Online ISTDP Therapy for Adults in Colorado and California

I provide online Intensive Short-Term Dynamic Psychotherapy (ISTDP) for adults located in Colorado and California.

People often seek therapy because anxiety, depression, emotional detachment, self-criticism, relationship difficulties, or longstanding patterns continue despite their best efforts to change. You may understand your difficulties intellectually but still find yourself repeating patterns that leave you feeling stuck, disconnected, overwhelmed, or unable to act in accordance with what matters to you.

ISTDP is an active, collaborative form of psychotherapy that helps us understand what is maintaining your suffering in the present. Together, we pay close attention to emotions, anxiety, protective patterns, and what happens between us during therapy. The goal is not to impose an explanation upon you. It is to help you recognize your experience more clearly, make meaningful choices, and develop greater emotional and relational freedom.

All people are welcome in my practice.

 

What Is ISTDP Therapy?

Intensive Short-Term Dynamic Psychotherapy is an experiential psychodynamic therapy. It focuses on how feelings, anxiety, defenses, and relationship patterns interact in the present moment.

Many protective patterns developed for understandable reasons. Avoiding feelings, turning against yourself, becoming detached, focusing exclusively on other people, intellectualizing, minimizing, or waiting for someone else to take the lead may once have helped you manage difficult relationships or overwhelming experiences.

Over time, however, these same patterns can interfere with intimacy, agency, emotional presence, and the ability to respond freely to your current life.

In ISTDP therapy, we work together to:

• Clarify what you want help with

• Recognize patterns that maintain your suffering

• Notice how anxiety affects your body, attention, and capacity to remain present

• Understand how you protect yourself from feelings or relational contact

• Increase your ability to experience emotions safely

• Strengthen your agency and freedom to make choices

• Examine how established patterns may appear in the therapeutic relationship

• Learn from your responses to therapeutic interventions

The work is focused, but it is not formulaic. I continually assess how you are responding so that we can adjust the pace and direction together.

 

What Can ISTDP Therapy Help With?

I have extensive experience helping adults address difficulties involving:

• Anxiety, including physical tension, persistent worry, social anxiety, racing thoughts, and intrusive thoughts

• Depression, self-criticism, hopelessness, lethargy, emotional detachment, and lack of motivation

• Trauma and the continuing effects of sexual, physical, or emotional abuse

• Grief and loss

• Relationship and intimacy difficulties

• Difficulty communicating or asserting needs

• Recurring patterns of withdrawal, people-pleasing, passivity, or self-defeat

• Sexual identity and related emotional or relational concerns

• Difficulties connected with major mental illness in oneself or one’s family

• Substance use when you are willing to examine how it affects your life and relationships

• Feeling cut off from emotions, wishes, or a sense of direction

This list is not exhaustive. Therapy begins with understanding the particular difficulties you want help with and whether my approach is appropriate for your needs.

 

What Are Sessions Like?

ISTDP therapy is collaborative and active. I will ask questions, share observations, and help us examine what is happening as closely as possible. At the same time, I cannot decide what matters to you, know your experience for you, or exercise your will on your behalf.

Your participation is essential. We will work together to establish a clear focus based on what you genuinely want to change.

During a session, we may explore:

• What you are feeling in the present moment

• How anxiety is showing up

• Whether a familiar protective response has become active

• What is happening in your relationship with me

• How a particular pattern affects your stated goals

• Whether an intervention is helping us understand the problem more clearly

I do not assume that every difficulty is a defense or that every emotion must be intensified. When the process is unclear, we slow down and investigate rather than forcing your experience into a predetermined explanation.

You can learn more about this way of understanding emotional processes in my guide to the Triangle of Conflict in ISTDP.

 

My Approach to Therapy

Pain in life is inevitable, but prolonged suffering is often intensified by patterns that have become automatic.

My role is to help you identify those patterns with clarity, compassion, and honesty. We will examine both their protective purpose and their present cost. The aim is not self-improvement through relentless criticism. It is greater self-reconnection—the ability to experience yourself more fully and live with increased freedom, intimacy, and agency.

Therapy is not something I do to you. I will bring my attention, training, curiosity, and full effort to the work, while respecting that your choices, feelings, and life remain your own.

Together, we will determine whether focusing on your emotions and deepest wishes for change can help you reduce debilitating symptoms, emerge from depression or detachment, improve your relationships, and live in greater alignment with yourself.

 

Video Recording and Confidentiality

Video recording is an integral part of how I practice. It allows for precise review of what occurs during therapy and helps me evaluate the effectiveness of our work more accurately than memory alone.

Recordings are part of the clinical record, protected by applicable confidentiality requirements, and made only with your written consent. They are stored on a private, secure hard drive that is not connected to cloud storage.

If you do not wish to have sessions recorded, I am happy to help you locate a therapist who does not use video recording.

 

About David Rudesill

David Rudesill, MSW, LCSW, is a psychotherapist, clinical supervisor, educator, author, and IEDTA Certified Teacher. He has worked in mental health since 2008 across community mental health, university counseling, integrated healthcare, academia, and private practice.

He is licensed as a clinical social worker in Colorado and California and provides online psychotherapy to adults located in those states.

His clinical approach emphasizes careful observation, emotional presence, anxiety and defense assessment, patient agency, and a collaborative therapeutic relationship.

 

Important Practice Information

• I provide individual therapy to adults age 18 and older.

• Therapy is offered online to people located in Colorado or California at the time of the session.

• I do not provide court-ordered or mandated treatment.

• I do not write letters or complete documentation requests until a thorough clinical assessment and consistent therapeutic relationship have been established.

• I cannot know in advance what you want to address in therapy. Our work depends upon your help in understanding what is troubling you and what you would like to change.

• Video recording is a prerequisite for working with me.

 

Frequently Asked Questions

Do I need to know anything about ISTDP before beginning?

No. You do not need any prior knowledge of ISTDP. We will discuss how I work and determine together whether the approach makes sense for your needs.

Do you provide in-person therapy?

My psychotherapy practice is conducted online.

Where must I be located?

You must be physically located in Colorado or California during therapy sessions because I am licensed in those two states.

Do you work with couples or children?

No. I provide individual psychotherapy to adults age 18 and older.

Is video recording required?

Yes. Video recording is integral to my clinical approach. We will discuss its purpose, storage, confidentiality, and consent before beginning treatment.

How do I know whether ISTDP is right for me?

An initial consultation gives us an opportunity to discuss what you want help with, how I work, and whether we believe the approach may be a useful fit. Neither of us has to decide that in advance.

How do I get started?

Please contact me with a brief description of what brings you to therapy and whether you will be located in Colorado or California for sessions.

Contact me about ISTDP therapy