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Michelle Puerner, LCSW

I specialize in the treatment of obsessive compulsive disorder (OCD) and complex anxiety disorders. Many of the people I work with have spent years trying to make sense of intrusive thoughts, compulsive behaviors, or anxiety patterns that never quite fit the explanations they were given.

OCD and anxiety often appear in ways that are misunderstood or misdiagnosed. Some people experience disturbing intrusive thoughts that feel completely inconsistent with their values. Others find themselves trapped in cycles of checking, reassurance seeking, rumination, or avoidance that gradually take over daily life.

I work with individuals and families across Montana and Colorado to help identify the patterns that keep these cycles going and build practical strategies that allow people to respond differently.

My work focuses on helping people face the thoughts they fear most while learning that those thoughts do not have to control their actions or define who they are.

Individual Therapy

I work with children ages five and up, teens, and adults experiencing OCD and anxiety disorders.

Many of my clients struggle with intrusive thoughts, compulsive behaviors, phobias, perfectionism, health anxiety, chronic guilt, or patterns of avoidance that interfere with daily life.

Some arrive feeling ashamed of harm related or taboo thoughts they have never felt safe saying out loud. Others are caught in mental loops that consume hours of their day through rumination, second guessing, or constant attempts to gain certainty.

My approach is structured, collaborative, and grounded in evidence based treatment. We focus on understanding the patterns that maintain anxiety and learning new ways to respond so those patterns begin to lose their hold.

Treatment often includes Exposure and Response Prevention (ERP), Acceptance and Commitment Therapy (ACT), and other behavioral approaches that help people build flexibility in the presence of uncertainty.

SPACE & Family Well-Being

Anxiety and OCD rarely affect only one person in a family. Over time, reassurance patterns, avoidance, and accommodations can become woven into daily routines.

I work with parents and caregivers to help shift those patterns in ways that support change while maintaining connection.

My work often incorporates the SPACE model, which helps parents reduce accommodations that unintentionally reinforce anxiety while helping their child build tolerance for distress.

I also draw from the Family Well Being approach described in When a Loved One Won’t Seek Mental Health Treatment. These approaches allow families to regain leverage and rebuild healthier dynamics even when a loved one is resistant to therapy.

This work is especially helpful for families navigating OCD, anxiety, ARFID, emotional shutdown, or situations where a young adult has become stuck in withdrawal or dependency.

How I Work

Good therapy is not only about reducing symptoms. It is about helping people reclaim their agency and reconnect with the parts of life that anxiety has pushed aside.

The goal is not to eliminate fear. The goal is to help you continue moving toward the life you want while fear is present.

I bring both clinical training and lived experience to this work. I understand how OCD can distort values and create constant doubt about whether you can trust your own mind. My role is to stay steady while we work through that uncertainty together.

I also live with Tourette’s syndrome. Because of this, treatment for tics and related conditions is especially meaningful to me. I incorporate Comprehensive Behavioral Intervention for Tics (CBIT) and other evidence based approaches that help people work with their symptoms rather than simply trying to suppress them.

Earlier in my career I worked primarily as a trauma therapist. Many of my clients still carry trauma histories, but our work focuses on how those experiences show up in the present through avoidance, compulsions, and shutdown patterns.

If you are seeking intensive trauma processing such as EMDR or somatic trauma work, I am happy to help connect you with a therapist who specializes in those approaches.

In addition to therapy, I provide consultation and training for clinicians and treatment teams, particularly around OCD diagnosis, treatment planning, and identifying reinforcement patterns that keep symptoms stuck.

A Bit More About Me

Therapy is a relationship, so here is a little about me outside the therapy room.

When I am not working, you will probably find me riding my motorcycle, snowboarding, listening to music, or traveling. I share my life with two dogs, Olive and Fig, who occasionally make appearances during telehealth sessions.

I believe in deep friendships, strong coffee, and living authentically even when it feels uncomfortable.

Where I work?

I offer therapy and coaching exclusively via telehealth from my home office in Kalispell, MT. All sessions are conducted through a secure, HIPAA-compliant Zoom platform. I provide therapy to patients in Montana and Colorado. Coaching and consultation through The Anxiety Break are available nationwide.

Details

Contact

Not sure where to start? Send an email or text, and we’ll help you figure out the next step.

Good therapy isn’t just connection. It’s science.

Every tool I use has been chosen for a reason. My work is rooted in evidence-based methods, refined through advanced training, and shaped by years of real-world experience with complex cases. Below is my education and professional training, the foundation behind the strategies we’ll use together.

Education

  • 2011 – Walla Walla University, Master of Social Work

  • 2005 – Montana State University, B.S. in Sociology (Justice Studies emphasis) with a minor in History

Licensures, Certifications, and Memberships

  • Licensed Clinical Social Worker (2013)

  • International OCD Foundation (2021)

  • Family Well-Being Consultant (2025)

  • OCD Eating Disorders Special Interest Group (IOCDF ED SIG)

  • Montana Sex Offender Treatment Association (MSOTA), Clinical Member #46 (2014)-Inactive (2024)

  • Association for the Treatment of Sexual Abusers (ATSA), Clinical Member (2017)-Inactive (2025)

These affiliations connect me to specialized clinicians and current research, ensuring my work remains informed and effective.

Continuing Education & Professional Development

I do my best to stay current with evolving research and clinical techniques through targeted trainings and professional conferences, including:

  • International OCD Foundation Annual Conference

  • Body Dysmorphic Disorder Foundation Annual Conference

  • Select eating disorder–focused trainings

  • Additional OCD, anxiety, and family systems continuing education

In addition to ongoing education, I’ve sought out in-depth, high-impact trainings that have shaped how I work in the therapy room.

Notable Professional Trainings

OCD, Anxiety, Behavioral, and ACT-Based Work

  • 2025 – Next Steps in ACT, 4-Day Intensive, Dr. Lisa Coyne

  • 2025 – Metacognitive Therapy, Dr. Pia Callesen, OCD Training School

  • 2024 – BTTI Pediatric OCD, International OCD Foundation

  • 2023 – Comprehensive Behavioral Intervention for Tics (CBIT), Dr. Douglas W. Woods, TAA

  • 2023 – I-CBT, OCD Training School

  • 2018 – DBT Skills Training, Behavioral Tech Institute

Family Systems & Parent-Based Models

  • 2024 – Family Well-Being Consultation, Dr. Alec Pollard

  • 2024 – SPACE Expanded: Failure to Launch & ARFID, Dr. Eli Lebowitz

  • 2023 – Supportive Parenting for Anxious Childhood Emotions (SPACE), Dr. Eli Lebowitz

Trauma-Informed and Attachment-Focused Therapies

  • 2019 – Emotionally Focused Therapy Externship (EFT), ICEEFT

  • 2018 – Eye Movement Desensitization and Reprocessing (EMDR)

  • 2016 – Cognitive Processing Therapy (CPT), Strong Star Training Initiative

Forensic Risk Assessment Trainings

  • 2018 – STABLE 2007 & ACUTE 2007 Risk Assessment, Global Institute of Forensic Research

  • 2017 – STATIC-99 Risk Assessment, Global Institute of Forensic Research