What are evidence-based treatments?
Evidence-based treatments are known as the “gold standard” for psychological treatment and intervention because of the wealth of research that supports their efficacy in symptom reduction and relapse prevention. Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Mindfulness Based Stress Reduction (MBSR), and Acceptance and Commitment Therapy (ACT) are all evidence-based treatments that Dr. Kisner utilizes to inform and guide her work with patients.
Please read below to learn about the difference between these treatment philosophies.
What is Cognitive Behavioral Therapy (CBT)?
CBT is a short-term, active, goal-oriented treatment that focuses on the connection between your thoughts, behaviors, and emotions. CBT emphasizes that you can change the way you feel by changing the way you think and act. Individuals are asked to evaluate their thinking and determine the ways in which thoughts can be erroneous or lack usefulness in their lives. Additionally, in CBT, you will learn new strategies to cope with stress in your life and more adaptive ways to interact with the world. Unlike more traditional therapies, CBT focuses on the present, using information from the past only as it informs your current situation. Treatment is viewed as a collaborative effort between therapist and patient where treatment goals are identified together and treatment helps the patient take steps to achieve those goals. Homework is often assigned in CBT as a way to help you to generalize the skills you are learning in therapy sessions to your daily life. Research has demonstrated that CBT is widely effective for the treatment of anxiety disorders and mood disorders.
What is Dialectical Behavior Therapy (DBT)?
Developed by Marsha Linehan, DBT is a specialized form of CBT that was initially created to treat individuals engaging in suicidal and self-injurious behaviors with a diagnosis of Borderline Personality Disorder. Because of its efficacy, DBT has since been adapted to treat a range of disorders of emotion regulation, characterized by the experience of intense emotions and impulsive behaviors. Intense emotions are often marked by increased sensitivity to feelings, stronger emotional reactions when triggered, and slower return to baseline functioning. Because intense emotions can often be distressing, impulsive behaviors are viewed as an attempt to avoid discomfort or make emotions go away. DBT views these impulsive behaviors as short-term focused with potential long-term consequences. DBT will teach you skills to regulate emotions, tolerate distress, accept painful life circumstances, act in more effective ways, and build the life you want to live.
Comprehensive DBT has four components: individual therapy once a week, DBT skills training once a week, phone coaching for skills generalization, and consultation team.
Skills taught in DBT skills training are:
- Mindfulness – skills to help individuals learn to stay in the present moment instead of living in the pain of the past or the anxieties of the future
- Distress Tolerance – strategies to get through a difficult situation without making it worse
- Emotion Regulation – helps people better understand and identify emotions as well as teaches active strategies to change painful emotions
- Interpersonal Effectiveness – skills to more effectively communicate with people in your life, build relationships, and maintain self-respect
- Middle Path – this is a set of skills specific to Adolescent and Family DBT designed to teach families how to navigate and negotiate conflict
What is Mindfulness-Based Stress Reduction (MBSR)?
MBSR is a treatment created by Jon Kabat-Zinn to help people better manage chronic pain and stress in their lives. Kabat-Zinn defines mindfulness as “the awareness that emerges through paying attention on purpose, in the present moment, and nonjudgmentally to the unfolding of experience moment by moment.” Based on principles of meditation, MBSR is highly respected within the medical community as a complementary treatment to enhance the efficacy of medical treatments and interventions. MBSR highlights the connection between the mind and body in the illness process and has been proven to be significantly effective in the treatment of a variety of health problems and emotional difficulties. MBSR aims to teach you to be a participant in your own health, wellness, and healing process and to focus on living life more fully. Research has suggested that the benefits of participating in an MBSR program include reductions in physical and emotional pain, improved ability to cope with chronic pain, effective stress-management tools and techniques, increased energy, enhanced self-esteem, feeling more relaxation, and overall improvements in quality of life. MBSR has also been adapted to treat depression and prevent relapse.
What is Acceptance and Commitment Therapy (ACT)?
Intense emotions, or the desire to avoid intense emotions, can often serve as an obstacle to building the life you want for yourself. Similarly, our thoughts or the stories we tell ourselves about who we are and what we can and cannot accomplish can be a great source of pain for us. Acceptance and Commitment Therapy (ACT) is an intervention that balances mindfulness and acceptance based strategies with behavioral commitment to build a life that is consistent with your core values. In ACT, the treatment focus shifts from trying to change and control unwanted thoughts and emotions to acceptance of pain and discomfort. Through mindfulness, ACT aims to help people gain distance from their maladaptive patterns and cognitive rigidity, with the overall goal of enhancing psychological flexibility. Additionally, ACT aims to help people identify what is truly important in their lives and clarify their core values, and to use this information as a guide to building a meaningful life.