Brenna Epifano, Ph.D., HSPP
Licensed Psychologist | OCD & Anxiety Specialist
Brenna Epifano, Ph.D., HSPP—known to clients as Dr. Brenna—is a licensed psychologist at River City OCD Clinic in Louisville, Kentucky. She specializes in working with adolescents and adults experiencing obsessive-compulsive disorder (OCD), anxiety, perfectionism, emotion dysregulation, self-criticism, and related concerns.
Dr. Brenna's approach is individualized, collaborative, and grounded in evidence-based treatment. Depending on a client's needs, her work may incorporate Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and Compassion-Focused Therapy (CFT).
But "evidence-based" doesn't have to mean impersonal.
Dr. Brenna believes meaningful therapy requires both acceptance and change: learning to respond to yourself with greater understanding and compassion while also becoming willing to recognize and change patterns that aren't working.
Sometimes that involves difficult conversations and uncomfortable moments.
It can also involve curiosity, humor, genuine connection, and discovering that personal strengths are every bit as relevant to treatment as the things someone wants to change.
Specialized treatment for OCD, anxiety, perfectionism, self-criticism, and related concerns using evidence-based approaches including Exposure and Response Prevention (ERP), Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and Compassion-Focused Therapy (CFT).
Specialties & Areas of Focus
OCD Treatment
Dr. Brenna works with individuals experiencing a wide range of OCD themes and presentations, including Contamination OCD, Harm-related obsessions, health anxiety, Just Right OCD, perinatal and postpartum OCD, Religious and Moral Scrupulosity, emetophobia (fear of vomiting), and other intrusive thoughts, compulsions, and OCD-related concerns.
Using Exposure and Response Prevention (ERP), Dr. Brenna helps clients gradually approach thoughts, situations, sensations, and uncertainties that OCD has taught them to fear while reducing the compulsive responses that keep the cycle going.
The goal isn't to prove that a feared outcome could never happen.
It's learning that uncertainty can be present without requiring a ritual, avoidance, reassurance, or another attempt to finally figure everything out.
Anxiety, Perfectionism & Self-Criticism
Dr. Brenna also works with anxiety disorders, depression, perfectionism, emotion dysregulation, and persistent self-criticism.
Perfectionism and self-criticism can create an exhausting arrangement: make a mistake, criticize yourself so it doesn't happen again; feel uncertain, think harder until you get it right; struggle with something, assume you should be doing better.
And when none of that works particularly well, criticize yourself for that too.
Dr. Brenna helps clients identify patterns that may be contributing to distress while developing more flexible and compassionate ways of responding to difficult thoughts, emotions, and perceived shortcomings.
Self-compassion doesn't mean pretending everything is fine or abandoning accountability. Sometimes it means creating enough room to see clearly what isn't working, and respond to it without having to beat yourself into submission first.
Perinatal & Postpartum OCD
Pregnancy and becoming a parent can bring enormous changes in responsibility, identity, uncertainty, and emotion.
For some people, it can also become fertile ground for OCD.
Perinatal and postpartum OCD can involve unwanted intrusive thoughts, images, or fears involving harm, contamination, responsibility, morality, health, or whether someone can trust themselves as a parent.
Because these thoughts can feel especially disturbing or inconsistent with how someone wants to feel about parenthood, people may hide them out of fear, shame, or concern about what the thoughts supposedly mean.
Dr. Brenna particularly enjoys working with parents and can help expecting parents who may be experiencing perinatal and postpartum OCD.
Treatment focuses not on proving that every feared outcome is impossible, but on helping clients change how they respond to intrusive thoughts, uncertainty, and the enormous responsibility that can accompany caring for another human being.
Eating Disorder Consultation & Outpatient Treatment
Dr. Brenna has extensive training and research experience in eating disorders, including Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, and Avoidant/Restrictive Food Intake Disorder (ARFID).
At River City OCD Clinic, she can provide consultation and level-of-care assessment to help adolescents, adults, and families better understand eating-disorder concerns, clarify treatment needs, and determine what type of care may be appropriate.
For clients whose needs are appropriate for routine outpatient psychotherapy, ongoing treatment with Dr. Brenna may also be an option.
Eating disorders can require multidisciplinary or more intensive care. Depending on the nature and severity of symptoms, appropriate treatment may involve collaboration with medical providers, dietitians, medication providers, or specialized eating-disorder programs.
When a different or higher level of care is indicated, Dr. Brenna can help clients and families understand the recommendations and identify appropriate next steps.
The goal isn't to make someone's needs fit the treatment available. It's to help determine the treatment that fits their needs.
What Therapy With Dr. Brenna Is Like
Acceptance and Change Can Both Be True
Dr. Brenna is a fan of dialectics, the idea that two things that initially appear to contradict each other can both be true.
That principle shapes the way she approaches therapy.
As Dr. Brenna describes it:
"I strive to balance acceptance and change in my work. I aim to foster self-validation and self-compassion, while also helping clients identify and address unhelpful thoughts, behaviors, and emotions."
You can acknowledge that something is genuinely difficult and work toward changing how you respond to it.
You can have compassion for yourself and take responsibility for your behavior.
You can recognize your strengths and identify patterns that aren't serving you.
Therapy doesn't always require choosing one side of the equation.
Sometimes the work is learning how to hold both.
Compassionate Doesn't Mean Avoiding Difficult Conversations
Dr. Brenna works to create a therapeutic environment where clients feel respected, understood, and comfortable showing up as themselves.
But feeling understood doesn't mean a therapist simply agrees with everything you do.
Dr. Brenna describes wanting clients to feel validated and confident while also providing honest, direct feedback when patterns may be contributing to stress or interfering with what they want from life.
Recovery is difficult enough.
A good therapeutic relationship can be compassionate enough to make room for difficult experiences and strong enough to have difficult conversations about them.
When Self-Criticism Becomes the Strategy
Self-compassion is more than a passing interest for Dr. Brenna.
Her doctoral research examined self-compassion interventions for eating disorders, and the relationship between self-criticism, emotion, and behavior continues to inform her clinical work.
People sometimes worry that reducing self-criticism will make them complacent.
If I'm not hard on myself, how will I improve?
But relentless self-attack isn't the only available source of motivation. Dr. Brenna helps clients explore whether criticism is actually producing the life and behavior they want, and whether accountability, curiosity, and compassion might sometimes do the job better.
Building a Life Worth Living
Dr. Brenna's extensive DBT training also influences how she thinks about treatment.
Therapy isn't simply about reducing symptoms.
It's about helping people build lives they actually want to participate in.
That means learning skills for managing difficult emotions and changing harmful patterns, but it also means identifying strengths, relationships, experiences, and values worth moving toward.
The objective isn't to become a person who never struggles.
It's to make struggle less capable of determining the shape of your life.
Professional Background
Dr. Brenna earned her Ph.D. in Clinical Psychology from the University of Louisville in 2024.
She completed her doctoral internship at Charleston Area Medical Center in West Virginia, where she developed a particular interest in working with individuals from underserved and rural communities and received additional training in evidence-based treatments, including comprehensive Dialectical Behavior Therapy (DBT) and Family-Based Treatment (FBT).
Her clinical training and experience include:
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Exposure and Response Prevention (ERP)
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Acceptance and Commitment Therapy (ACT)
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Dialectical Behavior Therapy (DBT)
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Compassion-Focused Therapy (CFT)
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Cognitive Behavioral Therapy (CBT)
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Family-Based Treatment (FBT)
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OCD and anxiety treatment
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Eating-disorder assessment and treatment
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Perinatal and postpartum OCD
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Emotion dysregulation
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Perfectionism and self-criticism
Dr. Brenna is a member of the Kentucky Psychological Association (KPA) and is pursuing membership with the International OCD Foundation (IOCDF).
She has authored or co-authored more than 25 research publications involving OCD and eating disorders, and her doctoral dissertation focused on self-compassion interventions for eating disorders.
Telehealth Across PSYPACT States
In addition to providing in-person treatment in Louisville, Kentucky, Dr. Brenna holds authorization through PSYPACT to provide telepsychology to eligible clients located in participating states.
PSYPACT can expand access to specialized OCD and anxiety treatment for individuals who may not have an appropriately trained OCD specialist nearby.
Because participating jurisdictions and telepsychology requirements can change, eligibility is determined based on the client's location and applicable regulations at the time services are provided.
Beyond the Therapy Room
Dr. Brenna grew up in the Chicagoland area, which means being a Cubs fan was apparently less of a choice and more of an inherited condition.
She is married to an avid Ohio State football fan, demonstrating either an impressive commitment to dialectical thinking or an unusually rigorous form of exposure therapy.
Dr. Brenna is also a mom and particularly enjoys working with young adults and new parents, populations that have given her both professional interests and, presumably, plenty of opportunities to appreciate the limits of human control.
Her household also includes two German Shepherds, Hera and Ajax.
She has warned us that they will be mentioned frequently.
We see no reason not to believe her.
Work With Dr. Brenna
Dr. Brenna provides specialized treatment for OCD, anxiety, perfectionism, self-criticism, emotion dysregulation, and related concerns through River City OCD Clinic in Louisville, Kentucky.
She works with adolescents and adults and particularly enjoys working with young adults and new parents, including individuals experiencing perinatal and postpartum OCD.
Dr. Brenna also provides eating disorder consultation and level-of-care assessment and may provide ongoing outpatient eating disorder treatment when a client's clinical needs are appropriate for that level of care.
She provides in-person services at our Louisville office and is authorized to provide telepsychology to eligible clients located in PSYPACT participating states.
You don't need to know exactly what diagnosis fits—or exactly what kind of treatment you need—before reaching out.
That's something we can begin figuring out together.