Specialty Clinic

Dialectical behavior therapy (DBT) is based on the concept of dialectics, wherein patients are asked to confront and manage difficult emotions, learn to cope with relationship issues, and advance in their therapy through four areas:

• Mindfulness. Mindfulness centers on helping the patient focus on the now, instead of the yesterday or the tomorrow. This means learning to use techniques and exercises to cope with anxious thoughts and worries.
• Emotion regulation. Emotional regulation focuses on helping patients identify and manage bursts of emotion, such as irritability and mood changes.
• Distress tolerance. Distress tolerance aims to help patients develop patience and calmness when dealing with negative emotions, rather than attempting to get away from the feeling.
• Interpersonal effectiveness. Interpersonal effectiveness helps patients learn how to communicate with others in ways that strengthen relationships.

Exposure Response Prevention (ERP) is a form of exposure therapy that aims to help patients cope with the anxieties and thoughts that develop when exposed to images, objects, or circumstances that may be distressing.

ERP centers on helping patients develop the tools to consciously avoid compulsive behavior when an anxious thought or feeling is triggered. This process can be slow going but is especially helpful in the treatment of phobias, certain anxiety disorders, and obsessive-compulsive disorders. Each session is guided by a trained therapist and multiple different exercises.

Cognitive-behavioral therapy (CBT) is one of the most heavily researched forms of talk therapy, or psychotherapy, and focuses on identifying and coping with maladaptive behavior. Patients are taught and trained to change the way they feel by changing the way they act, and even think, through thought exercises, frequent sessions, and a set of core principles:

• The root of many instances of mental health issues is unhelpful or faulty thinking, caused either by external or internal factors.
• Another root is unhelpful or faulty pattern-forming behavior, especially maladaptive coping mechanisms.
• Patients with mental health problems can improve by addressing their thoughts and behavior, and thereby affecting their psychological health to a certain degree.

CBT has been proven to be effective in the treatment of depression, anxiety, substance use disorder, eating disorders, and other forms of mental illness. CBT is more effective than many other forms of talk therapy and most effective in combination with medication. One of the reasons CBT is the primary modality for many therapists is because of its strong history of evidence from multiple peer-reviewed studies and decades of research.

There is also a heavy emphasis on flexibility. While all CBT is based on the core principles mentioned, therapists are encouraged to mold a program that suits their patients. Strategies for doing so may include:

• Understanding that one’s perception is affecting one’s feelings and emotions, rather than reality itself.
• Developing a greater sense of empathy, and understanding how others see the world.
• Learning to use certain logic or mental rhetoric to deal with illogical thoughts.
• Building one’s self-confidence and self-esteem through healthier habits.

In many cases of CBT, there is also a focus on learning to become one’s therapist over time. This isn’t a goal but is rather a byproduct of continuing to go through lessons at one’s own pace at home and continuing to work with developed coping skills.

Brainspotting is a form of trauma therapy developed by Dr. David Grand. It focuses on diagnosing and treating trauma disorders through eye positioning. It is based on the idea that certain eye positions may change how the brain is affected by talk therapy due to how memories and experiences are physically stored in our central nervous system. Physical cues and guides are used to help patients shift their focal point throughout the therapeutic process to identify the right spot.

Brainspotting is used to help resolve traumatic memories and triggers, PTSD, adjustment disorders and attachment issues.

Acceptance and commitment therapy (ACT) is a form of psychotherapy that stems from cognitive-behavioral therapy (CBT). It focuses on improving distress tolerance by learning to work through and accept feelings that are often appropriate to certain traumatic experiences and thus learning to move on from them – rather than avoiding them, which leads to repression.

The Havening Techniques® are therapeutic modalities designed to help patients with trauma disorders. These are based on the idea that the portion of the brain affected by the traumatic experience can be targeted and healed. These techniques may also be used for stress management.

Eye Movement Desensitization and Reprocessing (EMDR) is a form of therapy focused on trauma disorders. It operates on the idea that traumatic experiences are represented by blocks in the brain, which can be treated by exposing a patient to certain verbal or visual triggers while providing specific external stimuli (from hand-tapping and audio stimulation to side-to-side eye movements). These may lead to a quicker breakthrough during therapy, as well as improved therapeutic results than simple exposure therapy.

EMDR utilizes a three-step protocol:

• Past experiences have led to psychological dysfunction.
• The circumstances that elicit distress are targeted, while the external stimuli serve to desensitize (reduce the impact).
• Potential future events are taken into consideration during therapy, to help patients develop adaptive coping skills.

Trauma Resiliency Model (TRM) treats the physical effects of traumatic experiences. TRM is built on the idea that trauma affects the body, first, and the mind second.

Through combined mental and physical therapy, patients learn to build greater resilience to their innate fear-based reactions and defensive responses and learn to overcome excessive survival responses for the sake of therapeutic relief.

Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is a form of CBT focused on treating trauma disorders in children, teens, and adults alike.

As it is based on CBT, TF-CBT utilizes the same proven framework to target cases of trauma, and help patients identify how their experiences have changed their thoughts and behavior.

It may often involve other non-offending friends and family members, especially in the case of younger patients, to help provide the basis of a strong support network for continued treatment and the development of crucial coping mechanisms.