I vary my approach to therapy with each client. As Lane Pederson stated, “successful therapists need to learn and become competent in a variety of treatments to find a goodness of fit between clients, therapists, and approaches.” (1) In addition to Dialectical Behavior Therapy, Cognitive Behavioral Therapy, and Positive Psychology listed and discussed below, I also use aspects of Solution-Focused Therapy and Creative Therapies.
Dialectical Behavior Therapy
Dr. Marsha Linehan at the University of Washington developed Dialectical Behavior Therapy or DBT in the 1980’s. It was originally developed and researched for use with clients with Borderline Personality Disorder. However, since its development, use of DBT has been widely expanded. The DBT treatment approach has been researched and found to be effective in the treatment of chronic suicidality, non-suicidal self harm/injury, substance use, eating disorder, depression, anxiety, anger, improving social and global functioning, and other complex problems.
DBT has a very practical focus of assisting clients who are really struggling. Clients learn first to identify and to tolerate/manage their pain, and then to improve emotional regulation, to gain behavioral control, and to improve social relationships. DBT is change-oriented, but clients also experience acceptance from the relationship with the therapist and by learning to accept themselves and their emotions and circumstances. DBT can be customized to the meet the needs of each client.
I use adapted Dialectical Behavior Therapy and not the standard version developed by Dr. Linehan. I find that DBT is a great fit for struggling pre-teens and teens, and it fits my personality as a therapist—looking for practical solutions and real results. I love that when we have completed out time of working together, teens (and adults) can take a “toolbox” of skills that can be applied to their everyday lives. Clients use homework and skills practice out of their sessions to learn and improve skills application. (2, 3, 4)
Cognitive Behavior Therapy
Cognitive Behavioral Therapy (CBT) is a widely used, evidence-based treatment for many emotional and mental disorders including depression, anxiety, pain management, sleep difficulties, relationship problems, drug and alcohol abuse.
The primary idea behind this therapy is that by addressing incorrect thinking and beliefs and activating positive behavioral interventions, clients experience decreased symptoms and increased well being. CBT is practical and goal-oriented and adaptable to individual client needs. Although CBT strategies are used with young children in play therapy, in my practice I have found these strategies to be most effect with teens and adults with more complex thinking abilities. It is very helpful to clients when they realize they can change unhelpful thinking patterns that are causing distress in their lives. I like the flexibility of being able to use either a structured approach of teaching common thinking errors or a more unstructured approach in conversation with a client.
Although I don’t use Positive Psychology as a primary therapy in my practice, I include it here because I have found the principles of Positive Psychology helpful in conjunction with other therapies in assisting client as they work towards wellness. Seligman and Csikszentmihalyi define positive psychology as “the scientific study of positive human functioning and flourishing on multiple levels that include the biological, personal, relational, institutional, cultural, and global dimensions of life”.
The primary principles of Positive Psychology are described by the acronym— PERMA—suggested by Martin Seligman:
- Positive Emotion
These principles are supported by research studies, and I find them really interesting. Just ask me about the baseball card study or the happy nun studies.
Pederson, Lane, Dialectical Behavior Therapy, 2015
3 Pederson, Lane, Dialectical Behavior Therapy, 2015
4 http://www.psychiatrictimes.com/special-reports/dialectical-behavior- therapy-skills-training-effective-intervention
6. Seligman, Martin, Flourish, 2012