Learn About Anxiety and Depression Treatment
At FRTC, we use only evidence-based treatments. This means, we only used those methods shown by research to be the most effective.
For the treatment of anxiety disorders and mood disorders such as depression, the most effective treatments are usually belong to a group of treatment known as Cognitive Behavioral Therapies, or CBT for short. CBT includes many different treatments, developed for specific problems and thoroughly researched.
Read on to learn about CBT, and some of the CBT therapies we use at Front Range Treatment Center. Then, contact us to learn how CBT can help you reach your goals and improve your quality of life.
Learn About Anxiety And Depression
Anxiety disorders include generalized anxiety disorder (GAD), panic disorders and panic attacks, obsessive compulsive disorder (OCD), specific phobias, and post-traumatic stress disorder. Click below to learn more about anxiety disorders.
Depression and related disorders include major depression, bipolar disorders, and other issues related to depressed mood. Click below to learn more about depressive disorders.
What is Cognitive Behavioral Therapy (CBT)?
FRTC only uses techniques shown by research to be effective. For decades, research has shown that cognitive behavioral therapy, or CBT, is one of the most effective forms of therapy. But what exactly is CBT?
The Theory: Cognitive Behavioral Therapy, or CBT, is based on the concept that thoughts, emotions, and behaviors are interconnected. By changing one, you change the others. Sometimes it can be very difficult to change the way we feel, for example, or to quit a certain behavior. According to CBT, you may be able to change how you think about something, and a natural change in how you feel and act will follows.
What We Do: Using CBT techniques, clients are asked to examine their thoughts, emotions, and behaviors in a systematic way. Often, clients will keep detailed records or journals. They may chart their mood, or measure certain behaviors. Patterns are identified and examined. Usually the client will be asked to practice certain skills or exercises outside of therapy. Progress is charted and carefully tracked to make sure there is improvement.
Our trained CBT therapists evaluate your situation and goals, then select the best type of treatment for you. In Cognitive Behavioral Therapy programs, your clinician is focused on addressing a specific problem utilizing proven CBT techniques. You don't just chat- you have a goal, and work towards it. Together, you and your clinician will track your progress to ensure you are heading in the right direction.
Picking a CBT therapist can be a difficult decision. FRTC offers free phone consultations to determine if our services are a good fit for your needs.
One of the newest ways counseling professionals treat anxiety and depression is with a method called “transdiagnostic cognitive behavioral therapy.” The word transdiagnostic simply means "across different diagnoses." It refers to treatments that are used for multiple problems, and not narrowly tailored for specific problems.
There is a current trend toward treatments that target underlying issues rather than specific symptoms. Why is this a good thing? Shouldn't we want to tailor psychological treatments to specific problems? The answer is, it depends on the problem, and on the patient.
You see, often times diagnoses overlap. Sometimes a person's diagnosis will change over time as their underlying issues manifest in different ways. Here are some common ways in which diagnoses overlap:
Anxiety and Depression: These are closely related issues. Often, persons will present with symptoms of both anxiety and depression. Someone may struggle with anxiety at one point in their life, and later suffer from more depressive symptoms.
Panic and generalized anxiety and worry: A patient who experiences panic attacks and seeks treatment for those attacks may find that their panic attacks cease, only to be replaced by general feelings of anxiety and worry.
Panic and depression: Panic disorder with co-morbid major depression is a very common pairing.
Eating disorders: Persons suffering from eating disorders often suffer from underlying depression and/or anxiety.
Borderline personality disorder: The difficulty with emotion regulation that underlies BPD often leads to other emotional problems. These include:
Depression: 71% to 83% lifetime rate for BPD patients
Any Anxiety Disorder: 88%
Panic Disorder: 34% to 48%
PTSD: 47% to 56%
Substance Abuse: 50% to 65%
Eating disorders: 7% to 26%
Why is this a good thing? Shouldn't we want to tailor psychological treatments to specific problems? The answer is, it depends on the problem, and on the patient. You see, often times diagnoses overlap. Sometimes a person's diagnosis will change over time as their underlying issues manifest in different ways. By using a transdiagnostic approach, our trained CBT psychologist can better treat patients with anxiety and depression, and other co-morbid diagnoses.
With transdiagnostic CBT underlying mental processes are targeted, rather than the current manifestations of a patient's disorder. According to CBT, thoughts, emotions, and behaviors are linked. Psychological problems are addressed by analyzing each, looking for patterns, and attempting to break those patterns. Transdiagnostic CBT applies CBT techniques and principals in a systematic way to address emotional, cognitive, and behavioral problems at a deep level.
Here are some of the key components of transdiagnostic CBT treatments:
Motivation Enhancement is often the first task in treatment. Therapy can be hard work. It is important to identify reasons why all that hard work will be worth it. The client and therapist work together to prepare the client for the rewarding but difficult process ahead.
Mindfulness in this context simply means awareness- awareness of one's thoughts and emotions. Many people do not realize they have difficulty noticing when they are experiencing strong emotions, and identifying what those emotions are. Others struggle with identify their thoughts, or have difficulty maintaining attention.
Persons with borderline personality disorder often have difficulty identifying and describing what they are feeling. For example, they may mistake shame or sadness for anger. Persons with anxiety and depression may not be skilled at identifying emotional triggers.
By practicing being mindful, clients improve their ability to identify their thoughts and emotions- the first step in changing them.
Tracking Thoughts, Emotions and Behaviors
Keeping track of thoughts, emotions, and behaviors is an important part of all CBT treatments. For example, most clients will be asked to track their daily level of depression and anxiety. If a client has panic attacks, they will track those as well. This allows the client and therapist to look for patterns and triggers, and to measure progress. Here are some of the things clients may be asked to track, if relevant for their treatment:
Relevant thoughts (for example, about suicide)
Challenging Thoughts and Changing Behaviors
Challenging Thoughts and Changing Behaviors is an important step in CBT. After identifying maladaptive, harmful thoughts and behaviors, the client and therapist work together to begin the process of changing them. For example, a client with panic attacks may believe that a rapid heartbeat is a sign of a heart attack. They will be asked to challenge that thought with evidence, and will over time develop a more balanced belief. The new belief will result in less distress.
Exposure is the process of "exposing" a client to thoughts, sensations, and situations that illicit distress. This has two effects. First, whenever we experience anything for an extended period of time, our level of distress goes down. Second, the client also starts to learn that the situations they believe are dangerous are, in fact, not dangerous. There are different types of exposure.
Bodily sensations: Such as a rapid heartbeat, light headedness, cold or heat. Clients may induce these in session with their therapist, and at repeat the process later at home. This type of exposure is especially important for persons with panic attacks triggered by bodily sensations.
Thoughts: This includes distressing thoughts, such as those persons with obsessive-compulsive disorder have. Over time, the client learns that thoughts are not, by themselves, harmful.
Memories: Exposure to memories is an important part of treating trauma, such as with PTSD. Persons will be asked to recite the story of their traumatic experiences. They may record those, and listen to them later as homework.
Situations: Clients will spend time in situations that illicit distress. For example, clients with a fear of driving will be asked to drive increasing distances in a systematic manner. Over time, their distress goes down.
Learn About Other CBT Therapies
Prolonged Exposure Therapy
What it is used to treat: the effects of trauma, including PTSD
The Theory: According to the theory behind prolonged exposure therapy, persons that who have experienced a traumatic event attempt to avoid anything that reminds them of that event. That includes thinking about the event. Some people avoid certain places or activities. Others self-medicate with drugs or alcohol, or engage in other risky behavior to avoid the memories and feelings surrounding their trauma. Unfortunately, this only reinforces the idea that those things are dangerous and should be avoided. By not confronting them, emotions stay high, and it becomes impossible to learn they are not actually dangerous. However, when we do confront them, emotions naturally go down, and learning can occur.
What We Do: In PET, clients first learn distress tolerance skills that allows them to deal with negative feelings. Then, they are very gradually exposed to things related to their trauma in a safe environment. This is done in a systematic and gradual way so it is not too distressing. They may start with thinking about items or places related to their traumatic incident. Then, they may be asked to tell the story of the incident. This is repeated, each time with less distress. Eventually, with the event confronted and the emotion reduced, it becomes simply another memory- in the past, and unable to cause harm.
Exposure and Response Prevention
What it is used to treat: Obsessive Compulsive Disorder
The Theory: Persons with OCD have distressing thoughts that they want to avoid (obsessions). They often engage in repetitive behaviors in order to address those distressing thoughts (compulsions). Sometimes, compulsions have a very clear link to a specific obsessions. For example, someone may obsessive over cleanliness or germs, and have a compulsion to wash their hands. At other times, there is no clear link between the obsession and the compulsion. In either case, the compulsion reduces the anxiety that comes along with the obsession. This reinforces the behavior- because the feared outcome did not occur, the person has incentive to continue the compulsive behavior.
What We Do: In Exposure and Response Prevention, clients are asked to confront their obsession, without engaging in their compulsion. This is done in a systematic and gradual way so it is not too distressing. A client with an obsession about cleanliness may think about be asked to think about something unclean, for example. Later, they may be asked to put their hands into something unclean and not wash their hands. All emotion eventually decreases, so the distress decreases as well. When the client does not experience their fear outcome (such as getting sick from germs), the need to engage in the compulsion decreases as well.
Motivational Enhancement Therapy
The Theory: According to Motivational Enhancement Therapy, or MET, persons with substance abuse issues vary widely in how ready they are to make positive changes. Importantly, some persons know they need to make changes, and may even seek professional help, but are still not truly ready to change their substance use.
What We Do: In MET, clients are encouraged to examine their own motivations, their strengths, and desire to change. It is a collaborative process, undertaken in a supportive environment.
Behavioral Activation Therapy
What it is used to treat: Depression
The Theory: When depressed, people naturally disengage. They stop engaging in activities they used to enjoy, and they tend to isolate themselves from others. This creates a cycle with reinforces the depression, and blocks opportunities for pleasant experiences.
What We Do: The goal of Behavioral Activation Therapy, or BA, is to increase the number of positive experiences in the clients life. First, it is important to identify what the client enjoys and values. Next, the importance of positive experiences is stressed, and the client learns they are beneficial even when they would rather avoid them. Then, activities are scheduled and positive experiences tracked. In addition, barriers that encourage avoidance and disengagement are identified and addressed.
Teletherapy is therapy conducted using technology when the client and the therapist are not in the same location. Today, most teletherapy is conducted using secure internet videoconferencing apps- sort of like Skype or Facetime. At FRTC, some clients may be able to conduct some or all of their sessions online. This may be helpful for clients living in rural areas, for example.
There are complex guidelines that determine who may be eligible, and face to face meetings are always preferred if possible. Contact us for more information, to determine if teletherapy is right for you.