Michelle Puerner, LCSW

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 vicious cycle— 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 obsessive cycles, weighed down by moral distress, or caught in patterns that 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 disrupting relationships at home. I support families with children, teens, and adults (ages five and up) in reducing accommodation, rebuilding connection, and responding with clarity instead of control.

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—which allows us to adapt flexibly to your family’s needs. Whether you’re dealing with anxiety, OCD, ARFID, emotional shutdown, or a loved one who refuses treatment entirely, the goal remains the same: shift the pattern, not the person.

This includes families navigating Avoidant/Restrictive Food Intake Disorder (ARFID)—especially when it’s tangled up with sensory rigidity or compulsive avoidance—and those facing “failure to launch,” when a young adult feels stuck in withdrawal or dependency. In every case, we focus on reducing burnout, restoring leverage, and opening the door to meaningful change—even when your loved one isn’t ready to walk through it yet.

Because I’m trained in multiple approaches—and deeply value flexibility—we’re not locked into a single model. Instead, we integrate the best 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 reduce symptoms. It gives people back their agency— and it restores connection where fear has taken over.

The goal isn’t to make the fear go away.

It’s to help you walk toward the life you want, even while fear is still whispering in your ear.

My work is shaped not only by my clinical background, but by lived experience. I understand how OCD can twist values into fear, and how exhausting it is to feel like your thoughts are lying to you. That insight helps me stay steady when things feel uncertain—and it allows me to hold hope, even when you can’t yet see the way forward.

I also have Tourette’s, and CBIT (Comprehensive Behavioral Intervention for Tics) holds a special place in my heart. I understand firsthand what it’s like to live in a body that doesn’t always cooperate—and how frustrating it can be when treatment focuses only on suppression instead of support. My approach with tics is grounded in both evidence and empathy.

While I was once a trauma therapist, I now specialize in treating OCD and anxiety. Many of my clients have trauma histories, but we focus on how those experiences show up through avoidance, compulsions, or shutdown in the present—not just on the past itself. If you’re looking for a therapist to support deep trauma processing (like EMDR or somatic trauma resolution), I’d be happy to help you find the right fit.

I also provide consultation and training for clinicians and treatment teams—particularly around OCD, diagnostic clarity, and identifying compulsions and the reinforcement patterns that keep them in place.

If you’re looking for therapy that pushes beyond surface-level coping skills and into real, sustainable change—you’re in the right place. I offer sessions 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 probably doing something pathetically work-related (and loving it), snowboarding, hiking, or traveling. I share my life with two amazing dogs—Olive and Fig—who you’ll probably meet if we’re on Zoom. I also believe in deep friendship, 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, Montana—usually joined by my dogs, Olive and Fig (don’t worry, they don’t tell secrets). All sessions are conducted through a secure, HIPAA-compliant Zoom platform.

Licensure

  • Montana

  • Colorado

    Coaching and consultation services are available in all 50 states through The Anxiety Break.

Details

Contact

If you’re not sure where to start, email or text—I’m happy to help guide the next step.

Good therapy isn’t just vibes—it’s science. I’ve trained in the most evidence-based tools available for treating OCD, anxiety, family systems, and behavior change. Below is my education and notable training that will influence our work together.

Education:

2011: Walla Walla University, Masters of Social Work

2005: Montana State University, B.S. in Sociology w/ emphasis in Justice Studies & minor in History

Licensures, Certifications and Memberships:

Licensed Clinical Social Worker (2013)

Montana Sex Offender Treatment Association (MSOTA), Clinical Member #46 (2014)

Association for the Treatment of Sexual Abusers (ATSA), Clinical Member (2017)

International OCD Foundation (2021)

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 Reprocessing (EMDR)

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

Forensic Risk Assessment Certifications

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

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

Professional Experience:

Adaptive Therapeutic Solutions, PLLC, Therapist/Owner: April 2014- Present

Veterans Administration: Hud Vash Social Worker: January 2016- September 2017

Montana State Prison: ClinicalTherapist & Sex Offender Therapist:May 2011- January 2016

Montana State Probation & Parole, Probation Officer: August 2005- May 2011