Therapy
Therapy that gets to the point.
Cognitive behavioral and trauma-informed work for anxiety, low mood, panic and grief, by phone or video, anywhere in California. Short and focused, or ongoing, depending on what the problem actually needs.
Brandy Roggentien, LCSW, Licensed Clinical Social Worker (LCSW) #22723, California Board of Behavioral Sciences.
What the work looks like
Therapy here is a working conversation. You talk, I listen properly, and then I tell you what I am seeing. That last part is the bit clients mention most often, and it is deliberate. A therapist who only reflects your own words back at you for an hour is comfortable and slow, and you are paying for clinical judgment.
The first session
We cover what brought you here, how long it has been going on, what you have already tried, and what you want to be different. I will ask about sleep, appetite, work, relationships and what the last really bad day looked like, because those tell me more than a diagnosis does. By the end you will have my honest read and a sense of whether we fit.
After that
We pick the one or two things that would change the most if they moved, and work on those. I keep an eye on whether it is actually working. If we are six sessions in and nothing has shifted, I will say that out loud and we will change the approach rather than quietly continuing.
Ending
I will tell you when I think you are done. Some clients taper to monthly and then stop. Some finish cleanly and come back a year later for something new, which is a perfectly good use of a therapist. The goal is that you need me less, not more.
Formats
Pick the size of the thing.
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Short and focused
Three sessions of about 45 minutes, by phone or video, used as you need them rather than on a fixed weekly schedule. Right for one defined problem where you want clinical input and a plan.
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Ongoing therapy
Continuing work at a frequency that fits your life, for things that need more than a few conversations: trauma, long-standing anxiety, patterns that keep reappearing in different relationships.
Who I see
Adults, teenagers and families, across a wide age range. One of the referring clinicians below describes it as being "extraordinarily engaging with all age groups", which I would rather have said about me than almost anything else.
- Adults carrying anxiety, panic, low mood or grief.
- People with a trauma history, recent or very old. See trauma therapy.
- Teenagers, and parents trying to work out what is happening with one. See children, teens and schools.
- Caregivers, including people looking after a parent while raising their own family.
- People whose work has outrun them: shift workers, commuters, the self-employed.
I work across California by telehealth, which means the practical obstacles that stop people starting therapy mostly disappear. No drive, no waiting room, no hour taken out of the middle of a working day.
Questions about therapy
How do I know whether I need therapy?
A rough guide: something has been going on for a few months, it is affecting sleep, work, study or the people around you, and the things that usually help have stopped working. You do not have to be in crisis. Most of my clients were managing, just at a cost they had stopped noticing.
What approaches do you use?
Primarily cognitive behavioral work, which looks at the loop between what you think, what you feel and what you then do, and at which part of that loop is easiest to interrupt. Layered over trauma-informed practice, so the pacing is set by what you can tolerate rather than by a protocol.
My earlier training was in applied behavior analysis at UCLA, which shows up as a persistent interest in what is maintaining a pattern right now.
Will you give me homework?
Sometimes, and only the kind that is worth the effort. Usually it is noticing something specific during the week, or trying one deliberate change and reporting back on what happened. If you do not do it, we talk about what got in the way, because that is usually the more interesting material.
Do you prescribe medication?
No. I am a clinical social worker, not a physician or psychiatrist. Where medication looks worth considering, I will say so and work alongside your doctor or a psychiatrist. Plenty of people do well without it, and plenty do better with it; neither is a failure.
Is what I say confidential?
Yes, with the legal limits every California clinician works under: a serious risk of harm to you or someone else, suspected abuse of a child, an elder or a dependent adult, and a court order. I will go through all of it with you at the start, and you can ask me about any of it at any point.
What if we are not a good fit?
Then say so, or I will. A bad fit is nobody's fault and continuing anyway helps no one. I would rather spend a session pointing you toward someone better suited than keep an appointment slot filled.
Start with a phone call
About ten minutes, no charge, no obligation. Tell me what has been going on and I will tell you honestly whether I am the right person for it.