Dialectical Behavior Therapy (DBT)
Dialectical Behavior Therapy (DBT) is an evidence based therapy originally developed to assist people with borderline personality disorder in managing their lives more effectively. Since it’s development, research has shown that DBT is an effective treatment modality for many other concerns. Currently DBT is used to treat concerns such as: trauma, substance use/abuse, personality disorders, bipolar disorder, depression, anxiety, self-harm, and chronic instability in interpersonal relationships. Dialectical behavior therapy can be implemented at varying levels of intensity, such as in skills training groups, DBT informed interventions in individual therapy, to long term individual and group programs adhering to the full model of therapy.
At it’s core, DBT is a treatment for shame. Often in life people are born with high levels of emotional intensity or sensitivity. While the depth of this emotional experience has many strengths, including the capability for creativity, compassion, empathy, and deep connection to others, when such a person is born into an environment that is cold and invalidating the emotional wounds run deep and can be carried for years or even decades. DBT is a therapy that provides validation, support, empathy, and understanding while impacting tangible tools for creating a life worth living. Individuals participating in DBT can expect to learn skills in: mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness. Our clinicians are trained in DBT under the Linehan certification board and are prepared to partner with you on your journey.
Prolonged Exposure Therapy (PE)
Prolonged Exposure Therapy (PE) is an evidenced-based treatment for trauma with over 20 years of research. This model of therapy is considered to be a first line treatment for trauma by the Department of Veteran’s Affairs and the American Psychological Association and produces clinically significant improvement in 80% of participants with chronic PTSD. Benefits of this therapy occur after approximately 8-18 weekly sessions. PE is based on cognitive and behavioral theories. When trauma occurs, the brain associates other non-traumatic stimuli present with the trauma. When these stimuli are later encountered after the trauma ends the brain interprets these as dangerous, causing fear and anxiety. Avoiding these stimuli is a common response to trauma, however this avoidance reinforces fear and feelings of incompetence. The goal of PE is to gradually reengage in life after trauma. PE teaches people to gradually and systematically approach trauma related memories, feelings, and situations that are objectively safe. By approaching these, the person increases their ability to distinguish between safe and dangerous stimuli, and learns that trauma related memories and cues are not dangerous and do not need to be avoided.
This is accomplished through two types of exposures: imaginal exposure and in vivo exposure. Imaginal exposure occurs during sessions and involves describing the event in detail with guidance and support from the therapist. In vivo exposures involve gradually confronting avoided situations as homework outside of sessions. The therapist and client identify situations appropriate for exposure and devise a plan to gradually confront those that are objectively and reasonably safe and within a manageable threshold of distress. During this process, the client is empowered to make decisions about which exposures they want to participate in, and the level of exposure they are comfortable with. It is important to note that clients are never asked to engage in activities that are unsafe or traumatic. By engaging in these two forms of exposure, participants increase their confidence, sense of mastery, daily functioning, and ability to cope with courage. PE is a flexible therapy modified to meet the needs of the client. Many of our therapist are trained in PE and would be honored to support you in reentering your life!
Cognitive Processing Therapy (CPT)
Cognitive Processing Therapy (CPT) is an evidence-based treatment, delivered over 12 sessions, for reducing or eliminating symptoms caused by traumatic experiences. This therapy is considered to be one of the most effective treatment modalities for trauma and is recommended as a first line treatment by the Department of Veterans Affairs, and the American Psychological Association. CPT uses cognitive behavioral principles to teach participants strategies for challenging and modifying unhelpful beliefs related to trauma. This allows the participant to develop new ways of understanding and conceptualizing the event and reduces ongoing negative effects related to trauma.
Trauma causes people to think differently about themselves and their environment, which leads to negative emotions (i.e. fear, anxiety, guilt, anger) that can halt the natural recovery process. Post traumatic symptoms stem from conflict between beliefs about the self and the world held prior to experience a traumatic event and beliefs stemming post-traumatic information. The conflicts are called stuck points, and they result in the maintenance of post-traumatic distress. Towards the end of treatment, specific challenges related to safety, trust, power and control, esteem, and intimacy are addressed. The focus of therapy is to develop skills that can be applied now and in the future. Many of our therapists are trained and experienced in delivering CPT and are eager to assist you in moving past your stuck points and back into your life.
Eye Movement Desensitization and Reprocessing (EMDR)
No one knows how any form of psychotherapy works neurobiologically or in the brain. However, we do know that when a person is very upset, their brain cannot process information as it does ordinarily. One moment becomes “frozen in time,” and remembering a trauma may feel as bad as going through it the first time because the images, sounds, smells, and feelings haven’t changed. Such memories have a lasting negative effect that interferes with the way a person sees the world and the way they relate to other people.
EMDR (Eye Movement Desensitization and Reprocessing) is a cost-effective, non-invasive, evidence-based treatment for conditions such as: trauma, panic attacks, complicated grief, dissociative disorders, disturbing memories, pain disorders, stress reduction, abuse, and personality disorders. Developed by Francine Shapiro, PhD in the late 1980′s, EMDR is an eight-phase treatment which comprehensively identifies and addresses experiences that have overwhelmed the brain’s natural resilience or coping capacity, and have thereby generated traumatic symptoms and/or harmful coping strategies. Through EMDR therapy, patients are able to reprocess traumatic information until it is no longer psychologically disruptive. EMDR works through bilateral movements using auditory, tactile (touch) or visual processing methods, similar to what is occurring during REM sleep, to activate the brain’s natural processing and healing capabilities.
During this procedure, patients tend to “process” the memory in a way that leads to a peaceful resolution. This often results in increased insight regarding both previously disturbing events and long held negative thoughts about the self. For example, an assault victim may come to realize that he was not to blame for what happened, that the event is really over, and, as a result he can regain a general sense of safety in his world. EMDR has been validated in Vietnam Veterans and rated by the Department of Veteran’s Affairs as a “highly recommended” treatment for trauma. Several of our clinicians are trained in EMDR under the EMDR International Association’s standards for training and certification.
Mindfulness meditation is moment to moment awareness. It involves showing up for each of the moments of our lives, whether pleasant or unpleasant, without striving or judging. Mindfulness practice is ideal for cultivating greater awareness of the unity of mind and body, as well as of the ways the unconscious thoughts, feelings, and behaviors can undermine emotional, physical, and spiritual health. Developed by Dr. Jon Kabat-Zinn, Mindfulness Based Stress Reduction (MBSR) has evolved into a common form of complementary medicine addressing a variety of health problems. Mindfulness has been supported in research to be effective in treating concerns such as: depression, anxiety, trauma, addictions, stress, and in improving the quality of life for individuals experiencing chronic pain or illness. Research shows that Mindfulness can decrease the reliance on addictive medications while showing improvements in the management of chronic pain. Mindfulness has also been proven beneficial in improving the quality of parenting and relationships. Our therapists are prepared to teach you mindfulness skills and help you develop a mindfulness practice that you can sustain throughout life.
While the mention of hypnosis may conjure images of stage acts and people being made to cluck like a chicken for entertainment, clinical hypnosis is a widely researched and evidenced based technique that has been shown to be beneficial in addressing many concerns, including: addictions, personal growth, self-esteem, trauma, anxiety, depression, dissociation, chronic pain and illness, confidence, and sexual disorders. Hypnosis is a highly relaxed altered state of awareness, perception, or consciousness that is used to address concerns by speaking to the unconscious mind. It is a state of inner absorption, concentration, and focused attention. It’s like using a magnifying glass to focus the rays of the sun and make them more powerful. While hypnosis has been used since ancient times and has been a part of healing by psychologists and physicians for hundreds of years, it was validated as a clinical tool by the American Medical Association in 1958, and the American Psychological Association in 1960. Several of our therapists have participated in extensive training in Clinical Hypnosis and have completed the 50 hours of training required for the practice of Hypnosis in the State of Florida.