Common questions, plain answers.

Use the contact page to reach out. You can also call (408) 673-1906 or email ryan@decookmhs.com directly. The first step is a free 15-minute consultation where we can talk through what you are dealing with and whether this is likely to be a good fit.

The first full session is primarily an assessment. We will cover what brings you in, relevant history, what you have already tried, and what you are hoping to get out of therapy. I will also explain how I work and what the treatment process is likely to look like for your situation. You will have a chance to ask questions. It should feel like a collaborative conversation, not an interrogation.

Yes. Many of my clients are coming to therapy for the first time. This is often because of panic or a traumatic experience that has become difficult to manage on their own. I work to make the process clear and understandable from the start. I explain why we are doing what we are doing and what progress typically looks like.

Adults 25 and older, located anywhere in California or Colorado, who are dealing with panic attacks or panic disorder, the lasting effects of a specific traumatic experience, or a Colorado workers’ compensation-related behavioral health need. I work best with people who are ready to do active work in sessions, not just talk about problems. If you want to understand what is happening and do something about it, that tends to be a good sign.

It depends on what you are working on and how things unfold. For panic disorder, meaningful improvement often happens within 8–20 sessions of structured CBT and Mindfulness. Trauma work varies more. Some people with less complex traumatic events may move through processing relatively quickly; others need more time, particularly when there are multiple events or the impact has been long-standing. I will give you an honest picture of where things stand and what to expect as we go.

Panic attacks are sudden, intense surges of fear or alarm that peak within minutes and include physical symptoms: racing heart, shortness of breath, chest tightness, dizziness, tingling, nausea, or a sense of disconnection from reality. Many people fear they are having a medical emergency or losing control. If you have had comprehensive medical workups that found nothing wrong and continue to have episodes like this, panic is very likely what is happening.

Primarily Cognitive Behavioral Therapy (CBT), which addresses the thoughts, physical patterns, and behaviors (especially avoidance) that keep panic going. This can include structured steps of exposure therapy. Mindfulness helps teach how to not fight the panic and reduces symptoms over time. Treatment includes understanding the panic cycle, learning to interpret body sensations differently, and gradually approaching the situations and sensations that have become associated with panic. It is structured, practical, and evidence-based.

Avoidance is one of the central things we address in panic disorder therapy. It is very common. Over time, avoidance expands and narrows your life without you fully realizing how much has changed. The goal is not to force you into situations immediately but to work through avoided situations systematically, at a pace that is structured and manageable. Many people reclaim driving, travel, and other activities through this process.

Exposure work — gradually approaching what you have been avoiding — is one of the most effective components of panic treatment. Nothing happens without your understanding of why we are doing it and your consent to proceed. The goal is not to overwhelm you; it is to give your nervous system direct experiences that correct the false alarm it has learned to generate. I will explain each step before we do it.

Adults who have experienced a specific, identifiable traumatic event or set of events during adulthood or childhood — accidents, physical or sexual assault, workplace incidents or violence, witnessing a traumatic event, sudden loss, or traumatic medical experiences. The common thread is not the category but the impact: something happened, and your nervous system has not fully moved on from it.

EMDR (Eye Movement Desensitization and Reprocessing) is an evidence-based therapy for trauma that uses bilateral stimulation, typically eye movements, tapping, or auditory tones, to help the brain reprocess distressing memories. The goal is not to erase the memory but to change how it is stored, so that it no longer triggers the nervous system as if the event is still happening. EMDR has been extensively researched since the late 1980s and is recognized by the American Psychological Association, the World Health Organization, and the VA.

EMDR is most effective for trauma rooted in specific events — accidents, assaults, workplace incidents, sudden loss, and similar experiences. It can also address cumulative trauma (repeated difficult experiences), though the approach may differ. If your symptoms are connected to something that happened, even if you are not sure it “counts” as trauma, it is worth discussing in a consultation.

Not necessarily. EMDR does not require a full verbal retelling of everything that happened. What it requires is that you can bring the memory to mind and identify a few aspects of it, which is different from narrating it in detail. Some people share relatively little verbally and still do significant processing work. The level of verbal disclosure is largely your choice.

A useful starting point is to ask: do I have a specific experience that I can connect, even loosely, to symptoms I am having now? Hypervigilance, intrusive memories, avoidance, emotional numbing, persistent negative beliefs about yourself, or unexplained physical tension? If yes, and those symptoms are affecting your quality of life, trauma therapy is worth exploring. You do not need a formal PTSD diagnosis.

Yes. EMDR can be delivered effectively via telehealth, and there is a strong research base supporting online delivery. Bilateral stimulation is adapted for screen-based sessions. I work with clients in California and Colorado via telehealth.

Yes, in Colorado, when behavioral health counseling is clinically appropriate, authorized, and the presenting concerns fall within the scope of my practice. This includes psychological responses to workplace injury, trauma reactions, adjustment difficulties, work-related panic attacks, and return-to-work anxiety. I am not currently accepting workers’ compensation cases in California.

Behavioral health counseling can be part of an authorized treatment plan in a workers’ compensation case. The process typically requires a referral and authorization from the insurer or employer before treatment begins. My role is only clinical. I do not manage claims, provide legal advice, or advocate for claim outcomes.

Workers’ compensation cases involve documentation requirements that differ from standard therapy. Progress notes and clinical documentation may be shared with authorized parties. I am transparent about what is documented and reported before we begin. This is an important topic to discuss directly in the initial consultation.

Yes. Sessions are available via telehealth to clients in California and Colorado. If you have questions about in-person options, raise them in the consultation.

Yes. I currently accept the following insurance plans: Aetna, BlueCross and BlueShield, Carelon Behavioral Health, Cigna and Evernorth, Optum, United Medical Resources (UMR), and UnitedHealthcare / UHC / UBH. Colorado Worker’s Compensation is also accepted for eligible cases. I also work with clients on an out-of-network basis. Please confirm current in-network status when scheduling, as plan participation can change.

$195 per 50-minute session in California; $175 in Colorado. I do offer a sliding scale. I am happy to discuss fees, sliding scale availability, and payment options during the consultation.

I am licensed as an LCSW in California and Colorado and see clients throughout both states via telehealth — including the San Francisco Bay Area, Los Angeles, San Diego, Denver, Boulder, Colorado Springs, and Fort Collins. Workers’ compensation counseling is available in Colorado only.

The free 15-minute consultation exists for exactly this reason. It is a low-pressure conversation. You can ask questions, get a sense of how I work, and I can let you know whether your situation sounds like something I can help with. There is no obligation to schedule anything after it.