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Staff Spotlight: Aric Eaglestone

Posted on by Mountain Valley Treatment Center

Nourishing More Than Just Meals

Aric Eaglestone is a natural in the kitchen—his grandmother noticed his efficiency starting at a young age. After graduating from culinary school and working in 11 different restaurants across New York, Florida, and Vermont, Eaglestone joined Mountain Valley as chef. Unlike the hectic, impersonal world of restaurant life, he says Mountain Valley’s people and atmosphere make all the difference.

And for the staff and residents, Eaglestone’s expert cooking is one of the top perks of living and working on campus.

“Eric knows how to feed our mouths—and in doing so, he feeds our hearts,” one resident shared.

What brought you to Mountain Valley?

“The only real jobs I’ve ever had were cooking. At my first real restaurant job, they told me that I should go to cooking school, and I took off,” Eaglestone explains. “After working in the industry for many years, finding Mountain Valley was a godsend. I’ve had parents come back on graduation day and thank me personally, and that really hits home.”

What does a typical day look like for you?

Eaglestone starts most days with some shopping. About 75 to 80 percent of the center’s produce is ordered from a purveyor, but he hand-selects the rest to keep things fresh. He often swings by McNamara’s Dairy for local ingredients before heading back to prepare lunch.

“The food’s delicious,” said one resident. “I like that we’ve got a schedule, but he still mixes it up. Like that time he did mac and cheese for Taco Tuesday? That was awesome.”

Eaglestone makes it a point to offer healthy choices, especially in the summer, when he avoids steam tables and rotates in fresh salads once or twice a week. He personally serves both lunch and dinner, which gives him regular, face-to-face interactions with every resident and staff member.

After lunch, he cleans up, receives deliveries if they’re scheduled, and starts prepping for dinner. On the evening of this interview, he had brisket and ribs smoking outside and was deciding whether mac and cheese would be the best side dish.

“Best brisket I ever had. No question,” one resident said.
Another added, “Anxiety’s never tasted better.”

He typically wraps up by 6 p.m. and is home in time to be with his family—weekends off being another bonus of the role.

What are some of the most popular meal requests?

Eaglestone keeps a whiteboard in the kitchen where residents can write in their cravings and favorites. For new residents who haven’t made their way to the board yet, he’ll often ask what foods they miss from home.

“Eric makes kick-ass food,” said a resident. “But it’s more than that—he somehow caters to everyone individually, which I’ve never seen one person do before.”

If there’s nothing new on the board, he falls back on a semi-rotating menu planned three to four weeks ahead. Crowd-pleasers like chicken tenders and mac and cheese are frequent requests, but he also introduces variety through themed dinners and Friday’s Farm to Table session, where residents help prepare weekend meals.

“I really enjoy all of Eric’s cooking and everything he helps us out with throughout the day,” said another resident. “It’s always fun to chat with him when I’m grabbing food. I really appreciate him.”

Theme nights keep things fun and familiar—Taco Tuesdays, pasta Wednesdays (when the full staff is on campus), and frequent comfort-food favorites. One upcoming Friday, Eaglestone and the residents will be making a big batch of chicken curry together.

What’s the best part of your job?

“My favorite part is when someone who doesn’t really open up will respond to food—that’s a win for me,” Eaglestone shared. “Especially if I ask what they like, I make it for them, and they have a positive reaction.”

It’s that quiet connection—through something as simple as a meal—that makes his work meaningful. “When the parents come back at graduation and say, ‘thanks for making a difference,’ that makes it all worthwhile for sure,” he added. “I would love to retire here. I don’t see myself working anywhere else.”

For families visiting the Upper Valley, Eaglestone recommends checking out:

– Tuk Tuk Thai
– Harpoon Brewpub
– Windsor Station
– Worthy Burger
– Worthy Kitchen
– Redcan
– Wolf Tree

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Staff Spotlight: Nathan Thoele

Posted on by Mountain Valley Treatment Center

Nathan Thoele is part of Mountain Valley’s leadership team, serving as the Residential Director. He leads a skilled team of residential counselors who work directly with MVTC residents on a 24/7 schedule. Nathan has a unique background that took him from working in summer camps, to AmeriCorps, to five years at the Vermont Institute of Natural Science as lead bird trainer and environmental educator. Today, he’s using his coaching and listening skills to ensure that MVTC is a safe and welcoming place for everyone.

What brought you to Mountain Valley?
I thought I wanted to be an ecologist, so I went to Prescott College to get a degree in something related to that. While on that journey, I realized that my favorite part about ecology was teaching it to people. I switched to an environmental education degree. After graduating, I moved to Vermont to put that degree into practice. I worked as a camp counselor, a conservation assistant, and an educator. After a couple of years of that, I landed at VINS and became one of their live bird show presenters, their primary bird trainer, and their volunteer trainer.

I got really into training people and learned that I liked coaching people to do specific and complex things. My job at VINS was to train people to train birds, and I enjoyed helping my co-workers make sense of the confusing parts of the job.

After being there for a while, I realized I wanted to work with people more than animals. I started looking for the next step in my career and found Mountain Valley. I specifically came here with the desire to practice my skill of listening. At VINS, someone pointed out that I seemed to have a profound desire to listen to people. I thought that seemed true, and when the job at Mountain Valley popped up, I took a leap of faith to try something new.

Tell us how your position has evolved over the last five years.
Originally, I was hired for an overnight residential counselor position. Everett Logan knew I was interested in more adventure- and outdoor-related activities, so he kept an eye out for a day shift position for me. Once it opened, I slid over and started some module facilitation. I created the Nature’s Classroom module, which is still very popular with residents today, though it looks a little different now. I also created a module about interpersonal skills that residents loved. After that, I moved up to a supervisor position, and then the Residential Director position opened. I applied and got it.

I’ve worked on every shift the residential team has—days, evenings, weekends, nights. That experience made me feel confident that I could serve Mountain Valley well as the Residential Director. I have a good perspective on what the residential staff are expected to do and how they do it.

What does a typical day look like for you?
I have 21 people on my team and directly supervise the supervisors for each shift. When I come into the office each day, I check to make sure we’re on top of any incidents and review my email to coordinate parent visits. Then it’s a lot of bouncing around—a lot of my job is checking in with other residential counselors and meeting with the supervisors multiple times per week. I also spend time with residents, and they’ll frequently ask me logistical questions about what is or isn’t allowed on campus, how home visits work, whether they can move their assigned laundry day, and so on. I answer them and try to have some deeper-level conversations as well.

Back at my desk, I spend time planning trainings for staff, coordinating with parents of residents, reviewing documentation, answering emails that ask complex questions, and handling a myriad of other clerical tasks. And, of course, I attend several routine meetings each week, in addition to impromptu meetings designed to address incidents as they arise.

What qualities do you look for when you’re hiring a new residential counselor?
I want residential counselors to have the impulse to trust residents rather than doubt them. In psychological terms, that’s unconditional positive regard and client-centered thinking. Beyond that, I want our staff to have good empathetic listening skills—listening geared toward empathy, not just cognitive understanding.

It’s important for our staff to balance setting firm boundaries with being flexible. We want our staff to engage with residents and be willing to embrace some discomfort alongside them. I can train some of this, but it’s important to be a people person.

What’s the most rewarding part of your job?
The time I get to spend with residents and the breakthroughs I witness. Just a few days ago, I was walking through the woods with one of our residents, who tends to avoid all emotional topics. I broached that subject with him and asked him why. We ended up having a very emotional conversation that ended with him kneeling on the ground in the forest and crying. He told me some things that I and other MV staff knew indirectly but that he had not said to anyone face-to-face before. It was a first for him and a profound moment for both of us.

I see the members of my team grow as professionals, and that always brings me joy. I’ve spent many afternoons having hard and crucial discussions with some of my staff as they grapple with the tough work we do. Witnessing them make sense of the work is truly special.

And finally, I am compelled to grow constantly. After five years, I am still challenged. Sometimes the challenge feels like too much, sometimes not enough. But overall, I like that I can look at who I was even just one year ago and see how much I have changed for the better. What I find most rewarding about this job is growth. We’re all growing all the time, and I love that.

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Why Summer Isn’t Always a Vacation for Teens with Anxiety

Posted on by Mountain Valley Treatment Center

For most adults, summer evokes a sense of ease—time off, warmer days, fewer demands. It’s natural to assume that teens feel the same. And for many, they do. But for adolescents with anxiety, summer often brings less relief than expected. Some teens even become more dysregulated once school ends. Parents may wonder: How can my child be struggling when the stressors of school are gone? Isn’t summer supposed to be the easy season?

From a clinical perspective, there’s a clear explanation—and a path forward.

Why the Absence of Pressure Doesn’t Always Equal Peace

During the school year, structure provides containment. For an anxious teen, daily routines—waking up, attending classes, managing assignments—can serve as external regulators that help keep internal distress in check. While these routines may create pressure, they also offer predictability and rhythm.

Summer removes that structure. Days become unbounded. Routines dissolve. And for many teens with anxiety, this shift creates a destabilizing vacuum. Without a framework to organize time, they feel unmoored. Uncertainty increases, and with it, so does anxiety.

This speaks to a core trait in anxiety disorders: intolerance of uncertainty. The anxious brain struggles to tolerate the unknown, often preferring the discomfort of overstimulation to the perceived threat of having nothing to anchor to. In this context, summer’s wide-open freedom can feel less like a break and more like a cliff.

How the Anxiety Maintenance Cycle Shows Up in Summer

One of the most common patterns seen in anxious teens over the summer is a rise in avoidant behavior. With fewer external expectations, teens may begin to opt out of discomfort—social interactions, physical activity, even basic responsibilities. What may initially look like rest or “needing a break” can, in reality, become a retreat from the world.

Clinically, we understand this as the anxiety maintenance cycle: anxiety prompts avoidance, which provides short-term relief, which in turn reinforces the anxious belief that the avoided thing is dangerous. Over time, avoidance shrinks a teen’s world. What started as taking a few days off can quickly become chronic social withdrawal, disrupted sleep, loss of motivation, or increased reliance on maladaptive coping strategies.

At the same time, other teens go in the opposite direction. Sensing their child’s discomfort with open-ended time, some parents overcompensate—stacking the summer with camps, classes, college prep, and travel. While structure can be protective, overscheduling an anxious teen can trigger overcontrol, perfectionism, and performance anxiety, especially in those who mask their distress with high achievement.

In both scenarios—withdrawal or overdrive—the teen’s anxious nervous system is not regulating. It’s reacting.

Nervous System Dysregulation in the Absence of Anchors

Anxiety is not just a cognitive experience—it’s physiological. During the school year, daily movement, social engagement, intellectual stimulation, and consistent routines all serve as regulators. They provide feedback loops that help organize the nervous system.

When those inputs disappear, it’s not uncommon for teens to become dysregulated. Parents may observe increased irritability, emotional lability, fatigue, or somatic complaints (like headaches or GI issues). Sleep patterns may become erratic. Motivation may plummet. And without the demands of school to mask it, underlying distress rises to the surface.

This is why “just relaxing” rarely works as a strategy for teens with anxiety. The nervous system requires intentional regulation—not just time off.

What Can Parents Do?

There’s no universal summer strategy that works for every teen. But there are a few clinical principles that can help guide parents in supporting their child’s emotional health:

1. Create Light but Reliable Structure
Daily anchors—consistent sleep/wake times, meals, light physical activity, scheduled therapy—can restore rhythm without overwhelming. The structure doesn’t need to mimic school but should provide a scaffold to help the teen feel contained.

2. Watch for Patterns of Avoidance
Avoidance is the hallmark of anxiety. If your teen is consistently retreating from social situations, physical activity, or new experiences, it’s important to interrupt that pattern gently but directly. Help them take small steps back toward engagement—even when it’s uncomfortable.

3. Support Regulating Activities
Encourage movement, time in nature, creative expression, and face-to-face social interaction. These all support nervous system regulation. Excessive screen time, isolation, or late-night sleep schedules tend to do the opposite.

4. Don’t Wait for Motivation
Anxious teens often say they don’t “feel like” doing things that might help. Waiting for internal motivation before acting only reinforces avoidance. Instead, use behavioral activation—support them in engaging first, with the understanding that motivation often follows action, not the other way around.

5. Separate the Teen from the Anxiety
When teens push back on plans or resist doing hard things, it’s often the anxiety talking. Help them externalize it: “I wonder if your anxiety is telling you this will be too hard. What would it be like to push back on it instead of listening to it?”

6. Model Calm Executive Function
Anxiety thrives in ambiguity. If parents leave every decision up for negotiation, anxious teens will often default to avoidance. It’s okay—and often necessary—for parents to make calm, confident decisions, especially when anxiety is driving the conversation. Being empathic doesn’t mean being passive.

A Different Kind of Growth

Summer doesn’t have to be perfect. It doesn’t need to be packed or left entirely open. What it can be is a space for developmentally appropriate challenge, nervous system recalibration, and increased emotional awareness.

Anxiety doesn’t take a vacation—but that doesn’t mean teens can’t learn to navigate it with more confidence. With a balance of routine, rest, and gentle exposure to discomfort, summer can be a season not of avoidance, but of quiet growth.

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Understanding the Interplay Between ADHD, OCD, and Anxiety

Posted on by Mountain Valley Treatment Center

While often treated as discrete diagnoses, ADHD, OCD, and anxiety frequently coexist, creating complex clinical presentations that can obscure accurate diagnosis and complicate effective treatment planning. In a recent episode of the Fear Less podcast, Mountain Valley Executive Director and host Zack Schafer spoke with Dr. Roberto Olivardia, clinical psychologist and expert in ADHD, to examine the nuanced ways these conditions intersect and manifest in daily life.

Reconceptualizing ADHD: Beyond Attention Deficits

Attention-Deficit/Hyperactivity Disorder (ADHD) remains one of the most commonly diagnosed yet persistently misunderstood mental health conditions. The condition was recently reexamined in a New York Times article titled “Have We Been Thinking About A.D.H.D. All Wrong?”, in which author Paul Tough investigates its history, diagnostic controversies, and the evolving understanding of its etiology.

Dr. Olivardia emphasizes that ADHD is best understood not as a consistent inability to pay attention, but rather as a dysregulation of attention. Individuals with ADHD often shift between inattentiveness and hyperfocus depending on the level of external stimulation. The ADHD brain, as he explains, is chronically under-stimulated, which may lead to difficulties engaging with routine or mundane tasks while fostering intense focus on activities perceived as novel or rewarding.

This tendency to seek stimulation can present in ways that are frequently mischaracterized. A child who disengages from a classroom lesson but becomes entirely absorbed in a video game may not be “unmotivated” but instead responding to internal neurological cues related to stimulation and reward.

Impulsivity, Hyperactivity, and Executive Function Challenges

In addition to attention dysregulation, ADHD is marked by significant difficulties with impulse control and executive functioning. Dr. Olivardia describes the ADHD brain as often acting before thinking, leading to challenges in self-regulation, decision-making, and task completion. This may present behaviorally as interrupting others, seeking immediate gratification, or engaging in high-risk behaviors.

Importantly, hyperactivity is not uniform across individuals. Some exhibit observable physical restlessness, while others experience internal hyperactivity in the form of racing thoughts and cognitive overstimulation. Both forms can undermine focus and create barriers to sustained engagement.

Deficits in executive function—a set of cognitive processes responsible for organizing, initiating, and completing tasks—are particularly impactful. These impairments can disrupt functioning across virtually all life domains, from maintaining self-care routines to managing relationships, academic responsibilities, or occupational tasks.

Co-Occurrence and Diagnostic Overlap with OCD and Anxiety

Although ADHD is classified as a neurodevelopmental disorder, it often co-occurs with anxiety disorders and OCD. All three involve dysregulation of thought and behavior, though their mechanisms differ. OCD is characterized by intrusive thoughts and compulsive behaviors aimed at reducing distress, while anxiety often involves persistent worry about future events or perceived threats.

Dr. Olivardia explains that the under-stimulation characteristic of ADHD may lead individuals to experience discomfort, which they attempt to alleviate through compulsive actions or obsessive thinking patterns. This may resemble or exacerbate symptoms of OCD or anxiety, even when the root cause lies in the neurological underpinnings of ADHD.

Moreover, emotional dysregulation—common in ADHD—can intensify anxiety. When individuals with ADHD struggle to manage emotional responses, they may experience heightened states of overwhelm, prompting reactive behaviors that resemble compulsions or fuel obsessive thinking.

This overlap is particularly pronounced in children, where undiagnosed ADHD may initially be misattributed to anxiety or OCD. As children encounter consistent difficulties with focus, time management, or organization, they may become increasingly anxious or develop compulsive behaviors to manage the resulting stress.

A Comprehensive Approach to Treatment

Dr. Olivardia advocates for an integrated treatment approach that combines medication with behavioral interventions. While stimulant medication is often effective in addressing the neurochemical aspects of ADHD—namely by increasing dopamine availability—it is not sufficient as a standalone intervention.

Both Dr. Olivardia and Paul Tough emphasize that although medication may mitigate distractibility and behavioral impulsivity, it does not inherently improve life functioning. Skills-based interventions remain essential. Cognitive-behavioral therapy (CBT), ADHD-specific coaching, and structured organizational systems provide individuals with practical tools to manage daily challenges. These may include breaking tasks into smaller, manageable parts, using external reminders and calendars, or establishing consistent routines.

Dr. Olivardia underscores the importance of understanding ADHD not solely as a deficit, but as a form of neurodiversity. The traits that make the ADHD brain prone to distraction or impulsivity are often the same traits that support creative problem-solving, innovation, and entrepreneurship. Recognizing and embracing this duality is key to helping individuals leverage their strengths.

Harnessing Stimulation for Creative and Productive Expression

A core feature of ADHD—the drive for novelty and stimulation—often leads individuals toward creative outlets. Dr. Olivardia notes that individuals with ADHD frequently find success in domains that reward innovation and spontaneity, such as music, visual art, or entrepreneurial ventures.

Reflecting on his own experiences, he describes inventing games as a child as a strategy for self-regulation and stimulation. For many, these activities are not simply hobbies but essential mechanisms for managing their neurological needs. When individuals with ADHD are supported in identifying and pursuing these interests, they often develop adaptive pathways for navigating the world in ways that are personally meaningful and professionally rewarding.

Moving Toward Nuanced Understanding and Tailored Support

The intersection of ADHD, OCD, and anxiety demands a nuanced approach to both diagnosis and intervention. Accurate assessment must account for overlapping symptoms and the ways in which ADHD may obscure or amplify other psychiatric conditions.

Understanding the core mechanisms of ADHD—particularly attention dysregulation, executive dysfunction, and emotional reactivity—can help reduce stigma and facilitate more effective, personalized care. As Dr. Olivardia’s work demonstrates, the path forward lies not in reducing individuals with ADHD to a set of deficits but in acknowledging their complexity and cultivating the conditions in which they can thrive.

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Embracing Fear and Grief: A Mother’s Story of Bravery

Posted on by Mountain Valley Treatment Center

It is widely recognized that grief and loss can be accompanied by a wide range of emotional experiences. Among the most commonly reported are anxiety and fear. In addition to the growing body of research on the interplay between grief and anxiety, one author, Claire Bidwell Smith, LCPC, brought specific attention to this phenomenon in her 2018 book Anxiety: The Missing Stage of Grief.

Despite our understanding of the complex relationship between anxiety, fear, and grief, the experience often remains overwhelming and deeply debilitating. Yet within our deepest fears and most profound losses lies an invitation: to discover new ways of living fully, to connect more deeply, and to transform pain into purpose.

Myra Sack was recently featured on the Fear Less podcast, where she shared her story of confronting fear while navigating the devastating loss of her infant child, Javi, to Tay-Sachs disease. Since Javi’s passing, Myra has founded the nonprofit organization E-Motion, which centers its work on three pillars of healing: movement, ritual, and community. The following article explores some of the wisdom Myra shared during the episode.

From Joy to Terror: The Arc of Fear and Anxiety

“The first time fear showed up was in stark contrast to the awe and beauty and joy when Javi was first born… What if we as parents aren’t enough?”

When Myra and her husband welcomed Javi into the world, fear and anxiety lurked beneath the joy of new parenthood. Like many, their “future-oriented mindset” brought with it quiet questions: Will I be enough? What if something goes wrong? Initially, this was anxiety—an uncertain anticipation of danger not yet realized.

At 15 months, Javi began missing developmental milestones. Myra remembers “the tightness of my chest… the heaviness of my legs”—somatic echoes of fear emerging with every missed crawl or unsteady step. Then came the crushing diagnosis: a physician’s testing error revealed that Javi had Tay-Sachs, a life-limiting neurodegenerative disease. Fear became terror as they confronted an ending they “knew was the worst one possible.”

Even in the darkest moments, Myra found a crucial insight:

“That fear… is outside of us. It’s not us. And we can engage with it.”

By choosing to engage with their fear—rather than resist it—Myra and her husband were able to live with presence, love, and purpose.

Pillar One: Movement—Harnessing the Rhythm of Healing

“Patterned, repetitive, rhythmic activity… is the strongest somatosensory memory that we have.”

For Myra, movement was not merely exercise but a regulated, embodied way to process trauma. Inspired by the work of Dr. Bruce Perry, she discovered that walking, running, and swaying tap into a deep-seated rhythm—one tied to our earliest days, listening to a mother’s heartbeat.

  • Presence in motion: Rather than mentally rehearsing to-do lists, Myra began noticing purple flowers on her runs—Javi’s favorite color—turning each outing into a mindful act of remembrance.

  • Dosed exposure: In E-Motion’s 10-week cohorts, participants alternate between gentle rituals and communal movement, providing a “moderate and predictable” encounter with grief rather than a single, overwhelming outpouring.

Both concepts align closely with our work at Mountain Valley. Rhythmic, repetitive movement is a powerful tool for regulating an anxious nervous system, and our Occupational Therapists incorporate these sensory strategies into each resident’s care. The idea of “dosed exposure” also mirrors the gradual exposure approach we take when helping residents face their fears—whether rooted in trauma, loss, or phobia. Safely “dosing” into what feels difficult helps build resilience rather than reinforce avoidance.

Pillar Two: Ritual—Anchors in Chaos

“Ritual is the antidote to helplessness.” —Suki Miller

When Javi could no longer chew her favorite blueberries, Myra and Matt adapted: first pancakes, then smoothies. After Javi’s passing, making a vibrant blueberry smoothie became Myra’s micro-ritual—a daily, dosed reminder of her daughter’s life and love.

Rituals:

  • Create predictability in an unpredictable world

  • Provide a container for feeling—whether sacred or painful—in a manageable way

  • Empower agency in times of helplessness

For anyone navigating anxiety—whether in preparation for an exam or in the wake of a loss—personal rituals such as morning breathing, weekly journaling, or lighting a candle can provide grounding and rhythm.

That said, we must use rituals wisely. In anxiety disorders and related conditions like OCD, rituals can sometimes evolve into compulsions that begin to run one’s life. The use of ritual to foster emotional healing is ancient, intuitive, and powerful—but it must be approached with mindfulness and intention.

Pillar Three: Community—Bearing Pain Together

“We need other people to hold our pain and our love… we can’t do it in isolation.”

Grief and anxiety often thrive in isolation. Myra found healing not in solitude, but in communal spaces—especially those with near-peer support, where vulnerability fosters connection. In E-Motion’s movement groups:

  • Participants name their loved one aloud, sway together, then walk and talk

  • They share “psychological Teflon”—the experience of being seen, believed, and remembered

This practice isn’t limited to bereavement. For those with anxiety or OCD, community—whether in a therapy group, classroom, or faith circle—can provide the same life-sustaining support. Rather than compare our pain in the “Lost Olympics,” we can affirm: Your fear matters. Your grief matters. We’re here. That ethos is central to our approach at Mountain Valley.

Moving Forward: Love Bigger Than Fear

Myra and Matt chose to grow their family, welcoming a second daughter, Kaia. Even while awaiting prenatal test results with anxiety, they practiced noticing “future-telling stories” and returning gently to the present moment.

They came to believe that love, even with all its risks, was worth it:

“The love can be bigger than the fear… the risk of losing again is worth it, because the possibility of loving big is more motivating.”

A Call to Practice

Whether you’re wrestling with anticipation or mourning a loss, consider these gentle invitations:

  1. How can I move with purpose today? Notice your breath, your steps, your surroundings.

  2. What simple ritual could anchor me? Choose a recurring act—a candle, a cup of tea—that holds meaning.

  3. Who can walk beside me? Reach out to someone who will listen, witness, and remember with you.

When we choose to meet fear and grief—rather than fight or flee—we often uncover unexpected reservoirs of clarity, compassion, and strength. As Myra’s story shows, these practices don’t erase pain, but they offer a way to live fully through it.

🎧 Listen to the full conversation with Myra Sack on the Fear Less podcast: Embracing Fear and Grief

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OCD and Addiction: A Commonly Missed Comorbidity

Posted on by Mountain Valley Treatment Center

At Mountain Valley Treatment Center, we believe in addressing the full picture of mental health—especially when diagnoses and symptoms are complex and overlapping.

Comorbidities are incredibly common, particularly with obsessive-compulsive disorder (OCD). A recent systematic review and meta-analysis by Sharma et al. (2021) found that 69 percent of people with OCD have at least one other comorbid mental health condition. The study highlights that the most common comorbidities are mood disorders (anxiety, depression, etc.), neurodevelopmental disorders (Autism Spectrum Disorder [ASD], Attention-Deficit/Hyperactivity Disorder [ADHD], etc.), and OCD-related disorders (Hoarding Disorder, Body Dysmorphic Disorder [BDD]).

However, one of the least recognized and acknowledged comorbidities with OCD is Substance Use Disorder (SUD) and behavioral addictions (technology addiction, sex addiction, gambling addiction, etc.).

In a recent episode of the Fear Less Podcast, our host and Executive Director, Zack Schafer, spoke with Jayme Valdez, LMHC, about the overlap between OCD and addiction. Jayme is the founder of Clearview OCD Counseling and specializes in treating OCD, anxiety, trauma, and addiction. She brings a wealth of insight into the topic of co-occurring OCD and addiction. The following are some highlights from their conversation.

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Understanding the Relationship Between OCD and Addiction

In the episode, Jayme discusses empirical research on the co-occurrence of OCD and addiction. The International OCD Foundation (IOCDF) reports that roughly 25 percent (or one in four) individuals struggling with OCD meet the criteria for a co-occurring substance use disorder. Additionally, studies have shown that upwards of 70 percent of individuals with OCD have co-occurring behavioral addictions. Internet addiction, phone addiction, food addiction, sex addiction, and pornography addiction are commonly reported.

Although there is a clear correlation between OCD and addictive disorders, the nature of the relationship is still being explored.

Jayme and Zack note that, for some individuals, substance use or addictive behaviors serve the function of “self-medicating” their OCD. This is supported by research, with studies indicating that individuals with OCD who use substances such as alcohol or marijuana often report doing so to reduce anxiety, “drown out” intrusive thoughts, or cope with emotional distress.

In addition, Jayme and Zack explore the shared phenomenology of the two disorders that may help explain the high rates of comorbidity. Both OCD and addiction involve cyclical patterns—experiences of intrusive thoughts or urges, emotional distress, and compulsive or impulsive behavioral responses aimed at achieving temporary relief. This shared pattern is not merely coincidental; biological and neuroscientific research suggests that similar underlying brain pathways are involved in both disorders.

Treating OCD and Addiction: A Concurrent Model for Healing

Given the relationship between OCD and addictive behavior, it is not only necessary to create a treatment model that addresses both disorders—it may be more feasible than expected, given the overlap.

In the episode, Jayme draws from both her professional experience and personal recovery journey to explain how these co-occurring disorders can be treated concurrently.

Here are some key points from the discussion:

  • Treatment Hierarchies:
    When addressing a co-occurring disorder, it is essential to ask, “Where do we start?” Jayme explains that her first step is always to assess and address safety risks. Once those are managed, she focuses on the issue causing the greatest dysfunction in the individual’s life. Establishing a treatment hierarchy helps both the therapist and the individual stay focused on what matters most.
  • Harm Reduction:
    The goal of treatment does not always need to be “abstinence,” “extinction,” or “remission.” The focus should be on reducing the harm that addictive or compulsive behaviors cause in an individual’s life.
  • Psychoeducation:
    Both OCD and addictive behaviors are often misunderstood—even by those experiencing them. Providing thorough psychoeducation about the signs and symptoms, the cycles of OCD and addiction, and available treatment approaches is critical for success.
  • Exposure and Response Prevention (ERP) Principles:
    Although ERP is considered the gold standard treatment for OCD, its principles also apply to addiction. Exposing individuals to triggers and teaching them how to “surf the urge” to engage in compulsive or impulsive behaviors is central to effective treatment.
  • Acceptance and Commitment Therapy (ACT):
    ACT focuses on helping individuals accept internal experiences while taking values-driven action. Breaking the cycle of OCD and addiction depends on one’s motivation and willingness to change. Identifying personal values and aligning behavior with one’s aspirations is central to facilitating meaningful change.

Listen to the Full Conversation

This episode is rich with expert insight, personal vulnerability, and deep wisdom for professionals, families, and anyone navigating the complexities of co-occurring OCD and addiction. Jayme’s story and expertise offer hope to those feeling stuck in harmful cycles or struggling to find effective support.

🎧 Listen to the full episode here

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Occupational Therapy for Anxiety and OCD: How OT is Changing Treatment at Mountain Valley

Posted on by scottc

A Practical Approach to Healing Through Engagement

At Mountain Valley, the focus is not just on reducing anxiety and OCD symptoms but on helping teens heal, rehabilitate, and develop the real-world skills they need to engage in life with confidence. While traditional therapy is a critical piece of the puzzle, occupational therapy (OT) plays an equally vital role in supporting young people as they overcome fears, build life skills, and re-engage with everyday activities.

Under the leadership of Zack Schafer, an occupational therapist (OT) and the executive director of Mountain Valley, OT has been woven into the very fabric of the treatment model, ensuring that healing is not just about talking through fears but about actively confronting and overcoming them through purposeful, real-life activities.

Mountain Valley Treatment Center

What Is Occupational Therapy, and Why Is It Essential for Anxiety Treatment?

Unlike traditional talk therapy, occupational therapy focuses on action and engagement. It introduces teens to purposeful activities that help them develop the skills needed to navigate daily life, increase independence, and manage challenges in real-world situations. For those struggling with anxiety and OCD, OT is a game-changer because it shifts the focus from talking about fears to actively confronting and working through them.

At its core, OT helps individuals engage with their environment in meaningful ways. Whether it’s learning to wake up on time, manage personal hygiene, cook a meal, navigate a conversation, or be of service, occupational therapists help teens practice and master their ability to participate in daily life.

At Mountain Valley, OT is seamlessly integrated into every level of treatment—from program-wide scheduling to individual therapy sessions—ensuring that each resident gains the tools to translate therapeutic progress into real-world success.

How Mountain Valley Integrates Occupational Therapy into Treatment

Mountain Valley’s OT framework operates on three levels:

1. The Macro Level: How OT Shapes the Entire Program

At the macro level, OT principles guide the structure and daily routine at Mountain Valley. The goal is to mimic real-life environments and responsibilities so that teens develop skills they can carry with them beyond treatment.

One key concept guiding Mountain Valley’s approach is the Five Cs of Occupational Engagement, adapted from the work of occupational scientist Dr. Rachel Thibault:

  • Centering – Activities that are routine, repetitive, and provide a sense of calm and focus (e.g., walking, breathing exercises, knitting, laundry, dishes).
  • Contemplation – Activities that foster reflection and experiences of awe (e.g., journaling, nature walks, prayer, meditation).
  • Connection – Activities that foster relationships and a sense of belonging (e.g., group activities, community meetings, team-building exercises).
  • Contribution – Activities that provide opportunities to be of service (e.g., farm work, meal preparation, community service, community responsibilities).
  • Creativity – Activities that encourage imagination, self-expression, and problem-solving (e.g., art, music, storytelling, role-playing).

Every group activity, chore, and therapeutic module at Mountain Valley is designed with these core occupational needs in mind, ensuring that the entire treatment environment supports both healing and skill development.

2. The Meso Level: OT as a Consultant in Treatment Planning

At the meso level, OT plays a consultative role, supporting both clinicians and residential staff in developing strategies that help teens overcome functional challenges.

Some key ways OT is used in treatment planning at Mountain Valley include:

  • Customizing exposure therapy – Helping clinicians design and adapt exposures in ways that feel manageable, structured, and functional.
  • Supporting executive functioning – Providing visual schedules, step-by-step guides, and organizational tools for teens struggling with time management and task completion.
  • Helping with sensory and emotional regulation – Teaching staff about residents’ sensory processing needs and ensuring the environment provides the necessary sensory input for regulation.
  • Guiding life skills training – Teaching residential staff how to scaffold daily living skills so that teens gradually gain independence.

For example, if a teen struggles with cleaning their room, the OT might:

  • Create a visual checklist to break down tasks into manageable steps.
  • Work with staff to introduce verbal and physical prompts as needed.
  • Gradually reduce support as the teen becomes more independent.

This approach ensures that daily activities don’t just feel like rules or chores—they become essential parts of the therapeutic journey.

3. The Micro Level: Direct OT Interventions with Teens

At the micro level, occupational therapy sessions focus on hands-on skill-building and individualized coaching, helping teens foster self-awareness and confidence so they can re-engage in everyday activities that may have felt overwhelming before.

Some key areas where direct OT interventions help include:

1. Activities of Daily Living (ADLs)

Many teens with anxiety and OCD struggle with basic self-care routines. OT sessions help them:

  • Develop functional morning and evening hygiene routines (brushing teeth, showering, skincare).
  • Learn how to dress appropriately and comfortably.
  • Build confidence in cleaning and organizing personal space.

For some teens, these are not just tasks—they are significant barriers to independence. Something as simple as learning how to shower properly can dramatically improve self-esteem and quality of life.

2. Social Participation & Communication Skills

Social anxiety can make even basic interactions feel overwhelming. OT helps teens:

  • Role-play social situations to build confidence in real-world interactions.
  • Learn conflict resolution and assertiveness skills.
  • Develop comfort in group settings through structured, supportive activities.

For many teens, learning to navigate social interactions in therapy makes it easier to apply these skills in real life.

3. Life Skills & Exposure Therapy Integration

One of the most powerful aspects of OT at Mountain Valley is how seamlessly it integrates with Exposure and Response Prevention (ERP).

Rather than just talking about fears, OT helps teens engage in real-life activities that naturally challenge their anxiety. Examples include:

  • Shopping trips – Practicing interactions with cashiers, handling money, and managing social anxiety.
  • Cooking projects – Encouraging independence and responsibility in meal preparation while building executive functioning skills.
  • Public transportation practice – Gradually exposing a teen to navigating public spaces, asking for directions, and following schedules.

This practical approach ensures that exposure therapy feels purposeful and meaningful rather than just a clinical exercise.

4. Sensory Processing and Regulation

Each resident at Mountain Valley participates in a sensory assessment with the OT to develop self-awareness of their sensory system. This assessment includes practical recommendations for sensory-based strategies that can support emotional and overall well-being. Examples include:

  • Chewing gum to improve focus.
  • Using movement to increase alertness.
  • Using deep pressure and touch to promote calmness.

Why Occupational Therapy Is Essential for Long-Term Success

Many teens struggling with anxiety and OCD know what they need to do, but their anxiety keeps them from doing it. Occupational therapy bridges this gap by helping them take action in a way that feels structured, manageable, and supportive.

By focusing on real-world skills, independence, and engagement, OT helps teens not only reduce anxiety symptoms but also build a life worth living.

If you or a loved one is struggling with anxiety or OCD, occupational therapy could be the missing piece in treatment.

Learn More: Listen to the Fear Less Podcast Episodes on OT

🎧 Listen to Zack interview Camille Wrege:
Occupational Therapy & Mental Health: Camille’s Journey to Helping Teens Overcome Anxiety

🎧 Solo episode with Zack on OT at Mountain Valley:
How Occupational Therapy Is Changing Mental Health Care at Mountain Valley

MOVING MOUNTAINS

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From Resident to Resilience: A Family’s Journey Through Mountain Valley

Posted on by Mountain Valley Treatment Center

Anxiety can be an isolating and overwhelming experience, not just for the individual struggling but for their entire family. In a recent episode of the Fear Less podcast, former Mountain Valley resident Hayden Fleischer and his mother, Amy, reflected on their journey—from Hayden’s struggles with severe anxiety to his transformation through treatment and his current role as a residential counselor at Mountain Valley. Their story is one of resilience, growth, and the power of community in healing.

Hayden and Mom

The Decision to Seek Treatment

Before arriving at Mountain Valley in 2018, Hayden was trapped in a cycle of severe anxiety and depression that affected every aspect of his life. Missing nearly 60 days of school each year due to illness and exhaustion, he struggled both academically and socially. His mother, a psychotherapist, carried the weight of not recognizing the true extent of his anxiety earlier.

As Hayden’s 18th birthday approached, his parents faced the difficult decision of whether to enroll him in Mountain Valley. At first, Hayden resisted, clinging to the hope that his senior year would be different. However, his parents, recognizing the urgency of early intervention, made the tough call—one they now view as life-changing.

A Challenging Start, A Life-Changing Experience

Like many new residents, Hayden’s first days at Mountain Valley were filled with reluctance and fear. He struggled to adjust, even losing his appetite—an unusual shift for him. However, through gradual exposure therapy and the unwavering support of the residential staff, he began to engage in the program.

One pivotal moment came during an exposure exercise involving a mountain hike to a fire tower. On a family visit, he attempted to climb but turned back before reaching the top. Later, with the encouragement of peers and staff, he conquered his fear—reaching the summit and climbing the tower. This moment symbolized not just overcoming a specific fear but the broader realization that he was more capable than his anxiety had led him to believe.

Relearning Life Skills and Restoring Relationships

Beyond therapy, Mountain Valley provided Hayden with the opportunity to reconnect with joy and social engagement. His mother recalled seeing the “sparkle” return to his eyes—a brightness she hadn’t seen since childhood. Family therapy played a crucial role in mending relationships, particularly with his older brother, who had unknowingly distanced himself due to Hayden’s anxiety.

One of the most profound lessons for Hayden’s family was understanding the difference between support and accommodation. While their instincts had always been to ease Hayden’s distress, they realized that, at times, they were reinforcing his anxiety. Through Mountain Valley’s guidance, they learned to support him in a way that encouraged resilience rather than avoidance.

The Transition and Beyond

After 87 days at Mountain Valley, Hayden transitioned to boarding school—a decision he initially resented but later recognized as crucial to maintaining his progress. The fresh environment allowed him to apply his new skills without falling back into old patterns. From there, he went on to excel in college, eventually earning a 4.0 GPA in his final semesters.

Today, Hayden has come full circle. Now a residential counselor at Mountain Valley, he uses his lived experience to guide and support current residents. He remembers the fear in their eyes—because he once felt the same way. He also understands the immense power of time, community, and structured support in overcoming anxiety.

A Message to Families Considering Treatment

Both Hayden and Amy acknowledge the difficulty of deciding to send a child to treatment. The guilt, the fear, the uncertainty—these emotions are real and valid. However, as their story illustrates, taking that step can lead to profound transformation.

Amy reflects, “There were years we lost to anxiety, but now we’ve gained so much. Watching Hayden thrive and seeing him rediscover his spark has been incredible. We don’t just have our son back—we have a stronger, more connected family.”

For those considering Mountain Valley, Hayden offers this advice: “It’s okay to accept help. You don’t have to do this alone. Give the program time, lean on the support around you, and trust that things can get better.”

Mountain Valley is more than a treatment center—it’s a place where young people reclaim their lives, families rebuild connections, and resilience is fostered every day.

Listen to This Episode of Fear Less:

MOVING MOUNTAINS

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White Knuckling: How It Impacts Residents at Mountain Valley Treatment Center

Posted on by Mountain Valley Treatment Center

“White knuckling” vividly describes the act of forcing oneself through an anxiety-provoking situation. Picture gripping the handlebars of a bicycle as you struggle to balance on an uphill climb or holding onto ski poles with all your might as you descend a steep slope. In both cases, the tighter you grip and the more rigid you become, the harder it is to adjust and navigate effectively. When skiing downhill, for example, white knuckling makes you stiffer, increases your risk of falling, and prevents you from flowing with the terrain.

At Mountain Valley, we often see this response in residents working through their fears and anxieties. While it may feel like a survival strategy, white knuckling is often more of a hindrance than a help.

What Is White Knuckling?

White knuckling refers to enduring anxiety through sheer willpower, without addressing or accepting the underlying thoughts and emotions. Imagine being on a turbulent plane ride, clutching the armrests with all your strength as if your grip alone could stabilize the aircraft. It’s a reactive, fear-driven coping mechanism that reinforces the belief that the situation is dangerous or unbearable.

White Knuckling in Exposure Therapy

At Mountain Valley, we use Exposure Response Prevention (ERP), an evidence-based therapeutic approach for treating OCD and anxiety. ERP involves gradually facing fears without engaging in avoidance or compulsive behaviors.

White knuckling during ERP looks like muscling through exposures with a mindset of “I just have to get through this.”While the resident may complete the exposure, they miss the opportunity to engage meaningfully with their anxiety and build true resilience.

Why White Knuckling Falls Short

White knuckling reinforces the belief that anxiety-inducing situations are genuinely threatening. It keeps residents stuck in emotional reasoning, where feelings of fear are mistaken for actual danger. For example, gripping a hospital bed during a feared visit doesn’t make the environment any safer. Instead, it solidifies the resident’s belief that hospitals are inherently unsafe and that their fear is justified.

By holding onto control so tightly, residents avoid the discomfort of allowing fear and uncertainty to exist. This compromises the effectiveness of the exposure and hinders long-term progress. The exposure becomes an exercise in endurance rather than a step toward greater psychological flexibility.

A Real-Life Example

Consider a resident with contamination OCD. Their sibling needs urgent care, and they agree to drive them to the hospital—a place they’ve avoided for years. During the visit, they mentally and physically brace themselves, holding their breath and counting down the seconds until they can leave. Once they’re back home, the relief is immense.

But what happens next? The hospital becomes an even stronger source of fear, reinforcing avoidance patterns and undermining their progress in therapy.

Alternatives to White Knuckling

So, what can residents do instead? At Mountain Valley, we encourage a different approach—one rooted in Acceptance and Commitment Therapy (ACT) principles and compassionate exposure work.

1. Choose Willingness Over Avoidance

  • Be open to experiencing fear and discomfort rather than fighting it. The goal isn’t to eliminate anxiety but to build tolerance for it.

2. Engage Fully in Exposures

  • The quality of exposure matters. Instead of going through the motions, engage authentically with the experience. Notice thoughts and feelings without judgment.

3. Focus on the Present Moment

  • Use mindfulness techniques to ground yourself in the here and now. Pay attention to your surroundings and allow discomfort without trying to escape it.

4. Loosen the Grip

  • Recognize when you’re holding on too tightly—physically or mentally—and intentionally soften. Even small moments of letting go can create meaningful shifts.

5. Practice Feeling More

  • Instead of striving to feel less anxiety, aim to feel it more fully and with curiosity. This paradoxical approach often reduces the intensity of fear over time.

6. Be Patient and Gentle

  • Change is a process. Like learning to play an instrument or mastering a sport, progress comes with practice, repetition, and self-compassion.

Why This Matters

Residents at Mountain Valley often begin their journey with a strong desire to feel better and regain control over their lives. While white knuckling may seem like a necessary step, it ultimately keeps them stuck.

By embracing discomfort and engaging in exposures with openness, residents can move beyond the grip of anxiety and OCD. They learn that true growth comes not from avoiding fear but from facing it with courage and intention.

A Path Toward Freedom

Choosing alternatives to white knuckling isn’t just about therapy—it’s about reclaiming life. Residents who practice these skills discover they can navigate difficult situations without losing sight of their values. They reconnect with what matters most—whether it’s family, friendships, academics, or personal growth—and take meaningful steps toward a bigger, more fulfilling life.

At Mountain Valley, we stand beside our residents as they let go of the metaphorical handlebars and step into their power. Together, we transform fear into freedom and resistance into resilience.

MOVING MOUNTAINS

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Acceptance and Commitment Therapy (ACT) at Mountain Valley: Guiding Young People Toward a Valued Life

Posted on by Mountain Valley Treatment Center

At Mountain Valley Treatment Center, our mission is to help adolescents and young adults overcome the challenges posed by anxiety, OCD, and related disorders. Among the many evidence-based approaches we employ, Acceptance and Commitment Therapy (ACT) stands out as a cornerstone of our therapeutic framework. This dynamic modality not only complements other interventions, such as Exposure and Response Prevention (ERP), but also empowers our residents to embrace their inner experiences while pursuing a life aligned with their values.

What is ACT?

Acceptance and Commitment Therapy, or ACT (pronounced as a single word, “act”), is a mindfulness-based behavioral therapy that focuses on psychological flexibility. Developed by psychologist Steven C. Hayes, ACT combines acceptance strategies with commitment and behavior-change techniques to help individuals live meaningful lives despite the presence of difficult thoughts and feelings. The approach revolves around six core processes:

  1.   Acceptance: Allowing inner experiences, such as thoughts, feelings, and sensations, to exist without unnecessary struggle.
  2.   Cognitive Defusion: Learning to unhook from unhelpful thoughts by viewing them as transient mental events rather than absolute truths.
  3.   Being Present: Cultivating mindful awareness of the current moment.
  4.   Self-as-Context: Recognizing oneself as distinct from thoughts and emotions.
  5.   Values: Identifying what truly matters and provides meaning.
  6.   Committed Action: Taking effective steps toward a life guided by those values.

How We Use ACT at Mountain Valley

At Mountain Valley, ACT plays a pivotal role in helping residents navigate their anxiety and OCD. Our clinicians integrate this approach into individual and group therapy sessions, tailoring interventions to meet the unique needs of each resident.

1. Acceptance: Making Peace with Inner Experiences

A key aspect of ACT is teaching residents to accept their inner experiences without judgment or resistance. For example, a resident struggling with OCD might feel an intense urge to perform a compulsion. Through ACT, they learn to allow that urge to exist without acting on it. This process is often explained using metaphors, such as “the wave in the ocean,” which illustrates how thoughts and feelings rise, peak, and eventually fall if we let them.

To facilitate this acceptance, we teach residents specific coping skills, such as the “ACE” technique:

  • Anchor: Ground yourself in the present moment.
  • Cope: Weather the emotional storm with mindfulness.
  • Engage: Focus on the task or value-driven behavior at hand.

2. Values: Defining What Matters Most

Connecting with personal values is at the heart of ACT. At Mountain Valley, we help residents explore what truly matters to them, such as family, friendships, education, or personal growth. By identifying their values, residents can begin to align their actions with these guiding principles. For instance, a resident who values connection might choose to attend a group activity despite their social anxiety.

3. Committed Action: Taking Steps Toward a Meaningful Life

With acceptance and values as a foundation, ACT encourages residents to take effective, value-driven actions. This means facing fears and discomforts while staying true to their values. For example, a resident with emetophobia (fear of vomiting) may attend school or eat meals despite their anxiety, guided by their commitment to education and health.

4. Enhancing ERP with ACT

ACT complements ERP, a widely recognized treatment for OCD and anxiety. While ERP focuses on gradual exposure to feared stimuli and preventing avoidance or compulsive responses, ACT enhances this process by addressing internal experiences. Residents learn to accept their anxiety or fear while continuing to engage in exposure tasks. This dual approach ensures that residents not only confront their fears but also develop resilience and psychological flexibility.

Tangible Skills for Everyday Use

ACT provides residents with practical skills that extend beyond therapy sessions. One particularly impactful skill is thought defusion, which helps residents unhook from unhelpful thoughts. By recognizing thoughts as temporary mental events rather than absolute truths, residents can reduce the power these thoughts hold. For example, instead of saying, “I can’t do this,” a resident might reframe it as, “I’m noticing the thought that I can’t do this,” creating space to act in line with their values.

ACT in Action: Building a Rich, Full Life

The ultimate goal of ACT at Mountain Valley is to help residents live rich, full, and meaningful lives. This means embracing all aspects of their experience—both the joys and the challenges. Residents come to understand that a valued life includes discomfort and that growth often happens outside their comfort zones. By embodying ACT principles, our clinicians model resilience and authenticity, fostering a supportive and transformative environment for our residents.

Resources for Learning More

If you’re curious about ACT, consider exploring these resources:

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