Therapeutic Approaches & Group Therapy

Quarternote Counseling uses a variety of modalities to tailor the therapy session to the individual needs of each client. Please continue reading below to learn more about these modalities and approaches.

Eye Movement Desensitization and Reprocessing (EMDR)

Eye Movement Desentization, Quarternote CounselingEMDR involves bilateral stimulation through eye movements or alternating left and right light touch. It is a physiologically based therapy that helps a person perceive disturbing material in a new and less distressing way.

When a person experiences an upsetting event the brain often cannot process information in the conventional manner. The incident can feel as if it happened yesterday, and thinking about it can feel as bad as going through it the first time. According to the EMDR International Association, “EMDR seems to be similar to what happens naturally during dreaming REM (Rapid Eye Movement) sleep.”

Some clients appreciate that the participant does not have to discuss disturbing memories in detail. Bringing up the memory and simply saying, for example, “It was something upsetting that happened when I was 12 years old” is often sufficient to identify the target memory for desensitization.

According to leading trauma expert Dr. Bessel van der Kolk of The Trauma Center at the Justice Resource Institute, EMDR is one of the best approaches for individuals who have Post Traumatic Stress Disorder, and it is also useful for those who have trauma symptoms that fall short of the full PTSD diagnosis.

(See EMDR International Association’s website for more information on this approach.)

Internal Family Systems (IFS)

Internal Family Systems is an evidence-based model of psychotherapy based on the belief that the mind is naturally multiple. Our inner parts contain valuable qualities, but when forced into extreme roles by life circumstances they may create the opposite impact of their original intent. For example, a boundary setting part could be forced by a very threatening life experience into the extreme role of rageful confrontation in order to protect the person. By continuing in that extreme role, it could actually end up causing the person damage, such as rupture of a valued relationship, job loss, or even legal consequences.

IFS is also based on the belief that each person has a core Self, which embodies kindness and compassion, that knows how to heal. When connected to Self we can heal our injured parts so we can live with confidence, all parts of us can team up harmoniously and we have CHOICES about how to behave towards others and ourselves.

In IFS all parts of the client are welcome. The client is invited to listen to their parts rather than try to eliminate aspects of themselves. Even clients who have lived through childhoods of abuse and neglect can experience self-acceptance, stability and personal growth when they connect with their “Self”.

In IFS there are no “bad” parts, and the goal of therapy is not to eliminate parts but to help them find their non-extreme roles. Extreme parts carry “burdens” that are not inherent in the function of the part, such as extreme beliefs and emotions. Parts can be helped to “unburden” and return to their natural balanced and harmonious role in the system When the goals of therapy are achieved, all parts will exist and lend talents that reflect their non-extreme intentions.

IFS is effective with clients experiencing a wide array of symptoms including but not limited to: anxiety; depression; addiction; PTSD; dissociation (including Dissociative Identity Disorder); self-harm; suicidal thoughts; behavioral challenges; attention problems; compulsions; the hearing of internal voices. It is also helpful in family and couples’ therapy.

This description of IFS is informed by and paraphrases information that can be found in the following website, which clients are invited to review to obtain more detailed information about the model at

Clients might also find it helpful to consult the book Introduction to the Internal Family Systems Model, by Richard C Schwartz, PHD, Trailheads Publications, Oak Part, Illinois, 2001. It can be purchased from the IFS Institute Website.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is an evidence-based approach that aims to improve mental health by helping the client challenge and change thoughts, beliefs, attitudes and behaviors. CBT helps the client improve emotional self-regulation and develop personal coping strategies. The focus is usually the present. CBT is different from many other types of therapy in that it does not focus on the unconscious meanings of behaviors. CBT is problem-focused and action-oriented.

The therapist will help the client identify “cognitive distortions” such as overgeneralizing, magnifying negatives, minimizing positives and catastrophizing, and replace them with more realistic and rational thoughts, thereby decreasing emotional pain and maladaptive behaviors.

Quarternote Counseling therapists often weave CBT approaches into other treatment modalities, as appropriate for the client’s presenting issues.

Group Therapy

The following are groups that will be offered in 2023 if there is sufficient interest. Groups will run 8 weeks, once a week, at times that accommodate the greatest number of potential clients. Weekend times are a possibility for the Equine groups. Each group will be offered at a package cost of $400 for the 8-session program (equal to $50 per session), except for the equine groups, which will cost slightly more, exact cost to be determined by the number of individuals in the group. These groups are not covered by insurance.

Internal Family Systems Mindfulness/Meditation Group – This will combine standard Mindfulness/Meditation practices with IFS parts work. Please visit the IFS Institute website at for an explanation of IFS. Depending on interest level, this group will be offered online and/or in person.

Dance/Movement Therapy Group for Chronic Pain/Anxiety/Depression – These in-person closed groups will use dance and movement principals to promote mind-body awareness, self-concept, and interpersonal connection. For more information about dance/movement therapy, we recommend reviewing the American Dance Movement Therapy website here:

Equine Assisted Psychotherapy – Offered by an outside organization, Quarternote Counseling will provide referral service and monitor quality of program. Clients will travel to a horse farm in Nokesville, Virginia for 1 to 1.5 hour long sessions in which they interact with horses on the ground (no riding). Therapy is offered in the Equine Assisted Growth and Learning Association (EAGALA) model. Price dependent on number of participants. Possibility for both adolescent and adult groups. Offered April to October 2023. Visit the EAGALA website at for an explanation of Equine Assisted Psychotherapy.

If you would like to place yourself on the interest list for one or more of these groups, please complete the Contact Form located here.