Lying awake at 3 AM while your mind replays everything that went wrong. Dragging through another day with pain that nobody else can see. Worrying so much your chest is tight before your feet hit the floor. Feeling nothing when you used to feel something. You've tried pushing through it. Ignoring it. Waiting for it to pass. It's not working. I'm Bryan Barry, a licensed clinical social worker with over 20 years of experience in VA and private practice settings. I specialize in helping adults break the cycle of chronic pain, insomnia, anxiety, and depression using structured, evidence-based CBT. Sessions are focused, practical, and built around skills you can use immediately. You'll get homework. We'll track your progress. Most clients start noticing real shifts within the first few weeks. If you're ready to stop managing and start changing, let's talk. Evening and weekend telehealth available in Missouri and South Carolina. Because therapy should work as hard as you do.
Our first session is a working session, not just an intake interview. We'll start with introductions, but I won't spend the whole hour collecting your life history. I want to know what's happening right now — what brought you in, what symptoms are disrupting your life, and what you've already tried. I ask direct questions because I want a clear picture quickly, and most clients tell me they appreciate not having to wonder where the conversation is going. Once I understand what you're dealing with, I'll explain exactly how we're going to work on it. If you're not sleeping, I'll walk you through CBT for Insomnia — the most effective treatment for chronic insomnia, more effective than medication with longer-lasting results. Most people see improvement within four to six weeks. If chronic pain is part of the picture, I'll explain how CBT for Chronic Pain works — how your thoughts about pain interact with the pain itself, and how changing that response reduces both suffering and functional impairment. If anxiety or depression is the primary concern, I'll show you how the cognitive model works and why understanding the connection between your thoughts, feelings, and behaviors is the key to changing all three. Before we wrap up, we'll set specific, measurable goals together. Not "feel better." Goals like sleeping through the night, getting through a workday without a panic spike, reducing pain interference enough to do the things you've stopped doing. I want you to be able to look back in a month and point to concrete evidence that something has changed. You'll leave the first session knowing what we're doing, why it works, and what your first homework assignment is. You'll also know whether this is the right fit — because I'll tell you honestly if it's not, and point you toward someone who is.
You've probably seen a lot of therapist profiles that list anxiety and depression. So do I. The difference is that I specialize in the specific combination of chronic pain, insomnia, anxiety, and depression — conditions that feed each other in a cycle most general therapists aren't trained to break. I have specialized training in CBT for Insomnia and CBT for Chronic Pain. These are targeted, research-supported protocols — not standard talk therapy loosely applied to sleep or pain. That distinction matters because insomnia and chronic pain respond to very specific interventions, and applying the wrong approach wastes your time and money. I also practice Rational Emotive Behavior Therapy, which goes deeper than standard CBT. While CBT catches and challenges distorted thoughts in specific situations, REBT targets the rigid core beliefs underneath — the demands, the self-judgments, and the frustration intolerance that keep people stuck in the same cycles for years. This combination means we're not just putting out fires. We're addressing what generates them. The other thing I bring is structure. Every session has a focus. You get homework — not busywork, but targeted exercises that accelerate the process. We track progress with standardized measures so you can see the change, not just hope for it. Twenty years in VA and private practice taught me that the clients who improve fastest are the ones who learn specific skills and practice them between sessions. That's how I run my practice.
You're a good fit for my practice if you're dealing with insomnia that won't quit no matter what you've tried, chronic pain that's taken over your daily life, anxiety that makes it hard to focus or function, or depression that drains your motivation and makes everything feel pointless — or some combination of all of these. You don't need to be in crisis to reach out. Many of my clients are functioning — going to work, taking care of their families — but they're running on empty and they know something has to change. You're a good fit if you want a therapist who is direct and structured rather than passive and open-ended. You're willing to do the work between sessions — the homework, the practice, the tracking — because that's where the real change happens. I work with adults of all backgrounds, including veterans and first responders who are tired of being told to tough it out. You don't need to be excited about homework. You just need to be willing.
Top specialties
Anxiety
Depression
Insomnia/Sleep Issues
Other specialties
Anger Management
Chronic Illness
Health/Medical Issues
I identify as
Man
Adults (18 to 64)
Elders (65 and above)
Missouri
Aetna
Cognitive Behavioral (CBT)
CBT is the foundation of everything I do. It's built on one core idea: it's not the events in your life that create your suffering — it's how you interpret them. Your thoughts drive your feelings, and your feelings drive your behaviors. When the thoughts are distorted or rigid, everything downstream follows. In practice, this means we identify the specific thinking patterns keeping you stuck and change them systematically. You'll learn to catch automatic thoughts, test them against the evidence, and replace them with something more accurate and useful. This isn't vague self-reflection — it's a structured skill you practice between sessions until it becomes second nature. I also hold specialized training in CBT for Insomnia (CBT-I) and CBT for Chronic Pain (CBT-CP). CBT-I is the most effective treatment for chronic insomnia — more effective than sleep medication with longer-lasting results. CBT-CP targets the way your thoughts about pain interact with the pain itself, reducing both suffering and functional impairment. These aren't generic CBT applied loosely to sleep or pain. They're targeted protocols with strong research behind them.
Cognitive Behavioral Therapy for Insomnia (CBT-i)
If your mind won’t slow down at night, CBT-I helps retrain your sleep system. We’ll identify habits and thoughts that keep your body in alert mode, then use proven methods like sleep scheduling, cognitive reframing, and relaxation skills to reset your natural rhythm. Clients typically notice improvement within a few weeks—falling asleep faster, waking less often, and feeling rested again.
Acceptance and commitment (ACT)
ACT is especially powerful for clients dealing with chronic pain, ongoing anxiety, or depression that hasn't fully responded to other approaches. Instead of fighting your difficult thoughts and feelings or waiting for them to go away before you start living, ACT teaches you to carry them while moving toward the life you actually want. The core shift is this: you stop spending all your energy trying to control how you feel and start redirecting it toward what matters to you. For chronic pain clients, this means building a life that isn't organized around avoiding pain. For anxiety clients, it means acting on your values even when anxiety is loud. For depression, it means reconnecting with what you care about even when motivation is low. ACT pairs naturally with CBT. Where CBT changes the content of your thinking, ACT changes your relationship to your thinking. Together they give you tools for both — challenging the thoughts that are wrong and carrying the ones that won't budge.
Mindfulness-Based Therapy
I integrate mindfulness techniques into my work with clients dealing with chronic pain, insomnia, anxiety, and depression. Mindfulness isn't about clearing your mind or achieving some state of calm — it's about learning to notice what's happening in your body and your thinking without getting hijacked by it. For insomnia, mindfulness helps break the cycle of lying in bed monitoring yourself for sleep, which is one of the behaviors that keeps insomnia going. For chronic pain, it helps separate the physical sensation from the catastrophic thinking that amplifies it. For anxiety, it builds the skill of observing anxious thoughts without treating them as emergencies. For depression, it interrupts the ruminative loops that keep pulling you deeper. I teach mindfulness as a practical skill, not a philosophy. You'll practice specific techniques between sessions and we'll track what's working. It's one tool in the toolkit — not the whole toolkit.
1 rating with written reviews
March 17, 2026
I am new to the process, and I chose the friendliest face that fit the criteria that I had selected. Our first session went very well, and I am even more comfortable with Bryan afterwards.