<p>In seeking treatment to anxiety issues, it seems the therapy of choice is Cognitive Behavioral Therapy.<br>
We have gone to a couple therapists who say they specialize in it, but…I sometimes feel like there isn’t much to it. Maybe that’s the way it’s supposed to be. Is it to be expected that it will be very simple changes discussed?
The routine has seemed to be talk about how things have been going, then maybe talk about a possible strategy…maybe one we’ve already been doing and plan to tweak, or maybe a new idea (like try to exercise more, or try to have a worry time during the day…).
Actually my D has felt worse when we are in the therapist’s office. She seems to like the therapist we have seen most recently. It’s just going to a place for people with ‘issues’ and then sitting there focusing on anxiety, makes her feel anxious. So we haven’t gone for a while. Her therapist said it was probably best not to make her go if it’s not comfortable, and that not doing anything, can actually be doing something in a way, using strategies already learned, etc. Much of what we have read agrees with this…that the main thing to do basically boils down to ‘just keep swimming’. 
I don’t know what I really expected appointments to be, but I have left wondering how we know if we are actually working with someone who is truly doing cognitive behavioral therapy or not.</p>
<p>Is that similar to DBT?
Im on the waiting list for one of these groups.
[Fremont</a> Community Therapy Project](<a href=“http://www.therapyproject.org/dbt.php]Fremont”>Fremont Community Therapy Project)</p>
<p>I have had cognitive therapy & that was good in a life coach sort of organizational way, but I needed a little more I think.</p>
<p>I don’t really know what helps with anxiety, it seems individual, but if certain situations make it worse, it does seem like having a plan could help, as long as they have an alternative if they cant implement that by themselves.</p>
<p>I don’t know if your daughter is on medication, and heaven knows I am not a pusher of meds, but oftentimes a little medication can make therapy more effective.
If you’re depressed and cant bring yourself to make any of the changes that would help, something that lifts your mood a little, might just be enough to keep going.
Same for anxiety.
And it doesnt necessarily mean they will need the meds for very long.</p>
<p>So the idea is that there are certain behaviors or feelings that are not likely to be changed by rational thought. Instead of “understanding”, the focus is on the behavior itself, and different strategies that will help overcome the maladaptive behavior. While it is true that feelings influence behavior, it is also true that behavior can influence feeling.</p>
<p>In some sense, it is “what works” therapy - if strategies work, one continues and expands them; if they don’t, other strategies are tried. DBT differs from CBT in that, while it uses CBT techniques, it also focuses on symptom tolerance and mindfulness. (DBT is usually considered a bit more heavy duty, in that simpler approaches to deal with symptoms may not have been sufficient in the past.)</p>
<p>Is there a reason you are doing the therapy along with your D? Does she want you to hear about all her anxieties? Are you sure she can be totally honest with you there?</p>
<p>On a large poster board, I list the 10 Irrational kinds of thinking, nicely explained in Feeling Good book (and workbook, and later works). Work with client to identify what he/she uses the most often. Use specific examples. Encourage client to come up with other strategies. role play. In a group setting, we use large blackboard, and participants add their suggestions. Have specific goals, practice, learn the triggers. Sometimes having a “good” parent present extends the treatment, as parent becomes a sounding board at home, and learns how/what to say with the client.</p>
<p>Besides learning different ways to think about a situation, one can also focus on styles, e.g. perfectionism, procrastination. Book chapters on the most common types.</p>
<p>Mini did a good job on DBT. The tapes are fairly heavy, and need to be seen repeatedly and discussed in small doses. Very helpful with bipolar disorder.</p>
<p>EK makes good point about when meds can help.</p>
<p>My comment is so brief to really capture CBT, but hope it helps a little.</p>
<p>The therapist must be specifically certified and trained in CBT. If you are not sure, ask about her credentials. Many therapists say they are using CBT but are not actually specializing in it.</p>
<p>Our child has preferred CBT to other talk therapy as it focuses more on moving forward and teaches specific techniques to counteract anxiety causing thoughts and situations. There is usually a lot of “homework” to practice these techniques.</p>