“The focus of therapy must not be why am I the way I am, but rather what keeps me stuck, and how can I move forward.”

Dr. Arthur Freeman

CBT - Cognitive Behavior Therapy

Cognitive Behavior Therapy (CBT) is based on the observation that emotional problems come from thoughts, ideas and beliefs that are exaggerated, distorted, mistaken, or unrealistic. These thoughts play a major role in emotional problems. An individual’s beliefs, assumptions, and basic rules (schemas) help to shape their perception and interpretation of internal and external events.

There are general and specific goals that guide and structure therapy. In effect, the disorder (for example, depression or anxiety) is not treated, but rather the component parts of the disorder are the focus of treatment. We treat the "problem" by breaking it down to the smallest parts and deal with them in "easier to digest" fashion. This relieves the client of the idea that everything must change for them to be able to be happier, more successful, or more connected with family and loved ones.

People seek therapy for three main reasons: 1) Crisis circumstances (situational) - something has been said or done which has created an emergent situation interpersonally, intrapersonally, or environmentally. 2) Problematic interactions (skill-based) - an interpersonal difficulty due to a lack of skills. 3) Pathological process (mode/trait focused)- a more consistent stylistic response that has caused problems for the individual.

The unique features of the presenting problem usually represent the exaggeration or deficits of basic skills in responding to internal and situational stimuli. The problem comes when an individual’s reactions differ markedly from those of the general population. Of course, problems differ because they may be mild, moderate or severe.

In the course of therapy, the basic rules of life or schema must be made explicit. When schema are challenged, anxiety will result. Schema exist as personal, family, gender, social, religious or cultural “rules” or demands.

We consider the person’s genetic makeup (genotype), the physical manifestation of the symptoms (phenotype) and the social network (sociotype). The interplay of these elements make for the colors and shading of any behavior.

The beliefs hardest to modify are those learned very early in life, were strongly reinforced, were modeled by significant others, or acquired from a credible source. Although most schema were acquired in childhood from individuals in their family of origin, the therapy must focus, as much as possible, on the here-and-now. The therapist and the patient work together at setting treatment goals that are: reasonable, sequential, proximal, well-defined, within the patient’s skill repertoire, agreed to, and seen by the patient as valuable.

The therapist and client work together as a team to identify, examine, and define problems, and then work collaboratively to develop solutions and resultions to the identified problems.