I use evidence based tools and practices to assist in helping you to adapt new coping skills and strategies to achieve a rich and meaningful life. Cognitive Behavioral Therapy Reviewed by Psychology Today Staff: Cognitive behavioral therapy (CBT) is a short-term form of psychotherapy based on the idea that the way someone thinks and feels affects the way he or she behaves. CBT aims to help clients resolve present-day challenges like depression or anxiety, relationship problems, anger issues, stress, or other common concerns that negatively affect mental health and quality of life. The goal of treatment is to help clients identify, challenge, and change maladaptive thought patterns in order to change their responses to difficult situations. Originally called simply “cognitive therapy,” what is now CBT was developed in the 1960s and 1970s by psychiatrist Aaron Beck, who found that helping depressed patients recognize and challenge their automatic negative thoughts had a positive impact on their symptoms. Beck drew on theories developed by psychologist Albert Ellis, the creator of rational emotive behavior therapy (REBT), among others, to develop an approach that was short-term and goal-oriented, in contrast to the dominant modalities of the time. Though it was originally designed to treat depression, since its inception CBT has been found to be effective for a wide range of mental health conditions and day-to-day psychological challenges, and is recommended as the first-line treatment for disorders including depression, anxiety, and insomnia.

I will use this modality to assist you in quickly finding practical solutions to improve your life. Solution-Focused Brief Therapy Reviewed by Psychology Today Staff: Solution-Focused Brief Therapy (SFBT) is one of the world's most widely used therapeutic treatments (De Shazer, 2007, Hsu, 2011). Unlike traditional forms of therapy that take time to analyze problems, pathology, and past life events, SFBT concentrates on finding solutions in the present and exploring one’s hope for the future in order to find a quick and pragmatic resolution of one’s problems. This method takes the approach that you know what you need to do to improve your own life and, with the appropriate coaching and questioning, are capable of finding the best solutions. SFBT was developed by Insoo Kim Berg, Steve de Shazer, and their colleagues in the late 1970s. Disillusioned by the results of traditional psychoanalysis, Berg and de Shazer wanted to create a new type of therapy that dealt less with the “why” behind challenges patients face, and more with the “how” of treating them. Originally begun out of Berg’s living room, the group went on to found the Milwaukee Brief Family Therapy Center in the early 1980s. A review of 43 studies on SFBT found that there was “strong evidence that Solution-Focused Brief Therapy was an effective treatment for a wide variety of behavioral and psychological outcomes.” SFBT has become particularly popular in non-Western countries, another study showed. Though the treatment started in North America, since 2013 the amount of research on SFBT in non-Western countries is twice that of Western countries. The approach is particularly popular in Asia. In the 1980s, Berg was invited to speak and give workshops on the technique in Hong Kong. The treatment received attention and study, and soon after reached Mainland China. Researchers suggest that the efficacy, practicality, and optimistic nature of the treatment translate well across cultures, and that the approach allows patients to maintain familial relations and personal dignity while addressing mental health issues.

I focus on understanding of a client's background and belief system as it relates to their race, ethnicity, sexual orientation, gender, or other important elements that make up someone's culture and/or identity. Culturally Sensitive Therapy Reviewed by Psychology Today Staff; Culturally sensitive therapy is an approach to psychotherapy that emphasizes the therapist's understanding of a client’s background and belief system as it relates to their race, ethnicity, sexual orientation, gender, or other important elements that make up someone’s culture and/or identity. Therapists can incorporate cultural sensitivity into their work to accommodate and respect differences in the opinions, values, and attitudes of various cultures and different types of people and to provide the most effective treatment for a particular client. Cultural sensitivity allows a therapist to gain and maintain cultural competence, which is the ability to first recognize and understand one’s own culture and how it influences one's relationship with a client, then understand and respond to a culture that is different from one’s own. The need for this understanding may be based on characteristics such as age, beliefs, ethnicity, race, gender, religion, sexual orientation, or socioeconomic status. Finding a therapist who is culturally sensitive can help clients—especially those who don’t identify with the dominant culture group—feel understood by their therapist, which often contributes to a stronger therapeutic alliance. By contrast, feeling as if a therapist doesn’t understand or respect one’s culture can lead some clients to give up on therapy or avoid seeking it altogether. In recent years, widespread societal discussions and shifting ideas about race, gender, sexual orientation, and other related topics have increased the demand for culturally sensitive therapy, and many therapists now actively seek to increase their cultural competence through education, training, and self-reflection. Contents When It's Used What to Expect How It Works When It's Used Cultural sensitivity practices are not tied to one therapeutic modality. Rather, they can be applied to any type of therapy or client concern, ideally helping the client feel more comfortable, strengthening the therapeutic alliance, and making the treatment more effective. Therapists who identify as culturally sensitive may practice individual therapy, couples therapy, or group therapy. While some therapist training programs now mandate classes in cultural sensitivity, others do not; therefore, it’s often necessary for therapists to seek out additional training or education in order to become more culturally competent. Cultural competence can also be strengthened through self-reflection and individual therapy. What to Expect A culturally sensitive therapist follows guidelines for working with diverse groups of people and understands that racial, cultural, religious, gender, and sexual identities interact with one’s beliefs and behavior. The expectation and ultimate goals for both the therapist and the client are notable progress and improvement, sometimes despite cross-cultural boundaries and differences. Therapists who successfully integrate cultural sensitivity practices into their treatment recognize and respect differences and take steps to communicate and interact empathetically with clients from diverse backgrounds. At the same time, they recognize that every individual is unique and that two clients who hail from the same culture may still have very different beliefs, values, and preferences. A culturally competent therapist will therefore keep an open mind and ask questions to determine which approach is best for a particular client. Research has helped document the positive effects of cultural sensitivity practices and has also outlined specific examples of how therapists can be more culturally competent in their interactions with clients of different backgrounds. For instance, one study noted that therapy with Latino clients tended to be less effective when the therapist was seen as distant. Understanding and applying the cultural expectation of disclosing some personal information, for example, may help clients who identify as Latino feel a stronger bond with their therapist. Other studies show that certain behaviors, such as familiar use of language and a general display of personable traits, can play a particularly important role in some cultures; avoiding these approaches can alienate clients. Alternatively, some studies have found that clients who hail from more collectivist Eastern cultures may feel more comfortable when their therapist takes on an “expert” role and may dislike the more collaborative approach that is common in Western, individualist cultures. Being aware of these potential preferences, and tailoring their approach accordingly, can help therapists formulate treatment plans that are suited to each client. Importantly, therapists should demonstrate knowledge of how events that take place outside the therapy room could be affecting their client’s well-being or state of mind. Clients of color may feel distressed by racial tension or race-related protests, for example; acknowledging this during therapy, and discussing it directly if the client wishes, can help clients feel like they don't have to censor themselves for their therapist's comfort. Therapists who practice cultural sensitivity may deviate from standard therapeutic methods; however, they must also adhere to their profession’s ethical guidelines, for example, when it comes to the disclosure of personal information. How It Works Advocates for cultural sensitivity argue that it is more effective to vary the therapeutic approach from person to person, depending on a client’s culture, than to simply use the same standard treatment approach for everyone. Cultural competence is also thought to vastly improve the therapeutic alliance—even if therapist and client do not share the same culture, a client who feels like her culture is recognized and acknowledged will likely feel closer to her therapist than one who feels like her identity is ignored or minimized. While some therapists argue that highlighting differences between individuals may offend some clients, and therefore damage the therapeutic relationship, it is generally believed that openly showing respect for someone’s culture and beliefs can result in more effective treatment and a more positive outcome for both client and therapist. What to Look For in a Culturally Sensitive Practitioner An individual seeking a culturally competent clinician should look for a licensed therapist or counselor who communicates an awareness of the client’s culture, beliefs, and practices. It’s OK for potential clients to ask questions about the therapist’s familiarity with their specific culture, as well as determine whether the therapist’s goals and strategies align with the client’s own. As with any therapist, clients should seek someone with whom they feel comfortable discussing personal issues. References Barnett JE and Bivings Nd. Culturally sensitive treatment and ethical practice. American Psychological Association Divisions. Division 31: State, Provincial and Territorial Psychological Association Affairs. Sue S, Zane N, Hall GC and Berger LK. The case for cultural competency in psychotherapeutic Interventions. Annual Review of Psychology. 2009;60:525-548. American Psychological Association. Guidelines for providers of services to ethnic, linguistic, and culturally diverse populations. American Speech-Language-Hearing Association Tsui, P., & Schultz, G. L. (1985). Failure of rapport: Why psychotherapeutic engagement fails in the treatment of Asian clients. American Journal of Orthopsychiatry, 55(4), 561–569. https://doi.org/10.1111/j.1939-0025.1985.tb02706.x Last updated: 09/19/2022

Acceptance and Commitment Therapy Reviewed by Psychology Today Staff Acceptance and commitment therapy (ACT) is an action-oriented approach to psychotherapy that stems from traditional behavior therapy and cognitive behavioral therapy. Clients learn to stop avoiding, denying, and struggling with their inner emotions and, instead, accept that these deeper feelings are appropriate responses to certain situations that should not prevent them from moving forward in their lives. With this understanding, clients begin to accept their hardships and commit to making necessary changes in their behavior, regardless of what is going on in their lives and how they feel about it. ACT was developed in the 1980s by psychologist Steven C. Hayes, a professor at the University of Nevada. The ideas that coalesced into ACT emerged from Hayes’s own experience, particularly his history of panic attacks. Eventually, he vowed that he would no longer run from himself—he would accept himself and his experiences.

Strength-Based Therapy Reviewed by Psychology Today Staff Strength-based therapy is a type of positive psychotherapy and counseling that focuses on your internal strengths and resourcefulness, rather than on your weaknesses, failures, and shortcomings. The tenet is that this focus sets up a positive mindset that helps you build on your best qualities, find your strengths, improve resilience, and change your worldview to one that is more positive. Practitioners believe the main reason to discuss a patient’s problems is to discover the inner strengths clients can tap into in order to build solutions. The technique was developed in the 1950s and subsequently refined by professor and psychologist Donald Clifton. The American Psychological Association has called Clifton “the father of strength-based therapy and the grandfather of positive psychology.” In the ensuing decades, strength-based therapy evolved from the work of people in various disciplines, including social work, counseling psychology, positive psychology, solution-focused therapy, and narrative therapy. Strength-based therapy stands apart from other treatments in its use of client involvement. While practitioners should have a robust background in traditional theoretical models of treatment, practitioners of strength-based therapy believe that treatment should be individualized, with solutions coming from clients themselves, guided by a therapist’s expertise. One criticism of strength-based therapy has been that it assumes people have everything they need within them to solve any problem. Proponents of the therapy would say that, while some problems are tremendously complex, therapists can and do still bring their own expertise to bear. Contents When It's Used What to Expect How it Works What to Look for in a Structural Family Therapist When It's Used Strength-based therapy is widely used and can fit into many other treatment modalities. It can be useful for: Anyone with poor self-esteem, or who has emotional issues resulting from an abusive relationship with a parent or partner. People with serious mental health problems, such as depression, anxiety, and schizophrenia. With couples and families seeking to help relationships. Those with an aversion to the idea of “therapy,” and looking for help focused not on pathologizing them, but on working with them to help them solve on their own difficulties. The effectiveness of strength-based therapy differs from other treatments in that it views an improved quality of life and well-being to be of paramount importance as much as it does the remission of particular psychiatric diagnoses. Many proponents of strength-based therapy do not benefit from a deep analysis of their troubles, and respond better to the bond they build with a therapist by discussing how past positive experiences and personal strengths can be guideposts for a treatment plan. What to Expect Strength-based therapy is talk therapy that guides you toward a retelling of your personal history of traumas, stressors, and pain with more emphasis on yourself as a survivor than as a victim, and more emphasis on your strengths and survival skills than on your weakness. The goal is for you to recognize that you may already have the skills and strength to cope with tough situations, if you are able to use them effectively. A strength-based clinician may or may not diagnose you with a psychiatric condition, but one of the core goals of the treatment is to allow you to view these conditions as just one part of your identity, rather than a defining characteristic. Strength-based therapy has shown promising results in clinical trials compared with other therapy types, but it may not work for everyone. For some difficulties, the elimination of symptoms should, in fact, take precedence over the cultivation of strengths. For patients with narcissistic tendencies, the focus on their strengths may make them too comfortable, and less likely to examine the challenges that brought them to seek help in the first place, for example. How It Works The first step in strength-based therapy is the task of gathering information about who you are. A therapist will ask questions of you and you to help identify where your strengths lie and when you’ve achieved success over significant challenges in the past. The therapist will also ask questions about what you hope to achieve in the future, and what progress would look like for you. From here, both patient and therapist will work on a plan to use the strengths you have to make incremental changes in your life to help get you to the place you want to be. Drawing attention to your successes can remind you of your inner strength and give you hope and confidence to tackle the plan in front of you. The strength-based therapy approach treats you as an expert on yourself, and so is client-specific, with treatment plans emerging from the individual moreso than from the therapist or from theoretical frameworks that teach how to treat particular problems. Feedback between you and the therapist on what’s working and what isn’t is of the utmost importance for this reason. What to Look for in a Strength-Based Therapist It’s most important to look for someone with experience in the practice and someone with whom you feel comfortable discussing personal matters. Strength-based therapy can be integrated into other psychotherapy or counseling practices. There is no official accreditation required to practice strength-based therapy. References Jones-Smith, E. Strengths-Based Therapy: Connecting Theory, Practice and Skills. Chapter 1. (2014, SAGE Publications.) Xie H. Strengths-based approach for mental health recovery. Iran J Psychiatry Behav Sci. Autumn/Winter 2013;7(2):5-10. Scheel MJ, Davis CK and Henderson JD. Therapist use of client strengths: A qualitative study of positive processes. The Counseling Psychologist. 2012. Strengths-based cognitive-behavioural therapy: A four-step model to build resilience. Clinical Psychology & Psychotherapy. July/Aug 2012;19(4):283-290. Murphy, J. J., & Sparks, J. A. (2018). Strengths-based Therapy. Taylor & Francis. https://bookshelf.vitalsource.com/books/9781315512952 Rashid, T. (2015). Positive psychotherapy: A strength-based approach. The Journal of Positive Psychology, 10(1), 25-40. Last updated: 09/01/2022