Karol specializes in substance abuse treatment and has years of experiencing supporting people in recovery. Karol Owen, LPCC-S I specialize in: Substance Abuse Depression Life Transitions About Me I am a Licensed Professional Clinical Counselor (LPCC) with nearly 3 decades of experience supporting adolescents and adults across a wide range of emotional, behavioral and mental health needs. Since the beginning of my career I have been committed to providing compassionate, evidence-based care ground in trauma-informed practices and person-center principles. In addition, I have specialized training in working with people experiencing secondary traumatic stress particularly those in high impact professions such as healthcare workers, therapists and first responders. I understand the unique emotional and physical toll these roles can take and strive to help people strengthen resilience, restore balance and prevent burnout and compassion fatigue. At the heart of my work is the belief that every person has the capacity for resilience, healing and traonformation–and that therapy can be a powerful place to gain and rediscover that strength. Contact I have new client availability! karol@cognitiverefinery.com 270-266-1188

Alex specializes in treating sports performance concerns and chronic illness. Alexandra do Couto, LPCA I specialize in: Sports Performance Chronic Illness Depression About Me I am passionate about helping people bridge the gap between their current and ideal selves, with the ultimate goal of leading a more fulfilling life. Whether that is confronting your relationship with anxiety, acknowledging how behaviors play a role in your current state, learning how to acknowledge and express your emotions, or working to set boundaries around what is truly important to you, my goal is to help you feel more in sync with your optimal self. With experience as a certified mental performance consultant, lifestyle interventionist, and a licensed mental health counselor, clients who are navigating difficulties in their sport/performance arenas, work, or physical health (such as chronic illnesses or injury) are a great match. I also have experience working with individuals diagnosed with anxiety/depression, ADHD, autism, and those struggle with managing life transitions. I often pull from Acceptance and Commitment Therapy (ACT) as I work to help people face life’s challenges more adaptively and make choices more in line with their values. I do strive to take an eclectic approach that best meets my clients’ needs though, blending in Cognitive Behavioral Therapy, Motivational Interviewing, and Person-Centered Therapy styles when appropriate. I enjoy taking a little more of a hands-on approach, walking the path right alongside my clients. I look forward to the opportunity to working with you! Contact I have new client availability! alex@cognitiverefinery.com 270-266-1188

Neuropsychological testing to address ADHD, Autism, Learning Disabilities, Memory Concerns, and Brain Injuries. Now Scheduling for August 2026. Neuropsychological Testing Consultation Not sure of your testing needs? Schedule to meet in person to learn more. Children's Testing We offer comprehensive testing for children ages 7+. Adult Testing We offer testing and briefer screening assessments depending on your needs ABOUT NEUROPSYCHOLOGICAL TESTING Neuropsychologists are specially trained clinical psychologists with expertise in the relationship between brain functioning and behavior. Essentially, they understand how your brain works and how it interacts with several other factors (emotional, behavioral, social) to influence your day-to-day experiences. Neuropsychological testing is a tool you can use to better understand your strengths and weaknesses across multiple domains. For example, neuropsychological assessments evaluate your ability to remember, concentrate and pay attention when needed, communicate effectively, read, write, solve problems, plan, organize, and make decisions. Assessments of mood, behavior, and practical daily living skills also provide important information and offer greater detail to inform the broader picture and help us place your strengths and weaknesses in your unique context. Results can inform treatment and provide valuable insights to help you, your family, and your treatment providers decide what’s needed to support you in your environment. For example, results often inform decisions about medications, types of therapies that might be needed, and other strategies that will best support you in your routine daily activities. Assessment results can also help to determine whether there is a pattern that points to a specific diagnosis or might be consistent with a diagnosis you already have. They may also help to establish a cognitive baseline and monitor for changes over time that might affect your daily functioning. Additionally, testing is a key step for developing plans to improve or maintain brain health and daily functioning. Attention and Executive Functioning Concerns Testing may be helpful for individuals struggling with focus, organization, impulsivity, time management, or follow-through. Diagnostic Clarification Neuropsychological evaluation can be useful when there is uncertainty about the cause of your symptoms and a clearer picture is needed to guide treatment, school support, or other services. Learning and Academic Difficulties Assessment can help clarify whether challenges with reading, writing, math, retention, or academic performance may reflect a learning disorder or related cognitive concern. Autism or Developmental Questions For some individuals, testing can help clarify developmental, social, communication, or behavioral patterns that warrant further understanding. Memory and Cognitive Changes Testing can help evaluate concerns related to memory, concentration, word finding, processing speed, or changes in daily functioning. Emotional or Behavioral Impact Mood, anxiety, trauma, and stress can affect functioning. Testing can help distinguish emotional factors from underlying cognitive issues. Who Might Benefit From Testing? Pricing and Fees Consultation $200 Unsure of your testing needs? Schedule a consultation appointment to meet one on one with the neuropsychologist to assess your next best step. *This fee is deducted from your testing package. Memory Screening $800 - 1000 Do you have concerns about dementia or other age-related changes in your thinking? This is the starting place to get answers. Typically 4-5 hours of clinical time including face to face testing, test scoring and interpretation, feedback session, and clinical report. Children's Comprehensive Testing $2500 - 3000 Rate includes records review, consultation with other providers as needed, face to face testing time, test scoring and interpretation, feedback session, and clinical report. Approximately 15 hours of service. Adult Comprehensive Testing $1800 - 2200 Rate includes records review, consultation with other providers as needed, face to face testing, test scoring and interpretation, feedback session, and clinical report. Typically 9 to 11 hours of clinical time. We believe in upfront pricing. No surprises. We do not accept insurance for testing services. We accept payment via cash, check, or credit card; we accept all major credit cards including Visa, MasterCard, AmEx, and Discover. We also accept health savings account (HSA) and flex savings account (FSA) cards with a Visa, Discover, MasterCard, or AmEx logo on the card. What to Expect During a Neuropsychological Assessment Prior to your first appointment, it would be very helpful to have any records relevant to the current situation (e.g., medical records, scans, laboratory results, academic records). Clinical Intake Session (typically around 1-1.5 hrs). During this appointment, the provider will talk with you to gather information about your history, current concerns, and goals for evaluation. You and/or your family may also be asked to complete questionnaires pertaining to mood, thinking abilities, and the performance of routine daily activities during this session. Testing Sessions (typically 2 sessions, ranging from 2-4 hours). During this session(s), you will complete a variety of assessments and measures designed to examine your thinking abilities, academic skills, emotional functioning, and functioning in your day-to-day environment. Results and Feedback Session (typically 1-1.5 hrs). During the feedback session, we will review your test results and the provider will help you better understand what they mean. You will learn more about how your strengths and weaknesses show up in your day-to-day life. Findings will be explained in depth and you will receive personalized recommendations to address potential weaknesses. Depending on the nature of the evaluation, you can expect to receive a detailed report approximately 4 weeks after completion of the evaluation. This will be provided during the feedback session. Frequently Asked Questions What does a neuropsychological assessment measure? Attention and concentration Information processing speed Memory and learning Language skills Visuospatial skills Executive functioning Reasoning and problem solving General intellectual ability Motor speed and coordination Mood and personality Who might benefit from a neuropsychological evaluation? Children and adults who are experiencing problems with learning, attention, behavior, emotions, and functioning at school, work, or in performing other routine daily activities Who might not be appropriate for outpatient neuropsychological testing? Anyone who has medical, psychiatric, or behavioral conditions that are currently in an acute or severe phase. When you are experiencing acute or severe effects of an illness, you aren’t able to perform your best and you might be very far away from your baseline. This may confound the test results and limit the interpretation and conclusions that can be made with confidence. These conditions should be addressed and stabilized by appropriate providers prior to testing. If substance use is current, it is difficult to confidently establish your baseline cognitive abilities, and this will confound the results as well. It is very important that you are substance-free for at least 48-72 hours. Anyone with a severe intellectual or neurocognitive disorder that limits the ability to communicate or engage in testing. Court-ordered evaluations and legal involvement. Participation in any legal proceeding and evaluations for any legal purpose will not be conducted. What happens during the testing session? During the testing session, you will work one-on-one with the provider. You will be asked to answer questions and complete a number of tasks related to a variety of cognitive processes. Neuropsychological assessments use a variety of formats including question-and- answer, paper-and-pencil, and computer-based methods. All tasks are designed to assess important areas of functioning in cognition, emotion, and adaptive behavior/routine daily functioning. If you have a family member or friend accompany you to the appointment, they will be asked to wait in the waiting room during the testing sessions. This helps reduce the likelihood that your test results are affected by distraction. For minors, a parent or legal guardian must remain on the premises during the appointment. Should I do anything to get ready for the appointments? Dress comfortably Take the medications you normally take, and bring any you may need during testing (such as midday doses). Get a good night’s sleep Bring glasses or hearing aids if you typically use them The testing sessions can be lengthy, so please feel free to bring snacks and drinks If the patient may have trouble providing information about their history, it is helpful for a family member, friend, or caregiver who knows the patient well to accompany them Is there anything I should study before the testing? No. The tests are designed to better understand various aspects of cognitive functions. There is nothing to learn or practice beforehand. Ready to Reach Out? If you would like to get scheduled or learn more, please fill out our interest form and we will contact you to get started! Testing Interest Form Dr. Melissa Mathews Neuropsychologist EDUCATION AND EXPERIENCE I am a licensed clinical neuropsychologist specializing in comprehensive neuropsychological evaluations for individuals across the lifespan. With over 15 years of experience, I have worked with children and adults to assess a broad spectrum of conditions including dementia, mild cognitive impairment, ADHD, traumatic brain injury, and complex medical or neurological disorders. I am committed to providing thorough, evidence-based evaluations that translate complex brain-behavior findings into clear, practical recommendations for patients, families, and referring providers. My approach is collaborative, compassionate, and always patient-centered. I earned a Ph.D. in clinical psychology from the University of Massachusetts-Amherst and completed specialized training in neuropsychology, including an internship at the University of Alabama-Birmingham and a two-year postdoctoral residency at the University of Kentucky in the Department of Neurology/Sanders-Brown Center on Aging.

Select a Therapist Finding a therapist is a lot like trying on shoes - you have to find a good fit, but you are much more likely to find a good fit if you select a therapist who is skilled in treating the concerns that lead you to seek therapy. CLICK ON PHOTO TO LEARN MORE Megan Harden, LCSW Obsessive Compulsive Disorder Phobias Body Focused Repetitive Behaviors Jim Croxton Clinical Consultation Normanda Lawless, LPCC Trauma Post Traumatic Stress Disorder Life Transitions Donald Evans, LCSW LGBTQIA+ Obsessive Compulsive Disorder Trauma Kayla Ashby, LPCC Narcissistic Partner Abuse Trauma Adjustment Issues Cejay Moore, LPCC Religious Trauma Obsessive Compulsive Disorder Life Transitions Chris Chandler, PsyD Children's Behavioral Issues Adjustment Issues Anxiety Disorders Peyton Collins, LCSW Autism Spectrum Disorder OCD- All ages Anxiety Ninoska Moratin, LPCC Couples Counseling Affairs and Betrayals Trauma Austin Weiler, LCSW Obsessive Compulsive Disorder ADHD Trauma Dori Ryherd, LCSW Life Transitions Trauma Insomnia Bella McCall, LPCC Obsessive Compulsive Behaviors Phobias Anxiety Disorders Olivia Ellis, LPCA Eating Disorders Anxiety Disorders Adjustment Issues Jessica Bird, MSCFT Open Relationships Non-Monogamy Sexual Concerns Couples Counseling Jamee Coombes, LCSW Depression Anxiety Stress and Burnout Kate Barnes, LCSW, PHM-C Perinatal Mental Health Chronic Illness Grief Briana Rushing, LPA Bordeline Personality Disorder Autism ADHD Emma Graviss, CSW Children's Behavioral Concerns Trauma Anxiety Dr. Evelyn Peck Couples Counseling Trauma Mood Disorders Brittany Jinkins, LCSW Obsessive Compulsive Disorder ADHD Autism Julia McKinney, LPCC Post Traumatic Stress Disorder Anxiety Life Transitions Karol Owen, LPCC-S Substance Abuse Depression Life Transitions Alexandra do Couto, LPCA Sports Performance Chronic Illness Depression Dr. Melissa Mathews Neuropsychological Testing Adam Wink, LPCA Grief and Loss Relational and Life Transitions Anxiety Disorders Kenzie Skaggs Clinical Intern Kale Iwanski Clinical Intern The Administrative Team Brianne Simpson Office Manager Hanna Forrest Client Care Coordinator Emma Thomas Client Care Coordinator Alicia Matthews Client Care Coordinator Kymber Lamers Client Care Coordinator Theodore Harden Administrative Assistant

Kenzie is a clinical intern at TCR working under the supervision of Cejay Moore, LPCC. Kenzie Skaggs Clinical Intern - Accepting Clients *There is no cost for services provided by TCR's clinical interns About Me Hi, I'm Kenzie. I am a Clinical Mental Health Counseling graduate student and counseling intern passionate about helping individuals navigate life's challenges with greater confidence, self-understanding, and resilience. My clinical interests include disordered eating, trauma, obsessive-compulsive disorder (OCD), perinatal mental health, and anxiety disorders. I especially enjoy working with children, adolescents, and young adults and strive to create a therapeutic environment where clients feel safe, supported, and empowered to share their experiences without fear of judgment. My approach to counseling is person-centered and collaborative, grounded in the belief that each individual is the expert of their own story. I integrate evidence-based interventions, including Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), psychoeducation, and strengths-based approaches while tailoring treatment to each client's unique needs, goals, and experiences. I believe meaningful change occurs within a strong therapeutic relationship. My goal is to provide a warm, compassionate, and authentic space where clients feel heard, valued, and understood. Together, we can explore challenges, develop effective coping strategies, and work toward creating a life that feels more fulfilling and aligned with your values. I consider it a privilege to walk alongside clients in their healing journey and am committed to helping each person discover their strengths while fostering growth, resilience, and lasting change. Contact I have new client availability! kenzie@cognitiverefinery.com 270-266-1188

Alex specializes in treating sports performance concerns and chronic illness. Adam Wink, LPCA I specialize in: Grief and Loss Relational and Life Transitions Anxiety Disorders About Me I help my clients navigate relationship crossroads. Whether you're trying to save a struggling relationship, deciding whether to stay or leave, or grieving the loss of a relationship, I provide support for the anxiety, anger, grief, and uncertainty that often accompany these transitions. Together, we'll work to better understand your experiences, develop healthier patterns, and help you move forward with greater clarity, confidence, and connection. Using evidence base approaches, I help clients improve communication, manage difficult emotions, set healthy boundaries, and clarify their values. Together, we build practical skills to navigate conflict, express needs effectively, make values-based decisions, and create meaningful, lasting change in your relationships and life. When a relationship is at a crossroads, it's easy to feel overwhelmed by anxiety, grief, anger, and uncertainty. If you're struggling to find clarity or a way forward, I can help. Together, we'll work toward healing, understanding, and meaningful change. Contact I have new client availability! adam@cognitiverefinery.com 270-266-1188

Kale is a clinical intern at TCR working under the supervision of Megan Harden, LCSW. Kale Iwanski Clinical Intern - Accepting Clients *There is no cost for services provided by TCR's clinical interns About Me Hi, I’m Kale. I am currently completing my internship as part of the Clinical Mental Health Counseling Master’s program at Western Kentucky University. I am passionate about helping people bridge the gap between their current and ideal selves so they can live more fulfilling lives. My clinical interests include life transitions, couples counseling, and a wide range of mental health conditions, including OCD, depression, and eating disorders. I am particularly interested in working with motivated clients, regardless of their condition or prior therapeutic experience. In my work, I strive to take a tailored, integrative approach with each client. I am currently developing my skills in Motivational Interviewing, Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT), and Supportive Therapy. As an intern, I bring a fresh perspective and a committed presence, collaborating with my clients under the clinical supervision of Megan Harden, LCSW. Contact I have new client availability! kale@cognitiverefinery.com 270-266-1188

Notice of Privacy Practices THIS NOTICE DESCRIBES HOW YOUR PROTECTED HEALTH INFORMATION MAY BE USED AND DISCLOSED, YOUR RIGHTS REGARDING THAT INFORMATION, AND OUR LEGAL RESPONSIBILITIES. PLEASE REVIEW IT CAREFULLY. At The Cognitive Refinery, we understand that your health information is deeply personal. Protecting the privacy and security of your information is an essential part of the care we provide. Federal law, including the Health Insurance Portability and Accountability Act (HIPAA), requires us to maintain the privacy of your Protected Health Information (PHI), provide you with this Notice of our privacy practices, and follow the terms of this Notice. Protected Health Information (PHI) includes information that identifies you and relates to your past, present, or future physical or mental health, the healthcare services you receive, or payment for those services. How We May Use Your Information: Treatment Within Our Practice Your Protected Health Information may be used by members of The Cognitive Refinery who are involved in providing your care. This may include consultation between clinicians, clinical supervision, administrative staff performing necessary scheduling or billing functions, and other internal operations required to provide quality behavioral health services. Your session notes and other clinical documents are not viewable by our administrative employees. Only your therapist and their supervisor can access this information within the practice. The Cognitive Refinery requests your written authorization before communicating with physicians, psychiatrists, therapists, schools, attorneys, or other providers and organizations outside of our practice, unless disclosure is otherwise required or permitted by law, such as during an emergency or when mandatory reporting laws apply. Payment We may use your information as necessary to bill insurance companies, collect payment for services, verify insurance eligibility, process payments through our payment processor, or respond to insurance requests related to payment. If another individual will be responsible for payment or wishes to discuss your billing information, we require your written authorization before communicating with that individual. Health Care Operations We may use your information for activities necessary to operate our practice, including quality improvement, staff training, licensing, accreditation, credentialing, auditing, legal compliance, business planning, and other administrative functions necessary to provide effective behavioral healthcare. Electronic Communication We may communicate with you regarding appointment reminders, scheduling, billing, or other administrative matters using text message, email, telephone, or our secure client portal, depending on your communication preferences. We do not routinely leave voicemail appointment reminders. These reminders are provided through our electronic health record system and are sent through text or email depending on identified preferences. While we make reasonable efforts to safeguard electronic communications, no method of electronic communication can be guaranteed to be completely secure. We encourage clients to avoid transmitting sensitive clinical information through standard email or text messaging whenever possible. How We Protect Your Information The Cognitive Refinery maintains administrative, technical, and physical safeguards designed to protect the confidentiality, integrity, and availability of your Protected Health Information. Access to client information is limited to workforce members who require access to perform their job responsibilities. We utilize secure technology systems and work with third-party service providers that support functions such as electronic health records, secure communications, payment processing, information technology, and cloud-based services. When these providers have access to Protected Health Information, they are required to safeguard that information in accordance with applicable law and, where required, enter into Business Associate Agreements with our practice. Situations Where We May Disclose Information Without Your Authorization Federal and state law permit or require certain disclosures without your written authorization. Examples include: When required by federal, state, or local law. Reporting suspected child abuse, elder abuse, or abuse of vulnerable adults. Responding to court orders or other lawful legal processes. Certain public health reporting requirements. Reporting information necessary to prevent or lessen a serious and imminent threat to the health or safety of you or another person. Health oversight activities such as licensing, audits, or investigations. Certain law enforcement purposes when permitted or required by law. Workers' compensation claims and other specialized government functions as authorized by law. Uses Requiring Your Written Authorization Except as otherwise permitted or required by law, we will obtain your written authorization before releasing your Protected Health Information to individuals or organizations outside The Cognitive Refinery. Examples include: Communication with outside healthcare providers when not otherwise required by law. Communication with family members or friends involved in your care. Release of records to attorneys, employers, schools, or other third parties. Any other disclosure that is not otherwise permitted by HIPAA or applicable law. You may revoke an authorization at any time by submitting a written request, although the revocation will not apply to actions already taken in reliance upon your authorization. Clinical Records and Psychotherapy Notes HIPAA distinguishes between your clinical record and psychotherapy notes. Your clinical record contains documentation used to provide and coordinate your care. Subject to applicable law, these records may be released with your written authorization or as otherwise permitted or required by law. Psychotherapy notes are separate notes maintained by a therapist for personal use in analyzing the contents of conversations during therapy. These notes receive special protection under HIPAA and generally are not released, even with a standard authorization, except in the limited circumstances specifically permitted by law. Marketing and Sale of Information The Cognitive Refinery does not sell Protected Health Information. We do not use client names, photographs, or other identifying information for marketing purposes. Testimonials are only used with your specific written authorization and without identifying information. Your Rights You have the right to: Inspect or obtain a copy of your clinical record, subject to limited exceptions permitted by law. Request that your record be amended if you believe information is incomplete or inaccurate. Request an accounting of certain disclosures of your information. Request restrictions on certain uses or disclosures of your information. While we will consider all requests, we are not always legally required to agree. Request that we communicate with you in a particular manner or at a particular location. Obtain a paper or electronic copy of this Notice at any time. File a complaint if you believe your privacy rights have been violated. You will never be penalized or retaliated against for exercising your privacy rights or filing a complaint. Our Responsibilities The Cognitive Refinery is required by law to: Maintain the privacy and security of your Protected Health Information. Notify you following a breach of unsecured Protected Health Information when required by law. Provide you with this Notice of Privacy Practices. Follow the terms of this Notice currently in effect. We reserve the right to revise this Notice at any time. Any revisions will apply to all Protected Health Information maintained by our practice. The current version will always be available upon request and on our website. Questions or Complaints If you have questions about this Notice or believe your privacy rights have been violated, please contact: Megan Harden, LCSW Owner, The Cognitive Refinery 948 Elm St. Suite 2 Bowling Green, KY 42101 and 1039 College St. Floors 1 and 4 Bowling Green, KY 42101 compliants@cognitiverefinery.com 270-266-1188 You may also file a complaint with the Office for Civil Rights at the U.S. Department of Health and Human Services. Filing a complaint will not affect your care, and you will not be retaliated against for exercising your rights.

The Cognitive Refinery is a therapy practice located in downtown Bowling Green, KY with in person and online counseling options treating anxiety, trauma, depression, and relationship issues. New Client Inquiry At The Cognitive Refinery we do things a little differently... It is our goal to get you well! We do not believe that anyone should live in therapy and love seeing clients "graduate" from treatment! We prioritize staying on top of the latest information in our field and offer evidenced based treatment. We administer treatment approaches that are statistically proven to yield results. Our therapists have longevity with our company and you will be able to build a relationship with someone who can work with you start to finish. We offer a modern approach to therapy. We have afternoon and evening appointments for your convenience, digital correspondence including appointment reminders, telehealth or face to face sessions, and responsive client care. Learn More >> INSURANCE We accept nearly all major insurance plans. Aetna, Anthem, Baptist, Beacon, Blue Cross, Blue Shield, CHC Medical Plan, CareSource, Cigna, ComPsych, GEHA, Humana, Medicaid, Medicare, Optum, Passport Health Plan, WellCare And More. Contact the office for verification. *We are currently not in network with AmBetter. What Do We Treat? Anxiety Addiction ADHD Behavioral Issues BFRBs Codependency Depression Emotional Disturbances Family Conflicts Grief Guilt and Shame Intrusive Thoughts Marital and Premarital Eating Disorders Life Transitions OCD Perinatal Concerns School Issues Self Esteem Stress Trichotillomania Trauma and PTSD +More Learn More About Our Treatment Approaches Our training and use of evidenced based approaches makes all the difference in outcomes. *New* Neuropsychological Testing We provide honest referrals. If we are not the right fit we will help you find who is! Interest Form Complete our interest form to be contacted about starting therapy! Contact

Frequently Asked Questions Submit a Question Frequently Asked Questions TCR What is the cost of a session? It depends on your insurance. If you have a co-pay then you will pay that amount. You may have to meet a deductible and the rate you will pay for a session is set by your insurance company. We are happy to let you know what this will be by contacting our office. If you have Medicaid it is typically covered at 100%. Our private pay rates are as follows:Doctoral Clinicians:30 min - $8545 min - $11060 min - $150Couples - $170 Fully Licensed:30 min - $8545 min - $11060 min - $150Couples - $150 Associate License:30 min - $5545 min - $7060 min - $90Couples - $110 What is the difference in an associate's license and being fully licensed? After completing a degree in a counseling related field, a therapist must complete supervision hours, typically over the course of 2 years, before they are eligible to take a test for full liscensure. Therapists with an associates license are still completing training and are being supervised by a fully licensed therapist. Associates licenses include CSWs and LPCAs. LCSWs and LPCCs are fully licensed. Do you offer telehealth/ online therapy? Yes, all of our therapists offer online therapy options. We have one therapist who is 100% online and the rest are all a mix of online and face to face. What types of therapy do you have training in? Our therapists have training in many different approaches including: Acceptance and Committment Therapy (ACT) Dialectial Behavioral Therapy (DBT) Cognitive Behavioral Therapy (CBT) Exposure Response Prevention (ERP) Inference Based Cognitive Behavioral Therapy (ICBT) Comprehensive Model for Behavior (ComB) Habit Reversal (HR) Prolonged Exposure (PE) Trauma Focused Cognitive Behavioral Therapy (TF-CBT) Cognitive Processing Therapy (CPT) Internal Family Systems (IFS) Supportive Parenting for Anxious Childhood Emotions (SPACE) Gottman (couple's counseling treatment approach) Yoga Calm Motivational Interviewing (MI) Solution Focused Brief (SFBT) Reality Therapy Sensorimotor Psychotherapy Emotional Freedom Technique (EFT) See Our Treatment Approaches Page For More Information Do you offer internships? Yes, we typically select one graduate student each school year. We offer an experience where students get to observe, learn, and practice in a supportive but challenging enviornment. Students work up to managing a small pro-bono caseload prior to graduation. Do you offer anger management or domestic violence groups? No, these are not groups that we provide. Do you write Emotional Support Animal (ESA) letters? This is done on a case by case basis when appropriate for existing clients. We do not see clients for single sessions and make recommendations or provide letters. Are you hiring? We are accepting resumes for qualified candidates. We offer a competitive package - W2 employment, medical benefits, CEU budget, support staff, office overhead, furniture, EHR... and more. What forms of payment to you accept? Cash, check, credit/ debit, HSA. What hours do you offer appointments? Each therapist makes their own schedule and has different availability. The office is open from 8:30am - 7pm Monday - Thursday and 8:30am to 5pm on Fridays. Some therapists offer morning and late night appointments outside of these hours. Saturdays by appointment only. Closed on Sundays. Are you faith based? No. We are not faith based and are not "Christian Counselors". We do see spiritual beliefs as a resource and will intergrate this into your treatment when appropriate, but we are not approaching your treatment through a religious lens. Do you work with same-sex couples? Yes. The approaches that we use for couple's counseling (primarily Gottman) are as effective with same sex couples as they are with heterosexual couples. Do you prescribe medication? No, but we do provide referrals for our clients to trusted psychiatrists and psychiatric nurse practitioners. Why are couples sessions not billed to insurance? Insurance companies require that services be tied to one identified client with a mental-health diagnosis and a medically necessary treatment plan. Couples counseling focuses on the relationship itself rather than diagnosing or treating one partner for a specific mental-health condition. Because of this, it does not meet insurance criteria for reimbursement. To ensure ethical care, protect your privacy, and allow full flexibility in treatment goals, couples sessions are offered as private-pay services. Our couples counseling rate range from $100 to $160 per hour depending on the licensure of the therapist providing the service. Do you only have one location? We currently have 2 locations in downtown Bowling Green. You will be notified if the therapist that you are seeing is located at our secondary location. Primary Location: The Potter Building 948 Elm Street Bowling Green, KY 42101 Secondary Location: The Milliken Building 1039 College Street Bowling Green, KY 42101 Do you offer testing? We offer neuropsychological testing for children and adults. Comprehensive children's testing: Learning disorders (reading, writing, math) ADHD Intellectual disability Academic difficulties/underachievementAll neuropsychological services are out of pocket, meaning that we do not accept insurance for these services. Autism Assessments for neurological conditions: Dementia syndromes Mild cognitive impairment (MCI) Traumatic brain injury (mild, moderate, severe) Stroke and cerebrovascular disease Brain tumors and effects of neurosurgery Epilepsy and seizure disorders Hypoxic/anoxic brain injury Normal pressure hydrocephalus Neurodevelopmental disorders persisting into adulthood) Evaluations for medical conditions impacting cognition: Effects of chemotherapy Sleep disorders Metabolic or endocrine disorders (thyroid disease, diabetes) Autoimmune and inflammatory disorders Long COVID or post-viral cognitive symptoms All of our testing services are private pay, meaning we do not accept insurance for these services. See Our Testing Page For More Information ADVICE FROM CURRENT CLIENTS: Make sure you’re comfortable talking with the therapist you choose and make sure they are knowledgeable about the concerns you have. Go open minded, be honest about your symptoms, let them guide you. You may have to switch therapist to find the right fit, but TCR will have the one you need. Give it time. I didn't feel like I was making progress for the first 4 months. Then, I suddenly was. I think it takes time for your therapist to notice patterns and get to know you, just like it takes you as a client time to be comfortable with them. Be open about what you struggle with, the progress comes when you are open about the problems you face and any trauma you may have dealt with, as hard as that can be and as silly as it sounds when you tell someone you struggle with something as minuscule as checking door locks or light switches. Be receptive and open to trying things that seem difficult in therapy (like OCD Exposures), some of them were genuinely frightening to think about beforehand, but months away from those exposures, I had almost forgotten about some of those things till just now. It’s pretty awesome to be able to type that right now. It might be scary and hard at first but it will be the best thing you ever do for yourself. Trust the process. Be open and honest and you will get excellent results. I would say picking a therapist is not as simple as picking a restaurant, its something you should really do your homework on and decide what person fits best for you and your situation. Be honest with yourself so you can be honest with your therapist so you can REALLY get to the root of your issues and begin to heal. I'd let them know to get comfortable asking for all of the options you all have available from telehealth, schedules, therapists, etc I think so many people are used to therapists office where they don't feel empowered to explore things that work. Just be honest and it is ok if it takes awhile to warm up. IT IS OK TO CRY I would tell them not to be nervous, the staff at TCR will make you feel very welcomed. You will know that the staff there are very knowledgeable and you will get the help you need. Be willing to receive the help you need. I would just say don't be afraid to open up or talk about the things that are really impacting you. I feel like you miss out on the opportunity to heal and grow by holding back. It has been an ongoing journey to be more vulnerable and focus on those important experiences that have caused me distress. The more I am able to address it, the better I feel. For clients starting ERP - try really hard to commit to doing exposures. It’s so tough but worth it IF you’re consistent. The work doesn’t stop when the session is over. Keep pushing yourself for your mental health when you can, and bring what you find back to your therapist. Use the fidget toys if you are anxious. Start soon!

OCD Therapy Megan Harden, LCSW I specialize in: Obsessive Compulsive Disorder Phobias Body Focused Repetitive Behaviors Anxiety Disorders About Me Hello! I specialize in the treatment of OCD, phobias, anxiety disorders, and Body Focused Repetitive Behaviors (BFRBs), such as hair pulling and skin picking. OCD does not always look like handwashing and concerns about germs - sometimes it's intrusive thoughts with the desire for reassurance. OCD frequently fixates on what’s important in a person’s life and common sub-types include worries about health issues, sexuality, fear of pedophilia, harming self/others, contamination, concerns about religion/ morality, or obsessions about relationships. If this sounds like you it is important to know that therapy can help you get your life back! I utilize Exposure Response Prevention (ERP), Inference Based Cognitive Behavioral Therapy (ICBT), and Supportive Parenting for Anxious Childhood Emotions (SPACE) as treatment approaches for OCD. I have training in ERP from the IOCDF. I've completed a certification for BFRB treatment through the TLC Foundation for BFRBs. Additionally I have training in Acceptance and Commitment Therapy (ACT), Cognitive Processing Therapy (CPT), Cognitive Behavioral Therapy (CBT), and Prolonged Exposure for Trauma (PE). In addition to owning TCR and maintaining a full caseload I also teach a class at Western Kentucky University and have 2 little girls. I am a supervisor for therapists working towards full licensure. I offer afternoon and evening appointments in person or on telehealth. I am licensed in KY and NY. Testimonials: Megan changed my life. She helped me understand not only how to deal with my day to day anxieties but also how to recognize them. Facing them head on has allowed me to name them & then let them go. I learned that what I thought were small things were actually causing a lot of unnecessary interference. I’m in the most sound state of mind of my life because of her. Yet, there is more growth to be had, as there always will be! - Client Survey Megan is an amazing therapist and has changed my life. She excels in treating OCD and I recommend her to everyone. - Facebook Review I highly recommend the Cognitive Refinery. Megan has been one of the most professional and effective therapists I have seen. It is evident that she puts long hours, and lots of effort into helping people through their struggles. You won't find a better therapist in the area. - Facebook Review Megan is amazing! Not afraid to call bullshit, and has the right mixture of holding one accountable, but empowering me the patient at the same time. Well worth the copays! - Client Survey I cannot say enough good things about this place. Megan has been absolutely incredible. I was a little hesitant to go to therapy and was so concerned about finding someone qualified and someone I was able to feel comfortable with. Megan has been just that and so much more. My experience here has truly been life changing. I tell everyone how great Megan is! - Facebook Review My experiences at TCR have been uniformly positive. My therapist is a treasure and I genuinely feel privileged to be working with her. Something that stood out to me from the beginning was her conviction that I will complete treatment-- that therapy isn't a forever thing. This made me feel real hope-- it also gave me confidence in my therapist and in the process. - Client Survey Megan, obviously, is the best part of TCR. Her guidance, unwavering support, and ability to meet me where I was while also pushing me to get me where I am has been a literal life-changer. I wouldn’t be who I am now if it wasn’t for her. - Client Survey Megan is truly the most personable, knowledgeable therapist. She has curated such a phenomenal crew of personnel that really take pride in their work. I love how attentive TCR is to its clients and I will be sticking with them! - Client Survey I have learned so much about myself in therapy, and although I have a ways to go, I am optimistic about treatment. I trust my therapist-- she keeps earning my trust again and again-- and I feel supported, cared for, and heard every time I meet with her. - Client Survey The best part of my experience at TCR has been having Megan as my therapist. Megan has truly changed my life. I have never experienced this level of control over my anxiety and OCD before, and it is truly a testament to her treatment and her expertise as a clinician. - Client Survey Contact If you are looking for OCD treatment then I am the therapist you are looking for! I look forward to working with you! megan@cognitiverefinery.com 270-266-1188

Emma is a children's therapist trained in multiple treatment appraches for trauma. Emma Graviss, CSW I specialize in: Children's Behavioral Concerns Trauma Anxiety About Me Hi, I’m Emma. I’m a Certified Social Worker (CSW) with experience in community mental health, and underserved rural communities. My work has centered on supporting children, adolescents, and families as they navigate behavioral, emotional, and trauma-related challenges. I’m passionate about building a collaborative, empowering healing process. I have experience serving clients ages 5–18+, with particular focus on autism spectrum disorder (ASD), childhood trauma, anxiety, depression, and PTSD. I take a relational and authentic approach—meeting clients where they are, honoring their voice, and creating space for trust, curiosity, and growth. I utilize evidence-based interventions such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Accelerated Resolution Therapy (ART), and Trauma Affect Regulation: Guide For Education and Therapy (TARGET), as well as expressive art therapies to support emotional regulation, trauma processing, and overall well-being. I tailor each approach to the unique needs of the young person and family I’m working with. I’ve had the privilege of supporting children and families across diverse environments—from community settings to clinical private practice. I strive to offer a warm, grounded, and compassionate space where each client feels understood, supported, and genuinely cared for. Contact Looking for a children's therapist to address trauma or anxiety? Lets see if we are a good fit! emmag@cognitiverefinery.com 270-266-1188