What is Cognitive-Behavioral Therapy?
How is Cognitive-Behavioral Therapy different from talk therapy?
How do I know if this type of treatment will work for me?
Will I need to take medication?
How often do I need to come?
How long will treatment take?
How long is a session?
Cognitive-Behavioral Therapy, or CBT, is a method of psychological treatment that helps people change the way they feel by modifying the thoughts and responses to everyday situations that contribute to emotional distress and prevent them from living a fully satisfying life. Since the mid 1970s, when psychiatrist Aaron Beck first introduced it as a promising new treatment for depression, there have been thousands of research studies demonstrating its effectiveness for such problems as anxiety, depression, obsessive-compulsive disorder, eating disorders, insomnia, ADHD, panic disorder, social phobia, and even relationship issues. Hence, CBT is termed an “evidence-based treatment.”
Technically speaking, CBT is one type of talk therapy as opposed to a psychopharmacological, or medication-based, intervention. When people say they’ve “gone through talk therapy,” however, they’re often referring to an approach that is less structured than CBT and not as goal-oriented. In CBT, the emphasis is more on the here-and-now than on the past and more on the “hows” than the “whys.” So, instead of focusing primarily on why your problems have developed, we look at how you can makes changes in your thinking and behavior to help you move forward and achieve your goals. Another aspect of CBT that sets it apart from other types of talk therapy is its collaborative, transparent nature. The therapist plays a variety of roles– teacher, personal trainer, coach, detective—to help you identify specific targets for change, develop new ways of thinking about your problems, test out different behavioral approaches, and motivate you to stay with it.
During the initial consultation, we assess whether CBT is the right approach for you and if this is the optimal time for you to begin. In my experience, a willingness to get involved actively in your treatment and put in the work it takes to change your thoughts and behavior is the most important prerequisite for a successful CBT experience. One hallmark of CBT is “homework,” which can take many forms but always involves mutually agreed upon assignments for you to do between sessions to practice new skills. Despite CBT’s excellent, research-tested track record, there is, of course, no way to guarantee a particular individual’s response. For that reason, I often spend several sessions before starting the treatment phase of therapy on building motivation, identifying potential obstacles, and laying the groundwork for the active therapeutic phase.
Studies have shown CBT to be as effective as a combination of medication and CBT and more effective than medication alone for the treatment of some conditions. If you have a strong objection to medication, we’ll take your preference into consideration when we design your treatment plan. In cases where medication is recommended, I can refer you to psychiatrists with whom I have a close, collaborative relationship, so that we can work together to provide you with the optimal care. If you already have an established relationship with a prescribing physician, I’ll ask for your permission to contact your treatment provider to ensure cohesive treatment.
The recommended frequency of sessions will vary depending on your condition. At the start of therapy, you can expect to come at least weekly and, less commonly, even two or three times a week while we’re developing a personal treatment plan, stocking the therapeutic toolkit, and practicing cognitive-behavioral strategies. Once you’ve learned to implement the techniques, sessions will take place on a more extended schedule as you develop the skills to manage your own treatment with the ultimate goal of becoming your own therapist.
The length of treatment will vary depending on the nature of your problem and the time you’re willing to devote to the therapeutic assignments between appointments, but many people notice a significant improvement in as few as six to eight sessions. CBT is designed to be a relatively short-term therapy—months, not years.
The first visit is an evaluation that takes 90 minutes. Subsequent appointments are typically 45 minutes. For some types of treatment, such as Exposure/Response Prevention for Obsessive-Compulsive Disorder, it may sometimes be necessary to schedule 90-minute sessions.
I don’t participate in any insurance plans and ask for payment at the time of service through Ivy Pay, a HIPPA-compliant payment app. I will email you a detailed receipt with all the necessary information you need to submit to your insurance company for reimbursement at the out-of-network rate. Many insurance plans, including Blue Cross-Blue Shield for federal employees, offer generous, out-of-network benefits, but you need to contact your insurance company about the details of your coverage. It is your responsibility to file claims, but I will fill out any necessary forms needed for preauthorization.
You can contact me by email or phone to set up a time for us to be in touch by phone to schedule an appointment. I find it’s helpful for us to talk before making the appointment to allow you to ask questions, clarify my office policies, and determine if I’m a good fit for you and if you are an appropriate candidate for teletherapy.