Specialties
Dr. Stiede has an extensive training background in the assessment and treatment of children, adolescents, and adults with anxiety and obsessive-compulsive related disorders. He approaches treatment through a theory-guided, evidence-based framework with care that is personalized and hands-on. Treatment is tailored to each individual, with interventions thoughtfully adapted to meet each patient’s specific needs and goals. He works collaboratively with patients to help them apply therapeutic strategies in their everyday lives and manage symptoms in real-world settings.
Unlike larger clinics or treatment systems, Dr. Stiede is directly involved in every stage of the care process, including initial consultations, scheduling, coordination with other healthcare providers/schools, and ongoing clinical treatment. This continuity allows him to develop strong therapeutic relationships and provide more consistent, individualized care. He strives to ensure that his dedication to patient well-being is reflected in the quality and attentiveness of the services he provides.
Cognitive Behavioral
Therapy (CBT)
Exposure and Response Prevention (ERP)
Cognitive behavioral therapy (CBT) is the gold standard treatment for anxiety disorders that focuses on the interactions between a person’s thoughts, behaviors, feelings, and physiological sensations. First, the therapist provides psychoeducation related to the nature of anxiety, anxiety disorders, the CBT model, and treatment details. Then, patients receive emotional awareness training to help them recognize somatic, behavioral, and cognitive cues of anxiety so they can use their anxiety management tools more effectively. Patients are also taught how to problem-solve anxiety-provoking situations. Further they are taught to identify maladaptive thoughts that contribute to anxiety and balance these with more adaptive thoughts. To help develop alternative thoughts, patients ask themselves a series of questions to assess and challenge overestimation of threat and negative consequences. Finally, patients engage in exposure, in which they gradually confront feared situations, sensations, or objects to help reduce anxiety in the long term and stop avoidance. When patients repeatedly go toward feared situations without a negative outcome, it results in a decrease of the feared response.
Exposure and Response Prevention (ERP) is a form of Cognitive Behavioral Therapy (CBT) in which individuals gradually face feared situations, sensations, or objects while refraining from engaging in rituals or avoidance behaviors. Each exposure is carefully tailored to address the individual’s specific anxiety or OCD symptoms, allowing patients to learn through direct experience that they can tolerate distress and that anxiety, even at high levels, is temporary. With consistent practice, both the frequency and intensity of symptoms tend to decrease. For children and adolescents, exposures are developmentally adapted and often incorporate personal interests or preferred activities to support engagement and adherence to treatment. To learn more information about ERP, feel free to check out the following site: https://iocdf.org/ocd-treatment-guide/exposure-response-prevention/
Comprehensive Behavioral Intervention for Tics (CBIT)
Habit Reversal Training (HRT)
Comprehensive behavioral intervention for tics (CBIT) is the most well-supported, nonpharmacological treatment for children and adults with tic disorders. First, it includes education about tic disorders to reduce the blame and stigma related to tics and allow families the opportunity to ask questions about the disorder. Then, the therapist assesses patterns of when tics are most and least bothersome to help figure out strategies to reduce tic frequency. The therapist also uses habit reversal training (HRT) to teach the patient how to recognize and manage their tics. HRT includes increasing awareness of the tics, developing tic blockers to help physically prevent the completion of the tics, and teaching a support person how to praise and increase compliance of the tic blockers. To learn more information about CBIT, feel free to check out the following site: https://tourette.org/research-medical/cbit-overview/.
Habit reversal training (HRT) is a technique that helps reduce repetitive behaviors, such as tics, hair pulling, skin picking, and nail biting. It consists of awareness training, competing response training, and social support training. Awareness training includes developing a detailed description of the habit, learning to detect the habit, and acknowledging the earliest signs of the habit, such as an urge to do the movement or an early portion of the behavior. After the patient can reliably acknowledge the occurrence of the habit in real time, competing response training is implemented to teach the patient a behavior that physically prevents the completion of the habit. Patients are instructed to engage in the competing response when they recognize a warning sign for the habit or upon the actual occurrence of the habit behavior. Finally, social support training includes teaching family or friends to praise the patient for correct implementation of the competing response or remind the patient to practice the competing response if they miss an occurrence of the habit or do not use the competing response correctly. To learn more information about HRT, feel free to check out the following site: bfrb.org.