Therapist treating depression, anxiety, and burnout. Jamee Coombes, LCSW I specialize in: Depression Anxiety Stress and Burnout About Me Hello! I am a LCSW (Licensed Clinical Social Worker) who graduated from Washington University in St. Louis with my master’s in social work. I began my journey as a mental health therapist working in the community and providing individual therapy in people’s homes. I moved on to work with Veterans for several years. My experience has allowed me to hold space and give hope to people from all walks of life. I bring my strengths (kindness, fairness, social intelligence, curiosity, and hope) to the table along with my training (CBT, ACT, Social Skills Training). I focus on utilizing your strengths to improve your mental health and have experience creating plans for maintaining mental health recovery. I offer an open space without judgement to explore needs, goals, strengths, and challenges. I am only available for tele-mental health sessions. Tele-mental health works very well as long as you are able to find a private and confidential spot for each session. One of the key components in therapy is simply having 45-60mins to focus on you. Considering seeking a therapist is a big and scary step, but you are halfway there and just a few more steps and you can begin your journey to improve your mental health. When I am not providing therapy, I am working on creating a happy sustainable homestead with my husband and my son. Contact Looking for help with depressive symptoms? Let's see if we are a good fit to work together! jamee@cognitiverefinery.com 270-266-1188

Kate is a Perinatal Mental Health Specialist who also works with chonic illness and grief. Kate Barnes, LCSW, PMH-C I specialize in: Perinatal Mental Health Chronic Illness Grief About Me I specialize in the assessment and treatment of Perinatal Mood and Anxiety Disorders (PMADs) as well as adjustment concerns related to fertility, pregnancy, postpartum, pregnancy loss, and infant bereavement. I am certified in Perinatal Mental Health treatment through Postpartum Support International and serve as an active member of the Kentucky PSI chapter and board. My practice with the perinatal population is built on the combined foundation of extensive professional training and intimate lived experience. I'm the mom to two incredible gifts: one living son and one stillborn daughter. My career in perinatal mental health is my love letter to them both. In addition to perinatal support, I also provide evidence-based therapies to individuals diagnosed with chronic or life-limiting illnesses. I have experience working in pediatric palliative care and pain intervention/management. Clients who may find this service especially helpful are teenagers and young adults diagnosed with autoimmune issues or genetic disorders such as hEDS and fibromyalgia. My primary goal as a clinician is to support you through the grief that accompanies chronic illness while empowering you to face it with boldness, defiance, and resolve. I look forward to meeting with you and exploring the ways we can work together to meet your needs. With help, you can and will be well. Contact Looking for a specialist to support you throughout your pregnancy, birth, and postpartum? I am here for you! kate@cognitiverefinery.com 270-266-1188

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 - $75 45 min - $100 60 min - $140 Couples - $160 Fully Licensed: 30 min - $75 45 min - $100 60 min - $140 Couples - $140 Associate License: 30 min - $45 90 min - $60 60 min - $80 Couples - $100 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(/treatmentapproaches) 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(/services-6) 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!

Narcissistic Abuse Kayla Ashby, NCC, LPCC I specialize in: Narcissistic Relationship Abuse Trauma Adjustment Issues Depression About Me My aim is to provide direct, effective therapy to serve others in ways that influence insight. I wholeheartedly believe it takes a lot of courage in wanting to become aware and gain an understanding of the effects of mental health on the mind and body. In collaboration, we seek to identify the means of growth and self-development. It is my belief that acceptance is key in moving towards our goals while also introducing a variety of coping skills. I look forward to guiding others in coming to peace within… in whatever interpretation or method it presents. The profound manipulation wielded by narcissists often leaves individuals stripped of their essence, casting shadows on their identity. As a compassionate therapist specialized in aiding survivors of narcissistic abuse, I illuminate the intricate web of narcissism's complexities, unraveling the layers of deception and restoring a sense of self. Through a fusion of acceptance work, I hope to empower individuals to navigate through the labyrinth of manipulation, fostering self-awareness, resilience, and profound self-trust. My goal is to guide others in a way that allows not only space for growth and introspection, but also provides the means to gain insight and progression towards specific goals, and the ability to achieve them. I offer morning, afternoon, and early evening appointments as well as digital correspondence if needed. Testimonials: Confirmation from a professional that what I am experiencing is not okay. Before I was in treatment with Kayla, I constantly questioned whether or not I was the problem. -Client Survey Kayla is a wonderful and knowledgeable therapist! She makes my appointments worthwhile every time. - Client Survey I got to talk to someone about what was going on with me at the time. Kayla really helped me, she was wonderful. - Client Survey I look forward to my sessions with Kayla, and she reminds me that it is okay to stick up for myself. - Client Survey Contact Reach out for more information! kayla@cognitiverefinery.com 270-266-1188

Trauma Therapist Normanda Lawless, NCC, LPCC-S I specialize in: Trauma PTSD Life Transitions About Me I have been working in the counseling field since 2015, gaining experience in diverse settings including community mental health, inpatient care, and outpatient services. My areas of expertise include trauma, PTSD, and navigating life transitions. I am passionate about using evidence-based approaches to help clients reduce the impact of trauma responses and lead more fulfilling lives. I am trained in Internal Family Systems (IFS), Cognitive Behavioral Therapy (CBT), Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Written Exposure Therapy (WET), and Prolonged Exposure (PE). These therapeutic methods empower clients to identify and manage trauma responses, improve self-worth, build healthy coping skills, and make trauma memories less pervasive. I work with adolescents (ages 16 and older) and adults, offering both individual and family therapy services. My goal is to provide a safe and supportive space where clients can heal, grow, and achieve lasting change. I offer supervision services for individuals pursuing their full licensure. Testimonials: Normanda is a great therapist. My feelings are validated, I feel heard, and I learn new things from her. - Client Survey Normanda Lawless is an amazing clinician. She is kind, empathetic and can help guide you through your story and experience to have the life you want. Highly recommend getting in to see her and how she can help you! - Facebook Review Normanda Lawless is an excellent clinician. She demonstrates excellent patience and understanding with her clients and provides a relaxing environment that allows her clients to feel comfortable and at home. - Facebook Review Normanda has been fantastic! I have tried several therapists off-and-on over the course of the last 12 years as I have moved and various "life things" have happened, but she has been my favorite. Not only is she knowledgeable and clearly competent in her field, but she is easy to talk with and relate to. Would highly recommend her to others! - Client Survey Normanda is wonderful and she has helped me to be more aware of myself - Client Survey Normanda has been great! She remembers all of the small details that don’t seem important, but actually are! She’s been a lovely therapist. - Client Survey I’m getting results and Normanda is warm and understanding. - Client Survey My therapist is amazing. She's been the best therapist I've seen over the years and I'm finally getting some results. She's also flexible and her hours work with mine. - Client Survey Contact Let's get started! normanda@cognitiverefinery.com 270-266-1188