested, your much-loved little son, and so withdrew from him; That you could not tolerate being
- [Codependency and Acceptance and Commitment Therapy](https://cognitivetherapyworcester.com/mindful-behaviorist-act-and-codependency.html/) - This morning I'm writing about our tendency to take too much responsibility for other people's lives. The concept of codependence has been around since the '80s. Originally it was associated with the partners of alcoholics. I think it has a much wider application. In myself and other parents, I have noticed a tendency to personalize
- [Anger and Acceptance and Commitment Therapy](https://cognitivetherapyworcester.com/sit-with-anger-and-frustration.html/) - This morning is a good time for me to write about how to sit with anger and frustration. One of my very reliable clients has had a difficult time making it to evening appointments due to snow and traffic delays. (I'm writing this on February 28th, so many readers will understand.) We decided to meet
- [Mindful Behaviorist - An Acceptance and Commitment Therapy story about dealing with "should" thoughts.](https://cognitivetherapyworcester.com/mindful-behaviorist-an-acceptance-and-commitment-therapy-story-about-dealing-with-should-thoughts.html/) - This afternoon I am writing about a ordinary burden with which I and many of my clients struggle - "should" thoughts. Readers of previous blog posts will recall my writing about the grimmer thoughts that plague us - thoughts about being inept, life being meaningless, etc. Today we are looking at the stuff that gets
- [Mindful Behaviorist - Loving and Leaving Winter - An Acceptance and Commitment Therapy story](https://cognitivetherapyworcester.com/mindful-behaviorist-loving-and-leaving-winter-an-acceptance-and-commitment-therapy-story.html/) - I have always been a person who loved winter. As I write the snow is falling and coating the iced-up banks that first fell in February. It's March 1st, and daffodils are coming up in Wales where I was born. When the temperature hits the 40s on Wednesday, for the first time this year,
- [Mindful Behaviorist - Sunday afternoon depression - An ACT story](https://cognitivetherapyworcester.com/mindful-behaviorist-how-i-overcame-sunday-afternoon-depression-an-act-story.html/) - I no longer cook often for my whole family. Bereavement, and my adult daughters moving away, has taken away a role I loved. Like everyone, I am most prone to feel the ache of loss when I am not working and have nothing in particular to do. That used to make Sunday afternoons hard. My
- [Mindful Behaviorist - An Acceptance and Commitment Therapy story about improving my behavior by keeping track of negative habits.](https://cognitivetherapyworcester.com/mindful-behaviorist-a-story-about-improving-my-behavior-by-keeping-track-of-negative-habits.html/) - Have you ever tried to change your habits by keeping track of them? A few years ago, because of my own mistake, I ended up without health insurance for a month. This may, to less fortunate people, appear to be rather minor, especially since I was not sick and had no reason to suppose I
- [Mindful behaviorist - Helen talks about CBT (Ramona interviews).](https://cognitivetherapyworcester.com/mindful-behaviorist-helen-talks-about-cbt-ramona-interviews.html/) - In this video I am talking to Ramona of Ramona Interviews about how CBT works. I created an imaginary client to use as an example. She is 30 years old, is depressed and socially anxious, and binge eats when she comes home from work. Mindful Behaviorist - Helen Turano talks about CBT
- [Mindful Behaviorist - first post](https://cognitivetherapyworcester.com/mindful-behaviorist-first-post.html/) - This is a the first posting for my new blog, the Mindful Behaviorist. What does the blog's name reveal about how I do therapy with adults? Let's look at being behavioral first. To me, this means that I have a "toolbox" of things I can teach clients to DO (not just think about). These may

## Pages

- [Cognitive Behavior Therapy](https://cognitivetherapyworcester.com/) - Psychotherapist Helen Turano offers cognitive behavior therapy (CBT), dialectical behavio therapy (DBT), ERP and ACT in Worcester, MA.
- [I-CBT (Inference Based Cognitive Behavior Therapy for OCD)](https://cognitivetherapyworcester.com/i-cbt-inference-based-cognitive-behavior-therapy-for-ocd/) - ICBT offers a new type of CBT for OCD. It is based on the premise that people with OCD have normal reasoning except when their obsessions are triggered. They then switch to obsessional reasoning (also referred to as 'inferential confusion'). In I-CBT clients learn to identify their obsessional reasoning style, no matter in
- [Obsessive Compulsive Disorder (OCD)](https://cognitivetherapyworcester.com/obsessive-compulsive-disorder/) - Obsessive compulsive disorder treatment has a high rate of success when done correctly. It is important that you see a trained clinician who can fine-tune the treatment to your individual needs. I am a graduate of the Advanced Forum of the Behavior Therapy Training Institute of the International OCD Foundation (IOCDF). I treat OCD
- [Fees and Policies](https://cognitivetherapyworcester.com/fees-and-policies/) - Insurance and fees. I am a provider for all Blue-Cross Blue-Shield products in Massachusetts, and can accept most out-of-state BC/BS. High Deductible plans. More and more, people have to satisfy high deductible amounts before their insurance begins to pay. You would pay anyway to see a therapist without specialized training. There can be no guarantees,
- [Exposure and Response Prevention  (ERP)](https://cognitivetherapyworcester.com/exposure-and-response-prevention-erp/) - Exposure and Response Prevention treatment (ERP treatment) is the "gold standard" treatment for anxiety disorders including OCD, Panic, Phobias, and Social Anxiety. ERP is a method of facing your fears directly, in a graduated way, with lots of support. It is always done with client collaboration and there is no pressure to go faster than
- [Resource Library](https://cognitivetherapyworcester.com/resource-library/) - Mindfulness of thoughts, feelings and sensations. Loving Kindness Meditation. Practicing Wise Mind.
- [Contact](https://cognitivetherapyworcester.com/contact/) - How do I make an appointment? If you would like to make an appointment, please call me and leave a brief message with your name, cellphone number, insurance if you plan to use it, and your email address. Also say a few words about the reasons you are seeking therapy. This helps me to know
- [Trichotillomania and Skin Picking](https://cognitivetherapyworcester.com/psychotherapy-for-trichotillomania-and-skin-picking-in-worcester-ma/) - Trichotillomania treatment can be difficult to find. Until recently, there has been little public awareness of the problem. Trich. and other Body Focused Repetitive Behaviors can be difficult to stop. Sometimes clients feel ashamed and embarrassed and avoid seeking treatment. But there is no more reason to feel embarrassed about pulling your
- [Treatment and services](https://cognitivetherapyworcester.com/treatment-and-services/) - Acceptance and Commitment Therapy. Cognitive Behavior Therapy. Exposure and Response Prevention. Comprehensive Behavioral Intervention for Tics (CBIT). Comprehensive Behavioral Treatment for Trichotillomania/Picking supplemented with Habit Reversal Training. Radically Open DBT http://www.abct.org/Information/?m=mInformation&fa=fs_radical_open (individual) for 'overcontrolled' clients with severe social anxiety/depression. Treatment of oppositional behaviors as well as anxiety in children and teens. Treatment of ADHD.
- [Tics and Tourette Disorder](https://cognitivetherapyworcester.com/tics-tourette-disorder/) - I am a certified in CBIT (Comprehensive Behavioral Intervention for Tics) treatment by the Tourette Association of America. CBIT is the first-line treatment for tic disorders. Please read a brief overview of CBIT here. About 6 children in 1000 are affected by chronic motor and vocal tics. These disorders tend to peak in early adolescence,
- [Teletherapy](https://cognitivetherapyworcester.com/teletherapy/) - I can provide teletherapy for clients who (regardless of where they live) are located in Massachusetts, Vermont or Florida at the time of the session. I believe teletherapy has great potential as a convenient, effective alternative to in-office visits. Most BCBS plans provide coverage for teletherapy. I no longer provide in-office sessions. I use
- [Social Anxiety](https://cognitivetherapyworcester.com/social-anxiety/) - If you are afraid that others will judge you negatively and therefore avoid social situations, you are suffering from Social Anxiety. Some people have specific fears, such as of public speaking. Other people are anxious in most social situations. Children and teens might avoid sitting with others at lunch. Adults might avoid asking for a date.
- [Radically Open Dialectical Behavior Therapy (RO-DBT) and DBT](https://cognitivetherapyworcester.com/dbt-skills-training/) - Recently I have begun using Radically Open DBT with clients. This is an exciting new treatment for overcontrolled clients, including those with chronic depression, severe anxiety, obsessive-compulsive personality disorder and autism. The ideal structure for treatment, as in "regular" DBT, is individual work accompanied by a skills-training class. Currently I cover the class material in session
- [Psychotherapy Specialties](https://cognitivetherapyworcester.com/psychotherapy-specialties/) - I specialize in treating :Obsessive compulsive disorder ,Anxiety Disorders, Depression, Attention Deficit Hyperactivity Disorder. Trichotillomania and Skin Picking (also called Excoriation or Dermatillomania.) Tic Disorders and Tourette's. I work with "overcontrolled" clients using Radically Open DBT, http://www.radicallyopen.net I have a lot of experience treating substance-abusing clients in psychotherapy, and can help you work to stop or cut down
- [Frequently Asked Questions](https://cognitivetherapyworcester.com/frequently-asked-questions/) - What's different about CBT? -- CBT is evidence-based. CBT therapists are generally more interactive than many psychodynamic psychotherapists. CBT therapists provide a lot of education. Many clients find this very reassuring. Instead of feeling afraid and alone, they learn that their problems can be successfully treated. CBT therapists will frequently give "homework". For example, I
- [Client portal](https://cognitivetherapyworcester.com/client-portal/) - By clicking the link below, current clients may communicate through my secure web portal or app, and sign in for teletherapy. https://www.therasoftonline.com/tms/clientportal.aspx I provide clients with a 4 digit random number PIN. Please enter your (or your child's) last name, date of birth, and PIN, and you will be able to enter the portal. You
- [About Helen Turano,LICSW](https://cognitivetherapyworcester.com/about-helen-turano-licsw/) - I grew up in the UK and came to the USA as a young adult. I have more than twenty-five years of experience as a social worker. As well as working as a therapist, I have been a supervisor at an emergency services team, and an inpatient social worker at psychiatric hospital. In addition to
- [Children and Adolescents](https://cognitivetherapyworcester.com/children-and-adolescents/) - Working with children and teens is especially challenging and rewarding. I specialize in treating children with the anxiety disorders and OCD and related issues, including ADHD, trichotillomania, skin picking and tics. Cognitive therapy, Acceptance and Commitment Therapy, Exposure and Response Prevention, COMB and CBIT are all helpful to children and teens. The younger the child,
- [Attention Deficit Disorder](https://cognitivetherapyworcester.com/executive-functioning-difficulties-and-addadhd/) - I am a Certified ADHD Professional and a member of the Institute of Certified ADHD Professionals, https://wwwadhdcert.com. Attention Deficit Hyperactivity Disorder can be "comorbid" (occur together) with some of my other specialities, including anxiety, OCD, trichotillomania/skin picking and tic disorders. Quite frequently it has to be first problem addressed. Parents report behavioral issues that are
- [Irritable bowel syndrome (IBS)](https://cognitivetherapyworcester.com/irritable-bowel-syndrome-ibs/) - IBS is a physical illness which is made worse by the anxiety many clients feel about having attacks. That anxiety can lead to giving up valued activities and leading a restricted life. CBT treatment with ACT and Exposure and Prevention therapy can really help. We work on gradually challenging avoidance so the client
- [Panic Disorder](https://cognitivetherapyworcester.com/panic-disorder/) - The symptoms of a panic attack can include racing heart, shortness of breath, "unreal" feelings, tingling feet and hands, and dizziness. Many people have had one or more panic attacks. People develop panic disorder when they start believing that the panic means that something catastrophic is going to happen. They believe that they will die,
- [Phobias](https://cognitivetherapyworcester.com/phobias/) - Phobia treatment with CBT has been demonstrated to be effective. Phobias can range from the minor - common ones like fear of mice and spiders, which are not disabling unless your work puts you into contact with these creatures every day - to the major. If you cannot get necessary vaccinations because of fear of
- [How CBT Works - Helen Turano, LICSW](https://cognitivetherapyworcester.com/how-cbt-works/) - How Cognitive Behavior Therapy Works - Interview Ramona Interviews Helen Turano About CBT (Transcript) Ramona: I am Ramona, and welcome to Ramona Interviews. With me in the chair today is Helen Turano. Now, she's a Cognitive Behavior Therapist, and this is going to be a really interesting show, so I would like you to stay
- [Acceptance and Commitment Therapy (ACT)](https://cognitivetherapyworcester.com/acceptance-and-commitment-therapy/) - Acceptance and Commitment Therapy (ACT) is really helpful, not just for people new to treatment, but also for people who have seen other therapists and are disappointed in their progress. Often, they can describe more realistic and potentially empowering ways to look at their situation, but can't use that logic to help them improve their
- [Meet Helen Turano - Video](https://cognitivetherapyworcester.com/meet-helen-turano-video/) - Meet me and see how I work: Call me at 508-735-4468 or email me at hturano@tsecuremail.com.

## Categories

- [Cognitive Behavioral Therapy Worcester](https://cognitivetherapyworcester.com/category/cognitive-behavioral-therapy-worcester/) - Cognitive Behavioral Therapy Worcester
- [Worcester Cognitive Behavior Therapy](https://cognitivetherapyworcester.com/category/worcester-cognitive-behavior-therapy/) - Worcester Cognitive Behavior Therapy