The therapy world is filled with myriad approaches to understanding and working with the human condition. The following descriptions may help you understand some of the more popular techniques and approaches our therapists employ.
ACCEPTANCE AND COMMITMENT THERAPY (ACT)
Acceptance and Commitment Therapy is an empirically-based psychological intervention that uses acceptance and mindfulness strategies mixed with commitment and behavior-change strategies, to increase psychological flexibility. The objective of ACT is not to eliminate difficult feelings, but to be present for whatever life brings us and to "move toward valued behaviors" in response. Acceptance and commitment therapy invites people not to avoid, but to be available to unpleasant feelings, and to learn not to overreact to them. Its therapeutic effect is a positive spiral where feeling better about sometimes feeling bad leads to more resilience and a more realistic understanding of the nature of the human experience. Being able to tolerate negative experiences more easily, creates more opportunities for positive experiences.
Animal-Assisted Therapy (AAT)
Animal-assisted therapy involves animals as an adjunctive component of treatment. A therapist who has a pet in the office may be less threatening, particularly to children or vulnerable adults. This can help to build rapport and a sense of safety. Westside’s therapy dogs are trained to provide affection and comfort. Dr. Theodore McTubbins (Theo) entered the field of therapy at a very young age. Working with Ben Heinrichs, LPC, Theo brings levity and curiosity to every encounter. The lovely Zola works with Alison Manley, LPC in our downtown office, while Bug is with Jason Levine, and Buddy is with Faith Lerner, LCSW.
Only present when the client agrees, therapy dogs have been found to have calming effects on humans, activating the parasympathetic nervous system, resulting in lower blood pressure and heart rate. When discussing difficult emotions, clients report feeling comforted by the presence of an affectionate animal.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) is a treatment rooted in the notion that many emotional problems and unwanted behaviors are based in irrational thoughts and belief systems. The focus is on developing personal coping strategies to solve current problems and change unhelpful cognitive patterning. It is a problem-focused, and action oriented approach, where the therapist’s role is, in the context of a supportive therapeutic relationship, to help the client develop concrete thought and action plans to combat unwanted feelings and acts. CBT is based in the belief that thought distortions and maladaptive behaviors play a role in the development and maintenance of psychological problems such as depression and anxiety, and that symptoms and associated distress can be reduced by teaching new information-processing skills and coping mechanisms. Much of the research on the effectiveness of psychotherapy has been conducted using CBT, hence it has been identified as “evidence-based” practice. Used for depression, anxiety, eating disorders, phobias, social anxiety, OCD.
Cognitive behavioral therapy for insomnia (CBT-I) is a technique for treating insomnia without (or alongside) medications. Insomnia is a common problem involving trouble falling asleep, staying asleep, or getting quality sleep. CBT-I aims to improve sleep habits and behaviors by identifying and changing the thoughts and the behaviors that are affecting the ability to allow the person to sleep or sleep well. The first step in treating insomnia with CBT-I is to identify the underlying causes of the insomnia. People with insomnia should evaluate or have their sleep patterns evaluated and take into account all possible factors that may be affecting the person's ability to sleep. This would involve keeping a sleep diary or journal for a couple weeks. The journal will help identify habits of thought or behavior, stress, etc. that could be contributing to the person's insomnia. After identifying the possible underlying cause and the factors contributing to the insomnia, the person can begin taking steps towards getting better sleep. In CBT-I these steps include stimulus control, sleep hygiene, sleep restriction, relaxation training, and cognitive therapy. CBT-I has been found to be an effective form of treatment of insomnia. It is also effective in treatment of insomnia related to or caused by mood disorders. Those with PTSD have also shown improvement.
Dialectical Behavioral Therapy (DBT)
Dialectical behavior therapy (DBT) is a therapy designed to help people change patterns of behavior that are not helpful, such as self-harm, suicidal ideation, and substance abuse. This approach emphasizes helping people increase their emotional and cognitive regulation by learning about the triggers that elicit reactive states, which in turn are expressed through unwanted feelings and actions. DBT works to identify effective coping skills, and to then apply them appropriately to interrupt the maladaptive sequence of trigger-reaction-unwanted feeling/action. DBT assumes that every individual is doing the best he or she can, but is either lacking the skills necessary to respond more skillfully, or has unintentionally been reinforced in negative behaviors. DBT is a modified form of CBT, incorporating principles of distress tolerance, acceptance, and mindfulness to expand the repertoire of effective coping. Used for depression, anxiety, suicidal ideation, self harm, eating disorders, trauma.
Eye movement desensitization and reprocessing (EMDR) is a treatment that works to address disturbing memories from trauma. According to this approach, when a traumatic or distressing experience occurs, it can overwhelm our normal coping mechanisms, causing the memory and associated stimuli to be inadequately processed. This information is then stored in an isolated memory network, which does not allow it to properly integrate and dissipate. Such memories, stored intact so to speak, can be re-activated by specific triggers. In this approach, in the context of a supportive relationship, clients are instructed to recall distressing events while the therapist provides bi-lateral sensory input, usually with a light, and instructs the client in side to side eye movements. The theory is that this will engage the brain’s natural adaptive information processing mechanisms, moving the traumatic material into circuits where it can be properly absorbed and integrated, as most memories are. EMDR was originally designed to treat PTSD, and has been found my many to be effective where more traditional approaches are not.
Insight Oriented (IOT)
Insight oriented psychotherapy (IOT) focuses on helping clients develop a deep understanding of their feelings, motivations, fears and desires. It is based in the idea that we are not always completely conscious of what motivates our behaviors or triggers our reactions, but that in conversation with the therapist who is attuned to patterns and themes, they reveal themselves. By making the unconscious conscious, we are positioned to make mindful choices such that our actions and reactions are more aligned with our current-day goals and priorities, rather than in response to outdated reflexive assumptions rooted in our personal history. A client-centered therapy, IOT work attempts to focus on the innate strengths of the individual, working to identify distortions that lead to problems. Used for depression, anxiety, self doubt, imposter syndrome, search for meaning, and more.
Interpersonal psychotherapy (IPT) is a time-limited, attachment-focused psychotherapy that centers on resolving interpersonal problems. Usually completed in 12-16 weeks, IPT is a structured approach based on the principal that relationships and life events impact moods and vice versa. The goals of IPT are to reduce symptoms, improve interpersonal skills, and increase social support. By examining the functioning of the interpersonal units, identifying problem areas and communication break downs, clients learn to be present focused, and collaborative in their efforts to understand and improve their relationships. The therapy relationship provides a workshop within which to develop more self awareness, and practice new skills. Can be useful in working with depression, anxiety, family issues, couples issues
Mindfulness Based Cognitive Therapy (MBCT)
Mindfulness based cognitive therapy (MBCT) and Mindfulness based stress reduction (MBSR) are both practices that integrate the use of a dedicated practice of mindfulness meditation and awareness to facilitate calm and well-being. A practice of mindfulness has been found to be robustly effective in treating psychiatric disorders and general states of stress or unhappiness. Focusing on becoming aware of all incoming thoughts and feelings and accepting them, but not attaching or reacting to them, known as “Decentering," aids in disengaging from self-criticism, rumination, and dysphoric moods that can arise when reacting to negative thinking patterns. Similarly, developing a single pointed focus whereby a person can be in and aware of the present moment without judgment significantly reduces felt stress states and positions the individual to make clear choices not dictated by emotion. MBCT was originally designed to address major depressive disorder, and has been found effective with addictions and anxiety, while MBSR has a very wide application.
motivational interviewing (MI)
Motivational interviewing (MI) is a method that works on facilitating and engaging intrinsic motivation within the client in order to change behavior. Goal-oriented, and client-centered, the idea is to help clients find their own reasons for changing their behaviors, by encouraging them to explore and resolve ambivalence. Focused and goal-directed, the therapists work to influence clients to consider making changes deemed to be in their best interest, rather than non-directively exploring their own goals and values. Around a desired change, the therapist works to elicit personal motivation for that change from the client. The examination and resolution of ambivalence is a central purpose, and the counselor is intentionally directive in pursuing this goal. MI is non-judgmental, non-confrontational and non-adversarial. The therapist attempts to increase the client's awareness of the potential problems caused, consequences experienced, and risks faced as a result of the behavior in question.The strategy seeks to help clients think differently about their behavior, and ultimately to consider what might be gained through change.
Narrative therapy is a form of psychotherapy that seeks to help people identify their values and the skills and knowledge they have to live these values, so they can effectively confront whatever problems they face. The therapist seeks to help the person co-author a new narrative about themselves by investigating the history of those qualities. Narrative therapy claims to be a social justice approach to therapeutic conversations, seeking to challenge dominant discourses that it claims shape people's lives in destructive ways. The approach was developed during the
While narrative work is typically used in family therapy, many authors practitioners report using these ideas and practices in community work, schools and higher education.s.
Solution focused (brief) therapy is a goal-directed collaborative approach to psychotherapeutic change that is conducted through direct observation of clients' responses to a series of precisely constructed questions. Solution Focused Brief Therapy focuses on addressing what clients want to achieve, exploring the history and provenance of problem(s, and developing concrete plans to move toward those goals.] Solution Focused therapy sessions typically focus on the present and future, attending tp the past only to the degree necessary for communicating empathy and accurate understanding of the client's concern