Health and Psychology

What is Therapy?  

There are different types of therapy.  Some types of therapy are classified as evidence based-meaning they have research to support the fact that they are effective.  These include types of therapy for anxiety, depression, personality disorders, and trauma.  The main therapies are that are considered evidence based are Cognitive Behavioral Therapy, Acceptance and Committment therapy, Mindfulness Therapy, Behavior Therapy, Trauma Focused therapy and there are some short term dynamic therapies that are evidence based.  Other types of therapies are dynamic therapies that look at relationships in the past and use the therapeutic relationship to help with new relationships.  Then there is supportive psychotherapy.  While some people can make good use of supportive psychotherapy, there's no research that suggests that simply going to talk with a professional while not learning any specific skills nor changing any specific behavior will prove to have any long term impact.

How do I know if I'm getting a specific type of therapy?

You can ask the person doing the therapy what type of therapy they are doing.  You can also do some research on the various types of theapies to see what might be most effective for you.  Cognitive behavioral therapy is quite specific.  There is an agenda mutually created at each session to cover what you want to cover in the session.  You are taught specific skills to change how you are thinking about what happens to change how you feel.  You will learn to complete checklists and forms to document how you feel and what you think about.  You'll complete rating scales so you can see how you feel and how your feelings change over time.

My therapist says they are doing cognitive behavior therapy with me, but I've never completed any rating scales, done any homework, or done anything like what you mentioned.  Why not?

Good question and one I would ask your therapist.

What kind of therapy do you do at your office?

We have five therapists working at 3 different offices.  We are trained in short term and long term dynamic therapies, trauma focued treatment, and behavioral treatments including CBT.  

Personally I prefer to start off with some cognitive therapy to manage any symptoms of anxiety, depression and trauma and to help clarify and assess what is happening and ensure the diagnosis is correct in the first visit or two.   This is especially true if there are any medical conditions that may be compounding issues in treatment.  I'll coordinate with any medical personnel and help with referrals for evaluation and treatment if needed.  The initial goal is symptom reduction.  Psychotherapy can generally reduce symptoms of anxiety and depression relatively quickly, usually within 6 to 10 visits (as long as it takes most psychiatric medications for depression to start to work).  If symptoms of anxiety or depression persist after an initial course of cognitive therapy then it's very important that all other medical causes for the symptoms have been ruled out and a referral back to a physician is in order with a complete set of labs.  If the underlying medical condition is known, then that condition needs to be adequately managed to lessen the impact of that condition on mood state.  If it's an orphan medical condition or there is an unknown medical condition or there are no known treatments for the condition, then we can assist in setting up support systems, networking with researchers, clinical trials, and treatment options.  We can also help with diagnosis with the physician.  We spend much longer than an average physician does and can take a specific history of the symptoms, onset, course of symptoms, and set up diagnostic evaluations (both psychological and medical) to look at symptoms over time.  We can help with coping with changes in ability level and assist with coping with disability or illness as it progresses.

We also offer specific treatments for short and long term behavior change such as diabetic control, exercise management, weight loss, and improved compliance with prescription and non-prescription medication.  All of these are behaviorally focused.