CBT, TF-CBT, DBT…What does it all mean? Therapy modalities and theories explained.

Therapists love their alphabet soup. When looking for a therapist you may have come across terms and acronyms that don’t make sense. CBT, TF-CBT, ACT, DBT, EMDR,…is it so hard to type out the full words?! In this post I’m going to define some common therapy modalities/approaches that your therapist may use. This is not an exhaustive list, but a list of some more common types that you may not be familiar with.

  • First, What is a Therapy Modality/Approach?

This simply means the approach your therapist takes when they think about how their clients can best heal. Some therapists are purists and pick one and stick to it. Some are flexible and tailor their approaches to what best suits a clients need. Below you’ll find various models that you might hear in therapy.

  • Cognitive Behavioral Therapy (CBT): a mode of treatment that focuses on how a persons thoughts, feelings and behaviors interact and influence each other. Much of this therapy works to identify unhelpful thinking patterns, reframe those into more helpful thinking patterns and thus improve behavior outcomes. This type of therapy is more works based with worksheets, homework and charting with the goal of spurring on behavior change. This type of therapy is not talk based where you verbally process your problems to gain healing through insight.
  • Trauma Focused – Cognitive Behavioral Therapy (TF-CBT): a mode of treatment that is a variation of the above type, but with the addition of heavy building of coping skills, education about trauma, and the addition of a “trauma narrative” (writing out what happened to you) to process the event and reduce the involuntary reoccurrence of traumatic memories and symptoms of the traumatic episode.
  • Acceptance Commitment Therapy (ACT): uses acceptance and mindfulness strategies mixed in different ways with commitment and behavior-change strategies, to increase psychological flexibility. With this approach people work to accept the things about their lives they cannot change, and in that acceptance, peace can begin. Commitment is used to take the acceptance to the next step and make choices to change behaviors that cause unhelpful stress.
  • Mindfulness: this approach uses your powers of observation, deep breathing, meditation and acceptance to bring awareness to our thoughts. Awareness, education, deep breathing and meditation make up the majority of this approach.
  • Dialectical Behavior Therapy (DBT): the term “dialectical” comes from the idea that bringing together two opposites in therapy — acceptance and change — brings better results than either one alone. (WebMD) . In DBT much work is done on critically looking at behaviors that are unhelpful and linking those behaviors to thoughts and feelings that may contribute to it. This type of therapy is “works” intensive and does not rely heavily on talk therapy for comfort. The results are lasting behavior change and increased understanding of why unhelpful behaviors are occurring.
  • Eye Movement Destabilization and Reprocessing (EMDR): [From the EMDR institute at emdr.com] “EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapy that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences.  Repeated studies show that by using EMDR therapy people can experience the benefits of psychotherapy that once took years to make a difference. It is widely assumed that severe emotional pain requires a long time to heal.  EMDR therapy shows that the mind can in fact heal from psychological trauma much as the body recovers from physical trauma.  When you cut your hand, your body works to close the wound.  If a foreign object or repeated injury irritates the wound, it festers and causes pain.  Once the block is removed, healing resumes.  EMDR therapy demonstrates that a similar sequence of events occurs with mental processes.  The brain’s information processing system naturally moves toward mental health.  If the system is blocked or imbalanced by the impact of a disturbing event, the emotional wound festers and can cause intense suffering.  Once the block is removed, healing resumes.  Using the detailed protocols and procedures learned in EMDR therapy training sessions, clinicians help clients activate their natural healing processes”….”EMDR therapy is an eight-phase treatment.  Eye movements (or other bilateral stimulation) are used during one part of the session.  After the clinician has determined which memory to target first, he asks the client to hold different aspects of that event or thought in mind and to use his eyes to track the therapist’s hand as it moves back and forth across the client’s field of vision.  As this happens, for reasons believed by a Harvard researcher to be connected with the biological mechanisms involved in Rapid Eye Movement (REM) sleep, internal associations arise and the clients begin to process the memory and disturbing feelings. In successful EMDR therapy, the meaning of painful events is transformed on an emotional level.”
  • Solution-Focused Therapy: this type of therapy focuses on the problems that you describe and works to find the solutions that work for you. There are tangible goals, markers for those goals, and measurable objectives that are formed to help therapist and client stay on track to meet the goals that the client lays out. As in all therapy, the client sets the pace and describes what they want changed in their life and works in collaboration with the therapist to shape what solutions can look like.
  • Insight Therapy: this is a form of talk therapy that focuses less on measurable objectives and more on processing the ebbs and flows of your present and past. Your life brought you to where you are and there may be questions that formed along the way. In talk therapy, it is just that – you talk. You and your therapist discuss situations in your life, that you decide to bring up, in an effort to allow you to gain more understanding of your self.

“Although the world is full of suffering, it is also full of the overcoming of it.”

Helen Keller