Across Montana and Colorado, via telehealth

Most clients who reach this practice have already tried therapy. Some have tried many therapists. The pattern is consistent: general anxiety treatment did not match how their actual problem was working.

OCD and complex anxiety operate by specific mechanisms. Intrusive thoughts. Mental compulsions. Reassurance seeking. Avoidance. The persistent sense that something is not quite right. Treatment that does not target those mechanisms tends to leave the cycle running.

The Anxiety Break is a specialty practice focused on this work. Michelle Puerner, LCSW is the founding clinician, with advanced training through the International OCD Foundation's Behavior Therapy Training Institute, the SPACE program at Yale, and Family Well-Being Consultation with Dr. Alec Pollard. The practice serves children ages five and up, teens, adults, and families.

Who we work with

OCD across all subtypes, including taboo, harm, religious, sexual, and morality-based intrusive thoughts. Tic disorders. Complex anxiety presentations that overlap with trauma, eating concerns, or somatic symptoms. Family systems organized around a child's anxiety or a young adult who will not engage in treatment.

How we work

Treatment draws on Exposure and Response Prevention (ERP), inference-based CBT, Acceptance and Commitment Therapy (ACT), Comprehensive Behavioral Intervention for Tics (CBIT), and SPACE for family work. The approach is selected based on how the specific pattern operates, not applied as a default protocol.

What we offer

Individual therapy for OCD, anxiety, and tics. Parent work, including a SPACE Parent Workshop for parents of anxious children and teens, and a Family Well-Being Workshop for parents navigating accommodation, withdrawal, or more entrenched family patterns.

For clinicians: I offer group consultation and trainings for therapists working with OCD, anxiety, and complex presentations, plus individual consultation and supervision for clinicians and treatment teams.

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