Tom Bivona, Psy.D.
Post-Doctoral Candidate | OCD & Anxiety Specialist | Licensed Psychologist - Temporary
Tom Bivona, PsyD—known to clients as Dr. Tom—is a Licensed Psychologist – Temporary and Post-Doctoral Candidate at River City OCD Clinic in Louisville, Kentucky. He works with adolescents and adults experiencing obsessive-compulsive disorder (OCD), anxiety, PTSD and trauma-related concerns, depression, and related difficulties.
Dr. Tom's approach to therapy is active, practical, and collaborative. He believes understanding why you're struggling can be valuable, but understanding is usually the beginning of the work, not the end of it.
Therapy provides an opportunity to learn new ways of responding to difficult thoughts, emotions, fears, and situations. The real change often comes from practicing those responses repeatedly, both inside and outside the therapy room.
That doesn't mean therapy needs to feel like psychological boot camp.
Dr. Tom combines a direct, goal-oriented approach with humor and a strong therapeutic relationship. Clients can expect therapy to have a purpose, opportunities to practice what they're learning, and honest conversations about what's working, what isn't, and what might be worth trying next.
Specialized treatment for OCD, anxiety, and PTSD using evidence-based approaches including Exposure and Response Prevention (ERP), Cognitive Behavioral Therapy (CBT), Cognitive Processing Therapy (CPT), and Prolonged Exposure Therapy.
Specialties & Areas of Focus
OCD Treatment
Dr. Tom specializes in treating Obsessive-Compulsive Disorder (OCD) using Exposure and Response Prevention (ERP), the first-line psychological treatment for OCD.
OCD can involve intrusive thoughts, images, sensations, or doubts followed by attempts to reduce distress or gain certainty through compulsions. Those compulsions aren't always obvious. They can include visible rituals, but also avoidance, reassurance seeking, checking, reviewing memories, analyzing thoughts, or trying to determine what an intrusive thought "really means."
ERP helps clients gradually approach the thoughts, situations, sensations, and uncertainties OCD has taught them to fear while reducing the compulsive responses that keep the cycle going.
The objective isn't to eliminate every uncomfortable thought or guarantee that nothing bad will happen.
It's learning that a thought, feeling, or uncertainty can show up without automatically determining what you do next.
Anxiety & Avoidance
Dr. Tom also treats anxiety disorders, including social anxiety and other concerns in which fear and avoidance have begun limiting someone's life.
Avoidance makes sense in the short term. If something makes you anxious, staying away from it can provide immediate relief.
Unfortunately, relief can also teach the brain an unintended lesson:
Good thing we avoided that. It must have been dangerous.
Over time, life can become increasingly organized around what might trigger anxiety.
Using exposure-based approaches, and strategies informed by cognitive defusion, mindfulness, and values-based strategies, Dr. Tom helps clients practice approaching situations differently, learning through experience that discomfort can be tolerated and doesn't always need to be escaped, controlled, or solved before moving forward.
Trauma & PTSD
Dr. Tom has specialized experience treating post-traumatic stress disorder (PTSD) and trauma-related concerns using evidence-based approaches including Cognitive Processing Therapy (CPT) and Prolonged Exposure Therapy (PE).
After trauma, reminders of what happened can begin to feel dangerous themselves. People may avoid memories, conversations, places, emotions, or situations associated with the experience. Others may find themselves struggling with beliefs about safety, trust, responsibility, guilt, or what the experience means about themselves or the world.
Evidence-based trauma treatment helps clients approach what has become difficult to face while examining patterns that may be keeping the effects of trauma alive.
The goal isn't to erase what happened.
It's to help what happened take up less control over what happens next.
Depression & Related Concerns
Dr. Tom also has experience working with depression and other concerns that can overlap with anxiety, OCD, and trauma.
Depression often encourages withdrawal: do less, wait to feel motivated, and return to life when you feel better.
Unfortunately, waiting for motivation can sometimes make the world smaller.
Treatment may involve identifying patterns that maintain depression, gradually increasing meaningful activity, developing more flexible ways of responding to thoughts and emotions, and practicing behaviors that move life in a useful direction, even when motivation hasn't caught up yet.
What Therapy With Dr. Tom Is Like
Therapy Is Something You Practice
Dr. Tom sometimes compares therapy to athletic training or learning an instrument.
Meeting with a trainer once doesn't automatically make someone stronger. One music lesson doesn't teach someone to play the guitar.
The lesson matters, but so does what happens between lessons.
Therapy works similarly.
Sessions provide a place to understand patterns, learn strategies, practice difficult things, troubleshoot obstacles, and decide what to try next. But lasting change requires taking that work into everyday life.
That might mean practicing an exposure daily, responding differently to an intrusive thought, approaching something you've been avoiding, or trying a skill when the situation actually arises.
The expectation isn't perfection. It's practice.
Direct, Practical & Collaborative
Dr. Tom's style is straightforward and action-oriented.
He works collaboratively with clients to establish goals and understand what they want their lives to look like, not simply which symptoms they want to eliminate.
From there, treatment focuses on identifying the patterns getting in the way and practicing alternatives.
Sometimes that means Dr. Tom will point out something that isn't working. Sometimes it means designing an experiment rather than spending another hour using logic to make sense of an intrusive thought. And sometimes it means recognizing that the thing your anxiety desperately wants you to avoid may be exactly where the therapeutic work needs to happen.
Direct doesn't have to mean cold. Dr. Tom values humor, collaboration, and a genuine therapeutic relationship alongside the structure of evidence-based treatment.
Experience Changes Things
People can become extremely knowledgeable about their own anxiety.
They may understand exactly where it came from, recognize every cognitive distortion, know why avoidance reinforces fear, and be able to explain their OCD cycle with impressive accuracy.
And still feel stuck.
That's because insight and behavior aren't the same thing.
Dr. Tom helps clients move from knowing differently to practicing differently.
The question eventually becomes less "Why am I like this?" and more "Given that this is what my mind is doing right now, what am I going to practice doing next?"
Professional Background
Dr. Tom earned his Doctor of Psychology (PsyD) from Spalding University in 2024.
His clinical work has included specialized experience treating OCD, anxiety disorders, PTSD and trauma-related concerns, eating disorders, depression, and substance-use disorders.
His clinical training and experience include:
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Exposure and Response Prevention (ERP)
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Cognitive Behavioral Therapy (CBT)
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Cognitive Processing Therapy (CPT)
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Prolonged Exposure Therapy (PE)
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Cognitive defusion, mindfulness, and values-based strategies
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Dialectical Behavior Therapy (DBT)-informed strategies
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Exposure-based treatment for anxiety disorders
In addition to his clinical work, Dr. Tom has taught clinical psychology graduate students at Pepperdine University, Bellarmine University, and Spalding University.
Dr. Tom practices as a Licensed Psychologist under the supervision of Melissa Gibson, Psy.D., HSPP, of BeWell Kentucky.
Beyond the Therapy Room
Dr. Tom grew up on Long Island, New York, before experiencing what he describes as a temporary lapse in judgment and enlisting in the military in his twenties. He spent the next twelve years moving around the country with the Air Force, graduate school, and his predoctoral internship before his wife and four stepchildren gave him a pretty compelling reason to finally put down roots in Louisville.
Still apparently undecided about what he wants to be when he grows up, Dr. Tom keeps himself busy teaching aspiring clinicians at three universities, dabbling in psychology research, and serving as an officer in the Air National Guard when he isn't seeing clients at River City OCD Clinic. His military service has also taken him overseas, including a deployment providing flightline security at Bagram Air Base in Afghanistan.
Outside of work, Dr. Tom is a self-described massive nerd. Mention Dungeons & Dragons, Magic: The Gathering, or Warhammer 40,000, and you've probably found a reliable way to get his attention. He's also an avid marksman and martial artist who regularly represents his military base in marksmanship competitions.
Unfortunately for Dr. Tom, his stepchildren also practice jiu-jitsu with him and apparently have no reservations about critiquing his performance.
Whether he's teaching, practicing psychology, serving in the military, or being humbled by his own family, Dr. Tom tries to approach whatever he's doing with warmth, curiosity, irreverence, and a healthy sense of humor.
Work With Dr. Tom
Dr. Tom provides specialized treatment for OCD, anxiety, PTSD, depression, and related concerns through River City OCD Clinic.
He works with adolescents and adults and takes an active, evidence-based approach designed to help clients not only understand the patterns keeping them stuck, but practice responding differently to them.
If you're looking for therapy that combines collaboration and humor with clear goals, practical strategies, and a willingness to actually work on the things anxiety would prefer you avoid, Dr. Tom may be a good fit.
You don't have to arrive already knowing exactly what diagnosis fits or exactly what needs to change.
Figuring that out can be part of the work.