This is a sample of some of our treatment methods.
At In-Focus Psychotherapy, we employ multiple perspectives or “lenses” to fully understand client concerns and begin multiple avenues of change. The overarching goal of treatment is a custom fit – a collection of treatment goals that fit the client’s understanding of their concern and the constraints of their day-to-day life.
Cognitive Behavioral Therapy (CBT)
A well-known evidence-based treatment, CBT focuses on analyzing automatic thoughts and exploring thinking patterns influence how we feel and behave. One of the downsides to being human is that our capacity for abstract thinking can result in taking thoughts too literally or overemphasizing negative thoughts while discounting positive or neutral thoughts. Another tenet of CBT is that existing beliefs systems about self and others influence our thinking.
Pros:
- Keeps a focus on the client’s concern and their current day to day life.
- Well organized – easy for clients to apply therapy to specific situations.
- Helps clients see the relationship between thoughts, feelings, and behaviors (The Cognitive Triad).
- It is easy to apply elements of CBT to other treatment approaches.
Cons:
- Can be narrow in scope and not focused enough on past events.
- Some clients prefer a less organized, non-directive approach.
- Puts more focus on cognition that emotion.
- Assumes that the client has some type of problematic thinking tendency, which may not be the case.
Acceptance and Commitment Therapy (ACT)
ACT leverages the utility of acceptance-based strategies. Too often, we try to overanalyze or “fight” some of the thinking we have. In contrast to analyzing thinking like CBT, ACT strategies aim to diffuse us from distressing thoughts. Sometimes a “thought is just a thought” and does not need to be responded to with a high level of cognitive effort. We can accept that distressing thoughts will occur in our day-to-day life – and still choose where to commit our energy and time by prioritizing our core values and guiding principles. In the end, the hope is that we spend less time mired in unproductive thinking and more time fully engaged in vital areas of our life.
Pros:
- Straightforward approach and understandable rationale
- Incorporates mindfulness and acceptance strategies that many clients find highly useful.
- Components of ACT can be applied to specific, present, concerns.
Cons:
- Some clients would rather analyze thinking (it just depends on the fit and preferences of the client)
- A cognitive therapy that doesn’t emphasize emotional content as much as other methods.
Emotion Focused Therapy (EFT)
EFT is another evidence-based approach that explores the utility of our emotions. We all have certain emotions that come more easily to us, and others that seem hard to access or utilize. EFT focuses on our emotional experiences and seeks to determine which emotions are helping us adapt to life concerns, and which emotions seem to hinder our growth. EFT considers that we use more accessible emotions to help us cope with less accessible emotions.
Pros:
- Effective in helping us understand problematic emotional responses.
- Increases correspondence with our emotions to improve coping and decision making.
- Helpful in targeting specific situations or relationships that trigger difficult emotions.
- Easy to apply elements of EFT to other treatment approaches.
Cons:
- A non-directive treatment path. Requires clients to “go with the flow” for a few sessions.
- Not all concerns are amenable to an emotion-driven approach to therapy.
- Some clients just don’t like talking about emotions and prefer other approaches.
Identity Based Approaches
One important factor in effective therapy is understanding a client’s unique identity and their experiences in society. Identity Based Approaches explore how issues of power and discrimination impact individual experiences and contribute to mental health concerns. A key element of Identity Based Approaches is the intersectionality of a client’s unique identities, and how their experiences with social norming and social learning can inform goals and treatment. An important strategy is deconstructing some of the societal values and narratives that the client finds limiting.
Pros:
- Focuses on the client’s cultural, gender, and racial identities.
- Recognizes the impact of social systems on the individual client.
- Affirms the existence of power dynamics that have differential impact.
- Can be incorporated into choosing ancillary treatment options and case formulation.
Cons:
- Some specific problems will get faster results with a more symptom-oriented clinical focus.
Psychodynamic Approaches
Psychodynamic approaches comprise a group of interventions that explore how our past experiences play out in the present. Psychodynamic thinking holds that different areas of our psyche are held in a “dynamic” – and create opposing ideas and desires that we have to balance to navigate life challenges. Often, these dynamics are patterns of feeling and relating that we experience as cyclical and consistent. Psychodynamic interventions hold that some of these dynamics lose their utility over time and should change and adapt to new life challenges.
Pros:
- Clients report that this type of therapy feels very individualized with a high level of clinician understanding.
- Clients explore past narratives and construct hypotheses of how past experiences impact current day to day life.
- Clients generally feel that this type of work gets to the “root” of their problems and creates lots of personal insight.
Cons:
- A less directive approach that requires more session time.
- Clients need to be willing to share personal narratives that may be more tangentially related to the problem focus.
- There is some “lag time” in translating psychodynamic insights into real life applications that relieve symptoms.
Trauma Focused Approaches
Effective trauma treatments (e.g. Trauma-Focused CBT, EMDR) share some common components that increase efficacy and help clients gain insight. One component is exposure to traumatic stimuli, done in a stepwise, safe, manner. The exposure component helps clients decrease avoidance of people and places and re-tell their story. A second key component is cognitive re-processing. Cognitive reprocessing takes trauma memories out of “emotional memory” and into declarative memory, allowing clients to eventually think about the trauma without undue distress. A third key component is gaining an understanding of how traumatic experiences impact the physical self, and ways that we physically react to the trauma.
Pros:
- Most clients benefit from one of these three components, if not all.
- Follows a direct, easy to understand rationale that puts client at ease.
- Can lead to fairly rapid relief of symptoms.
Cons:
- It is inherently difficult to discuss trauma and the initial sessions can feel overwhelming.
- Requires some sessions to set the plan and assess client safety and relational factors to make sure they have a foundation to explore the trauma.
Family Systems Approaches
Family systems approaches, when applied to individual and couples therapy, explore how we learn to relate to our families of origin and current family structures. Foci of clinical attention are the roles we take in our family, the “unspoken rules” of our family, and the communication patterns of our family. One key idea in family systems approaches is the idea that we are interdependent – that if one family member makes a change, the other members of the family are impacted in some way. Family systems therapy keeps a focus on teaching family members to support the changes that other members make toward growth. In couples counseling, family systems work focuses on sources of stress that lead to negative sentiments between partners. Then, the focus becomes on mobilizing positive sentiments that are often more accurate and provide a buffer to these stressors.
Pros:
- Puts a focus on how client relationships impact day to day stressors.
- Identifies ways to improve key relationships.
- Lends insight into how our past and present relationships impact our mental health.
- Accounts for how we manage when people around us refuse or change or refuse to support our growth.
Cons:
- Not all concerns have a familial or relational component.
- Some clients prefer to focus on personal variables they feel more in control of.
- A bit more time intensive than other modalities.
