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The Acronyms of Therapy

CBT, DBT, ACT, EFT...WTF

You've either seen the acronyms before and ignored them and focused on the therapist's other profile contents or your doctor told you "you need a CBT therapist" and you went with it because you trust them to know, but these acronyms can have a huge impact and should be understood.


No one really explains what these 3 or 4-letter abbreviations mean but they are indicators of what kind of therapy you are going to get which will be a big indicator of how well you will "click" with your therapist and ultimately how well therapy will work for you. These acronyms are the foundation of how your therapist operates, how they see the world, how they conceptualize what your issues are and how they can help you. These are theoretical orientations, foundations that guide what techniques and interventions your therapist will use. They are all different and not every one of them will be your cup of tea.


Let me break down a few of the big ones you may see.


 

CBT - Cognitive Behavior Therapy - a structured, goal-oriented type of talk therapy, it's meant to identify, challenge and change inaccurate or distorted thought patterns, emotional responses, and behaviors. CBT is less concerned about the past; the focus is primarily on moving forward. CBT's primary tenant is the idea that our thoughts and behaviors influence our feelings, so changing the way we think about and react to situations will help us feel better.


REBT- Rational Emotive Behavior Therapy - A type of CBT (even thought to be the basis for CBT), REBT focuses more on taking action when it comes to changing thought and behavior patterns. Based on the belief that people are naturally goal-directed but that they are also self-defeating and irrational, REBT brings awareness to how thoughts, emotions, and behaviors are all connected and influence each other. REBT is considered a short-term therapy and uses a model, the ABC model (Activating Event > Belief > Consequences) to move towards healthier ways of meeting life goals.


MBT - Mindfulness-Based Therapy - There are several types of MBT including mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT). MBSR uses meditation, yoga, and the observation of physical experiences to reduce stress. The hope is that reducing one’s overall stress will allow one to evaluate their thoughts. In MBCT, rather than reducing one’s general stress to address a specific problem, attention is focused on one’s thoughts and associated emotions. DBT and ACT, described next, may also be considered MBT.


DBT - Dialectical Behavioral Therapy - a derivative of CBT that looks at how to calm intense emotional reactions. Originally developed for clients who are diagnosed with Borderline Personality Disorder but now widely used for other things, DBT helps with distress tolerance, emotional regulation, and interpersonal effectiveness with mindfulness techniques and interventions.


CPT - Cognitive Processing Therapy - Also a type of CBT, this 12-session approach is specifically geared to treat PTSD (Post-Traumatic Stress Disorder) by having one consider more helpful ways of looking at the traumatic event. Thoughts are challenged and different perspectives are considered and it is up to the client to decide whether a new perspective makes sense and adopt it.


ACT - Acceptance and Commitment Therapy - This form of therapy works on accepting the present situation "as is" instead of trying to change it by utilizing mindfulness skills. In ACT, recurring thought patterns are identified, a sense of acceptance is established and a review of what you've learned about yourself is encouraged. ACT pulls from the Buddhist belief that pain is inevitable but suffering is a choice, so by refocusing on the present moment and what is within our control to change, we can move out of suffering.


EFT - Emotionally Focused Therapy - This type of psychotherapy is fused with the science of adult attachment, ie. personal relationships and personality. EFT prioritizes emotion and emotional regulation because it views emotions as strongly linked to identity and how we make daily decisions as well as relate to one another. A big component of EFT is that being emotionally unaware of your emotions or ignoring/avoiding/compartmentalizing your emotions can lead to negative outcomes in life. So, in EFT therapy you learn to face and manage your emotions.


PCT - Person-Centered Therapy - This type of therapy generally looks like an unstructured conversation between therapist and client. PCT therapists do not try to change or challenge their client's thoughts because the theory of growth in this type of therapy comes from the therapeutic relationship itself. Meaning, the therapist's role is to be a stable, secure, non-judgmental, and encouraging person, giving the client the comfort and space to pursue their own exploration.


IFS - Internal Family Systems - IFS brings the subconscious into the consciousness by identifying and addressing sub-personalities that are often in conflict with each other and healing past wounds and burdens. By observing and being present from a calm grounded "Self", one can reinstate harmony and safety within the subconscious allowing for less reaction-driven behavior and more confidence. clarity, and calm.


FOT - Focus-Oriented Therapy - a PCT type of therapy in that it allows the client to determine the pace of therapy and is heavily dependent on a strong alliance between client and therapist, FOT encourages deep inner listening in mind and body. FOT teaches people to pay attention to the messages the mind and body convey through a "felt sense" that can resolve issues and illicit change simply by staying present with what one finds.


FOAT - Focus-Oriented Art Therapy - This is a derivative of FOT and uses the wisdom of the body to reveal messages but utilizes art therapy to develop self-awareness, enhance creative intelligence, and promote growth.


ERP - Exposure and Response Prevention - this type of therapy is generally used to treat anxiety disorders such as OCD (Obsessive-Compulsive Disorder) by exposing people to the situations that trigger their anxiety or obsessions and helping them to prevent their compulsive responses. By habituating (or getting people used) to the event, people learn to tolerate their distress and overcome their suffering.


SFBT - Solution-focused brief therapy - this short-term therapy approach focuses on building solutions rather than solving problems. It builds on one's existing strengths, skills, abilities, and resources to approach an issue.


EMDR - Eye Movement Desensitization and Reprocessing - This is NOT a therapeutic approach; this is a therapy tool used to reprocess traumatic events so that a past incident no longer has an effect on present-day life. It generally blends well with most of the above-mentioned approaches and can be used in conjunction.

 

The list literally could go on and on and half of the therapeutic approaches don't even come in acronym form. Please keep in mind, all of these approaches are just theories and have a ton of research to back up their effectiveness on certain mental health issues but they are far from perfect and are not cures for everything and everyone. When looking for a therapist, check their profiles and web pages and see what approaches they use. Do your homework and look them up. If you feel like therapy hasn't worked for you in the past, try a different approach. It probably isn't because therapy isn't working, it's probably because the approach wasn't a good fit (or maybe the therapist).


LASTLY, here's my unpopular opinion (rant) and advice:


When you look at therapist profiles online, be weary of any therapists who list all of the approaches. As you can see from what you've read above, not all approaches can work together. While some approaches are so similar it's hard to differentiate, some of these theories contradict each other. It would be like someone saying they were orthodox Jewish and also Catholic at the same time. It sounds like an identity crisis! And while there are "eclectic" therapists that utilize multiple therapeutic approaches, it should make sense that those would be able to jive together. But 21 different approaches listed?? (I'm looking at you, therapists on psychologytoday.com)

I call bullshit on someone who lists FOT and SFBT together and on top of 19 other approaches. And, I would hope, that whatever type of therapy practitioners are using for their clients, they are also utilizing it in their own lives and that they're not just haphazardly reaching into their magical cardigan for the coping skill of the day and no real sense of where this is going. Besides, if someone lists 21 different approaches (because that's what they say they do) how proficient do you suspect they can really be at any single one of them? These aren't things we generally cultivate through a short class on theory in grad school. These take days and hours of training to master and understand. No one is going to that many trainings or they'd probably understand that they're full of shit. Or maybe they're hoping that you don't know that they are.


So there you have it, folx. The mystery of the acronyms of therapy is explained and why it's important for you to know what you're looking at so that you can get the best care possible. Best wishes to those who are still in search of a good therapist, I hope that helps a little.









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