Dr. Aaron T. Beck: The Father of Cognitive Behavioral Therapy 

On Monday, Nov. 1, the world lost an incredible psychiatrist when Dr. Aaron T. Beck, the aptly named “father of cognitive behavioral therapy” who pioneered the field and taught at the University of Pennsylvania and other colleges, died peacefully in his sleep at the impressive age of 100.  

Throughout his storied career, Dr. Beck earned many awards, including the prestigious Gustave O. Lienhard Award from the Institute of Medicine. He also co-authored 25 books and upwards of 600 articles over the years and, in 2017, was named the fourth most influential physician over the last century. 

In 1994, Dr. Beck, along with his daughter Dr. Judith Beck, co-founded the Beck Institute, a nonprofit organization committed to helping people around the world live more fulfilling lives through the promise of cognitive behavioral therapy, also known as CBT. 

What Is Cognitive Behavioral Therapy? 

At a very basic level, CBT is a talking therapy that’s all about helping people solve their problems by understanding how the way they think about the situation at hand influences how they respond to it. 

For example, if a small business owner who runs a tight ship gets a letter from the IRS and immediately starts thinking about the worst-case scenario, chances are they will be stressed out and respond irrationally to the circumstances — much to the chagrin of those in their lives.  

By learning that the way they mentally interpret an event influences how they’ll physically respond to it, the small business owner might use CBT to retrain how they react to letters from the IRS and remind themselves to take a deep breath the next time one invariably ends up in their mailbox. 

According to Dr. Beck, the way we think about issues can be established in childhood. And if we think about issues the wrong way, these cognitive errors could lead to problems down the road.  

By enrolling in CBT sessions, Dr. Beck believed people could unlearn these unproductive ways of thinking while developing healthier responses to unwelcomed situations. Rather than stumbling into a tricky situation and feeling overwhelmed, people can learn to break down big problems into smaller manageable parts, making it that much easier to respond to them in a calm, cool, and collected manner. 

Why Is Cognitive Therapy Important? 

There’s not much any of us can completely control in this world. That said, we do have control over how we think about the world and our experience in it. This is why CBT can be particularly helpful — and why Dr. Beck’s daughter, Dr. Judith Beck, is continuing her father’s work at the Beck Institute. 

With that in mind, let’s take a look at some of the main reasons therapists and their clients find CBT to be particularly attractive. 

It’s generally risk-free 

While clients might deal with uncomfortable emotions and sentiments during CBT sessions, this is more or less par for the course when it comes to any form of therapy. Aside from crying, getting upset, and otherwise feeling awkward, there’s very little risk when patients decide to use CBT to confront the problems they’re facing. 

That said, it’s important to remember that CBT is not a quick fix for behavioral and mental health issues. While it can be particularly helpful for many patients, it’s not the right treatment for everyone, e.g., those with complex mental health needs. 

It can help people overcome serious trauma 

Ultimately, the whole point of therapy is to help people become the best versions of themselves possible — and this is an area where CBT shines. By helping clients reframe how they think about issues, it’s possible to help them overcome all sorts of issues, including stress, anxiety, depression, and even more serious traumas, like sexual abuse and physical abuse. 

It produces quick results 

Whereas some approaches to therapy might take patients months or even years to overcome the issues they’re facing, CBT can deliver results quickly — in as fast as five sessions. This is attractive to both clients who want to solve their problems as quickly as they can and therapists who want nothing more than to improve their patients’ lives; the sooner that happens, the better. 

How CBT Changed the World 

At the end of the day, all of us see the world through a distorted lens, at least every now and again. Thanks to Dr. Beck’s innovative work in the realm of CBT, the stigma around mental health has perhaps faded at least a bit, as it made therapy more approachable to pretty much everyone. 

While the world is no doubt a little less bright due to Dr. Beck’s passing, we can take comfort in the fact that his work will live on through the Beck Institute — and that CBT will continue to evolve to provide more help to even more people who need it. 

To continue your learning, read more about the development of psychotherapy and our understanding of mental health here. Interested in CBT for yourself? Search for therapists near you and filter your results by Type of Therapy > Cognitive Behavioral Therapy (CBT). 

by David Panahi, Licensed Professional Counselor

3 Steps to Overcoming Negative Self-Talk

We are our worst critics. The things we say to ourselves are often far more damaging than what others say to us. I have battled negative self-talk for most of my life, and it affected my mood, energy level, and productivity. Most of us hope that life will be exciting and adventurous, but our inner critic ruins anything good.

That self-criticism brings a “yes, but” mentality to whatever is happening in our lives at the moment. “Yes, it is great that you graduated school, but who is going to give you a job?” “Yeah, you lost ten pounds, but you’re going to gain it again in no time.” Negative self-talk refuses to see the positive in what is happening, constantly focusing on doom and gloom. This does us no favors.

It’s easy to give in to self-criticism. The following steps are ways that I recommend my clients in therapy who are dealing with negativity.

1. Acknowledge when you’re engaging in negative self-talk.

Dr. Phil McGraw has a saying: “You can’t change what you don’t acknowledge.” The first step to changing a bad habit is noticing ourselves engaging in the behavior. You might want to journal about it or take a mental note when it is happening.

2. Identify the intentions behind your negative self-talk.

When we are not aware, our past frustrations and wounds influence our present behavior. Beneath the negative self-talk lies the intention of avoiding disappointment, hurt, and failure. We need to know why our brain associates the present experience with negativity in order to break the habit. 

3. Reframe your present experience.

In Cognitive Behavioral Therapy (CBT), reframing means understanding an experience, event, or idea from a different point of view. If our brains automatically focus on the negative, we need reframing to see the positive side of what is happening. 

Think again about my two examples above. 

• True, it might take some time to find a job fresh out of school, but this information doesn’t diminish your accomplishment! Graduating is a significant milestone.
• Sure, losing 10 pounds does not guarantee that you will always be physically fit. Still, you cannot discredit the fact that you lost those 10 pounds. 

Reframing our faulty perception empowers us to have a realistic view of what is happening. It also saves us from the emotional rollercoaster that we experience on a daily basis.

Start at the Beginning

My encouragement to you for today is to pause and pay attention to what kind of things you say to yourself. Then use the three-step technique to reframe those negative thoughts with positive ones.

Negative self-talk can be challenging to overcome. Consider enlisting the help of a therapist who can help you succeed. Click through to find a therapist near you.

Finding the Differences Between Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT)

Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) each play an important role in treating mental health issues. These two types of therapy fall under the umbrella of psychotherapy, also known as talk therapy. Throughout the therapeutic process, an individual facing challenges talks with a professional in a safe, confidential, growth-stimulating environment where they learn new skills on how to manage those challenges.

CBT and DBT are among the most common methods of psychotherapy used to treat mental health issues. While they share many similarities, they also have important differences.

What is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy, also known as CBT, primarily focuses on the relationship between thoughts and feelings. This line of thinking focuses on how thoughts impact feelings and how certain patterns of behavior can lead to mental health challenges. CBT also focuses on replacing unhelpful thoughts and behaviors with new actions and ways of thinking. Therapists often use CBT to treat mental health issues like depression, anxiety, substance abuse, and more.

Therapists use Cognitive Behavioral Therapy and work with clients to identify issues and challenges, uncover the causes, and establish new coping mechanisms, tools, and strategies to help get past or overcome them.

What is Dialectical Behavior Therapy?

Dialectical Behavior Therapy, also known as DBT, is a modified alternative to CBT. It was initially created to treat BPD (borderline personality disorder). Therapists often use DBT with clients who are experiencing suicidal thoughts or actions, but they have discovered new ways to treat other mental health issues through Dialectical Behavior Therapy.

DBT stresses the practice of mindfulness, increasing distress tolerance, strengthening emotional regulation skills, and growing relationships. Clients work with their therapist to uncover harmful thought patterns, accept them, and learn how to react to them healthily. Balance is critical in this form of therapy as clients work to accept their challenges and work toward change.

Differences Between CBT and DBT

Emphasis

The main difference between Cognitive Behavioral Therapy and Dialectical Behavior Therapy is a matter of emphasis: CBT focuses on thought patterns and their redirection; DBT focuses on balance and the relationship between acceptance and change. Both Cognitive Behavioral Therapy and Dialectical Behavior Therapy aim to ultimately help the client change their thought patterns.

Time

Cognitive Behavioral Therapy is usually completed after a short interval. These sessions focus on specific problems. With a set goal in mind, clients have something they’re working toward, and CBT is finished once they get there. DBT usually involves sessions over a more extended period of time where the therapist and client can consider the larger picture.

Setting

Another difference between CBT and DBT can be context. Cognitive Behavioral Therapy nearly always takes place in a one-on-one setting. The client and the therapist work together, and then the client will often have “homework” to take home. On the other hand, Dialectical Behavior Therapy can be used in both one-on-one and group settings.

Choosing a Method

Some therapists call upon multiple methods of therapy, also called modalities or models of therapy, which is often referred to as an eclectic approach; other therapists will choose the model they believe best to help each individual person; still others specialize in just one or two models. Both CBT and DBT are useful for treating a wide range of mental health issues. To determine which approach will work best for you, consult with a therapist. 

To connect with a therapist in your area, click here.

By Gary Trosclair, DMA, Licensed Clinical Social Worker

Do you really have OCD? Or is it OCPD?

OCD has become a household term we casually use to refer to anyone who needs to have things a certain way. As a casual term, it works well. It gives us a general sense of what’s being described. But if it’s used as an actual diagnosis to determine therapeutic treatment, it can cause problems. People who we might casually say have OCD may actually have a different condition, and the differences between these conditions call for a different approach to treatment.  

OCD, Obsessive-Compulsive Disorder, may look similar at first to a different condition, OCPD, Obsessive-Compulsive Personality Disorder, which is often overlooked and even misdiagnosed by clinicians. But OCD is an anxiety disorder, while OCPD is a personality disorder.

Diagnostic Difficulties

Far fewer people have OCD than have OCPD: 1.2% of the population has OCD,[1] while as much as 7.9% has OCPD.[2]   

About 20% of the people who have OCD also have OCPD,[3] making it difficult to distinguish between the two. And both diagnoses can be either severe or less-debilitating. Many people have some traits of Obsessive-Compulsive Personality Disorder but do not meet the full diagnostic criteria. These individuals can be very productive and fairly well-adapted socially.

Proper diagnosis should be completed by a licensed mental health professional. But following are some fundamental differences that may help you to better understand yourself in either case.

Symptoms: Specific vs. Generalized

People with OCD have specific obsessions (thoughts that are intrusive, involuntary, repetitive, irrational, and anxiety-provoking) and specific ritualistic compulsions (repetitive behaviors they can’t stop, such as checking and washing). On the other hand, the entire personality of someone with OCPD is affected by an overwhelming need to prioritize control, perfectionism, and order.

While people with OCD may try to control very particular things in order to quiet their obsessions, people with OCPD tend to be controlling universally. It’s as if the space they need to control is much larger. It’s not just the cupboards, it’s their entire world, and they can become very rigid about it.

Emotional Differences

People with OCD are more likely to feel anxious when specific things aren’t the way they want them to be. People with OCPD are more likely to feel angry if things aren’t the way they believe they should be.  

For instance, Angie, who suffers from OCD, is concerned about how the dishes get washed because she feels anxious if they aren’t absolutely clean.

But Arthur, who suffers from OCPD, insists that the correct thing is to have the entire house in order all the time. People with OCPD may justify their efforts to control by trying to prove that their way is the right way. They feel that they are trying to do the right thing to make life better for everyone, and their efforts can be helpful. But in many cases, they may become rigid in their actions, and, contrary to their motivations, they can make things more difficult for others.

People with OCD don’t necessarily restrict their emotions. However, they do try to control their thoughts (which can range from mildly uncomfortable to very disturbing) by doing compulsive things, such as repetitive and ritualistic cleaning and checking. 

But people with OCPD often try to control their emotions as well as their environment. They’re known for delaying gratification. They often give priority to their work, neglecting relationships and their own wellbeing. The emotions they are most aware of are anger, frustration, and resentment. They are more reluctant to be vulnerable than those with OCD, and may not even be aware of any underlying anxiety.

Angie gets anxious if the top is off the toothpaste tube because she fears germs. Arthur gets angry because it’s wrong to leave it off.

Shame or Pride about Their Condition

People with OCD don’t like their obsessions and compulsions and willingly seek help.

People with full-blown OCPD, because they try so hard to live their lives according to moral principles, are very proud of the way they live and don’t understand that they have a disorder. They tend to seek help only when forced to do so by a partner or when they become so depressed from trying to live with such demanding standards that they can’t go on that way any longer.

Motivations

People who have OCD are motivated to stay safe and to prevent catastrophes. People with OCPD are more motivated by rules and perfectionism. While they may justify their control by pointing to possible catastrophes, their underlying motivation often has more to do with wanting to avoid chastisement, blame, or failing to fulfill their responsibilities.

People with OCD are more clearly motivated to relieve their anxiety. While people with OCPD may also have underlying anxiety or a fear of being abandoned, their conscious concern is that they want to be respected rather than criticized.  

Behavioral Differences

While people with OCD may often behave in an insecure way because of their obsessions and compulsions, people with OCPD may become domineering, trying to hide their insecurities from themselves and others.  

People who have OCD spend much of their time in compulsive rituals such as cleaning and organizing. People with OCPD spend more time planning and working.

OCD efforts are usually maladaptive, except insofar as it helps them to maintain good hygiene. In contrast, some OCPD traits can be adaptive in a practical way, allowing them to succeed in the outer world, even if it makes them very unhappy. Because they are very conscientious, meticulous, energetic, and committed, they can make significant contributions in many fields, from art to public service to accounting. Most successful performers and athletes are compulsive to some degree.

Differences Among Compulsive Personalities

There are wide variations in the degree of unhealthiness among people with compulsive personalities, based on how controlling, perfectionistic, and rigid they are. Some, who don’t technically have OCPD but only have some compulsive traits, have very few maladaptive symptoms and can be very helpful in planning, organizing, and getting things done.

And there are wide variations in the style of compulsive personality: some are domineering, some are workaholics, some are compulsive people-pleasers, and others are so obsessive about getting things just right that they can’t get anything done.

Treatment

There is significant research to demonstrate that targeting the specific symptoms of OCD, as short-term Cognitive Behavioral Therapy (CBT) does,[4] can be effective for treating OCD.

There is far less research regarding the treatment of OCPD. In fact, according to psychologist and researcher Anthony Pinto, “there is no empirically validated gold standard treatment for OCPD.”[5]

However, there is reason to believe that approaching OCPD treatment by targeting specific symptoms may not be as effective as it is for OCD because of the pervasive nature of personality disorders. OCPD may benefit from a longer course of treatment in psychodynamic or expressive therapy.[6] This approach can help the individual to understand the possible benefits of their inherent personality style and to understand how those same traits can turn destructive when taken to extremes. Psychodynamic therapy can help them develop a better relationship with their emotions and use their need for control and perfectionism in a healthier way.

Getting to the Root Causes of OCPD

The causes of OCPD include genetic, environmental, and dynamic factors. These dynamic factors include the strategy the individual unconsciously adopted to cope with their particular combination of inherited traits and family situation. We can refer to these dynamic factors as old tapes, triggers, complexes, schemas, or patterns that they play out unwittingly, as if they were still living in the past with their families.

Attempting to treat the systemic, unconscious, and underlying character organization of OCPD by targeting just its external manifestations may not shift the underlying causes.

For example, some compulsives cope with their anxiety by externalizing, by getting those around them to do what they think should be done so that they feel safer. Other compulsives cope by internalizing, by taking too much responsibility on themselves and becoming people-pleasers to avoid a feared abandonment.

In most cases, people with OCPD feel a great need to prove themselves, and they attempt to do so with perfection, order, and control.  

Whatever the underlying dynamic, a therapeutic experience that gives the individual a chance to identify their specific coping strategy by seeing their old tapes play out in session with a therapist can be very effective. Does the client try to control the therapist? Does the client try to control his own emotions in session? Do they try to prove to the therapist that they are ethically good? This process often requires patiently developing awareness of emotions and the capacity to tolerate them in session, rather than reacting to them by trying to control themselves or the therapist.

The Potential Benefits of Compulsive Personality

If your basic character style is compulsive by nature, you won’t be able to change that. But you can begin to use your natural meticulousness, conscientiousness, and tendency to plan in a healthier, more conscious way that works well for you and the people around you. This can’t happen if efforts to change includes only trying to eradicate symptoms.  

I have referred to anxiety and a need for respect as motivations for the individual with OCPD. But on an even deeper level, they are motivated by a desire to help, plan, and repair in ways that can benefit everyone. Finding that original motivation can equip the OCPD sufferer with insight and direction, which can help them to heal and to be more helpful to those around them.

Footnotes

[1] National Institute of Mental Health website. Obsessive-Compulsive Disorder. https://www.nimh.nih.gov/health/statistics/obsessive-compulsive-disorder-ocd.shtml. Retrieved 12.23.20.

[2] Burkauskas, J. F., Naomi. (2020). History and Epidemiology of OCPD. In J. E. Grant, Anthony Pinto, Samuel Chamberlain (Ed.), Obsessive-Compulsive Personality Disorder (pp. 1-16). Washington, D.C.: American Psychiatric Association Publishing.

[3] Mancebo, M. C., Jane L Eisen, Jon E. Grant, Steven A. Rasmussen (2005). Obsessive Compulsive Personality Disorder and Obsessive Compulsive Disorder: Clinical Characteristics, Diagnostic Difficulties, and Treatment. Annals of Clinical Psychiatry, 17(4), 197-204. doi:10.3109/10401230500295305

[4] Foa, Edna B. (2010). Cognitive behavioral therapy of obsessive-compulsive disorder. Dialogues in Clinical Neuroscience. Jun; 12(2): 199–207.

[5] Pinto, A. (2020). Psychotherapy for OCPD. In A. P. Grant JE, Samuel R. Chamberlain (Ed.), Obsessive-Compulsive Personality Disorder (pp. 143-178). Washington, D.C.: American Psychiatric Publishing.

[6] Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65(2), 98-109. doi:10.1037/a0018378

To find a therapist in your area who can help you work through the concerns in your life, click here.

As a therapist working with diverse people who have diverse minds and diverse emotional struggles, I call upon a diverse range of ideas and skills for helping. I try (emphasis on try) not to idealize or devalue any one style of therapy, and to learn as much as I can from books, teachers, and colleagues. I know only about 50% of people in therapy get better (e.g., Lambert, 2013), so at this point, no style of therapy offers a “cure-all.” We’re all doing our best to help as many people as we can, but we’re also failing a lot.

Because of my familiarity with the mixed outcome data about psychotherapy, I get a bit concerned when I hear someone refer to any one school of therapy as a “gold standard,” or when one school of therapy becomes the “go-to” referral. The “gold standard” designation does not square with my awareness that the field of psychotherapy is quite young (around 120 years old if you start with Sigmund Freud) and still has a lot to learn. Nonetheless, proponents of cognitive behavioral therapy (CBT) make this claim (e.g., Cristea & Hoffman, 2018). Naturally, claims like this can influence people’s decisions when making referrals to therapy or when choosing a therapist.

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And who can blame us for believing a “gold standard” exists? It’s comforting to believe the treatment your doctor refers you to is the best treatment for your suffering, or that your therapist practices the best therapy out there. The idea alone can be relieving. But how do we decide what is or is not a “gold standard” treatment? Do we have adequate information for any therapy to make such a claim? What does the therapy research literature say about this?

Is CBT a “Gold Standard” Therapy?

In the 50 years since its founding, cognitive behavioral therapy (CBT; e.g., Beck, 2011) has developed a reputation as a “gold standard” treatment. It appears to be a first-line intervention for people with any kind of emotional difficulty and some physical difficulties. In my experience, most people who seek treatment for emotional struggles are initially referred to CBT. Medical colleagues have mentioned that CBT is the only therapy they are introduced to in school or encouraged to refer to, and I know of psychology programs that focus on CBT to the exclusion of other approaches to the mind, such as psychoanalytic and systems approaches. My observations indicate there is a general movement away from diversity in psychotherapy approaches to a “monoculture” of CBT and models derived from it.

There is no doubt some people benefit from CBT, but is it a true “gold standard”? Does research about CBT support its heavy use compared to other models? Has CBT demonstrated itself to be better than other therapies?

I do not claim to have decisive answers, but what I do have are two recently published journal articles that review the evidence regarding the effectiveness of CBT versus other therapies. I have picked out some findings from those articles that seem important to me, and I will share them below. Those who are interested in exploring the original sources in more detail can do so here and here. Both articles are concise and highly readable, even for people without advanced training in research and therapy.

Is CBT Effective?

In response to claims by CBT-oriented researchers that CBT is a “gold standard” treatment, Leichsenring, et al. (2018) and Shedler (2018) reviewed evidence. You can explore their article for details, but here I will restate their conclusions:

This is important information for anyone considering therapy, or who has been referred to CBT to the exclusion of other therapies. It may be especially important for people who have tried CBT, not benefited, and, sadly, blamed themselves or concluded therapy won’t work for them.

• Effectiveness vs. placebo. Some of the research cited by Leichsenring, et al. (2018, p. 3) suggests that while CBT may outperform the placebo effect slightly in a research setting, it does not outperform placebo enough to be considered more effective than placebo in a real-life clinical setting. Theoretically, that suggests that taking a sugar pill is equally effective to CBT.
• Effectiveness vs. control groups. The cited studies also show that CBT has only “limited superiority” to the control conditions it is compared to for research purposes (p. 3). Control conditions are comparison groups in which no treatment is given; for instance, one group in a study tries CBT, while the other group receives no intervention, such as remaining on a waiting list. In this sense, some evidence suggests CBT is only slightly superior to being on a waiting list and receiving no treatment.
• Remission rates. According to Leichsenring, et al. (2018, p. 3), only about 25% of people who tried CBT in the studies reviewed experienced remission, meaning only a quarter of people in the studies no longer had the condition they sought help for by the end of the study. Shedler’s (2018, p. 321) review supports this finding.
• Effectiveness vs. other therapies. The studies reviewed by Leichsenring, et al. (2018, p. 4) found no research evidence that CBT was superior to any other therapy.
• Effects of treatment can be short-lived. Shedler (2018, p. 322) notes a finding that 50% of people treated with CBT seek treatment for the same difficulties again within six to 12 months.
• No increases in effectiveness across decades. According to the Leichsenring, et al. (2018, p. 4) review, CBT research has not demonstrated an improvement in outcomes of CBT across five decades of research.

Based on this information alone, you may find yourself questioning why anyone would claim CBT is a “gold standard”—it has not demonstrated superiority, and the research seems, more than anything, to have demonstrated the limits of its effectiveness. This is important information for anyone considering therapy, or who has been referred to CBT to the exclusion of other therapies. It may be especially important for people who have tried CBT, not benefited, and, sadly, blamed themselves or concluded therapy won’t work for them.

Conclusion

No approach to therapy is a cure-all, and in fact there is much evidence for equivalence between therapies. If this is the case, though—that all therapies are limited and all produce roughly equivalent results—why are so many people referred to CBT? Why is there, as the review article claims and as I have observed, a “monoculture” of CBT?

A discussion of the scientific, economic, political, and ultimately human forces that have led to and perpetuated the myth of CBT as a “gold standard” is beyond the scope of this article, and readers interested in exploring that topic can check out the Leichsenring, et al. (2018) and Shedler (2018) articles in the references section below; both are quite articulate concerning these questions.

Whether we understand the reasons for the perpetuation of this belief or not, what is important is that consumers of mental health care are educated and aware of the well-documented limitations of CBT that seem to have been obscured by its self-presentation and public image as a “gold standard.”

Without a clear understanding of the virtues and limits of CBT, we may not consider other options that may be at least equally helpful. Even worse, we may blame ourselves and think we’re treatment-resistant when CBT doesn’t help. We may think we failed at the therapy when in fact the therapy failed us, as it does many people. If CBT fails us, we may think, “Therapy won’t work for me,” when in fact only one therapy out of many possible therapies didn’t work. Without more information about other evidence-based treatments, we may feel unnecessarily hopeless. That is why I felt these papers were important enough to share.

It may take some time before the medical and psychotherapy communities begin to recognize and respond to the research evidence that CBT is, like all therapies, helpful but limited. For now, however, we can help people make informed choices about their care. I hope you find this useful and look forward to your comments below.

References:

1. Beck, J. (2011). Cognitive behavior therapy, second edition. New York: Guilford Press.
2. David, D., Cristea, I., & Hofmann, S.G. (2018) Why cognitive behavioral therapy is the current gold standard of psychotherapy. Frontiers in Psychiatry, 9. doi: 10.3389/fpsyt.2018.00004
3. Lambert, M. J. (2013). The efficacy and effectiveness of psychotherapy. In M.J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy and behavior change (169-208). Hoboken, NJ: Wiley.
4. Leichsenring, F., Abbass, A., Hilsenroth, M. J., Luyten, P., Munder, T., Rabung, S., & Steinert, C. (2018). “Gold standards,” plurality and monocultures: The need for diversity in psychotherapy. Frontiers in Psychiatry, 9, 1-7.
5. Shedler, J. (2018). Where is the evidence for “evidence-based” therapy? Psychiatric Clinics of North America, 41, 319-329.

Many of us learned in high school biology class that genetic traits are passed down to us from our parents. We were taught that we have brown, blue, or green eyes because a parent did, we’re thin or fat because a parent was, and so on. Recent research expands this idea in a way that would have seemed inconceivable a few decades ago. We know the traits we pass down to our children can not only change based on our life experience. But we also know we can continue to alter our children’s pattern of genetic activity after they’re born. This area of genetics research is called epigenetics. It’s the study of alterations in gene function caused by changes in gene expression rather than in the genetic code.

This could all seem a bit disheartening to those of us dealing with anxiety, depression, anger issues, or other mental health concerns. If we’re depressed because of our parents’ experiences or how they treated us when we were babies, what hope is there for us? But if we couple epigenetics with research into cognitive behavioral therapy and neuroplasticity (the brain’s ability to form new neurons and glial cells and forge new connections), we have reason to be hopeful.

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In 2010, scientists at the University of Copenhagen fed male rats a diet high in fat and then watched as their offspring gained more weight than the babies of rats fed a regular diet. If traditional theories about genetics had been true, the diet of a rat’s parent shouldn’t have affected the weight of their offspring. The old thinking about genetics—that either you’re born with a gene that predisposes you to obesity or you’re not, and nothing you do in your life changes what gene you pass onto your children—is, according to studies like the Copenhagen one, incorrect.

To discover how gene alteration in rats occurs, scientists studied their sperm. “The genes in sperm cells are regulated by swarms of molecules, so-called epigenetic factors. These molecules can respond to environmental influences by silencing some genes and activating others as needed” (Zimmer, 2015). The research suggests the male rats were handing down epigenetic factors to their offspring.

A 2011 study at the University of Wisconsin showed that “when parents are under emotional, financial, or other forms of stress, it can alter their children’s patterns of genetic activity at least through adolescence and perhaps longer. And since some of the altered genes shape brain development, the effects of parental stress might permanently wire themselves into children’s brains” (Begley, 2011).

It was an earlier 2004 study that showed us how parents can alter a baby’s genes by their behavior toward them. Another rat study, this time at McGill University, revealed that when a mother rat licks and grooms her offspring, “it activates a gene that makes a receptor for stress hormones in the baby rats’ brains, which causes more receptors to be produced, which causes fewer stress hormones.” Thus, the offspring are more “well-adjusted, curious, and mellow” as adults (Begley, 2011).

So, the question becomes: If our parent’ lives before we’re born and their treatment of us when we’re children can have a huge effect on our mental and physical health as adults, what can we do about it if we, as adults, are suffering the consequences? Whether we’re dealing with childhood trauma, anxiety, or another mental health issue, believing so much of our personality is baked-in can be, well, depressing.

Learning more about epigenetics and neuroplasticity gives us a reason to strive to be healthier and happier people.

This brings us to another fascinating area of research: neuroplasticity and cognitive behavioral therapy (CBT). According to a study published in Translational Psychiatry in 2016, “patients with anxiety disorders exhibit excessive neural reactivity in the amygdala” and there is “compelling evidence that CBT for a common anxiety disorder simultaneously changes the physical structure and neurofunctional response of the amygdala” (Månsson, 2016).

This is good news for those of us who just got discouraged reading about epigenetics. CBT is the most widely used evidence-based psychological treatment. It focuses on patterns in cognition, coping strategies, and emotional regulation. CBT subjects learn extensively about the relationship between thoughts, feelings, and behavior, and they practice identifying maladaptive thoughts such as catastrophizing—jumping to worst-case scenarios.

In CBT, one learns to separate faulty thoughts and beliefs from one’s emotional responses and, consequently, one’s unhealthy behaviors. For example, when the thought “everything will turn out horribly” leads to the feeling “I might as well give up now,” you are likely to give up and thus prove to yourself that you were right all along. After weeks or months of successful CBT treatment, a person should learn to recognize when they catastrophize and change the thought from “everything will turn out horribly” to “I can’t predict the future; things may work out and surprise me,” changing the emotional response and thus the behavior.

Learning more about epigenetics and neuroplasticity gives us a reason to strive to be healthier and happier people. One, because they tell us that we can break negative thought patterns that keep us trapped in unhealthy behaviors. And two, because our actions impact our children—both before we decide to have them and after we bring them into the world.

If you struggle with negative thoughts and related behaviors, contact a therapist.

References:

1. Begley, S. (2011, September 12). Parents’ depression and stress leaves lasting mark on children’s DNA. Daily Beast. Retrieved from https://www.thedailybeast.com/parents-depression-and-stress-leaves-lasting-mark-on-childrens-dna
2. Essex, M. J., Boyce, W. T., Hertzman, C., Lam, L. L., Armstrong, J. M., Neumann, S. M. A., & Kobor, M. S. (2011, September 2). Epigenetic vestiges of early developmental adversity: Childhood stress exposure and DNA methylation in adolescence. Child Development. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1467-8624.2011.01641.x
3. Kays, J. L., Hurley, R. A., & Taber, K. H. (2012, April 1). The dynamic brain: Neuroplasticity and mental health. Neuropsychiatry and Clinical Neurosciences, 24(2). Retrieved from https://neuro.psychiatryonline.org/doi/full/10.1176/appi.neuropsych.12050109
4. MÃ¥nsson, K. N. T., Salami, A., Frick, A., Carlbring, P., Andersson, G., Furmark, T., & Boraxbekk, C.-J. (2016). Neuroplasticity in response to cognitive behavior therapy for social anxiety disorder. Translational Psychiatry, 6(2). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4872422
5. Weaver, I. C., Cervoni, N., Champagne, F. A., D’Alessio, A. C., Sharma, S., Seckl, J. R., … & Meaney, M. J. (2004). Epigenetic programming by maternal behavior. Nature Neuroscience, 7(8). Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15220929
6. Weinhold, B. (2006). Epigenetics: The science of change. Environmental Health Perspectives, 114(3). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1392256
7. Zimmer, C. (2015, December 3). Fathers may pass down more than just genes, study suggests. The New York Times. Retrieved from https://www.nytimes.com/2015/12/08/science/parents-may-pass-down-more-than-just-genes-study-suggests.html

What, exactly, is an emotion?

This question has long been debated. Nonetheless, this complex state can be said to involve cognitive appraisals, physiological changes, and behavioral responses. Take, for instance, fear—one of the most researched emotions. An event or situation that triggers fear results in a cognitive appraisal, a thought that evaluates the situation. This, in turn, brings about a physiological change in the body, such as an increased heart rate, increased temperature, or tense muscles. A behavioral response, such as screaming or running away, often follows.

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Researchers Alan S. Cowen and Dacher Keltner at the University of California, Berkeley have identified 27 categories of emotions, all of which serve a purpose. Without them, we would not know when to feel alarmed (anxiety), let down (disappointment), or safe (relaxation), for example. Emotions also inform others about our inner state, which in turn evokes their own emotions and promotes various social interactions.

Emotions become an issue when they are overwhelming, inappropriate for the situation, or we experience negative ones too often. Many of our difficulties with emotions come from the way we think about the world, things around us, things that happened to us, and so forth. Intense emotions can be distressing and may interfere with our ability to carry out day-to-day activities and the way we interact with others. Therefore, it is important to know how to manage intense emotions.

Cognitive behavioral therapy encourages individuals to do the following:

1. Label Your Emotions

The first step to help manage emotional discomfort is to label the emotions we are experiencing. It is important to become familiar with the different types of emotions, including those that are more complex (such as contempt, love, and remorse), so we can correctly label our experience of them.

2. Identify Thoughts Behind Your Emotions

The thoughts that precede our emotions also provide additional insights into our difficulties. The thought “I’m not as smart as other people at this meeting” can result in great distress and limit our verbal exchanges. However, we can change the way we think by asking ourselves if what we are thinking is true, helpful, or kind. If the answer is no, we have a way to modify our thinking (e.g., “People at this meeting are probably not worried about my intelligence”). This is known as cognitive reappraisal.

3. Carefully Examine Any Other Emotions

Believe it or not, many of us do not correctly identify emotions. We may say we are sad when what we are really experiencing is frustration or shame. Therefore, it is important to go back and reexamine what we are experiencing. Our thoughts should match our feelings. It is also important to realize we may be experiencing more than one emotion. This step enhances our understanding of what we are experiencing.

4. Rate Your Emotions

For experiences that seem too hard to manage or intolerable, it is helpful to rate the degree of emotion we are experiencing. This can be done using a scale of 0-10 or by giving a percentage of how much an emotion is being felt at a given moment. Ratings not only help us determine which emotions we are struggling with the most, they give us an idea of how we perceive the difficulty. A bonus is that ratings can be a great tool for monitoring improvements in the way we are feeling.

5. Practice Acceptance

There are times when cognitive reappraisal is difficult, especially if a professional is not there to help. More recent literature has evolved suggesting it is helpful, however, to notice the full experience of emotions with openness and curiosity. This practice involves recognizing patterns of thinking (e.g., “I’m often panicked”), physiological sensations (e.g., muscle tension), and maladaptive behavior (e.g., avoiding communication of personal needs) without changing them. This allows you to create “space” for these less pleasant emotions.

6. Increase Positive Emotions

Give attention to positive events, things that interest you, and practice gratitude. We can proactively modify our feelings not only by changing the way we think or creating space, but by attending to more pleasant experiences.

Conclusion

To successfully implement these strategies, you will need to practice, practice, and practice again. Change takes time and patience. Do not overemphasize reduction of negative emotions; remember, emotions are there for a reason. It is best to focus on personal growth and improvement. And if you are not experiencing the desired improvements, it may be time to seek professional help.

References:

1. Aldao, A. (2008). Coping and emotion regulation. In S. Hayes & S. Hoffman (Eds.) Processed Based CBT: The Science and Core Competencies of Cognitive Behavioral Therapy (pp. 261-272). Oakland, CA: Context Press.
2. Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.). New York, NY: Guilford Press.
3. Hockenbury, D. H., & Hockenbury, S. E. (2007). Discovering psychology. New York, NY: Worth Publishers.
4. Linehan, M. M. (1993). Cognitive behavioral treatment of borderline personality disorder. New York, NY: Guilford Press.
5. Papa, A., & Epstein, E. (2008). Emotions and emotion regulation. In S. Hayes & S. Hoffman (Eds.) Processed-Based CBT: The Science and Core Competencies of Cognitive Behavioral Therapy (pp. 137-152). Oakland, CA: Context Press.

Structured self-help programs, which allow participants to give themselves therapy, may work just as well as psychotherapy with a therapist, according to a study published in the journal Administration and Policy in Mental Health and Mental Health Services Research.

The study was a meta-analysis that analyzed data from previous studies of cognitive behavioral therapy (CBT). CBT is a semi-structured approach to therapy that encourages participants to recognize, understand, and correct automatic thoughts that lead to painful feelings and self-defeating habits. Because CBT focuses on addressing and correcting specific thought patterns, it is possible to distill its principles into a self-help program.

The study points to the value of self-help programs for those reluctant to share their experience with a therapist, those who can’t afford therapy, or those who can’t access a local therapist.

Is Do-it-Yourself CBT Just as Good as Therapy?

The analysis gathered data from 15 previous studies of 910 participants. Each study randomized participants to receive either self-help CBT or traditional CBT through a therapist. A total of 723 participants completed the treatment program. Participants used CBT for a variety of mental health issues, including depression, anxiety, and posttraumatic stress (PTSD).

[fat_widget_right]Researchers found no differences in completion rate between self-help and therapist-delivered CBT. Treatment outcomes were also broadly similar. This suggests both self-help and therapist-based programs can offer symptom relief.

Could Self-Help Programs Replace Therapy?

The study’s authors say self-help programs could be a good first line of defense against mental health issues. They don’t advocate an end to therapy. The analysis only examined self-help CBT, so the findings don’t extend to other types of therapy. A therapist can be helpful for exploring different types of treatment options, and some people in therapy may not have the motivation to keep up with a self-help program on their own.

Outcomes varied in both groups. In the self-help group, there was greater variability. The study did not directly assess why this might be, but its authors suggest the therapist may play a key role in standardizing outcomes. The therapeutic relationship could be a valuable tool for counteracting negative emotions in therapy, and this might ensure more standardized outcomes in people seeking therapy from a therapist.

This supports past research that suggests the therapeutic relationship is a key to therapy’s success. However, the study did not find significant differences between therapists. This may mean the competence of an individual therapist is secondary to the therapist’s ability to follow a standardized treatment program and respond to negative emotions.

In terms of access to mental health treatment, the study shows self-help programs may be an effective interim treatment until an appointment with a therapist can be made.

References:

1. Brown, M. (2017, August 23). Be your own therapist? Fine – if you’re up to the job. Retrieved from https://www.theguardian.com/commentisfree/2017/aug/23/therapist-self-help-therapy
2. King, R. J., Orr, J. A., Poulsen, B., Giacomantonio, S. G., & Haden, C. (2017). Understanding the therapist contribution to psychotherapy outcome: A meta-analytic study. Administration and Policy in Mental Health and Mental Health Services Research.

Parents of autistic children often participate in cognitive behavioral therapy (CBT) to address emotional and behavioral concerns in their children. According to a study published in the Journal of Autism and Developmental Disorders, parents who attended CBT with their children experienced improvements in their own mental health.

In the standard model of therapy for autistic children, parents are usually not active participants. They are often in a separate room. For this study, researchers asked parents to act as co-therapists, directly involving them in the process.

CBT is a type of therapy that aims to alleviate distress by correcting and redirecting automatic thoughts and behaviors. Therapists work with people in therapy to help them better manage emotional distress and to change problematic behavioral habits.

CBT: Benefits for Parents and Children

For the study, researchers recruited 57 autistic children between ages 8 and 12. None of the children had co-occurring intellectual disabilities.

[fat_widget_right]Some parents were randomly assigned to serve as co-therapists during their children’s CBT sessions. Another group was placed on a waitlist. As co-therapists, parents practiced emotional and behavioral regulation strategies alongside their children. They also wrote down their children’s thoughts during therapy activities.

Compared to waitlisted parents, the parents who acted as co-therapists experienced improvements on a wide range of mental health measures. They had fewer symptoms of depression, were more adept at regulating their own emotions, and were more mindful parents with better perceptions of their children. Because CBT often cultivates mindfulness and supports emotional regulation, these improvements are likely a direct result of the parents’ involvement in their children’s therapy.

CBT as a Tool for Understanding Autistic Children

Parents who participated in their children’s therapy felt the experience improved their understanding of their children. Writing down their children’s feelings and participating in therapy sessions with their children may have helped some parents better understand their children’s challenges.

“It created a very safe, predictable approach for my son,” said Jessica Jannarone, a parent who participated in the program, in an interview posted to YouTube. “I could hear firsthand from his own perspective and his words what it felt like to be him sometimes and to work on coping skills together. The difference it’s made in the last year is more than has happened in the past 10 for us.”

References:

1. Effects of cognitive behavior therapy on parents of children with autism. (2017, August 1). Retrieved from https://www.sciencedaily.com/releases/2017/08/170801131221.htm
2. Maughan, A. L., & Weiss, J. A. (2017). Parental outcomes following participation in cognitive behavior therapy for children with autism spectrum disorder. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-017-3224-z

Our circumstances don’t define us. Regardless of what happens in life, we always have the power to choose our attitude. So what’s the difference between someone who remains hopeful despite experiencing great suffering and the person who stubs his or her toe and remains angry the rest of the day? The answer lies in the person’s thinking patterns.

Psychologists use the term “cognitive distortions” to describe irrational, inflated thoughts or beliefs that distort a person’s perception of reality, usually in a negative way. Cognitive distortions are common but can be hard to recognize if you don’t know what to look for. Many occur as automatic thoughts. They are so habitual that the thinker often doesn’t realize he or she has the power to change them. Many grow to believe that’s just the way things are.

Cognitive distortions can take a serious toll on one’s mental health, leading to increased stress, depression, and anxiety. If left unchecked, these automatic thought patterns can become entrenched and may negatively influence the rational, logical way you make decisions.

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For those looking to improve their mental health by recognizing pesky cognitive distortions, we’ve compiled a list of 20 common ones that may already be distorting your perception of reality:

How to Change Thinking Patterns and Cognitive Distortions

For many, one or more of these cognitive distortions will look familiar. You may fall into one or more of these traps or know someone who does. The good news is that cognitive distortions don’t have to weigh you down like an anchor.

Thought patterns can be changed through a process referred to in cognitive therapy as cognitive restructuring. The idea behind it is that by adjusting our automatic thoughts, we are able to influence our emotions and behaviors. This is the basis of several popular forms of therapy, including cognitive behavioral therapy (CBT) and rational emotive behavioral therapy (REBT).

If you feel that one or more of the above cognitive distortions is contributing to feelings of anxiety, depression, or other mental health issues, we encourage you to consider finding a qualified therapist you trust to work with you and help transform your negative thoughts and beliefs into empowering affirmations that inspire and uplift you.

References:

1. Beck, Aaron T. (1976). Cognitive therapies and emotional disorders. New York: New American Library.
2. Beck, Aaron T. (1972). Depression; Causes and Treatment. Philadelphia: University of Pennsylvania Press.
3. Tagg, John (1996). Cognitive Distortions. Retrieved from http://daphne.palomar.edu/jtagg/cds.htm#cogdis

Most of us experience work stress, but can too many responsibilities, unrealistic expectations, and personality conflicts at work lead to an experience of trauma victimization over time?

In my years of private psychotherapy practice, I’ve seen several cases where individuals experience signs similar to posttraumatic stress as a result of work problems. In the beginning, I found this slightly odd. I wondered: could negative work experiences really lead to reactions similar to trauma experiences, like war or sexual assault? Lately, in conversations with colleagues, I’ve discovered this is fairly common, particularly in certain professions.

How Your Work Environment Can Leave You Feeling Victimized

I recently interviewed Arkansas professional counselor Rev. Rebecca Spooner, an ordained minister who left ministry to become a therapist. She specializes in counseling pastors and their families, and said that feeling victimized and traumatized by their work environment is relatively common among members of the clergy. Rev. Spooner explained that the demands and expectations of modern ministry set pastors up for personal failure and emotional trauma.

“The paradigms in ministry are flawed,” Spooner said. “A hundred years ago, pastors had four jobs: marry, bury, baptize, and preach on Sunday. Today, ministers are expected to be marriage therapists and grief counselors, organizational leaders, facilities and staff managers, marketing coordinators, community relations specialists, bloggers, motivational speakers, spiritual teachers, salespeople (increasing membership and giving), budget managers, visit the sick, be a friend, and serve on regional committees! It’s completely unrealistic. It sets everyone up for disappointment.”

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These experiences are similar to what’s happening in private companies in recent times, particularly since the economic crash of 2008. Companies have laid off people and expect those who remain to do more work for less pay. New performance measures are adding pressure, and employees are micromanaged. Among the EAP (Employee Assistance Program) referrals I see in my office, stress related to new and unrealistic work performance expectations ranks at the top of the list.

The people who see me for help with work-related stress have complaints that are similar to what Rev. Spooner sees among clergy: insomnia, irritability, mood swings, anger, feelings of disappointment and disillusionment about their career and employer, confusion about why they are unable to meet the demands placed on them, hopelessness, anxiety and fear, fatigue, muscle tension, family problems, feelings of isolation, ineffective coping, and substance abuse. It’s a long list! Work stress is a big problem in America.

Many of us are familiar with trauma reactions after major catastrophes, but few of us realize that a work environment characterized by unrealistic demands, personality conflicts, and limited free time for leisure can, over time, create an experience of victimization.

3 Ways Cognitive Behavioral Therapy Can Help

Cognitive behavioral therapy (CBT) helps individuals shift from perceiving themselves as having little control over their circumstances to becoming empowered to either change outside pressures or learn to cope with and relate to them differently. With practice, CBT techniques can help reduce stress and anxiety, improve mood, and increase confidence.

CBT treatment has helped ministers reduce the experience of stress and trauma caused by the challenges of their profession. These same techniques can also help most people heal from various traumatic and emotionally difficult situations. CBT reduces distress and helps to restore emotional balance. Here are three techniques from cognitive behavioral therapy to use in your own life.

1. Learn to identify the thoughts that increase your anxiety and your self-doubt. A large majority of individuals who come to see me for anxiety therapy are quite surprised when I mention that their thoughts are likely causing their anxiety. Most people believe anxiety is something that happens to them, something over which they have no control. But in fact, how we talk to ourselves about the situations we face has a great deal to do with how we feel. For example, if a minister tells herself that because her church is not growing she is not an effective leader and has failed God, she is likely to feel emotionally upset and believe that she is not capable of growing the church. By repeating self-defeating thoughts in her head, her self-esteem erodes. Eventually, she may just give up trying altogether and become depressed. This is the trick trauma plays on us: it tells us that something is wrong with us and that we are helpless, but most of the time our thoughts are not true.
2. Dispute the thought. Once you’ve identified the anxiety-producing or self-defeating thought, it’s time to dispute it. Here’s an example: “If I don’t grow the church, I’ll get fired.” Let’s examine if that thought is true. In most denominations, firing a pastor takes effort. First, the leadership of the church has to vote that they have lost confidence in the pastor. Then, they have to bring the issue to a congregational vote. In many cases, a national mediator becomes involved to help resolve the conflict and improve the employee/employer relationship between the church and the pastor. So the thought, “If I don’t grow the church, I’ll get fired” is not exactly true. What’s much more likely to happen is that if the church is not growing and leaders are dissatisfied, a conversation will occur about why that’s happening. And hopefully, that conversation will lead to solutions. Notice your own thoughts and question them. Are they true? How do you know for sure? What are some alternative explanations that might be more true?
3. Learn to relax. The third CBT technique that Rev. Spooner uses is relaxation training. When we learn to relax the tension in our muscles and reduce the speed of our thoughts, our brains function better. They see things more clearly. Gen. Colin Powell has a rule. He tells himself, “It ain’t as bad as you think. It will look better in the morning.” That’s partly because when our brains are rested, we see situations differently. Relaxation training can teach you to rest your brain. My personal hope is that one day, we will collectively learn to be realistic about our demands and expectations of people and be kinder to one another. Until then, if you find yourself feeling victimized, excessively pressured, or doubt your worth or abilities, try CBT. It really can help!

Psychotherapy is the first form of treatment for depression or anxiety and involves a variety of treatment techniques. During psychotherapy, the person experiencing depression or anxiety speaks with a licensed psychologist or therapist who helps him or her to identify and work on the causative factors. These factors trigger depression or anxiety by working in combination with chemical imbalances in the brain or heredity factors.

Psychotherapy helps people with depression or anxiety in the following ways:

• Understanding the behaviors, ideas, and emotions that contribute to depression or anxiety
• Identifying the problems or events that contribute to depression or anxiety and understanding which aspects of the problem they can solve
• Helping to regain a sense of control and pleasure in their lives
• Teaching them problem solving skills and coping techniques

Although psychotherapy can be performed in different ways, such as individual, family, and group therapy, there are also different approaches that psychotherapists can use to provide therapy. After having a brief talk with the client, the therapist will decide on the approach to use based on the underlying factors that contribute to the person’s depression. Many therapists specialize in one or more specific techniques or approaches. These different approaches to psychotherapy include psychodynamic therapy, interpersonal therapy, cognitive behavioral therapy, and solution focused therapy.

Psychodynamic Therapy
This therapy assumes that the person is depressed due to unresolved, unconscious conflicts that often stem from childhood. The goal of this therapy is for the person to understand and cope better with these feelings by talking about such experiences. Psychodynamic therapy usually takes place over several months and can produce excellent results.

Interpersonal Therapy
Interpersonal therapy mainly focuses on the person’s behaviors and interactions with family and friends. The goal of this therapy is to enhance self-esteem and improve communication skills during a short period of time. This therapy usually lasts for 3 to 4 months and works well for depression caused by social isolation, mourning, major life events, and relationship conflicts.

Psychodynamic therapy and interpersonal therapy help people resolve depression or anxiety caused by loss or grief, role transitions (like becoming a parent or caregiver), and relationship conflicts.

Cognitive Behavioral Therapy
Cognitive behavioral therapy helps people experiencing depression or anxiety to identify and change inaccurate perceptions they have about themselves and the world around them. The psychotherapist helps the client to think differently by directing attention to both the accurate and inaccurate assumptions they have about themselves and others.

This therapy is recommended for the following types of persons:

• People who think and behave in ways that trigger and perpetuate depression
• People who experience disability or interpersonal problems due to depression

Solution Focused Therapy
Solution focused therapy is a symptom-specific approach, which means it targets one or two stressors that are causing problems. The result might be helping the person find a better way to handle the boss at work or children at home. A person may simply learn techniques to handle anxiety. One therapist commented that solution focused therapy is like getting new tools in your toolbox to use immediately in your life, therefore helping you feel better quicker.

For an individual living with depression or anxiety, psychotherapy can promote better understanding of the condition and associated symptoms. For a person with depression, being able to talk with a psychologist or therapist who is there to listen, inquire, and help can be comforting as well as rewarding. After just a few sessions of psychotherapy, clients may feel a difference. Research suggests that three to five sessions often cause significant change. Talking through the issues can help identify behaviors and detrimental reactions or circumstances. Coping techniques can also be investigated during therapy sessions, and progress reports can be used to keep track of how these techniques work. For individuals experiencing anxiety or depression, being surrounded by loved ones or being encouraged to attend therapy sessions can provide immense support.