LMSW Therapist, Shanna Breen FAQs

Shanna Breen specializes in working with OCD and eating disorders. Here she answers the most commonly asked questions about her approach. 

• How do I know if I need treatment for OCD?

  It can be difficult to identify when or how OCD symptoms may require treatment.  This will vary from individual to individual and it is mostly determined by how much the symptoms are impacting one’s ability to live their life in an active and fullfilling way.  There are some symptoms that are tolerable and don’t cause any distress, however, it is still important to be mindful of how they have changed over time.

• How long does OCD therapy take to work?

  ERP is generally 12-15 sessions. This will be dependent on the individual.

• Is ERP part of OCD treatment?

  ERP is one form of treatment for OCD, .  It is considered the gold standard for treating OCD based on effectiveness and sustainability.

• How prevalent is OCD?

  There are estimated to be over 200 million people world wide, who are diagnosed with OCD.  Roughly 3 million people in the united states alone.

• What therapeutic interventions are helpful for anxiety?

  There are many helpful interventions for anxiety, but I primarily use cognitive behavioral therapy; more specifically ACT (acceptance and commitment therapy) and DBT (dialectical behavior therapy).

• Do you treat panic attacks or social anxiety?

  I treat both panic disorder and social anxiety.

• What's the difference between anxiety and excitement?

  Interestingly, our brains activate the same part of our brain (the amygdala), so at times, we will experience similar arousal characteristics.  The difference is how the brain interprets and prompts us to respond.  Where with anxiety our parasympathetic nervous system prompts us to respond to a threat, excitement releases chemicals in our brain (endorphins) to indicate something that is pleasurable.

• Can therapy alone treat an eating disorder?

  Therapy as well as the support of an ED specializing dietitian is recommended to treat an eating disorder.  Depending on the type of eating disorder and/or presence of other comorbidities, other specialists may be recommended. (ex. physician, psychiatrist, gastroenterologist, occupational therapist, and others).

• What are eating disorders exactly?

  An eating disorder is an umbrella term for mental disorders that have the presence of maladaptive eating behaviors that impair mental and physical health.

• What if I’ve been in treatment for an eating disorder before and relapsed?

  Eating disorders are incredibly challenging and complicated.  It is completely normal to have had treatment in the past and experience a relapse.  In life, we go through many changes as people and the challenges we may have had in the past, may not be the same in the future.  Additionally, eating disorders are never necessarily “cured” after treatment.  It is something that we live with all through our lives, that have times of better maintenance than others.  With recovery, similar to remission in illnesses, we may not even think of the eating disorder anymore, but the vulnerability is still there.

• Can therapists diagnose eating disorders?

  Therapists that are LCSWs, LMTs, and LPCs are able to diagnose eating disorders, as well as Psychiatrists (MD or DOs), and specializing Clinical Psychologists (PhD or PsyD).

• What types of therapy are used for eating disorders?

  There are many modalities that treat eating disorders.  Generally, it is recommended that some form of behavioral therapy (CBT, ACT and DBT) along with psychotherapy is utilized.  Depending on the individual and comorbidities, other modalities may be utilized.

• Will I have to give up my eating disorder behaviors immediately?

  This will be dependent on the individual, the type of eating disorder, medical factors and the level of severity.  Some eating disorders require a higher level of care, where all behaviors will need to be stopped as a medical necessity.  Some eating disorders, like ARFID, have a gradual reduction in behaviors and others might be cessation of some behaviors and gradual reduction of others.  Ultimately, the decision to stop will always be up to the individual and though it may be recommended, sometimes it is not always possible.  Either way, working with a team to get support around troubleshooting the barriers is part of the process, and we can help to bring client’s to a place where their symptoms are no longer controlling their lives.

• How do I get started?

  The first step is to reach out :). Finding an ED specializing therapist and dietitian to discuss what your options are and then taking it day by day from there.  Treatment is challenging and scary and it may take some time to find the right fit when looking for a clinician.  Thinking about how you like to be most supported and finding someone you feel most safe and comfortable with, will be essential.

I’m here to answer any questions you have, so please don’t hesitate to reach out to me.

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Shanna Breen, LMSW

Shanna Breen specializes in working with individuals facing challenges with managing behaviors stemming from OCD, anxiety, and eating disorders, as well as the intersection of other disorders and how they impact their behaviors. Additionally, individuals with stress and anxiety, who are hoping to learn coping skills to manage their emotions.

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