Portrait of Dr. Rachael St. Claire

Psychotherapy for Adults With Anxiety, OCD, Depression, and Life's Difficult Transitions — Telehealth Across Colorado

I provide psychotherapy for adults across Colorado through secure telehealth. My practice focuses on anxiety, chronic worry and rumination, OCD and intrusive thoughts, depression and mood disorders, and the emotional challenges that can accompany major life transitions, chronic illness, trauma, or longstanding patterns of feeling stuck in relation to yourself or others.

I work with adults seeking relief from painful emotions, distressing thoughts, and patterns of behavior that interfere with daily life. In an empathic and collaborative therapeutic relationship, we work together to better understand the enduring emotional, cognitive, behavioral, and relational patterns that may be contributing to these difficulties, so that therapy can support not only relief, but deeper and more lasting change.

Areas of Specialization

Anxiety, Worry, Fears, Phobias

  • Persistent worry, overthinking, rumination

  • Avoidant behavior to manage anxiety

  • Panic anxiety and panic attacks

  • Perfectionism, pressure, and fear of making mistakes

  • Reassurance-seeking and difficulty tolerating uncertainty

  • Social or performance anxiety

OCD, Intrusive Thoughts, & Compulsive Behaviors

  • Intrusive, unwanted thoughts that feel distressing, stuck, or difficult to dismiss

  • Compulsions, rituals, or avoidance aimed at reducing anxiety or gaining certainty

  • Reassurance-seeking, checking, and repeated mental review

  • Scrupulosity, moral OCD, and fears of being irresponsible or a bad person

  • Harm OCD, taboo thoughts, and other upsetting obsessional themes

Chronic Illness, Identity, & Emotional Well-Being

  • Distress related to changes in health, functioning, or daily life

  • Grief, fatigue, exhaustion, and the emotional toll of chronic illness

  • Shifts in identity, roles, independence, and sense of self

  • Living with uncertainty, ongoing symptoms, and medical stress

Relational, Emotional, and Self-Worth Patterns

  • Repeating relationship patterns and interpersonal difficulties

  • Boundaries, assertiveness, and fear of rejection

  • Shame, low self-worth, and chronic self-criticism

  • Feeling chronically misunderstood, unseen, emotionally alone, or disconnected

  • Longstanding patterns that affect mood, relationships, and your sense of self

Depression and Mood Disorders

  • Mood disorders across the adult lifespan, from younger adults to seniors

  • Acute, chronic, persistent, or recurrent depression and related mood difficulties

  • Persistent low mood, emptiness, loss of interest, or difficulty getting started in the day

  • Mood swings or periods of elevated, accelerated, or unusually energized mood

  • Late-life depression related to loss, medical stress, role changes, or isolation

Insomnia, Nighttime Worry, & Early Morning Waking

  • Difficulty falling or staying asleep

  • Waking during the night with worry, rumination, or emotional distress

  • Early morning waking with heaviness, dread, or low mood

  • Sleep disruption connected to stress, anxiety, or mood changes

How I approach my work with clients

My approach to psychotherapy is collaborative, individualized, and grounded in both evidence-based and depth-oriented treatment. I focus not only on the symptoms or problems bringing you to therapy, but also on the emotional, cognitive, behavioral, and relational patterns that may be contributing to them. In an empathic and thoughtful therapeutic relationship, we work together toward greater awareness and understanding, meaningful relief, and lasting change.

Process-Based Therapy (PBT)

Process-Based Therapy is an emerging approach to psychotherapy that focuses on the underlying patterns contributing to distress, rather than relying on diagnosis alone to guide treatment. Together, we identify the emotional, cognitive, behavioral, and relational processes most involved in the problem and tailor treatment accordingly.

Psychotherapy Approaches I Draw From

Psychodynamic Psychotherapy
Psychodynamic psychotherapy helps us understand the deeper emotional and relational patterns that shape how you experience yourself, other people, and the difficulties in your life. Informed by contemporary psychodynamic approaches, this work supports insight, self-understanding, and lasting change in longstanding patterns.

Acceptance and Commitment Therapy (ACT)
Acceptance and Commitment Therapy helps you relate differently to difficult thoughts, feelings, and inner experiences so they have less power over your life. This approach supports greater openness, psychological flexibility, and movement toward what matters most to you.

Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy helps us understand the connections between thoughts, emotions, and behaviors, especially when certain patterns begin to reinforce distress. By identifying unhelpful habits of thinking or responding, we can work toward changes that feel practical, grounded, and meaningful.

Exposure and Response Prevention (ERP)
Exposure and Response Prevention helps us work directly with the fear, uncertainty, and rituals that can keep OCD going. In a gradual and supportive way, this approach helps you face what feels difficult while reducing compulsions, reassurance-seeking, and avoidance.

Mindfulness-Based Cognitive Therapy (MBCT)
Mindfulness-Based Cognitive Therapy helps you develop a different relationship with thoughts, feelings, and mood shifts so they are less likely to pull you into cycles of worry, rumination, or depression. By combining mindfulness practices with cognitive therapy, this approach supports greater awareness, steadiness, and self-compassion.

Dialectical Behavior Therapy (DBT)
Dialectical Behavior Therapy helps us work with intense emotions, stressful relationships, and moments when it feels hard to stay grounded. By building skills in mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness, this approach supports both self-acceptance and meaningful change.

Mindfulness-Based Interventions
Mindfulness-based interventions help you develop a steadier and more compassionate awareness of thoughts, emotions, and bodily experience. This work supports a more grounded, flexible, and intentional way of responding to stress and emotional difficulty.

As Tsong Khapa wrote more than six centuries ago:

The human body at peace with itself,
is more precious than the rarest gem.
Cherish your body, it is yours for this one time only.
The human form is won with difficulty, it is easy to lose.
All worldly things are brief, like lightning in the sky;
this life you must know, as the splash of a raindrop;
a thing of beauty that disappears, even as it comes into being.
Therefore, set your goal,
make use of every day and night to achieve it.

— Tsong Khapa (1357–1419)