San Francisco Bay Area +1 (415) 497 5101
Rosa Thomas, Ph.D.
Clinical Psychologist
PSY 20906
Areas of Expertise:
Trauma Therapy
My goal for you as a result of trauma therapy is post-traumatic growth, the positive transformation into a new appreciation of life, newfound personal strength, improved relationships, and a vision of the new possibilities for your life.
In general terms, psychological trauma is a wounding or shocking experience, a stressor—acute, developmental, or ongoing—that results in psychological injury or pain. The types of traumatic experience can range from cruel or more obvious stressors like assault, rape, warfare, or car accidents, to the profoundly insidious, like a child who learns to be silent for fear of losing a parent’s protection. But common to these experiences are states of arousal, whether excessive or scant, that either overwhelm the psychological resources a person can summon to tolerate stress or fail to recruit the resources needed to survive, figuratively, the felt presence of a threat.
In trauma psychotherapy, not all “talk” is verbal, nor does all information received into awareness originate outside of a patient’s own thoughts or memories. Consequently, I may use more traditional therapy methods to help create conditions of psychological safety, including nonjudgmental language and a lifeline to the here-and-now. But I also rely on Herman's three-phase model of trauma treatment, meeting my patients where they are ready to work, whether in safety and stabilization, remembrance and mourning, or reconnection.
Eye Movement Desensitization and Reprocessing (EMDR) is my preferred method for treating trauma. It can be delivered in person (my preference) or online. An initial in-person assessment is required before online services can be provided. I also include Sensorimotor Psychotherapy, clinical hypnosis, and peripheral biofeedback on my palette of interventions.
(1) E.g., Herman, 1992
(2) See https://www.emdria.org/about-emdr-therapy/ for more information.
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Adult Psychotherapy
Psychotherapy brings a client and therapist into a collaborative process to relieve distress, improve performance, or enhance the quality of life.
Psychotherapy is “the talking cure” that follows a path that begins by establishing a therapeutic relationship. From my perspective, this relationship depends on careful listening, asking the right questions, identifying strengths, building trust, and tapping the courage and creativity we each enter the world with to meet goals for a fulfilling life. Through careful conversation, psychoeducation, and thoughtful therapeutic exercises, I use methods grounded in scientific understanding of mental processes, life course, and the importance of physical well-being to help bring about therapeutic change.
For adult psychotherapy patients, I prefer to work in a brief series of meetings when possible. Many people find sufficient relief within three to eight sessions, depending on the severity of the issues and when a focus can be well-defined. Others may prefer the spaciousness of a longer-term therapy, particularly when disruptive patterns of living and relating have deep roots.
Whether therapy is brief or longer-term, I aim to move beyond describing problems and discover with you the action of change needed to meet your goals. I look forward to congratulating you on your graduation from psychotherapy to “ordinary life”—not “normal”, but new, satisfying, and wholly yours.
Differential Diagnosis
Essential to care planning and treatment is an accurate diagnosis of the psychological issues that disrupt your quality of living.
Not all diagnoses reside in the Diagnostic and Statistical Manual, 5th edition, on which we mental health providers – and insurance companies – rely. Nor do all diagnoses make themselves apparent on the first assessment. Throughout care, I continually review how behaviors, emotions, and cognitive performance combine to clarify a diagnosis and move the therapy in the direction needed to support healing.
For example, involuntary trembling or an inner sensation of a buzzing restlessness could indicate that your body cannot metabolize the level of caffeine consumed. Likewise, dizziness and disorientation after a sudden movement like standing up could be signs of chronic under-hydration rather than anxiety. In addition, medical conditions like diabetes, heart disease, and chronic pain can show up as mood swings, depression, or irritability. Differential diagnosis is a critical element of understanding whether anxiety—broadly speaking, or ADHD, a learning disorder, a mood disorder, or other psychological issues, affects how a patient takes in or expresses information and manages experience.
I expect my patients to be partners with me to clarify the nature of life-interfering psychological performance. This collaboration may mean getting that overdue annual physical. It may mean bibliotherapy, i.e., readings to increase understanding outside of therapy so you can reserve your valuable resources for the work of treatment itself.
It may also mean completing assignments outside of sessions, like brief records of benchmark experiences, behavioral experiments “in the wild,” or short-term projects to access information that is hard to verbalize or cannot show up “on schedule” during therapy sessions.
Partnership in diagnosis and care also means bringing your “A-game” whenever possible in our therapeutic work to overcome the barriers to your psychological success and well-being.
Testing & Assessment
Testing is not a requirement of overcoming blockages in therapy. But it can shorten the time and cost of care and improve outcomes.
(1) © Springer Science+Business Media LLC 2010. Stable URL: https://link.springer.com/referenceworkentry/10.1007%2F978-0-387-78665-0_6467
As noted on the My Approach page, I see personality functioning as an individual's signature for being and living in the world. In other words, personality functioning is another way of talking about overall psychological functioning, i.e., 'the ability to achieve…goals within the self and in the external environment. It includes an individual's behavior, emotion, social skills, and overall mental health.' Psychological testing can help clarify differential diagnoses or indicate when care can be better delivered by a specialist in other areas of psychological practice.
I can provide testing and assessment as a standalone service for those seeking only a diagnostic workup. These evaluations generally include a report on functioning, a diagnosis or diagnoses if present, and treatment recommendations.
In addition, some psychological assessment may be indicated when most or all elements of the therapy seem to be working, but treatment progress feels stalled. In this situation, I work with patients to assess first things first, like the therapeutic alliance or adjustments to planned interventions. When these aspects of care are not at issue, I discuss administering and interpreting either a specific test or an abbreviated battery of tests to facilitate treatment planning and progress.
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Group Therapy
Negotiating Hierarchies Inquiry Group
A process-oriented group for working through identity and identity strain.
How do people of privilege—whether racial, ethnic, economic, gender, WEIRD country of origin, age, physicality, and so on—negotiate social hierarchies and the categories associated with them? This group is the continuation of an inquiry started as part of my research in culture and cognition many years ago. It is a process-oriented group for working through identity and identity strain. Participants agree to be anonymous contributors to publications on this topic.
