Cognitive Behavior Therapy:

Cognitive behavior thearpy (CBT) is a structured, skills-focused, and goal-oriented treatment. It is widely researched. This treatment effectively addresses a variety of concerns, including mood and anxiety disorders and trauma. CBT connects how thoughts, emotions, and behaviors affect one another. It teaches people how to modify problematic thoughts and behaviors associated with symptoms. Though understanding the past is helpful, cognitive behavior therapy focuses on present concerns. It emphasizes moving forward and actively solving problems. CBT is an umbrella of a treatment that includes other types of psychotherapies.

Exposure Therapy:

Exposure-based cognitive behavior therapy (CBT) is strongly proven to treat anxiety, trauma, and mood. It has the most extensive research for generalized anxiety, obsessive compulsive disorder, social anxiety, panic, post-traumatic stress disorder, and depression. It falls under the umbrella of CBT with a focus on behavioral experiments to approach one’s fears and emotions.

Research shows that avoiding triggers and unwanted emotions can have a counterproductive effect. Trying to avoid these triggers strengthens and reinforces the unwanted emotions, such as anxiety and shame. These problematic avoidance behaviors also interfere with living life fully. The goal of exposure therapy is to create new learning in fear-based situations. For example, learning that the probability of the feared outcomes is relatively low. It also involves understanding that the ability to cope is greater than predicted. Exposure therapy also allows for mastery over emotions, an ability to understand and regulate emotions.

Types of exposures include imaginal (structuring an exposure in one’s mind), in-vivo (real life), and interoceptive (to physical symptoms).

There are many examples of exposure based cognitive behavior therapy treatments. Exposure response prevention (ERP) for OCD. ERP helps remove compulsions. It also assists in tolerating the uncertainty that drives these compulsions. Prolonged exposure (PE) is used to treat trauma. It includes exposure to trauma cues and emotions. PE builds the ability to manage reminders and helps individuals stop avoiding and return to a meaningful life. Behavior activation (BA) is effective for depression. It uses exposure to joy building behaviors to reduce negative mood.

Dialectical Behavior Therapy:

Dialectical behavior therapy (DBT) is the gold standard of treatment for Borderline Personality Disorder (BPD). It was initially researched for BPD. Over time, it has evolved to treat multiple areas of dysregulation. These include emotions, thoughts, behaviors, relationships, and sense of self. DBT was developed as a modification to cognitive behavior therapy (CBT) when cognitive behavior therapy alone was not effectively treating severe emotion dysregulation. DBT is considered a “third-wave cognitive behavior therapy.” It emphasizes acceptance and validation in balance with change strategies.

DBT includes individual therapy, skills training, phone coaching, and specialty consultation team for the therapist. Individual therapy targets life threatening and therapy interfering concerns. It also aims to improve quality of life. Skills training teaches mindfulness, distress tolerance, emotion regulation, and relationship or interpersonal skills. Phone coaching supports the client in generalizing the treatment outside of sessions. The team for the DBT therapist ensures adherence to the therapy.

There are adaptations to DBT to successfully treat a variety of symptoms and developmental stages. Adaptations include DBT for children (DBT-C), and DBT for adolescents. There is also DBT for those coping with addiction or substance abuse (DBT-SUDS), as well as trauma (DBT-PE). Additionally, there is DBT for individuals who have completed treatment and seeking employment (DBT-ACES). Wise Mind Counseling offers DBT skills training and DBT-PE for adolescents and adults.

Mindfulness & Self-Compassion

Mindfulness can is commonly defined as being present in the moment, non-judgmentally. It emphasizes acceptance of the reality as it is, including of oneself, others, and the moment. Mindfulness is having an attitude of willingness and actively participating in life, including solving life problems.

Mindfulness is a core part of DBT and included in all types of cognitive behavior therapy approaches. Mindfulness teaches people to sense and experience emotions. It helps them to accurately express emotions. People learn to accept and validate emotions as they are. When people accept emotions, they become more capable of changing unwanted emotions. In exposure therapy, people use mindfulness as a way to let go of control, resistance, and avoidance that maintains anxiety. Mindfulness improves emotion regulation, reduces stress, and increases joy.

Self-compassion is an extension of mindfulness. The focus is on developing loving-kindness and understanding for oneself. This allows for experiences to be received non-judgmentally. It also helps to realize that everyone has pain, suffering, and imperfections. Self-kindness includes holding oneself accountable to change and in a caring manner. Acting as a caring cheerleader helps one achieve goals, increase progress in treatment, and live life in line with values.

Self-compassion approaches can be added to all therapies. People with mental health symptoms often experience self-criticism and judgments that interfere in quality of life. Increasing self-compassion is especially useful when treating depression, shame, disgust, and perfectionism.

Acceptance and Commitment Therapy

Acceptance and commitment therapy (ACT) is another “third wave of cognitive behavior therapy.” ACT incorporates mindfulness strategies of awareness and acceptance. ACT also focuses on goals and values in treatment. People learn how to have a healthy relationship with unwanted thoughts, feelings, and physical sensations. They learn to stop avoiding and allow the discomfort. Escaping the unwanted thoughts and emotions that is often maintaining symptoms. When people accept their thoughts and feelings as they are, they become more regulated. ACT highlights the importance of identifying goals and values to improve well-being. When treatment is structured around goals and values, people become willing and committed, and progress is more meaningful.