Connecting with the Therapist

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Bridge
Bridge is a quarterly
journal designed to
provide Bay Area helping
Y How To Choose A Therapist Z
professionals with up-todate articles and
Second Part of a Two-Part Series
By Amara Glorioso Brown, MFT
resources to help us help
others.
For more information,
contact this publication
at
bridgeinfo@hotmail.com
Amara Brown, MFT
415-391-1741
www.camft.org/Therapists/
AmaraBrown
Katie Cofer, MFT
415-826-2951
katiecofer@sbcglobal.net
Samantha Zylstra, MFTI
415-585-3132
www.samanthazylstra.com
How to Choose a
1
Therapist
by Amara Glorioso
Brown
EMDR: New
2
Possibilities for
Clinical Change
by Katie Cofer
An Age of
Connecting
Therapist
with
the
This is the second part of a twopart series on choosing a good
therapist.
In Part One I
addressed where to find
referrals and gave information
on differentiating among the
licenses and training under
which therapists practice. (If
you missed Part One, printed in
the Winter 2005 edition of
Bridge, feel free to contact me
either by email at
bridgeinfo@hotmail.com or
by calling 415-391-1741, and I
will be happy to get a copy to
you.)
Have Three Referrals
INSIDE THIS
ISSUE:
4
Medication
by Samantha Zylstra
Professional Focus 7
Connecting Bay Area Professionals
Spring 2006
Volume 1, Issue 3
The process of finding a
therapist can be overwhelming
to say the least. Hopefully, at
this point you have located a
few (I suggest two to three)
names and nu mb er s of
therapists from trusted sources,
and you have taken some time
to identify what you are hoping
to get out of therapy and what
attributes you might find
helpful in a person.
Now is the time to take what
may feel like a big step and call
the therapist.
I suggest
beginning by calling one
potential therapist at a time.
Start with the therapist you feel
most drawn to based on
whatever information you may
have.
Keep in mind that you are the
consumer of a service.
Obviously, give the therapist a
chance, but know that if the
“fit” is not good, you can
always call someone else.
Below are a few things you
may want to know to expect
and some things to look out for
to help you in choosing a
“good therapist” and avoiding
those that are not so good.
The First Phone Call
Usually, when you first call a
therapist you will hear a
voicemail
message.
Remember that therapists do
not answer the phone when
they are in session.
This
voicemail should be private
and confidential.
Leave a
message with your name, your
number, and some times when
you think the therapist might
reach you and you will be
available to talk. That’s it.
The first step. Give yourself a
pat on the back.
call. It is not necessary to go
into the details that bring you
to therapy at this time but it is
important to ask a few
questions.
•
Find out what the
therapist’s experience is
with the types of issues
you are facing. Depending
on the issue, special
training or experience may
be very helpful. At the
very least they should be
willing to learn more about
your issues to help with
treatment. If they do not
have experience in a
specific area (i.e., drug
treatment, eating disorders,
suicidality, etc.), ask them
for a referral to someone
who specializes in the
issues that you are facing.
•
Discuss fees.
Fees
charged can vary greatly in
dif f er ent ar eas a nd
depending on the
experience, degree and
license of the therapist.
Choose a therapist that
offers a fee that you feel
you can realistically
afford. If you have limited
income, many therapists
offer a sliding scale.
•
Don’t forget to find out
about office location and
available meeting times.
Most therapists will make a As you ask these questions and
few minutes to talk on the talk to the therapist, consider
phone when they return your not only the answers they give
Please turn to page 3
Y EMDR: New Possibilities for Therapeutic Change Z
By Katie Cofer, MFT
A man sees a therapist to deal with his
long-standing fear of flying. After
three sessions he is able to go on a fivehour flight without feeling any anxiety.
A young woman who has been held up
at gunpoint while on the job is
experiencing flashbacks of the event
and is unable to work. After five
sessions the woman no longer has
flashbacks and is able to return to her
job.
A nine-year-old girl, in the midst of a
therapy session, suddenly remembers
traumatic details of how her father
died and becomes very agitated. The
therapist asks the girl to beat
rhythmically on a drum while thinking
of some positive images, and ten
minutes later, the girl is happily
drawing pictures.
A young writer has been seeing a
therapist for writer’s block. When his
therapist suggests a technique that
involves tapping lightly on his knees
while he follows his thoughts, images,
and associations, he is somewhat
skeptical. But after about a month he
notices he has had some important new
insights and feels more energized visuals, sounds, scents, thoughts,
about his writing.
feelings, and body sensations.
Memories of successive distressing
events are then layered on top of the
What is EMDR?
original memories in memory
Different as these clinical situations networks of seemingly related
may seem, in each case the therapist events. This can create blockages in
was applying some form of EMDR the brain’s ability to process new
(Eye Movement Desensitization and information adaptively, that is, to
Reprocessing). EMDR is a relatively resolve distressing or traumatic
new therapeutic method that makes events.
use of the connection between body,
A psychologist named Francine
brain, and emotions to help resolve Shapiro discovered that it was
anxiety or memories of distressing or possible to stimulate the brain’s two
traumatic events.
hemispheres through “alternating
What is dramatically different about left-right visual, audio and tactile
EMDR as compared with traditional stimulation” (for instance, through
psychotherapies is that with simple hand movements, flashing lights,
traumas it can yield positive results in alternating tones or “buzzes” from
a much shorter time-frame, often in vibrating devices, or by simple hand
anywhere from one to five sessions. taps). This sort of bilateral sensory
More complex traumas, such as stimulation, coupled with the
childhood sexual abuse, take longer to therapeutic procedures of EMDR,
resolve.
can reduce the “charge” of
disturbing memories and emotions,
and enhance the brain’s ability to
How Does EMDR Work?
respond adaptively to situations by
Memories of distressing events are creating links to different memory
stored by the brain as a “gestalt,” networks. This process is also
complete with all the related sensory, referred to as neuronal integration.
emotional and cognitive information:
Please turn to page 6
From Trauma to Transformation
Powerful Therapy with EMDR
Traumatic experiences can become imprinted on a person’s brain and body in such a way that they can cause symptoms like
nightmares, flashbacks, disturbing body sensations, and limiting beliefs about life.
EMDR, Eye-Movement Desensitization and Reprocessing, is a powerful and well-researched therapeutic technique that
helps to process and release these traumatic memories. Depending on the type of trauma, treatment can be much faster than with
traditional therapy.
EMDR can also be very effective with other issues such as anxiety, phobias, depression, grief, and blocks to performance or
creativity. Once these old emotional residues are cleared from the body/mind, people often experience increased aliveness and a
sense of transformation in various areas of their lives.
I use EMDR, along with methods of body awareness, mindfulness, expressive arts, and traditional talk therapy, to help
clients release emotional pain and blockages that keep them from achieving their full potential for growth and self-expression.
For more information, please give me a call:
Katie Cofer, MFT (Lic. MFC #35856)
Tel. 415-826-2951, katiecofer@sbcglobal.net
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How to Choose a Therapist
Continued from page 1
but also how the questions are
answered. Does the therapist seem
comfortable and available?
If a
therapist seems defensive, irritable, ill
at ease or scattered, these may be red
flags. If, on the other hand, you feel a
beginning connection with the therapist
on the phone, schedule a first
appointment. If you don’t feel that
connection, tell the therapist that you
may call them back if you decide to
make an appointment and call another
referral from your list. Remember, you
are the customer. Feel free to shop
around a little if need be to find a good
connection.
As I mentioned in Part One, studies
show that it is the relationship formed
between the therapist and client, more
than any other factor, that makes
therapy work.
The First Session
Consider the first session as a sort of
interview for the therapist. It is a
chance for you to meet the therapist in
person and decide if he or she is
someone you can work with. Studies
show that it is in the relationship
between the therapist and the client that
therapy happens. I cannot stress this
enough. The relationship, more than
any training or experience, is key.
During this first session, take note:
Does it feel like a beginning connection
is being established? Does it feel safe?
Does he or she seem like a person that
you will be able to let your guard down
with and confide in? The first session is
also a chance for the therapist to assess
whether he or she can be helpful to you.
Take the time to let the therapist know
about the issues that you are facing.
You should expect to fill out a few
forms and go over office policies
regarding confidentiality, cancellations,
payment, and contact between sessions.
If you have questions ask them. A
professional and ethical therapist will
have no problem discussing his or her
office policies. This is also the time to
ask questions about what to expect
therapist will be open to discussing
what is or is not working for you in
the session and may even take
responsibility for their own part if
they have made a mistake.
Developing a relationship with your
therapist which involves this kind of
“feedback” can make the work
deeper and more rewarding.
In
general, it is a good idea to stick with
a therapist for two or three sessions
while you are attempting to sort out
your feelings, but don’t forget that
you are a consumer and should feel,
in general, satisfied with the service
you are paying for.
The exception to this is in regards to
a therapist who is acting illegally or
Assessing a “Good Fit”
unethically. These therapists should
It is important to notice how you feel be reported immediately to their
about therapy and a therapist in order licensing board.
to make a good choice in providers.
Remember that, although most people Be Courageous
find that therapy helps them to make
lasting positive changes in their lives, As I mentioned in Part One, a
most people also have periods of general rule of thumb with therapy
resistance, frustration and anger in is: The more that you put into it, the
their therapy. This resistance can be a more that you will get out of it. If
normal part of the process. Even when you have carefully chosen a therapist
change is positive, it is difficult. Most and have found one that is a “good
of us react to difficulties by protecting fit” with your needs, you have laid a
ourselves from the pain the change will good ground work for your
cause us. If, at the beginning or during experience in therapy. Many people
find that beginning therapy is the
“Studies show that it is the
most difficult part. Therapy is an
relationship formed between
investment of time and money and
the therapist and client, more
energy. That investment is one that
you make in yourself and will
than any other factor, that
positively affect your relationships
makes therapy work.”
with others. Step forward into this
the course of therapy, you find yourself investment with courage, and be
thinking: “This therapist is terrible!” or proud of the positive change you are
“He doesn’t know what he is doing!” choosing in your life.∞
or “How dare she think that about
me!”, it may be worthwhile to take
some time and try to separate what you
may be feeling in reaction to your
attempts to change from what may be
Amara Brown, MFT is in
signs that the therapist is “not good” or
private practice in San Franthe fit could be better. Ultimately, the
cisco. She can be reached at
choice is always yours. I strongly
415-391-1741 or at bridgesuggest talking to the therapist about
info@hotmail.com
your concerns. This may lead to
greater insight for you.
A good
during therapy and anything else that
may concern you. Some questions
might include:
•
What can I expect during a usual
session?
•
Are you open to feedback along
the way?
•
How will we know when to end
therapy?
•
Do you have any policies related to
ending?
•
Do you have any special skills or
training that might augment the
therapy? For example: Expressive
Arts therapy, dream work, EMDR,
etc.
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Y An Age of Medication Z
One Professional’s Thoughts on Psychopharmacological Treatment
By Samantha Zylstra, MFT Intern
We live in an age of medication.
Television advertisements sell us a
simple pill that can do anything from
fixing a sleeping problem to enhancing
erections.
The internet makes
purchasing drugs easy, with or without
a prescription.
As professionals
working in this modern age, I believe
it is important to take a closer look at
the implications of medication and
treatment, specifically regarding
mental illness. This article addresses
recognizing our own biases towards
medication, making referrals for
medication, discussing medication
with our clients, and our own working
knowledge of current
psychopharmacological medication.
To begin, I share my own experience
with a client and her struggle with
depr ession.
(H er name a nd
identifiable information have been
changed for confidentiality.)
although she was still bothered by the
underlying lack of desire, interest, or
enjoyment while with her friends and
her inability to sleep. She wanted to
know what else she could do to feel
better. We discussed the aspects of
treatment that had worked well and
then I suggested as a further addition
to therapy a referral for a psychiatrist.
Sally immediately responded, “Do
you think I am so sick that I need
drugs? Am I truly that pathetic?”
I explained to Sally that I don’t view
medication as a last resort, but as an
adjunct to therapy that in some cases
is very useful. I recommend she think
about it and we continue the
conversation at our next appointment.
One week later, Sally reported she
had a horrible week, and she was
willing to do whatever it would take
to feel better, even take drugs.
Sally’s Story
Sally, a 21-year-old woman, began
therapy because of a persistent
problem with depression.
She
reported an inability to experience any
pleasure, significant weight loss,
insomnia, isolation from friends and
difficulty functioning at work. Sally
said, “All I want to do is stay in bed all
day with the sheets pulled firmly over
my head.”
Sally reported she
remembered other times in her life
when she felt a lack of desire to do
much but she had never felt this “low”
before. After my initial assessment, I
began therapy and recommended Sally
make an appointment with her
physician for a full medical evaluation
to rule out any medical reasons for her
depression.
After several months of therapy, Sally
began to improve. She had made a
few new friends with whom she
wanted to spend time socially. She
was back to her usual weight and was
regularly getting to work on time.
Sally noticed the improvement,
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Responding to Medication
to pay for them? All of these
questions are valid. Depending on
who you are and whom you talk to,
ther e are differ ent answers.
Nonetheless, the answer to these
questions directly influences our
clients; therefore, I believe it is
crucial for us, as professionals, to
know our own bias regarding
medication.
Our personal bent on the use of
medication directly impacts our
clients. When we refer, if we ever
refer, and the type of referral we are
likely to give are all influenced by
our opinions on drug treatment. For
example, because I believe
medication can be an appropriate
adjunct to psychotherapy, I referred
Sally to a psychiatrist, but only after
I had worked with her for several
months.
If I believed a full
psychiatric exam was important at
the beginning of therapy, I would
have referred Sally sooner. If Sally
had a physiological-biological
deficiency and medication was the
only thing that would help her, did I
do a disservice to Sally by waiting
three months? My ultimate goal is
to journey with my clients down
their road to recovery, empowering
them to make the best choices for
their own healing. In order to do
this, I must keep my own opinions
and beliefs in check. It was not my
intention to deny Sally any form of
treatment nor to persuade her into
making a choice that she did not feel
was completely appropriate for her.
It is my hope that we, as
professionals, always have our
clients’ best interest in mind.
Keeping our own opinions and
beliefs in check seems an
appropriate method for maintaining
a focus on what is best for each
individual client.
Sally’s response to medication is not
uncommon. Many people do not wish
to be medicated or believe that
medication means they are crazy and
beyond hope. Alternatively, some
people believe that medication is a
quick fix on their road to recovery; If
they can just get a prescription, they
will feel fine and not need any adjunct
psychotherapy.
Others prefer nonwestern approaches to treatment. We,
as professionals, also have opinions
and hold beliefs about medication. In
the past ten years, there has been a
700% increase in the amount of
psycho-stimulants prescribed to
children and a 250% increase in
adolescents. (Dr. Mark Schiller,
February 12, 2006) Is this rise in
prescriptions due to better diagnosis
or to better drug availability and
options? Are we over-prescribing Sally’s Outcome
drugs because they seem like an easy
fix and insurance companies are likely Sally was prescribed the SSRI
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(s el ect iv e s er ot onin r eu pta ke
inhibitor) Prozac. After about three
weeks on the drug, she experienced a
lift in her mood. Most prominently,
she felt she was able to enjoy life
again. Sally and I had discussed the
need to take an antidepressant for
sever a l weeks befor e f eeling
symptomatic relief. Therefore, she
was not surprised when she didn’t feel
a change immediately. Sally was
pleased with the result, but she did not
want to remain on the drug for her
lifetime. We discussed the options
and I asked her to check in with her
psychiatrist.
As a Marriage and
Family Therapist Intern, I cannot
prescribe drugs or make specific drug
recommendations to my clients. But
it is appropriate for me to discuss my
clients’ feelings and thoughts around
drug treatment, side effects they are
experiencing, and concerns that they
may have. I also work to empower
them to have a voice with their
psychiatrist so that the psychiatrist
knows how they are doing and their
desired course of treatment. Further, I
have found it very useful to have all
clients sign a release form so I can
speak directly with their psychiatrist
in order to best meet the needs of my
clients.
In Sally’s case, after nine months of
drug treatment, she began to taper off
the drug. Sally, the psychiatrist and I
decided that there was no reason why
Sally should not begin tapering. She
had not experienced any depressive
episodes since beginning the drug and
was planning on staying in therapy on
a weekly basis. Sally’s story is a
success. Her goal for therapy was to
overcome her lack of pleasure and
inability to function socially or at
work. Through psychotherapy and
the use of medication she was able to
attain her goal. Further, she was
willing to take Prozac for awhile, but
did not want the medication to be a
lifelong necessity. In her case, this
was a possibility. In some cases,
medication ma intenance is a
necessity. It is important to discuss
this reality with clients who have
symptoms or relapse while on the
medication or during the tapering
cycle or whose diagnosis is known to
respond best to continuing use of
medication.
An Overview
Management
of
As well as inquire about their
regularity in taking their medication.
Sixth, keep a record of the
prescription and dosage. Remember
that while you see your client weekly,
if your client is lucky they see the
treating psychiatrist once a month, but
more often once a year. Therefore,
you have an opportunity to help your
client advocate for themselves if the
drug is not working and to contact
their doctor immediately if they are
having any severe side effects.
As professionals in the modern age, I
believe it is imperative to know and to
have articulated your own biases
towards or against medication. We
are better able to serve our clients and
meet them in a place they can find
most helpful when we understand our
own beliefs.∞
Medication
Managing medication begins with the
treating professional having a clear
understanding of his or her own bias.
Second, meet your clients where they
are with their opinions, fears,
hesitations, and excitement regarding
medication. Third, get signed releases
to effectively collaborate with any
other treating professional and your
client.
Fourth, have a working
knowledge of the most commonly
prescribed medications. Fifth, talk to
you client about the effects that they
are experiencing with the drug and
any side effects that they are noticing.
Sources and Resources:
● Peter Kramer (1997). Listening to
Prozac ● Peter Kramer (2005).
Against Depression ● Des maisons
(1998). Potatoes not Prozac ● J.
Preston, N. Varzos, D. Liebert (1998).
Warning:
Psychiatry May Be
Dangerous to your Mental Health.
Make Every Session Count
Samantha Zylstra is an MFT Intern in private practice in San Francisco. She can be reached at
www.samanthazylstra.com, or
415-585-3132
Practicing Psychotherapists
♦
♦
♦
♦
Are you looking for a way to bring new energy and depth to your work with adults?
Need a creative way to engage resistant adolescents?
Want to expand your skills in working with children?
Seeking a way to bring activity and interconnectedness to a group?
Adding Expressive Arts to your practice can be an exciting way to reenergize, increase insight and self expression, and creatively contain difficult feelings in your work with clients.
♦
Amara Glorioso Brown, MFT is available to provide consultation to assist you weaving a wide variety of arts modalities in to your current work. She is happy to suggest specific activities for clients, provide instruction in the use of
arts modalities and/or provide on-going consultation regarding the clinical application of the arts in your practice.
Call to set up an appointment: 415-391-1741
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EMDR: New Possibilities for Therapeutic Change
Continued from page 2
Uses of EMDR in Therapy
First of all, EMDR should only be
performed by licensed clinicians who
have undergone training approved by
the EMDR Institute. Practitioners
should have at least Level II training,
while certified EMDR therapists will
have received more advanced
training and extensive consultation
from an EMDR-certified facilitator
or trainer.
The effectiveness of EMDR with
traumatic incidents and PTSD is well
documented (see www.emdria.org).
T he Amer ican Psychological
Association has designated EMDR
as one of three “probably efficacious
treatments” for civilian PTSD.
Tra uma exp er t s such as
neuroscientist Bessel van der Kolk
consider EMDR, along with other
somatic trauma therapies, to be the
standard of care for trauma
treatment.
Because of the way EMDR acts on
the brain, it is effective with any
complaints that are accompanied by
an activation of the nervous system,
such as anxiety disorders, phobias,
stress/tension, sleep disturbances, or
restlessness. EMDR can also help
with unresolved grief, depression,
psychosomatic symptoms, blocks to
creativity, and any experience of
feeling “stuck.”
EMDR in Action
EMDR can be used on its own or
int egr at ed int o convent iona l
psychotherapy. Treatment is possible
in a conventional 50-minute session,
but it can be beneficial to use longer
sessions, often 75 or 90 minutes.
Before embarking on EMDR
treatment, a therapist will want to
know the history of the client’s
presenting issues, plus information
about family and developmental
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background, any traumatic events,
substance use, and the client’s social
support system.
At this point, the therapist will
usually experiment with the client to
see what form of bilateral stimulation
he or she prefers. Then the therapist
will spend some time on “resource
installation.” Here the therapist helps
the client to identify various resources
and strengths, and to focus on these
while the therapist does several sets of
bilateral stimulation to “install” or
anchor the resource in the client’s
neurophysiological system. A resource
might be a real-life figure, such as a
trusted person, a pet, a beloved place,
or something imagined, such as a
special safe place or sanctuary or some
symbolic, protective figure. The
therapist wants the client to be able to
access a positive internal state in case
the processing brings up difficult
emotions.
Then the therapist and client will
spend some time developing the
“target” that they will be working on.
Generally, therapists try to find the
earliest possible related memory, in the
belief that the overlying memories will
be cleared along with the earlier ones.
When therapist and client have found
an appropriate target, the therapist
helps the client to activate the memory,
or “light up” the neuronal network, by
asking questions evoking different
aspects of the event. The client gives a
subjective rating, on a scale of 0 to 10,
of the current intensity of distress,
which will serve as a reference point
during the processing for decrease of
the traumatic charge.
After this preparation or set-up, the
processing can begin. The rest of the
session will consist of a series of “sets”
of bilateral stimulation, during which
the client usually focuses on the
experience in silence and then debriefs
with the therapist. Here the therapist’s
skill in deepening the exploration and
interweaving new elements is key.
Periodically the therapist will ask the
client to return to the original target
and check to see how much the
distress level has decreased. Ideally,
the emotional charge will have gone
down, and often negative beliefs or
subject ive exp er ienc es of
helplessness or victimization will
have been replaced by spontaneous
insights and positive cognitions.
When this is the case, the therapist
“anchors” the new positive beliefs
with a few more sets of bilateral
stimulation. If some issues still seem
unresolved, the therapist will help
the client find ways to contain them
until they can be processed in
another session.
EMDR therapists often say that
EMDR diminishes distressing
emotions and enhances positive
ones. In the hands of a skilled
clinician, EMDR is like a power tool
that can free clients from the
debilitating effects of traumatic
experiences and enhance well-being
by facilitating natural growth and
healing processes. EMDR truly has
the potential to transport clients from
trauma to transformation.∞
Sources and Resources:
www.emdria.org
● La ur el Par nell (1997).
Transforming Trauma: EMDR.
● Francine Shapiro (2001). Eye
Movement Desensitization and
Reprocessing, Basic Principles,
Protocols and Procedures. (2nd ed.)
Katie Cofer, MFT is in private
practice in San Francisco. She
specializes in work with trauma and is
EMDR trained. Katie can be reached at
415-826-2951 or
katiecofer@sbcglobal.net.
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Couples Counseling
A Journey To Hope and Healing
Eating Disorder and
Body Image Support Groups
“I only see a fat, ugly body
in the mirror.”
♦
♦
Relationships are Sacred Work.
Sacred, because we are engaging in loving another person
and empowering them to be their best self.
Work, because it is daily effort that enables us to grow in
connectedness.
I believe relationships are worth this sacred work. If you and
your partner are stuck in an impasse, don’t wait. Hope and
healing are possible. For more information and to schedule an
appointment, contact Samantha Zylstra, MFT Intern 46427 at
415-585-3132 or visit www.samanthazylstra.com
•
•
•
Learn to empower your true self and overcome the eating
disorder struggle.
Develop positive outlets for self-expression.
Be comfortable in your own skin.
Samantha Zylstra has been running support groups for
women with eating disorders since 2004. She incorporates
the arts into all of her groups. For group or individual therapy, call today at 415-585-3132.
Professional Focus
Amara Glorioso Brown, MFT (#39414) is a depending on the needs and inclination of each
therapist in private practice in San Francisco. She
welcomes referrals for children, adolescent or adult
clients. In her work, she focuses on meeting each client
where he or she is and provides opportunities for insight
and client-directed positive change. She is trained and
experienced in both traditional, psychodynamic
psychotherapy and in expressive arts therapy. Her office
is arranged with materials and space to support work in a
variety of artistic modalities ranging from dramatic
enactment, sand tray, painting, collage, and play therapy
Katie Cofer, MFT (#35856) is a Licensed
Marriage and Family Therapist in private practice
in San Francisco. Her work is based on a
fundamental belief in the interconnectedness of
mind, body, heart and spirit. She integrates
relational talk therapy with somatic,
transpersonal, and expressive arts approaches.
She is also trained in EMDR, a powerful
technique that facilitates the clearing of traumatic
client. Her current clients come from many cultural
and socio-economic backgrounds and face a wide
variety of issues including: depression, anxiety,
loss, trauma, abuse, relationships, anger issues,
compassion fatigue and adolescent adjustment. She
offers a sliding scale for those with limited income
and is able to accept some insurance. Please call
with any questions, to make a referral or for an
initial appointment. 415-391-1741
memories and emotional stuck points. Through these
processes of self-discovery and healing, clients may feel
more connected with their core self and regain access to
their innate vitality and creativity. Some of Katie’s areas
of expertise include trauma, depression, anxiety, phobias,
unresolved grief, blocks to creativity, and cross-cultural
issues. Katie also works with children and adolescents
and is fluent in Spanish and German. She can be reached
at 415-826-2951 or katiecofer@sbcglobal.net.
Samantha Zylstra, MFT Intern (#46427) has a insight and client-directed choices for change.
private practice in San Francisco. She provides
services for couples, adults, and children who desire
healing in their lives. Samantha believes therapy is
an opportunity for personal growth and lasting
positive change.
Samantha’s approach to therapy is informed by her
desire to meet each client where they are at, creating
space for them to strengthen their core self. Her role,
as she sees it, is to listen deeply and responding
empathetically to help facilitate opportunities for
Samantha has a certificate of specialization in the
treatment of eating disorders. She runs eating
disorder support groups and expressive arts therapy
groups for developing healthy body image.
For more information regarding her therapeutic
approach or specialties, please call 415-585-3132 or
visit www.samanthazylstra.com
Samantha is under the supervision of Lori E. Opal,
MFT #35754.
BRIDGE,
P AGE
7
♦ Amara Glorioso Brown
♦ Katie Cofer
♦ Samantha Zylstra
Connecting Bay Area Professionals
315 Sanchez Street
San Francisco, CA 94114
Bridge
Bridge Quarterly Journal, Spring 2006 Issue
Bridge is a quarterly journal designed to provide Bay Area helping professionals with up-to-date articles and resources to help us help others.
Please contact us at bridgeinfo@hotmail.com or
Amara Glorioso Brown, 415-391-1741, www.camft.org/Therapists/AmaraBrown
Katie Cofer, 415-826-2951, katie-cofer@sbcglobal.net
Samantha Zylstra, 415-585-3132, www.samanthazylstra.com