​​Straight Up Psychology

David Fillmore   Registered Psychologist

Cognitive and Behavioural Therapies

The focus of these approaches is on helping a person learn skills and coping strategies. 

The basis of cognitive therapy is that thoughts can influence emotions or behaviours. Cognitive therapists believe that by changing, or reconditioning, their thoughts, people can change how they feel and what they do.

Behavioural therapies look more at learned behaviours and how a person’s environment has influenced those behaviours. Behavioural therapies then look at how to make changes in a person’s environment, and reinforce positive experiences, to affect changes in their behaviour.

Cognitive Behavioural Therapy (CBT), then, combines a cognitive approach (examining your thoughts) with a behavioural approach (examining the things you do) to therapy. Over time, CBT has been further modified to include new forms of therapies including Dialectical Behaviour Therapy, Acceptance and Commitment Therapy, Mindfulness and Schema Therapy.

Cognitive Behavioural Therapy

Cognitive Behavioural Therapy (CBT) looks at a person's patterns of thoughts, feelings and behaviours and how these patterns are connected and also reinforced or maintained by the person within his or her environment. CBT is a practical approach that focuses on helping people to change unhelpful or unhealthy thinking habits, feelings and behaviours in order to overcome their difficulties.

In CBT the therapist works with the client to identify negative or dysfunctional thought patterns, emotions and behaviours and to find ways of replacing them with healthier and more constructive ones by teaching them more effective ways of interpreting and thinking about their experiences.

CBT has been researched extensively, and proven highly effective in treating a variety of emotional and behavioural psychological and psychiatric difficulties including anxiety, depression, panic, phobias, low self-esteem, anger and stress management, substance abuse, obsessive compulsive disorders (OCD), eating disorders, relationship issues and other problems. For some problems CBT is as effective as medication and can also enhance the effects of medication. It has also been shown to be effective in the treatment of a number of medical conditions, including chronic pain and hypertension.

The results of CBT are long-term, and you can continue to use what you have learned in therapy to approach other problems in your life.

Dialectical Behaviour Therapy

Dialectical behaviour therapy (DBT) is a specific type of cognitive-behavioural approach that has been adapted to meet the particular needs of people who experience emotions very intensely.

In DBT, therapists and clients work to balance thoughts, feelings and actions, by learning about the triggers that lead to negative reactive states and assessing which coping skills to apply to these sudden, intense surges of emotion and help avoid undesired reactions. DBT also allows clients to work fundamentally on accepting who they are and meeting their own needs and wants while meeting the needs and wants of those who are important to them.

Dialectical Behaviour Therapy has had particular success as a treatment for suicidal behaviour, self-harming, eating disorders, unstable relationships, bipolar adolescents and borderline personality disorder.
 

Acceptance and Commitment Therapy

Acceptance and Commitment Therapy (ACT) is a branch of behavioural analysis that focuses not on changing or getting rid of undesirable thoughts, feelings or beliefs, but on accepting that these are part of who we are and allowing them to come and go as they please, while committing to action that allows us to move forward and improve our life.

Whether it is a situation you cannot control, a characteristic that is hard to change or a thought or feeling that overwhelms you, accepting it can allow you to move forward. In ACT, a therapist helps teach you skills to deal with distressing thoughts and feelings in such a way that they have much less impact and influence over you. They will also help you to clarify what is truly important and meaningful to you (your values), and help you to use that knowledge to guide, inspire and motivate you to achieve specific goals and change your life for the better.

Scientific data confirms that cultivating acceptance, along with mindfulness and openness to experience is highly effective for the treatment of a number of emotional and behavioural psychological issues including depression, anxiety disorders, substance abuse, chronic pain, PTSD, eating disorders, and even schizophrenia. 

Schema Therapy

Schema Therapy (or, more properly, Schema-Focused Cognitive Therapy) is based on the idea that many of our negative thoughts have their origins in our past experiences. They are often very stable, long-standing and self defeating patterns of thinking, feeling and behaving that create barriers to accomplishing our goals.

Some examples of schema beliefs are: "I'm not good enough", "something bad will happen", “people will leave me". They typically develop early in life (although they can also develop later) and stay with the person throughout adulthood. They are beliefs that the person doesn’t challenge, but has accepted to be a part of who they are even if they don’t realise it consciously, and are difficult to change.

It is rare for a schema to go away without receiving professional help. The schema sits in the sub-conscious part of the mind, and is very stubborn, constantly working to re-establish itself.

Schema Therapy is designed to help the person to break these persistent, negative patterns of thinking, feeling and behaving and to develop healthier alternatives to replace them. It is effective for help with personality disorders, chronic depression and other difficult individual and couples problems.

Mindfulness (or Mindfulness Based Cognitive Therapy)

The emphasis of mindfulness is on changing the relationship to thoughts rather than challenging them. When you're mindful, you observe your thoughts and feelings from a “distance”, without believing that there’s a right or wrong way to think or feel, or judging them to be good or bad.

While simply noticing the minds usual commentary and allowing the thoughts to pass transiently through the consciousness we are more readily able to stop identifying with unhelpful thought patterns and bring the mind to focus on what is happening in the present moment.

A number of therapeutic applications, based on mindfulness, have been developed for people experiencing a variety of mental health conditions, while clinical studies have documented the physical and mental health benefits of mindfulness, in particular its effectiveness in managing stress, anxiety and panic. It has also achieved positive results in the treatment of chronic pain, depression, obsessive thinking and other medical and mental health conditions, as well as enhanced relationship satisfaction, self-insight, intuition, memory and focus.