THERAPEUTIC STRATEGIES

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As we work together, there are numerous therapeutic approaches we may utilize.  In order to provide you the most effective treatment, we may incorporate various a therapeutic interventions depending on your unique needs.  Rest assured, we will always work together to determine the best approach for you, your child or family.

Psychotherapy is defined as the use of psychological methods to help an individual overcome certain thoughts or behaviors which may lead to psychological disorders. It is also known as “talk therapy” because the psychological methods all involve a client, or a few clients, and a licensed therapist communicating to work towards certain goals. 

There are four different kinds of psychotherapy: individual therapy, couples therapy, family therapy, and group therapy. 

• Individual therapy is a kind of psychotherapy which involves a one-on-one type of communication between one client and one licensed therapist. 
• Couples therapy is a version of psychotherapy which occurs between a therapist and a couple. Usually couples participate in therapy if there are parts of their relationship they want to strengthen. 
• Family therapy is when a therapist meets with a family, or some members of a family, and helps them work through certain issues by communicating in a safe space. 
• Group therapy is when a group of people meet with a therapist. As a group they work towards a common goal, while feeling supported by others around them. 

Psychotherapy includes many different techniques, some of which will be explained below. Examples include behavioral therapy, cognitive behavioral therapy, cognitive therapy, humanistic therapy, and psychoanalytic therapy. Psychotherapy is used to treat a wide variety of mental health disorders, such as addiction, anxiety, bipolar disorder, depression, eating disorders, obsessive-compulsive disorder (OCD), phobias, post-traumatic stress disorder (PTSD), substance use disorder. Psychotherapy can also be used to help individuals cope with stressful life events such as chronic pain/illness, divorce/break-ups, grief/loss, insomnia, low self-esteem, relationship issues, and stress. 

Behavioral therapy is rooted in behaviorism, which is the idea that we learn from our environment. Behavioral therapy is very focused in the sense that it focuses on modifying a specific behavior. There are many different kinds of behavioral therapy:

• Applied behavior analysis uses conditioning to change behaviors that may be problematic.
• Cognitive behavioral therapy (CBT) uses behavioral techniques, but focuses more on the problematic thoughts which drive certain behaviors. 
• Dialectical behavioral therapy (DBT) uses both behavioral and cognitive techniques in order to help people manage and cope with their emotions and stress, leading to improved interpersonal relationships. 
• Exposure therapy uses behavioral techniques to help individuals overcome certain fears. It does so by exposing people to the source of their fear while simultaneously introducing/practicing relaxation strategies. 

Behavioral therapy involves both classical and operant conditioning. Classical conditioning involves forming associations between a stimulus and a behavior in order to alter that behavior. Operant conditioning focuses on either increasing or decreasing a certain behavior, and does so by either reinforcing the behavior or not. 

Behavioral therapy is used to treat a wide a variety of mental disorders such as bipolar disorder, alcohol/substance use disorders, anxiety, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, borderline personality disorder (BPD), depression, eating disorders, panic disorders, phobias, and obsessive-compulsive disorder (OCD). 

DBT specifically focuses on providing therapeutic skills in four key areas.

• Mindfulness enables individuals to accept and be present in the current moment by noting the fleeting nature of emotions, which diminishes the power of emotions to direct their actions.
• DBT also inculcates distress tolerance, the ability to tolerate negative emotion rather than needing to escape from it or acting in ways that make difficult situations worse.
• Emotion regulation strategies give individuals the power to manage and change intense emotions that are causing problems in their life.
• Last but not least, DBT teaches techniques of interpersonal effectiveness, allowing a person to communicate with others in a way that is assertive, maintains self-respect, and strengthens relationships; a core principle is that learning how to ask directly for what you want diminishes resentment and hurt feelings.

DBT incorporates many of the techniques of cognitive behavioral therapy (CBT). It helps patients recognize and challenge the varieties of distorted thinking that underlie negative feelings and prompt unproductive behavior. For example, patients learn to identify when they are catastrophizing—assuming the worst will happen—in order to avoid acting as if it were the case. They review their own past and present experience for instances of all-or-nothing thinking, seeing everything in extremes of black or white, devoid of the nuance that is more generally the nature of life.

Mindfulness training is an important part of DBT. In addition to keeping patients present-focused, it slows down emotional reactivity, affording people time to summon healthy coping skills in the midst of distressing situations.

Exposure and response prevention therapy (ERP) is a type of behavioral therapy which gradually exposes people to situations designed to provoke a person’s obsessions, but does so in a safe environment. ERP provides patients with the coping skills for when a triggering situation may occur. 

ERP is mostly used to free people from the vicious cycle of obsessive thoughts and compulsive behaviors.  By exposing clients to a specific fear in a safe environment, the goal is for the patient to refrain from whatever harmful action that behavior is causing. For instance, if a person is obsessed with being clean, and because of that, they compulsively wash their hands, the therapist might try to expose them to germs in a safe environment, and help resist the urge to wash their hands incessantly. 

A trauma-informed specialist means that the therapist, or specialist, has been trained to assist clients who have dealt with trauma, rather than dysfunction. When a therapist has been specifically trained to treat clients who have experienced trauma, they are more likely to be able to view the behaviors a client is exhibiting as a function of their trauma. 

A trauma-informed specialist is different from someone who is simply trauma-informed. Someone who is trauma-informed usually has not done more than an introductory-level training program, whereas a trauma-informed specialist has usually been training in trauma-related treatments for many years. 

In every doctor-patient relationship, doctors need to complete an evaluation in order to completely understand their patient. Once that has happened, the doctor can be confident in their treatment suggestions. 

Specifically, in order for a therapist to diagnose a patient with a psychological disorder, that patient must meet a certain criteria listed in the DSM-5. They determine this through a series of evaluations. Licensed Clinical Therapists are trained to conduct these evaluations and recognize certain cues which eventually lead them to the right diagnosis.