Evidence Based Treatment
This term refers to treatments that are backed by scientific research and empirical evidence which shows they are effective for specific issues and populations. The importance of using evidence based treatments is to insure safe and efficacious treatments while decreasing the use of harmful or potentially unsafe and/or inaffective methods. Below are a few of the theoretical orientations that were emphasized during my graduate education. I have continued my training in these and other methods to better serve you.
Cognitive Behavioral Therapy (CBT)
CBT has become an umbrella term that encompasses many therapeutic practices. The earliest form was rational emotive behavior therapy (REBT) which was pioneered by Albert Ellis. In REBT, activating events combined with irrational beliefs about said events are thought to lead to negative emotional consequences and behaviors. The goal of REBT is to increase awareness of irrational thoughts and to reevaluate dogmatic or dysfunctional cognitions in order to decrease distress. Arron Beck, built off this model with cognitive therapy (CT) which focused on negative thoughts that individuals have about their self, the world, and their future. Although both CT and REBT share similarities, REBT focuses more on the philosophical root of rigid negative thought processes. Both are still widely taught and considered effective in understanding and treating psychological distress. CBT has also been used to treat anxiety and obsessive compulsive disorders through behavioral learning principles including exposure, response prevention, and habituation. More recent theories dubbed third wave CBT include acceptance and commitment therapy (ACT) and dialectical behavior therapy (DBT).
Additional resources on CBT.
-Psychcentral in depth description of CBT.
Acceptance and Commitment Therapy (ACT)
ACT is considered a third wave CBT therapy. It emphasizes acceptance of unwanted internal and external experience and the cessation of patterns of avoidance that unintentionally perpetuate human suffering. The importance of the context in which the behavior takes place, is stressed over the behavior itself. Clients and therapist work together to discover deeply personal client held values while increasing committed actions that bring their lives closer to these newly discovered value domains while decreasing avoidance behaviors. Mindfulness skills are taught to facilitate nonjudgmental acceptance of experiences, decrease fusion to thoughts and previously held concepts in client's conceptualized self-narratives, and to promote overall psychological flexibility.
Additional resources on ACT.
-Association for Contextual Behavioral Sciences (ACBS)
Dialectical Behavior Therapy (DBT) & Dialectical Behavioral Therapy for Children (DBT-C)
Dialectical behavior therapy was first developed to treat individuals engaging in chronic non-suicidal self injury and suicide attempts. It was the first treatment to show effecaciousness with those diagnosised with borderline personality disorder, and since its development it has been researched extensively for not only BPD but a number of other mental health diagnoses. Comprehensive DBT treatment includes weekly individual psychotherapy sessions, weekly skills training sessions, phone coaching, and weekly treatment team consultation meetings. Areas in skills training cover distress tolerance, emotional regulation, interpersonal effectiveness, the middle path (dialectics), and mindfulness practices. DBT skills coaching only, includes skills groups without individual psychotherapy, and has shown some effecaciousness for select diagnoses. Informed DBT psychotherapy incorporates skills and other aspects of comprehensive DBT without concurrent skills coaching or skills training groups. Comprehensive DBT has shown increased effecaciousness compared to DBT skills only and DBT informed psychotherapy. Deciding which approach (comprehensive DBT, DBT skills only, or DBT informed psychotherapy) depends on each client’s needs and their presenting mental health issues. I currently lead weekly DBT skills group for adults, and a multifamily DBT skills group. DBT has also been adapted for children ages 6-12 who are suffering with emotional and behavioral dysregulation issues. DBT-C is an evidence based approach that involves parents and primary caregivers in order to create an environment that will model and support more effective behaviors in children dealing with emotional and behavioral dysregulation issues.
Additional resources on DBT.
-Behavioral Tech
Additional resources on DBT-C.
-Randomized Clinical Trial
Motivational Interviewing (MI)
MI consists of therapeutic techniques that focus on increasing client directed conversation about motivation for change. It was developed by Dr. Miller & and Dr. Rollnick and originated from their work with individuals suffering from substance abuse. Since its development it has been shown to increase positive change with multiple client populations and issues, especially where there is ambivalence. It is not so much a specific therapy, but instead a treatment approach that emphasizes therapist skills to provide an inviting and constructive conversation about change.
Additional resources on MI.
-Psychcentral Client's Guide to MI
-Co-Founder Dr. Rollnick