James Fitzgerald Therapy PLLC

Types of Therapy that Influence Sessions

These are the types of therapies that I integrate into my integrative and holistic practice. They form the basis of my theoretical orientation. The different types of therapy influences and directs my approach to working with people.

DISCLAIMER

Please keep in mind, I am not currently certified by any of the organizations associated with the following therapy models and approaches. I will be taking continuing education courses in order to hold fidelity to these approaches. The theory, philosophy, construct, and concepts of the different therapy models informs my integrated and holistic practice. I integrate the resources, interventions, activities, practices, exercises, and techniques taught in these therapy models and approaches. 

Please note: You do not have to engage in every therapy approach described on this website, you may choose the approaches that you feel the most attracted to and resonate with. The information that follows is a more detailed outline and plan of action for the interventions, practices, and therapy approaches I integrate. The following therapy approaches are not listed in any particular order. They can be completed in a manner you find most effective and helpful. The most effective order I have found to date with many clients is:

1. Mindfulness approaches (mindfulness based stress reduction, mindfulness based cognitive therapy, dialectical behavior therapy mindfulness skills training, mindfulness meditation practices)
2. Mind/Body approaches and formal practices that teach discipline and focus while also benefitting your physical and mental health (yoga, tai chi, qui gong, karate, kung fu, juijitsu, etc.)
3. Mind/Body approaches to therapy that address stress and trauma that was stored in your genetic code and exists in your somatic experiences (somatic experiencing, polyvagal theory – safety and connection, sensorimotor psychotherapy)
4. Integrative Therapy that is holistic, strengths based, person centered, self directed, and intrinsically motivated that includes the whole person, body, mind, consciousness, and conscience (Internal Family Systems Theory and Parts Work)
5. Cognitive approach to therapy that addresses negative core beliefs, automatic negative thoughts, maladaptive schemas, thinking errors and patterns, and unwanted and unhelpful reactions and behaviors (Cognitive Behavioral Therapy, Motivational Enhancement Therapy, Acceptance and Commitment Therapy)
6. Emotional approach to therapy that addresses emotional dysregulation, hyper-reactivity, low distress tolerance, rejection sensitivity, demand avoidance, idealization and devaluation, low self-esteem, learned helplessness, hopelessness, and powerlessness (Dialectical Behavior Therapy, Emotion Focused Therapy, Emotional and Social Intelligence Training)
7. Health & Wellness Plan development planning and implementation (Life domain satisfaction in many areas, including: mental, emotional, gender, sex, intimacy, relationships, social, educational, occupational, financial, organizational, environmental, cultural, spiritual, political, ideological)
8. Executive Functions Coaching (Brain Rules Tips and Tricks: Organization, Time Management, Planning, Working Memory, Motivation, Reward, Discipline, Attention, Prioritizing, Persistence, and Delayed Gratification) 

Dialectical Behavior Therapy

Dialectical behavior therapy (DBT) is a type of psychotherapy that was developed by psychologist Marsha M. Linehan in the late 1980s. DBT can be used to treat mental health disorders such as borderline personality disorder, substance use disorders, and eating disorders. It has opportunities for practical application in the treatment of anxiety and depression as well. The goal of DBT is not only to reduce symptoms but also to help you improve your life skills and achieve your goals, and objectives.

Theory

The theory behind DBT is based on Eastern philosophy and Western psychology, which states that people have four basic affects: happy/joyful, sad/sorrowful, angry/irritable or afraid/fearful. These emotions are often experienced at the same time as one another; for example when you’re sad about something but also feel angry about it at the same time. According to this belief system it’s important for us not only understand our feelings but also learn how they interact with each other so we can regulate them effectively.

DBT is a comprehensive treatment approach used to help clients manage their problems and symptoms by teaching them how to improve the quality of their lives. It combines cognitive behavioral therapy with the concepts of acceptance, mindfulness, and dialectics. By accepting the way things are in reality, as opposed to arguing about events from the past or trying to predict what might happen in the future, this therapy teaches you to focus on what is going on around you right now instead of distracting yourself by thinking about something else.

In the context of Dialectical Behavior Therapy, dialectics involves adopting a stance that is based on acceptance of the existence of multiple realities. In other words, this means accepting that opposing viewpoints exist and that they cannot be reconciled into one unified belief system. Furthermore, acceptance of reality as it is implies that each person has their own distinct position in the world that may not be easily transferable to another person.

Therapy Sessions

The Principle of Guiding: I am just your guide and navigator. I am holding the map and key and share it with you on your journey. You will not be judged, lectured to, or criticized. I will not offer you unsolicited advice or suggestions, or tell you what you should do. I will be empathic, attuned, and compassionate, and listen to what you have to say. I will ask you questions that elicit and unlock the answers to your dilemmas. I will help you identify your body sensations, emotions, and thoughts, so that they can be discussed openly in sessions. I can teach you how to develop mindfulness, awareness, openness, emotional regulation skills, distress tolerance skills, coping skills, anger management, conflict resolution, communication skills, and grounding techniques.

By learning how to recognize when we’re having an emotion, we can better regulate our feelings before they become overwhelming (or harmful). For example, if I’m feeling angry at someone who cuts me off on the highway while driving, then instead of honking my horn at them in anger or yelling obscenities out my window–which would only make matters worse–I could practice deep breathing exercises or vagas nerve activation techniques, until I calm myself down enough so as not feel like exploding with rage anymore! This technique is called “self-soothing” because it involves calming yourself down by focusing on something else besides what’s causing these negative feelings inside yourself.”

Skills Training

Dialectical Behavior Therapy (DBT) is a practical form of therapy that can help you regulate your emotions, improve self-worth and build healthy relationships. The skills taught in DBT are intended to help you cope with the stresses of daily life. They include:

• General Skills
• Mindfulness Skills
• Emotion Regulation Skills
• Distress Tolerance Skills / Coping Strategies
• Interpersonal Effectiveness

 

Modules Summary

The modules are designed to address specific needs, be sequential and flexible, practical, culturally sensitive and applicable in multiple settings.

Mindfulness – This module introduces clients to the concepts of mindfulness and acceptance, and teaches them how they can use these skills to manage their emotional experiences more effectively. Clients learn various strategies for observing their emotional thoughts, physical sensations, and behaviors in a nonjudgmental way. They also learn how to accept their emotions when they arise, not suppress them or resist them. Using these skills allows clients to experience the full range of emotions in their lives and gives them the ability to identify triggers for different reactions.

Distress Tolerance – This module teaches clients how to tolerate distress effectively so that they can build their skills for tolerating future challenges. The goal of this module is for clients who experience intense emotions such as anxiety or anger that may lead them into problematic behaviors (e.g., self-harm). They will learn how those feelings come about; what happens when you have these feelings; what helps you feel better (e.g., mindfulness); what doesn’t help (e.g., avoidance); how these skills can be used when faced with another challenge later on down the road.”

Interpersonal Effectiveness – This module teaches clients how they can more effectively communicate with others by using effective communication strategies such as active listening skills which involves reflecting back what other people are saying without judgment or criticism.” Interpersonal effectiveness includes training in emotional intelligence, social intelligence, negotiating relationship rules, setting and enforcing healthy boundaries, and respectfully and assertively asking others for what you need, while not dismissing other people’s feelings, or refusing to let others meet their needs.

Emotion Regulation – This module teaches clients how to regulate their emotions. Through dialectical methods, clients will learn how to identify and label their emotions, as well as learn coping skills that can help them to control their behaviors and actions when they experience distressing situations. In addition, clients will be taught how to monitor their emotional states in order to prevent increasing levels of anger and sadness.

 

Module Details:

General Skills

In this module we will review the general skills of DBT. Lessons are broken down as follows: Goals of Skills Training; Options for Solving Any Problem; Overview—Introduction to Skills Training; Guidelines for Skills Training; Skills Training Assumptions; Biosocial Theory; Overview—Analyzing Behavior; Chain Analysis; Missing-Links Analysis

General Skills Training (Introduction & Orientation)

Mindfulness

Mindfulness is a state of active, open attention on the present. It’s a technique for avoiding thought traps and increasing self-awareness. Mindfulness can be practiced through meditation, but it can also be applied to everyday activities like eating breakfast or walking around your neighborhood. When practicing mindfulness with other people (such as during group therapy sessions), try to focus on what they are saying rather than thinking about what you want them to say next or how they might react if they said something different than what they actually did say. This requires letting go of expectations about how things should go and becoming more accepting of reality as it is in that moment–the good parts as well as any difficulties experienced along the way! Clients and visitors to this website are likely already aware of the numerous mindfulness-related skills that can benefit them in their daily life. These skills include “what” skills or skills that answer the question “What do I do to practice core mindfulness skills?” like observing, describing, and participating. There are also “how” skills or skills that answer the question “How do I practice core mindfulness skills?”, like the non-judgmental practice of mindfulness one-mindfully and effectively. Many of these mindfulness skills are necessary skills for learning the skills in the other modules; for example, the nonjudgment encouraged in mindfulness is also encouraged in distress tolerance, and the observing and describing skills can be helpful in identifying and labeling emotions.

Mindfulness Skills Training Module

Emotion Regulation

Emotion regulation is a skill that can be learned. It’s not the same as emotion suppression, which is the act of trying to block out emotions or push them away. It also isn’t the same thing as emotion management, which involves strategies for dealing with your feelings in an effective way. Emotion regulation includes strategies for managing your reactions to situations so that they’re less intense and last shorter periods of time than they would if you didn’t use these strategies. For example, if someone says something hurtful to you at work today (and it makes sense for them not knowing about your mental health issues), instead of getting angry at them like most people would do out of instinctual self-defense mode–you might take some deep breaths and remind yourself that this person doesn’t know anything about what happened between us earlier today so why should I let their words bother me? Or maybe even better yet: instead of reacting negatively right away because my initial reaction was anger then hurt followed by sadness etc., we could try using humor as an alternative response like chuckling softly under our breath while shaking our head back-and-forth slowly as though saying “no way!” Or even better still… Many clients who participate in DBT are struggling with highly sensitive emotional reactions and vulnerability to reactivity, and can benefit immensely from emotion regulation skills. Some of these skills that can help clients deal with their emotions include: Identifying and labeling emotions; Identifying obstacles to changing emotions; Reducing vulnerability to “emotion mind;” Increasing positive emotional events; Increasing mindfulness to current emotions; Taking the opposite action; Applying distress tolerance techniques.

Emotion Regulation Skills Training (Coping Skills)

Distress Tolerance

Distress tolerance is the ability to tolerate distress without resorting to maladaptive behaviors. For example, if you are feeling distressed by something that has happened and your first impulse is to yell at someone or drink alcohol, distress tolerance would be the skill that allows you to keep calm and talk through your feelings in a healthy manner. Distress tolerance is not the same as resilience; it’s possible for someone who hasn’t learned this skill yet (or has never been taught) to be resilient in times of crisis but still struggle with being able to tolerate ordinary stressors without falling apart. The goal of teaching distress tolerance skills is not only so that individuals can handle major life events better–it’s also so they can function normally on an everyday level! This module includes skills that are extremely important yet often overlooked: skills relating to accepting, tolerating, and learning from suffering. Many other mental health treatment regimens focus on avoiding pain, changing difficult situations, or walking away from circumstances that cause suffering, but the distress tolerance skills taught through Dialectical Behavior Therapy focus on dealing with the pain and suffering that is inevitable to the human condition. The distress tolerance module is split into four crisis survival strategies: Distracting; Self-soothing; Improving the moment; Thinking of pros and cons. In addition, there are many skills that relate to accepting and tolerating the current situation, like radical acceptance and willingness vs. willfulness.

Distress Tolerance Skills Training (Grounding Techniques)

Interpersonal Effectiveness – How to communicate effectively with others. How to ask for what you want in a way that doesn’t create conflict or cause disappointment. How to manage conflict when it arises, including how to use assertive communication when necessary. Setting boundaries and negotiating with other people who have their own needs and wants (this can be especially challenging if you’re very accommodating by nature) The skills in this module are related to interacting with others and resolving conflicts, especially in difficult or potentially harmful situations. These skills are intended to help clients function effectively when trying to ask for their needs, change something (e.g., making a request) or in enforcing boundaries, and trying to resist changes (e.g., refusing a request). The intention is to help you meet your goals and have your needs met in each situation while avoiding any harm to your relationships or to your self-respect.

Interpersonal Effectiveness Skills Training (Assertive Communication)

Conclusion

DBT is a complex treatment that requires a lot of time and effort. It can be difficult to understand at first, but the more you learn about it the more you’ll see how useful it can be in your life.

Internal Family Systems Theory (IFS) “Parts Work”

Internal Family Systems (IFS) is the approach I suggest for use in sessions. As my primary approach, it allows me the ability to integrate the other types of theray with it. It serves as a guide and offers a structured approach to the work. Internal Family Systems (IFS) Therapy is a method of psychotherapy that helps people explore the different parts of their personality and the relationships between them. The goal is to bring awareness to these parts, which are often unconscious, so you can better understand yourself and have more control over your life. (IFS) is a way of looking at the self, relationships and life in general. It can be helpful when you want to understand why you do what you do and how your feelings, thoughts and actions impact each other.

IFS uses the concept of parts: these are like parts of your personality (or Psyche) that have different needs or wants. The parts become a metaphor for the collections of different emotions, thoughts, beliefs, sensations, perceptions, interpretations, roles, and rules. For example, there might be an angry part of you inside which feels hurt by others but doesn’t know how to express itself appropriately; or there might be a scared part who hides from everyone because they think everyone will reject them if they get too close. Parts often have patterns of behaviour that repeat throughout life – for example if one part has been hurt by another person then it may keep trying again with new people despite all evidence that it won’t work out well for this person!

History of Internal Family Systems Therapy

Internal Family Systems Therapy was developed in the 1970s by Richard Schwartz, a clinical psychologist and psychotherapist. The work is rooted in the work of Carl Jung who believed that human beings are made up of several parts or aspects of themselves. These parts are known as “subpersonalities,” which can be thought of like an individual inside you with its own thoughts, feelings and behaviors. Schwartz expanded on this idea and developed Internal Family Systems Therapy as a way to help people heal their relationships with themselves and others by integrating these subpersonalities into one healthy whole self (see below). The basic idea is that we all have parts within us that can be thought of as people inside us. These parts are known as “subpersonalities” and they can have their own thoughts, feelings and behaviors. For example, you might have a part of yourself that wants to do well at work and another part that doesn’t care about doing well but just wants to goof off instead.

The Theory Behind Internal Family Systems Therapy

The Internal Family Systems model is a theory of personality, based on the work of Richard Schwartz. It’s based on a metaphor of the mind as a group of subpersonalities that interact with each other. This model has been used to explain how people develop and maintain psychological problems, including addictions and eating disorders. The theory was originally developed to explain why some clients were not responding well to traditional psychotherapy methods or medications; it was later expanded by Drs. Sue Gerhardt and Peter Fonagy into what they call “mentalization-based therapy” (MBT), which combines elements from IFS with attachment theory and CBT techniques for treating depression in adults and adolescents. In the Internal Family Systems model, the human mind has subpersonalities that can take control of our thoughts, feelings and behaviors. These “parts” (or “subpersonalities”) include child subpersonalities, which are sometimes called inner children; protector subpersonalities; victim subpersonalities; protagonist subpersonalities; persecutor subpersonalities and so on. Each part has its own beliefs about how things should be in the world, as well as its own needs and desires.

How Does IFS Work?

Internal Family Systems (IFS) is a way of working with the internal family system. IFS therapists help their clients to identify and understand their parts, communicate with them and work with them. The therapist also helps clients integrate the parts into one whole person who is able to live in the present time and make decisions based on what they want or need rather than letting old patterns control their behavior.
The heart of IFS is that we are all made up of different parts. These parts can be called “subpersonalities” or “ego states,” but the term “parts” is more neutral and less judgmental than these other terms. There are many ways to explore parts of your personality. You can explore parts of your personality in a variety of ways. You can do this on your own, with a therapist or with a coach.

On your own: Make lists of qualities that are important to you and then think about which ones make up the “you” inside you (e.g., kindness). Write down what each quality means to you and how it helps or hinders others around them (e.g., being kind makes me feel good about myself). Talk about these qualities with friends or family members who know you well enough to give useful feedback; some may even be able to name specific times when they saw one part of their personality emerge over another (e.g., “When I heard about this friend moving away from our town, I was so sad for her but also glad because now we’ll get along better.”).

With a therapist or coach: Work with someone who can help you identify which parts of your personality are most important to you (e.g., kindness) and what makes up those parts (e.g., being patient, kind and honest). Once you’ve done this, ask them how they think each part of your personality affects others around them (e.g., “I’m really impatient/bossy/strict”). Then ask for feedback on whether this is true for you; if so, how do people react?
Next, ask your therapist or coach to help you develop strategies for when one part of your personality becomes more important than others. For example, if you’re usually patient but then find yourself being impatient with someone at work or home, what do you need to do differently next time?

Conclusion

Internal Family Systems Therapy is a helpful way to explore and heal your inner world. It can be used by anyone who feels like they need help managing their emotions, relationships or self-esteem. The best part about IFS is that it’s a non-judgmental process that allows you to discover parts of yourself without feeling judged by others or yourself!

INTERNAL FAMILY SYSTEMS THERAPY INTRODUCTION

Mindfulness Based Cognitive Therapy

Mindfulness-based cognitive therapy (MBCT) combines cognitive behavioral techniques with mindfulness strategies in order to help individuals better understand and manage their thoughts and emotions in order to achieve relief from feelings of distress. MBCT was developed by Zindel Segal, Mark Williams, and John Teasdale. It is primarily derived from the earlier work of Teasdale, Jon Kabat-Zinn, and Phillip Barnard.

The approach, which is still relatively new—the first clinical trial was published in 2000—incorporates principles from Kabat-Zinn’s mindfulness-based stress reduction modality, an 8-week program designed to help people cope with the mental and physical effects of health concerns, and Bernard and Teasdale’s ICS (interactive cognitive subsystems) model. ICS is based on the premise that the human mind possesses different modes for receiving and processing data, the two primary modes of which are the “being” mode and the “doing” mode. The model also suggests mental health may be dependent on a person’s ability to detach from one mode and move between other modes, based on what is present in the environment. The MBCT program emphasizes the “being” mode, as this mode is believed to promote lasting emotional change, specifically for individuals experiencing recurrent depressive episodes.

A Mindfulness and Acceptance Model of CBT

The MBAC model is a variation of CBT that focuses on acceptance and mindfulness, rather than changing your thoughts. It’s based on the idea that if you accept your problems, you can learn to live with them instead of trying to get rid of them. The MBAC model also includes cognitive restructuring, behavioral activation, and relapse prevention techniques from traditional CBT approaches. The goal of these techniques is not necessarily to get rid of negative thinking but rather to change how we respond when we experience negative thoughts or feelings (e.g., by practicing mindfulness).

Mindfulness involves paying attention in a particular way: on purpose; in the present moment; nonjudgmentally–that is without judging yourself for having certain thoughts or sensations (such as anxiety). This means being aware only when you choose it rather than being constantly “on guard” against threats like danger or failure at all times while doing ordinary things like walking down the street or eating lunch at work each day!

How Does Mindfulness Based Cognitive Therapy Work?

Mindfulness Based Cognitive Therapy is a form of therapy that helps people to develop their awareness of their thoughts, feelings and body. By becoming more aware of these things in the moment, you will be able to better understand yourself and your experiences. The goal is for you to learn how to accept yourself as well as others around you so that over time your negative thinking patterns will begin to change. Mindfulness Based Cognitive Therapy can be used by anyone who wants help managing stress or dealing with depression or anxiety issues. It may also help those who have trouble sleeping because they are constantly worrying about things throughout the day (this can lead them into a cycle where they feel tired during the day because they aren’t getting enough sleep at night).

Mindfulness Based Cognitive Therapy was developed by Zindel Segal who wanted something different than traditional talk therapy techniques when treating patients with depression or anxiety disorders such as PTSD (Post Traumatic Stress Disorder). He found that many people were resistant towards traditional talk therapies because they didn’t want someone else telling them what was wrong with them; rather than focusing on trying get inside someone else’s head–which often leads down rabbit holes–mindfulness encourages individuals themselves explore their own thoughts/feelings instead!

Mindfulness Based Cognitive Therapy may be an effective way to manage depression, anxiety, and stress. The Mindfulness Based Cognitive Therapy Program is a type of treatment that may be effective for people who have had three or more episodes of depression. It is not a stand-alone treatment, but rather part of a larger treatment plan that includes medication, therapy and other types of support. MBCT has been shown to be effective in reducing the risk of relapse in those with recurrent depression by up to 50%. It is also used to treat depression and anxiety, as well as other conditions such as addictive behaviors, obsessive compulsive disorder (OCD), posttraumatic stress disorder (PTSD)

Research and Evidence for Mindfulness Based Cognitive Therapy

Studies have shown that mindfulness based cognitive therapy is effective. Studies have also shown that mindfulness based cognitive therapy is more  effective than other forms of therapy. In addition to these findings, research has shown that mindfulness based cognitive therapy may be a good alternative to medication for some people with depression and anxiety disorders. However, there are some limitations to these studies: they were done on small groups of participants (less than 100), so it’s difficult to generalize the results; most studies only looked at one outcome measure (e.g., “how many people improved?”); and findings may be different in a non-clinical population

MINDFULNESS BASED COGNITIVE THERAPY INTRODUCTION

Mindfulness Based Stress Reduction (MBSR)

The Mindfulness-Based Stress Reduction (MBSR) program is a widely recognized and evidence-based approach designed to alleviate stress, promote well-being, and cultivate mindfulness skills. Developed by Dr. Jon Kabat-Zinn in the late 1970s, MBSR has since become a popular therapeutic intervention and is often utilized in counseling settings. MBSR integrates mindfulness practices, such as meditation, body awareness, and gentle movement, with cognitive-behavioral techniques. The program aims to enhance an individual’s ability to respond to stressors in a more adaptive and mindful manner, ultimately reducing the negative impact of stress on mental and physical health.

Participants in the MBSR program engage in structured sessions typically lasting eight to ten weeks, with each session lasting approximately two to three hours. These sessions involve guided mindfulness exercises, group discussions, and educational components that explore the principles and applications of mindfulness. Through regular practice, MBSR cultivates self-awareness, attention regulation, and non-judgmental acceptance of present-moment experiences. Participants learn to observe their thoughts, emotions, and bodily sensations without clinging to or avoiding them, fostering a greater sense of resilience and psychological flexibility.

Research has shown that MBSR can significantly reduce stress, anxiety, and depressive symptoms. It has also been found to enhance overall well-being, increase self-compassion, and improve interpersonal relationships. Moreover, the skills acquired in MBSR can be applied beyond the program, enabling individuals to better cope with various life challenges and improve their overall quality of life. If you are seeking effective stress management strategies and wish to cultivate a greater sense of mindfulness and well-being, the Mindfulness-Based Stress Reduction program may be a valuable resource. I am experienced in delivering MBSR and can guide you through this transformative journey towards greater self-awareness and resilience.

Cognitive Behavioral Therapy (CBT)

Finding the right therapy approach is crucial for your well-being. One effective and widely used method I incorporate into my integrative approach and practice is Cognitive Behavioral Therapy (CBT). CBT is a goal-oriented and evidence-based form of therapy that focuses on the connection between our thoughts, emotions, and behaviors. By exploring these interconnected components, CBT helps individuals gain insight into the patterns and beliefs that contribute to their distressing thoughts and behaviors. During CBT sessions, we work together collaboratively to identify and challenge any negative or unhelpful thoughts and beliefs. This process can empower you to develop healthier thinking patterns, which, in turn, lead to more adaptive behaviors and improved emotional well-being.

If we hold fidelity to just CBT alone, it is a highly structured, manualized, and practical approach that equips individuals with a range of coping skills and strategies they can apply in real world experiences. You can learn to apply these techniques in your daily life to manage emotions, deal with challenges, and overcome obstacles. By actively engaging in CBT, you can cultivate resilience, develop problem-solving abilities, and foster positive change.

In my work with helping others, I integrate the CBT principles into my therapeutic approach to ensure that people I help receive personalized and effective treatment. I believe in the evidence that CBT empowers individuals and helps them navigate life’s challenges with confidence and resilience. If you’re seeking a counselor who utilizes Cognitive Behavioral Therapy, I want to support you on your journey toward personal growth and emotional well-being. In the CBT module we will explore and practice the following: Identifying core beliefs and narratives, intermediate beliefs and schemas. Recognizing automatic negative and irrational thoughts and cognitive distortions. Practice cognitive restructuring and challenging negative thinking patterns. Strengthening the mind-body connection. To compare the two most widely studied approaches; CBT focuses on thought processes and behaviors whereas DBT focuses on emotions and behaviors.

Cognitive behavioral therapy (CBT) is a form of psychotherapy that focuses on identifying, understanding and changing the thoughts and behaviors that cause emotional distress. In CBT, you’ll work with your therapist to identify unhelpful patterns in your thinking and irrational beliefs or assumptions. From there, you’ll be able to work together with your therapist to create more effective ways of thinking about problems in order to cope better with life challenges. CBT is not a distinct treatment technique. Instead, it is a general term which refers to a group of therapies. These therapies have certain similarities in therapeutic methodology. CBT was developed by Aaron Beck in the 1960s. It can be helpful for people who experience depression, anxiety and other mood disorders. Cognitive behavioral therapy focuses on changing how you think and act to improve your mood and reduce symptoms of mental health conditions.

Theory

CBT is a psychological theory that focuses on how people think, feel and behave. It assumes that thoughts, feelings and behaviors are influenced by their experiences and environment. The theory states that some changes in thinking patterns can help you to reduce negative emotions and increase positive ones. Cognitive behavioral therapy is grounded in the belief that how a person perceives events determines how they will act. It is not the events themselves that determine the person’s actions or feelings. For example, a person with anxiety may believe that “everything will turn out badly today.” These negative thoughts may influence their focus. They may then only perceive negative things that happen. Meanwhile, they may block out or avoid thoughts or actions that could disprove the negative belief system. Afterward, when nothing appears to go right in the day, the person may feel even more anxious than before. The negative belief system may get stronger. The person is at risk of being trapped in a vicious, continuous cycle of anxiety.

CBT also encourages you to take action in the real world by changing your behavior rather than just focusing on your thoughts or feelings alone. CBT therapists believe this approach helps people achieve long-term success because it teaches them how to change both their actions and attitudes towards themselves, other people and life events such as stressors (e.g., work deadlines). Cognitive behavioral therapy (CBT) is a type of psychotherapy that focuses on the relationship between thoughts, feelings, and behaviors. It aims to change patterns in thinking and behavior that are behind people’s problems, such as depression or anxiety. CBT assumes that our thoughts inform our emotions and behaviors; therefore if we change our thinking patterns, we can improve our moods and actions. CBT has been proven effective for many problems by research studies including anxiety and depression.

In sessions, you will follow a structured format that flows with the questions: What is the problem? What will be done in this session? What do you want to get out of the session? How will we know if it worked? How do you feel about what we’ve done today? In addition to these questions, it’s important to go over any homework assignments and discuss how they went.

Concepts

Core Beliefs are the most important beliefs that drive our thoughts and behaviors. They can be positive or negative, and they’re formed through a combination of genetics, environment, culture and life experiences. Core beliefs are often unconscious–meaning we don’t realize they’re there until we try to change them. That’s why CBT focuses on identifying your core beliefs and challenging them in order for you to see how they affect your life in a negative way. CBT has been shown to help people with depression and anxiety disorders because it teaches patients how their thoughts directly impact their moods: if you think positively about yourself or an event happening in your life (like getting a promotion at work), then chances are good that those positive feelings will lead to better outcomes than if someone else had made those exact same statements but spoken with pessimism instead!

Schemas are mental frameworks that organize, interpret, and predict information. We develop schemas based on our life experiences. Schemas can be positive or negative; they may also be self-defeating (i.e., leading to depression or anxiety). Cognitive behavioral therapy helps people identify their schemas by asking them questions like: What types of situations do you feel nervous about? What does this situation remind you of? How would someone else describe this situation? By exploring these types of questions with their therapist, clients learn more about their own personal patterns and how they relate specifically to the issue at hand (such as social anxiety). As clients gain insight into these patterns in themselves–or rather than just being told by others what those patterns might be–they become better equipped to challenge these negative thoughts when they arise during therapy sessions before they spiral out of control into full-blown panic attacks!

Automatic Thoughts are the thoughts that run through your head. They are not necessarily conscious, can be intrusive or conscious, and will influence how you feel and act. These automatic thoughts can be positive or negative, realistic or unrealistic, helpful or unhelpful. For example: “I’ll never get this done on time!” is an automatic thought that may lead to feelings of anxiety and stress; whereas “I’m doing my best” could help reduce these feelings by reminding you that there is no need to panic right now (and also reminds us of what we can do).

Interventions

Cognitive Restructuring: This intervention involves changing the way you think about a situation in order to change your feelings and behaviors. For example, if you feel sad because of something that happened at work, cognitive restructuring involves thinking about how other people would view the situation (and therefore not have as bad of a reaction), or considering what might happen next time so as not to get upset again.

Emotion Regulation: Emotions are important signals that tell us when something needs attention and action, but sometimes they’re too strong or last too long–in which case it can be helpful to learn skills for managing our emotions better so that we don’t let them control us! Some common emotion regulation techniques include relaxation exercises like deep breathing; mindfulness practices like meditation; taking breaks from tasks when feeling overwhelmed by them; identifying triggers for certain types of negative emotions (like feeling anxious before going into public spaces); finding ways other than drinking alcohol or eating junk food when stressed out.

Behavioral Activation is an intervention that involves someone using behaviors to influence their emotional state. It is often a part of cognitive behavioral therapy (CBT), but it can also be a standalone treatment. Most research into behavioral activation has focused on its effect on depression. This is because people with depression often lose interest in activities they used to enjoy or no longer find pleasure in their hobbies. A loss of interest in one’s hobbies can intensify the symptoms of depression, particularly if the person stops activities that were meaningful, that helped them maintain social connections, or that bolstered their self-esteem. Behavioral activation encourages people to engage in “antidepressant behaviors” to counter this.

Conclusion

All in all, CBT is a very effective form of therapy that can help you overcome your problems and lead a happier life. It’s important to remember that CBT is not just about changing your thoughts; it also involves changing the way you behave and interact with others around you. An evidence based best practice for mental health counseling. CBT helps people problem-solve. CBT also reveals the relationship between beliefs, thoughts, and feelings, and the behaviors that follow. Through CBT, people learn that their perceptions directly influence how they respond to specific situations. In other words, a person’s thought process informs their behaviors and actions. 

Cognitive behavioral therapists believe we can adjust our thoughts. This is thought to directly influence our emotions and behavior. The adjustment process is called cognitive restructuring. Aaron T. Beck is the psychiatrist widely considered to be the father of cognitive therapy. He believed a person’s thinking pattern may become established in childhood. He found that certain cognitive errors could lead to depressogenic or dysfunctional assumptions.

The cognitive behavioral process is based on an educational model. People in therapy are helped to unlearn negative reactions and learn new ones. These are positive reactions to challenging situations. CBT helps break down overwhelming problems into small, manageable parts. Therapists help people set and reach short-term goals. Then the therapist gradually adjusts how the person in treatment thinks, feels, and reacts in tough situations. Changing attitudes and behaviors can help people learn to address specific issues in productive ways.

Cognitive Processing Therapy (CPT)

Cognitive Processing Therapy is a highly effective and evidence-based treatment that focuses on helping individuals overcome the impact of traumatic experiences. It is specifically designed to address the effects of post-traumatic stress disorder (PTSD) and related symptoms. During CPT sessions, you are provided with a safe and supportive environment where you can explore your traumatic experiences and your cognitive responses to those events. CPT helps individuals gain a deeper understanding of the thoughts and beliefs that have developed as a result of their trauma.

The therapy consists of several core components. The first is education about PTSD and how it affects thinking patterns. Clients learn to recognize the impact of trauma on their thoughts, emotions, and behaviors. Next, CPT involves identifying and challenging unhelpful or distorted beliefs that may be contributing to distressing symptoms. Through structured exercises and discussions, clients develop healthier and more accurate ways of thinking about their traumatic experiences. This process helps them regain a sense of control and mastery over their thoughts, ultimately leading to a reduction in PTSD symptoms and an improved quality of life. Cognitive Processing Therapy is an active and collaborative therapy approach, empowering individuals to take an active role in their healing journey. By engaging in CPT, clients acquire valuable coping skills to manage distressing thoughts, emotions, and triggers associated with their trauma.

In my practice, Cognitive Processing Therapy is integrated into my approach, ensuring that clients receive individualized and evidence-based care. I am committed to providing a supportive and compassionate environment to help you process your trauma and move toward healing and recovery. If you’re an existing client interested in Cognitive Processing Therapy, I’m here to support you on your journey toward post-traumatic growth.

COGNITIVE PROCESSING THERAPY INTRODUCTION

Seeking Safety for Trauma & Post Traumatic Stress Disorder

 

Seeking Safety is an evidence-based, present-focused counseling model to help people attain safety from trauma and/or substance abuse. It can be conducted in group (any size) and/or individual modality. It is an extremely safe model as it directly addresses both trauma and addiction, but without requiring clients to delve into the trauma narrative (the detailed account of disturbing trauma memories), thus making it relevant to a very broad range of clients and easy to implement. Any provider can conduct it even without training. It has also been delivered successfully by peers in addition to professionals; and in all kinds of settings. It can be conducted over any number of sessions available although the more the better when possible. Seeking Safety was begun in 1992 under grant funding from the National Institute on Drug Abuse. It was developed by Lisa M. Najavits, PhD at Harvard Medical School and McLean Hospital. It has been used in many countries and has been translated into numerous languages.

Seeking Safety offers 25 topics that can be conducted in any order and as few or many as time allows: Introduction/Case Management, Safety, PTSD: Taking Back Your Power, When Substances Control You, Honesty, Asking for Help, Setting Boundaries in Relationships, Getting Others to Support Your Recovery, Healthy Relationships, Community Resources,  Compassion, Healing from Anger, Creating Meaning, Discovery, Integrating the Split Self, Recovery Thinking, Taking Good Care of Yourself, Commitment, Respecting Your Time, Coping with Triggers, Self-Nurturing, Red and Green Flags, Detaching from Emotional Pain (Grounding). Life Choices, and Termination.

The key principles of Seeking Safety

1)  Safety as the overarching goal (helping clients attain safety in their relationships, thinking, behavior, and emotions).  
2)  Integrated treatment (working on both trauma and substance abuse at the same time if the person has both)
3)  A focus on ideals to counter the loss of ideals in both trauma and substance abuse
4)  Four content areas: cognitive, behavioral, interpersonal, case management
5)  Attention to clinician processes (clinicians’ emotional responses, self-care, etc.)

 Seeking Safety Introduction/Overview & Main Menu

Acceptance and Commitment Therapy (ACT)

Acceptance and Commitment Therapy (ACT) is a type of psychotherapy that was developed by Steven C. Hayes and his colleagues in the early 1990s. ACT is based on the idea that psychological suffering is often caused by our attempts to control unwanted thoughts, feelings, and sensations. These attempts to control our internal experiences are often unsuccessful and can lead to increased suffering. ACT teaches people to accept their thoughts, feelings, and sensations without judgment. This acceptance does not mean that we have to like or agree with our internal experiences. It simply means that we allow them to be there without trying to change them. Once we have accepted our internal experiences, ACT teaches us to commit to living our lives in accordance with our values. Our values are the things that are important to us, such as love, compassion, courage, and integrity. ACT helps us to identify our values and to make choices that are consistent with those values.

ACT has been shown to be effective in the treatment of a variety of mental health problems, including anxiety, depression, chronic pain, and substance abuse. ACT is also a helpful therapy for people who are struggling with difficult life circumstances, such as job loss, divorce, or illness.

Here are some of the key concepts of ACT:

• Acceptance: The willingness to experience our thoughts, feelings, and sensations without judgment.
• Mindfulness: The awareness of the present moment without judgment.
• Values: The things that are important to us.
• Committed action: Taking action that is consistent with our values.
• Defusion: The process of separating ourselves from our thoughts and seeing them as just thoughts.
• Elaboration: The process of exploring our thoughts and feelings in order to understand them better.
• Self-as-context: The understanding that we are not our thoughts, feelings, or sensations. We are the observer of our thoughts, feelings, and sensations.

ACT is a powerful therapy that can help people to live more fulfilling and meaningful lives. If you are struggling with mental health problems or difficult life circumstances, ACT may be a helpful therapy for you.

ACCEPTANCE AND COMMITMENT THERAPY INTRODUCTION

Motivational Enhancement Therapy (MET)

Motivational enhancement therapy (MET) is a directive, person-centered approach to therapy that focuses on improving an individual’s motivation to change. Those who engage in self-destructive behaviors may often be ambivalent or have little motivation to change such behaviors, despite acknowledging the negative impact of said behaviors on health, family life, or social functioning. It helps individuals view behaviors more objectively, and through MET, an individual may become empowered to begin the process of change.

MET was one of three interventions tested in Project MATCH, a 1993 clinical trial of treatment options for those experiencing alcohol addiction, and an initiative of the National Institute on Alcohol Abuse and Alcoholism (NIAAA). MET is based on the principles of motivational psychology and employs techniques associated with Motivational Interviewing, a counseling style developed by William R. Miller and Stephen Rollnick. In MET, the style and techniques of Motivational Interviewing are incorporated into a structured therapeutic approach which involves a comprehensive assessment of an individual’s behaviors, as well as systematic feedback based on the findings. Detailed guidelines for MET are provided by the NIAAA.

The primary goal of MET is to help individuals overcome their ambivalence or resistance to behavior change. MET focuses on increasing intrinsic motivation by raising awareness of a problem, adjusting any self-defeating thoughts regarding the problem, and increasing confidence in one’s ability to change. Instead of identifying a problem and telling a person in therapy what to do about it, the therapist encourages a person in therapy to make self-motivating statements that display a clear understanding of the problem and a resolve to change.

Although MET may be used as a stand-alone treatment, it is more often employed in conjunction with other forms of therapy. This type of therapy can also serve as a form of pretreatment that may increase a person’s motivation to start a more specific form of therapy, such as cognitive behavioral therapy. MET might also be used along with a different form of therapy to reinforce one’s motivation to change

The primary goal of MET is to help individuals overcome their ambivalence or resistance to behavior change. MET focuses on increasing intrinsic motivation by raising awareness of a problem, adjusting any self-defeating thoughts regarding the problem, and increasing confidence in one’s ability to change. Instead of identifying a problem and telling a person in therapy what to do about it, the therapist encourages a person in therapy to make self-motivating statements that display a clear understanding of the problem and a resolve to change. 

Although MET may be used as a stand-alone treatment, it is more often employed in conjunction with other forms of therapy. This type of therapy can also serve as a form of pretreatment that may increase a person’s motivation to start a more specific form of therapy, such as cognitive behavioral therapy. MET might also be used along with a different form of therapy to reinforce one’s motivation to change.

MOTIVATIONAL ENHANCEMENT THERAPY INTRODUCTION

Transtheoretical Stages of Change Model

The Transtheoretical Stages of Change Model (TSCM) is a powerful framework that provides valuable insights into the process of behavior change, specifically within the context of mental health. By understanding this model, individuals can gain clarity and guidance as they embark on their journey towards positive mental well-being. This article aims to introduce and explain the key concepts of the TSCM, empowering individuals to navigate the stages of change with confidence and resilience.

1. Precontemplation Stage: Individuals may not be fully aware or willing to acknowledge their mental health concerns. They may exhibit resistance to change and be unwilling to seek help. This stage emphasizes the importance of raising awareness, providing education, and encouraging self-reflection to stimulate the individual’s readiness for change.

2. Contemplation Stage: Individuals start recognizing the need for change and consider the potential benefits of taking action. They may weigh the pros and cons, explore different strategies, and gather information. Encouragement and support are crucial in helping individuals solidify their commitment to change.

3. Preparation Stage: Individuals are ready to take concrete steps toward change. They may begin making small adjustments in their behavior, setting goals, and developing action plans. Building a strong support network, identifying potential obstacles, and developing coping strategies are essential in preparing for successful change.

4. Action Stage: The action stage represents the active implementation of change. Individuals engage in specific behaviors or interventions aimed at improving their mental health. This stage requires commitment, determination, and ongoing support. Implementing healthy habits, seeking therapy, practicing self-care, and adopting new coping mechanisms are examples of actions undertaken during this stage.

5. Maintenance Stage: The maintenance stage focuses on sustaining the progress achieved during the action stage. Individuals work to consolidate their new behaviors and coping strategies, ensuring long-term success. This stage involves developing resilience, managing setbacks effectively, and cultivating self-compassion. Building a supportive environment and celebrating milestones play a vital role in maintaining positive change.

6. Termination Stage: The termination stage represents the final stage in the TSCM, where individuals have successfully integrated the desired changes into their lives. The old habits and patterns have been replaced with healthier alternatives. While this stage may not be applicable to all aspects of mental health, it serves as an aspirational goal. Continuous self-reflection, self-awareness, and ongoing personal growth contribute to maintaining the benefits achieved.

Conclusion: The Transtheoretical Stages of Change Model offers a valuable framework for understanding and navigating the process of behavior change within the realm of mental health. Recognizing that change is a dynamic and multi-dimensional process allows individuals to approach their mental health journey with patience, perseverance, and self-compassion. By understanding the distinct stages and applying appropriate strategies at each step, individuals can increase their likelihood of achieving lasting positive change and fostering improved mental well-being.

STAGES OF CHANGE INTRODUCTION

Polyvagal Theory (Safety and Connection)

Integral Life Practice

An Integral Life Plan is a comprehensive framework that can be effectively incoprorated into life coaching, psychotherapy, and counseling to promote health and wellness. As a mental health counselor, I incorporate this approach into my practice to assist clients in improving their overall well-being. I also adhere to the principles in my own health and wellness life plan, and work with a life coach for my personal growth and self improvement.

The IFL acknowledges that individuals are complex beings with various aspects to their lives, including physical, mental, emotional, and spiritual dimensions. It recognizes that each of these dimensions contributes to a person’s overall health and happiness. By considering and addressing these dimensions in a holistic manner, an integral life plan helps individuals achieve a balanced and fulfilling life.

In psychotherapy, the integral life plan is utilized as a guide to identify areas of improvement and create a roadmap for personal growth. By examining various aspects such as physical health, emotional intelligence, relationships, career, and spirituality, clients can gain a comprehensive understanding of themselves and their goals. This approach helps individuals develop a deeper self-awareness and fosters personal development and fulfillment.

An integral life plan also emphasizes the importance of incorporating mindfulness practices and self-care strategies into daily routines. By practicing mindfulness, individuals become more present and aware of their thoughts, emotions, and actions, leading to better decision-making and overall mental well-being. Additionally, incorporating self-care activities such as exercise, proper nutrition, water intake, regular sleep cycles, and adequate relaxation supports physical health and vitality.

As a mental health counselor, I am dedicated to using the theory of an integral life plan to empower my clients in their journey towards improved health and wellness. By integrating this approach into our counseling sessions, we can explore the different dimensions of their lives and work collaboratively to develop a personalized plan for growth and well-being. If you are interested in utilizing the integral life plan theory to enhance your health and wellness, I invite you to reach out and inquire or broach the topic in our next session. Together, we can create a path towards a more balanced and fulfilling life.

INTEGRAL LIFE PLAN INTRODUCTION