White Pine Behavioral Health

Joel Guarna, PhD
Licensed Psychologist


Office Location:
25 Middle Street
Portland, ME  04101


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Issues treated at White Pine Behavioral Health LLC include:

(Click on the issue for more information)

Beyond Problems

Many of us know our struggle by name: we may call it Anxiety, Depression, Substance Abuse, or some other from an ever-growing list of diagnoses.  Just as often, however, our work is defined by what we are seeking:  greater closeness and intimacy, connection with others, a richer and more fulfilling life, a path that may begin with a nagging sense of emptiness but leads to a clearer sense of who we are and who we would like to be.  These ends justify--and dignify--the hard work of therapy and personal growth and lie at the heart of most people’s desire to change. 


Anxiety and Stress
Anxiety and stress are a normal and expected part of everyone's life.  However, some people find that their struggles with anxiety and stress can keep them from participating fully in life or keep them from enjoying the life they have. 
  Anxiety.  Some individuals struggle with persistent worrying that prevents them from remaining present and dealing with daily activities.  Others experience extreme anxiety in social situations, avoiding work or family functions or enduring them with much discomfort.  Still others have anxiety attacks, marked by strong physical reactions (heart beating, feeling hot and sweaty or dizzy), and the fear of these attacks can lead to rigid avoidance patterns that erode one's quality of life.  Problems with anxiety and even diagnosable anxiety disorders such as Panic Disorder and Social Phobia (sometimes called Social Anxiety Disorder) can be treated.  In fact, they are among the most readily treatable of all psychological conditions.  [Treatments: CBT and ACT.]
  Stress.  Extreme stress can overwhelm an individual's ability to cope.  Work demands, family problems, unexpected health problems, financial woes--all of these can lead to heightened and persistent stress that can challenge the coping of even the toughest individuals.  Chronic stress can lead to both emotional and physical health problems.  Even if your stress seems uncontrollable and due to external life demands, there is a good chance that you can learn more effective strategies to manage this stress, to keep your head above water until the situation improves.  [Treatments: CBT and ACT.]
  More information: Fact Sheet on Anxiety APA Help Center on Anxiety.


Depression and Problems with Mood
  [Treatments: CBT and ACT.]
  More information: Fact Sheet on Depression APA Help Center on Depression.


Trauma and Post-Traumatic Stress Disorder (PTSD)
  [Treatments: CBT and ACT.]
  More information: Fact Sheets on Trauma and PTSD.  APA Help Center on Trauma and PTSD.
Information from the National Center for PTSD.


Veterans' Issues and Adjusting to Post-Military Life
  [Treatments: CBT and ACT, Behavioral Couples Therapy (BCT)]
  Information from the Department of Veterans Affairs.


Substance Abuse, Addictions, Other Compulsive Behaviors
  Substance Abuse and Dependence.  People struggle with many different substances, from alcohol, to prescription pills, heroin and other opiates, cocaine, amphetamines (speed), and multiple substances.  Alcohol is the substance most commonly reported by individuals seeking help in my office, though I have experience working with most substances of abuse.  Unfortunately, many people never present for help and remain stuck in patterns of problematic drinking or using because they ask themselves the wrong opening question: "Am I an alcoholic (or addict)?"  While this question may ultimately be important, it is too overwhelming for most people considering change.  Most decide that they differ in some important ways from "true" alcoholics/addicts.  Many see their drinking/using as on par with the drinking of their peers.  Others simply believe that an admission of alcoholism or addiction would be too difficult and carry too many burdens--best to simply put the question out of mind for a while longer.  A better set of questions than the one above would be:
  • Is drinking (or using) causing me problems? 
  • Does it interfere in any important area of my life, or is it likely to interfere if my drinking (using) continues like it has? 
  • Are others concerned about how I drink (use)? 
  • Has it become too important to me, has it acquired a value that is out of proportion with what it is? 

If any of these questions leads to a "yes" answer, change may be worth making.  This change may, in fact, require major lifestyle changes.  However, it is possible that the needed change may be less severe and more manageable than you currently believe.  The good news is that there are evidence-based strategies to help you make these changes.  [Treatments: Specialized Help for Substance Abuse and Addictions, Behavioral Couples Therapy (BCT)]

  Addictions/Addictive Behaviors.  Problem gambling appears to respond to strategies similar to those employed with the chemical addictions.  Please call for details.  [Treatments: Specialized Help for Substance Abuse and Addictions, Behavioral Couples Therapy (BCT)]
  Other Compulsive Behaviors.  Internet and pornography use can evolve into fixed and problematic patterns that strongly resemble the patterns demonstrated by people struggling with the more typical addictions, such as to alcohol or illicit drugs.  Some individuals report a sense of "loss of control."  Others become dishonest with their families, hiding the behaviors to avert their sense of shame.  Many report failed attempts to curb the behavior on their own.  Whether we think of these behaviors as "addictions" in the traditional use of this term is secondary to a more pressing issue: for some individuals, these behaviors become problematic and are often difficult to change simply through wanting or intending to change, or through application of will power.  When working with these sorts of compulsive behaviors, I use cognitive-behavioral strategies similar to those I use with persons with chemical addictions.  These strategies are rooted in strong basic behavioral science and appear to have broad applicability.  While researchers work to identify the most effective strategies, these approaches offer hope for change now.  I would be glad to talk with you about these approaches.* (Additional information available in my Client Brochure.)  [Treatments: Specialized Help for Substance Abuse and Addictions, Behavioral Couples Therapy (BCT)]

*Note: Most insurance and managed care plans do not cover treatment for compulsive internet or pornography use.  As such, payment for therapy will be self-pay or "out of pocket."  (See the FAQs section about this.)  Please be sure you understand this issue prior to our first session--If you do not, please ask.   

In addition to these specific issues, I have experience treating individuals struggling with multiple problems, such as anxiety or mood problems co-occurring with alcohol or substance abuse.

Additional information on specific problems will be posted soon.  Please check back.


Office Location & Mailing Address
25 Middle Street
Portland, ME  04101


  Phone: 207-272-8500
Fax: 207-773-7386

Copyright 2006
White Pine Behavioral Health LLC