My Approach — ERP, ACT & IFS for Anxiety, OCD & Trauma | Dr. Molly St. Denis

Many of the people I work with have tried therapy before. They’ve found some relief, but the same patterns keep resurfacing. What they’re often looking for isn’t just to feel less anxious — it’s to live with greater purpose, connect more fully with others, and move through life with more freedom and authenticity.

I’ve found that the most meaningful and lasting results come from integrating mindfulness-based strategies and parts-work with traditional, gold-standard treatments for anxiety, OCD, and trauma. That means we’ll work on practical tools and symptom relief while also turning toward what’s driving the patterns underneath — at a pace and in a style that feels right for you.

The Methods I Use
ERP

Exposure & Response Prevention

ERP is the gold-standard treatment for anxiety and OCD. It involves gradually facing feared situations while resisting the urge to avoid or engage in compulsive behaviors. Avoidance reinforces anxiety over time by signaling to the brain that the feared situation is dangerous — and it forecloses opportunities for new learning. ERP breaks this cycle by helping your brain and body learn through direct experience that you can handle discomfort without relying on avoidance. Over time, this shifts your relationship to anxiety and builds greater trust in yourself.

ACT

Acceptance & Commitment Therapy

ACT focuses on building psychological flexibility — the ability to stay present with your internal experiences while taking meaningful action in line with your values. Rather than trying to eliminate uncomfortable thoughts or feelings, ACT helps you relate to them differently, so they no longer dictate your behavior. Together, we’ll identify what matters most to you and work toward building a life that reflects those values, not one organized around avoidance or rigid patterns.

IFS

Internal Family Systems

I work through a lens informed by Internal Family Systems (IFS). This framework helps us understand your different emotional responses as parts of you — shaped by past experience and often developed as ways to cope or protect. Rather than treating anxiety or trauma responses as problems to eliminate, we get curious about them: what role have they been playing, how are they trying to help, and how might they find more helpful ways of expressing themselves? This perspective supports exposure and trauma work by bringing greater compassion and collaboration to the process.

When Exposure Needs Support

Integrating IFS and ERP for OCD.

ERP is the gold-standard treatment for OCD, and for many people, well-delivered exposure is the most direct path to relief. But it isn’t always straightforward. Research suggests that a meaningful share of people — by some estimates between 25 and 40% — don’t respond adequately to first-line treatment on its own. Some find exposure too overwhelming to begin. Others can technically do the exposure, but white-knuckle their way through it or follow it with compulsions, reassurance, or resistance — which undercuts the response-prevention piece and cancels out much of the benefit.

Real change depends not just on facing the fear, but on being able to access genuine willingness, and that’s often where people get stuck: their nervous system is too activated, or the protective parts of them are too on guard to allow it. From an IFS perspective, when exposure pushes against those protective parts before they’re ready, it can provoke a backlash — symptoms intensify or resurface elsewhere, and the work can start to feel like whack-a-mole.

I don’t see this as treatment failure. More often, it means a person needs some groundwork before exposure can do its job — and this is where an IFS-informed lens becomes especially valuable. When we can help the anxious, protective parts of you settle, you’re able to turn toward obsessional fears from a steadier, more curious, more self-compassionate place (what IFS calls Self). From there, exposure becomes something you can genuinely engage with, rather than something you’re white-knuckling through.

The aim is never to make exposure softer or to sidestep what’s hard. It’s to build the internal conditions that let exposure actually take hold — especially for people who’ve struggled with or stepped away from traditional treatment before, whether because of trauma, attachment wounds, or an internal system that wasn’t yet ready for the demands of ERP. Used this way, IFS strengthens evidence-based OCD treatment rather than replacing it.

Putting It Together

One integrated approach, tailored to you.

This integrated approach addresses both immediate behavioral goals and your broader relationship with anxiety, OCD, or trauma over time. The aim is to help you develop greater psychological flexibility, build confidence in navigating difficult situations, and move toward a life that genuinely reflects what matters to you.

I tailor each person’s treatment to their unique goals and needs, so we can work at a pace and in a style that feels right for you.

What This Looks Like

What working together looks like.

You won’t be handed a one-size-fits-all protocol. We’ll start by understanding what’s bringing you in and what you want from our work, and we’ll agree together on what feels most important to focus on first. From there, the work unfolds collaboratively — practical and structured where that helps, gentle and exploratory where that’s what’s needed. Throughout, you’ll always understand what we’re doing and why.

Take the Next Step

Have questions?

The first step is a brief, free phone call so we can connect, talk through what you’re looking for, and see whether working together feels like a good fit.

Get in Touch