Cognitive Behavioral Therapy (CBT) is a short-term, goal oriented approach. CBT therapy focuses on helping you become more aware of the way you think and act in order to help you change the way you feel. CBT is one of the most widely supported forms of therapy because of its proven effectiveness in treating a wide variety of psychological concerns. We offer CBT Therapy for a wide variety of concerns, but we specialize in helping adults, both in Orlando and online, struggling with anxiety, depression, and trauma.
CBT is perhaps the most researched form of therapy worldwide. For decades, researchers have been trying to determine how different styles of therapy compare and which types are more effective in reducing symptoms. Countless studies have shown cognitive behavioral therapy to have positive results when compared to other types of therapy. Studies have also shown CBT in conjunction with medication to be more effective in treating severe depression and anxiety, than when treated with medication alone. CBT has been shown effective in treating the following concerns (among many others):
Our cognitive behavioral therapists specialize in the treatment of anxiety, depression, and trauma. For each of these concerns, there are specific CBT therapy programs recommended based on the symptoms you are experiencing.
Approximately 5%, or over one hundred thousand people, in the greater Orlando area will experience panic disorder at some point in their lives. We provide a CBT Treatment for Panic Disorder and Agoraphobia, created by the leading researchers Michelle Craske and David Barlow. Studies conducted over the past 20 years have shown that 70-90% of individuals who complete this treatment program are panic-free. Unlike with medication, however, the benefits of CBT have been shown to hold up for years after completing treatment.
Approximately 3.1%, or roughly 65,000 people in Orlando will struggle with Generalized Anxiety Disorder, just this year alone. For generalized anxiety disorder, we provide cognitive behavioral therapy based on a treatment program created by leading researchers. The program is part of the Treatments That Work series by Richard Zinbarg, Michelle Craske, and David Barlow. The CBT for GAD program is specifically designed to target the symptoms of generalized anxiety disorder. Research has shown that 70% of individuals who complete this program experience a significant improvement in their anxiety. This includes worrying less, experiencing less physical symptoms, and increased ability to relax and enjoy their lives outside of worry.
Approximately 150k (or roughly 7%) of Orlando is experiencing social anxiety disorder at any given time. For social anxiety disorder, we provide CBT treatment based on the program by Debra Hope, Richard, Heimburg, and Cynthia Turk. This treatment specifically focuses on a few key elements of social anxiety:
Approximately 140k people in Orlando, roughly 6.7%, will experience a major depressive episode at some point this year. We also offer cognitive behavioral therapy for depression that focuses on identifying how the cycle of depression is being maintained. In particular, we take a look at 5 key elements:
Approximately 3.5%, or roughly 75k people in Orlando, will develop PTSD at some point in their lifetime. For clients looking to work through traumatic experiences, we offer cognitive processing therapy. This therapy focuses on helping to:
The primary focus of CBT is to explore your belief system, your thoughts, and the meaning you make from your experiences. It is these underlying thoughts and beliefs that contribute, in part, to distressing feelings such as depression, anxiety. Together we will begin to connect how your perception of situations and events, shapes the way you feel and react. Over the course of therapy, you will learn techniques for managing your mood, the rationale behind them, and how to begin practicing these new skills in your everyday life.
CBT sessions are often planned out. There’s a tentative agenda for each session, focusing on skills and information for you to learn and practice. CBT is a very knowledge and skill based type of therapy. It follows a predictable pattern, so you can understand the intention behind what you’re doing, in and out of sessions, and how it will help you to feel better. This is a bit different from traditional “talk therapy” which varies more from week to week, often discussing whatever particular trouble is on your mind, and focusing more on insight than action.
It is an ideal approach for someone who is concerned that therapy may be a “waste of time just talking” as it forces both therapist and client to really hone in on the problem and begin chipping away at it in a systematic fashion. Thus, the structured nature of CBT is helpful in allowing you to get the most out of your time in therapy.
CBT, as with all forms of therapy widely available, has been subjected to a great deal of research to determine whether or not it’s actually effective. Unlike many other forms of therapy, however, because CBT follows a structured course, it can be easier to see if it’s “working.” For example, in CBT we often rate the severity of symptoms on a scale of 0-100 (My anxiety was at at 60 the last time I drove to the store) so we can see if symptoms are improving (Now when I drive, my anxiety doesn’t really get above a 20).
As it turns out, CBT has more empirical support to date than any other form of talk therapy – particularly in the treatment of depression, anxiety, and other common conditions. Studies have also shown that online Cognitive Behavioral Therapy appears to be just as effective.
CBT does not typically go on for years. In fact, most clients find they start to notice a change in their mood after only a few weeks. This is possible partly because of the approach and party because of the emphasis on practicing skills outside of session (where you spend most of your time). We do have clients who prefer longer-term therapy, either because they have multiple concerns they wish to work on or they are looking to work on “deeper rooted issues” such as unresolved pain from childhood.
In cognitive behavior therapy, you’ll set a list of goals you would like to accomplish or problems you would like to resolve while in treatment. Sessions are strategically focused on dealing with these issues and much less about “let’s go wherever the hour takes us.” If urgent issues come up that need to be addressed, we can take a short break from our regular path, but then we’ll return to our goals and re-focus.
Common goals that bring clients in to therapy include things like: decreasing worry or depressed mood, decreasing the intensity or frequency of physical symptoms, improving assertive communication, or challenging unhelpful patterns such as perfectionism, procrastination, or avoidance.
Once we have a shared understanding of what problems you’re experiencing and what goals you’d like to pursue in counseling, we will use this information to plan out the content of sessions and what approach we’ll take to address your concerns. Each week we will decide together what main topics would be most helpful to focus on, review your progress over the past week, and discuss any successes or difficulties you’ve had in applying the techniques on your own. Each session ends with a plan for what skills and techniques you can practice outside of session to begin conquering your problems.
CBT looks at what is going on in your life now and how to make changes to help you feel better in the present. If there is only limited success because the past is getting in the way (such as a very difficult upbringing or a past trauma that has never been addressed) then we can revisit these things for a bit to see how they may have affected you and how they may relate to your present concerns. If this is the case, we often incorporate elements of Emotion Focused Therapy and Mindfulness Training to assist in working through these areas.
As its name suggests, CBT focuses on your thoughts (your beliefs and your perceptions) and how these affect your mood. Through CBT you can learn to track your thoughts and challenge them so that you can begin to change the way you think, the way you see things, and thus the way you feel about them. Over time, CBT has also been shown to change your underlying beliefs that may be contributing to your troubles.
Some clients have difficulty identifying their automatic thoughts at first or difficulty catching them “in the moment” as they’re happening. For these clients, we’ve found mindfulness techniques to be particularly helpful in learning to identify their thoughts. Many of our clients report that the work they’ve done on changing their perspectives was key!
CBT focuses equally on your behaviors – your actions and reactions which often contribute to your mood as well. In cognitive behavioral therapy, you will practice changing the way you act and react in various situations, which often results in changing the way you feel. This means actively taking steps and testing out their effect on your mood.
For example, anxiety often gives us the urge to avoid. With CBT, we work on identifying what tactics you might be using to avoid certain things. We explore how avoiding certain situations may be contributing to feeling even more anxious next time. Then we come up with a plan to take action, facing the situation one step at a time, until your anxiety reduces.
Common behavioral techniques we teach include:
The ultimate goal of CBT is for you to become your own therapist!
Sometimes when you’re trying something new, I find it can be helpful to have an idea of what the step by step process looks like. Most clients I work with are initially curious about what we will talk about, what sessions will look like, how therapy will work, and what the end goal is. Here’s a general idea of what you can expect if you come to us for CBT.
Together we will work to create a “problem list” to help us understand all your current concerns and how they relate to one another. We start here because in order to make good use of our time together we need to know what we’re trying to accomplish.
Together we will figure out what underlying problems may be contributing to all of your current concerns and see if this fits with your view of yourself and your life. We’ll take a short bit of time to get an idea of how it all ties together. This piece is crucial because it helps me to understand how best to help you so that we can be intentional with our work together. Otherwise we run the risk of trying “this and that” and simply hoping something “sticks” along the way, which would be frustrating.
You will learn the basic process of cognitive behavioral therapy so that you know what to expect and understand the rationale behind the process. In order for CBT to be effective, you must understand the core principles of it and how it applies to your concerns.
You will learn you the basics of self-awareness including learning to identify your thoughts, feelings, and reactions using everyday examples. Learning to monitor your thoughts and reactions to daily situations will help you to really experience the impact these things have on your emotions. This step also helps you to become a bit more objective as you begin to observe yourself and your reactions, giving you increased ability to make changes when needed.
You will be encouraged to understand why these thoughts, feelings, and reactions “make sense” based on your past experiences, upbringing, and core beliefs. There is often a tendency to criticize ourselves for thinking and reacting the way we do at this point in CBT, labeling ourselves as “crazy” or “an idiot” when in reality it makes perfect sense that you think and react the way you do based on your beliefs and experiences.
You will learn how to challenge your thoughts and change your behaviors. We’ll teach you to objectively re-evaluate the way you look at everyday situations. This way you can begin choosing new perspectives that are less upsetting to you. We will also talk about new behaviors to replace old ones that might lead you to a more desirable outcome.
These new perspectives often seem too good to be true at first. So you’ll work to gain faith in your new perspectives by finding everyday opportunities to “test” them out. Together we’ll find “experiments” for you to try in your everyday life so you can see if your new perspective or new behavior holds up.
You will start to solidify these changes through practice and repetition. This is a key piece in what makes CBT effective long-term. As you practice changing your thoughts and reactions repetitively, over time you actually create lasting structural changes in your brain.
Together we’ll come up with a plan to help you maintain the changes you’ve made so you can keep up your progress on your own. This will involve identifying potential difficulties, putting accountability measures in place, and solidifying your motivation to keep up with the changes long-term.
We will meet less often so that you have more time between sessions to practice maintaining the changes you’ve made. We make adjustments to your maintenance plan and deal with any difficulties you have applying the techniques on your own.
Once you’re comfortable with your ability to maintain your progress without regular sessions, you’ll have successfully completed treatment. At that point, you can come back for maintenance sessions every so often or as needed if life really throws you a curve ball.
It can be challenging to work through on your own, but it can be an excellent addition to therapy. These books are full of coping skills for anxiety and depression.