Empower Your Mental Health: a Crash Course in CBT, DBT and ACT

You. Hey there, everybody, and welcome to this video where we're going to be talking about the different types of cognitive behavioral therapy. I'm your host, Dr. Donnelly Snipes. A lot of people did not realize that there were multiple types of cbt. So that'll be really interesting. But before we get into that, let's talk about what CBT is not the first thing. Cognitive behavioral therapy is not cold and impersonal. CBT therapists want to develop a secure, safe relationship where you feel empowered. That's really important in any sort of therapeutic situation. So the CBT therapist isn't just going to start barking orders like a drill sergeant or doing things for or to you. CBT is not confrontational. When a person is talking to me, if I hear what I think might be a cognitive distortion, I might point that out. But if they disagree, if they think it's on point, then they are the expert on themselves. So take what's useful, leave the rest sort of approach. CBT is not something the therapist does to somebody. You're not going to go into CBT therapy and have somebod work magic on you. CBT involves helping you identify the thought patterns, the cognitions, the behavioral reactions and the emotions that are associated with those things and figure out the helpfulness or unhelpfulness of those patterns and ways to modify those patterns that will help you move toward your rich and meaningful life. And finally, CBT is not for everyone and not for every diagnosis. If you are wanting something that is less directive, less goal oriented, and more feeling focused, then you may choose a humanistic therapist. If you are wanting something, there's psychoanalytic therapy out there. There is psychodrama. There are a lot of different approaches, approaches. And part of therapy and part of recovery is being in an environment and working with tools that are meaningful to you. So if cognitive behavioral therapy just sounds too structured for you, okay, there are other options out there. Likewise, CBT isn't appropriate for every diagnosis. Trauma is the perfect example. Yes, there are trauma informed versions of cognitive behavioral therapy. And trauma informed therapists can very effectively implement CBT to help people address trauma. But that is not necessarily the way somebody may want to address their trauma. EMDR is a very well studied, very effective alternative, best practice to addressing trauma. So it's important for people to recognize that CBT is not the only way. And CBT may be a good fit for some but not others. So what is cbt? We discussed what it is not. Cognitive behavioral therapy is a method of addressing problems that recognizes the Interactions between cognitions or your thoughts, your behaviors, and ultimately your feelings. And I know feelings doesn't make it into the acronym, but that's really what we talk about. So when you have these thoughts, what urges does it cause? What behaviors does it trigger? What feelings does it trigger and why? When you have particular feelings, how does that affect your thoughts and your behaviors? When you do particular things, when you engage in certain behaviors, how does that impact your mood and your thinking? For example, when you do something that you really enjoy, it's probably going to make you feel happy and content, which will alter your perceptions because you're going to be viewing the world through a safe, empowered, happy lens. Cognitive behavioral therapy asserts that when there is a change in one area, it has similar effects on all the other areas. So if you do something for yourself, let's just pick an easy one like starting to get better quality sleep. All right, that doesn't sound like it's really related at all. But if you are engaging in that behavior and you're feeling more rested, how does that affect your ability to concentrate? How does that affect your sense of optimism or pessimism? How does that affect your energy levels? How does that affect your mood? And it affects everything. And generally that positive behavior is going to have positive effects on your mood as well as your thinking patterns and your ability to think clearly. The first thing I want to talk about is the difference between skills and methods. Cognitive behavioral therapy has many, many different skills. And I have one video where I went over 35 different cognitive behavioral therapy skills. Skills that people can use in order to begin to address their thoughts, their feelings and or their behaviors. But skills alone are not methods. So think of skills like all the tools in your toolbox. That's great, but you have to know how to apply those tools in order to make any progress. You have to know how to use those tools in order to build a bookcase, for example. So it's important to recognize that there's a difference. And there's a lot of people out there that use a variety of skills that may be attributed to dialectical behavior therapy or acceptance and commitment therapy. However, they're not implementing the method. So knowing the difference between seeing a therapist who helps you learn DBT skills skills and seeing a therapist that uses DBT method in treatment, they're very different things. Before we start talking about the different types, I want to point out that you can learn more@docsnipes.com we now have self guided trainings and concierge coaching and recovery support. You can also support the channel by donating any amount@docsnipes.com donate or on cash app at Doc Snipes. So let's talk about REBT first. REBT was one of the first waves of cognitive behavioral therapy. And REBT stands for rational emotive. So emotions are making it in there. Behavior therapy. So the rational really addresses the thoughts, E, the emotions and then the behaviors. When people use rebt, they can go through a technique, a skill called the abcde. A stands for activating event. What happened? C stands for consequences. This happened. I got cut off in traffic. What was the consequence? I got really upset. Okay, well, how did I get from A to C? What happened in the meantime? The belief is that there are a litany of automatic thoughts we have based on our prior experiences that guide our reactions to the event. You may think to yourself, that person has no respect for me. That person could have killed me. This whatever you think that triggered your sense of threat and led to the feeling of anger or anxiety. Okay, it is what it is. D stands for dispute and restructure beliefs that are inaccurate based on the facts in context. So you're going to go back over those beliefs? They're not all inaccurate. Some of them may be spot on. Maybe they did literally run you off the road and put your life in danger. Okay, well, you're not going to change that one if they didn't know. If you think you know what I'm saying, reacting more strongly to this than maybe it warrants. Okay, then you may restructure those beliefs. The person was had no respect for you. It's another thought that comes up. How do you know? You don't know what they thought. What are some alternative explanations for why they may may have cut you off? Maybe you were in their blind spot. Maybe they were talking on the phone to somebody. Yeah, they're not supposed to be doing that. And it is disrespectful. But it didn't have anything to do with you. So examining those beliefs, disputing and restructuring as appropriate, and then you're left with accurate beliefs based on the facts and context. The E stands for evaluating the consequences your behavioral and your emotional reactions to determine the effectiveness and alternatives. So let's say I got cut off in traffic and yeah, it was a really near miss and it scared the snot out of me. All right, that is a legit reaction. What is the effectiveness of me continuing to stay angry about it? Continuing to be fearful in driving for the rest of the day? What are my alternatives? Likewise Is it helpful to continue to hold on to this anxiety or not? How could I use my energy differently? Well, maybe I could use my energy to be more on guard, thinking, hey, I'm driving during rush hour and there are a lot of people that are distracted right now, so I need to be more on my game to protect myself from all those people who are distracted. So REBT is really the base skill, if you will, for cognitive behavioral therapy. I mentioned dialectical behavior therapy earlier. DBT adds on to REBT and Linehan includes tools that like mindful awareness and responsiveness to your needs. So you become mindfully aware of how you're feeling in the moment and accept radically accepting it and maybe even looking at the dialectics, which means taking the good with the bad. She talks about evaluating vulnerabilities that led up to your level of distress. Right now, can you do some backward chaining and find out, oh, hey, you know, normally this wouldn't bother me, but last night the baby kept me up all night and I was late getting to work today and blah, blah, blah, So I had all these other stressors. Now I understand how I got to this point. Now I understand my level of distress in this particular situation. And she talks about developing distress tolerance and vulnerability prevention skills. So you start to learn how to sit with distress instead of feeling like you got to make it go away right away. Which takes us to acceptance and commitment therapy or act. And one of the core features of ACT is the radical acceptance of how you feel in the moment. I'm angry, I'm depressed, I'm anxious. However you feel it is what it is and struggling with it, getting angry about still being depressed or feeling anxious because you think you're never going to feel happy again or whatever. When you start adding feelings onto it, you start turning up the volume, you're amplifying your distress, you're sinking lower or getting more stuck in the quicksand. Whatever analogy you want to use, ACT encourages you to be aware of what's important in your rich and meaningful life and regularly evaluate whether you're using your energy to move toward or away from the things that are important in that rich and meaningful life. And Hayes calls this purposeful action. And finally, Pieces. And this is my approach of integrative cognitive behavioral therapy. PIECES is a holistic, trauma, informed, solution, focused cognitive behavioral method that pulls together all of the pieces. I believe it's important to recognize the interaction between your physical health and your behaviors. If you're in pain, you're probably going to do things differently than if you're not in pain, Your interpersonal relationships, your emotions, your thoughts, environmental influences like triggers or just things that make you feel uncomfortable or comfortable, and your spiritual beliefs or your sense of meaning, purpose and connection in the world. Each one of these things influences every other one of these things. If you are anxious, just generally anxious most of the time, how does that impact you physically? How does it impact your sleep? How does that impact your pain levels? How does it impact your relationships? Your ability to trust others? Your energy to even interact with others because you're so stressed out all the time? Your other emotions, your ability to think clearly, Your sense of safety and comfort in the environment? Generally, when people are anxious, they tend to be more hyper vigilant and more sensitive to sensory stimuli. And how does anxiety impact your spiritual beliefs or your sense of meaning and purpose and connection to the world? Do you believe that they are there to support you and you're in a safe place place, or they're out to get you? Do you believe that what you're doing is making a difference, or do you believe that you're just kind of spinning your wheels and counting the days? Cognitive behavioral therapy approaches tend to be more analytical and action oriented, seeking to help people understand and address patterns and interactions in their life. The cognitive behavioral therapist is curious, provides support and compassion, and in addition to tools to help you move from understanding the problem to addressing the problem.