I specialize in treating obsessive-compulsive disorder (OCD), anxiety disorders, and the in-between spaces where symptoms refuse to fit neatly into a diagnosis. These are often the struggles that get overlooked, misunderstood, or misdiagnosed. I work with individuals and families across Montana and Colorado to bring clarity where there’s been confusion.

With nearly 15 years of clinical experience and a specialized focus on OCD, anxiety, and family systems over the past five years, I help people face the thoughts they fear most, including taboo fears, harm-related obsessions, and body-based distress that’s often dismissed. I use evidence-based approaches like Exposure and Response Prevention (ERP), Acceptance and Commitment Therapy (ACT), and trauma-informed care, but my work goes deeper than techniques. Together, we uncover what’s been keeping symptoms in place and build strategies that move you forward with more clarity, more freedom, and more trust in yourself.

Individual Therapy

I’m a pediatric-trained OCD provider who works with children (ages five and up), teens, and adults facing OCD and anxiety disorders. My clients come to me with intrusive thoughts, compulsions, phobias, perfectionism, health fears, chronic guilt, and avoidance that disrupts daily life.

Many carry a quiet shame about harm or taboo thoughts, afraid to say them out loud anywhere else. Others feel trapped in a mental loop—ruminating for hours, second-guessing every choice, or chasing relief through reassurance and mental review. I offer a collaborative, structured approach that helps you understand what’s driving your symptoms so you can respond in new ways, not just cope with them.

Whether you’re stuck in thought spirals, weighed down by moral distress, or caught in patterns that even you can’t make sense of, I’ll help you name what’s happening and learn how to move through it without self-punishment or collapse.

SPACE & Family Well-Being

I work closely with parents and caregivers when a loved one’s mental health symptoms, avoidance, or behavioral challenges are straining relationships at home. I support families with children, teens, and adults (ages five and up) in reducing accommodation, rebuilding connection, and responding with intention.

I’m trained in multiple family-based models, including SPACE (Supportive Parenting for Anxious Childhood Emotions) and the Family Well-Being approach from When a Loved One Won’t Seek Mental Health Treatment. This allows us to adapt to your family’s unique needs. Whether you’re facing anxiety, OCD, ARFID, emotional shutdown, or a loved one who refuses treatment, the goal is the same: shift the pattern, not the person.

This includes families navigating Avoidant/Restrictive Food Intake Disorder (ARFID), especially when it overlaps with sensory rigidity or compulsive avoidance, and those facing “failure to launch,” when a young adult is stuck in withdrawal or dependency. In every case, we focus on reducing burnout, restoring leverage, and creating openings for meaningful change, even when your loved one isn’t ready to take the first step.

Because I’m trained in multiple approaches and value flexibility, we’re not limited to a single model. We blend the most effective elements of each to create a supportive, clinically rich environment where change becomes possible for everyone in the system.

How I Work

Here’s what I believe:

Good therapy doesn’t just ease symptoms. It helps you take back your agency and rebuild connection where fear has been running the show.

The goal isn’t to get rid of fear. It’s to help you continue moving toward the life you want, even while feeling fear.

My approach is shaped by both my clinical training and my lived experience. I know how OCD can twist your values and how exhausting it is to question whether you can trust your own mind. That’s why I stay steady when things feel uncertain, and why I can hold hope for you even if you can’t see the path forward.

I also live with Tourette’s, and CBIT (Comprehensive Behavioral Intervention for Tics) is especially close to my heart. I understand what it’s like to live in a body that doesn’t always cooperate, and how discouraging it can be when treatment focuses on shutting symptoms down instead of helping you work with them. My approach to tics blends evidence with empathy.

While I once worked primarily as a trauma therapist, I now focus on OCD and anxiety. Many of my clients have trauma histories, but our work centers on how those experiences show up now in avoidance, compulsions, or shutdown rather than only revisiting the past. If you’re looking for intensive trauma processing, such as EMDR or somatic trauma work, I can help connect you to a therapist who is the right fit.

Additionally, I provide consultation and training for clinicians and treatment teams, especially around OCD, accurate diagnosis, and spotting reinforcements that keep symptoms stuck.

If you want therapy that will challenge you beyond surface-level coping skills and into real, lasting change, you’re in the right place. I work with clients across Montana and Colorado.

Let’s do this differently.

Let’s do it vulnerably.

Let’s change the system together.

A Bit More About Me

Since therapy is also a relationship, here’s a bit more about me. When I’m not in session, I’m often doing something work-related (and loving it), riding my motorcycle, snowboarding, listening to music, or traveling. I share my life with two amazing dogs, Olive and Fig, who you’ll probably meet if we’re on Zoom.

I believe in deep friendships, good coffee, and living authentically, even when it’s scary.

Where’s Michelle?

I offer therapy and coaching exclusively via telehealth from my home office in Missoula, MT. All sessions are conducted through a secure, HIPAA-compliant Zoom platform.

Licensure

• Montana

• Colorado

• Coaching and consultation available in all 50 states through The Anxiety Break

Details

• Time zone: Mountain Standard Time

• Virtual office link: Always the same for every session. I like to keep things simple and consistent.

• Payment, insurance, and availability: See Fees & Service Models

Contact

• Phone: (406) 747-2066

• Email: therapy@michellepuerner.com

Not sure where to start? Send me an email or text, and I’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)

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

• OCD I-CBT Trauma Consultation Group

• 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