Cognitive Behavioral and Dialectical Behavioral Therapy and Specialized Addiction Treatment Services

Cognitive Behavioral Therapy (CBT)

• Research has proven that CBT is just as effective as antidepressant medication for the treatment of depression.
• Emphasizes the role of thinking in how we feel and how we behave.
• Also effective for anxiety, panic, obsessive-compulsive disorder, addiction, mood swings, personality disorders, PTSD, sleep disorders, poor self-esteem and relationship conflict
• Psycho-educational – Time limited treatment modality.
• Combines cognitive therapy with behavior therapy.
• Helps weaken unhealthy connection between stressors and a person’s habitual reaction to stressors.
• Teaches mind and body relaxation.
• Teaches Perspective.
• Teaches people how to identify the thinking that might be causing unwanted feelings and behaviors.
• Teaches people how certain thinking patterns are causing suffering and symptoms.
• Often more effective when psychiatric medication is also applied.
• Solution-focused form of therapy. With individual CBT therapy, sessions are highly focused. The problem is identified and then the skills are applied to solve the problem.
• Short term – 12-16 sessions.
• Homework is required.
• Clients learn to practice new adaptive thoughts and behaviors with the ineffective or “maladaptive” thought or behaviors.
• Treatment is collaborative rather than hierarchical.
• Focuses on thoughts and behaviors as the targets for change.
• CBT also examines the environmental, biological and emotional aspects of the client as these are all interconnected, and influence the thoughts and behaviors of the client.
• Clients often enjoy CBT because it is interactive, collaborative and goal-driven.

Dialectical Behavioral Therapy (DBT)

• Four Basic Modules taught in both individual and group settings over 3-6 months.
• Core Mindfulness
• Distress Tolerance
• Emotion Regulation
• Interpersonal Effectiveness
• Effective for couples having difficulty with communication and frequent conflict.
• Effective for high conflict families.
• DBT is also effective in treating anger, rage, chaotic relationships, mood swings, bipolar disorder, depression, anxiety, intense fear of abandonment, addiction/substance abuse, impulsive behavior, inadequate sense of self, chronic emptiness, family problems/conflict, lack of direction with life goals, interpersonal conflict, adolescent/child behavioral concerns, difficulty controlling emotions and/or tolerating stressful situations.
• Relatively new form of therapy used primarily for the treatment of Borderline Personality Disorder
• Combines constructive criticism with efforts to promote self-acceptance.
• Largely developed from Buddhist meditative practice

Dialectical Behavioral Therapy and Addiction Treatment

Addiction and impulsivity are often intertwined. DBT teaches four sets of skills; Mindfulness, Emotion Regulation, Distress Tolerance and Interpersonal Effectiveness. The goal is to improve self-awareness by slowing emotional and behavioral responses using very simple coping skills. In this way, the individual is more apt to accurately identify the current emotion. From here, the individual learns to integrate dialectic theory into their everyday lives. Dialect theory suggests that problems occur when individuals view situations, or the world in general, in extreme opposites, thereby engaging in all or nothing, right or wrong, black or white thinking. DBT seeks to find a middle ground, to lessen the distortions and find balance. In this type of therapy, we focus on the concept of radical acceptance and change. It teaches that we cannot avoid discomfort in life, but we can learn skills to tolerate discomfort, and work to change our perceptions of it. That is, it becomes acceptable to have negative feelings or emotions, and not engage in self-defeating or self-harming behaviors such as the abuse of substances. DBT is simple, practical and therefore easily grasped.

We teach the skills and emphasize the importance of practicing them, in order to realize their benefits. As mastery of skills is developed, the individual begins to experience self-efficacy and self-actualization. In time, the skills become a working part of the individual’s daily existence, and engaging specific skills for difficult situations, becomes second nature. The events and situations that once gave rise to problems, result in more reasonable, even wise ways of being. Rather quickly, the individual practicing DBT skills is different.

Individual Psychotherapy

The approach here is eclectic, person-centered, and reliant on a sound therapeutic relationship. Drawing from psychodynamic theory much of the time, we begin to identify both unconscious and rather surface maladaptive processes, that have been in existence, oftentimes, since childhood. These processes are often unrecognizable to the person seeking therapy, and so individual psychotherapy reveals what are often surprising roots of dissonance. We then begin the path toward awareness and, ultimately, change. Thus, the healing process begins. Individual Psychotherapy is often more open-ended, as opposed to the above time-limited types of therapy.