for Individuals, Couples and Families
I am licensed to perform psychotherapy in the State of California which may be reimbursable by medical insurance plans. My psychotherapy services include Emotionally Focused Therapy for Couples, Families and Individuals as well Dialectical Behavior Therapy. For more information about these strategies see below.
Emotionally Focused Therapy (EFT)
EFT is a systematic approach to couple’s therapy that has far and away the most positive impact on couple’s relationships in comparison with any other type of couple’s therapy. Research consistently shows that “70-75% of couples move from distress to recovery and approximately 90% show significant improvements.” EFT is based on a theory of adult bonding and that the connections we have with our romantic partners are experienced on an emotional level as vital lifelines of safety and security while conflicts are often a form of protest over the loss of safety, distance, or lack of accessibility of the partner.
What has been discovered by EFT also has implications and strategies that have been adopted for use with individuals and families. This is because no matter what age or stage of development we may be in, the key aspects of our mental health and well-being continue to correspond closely with the quality of our closest personal relationships. Additionally, the core of our self-image lives inside the foundation established by the safety and trust developed, or not developed, in our earliest key relationships. If this foundation never developed properly or it becomes unstable at any point, it can still be positively transformed in the context of our current key relationships.
Dialectical Behavior Therapy (DBT)
Dialectical Behavior Therapy (DBT) is a comprehensive therapeutic technique created by Marsha Linehan PHD, shown empirically to be effective for treating a variety of difficult to treat mental health conditions. The first studies were done with chronically suicidal women that met criteria for Borderline Personality Disorder. Multiple randomized control studies show that treatment with DBT compared to treatment as usual leads to fewer suicides, fewer suicide attempts, fewer self-harm incidents and a lower drop-out rate.
Further studies validated that DBT if effective with a variety of other conditions when a core problem of emotional vulnerability underlies the condition. Emotional vulnerability means experiencing emotions intensely with a slow return to baseline.
What is Dialectical?
Dialectical is a term from philosophy that involves finding truth in the synthesis of polar opposites. DBT uses the dialectical viewpoint to highlight the multiple tensions existing between the patient and her environment, and within herself, and relieve the tensions by bringing the conflicting viewpoints to a synthesis.
One of the tensions in the therapeutic relationship is between acceptance and change. Linehan found that her patients were highly resistant to change and often dropped out of therapy or had poor outcomes unless they were validated and accepted as they were. However, the patients who only received acceptance felt trapped and hopeless in the face of intense suffering and unrelenting problems. Add a result, she found that only by balancing acceptance and change created a stable pathway toward change with her clients in a relationship where the clients felt accepted.
What are the components of DBT?
DBT includes individual therapy, phone coaching and skills training. Skills training works to improve skill deficits and replace problematic behavior with skillful behavior. The four skill areas are mindfulness, emotion regulation, distress tolerance and interpersonal effectiveness. Cognitive restructuring is used to modify distorted thinking patterns. Behavior therapy is used to analyze the factors influencing and maintaining problematic behaviors and to pinpoint the most effective place to intervene with skills, exposure, contingency management or cognitive restructuring.
DBT recognizes the need for patients to use their new skills in their everyday lives and relationships to truly impact their lives. This is accomplished using three strategies. Patients are encouraged to call their therapists for live phone coaching as they learn to implement their skills in their lives. Diary cards are used to efficiently monitor and track problematic behaviors and thoughts as well as skill use and it's effectiveness. Finally, homework assignments are used to practice and improve skill usage.