Adlerian
Adlerian psychotherapy was founded by Alfred Adler (an ex-associate of Freud who rejected Freud’s notion that sex is the root of all psychological problems.) It takes a positive view of human nature: We are all goal-oriented creatures who are striving for social connectedness, and we are in control of our destiny. Many personal difficulties, Adler believed, stem from feelings of inferiority-he in fact coined the term “inferiority complex.”
An Adlerian therapist will identify, explore, and challenge a client’s current beliefs about their life goals. He or she will gather family history and will use information about a client’s behavior patterns to help the client set new, socially satisfying,and attainable goals. These could relate to any realm of life and could include developing parenting or marital skills, or ending substance abuse. Once these healthier objectives are set, the therapist may also assign homework, set up contracts with the client,and make suggestions on how the client can reach his or her new goals.

Art Therapy
It may look like a craft class, but art therapy is a serious technique that uses the creative process to help improve the mental health of clients. Art therapy can be used on children and adults to treat a wide range of emotional issues, including anxiety, depression, family and relationship problems, abuse and domestic violence, and trauma and loss.
Commonly found in hospitals and community centers, art therapy programs are based on the belief that the creative process is healing and life-enhancing. As they paint or draw, a skilled therapist can use the client’s works of art and her approach to the process as springboards to help her gain personal insight, improve her judgment, cope with stress, and work through traumatic experiences.

Biofeedback
Biofeedback is simply using signals from you own body to improve your health. If you’ve stepped on a scale or taken your temperature, for example, you’ve received “feed back” information that you then perhaps acted on.
A therapist may use more advanced biofeedback techniques to help clients suffering from anxiety, stress, or tension headaches. One such technique uses a machine that picks up electrical signals in the muscles. As the client tries to relax her muscles, she can get an immediate progress report by watching the speed of the signals, and thus learn how to better control her mind and body.

Christian/Bible-Based
Christian therapy seeks to help clients work through psychological issues using both traditional therapeutic methods and a philosophy based on the Christian religion and the teachings of the Bible. Christian therapists guide their clients’ emotional and spiritual growth simultaneously.

Client-Centered
Developed by Carl Rogers in the 1940s, the client-centered method is based on the empowering idea that the client holds the answers to her problems–not the doctor in the white coat. The client-centered therapist’s job, then, is to carefully listen and strive to understand the client, so that she can tap into her natural ability to grow and improve. Client-centered therapy helps the client live in the moment and focus on personality change, rather than on the origins of her personality structure.

Coaching
Life coaching is an increasingly popular profession that has no specific licensing or academic requirements. Though psychologists also often consider themselves life coaches, these therapists don’t focus on treating mental illness. Instead, they help individuals realize their goals in work and in life. An executive coach, for example, may be enlisted to help a chief executive become a better manager, while a “love” coach may map out a plan to help a client find romantic fulfillment.

Cognitive Behavioral (CBT)
Cognitive-behavioral therapy stresses the role of thinking in how we feel and what we do. It is based on the belief that thoughts, rather than people or events, cause our negative feelings. The therapist assists the patient in identifying, testing the reality of, and correcting dysfunctional beliefs underlying his or her thinking. The therapist then helps the client modify those thoughts and the behaviors that flow from them. CBT is a structured collaboration between therapist and client and often calls for homework assignments. CBT has been clinically proven to help clients in a relatively short amount of time with a wide range of disorders, including depression and anxiety.  (Please Read More on CBT below.)

Dream Analysis
While not commonly used as a stand-alone technique, therapists using a variety of methods may incorporate dream analysis into their practice. Exploring the meaning of dreams through symbols, myths, free association and memories may help clients process and understand their psychological issues. There are a variety of philosophies and approaches for analyzing dreams including Adlerian (where dreams are projections of a person’s current concerns), Gestalt (where every person and object in a dream represents an aspect of the dreamer), and psychoanalytic (where dreams are a key to what is happening in a person’s unconscious.)

Eclectic
Many practitioners now take an eclectic approach to therapy, drawing upon various aspects of cognitive-behavioral and psychodynamic methods to create their own custom-made approach. Such therapists often work with their clients to create a treatment plan that encompasses different techniques to best address the client’s particular problems and to appeal to her sensibility.

EFCT
Emotionally Focused Couples Therapy, or EFCT, is a structured approach to relationship revival. EFCT is a nine-step, three-event process for couples and families dealing with depression, post-traumatic stress, chronic illness, and other disorders. This therapy is proven to expand emotional response and initiate new cycles of interaction. EFCT presents a clear understanding of marital challenges and adult attachment. Research studies find that 70-75 percent of couples move from distress to recovery and 90 percent show improvement overall.

EMDR
EMDR (Eye Movement Desensitization and Reprocessing)is an information processing therapy that helps clients cope with trauma, addictions, and phobias. During this treatment, the patient focuses on a specific thought, image, emotion, or sensation while simultaneously watching the therapist’s finger or baton move in front of his or her eyes. Then the client is asked to think of new thoughts, while again simultaneously focusing on the external stimulus. EMDR practitioners believe that the treatment loosens one’s traumatic memories and allows them to be reprocessed with positive ones.

Existential
Existential psychotherapy is based on the philosophical belief that human beings are alone in the world, and that this aloneness can only be overcome by creating one’s own meaning, and exercising one’s freedom to choose. The existential therapist encourages clients to face life’s anxieties head on and to start making his own decisions. The therapist will emphasize that along with having the freedom to carve out meaning comes the need to take full responsibility for the consequences of one’s decisions. Therapy sessions focus on the client’s present and future rather than his past.

Family Systems Therapy
Family Systems therapists view problems within the family as the result not of particular members’ behaviors, but of the family’s group dynamic. The family is seen as a complex system having its own language, roles, rules, beliefs, needs and patterns. The therapist helps each individual member understand how her childhood family operated, her role in that system, and how that experience has shaped her role in her current family. Therapists with the MFT credential are usually trained in Family Systems therapy.

Family/Marital Therapy
Family and Marital therapists work with families or couples both together and individually to help them improve their communication skills, build on the positive aspects of their relationships, and repair the harmful or negative aspects.

Feminist Therapy
Feminist therapy focuses on empowering women and helping them discover how to break free from traditional molds that may be blocking their growth and development. Feminist therapy tends to be focused on improving women’s effectiveness in areas such as communication, assertiveness, self-esteem, and relationships.

Forensic Psychology
Forensic Psychology is the application of psychological knowledge to the criminal justice system. Forensic psychologists offer expert testimony in criminal and civil cases and may perform psychological autopsies and evaluate a person’s psychological competency to stand trial. They may also consult and train law enforcement, criminal justice, correctional, and mental health officials.

Gestalt
Gestalt therapy seeks to integrate the client’s behaviors, feelings, and thinking, so that her intentions and actions may be aligned for optimal mental health. The therapist will help the client become more self aware, to live more in the present, and to assume more responsibility for taking care of herself. Techniques of gestalt therapy include confrontation, dream analysis, and role playing.

Humanistic
The humanistic method takes a positive view of human nature and emphasizes the uniqueness of the individual. Therapists in this tradition, who are interested in exploring the nature of creativity, love, and self-actualization, help clients realize their potential through change and self-directed growth. Humanistic therapy is also an umbrella term for gestalt, client-centered therapy, and existential therapy.

Hypnotherapy
Hypnotherapy focuses on hypnosis, the Greek term for sleep. The practice uses exercises that relax people, bringing them to an altered state of consciousness. This process focuses on mastering self-awareness. Through trance-like analysis, hypnosis decreases blood pressure and heart rate, putting one’s physical body at ease. Working with memories, hypnotherapy helps a person to reframe, relax, absorb, dissociate, respond, and reflect. The process reconstructs healthier associations with a person’s past events. Dealing with a wide range of conditions, such as anxiety and depression, people become responsive to new solutions that can lead to personal development through hypnotherapy.

Interpersonal
IPT is a short-term psychotherapy in which therapist and client identify the issues and problems of interpersonal relationships. They also explore the client’s life history to help recognize problem areas and then work toward ways to rectify them. There are also specific therapies, such as Imago therapy, which focus on intimate relationships. In addition, interpersonal therapy is not to be confused with transpersonal psychology, which is the study of states in which people experience a deeper sense of who they are, or a sense of greater connectedness with others, nature or spirituality.

Jungian
Jungian or analytical therapy, developed by Carl Jung, seeks to help people access their unconscious to develop greater self-realization and individuation. Jung, a psychoanalyst, sought to understand the psyche via dreams, art, mythology, world religion and philosophy. The Jungian therapist helps the patient find more meaning in her life, with respect for the mysterious nature of the soul.

Mindfulness-based Cognitive Therapy (MBCT)
For patients with chronic pain, hypertension, heart disease, cancer, and other health issues such as anxiety and depression, mindfulness-based cognitive therapy, or MBCT, is a two-part therapy that aims to reduce stress, manage pain, and embrace the freedom to respond to situations by choice. MCBT blends two disciplines–cognitive therapy and mindfulness. Mindfulness helps by reflecting on moments and thoughts without passing judgment. MBCT patients pay close attention to their feelings to reach an objective mindset, thus viewing and combating life’s unpleasant occurrences.

Play Therapy
Generally for children ages 3 to 11, play therapy is a form of counseling that relies on play to help therapists communicate with children and diagnose their mental health. Because children develop cognitive skills before language skills, play is an effective way to understand a child. The therapist may observe a child playing with toys–such as playhouses and dolls–to understand the child’s behavior and diagnose the problem.

Psychoanalytic
Psychoanalysis is a form of therapy wherein the patient explores his patterns of thinking and behavior–often originating in various childhood developmental phases–through free-association and identification with the analyst. Psychoanalysts treat patients intensively. Modern adherents of psychoanalysis may treat patients less frequently, and may take a more interactive approach, whereas traditional psychoanalysts rarely reveal their own views or feelings during therapy.

Psychodynamic
Psychodynamic therapy, also known as insight-oriented therapy, evolved from Freudian psychoanalysis. Like adherents of psychoanalysis, psychodynamic therapists believe that bringing the unconscious into conscious awareness promotes insight and resolves conflict. But psychodynamic therapy is briefer and less intensive than psychoanalysis and also focuses on the relationship between the therapist and the client, as a way to learn about how the client relates to everyone in her life.

Psychological Testing
Psychological testing refers to assessments of a client’s mental, emotional, and intellectual health. Neuropsychological testing, for example, addresses a patient’s problems with cognitive functioning and can require hours of examination. Nonprofessionals, such as potential employers or educational institutions, now commonly administer achievement or aptitude tests to evaluate potential candidates. Intelligence tests and personality tests are offered through Internet sites, though their quality varies widely.

Rational Emotive Therapy
Rational Emotive Therapy, or Rational Emotive Behavioral Therapy, was developed by Albert Ellis and was one of the first cognitive-behavioral therapy approaches. RET posits that our emotions result from our beliefs, many of which are irrational, and thus cause us to suffer unnecessarily. The RET therapists will question the client’s beliefs to help use her natural ability to think clearly. The therapist will then encourage her to change her actions to align with her new, rational beliefs to relieve her emotional problems. This active approach often includes homework assignments.

Relational Therapy
Relational life therapy offers strategies to combat marital dysfunction and restore harmony in relationships. Couples–those recovering from affairs, traumatic events, or a lull in passion–can find RLT helpful. To repair discord, the therapist identifies the main conflict upsetting the couples’ emotional intimacy. Once the partners see how they both contribute to the problem, the therapist teaches them skills to improve the ways they relate to each other. Couples may see a change in their relationship within three to six months.

Theraplay is a therapeutic approach that uses elements of play therapy with the intention of helping parents and children build better attachment relationships through attachment-based play. It was developed in 1967 in Chicago by Ann M. Jernberg.

Self-Psychology
Self-psychology is a mode of psychoanalytic treatment founded by Heinz Kohut. It posits that each individual’s self-esteem and vitality derive from and are maintained by the empathic responsiveness of others to his or her needs. The self-psychology practitioner will thus emphasize the role of empathic listening in treating clients.

Social-Learning Therapy
Social-learning therapy is an active teaching approach to helping clients improve relationship and social skills. The therapist models desirable behavior for clients, who then mimic the behavior.

Solution Focused Brief Therapy (SFBT)
Solution-focused therapy, sometimes called “brief therapy,” focuses on what clients would like to achieve through therapy rather than on their troubles or mental health issues. The therapist will help the client envision a desirable future, and then map out the small and large changes necessary for the client to undergo to realize her vision. The therapist will seize on any successes the client experiences, to encourage her to build on her strengths rather than dwell on her problems or limitations.

Transactional Analysis
Transactional analysis focuses on cognitive and behavioral functioning. The therapist helps the client evaluate her past decisions and how those choices affect her present life, in the belief that greater awareness will lead to better decision-making and judgment calls in the future.

Transpersonal
Transpersonal therapy emphasizes the transcendent or spiritual aspects of a client’s development. A transpersonal therapist may help the client cultivate a greater sense of connectedness with others, with nature, and with a higher spirit.

Theraplay is a therapeutic approach that uses elements of play therapy with the intention of helping parents and children build better attachment relationships through attachment-based play. It was developed in 1967 in Chicago by Ann M. Jernberg.

Psychodrama is the use of action techniques to explore an individual’s private and public world in a multi-dimensional way.  It is also useful in helping the individual to express unexpressed feelings and to find and practice new ways to change unsatisfying situations in life. Psychodramatic interventions are designed to encounter people where they are, in the present and assist them in contacting and developing the best that is within themselves, whatever their functioning level.  Psychodrama reinvests power in people. Clinically, psychodrama can be used with groups, couples or individuals.

A psychodrama director is the leader of a psychodrama session (usually a psychotherapist, psychologist, counsellor or other mental health professional) who by his/her actions is aimed to help the protagonist enact significant scenes from his life and experiences in a meaningful and therapeutically beneficial way. The psychodrama director is also responsible for the overall psychotherapeutic process in the Psychodrama group. According to the founder of Psychodrama, Jacob L. Moreno, the director is one of the five basic elements of psychodrama: protagonist, auxiliary ego, audience, stage and director.

Tamara uses cognitive-behavioral therapy to treat most of her clients , however is open to using other forms of intervention as all cases are assessed and treated on an individual bases. Here  is more detail information on cognitive-behavioral therapy.

Cognitive-Behavioral Therapy

Cognitive-Behavioral Therapy (CBT) is an empirically supported treatment that focuses on patterns of thinking that are maladaptive and the beliefs that underlie such thinking. For example, a person who is depressed may have the belief, “I’m worthless,” and a person with a phobia may have the belief, “I am in danger.” While the person in distress likely holds such beliefs with great conviction, with a therapist’s help, the individual is encouraged to view such beliefs as hypotheses rather than facts and to test out such beliefs by running experiments. Furthermore, those in distress are encouraged to monitor and log thoughts that pop into their minds (called “automatic thoughts”) in order to enable them to determine what patterns of biases in thinking may exist and to develop more adaptive alternatives to their thoughts. People who seek CBT can expect their therapist to be active, problem-focused, and goal-directed.

Studies of CBT have demonstrated its usefulness for a wide variety of problems, including mood disorders, anxiety disorders, personality disorders, eating disorders, substance abuse disorders, and psychotic disorders. While a full description of the treatment and presenting problems for which it is useful is beyond the scope of this brief overview, a brief summary of several treatments will be presented.

CBT has been shown to be as useful as antidepressant medication for individuals with depression and is superior in preventing relapse. Patients receiving CBT for depression are encouraged to schedule activities in order to increase the amount of pleasure they experience. In addition, depressed patients learn how to restructure negative thought patterns in order to interpret their environment in a less biased way. CBT for Bipolar Disorder is used as an adjunct to medication treatment and focuses on psychoeducation about the disorder and understanding cues and triggers for relapse. Studies indicate that patients who receive CBT in addition to treatment with medication have better outcomes than patients who do not receive CBT as an adjunctive treatment.

CBT is also a useful treatment for anxiety disorders. Patients who experience persistent panic attacks are encouraged to test out beliefs they have related to such attacks, such as specific fears related to bodily sensations, and to develop realistic responses to such beliefs. This treatment is very effective for those who experience such problems. Patients who experience obsessions and compulsions are guided to expose themselves to what they fear and beliefs surrounding their fears are identified and modified. The same is true for people with phobias, including phobias of animals or phobias of evaluation by others (termed Social Phobia). Those in treatment are exposed to what they fear and beliefs that have served to maintain such fears are targeted for modification.

Over the past 10 years, CBT for schizophrenia has received considerable attention in the United Kingdom. While this treatment continues to be in its infancy in the United States, the results from studies in the United Kingdom have stimulated considerable interest in therapists in the U.S., and more therapists are conducting the treatment now than just a few years ago. In this treatment, patients are encouraged to identify beliefs and their impact and to engage in experiments to test their beliefs. Treatment focuses on thought patterns that cause distress and also on developing more adaptive, realistic interpretations of events. Delusions are treated by developing an understanding of the kind of evidence the person uses to support the belief and encouraging the patient to recognize evidence that may have been overlooked that does not support the belief. Furthermore, the assumed omnipotence of “voices” is tested, and patients are encouraged to utilize various coping mechanisms to test the controllability of auditory hallucinations.

While the above summary is certainly not comprehensive, it provides a brief overview of the principles of CBT and how it applies to various presenting problems. CBT’s focus on thoughts and beliefs are applicable to a wide array of issues. Because CBT has excellent empirical support, it has achieved wide popularity both for therapists and consumers. Those who may receive CBT training include psychologists, psychiatrists, social workers, and psychiatric nurses. Those seeking treatment using a CBT approach are encouraged to ask their therapist what CBT training they have had or to contact a Center for Cognitive Therapy and request a referral in their geographical location.

Reviewed by Debbie M. Warman, Ph.D. and Aaron T. Beck, M.D., June 2003

Cognitive behavioral therapy

Definition

By Mayo Clinic staff

Cognitive behavioral therapy is a type of psychotherapy based on the idea that your own distorted thoughts and beliefs lead to your negative moods and unhealthy behavior. Cognitive behavioral therapy says that other people, situations and events aren’t responsible for your mood and behavior — you are.

According to the theory behind cognitive behavioral therapy, you have automatic but inaccurate thoughts or beliefs in certain situations. These inaccurate thoughts lead to unhealthy moods and behavior, such as anxiety and overeating. Cognitive behavioral therapy helps you become aware of these inaccurate thoughts and beliefs. You learn to view situations more realistically. This allows you to behave and react in a healthier way — even if the situation itself hasn’t changed.

Cognitive behavioral therapy is a common type of psychotherapy. It combines features of both cognitive therapy and behavior therapy. Cognitive behavioral therapy is helpful for numerous mental illnesses and stressful life situations.

Why it’s done

By Mayo Clinic staff

Cognitive behavioral therapy is one of many effective ways to treat a wide range of mental illnesses and life stressors.

When to consider cognitive behavioral therapy
Cognitive behavioral therapy may be used because:

• It’s your preferred treatment choice
• You don’t want to take psychiatric medications
• You’ve tried other treatments and they haven’t worked
• Other treatments aren’t appropriate for your situation — for instance, you can’t tolerate the side effects from antidepressants
• You want to experience emotional growth and healing
• You’re having a hard time overcoming negative moods and self-destructive behavior
• You want to prevent a relapse of your condition after stopping other treatment

Conditions and issues cognitive behavioral therapy may help
Conditions and problems that may benefit from cognitive behavioral therapy include, but aren’t limited to:

• Grief
• Anger
• Abuse
• Medical illnesses, such as chronic fatigue syndrome
• Relationship problems
• Sleep disorders
• Work problems
• Sexual disorders
• Depression
• Bipolar disorder
• Anxiety disorders
• Phobias
• Eating disorders
• Substance abuse disorders
• Personality disorders
• Psychotic disorders, such as schizophrenia

In severe cases, cognitive behavioral therapy may be more effective when it’s combined with other treatments, such as psychiatric medications.

Risks

By Mayo Clinic staff In general, cognitive behavioral therapy poses little risk. Because therapy can explore painful feelings and experiences, though, you may feel emotionally uncomfortable at times. Some forms of cognitive behavioral therapy, such as exposure therapy, may require you to confront situations you’d rather avoid — such as airplanes if you have a fear of flying. This can lead to temporary distress or anxiety. But the coping skills you learn should help you later on to manage and conquer distressful feelings and thoughts.

How you prepare

By Mayo Clinic staff

You might decide on your own that you want to try cognitive behavioral therapy, or a doctor, relative, friend, employer or someone else may suggest therapy to you. In any case, consider these points to prepare for starting cognitive behavioral therapy:

• Find a therapist. You can find a therapist on your own — looking through the phonebook, for instance — or you can get a referral from your doctor, health insurance plan, friend or other trusted source. Be sure to ask a prospective therapist if he or she is trained in cognitive behavioral therapy.
• Understand the costs. If you have health insurance, contact your health plan to be sure you understand what coverage it offers for psychotherapy treatment. Some health plans cover a set number of psychotherapy sessions per year. Also, talk to your therapist about fees and payment options.
• Review your issues. Before your first appointment, spend some time thinking about what issues you’d like to work on. While you also can sort this out with your therapist, having some sense in advance may provide a starting point.

Risks

By Mayo Clinic staff In general, cognitive behavioral therapy poses little risk. Because therapy can explore painful feelings and experiences, though, you may feel emotionally uncomfortable at times. Some forms of cognitive behavioral therapy, such as exposure therapy, may require you to confront situations you’d rather avoid — such as airplanes if you have a fear of flying. This can lead to temporary distress or anxiety. But the coping skills you learn should help you later on to manage and conquer distressful feelings and thoughts.

How you prepare

By Mayo Clinic staff

You might decide on your own that you want to try cognitive behavioral therapy, or a doctor, relative, friend, employer or someone else may suggest therapy to you. In any case, consider these points to prepare for starting cognitive behavioral therapy:

• Find a therapist. You can find a therapist on your own — looking through the phonebook, for instance — or you can get a referral from your doctor, health insurance plan, friend or other trusted source. Be sure to ask a prospective therapist if he or she is trained in cognitive behavioral therapy.
• Understand the costs. If you have health insurance, contact your health plan to be sure you understand what coverage it offers for psychotherapy treatment. Some health plans cover a set number of psychotherapy sessions per year. Also, talk to your therapist about fees and payment options.
• Review your issues. Before your first appointment, spend some time thinking about what issues you’d like to work on. While you also can sort this out with your therapist, having some sense in advance may provide a starting point.

What you can expect

By Mayo Clinic staff

Starting cognitive behavioral therapy
Usually you go to a therapist’s office for cognitive behavioral therapy sessions. A therapist may have an office in a medical clinic, an office building or a private home. Therapy also can take place in a hospital, if you’ve been admitted for treatment. You usually meet with your therapist once a week for a session that lasts about 45 to 60 minutes. Cognitive behavioral therapy also can be done for your whole family or in group sessions for people with similar issues.

Your first cognitive behavioral therapy session is usually a time for the therapist to gather information about your situation. The therapist may ask you to fill out forms about your current and past physical and emotional health. All this information helps the therapist gain a deeper understanding of your situation and whether you might benefit from other or additional treatment, such as medications. It might take a few sessions for a full evaluation of your situation and issues.

Exploring your therapist’s approach
At any time during cognitive behavioral therapy, especially in the beginning, feel free to ask your therapist questions about:

• His or her general approach
• The goals of your treatment
• How long therapy may last
• When and how to contact your therapist during a crisis
• Any other details about your therapeutic relationship

In general, conversations with your therapist are confidential. However, in certain situations a therapist may be required by law to report serious concerns to authorities. Talk to your therapist about any worries you might have about confidentiality.

During psychotherapy
For cognitive behavioral therapy, as with most types of psychotherapy, you and your therapist generally sit facing each other during sessions. Your therapist encourages you to talk about your thoughts and feelings and what’s troubling you. You may find it hard to open up about your feelings. Your therapist can help you gain more confidence and comfort.

Cognitive behavioral therapy is generally focused on specific problems and goals affecting you now. Each session may have a specific agenda to guide discussion. As you go through the cognitive behavioral therapy process, your therapist may ask you to do “homework” — activities, reading or practices that build on what you learn during your regular therapy sessions. Along with homework, your therapist may ask that you schedule time for activities you enjoy or once enjoyed.

Because psychotherapy sometimes involves intense emotional discussions, you may cry, get upset or have an angry outburst during a session. You may also feel physically exhausted after a session. Your therapist helps you cope with these feelings and emotions.

Five typical steps in cognitive behavioral therapy
Although there are different ways to conduct cognitive behavioral therapy, it typically includes five steps:

1. Identify troubling situations or conditions in your life. These may include such issues as a medical condition, divorce, grief, anger and specific mental illnesses, such as panic disorder or bipolar disorder. You and your therapist may have to spend some time deciding what problems and goals you want to focus on.
2. Become aware of your thoughts, emotions and beliefs about these situations or conditions. Once you’ve identified the problems you want to work on, your therapist encourages you to share your thoughts about them. This may include what you tell yourself about an experience (your “self-talk”), your interpretation of the meaning of a situation, and your beliefs about yourself, other people and events. Your therapist may suggest that you keep a journal of your thoughts and self-talk. Your thoughts and beliefs may be positive, negative or neutral. They may be rational (based on reason, logic or facts) or they may be irrational. As you continue with cognitive behavioral therapy, you explore negative or inaccurate thought patterns and work to replace them with more positive, accurate thinking.
3. Identify negative or inaccurate thinking. Your thoughts about a situation or condition can affect the way you react to it. Inaccurate or negative thoughts and beliefs about something or someone can lead you to react in undesirable ways. To help you determine whether distorted thinking may be contributing to your problem, your therapist may ask you to pay attention to your physical, emotional and behavioral responses to a troubling event.
4. Challenge negative or inaccurate thinking. As you continue to examine your thinking patterns, your therapist may encourage you to test the validity of your thoughts and beliefs. This may include asking yourself whether your view of an event fits the facts and logic, and whether there might be other explanations for a situation. This step can be difficult. You may have long-standing ways of thinking about your life and yourself. Many thought patterns are first developed in childhood. Thoughts and beliefs that you’ve held for a long time feel normal and correct to you. You may not easily recognize inaccuracies in your thinking.
5. Change your thoughts and beliefs. The final step in the cognitive behavioral therapy process is to replace negative or inaccurate thinking with positive and accurate thoughts and beliefs. By changing your view of a situation and your view of yourself, you may be able to find more constructive ways to cope — your behavior will become less harmful or self-defeating. Changing your thought patterns also can be difficult. Thoughts often occur spontaneously or automatically, without any effort on your part. It can be hard to control or turn off your thoughts. Thoughts can be very powerful, and they aren’t always based on logic. It takes time and effort to learn how to replace distressing thoughts with rational, positive ones. Your therapist can help you recognize and challenge distorted thinking with more realistic thinking. Your therapist also may help you identify behaviors you wish to change and give you the chance to practice new ways to deal with situations that trigger negative, distorted thoughts.

Length of psychotherapy
Cognitive behavioral therapy is generally considered short-term therapy — about 10 to 20 sessions. You and your therapist can discuss how many sessions may be right for you. Factors to consider include:

• The type of disorder or situation
• Severity of your symptoms
• How long you have had your symptoms or have been dealing with your situation
• How quickly you make progress
• How much stress you’re experiencing
• How much support you receive from family members and other people

Results

By Mayo Clinic staff

Cognitive behavioral therapy may not cure your condition or make an unpleasant situation go away. But overall, it’s a highly effective treatment. It can give you the power to cope with your situation in a healthy way and to feel better about yourself and your life.

Benefits of cognitive behavioral therapy
Cognitive behavioral therapy can help you:

• Gain a better understanding of your condition or situation
• Identify and change behaviors or thoughts that negatively affect your life
• Explore relationships and experiences
• Find better ways to cope and solve problems
• Learn to set realistic goals for your life
• Feel better about yourself
• Reduce the likelihood of a relapse

Getting the most out of cognitive behavioral therapy
Cognitive behavioral therapy isn’t effective for everyone. But you can take steps to get the most out of your therapy and help make it a success, including:

• Approach therapy as a partnership. Cognitive behavioral therapy is most effective when you’re an active participant and share in decision making. Make sure you and your therapist agree about the major issues and how to tackle them. Together, you can re-evaluate progress and goals over time.
• Be open and honest. Success with psychotherapy depends on your willingness to share your thoughts, feelings and experiences, and on being open to new insights and ways of doing things. If you’re reluctant to talk about certain things because of painful emotions, embarrassment or fears about your therapist’s reaction, let your therapist know.
• Stick to your treatment plan. If you feel down or lack motivation, it may be tempting to skip sessions. Doing so can disrupt your progress. Aim to attend all sessions and to give some thought to what you want to discuss. Tell your therapist if you have reservations about therapy.
• Don’t expect instant results. Working on emotional issues can be painful and may require hard work. It’s not uncommon to feel worse during the initial part of therapy as you begin to confront past and current conflicts. You may need several sessions before you begin to see improvement.
• Do your homework between sessions. If your therapist gives you work outside of your regular therapy sessions, be sure to do it. Doing these homework assignments is important because they help you apply what you’ve learned in the psychotherapy sessions.
• Make sure you feel comfortable with your therapist. Successful cognitive behavioral therapy depends on a productive and trustful relationship between you and a therapist. Talk to your therapist if any part of your therapy troubles you. If you’re still uncomfortable, consider finding another therapist with whom you feel more at ease.

According to the American Art Therapy Association:

Art therapy is a mental health profession that uses the creative process of art making to improve and enhance the physical, mental and emotional well-being of individuals of all ages. It is based on the belief that the creative process involved in artistic self-expression helps people to resolve conflicts and problems, develop interpersonal skills, manage behavior, reduce stress, increase self-esteem and self-awareness, and achieve insight.

Art therapy integrates the fields of human development, visual art (drawing, painting, sculpture, and other art forms), and the creative process with models of counseling and psychotherapy. Art therapy is used with children, adolescents, adults, older adults, groups, and families to assess and treat the following: anxiety, depression, and other mental and emotional problems and disorders; mental illness; substance abuse and other addictions; family and relationship issues; abuse and domestic violence; social and emotional difficulties related to disability and illness; trauma and loss; physical, cognitive, and neurological problems; and psychosocial difficulties related to medical illness. Art therapy programs are found in a number of settings including hospitals, clinics, public and community agencies, wellness centers, educational institutions, businesses, and private practices.