Therapy 101: Acceptance and Commitment Therapy

If you’ve ever looked into getting therapy, then it’s likely that you’ve heard a lot of different terms thrown around to describe it. There are many different therapy techniques and modalities out there. This blog post is part of a series that is meant to explain some of the more common forms of therapy you’re likely to encounter as you look into potential therapists.

What Is Acceptance and Commitment Therapy?

Acceptance and commitment therapy, better known as ACT, is a 3rd wave behavior therapy that has been gaining momentum. In recent years there have been studies looking into the effectiveness of ACT for a variety of uses.

Whereas CBT focuses on changing thoughts ACT focuses more on accepting thoughts and distressing feelings as part of life. Acceptance and commitment therapy is about learning skills on coping with distress, like DBT.

How does ACT Work?

ACT has 6 primary processes that it works on. The concept is that ACT is about increasing psychological flexibility, which is meant to help with coping with negative experiences. Naturally, one of these processes is acceptance.

Acceptance is exactly what it sounds like, it means coming to accept the negative things that happen and the negative feelings, emotions, or thoughts we may be having. ACT does not encourage avoidance of these things or trying to change negative feelings into neutral or positive ones.

Cognitive defusion is another component of psychological flexibility. When we talk about defusion in this sense, what we mean is altering how we think about negative things. Instead of trying to avoid them or change them, the focus is on changing the negative impact they have on us.

Being present, something that is rooted in mindfulness, is also an aspect of ACT. It encourages individuals to be present in their feelings and the current moment, even when it’s unpleasant. It encourages non-judgemental evaluations of the world around them and the world inside of them.

Mindfulness is also part of self as concept. This is something that in ACT is used to foster a sense of self that recognizes that events occur but they do not have to define the self. This is part of acceptance and tolerance of distressing things we may be experiencing.

Values are one of the cornerstone components of ACT in that clients are encouraged to find meaning in their lives through values that they identify. These values are used to explore clients’ behaviors. This lets them see if these behaviors line up with the values they wish to live.

Finally, committed action is a pattern of thinking that links all of the previous concepts together. It’s using the skills learned through therapy to formulate long-term goals for living in a way that will help them live up to their values.

What is Acceptance and Commitment Therapy Used For?

ACT can be used in a variety of mental health contexts. It is often used for individuals with specific phobias, mood disorders, anxiety, and substance use disorder. ACT is also used for individuals who are experiencing high levels of stress, such as work stress, and life transitions. These transitions can include grief and loss, moving, marriage (though happy, this can still cause a lot of stress!), etc. There is also some research that has been exploring the use of ACT for individuals with chronic illness and pain.

How do I Find an ACT Therapist?

Many therapists incorporate some form of ACT into their work. Here at Compassionate Counseling Company, we have a few! Emily, Niah, and Theresa all incorporate ACT into their work with clients. Also keep in mind that many therapists use core principles of ACT without listing themselves as using ACT. At the end of the day, it’s about your connection with a therapist and making sure your goals are aligned.

Another way to find a therapist is to use your insurance’s provider list. You can look up the therapists in that database online to see what modalities they use with their clients!

Resources:

https://contextualscience.org/the_six_core_processes_of_act

https://positivepsychology.com/act-acceptance-and-commitment-therapy/#hero-single

https://www.socialworktoday.com/archive/090208p36.shtml

January 24, 2025January 24, 2025

Therapy 101: Dialectical Behavior Therapy

What is DBT?

DBT stands for dialectical behavioral therapy. It’s quickly becoming a very common form of therapy used by many clinicians and has many clinical studies to back up its effectiveness. Dialectical refers to the idea of reconciling two opposing thoughts, such as knowing someone has harmed you while also acknowledging they are not a bad person.

This form of therapy was originally designed to help individuals with borderline personality disorder. BPD often comes with intense emotions and risky, usually self-destructive behavior as a result of emotional dysregulation. DBT is meant to help individuals tolerate distress more effectively and thus regulate their emotions more successfully. This in turn helps to reduce harmful behavior, such as self-harm and suicide attempts.

When followed strictly, DBT uses a combination of one-on-one therapy with a client and a trained therapist and group skills sessions. There is also a “light” form of DBT that removes the group skills sessions and involves only the one-on-one therapy.

Can DBT be Used for Other Purposes?

DBT has been shown to be effective in treating eating disorders (especially binge eating and bulimia), bipolar disorder, PTSD, and schizophrenia. It can also be used with those who have major depressive disorder, generalized anxiety disorder, and other similar mental illnesses.

How Does It Work?

Dialectical behavioral therapy approaches clients’ problems with the idea that there is some sort of skills deficit that is making it difficult for clients to cope with their emotions and things that go on. Harmful behaviors stem from high levels of distress as a result of this. Through this idea, DBT focuses on skills building and also on increasing distress tolerance in clients.

There are four basic skills that therapists work with clients on: mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness.

Therapists will use a variety of activities and help teach clients different ways they can work on these skills outside of the session.

In more traditional DBT there are four stages that therapy proceeds in. It starts with helping to stabilize the client if they’re in crisis and allowing them to feel safe. The second stage focuses on exploring emotional pain. In the third stage, clients work on setting SMART goals and maintaining healthy behaviors. Finally, in the fourth stage, clients look at the big picture and work towards achieving them.

How do I Find a Therapist?

There are many ways to find a DBT therapist. Right here at Compassionate Counseling Company we have clinicians who integrate DBT into their sessions (Niah, Kelly, Jessica, and Emily). However, if you’re looking for the more traditional form of DBT, then the DBT-Linehan Board of Certification is the best place to find one. If you plan to use insurance, make sure the provider is covered under your plan! You can use your insurance company’s provider search to check.

Resources:

https://my.clevelandclinic.org/health/treatments/22838-dialectical-behavior-therapy-dbt

https://dialecticalbehaviortherapy.com/

https://eddinscounseling.com/dbt-101-dialectical-behavior-therapy

https://www.mcleanhospital.org/essential/dbt

https://www.verywellmind.com/dialectical-behavior-therapy-1067402

December 6, 2024December 5, 2024

The Mental Health Benefits of Counseling

Almost every week, we mention how speaking to a therapist or counselor can be of benefit for addressing a variety of needs. However, this is the first time we’ll be addressing the benefits of counseling more closely. Of course it can be used to address specific mental health disorders but it also has more far reaching benefits than just helping people to cope with mental illness.

What is Therapy?

Therapy, or counseling, often refers to talk-therapy or talk-psychotherapy. This is a form of treatment which involves speaking to a trained professional about a problem you’re having. The professional then uses evidence based practices to help you build skills to then address whatever concern brought you to therapy.

One of the main benefits of counseling is that there is no one size fits all approach. There are so many different forms of therapy. For example, cognitive behavioral therapy (CBT) is one of the most well-known forms. And many people often think of psychodynamic or psychoanalytic therapy when they first imagine therapy (you know, Freud and a couch).

However, there is also ACT, DBT, EMDR, ERT, and many, many more. Many of these forms of therapy were developed to target specific mental disorders or problems that people may be having. Motivational Interviewing (MI), for example, was developed for addressing substance use disorder.

What Does Therapy Help With?

There are many benefits of counseling to consider. Of course, it can help with mental illness, such as depression or anxiety disorders. However, it can also help with things like coping with grief or loss, dealing with stress, handling transitions, and other issues people may be facing.

Therapy can also help with working on self-esteem, problem solving skills, self-confidence, and coping with rough patches in your life. Most people who go to therapy only do so for a short period of time, usually to help resolve a current issue such as the death of a loved one.

People also seek out therapy to help with communication skills, relationship problems, and for help addressing conflicts they may be facing in life.

How Do I Find a Therapist?

Word of mouth is an excellent way of finding a therapist. Ask around and see if you can get recommendations from doctors or people you know who have gone to therapy. Your insurance provider is also a great resource for finding a therapist as that will be the easiest way to insure that the cost of your sessions will be covered.

We have a large list of clinicians here that are also an option for those looking into the benefits of counseling and considering getting counseling themselves.

Resources:

https://www.avila.edu/2022/12/13/5-benefits-of-working-with-a-mental-health-counselor/

https://www.coe.edu/student-life/health-wellness/mental-health-counseling/potential-benefits-counseling

https://www.harmonyridgerecovery.com/10-benefits-of-mental-health-counseling

https://www.healthline.com/health/benefits-of-therapy

https://www.mhanational.org/therapy

https://positivepsychology.com/counseling-process

https://online.sbu.edu/news/5-ways-mental-health-counseling-builds-stronger-communities

https://www.verywellhealth.com/benefits-of-therapy-5219732

April 8, 2024July 9, 2024

Bipolar Disorder Overview

According to the World Health Organization (WHO), 1 in 8 people in the world currently live with a mental health disorder. This equals out to 970 million people. As of 2019, of those 970 million people in the world, 40 million had bipolar disorder.

Bipolar disorder is a mental health disorder characterized by extreme highs and lows (it was previously known as manic-depressive disorder). These highs and lows often come in cycles of depression or mania. But they sometimes can be seen as a “mixed state” in which symptoms of both are present. Mania in adults is characterized by high, euphoric moods, increases in energy, decreases in appetite and sleep, and can sometimes also include thoughts of grandeur, delusions, and at the most extreme, hallucinations.

Children are more likely to exhibit irritability and emotional outbursts than these more well-known highs. Hypomania is a less severe form of mania that can affect many people with bipolar disorder. Depression in bipolar individuals can be seen as very low mood, low energy, and feelings of hopelessness. Bipolar disorder has a high rate of suicide completion, with one in every five people with the disorder completing suicide. This highlights the importance of treatment for individuals with this disorder.

The misdiagnosis rate is unfortunately high, which delays proper treatment. Women and female presenting persons are more likely to be misdiagnosed with depression and men and male presenting persons are more likely to be misdiagnosed with schizophrenia. Bipolar affects these groups in equal rates.

Typical onset of this disorder is found in adulthood, however it can occur in adolescence and early childhood. There does seem to be a genetic component to this disorder, as it is more common in individuals who have at least one parent with unipolar depression (major depressive disorder) or bipolar disorder. Individuals with an immediate family member who has bipolar disorder are also more likely to develop it sooner in life.

Bipolar Disorder Types

There are three types of bipolar disorder based on how cycles present. No type is more or less “severe” than the other in terms of the challenges someone may face and the types are not determined by impact on a person’s life but on types of symptoms.

Bipolar I typically presents with manic symptoms that last at least a week. These manic symptoms can also result in the need for emergency care depending on severity. Depression in bipolar I typically lasts at least two weeks.

Bipolar II is characterized by episodes of hypomania and depression. These hypomanic episodes can be less severe than traditional mania and usually do not require emergency medical attention. Depressive cycles tend to be more common with bipolar II.

Cyclothemia, or cyclothemic disorder, is a disorder that involves cycling between hypomania and depressive episodes. These episodes are usually shorter than in bipolar I or II.

Treatment

Typically, we see the use of mood stabilizers and anti-depressants used as the first line treatment for this disorder. Lithium is the most well-known mood stabilizer and was the first one developed as an effective treatment for bipolar. However, many more are now available. SSRI’s and SNRI’s are also commonly used in combination with mood stabilizers. Atypical antipsychotics are often used along with these other medications. According to WHO, 9 in 10 patients are happy with their treatment plan and medications.

Therapy is also part of an effective treatment plan for bipolar. Through therapy, clients are able to learn how to address troubling thoughts, identify potential triggers for cycling and signs a depressive or manic cycle may be coming, and how to change their behaviors. Therapy can also be a way of providing support and education to bipolar clients and their families.

My Story

I was diagnosed with bipolar II when I was 12 years old, though it’s very likely I developed it much earlier. Bipolar is considered a progressive disorder and developing it so early meant it was likely my symptoms would be severe. Progression is associated with more frequent episodes, more difficulty in treatment, more severe episodes, and a higher likelihood of suicide attempt and completion.

Treatment was difficult at first for me. I tried many medications that did not work well for my case. My age was a complicating factor in this, of course, as many medications at the time (2002) were not approved for use in children. I reacted poorly to the medications that were available to me and eventually I stopped treatment.

My adolescence was, understandably, difficult. I often experienced rapid cycling, which is categorized as four or more cycles within a year. My depressive symptoms were very severe, resulting often in difficulty in functioning socially and in school.

According to all odds, it was likely only going to get worse. Many bipolar patients experience disability from their disorder. However, in my early 20’s, I went back to trying medications. It took a few years to find an effective treatment regimen. Some medications had side effects I couldn’t tolerate and others didn’t make a difference in my depressive symptoms. After some time I was able to find something that worked for me.

Combining an effective medication schedule with therapy allowed me to gain the skills I needed to achieve a normal level of functioning. These skills were recognizing when a cycle may be coming so that I could take steps to try and prevent it from being too severe, learning how to combat the thoughts and feelings that came with depression and could sometimes lengthen my depressive cycles, and learning when to reach out for more help. Learning when a medication had reached its limit to help me and I needed more support in that area was crucial for my treatment success.

Despite the odds stacked against me with my early onset and severity of symptoms, I was able to achieve a level of functioning that has allowed me to thrive as an adult. I was able to continue working and then eventually attended college and am on my way to a graduate program. Bipolar disorder can be a scary diagnosis, but with proper treatment and education on the disorder, it is possible to have a high quality of life and, more importantly, a full life that is characterized by achieving one’s goals, having good friends, and seeing one’s dreams through.