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Read. Listen. Learn. Disorders & Treatment Disorders & Treatment Trauma & Post Traumatic Stress Disorder Suicide & Suicidal Thinking Generalized Anxiety Disorder (GAD) Borderline Personality Disorder Panic Disorder Self-Harm & Self-Injury Major Depressive Disorder (MDD) Podcast: PSYCHē Says Do you have an idea for a topic you wish PSYCHē would talk about? Submit your ideas here ! We might just cover it in a future podcast! Apple Podcast Spotify Listen Here Blog Posts Understanding the Difference Between OCPD and OCD Cringy Reassurance Seeking Group Therapy: Main Types and Their Unique Benefits RO-DBT vs. Traditional DBT: Which is Right for You? Grief: Five Stages and Perspectives from Psychological Theories Understanding the Nuances of Somatic Experiencing (SE) Therapy Read More

Self-Harm & Self-Injury Self-harm is a solution, not the problem. The therapist’s job is to find out the problem—and try some different solutions. ​ Cutting, scratching, burning, hitting, and pinching are some of the ways people hurt themselves. Though self-harm can be the reason for coming to therapy, it is more often than it is considered a symptom—not the problem itself. But make no mistake, self-harm is a VERY big deal. There is a 37-50 times greater risk that a person who self-harmed will attempt suicide within the next year. Regardless of whether it was “superficial” or severe, self-harm should never be ignored, dismissed, or minimized. ​ The reason for the rise in self-harm (particularly in teenage girls) over the last several years is unclear. A study in the UK found that self harm among girls aged 13 to 16 rose by 68% in a three year span. It has been suggested that the increase in self-harm can be attributed to a corresponding growth in social media a nd internet use, rising school stressors, busy schedules, and a growing number of websites which glorify self-harm. Regardless of the global contributors, each individual has their own personal reasons for choosing self-harm as a way to cope. ​ Similar to addiction, the more someone self-harms, the more difficult it is to stop. That’s why it is so important for caregivers of minors to make it clear that self-harm is not permitted. Drinking, drug use, and self-harm may be “self-medicating,” but they do not have to be accepted without consequence. Caregivers have the power to control the environment to minimize temptation by removing harmful items, performing “body checks,” and even monitoring a kid 24-7, creating a sort of “in-home residential” program. Remember, self-harm is a big deal, and preventing this dangerous habit from forming is the best way to protect kids from a lifetime of struggle. ​ For adults, if stopping self-harm is the goal, the solution is to find the actual problem and replace the old solution (self-harm) with new solutions (skills). Those who self-harm do so for a variety of reasons and it is impossible to know “why” someone self-harmed just by speculating. Sometimes there is one reason, sometimes there are multiple. Frequently, a person may think it is one reason, only to find that once they were asked the right questions, they discovered other things that contribute. To conclude that someone self-harmed “just for attention” is short-sighted. Working with a therapist who asks specific and matter-of-fact questions to help tease apart the different pieces of the puzzle is essential. But the bottom line is, for adults, being willing to take self-harm “off the table” as a coping response is key. PSYCHe PLLC has therapists ready to help. Get Started

Client Resources Our library of resources is in the works, if there’s something you’d like to see, just let us know Crisis Contacts National Suicide Prevention Lifeline: 988 Crisis Text Line : Text "HELLO" to 741741 National Domestic Violence Hotline: 1-800-799-SAFE (7233) National Sexual Assault Hotline: 1-800-656-HOPE (4673) The Trevor Project (Crisis Intervention for LGBTQ Youth): 1-866-488-7386 Disaster Distress Helpline (for those affected by natural or human-caused disasters): 1-800-985-5990 Frequently Recommended Residential Treatment Centers Hillside (Adolescent Females and Males) Website 404.846.5118 ​ Family First (Adolescent Males) Website 561.328.7370 ​ McLean Hospital (Adolescents and Adults) Website 800.333.0338 ​ Silver Hill Hospital (Adolescents and Adults) Website 866.542.4455 Lifeskills South Florida (Adults) Website 844.749.1560 ​ Timberline Knolls (Adult Females) Website 844.335.1809 ​ Skyland Trail (Adults) Website 866.504.4966 ​ Sierra Tucson (Adults) Website 844.335.1495 ​ Recommended Reading For Parents: ​ Stop Negotiating with your Teen by Janet Sasson Edgette ​ Parenting Your Out of Control Teenager by Scott P. Sells Mindfulness Practice

Sarah (Fink) Nehdi, LMHC Sarah is known for her kindness, responsiveness, and warm and inviting smile. She is easy to talk to but can also "get real” in a way that doesn’t put you on the defensive. She has worked with kids, adolescents, adults, and families for over 7 years providing therapy for depression and anxiety, but also enjoys helping people through life transitions. Sarah completed her undergraduate degree at Georgia State University, received her Master's of Education in Clinical Mental Health Counseling at Clemson University, and is a licensed Mental Health Counselor. She has been intensively trained in Radically Open Dialectical Behavior Therapy (RO-DBT) and leads an online RO-DBT group weekly. Fun fact: Along with her background in mental health and psychology, Sarah has also completed a cosmetology program, which further informs her passion for self-care, attention to detail, and the pride and satisfaction that comes with taking care of yourself physically and emotionally. Sarah knows taking the first step to finding a therapist isn't easy and doesn't take that show of strength lightly or the fact that you chose her, for granted! When she's not seeing clients, Sarah loves traveling to new places, finding new podcasts, cooking, and playing with her adorable Golden Retriever, Teddy. Sarah also loves coffee, dark chocolate, any kind of baby animal, home decorating, and visiting bodies of water, big or small. Sarah is available to see clients in Massachusetts, Tennessee, New York, Vermont, and Florida. “Sometimes the bravest and most courageous thing to do is just to keep putting one foot in front of the other.” - Sarah Nehdi, LMHC Request Consult

Dialectical Behavior Therapy (DBT) Not all DBT is the same. Click here to find out what questions to ask to find out if a therapist is truly a DBT Therapist. PSYCHē was founded by a DBT-Linehan Board of Certification, Certified Clinician™ The effectiveness of Dialectical Behavior Therapy (DBT) has been supported by research for treating a variety of issues. Originally developed by Marsha Linehan, PhD. in the 1980's to treat severe suicidality and self-injury, it is notorious for treating Borderline Personality Disorder in women, but research now suggests it is effective in improving a variety of conditions and diagnoses. In recent years, DBT has been empirically validated for treating other issues such as depression, impulsivity, anger, eating disorders, & more. What to Expect in DBT Individual DBT Sessions DBT-to-fidelity asks for a "gentleman's agreement" to commit to a 1-year of weekly therapy. Stage 1 of DBT treatment sessions focus on stabilizing mood and changing behavior. A heavy emphasis is placed on mindfulness and applying skills learned in DBT group to your specific situation. DBT therapists help clients build “a life worth living.” ​ Stage 2 of DBT includes processing traumatic memories through exposure treatments or changing unhelpful core beliefs that are a result of traumatic invalidation. DBT Skills Training Group Weekly DBT-Skills Training Groups cover specific skills to increase mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. DBT Skills Groups are like a class (not therapy). ​ Standard DBT for Adults involves a minimum of 52 weeks of group so that all of the skills are reviewed at least twice. The material covered is from Marsha Linehan's "DBT Skills Training Handouts and Worksheets ." Members can join anytime. Phone Coaching and Between Session Support Clients participating in true DBT programs receive intersession support through telephone, text, and email. Therapists assist clients with in-the-moment crisis management, task accountability, and case management. The main priority of intersession contact is to maintain active use of DBT Skills for effective coping. Parent Coaching & Support (DBT for Adolescents) Kids don’t come with a handbook. That’s why caregivers with children in therapy at PSYCHē most often meet with a parent coach to get a behavioral therapy education. Parents learn tips and tricks to implement with their child at home. Coaches create plans to assist caregivers in changing things as quickly as possible—and when the behavior is life-threatening, time is of the essence! Board Certification matters. Becoming a DBT-Linehan Board of Certification, Certified Clinician isn’t easy. It involves multiple steps including: ​ Attending 2 week-long intensive DBT trainings which are separated by several months Meeting weekly with a DBT consultation team assigned to you from the intensive program for 2.5 hours each we Consultation team case presentation Passing a multiple-choice exam of 110 questions and 10 pilot questions held at a Pearson Vue testing site based upon the DBT Texts and trainings Submitting 3 video recorded therapy sessions and passing 2 out of 3 for adherence Passing a written DBT case conceptualization of the patient participating in the recordings Evidence of engaging in regular mindfulness practice PSYCHē DBT therapists participate in a weekly peer consultation team meetings to maintain DBT-to-Fidelity. Get Started

PSYCHē Says Podcast

Group Gift Certificates First name Last name Email Phone Is this for you or someone else? Me Someone else Name Email Group package options Choose a group type Purchase Now Terms & Conditions: Prices are available through December 2023. Group member must begin attendance in January 2024. Group member must participate in a brief orientation meeting prior to the first group. The purchased packages include a specific number of group sessions, and this number decreases each week, regardless of group member's actual attendance. NO REFUNDS will be provided for missed sessions, regardless of the reason. When the package ends, standard rates for groups apply, and participants may continue by placing a credit card on file. Please note that a package is not a FULL round of DBT skills as they typically span 24-48 weeks. In the event that a refund request is placed BEFORE February 2024, a full refund minus a $50 administrative fee will be provided. Once the necessary consents are completed and payment is submitted, you will receive a confirmation in your email along with an e-certificate. By purchasing a package you consent to the restrictions listed above.

Panic Disorder The good news is, panic attacks are highly treatable ​ And although they can make you feel like you are going crazy or dying, they can’t actually make you lose your mind, and in the short term are actually no more dangerous in the short term than hopping on a treadmill would be. The downside is, that they feel horrible and can really be a burden if you experience them frequently and/or avoid living your life to the fullest because you’re afraid of having one. ​ The first step in getting past panic attacks is to educate yourself and begin gathering information. We will want to know when they started, how long they last, what they feel like, and whether you have any underlying illness. It is essential to rule out other medical conditions which could be the cause of your panic attacks such as a thyroid disorder or the unpleasant side effects of medication. You will fill out forms like these that provide information on the specifics of your symptoms. We don’t just talk about it! ​ Next, your provider will discuss the vicious negative reinforcement cycle of anxiety/panic and avoidance. Here’s a hint: AVOID AVOIDING! You will also learn about how the fight-flight system works (it works too well sometimes), the role that sleep and diet play in anxiety, and how to respond when panic creeps in... ​ Once you are on board with understanding the causes and contributors, your therapist will quickly move on to something that may seem truly insane, interoceptive exposure. This process actually changes some of your deeply ingrained beliefs from the inside out--but no one said it was comfortable! Depending on how fast you jump on board with the whole process (and how much homework you complete) you could be finishing up therapy panic free in 6-10 sessions. ​ For More information: Society of Clinical Psychology, Division 12, American Psychological Association Summary & Treatment Resources ​ ​ Get Started

Book an Intake Stephanie Vaughn, Psy.D. Clinical Psychologist-HSP & DBT-Linehan Board of Certification Certified Clinician™ Founder & Owner of PSYCHē, PLLC Dr. Vaughn is a seasoned Cognitive Behavioral Therapy (CBT) and Linehan Board Certified Dialectical Behavior Therapist™ (DBT) , national speaker, and has served as an expert consultant for a variety of institutions including the U.S. Department of Defense, Kennedy Krieger Hospital, Jacksonville Naval Hospital, Kentucky Western State Hospital, & Camp Pendleton Marine Base. She earned a Doctor of Psychology (Psy.D.) degree from the Georgia School of Professional Psychology, completed a Doctoral internship at Vanderbilt University (where she also founded their DBT Peer Consultation team), and completed her post-doctoral work at the Department of Veteran Affairs - Intensive PTSD Program, conducting Prolonged Exposure (PE) for combat veterans and women with Military Sexual Trauma. She served for 6 years as a provider for Logistics Health Incorporated (LHI) conducting fitness-for-duty evaluations for soldiers preparing to enter the military. ​ Dr. Vaughn is available to see clients in Tennessee, Massachusetts, and participating PSYPACT states. "The rumors are true. Being a PSYCHē therapist isn't easy. Our clients expect more from their therapist, therefore, so do we." - Dr. Vaughn If you don't see a day or time that works for your schedule, please email newclients@psychepllc.com

Generalized Anxiety Disorder (GAD) Do I have anxiety? Do I have social anxiety? Why do I have anxiety? ​ When the list of worries is too long to count, you can bet Generalized Anxiety Disorder (GAD) is the diagnosis. Therapists think of it as the “roulette wheel” of anxiety and worry—and can have mental and physical symptoms to the mind and the body. Many people with GAD actually have a healthy sense of humor about their tendency to overthink, despite how debilitating it can be, and it’s not hard to find good natured memes and GIF’s with constant worry as their main theme. There are several theories on the causes of GAD including genetics, substance abuse, diet, a history of abuse, and exposure to stressful situations. However, even when the causes cannot be changed, such as the case with a family history of anxiety, there are still interventions that can help. At times, worrying about the “what ifs” can actually be a way to avoid confronting and solving real issues. Pausing and asking yourself the question, “Is there an actual problem that I’m avoiding by worrying about something I can’t control?” can sometimes be enough to interrupt a mind that’s “work-procrastinating.” Another Cognitive Behavioral Therapy (CBT) technique is the “worry chair,” which involves postponing worries until a certain time and place (i.e. in the designated chair) and then worrying your little heart out. If you think about worry like snacking, it’s basically a “diet” of the mind. ​ GAD often goes hand-in-hand with other mood and anxiety disorders. A person may meet the criteria for Panic Disorder , OCD , or Depression in addition to the background noise of chronic worry. Sometimes Bipolar Disorder is misdiagnosed as GAD because both disorders can both involve rapid thoughts that cause distress, sleep problems, difficulty concentrating, and irritability. It’s important to see an expert for a thorough and accurate diagnosis because although both disorders require some of the same treatments, (such as maintaining a healthy lifestyle and CBT) the medications prescribed for GAD versus Bipolar Disorder can be very different. Get Started

Get Started We’re ready when you are. Schedule a Consultation Contact us to book an online consultation with one of our clinicians so you can get started in the right therapy with the right therapist. Sign Up for Consultation Join Online Group Ready to get started with one of our online DBT or RO-DBT group without a hassle? No problem. We made it simple to sign up, make your payment, and get started fast. Enroll in Group Therapy Have Questions? We’re here to help. Fill out the form and we’ll get back to you ASAP. Name Email Phone Preferred method of contact State seeking services in Interested in the following services How can we help? I understand that PSYCHē does not accept insurance. Send We’ll get back to you shortly! You can also email us at info@psychepllc.com if you need further assistance. PSYCHē therapists know their stuff. If “just talking” was the answer, you wouldn’t be here now. Finding someone with the specific training you need AND that you can open up to isn’t easy…especially if you aren’t a therapist! Let us help. Whether it’s Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT) , supportive, existential, or something else, we can connect you with a therapist who knows what they’re doing and can get you talking. Some say our expectations for therapists are too high. Having a license isn’t enough. We set a higher standard for our therapists—some say too high. PSYCHē clinicians go beyond state requirements. They arrive on time, communicate with your providers, and are people you would actually want to talk to. They are specialists in their craft and they connect with clients better. PSYCHē therapists remember your story, follow-up, and do what they say they’re going to do. They continue to expand on their education and are dedicated to the art and the science of DOING therapy. Ready to get started with a licensed therapist in your state? Let’s do it.

Your Rights and Protections Against Surprise Medical Bills When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing. What is “balance billing” (sometimes called “surprise billing”)?: When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a healthcare facility that isn’t in your health plan’s network. “Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit. ​ “Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. You are protected from balance billing for: Emergency services: If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balanced billed for these emergency services. This includes services you may get after you’re in stable condition unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services. ​ Certain services at an in-network hospital or ambulatory surgical center: When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed. ​ If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections. You’re never required to give up your protection from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network. When balance billing isn’t allowed, you also have the following protections: ​ You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly. Your health plan generally must: ​ Cover emergency services without requiring you to get approval for services in advance (prior authorization). Cover emergency services by out-of-network providers. Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits. Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit. If you believe you’ve been wrongly billed, you may contact: ​ Valerie Peppers at 615-274-8400 or email billing@psychepllc.com The U.S. Centers for Medicare & Medicaid Services (CMS) at 1-800-MEDICARE (1-800-633-4227) or visit https://www.cms.gov/nosurprises for more information about your rights under federal law. The Tennessee Department of Commerce and Insurance at 615-741-2218 or 1-800-342-4029. ​ Visit cms.gov/nosurprises for more information about your rights under federal law. ​ Good Faith Estimate You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, healthcare providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services. ​ You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees. Make sure your healthcare provider gives you a Good Faith Estimate in writing at least one business day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate. ​ Get More Information For questions or more information about your right to a Good Faith Estimate, visit cms.gov/nosurprises or call 1-800-MEDICARE (1-800-633-4227).