Many of the mental health clinicians of CWC come from a variety of clinical backgrounds and training. While many of us are considered early in our careers, we have trained for several years refining our clinical skills and we remain in active supervision to ensure quality of care. Clinicians meet regularly to discuss client cases (i.e., the medical model), process challenges faced by some clients, and learn new intervention skills. Below you will find some of the more popular theoretical orientations for mental health. These definitions are brief and attempt to capture the global nature of each modality. Irrespective of the theoretical modality, each mental health clinician can adapt his or her orientation to meet the needs of the person s/he is working with.
ACT was created by Dr. Hayes, and falls under the cognitive or CBT umbrella with an emphasis on relational frame theory and behavioral modification. Its different from a traditional CBT model in that ACT teaches clients to watch, embrace, and accept their emotions in a non-judgmental and compassionate way. ACT has been proven to be effective in working with a multitude of mental health concerns including chronic pain, addictions, smoking cessation, depression, anxiety, psychosis, workplace stress, and diabetes management.
Seen as one of the most empirical modalities, many mental health clinicians are treating from a CBT approach, but not always the “textbook” CBT that has been researched for many years. Clinicians at the CWC approach CBT primarily from the work of Aaron Beck (and now his daughter Judith Beck). In addition to establishing a trusting relationship, CBT identifies maladaptive coping skills, irrational thoughts, learned behaviors, and emotional responses to life events. CBT is directive, time limited, educational, and will often include exercises (i.e., homework) to complete before the next session. It is so much more than journaling; CBT can be a lot of work so we assess how ready a client is for this change and then adapt as needed.
DBT was created by Marsha Linehan, Ph.D., a psychologist and researcher at the University of Washington. It falls under the cognitive or CBT umbrella, and is unique in its skill building and focus on mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Largely routed in Buddhist principles, DBT has been shown to be one of the most effective treatments for a variety of mental health concerns, primarily with borderline personality disorder, but also with mood disorders, anxiety, sexual abuse, and addictions.
MI comes from the work of Miller & Rollnick and focuses on how ready someone is for change. As such, a large piece of the treatment focuses on Prochaska & DiClemente’s Stages of Change. Ultimately, we work with clients to determine how motivated they are to change, we provide support, establish goals and has shown to be lost effective in treating various addictions, parenting and eating disorders.
MBSR is a third wave cognitive and behavioral therapy that focuses on mindfulness and teaches each client to be in the present moment, accept feelings as they come in, and nonjudgmentally. While this can be a 8-12 week manualized program, we integrate these principles into the CBT clinical work. For example, yoga is a piece of the program and most clinicians encourage clients to practice yoga in conjunction with their clinical work with a clinician at the CWC.
Also known as Rogerian psychotherapy after Carl Rogers. The mental health clinician facilitates a trusting relationship between her/him and the client, and treatment is self-directed. The hallmark factor is known as “unconditional positive regard” defined by nonjudgmental listening, empathy, and positive self-regard instilled in the client. The client is seen as fully potential of growth and as a “good” entity with the authority for himself. While person-centered itself is not evidenced-based, it is a critical part to effective mental health counseling.
REBT focuses on the emotional well being of an individual examining his or her thoughts, beliefs, and behaviors. This is not dissimilar when compared with CBT. In fact, Aaron Beck, the pioneer of CBT, is often cited with Alfred Ellis, the pioneer of REBT. REBT tends to be more directive and is action-oriented. REBT focuses on the present and challenges unhelpful thinking that yields emotional distress or self-defeating behaviors.