CBT & DBT

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy is a leading evidence-based therapy that helps combat depression, OCD, and other conditions.[1] Cognitive Behavioral Therapy helps clients recognize the way the thoughts they accept as true effect their mood, relationships, and life experience. After clients feel safe with their therapist, they are taught to combat distorted thoughts.

Our lives are experienced as an interpretation of reality. Each person interprets reality in a unique way. This is one reason eye-witness testimonies are so unreliable. Our brains focus on aspects of our environment based on our interests, focus, and beliefs. If we interpret an experience a certain way and accept that interpretation as reality, our brain uses that interpretation to form beliefs about new experiences that may not be similar enough for the same interpretation to maintain its accuracy. This process occurs below the level of conscious awareness.

One aspect of Cognitive Behavioral Therapy is becoming more aware of our thoughts as potential interpretations of our experience, and not automatically accepting that every thought we think is a true representation of reality. Since it is easy to develop cognitive distortions, most people have some distorted thoughts. Some distortions, including those that diminish our perception of our own value and those that view the world or others as inherently bad, often lead to depression and anxiety. Learning to choose the thoughts we accept and discard those that hinder our ability to thrive makes a tremendous difference in the quality of our lives.

Distorted thoughts are thoughts that are irrational in nature and giving power to such thoughts leads to severe issues like clinical depression. We give those thoughts power when we accept them as true, ruminate about them, and act as if they are true. For example, someone who does not believe they can get a job they want because (insert distorted thought), will not even try. Based on their interpretation of reality, there is no reason to try.

As an example, a woman (not a client) who was qualified for a Senior Vice President role at a large company did not believe that the company would hire a woman for the role. Even though she wanted the job, she did not apply for the position because she did not believe she would be offered the job. The company ended up hiring a visibly pregnant woman for the role.

During CBT, clients learn to identify their distorted thoughts, combat them, and to replace them with thoughts that are healthier and more empowering. When progress is made, it can feel as if their life before therapy was lived walking through murky fog and now the sun has come out, illuminating their path. Furthermore, clients practice preventative methods to make sure that distorted thoughts do not come back.

Cognitive Behavioral Therapy is a highly effective therapy for many clients and recovery is often long-term or permanent for clients who actively engage in their treatment.

Cognitive Process Therapy

We use many different kinds of cognitive therapies at our clinic to ensure that treatment plans are personalized and maximized for effectiveness. Another kind of cognitive therapy we use is called Cognitive Process Therapy.

This therapy is used to combat trauma and has proven to be equally effective as EMDR[2] and more than bio or neurofeedback.[3] It’s less invasive and can be faster to execute. This is due to the fact that it incorporates a combination of desensitization, exposure, and thought challenge.

Dialectical Behavioral Therapy (DBT)

Dialectical Behavioral Therapy combines eastern practices like Buddhism and mindfulness with cognitive therapy. Although Buddhist practices are incorporated in the therapy, the processes are compatible with other worldviews. In other words, you can belong to another religion and benefit from the practice. You do not have to become a Buddhist.

DBT is an effective evidence-based treatment that combats emotional and mood instability.[4] Furthermore, it helps clients provide themselves with a variety of coping tools that provide them with the ability to manage and contain their emotions.   

The “Dia” in Dialectical means two, and more specifically this refers to clients having two opposing thoughts that lead to them feeling torn apart (i.e. “I love him, no I need to leave him”).

DBT neutralizes this cognitive dissonance and provides clients with some lasting relief through coping skills based on acceptance, gratitude, mindfulness, boundary placements, and self-care. DBT is most frequently used to facilitate behavior changes, including substance abuse and self-harm; suicidal ideation; and, mood disorders. DBT is also supported by empirical evidence as a treatment for Borderline Personality Disorder (BPD).[5]

References:

[1] Frick, A., Thinnes, I., & Stangier, U. (2020). Metta-based group meditation and individual cognitive behavioral therapy (MeCBT) for chronic depression: study protocol for a randomized controlled trial. Trials, 21(1), 1-14.

[2] Seidler, G. H., & Wagner, F. E. (2006). Comparing the efficacy of EMDR and trauma-focused cognitive-behavioral therapy in the treatment of PTSD: a meta-analytic study. Psychological medicine, 36(11), 1515-1522.

[3] Marzbani H, Marateb HR, Mansourian M. Neurofeedback: A Comprehensive Review on System Design, Methodology and Clinical Applications. Basic Clin Neurosci. 2016;7(2):143–158. doi:10.15412/J.BCN.03070208

[4] Reynolds, S. K., & Linehan, M. M. (2020). Behavioral Assessment in DBT: Commentary on the Special Series. Cognitive and Behavioral Practice, 27(1), 50-54.

[5] Chapman A. L. (2006). Dialectical behavior therapy: current indications and unique elements. Psychiatry (Edgmont (Pa. : Township)), 3(9), 62–68.