Cognitive Behavioral Therapy (CBT)
Cognitive Behavior Therapy (CBT) is based on the ideas that how you think (cognition), how you feel (emotion) and how you act (behavior) all interact together. Specifically, your thoughts determine your feelings and your behavior. Therefore, negative thoughts can cause you distress and result in problems in functioning and quality of life.
CBT treatment is structured, goal-oriented, and focuses on identifying those irrational or maladaptive thoughts that lead to negative emotion; the therapist will often work with the person to challenge the negative thoughts on the basis of evidence from the person’s experience by reframing it, meaning to re-interpret it in a more realistic light. This helps the person develop more rational beliefs and healthy coping strategies.
CBT is different from other kinds of psychotherapy or "talk therapy." The CBT approach is an educational, problem solving approach, which focuses on enhancing a person’s skills to overcome negative situations. Rather than focusing solely on why a person feels anxious, we will attempt teach a person how to feel less anxious.
An important part of your therapy will be practicing new skills that you will learn in our sessions. We will ask you to practice outside our sessions, and we will work together to set up homework assignments for you to facilitate progress. We might ask you to do exercises, to keep records, and perhaps to do other tasks to deepen your learning. Change will sometimes be easy and quick, but more often it will be slow and frustrating, and you will need to keep trying. However, you can learn new ways of looking at your problems that will be very helpful for changing your thoughts, feelings, and behaviors.
Exposure Response Prevention (ERP)
Exposure Response Prevention (ERP) is a part of the cognitive behavioral treatment program that we offer for anxiety-related problems such as Phobias, Panic Disorder, Social Anxiety, Generalized Anxiety Disorder and Obsessive-Compulsive Disorder.
“Exposure” therapy is a gradual process in which a person is exposed to the feared situations or objects that have caused anxiety, which often resulted in compulsions and/or avoidance. In ERP, a person is taught to expose themselves to that which they fear. As the anxiety rises, they then work to resist the usual compulsion/avoidance that reduces the anxiety, which is called “Response Prevention.” In order to become comfortable with the cues that produce anxiety, a person must be exposed to them long enough to learn that nothing bad will happen. The person stays in the situation until the anxiety levels have decreased, a process called “habituation.” ERP is based on the idea that the person will learn that these feelings of anxiety will decrease over time, will not cause harm, resulting in decreased anxiety. Exposure to the situations (or thoughts) that cause anxiety or catastrophical thoughts is repeated until the person feels a marked relief of the anxiety symptoms.
A person is NEVER asked to participate in an exposure situation that would be harmful to them. We accompany individuals into the avoided places and situations, help them confront avoided thoughts, while providing instruction and appropriate levels of reassurance.
While anxiety or other discomfort may get worse in the first few minutes of an exposure, it is important to continue exposure until the discomfort has diminished. Escaping discomfort only reinforces avoidance as a coping tactic, and produces all the limitations associated with avoidance—like avoiding safe places or situations that might be fun, beneficial or essential for a career, and a full family life. It also increases the likelihood that the anxiety might spread, first to similar triggers and eventually to triggers that have little or nothing to do with the original anxiety.
Habit Reversal Technique (HRT)
HRT is a four step-program specific to treating undesirable habits such as hair pulling, nail biting, and skin picking. This process seeks to help sufferers first identify, and then eliminate, avoid, or change the particular activities, environmental factors, states, or circumstances that trigger hair pulling, nail biting, and skin picking. The goal of HRT is to consciously control these triggers or stimuli that lead to pulling, biting, and picking, resulting in creating new learned connections between the urge and new non-destructive behaviors.