Motivational Interviewing

Motivational Interviewing or MI is an evidenced based, solution-focused therapy aimed at helping people attain their goals, despite feeling stuck, ambivalent, helpless, or hopeless. Motivational Interviewing is very effective in helping people materialize the willingness, ability, and readiness to make substantial changes in their lives. This form of treatment is extremely helpful for people suffering with substance use problems, alcohol use problems, other addictions, as well as chronic procrastination. Motivational Interviewing is especially designed for people who may not even want to get better, but may in fact want-to-want to get better.

Motivational Interviewing is also used in the management of health conditions such as diabetes, asthma, heart disease, and weight management. Principles of MI include expressing empathy towards clients, helping clients become aware of the discrepancy between their values and their current behavior patterns, finding healthy ways to resolve resistance, supporting self-efficacy, and developing autonomy.

Unlike traditional therapies where resistance can be seen as a barrier to treatment, MI views resistance as a realistic and natural part of the process. In Motivational Interviewing, the therapist respects where the client is at any moment, does not try to impose his or her values onto the client, and rather tries to understand the client’s perspective.  MI supports client self-efficacy and optimism. This method works very well with ambivalent clients and those who may be quite unmotivated or unprepared to make changes in their lives. It is also a great catalyst to longer term treatment options including CBT or DBT, as well as 12 Step groups like Alcoholics Anonymous (AA), Narcotics Anonymous (NA), Overeaters Anonymous (OA), Gamblers Anonymous (GA), etc.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT), developed by Dr. Aaron Beck, is a psycho-social therapy that focuses on challenging and changing what is known as “cognitive distortions”. CBT is based on Cognitive Theory, which believes that we develop “maladaptive schemas”, or thought patterns, that become our automatic thoughts. CBT can help a client change a belief into a hypothesis that they can then contest in real time. Cognitive distortions can retrace back to as early as our childhood experiences. Such unhelpful thinking styles include all-or-nothing thinking, jumping to conclusions, unnecessary labeling, overgeneralizing, placing irrational demands on ourselves or others, always expecting the worst, constant self-condemnation, and more. CBT also helps people improve their ability to regulate their emotions, and encourages clients to develop personal coping strategies to manage the stressors in their lives. One of the main goals of Cognitive Behavioral Therapy is to enable clients to be able to see the way their thoughts, emotions, and behaviors interact, and furthermore be able to have more control over how they think, feel, behave, and experience the world as a whole.

Dialectical Behavior Therapy (DBT)

Dialectical Behavioral Therapy (DBT), developed by Dr. Marsha Linehan, is a heavily researched therapeutic modality that is extremely effective in treating a variety of psychological health issues, such as anxiety, depression, anger, self-harm, substance use, suicidality, emotional instability, impulsivity, unhealthy relationship patterns, as well as symptoms associated with Borderline Personality Disorder. DBT is also commonly used for people for whom traditional talk therapies have been unsuccessful. The word “dialectical” means the synthesis between two opposites, in this case helping clients implement acceptance and change at the same time.

DBT includes a combination of behavioral science, dialectical philosophy and Zen practice. Research has additionally been shown to be effective for reducing suicide attempts, severe depression, hopelessness, and self-mutilation. The goal of Dialectal Behavioral Therapy is to transform negative thinking patterns and destructive behaviors into positive outcomes. Techniques learned in DBT include interpersonal effectiveness, distress tolerance, emotion regulation, and mindfulness skills. Specifically, DBT provides clients with the ability to develop new coping skills in order to help manage painful emotions and decrease conflict in relationships.

Rational Emotive Behavior Therapy (REBT)

Rational Emotive Behavioral Therapy (REBT), developed by Dr. Albert Ellis, is one of the most influential forms of therapy, as it hugely influenced the development of Cognitive Behavior Therapy (CBT). Much of REBT stems from Eastern Philosophy as well as Greek Philosophy. It’s viewpoint parallels the Greek Philosopher Epictetus, who  was famous for writing how he believed that people were not disturbed by the things in their lives, but rather by the views they had about the things in their lives.

REBT begins by helping clients understand how it is not necessarily situations in our lives, nor our past, nor our parents, that cause us to feel and behave the way we do. Rather, it is the unhealthy, irrational belief systems, perceptions, attitudes, and thought patterns that we have developed over time, that cause our emotional distress which, in turn, leads to unhealthy actions and behaviors that interfere with current life goals. This can quickly become a self-defeating cycle, as we then have more destructive perceptions towards our own emotions and behaviors, which lead to more unhealthy behavior and negative outcomes. While in some ways, this means that we are in fact the architects of our own pain and suffering, the good news is that REBT enables us to take the necessary action and make the necessary changes to get better and create a new world for ourselves. REBT is especially effective in helping clients work through and change patterns of anxiety, anger, depression, negative self-image, resentment, guilt, and shame.

REBT therapists are trained to not only identify irrational beliefs that may be pervading clients’ lives, but help clients to be able to do this for themselves. One of the main goals of REBT is to enable clients to get to a place where they can become their own therapists. REBT helps clients dispute and challenge their irrational and unhealthy belief systems, and in return replace them with adaptive, rational belief systems, which will in turn lead to healthy emotions, thoughts, and behavior patterns.

Mindfulness 

Mindfulness is defined as the psychological process of bringing one’s attention to the present moment. It is not a way to reduce stress, but rather a way to tolerate stress. Mindfulness can be a powerful tool to help clients push forward, in therapy and in life. Using it consistently has the ability to help train the mind for a happier, healthier life. One of the important aspects of mindfulness is to remember that there are many different types that can be introduced to a client. Mindfulness can take the form of walking, eating, playing music, writing, painting, experiencing nature, and much more. The more you practice mindfulness, the more familiar and comfortable you get with this technique. Mindfulness gives clients more control and more choices, reduces suffering, increases the capacity for pleasure, and increases compassion for ourselves and others.

Gestalt Therapy

Gestalt therapy, developed by Dr. Fritz Perls, is an experiential, phenomenological (say what?!), here-and-now focused therapy that utilizes experimentation, creativity, guided imagery, dream work, and many more interventions to help clients heal in the present moment. Gestalt Therapy gave birth to one of the most profound therapeutic interventions, the “empty chair.” This practice, amongst others, helps clients increase their awareness of their own experience, as well as processing and resolving interpersonal conflicts, by creating dialogue between the many parts of who we are, in real time. This is also an extremely powerful technique in helping people resolve resentments, anger, and histories of abusive, traumatic, or very difficult childhoods. Gestalt Therapy values the concept of “resolving unfinished business”, and really helps clients learn how to become mindful of our own needs, and furthermore create powerful tools to consistently get our needs met.

Gestalt Therapy is also based on the idea that people are always in the process of becoming, rediscovering, and remaking themselves. Its approach to mental health practice is that individuals must be understood in the context of their ongoing relationship with their environment. This therapy helps clients gain awareness of what they are experiencing and how they are experiencing it. Gestalt Therapy values the acceptance of personal responsibility, as well as working towards establishing a deeper contact with the world. Ultimately, it helps guided people towards self-support.

Exposure and Response Prevention (ERP)

Exposure and Response Prevention is an extremely effective therapy for anxiety, most specifically Obsessive Compulsive Disorder (OCD), Pure Obsessional OCD (Pure-O), Panic Disorder, Social Anxiety, Body Dysmorphic Disorder (BDD)and Phobias. While Exposure Therapy may seem scary and extreme, as many clients get turned off just by the sound of it, it is actually immensely helpful, and always done in a safe, supportive environment. Many clients who have suffered terribly for years, plagued by debilitating obsessions, compulsions, ruminations, panic attacks, fears, and anxiety, experience substantial relief, sometimes within just a few sessions.

ERP is based on the time-tested principle that anxiety symptoms will be most greatly reduced through exposing ourselves to the things that scare us most (in a safe manner), without engaging in the behaviors that we typically engage in to reduce our own anxiety. You see, many people are surprised to learn that many of the things that they think are relieving their anxiety, are actually reinforcing it in the long run and making it much worse. Behaviors such as avoiding anxiety-provoking situations, being hyper-attentive to making sure that everything is ok, and responding to anxiety with mental or physical compulsions in order to calm down, actually fuel the initial obsession or anxiety to keep coming back. Very often even anti-anxiety medications such as benzodiazepines (Xanax, Ativan, Klonopin, Valium) become just another destructive compulsion or band-aid, continuing to make the initial anxiety come back stronger and stronger each day.

On the flip side, when we practice exposing ourselves to what we fear, in a very specific, therapeutic way, we begin to experientially and naturally learn how to tolerate, manage, and let go of the unwanted, intrusive thoughts, emotions, or physical symptoms that are causing us so much stress and turmoil. By learning how to face our fears, we actually rob the anxious thoughts of their power. It is kind of like getting into a pool. It may feel ice cold at first, but once you start to get in more and more, you get used to it and it no longer feels cold at all. In fact you don’t want to get out! Another example that we like to use includes watching a really scary horror movie. If every time the gory chainsaw scene comes on, you cover your eyes and ears, pull the blanket over your head, and fast-forward through it, the scene will never gets less scary. If we find a way to watch the scary horror scene, and tolerate it, and then do that over and over and over again in a therapeutic way (ERP should not be tried on your own as it requires specific techniques), eventually it won’t be scary at all. In fact it may start to become kind of funny and entertaining. Oh here comes the chainsaw scene, no big deal!

There are numerous forms of Exposure Therapy. When exposing oneself to feared outcomes is either impractical or unsafe, imaginal exposure is straightforward to implement and highly effective. Imaginal exposure allows us to still be able to become desensitized to our triggers, intrusive thoughts, panic, anxiety, etc., without actually having to experience it in real life.

Some of the biggest, quickest, and sustaining breakthroughs we have seen have been a result of Exposure and Response Prevention – it is really the gold standard in treating many forms of anxiety.

Psychodynamic

The Psychodynamic approach to therapy includes theories that tend to view human functioning based upon the interaction of unconscious drives, conflicts, and motives. Psychodynamic Therapists believe that our feelings, thoughts, behaviors, and decisions are heavily influenced by our past experiences and that many of our psychological problems may be rooted in our childhood experiences. In therapy the client is encouraged to speak their minds freely about their thoughts, dreams, fears, and desires. By doing so, with the help of a skilled therapist, meaningful insight can arise which can then help us to change. This perspective also wishes to identify “defense mechanisms” that we develop to keep us safe. Unfortunately many of these defense mechanisms end up becoming problems of their own. This approach analyzes unresolved conflicts and experiences that ultimately may result in mental health struggles such as depression, anxiety, anger, relational conflict, or substance abuse. Overall, this therapy uses client self-reflection as well as the power of the therapeutic alliance between client and therapist, to explore and ameliorate maladaptive coping mechanisms and dysfunctional relationship patterns.

EMDR

Eye Movement Desensitization & Reprocessing (EMDR) is a methodology of adaptive information processing that utilizes bilateral stimulation (BLS) ─ eye movements, tapping, or auditory tones ─ in order to accelerate the brain’s capacity to process and heal a troubling memory. BLS stimulates the same eye movements which occur during Rapid Eye Movement (REM) during dream sleep. BLS causes the two brain parts to work together to reintegrate a memory. Some clients can experience relief or positive effects in just a few sessions and others need more sessions.

EMDR is effective in treating trauma-related symptoms, whether the traumatic event occurred many years ago or yesterday. It gives desired results without requiring talking in detail about the distressing issue, without using drugs, and requires no “homework” between sessions. EMDR therapy allows the brain to heal in a natural process, rather than focusing on emotions, thoughts, or behaviors resulting from the distressing issue.

Research has demonstrated that EMDR is effective for the treatment of anxiety, panic attack, post-traumatic stress symptoms (such as intrusive thoughts, nightmares, and flashbacks), sexual and physical abuse, disturbing memories, complicated grief, chronic pain, dissociative disorders, depression, phobias, identity crisis, sleep disturbances, substance abuse/addiction, and other traumatic experiences.

For more information visit: https://www.emdria.org/news-and-announcements/new-what-is-emdr-therapy-video/