Cognitive Behavioral Therapy

Cognitive theory holds that the chief determinant of emotion, motivation, and behavior is a person's thinking or "cognition", which is a conscious process. The basic idea is that irrational or unrealistic thoughts produce distorted and disturbing emotions and behavior. Change consists of expanding or modifying conscious thought until perception more nearly approximates reality, leading to rational thought. New activities and new kinds of behavior can alter perception. Put another way, this is the idea that it is sometimes easier to 'act your way into better thinking' than it is to 'think your way in to better acting'. Goals are established and mutually agreed upon. Time is spent examining and modifying "self-talk" (the things we tell ourselves about ourselves) and irrational beliefs. Research shows that cognitive therapy is the treatment of choice for people dealing with depression.

Client Centered Therapy

Hallmarks of the client-centered approach to counseling and therapy are the therapist's flexibility and a nonauthoritarian stance -- the belief that people are essentially forward moving, goal/growth oriented, and concerned with fulfilling their basic potientialities (self-actualization). Carl Rogers who developed the client-centered model of therapy suggested that, "The best vantage point for understanding behavior is from the internal frame of reference of the individual." To gain this understanding, "accurate empathy" --the therapist's ability to recognize a person's reality as they see it-- is required. Other noteworthy characteristics of this approach to counseling are that it: focuses on the client as a person rather than strictly on the client's problem; has a positive view of the person; provides achievable goals for the person; and can be individualized to a person's particular needs.

Existential Theory

There is no "existential psychotherapy" per se, it is more of a philosophical viewpoint that emphasizes a person's individual uniqueness and capacity for change. An existential approach to counseling or therapy starts with the idea that a person discovers their uniqueness through the way they relate to their subjective experience of life, and can chose to be and live as they wish. There are five general concepts of existential thought: disillusionment, freedom of choice, meaning in suffering, necessity of dialogue, and a stance of responsible commitment. Accordingly, as your therapist, I have no prescriptions of how you should live-- my job is to aid in the "unblocking process" that will allow you to resume your own unique growth and emergence. I affirm your right to self-determination and your inherent value as a unique person with a worldview (truth) that is yours to develop and steer.

The values conveyed in the existential model are: people have free choice; they have inherent worth in their individual perspective of life and their right to assert that perspective; they require a dynamic interaction with their environment and others in it in order to grow and this growth is an interactive and responsive process; suffering is an essential and inevitable component of the growth process. This suffering can also be thought of as "inspirational dissatisfaction". People are often the best experts on themselves and through a process of experience, insight, and dialogue (i.e., counseling and therapy), they are able to chose to think, feel, and act differently.

Mindfulness and Meditation

We all want happiness and want to avoid suffering. No matter how successful or comfortable our lives are on the outside, we may still be unhappy, disturbed, or worried on the inside. An imbalance occurs if we focus too much attention on our external lives and give too little importance to inner landscapes. Many people find it painful to look within themselves. Mindfulness is a meditative awareness--a new way of paying attention that cultivates the capacity to see things more clearly, as they are. Mindfulness is a process of inner discovery. It is a method for training the mind to expand its scope of awareness while refining its clarity. Goals include: reaching beyond the limiting ways we see ourselves; identifying hidden mental and emotional habits/patterns and loosening the grip they have on us (for example- a fear of being controlled or oversensitivity to signs of rejection); transformation of awareness, or a sort of "emotional alchemy" where all experiences are embraced in mindfulness as part of a transformative path; clarity and lightness of being.

Gestalt Therapy

Fritz Perls, a key proponent of Gestalt, said that the essence of Gestalt is the awareness process. Gestalt theory also emphasizes: understanding of the person's point of view or situation as they experience it; engaging in the present moment--acceptance of oneself in the "here and now"; and respect for a person's internal experience. The therapist's task is to help people overcome barriers that block awareness. Therapeutic work is rooted in the person's own perspective and emphasizes development of self-awareness self-knowledge. Change begins to happen when we allow ourselves to accept and be exactly where we are at any given moment.

Motivational Enhancement Therapy or 'Motivational Interviewing'

Research has clearly shown that for most people who have a substance use problem, the traditional 12-step treatment ("Minnesota Model" / confrontational) approach is simply NOT effective. Alcoholics Anonymous and Narcotics Anonymous work for some people (about 2 out of every 10, or 20%), but certainly not for all or even most. There are those for whom the AA and NA 12-step approach works, and for them it is a life saver. However, one size does not fit all! As a clinician, it is my ethical and professional responsibility to utilize the most effective approaches available. What has been proven to be therapeutically effective in working with people who have substance use issues is a "transtheoretical model of change" or "Motivational Interviewing".

In their work, "Handbook of Alcoholism Treatment Approaches", Reid Hester & William Miller (2003) describe stages of change, "In this model the person starts out in a state of precontemplation, in which change is not even being considered. As some reasons for change become apparent, ambivalence emerges and the person enters the contemplation stage, which a fluctuating balance of pros and cons for change. The preparation stage begins when this balance tips in the pro-change direction, and the person starts considering and planning how change might occur. The action stage involves taking active steps toward change, and blends into the maintenance stage of retaining changes that have been made. If maintenance is not successful, the person recycles through the stages."

Hester and Miller go on to say, "Motivational interviewing, then, is a therapeutic style, a way of being with clients. It is not a technique, or a way of tricking people into doing what you want them to do. Motivational interviewing is a clinical style for evoking the client's own intrinsic motivation for change".

Perhaps you've been considering therapy and are wondering what to expect. Read my Frequently Asked Questions About Therapy for more insight into what therapy is all about.