Types Of Therapies
As a psychologist, I employ evidence-based therapies for optimal treatment outcomes.
These therapies are carefully selected to ensure efficacy, scientifically proven to be effective, and align with best practices in the field.
These therapies include:
Cognitive behaviour therapy (CBT):
CBT focuses on the way we think.
How do we interpret a situation/event?
How does our thinking affect the way we feel?
Does it affect the way we behave or respond?
​
CBT requires active participation. It involves problem solving and goal setting.
CBT is based on the cognitive model below:
Situation/event
Interpretation/automatic thought about the situation
Reaction (emotional, physiological, behavioural)
Is our interpretation based on how we feel?
Is it based on an assumption?
We could be adding to our suffering.
Example: I wave at a friend from a distance at a shopping centre. She looks straight ahead and does not wave back. Automatic thoughts: “Have I done something to upset her? She doesn’t like me.” Quick recall of our last encounter. “I probably offended her. I’m not a good friend”. Emotions: anxiety, guilt. Reaction: I can’t stop thinking about it. I avoid her.
Fact: Friend wasn’t wearing her glasses at the shops. She didn’t see me. Friend is confused about me avoiding her.
In CBT, we learn how to challenge negative thoughts and understand where those thoughts come from. Our thoughts may emanate from our core beliefs i.e. global, rigid beliefs and ideas that we have about ourselves, other people and the world.
We can test these beliefs and challenge our assumptions.
​
The benefits? A change in emotion and a change in behaviour.
Dialectical behaviour therapy (DBT):
DBT is a cognitive-behavioural treatment that addresses difficulties in regulating emotions and behaviours. It takes into consideration our interpretation of an event and what factors led to that interpretation e.g. our personality, past experiences, biology, coping skills.
Emotional dysregulation can lead to communication issues in relationships, not getting our needs met, giving in to unhelpful urges such as excessive drinking, self-harm; and not being able to handle everyday issues because emotions become too intense. This can lead to feeling misunderstood and poor self-image.
​
DBT promotes skills and practical strategies to improve quality of life. The aim is to not make matters worse.
DBT promotes acceptance of oneself and making change in behaviours. It consists of learning and applying skills such as:
* Mindfulness: An acceptance skill. Having awareness, being “awake”; allowing experiences rather than trying to avoid them. Focusing on the present moment without judgement Thought with judgement: “This is bad. Anxiety will ruin my day”. The judgment might divert our energy from positive experiences and from problem solving.
​
* Distress tolerance: An acceptance skill. Tolerate and get through a crisis; and accepting life in that moment without always trying to escape the discomfort – which could have long term consequences.
​
* Emotional regulation: A change skill. Use of mindfulness skills to be aware of emotions, being more flexible in our thinking, identifying how we avoid emotions and understanding how our emotions drive our behaviours. We do this by changing our emotions, reducing vulnerability to these emotions and problem solving.
​
* Interpersonal effectiveness: A change skill. Learning how to say ‘no’, learning how to get our needs met, being assertive – as opposed to aggressive, passive or passive aggressive. Learning how to see someone else’s perspective and nurture relationships. Learning how to validate others. Learning how to enhance self-respect when communicating.
​Eye movement desensitisation and reprocessing (EMDR) therapy:
EMDR was originally designed for PTSD.
EMDR can be used for depression and anxiety including panic, phobia, and somatic symptoms.
EMDR was designed to:
-
Reduce the vividness of traumatic memories/images/experiences.
-
Reduce the emotional intensity that arises when thinking about the traumatic memory.
-
Reformulate negative beliefs that have arisen because of the traumatic memory.
-
Processing a memory into a more adaptive state so that life is not affected as much by PTSD symptoms such as disturbing dreams, anxiety, avoidance of events/situations, hypervigilant behaviours and intense reactions to reminders.
EMDR uses a three-pronged protocol that targets: past events, present events that cause distress and anticipated future events that may cause distress. It can be used a stand-alone treatment or within a wider treatment plan.
Prolonged exposure therapy:
The aim of prolonged exposure therapy is to emotionally process traumatic experiences to reduce and eliminate PTSD and trauma symptoms. Avoidance and anxiety/fear are common reactions to PTSD. Avoidance can negatively affect quality of life.
Prolonged exposure is exposure to anxiety provoking situations and memories to overcome the anxiety.
It involves the following:
-
Understanding PTSD and trauma symptoms and understanding common reactions to trauma.
-
Learning and developing grounding techniques such as breathing.
-
Exposure to situations that are avoided.
-
Imaginal exposure – recounting trauma memories. The aim is to reprocess the memory and experience reduced PTSD symptoms.
Acceptance and Commitment Therapy (ACT):
ACT focuses on living a meaningful life and accepting that pain is a part of that life.
It helps to identify what we value, why it is difficult not to follow those values.
​ACT can help when we feel demotivated and resistant.
To lead a meaningful life, ACT explores the following:
-
Values - what matters to you?
-
Committed action i.e. realising our values, goal setting, learning skills, exposing ourselves to fear
-
Greater awareness of our thinking, emotions and behaviours.
-
Psychological flexibility – being open, being present and doing what matters.
-
Cognitive defusion. Separating from our thoughts, images, memories. Instead of being completely guided by negative judgements and finding it hard to let go of thoughts/worries – we learn how to detach from them. We hold them lightly.
-
Mindfulness – being in the present rather than autopilot. Consciously paying attention.
-
Acceptance – opening to our reality. Reducing the struggle that can come with denial and avoidance.