Because I develop tailored treatment plans for each person with whom I work, treatment will vary depending on your unique concerns, preferences, and situation.  Typically, however, treatment lasts for about 8-40 sessions and includes some or all of the following components.  If you read only one component, read Item 6 on facing your fears.

1. Assessment.  This phase includes assessing what type of anxiety you are experiencing, what things trigger your anxiety, and establishing goals of treatment.

2. Motivational enhancement. This step is not always indicated, but for many, the very act of making the commitment to do something to improve your situation is a huge step. Many people arrive ambivalent about therapy, unsure if anyone can really help them.  If this is the case, we can discuss where you’re at in terms of your hopefulness and willingness about change, and we’ll see if we can work together to clarify any ambivalence and strengthen your commitment to change.

3. Immediate symptom reduction. Where appropriate, we will look for ways to start getting you some relief as soon as possible.  Not only is this typically in line with your goals, it can also serve to reinforce your commitment to the process.  Therapy shouldn’t just be hard work and drudgery—it should be rewarding!

4. Education. In most treatments, psychoeducation is an important component.  For example, this might include education about a particular type of anxiety, or information about the causes and best ways to treat anxiety.  CBT is a collaborative, empowering model that coaches consumers to be informed about their treatment.

5. Skills acquisition and practice. Depending on your treatment plan, we will learn and practice certain skills, such as mindfulness, stress reduction strategies, assertiveness, distress tolerance, thought challenging, and taking “positive risks”.

6. Facing your fears, or “exposure”. The natural response to feeling anxious is often avoidance.  When we’re feeling uncomfortable or anxious, we might avoid certain situations, things, or social interactions, or use procrastination to avoid tasks.  Or we might try to avoid our own thoughts or feelings by turning to television, alcohol, drugs, or other distractions. Avoidance takes countless forms. The unfortunate consequence is that avoidance keeps us stuck.  By avoiding our fears, we deprive ourselves of the only experience that can help us overcome and disconfirm those fears. To break out of this catch 22, we work together to have you tackle your anxieties in a safe and methodical manner, always at your own pace. You take the “positive risks”, and I provide the coaching and tools for you to complete this process in a successful and supported manner. For me as a therapist, this is an incredibly rewarding process, as I get to witness people stretching themselves and doing things they never thought possible.

7. Consolidation and relapse prevention. This is often a relatively brief phase, and consists of reviewing and consolidating the progress you have made and devising a plan for how to address anxiety as it comes up in the future. A key reason why CBT is able to be a short-term approach is because it empowers you to become your own cognitive behavioral therapist.  You are able to take the new skills, learning, and perspectives with you to tackle future hurdles as they will inevitably come up.

 

 “Facing it, always facing it, that’s the way to get through.”

– Joseph Conrad