In-Person in Seattle, WA 98103
Online in
PSYPACT states
Alabama, Arizona, Arkansas, CNMI, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Maryland, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Washington, D.C., West Virginia, Wisconsin, Wyoming
I work especially well with thoughtful, capable people who may understand themselves intellectually yet continue to feel caught in patterns they cannot resolve through insight or effort alone. Many of my patients are accustomed to functioning well, carrying responsibility, and caring for others while privately struggling with anxiety, depletion, shame, emotional overwhelm, or disconnection from themselves.
What distinguishes my practice is the depth and individuality of the work. I do not reduce people to diagnoses or apply the same treatment formula to everyone. I seek to understand how your history, relationships, identities, strengths, and protective strategies have shaped your inner world. I am attentive not only to what you tell me, but also to what may be difficult to articulate, what repeatedly gets enacted in relationships, and what unfolds between us in therapy.
My style is thoughtful, engaged, and collaborative. I respect complexity and do not impose artificial urgency, but I am not passive. I will help us notice when fear, avoidance, or familiar patterns begin to limit what feels possible. My goal is to offer a relationship in which you can become more fully known, develop a different relationship with your internal experience, and gain greater freedom to choose how you want to live.
Client Focus
Session Format: Individual sessions.
Age Specialty: Adult, Senior, Young Adult
Demographic Expertise: Military / Veterans, Persons with Disabilities, Women clients.
Languages: English
Treatment Approach
- Acceptance & Commitment Therapy (ACT) Helps people accept difficult thoughts and feelings instead of fighting them, while committing to actions that reflect their values. It blends mindfulness with practical behavior strategies.
- Behavioral Therapy Uses learning techniques like reinforcement and practice to change unwanted behaviors. It is often applied to phobias, anxiety, and habits.
- Cognitive Behavioral Therapy (CBT) One of the most widely used approaches, CBT helps people identify unhelpful thoughts and replace them with healthier patterns. It is effective for anxiety, depression, and many other concerns.
- Cognitive Processing Therapy (CPT) An evidence-based treatment for PTSD that teaches clients to reframe unhelpful thoughts about trauma. It helps reduce guilt, shame, and fear.
- Interpersonal Therapy (IPT) A short-term approach focused on improving relationships and social support. It is often used for depression and grief.
- Mindfulness-Based Cognitive Therapy (MBCT) Combines mindfulness practices with CBT to prevent depression relapse. It helps people notice thoughts without judgment and respond more calmly.
- Motivational Interviewing (MI) A collaborative, client-centered approach that strengthens motivation for change. It is especially effective for addictions and health behaviors.
- Psychodynamic Therapy Explores unconscious thoughts and patterns that influence current behavior. It builds insight into how the past impacts the present.
- Solution-Focused Brief Therapy (SFBT) Focuses on solutions and future goals rather than past problems. It is practical, short-term, and goal-driven.
Approach Description: My work is grounded primarily in psychodynamic therapy. I believe that much of emotional life unfolds outside conscious awareness and that meaningful change occurs through experience, not insight or instruction alone. People often enter therapy motivated and self-aware yet continue to repeat familiar emotional or relational patterns. I do not view this as a failure of will or intelligence. These patterns frequently began as adaptive ways to preserve connection, manage uncertainty, avoid danger, or protect parts of the self that did not feel safe to express.
Therapy is a collaborative process of becoming curious about the meanings beneath symptoms and the patterns organizing your emotional and relational life. Together, we attend to how these patterns appear in relationships, work, the body, and the therapeutic relationship itself. What emerges between us can offer valuable information about your expectations, defenses, fears, and longings. It can also create an opportunity to experience greater honesty, safety, curiosity, and freedom within a relationship.
Although psychodynamic therapy provides the foundation for my work, I integrate Acceptance and Commitment Therapy and other empirically supported interventions according to the individual and the needs of the moment. Our work may include mindfulness and acceptance, values clarification, behavioral change, emotion-regulation strategies, interpersonal interventions, and carefully paced trauma or exposure-based work.
These approaches serve complementary purposes. Practical interventions can help you respond more flexibly to difficult thoughts, emotions, bodily sensations, and urges. Psychodynamic exploration helps us understand why particular experiences carry the meaning they do and why certain patterns persist. Together, we can address immediate suffering while also creating deeper and more enduring change.
Fees & Insurance
Fees
- Average Session Fee My standard 50-minute session fee is $300. I do not bill insurance directly, but I provide superbills that clients may submit for possible out-of-network reimbursement. Coverage varies by plan, so patients are encouraged to confirm their benefits with their insurer.
- Out of Network
Education & Credentials
Cascade Psychological Services, PLLC PsyD, PMH-C
- Female
- License # 61139532
- Licensed in WA
- PSYPACT Mobility # 13773
- Practicing Since 2010
Education: I have a doctorate from an American Psychological Association-accredited clinical psychology program. I completed my predoctoral internship at the Louis Stokes Cleveland Veterans Affairs Medical Center and hold a Perinatal Mental Health Certification from Postpartum Support International.
Cascade Psychological Services, PLLC Practice Details
Therapy Sessions
- Available In-Person in Seattle, WA 98103
- Available Online for residents of PSYPACT states Alabama, Arizona, Arkansas, CNMI, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Maryland, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Washington, D.C., West Virginia, Wisconsin, Wyoming
Cascade Psychological Services provides individual psychotherapy and psychological assessment for adults. Dr. O’Brien works with concerns including anxiety, depression, trauma and posttraumatic stress, grief, neurodivergence, emotional dysregulation, burnout, chronic stress, perfectionism, and difficulties involving identity, intimacy, trust, boundaries, conflict, or self-worth.
Her practice is particularly well suited to people whose competence may obscure significant internal distress, including physicians and other healthcare professionals, executives, caregivers, veterans, service members, and military-connected individuals. She also has specialized training in perinatal and reproductive mental health and works with infertility, pregnancy and postpartum adjustment, traumatic birth, reproductive loss, changing identity, and menopause.
Additional areas of focus include chronic illness and pain, divorce and family restructuring, relational and attachment trauma, overfunctioning, shame, and the emotional consequences of having learned that one’s value depends on achievement, usefulness, or caring for others. Services are available in person in Seattle and through telehealth in Washington and participating PSYPACT states.
Dr. O’Brien also provides comprehensive psychological assessment when a deeper understanding of cognitive, emotional, behavioral, or personality functioning would be helpful. Assessment is collaborative and intended to clarify both difficulties and strengths while offering practical, personally meaningful recommendations.