Collaborative Care with Referral Providers

A specialized somatic and psychological approach for your complex patients.

I am an LCSW accepting Arizona clients for my 100% virtual, HIPAA-compliant psychotherapy practice. I specialize in integrating mind-body approaches for patients experiencing centralized sensitization symptoms, medically unexplained issues, relational or life disruptions, health-related trauma, PTSD, and other co-occurring intersections.

Most Common Clinical Indications for Referral

  • Centralized or neuroplastic conditions, such as Fibromyalgia, CRPS, FND, migraines, IBS, and pelvic pain.

  • Persistent musculoskeletal pain where organic pathology has been ruled out or stabilized, but pain persists.

  • High stress or somatic amplification complicating physical therapy rehabilitation or other medical treatment.

  • Medical trauma, health anxiety, identity loss, or relational strain stemming from chronic conditions.

Michael Tugendhat, LCSW, smiling in a navy shirt. Telehealth trauma therapist in Scottsdale.

Specialized Interventions for Complex Clients

Individual Psychotherapy Approaches

  • Addresses internal conflicts, chronic stress responses, and parts of self that frequently amplify physical symptoms. Developing ways of working with protective parts and underlying vulnerabilities gives clients a path to process experiences driving their symptoms.

  • Retraining the brain to appraise non-dangerous somatic sensations experientially, leading to reduced centralized pain loops. This approach often uses Somatic Awareness and Tracking to encourage clients a way to approach fearful sensations, emotions, beliefs, and behaviors related to their presenting symptoms.

  • Desensitizes the nervous system's hyper-reactive, emotional, and trauma-based response. Clients may be encountering symptoms that correspond to past medical trauma, attachment injuries, past abuses, or chronic stressors. By processing these experiences in the central nervous system, we work toward a clinical reduction in autonomic arousal, somatic pain, and physical-emotional distress.

  • Accesses the subcortical and limbic brain to locate, process, and release neurophysiological sources of emotional and physical trauma. This is a particularly effective modality for clients who struggle to verbalize internal experiences or have little to no memory of specific traumatic events.

Couples Psychotherapy Approaches

  • This is an adaptation of Internal Family Systems Therapy (IFS) for couples and relationships. Resolving relational conflict frequently lowers systemic stress, grounds the client’s autonomic nervous system, and improves overall treatment compliance. This approach helps clients differentiate from the protective and vulnerable parts of self that maintain negative relationship cycles, which often inadvertently increases pain and functional impairments.

  • Resolving relational distress frequently lower pain thresholds and systemic stress that otherwise keeps clients’ nervous systems stuck in negative symptomatic feedback patterns. Leveraging the attachment system offers clients a way to see the negative cycle of interaction as the enemy, not each other, as they work toward safety, connection, and repair.

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Certifications & Trainings

  • Internal Family Systems (IFS)

  • ICEEFT-Certified Emotionally-Focused Couples Therapist (EFCT)

  • Eye Movement Desensitization and Reprocessing (EMDR)

  • Intimacy from the Inside Out (IFIO)

  • Emotion-Focused Therapy (EFT)

  • Exposure and Response Prevention (ERP) for OCD, Anxiety

  • Brainspotting

Informed Provider Trainings

  • Pain Reprocessing Therapy (PRT)

  • Emotion Awareness & Expression Therapy (EAET)

  • ADHD & Executive Functioning

  • Working with Collective Trauma

  • Polyvagal for Nervous System Regulation

  • Relational Mindfulness

Therapy Format

100% Telehealth (Secure, HIPAA-Compliant Video Sessions).

Insurance & Billing

Effective July 31, 2026, Pain to Presence Psychotherapy LLC is an in-network provider with Aetna Commercial plans or an applicable medical rental network. Out-of-network clients may inquire about a sliding scale rate and a superbill for potential reimbursement.

Therapy Service Area

Serving adults and couples in Arizona. At this time, clients must be located in Arizona for the duration of the session.

Our Collaborative Promise

We close the referral loop. With the patient's consent, we’ll work alongside your office to ensure a unified approach to support each client.

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