TYPES OF TREATMENT
Taking Care of You
COGNITIVE BEHAVIORAL THERAPY
The Concord Center specializes in cognitive behavioral therapy (CBT). CBT is a type of psychotherapy that focuses on the relationship between thoughts, emotions, physical sensations, and behaviors—and how this relationship can cause distress or impairment for people. CBT has been shown through research to be helpful for a wide range of problems, including anxiety disorders, obsessive compulsive and related disorders, post-traumatic stress disorder, mood disorders, eating disorders, and more.
CBT is a directive, skills-based treatment that relies heavily on a collaborative relationship between your therapist and you (and/or your child). CBT is generally short term, though duration of treatment varies depending on the presenting problem and preference. For maximum benefit, you/your child should expect to complete between-session assignments.
In addition to traditional CBT, The Concord Center offers a range of specialized cognitive behavioral treatments, including:
ACCEPTANCE AND COMMITMENT THERAPY (ACT)
Like traditional CBT, ACT is empirically supported for treating many different kinds of problems. ACT focuses on developing key mindfulness and acceptance skills while pursuing values-driven behavioral change. In other words, ACT teaches you willingness to experience difficult thoughts and feelings in order to move towards what is most important to you. In addition, ACT helps you learn to recognize and let go of persistent unhelpful thoughts.
COMPREHENSIVE BEHAVIORAL INTERVENTION FOR TICS (CBIT)
CBIT is a type of behavioral therapy for Tourette’s Disorder and other tic disorders. The treatment progresses through several stages, including 1) Becoming more aware of tics and the urges preceding tics, 2) Learning how to substitute a competing action(s) for the tics, and 3) Changing situations and emotional states in which tics are most likely to occur. CBIT is usually short term (i.e., 8 sessions) though the treatment length can be tailored to the individual.
COMPREHENSIVE MODEL FOR BEHAVIORAL TREATMENT OF BODY FOCUSED REPETITIVE BEHAVIORS (COMB)
Body focused repetitive behaviors (BFRBs) include compulsive hair pulling, skin picking, nail biting, and more. ComB has been shown through research to effectively reduce the frequency and intensity of BFRBs. ComB involves identifying specific triggers for the behavior as well as factors that maintain the behavior. Based on this analysis, the therapist teaches you a set of tailored strategies to resist engaging in the unwanted behavior, adjusting as needed over the course of treatment.
DIALECTICAL BEHAVIORAL THERAPY (DBT)
DBT teaches skills to help you to better regulate your emotions. Strategies consisting of Mindfulness, Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness, help you to replace more problematic coping strategies including self-harm, suicidal thoughts and behaviors, impulsivity, and other risky behaviors that have negative consequences. DBT is an effective treatment for a wide range of presenting problems and diagnoses. It typically consists of a weekly individual meeting, didactic group, and access to your therapist for skills coaching.
Dialectical Behavior Therapy for pre-adolescent children, also known as DBT-C, is an evidence-based treatment for children ages 7-12 years old who struggle with emotional sensitivity and behavioral dysregulation. DBT-C is based on the theoretical model, principles, and therapeutic strategies of standard DBT and is modified for children’s developmental level. DBT-C involves a significant parent training component where parents first attend parent guidance sessions to learn validation and behavior management strategies, and then children join therapy to learn coping skills, problem-solving, and didactics about emotions.
EXPOSURE/RESPONSE PREVENTION (ERP)
ERP is a very important and effective part of treatment for any anxiety disorder, OCD, or PTSD. ERP involves learning to fully experience the different situations, images, thoughts, and/or sensations you avoid because of anxiety. The “response prevention” part of ERP means facing your fears without engaging in a compulsion or “safety behavior”-- for example, for someone who is fearful of germs, resisting the urge to wash hands after exposure to touching something dirty. The goals of ERP are to test out what you believe will happen in feared situations and to help you gain confidence that you can handle it. Though ERP may sound intimidating, the therapist works closely with you or your child to ensure the pace of the exposure is manageable.
PARENT-CHILD INTERACTION THERAPY (PCIT)
PCIT is a treatment for young children ages 2-7 who display attentional, emotional and/or behavioral regulation challenges (e.g., trouble sustaining focus, excessive tantruming, acting in an oppositional or defiant manner).
In PCIT, parents and children are seen together in weekly, 60-minute sessions with a therapist. Goals of the treatment are to: 1) reduce challenging childhood behaviors, and 2) equip parents with specialized parenting skills to help them manage behavioral problems at home and in the community by directly coaching them in how to do so. PCIT has two phases. One phase focuses on promoting positivity in parent-child interactions through play, and gets parents and children back on track in their relationship. This sets the foundation for the second phase of PCIT, which focuses on increasing child compliance by teaching parents concrete disciplinary techniques (e.g., setting limits, giving effective commands, etc.)
SUPPORTIVE PARENTING FOR ANXIOUS CHILDHOOD EMOTIONS
Supportive Parenting for Anxious Childhood Emotions (SPACE) is a short-term intervention for caregivers of children and adolescents who experience anxiety and related challenges. Developed at Yale University’s Child Study Center, SPACE has been shown to be as efficacious as individual cognitive-behavioral therapy (CBT) in treating child and adolescent anxiety.
SPACE is unique in that the treatment is delivered only to parents, without the need for child participation. Parents learn to respond effectively to their child’s anxiety, in a way that both validates the child’s experience and also shows confidence in the child’s ability to tolerate discomfort. Parents work collaboratively with the therapist to develop a clear plan to take small, gradual steps in reducing accommodation (or things they do or don’t do because of their child’s anxiety). The result is a child or teen who can better self-regulate and cope with anxiety independently.
UNIFIED PROTOCOL (UP)
The UP is an empirically supported treatment that targets problems that tend to occur across all anxiety and depressive disorders. The UP involves learning about your emotions and their functions as well as key mindfulness skills. You will also learn to identify and challenge unhelpful thinking patterns and then practice exposure to uncomfortable situations and physical sensations.