Professional photo of Dr. Rachael St.Claire, licensed psychologist, in Colorado.

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

I provide evidence-based psychotherapy for adults across the lifespan through secure telehealth throughout Colorado, including the Denver metro area, Boulder, Colorado Springs, and Fort Collins. I specialize in treating anxiety, chronic worry and rumination, OCD, depression, and the emotional challenges associated with major life transitions and chronic illness.

I also work with adults who feel stuck, overwhelmed, or disconnected from what matters most — people who may not have a clear diagnosis but recognize that persistent worry, avoidance, or self-criticism are making daily life harder. Whether your suffering is clearly defined or difficult to name, therapy can help you shift these patterns and build a more grounded, intentional way of living.

Areas of Specialization

Many of these concerns overlap — and that's expected. The categories below reflect common patterns I work with, not rigid boxes. We'll explore what applies to you.

Anxiety Disorders & High-Functioning Anxiety

  • Persistent or generalized anxiety

  • Health anxiety

  • Emotional overwhelm or stress reactivity

  • Morning anxiety or dread

  • Anxiety related to aging, identity, or life transitions

OCD & Intrusive Thoughts

  • Harm OCD

  • Scrupulosity / moral OCD

  • Checking and reassurance-seeking

  • Intrusive, unwanted thoughts

  • Rumination-centered OCD patterns

Psychological Adjustment to Chronic Illness

  • Anxiety related to health changes

  • Emotional exhaustion and fatigue

  • Identity and role shifts due to illness

  • Managing uncertainty and medical stress

Chronic Worry, Overthinking, & Rumination

  • Feeling “stuck in your head”

  • Repetitive negative thinking

  • Difficulty disengaging from worry

  • Rumination after conversations or decisions

  • Worry that interferes with sleep

Depression in Adults & Older Adults

  • Persistent low mood or loss of interest

  • Depression linked to life changes or chronic illness

  • Morning heaviness and difficulty initiating the day

  • Co-occurring anxiety, worry and rumination

Sleep Disturbance Connected to Anxiety or Mood

  • Difficulty falling asleep due to worry

  • Nighttime rumination

  • Middle night and early morning awakening driven by anxiety or mood disruption

How I approach my work with clients

I work with you — not just your symptoms. Our sessions are honest, direct, and collaborative. Together we explore the thoughts, emotions, and behavioral patterns that shape your daily life, drawing on proven therapeutic approaches and mindfulness traditions. My goal is to help you develop the flexibility and self-awareness to navigate challenges on your own terms. Based in the Denver metro area, I offer secure video-based telehealth sessions to adults throughout Colorado.

Process-Based Therapy (PBT)

Process-Based Therapy is a modern, highly personalized form of psychotherapy that goes beyond simply treating symptoms or “labels.” Instead of relying on a one-size-fits-all treatment protocol, PBT helps us understand how your anxiety, low mood, rumination, or intrusive thoughts work together within the larger story of your life.

Together, we map the patterns, habits, and emotional processes that keep you feeling stuck and identify the most impactful places to create change. This approach is especially helpful for people who have tried therapy before and didn’t get the results they hoped for.

PBT is active, collaborative, and deeply tailored to you—not just to a diagnosis. Our goal is to strengthen the skills that help you adapt to stress, navigate challenges with more confidence, and build a life that feels grounded, meaningful, and aligned with your values.

Process-Based Therapy is still relatively uncommon in Colorado. As one of few PBT-trained psychologists in the state, I bring this approach to clients throughout the Denver area and beyond via telehealth.

Psychotherapy Approaches I Draw From

I integrate multiple science-based psychotherapy treatment methods to meet you where you are — no single approach works for everyone, and your therapy should reflect your unique needs. The approaches I draw from most frequently include:

Acceptance and Commitment Therapy (ACT)

ACT helps you cultivate psychological flexibility so you can respond more skillfully to distressing thoughts and feelings. Rather than trying to fight or suppress your internal experiences, you learn to notice them with openness and to anchor yourself in what truly matters to you. This approach combines mindfulness strategies with values‑based action, so you spend less energy struggling and more energy moving toward a meaningful life. It’s especially helpful for anxiety, chronic worry, and perfectionism.

Cognitive Behavioral Therapy (CBT)

CBT is a structured, goal‑oriented therapy that examines the relationships between your thoughts, behaviors, and emotions. By identifying patterns that keep you stuck—such as catastrophic thinking or avoidance behaviors—you gain tools to challenge and change them. Together we develop practical strategies for shifting unhelpful thoughts and building healthier habits. CBT has a strong evidence base for treating anxiety disorders, depression, OCD, and stress‑related problems.

Exposure and Response Prevention

ERP is a specialized form of cognitive behavioral therapy designed to treat obsessive‑compulsive disorder and related anxiety conditions. In a safe, gradual manner, you’re guided to face feared thoughts, images, or situations while resisting the urge to perform compulsive rituals. This process retrains your brain to tolerate uncertainty and reduces the anxiety that drives obsessions and compulsions. ERP has strong research support and is considered a gold‑standard treatment for OCD and certain phobias.

Mindfulness-Based Cognitive Therapy (MBCT)

MBCT weaves together cognitive therapy techniques and mindfulness practices to interrupt cycles of worry, rumination, and depressive thinking. You’ll learn to observe thoughts and feelings with curiosity rather than getting swept away by them. This increased awareness helps you recognize early warning signs of anxiety or mood shifts and respond with compassion. MBCT is particularly effective for preventing relapse in recurrent depression and for reducing chronic stress.

Dialectical Behavior Therapy (DBT)

DBT teaches four core skills—mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness—to help you navigate intense emotions and challenging relationships. It provides concrete tools for calming your body, understanding your feelings, and communicating more clearly. DBT encourages both acceptance of where you are and commitment to change, which can be especially powerful for people who feel emotionally reactive or overwhelmed. Research supports its use for mood disorders, impulsivity, and self‑destructive patterns.

Mindfulness-Based Interventions

Mindfulness‑based interventions cultivate present‑moment awareness and compassionate attention. Through guided practices, you develop the ability to observe thoughts, sensations, and emotions without judgment, which reduces reactivity and fosters stability. These skills can be integrated into any therapy to help manage stress, anxiety, and mood swings. Practicing mindfulness supports greater self‑compassion and helps you respond rather than react to life’s challenges.

Buddhist‑Informed Psychotherapy

Buddhist‑informed psychotherapy integrates principles from early Buddhist wisdom—such as impermanence, compassion, insight, and non‑identification—with contemporary psychological science. This approach offers a deeper understanding of how suffering arises and provides practical tools for cultivating clarity, intention, and wise action in daily life. It complements evidence‑based methods by inviting a more spacious and flexible relationship with your inner experience. Many clients find that incorporating these teachings helps them move beyond symptom relief toward a more mindful and meaningful way of living.

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)