Types of CBT

Below is a description of the types of CBT available at NYC Cognitive Behavioral, PLLC:

NYC Cognitive Behavioral, PLLC is committed to providing our patients with state-of-the-art cognitive behavior therapy (CBT). Our center keeps staff aware of the latest developments and research in traditional CBT as well as promoting training in “third generation” CBT.

Which type of CBT fits best for you will be determined by; the nature of your specific difficulties, the results of previous therapies, your own unique background, your own preferences, your unique strengths and weaknesses.

1) Behavior Therapy (BT) : After traditional freudian (psychoanalytic) therapies peaked, behavior therapy became the beginning of a modern approach to therapy. BT was the first of the truly scientifically proven therapies. The behavioral science of learning, i.e., how we learn to react emotionally, behaviorally and cognitively, is still the basis of all modern cognitive-behavior therapy (CBT). Today behavior therapy is still practiced by world renown specialists like David Barlow, PhD (Boston University) & Edna Foa, PhD (University of Pennsylvania). Its basic interventions such as exposure or exposure response prevention (a type of desensitization) , may still be the most powerful treatment for anxiety disorders (Phobias, Panic attacks, Obsessive Compulsive Disorder, etc). BT also continues to prove its effectiveness as a treatment for major depression. Other examples of behavioral interventions include, behavioral activation, social skills training and communication training. The latest research trials continue to demonstrate just how essential behavioral change and activation is to changing all other aspects of our reactions, e.g., thinking and emotions. Read more…

2) Cognitive Therapy (CT) : One of the specific types of cognitive-behavior therapies, it was created by Aaron Beck, MD at the University of Pennsylvania, but now practiced as the primary form of therapy all over the world. “Cognitive” literally means knowing or thinking, so CT emphasizes directly changing how we think. By changing how we think, we can change our emotional and behavioral reactions. CT emphasizes interventions such as, evidence based thinking, hypothesis testing our thoughts, activity scheduling and prediction. It is the most scientifically proven therapy for depression and anxiety disorders; scientifically proven controlled research trials have shown its effectiveness is often comparable to medication therapy. CT has also gone on to accumulate hundreds of proven effective results for anxiety disorders, personality disorders, eating disorders, phobias, marital discord, ADHD, and aspergers syndrome, etc. Several of Our staff are proud to be credentialed by the Academy of CT., the only national credentialing organization standardizing CT. Since CT has become the most proven and recommended type of therapy, many psychotherapists now claim to know how to do CT, unfortunately very few are actually credentialed or trained to do so. Read more…

3)Cognitive-Behavioral Therapy (CBT) : Essentially an integration of both cognitive and behavioral therapies. One of the most highly recommended and scientifically proven combinations of the modern therapies mentioned above. It is a generic term used to refer to a broad, non-specific combination of behavior therapy and cognitive type therapies. When used loosely, the term CBT is sometimes used interchangeably (though mistakenly) with the term “cognitive therapy” (CT), and while the two share may share many similarities, technically CT refers to a more specific brand of CBT. Technically CT emphasizes a more thought focused set of interventions, based on model espoused by Aaron Beck, MD. Dr. Beck along with the other CBT founding father, Albert Ellis, PhD, are both acknowledged as revolutionizing what the world now considers to be talk therapy. CBT when provided by a truly trained and experienced CBT provider effectively combines the best that modern science can provide in utilizing all of the interventions developed within traditional and third generation CBT’s. Everyone now claims to do CBT, few have really been educated, trained, supervised and experienced in delivering the real thing. Read more…

Third Wave CBT’s

A generic term used to describe a loosely affiliated group of CBT’s which share an interest in continuing the scientific & behavioral roots of CBT, but have included and expanded beyond the traditional CBT emphasis on changing or controlling symptoms and disorders. Instead many explore acceptance and minfulness as an alternative to over-control, and emphasize wellness, rather than disorders & symptoms.

4)Acceptance and Commitment Therapy (ACT) : ACT and other so called “third generation” CBT’s are still very interested in some of the main principles of CBT; the importance of behavior, empirically based theory and treatments, the importance of dealing with our inner experience, e.g., thoughts/sensations/emotions. All CBT’s including ACT, share an interest in the effects of thoughts on a person’s life, however ACT more fully explores the role of acceptance in our emotional and cognitive conundrums. It emphasizes procedural knowledge (body knowledge) as a way of learning what paradoxically happens when we try too hard to control our thoughts or inner emotions. Instead it introduces and explores mindfulness exercises as an alternative way to re-experience acceptance of our inner states. This is emphasized since so many emotional disorders can be worsened by attempts at over control, over-compensation, compulsiveness , emotional avoidance and other forms of rigid misguided coping. ACT incorporates mindfulness exercises, a present orientation, values exploration, commitment to gradual action toward our values, a non-literal experience of our thoughts, and a expanded definition and experience of our self. It’s creator Steven Hayes, PhD., has been making sure that acceptance and mindfulness is scientifically integrated into psychotherapeautic theory, not just dropped in as an after thought. He along with many other ACT therapists have generated alternative ideas and methods for re-experiencing or re-acting to our inner lives, re-evaluating the purpose of our lives, and therefore re-directing attention and actions in our lives. Read more…

5) Dialectical Behavior Therapy (DBT): One of the first CBT treatments to incorporate the scientific principles of traditional CBT, it bravely blazed the way into new third generation CBT territory. Originally developed by Marsha Linehan, PhD., to treat the most complex and intractable type of syndromes, e.g., personality disorders, impulsive and suicidal symptoms (borderline personality disorder in particular). DBT has shown results, where other treatments failed. It has since been applied to a variety of personality problems, and other complex and chronic cases. It is based on a dialectical philosophy which challenges us to face and make our peace with the complex and opposite truths often inherent in many situations. The most basic of these paradoxes being between accepting ourselves or changing ourselves. It is a skill based approach, which encourages balancing the best of our emotional and objective selves. Its core skill is mindfulness (learning a non-judgmental, present centered intentional awareness), and applying this mindful awareness to life via the other major DBT skills; emotion regulation, distress tolerance, and interpersonal skills.
DBT has been successfully applied to a wide variety of problems where emotional dys-regulation and destructive impulsivity/avoidance has interfered with living. DBT treatment has been applied to not only personality problems but, substance abuse, trichitollomania, eating disorders, explosive anger, depression and anxiety.

6) Functional Analytic Psychotherapy (FAP):
An very interpersonal form of therapy which can be used to treat a wide variety of problems, such as anxiety disorders, but which can also be used to enhance our ability to approach challenging life circumstance with courage and care. FAP challenges both therapist and client to utilize the time in session to raise mindful awareness for our behavior, noticing how and where it works and where it dosen’t, using this in session emphasis FAP goes on to practice courage by opening up to our emotions and finally finding a compassionate way of encouraging and maintaing working purposeful behavior beyond the session and into our daily lives. The three elements of practicing mindful awareness, courage and loving acceptace (ACL) in and out of session are at the very heart of this third generation form of behavior therapy.

7) Compassion Informed Psychotherapy: Recently empirical and scientific information about how brain works are shedding new light on how evolution has helped our brain to develop some very special social & emotional abilities. Therapies like, Compassion Focused Therapy (CFT) & Mindful Self Compassion (MSC) Therapy, are taking advantage of this new science by interagting it into interpersonal therapies. These compassion therapies, practice and develop these very special forms of social-emotiona intelligence, in and out of session, to treat anxiety and depression while enhancing our day to day lives.

8) Mindfulness Based Cognitive Therapy (MBCT): One of the first expanded cognitive therapy protocols to formally integrate mindfulness into reacting to thoughts. It is Based on mindfulness type treatments such as Jon Kabbat-Zinn’s, Mindfulness Based Stress Reduction, which has had impressive scientific results with chronic pain, hypertension, gastrointestinal disorders, and other medical disorders, The team of Z. Segal, M. Williams and J. Teasdale, have shown good results with MBCT for treating re-current chronic depression. MBCT, emphasizes changing not the content of our thoughts, but our reaction to our thoughts. MBCT practices distancing ourselves mindfully from our thoughts, by practicing a greater awareness of how we judge our thoughts, and how this tendency then contributes to our having “secondary emotions”, e.g., we get depressed about having depressed thoughts. Mindfulness and a compassionate perspective helps to break this vicious cycle common to many ruminative type process, and teaches us to constantly refocus on making choices to improve day to day, minute to minute lives.

9) Integrative Couples Behavior Therapy (ICBT): Developed at the “Love Lab” at University of Washington, by Neil Jacobsen, PhD and Andrew Christensen, PhD. It has integrated the best scientific principles of couples behavior change & conflict resolution, with the vitally important acceptance of our partners sensitivities and traits. Through communication tools such as empathic listening, a better understanding of how we love the very characteristics we may also hate in our partners, we may learn to change our expectations and assumptions about our partners. This is combined with committed attempts at conflict resolution; problem definition, brain storming, hypothesis testing, revisiting the results of the experiment and incorporating what has been learned. Communication skills are rehearsed, as is pleasure planning and positive tracking.

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