mind by design counseling online therapy in new jersey for anxiety, grief, women teens and adults NJ online therapist near me

Mind by Design


Exposure Therapy
Overcome Fear & Anxiety Online & In Person | NJ

Exposure Therapy is a type of cognitive behavioral therapy. Depending on the interventions being used and the mental health condition being treated, exposure therapy is sometimes referred to as Prolonged Exposure Therapy and Exposure & Response Prevention Therapy.

Exposure therapies are evidence-based treatments that help individuals confront and reduce the fear associated with traumatic memories, phobias, or triggers. By facing these fears directly, individuals can decrease their sensitivity over time, leading to reduced symptoms and improved quality of life.

Understanding Exposure THerapy Basics

Exposure & Response Prevention (ERP)

Used primarily for OCD, this technique involves exposing individuals to their triggers and teaching them to resist the urge to perform a compulsion.

Prolonged Exposure Therapy (PE)

Particularly effective for PTSD, this therapy involves recounting the traumatic event multiple times until the associated anxiety decreases.


Prolonged Exposure Therapy Protocol

Education and Rationale: The first step involves educating the individual about PTSD and the PE therapy process. The therapist explains how avoidance of trauma-related thoughts, feelings, and situations maintains PTSD symptoms. Understanding the rationale behind exposure therapy is crucial for patient engagement and motivation.


Breathing Retraining: This step involves teaching the individual controlled breathing techniques. The goal is to help them manage immediate anxiety and stress responses. Controlled breathing is a skill that can be used throughout the therapy and in other stressful situations.


Creating a Hierarchy of Fears: The therapist works with the individual to create a list of feared situations, thoughts, and memories related to the trauma. These are then organized into a hierarchy, starting from least to most distressing. This hierarchy guides the exposure exercises.


In Vivo Exposure: In vivo exposure involves gradually confronting real-world situations that are safe but have been avoided because they are trauma-related or trigger PTSD symptoms. The individual is encouraged to engage with these situations according to the hierarchy, starting with less challenging ones and progressively moving to more difficult ones.


Imaginal Exposure: This step involves repeatedly revisiting and recounting the traumatic memory in the presence of the therapist. The individual is encouraged to describe the traumatic event in detail, including their thoughts, feelings, and sensory information. This helps in processing the trauma and reducing its emotional impact.


Processing the Exposure: After each imaginal exposure, the therapist and individual discuss the experience. This processing phase is crucial as it helps the individual understand their reactions and challenge any unhelpful beliefs about the trauma. It also reinforces the learning that occurs during exposure.


Homework Assignments: Homework is an integral part of PE therapy. Individuals are often asked to listen to recordings of their imaginal exposure sessions and to practice in vivo exposures between sessions. This helps to reinforce the skills learned in therapy and accelerates progress.


Regular Review and Assessment: Throughout the therapy, the therapist regularly reviews the individual’s progress. This includes assessing changes in PTSD symptoms and discussing any difficulties encountered during the exposures. Adjustments to the treatment plan are made as needed.


Relapse Prevention and Conclusion: The final phase of PE therapy focuses on maintaining gains, managing any future symptoms, and preventing relapse. The therapist helps the individual develop a plan to continue using the skills learned in therapy and to cope with potential future stressors or trauma reminders.


Prolonged Exposure therapy typically spans over a period of about 8-15 sessions, though this can vary depending on individual needs. 

Exposure & Response Prevention Protocol

Assessment and Education: The first step involves a detailed assessment of the individual’s specific obsessions and compulsions. The therapist educates the individual about OCD and the principles of ERP, explaining how avoidance and compulsive behaviors reinforce OCD symptoms.


Identifying Triggers and Compulsions: The therapist works with the individual to identify specific triggers (thoughts, images, objects, situations) that provoke their OCD symptoms and the compulsive behaviors they engage in as a response.

Developing a Hierarchy of Triggers: Together, the therapist and the individual create a hierarchy or list of these triggers, ranking them from least to most anxiety-provoking. This hierarchy is used to guide the exposure exercises in a gradual and controlled manner.


Exposure Exercises: The individual is gradually exposed to their triggers, starting with the least anxiety-provoking and moving towards more challenging ones. These exposures can be in vivo (directly facing real-life situations) or imaginal (vividly imagining the feared scenario).


Response Prevention: Alongside exposure, the individual is taught and encouraged to resist performing their usual compulsive behaviors. The goal is to learn that they can tolerate the anxiety and distress without resorting to compulsions, and that anxiety naturally decreases over time.


Processing the Experience: After each exposure exercise, the therapist helps the individual process the experience, discussing the anxiety levels experienced and the thoughts and feelings that emerged. This helps in understanding and restructuring any maladaptive beliefs related to the obsessions.


Homework Assignments: ERP therapy involves regular homework assignments where the individual practices the exposure exercises and response prevention techniques outside of therapy sessions. This is crucial for the success of ERP, as it allows for more frequent practice and generalization of skills to everyday life.


Regular Review and Adjustment: The therapist regularly reviews the individual’s progress, including any difficulties encountered during the exercises. The treatment plan is adjusted as needed, based on the individual’s progress and tolerance of the exposures.


Relapse Prevention and Maintenance: Towards the end of therapy, focus shifts to maintaining the gains achieved, preventing relapse, and managing any future symptoms. The individual is equipped with strategies to cope with potential future triggers and to continue practicing the skills learned in therapy.


ERP is typically conducted over a period of several weeks to months, depending on the individual’s needs. It’s important to note that ERP can be challenging, as it requires facing significant anxiety. Therefore, it should be conducted under the guidance of a trained specialist.

Exposure Therapy Skills

Exposure Therapy for Generalized Anxiety

Interoceptive Exposure: Clients are exposed to bodily sensations associated with panic or anxiety.
Worry Outcome Exposure: Clients are asked to imagine the worst-case scenarios of their worries and then analyze the likelihood and potential coping strategies.

Exposure Therapy for Specific Phobias

Systematic Desensitization: Clients are taught relaxation techniques and then exposed to the phobic stimulus in a stepwise manner, starting from the least fear-inducing to the most.
In Vivo Exposure: Direct real-life exposure to the feared object or situation

Virtual Reality Exposure Therapy

Utilizing virtual reality technology, clients are immersed in a computer-generated environment where they can confront and process their fears in a controlled setting. This method is especially beneficial for individuals who might find real-world exposure challenging or impractical.

Principles & Benefits of Exposure Therapy

The core principle behind exposure therapies is the systematic and gradual exposure to feared stimuli. This exposure helps individuals realize that their fears are often irrational, and over time, the anxiety associated with these fears diminishes.

The Benefits of Exposure Therapy Include:


  • Directly addresses specific phobias or traumatic memories.
  • Provides tools and strategies to confront and manage fears.
  • Exposure Therapy is supported by numerous research studies showcasing its effectiveness.

What Clients Can Expect in Exposure Therapy

During exposure therapy, clients can expect:


Assessment: The therapist will begin by understanding the nature of the client’s fear or anxiety.


Hierarchy of Fears: Together with the therapist, the client will create a list of feared situations, ranking them from least to most anxiety-provoking.

Gradual Exposure: The client will be gradually and systematically exposed to the feared situations, starting with the least anxiety-inducing and moving up the hierarchy.


Support: Throughout the process, the therapist will provide guidance, support, and tools to help the client manage their anxiety during exposure.

Frequently Asked Questions
about Online Therapy in New Jersey

How do I get started as a new client?

New Clients can reach out to us directly via call, text or email here:




Or, you can complete a new client form and we’ll reach out to you within 24 hours here:

new client contact form request contact

What is your cancellation policy?

We ask that clients provide at least 24 hours notice in the event that they need to cancel to avoid the 50% cancellation fee. we understand that life happens and do our best to be flexible & reschedule.

Does my insurance cover my visits?

We provide”Courtesy Billing” for clients who are using the Out-of-network insurance benefits.

Our Insurance Page shares a small blurb about Why We Left Insurance Panels

Do you offer traditional talk therapy?

of course! though we have some unconventional therapy approaches, we are rooted in evidenced based practices. Talk therapy is a major player in the therapy room! See What we Treat and Integrative Services for more information

Is Online Therapy As Effective As In-Person Therapy?

Online therapy is essentially face-to-face counseling, just conducted remotely. Studies show that teletherapy is as effective as traditional counseling. Professional organizations and state governments recognize its benefits and have set regulations for it. However, like any therapy, its success in achieving your goals isn’t guaranteed. It’s important to discuss with your therapist whether teletherapy is working for you.

Can I Change Therapists If I'm Not Happy?

Yes, you can switch therapists to another provider within the practice, or we can provide you a referral if preferred. We want to ensure that your time and effort are well spent, and that you are getting the relief you need, that’s why we work collaboratively with each other in the practice, as well as outside therapists who we know and trust.

How Do I Know If Therapy Is Helping?

You should feel like you’re making progress. Signs it’s working include:

Feeling comfortable talking to your therapist
Your therapist respects boundaries
You’re moving towards your goals
You feel listened to
You’re doing better in life
Your self-esteem is getting better

Is Online Therapy Easy to Use for Non-Tech-Savvy People?

Yes, it’s pretty simple to access sessions. You’ll need basic internet skills, such as opening and visiting the patient link sent to you via email. It’s similar to video chatting like Facetime or Zoom. We can also walk you through it on the phone the first time to ensure a strong connection

What Questions Should I Ask My New Therapist?

Feel free to ask anything. Some good questions are:

  • How often will we meet?
  • What do you specialize in?
  • What experience do you have with my issue?
  • What outcomes can I expect?
  • How will I know I’m progressing?
  • How long do you usually work with clients?
  • How will we set my treatment goals?

How Should I Prepare for My First Session?

Showing up is all that you need to do! But if you really want to get the most out of session, it could help to take some time to think about what you want from therapy. It helps to write down your goals, questions you have or things that you feel are important to share. 

What is the difference between associate therapists & fully licensed therapists?

Our Qualifications:

Our founder, Rebecca Sidoti, is a highly qualified, state-licensed therapist and supervisor with extensive training in anxiety related disorders and innovative treatment such as Ketamine Therapy. Mind by Design Counseling adheres to standards set by the our governing counseling boards.

To see each providers credentials, training and licenses, visit our “Meet the Therapists” Page to learn more.


  • LAC/LSW are therapists who may practice clinical work under the supervision of a fully licensed therapist.
  • LPC/LCSW are therapists who have completed the necessary clinical hours post-graduation under supervision and can practice clinical work independently.

What Geographic Areas Are Served?

Currently, we serve clients in New Jersey and are expanding to other states as telehealth laws evolve. While telehealth offers the convenience of attending sessions from anywhere, state laws require clients to be in-state during their session.

Is Virtual Counseling Suitable for Everyone?

Online therapy might not be as effective for individuals with chronic suicidal thoughts, severe trauma, significant mental health history, or those recently in intensive care. Such cases often benefit more from traditional, in-person counseling. We’ll help you decide if our online services are right for you during your intake and evaluation.

What Equipment is Needed for Online Therapy?

To join a session, log in using the credentials we provide. No downloads are needed. Our platform, compatible with both individual and group sessions, requires:
A computer or mobile device with a webcam and internet access.
We’ll help you test your setup before your first appointment to ensure a reliable connection. iOS users should use the Safari browser for mobile and tablet sessions.

What Questions Will Therapists Ask Me?

It depends on your goals. Expect questions about your thoughts, feelings, relationships, work, school, and health. They’ll ask to understand your therapy goals.

How Do You Keep Client Information Secure?

Security and Confidentiality of Sessions:
Your privacy is crucial to us. We use TherapyNotes, a HIPAA-compliant platform, ensuring secure and confidential teletherapy sessions. This platform’s security features include encrypted video connections, secure data transfers, and encrypted databases, ensuring your information is safe at all times.

What is VRT used for?

we use VRT to support Exposure Therapy, a long standing traditional therapy modality to treat phobias, anxiety and stress. we send a headset directly to your home so you can access VRT from anywhere.

VRT not only helps with exposure therapy for phobias, but is great for ADHD, mindfulness, PTSD and social anxiety.