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How can I best help?

In the event that my practice is full, please let me know how I can best help you. Select ALL that apply:

I am interested in working with Laina Keim, PhD. Please forward the information I submit to Dr. Keim.

I am interested in working with China Bolden-Jarvis, PhD. Please forward the information I submit to Dr. Bolden-Jarvis.

I am interested in working with Vanessa Lim. Please forward the information I submit to her.

I am interested in working with one of STAAR DBT's graduate students in training.

Please forward the information I submit on this form to other providers and advanced doctoral student trainees who may be a good fit and have immediate openings, so that they may contact me directly.

Please keep me in your wait pool. In the event that a space opens up in your schedule, please contact me at that time to explore if we might work together.

If applicable, please select the therapy/therapies you are specifically seeking: *

Dialectical Behavior Therapy (DBT) - individual therapy

DBT Skills Group

Cognitive Behavior Therapy (CBT) - general

Exposure Therapy (anxiety/phobias/OCD)

Prolonged Exposure Therapy (PTSD/trauma)

Behavioral Parent Training

Theological Interventions (integrated with one of the above treatments)

Not sure

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I acknowledge that electronic communication, including web forms and email, is limited in terms of privacy and may be intercepted by a third party. I understand that this electronic communication does not constitute a therapeutic relationship. I hereby release Dr. Michonski from any and all liability that may occur due to electronic communication over a non-secure network.