Psychological Services Methodologies

Cognitive Behavioral Therapy (CBT)

CBT is a goal-oriented, short-term therapy approach with an emphasis on problem solving. CBT, which was developed by Aaron Beck, MD, focuses on the concept that our thoughts influence our mood and behavior. By examining and changing our thinking, we can change our behaviors and emotions. CBT tends to be short and on average, lasts 6-9 months with one 50-minute session per week. CBT is primarily used to treat anxiety and depression, but has been empirically supported to also help with a variety of other problems. Sessions typically begin with a weekly check-in, followed by setting a session agenda, where the therapist gives summaries as needed. The therapist will then assign the client homework and summarizes the session, giving feedback as needed.

Family Focused Treatment (Bipolar Disorder)

Family Focused Therapy (FFT) has been empirically supported to treat bipolar disorder, typically with adolescents. FFT focuses on changing the way family members interact, improving how they function as a unit, and improving how they function individually. Several studies have shown that FFT benefits both the family members involved in the treatment, as well as the patient. During sessions, the patient and family members meet with a therapist trained in working with bipolar disorder addressing such treatment areas as: psychoeducation, coping skills, behavior management, and communication skills.

Dialectical Behavior Therapy (DBT)

DBT is an empirically supported form of cognitive therapy developed by Marsha Linehan in the late 1980’s. DBT is primarily used to treat borderline personality disorder, but has shown clinical and research promise with many other mental health disorders. DBT focuses on balancing acceptance and change. A comprehensive DBT program includes the following: several assessments and pre-treatment sessions; weekly individual therapy; weekly group skills training; coaching from a therapist in between sessions to help the client generalize the skills they learn; and weekly DBT therapist team meetings. In order to receive comprehensive DBT, all five of these modalities must be met. At STAR of CA, we focus on skills training, where we teach mindfulness skills, emotion regulation skills, interpersonal effectiveness skills, and tolerating emotional distress skills. Clients are typically taught one skill per session, and are often assigned diary cards to fill out each day of the week and bring in to session on a weekly basis.

Behavioral Therapy

Behavioral therapy is focused on helping client’s understand how altering their behavior can also lead to changes in how they feel. The goal of behavioral therapy, which has been empirically tested to treat many mental health disorders, is to change potentially self-destructing behaviors. Behavior therapy seeks to increase chances for positive experiences by self-monitoring, scheduling weekly activities, role-playing, and behavior modification techniques. Psychoeducation, mood scaling, and behavioral rehearsal are often used in a typical weekly session.

Prolonged Exposure

Prolonged exposure therapy (PE) is a form of behavior therapy and can be integrated with cognitive behavioral therapy, which has been empirically supported to successfully treat posttraumatic stress disorder (PTSD). PE focuses on the client re-experiencing the traumatic event by remembering it and engaging with, rather than avoiding the traumatic memories. This is often referred to as “exposure.” The main components of PE include imaginal exposure, where the client re-experiences the trauma, repeats it out loud, then processes it; and in-vivo exposure, where the exposure to the trauma is distressing, but not dangerous. Imaginal exposure typically takes place in the context of sessions; whereas with in-vivo exposure, the therapist and client work together to assign homework to the client to complete outside of session.

Trauma Focused-Cognitive Behavioral Therapy (TF-CBT)

TF-CBT is designed to treat posttraumatic stress disorder in children and adolescents. TF-CBT was initially developed to focus on the trauma associated with child sexual abuse, domestic violence, and traumatic loss, to name a few. TF-CBT is designed for therapists to provide parallel treatment to children and their parents or guardian, with several conjoint parent-child sessions included. TF-CBT generally lasts between 12-16 sessions, and focuses on the following components: psychoeducation and parenting skills, relaxation skills, affect expression, regulation skills, cognitive coping skills, processing, a trauma narrative, in-vivo exposure when needed, and enhancing safety and future development.

Parent Management Training (PMT)

PMT trains parents to manage their children’s behavioral problems both at home and in school. In PMT, parent-child interactions are altered in ways to promote prosocial behavior in children and to decrease oppositional or antisocial behavior. Treatment sessions typically include social learning techniques instruction, where the therapist will provide psychoeducation, models the technique, and coaches the parent on implementing the skill in the home. Parents are also taught how to observe, define, and record their child’s behaviors in order to better understand the problem behaviors. PMT is one of the most extensively studied treatments for children that has been shown to decrease oppositional, aggressive, and antisocial behavior.

Parent-Child Interaction Therapy (PCIT)

Parent-Child Interaction Therapy is an empirically supported intervention that was initially developed to treat families with young children (between the ages of 2-7) exhibiting externalizing behavior problems. Study outcomes of PCIT have demonstrated improved parenting skills, decreased child behavior problems, and generalization to other settings and siblings. PCIT is conducted through weekly, 50 minute, therapy sessions. It is composed of a two-stage model that blends developmental theory, social learning theory, behavioral principles, and play therapy. During the first phase (Child Directed Interaction), parents are taught through a didactic and coaching format, on ways to enhance their relationship with their child and increase positive interactions. In the second phase (Parent Directed Interaction), a focus on teaching behavioral management skills are introduced. Treatment length varies depending on how quickly parents master skills and on improvement of the child’s behavior. At STAR of CA, we focus on teaching the same skills of PCIT in a two-phase model, however, treatment is delivered in a format that varies from traditional PCIT.