Therapeutic Modalities

Cognitive behavioral therapy (CBT) is a form of psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety, alcohol and drug use problems, marital problems, eating disorders, trauma, and severe mental illness.

CBT helps you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more effective way. CBT can be a very helpful tool — either alone or in combination with other therapies — in treating mental health disorders. But not everyone who benefits from CBT has a mental health condition. CBT can be an effective tool to help anyone learn how to better manage stressful life situations.

CBT is a useful tool to address emotional challenges that may help you:

• Manage symptoms of mental illness
• Prevent a relapse of mental illness symptoms
• Treat a mental illness when medications aren’t a good option
• Learn techniques for coping with stressful life situations
• Identify ways to manage emotions
• Resolve relationship conflicts and learn better ways to communicate
• Cope with grief or loss
• Overcome emotional trauma related to abuse or violence
• Cope with a medical illness
• Manage chronic physical symptoms

Cognitive processing therapy (CPT) is a specific type of cognitive behavioral therapy that helps patients learn how to modify and challenge unhelpful beliefs related to the trauma.

CPT was developed in the late 1980s and has been shown to be effective in reducing PTSD symptoms related to a variety of traumatic events including child abuse, combat, rape and natural disasters. CPT is endorsed by the U.S. Departments of Veterans Affairs and Defense, as well as the International Society of Traumatic Stress Studies, as a best practice for the treatment of PTSD.

CPT helps clients learn how to challenge and modify unhelpful beliefs related to the trauma. In so doing, clients create a new understanding and conceptualization of the traumatic event so that it reduces its ongoing negative effects on current life.

CPT is based on the idea that PTSD symptoms stem from a conflict between pre-trauma beliefs about the self and world and post-trauma information. For example, a pre-trauma belief could be The world is a safe place, and nothing bad will happen to me, while post-trauma information may suggest that the world is, in fact, dangerous and hazardous. These conflicts are called “stuck points” and are addressed through various techniques such as writing about the traumatic event.

Your therapist will help you identify and address stuck points and ​errors in thinking, including thoughts like I am a bad person or I did something to deserve this, for example. Your therapist may help you address these errors or stuck points by having you gather evidence for and against those thoughts.

Cognitive-behavioral conjoint therapy for PTSD (CBCT for PTSD) is designed to improve post-traumatic stress symptoms and enhance intimate relationships when one or both partners suffer from PTSD.

While PTSD is an individual response to a trauma, it has a detrimental effect on intimate and family relationships, and yet the quality of a client’s relationships will impact their recovery. By involving a family member or romantic partner in CBCT, clients find it improves their relationships and moves them from isolation to connection.

There are three phases:

Phase 1 includes psychoeducation about the influences of PTSD symptoms and relationship functioning. The couple is given exercises to promote positive feelings and behaviors, and conflict management skills.

In Phase 2, exercises are used to address areas of avoidance and the desire to numb ones feelings, and to increase relationship satisfaction. Couples engage in activities to promote approaching, rather than avoiding feared situations.

Phase 3 – with improved relationship skills, the couple will focus on problematic core beliefs that have been impacted by trauma and maintain PTSD and relationship difficulties.

Dialectical behavior therapy (DBT) is a type of talk therapy based on cognitive behavioral therapy (CBT). It is specially adapted for people who feel emotions very intensely.

The goal of DBT is to help you:

• Understand and accept your difficult feelings
• Learn skills to manage them
• Become able to make positive changes in your life

‘Dialectical’ means trying to understand how two things that seem opposite could both be true. For example, accepting yourself and changing your behavior might feel contradictory. But DBT teaches that it is possible for you to achieve both these goals.

DBT acknowledges the need for change by accepting situations and recognizing the constant flux of feelings—many of them contradictory—without having to get caught up in them.

DBT is more likely to work for you if:

• You are committed to making positive changes in yourself
• You are ready to work hard at therapy, and do homework assignments
• You are ready to focus mostly on your present and future, rather than your past

Emotional freedom technique (EFT) tapping is a mind-body method of tapping acupuncture points (acupoints) on the hands, face, and body with your fingertips while focusing on an issue or feeling you’re hoping to resolve. This method may reduce stress and anxiety, improve performance, lessen cravings, and help resolve fears.

Tapping, or EFT, is a mind-body therapy that draws on the traditional Chinese medicine practice of acupuncture, and it is used today as a self-help approach in modern psychology. It involves tapping key acupoints while focusing on uncomfortable feelings or concerns, and using positive affirmations to neutralize those feelings.

Research suggests that EFT tapping can relieve stress, diminish cravings, improve performance, and even help relieve symptoms of post-traumatic stress disorder (PTSD).

Standard EFT tapping typically incorporates nine acupoints on the face, hands, and body:

• Eyebrow – where the eyebrows start at the bridge of the nose
• Side of the Eye – on the bone along the outside of either eye
• Under the Eye – on the top of the cheekbone under either eye
• Under the Nose – the area beneath the nose and above the upper lip
• Chin Point – the crease between your bottom lip and chin
• Collarbone Point – about two inches below and to the side of where your collar bones meet
• Under the Arm – on each side, about four inches beneath the armpits
• Top of the Head – directly on the crown of your head
• Karate Chop – the outer edge of the hand, on the opposite side from the thumb

However, EFT tapping involves more than stimulating these acupoints — it also incorporates mental focus.

One of the first steps in tapping is to identify a feeling or situation that’s bothering you and create a statement that acknowledges the feeling or problem, followed by a phrase of acceptance. For example: “Even though I’m overwhelmed with work, I deeply and completely accept myself.”

Over time, clinical tapping sessions teach the brain to respond to stressful memories in a neutral way. After clinical EFT, people retain the details of the traumatic memory minus the emotional response, or they have a lessened experience of the emotional response.

Existential psychotherapy is a style of therapy that places emphasis on the human condition as a whole. Existential psychotherapy uses a positive approach that applauds human capacities and aspirations while simultaneously acknowledging human limitations.

Existentialism proposes that people have the freedom, and the responsibility, to make our own choices and that leaning on institutions or other individuals to tell us how to make our moral choices is inauthentic and hinders our personal development. According to existential thought, we must look within ourselves to find meaning, to assert our values, and to make the decisions that shape our lives.

Existential psychotherapy is based on some of the main ideas behind existentialism as a philosophy, including:

• We are responsible for our own choices.
• We are all unique individuals due to the choices we make, and we are constantly remaking ourselves through these choices.
• We make our own meaning in life.
• Anxiety is a natural feature of human life.
• We must come to terms with this anxiety to live authentically

Built on these foundations, existential therapy aims to aid clients in accepting and overcoming the existential fears inherent in being human. These fears include:

• Freedom and responsibility
• Death
• Isolation
• Meaninglessness

Coming face to face with any of the above, or realizing that you will confront one or all of these eventually, can provoke an overwhelming sense of dread or anxiety, potentially leading to a multitude of psychological and emotional dysfunctions. Without accepting and finding a way to live with these realities of being human, it is impossible to live authentically.

Eye Movement Desensitization and Reprocessing (EMDR), as with most therapy approaches, focuses on the individual’s present concerns. The EMDR approach believes past emotionally-charged experiences are overly influencing your present emotions, sensations, and thoughts about yourself. As an example: “Do you ever feel worthless although you know you are a worthwhile person?”

EMDR processing helps you break through the emotional blocks that are keeping you from living an adaptive, emotionally healthy life.

EMDR uses rapid sets of eye movements to help you update disturbing experiences, much like what occurs when we sleep. During sleep, we alternate between regular sleep and REM. This sleep pattern helps you process things that are troubling you.

EMDR replicates this sleep pattern by alternating between sets of eye movements and brief reports about what you are noticing. This alternating process helps you update your
memories to a healthier present perspective.

Click here to learn more about EMDR…

Faith-based therapy, such as Christian counseling, combines behavioral science, found in most counseling practices, with teachings found in scripture. It allows an individual to find healing through God rather than oneself or another person.

People are wholistic beings including the physical, relational, mental, social, and spiritual.  Finding to what extent one’s faith is important gives opportunity for deeper healing and more diverse coping skills.

There are many spiritual acts that aid people in their recovery. At other times, faith can create inner conflict. This is why therapy and faith go together; together they can help clients understand the inner conflict rather than battling it or denouncing their faith. Faith that there is a greater being than oneself is now being seen as a valuable tool when it comes to coping with difficult mental struggles.

Insight oriented therapy approaches mental health counseling with a specific focus on helping you understand your inner motivations and workings. Your therapist will use insight oriented therapy to encourage you to analyze and further understand how events of your past are negatively influencing your current thoughts, feelings, and unconscious behaviors.

Insight oriented therapy, or insight therapy, is a client-centered type of talk therapy that can help you understand yourself better. During each session, the client will recall situations from their life. The therapist helps identify patterns of behavior or feelings and encourages the client to examine them more closely. The philosophy behind this method is that understanding and analyzing the issues that have negatively affected your life will help you identify and change any destructive patterns you have.

Insight oriented therapy can be a very effective way to help you overcome challenging behavioral and mental health issues. This therapeutic approach treats various disorders including eating disorders, substance use disorders, personality disorders, mood disorders, anxiety disorders. Insight therapy will help you understand what motivates you and in turn empower you to make positive changes in your life.

Integrative behavioral couple therapy (IBCT) is a relatively new approach to couple therapy. Integrative Behavioral Couple Therapy is “integrative” in at least two senses: First, it integrates the twin goals of acceptance and change as positive outcomes for couples in therapy. Couples who succeed in therapy usually make some concrete changes to accommodate the needs of the other but they also show greater emotional acceptance of the other. Second, IBCT integrates a variety of treatment strategies under a consistent behavioral theoretical framework.

IBCT consists of two major phases, an evaluation/feedback phase and an active treatment phase. The first three sessions consist of an evaluation period where the therapist learns about the concerns of the couple.

In the first session, the therapist usually sees both partners together, learns what brings the couple to therapy, and obtains a brief history of their relationship. During this first session, the therapist normally gives each partner some questionnaires to complete and bring to their individual sessions, which are the next two sessions.

In these next two individual sessions, the therapist explores each partner’s relationship concerns and individual history.

In the fourth session, the therapist sees both partners together for the “feedback session.” The therapist may gather some final information in the beginning of the session, but most of the session is devoted to feedback from the therapist, in which the therapist describes the couple’s difficulties and strengths and how therapy will try to assist the couple. The couple actively participates in this feedback, giving their reactions, adding information, and correcting the therapist’s impressions as needed.

Motivational interviewing is a therapeutic method that helps clients resolve ambivalent feelings and insecurities to find the internal motivation people need to change their behavior. It is a practical, empathetic, and short-term process that takes into consideration how difficult it is to make life changes.

Originally, motivational interviewing was focused more on treating substance use disorders by preparing people to change addition-related behavior. Over time, however, motivational interviewing has been found to be a useful intervention strategy in addressing other health behaviors and conditions such as diabetes control, diet, obesity prevention, physical activity, sexual behavior, and smoking.

Motivational interviewing can also be used as a supplement to cognitive behavioral therapy (CBT) for anxiety disorders, such as generalized anxiety disorder, social anxiety disorder, and post-traumatic stress disorder (PTSD). This approach has even been used to reduce the fear of childbirth.

There are several reasons why motivational interviewing is a widely used form of mental health therapy, including:

• Building the client’s self-confidence and trust in themselves
• Helping clients take responsibility for themselves and their actions
• Lowering the chance of future relapse
• Preparing clients to become more receptive to treatment
• Showing clients that they have the power to change their lives themselves
• Teaching clients to take responsibility for themselves

Motivational interviewing works best for people who have mixed feelings about changing their behavior. If you have absolutely no desire to change your behavior, or are already highly motivated to change, you may not reap the benefits of this approach.

Person-centered therapy operates on the humanistic belief that the client is inherently driven toward and has the capacity for growth and self-actualization; it relies on this force for therapeutic change. The role of the therapist is to provide a nonjudgmental environment conducive to honest self-exploration.

Person-centered therapy, also known as Rogerian therapy or client-based therapy, employs a non-authoritative approach that allows clients to take more of a lead in sessions to discover their own solutions.

The approach originated in the work of American psychologist Carl Rogers, who believed that every person is unique and, therefore, everyone’s view of his or her own world, and their ability to manage it, should be trusted. Rogers was a proponent of self-actualization, or the idea that each of us has the power to find the best solutions for ourselves and the ability to make appropriate changes in our lives. This approach was initially referred to as non-directive therapy, since it required the therapist to follow the client’s lead and not direct discussion.

During person-centered therapy, a therapist acts as a compassionate facilitator, listening without judgment and acknowledging the client’s experience without shifting the conversation in another direction. The therapist is there to encourage and support the client without interrupting or interfering with their process of self-discovery, as they uncover what hurts and what is needed to repair it.

Play Therapy isn’t Just Play

Play Therapy is an evidence-based practice for working with children in mental health.

Play Therapy uses the natural language of children and the powers of play to help children process their feelings and experiences.

The Association for Play Therapy (APT) defines Play Therapy as “the systematic use of a theoretical model to establish an interpersonal process wherein trained Play Therapists use the therapeutic powers of play to help clients prevent or resolve psychosocial difficulties and achieve optimal growth and development.”

What this means is that Play Therapy is not the same as regular, everyday play. While spontaneous play is a natural and essential part of the developmental process, Play Therapy is a systematic and therapeutic approach.

Play Therapy should only be provided by mental health professionals who have met the required education, licensure, and additional specialized training and supervision specific to Play Therapy.

Play is…

• a child’s language
• an essential part of child development
• fun!

Play can…

• expand self-expression, self-knowledge, self-actualization and self-efficacy
• relieve feelings of stress and boredom
• connect people in a positive way
• stimulate creative thinking
• regulate our emotions
• allow us to practice skills and roles needed for survival

Learn more about Play Therapy…

Solution-Focused Brief Therapy (SFBT), also called Solution-Focused Therapy (SFT), is a short-term, goal-focused, evidence-based therapeutic approach that incorporates positive psychology principles and practices to help clients change by constructing solutions rather than focusing on problems. In the most basic sense, SFBT is a hope friendly, positive emotion eliciting, future-oriented vehicle for formulating, motivating, achieving, and sustaining desired behavioral change.

Solution-focused therapists develop solutions by first generating a detailed description of how the client’s life will be different when the problem is gone or their situation improved to a degree satisfactory to the client. The therapist and client then carefully search through the client’s life experience and behavioral patterns to discover the necessary resources needed to co-construct a practical and sustainable solution that the client can readily implement.

Typically this process involves identifying and exploring previous exceptions (for example, times when the client has successfully coped with or addressed difficulties and challenges). SF therapists and their clients consistently collaborate in identifying goals reflective of clients’ best hopes and developing satisfying solutions.

Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-based treatment for children and adolescents impacted by trauma and their parents or caregivers. Research shows that TF-CBT successfully resolves a broad array of emotional and behavioral difficulties associated with single, multiple and complex trauma experiences.

TF-CBT is a structured, short-term treatment model that effectively improves a range of trauma-related outcomes with the child/adolescent and caregiver. Although TF-CBT is highly effective at improving youth post-traumatic stress disorder (PTSD) symptoms and diagnosis, a PTSD diagnosis is not required in order to receive this treatment. TF-CBT also effectively addresses many other trauma impacts, including affective (e.g., depressive, anxiety), cognitive and behavioral problems, as well as improving the participating parent’s or caregiver’s personal distress about the child’s traumatic experience, effective parenting skills, and supportive interactions with the child.

While TF-CBT was originally developed to address the needs of children who experienced sexual abuse, it has been used and studied for many other populations of traumatized youth. Research now documents that TF-CBT is effective for diverse, multiple and complex trauma experiences, for youth of different developmental levels, and across different cultures.