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Our Approach
Our hope is to provide treatments approaches that are the most likely to lead to changes in the areas where you are seeking help. Fortunately, psychotherapy has been studied extensively, and we are learning a good deal about the approaches that work especially well for specific types of problems. Our practice is largely based on cognitive-behavioral therapy and on dialectical behavior therapy . These approaches to treatment have been well studied and are practical, focused in the present, and involve the therapist and client collaborating to set goals.
What is cognitive-behavioral therapy (CBT)?
CBT is an approach to treatment that focuses on identifying as specifically as possible the problems that a client is having, examining the causes that maintain these difficulties, and generating alternative approaches that break problematic cycles. All people, even those who are not encountering emotional distress, tend to think in ways that are subjective, filtering out a good deal of information about what is going on around them. This tendency to think subjectively becomes more extreme during periods of emotional turmoil, and can often can create or maintain anxiety and depression. For example, we may tend to overestimate the probability that negative events will occur, while underestimating our ability to cope with them. We may also tend to blame ourselves for unwanted outcomes and yet feel that we have little control or ability to improve our situation. CBT challenges our thoughts about self, world, and future by collecting objective evidence to more clearly evaluate current beliefs. We first practice becoming aware of negative thoughts (which are often automatic and almost subconscious in nature), and then we look at how to challenge them so that they do not deflate and work against us.
Behaviorally, CBT seeks to reduce maladaptive behaviors (often avoidance and self-destructive behaviors) and to increase more adaptive choices. Often clients will start out "monitoring" problematic behaviors, like overeating, excessive drinking, hair-pulling, or procrastinating. This monitoring can enlighten both client and therapist about patterns of behavior and what factors maintain them. Surprising though it may sound, usually there are hidden reinforcements for problematic behavior-like temporary reductions in anxiety or increased support from other people. We will strive to understand the cycle and then to intervene, by replacing unwanted behaviors with more adaptive coping strategies. In many cases, CBT has been shown to be as effective or more effective than drug therapy or other approaches to psychotherapy.
What is dialectical behavior therapy (DBT)?
DBT weds Zen philosophy and behavioral science to create a central "dialectic" of acceptance and change. This is an active, skill-based therapy developed and researched by Dr. Marsha Linehan and her colleagues. DBT strives to decrease interpersonal chaos, unpredictable moods, and impulsive behavior. One foundational element is mindfulness-the ability to focus our attention as we choose (not so easy to do in the demanding, chaotic lives many of us lead). DBT also teaches skills related to distress tolerance (how to manage anxiety and get through crises without making things worse); emotion regulation (how to identify and manage powerful emotional states while reducing vulnerability); and interpersonal effectiveness (how to maintain strong bonds with others, preserve self-respect, and achieve one's own needs).