Cognitive Behavior Therapy:

CBT is a type of psychological treatment that is widely researched and effectively treats a variety of concerns, including mood and anxiety disorders and trauma. CBT connects how thoughts, emotions, and behaviors affect one another. It is a structured and skills focused treatment. CBT identifies problematic thoughts and behaviors associated with symptoms and teaches new coping skills. Although it is helpful to understand how the past influences the current, CBT focuses on the problems in the present moment and how to move forward. CBT is an umbrella of a treatment that includes other types of psychotherapies.

Exposure Therapy:

Exposure-based 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 unwanted emotions and triggers associated with them only 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 the feared-based situations, such as learning the probability of the feared outcomes is relatively low or the ability to cope was 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).

Examples of exposure treatments include: exposure and response prevention (ERP) for OCD, prolonged exposure (PE) for trauma, and behavior activation (BA) for depression.

Dialectical Behavior Therapy:

DBT is the gold standard of treatment for Borderline Personality Disorder (BPD). It was initially researched for BPD and has evolved to treat multiple areas of dysregulation, such as emotions, thoughts, behaviors, relationships, and sense of self. DBT was developed as a modification to CBT when CBT alone was not effectively treating severe emotion dysregulation. DBT was considered a “third-wave CBT” and emphasized acceptance and validation strategies in balance with change strategies that existed within CBT.

DBT includes individual therapy (to target life threatening and therapy interfering concerns and improve quality of life), skills training (to teach mindfulness, distress tolerance, emotion regulation, and relationship or interpersonal skills), phone coaching (outside of treatment to support the client in generalizing the treatment), and the DBT therapist serves on a DBT team to ensure adherence to the therapy.

Similar to CBT, DBT has adapted approaches for specific symptoms, such as DBT for substance abuse (DBT-SUDS), trauma treatment while receiving DBT (DBT-PE), DBT for children (DBT-C), DBT for adolescents, and DBT for those who have completed treatment and are 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 CBT. Mindfulness teaches people to sense and experience emotions, to accurately express them, to 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, to allow for experiences non-judgmentally, and to realize that everyone has pain, suffering, and imperfections. Self-kindness includes holding onself 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 judgements 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 includes the awareness and acceptance strategies used in mindfulness, as well as a focus on goals and values in treatment. People learn how to have a healthy relationship with unwanted thoughts, feelings, and physical sensations. It is the avoidance of these private experiences that is often maintaining the mental health symptoms. When people are taught new acceptance skills, the idea is to learn to clarify goals and values and increase commitment to behavior changes. Structuring treatment around one’s values allows for progress in a meaningful manner.