Therapist profile: Rachel Davidow

Therapist profile: Rachel Davidow

From time to time I will be interviewing therapist colleagues with various specializations and backgrounds. The purpose of these interviews is to contribute to public education so that therapy clients can be better equipped to find an approach and therapist that suits their unique challenges.

I met Rachel Davidow in 2020 when we were both psychotherapists at a residential eating disorder clinic in the Boston area. Rachel is a native of Massachusetts, and she works full time in private practice serving clients with various anxiety disorders, including obsessive compulsive disorder (OCD), and anxiety related disorders (phobias, social anxiety, generalized anxiety, etc.)

Rachel is a Licensed Independent Clinical Social Worker (LICSW) in the states of Massachusetts, New Hampshire, and Connecticut. She works in private practice both in person (coming soon with office space starting this summer 2024!) and via telehealth in Arlington, just outside of Boston. She is available to work with anyone in Massachusetts, New Hampshire, and Connecticut. You can learn more about Rachel here at her website RachelDavidow.com. 

Ellis Kim: Rachel, help our readers understand more about how and why you became a therapist. 

Rachel Davidow: I have always been fascinated by psychology and have found that providing services to individuals struggling with their mental health to be extremely rewarding. I went to Boston University for my undergraduate degree in psychology and minor in women's, gender, and sexuality studies in 2015. Afterwards, I earned a masters in social work from the University of Pennsylvania in 2017. 

E: I worked with you at a clinic that focused on acute eating disorder treatment, and you left before me and you went on to focus on OCD treatment. Are those two areas of work related, or did you simply find you were more drawn to OCD work?

R: There is definitely a relationship between OCD and eating disorders. Both disorders have behavioral elements that function as a way to alleviate distress and/or feel more in control. Both OCD and eating disorders can involve perfectionistic personality types, rigid beliefs or "rules" with corresponding behaviors. For example believing that one cannot touch doorknobs because they are contaminated and could make them sick could be compared to someone with an eating disorder avoiding foods or entire groups because of fear of weight grain. Both of these behavioral symptoms offer short term relief from anxiety or distress and long term reinforce the narrative of the mental illness. A number of clients I have worked with struggle with both OCD and an eating disorder or disordered eating. While eating disorders are no longer my area of specialization, I'm really grateful to have had the training so I can better assist clients in getting connected to needed services like registered dieticians and other resources. 

E: Tell us about how you treat OCD. What modalities and approaches do you utilize, and where did you learn about those approaches?

R: I primarily use Exposure Response Prevention (ERP), Cognitive Behavioral Therapy (CBT), and Acceptance Commitment Therapy (ACT). These are all evidence based behavioral and experiential therapies to treat OCD and anxiety disorders. I worked at an Intensive Outpatient Program/Partial Hospital Program specializing in OCD as well as mood disorders, and received intensive training in these modalities as well as Behavioral Activation (BA) for depression. Working with folks struggling with more severe and functionally impairing symptoms of OCD and/or depression using these behavioral treatments was a really gratifying experience. I also received a certification and intensive training in Prolonged Exposure Therapy (PE) for PTSD, early in my career working at a city funded initiative in Philadelphia for evidence based treatments to be more accessible to the community. This training gave me a deep appreciation for exposure therapy and seeing firsthand how powerful and effective it can be. 

E: Besides your focus on clients with OCD, what are other types of challenges you frequently help clients work through? What approaches and philosophies on mental health treatment have influenced you the most, and how do they manifest in your work with clients?

R: I often work with clients with phobias, the most common one I see in my practice is emetophobia or the fear of vomiting. I have seen other phobias as well including but not limited to fear of heights, fear of insects, fear of death, and fear of flying. Many clients also struggle with low mood or depression. A guiding philosophy in my practice is values exploration and helping clients to understand what is most important to them to help them feel like they are leading more meaningful and fulfilling lives. This can be such a powerful tool in feeling empowered to choose values over fear. 

E: Give our readers a picture of a common type of client you work with. What kinds of challenges have they faced both historically and also in the present. What have they tried already to get relief, and what kind of work do you do with them that tends to help them make progress they haven’t already made?

R: Most clients I work with struggle with anxiety and/or OCD. They can feel plagued by intrusive thoughts and doubts often around safety, harm, health of themselves or their loved ones. They engage in behaviors to typically avoid or alleviate distress around triggers and work to prevent a feared outcome. These behaviors can become consuming of one's time and energy and interfere with functioning to work, have relationships, or even take care of oneself like eating, hygiene, or other activities of daily living. For example, an individual with superstitious OCD may have a "rule" they need to pass through a doorway a certain amount of times and repeat other activities for fear that if they do not they or a loved one may have harm come to them. To not engage in this compulsion feels risky and irresponsible for this client. I use a collaborative and structured approach with the client to learn new information and skills through exposures to challenge OCD's rule. For this client we could practice first decreasing the number of times they are going through a doorway and then process how to tolerate feelings without engaging in a compulsion. We would explore how the expected outcome may or may not have occurred after an exposure to help reinforce this learning process. 

E: What else is important for readers to know about you?

R: I am a big believer that every individual is different and can benefit from different approaches and tools in therapy. I do not think one size fits all individuals and strive to practice flexibility and creativity in my own practice to meet clients’ needs. Clients usually describe me as positive, compassionate, and sometimes silly. Humor is one of my favorite coping skills and I find a lot of joy in bringing it into my practice as well. 

E: Rachel, thank you so much for the work that you do, and it’s a pleasure to be your colleague in the great city of Boston.