Cognitive Behavioural Therapy (CBT)
Cognitive Behavioural Therapy works from the perspective that our thoughts have a huge impact on how we respond to anything we experience. The same event (ex. a friend passes you on the street without saying "hi") can lead to wildly different responses depending on how we think about it. Those response can include triggering certain emotions (anger, sadness, anxiety), which then lead us to act certain ways. Those actions can be effective (take a breath to calm down when we're upset) or can maintain or worsen our emotions (yelling at your friend can lead to even more anger, guilt, and sadness).
In CBT we try to identify thought patterns that aren't accurate or effective, and may be exacerbating your emotional reactions. We also identify ways you may be acting (like avoiding things you're afraid of, staying in bed when you're depressed, snapping at your partner when you feel frustrated) that are getting in the way of your goals, and learn skills to help you act more effectively.
CBT is very effective in treating anxiety disorders, OCD, PTSD, and depression.
Acceptance and Commitment Therapy (ACT)
Acceptance and Commitment Therapy (ACT) is a type of CBT. It follows similar principles - that our thinking impacts the way we feel and act. However, instead of working on identifying thoughts and challenging their accuracy, in ACT we work on trying to accept whatever thoughts or feeling we may be experiencing, and instead focus on acting in ways that are consistent with our values. By using mindfulness skills to practice letting ourselves experience difficult thoughts and emotions, we will learn how to stop our automatic reaction of avoidance and fighting against unwanted thoughts and emotions. By doing this, we have more attention and energy to focus on acting in ways that lead us towards the meaningful things in our lives, whether those are in our relationships, work, family, or hobbies. By doing this, we can help create psychological flexibility, or the ability to change our reactions according to what will be most effective in each situation.
CBT is very effective in treating anxiety disorders, depression, burnout, chronic pain, and PTSD.
Dialectical Behavioral Therapy (DBT)
Dialectical Behavioural Therapy (DBT) is a combination of CBT, mindfulness, and skills training that focuses on identifying if acceptance or change is needed in a situation, and learning skills that will help you achieve that. Sessions are focused on analyzing situations where you acted ineffectively (ex. having too many drinks the night before and being hungover at work; yelling at your partner because they didn't recognize how difficult your day had been), identifying skills you could use to change the situation or your reaction to it, and practicing those skills.
In this way, DBT is very skills-focused, with focus on the following areas:
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Distress tolerance skills: short-term skills to help in the moment when your emotional and physical experiences feel overwhelming. These skills aren’t meant to be used long-term, but can be helpful in getting through crisis situations.
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Emotion regulation skills: learning how to identify which emotions you are feeling, why you are feeling them, and how to manage them effectively.
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Mindfulness skills: learning how to live in the present moment, in a non-judgmental way, without being caught up in worries about the future or thoughts about the past.
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Interpersonal effectiveness skills: learning how to communicate with others in a way that is more likely to help you be understood and have your goals met.
These skills are particularly helpful for people who have been experiencing burnout, anger management issues, self-harm, substance use, or impulse control problems.
Couples Therapy
Dialectical Behavioral Therapy (DBT) for couples uses the same principles as DBT for individual therapy: we focus on identifying situations where acceptance or change will be most effective in decreasing conflict and increasing affection and intimacy in relationships. While this therapy is often done with romantic couples, it is also effective with family members, friends, and roommates.
Just like individual DBT, couples DBT focuses on building skills:
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Distress tolerance skills: short-term skills to help in the moment to avoid miscommunication and conflict. These skills aren’t meant to be used long-term, but can be helpful in getting through crisis situations until you are able to regroup with your partner and discuss the situation more effectively.
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Emotion regulation skills: learning how to identify which emotions you are feeling, why you are feeling them, and how to manage them effectively, as well as which emotions your partner may be feeling, and how to help them be skillful in managing them.
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Mindfulness skills: learning how to live in the present moment with your partner, in a non-judgmental way, without being caught up in worries about the future or thoughts about the past.
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Interpersonal effectiveness skills: learning how to communicate with your partner in a way that is more likely to help you be understood and have your goals met.
Family Skills Training
It can be very difficult to know how to help family members who are having experience you have never had or don't know how to deal with. For someone who has never experienced severe depression, it may seem helpful to tell someone to "look at the bright side of things". Similarly, when family members or friends are more emotionally sensitive or reactive than you are, it can feel like you are living in 2 separate realities: They may become upset or anxious in response to something you didn't notice, or their level of anger or sadness may be much more intense than makes sense to you.
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To learn about your loved one's mental health struggles and how they may be impacting your relationship with them.
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To learn skills to help you manage your own reactions to your loved one's struggles, as well as relationship skills to help you more effectively communicate with your loved one, and support them in their own skills use.
DBT skills training largely follows the same emotion regulation, mindfulness, and interpersonal effectiveness skills taught in individual DBT. It is very helpful for family members whose loved ones are in individual DBT, but can also be of benefit for anyone whose loved one is experiencing severe