Therapy with Luke Allen, LP

Luke Allen is a Licensed Psychologist in Oregon specializing in LGBTQ+ topics, anxiety, and body-focused repetitive behaviors. We asked Luke more about his work with clients and his guiding philosophies on therapy.

Luke’s background and personal life

How did you decide to become a therapist?

Of course, like most therapists, we want to help others. But I have always been dissatisfied with that response alone. Therapists have a lot of self-interested reasons for going into this work, myself included. I grew up in a lot of unhealthy environments and circumstances. I wanted to learn how to counter-act that and develop healthier relationships in my life.

Going into psychology was a nice way to combine knowledge of healthy relationships, self-improvement, and personal growth, with a livable career while also being able to help others.

What was your previous work before going into private practice?

Prior to going into full-time teletherapy private practice, I worked a number of roles including: staff psychologist (at a university counseling center), Licensed Professional Counselor (LPC) in various settings, clinical supervisor, a group therapy facilitator (ACT, interpersonal process, psychedelic integration and safety, LGBT+ support, coping skills groups), an assessment specialist, assistant coordinator for a sexual and gender diversity resource center, and college instructor.

What do you enjoy doing in your free time?

I am an avid hiker and backpacker. It's why I love the Southwest and Pacific Northwest. I also enjoy reading (sci-fi, fantasy, philosophy, psychology), chess, wine, and computer-based role-playing games.

Luke’s specialties and therapy philosophies

What guiding principles inform your work?

I place a high priority on client autonomy. Society and people may tell us that certain behavior, identities, and forms of expression are unhealthy or to be avoided (e.g., occasional illicit drug use, being transgender, genderqueer, or non-binary). I take a values-based approach, which means I am less concerned about what society believes is problematic and more concerned with what you believe is problematic. You may be part of some of the kink community, a safe and functional drug user, or just have an unconventional way of expressing yourself.

I am not going to imply or suggest you change your behavior just because there may some sort of societal taboo. What I want to do is to help you be your authentic self and pursue the life or relationships you want (i.e., your values) even when society may disagree and even when unwanted thoughts, feelings, or sensations arise.

What clientele do you work with most frequently?

I work most frequently with LGBT+ clients, both youth and adults (typically ages from 15 to 60). I am part of the LGBT+ community and many of my clients are transgender or non-binary identified. I am drawn to this population because of the value I place on autonomy. I want to help people better express themselves even when society may not be accepting or affirming.

Can you tell us more about your specialty in working with LGBT+ clients?

Not always of course, but often LGBT+ clients feel disaffirmed or as if they to hide parts of their-self from others (e.g., from family or work). This can manifest in a variety of ways, such as suppressing one's sexuality or gender identity, avoiding behaviors or activities that are perceived as "stereotypical," or conforming to traditional gender roles. And sometimes people just want a therapist who "gets it" and they don't have to educate their therapist on language and their community.

I assist clients in navigating their relationships, developing sources of support, and weighing what is most important to them (e.g., expressing themself vs. the potential for discrimination). For transgender non-binary clients, I also assist by providing evaluations and letters required for surgery.

Can you tell us more about your specialty in anxiety?

Anxiety is rather a broad umbrella category to describe a lot of experiences or disorders. I often see clients coming into therapy to want to get rid of their anxiety, excessive worry, or panic and to identify the "root cause" for the way that they are. Honestly, I am not certain how much I can help if those are the goals. Anxiety and worry are part of the human experience, of course.

I also recognize that understanding the "root cause" can be important. But I want to help clients reframe things to: "If anxiety was no longer an issue for you, what would you be doing differently or more of in your life?" Whatever their response is to this question, is what I want to start helping them do. Therapy is an investment in time and money. I want to cut right to the chase and help them in the area where we can be most effective right away.

For specific and well-defined forms of anxiety (e.g., panic), I help clients by assisting them in willingly and intentionally coming into contact with their fears and breaking unhelpful patterns of avoidance.

Can you tell us about your work with clients struggling with various body-focused repetitive behaviors?

People with body-focused repetitive behaviors (BFRBs) experience a range of challenges, including difficulty controlling their urges to engage in repetitive behaviors such as hair-pulling (trichotillomania), skin-picking (dermatillomania), or nail-biting. These behaviors can lead to physical damage, social isolation, and negative emotional consequences such as shame or embarrassment.

I help clients with BFRBs by using evidence-based therapies that have been shown to be effective. I work together with the client to identify triggers for their behaviors and develop alternative coping strategies.

What do you find most rewarding about your work?

It is rewarding to see people grow and better express themselves throughout therapy. It is nice to see the progress over time as their relationships improve and they engage in more valued activities or activities that are important to them. I also work quite a bit with anxiety (e.g., panic), depression, and body-focused repetitive behaviors.

There are specifically tailored treatments that are very effective to address these problems. I love it when motivated clients come in, we develop a treatment plan, they follow through, and then we see clear and concrete improvement in 6, 12, or 18 sessions.

Therapy sessions with Luke

What will our first session together be like? What happens in ongoing sessions?

In the first session, I'll learn about your issues and goals through a standard intake evaluation. In later sessions, we'll work on your problem areas, and I'll teach you concepts through in-session exercises. We'll periodically check if we're on track and I'll give you exercises to do outside of therapy.

How long do clients typically see you for?

This depends on what a client is coming in to address. For clearly defined problems (e.g., panic, phobias, single depressive episode, body-focused repetitive behaviors, OCD), treatment is relatively straightforward. Often, being addressed in 6 to 18 sessions. Therapy does not always have to be about symptom reduction, it can also be about self-improvement. Therapy can continue for as long as you still feel I am helping you achieve your goals and providing value.

Are there any books you often recommend to clients?

Many interpersonal problems and disagreements (as well as philosophical and political ones) are often caused, or exacerbated, by poor communication. For this reason, and while it isn't really a therapy or self-help book, Thank You for Arguing (4th Ed.): What Aristotle, Lincoln, and Homer Simpson Can Teach Us About the Art of Persuasion. In addition to general communication strategies, it provides tools for de-escalation and speaking to your audience's values.

How do you help ensure I'm making progress in therapy?

Most therapy will not be effective if we are just talking about problems. So, while discussing “problems” will be part of it, we will also talk about goals. Therapy is a little like learning a musical instrument, you will not improve if the only time you practiced was that one hour a week with your instructor.

If you are coming in for panic or anxiety, we will likely identify activities or exposure exercises for you to engage in between sessions. If you are coming in for depression, we will likely identify small steps you can start engaging in despite the depression (e.g., exercise, beginning to develop more social connections, or experiential ways to respond differently to those unwanted thoughts and feelings). I will check in periodically with you to make sure you still feel like you are getting what you need from therapy.

How do I know that it’s time to start seeking therapy?

If excessive worry or anxiety or being down and depressed are getting in the way of living your life, then it may be time to find a therapist. If you're coming to a new understanding of your gender or sexuality and you want a comfortable space to discuss those life transitions or changes with a knowledgeable and supportive therapist, then it might be time to find a therapist.

How can I prepare for our first session?

The first session is a little bit less like therapy, and more like an interview. I want to get a fuller picture of your background, history, and previous attempts you’ve made to address your current struggles. I remember the first time I attended therapy. I was barraged with questions for an hour when I expected something a little more therapeutic. However, getting information about your background is important as it lets me get a fuller picture of your life, history, struggles, social context, and support system. More importantly, it also helps me better conceptualize our treatment plan. So, it will be helpful to be mentally prepared to answer a lot of questions in the first appointment.

How will I know it’s time to end my time in therapy with you or reduce session frequency?

One key indicator is when the anxiety, depression, or whatever brought you into therapy is no longer preventing you from living the life you want, doing the things you want, and you are showing up in the ways that you want to show up in your relationships. The less anxiety, depression, or other problems get are getting in the way for you, then we might be ready to discontinue or reduce frequency. I only want to keep in therapy for as long as you feel you are receiving value.

Why should I seek therapy, rather than turning to my partner, friends, or other loved ones?

GREAT question. For some of your concerns, it is important for you to have friends and loved ones to talk to. Having quality social connections and relationships are such a huge part of mental health. In fact, if you feel you don’t have those types of relationships now, then developing those might be one of our explicit goals in therapy. But to answer the question more directly: it may be time to seek therapy if you’ve already tried talking to friends or loved ones and it wasn’t helpful.

If your concerns are very specific such as having panic attacks, navigating transitioning, or body-focused repetitive behaviors (versus broad life stress), then it is more likely you may benefit from working with a professional with specialized training rather than just a friend alone.

Visit Luke’s profile to watch his introductory video, read more about him, and book an initial call!