Personalized psychotherapy sessions are offered to meet individual needs. Sessions typically last 45-50 minutes and occur weekly, but more intensive therapy options are available based on individual requirements.
Currently sessions are conducted remotely using doxy.me, a secure telemedicine platform. I also offer a limited number of in person sessions at my Tarrytown, NY office. Telehealth CBT makes therapy more accessible and convenient. There is a substantial body of research and numerous meta-analyses backing the efficacy of telehealth CBT (tCBT) finding it to be as effective as in person therapy for a range of conditions particularly depression and anxiety.
Family or significant others are often invited to participate in both the assessment and intervention phases of cognitive behavioral therapy, as clinically needed. This is particularly helpful when family members are involved in reinforcing negative behaviors or rituals related to the patient's anxiety. Participation in therapy helps guide family members toward healthier ways to interact with and support the person experiencing anxiety.
Small group therapy sessions provide psychoeducation, support, and practical cognitive-behavioral methods like cognitive restructuring and exposure therapy. These groups are tailored to specific diagnostic presentations and typically consist of 5-7 members who meet once a week for 75 minutes for a limited period.
Clinicians seeking supervision and consultation on Cognitive Behavioral Therapy (CBT) for Anxiety and Obsessive Compulsive Disorders are welcome to contact John Silvestre.
The OCD & Appearance Spectrum
OCD and body-focused obsessions often peak or shift during the high-stress years of adolescence and the transition to college.
Obsessive-Compulsive Disorder (OCD): Using Exposure and Response Prevention (ERP), I help teens face intrusive thoughts and fears without relying on time-consuming compulsions that interfere with school and social life.
Appearance Obsessions (BDD): I address the "digital-age" struggle of Body Dysmorphic Disorder, dismantling rituals like mirror-checking and social media comparison.
Trichotillomania & Skin Picking (BFRBs): Utilizing Habit Reversal Training (HRT) and the ComB (Comprehensive Behavioral) model, therapy’s goal is to identify environmental and sensory triggers to build sustainable replacement skills.
Depression & Anxiety
Today’s young adults face unprecedented academic pressure and social media burnout.
Behavioral Activation: For those struggling with depression, therapy focuses on re-engaging with values-based activities to break the cycle of withdrawal.
Social Anxiety: I build concrete skills to navigate the complexities of modern social interactions, including cognitive reestructuring and exposure.
The Role of the Family: Moving from "Accommodation" to Empowerment
For parents of teens and young adults, the most common challenge is Family Accommodation. This occurs when parents—with the best intentions—help the child avoid anxiety by participating in their rituals or avoidance, providing constant reassurance, or removing all stressors. While this lowers distress in the short term, it often inadvertently "feeds" the disorder.
My approach includes:
CBT for College Readiness
For many 18-to-25-year-olds, the transition to college acts as a "stress test" for their coping skills.
We work on: Self-Management: Learning to manage symptoms and medication without daily parental oversight.
Resilience Building: Developing the emotional tools to handle the inevitable setbacks of campus life.