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# Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist

Advanced Therapy for Insight, Growth, and Performance

## Posts

### [Long-Distance Relationship Therapy: Managing and Enjoying Love From Afar](https://dralanjacobson.com/long-distance-relationship-therapy-managing-and-enjoying-love-from-afar/)

**Published:** September 11, 2026
**Author:** Dr. Alan Jacobson

**Content:**

Practical, evidence-based support for long-distance couples and long-distance marriages — delivered virtually, nationwide.

Long-distance relationships get a bad reputation they often don’t deserve. In my practice, I work with couples who are dating long-distance, engaged long-distance, and married long-distance — and what I see, over and over, is that distance itself rarely breaks a relationship. What breaks relationships is unmanaged uncertainty: no shared plan, no consistent communication rhythm, and no space to work through the specific stresses that come with loving someone you can’t reach out and touch. Long-distance relationship counseling gives couples exactly that structure, so the relationship doesn’t just survive the distance — it can genuinely thrive during it.

This page covers how I help couples manage and fully enjoy long-distance relationships, including a dedicated look at long-distance marriage, and where to go next if a specific issue — like [fear of intimacy](https://dralanjacobson.com/fear-of-intimacy/) or deciding whether to close the distance — is at the center of what you’re working through.

## Why Long-Distance Relationships Are Harder — And Why They Can Still Work

Long-distance couples face a specific set of pressures that geographically close couples don’t: fewer nonverbal cues, no shared physical routines, higher stakes attached to the time you do get together, and an open question about the future hanging over the relationship. It’s reasonable that these things create strain. What’s less well known is that research on long-distance relationships doesn’t support the idea that distance predicts failure. Recent work on long-distance couples, including a 2026 study in the *Journal of Social and Personal Relationships*, has found real social and relational benefits associated with managing a relationship across distance, particularly around communication quality and appreciation for time together.

The [Gottman Institute](https://www.gottman.com/blog/long-distance-relationships/) has written similarly: long-distance relationships can work as well as, or better than, geographically close ones when couples build intentional habits around communication, trust, and shared goals. The distance isn’t the deciding factor. How you manage it is.

## Common Challenges I Help Long-Distance Couples Work Through

- **Trust without daily visibility.** Learning to trust a partner you can’t observe day-to-day, without that trust curdling into anxiety or surveillance behavior.
- **Communication overload or communication avoidance.** Some long-distance couples talk constantly and still feel disconnected; others go quiet to avoid conflict they can’t easily repair over a screen.
- **Ambiguity about the future.** Not knowing when, or whether, the distance will end — and how to keep investing in a relationship with an open-ended timeline.
- **Intimacy and physical connection.** Sustaining emotional and physical closeness with limited in-person time, and navigating the adjustment period during visits and reunions.
- **Loneliness and resentment.** Especially when one partner’s daily life (a new city, a demanding job, a deployment) is largely invisible to the other.
- **Decision fatigue.** Constantly re-litigating whether, when, and how to close the distance, which can wear down even a strong relationship.

**A note on distance and closeness:** For some couples, the distance itself can start to feel protective — a way of staying connected without fully testing whether you can tolerate everyday proximity. If that sounds familiar, it may be less about the relationship and more about an underlying [fear of intimacy](https://dralanjacobson.com/fear-of-intimacy/), which is worth exploring on its own. 

## How I Help Long-Distance Couples Manage and Enjoy the Relationship

My approach to long-distance relationship therapy draws on the same evidence-based couples therapy modalities I use with geographically close couples — [Emotionally Focused Therapy (EFT)](https://dralanjacobson.com/eft-therapy-for-couples/), [Integrative Behavioral Couples Therapy](https://dralanjacobson.com/integrative-behavioral-couples-therapy/), and [Relational Life Therapy](https://dralanjacobson.com/relational-life-therapy-rlt/) — adapted specifically for the realities of distance. In sessions, we typically work on:

- Building a communication rhythm that feels sustainable rather than exhausting, instead of defaulting to constant contact or long silences
- Naming and working through the underlying attachment fears that distance tends to amplify — jealousy, reassurance-seeking, withdrawal
- Creating a realistic, mutually agreed-upon plan (or planning process) for the future of the relationship, so uncertainty has a container
- Rebuilding intimacy and connection during visits, without the pressure of trying to “fit a whole relationship” into a few days
- Addressing conflict patterns that get worse over video or text, where tone and nuance are easy to lose

Because long-distance couples are, by definition, spread across cities, states, or countries, I offer [virtual couples therapy](https://dralanjacobson.com/virtual-couples-therapy/) as a primary format — not a workaround. With PSYPACT authority covering 44 states and individual licensure in Massachusetts, California, New Hampshire, and New York, I can see both partners together on the same call even when they’re logging in from two different time zones.

## Managing a Long-Distance Marriage

Married couples living apart face a different set of demands than dating couples, because a marriage already carries shared finances, shared decisions, and often children or aging parents — all of which have to be coordinated across a distance. I regularly work with spouses navigating:

- **Military deployment or relocation**, where one spouse’s schedule and availability are largely outside either partner’s control
- **Work relocation**, including situations where one spouse has moved for a job while the other stays behind for children’s schooling, a lease, or their own career
- **Immigration and visa timelines**, where the length of separation is genuinely unknown
- **Caregiving obligations**, such as one spouse relocating temporarily to care for an aging or ill parent

In [marriage counseling](https://dralanjacobson.com/marriage-counseling/) adapted for long-distance couples, we focus on keeping the marriage itself — not just the logistics of it — strong: maintaining emotional and physical intimacy without regular contact, making joint decisions when one partner has more day-to-day information than the other, co-parenting across two households when children are involved, and managing the isolation that can build in a marriage even when the underlying relationship is solid. The goal isn’t simply getting through the separation. It’s coming out the other side of it as close, or closer, than you started.

### Composite Example: Coordinating a Long-Distance Marriage Through a Deployment

*The following is a composite illustration based on common presenting concerns, not a specific client.* A married couple came to therapy six months into a military deployment that had already been extended once, with no firm end date. Both partners described feeling “fine” individually but increasingly distant from each other — conversations had become logistical, focused on finances and their child’s schedule, with little room for anything else. Over several sessions, we worked on rebuilding a communication rhythm that made space for connection, not just coordination, and helped both partners name the ambiguous loss each was carrying separately. By the time of reunification, they had a concrete plan for the transition home, which they credited with making the return far smoother than either expected.

## Deciding Whether to Close the Distance

At some point, most long-distance couples face a decision point: relocate, propose, move in together, or reassess whether to continue. These decisions carry real weight, and they’re often made under time pressure — a lease ending, a job offer, a family expectation — that doesn’t leave much room for genuine reflection. [Discernment counseling and pre-engagement counseling](https://dralanjacobson.com/discernment-counseling-pre-engagement-counseling/) give both partners a structured, low-pressure way to clarify what each of you actually wants, separately and together, before making a decision that’s difficult to reverse. For long-distance couples specifically, this often means examining honestly whether the relationship works because of the distance, in spite of it, or some of both — so that closing the gap is a decision made with clear eyes, not just relief at the idea of finally being in the same place.

If distance isn’t the core issue — if communication, trust, infidelity, or a general sense of disconnection is what’s bringing you to therapy — my general [couples therapy](https://dralanjacobson.com/couples-therapy/) page covers the full range of concerns I work with, long-distance or not.

## Where to Go From Here

[Couples Therapy*The full range of issues I work with →*](https://dralanjacobson.com/couples-therapy/)[Marriage Counseling*For long-distance and local marriages →*](https://dralanjacobson.com/marriage-counseling/)[Discernment Counseling*Deciding whether to close the distance →*](https://dralanjacobson.com/discernment-counseling-pre-engagement-counseling/)[Fear of Intimacy*When distance becomes a buffer →*](https://dralanjacobson.com/fear-of-intimacy/)[Virtual Couples Therapy*Nationwide, PSYPACT-licensed sessions →*](https://dralanjacobson.com/virtual-couples-therapy/)

### Ready to Start Long-Distance Relationship Counseling?

Sessions are available virtually nationwide, with both partners able to join from different locations.

[Schedule a Free Consultation](https://www.picktime.com/scheduleaconsult)

## Long-Distance Relationship Therapy: FAQ

Can a long-distance relationship actually work long-term?Yes. Research on long-distance couples consistently finds that geographic separation, by itself, does not predict relationship failure — several studies show long-distance partners report communication and trust levels equal to or higher than geographically close couples, largely because distance forces more intentional conversation. What predicts success is how a couple manages the distance: whether they have built reliable communication rituals, agreed on a realistic timeline for closing the gap, and can tolerate the uncertainty in between. In therapy, I help long-distance couples build exactly that structure so distance becomes a manageable chapter rather than a constant strain.

What is the biggest challenge long-distance couples bring to therapy?The challenge I see most often isn’t communication frequency — most long-distance couples talk constantly. It’s uncertainty: not knowing when, or whether, the distance will end, and carrying that ambiguity while still trying to build trust and intimacy. That uncertainty tends to show up as low-grade anxiety, jealousy, or conflict over small things that are really about the bigger unresolved question. Long-distance relationship counseling gives couples a structured space to name that uncertainty directly, decide together how to handle it, and rebuild a sense of security even before the geography changes.

How does discernment counseling help long-distance couples decide whether to close the distance?When one partner is weighing a move, a job change, or a proposal to finally live in the same city, the stakes can feel too high to talk through alone. Discernment counseling and pre-engagement counseling give both partners a structured, low-pressure format to clarify what they each actually want — separately and together — before making an irreversible decision. For long-distance couples specifically, this often means examining whether the relationship works because of the distance, in spite of it, or somewhere in between, so the decision to close the gap is made with clear eyes.

Can distance itself become a way to avoid real intimacy?Sometimes, yes. Distance can function as a built-in safety valve — it allows a couple to feel deeply connected during visits and calls while never fully testing whether they can tolerate day-to-day closeness. For partners with an underlying fear of intimacy, long distance can feel easier than living together precisely because it limits exposure to the vulnerability that constant proximity requires. This isn’t true for every long-distance couple, but when a relationship has stayed long-distance far longer than circumstances require, it’s worth exploring together in therapy.

We’re married but living apart for work, military service, or family caregiving — do you work with that?Yes. A long-distance marriage brings its own pressures — coordinating finances and parenting across two households, maintaining physical and emotional intimacy without regular contact, and managing the isolation that can build even with a strong marriage underneath it. I work with married couples navigating deployment, relocation for work, immigration timelines, and caregiving obligations that keep them apart, using marriage counseling approaches adapted for partners who may be in different time zones or countries. The goal is a marriage that stays strong across the distance, not just one that survives it.

Do you offer virtual couples therapy if we live in different states?Yes. I hold PSYPACT authority covering 44 states, along with individual licensure in Massachusetts, California, New Hampshire, and New York, so I can provide virtual couples therapy to long-distance partners even when they’re logging in from two different states — which is often exactly the situation long-distance couples are in. Sessions happen over secure video, and many long-distance couples find it easier to schedule consistent therapy this way than to coordinate an in-person appointment around visits.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Couples Therapies

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### [Perfectionism and Its Link to Anxiety and Burnout](https://dralanjacobson.com/perfectionism-and-its-link-to-anxiety-and-burnout/)

**Published:** September 8, 2026
**Author:** Dr. Alan Jacobson

**Content:**

Perfectionism · Anxiety & Burnout

High standards aren’t the problem. It’s the specific flavor of perfectionism, the fear of ever falling short of them, that quietly drives anxiety and burns people out.

9 min read · Anxiety & Performance-Related Stress

**The short version:** Research distinguishes two components of perfectionism: high personal standards (“perfectionistic strivings”) and the harsh self-criticism and fear of mistakes that often rides along with them (“perfectionistic concerns”). It’s specifically the second component that’s strongly linked to both anxiety and burnout, not ambition or high standards on their own. That distinction matters, because it means the goal in therapy usually isn’t to lower your standards, it’s to separate them from the fear driving them. 

In this article

- [The perfectionism most people miss: strivings vs. concerns](#two-kinds)
- [How perfectionism turns into anxiety](#anxiety-link)
- [How perfectionism turns into burnout](#burnout-link)
- [Signs it’s crossed a line](#signs)
- [What actually helps](#what-helps)
- [Frequently asked questions](#faq)

.38–.43Correlation between perfectionistic concerns and anxiety symptoms in adults, across a systematic review1

Medium–LargeSize of the relationship between perfectionistic concerns and burnout, per a 43-study meta-analysis2

BidirectionalA 2024 longitudinal study found perfectionism and anxiety symptoms predict increases in each other over time3

## The Perfectionism Most People Miss: Strivings vs. Concerns

Clinical research on perfectionism splits it into two components that feel similar day to day but behave very differently. **Perfectionistic strivings** are the setting of very high personal standards. **Perfectionistic concerns** are the fear of not meeting them: harsh self-criticism after a mistake, chronic doubt about whether your work is “good enough,” and a sense that your worth is on the line every time you’re evaluated.

A meta-analysis of 43 studies and nearly 10,000 participants found that perfectionistic concerns had a medium-to-large positive relationship with burnout, while perfectionistic strivings had only a small or non-significant relationship, and once statistically separated from the concerns component, “pure” strivings actually related negatively to burnout.2 In plain terms: wanting to do excellent work doesn’t burn people out. Being terrified of what it means about you if you don’t is what burns people out.

## How Perfectionism Turns Into Anxiety

Perfectionistic concerns and anxiety share the same underlying machinery: a threat-detection system that’s constantly scanning for the possibility of failure, judgment, or falling short. A systematic review and meta-analysis of adult perfectionism research found perfectionistic concerns correlated with anxiety, OCD, and depressive symptoms at a consistent medium strength (r = .38 to .43), describing perfectionism as a transdiagnostic process that cuts across several conditions rather than being specific to any one of them.1 A companion meta-analysis found a similar pattern in young people specifically.4

A 2024 longitudinal study using cross-lagged modeling found something further: the relationship runs in both directions over time. Perfectionistic concerns predicted later increases in generalized anxiety and depressive symptoms, and those symptoms in turn predicted further increases in perfectionistic concerns.3 That reciprocal loop is a big part of why perfectionism-driven anxiety can feel so entrenched: each bad outcome doesn’t just cause distress, it reinforces the belief that intense self-monitoring is necessary to prevent the next one.

## How Perfectionism Turns Into Burnout

Burnout, characterized by exhaustion, cynicism or detachment, and a reduced sense of effectiveness, is exactly what you’d expect from a nervous system that treats every task as a referendum on your worth. The same meta-analysis found this pattern held across work, academic, and sport domains, with the relationship between perfectionistic concerns and burnout sometimes even stronger specifically in workplace settings.2 This is a common pattern we see in high-achieving clients, executives, founders, students at competitive schools, whose perfectionism was rewarded for years before it eventually became the thing driving them into the ground.

**An important nuance:** this isn’t an argument against having high standards, and therapy for perfectionism-driven anxiety or burnout isn’t about talking someone into caring less or aiming lower. The research is fairly clear that pure perfectionistic strivings, high standards without the self-critical fear attached, aren’t strongly linked to burnout and may even be protective.2 The actual target is the fear and self-criticism riding alongside the standards, not the standards themselves. 

**Signs perfectionism has crossed into a problem:** your sense of self-worth rises and falls almost entirely with performance; a single mistake feels catastrophic rather than normal; you procrastinate or avoid starting things specifically because you’re afraid of doing them imperfectly; you can’t enjoy an accomplishment because you’re already worried about the next one; or you’re experiencing physical exhaustion, cynicism, or a flattened sense of effectiveness at work or school. 

## What Actually Helps

Two evidence-based directions stand out. First, cognitive behavioral therapy for generalized anxiety appears to reduce perfectionism as a byproduct of treatment, not just anxiety symptoms themselves, which fits with the idea that the two are tangled together rather than separate problems requiring separate treatments.5 Second, self-compassion-focused approaches target the self-criticism component directly: a randomized controlled trial of a brief self-compassion intervention found significant reductions in maladaptive perfectionism alongside reductions in anxiety and depression symptoms.6 Self-compassion research consistently finds it’s associated with lower perfectionism while still correlating positively with high personal standards, which lines up with the strivings-versus-concerns distinction: you can keep the standards and lose the fear.

### Separate the standard from the story about what missing it means

“I want this to be excellent” and “if this isn’t excellent, I’ve failed as a person” are two different beliefs. Therapy often starts by making that distinction explicit, since most people have never separated them.

### Practice noticing self-criticism as data, not truth

The harsh internal commentary after a mistake feels like accurate feedback. Learning to notice it as a habitual pattern, rather than an objective assessment, is often the first real shift.

### Build in evidence that “good enough” doesn’t lead to disaster

Deliberately submitting something at 90% instead of 100%, on a low-stakes task, and observing that the world doesn’t end, is a form of exposure that directly challenges the fear driving perfectionistic concerns.

If perfectionism is tangled up with generalized worry, panic, or another anxiety pattern, our overview of [types of therapy for anxiety](https://dralanjacobson.com/best-types-of-therapy-for-anxiety/) covers how CBT, ACT, and other approaches are matched to different presentations. If burnout is showing up specifically in a work or leadership context, this pattern comes up often in [executive coaching](https://dralanjacobson.com/executive-coaching/) and [founder coaching](https://dralanjacobson.com/founder-coaching/) as well as in individual therapy.

Related resources

- [Best Types of Therapy for Anxiety](https://dralanjacobson.com/best-types-of-therapy-for-anxiety/)
- [Acceptance and Commitment Therapy (ACT)](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/)
- [Cognitive Behavioral Therapy (CBT)](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/)
- [Personal Growth Counseling](https://dralanjacobson.com/personal-growth-counseling/)
- [Sports Psychology](https://dralanjacobson.com/sports-psychology/) — for performance-related perfectionism
- [Which Type of Therapy Is Right for You?](https://dralanjacobson.com/which-type-of-therapy-is-right-for-you-a-practical-guide/)

### Recognize yourself in this?

A free consultation is a low-pressure way to talk through what perfectionism has been costing you, and what a different relationship with your own standards could look like.

[Schedule a Free Consultation](https://www.picktime.com/scheduleaconsult)[Explore Individual Therapy](https://dralanjacobson.com/individual-therapy/)

Is perfectionism itself a mental health diagnosis?No, perfectionism isn’t a standalone diagnosis. Research describes it as a transdiagnostic trait, meaning it shows up across and contributes to several conditions, including generalized anxiety disorder, OCD, and depression, rather than being a diagnosis on its own.

Is all perfectionism unhealthy?No. Research distinguishes “perfectionistic strivings” (high personal standards) from “perfectionistic concerns” (fear of mistakes and harsh self-criticism). Strivings alone aren’t strongly linked to anxiety or burnout and may even be protective; it’s the concerns component, the fear and self-criticism, that drives negative outcomes.

Why does perfectionism lead to burnout instead of just better results?Burnout involves chronic exhaustion, cynicism, and a reduced sense of effectiveness, which tends to result from sustained stress rather than sustained effort alone. When self-worth is tied to flawless performance, ordinary setbacks are experienced as threats, keeping the nervous system in a chronically activated state that eventually depletes rather than sustains performance.

Can perfectionism cause anxiety even without a diagnosable anxiety disorder?Yes. Perfectionistic concerns are associated with anxiety symptoms on a continuum, and someone can experience significant perfectionism-driven anxiety, chronic worry, self-criticism, fear of evaluation, without meeting full criteria for an anxiety disorder. It’s still a legitimate reason to seek support.

Will therapy make me lower my standards?Not typically, and that’s usually not the goal. Effective treatment tends to target the fear and self-criticism attached to your standards rather than the standards themselves, since research suggests high standards alone aren’t what drives anxiety or burnout.

What’s the difference between healthy ambition and perfectionism-driven burnout?Healthy ambition tends to coexist with the ability to feel satisfaction after a good outcome and to tolerate an imperfect one without a collapse in self-worth. Perfectionism-driven burnout usually involves an inability to feel “done,” ongoing self-criticism regardless of results, and physical or emotional exhaustion that doesn’t resolve with rest alone.

**Sources**1. Limburg, K., et al. “The relationships between perfectionism and symptoms of depression, anxiety and obsessive-compulsive disorder in adults: a systematic review and meta-analysis.” *Cognitive Behaviour Therapy* (2023). [tandfonline.com](https://www.tandfonline.com/doi/full/10.1080/16506073.2023.2277121)
2. Hill, A. P., & Curran, T. “Multidimensional Perfectionism and Burnout: A Meta-Analysis.” *Personality and Social Psychology Review*, 20(3), 269-288 (2016). [journals.sagepub.com](https://journals.sagepub.com/doi/abs/10.1177/1088868315596286)
3. “Perfectionism as a transdiagnostic process in depression and generalized anxiety disorder: Evidence from a longitudinal study of young women.” (2024). [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/42190294/)
4. “Associations between perfectionism and symptoms of anxiety, obsessive-compulsive disorder and depression in young people: a meta-analysis.” *Cognitive Behaviour Therapy* (2023). [tandfonline.com](https://www.tandfonline.com/doi/full/10.1080/16506073.2023.2211736)
5. “The relationship between perfectionism and treatment outcomes among people receiving internet-based cognitive behaviour therapy for Generalised Anxiety Disorder.” *Cognitive Behaviour Therapy* (2025). [tandfonline.com](https://www.tandfonline.com/doi/full/10.1080/16506073.2025.2465737)
6. “A Randomized Control Trial of a Brief Self-Compassion Intervention for Perfectionism, Anxiety, Depression, and Body Image.” *Frontiers in Psychology* (2021). [pmc.ncbi.nlm.nih.gov](https://pmc.ncbi.nlm.nih.gov/articles/PMC8695611/)

![Perfectionism and Anxiety and Burnout](https://dralanjacobson.com/wp-content/uploads/2026/09/aioseo-ai-perfectionism-medium-landscape-20260908-143852-1024x687.jpeg "Perfectionism | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist") ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Symptom Relief

---

### [College Counseling Centers vs. Private Therapy: Working Together](https://dralanjacobson.com/college-counseling-centers-vs-private-therapy-working-together/)

**Published:** September 5, 2026
**Author:** Dr. Alan Jacobson

**Content:**

College Mental Health · How the Two Systems Fit Together

College counseling centers and outside therapists aren’t competitors. They’re built for different jobs, and the best outcomes often come from using both.

10 min read · Therapy for Young Adults

**The short version:** College and university counseling centers are staffed by skilled, dedicated clinicians and are designed around a stepped-care model built for triage, crisis response, and short-term support during the academic year. That design is a strength for what it’s built to do, and it’s also exactly why centers routinely and appropriately refer students to outside private-practice therapists for longer-term, specialized, or year-round care. Understanding the difference in mission, not quality, helps students and families choose well and use both resources as intended. 

In this article

- [What college counseling centers are built to do well](#what-centers-do-well)
- [The structural reality behind session limits and referrals](#structural-reality)
- [Side-by-side: two different designs, not two different quality levels](#comparison-table)
- [How the two work well together](#working-together)
- [Frequently asked questions](#faq)

Every fall, a familiar question comes up for students and the families supporting them: should I use my college’s counseling center, find an outside therapist, or both? It’s worth saying clearly up front: college counseling centers do genuinely excellent, often under-resourced and under-appreciated, work. Many of the students I see privately have already had a positive experience at their campus counseling center, and a meaningful number are referred to me directly by counselors there, who know their limitations honestly and want their students matched with the right level and length of care. This piece isn’t about which option is “better.” It’s about what each one is actually designed to do, so that the choice (or the referral) makes sense rather than feeling like a rejection or a downgrade.

## What college counseling centers are built to do well

Modern campus counseling centers, sometimes called CAPS (Counseling and Psychological Services), have moved toward what’s known as a **stepped-care model**: a system that matches students to the right intensity of support quickly, starting with lighter-touch options (a single consultation, brief screening, group support) and stepping up to more intensive individual care only as needed. Reporting on this shift has described counseling centers organizing care into clinical tracks, including a single-session track, a brief-counseling track (roughly one to three sessions), a crisis-management track, a short-term individual track (often six to eight sessions within a semester), and, notably, a **transition-of-care track** specifically built to connect students who want ongoing counseling with a community provider.1 That last track isn’t a failure of the system; it’s a designed, intentional feature of it.

This structure lets centers do several things well: same-day crisis response (centers reported an average of about 125 unique students seen for crisis appointments and 166 crisis appointments overall in the most recent national survey year), free or low-cost access embedded directly in student life, and, for many students, real and measurable benefit — 73% of counseling center clients in that survey reported that services positively affected their academic performance, and 71% said counseling helped them stay in school.2 Centers also increasingly embed counselors directly within athletics departments, specific schools, or residence life, meeting students where they already are.2

6–8Sessions in a typical short-term counseling-center track per semester1

9.2Average full-time-equivalent clinical staff at a four-year college counseling center2

73%Of counseling-center clients who said services helped their academic performance2

## The structural reality behind session limits and referrals

Given that design, it’s easier to understand why session limits and referrals to outside providers are so common, and why they reflect capacity and mission rather than a judgment about a student’s need. According to the most recent national survey of counseling center directors, 43% of institutions cap the number of sessions a student can access in a given year, while a slight majority (55%) have no formal limit but still work within a short-term framework in practice.2 Staffing is stretched thin nationally: one recent survey of CAPS directors found 80% of centers operating at a ratio of at least one counselor per 500 students, with nearly half reporting one counselor for every 1,000 or more students.3 Centers also lose roughly 12% of their clinical staff to turnover in a typical year, most often citing salary and working conditions rather than dissatisfaction with the work itself.2

Put together, this explains the handful of situations, described directly on my [page on therapy for college students](https://dralanjacobson.com/therapy-for-college-students/), where a counseling center will refer a student to an outside private practice: when a concern is best addressed year-round rather than only during the academic calendar, when it extends beyond what a campus’s educational mission is set up to treat, or when a student needs a specialty (sports psychology, fear of flying, certain evidence-based protocols) that a given center doesn’t have on staff. None of these are about a student being “too much” for the center to handle well — they’re about matching a student’s actual needs to the setting built for them.

**Give credit where it’s due:** the clinicians working inside these systems are not the constraint; the structure is. A counselor managing a caseload under a 1:500 or 1:1,000 ratio, inside a stepped-care model built around brief tracks, is making smart, defensible clinical decisions about how to serve the most students well. A referral out is frequently the most clinically sound choice available to them, not a workaround for a service gap. 

## Side-by-side: two different designs, not two different quality levels

FeatureTypical College Counseling CenterPrivate-Practice TherapyCostFree or low-cost, funded through student feesPrivate pay; often reimbursable in part through out-of-network insurance benefitsSession modelStepped care with brief, short-term, and crisis tracks (often 1–8 sessions)1Open-ended, determined by clinical need rather than a fixed trackCalendarGenerally follows the academic year, with limited summer/break coverageYear-round, continuous through breaks, summers, and after graduationLocation continuityTied to the specific campusWith PSYPACT-licensed providers, can continue across home and school statesSpecialty depthBroad generalist coverage; specialty availability varies by center and staffingCan be selected specifically for a clinical specialty or modalityCrisis responseOften same-day or walk-in, embedded in campus emergency systemsScheduled care; not typically a same-day crisis resource

## How the two work well together

Because these are two designs for two different jobs, plenty of students use both at once, or move between them, without it being a sign that either one “failed.” A student in crisis or needing same-day support is well served starting at their counseling center. A student who wants weekly, uninterrupted work on an anxiety pattern that started in high school, or who needs a specific clinical specialty, is often better served, from the start or after a warm transition-of-care referral, by an outside private practice. Some students genuinely benefit from both simultaneously: campus-based group support or workshops alongside individual work with an outside therapist.

If you’re a student weighing this choice, or a counselor considering a referral, my [Therapy for College Students](https://dralanjacobson.com/therapy-for-college-students/) page goes into more detail on how I specifically work with students transitioning from a campus counseling relationship, including how [choosing the right therapeutic approach](https://dralanjacobson.com/which-type-of-therapy-is-right-for-you-a-practical-guide/) and using [virtual therapy](https://dralanjacobson.com/virtual-therapy-guide/) can make year-round, cross-state continuity practical for a student who splits time between a dorm and a home address.

Related resources

- [Therapy for College Students](https://dralanjacobson.com/therapy-for-college-students/) — full overview of services and approach
- [Which Type of Therapy Is Right for You?](https://dralanjacobson.com/which-type-of-therapy-is-right-for-you-a-practical-guide/)
- [Group Therapy for Young Adults](https://dralanjacobson.com/group-therapy-for-young-adults/)
- [ADHD Coaching for College Students](https://dralanjacobson.com/adhd-coaching-for-college-students-effective-enduring/)
- [Virtual Therapy Guide](https://dralanjacobson.com/virtual-therapy-guide/)
- [College Accommodations Testing](https://psychologicalassessments.com/college-accommodations/)
- [Therapeutic Tutoring for College Students](https://therapeutictutoring.com/therapeutic-tutoring-for-college-students/)

If a counseling center refers you or your student elsewhere, it’s worth reading that referral for what it usually is: a thoughtful clinical decision made by people who know their own system well, aimed at getting the right level and length of care, not a sign that anything went wrong.

### Referred by your counseling center, or considering outside support?

I work closely with campus counseling centers nationwide and regularly provide the year-round, specialized, or longer-term care that complements what they do best.

[Schedule a Free Consultation](https://www.picktime.com/scheduleaconsult)[Explore Therapy for College Students](https://dralanjacobson.com/therapy-for-college-students/)

Does it mean something is wrong with me if my counseling center refers me elsewhere?No. Referrals typically happen because of how the center’s model is structured, not because of anything about the student. Many centers use a “transition-of-care” track specifically designed to connect students who want longer-term counseling with a community provider, which is a normal, planned part of how these systems work.

Why do college counseling centers have session limits?Most centers operate on a stepped-care model designed to serve as many students as possible with brief, short-term, and crisis-focused tracks, often six to eight sessions per semester for standard individual counseling. With staffing ratios frequently at one counselor per 500 to 1,000 or more students nationally, session limits and short-term tracks are how centers extend care responsibly across their whole student population.

Can I use my college counseling center and an outside therapist at the same time?Yes, and many students do. It’s common to use a counseling center for crisis support, workshops, or brief check-ins while working with an outside therapist for ongoing, weekly individual therapy, especially around concerns that predate college or are expected to continue after graduation.

What happens to my counseling center support during school breaks or after graduation?Most college counseling centers primarily operate on the academic-year calendar, with limited coverage over the summer or extended breaks, and services generally end at graduation. This is one of the most common reasons for a referral to outside private-practice therapy, which can continue without interruption year-round and beyond a student’s time at the institution.

How is an outside therapist able to see me both at school and at home?Psychologists who participate in PSYPACT, an interstate compact for telepsychology, can provide services to clients located in any of the many participating states without needing a separate license in each one. For a student who splits time between a home state and a school state, this means therapy can continue without a gap, rather than needing to restart with a new provider each semester.

Are college counseling centers a good place to start even if I might need more than they offer?Often, yes. Counseling centers are well positioned for initial assessment, crisis support, and short-term work, and their clinicians are typically well informed about when a concern would benefit from a referral. Starting there and being referred onward, if needed, is a normal and often efficient path, not a wasted step.

**Sources**1. Inside Higher Ed. “Counseling Centers Triage Students by Mental Health Needs.” [insidehighered.com](https://www.insidehighered.com/news/2023/04/07/counseling-centers-triage-students-mental-health-needs)
2. Association for University and College Counseling Center Directors (AUCCCD). 2023-2024 Annual Survey Report. Summarized in Inside Higher Ed, “Counseling Center Demand on the Decline, Staffing Issues Remain” (March 11, 2025). [insidehighered.com](https://www.insidehighered.com/news/student-success/health-wellness/2025/03/11/report-college-campus-counseling-center-usage-and)
3. TimelyCare. Survey of CAPS Directors, December 2025. Summarized in “How Wait Times Impact the Health and Well-Being of College Students.” [timelycare.com](https://timelycare.com/blog/how-wait-times-impact-the-health-and-well-being-of-college-students/)

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Young adults and College Students

---

### [Signs Your Family Would Benefit from Therapy](https://dralanjacobson.com/signs-your-family-would-benefit-from-therapy/)

**Published:** August 31, 2026
**Author:** Dr. Alan Jacobson

**Content:**

For Families & Adult Relatives

Every family has friction. This is about telling the difference between a rough patch and a pattern that’s quietly running the relationship.

 🖋️ Dr. Alan Jacobson, Psy.D., MBA ⏱️ 7 min read 🔬 Clinically reviewed 

Families rarely arrive at therapy after a single bad conversation. More often, it’s the accumulation — the same argument resurfacing in new clothes, a sibling relationship that’s gone quiet, a holiday gathering everyone privately dreads. None of that means a family is broken. It usually means the patterns holding things together need a new structure, guided by someone outside the system who isn’t holding any of the old roles.

 **Quick answer:** A family may benefit from therapy when the same conflicts keep resurfacing without resolution, communication has become guarded or avoidant, a major transition has strained relationships, or one relationship’s tension is quietly affecting everyone else. Family therapy isn’t about identifying who’s at fault — it’s about changing patterns that no longer serve anyone. See our [family therapy overview](https://dralanjacobson.com/family-therapy/) for how the process actually works. 

### In this article

1. [This is about patterns, not perfection](#patterns)
2. [Signs worth paying attention to](#signs)
3. [Common moments that bring families to therapy](#triggers)
4. [Does family therapy actually work?](#works)
5. [What family therapy is not](#not)
6. [Frequently asked questions](#faq)

## This Is About Patterns, Not Perfection

Disagreement, distance, and the occasional blow-up are normal in any family — they’re not, by themselves, signs that something is wrong. What tends to indicate a deeper pattern worth addressing is *repetition without resolution*: the same conflict, the same silence, the same walking-on-eggshells feeling, showing up again and again regardless of who apologizes or how much time passes.

## Signs Worth Paying Attention To

#### Communication signs

- Conversations that reliably end in the same argument
- Topics everyone has quietly agreed not to bring up
- Family members communicating through a third person

#### Roles & conflict signs

- One person consistently cast as the “problem”
- Coalitions or sides that form during disagreements
- Old roles (peacemaker, scapegoat, caretaker) that feel stuck

#### Emotional climate signs

- Gatherings that feel tense before anything’s even happened
- A sense of walking on eggshells around certain topics or people
- Closeness that’s quietly faded without a clear cause

## Common Moments That Bring Families to Therapy

Families often reach out around a specific transition or turning point rather than a single crisis:

#### Frequent starting points

- Adult children and parents wanting a different kind of relationship — see [adult family therapy](https://dralanjacobson.com/adult-family-therapy/)
- Sibling relationships strained by old roles or long-standing conflict — see [adult sibling therapy](https://dralanjacobson.com/adult-sibling-therapy/)
- A relationship that’s gone cold or distant — see [family estrangement therapy](https://dralanjacobson.com/family-estrangement-therapy/)
- Blending households after a remarriage or new partnership — see [blended family therapy](https://dralanjacobson.com/blended-family-therapy-step-parent-counseling/)
- Political or values-based conflict that’s spilled into every gathering — see [therapy for political differences](https://dralanjacobson.com/politics-and-family-therapy/)
- A specific, recurring relationship strain, such as a mother-daughter dynamic — see [mother-daughter therapy](https://dralanjacobson.com/mother-daughter-therapy/)

## Does Family Therapy Actually Work?

Yes — and it’s one of the more thoroughly studied areas of psychotherapy. A 2025 review of the evidence base for couple and family-systemic interventions in adult-focused problems found that these approaches are, across a wide range of concerns, as effective as individual therapy, and more effective for certain issues, including relationship distress and reducing situational intimate partner conflict ([Carr, 2025, Journal of Family Therapy](https://doi.org/10.1111/1467-6427.12481)). The evidence spans relationship distress, mood and anxiety difficulties, and adjustment to major life stressors — the kinds of everyday strains that bring most families to therapy in the first place.

## What Family Therapy Is Not

 **It’s not about assigning blame.** Effective family therapy treats the relationship system as the client, not any one individual. Even when one person’s behavior is the presenting concern, the underlying patterns usually involve everyone. 

 **It doesn’t require everyone to be equally on board at first.** Motivation often varies among family members, especially early on — that’s normal, not a reason to wait until everyone is equally enthusiastic. 

### Recognize some of these patterns?

A consultation is a low-pressure way to talk through what your family is experiencing and whether family therapy is the right next step.

 [Schedule a Consult](https://www.picktime.com/scheduleaconsult) [Explore Family Therapy Approaches](https://dralanjacobson.com/which-type-of-family-therapy-is-right-for-you/)

## Frequently Asked Questions

  Does everyone in the family need to attend every session?Not necessarily. Family therapy can involve the whole household, a specific pair of relationships, or shift over time depending on what’s being addressed. A therapist can help determine who should be involved and when.

   What if one family member doesn’t want to participate?This is common, and it doesn’t have to stop the process. Sometimes work begins with the members who are willing, and others join later as trust builds — or an individual client works on family-related patterns even if not everyone attends.

   Is family therapy only for families in crisis?No. Many families seek therapy proactively, around a transition or a pattern they want to change before it becomes a bigger problem, not only after a major rupture.

   How is family therapy different from one person just going to individual therapy?Individual therapy focuses on one person’s experience. Family therapy treats the relationship system itself as the focus, which is often more effective when the difficulty lives primarily in how people interact rather than within any one person.

   What if we’ve tried talking things out on our own and it hasn’t helped?That’s one of the clearest signs family therapy could help. A trained therapist can see patterns that are difficult to notice from inside the relationship, and can guide conversations in ways that are hard to replicate without outside structure.

   Can family therapy help with adult children and parents, not just younger kids?Yes — this is actually a common and well-supported focus area, including relationships between adult siblings, adult children and parents, and extended family, not just families with young children still at home.

#### Sources & Further Reading

1. Carr, A. (2025). [Couple therapy and systemic interventions for adult-focused problems: The evidence base.](https://doi.org/10.1111/1467-6427.12481) Journal of Family Therapy.
 
This article is for informational purposes and is not a substitute for individualized clinical guidance.

![Signs your Family Could Benefit from Therapy](https://dralanjacobson.com/wp-content/uploads/2026/08/Family-Therapy-Signs-1024x538.png "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist") ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Family therapies

---

### [Signs You Might Benefit From Therapy](https://dralanjacobson.com/signs-you-might-benefit-from-therapy/)

**Published:** August 30, 2026
**Author:** Dr. Alan Jacobson

**Content:**

Getting Started With Therapy

You don’t need a diagnosis or a crisis to benefit from therapy — just something that’s been sitting heavier than it should for longer than it should.

 🖋️ Dr. Alan Jacobson, Psy.D., MBA ⏱️ 7 min read 🔬 Clinically reviewed 

Most people wait far longer than they need to before starting therapy — often telling themselves it’s not “bad enough” yet, that they should be able to handle it alone, or that therapy is for other people’s problems, not theirs. In reality, therapy is one of the few forms of care that works just as well for everyday struggles as it does for diagnosable conditions. The question isn’t really “is this serious enough” — it’s “is this costing me more than it should.”

 **Quick answer:** You might benefit from therapy if a feeling, pattern, or life event has been affecting your mood, relationships, work, or daily functioning for a while, and your own efforts and support system haven’t fully resolved it. Therapy isn’t reserved for crises — research shows it helps across a wide range of struggles, from clinical conditions to everyday stress and life transitions. If any of the signs below sound familiar, it may be worth exploring our [therapy approaches](https://dralanjacobson.com/types-of-therapy/). 

### In this article

1. [You don’t need to be in crisis](#no-crisis)
2. [Signs worth paying attention to](#signs)
3. [Common life moments that bring people to therapy](#moments)
4. [Why people wait — and why that’s costly](#waiting)
5. [Does therapy actually work?](#works)
6. [Finding the right approach](#fit)
7. [Frequently asked questions](#faq)

## You Don’t Need to Be in Crisis

One of the biggest misconceptions about therapy is that it’s only for people who are falling apart. In practice, a large share of people in therapy are functioning reasonably well on the outside — going to work, managing a household, showing up for others — while quietly carrying something that’s harder than it looks. The American Psychological Association notes that people seek therapy for a wide range of reasons: some have felt depressed, anxious, or angry for a long time, while others are navigating a specific event like a breakup, job loss, or grief, or simply want support working through questions about identity or self-esteem ([APA, Understanding Psychotherapy](https://www.apa.org/topics/psychotherapy/understanding)).

## Signs Worth Paying Attention To

#### Emotional signs

- A prolonged sense of sadness, anxiety, or anger that doesn’t lift
- Feeling “stuck,” numb, or mentally fatigued much of the time
- Overreacting to small setbacks or feeling on edge often

#### Behavioral & relational signs

- Withdrawing from people or activities you used to enjoy
- Repeated conflict or communication breakdowns in relationships
- Using alcohol, food, or other coping habits more than you’d like

#### Functional signs

- Trouble concentrating on work or everyday tasks
- Sleep, appetite, or energy that’s been off for weeks
- Problems that haven’t improved despite your own efforts

None of these signs alone means something is seriously wrong — but when one or more has been present for a while and isn’t resolving on its own, that’s usually a good signal that outside support could help ([APA, Understanding Psychotherapy](https://www.apa.org/topics/psychotherapy/understanding)).

## Common Life Moments That Bring People to Therapy

Therapy isn’t only for ongoing patterns — many people start during a specific chapter of life that’s harder to navigate alone:

#### Frequent starting points

- A major [life transition](https://dralanjacobson.com/life-transitions-therapy/) — a move, career change, divorce, or becoming a parent
- Grief or loss, whether recent or unprocessed from years ago
- Persistent self-doubt, perfectionism, or difficulty setting boundaries
- Relationship or family conflict that keeps repeating in the same pattern
- A general sense of wanting more clarity, direction, or [personal growth](https://dralanjacobson.com/personal-growth-counseling/) — even without a specific problem to name

## Why People Wait — and Why That’s Costly

11 yearsAverage delay between symptom onset and starting treatment

On average, people wait about 11 years between when a mental health symptom first appears and when they actually receive treatment ([NAMI, Mental Health By the Numbers](https://www.nami.org/mental-health-by-the-numbers/)). That gap tends to widen the struggle rather than shrink it — patterns that could have been addressed early often become more entrenched, and their ripple effects into relationships, work, and health accumulate the longer they go unaddressed.

 **Worth knowing:** Waiting for things to get “bad enough” isn’t a neutral choice — it’s a choice with a cost. You’re allowed to seek support for something that isn’t a crisis yet. 

## Does Therapy Actually Work?

Yes, and the evidence base is substantial. A 2024 systematic review and meta-analysis examining outcomes across eight major mental health conditions — including depression, generalized anxiety, panic disorder, PTSD, OCD, and social anxiety — found that psychotherapy consistently produced better outcomes than no treatment or control conditions across all of them ([Cuijpers et al., 2024, World Psychiatry](https://doi.org/10.1002/wps.21203)). The same research is candid that improvement isn’t always complete or instant — response varies, and for some people it takes trying more than one approach to find what fits. That nuance matters: therapy is well-supported, but it’s also a process, not a single fix.

## Finding the Right Approach

Different struggles respond to different approaches, which is part of why an initial consultation matters as much as it does. A few paths worth knowing about:

#### Approaches we offer

- [Cognitive Behavioral Therapy (CBT)](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) — for reshaping unhelpful thought patterns
- [Acceptance and Commitment Therapy (ACT)](https://dralanjacobson.com/act-psychotherapy/) — for building a values-driven life alongside discomfort
- [Compassion Focused Therapy](https://dralanjacobson.com/compassion-focused-therapy/) — for reducing harsh self-criticism
- [Schema Therapy](https://dralanjacobson.com/schema-therapy/) — for patterns rooted in early relationships
- [Life Transitions Therapy](https://dralanjacobson.com/life-transitions-therapy/) — for navigating major change
 
See our full [overview of therapy approaches](https://dralanjacobson.com/types-of-therapy/) for more.

### Not sure if it’s “worth” starting therapy?

A consultation is a low-pressure way to talk through what you’re experiencing and whether therapy makes sense right now.

 [Schedule a Consult](https://www.picktime.com/scheduleaconsult) [Explore Therapy Options](https://dralanjacobson.com/types-of-therapy/)

## Frequently Asked Questions

  Do I need a diagnosis to start therapy?No. Many people in therapy don’t have a formal diagnosis — they’re working through stress, a life transition, relationship difficulties, or a general sense of feeling stuck. Therapy is well-suited to both diagnosable conditions and everyday struggles.

   How do I know if what I’m feeling is ‘serious enough’ for therapy?If something has been affecting your mood, relationships, sleep, or ability to function for a while — and your own efforts haven’t fully resolved it — that’s generally reason enough. You don’t have to wait for a crisis to justify getting support.

   What if I’ve tried to handle things on my own and it hasn’t worked?That’s actually one of the clearest signs therapy could help. A trained therapist brings tools, structure, and outside perspective that are hard to access through willpower or self-help alone.

   Is therapy only helpful for people with severe symptoms?No. Research on psychotherapy outcomes spans everything from severe, diagnosable conditions to milder, everyday distress. Many people benefit from therapy for personal growth, self-understanding, or navigating a specific life change, without any severe symptoms at all.

   How long does it typically take to feel better?It varies widely by person and concern. Some people notice shifts within a few sessions; others need longer-term work, especially for patterns rooted in early life experiences. A good therapist will discuss expected timelines and check in on progress along the way.

   What if the first therapist I try isn’t the right fit?That’s common and okay. Fit matters — in approach, personality, and communication style. Many people see meaningful improvement after adjusting the approach or working with a different therapist, so it’s worth continuing to look rather than assuming therapy itself isn’t working.

#### Sources & Further Reading

1. American Psychological Association. [Understanding psychotherapy and how it works.](https://www.apa.org/topics/psychotherapy/understanding)
2. Cuijpers, P., Miguel, C., Ciharova, M., et al. (2024). [Absolute and relative outcomes of psychotherapies for eight mental disorders: A systematic review and meta-analysis.](https://doi.org/10.1002/wps.21203) World Psychiatry, 23(2), 267–275.
3. National Alliance on Mental Illness. [Mental health by the numbers.](https://www.nami.org/mental-health-by-the-numbers/)
 
This article is for informational purposes and is not a substitute for individualized clinical guidance. If you are in crisis, please contact the 988 Suicide & Crisis Lifeline by calling or texting 988.

![Signs you might benefit from therapy](https://dralanjacobson.com/wp-content/uploads/2026/08/featured-signs-therapy-1024x538.png "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist") ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Finding therapy

---

### [People-Pleasing and Boundary-Setting: Why 'No' Feels So Hard](https://dralanjacobson.com/people-pleasing-and-boundary-setting/)

**Published:** August 28, 2026
**Author:** Dr. Alan Jacobson

**Content:**

Relationships & Self-Worth

If saying “no” fills you with guilt, and you can name everyone else’s needs faster than your own, you’re not alone — and there’s a well-researched path back to yourself.

 🖋️ Dr. Alan Jacobson, Psy.D., MBA ⏱️ 8 min read 🔬 Clinically reviewed 

People-pleasing rarely announces itself as a problem. It looks like being easygoing, generous, low-maintenance — the person who always says yes, smooths things over, and never wants to be a bother. But when that pattern is constant, and it comes at the cost of your own needs, it stops being kindness and starts being a survival strategy that quietly runs your life. The encouraging part: boundary-setting is one of the most well-studied, teachable skills in psychology, and most people see meaningful change faster than they expect.

 **Quick answer:** People-pleasing is a pattern of consistently prioritizing others’ needs, expectations, and approval over your own, often rooted in a learned belief that your worth depends on keeping others happy. It’s not a formal diagnosis, but it’s a well-studied psychological pattern linked to anxiety, resentment, and burnout — and it responds well to boundary-setting skills, which decades of research show can be learned at any age. If this pattern feels tied to old relationship or family dynamics, [personal growth counseling](https://dralanjacobson.com/personal-growth-counseling/) can help you work through it directly. 

### In this article

1. [What people-pleasing actually is](#what-is-it)
2. [Where the pattern comes from](#where-from)
3. [Signs you might be a people-pleaser](#signs)
4. [People-pleasing vs. genuine kindness](#comparison)
5. [The real cost of chronic people-pleasing](#cost)
6. [How to start setting boundaries](#steps)
7. [Scripts for saying no](#scripts)
8. [Frequently asked questions](#faq)

## What People-Pleasing Actually Is

People-pleasing has recently gained solid empirical footing as its own psychological construct, distinct from simply being agreeable or kind. A 2026 study developing and validating a People Pleasing Scale identified three core dimensions: an exaggerated sense of *responsibility* for others’ feelings, chronic *neglect of one’s own needs*, and an outsized focus on meeting *others’ expectations* ([Blötner, 2026, Current Psychology](https://doi.org/10.1007/s12144-026-09519-2)). Notably, the research found people-pleasing is measurably distinct from ordinary agreeableness and empathy — it’s not just “being a nice person,” but a specific pattern with its own psychological signature and costs.

This lines up with an older concept in cognitive psychology called *sociotropy* — a personality style marked by a strong need for approval and a heightened sensitivity to disapproval or rejection, first described by Aaron Beck in his cognitive model of depression. Sociotropic individuals tend to base their self-worth heavily on how others perceive them, which makes boundary-setting feel disproportionately risky.

## Where the Pattern Comes From

For many people, people-pleasing traces back to what trauma-informed clinicians call the **fawn response** — a survival strategy, alongside fight, flight, and freeze, in which appeasing and accommodating others becomes the safest way to avoid conflict or harm. It often develops in childhood, particularly when a caregiver’s mood was unpredictable and staying attuned to their needs felt safer than expressing your own ([Psychology Today, 2025](https://www.psychologytoday.com/us/blog/bipoc-mental-health/202504/demystifying-the-fawn-response)).

 **Worth knowing:** “Fawn response” is a clinical framework used widely in trauma-informed therapy, not a formal DSM-5-TR diagnosis. That doesn’t make it any less real or worth addressing — it simply means the right next step is usually therapy focused on the underlying pattern, not a diagnostic label. 

## Signs You Might Be a People-Pleaser

#### In your reactions

- Saying yes before you’ve actually decided
- Feeling guilty or anxious after saying no
- Apologizing for things that aren’t your fault

#### In your relationships

- Avoiding conflict even when something bothers you
- Struggling to state a differing opinion
- Feeling responsible for other people’s emotions

#### Underneath it all

- A fear that boundaries will end the relationship
- Difficulty naming your own needs, even privately
- Quiet resentment that builds over time

## People-Pleasing vs. Genuine Kindness

  Genuine kindnessPeople-pleasing   Comes from choiceComes from fear of consequences Feels good afterwardOften leaves resentment or exhaustion Can coexist with saying no“No” feels unsafe or unavailable Self-worth stays intact either waySelf-worth depends on the other person’s approval 

## The Real Cost of Chronic People-Pleasing

Left unaddressed, chronic people-pleasing tends to compound. Research on assertiveness — the skill most directly opposite to fawning — has found that people who regularly enforce boundaries are significantly less likely to experience burnout, while low assertiveness is linked to elevated stress, anxiety, and depression across age groups. A clinical review described assertiveness training as “a forgotten evidence-based treatment,” noting decades of evidence that low assertiveness is a transdiagnostic factor across anxiety, depression, and relationship difficulties — yet it’s rarely taught explicitly in adult life ([Speed, Goldstein, & Goldfried, 2018, Clinical Psychology: Science and Practice](https://onlinelibrary.wiley.com/doi/abs/10.1111/cpsp.12216)).

## How to Start Setting Boundaries

#### Notice the pause before you say yes

Before answering a request, build in even a five-second pause — or a “let me check and get back to you.” That pause interrupts the automatic fawn reflex and gives you room to actually decide.

#### Start with low-stakes boundaries

Practice on smaller, lower-risk situations first — declining a minor request, expressing a small preference — before tackling higher-stakes relationships. Confidence builds through repetition.

#### Expect discomfort, not danger

Guilt or anxiety after setting a boundary is common and usually fades. It’s a sign you’re doing something unfamiliar, not a sign you’ve done something wrong.

#### Watch how people actually respond

People-pleasing often persists because we assume boundaries will cause a bigger reaction than they do. Paying attention to the real (usually mild) response helps rewire that expectation over time.

#### Get support if the pattern feels stuck

If boundaries consistently trigger intense fear, or the pattern traces back to a difficult family or relationship history, structured therapeutic work tends to move things faster than willpower alone.

This sequence lines up with what clinical trials on assertiveness training actually show: in a randomized controlled trial of adolescent girls, six sessions of structured problem-solving and assertiveness training produced significant improvements in both self-esteem and overall mental health scores compared to a control group ([Golshiri, Mostofi, & Rouzbahani, 2023, BMC Psychology](https://pmc.ncbi.nlm.nih.gov/articles/PMC10084687/)) — evidence that this is a trainable skill, not a fixed personality trait.

## Scripts for Saying No

#### Simple phrases to practice out loud

- “I can’t take that on right now, but thank you for thinking of me.”
- “That doesn’t work for me — let’s find another option.”
- “I need to think about it before I commit to anything.”
- “I hear you, and I still need to say no.”
- “I’m not going to be able to do that this time.”

 **Tip:** You don’t need an elaborate justification for a boundary. A short, clear statement — without over-explaining or over-apologizing — is usually more effective, and it models to others that your “no” doesn’t require their approval. 

#### Related therapy approaches

- [Cognitive Behavioral Therapy (CBT)](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) — for reshaping the thoughts that make boundaries feel dangerous
- [Acceptance and Commitment Therapy (ACT)](https://dralanjacobson.com/act-psychotherapy/) — for acting on your values even when discomfort shows up
- [Schema Therapy](https://dralanjacobson.com/schema-therapy/) — for patterns that trace back to early relationships
- [Compassion Focused Therapy](https://dralanjacobson.com/compassion-focused-therapy/) — for reducing the self-criticism that fuels people-pleasing
- [Life Transitions Therapy](https://dralanjacobson.com/life-transitions-therapy/) — for boundary shifts during major life changes

### Ready to work on this directly?

If people-pleasing is costing you energy, relationships, or peace of mind, we can help you build boundaries that actually hold.

 [Schedule a Consult](https://www.picktime.com/scheduleaconsult) [Explore Therapy Options](https://dralanjacobson.com/types-of-therapy/)

## Frequently Asked Questions

  Is people-pleasing a mental health diagnosis?No. People-pleasing isn’t a formal diagnosis in the DSM-5-TR, but it’s a well-studied psychological pattern that can meaningfully affect anxiety, self-esteem, and relationships — and it’s very much something therapy can address.

   Why does saying no feel so much harder for some people?For many people-pleasers, boundaries were unsafe or unrewarded earlier in life — often in childhood relationships where accommodating others felt necessary for connection or safety. That history can make an ordinary “no” feel disproportionately risky even in safe adult relationships.

   Can people-pleasing actually be changed, or is it just a personality trait?Research on assertiveness training — the skill most directly opposite to people-pleasing — consistently shows measurable improvement after relatively short, structured practice, including in randomized clinical trials. It’s a learnable skill, not a fixed trait.

   What’s the difference between people-pleasing and just being a kind person?Genuine kindness comes from choice and tends to feel good afterward. People-pleasing comes from a fear of consequences — disapproval, conflict, rejection — and often leaves resentment or exhaustion in its wake, even when the action looks identical from the outside.

   Will setting boundaries damage my relationships?Usually not. Most people overestimate how strongly others will react to a reasonable boundary. Relationships that can’t tolerate any boundaries at all are often already unbalanced — and boundaries tend to make sustainable relationships healthier, not weaker.

   When should I consider therapy instead of just practicing on my own?If boundary-setting consistently triggers intense fear or guilt, if the pattern seems tied to a difficult family history, or if self-directed practice isn’t moving the needle, working with a therapist can identify what’s reinforcing the pattern and build skills more directly.

#### Sources & Further Reading

1. Blötner, C. (2026). [Valuing others over oneself: Development and validation of a people pleasing scale in two German samples.](https://doi.org/10.1007/s12144-026-09519-2) Current Psychology, 45(9), 952–.
2. Speed, B. C., Goldstein, B. L., & Goldfried, M. R. (2018). [Assertiveness training: A forgotten evidence-based treatment.](https://onlinelibrary.wiley.com/doi/abs/10.1111/cpsp.12216) Clinical Psychology: Science and Practice, 25(1), e12216.
3. Golshiri, P., Mostofi, A., & Rouzbahani, S. (2023). [The effect of problem-solving and assertiveness training on self-esteem and mental health of female adolescents: A randomized clinical trial.](https://pmc.ncbi.nlm.nih.gov/articles/PMC10084687/) BMC Psychology, 11, 113.
4. Psychology Today. (2025). [Demystifying the fawn response.](https://www.psychologytoday.com/us/blog/bipoc-mental-health/202504/demystifying-the-fawn-response)
 
This article is for informational purposes and is not a substitute for individualized clinical guidance.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Symptom Relief

---

### [Is Therapy Tax-Deductible? Using HSA/FSA for Sessions](https://dralanjacobson.com/is-therapy-tax-deductible-using-hsa-fsa-for-sessions/)

**Published:** August 18, 2026
**Author:** Dr. Alan Jacobson

**Content:**

# Is Therapy Tax-Deductible? Using HSA/FSA for Sessions

 by [Dr. Alan Jacobson](https://dralanjacobson.com/author/alanjacobson/ "Posts by Dr. Alan Jacobson") | Aug 18, 2026 | [Finding therapy](https://dralanjacobson.com/category/finding-therapy/)

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: August 18, 2026

Fees & Insurance · Tax Season Planning

"Can I write this off?" is one of the most common questions I get around tax season. The honest answer is: it depends on which write-off you mean — a tax deduction and an HSA/FSA are two very different things, with very different rules.

 🖋️ Dr. Alan Jacobson, Psy.D., MBA ⏱️ 8 min read 🔬 Reviewed for accuracy

Therapy is a real, meaningful expense, and it's fair to want to know whether any of it comes back to you at tax time. There are two separate ways that can happen: itemizing medical expenses on your federal tax return, or paying with pre-tax dollars from an HSA or FSA. They work completely differently — one requires you to clear a fairly high bar, the other doesn't. This guide breaks down exactly how each one works, with current IRS numbers.

 **Quick answer:** Therapy is IRS-eligible as a medical expense, but a direct tax deduction only helps if your total medical costs exceed 7.5% of your income and you itemize — a high bar for most people. HSA/FSA funds, by contrast, apply from dollar one with no threshold, making them the more reliable way most clients see savings on session fees. See our [Fees & Insurance](https://dralanjacobson.com/#fees) section for our current rates and payment options.

### In this article

1. [Two different things: tax deduction vs. HSA/FSA](#two-things)
2. [Deducting therapy on your taxes](#deducting)
3. [Using HSA/FSA for therapy](#hsa-fsa)
4. [HSA vs. FSA: which one applies to you](#compare)
5. [The fine print: when you might need a letter](#fine-print)
6. [A worked example](#example)
7. [Frequently asked questions](#faq)

## Two Different Things: Tax Deduction vs. HSA/FSA

People often use "tax write-off" to mean both of these, but they work in opposite ways:

- **Itemized medical deduction:** Filed once a year on your tax return. You only benefit from the portion of your total medical expenses that exceeds a percentage of your income — and only if you itemize instead of taking the standard deduction.
- **HSA/FSA:** Pre-tax money set aside from your paycheck throughout the year, used directly to pay for eligible expenses as you go — no income threshold, no itemizing required.

For most people, the HSA/FSA route produces far more consistent savings. The tax deduction route is still worth understanding, especially in a year with significant out-of-pocket mental health costs.

## Deducting Therapy on Your Taxes

Therapy qualifies as a deductible medical expense under IRS rules, since it's care aimed at diagnosing, treating, or managing a condition. But claiming that deduction comes with two real conditions, per the IRS's official guidance on medical and dental expenses:

- **You must itemize.** The deduction is claimed on Schedule A, so it only helps if your total itemized deductions (medical expenses, mortgage interest, charitable giving, etc.) exceed your standard deduction.
- **Only the amount above 7.5% of your AGI counts.** You can deduct only the portion of your total medical and dental expenses that exceeds 7.5% of your adjusted gross income (AGI) — not the full amount you spent ([IRS, Topic No. 502](https://www.irs.gov/taxtopics/tc502)).

In practice, this means the deduction mostly benefits people with a high total medical spend in a given year — a combination of therapy, testing, medications, and other care — relative to their income. For many people in an average year, HSA/FSA funds end up doing more of the actual work.

## Using HSA/FSA for Therapy

Therapy sessions are a qualified expense under both Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs), according to IRS Publication 502, which we accept directly as payment ([IRS Publication 502](https://www.irs.gov/publications/p502)). Unlike the itemized deduction, there's no income threshold to clear — every dollar you spend through an HSA or FSA is already pre-tax, so the savings apply immediately.

$3,4002026 FSA contribution limit per employee (IRS Rev. Proc. 2025-32)

$4,4002026 HSA limit, self-only coverage (IRS Rev. Proc. 2025-19)

$8,7502026 HSA limit, family coverage (IRS Rev. Proc. 2025-19)

## HSA vs. FSA: Which One Applies to You

HSAFSAEligibilityRequires a high-deductible health plan (HDHP)Offered through many employer plans regardless of deductible type2026 limit$4,400 self-only / $8,750 family$3,400 per employeeUnused fundsRoll over indefinitely — the account is yours long-termMostly "use it or lose it," though many plans allow a $680 carryoverWho controls itYou — it stays with you even if you change jobsTied to your current employer's plan

## The Fine Print: When You Might Need a Letter

 **Worth knowing:** Individual therapy for a diagnosed condition is straightforwardly eligible. [Couples and marriage counseling](https://dralanjacobson.com/marriage-counseling/) is a more nuanced case — by default, it's generally not considered a qualified medical expense, even when recommended by a provider. It can become eligible when it's specifically focused on treating a diagnosed mental health condition, which typically requires a Letter of Medical Necessity from your provider. If this applies to you, ask us about documentation during your consultation.

## A Worked Example

#### Combining a superbill with FSA funds

Weekly 50-minute session fee$210

Paid directly from FSA card (pre-tax)−$210

Superbill submitted to insurance for possible reimbursementVaries by plan

Net effectFull fee paid in pre-tax dollars, plus a shot at partial reimbursement

For more on how the reimbursement side works, see our guide on [how superbills work](#).

### Want to plan out your costs before your first session?

A free 20-minute consultation is a good time to ask about fees, HSA/FSA, and what documentation you might need.

 [Schedule a Free Consult](https://www.picktime.com/scheduleaconsult) [Read Therapy FAQs](https://dralanjacobson.com/therapy-faqs/)

## Frequently Asked Questions

 Is therapy always tax-deductible?Therapy is an eligible medical expense, but it only produces an actual tax deduction if you itemize your deductions and your total medical expenses for the year exceed 7.5% of your adjusted gross income. Many people don't clear that bar in a typical year.

 Do I need a diagnosis to use HSA/FSA for therapy?Individual psychotherapy for a diagnosed or diagnosable condition is generally eligible without extra documentation. Some situations — like couples counseling — may require a Letter of Medical Necessity confirming the treatment is addressing a specific diagnosis.

 Can I use both a superbill and my HSA/FSA at the same time?Yes. You can pay your session fee with HSA/FSA funds and still submit a superbill to your insurance for potential additional reimbursement, though you generally cannot be reimbursed twice for the same expense from two different sources.

 What happens to unused FSA money at the end of the year?Most FSA plans operate on a "use it or lose it" basis, though many now allow a limited carryover into the next year. HSA funds, by contrast, roll over indefinitely and never expire.

 Are HSA/FSA contribution limits the same for everyone?No. HSA limits depend on whether you have self-only or family high-deductible health plan coverage, and FSA limits are typically set per employee regardless of coverage type. Limits are adjusted annually by the IRS.

 Do you provide documentation for HSA/FSA or tax purposes?Yes. We accept FSA and HSA cards directly as payment, and we can provide a superbill or other documentation your plan administrator may request, including a Letter of Medical Necessity when applicable.

#### Sources & Further Reading

1. Internal Revenue Service. [Topic No. 502, Medical and Dental Expenses.](https://www.irs.gov/taxtopics/tc502)
2. Internal Revenue Service. [Publication 502, Medical and Dental Expenses.](https://www.irs.gov/publications/p502)
3. Internal Revenue Service. [Revenue Procedure 2025-19](https://www.irs.gov/pub/irs-drop/rp-25-19.pdf) (2026 HSA and HDHP limits).
4. Internal Revenue Service. [Revenue Procedure 2025-32](https://www.irs.gov/pub/irs-drop/rp-25-32.pdf) (2026 inflation adjustments, including FSA limits).

This article is for general informational purposes and is not tax advice. Please consult a qualified tax professional about your specific situation.

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**Categories:** Finding therapy

---

### [Therapist Styles Explained: How Your Therapist Works](https://dralanjacobson.com/therapist-styles/)

**Published:** April 18, 2026
**Author:** Dr. Alan Jacobson

**Content:**

If you’ve tried therapy before and it didn’t work, the problem may not have been therapy itself. **It may have been the style.**

Two therapists can share identical credentials, use the same clinical model, and produce completely different experiences. One feels like a real conversation — challenging, clarifying, energizing. The other feels flat, or like you’re performing for someone who is just nodding. That difference almost always comes down to therapist style: the way a clinician shows up in the room, manages the relationship, and engages with you as a person.

This page is specifically about that — what therapist styles are, how they differ, and how to figure out which one you actually need.

Most people researching therapy focus on the *what* — CBT vs. psychodynamic, individual vs. group, short-term vs. open-ended. That information matters, and I cover [therapy models in depth elsewhere on this site](https://dralanjacobson.com/types-of-therapy/). But style — the *how* — is often what determines whether therapy works for a specific person. Research on the therapeutic alliance consistently shows that the quality of the relationship between client and therapist is one of the strongest predictors of outcome, frequently more predictive than the specific model used.

If you’re still figuring out *where* to find a therapist, start with [Therapist Finders Compared](https://dralanjacobson.com/therapist-finders-compared/). If you want broader guidance on evaluating fit, see [How to Find a Good Therapist](https://dralanjacobson.com/how-to-find-a-good-therapist/). This page picks up where those leave off.

## What Is Therapist Style — and Why Does It Matter?

A **therapy model** is the structured clinical framework a therapist uses — the theory of change, the techniques, the sequencing. A **therapist style** is the interpersonal and relational way they actually show up. It includes their directiveness, warmth, communication register, use of humor, tolerance for silence, and whether they tell you what they think or guide you to find it yourself.

Most therapy directories let you filter by model. Almost none let you filter by style. Yet for many people — especially those who have tried therapy before — style is the missing variable. A highly structured CBT therapist and a warm, exploratory CBT therapist are using the same model and will produce very different experiences. Knowing which one you need is not a minor detail. It is the question.

## The Core Style Dimensions

Therapist styles can be understood along several key spectrums. Most clinicians fall somewhere in the middle of each, but understanding where you need someone to be is the starting point for a much better search.

 Directive vs. Non-Directive structure ↔ openness 

Directive therapists guide sessions with an agenda, set goals, assign homework, and move things forward with intention. Non-directive therapists follow your lead, letting the session unfold from what you bring.

Fits directive: people who feel lost without structure, or who want measurable progress. Fits non-directive: people who need space to process without feeling managed.

 Warm and Relational vs. Boundaried and Neutral connection ↔ clinical 

Some therapists are openly warm — they remember details, express care directly, and bring a genuine human quality to the work. Others maintain more clinical neutrality, believing their own presence should stay out of the process.

Style mismatch here is one of the most common reasons clients disengage from therapy early, often without knowing why.

 Challenging vs. Validating direct ↔ supportive 

Some therapists push back, name patterns directly, and invite productive discomfort. Others prioritize feeling heard above all else. Neither is better — but a person who has been over-validated everywhere often needs someone who will actually say something.

Fits challenging: analytical, high-achieving, or insight-hungry clients. Fits validating: those who feel chronically misunderstood or early in trust-building.

 Structured vs. Exploratory goal-focused ↔ open-ended 

Structured therapists work from a plan — sessions have an arc, there are measurable goals, and progress is tracked. Exploratory therapists treat the process itself as the mechanism of change, following curiosity more than a map.

Fits structured: anxiety, ADHD, performance goals, time-limited treatment. Fits exploratory: identity questions, existential concerns, long-standing relational patterns.

 Self-Disclosing vs. Opaque present ↔ neutral 

Some therapists share relevant personal reactions or experience as a clinical tool — used judiciously, this can normalize, humanize, and deepen the work. Others keep themselves largely out of the picture, believing the client’s material should stay central.

Fits self-disclosing: clients who feel alone in their experience, or who do better in relationships that feel mutual. Fits opaque: clients who need clear boundaries or are working through intense transference.

 Conversational vs. Formal natural ↔ clinical register 

The register a therapist uses — how they speak, whether they use clinical language, how they handle humor and levity — shapes whether the room feels like a professional service or a genuine working relationship. Both can be effective. They attract very different clients.

Fits conversational: people who disengage from formal settings or find clinical language distancing. Fits formal: clients who find clear professional boundaries reassuring.

## “Why Didn’t Therapy Work for Me Before?” — A Style Mismatch Checklist

Most clients who leave therapy prematurely attribute it to therapy itself not working for them. Often, the more accurate explanation is a style mismatch with a specific clinician. Here are common complaints reframed as what they usually indicate:

 “I felt like I was just venting with no direction.” → You likely needed a more **directive** therapist — someone who structures sessions and tracks progress explicitly. 

 “It felt cold and transactional.” → You needed a more **warm and relational** style. Not all good therapists are warm — but you needed one who is. 

 “I never felt challenged — just validated.” → You needed a more **challenging and direct** therapist willing to name patterns and push back constructively. 

 “Every session felt like starting over.” → You needed more **structure and continuity** — a therapist who tracks a thread across sessions and works toward defined goals. 

 “I couldn’t tell if they even had opinions.” → You needed more **therapist presence** — someone who brings themselves into the room rather than maintaining studied neutrality. 

 “It felt like therapy-speak — nothing felt real.” → You needed a more **conversational register** — a therapist whose natural way of talking matches how you think and communicate. 

## How to Identify Your Style Preference

Before your next consultation, spend a few minutes with these questions. You don’t need definitive answers — but having a sense of your preferences gives you something concrete to ask about.

1. Think of a teacher, coach, or mentor who genuinely helped you. What did they do that worked? Were they structured or flexible, challenging or supportive, direct or exploratory? That’s often a strong signal about your learning and growth style.
2. What frustrated you most in any therapy you’ve tried before — or in any helping relationship that didn’t land? Name the feeling, not the diagnosis. That frustration is data.
3. Do you work better when someone tells you what they think, or when they help you arrive at your own conclusions? There’s no right answer, but it matters significantly for which therapist style will fit.
4. Do you want sessions to have an agenda and measurable movement, or do you need open space where the most important thing can surface on its own?
 
## What to Ask in a Consultation

Most people ask a potential therapist what model they use. Almost nobody asks about style. These questions will tell you far more about whether the fit is right:

“How would you describe your style in session — are you more directive, or do you tend to follow where I lead?”

“Do you give direct feedback and name what you’re observing, or do you mostly guide me to find my own answers?”

“How structured are your sessions typically? Do you track goals across sessions?”

“Do you assign homework, or is the work primarily done in session?”

“How do you handle it if I feel like something isn’t working?”

“This is how I’d describe what I need — does that fit how you typically work?” *(Then describe your preferences from the section above.)*

A good therapist will answer these questions directly and without defensiveness. Vague or deflecting answers to style questions are themselves useful information.

## How My Style Works — and Who It Fits Best

I want to be direct about where I fall on each of these dimensions, because I think you deserve to know before you commit to a consultation.

### Directive, with room to explore

I work from a plan. Sessions have structure, we track where we’re going, and I’ll notice if we’re drifting without purpose. At the same time, I follow the energy in the room — if something important surfaces, we go there.

### Warm and genuinely engaged

I remember what you told me three sessions ago. I care about what happens to you between sessions. The relationship we build is not incidental to the work — it is part of the work.

### Direct and willing to challenge

I will tell you what I observe, including things that might be uncomfortable to hear. I do this with care, not bluntness — but I’m not here to simply validate. If a pattern is keeping you stuck, I’ll name it.

### Conversational register

I don’t talk like a textbook. Sessions feel like a real conversation between two people who are both taking the work seriously. Humor has a place here when it serves the moment.

### Who tends to get the most from working with me

Analytically-minded clients. High achievers who are hard on themselves. People who’ve tried therapy before and felt like something was missing. Adults navigating anxiety, major transitions, performance pressure, or longstanding patterns they’re finally ready to examine.

If that doesn’t sound like the right fit for where you are right now, I’ll tell you honestly — and I’m glad to help you find a colleague whose style is a better match.

## When Therapist Style Matters Most

Style is always relevant, but it tends to be especially predictive of outcome in these situations:

 Previous therapy that didn’t click Trauma and PTSD ADHD in adults High-achieving or analytical clients Adolescents and teens Couples therapy Performance anxiety Existential or identity questions Clients who intellectualize Long-standing relational patterns 

In these situations, the right model applied by the wrong-style therapist often produces little movement. The right style with a competent clinician — even before the “perfect” model is identified — tends to unlock progress quickly.

 If you’re not sure what style you need, or want to talk through whether my approach sounds like a fit, I’m always happy to have that conversation — no pressure, no obligation.

 [Schedule a Free Consultation](https://www.picktime.com/scheduleaconsult) Also see: [Therapist Finders Compared](https://dralanjacobson.com/therapist-finders-compared/) · [How to Find a Good Therapist](https://dralanjacobson.com/how-to-find-a-good-therapist/) · [Therapy Approaches](https://dralanjacobson.com/types-of-therapy/) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [How to Find a Marriage Counselor Who’s the Right Fit](https://dralanjacobson.com/how-to-find-a-marriage-counselor-or-therapist-whos-actually-the-right-fit/)

**Published:** May 4, 2026
**Author:** Dr. Alan Jacobson

**Content:**

## How to Find a Marriage Therapist: **Quick Answers**

### **How to find a marriage counselor or therapist?**

 Start with licensed providers who specialize in couples work, verify credentials, look for evidence-based approaches (e.g., EFT, Gottman), and schedule 1–2 consultations to assess fit, structure, and goals.

### **How to find couples therapy near you?**

 Use trusted directories, filter for “couples/marriage,” confirm insurance or self-pay options, and prioritize therapists who clearly outline their method and outcomes.

### **Is online marriage therapy effective?**

 Yes—**online marriage therapy** can be as effective as in-person for many couples, especially when sessions are structured and both partners are engaged.

### **What is the most important aspect of how to find marriage therapy?** 

A therapist with expertise in couples dynamics, a clear framework, measurable goals, and a strong therapeutic alliance with *both* partners.

---

## How to Find a Couples Therapist: T**he Next Step**

![How to find a marriage counselor](https://i0.wp.com/dralanjacobson.com/wp-content/uploads/2026/05/aioseo-ai-just-one-happy-couple-wal-medium-auto-landscape-20260505-131946.png?fit=%2C&ssl=1 "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")If you’re serious about figuring out *how to find a marriage counselor* or *how to find couples counseling* that actually works, the best next move is simple:

Schedule a brief consultation
Ask the right questions
Pay attention to [fit—not just credentials](https://dralanjacobson.com/choosing-the-best-therapist-for-you/)

If you want a structured, evidence-based approach—and an honest assessment of whether I’m the right person to help—you can reach out and **[schedule a consultation](https://www.picktime.com/scheduleaconsult#book/services)**.

---

## **The Real Question: How to Find Couples Counseling That Works for *You*** 

If you’ve been Googling *how to find a marriage therapist* or *how to find couples therapy*, you’ve probably noticed something: there are a lot of options—and not all are created equal.

The difference between “we tried therapy” and “this changed our relationship” usually comes down to three things:

1. **Fit** (you both feel understood and challenged in the right ways)
2. **Method** (the therapist uses a proven framework, not just conversation)
3. **Focus** (clear goals and measurable progress)

Let’s make this practical.

---

## **How to Find a Marriage Counselor: A Step-by-Step Approach**

### **1) How to Find a Marriage Counselor: Start with specialization—not just availability**

Not every therapist is trained in couples work. Look specifically for:

- “Couples therapy” or “marriage counseling” listed as a primary [therapy service](https://dralanjacobson.com/)
- Training in approaches like: 
    - [Emotionally Focused Therapy (EFT)](https://dralanjacobson.com/eft-therapy-for-couples/)
    - Gottman Method
    - Integrative Behavioral [Couples Therapy](https://dralanjacobson.com/couples-therapy/) (IBCT)

👉 Why this matters: [Couples therapy](https://dralanjacobson.com/couples-therapy/) is *not* just individual therapy with two people in the room.

---

### **2) Verify credentials and experience**

At minimum, look for licensed clinicians (e.g., psychologist, LMFT, LCSW). Then go one layer deeper:

- How many couples do they see weekly?
- Do they handle high-conflict dynamics, infidelity, or specific issues you’re facing?
- Do they use structured assessments?

---

### **3) Ask how therapy is structured**

A strong therapist should be able to answer:

- “What does the first 3–5 sessions look like?”
- “How do you measure progress?”
- “What happens if we’re stuck?”

If the answer is vague (“we’ll just talk and see”), keep looking.

---

### **4) Consider online marriage therapy**

Many couples assume in-person is better—but that’s not always true.

**Online marriage therapy** can:

- Increase consistency (fewer cancellations)
- Reduce logistical stress (childcare, commuting)
- Allow partners to show up more relaxed and open

---

### **5) Evaluate the *fit* after 1–2 sessions**

This is huge.

Ask yourselves:

- Do we both feel heard—not just one of us?
- Is the therapist balanced (not “taking sides”)?
- Are we leaving sessions with insight *and* tools?

If not, it’s okay to pivot. That’s not failure—that’s calibration.

---

## How to Find a Marriage Therapist: 3 **Scenarios**

### How to Find a Marriage Therapist for **Constant conflict and communication breakdown**

**Presenting issue:** Frequent arguments that escalate quickly; both partners feel misunderstood.

**Approach used:**

- Emotionally Focused Therapy (EFT)
- Communication restructuring
- Identifying underlying attachment needs

**What changed:
 Instead of arguing about surface issues (“You never listen”), the couple learned to express deeper emotions (“I feel unimportant and shut out”). Conflict decreased because they were finally addressing the *real* issue.

---

### **How to Find a Marriage Therapist for Emotional Distance and Disconnection**

**Presenting issue:** No major fights—but no closeness either. Feels like roommates.

**Approach used:**

- Gottman Method interventions
- Rebuilding “love maps” and emotional attunement
- Structured connection rituals

**What changed:
 They moved from passive coexistence to intentional connection—daily check-ins, shared meaning, and increased emotional responsiveness.

---

### How to Find a Couples Therapist for **Trust Rupture**

**Presenting issue:** One partner broke trust; both unsure if repair is possible.

**Approach used:**

- Structured repair model (accountability + transparency)
- Trauma-informed processing for the injured partner
- Gradual rebuilding of safety and trust

**What changed:
 The focus shifted from “Should we stay together?” to “Can we rebuild something stronger?”—with clear milestones for trust repair.

---

## **How I Can Help (and When I’ll Tell You I’m Not the Best Fit)**

Through the **Foresight Psychological Institute**, my approach is structured, evidence-based, and tailored to your functioning as a couple.

Here’s what that looks like:

- Clear assessment of your relationship dynamics early on
- Use of validated frameworks (not guesswork)
- Practical tools you can apply immediately—not just insight

And just as important:

If your situation calls for something outside my specialty—higher-acuity care, a different modality, or even a different personality fit—I’ll tell you directly and help you find the right provider. That’s part of doing this well.

---

## FAQs: About How to Find a Marriage Counselor

### How do I find a *good* marriage counselor?

Look for a licensed therapist who specializes in couples or marriage counseling, uses evidence-based approaches like EFT or Gottman Method, and has experience with the specific issues you are facing. A consultation can help determine whether the therapist is the right fit for both partners.

---

### How do I find a marriage therapist near me?

You can [find a marriage therapist](https://dralanjacobson.com/marriage-counseling/) through professional directories, referrals from healthcare providers, or specialized practices that offer couples therapy. Many therapists now offer both in-person and [online sessions](https://dralanjacobson.com/virtual-couples-therapy/).

---

### How do I find couples therapy that actually works?

The most effective couples therapy usually includes a structured treatment approach, clear goals, practical tools between sessions, and a therapist who maintains balance and neutrality between partners.

---

### Is online marriage therapy effective?

Yes. Research suggests that online marriage therapy can be highly effective for many couples, especially when both partners actively participate and sessions occur consistently.

---

### What is the difference between marriage counseling and couples therapy?

Marriage counseling often focuses on relationship challenges within a marriage, while couples therapy may also include unmarried partners, dating couples, or long-term relationships. In practice, the terms are frequently used interchangeably.

---

### When should couples seek counseling?

Couples should consider counseling when communication becomes difficult, conflicts repeat without resolution, emotional distance increases, trust is damaged, or major life stressors begin affecting the relationship.

---

### Can couples therapy help after infidelity?

Yes. Couples therapy can help partners process betrayal, rebuild communication, establish accountability, and determine whether trust and emotional safety can be restored.

---

### What should I ask during a couples therapy consultation?

Helpful questions include:

- What therapy methods do you use?
- How do you measure progress?
- What experience do you have with our specific concerns?
- How long does couples therapy typically last?

---

### How long does marriage counseling take?

Some couples experience improvement within a few months, while more complex issues may require longer-term work. Frequency, motivation, and the severity of relationship stress all affect the timeline.

---

### How to Find a What if one partner does not want therapy?

It is common for one partner to feel hesitant initially. Beginning with a low-pressure consultation or individual session can sometimes help reduce anxiety and increase openness to the process.

---

## Frequently Asked Questions About Marriage Counseling and Couples Therapy

### How do I find a good marriage counselor?

Look for a licensed therapist who specializes in couples or marriage counseling, uses evidence-based approaches like EFT or Gottman Method, and has experience with the specific issues you are facing. A consultation can help determine whether the therapist is the right fit for both partners.

### How do I find a marriage therapist near me?

You can find a marriage therapist through professional directories, referrals from healthcare providers, or specialized practices that offer couples therapy. Many therapists now offer both in-person and online sessions.

### How do I find couples therapy that actually works?

The most effective couples therapy usually includes a structured treatment approach, clear goals, practical tools between sessions, and a therapist who maintains balance and neutrality between partners.

### Is online marriage therapy effective?

Yes. Online marriage therapy can be highly effective for many couples, especially when both partners actively participate and sessions occur consistently.

### What is the difference between marriage counseling and couples therapy?

Marriage counseling often focuses on relationship challenges within a marriage, while couples therapy may also include unmarried partners, dating couples, or long-term relationships. In practice, the terms are frequently used interchangeably.

### When should couples seek counseling?

Couples should consider counseling when communication becomes difficult, conflicts repeat without resolution, emotional distance increases, trust is damaged, or major life stressors begin affecting the relationship.

### Can couples therapy help after infidelity?

Yes. Couples therapy can help partners process betrayal, rebuild communication, establish accountability, and determine whether trust and emotional safety can be restored.

### What should I ask during a couples therapy consultation?

Helpful questions include: What therapy methods do you use? How do you measure progress? What experience do you have with our specific concerns? How long does couples therapy typically last?

### How long does marriage counseling take?

Some couples experience improvement within a few months, while more complex issues may require longer-term work. Frequency, motivation, and the severity of relationship stress all affect the timeline.

### What if one partner does not want therapy?

It is common for one partner to feel hesitant initially. Beginning with a low-pressure consultation or individual session can sometimes help reduce anxiety and increase openness to the process.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Couples Therapies

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### [Rejection-Sensitive Dysphoria: Why Criticism Feels Unbearable (And What Helps)](https://dralanjacobson.com/rejection-sensitive-dysphoria/)

**Published:** August 16, 2026
**Author:** Dr. Alan Jacobson

**Content:**

# Rejection-Sensitive Dysphoria: Why Criticism Feels Unbearable (And What Helps)

 by [Dr. Alan Jacobson](https://dralanjacobson.com/author/alanjacobson/ "Posts by Dr. Alan Jacobson") | Aug 16, 2026 | [Symptom Relief](https://dralanjacobson.com/category/symptom-relief/)

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: August 17, 2026

ADHD & Emotional Regulation · Therapy Blog

A single offhand comment can wreck your whole day. Constructive feedback feels like an attack. You've spent years wondering why criticism hits so much harder for you than it seems to for everyone else — and whether something is actually wrong with you for reacting this way.

 🖋️ Dr. Alan Jacobson, Psy.D. ⏱️ 9 min read 🔬 Clinically reviewed

**Rejection Sensitive Dysphoria (RSD)** is a term used to describe the intense, often overwhelming emotional pain triggered by real or perceived rejection, criticism, or failure — a pattern seen frequently, though not exclusively, in people with ADHD. It's one of the most under-discussed parts of ADHD, largely because it shows up as an emotional reaction rather than the inattention or hyperactivity most people associate with the diagnosis. If you've ever been told you're "too sensitive," or you've spent hours replaying a minor comment from a coworker, this pattern may sound familiar.

 **Quick answer:** RSD isn't a formal diagnosis, but it describes a real and researched pattern of emotional dysregulation strongly linked to [ADHD](https://dralanjacobson.com/adhd-therapy-for-adults/). It responds well to therapy — particularly approaches that build emotional regulation skills and address the underlying self-critical beliefs that make rejection feel so dangerous.

### In this article

1. [What Rejection Sensitive Dysphoria is](#what-is-it)
2. [Is RSD a real diagnosis?](#real)
3. [Signs you might experience RSD](#signs)
4. [RSD vs. typical sensitivity to rejection](#compare)
5. [Why ADHD brains are prone to RSD](#why)
6. [How therapy helps](#treatment)
7. [Frequently asked questions](#faq)

## What Rejection Sensitive Dysphoria Is

The term was popularized by psychiatrist William Dodson, who described it as extreme emotional sensitivity and pain triggered by the perception — accurate or not — of being rejected, teased, criticized, or of falling short of your own or others' expectations ([ADDitude Magazine](https://www.additudemag.com/rejection-sensitive-dysphoria-and-adhd/)). "Dysphoria" here refers to the word's original Greek meaning: unbearable pain. For many people with RSD, that's not an exaggeration — the emotional response can feel physically overwhelming, arriving almost instantly and disproportionately to the actual trigger.

According to the [Cleveland Clinic](https://my.clevelandclinic.org/health/diseases/24099-rejection-sensitive-dysphoria-rsd), RSD is understood as a symptom of the broader emotional dysregulation that's common in ADHD, rather than a standalone condition. It can show up as sudden intense sadness, anger turned inward or outward, or a rush of shame — often followed by rumination that can last for hours or days.

## Is RSD a Real Diagnosis?

 **Worth knowing:** Rejection Sensitive Dysphoria is not currently a formal diagnosis in the DSM-5-TR, and it hasn't been extensively studied under that exact name. That doesn't mean the experience isn't real — a growing body of research on emotional dysregulation in ADHD, including a recent qualitative study of adults' lived experience of rejection sensitivity, supports that this pattern is genuine, common, and clinically significant ([PLOS ONE, 2024](https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0314669)). The DSM-5-TR itself now acknowledges quickness to anger, frustration, and emotional overreactivity as associated features of ADHD, even without using the term "RSD" specifically.

In practice, this distinction matters less than it might seem. Whether we call it RSD, emotional dysregulation, or rejection sensitivity, the lived experience and the treatment approach are largely the same.

## Signs You Might Experience RSD

**Instant, intense reactions**Criticism or perceived slights trigger an immediate flood of shame, anger, or sadness — often out of proportion to the actual event.

**People-pleasing or perfectionism**Working extremely hard to avoid any possibility of criticism or disapproval in the first place.

**Avoidance**Steering clear of situations with any risk of rejection — new relationships, asking for help, applying for opportunities.

**Rumination**Replaying a comment or interaction for hours or days after it happened.

**Reading rejection into neutral events**Interpreting a delayed text reply or a flat tone of voice as evidence you've done something wrong.

**Physical symptoms**A racing heart, stomach drop, or wave of heat when facing potential criticism or disapproval.

## RSD vs. Typical Sensitivity to Rejection

Almost everyone dislikes being criticized or rejected — the difference with RSD is one of intensity, speed, and duration.

Typical SensitivityRejection Sensitive DysphoriaIntensityMild to moderate discomfortOverwhelming, often described as unbearableSpeed of onsetGradualNear-instantaneousDurationFades within minutes to hoursCan persist for hours or daysTrigger thresholdClear, significant criticismMinor, ambiguous, or imagined slightsBehavioral impactLimitedCan drive major life avoidance patterns

## Why ADHD Brains Are Prone to RSD

Emotional dysregulation is now understood as a core, though historically overlooked, feature of ADHD — not a separate problem that happens to occur alongside it. ADHD affects the brain's capacity to regulate emotional intensity the same way it affects attention and impulse control, which means emotional reactions can arrive faster and bigger, with less of a buffer to process them before they take over. Layer years of being told to "just try harder" or "stop overreacting" on top of that neurological reality, and many people with ADHD develop a deep, learned expectation of criticism — which then makes them scan constantly for signs of it.

This is compounded by a lifetime of lived experience: many adults with ADHD received disproportionate correction, criticism, and social rejection growing up, simply for traits rooted in their neurology. That history shapes how the nervous system interprets ambiguous social signals well into adulthood.

## How Therapy Helps

RSD responds well to therapy because it involves two treatable pieces: the speed and intensity of the emotional reaction itself, and the underlying beliefs ("I'm not enough," "people are always about to leave") that make rejection feel so dangerous in the first place. In my practice, I typically draw on:

#### Approaches I use for RSD and emotional dysregulation

- [Cognitive-Behavioral Therapy (CBT)](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) — identifies and restructures the automatic interpretations that turn a neutral event into a perceived rejection
- [Acceptance and Commitment Therapy (ACT)](https://dralanjacobson.com/act-psychotherapy/) — builds the capacity to feel the wave of emotion without letting it dictate avoidance or withdrawal
- [Compassion-Focused Therapy (CFT)](https://dralanjacobson.com/compassion-focused-therapy/) — directly targets the harsh inner critic that often amplifies RSD reactions
- [Schema Therapy](https://dralanjacobson.com/schema-therapy/) — for RSD rooted in longstanding patterns from childhood experiences of criticism or rejection

If ADHD hasn't been formally diagnosed and you want clarity on whether it's driving these patterns, our sister site offers [comprehensive ADHD testing for adults](https://psychologicalassessments.com/psychological-testing-for-adhd-in-adults/). If you already know ADHD is part of the picture, our [ADHD Coaching](https://dralanjacobson.com/adhd-coaching-for-adults-help-for-focus-and-concentration/) page covers a complementary, skills-based approach.

### Tired of feeling wrecked by every piece of feedback?

A free 20-minute consultation is a low-pressure way to find out whether this is a fit — no obligation.

 [Schedule a Free Consult](https://www.picktime.com/scheduleaconsult) [Explore Adult ADHD Therapy](https://dralanjacobson.com/adhd-therapy-for-adults/)

## Frequently Asked Questions

 Is Rejection Sensitive Dysphoria an official diagnosis?No. RSD is not currently listed as a standalone diagnosis in the DSM-5-TR. It's best understood as a descriptive term for a pattern of intense emotional dysregulation tied to perceived rejection or criticism, most often seen alongside ADHD. The experience itself is well documented, even though the specific label isn't a formal clinical category yet.

 Can you have RSD without having ADHD?Rejection sensitivity as a broader concept can occur without ADHD, and it overlaps with anxiety, depression, and certain personality patterns. However, the specific intensity and rapid onset described as RSD is most commonly discussed in the context of ADHD-related emotional dysregulation.

 Is medication the only treatment for RSD?No. While some people find certain ADHD medications reduce the intensity of RSD reactions, therapy — particularly CBT, ACT, and compassion-focused approaches — can directly address both the emotional intensity and the underlying beliefs that drive it, with or without medication involved.

 How is RSD different from generalized rejection sensitivity in psychology research?Rejection sensitivity has been studied in psychology for decades as a tendency to anxiously expect, readily perceive, and intensely react to rejection. RSD, as popularized in the ADHD community, describes a related but more acute and rapid-onset version of this pattern, specifically tied to ADHD-related emotional dysregulation.

 Can children experience RSD, or is it only in adults?Children with ADHD can absolutely experience intense reactions to criticism or rejection. It's discussed more often in adults partly because adults have the language and self-reflection to describe the internal experience, while in children it may just look like a meltdown after being corrected.

 Will RSD go away on its own as I get older?For some people the intensity softens somewhat with life experience and self-understanding, but it typically doesn't resolve without some form of intervention. Structured therapy tends to produce more reliable and faster improvement than waiting it out.

#### Sources & Further Reading

1. Cleveland Clinic. ["Rejection Sensitive Dysphoria (RSD): Symptoms & Treatment."](https://my.clevelandclinic.org/health/diseases/24099-rejection-sensitive-dysphoria-rsd)
2. ADDitude Magazine. ["RSD: Meaning of Rejection Sensitive Dysphoria, ADHD Link."](https://www.additudemag.com/rejection-sensitive-dysphoria-and-adhd/)
3. PLOS ONE (2024). ["The Lived Experience of Rejection Sensitivity in ADHD — A Qualitative Exploration."](https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0314669)
4. The Conversation. ["What Is Rejection Sensitive Dysphoria in ADHD? And How Can You Manage It?"](https://theconversation.com/what-is-rejection-sensitive-dysphoria-in-adhd-and-how-can-you-manage-it-259995)

This article is for informational purposes and is not a substitute for individualized clinical advice.

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**Categories:** Symptom Relief

---

### [How Superbills Work: Get Reimbursed for Out-of-Network Therapy](https://dralanjacobson.com/how-superbills-work-out-of-network-therapy/)

**Published:** August 17, 2026
**Author:** Dr. Alan Jacobson

**Content:**

# How Superbills Work: Get Reimbursed for Out-of-Network Therapy

 by [Dr. Alan Jacobson](https://dralanjacobson.com/author/alanjacobson/ "Posts by Dr. Alan Jacobson") | Aug 17, 2026 | [Finding therapy](https://dralanjacobson.com/category/finding-therapy/)

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: August 17, 2026

Fees & Insurance · Getting Started

Working with an out-of-network therapist doesn't mean paying full price with nothing back. A superbill is the document that turns your sessions into a legitimate insurance reimbursement claim — here's exactly how it works.

 🖋️ Dr. Alan Jacobson, Psy.D., MBA ⏱️ 8 min read 🔬 Reviewed for accuracy

One of the most common questions I hear during a first consultation is some version of: "You don't take my insurance — so is this actually going to cost me full price?" For many clients, the honest answer is no. As an out-of-network provider, I don't bill your insurance directly, but I do provide a **superbill** — a detailed, insurance-ready receipt you submit yourself for potential partial reimbursement. This guide walks through exactly what that process looks like, what you're legally entitled to, and how to avoid the most common reasons reimbursement claims get delayed or denied.

 **Quick answer:** A superbill is an itemized receipt containing your diagnosis code, procedure code, and provider information that you submit to your insurance company for out-of-network reimbursement. Many PPO plans reimburse a meaningful share of the session fee once you meet your deductible. You're also protected by federal law (the No Surprises Act and Mental Health Parity Act) throughout this process. See our [Fees & Insurance](https://dralanjacobson.com/#fees) section for our current rates and policies.

### In this article

1. [What a superbill actually is](#what-is-it)
2. [What's on a superbill](#contains)
3. [Step-by-step: getting reimbursed](#steps)
4. [How much will you actually get back?](#how-much)
5. [Your legal protections](#rights)
6. [Is therapy HSA/FSA eligible?](#hsa)
7. [Frequently asked questions](#faq)

## What a Superbill Actually Is

A superbill is an itemized receipt that an out-of-network provider gives you so you can submit a reimbursement claim directly to your own insurance company. Unlike in-network billing, where the therapist's office handles claims submission for you, out-of-network reimbursement puts you in the driver's seat: you pay the full session fee upfront, then submit the superbill yourself (or through a claims-filing app) to request partial reimbursement based on your specific out-of-network benefits.

This isn't a workaround or a loophole — it's a standard, well-established part of how out-of-network healthcare billing works across mental health and medicine generally.

## What's Actually on a Superbill

For a superbill to be processed, it needs to include the specific information your insurer's claims system requires:

- **Provider information** — name, license type and number, National Provider Identifier (NPI), and practice address
- **CPT procedure code** — the billing code for your session type (for example, 90837 for a 53+ minute individual psychotherapy session)
- **ICD-10 diagnosis code** — insurers only reimburse for medically necessary care, which requires a diagnosis on file
- **Dates of service** — each session date, billed individually
- **Charges and payments** — the fee for each session and what you paid

A diagnosis code is a required part of this process for any mental health superbill, not something specific to my practice — insurance companies need it to determine medical necessity before reimbursing anything.

## Step-by-Step: Getting Reimbursed

#### Call your insurer before your first session

Ask specifically about your "out-of-network outpatient mental health" benefits — not just general out-of-network coverage, since mental health can sometimes be handled by a separate behavioral health administrator.

#### Request your superbill

We provide a superbill you can request after your sessions — many clients request theirs monthly to keep the submission process manageable.

#### Submit it to your insurer

Most insurers accept submissions through an online member portal, a mobile app, or by mail with a simple claim form attached.

#### Track your deductible

Most out-of-network benefits don't kick in until you've met a separate out-of-network deductible — track your running total so you know when reimbursement should start.

#### Follow up if needed

Claims can take several weeks to process. If you haven't heard back, a quick call to your insurer with your claim number usually gets things moving.

## How Much Will You Actually Get Back?

50–80%Typical share of session cost PPO members report being reimbursed, after meeting their deductible

17%Share of inpatient mental health/substance use payments in large employer PPO plans that were out-of-network

Reimbursement amounts vary considerably by plan, and insurers typically reimburse based on their own "allowed amount" for your CPT code — which may be lower than what you actually paid — rather than the full billed fee. Peterson-KFF Health System Tracker's analysis of large employer health plans found meaningful out-of-network utilization for mental health and substance use care specifically, underscoring that this is a common, expected part of how many people access care outside their network ([Peterson-KFF Health System Tracker](https://www.healthsystemtracker.org/brief/an-analysis-of-out-of-network-claims-in-large-employer-health-plans/)).

 **Worth asking your insurer directly:** "What is your allowed amount for CPT code 90837, and what percentage of that do you reimburse for out-of-network outpatient mental health care?" This single question gets you a far more accurate estimate than a general coverage summary.

## Your Legal Protections

#### Good Faith Estimate (No Surprises Act)

Federal law requires that uninsured and out-of-network clients receive a written Good Faith Estimate of expected costs before care begins. If your actual bill ends up at least $400 higher than the estimate, you have the right to dispute it ([CMS, No Surprises Act](https://www.cms.gov/files/document/nsa-keyprotections.pdf)).

#### Mental Health Parity Act

If your health plan covers out-of-network benefits for medical or surgical care, federal law requires it to offer comparable out-of-network benefits for mental health and substance use care — insurers cannot apply stricter limits to mental health coverage than to physical health coverage ([CMS, MHPAEA](https://www.cms.gov/marketplace/private-health-insurance/mental-health-parity-addiction-equity); [U.S. Department of Labor](https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/mental-health-and-substance-use-disorder-parity)).

You can find our current Good Faith Estimate practices on our [Fees & Insurance](https://dralanjacobson.com/#fees) section and our [Practice Policies](https://dralanjacobson.com/practice-policies/) page.

## Is Therapy HSA/FSA Eligible?

In most cases, yes. According to IRS Publication 502, the cost of psychotherapy and counseling qualifies as an eligible medical expense when it's intended to diagnose, treat, or manage a condition — which describes the large majority of individual therapy ([IRS Publication 502](https://www.irs.gov/publications/p502)). We accept FSA and HSA cards directly as payment, and your superbill can also serve as documentation if your plan administrator requests it. We recommend confirming your specific plan's requirements with your administrator, since some plans request a letter of medical necessity for certain situations.

#### Questions to ask your insurer before your first session

- *"Do I have out-of-network benefits for outpatient mental health services?"*
- *"What is my out-of-network deductible, and how much have I met this year?"*
- *"What is your allowed amount for CPT code 90837, and what percentage do you reimburse?"*
- *"How do I submit a superbill — through a portal, app, or mail?"*
- *"Is there a limit on the number of sessions covered per year?"*

### Still not sure what your plan actually covers?

A free 20-minute consultation is a good place to ask questions about fees, superbills, and what to expect — no pressure, no obligation.

 [Schedule a Free Consult](https://www.picktime.com/scheduleaconsult) [Read Therapy FAQs](https://dralanjacobson.com/therapy-faqs/)

## Frequently Asked Questions

 Do I need a diagnosis to get a superbill?Yes. Insurance companies require a diagnosis code to determine medical necessity before reimbursing any claim, so a diagnosis is a standard part of every mental health superbill, regardless of provider.

 Is my reimbursement guaranteed?No. Reimbursement depends entirely on your specific insurance plan's out-of-network benefits, deductible status, and allowed amounts. We recommend contacting your insurer directly before your first session to get an accurate picture of what to expect.

 What if my insurance denies the claim?Common reasons include an unmet out-of-network deductible, a plan that excludes out-of-network mental health benefits entirely, or missing information on the claim form. If you believe a denial is incorrect, you can request a written explanation and, in some cases, file an appeal directly with your insurer.

 Can I use an app to submit superbills instead of doing it myself?Yes. Several third-party services exist specifically to submit superbills and track reimbursement on your behalf for a fee. Many clients also submit directly through their insurer's member portal at no additional cost.

 Does a superbill affect my privacy the way in-network billing might?A superbill includes a diagnosis code, which becomes part of the claims record your insurer maintains, similar to in-network billing. If privacy from your insurer is a significant concern, this is worth discussing during your consultation.

 Will you help me understand my Good Faith Estimate?Yes. Federal law requires we provide a Good Faith Estimate of expected costs before your first appointment, and we're happy to walk through it with you and answer any questions.

#### Sources & Further Reading

1. Centers for Medicare & Medicaid Services. ["No Surprises Act: Overview of Key Consumer Protections."](https://www.cms.gov/files/document/nsa-keyprotections.pdf)
2. Centers for Medicare & Medicaid Services. ["The Mental Health Parity and Addiction Equity Act (MHPAEA)."](https://www.cms.gov/marketplace/private-health-insurance/mental-health-parity-addiction-equity)
3. U.S. Department of Labor. ["Know Your Rights: Parity for Mental Health and Substance Use Disorder Benefits."](https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/mental-health-and-substance-use-disorder-parity)
4. Internal Revenue Service. [Publication 502, Medical and Dental Expenses.](https://www.irs.gov/publications/p502)
5. Peterson-KFF Health System Tracker. ["An Analysis of Out-of-Network Claims in Large Employer Health Plans."](https://www.healthsystemtracker.org/brief/an-analysis-of-out-of-network-claims-in-large-employer-health-plans/)

This article is for general informational purposes and is not a substitute for confirming your specific benefits directly with your insurance provider.

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**Categories:** Finding therapy

---

### [Imposter Syndrome: Why High Achievers Feel Like Frauds](https://dralanjacobson.com/imposter-syndrome/)

**Published:** August 15, 2026
**Author:** Dr. Alan Jacobson

**Content:**

# Imposter Syndrome: Why High Achievers Feel Like Frauds

 by [Dr. Alan Jacobson](https://dralanjacobson.com/author/alanjacobson/ "Posts by Dr. Alan Jacobson") | Aug 15, 2026 | [Symptom Relief](https://dralanjacobson.com/category/symptom-relief/)

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: August 15, 2026

Anxiety & Performance · Therapy Blog

If you've ever felt like you're one mistake away from being "found out," despite real evidence of your competence, you're experiencing one of the most common — and most misunderstood — psychological patterns among high achievers.

 🖋️ Dr. Alan Jacobson, Psy.D. ⏱️ 9 min read 🔬 Clinically reviewed

**Imposter syndrome** — also called the *impostor phenomenon* — is the persistent feeling that your accomplishments are the result of luck, timing, or deception rather than genuine ability, paired with the fear that you'll eventually be exposed as a fraud. It shows up constantly in my practice: among [founders](https://dralanjacobson.com/founder-coaching/) scaling a company they secretly feel unqualified to run, [executives](https://dralanjacobson.com/executive-coaching/) newly promoted into rooms they don't feel they belong in, and students and [early-career professionals](https://dralanjacobson.com/early-career-coaching/) convinced their offer letter was a mistake.

 **Quick answer:** Imposter syndrome isn't a diagnosis or a personality flaw — it's a learned pattern of thinking that can be identified and unlearned. It responds well to structured approaches like [CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/), [ACT](https://dralanjacobson.com/act-psychotherapy/), and [compassion-focused therapy](https://dralanjacobson.com/compassion-focused-therapy/), usually within a matter of weeks to a few months.

### In this article

1. [What imposter syndrome actually is](#what-is-it)
2. [How common it is](#stats)
3. [Signs you might be experiencing it](#signs)
4. [The 5 types of imposter syndrome](#types)
5. [What causes it](#causes)
6. [How therapy helps](#treatment)
7. [Frequently asked questions](#faq)

## What Imposter Syndrome Actually Is

The term was coined in 1978 by psychologists [Pauline Clance and Suzanne Imes](https://paulineroseclance.com/pdf/ip_high_achieving_women.pdf), who studied a group of high-achieving women who, despite outstanding academic and professional records, privately believed they weren't as intelligent or capable as others perceived them to be. They coined it the "imposter *phenomenon*," not a syndrome — an important distinction, since it describes a pattern of thought and feeling, not a mental disorder. The [American Psychological Association](https://dictionary.apa.org/impostor-phenomenon) defines it similarly today: a persistent belief in one's own inadequacy despite objective evidence to the contrary.

What makes imposter syndrome tricky is that it doesn't correlate with actual competence. In fact, the more capable and accomplished someone becomes, the more evidence they often have to explain away — leading to a widening gap between how others see them and how they see themselves.

## How Common Is Imposter Syndrome?

A 2020 systematic review published in the *Journal of General Internal Medicine* pooled data across dozens of studies and found that imposter feelings are far more widespread — and far less gender-specific — than popular culture suggests.

9–82%Prevalence range across study populations, depending on the measure used

~50%Of studies find no significant difference in rates between men and women

1978Year the term was first coined in clinical research

The same review found imposter feelings are consistently associated with anxiety, depression, and burnout, and can meaningfully affect job performance and job satisfaction over time — which is one reason it's worth addressing directly rather than waiting for it to pass on its own. ([Bravata et al., 2020, Journal of General Internal Medicine](https://link.springer.com/article/10.1007/s11606-019-05364-1))

## Signs You Might Be Experiencing It

Imposter syndrome doesn't always look like obvious self-doubt. In high-functioning people, it often hides behind overwork and outward confidence. Common signs include:

- Attributing your success to luck, timing, or other people rather than your own ability
- Chronic overpreparation, or working far harder than the task seems to require, "just in case"
- Difficulty accepting compliments or internalizing praise
- A persistent fear that you'll be "exposed" during your next big project, promotion, or evaluation
- Downplaying your achievements or deflecting credit in conversation
- Anxiety that intensifies right after a success, rather than easing

If several of these feel familiar, it may be worth exploring further — our [Anxiety & Stress](https://dralanjacobson.com/best-types-of-therapy-for-anxiety/) page covers related patterns, and a [free consultation](https://www.picktime.com/scheduleaconsult) is a low-pressure way to talk it through.

## The 5 Types of Imposter Syndrome

Psychologist Valerie Young's widely used framework, from the [Impostor Syndrome Institute](https://impostorsyndrome.com/articles/5-types-of-impostor-syndrome/), breaks the pattern into five distinct "competence types." Recognizing which one fits you is often the first useful step in treatment.

#### The Perfectionist

Sets excessively high standards and experiences even minor flaws as evidence of failure.

#### The Natural Genius

Believes competence should come quickly and easily; struggling with something new feels like proof of inadequacy.

#### The Soloist

Feels that asking for help exposes incompetence, so achievement has to happen alone to "count."

#### The Expert

Fears being exposed for "not knowing enough," even after years of experience, and over-credentials as a result.

#### The Superwoman/Superman

Measures worth by pushing harder across every role — work, parenting, relationships — often at the cost of burnout.

## What Causes Imposter Syndrome

There's rarely a single cause. In my clinical work, it tends to develop from some combination of:

- **Family dynamics growing up** — being labeled "the smart one," or growing up in a home where achievement was tightly linked to approval
- **Being a "first" or "only"** — the first in your family to attend college or reach a leadership role, or being one of few people who look like you in the room
- **High-pressure transitions** — a promotion, a new degree program, founding a company, or any jump into unfamiliar territory (see our [Life Transitions](https://dralanjacobson.com/life-transitions-therapy/) page)
- **Perfectionistic or comparison-driven environments** — competitive schools, workplaces, or social circles that reward constant achievement

 **Worth knowing:** Imposter feelings are not a reliable signal of your actual ability. They're a pattern of interpretation — and patterns of interpretation can be changed with the right approach.

## How Therapy Helps

Imposter syndrome responds well to treatment because it's fundamentally a pattern of distorted self-appraisal, not a fixed trait. In my practice, I typically draw on a combination of approaches depending on what's driving it for a given person:

#### Approaches I use for imposter syndrome

- [Cognitive-Behavioral Therapy (CBT)](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) — identifies and restructures the automatic thoughts ("I only got this job by luck") that fuel the cycle
- [Acceptance and Commitment Therapy (ACT)](https://dralanjacobson.com/act-psychotherapy/) — builds the ability to act on your values even while imposter thoughts are present, rather than waiting to "feel ready"
- [Compassion-Focused Therapy (CFT)](https://dralanjacobson.com/compassion-focused-therapy/) — targets the harsh inner critic that often sits underneath imposter feelings
- [Personal growth-focused work](https://dralanjacobson.com/personal-growth-counseling/) — for people who want to move past coping and build a more durable, internalized sense of competence

This work tends to move relatively quickly. Most clients notice a meaningful shift within a handful of sessions, particularly when imposter syndrome is the primary concern rather than one symptom among several. You can read more about what to expect on our [Therapy Approach](https://dralanjacobson.com/types-of-therapy/) page.

### Ready to stop feeling like a fraud in rooms you've earned a seat in?

A free 20-minute consultation is the easiest way to find out if this is a fit — no pressure, no obligation.

 [Schedule a Free Consult](https://www.picktime.com/scheduleaconsult) [Meet Dr. Jacobson](https://dralanjacobson.com/my-bio/)

## Frequently Asked Questions

 Is imposter syndrome a real diagnosis?No. Imposter syndrome (more precisely, the "impostor phenomenon") is not a diagnosis in the DSM-5. It's a well-documented psychological pattern — a way of interpreting your own success — rather than a clinical disorder. That said, it's very real in its effects and is strongly linked to anxiety, depression, and burnout when left unaddressed.

 What causes imposter syndrome?Common contributors include family dynamics around achievement, being a "first" or "only" in a role or environment, major life or career transitions, and perfectionistic or highly competitive settings. It usually develops from a combination of these factors rather than one single cause.

 Does imposter syndrome go away on its own?For some people it fades with time and experience; for many high achievers, it persists or even intensifies as their accomplishments grow, since each new success creates more to "explain away." Structured approaches like CBT and ACT tend to resolve it far more reliably and quickly than waiting it out.

 Is imposter syndrome only a problem for women?No. While the original 1978 research focused on high-achieving women, later research has found that roughly half of studies show no significant gender difference in prevalence. It's also common among men, particularly in leadership, entrepreneurship, and STEM fields.

 Can therapy actually help with imposter syndrome?Yes. Because imposter syndrome is a pattern of thought rather than a fixed trait, it responds well to targeted approaches like Cognitive-Behavioral Therapy, Acceptance and Commitment Therapy, and Compassion-Focused Therapy. Most clients see meaningful change within several sessions.

 How is imposter syndrome different from healthy self-doubt?Healthy self-doubt is proportional, motivates preparation, and updates as you gather evidence of your competence. Imposter syndrome is persistent and resistant to evidence — success doesn't reduce the fear of being "found out," and in many cases it increases it.

#### Sources & Further Reading

1. Clance, P. R., & Imes, S. A. (1978). ["The Imposter Phenomenon in High Achieving Women: Dynamics and Therapeutic Intervention."](https://paulineroseclance.com/pdf/ip_high_achieving_women.pdf) Psychotherapy: Theory, Research and Practice, 15(3), 241–247.
2. Bravata, D. M., et al. (2020). ["Prevalence, Predictors, and Treatment of Impostor Syndrome: A Systematic Review."](https://link.springer.com/article/10.1007/s11606-019-05364-1) Journal of General Internal Medicine.
3. American Psychological Association. ["Impostor Phenomenon" — APA Dictionary of Psychology.](https://dictionary.apa.org/impostor-phenomenon)
4. Young, V. ["5 Types of Impostor Syndrome."](https://impostorsyndrome.com/articles/5-types-of-impostor-syndrome/) Impostor Syndrome Institute.
5. Harvard Business Review. ["End Imposter Syndrome in Your Workplace."](https://hbr.org/2021/07/end-imposter-syndrome-in-your-workplace) (2021).

This article is for informational purposes and is not a substitute for individualized clinical advice.

### *Related*

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**Categories:** Symptom Relief

---

### [Therapy Online: Approaches, Techniques, and Outcomes](https://dralanjacobson.com/therapy-online-approaches-techniques-and-outcomes/)

**Published:** January 1, 2026
**Author:** Dr. Alan Jacobson

**Content:**

As a psychologist who has delivered thousands of hours of telehealth, I no longer view online therapy as a substitute for office-based care. It is its own distinct modality with its own clinical advantages: clients engage from their real environments, exposures occur in vivo, executive functioning supports are built directly into daily routines, and emotionally charged patterns emerge naturally rather than being artificially contained within an office. Many clients report something else, too — that opening up is easier from familiar surroundings. Shame softens. Vulnerability deepens. Sessions become collaborative working meetings rather than formal appointments.

This article covers how the major evidence-based approaches are adapted for online delivery, and what treatment actually looks like across five very different cases. (For the research on whether online treatment works as well as in-person, see [my full review of the effectiveness evidence](https://dralanjacobson.com/is-virtual-therapy-as-effective-as-in-person/); for logistics, fees, and how sessions run in my practice, see the [Complete Virtual Therapy Guide](https://dralanjacobson.com/virtual-therapy-guide/).)

## It Starts With Assessment, Not a Menu

In my practice, telehealth is never one-size-fits-all. Each engagement begins with careful assessment — often integrating cognitive, executive functioning, emotional, and personality-based measures — so the approach matches not only the diagnosis but the person’s learning style, goals, and life context. Whether the focus is anxiety, ADHD, OCD, burnout, or deeper identity and relational patterns, the plan is built to be strategic, strengths-based, and sustainable. The result is not just improvement, but momentum.

## Core Approaches, Adapted for Online Work

- **Cognitive Behavioral Therapy (CBT):** shared screens turn thought records, behavioral experiments, and exposure hierarchies into live collaborative documents. Strong online for anxiety, depression, insomnia (CBT-I), panic, perfectionism, and performance concerns.
- **Exposure and Response Prevention (ERP):** arguably *stronger* online — the feared triggers for OCD live at home, in the car, at the sink, and virtual sessions let exposures happen exactly where the compulsions do.
- **Schema Therapy:** longer-term work on lifelong emotional patterns rooted in early experience. The relational depth translates fully to video, and meeting clients in their own space often surfaces the patterns faster.
- **ADHD treatment and executive functioning coaching:** systems get built in the actual environment where they’ll be used — the real desk, the real calendar, the real morning routine — instead of described secondhand.
- **Panic-focused interventions:** interoceptive exposure and skills practice can happen in the settings where panic actually strikes, with support in the room (virtually) the first times through.

## Five Cases, Five Models, One Platform

These examples — composites drawn from my practice with details altered to protect privacy — were selected to show range: online therapy is not a single technique but a platform for delivering many evidence-based models with precision and real-world relevance.

Schema Therapy### The executive whose burnout wasn’t about workload

A high-performing leader arrived with classic burnout — exhaustion, cynicism, dread. Assessment pointed deeper: an unrelenting-standards pattern rooted in early experience, driving overcommitment no schedule change could fix. Schema-focused work over video traced the pattern to its origins and restructured it; meeting during his workday, in his actual office, meant the material was never abstract. The burnout resolved because its engine did.

Exposure & Response Prevention### The young adult whose OCD lived in her apartment

Contamination-focused OCD had organized her entire home around avoidance. In-office treatment would have meant describing her kitchen; virtual treatment meant being *in* it. Exposures were conducted live in the exact locations the compulsions occurred, with response prevention coached in real time. Progress that typically takes months of generalization from office to home happened directly, because there was no gap to generalize across.

CBT### The professional with anxiety and 2 a.m. rehearsals

Chronic worry, insomnia, and pre-meeting dread responded to structured CBT with CBT-I: shared-screen thought records, behavioral experiments between sessions, and a sleep protocol tracked collaboratively. Sessions scheduled over lunch — impossible with a commute — kept treatment consistent through his busiest quarter, which was precisely when he needed it.

ADHD & Executive Functioning### The graduate student whose systems never survived the week

Every planner and app had failed her because they’d been designed in the abstract. Camera in hand, we built the system in her real workspace — the actual desk, the actual whiteboard, the actual Sunday-evening reset — and troubleshot it live when it wobbled. Combined with treatment for the shame the ADHD had accumulated, the difference wasn’t just organization; it was self-trust.

Panic-Focused Treatment### The new parent whose panic attacks arrived in the car

Panic had started on highway drives and was spreading. Treatment combined interoceptive exposure with graded real-world practice — early sessions from home, later check-ins conducted moments before planned drives, the virtual equivalent of a clinician in the passenger seat. The “booster before the trigger” structure that telehealth makes possible turned out to be the treatment’s backbone.

**The common thread:** in each case, therapy happened where the problem lived. Online therapy is not a diluted version of care — it’s a platform that lets treatment live where life actually unfolds, creating change that is durable in the world beyond the session.

## Online Therapy Approaches: Frequently Asked Questions

Which therapy approaches work well online?Nearly all of the major evidence-based models: CBT (including CBT-I for insomnia), exposure and response prevention for OCD, Schema Therapy, ACT, psychodynamic therapy, motivational interviewing, and ADHD-focused treatment all adapt fully to video. A small number of methods favor in-person delivery — standard-protocol EMDR, play therapy for young children, and some somatic techniques. Exposure-based work often works better online, because practice happens in the real settings where symptoms occur.

How do you decide which approach to use?Through assessment rather than default. Treatment begins with a careful evaluation — often integrating cognitive, executive functioning, emotional, and personality-based measures — so the approach matches not just the diagnosis but the person’s learning style, goals, and life context. Two clients with the same diagnosis may receive quite different treatment plans, and the plan is revisited as the work progresses.

Can intensive treatments like ERP or Schema Therapy really be done over video?Yes — and ERP is a case where video frequently improves the treatment, since exposures can be conducted live in the exact home locations where obsessions and compulsions occur, rather than simulated in an office. Schema Therapy’s longer-term relational work also translates fully; many clients open up more readily from familiar surroundings, which deepens rather than dilutes the process.

What outcomes can I expect from online therapy?The same outcomes the research shows for in-person care: meaningful improvement across anxiety, depression, OCD, ADHD-related difficulties, and relational patterns when the approach fits the problem. Realistically, therapy doesn’t erase life stressors — it builds durable capacity to handle them. Because online treatment is embedded in your real environment, gains often transfer to daily life faster, with less of the gap between “what I do in session” and “what I do at home.”

## Find the Right Approach for Your Situation

Schedule a free consultation. We’ll discuss what you’re facing and which treatment model fits — designed around assessment of your actual situation, not a one-size-fits-all program.

[Schedule a Free Consultation](https://www.picktime.com/scheduleaconsult)

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?## More Frequently Asked Questions: Online Therapy

Common questions about how online therapy works, who it helps, and what to expect from virtual treatment.

### Is online therapy as effective as in-person therapy?

Yes — and in some respects it can be more effective. A large and growing body of research supports the clinical equivalence of telehealth and in-person treatment across a wide range of conditions, including anxiety, depression, OCD, ADHD, and trauma. Beyond equivalence, online therapy offers a clinically meaningful advantage called [ecological validity](https://en.wikipedia.org/wiki/Ecological_validity): interventions happen in the client’s real environment — their home, dorm, office, or car — rather than in a neutral office setting. Exposures occur in vivo, executive functioning supports are built directly into daily routines, and emotional patterns emerge naturally. This often accelerates and deepens the work.

### What conditions and approaches can be treated effectively online?

Online therapy supports the full range of evidence-based treatment models. Dr. Jacobson delivers [CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) online for depression and anxiety, [Exposure and Response Prevention (ERP)](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/) for OCD, [Schema Therapy](https://dralanjacobson.com/schema-therapy/) for deep-rooted emotional patterns, [ADHD therapy](https://dralanjacobson.com/adhd-therapy-for-adults/) and coaching, [panic-focused treatment](https://dralanjacobson.com/panic-attack-treatment/), and [integrated treatment for depression and anxiety](https://dralanjacobson.com/therapy-for-depression-and-anxiety/). Telehealth is not a reduced version of these approaches — it is a platform that enables their full delivery, often with greater real-world relevance and between-session integration than office-based work alone.

### What are the practical advantages of doing therapy online?

Beyond clinical effectiveness, online therapy offers significant practical benefits. It eliminates commute time, removes geographic barriers, and makes it far easier to maintain consistent attendance — one of the strongest predictors of good treatment outcomes. It supports [continuity of care](https://pmc.ncbi.nlm.nih.gov/articles/PMC9125858/) during relocations, travel, illness, or demanding life stages. Many clients also report feeling more comfortable opening up in their own environment — shame softens, and sessions take on a collaborative, working-meeting quality rather than a formal clinical one. For students, the ability to continue therapy between semesters without interruption is particularly valuable.

### Can complex treatments like Schema Therapy or ERP really be done via video?

Yes — and the case examples on this page illustrate exactly how. Schema Therapy online uses digital inventories, shared whiteboard life-timeline mapping, screen-partitioned chair dialogues between schema modes, guided imagery rescripting with recorded audio for daily playback, and digital schema flashcards. ERP for OCD is delivered via in-home exposure coaching over video — which is actually a clinical advantage, since contamination and other OCD triggers live in the home environment, not in a therapist’s office. Complex treatment is not just possible online; the format often makes it more precise and contextually relevant than office-based delivery.

### Can I see Dr. Jacobson online if I live in a different state?

In most cases, yes. Dr. Jacobson is a [PSYPACT](https://psypact.org/)-participating psychologist licensed to practice in 44 states. This means clients can begin therapy in one location and continue without interruption if they relocate, travel, or split time between states. It also makes Dr. Jacobson accessible to clients in states where specialized services — such as [OCD therapy](https://dralanjacobson.com/therapy-for-ocd/), [fear of flying treatment](https://dralanjacobson.com/fear-of-flying-therapy/), or [sports psychology](https://dralanjacobson.com/sports-psychology/) — may not be readily available locally. A full list of covered states is available on the [locations page](https://dralanjacobson.com/locations/).

### How is an online therapy session actually structured?

Sessions follow the same clinical structure as in-person appointments — typically 45–55 minutes — with the addition of tools that enhance the virtual format. These include screen sharing for live completion of thought records, cognitive maps, or planning documents; shared digital workspaces for between-session skill tracking; and, where clinically indicated, real-time in-vivo coaching during exposures or behavioral experiments. Session recordings (with consent) allow clients to revisit key interventions. The goal is not to replicate the office experience online but to build a richer, more embedded form of treatment that meets clients where their lives actually unfold.

### What’s the difference between online therapy and apps or AI-based mental health tools?

Online therapy with a licensed psychologist is clinical treatment — individualized, diagnostically informed, and delivered by a credentialed professional with ethical and legal accountability. Apps and AI-based tools can be useful adjuncts for mood tracking, psychoeducation, and between-session skill reinforcement, and they represent an exciting area of emerging innovation in telehealth. However, they are not substitutes for clinical assessment, diagnosis, or the therapeutic relationship that drives meaningful and lasting change. Dr. Jacobson’s practice integrates evidence-based digital tools where appropriate while keeping the clinical relationship at the center of care. For more on emerging innovations, see the best online therapy guide.

### How do I know if online therapy is the right fit for me?

The best way to find out is through a free 20-minute consultation. In that conversation, Dr. Jacobson will ask about what you’re experiencing, what approaches you may have tried, and what your goals are — and you’ll get a candid sense of whether online therapy, and this particular fit, makes sense. Most people find the conversation more straightforward than they expected. You can also explore the [guide to choosing a therapy approach](https://dralanjacobson.com/which-type-of-therapy-is-right-for-you-a-practical-guide/) and the [virtual therapy guide](https://dralanjacobson.com/virtual-therapy-guide/) for more context before reaching out.

Ready to get started with online therapy?

Schedule a free 20-minute consultation with Dr. Jacobson. No commitment required — just an honest conversation about where you are and what might help.[ Schedule a Free Consultation](https://www.picktime.com/scheduleaconsult)

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Virtual

---

### [Teenage Girls with ADHD: Signs, Causes & Support](https://dralanjacobson.com/teenage-girls-with-adhd/)

**Published:** June 29, 2025
**Author:** Dr. Alan Jacobson

**Content:**

ADHD in teenage girls often presents as inattention, emotional sensitivity, and internal overwhelm rather than obvious hyperactivity. Because symptoms are more subtle, they are frequently misunderstood or overlooked, leading to struggles with school, relationships, and self-esteem.

### Common signs include:

- Daydreaming, distractibility, and difficulty staying organized
- Emotional reactivity, overwhelm, or mood swings
- Low self-esteem or feeling “not good enough”
- Social challenges or difficulty maintaining friendships

## Why ADHD in Teenage Girls Is Often Missed

- Symptoms are more inattentive than disruptive
- Girls often mask or compensate for difficulties
- Behaviors are misinterpreted as anxiety, mood, or personality traits

## Introduction to this Therapy Method

Attention-Deficit/Hyperactivity Disorder is often underdiagnosed in girls, particularly during childhood. Many teenage girls with ADHD are not identified until late, when academic, emotional, and social demands have already intensified. Unlike the stereotypical hyperactive presentation seen more often in boys, symptoms of ADHD in a teenage girl are more likely to be inattentiveness, internalized symptoms, and [emotional dysregulation](https://psychologicalassessments.com/emotional-dysregulation-testing/), often mistaken for anxiety or mood issues.

Early recognition and support of symptoms of ADHD in a teenage girl can make a significant difference in a girl’s academic confidence, self-esteem, and overall well-being. A good start is the teenage girls ADHD checklist below or more formal [psychological testing](https://psychologicalassessments.com/). Then, therapy for ADHD in a teenage girl can make a huge difference.

**Ready to Understand & Support Your Teen?**
If it feels like your daughter’s struggles go deeper than just “teenage behavior,” ADHD might be part of the picture. [Contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult), and we can discuss a personalized plan to help your teen thrive in school and life, overcoming barriers and tapping into the superpowers the diagnosis can create.

## Common Symptoms of ADHD in a Teenage Girl

ADHD in teen girls may present in less overt ways than in boys. Symptoms of ADHD in a teenage girl may include:

- **Inattentiveness**
    - Frequently daydreaming
    - Struggling to complete assignments or stay organized
    - Forgetting or losing things (homework, keys, etc.)
    - Appearing “spacey” or disengaged
- **Emotional Dysregulation**
    - Overwhelm or meltdowns from small setbacks
    - High sensitivity to criticism
    - Mood swings, irritability
- **Impulsivity (less common but still present)**
    - Interrupting others or blurting out thoughts
    - Difficulty waiting her turn
- **Executive Dysfunction**
    - Procrastination despite good intentions
    - Trouble planning, managing time, and staying on task
- **Masking and Burnout**
    - Working hard to appear “together” but breaking down privately
    - Mimicking peers to compensate for focus or social difficulties

### Teenage Girls ADHD Checklist

Use this informal checklist as a starting point. It is not a diagnostic tool but can help identify potential areas of concern:

- Frequently forgets assignments or loses track of tasks
- Spends hours on homework but produces incomplete work
- Describes herself as overwhelmed, scattered, or anxious
- Has strong emotional reactions or frequent shutdowns
- Struggles with procrastination or motivation
- Desires to do well but can’t follow through consistently
- Easily distracted by internal thoughts or external stimuli
- Difficulty with sleep, often due to a racing mind
- Sensitive to rejection, criticism, or perceived failure
- Has been labeled “smart but lazy” or “too sensitive”

You can use this teenage girls ADHD checklist as a quick reference, but an actual diagnosis should involve a professional.

### Why ADHD in Girls Is Often Missed or Misunderstood

ADHD in teenage girls frequently presents differently than in boys. Instead of the classic hyperactivity many people expect, girls are more likely to struggle with **inattention, organization, daydreaming, and internalizing symptoms** that don’t disrupt classrooms or social settings. Because these traits are less obvious, they are often mistaken for typical adolescent behavior, personality quirks, or stress. This “hidden” presentation contributes to delayed or missed diagnoses in girls.

### Why Symptoms Change in the Teenage Years

As demands for organization, independent study, time management, and social navigation increase during adolescence, previously compensable ADHD traits often become more apparent. Hormonal changes and transitions between structured and unstructured settings can further challenge attention and regulation.

### How ADHD Affects Daily Life & Mental Health

Teenage girls with undiagnosed or untreated ADHD are more likely to experience:

- **Academic struggles**, despite effort
- **Anxiety**, **depression**, and emotional dysregulation
- **Low self-image** and sense of self-efficacy
- Greater risk of co-occurring challenges such as eating concerns or risk-related behavior

Recognizing these patterns early can make a major difference in emotional well-being and long-term success.

## Teenage Girls with ADHD Treatment

There are many strategies for the treatment of symptoms of ADHD in a teenage girl, including:

### Individual and Family Therapy

- [Cognitive Behavioral Therapy for ADHD](https://dralanjacobson.com/cbt-for-adhd/) (CBT): Teaches teenage girls with ADHD practical coping strategies and reframing skills.
- [Executive Function Coaching](https://dralanjacobson.com/executive-functioning-coaching/): Helps teenage girls with ADHD develop planning, organization, and study habits.
- Family or Parent Coaching: Supports better communication and structure at home.

### Medication Possibilities

- Stimulants (e.g., Adderall, Vyvanse): Often the first line of treatment; can improve focus and impulse control.
- Non-stimulants (e.g., Strattera, Intuniv): Useful for girls with anxiety or side effects from stimulants.

### [Academic Accommodations](https://psychologicalassessments.com/testing-for-educational-accommodations/) for Teenage Girls with ADHD

- Extended time on tests
- Note-taking support
- Graphic organizers or task checklists
- Reduced homework load or flexible deadlines
- Preferential seating or quiet testing environments

### Self-Help Strategies

- Use Visual Timers and Checklists: These tools help with time awareness and task completion.
- Break Tasks into Chunks: Small, doable steps reduce overwhelm.
- Body Doubling: Studying or working alongside someone can help maintain focus.
- Daily Routines: Create a structure for mornings, homework, and sleep.
- Positive Affirmations: Counteract low self-esteem and impostor syndrome.

### Holistic and Lifestyle Approaches for Teenage Girls with ADHD

- [Mindfulness Therapy](https://dralanjacobson.com/mindfulness-therapy/) and Practice: Yoga, meditation, or breathwork can improve emotional regulation for teenage girls with ADHD.
- Nutrition: Consuming balanced meals rich in protein, omega-3 fatty acids, and complex carbohydrates supports brain health.
- Movement: Regular exercise (even short walks or dance breaks) boosts dopamine and mood.
- Sleep Hygiene: Consistent sleep-wake times, screens off before bed, calming bedtime routine.
- [Creative Counseling](https://dralanjacobson.com/creative-counseling/): Art, journaling, or music can help process emotions and reduce stress.

## Therapy for Girls with ADHD

This section covers therapy approaches for ADHD in teenage girls specifically. For the full guide covering earlier childhood presentations and general support strategies across all ages, see [Therapy for Girls with ADHD](https://dralanjacobson.com/therapy-for-girls-with-adhd/).

*Understanding Methods, Outcomes, and Real-Life Benefits*

### Why Therapy for ADHD in a Teenage Girl Matters

Teenage girls with ADHD are often underdiagnosed or misdiagnosed, especially when symptoms present as inattentiveness, internal restlessness, emotional dysregulation, or anxiety. Therapy can provide much-needed support, skill-building, and emotional validation, especially for girls navigating academic, social, and emotional challenges during adolescence.

ADHD in girls often goes unrecognized until adolescence, when increased academic and social demands overwhelm their ability to compensate. While boys with ADHD are often identified due to hyperactive or disruptive behaviors, girls may mask symptoms with perfectionism, people-pleasing, or internalized anxiety. Therapy plays a crucial role in helping these girls understand their unique neurodivergent profile, develop strategies for managing life’s demands, and heal from years of misunderstood struggles.

### Evidence-Based Therapy for Girls with ADHD

1. **Cognitive Behavioral Therapy for girls with ADHD**
    CBT helps girls recognize and reframe negative thinking patterns, build self-awareness around impulsive or inattentive behaviors, and learn strategies for time management, emotional regulation, and organization.
2. **Executive Function Coaching:**
    Often integrated with therapy or provided separately, this focuses on building practical skills such as planning, task initiation, prioritization, goal-setting, and follow-through—areas often impaired in ADHD.
3. **Mindfulness-Based Therapy for girls with ADHD:**
    Mindfulness practices improve attention, reduce emotional reactivity, and foster a calmer, more self-compassionate mindset—especially helpful for girls with both ADHD and anxiety.
4. **[Dialectical Behavior Therapy](https://dralanjacobson.com/dbt-for-teens/) (DBT) Skills:**
    While DBT was developed for more severe emotional dysregulation, its core modules, such as distress tolerance, interpersonal effectiveness, and emotional regulation, are useful for teens with ADHD who also struggle with mood instability.
5. **[Family Therapy](https://dralanjacobson.com/family-therapy/) or Parent Training:**
    Helping parents learn how to support their daughter through consistent routines, limit-setting, collaborative problem solving, and positive reinforcement is often critical to long-term success.
6. **[ADHD Psychoeducation](https://dralanjacobson.com/psychoeducation/) and Identity Work:**
    Girls who are diagnosed later may experience shame or self-doubt. Therapy often includes education about ADHD, validating neurodivergence, and building confidence in their strengths.

### How Therapy for ADHD in a Teenage Girl Helps

- **Academic Functioning:** Improves organization, time management, and study habits.
- **Self-Esteem and Identity:** Reduces feelings of “being different” or “failing,” especially in girls who have masked symptoms.
- **Emotional Regulation:** Helps manage frustration, overwhelm, anxiety, and mood fluctuations.
- **Social Relationships:** Builds communication and assertiveness skills, supporting healthier peer and family interactions.
- **Motivation and Self-Compassion:** Therapy helps girls feel less alone and more empowered to handle setbacks.

## Case Example 1: Symptoms of ADHD in a Teenage Girl who is also Gifted

Emma, 16, came from a high-achieving family and was described as imaginative and highly verbal. She loved to read, draw, and debate in class—but was chronically disorganized, emotionally sensitive, and overwhelmed by deadlines. Her symptoms were masked for years by her intelligence and a perfectionistic streak. She was labeled as “not living up to her potential.” After a mid-year academic crash in 10th grade and increasing anxiety, a [comprehensive psychological evaluation](https://psychologicalassessments.com/the-comprehensive-psychological-evaluation/) confirmed ADHD-Inattentive Type.

### Therapy for ADHD in a teenage girl:

- **Cognitive Restructuring (CBT):** Emma worked with me to identify and reframe perfectionistic thoughts like “If I can’t do it perfectly, I shouldn’t start at all.” She learned to tolerate “good enough” work and use self-talk scripts to counter her inner critic.
- **Executive Function Coaching:** Sessions included hands-on skills training using a visual task board, time-blocking in a digital calendar, and Pomodoro study sessions. She practiced estimating how long tasks would take and “gamified” routines to build momentum.
- **Psychoeducation & Identity Work:** Emma had several sessions focused on understanding how ADHD shows up differently in girls. Through journaling and [narrative therapy](https://dralanjacobson.com/narrative-therapy/), she explored how internalized shame had shaped her self-concept, and began developing a more compassionate, neurodivergent-affirming identity.
- **Parent Collaboration:** I coached her parents on shifting from criticism (“Why didn’t you finish that?”) to supportive prompts (“What’s your first step?”), fostering a home environment of accountability without shame.

**Outcomes:** After five months of weekly therapy, Emma became more consistent in turning in work, began advocating for extended time and scaffolded assignments, and described feeling “smarter and more normal.” Her anxiety reduced significantly, and she began mentoring a younger peer with similar challenges.

## Case Example 2: Symptoms of ADHD in a Teenage Girl with Co-Occurring Depression

Maya, 14, had been diagnosed with ADHD-Combined Type at age 9. Initially treated with medication, she had never received therapy. In middle school, she began experiencing low mood, irritability, frequent crying spells, and withdrawal from friends. Her grades declined, and she started skipping assignments altogether. A reevaluation confirmed that Maya was now also experiencing Major Depressive Disorder, likely fueled by repeated failures and social isolation related to untreated executive function challenges.

### Therapy Goals and Methods for ADHD and Depression in Teenage Girls:

- **Behavioral Activation (for Depression):** Maya and I co-developed a “Mood Ladder” activity schedule, listing small, manageable behaviors she could complete each day (e.g., “text a friend,” “get dressed before 10 a.m.”). Positive reinforcement was used to rebuild reward pathways disrupted by depression.
- **CBT for Thought-Behavior Loops:** Therapy focused on identifying the vicious cycle of “I always screw up → Why try? → More missed assignments → More shame.” She practiced using CBT worksheets and an “evidence board” to argue against cognitive distortions like catastrophizing or overgeneralization.
- **DBT Skills for Emotion Regulation:** Given Maya’s tendency toward mood swings and frustration outbursts, I incorporated DBT-based techniques, especially TIPP skills (Temperature, Intense Exercise, Paced Breathing, Progressive Relaxation) and mindfulness exercises to tolerate distress.
- **Executive Function Support:** Maya started using color-coded folders, weekly planning check-ins, and a reward-based to-do list system. She and I role-played how to request help or extensions when overwhelmed.
- **Family Therapy Check-Ins:** Family sessions helped her parents differentiate between willful avoidance and emotional paralysis. They developed a system for daily check-ins without nagging, and practiced validating rather than minimizing Maya’s emotional experiences.

**Outcomes:** Over the course of eight months, Maya’s PHQ-9 scores (a measure of depression) decreased from moderately severe to minimal. Her energy and interest returned, she rejoined her school’s art club, and her late work rate dropped dramatically. She gained confidence in her ability to function, even on hard days, and became a strong self-advocate during her IEP review.

## Q&A: Therapy and Support for Teenage Girls with ADHD

Here are some common questions I receive:

### Q: What are standard treatment options for teenage girls with ADHD?

ADHD treatment in adolescent girls is most effective when it’s multimodal, combining several approaches:

- Psychotherapy: 
    - *Cognitive Behavioral Therapy (CBT)* teaches emotional regulation, time management, and strategies for reframing negative thoughts.
    - *Executive Function Coaching* focuses on planning, organization, and managing multi-step tasks.
    - *Dialectical Behavior Therapy (DBT) Skills* can be helpful, especially when emotion dysregulation or impulsivity is present.
    - *Narrative Therapy* supports identity development and combats shame from years of being misunderstood.
- Medication: Stimulants (e.g., Adderall, Vyvanse, Ritalin) and non-stimulants (e.g., Strattera, Intuniv) are often prescribed to improve focus, reduce impulsivity, and support mood regulation. Medication can be life-changing when paired with therapy and educational supports.
- Academic Accommodations: These might include extended time, use of planners, flexible deadlines, organizational coaching, and testing in a reduced-distraction setting. They’re usually provided through a 504 Plan or IEP.
- Coaching / Family Therapy: [ADHD coaching](https://dralanjacobson.com/adhd-coaching-for-adults-help-for-focus-and-concentration/) helps the client understand their unique challenges, opportunities, and strengths. Helping parents understand how ADHD uniquely presents in girls, and how to shift from frustration to support, is often critical to success.

### Q: What are self-help strategies for teenage girls with ADHD?

- **Visual Schedules and Color Coding** — Use color-coded notebooks, whiteboards, or planner apps to organize tasks by subject or priority.
- **Timers and Reminders** — Set alarms for transitions, homework blocks (e.g., Pomodoro technique), or hydration breaks. Use smartwatches or phone alerts.
- **Body Doubling** — Doing homework or chores alongside a friend, sibling, or parent increases focus and reduces overwhelm.
- **Checklist Systems** — Break down large tasks into small, checkable steps (e.g., “Step 1: Open Google Docs. Step 2: Title the paper.”).
- **Self-Talk Scripts and Affirmations** — Practice countering negative thoughts (e.g., “This is hard, but I can figure it out”) to reduce shame and anxiety.
- **Recharge Routines** — Build in non-screen, calming activities such as drawing, journaling, taking a walk, or using fidget tools.

### Q: What are holistic ideas for supporting teenage girls with ADHD?

- **Mindfulness and Meditation** — Apps like Headspace, Insight Timer, or Mindful Teen offer guided practices to reduce reactivity and boost focus.
- **Yoga and Movement Practices** — Activities such as yoga, martial arts, or dance can enhance body awareness, emotional regulation, and dopamine levels.
- **Dietary Support** — Balanced meals rich in protein and omega-3 fatty acids may help improve focus and mood. Reducing excessive sugar or processed foods can also help with energy stability.
- **Nature and Green Time** — Spending time in nature (even a walk in the park) has been shown to reduce ADHD symptoms and enhance mood.
- **Creative Outlets** — Art, music, storytelling, or crafts provide a space for expression and a break from overstimulation.
- **Sleep Hygiene** — ADHD often disrupts sleep patterns. A consistent wind-down routine, reduced evening screen time, and soothing rituals (e.g., warm tea and aromatherapy) can promote better rest.

### Q: What does an attention deficit in adolescent girls typically look like?

In girls, ADHD, especially the Inattentive Type, can present very differently from the hyperactive patterns more commonly seen in boys. Here is another quick teenage girls ADHD checklist:

- **Daydreaming or Spacing Out** — She appears “in her own world,” especially during class or conversations.
- **Forgetfulness and Disorganization** — Loses papers, forgets homework, misses deadlines, or leaves tasks half-finished.
- **Emotional Sensitivity** — She may cry easily, become overwhelmed by small challenges, or react strongly to perceived criticism.
- **Overthinking or Anxiety** — She ruminates and struggles to “turn off” her thoughts or worries excessively about underperforming.
- **Masking or Perfectionism** — Works extremely hard to cover up difficulties, often resulting in burnout or internal shame.
- **Internal Hyperactivity** — Instead of external movement, girls may feel “wired,” fidget mentally, or shift rapidly between thoughts.

Because these symptoms can be misinterpreted as anxiety, depression, or laziness, many girls go undiagnosed until their teen years, or even adulthood. Therapy, testing, and supportive care can be life-changing when these patterns are finally understood and addressed.

### Do ADHD and depression in teenage girls often co-occur?

Yes, ADHD and depression in teenage girls often co-occur, and the overlap is both clinically significant and frequently underrecognized.

**Why the co-occurrence of ADHD and depression in teenage girls happens**

1. **Underdiagnosis of ADHD in Girls:** Girls with ADHD, especially the inattentive type, are often overlooked because they may appear more distracted or daydreamy rather than hyperactive. Without proper identification and support, these girls may internalize their struggles, leading to chronic frustration, poor self-esteem, and eventually depression.
2. **Emotional Dysregulation:** ADHD often involves difficulty regulating emotions. Teenage girls with ADHD may experience intense emotional reactions, rejection sensitivity, and interpersonal struggles, which can contribute to depressive symptoms over time.
3. **Academic and Social Challenges:** Executive functioning deficits (e.g., trouble with planning, time management, and organization) can lead to repeated failures or underperformance in school, which chips away at self-worth. Social difficulties, such as peer rejection or feeling “different,” can further increase the risk for depression.

Studies suggest that 25–50% of girls with ADHD also experience clinically significant symptoms of depression at some point during adolescence. Girls with ADHD are 2–3 times more likely to develop depression compared to girls without ADHD. This is why early therapy for ADHD in a teenage girl is so vital.

## Final Thoughts

Teenage girls with ADHD often go unseen because their symptoms don’t always match the classic presentation. When understood and supported, these girls can thrive academically, socially, and emotionally. If you suspect ADHD, perhaps from the teenage girls ADHD checklist above, consider a formal evaluation with a licensed psychologist who specializes in adolescent assessment. Early intervention empowers girls to understand their brains, embrace their strengths, and build a path to success.

Therapy for ADHD in a teen girl is about much more than “fixing forgetfulness.” It’s about giving young women the tools, insight, and validation they need to thrive as their authentic selves. I also offer therapy for ADHD and depression in teenage girls, [therapy for ADHD in teenagers](https://dralanjacobson.com/adhd-treatment-for-teens/) in general, and [natural ADHD treatment](https://dralanjacobson.com/natural-adhd-treatment-for-adults/). These treatments can open the door to new skills, new self-understanding, and new possibilities. I also provide treatment for symptoms that often co-occur with ADHD, such as [therapy for anxiety in teens](https://dralanjacobson.com/therapy-for-teen-anxiety/).

If you have any questions about therapy for girls with ADHD or my practice, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## FAQ — Teen Girls & ADHD

### How is ADHD different in girls than in boys?

ADHD in girls is often characterized by inattention and subtle executive functioning challenges rather than overt hyperactivity. This can lead to symptoms being overlooked or misattributed to shyness, anxiety, or puberty.

### Why do girls with ADHD get diagnosed later?

Girls are more likely to mask symptoms or develop coping strategies that hide their struggles, and adults often interpret inattentive behaviors as personality rather than ADHD.

### What are signs of ADHD in a teen girl?

Indicators include difficulty organizing schoolwork, frequent forgetfulness, daydreaming, trouble sustaining attention, emotional overwhelm, and inconsistent performance across settings.

### Can a teenage girl have ADHD and anxiety or depression?

Yes — girls with ADHD are more prone to internalizing symptoms, including anxiety and depression, especially if ADHD isn’t recognized or supported early.

### Is it too late to help a teen girl who has struggled for years?

No — many girls first receive a diagnosis later in adolescence or even adulthood, and targeted support and strategies can still have powerful positive effects on academic performance, relationships, and self-confidence.

### How does a school 504 Plan or IEP evaluation work alongside private therapy?

The two serve different purposes and work best in tandem. A school evaluation determines eligibility for accommodations like extended time, preferential seating, or reduced homework load, and is typically narrower in scope than a private evaluation. Private therapy addresses the emotional, behavioral, and skill-building side — self-esteem, executive function coaching, family communication — that a school evaluation doesn’t cover. Many families pursue both: a school-based 504 Plan or IEP for the classroom accommodations, alongside [therapy](https://dralanjacobson.com/therapy-for-girls-with-adhd/) and, where a more comprehensive diagnostic picture is needed, private [psychological testing for accommodations](https://psychologicalassessments.com/testing-for-educational-accommodations/). Coordinating the two — for example, sharing therapy progress notes or testing results with the school team — often strengthens both processes.

  ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Therapy Specialties

---

### [Therapy for Depression and Anxiety](https://dralanjacobson.com/therapy-for-depression-and-anxiety/)

**Published:** August 17, 2024
**Author:** Dr. Alan Jacobson

**Content:**

### Therapy for Depression and Anxiety

Depression and anxiety rarely show up in isolation — for a large share of the clients I see, they arrive together, feeding off each other rather than taking turns. Someone might come in because chronic worry has worn them down into hopelessness, or because a low, flat mood has made every uncertainty feel unmanageable. This post focuses on what changes clinically when you’re dealing with both at once: how the symptoms interact, how I decide what to address first, and which combinations of therapy tend to work best for the overlap.

If you want the full picture of a specific approach — what CBT actually involves, or how ACT works — I’ve linked out to dedicated posts on each below rather than repeating them here. You’re also welcome to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

### Why Depression and Anxiety Overlap

Depression and anxiety share more machinery than their names suggest:

- **Overlapping symptoms.** Sleep disruption, poor concentration, fatigue, irritability, and avoidance show up in both conditions, which is part of why they’re easy to miss as two separate things rather than one.
- **Each one can maintain the other.** Chronic worry burns through energy and motivation, which can tip into depressive withdrawal. A flat, hopeless mood, in turn, can make ordinary uncertainty feel catastrophic, which fuels more anxiety.
- **Diagnosis isn’t always clean.** Some clients meet criteria for both a depressive and an anxiety disorder; others have a single diagnosis — like Adjustment Disorder with Mixed Anxiety and Depressed Mood — that captures the blend without treating them as two separate illnesses. Getting this distinction right matters for how treatment is sequenced.

### How Treating Both Together Changes the Plan

When only one condition is present, the choice of approach is usually straightforward. When both are present, the harder question is often *what to address first* — and that decision usually comes down to which symptom is doing the most damage to daily functioning right now.

- If **panic or acute worry is driving avoidance** that’s deepening isolation and low mood, I’ll often start with exposure-based work or CBT aimed at the anxiety, on the logic that reducing avoidance creates room for mood to lift on its own.
- If **low energy and hopelessness are the bigger barrier** — to the point that a client can’t engage with exposure homework or worry logs — I may start with behavioral activation or MBCT to rebuild enough momentum for the anxiety work to land.
- Many clients end up on a **braided plan**, using one approach for the acute symptom and layering in a second once there’s enough stability to sustain it.

### Approaches That Work Well for the Overlap

ApproachWhy it fits co-occurring depression and anxietyLearn moreCognitive Behavioral Therapy (CBT)Targets the negative thought patterns and avoidance common to both conditions; usually the fastest-acting option[CBT for Depression](https://dralanjacobson.com/cbt-for-depression/)Mindfulness-Based Cognitive Therapy (MBCT)Reduces rumination (a depression driver) and reactivity to worry (an anxiety driver) at the same time[MBCT](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/)Acceptance and Commitment Therapy (ACT)Helps clients stop struggling against both low mood and anxious thoughts, and re-engage with valued activity despite them[ACT Psychotherapy](https://dralanjacobson.com/act-psychotherapy/)Interpersonal Therapy (IPT)Effective when both conditions are tied to a relationship issue, loss, or life transition[Interpersonal Therapy](https://dralanjacobson.com/interpersonal-therapy/)Exposure TherapyAddresses the avoidance that often links panic or specific fears to depressive withdrawal[ERP: Exposure and Response Prevention](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/)Psychodynamic TherapyUseful when both conditions trace back to longer-standing relational or early-life patterns[Psychodynamic Therapy](https://dralanjacobson.com/psychodynamic-therapy/)Dialectical Behavior Therapy (DBT)Helpful when emotional intensity or dysregulation sits underneath both conditions, particularly in teens[DBT for Teens](https://dralanjacobson.com/dbt-for-teens/)### Beyond Talk Therapy

Exercise, sleep, nutrition, and stress-management skills all move the needle on both conditions at once — the physiology behind sleep loss or a sedentary routine doesn’t distinguish between depression and anxiety. I cover this in more depth in [Effective Therapy for Depression](https://dralanjacobson.com/therapy-for-depression/); we’ll also talk through what’s realistic for you as part of treatment planning.

### Case Example: Sequencing Treatment for Co-Occurring Symptoms

Mandy, 32, came in reporting six months of persistent sadness, fatigue, and hopelessness alongside intense worry about her job and frequent panic attacks. Her sleep was poor and she’d withdrawn from social activities she used to enjoy. The clinical question wasn’t *which single therapy fits Mandy* — it was how to sequence and combine approaches given that both mood and anxiety symptoms were active and reinforcing each other.

We started with **CBT**, focused first on the panic and catastrophic thinking driving her avoidance, since reducing that avoidance was a prerequisite for the behavioral activation piece to work later. Once panic frequency dropped, we layered in an **8-week MBCT track** to address the rumination that was keeping her mood low even as her anxiety symptoms improved. Sleep hygiene and stress-management work ran in parallel throughout.

By week 12, Mandy’s panic attacks had become rare, her mood had lifted enough to re-engage socially, and she reported feeling like she had tools for both problems rather than just the one we’d started with.

*(If you’re looking for an adolescent case example, see [Therapy for Teen Anxiety](https://dralanjacobson.com/therapy-for-teen-anxiety/), which includes two in-depth cases involving anxiety and co-occurring mood symptoms.)*

### Frequently Asked Questions

**Can you have depression and anxiety at the same time?** Yes. It’s one of the most common combinations in mental health treatment. The two conditions share overlapping symptoms — sleep problems, poor concentration, fatigue, and irritability — and each can intensify the other, which is why many people experience both rather than one or the other.

**Should depression or anxiety be treated first?** It depends on which symptom is doing the most damage to daily functioning. If panic or acute worry is driving avoidance and isolation, I’ll often start with the anxiety. If low energy and hopelessness are blocking someone from engaging in exposure work or worry logs, I may start with depression-focused approaches like behavioral activation. Many clients end up on a combined plan rather than a strict sequence.

**Is one type of therapy enough to treat both depression and anxiety?** Sometimes. CBT and MBCT both address the negative thought patterns and rumination that fuel each condition, so a single approach can cover a lot of ground. More often, I braid two approaches together — CBT for the anxiety symptoms and MBCT for the rumination, for example — depending on how the two conditions are showing up for you specifically.

**How long does therapy take when depression and anxiety occur together?** Timelines vary, but many clients see a meaningful shift within 8 to 16 weeks, particularly with structured approaches like CBT or MBCT. Comorbid presentations can take a bit longer than a single diagnosis since there’s more to address, though improving one condition often helps the other along the way.

**Do teenagers experience depression and anxiety together?** Yes, and it’s common. Adolescents often present with a mix of both — for example, Generalized Anxiety Disorder alongside an Adjustment Disorder with depressed mood — rather than a single clean diagnosis. See [Therapy for Teen Anxiety](https://dralanjacobson.com/therapy-for-teen-anxiety/) for case examples of how this shows up and gets treated in teens.

**Is medication necessary for treating both conditions?** Not necessarily. I never require medication, but for more severe or treatment-resistant presentations, I encourage clients to at least get evaluated for it alongside therapy. Many people manage co-occurring depression and anxiety with therapy alone.

### Summary and My Integrative Practice

When depression and anxiety show up together, the goal isn’t picking one diagnosis to treat and hoping the other resolves on its own — it’s understanding how the two are reinforcing each other and sequencing treatment accordingly. I offer this as individual, couples, or family therapy, and it can be woven together with [life transitions therapy](https://dralanjacobson.com/life-transitions-therapy/) or my work with [college students](https://dralanjacobson.com/therapy-for-college-students/) where relevant.

### Contact Me for Therapy for Depression and Anxiety

If you’re dealing with both depression and anxiety and want to talk through what a combined treatment plan might look like, [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Symptom Relief

---

### [Presentation Anxiety: Symptoms, Causes & How to Cope](https://dralanjacobson.com/presentation-anxiety/)

**Published:** August 28, 2023
**Author:** Dr. Alan Jacobson

**Content:**

Presentation anxiety is the specific dread that surrounds delivering prepared remarks — the quarterly review, the client pitch, the conference talk, the all-hands update. It’s a close cousin of general public speaking fear, but it has its own signature: you often know your material cold, the audience frequently includes people who influence your career, and the event sits on your calendar for weeks, giving anticipation plenty of time to work. This page is about understanding that experience — what it feels like, where it comes from, and how to tell ordinary nerves from something worth treating.

## What Presentation Anxiety Feels Like

### Physical Symptoms

- Racing heart and shallow, quick breathing
- Trembling hands, shaky or tight voice
- Sweating, flushing, dry mouth
- Stomach distress before or during
- Feeling lightheaded or “unreal” at the front of the room

### Cognitive Symptoms

- Mind going blank despite thorough preparation
- Racing catastrophic predictions (“I’ll freeze, they’ll know”)
- Intense self-monitoring while speaking
- Hostile replay of the presentation for days afterward

### Behavioral Signs

- Over-preparing to the point of exhaustion — or avoiding preparation because it triggers the dread
- Reading slides verbatim as a shield
- Rushing to finish; avoiding eye contact and Q&A
- Delegating, declining, or calling in sick when presentations loom

### Anticipatory Pattern

- Sleep disruption in the nights before
- Dread that begins when the meeting invite lands
- Inability to focus on other work as the date approaches
- Relief after the event that quickly gives way to dread of the next one

## Why Presentations Trigger It — Even When You Know Your Material

- **Evaluation with stakes.** A presentation is a performance review in miniature. When your manager, leadership, or a client is in the room, your brain isn’t wrong that judgment is occurring — it’s just wildly overestimating the consequences of imperfection.
- **The hierarchy effect.** Presenting *up* — to executives, boards, senior clients — reliably amplifies anxiety. Status-conscious threat detection is deeply wired, which is why the same content feels easy with peers and terrifying with the VP present.
- **The long runway.** Unlike spontaneous speaking, presentations are scheduled. Weeks of anticipation give anxiety time to build, and the mental rehearsal of failure can be more punishing than the event itself.
- **Formality and structure.** Prepared remarks create a script to deviate from, and therefore a way to visibly “get it wrong” — a failure condition casual conversation doesn’t have.
- **Remote and hybrid formats.** Presenting to a grid of muted cameras removes the feedback anxious speakers rely on to confirm things are going fine, while adding tech failure as a fresh category of threat.
- **History.** One presentation that went badly — a freeze, a hostile question, visible shaking — can teach the brain that presentations are dangerous, and the lesson generalizes fast.
 
## Ordinary Nerves or Something More?

### Normal presentation nerves

Butterflies beforehand, energy that settles within a few minutes of starting, honest relief afterward. Performance is essentially unaffected, and you don’t organize your work life around avoiding the next one.

### Performance-limiting anxiety

Symptoms intrude on delivery — rushing, blanking, reading verbatim — and preparation is driven more by dread than diligence. You get through presentations, but at a real cost in sleep, focus, and confidence, and you quietly steer away from opportunities that involve them.

### Severe presentation anxiety

Panic-level symptoms, presentations avoided outright or endured with extreme distress, career decisions shaped by the fear — turning down roles, staying silent in meetings, dreading events weeks out. At this level, the anxiety is running the show, and it responds far better to treatment than to more forced repetitions.

## Strategies Specific to Presentations

General techniques for speaking anxiety — breathing, grounding, attention control, practice ladders — are collected in my [public speaking fear toolkit](https://dralanjacobson.com/public-speaking-fear/). These additions are specific to the prepared-remarks format:

- **Build slides as signposts, not scripts.** Dense slides invite reading; sparse ones force you to speak from command of ideas — which is more flexible under pressure and better received.
- **Over-rehearse the opening and the transitions.** Anxiety spikes at the start and at every “how do I get from this slide to the next” seam. Automate those junctions and the material in between flows.
- **Prepare for questions separately.** Much presentation dread is really Q&A dread. Draft the five hardest questions you could face and rough answers — including a graceful “I’ll follow up on that,” which is a complete and professional answer.
- **Do a full tech rehearsal for remote presentations.** Same platform, same screen-share, same slides. Removing tech uncertainty removes an entire tributary of the anxiety.
- **Schedule strategically when you can.** If you have any influence over timing, present earlier in the meeting and earlier in the day — shrinking the runway shrinks the anticipation.
 
**If it’s more than nerves:** presentation anxiety at the performance-limiting or severe level is highly treatable — typically within months, not years. My [public speaking anxiety therapy](https://dralanjacobson.com/public-speaking-anxiety/) page covers exactly how that works, including an intensive format for when the big presentation is already on the calendar.

## Frequently Asked Questions

### What is presentation anxiety?

Presentation anxiety is fear and physiological distress tied specifically to delivering prepared remarks — work presentations, pitches, talks — rather than social interaction or spontaneous speaking generally. It combines fear of evaluation with a long anticipation window, and it commonly affects people who are otherwise confident, including experienced professionals.

### Is presentation anxiety different from public speaking anxiety?

It’s best understood as a specific form of it. The underlying mechanics — threat response to social evaluation — are the same, but presentations add distinctive features: scheduled anticipation, workplace stakes, hierarchy in the audience, and a formal script to deviate from. Treatment approaches are the same and equally effective for both.

### Why am I confident one-on-one but anxious presenting?

Because they’re different situations to your nervous system. Conversation offers constant feedback, turn-taking, and no formal failure conditions; presenting means sustained evaluation by multiple people with no relief structure. Being anxious in one and comfortable in the other is extremely common and says nothing about your competence.

### How do I stop my voice and hands from shaking during a presentation?

In the moment: slow, low breathing with long exhales, grounding through your feet, deliberately slowing your pace, and holding notes or a clicker rather than loose paper (which amplifies visible tremor). Longer term, the shaking diminishes as overall anxiety is treated — it’s a symptom of the alarm response, not a separate problem to fix.

### Can presentation anxiety hurt my career — and when should I get help?

Untreated, it can: declining visibility opportunities, avoiding roles that involve presenting, and underperforming relative to your actual ability all have cumulative costs. Seek help when avoidance is shaping decisions, symptoms reach panic level, or dread consumes the weeks before events. It’s one of the most treatment-responsive forms of anxiety, so the cost-benefit of getting help early is strongly in your favor.

## Understand It. Then Outgrow It.

If this page described your experience, a free consultation is a low-stakes way to find out what would actually change it — in person or virtually in 40+ states.

 [Schedule a Free Consultation](https://www.picktime.com/scheduleaconsult) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Public Speaking Fear

---

### [Public Speaking Fear Toolkit](https://dralanjacobson.com/public-speaking-fear/)

**Published:** June 20, 2023
**Author:** Dr. Alan Jacobson

**Content:**

This is a working toolkit for managing fear of public speaking on your own — practical, psychologist-designed techniques organized around the three moments that matter: before you speak, while you’re speaking, and after you finish. Use what fits, practice the exercises at the bottom, and if you find the fear is bigger than the tools, there’s a clear next step at the end.

### Before You Speak

- **Prepare to the point of flexibility, not memorization.** Know your material well enough to say it three different ways. Memorized scripts are brittle — one lost sentence and the whole structure wobbles. Command of ideas is sturdy.
- **Rehearse out loud, on your feet.** Silent review is not rehearsal. Your mouth, breath, and body need the practice reps, not just your eyes.
- **Do a tech and space preview.** Visit the room, test the slides, or do a dry run on the exact video platform. Familiarity removes an entire category of surprise.
- **Rehearse your opening until it’s automatic.** Anxiety peaks in the first sixty seconds. An opening you could deliver half-asleep carries you through the spike, and it settles from there.
- **Visualize success — specifically.** Picture yourself speaking steadily, pausing, recovering smoothly from a stumble. Mental rehearsal of realistic success (not perfection) measurably reduces anticipatory anxiety.
- **Reframe the arousal.** Racing heart and adrenaline are the same physiology as excitement. Telling yourself “I’m ready” works better than commanding yourself to calm down — your body is mobilizing to perform, not malfunctioning.
- **Handle the basics.** Sleep the night before, go easy on caffeine, eat something, and arrive early enough that rushing isn’t part of the story.

### While You’re Speaking

- **Breathe low and slow.** Before you begin and at every transition: a slow breath into your belly, longer on the exhale. This directly downshifts the alarm response — it’s physiology, not a platitude.
- **Slow down and use pauses.** Anxious speakers rush; pausing feels like an eternity to you and reads as confidence to everyone else. A pause is also where your next thought catches up.
- **Put your attention on the message, not on yourself.** Self-monitoring (“do I look nervous?”) feeds the fear. Redirect to the job: getting this idea into their heads. Attention can only be one place at a time — choose the task.
- **Find the friendly faces.** Every audience has nodders. Speak to them, especially early. Skip the one person scowling at their laptop — they’re answering email, not judging you.
- **Let mistakes pass without ceremony.** Lose a word? Pause, sip water, continue. Audiences forget stumbles within seconds unless the speaker’s reaction tells them it was a catastrophe.
- **Plant your feet, or move with purpose.** Grounding through your feet — literally feeling the floor — interrupts the shaky, floaty feeling and steadies your voice with your posture.

### After You Finish

- **Ban the instant post-mortem.** The hour after speaking is the worst possible time to evaluate your performance — anxiety reviews the tape with a hostile edit. Give it a day.
- **Then review in ratio.** Name three things that worked before one thing to improve. This isn’t self-esteem fluff; it’s correcting the attentional bias that only files the flaws.
- **Log the win.** Keep a running note of every speaking situation you didn’t avoid. This record is what you consult the next time your brain claims you “always” fall apart.
- **Book the next rep.** Confidence is built by accumulated exposure, and each speaking experience makes the next one easier. The worst move after a hard presentation is a six-month gap.

## Daily Practice Exercises

The tips above manage the event; these exercises shrink the fear between events. Ten to fifteen minutes a day is plenty:

- **Read aloud and record.** A few minutes daily — an article, a book passage — recorded on your phone. Listening back desensitizes you to your own voice, the thing most people hate most.
- **Climb the camera ladder.** Deliver a two-minute talk to a mirror, then to your phone camera, then send a video to one trusted person, then present to two. Each rung is a small, controlled exposure.
- **One voluntary comment per meeting.** If meetings are your arena, commit to speaking up once, early, in every one — early, because waiting lets the anxiety compound.
- **Practice the breath before you need it.** A slow-exhale breathing routine done daily for two minutes works far better in the moment if it’s already automatic.
- **Consider a practice group.** Organizations like Toastmasters exist precisely to provide friendly, structured repetitions — the single most valuable commodity for this fear.
 
**When self-help isn’t enough:** if you’re turning down opportunities to avoid speaking, experiencing panic-level symptoms, or spending weeks dreading a single event, the fear has outgrown a toolkit — and that’s a treatment issue, not a willpower issue. My [public speaking anxiety therapy](https://dralanjacobson.com/public-speaking-anxiety/) page explains exactly how the clinical work goes deeper than these tips, including an intensive option if your presentation is soon.

## Frequently Asked Questions

### How can I calm my nerves right before speaking?

Use the two tools with the fastest physiological effect: slow, low breathing with extended exhales, and grounding through your feet. Pair them with a rehearsed-to-automatic opening line and a reframe — the adrenaline is mobilization, not malfunction. Avoid last-minute cramming, which spikes anxiety without improving performance.

### Why does my mind go blank when I speak in public?

Acute anxiety diverts resources from working memory — the mental workspace that holds your next sentence. It’s a threat response, not a knowledge failure. The countermeasures: know ideas rather than scripts, pause and breathe when it happens (the thought returns faster than it feels), and reduce baseline anxiety through practice so the response triggers less.

### Is it normal to hate public speaking?

Extremely. Fear of public speaking is one of the most commonly reported fears there is, and some speaking anxiety is nearly universal — including among experienced presenters. The question isn’t whether you feel nerves; it’s whether the fear is limiting your choices, which is the line between normal and worth addressing.

### Can practice alone cure fear of public speaking?

For mild to moderate fear, structured practice and the techniques on this page often produce real improvement. But practice alone can plateau — especially when the fear is fueled by deeper patterns like perfectionism, past humiliation, or fear of visible anxiety. If repetitions aren’t shrinking the dread, that’s the signal to add professional treatment rather than more willpower.

### When should I see a therapist about public speaking fear?

When avoidance is costing you opportunities, when symptoms reach panic level, when dread consumes weeks before an event, or when self-help has stalled. Public speaking anxiety responds unusually well to therapy, so waiting rarely serves you — a free consultation can clarify quickly whether treatment makes sense for your situation.

## Tools First. Help If You Need It.

If the toolkit gets you where you want to go, wonderful. If the fear is bigger than the tips, a free consultation is the fastest way to find out what would actually move it.

 [Schedule a Free Consultation](https://www.picktime.com/scheduleaconsult) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Public Speaking Fear

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### [How to Choose Online Therapy: Private Practice vs. Platforms](https://dralanjacobson.com/online-therapy-private-practice-vs-platforms/)

**Published:** February 5, 2026
**Author:** Dr. Alan Jacobson

**Content:**

Search for the best online therapy and you’ll find listicles ranking subscription platforms — useful if a platform is what you need, useless for the prior question: *which kind* of online therapy fits your situation? That’s the question this guide answers. There are really three different products sold under the name “online therapy,” and they differ in who treats you, how care is matched to you, and what happens when your needs turn out to be complex. (If you’ve already decided and want the practical details of how virtual sessions work — technology, privacy, fees — see my [Complete Virtual Therapy Guide](https://dralanjacobson.com/virtual-therapy-guide/).)

## The Three Options Behind “Online Therapy”

### Option A: Private-practice telehealth

You choose a specific licensed clinician — a psychologist, therapist, or psychiatric provider — who happens to deliver care by video. This is the highest-customization option: you select the person for their specialization, approach, and experience with problems like yours, and treatment is designed around assessment rather than assignment. It’s the strongest fit when you want continuity with one clinician, when your situation involves diagnostic complexity, or when you’re seeking a specific specialty. The tradeoff: sought-after clinicians can have waitlists, and self-pay fees are typically higher than platform subscriptions — though virtual private-practice fees are often lower than the same clinician’s office rate. (If you’re weighing private practice against clinics and hospitals more broadly — not just online — I’ve covered that in [Finding a Private Practice Therapist](https://dralanjacobson.com/finding-a-private-practice-therapist/).)

### Option B: Subscription therapy platforms

Services like BetterHelp and Talkspace match you to a therapist from a large network for a weekly or monthly fee, often with messaging between sessions. Genuine strengths: fast starts, lower price points, easy therapist switching, and a low-friction entry into care — for many people, a platform is how therapy finally begins, and that matters. The structural tradeoffs are worth knowing: you’re matched rather than choosing, sessions may be shorter than the standard clinical hour, therapist turnover is common, and platforms are built around generalist talk therapy — they’re not designed for comprehensive assessment, complex diagnostic questions, or highly specialized treatment.

### Option C: Coaching and structured programs

Executive functioning coaching, performance coaching, and app-based structured programs can be excellent adjuncts — particularly for routines, accountability, and behavior change. Keep the boundary clear: coaching is not therapy. It doesn’t diagnose, it doesn’t treat clinical conditions, and it’s not the right primary care for significant symptoms. It pairs well *with* therapy; it doesn’t replace it.

**The honest matching rule:** if your needs are focused and you mainly want a supportive, skilled generalist quickly and affordably, a platform may serve you well. If your situation includes diagnostic complexity — ADHD vs. anxiety, trauma overlays, autism-related social stress, learning and executive functioning questions — or you want treatment planned from real assessment, you’ll be better served choosing a specific clinician with strong assessment training. That’s not a sales line; it’s triage, and a good clinician of any kind will tell you which one you need.

## Who’s Behind the Screen: Clinician Types

- **Clinical psychologist (Ph.D./Psy.D.):** doctoral training in therapy plus psychological assessment and diagnosis. The right choice when the diagnostic picture is unclear or when testing may inform treatment.
- **Therapist/counselor (LICSW, LMHC, LMFT):** master’s-level clinicians who provide the bulk of excellent talk therapy. Training emphasis varies — social workers, mental health counselors, and family therapists come from different traditions, all legitimate.
- **Psychiatrist / psychiatric NP:** medication evaluation and management, sometimes therapy but commonly meds-focused. If medication is or may become part of your care, you’ll want one of these on the team regardless of who provides therapy.

Licensure is jurisdictional: whoever you choose must be licensed for the state you’re in. This is where credentials like PSYPACT (the psychology interstate compact) matter for anyone who travels or relocates.

## How to Spot High-Quality Online Care

Whichever option you’re evaluating, ask directly — a solid clinician won’t be defensive, and will have organized, reassuring answers:

- Are you licensed in my state, and what’s your license type?
- What’s your specific experience with my concern — and how many clients like me have you treated?
- What approach would you use for my situation, and why that one? (For what the main approaches look like online, see my article on [online therapy approaches, techniques, and outcomes](https://dralanjacobson.com/therapy-online-approaches-techniques-and-outcomes/).)
- How will we know it’s working — what does progress look like, and when would we reassess?
- What happens if I need something you don’t provide — assessment, medication, higher level of care?
- What platform do you use for sessions, and is it HIPAA-compliant?

Evasive or defensive answers to any of these are the clearest red flag in the search process.

## What You Can Reasonably Expect

Delivered well, online therapy is the same evidence-based care you’d get in an office — the research consistently shows equivalent outcomes, which I’ve covered in depth in [Is Virtual Therapy as Effective as In-Person?](https://dralanjacobson.com/is-virtual-therapy-as-effective-as-in-person/) The most realistic and most empowering expectation is this: even the best online therapy doesn’t erase your stressors — it upgrades your capacity to handle them. When the match is good, people typically report better emotional regulation, concrete skills they actually use, improved relationships and boundaries, and a clearer relationship with their own patterns. When the match is wrong, no delivery format fixes it — which is why the choosing step you’re doing right now matters more than any platform ranking.

## Choosing Online Therapy: Frequently Asked Questions

What’s the real difference between a therapy platform and a private-practice therapist online?Who selects your clinician, and what the care is built around. Platforms match you to an available therapist from a network, optimize for accessibility and price, and center on generalist talk therapy. Private practice means choosing a specific clinician for their specialization and approach, with treatment planned around assessment of your particular situation. Platforms excel at fast, affordable starts; private practice excels at complexity, specialization, and continuity with one clinician over time.

How do I know if I need a psychologist rather than a therapist or counselor?Consider a psychologist when the diagnostic picture is unclear (Is this ADHD, anxiety, or both? Is something being missed?), when formal testing might inform treatment, or when your situation involves overlapping conditions, learning and executive functioning questions, or autism-related concerns. For well-defined concerns where the path is talk therapy, master’s-level therapists provide excellent care. If medication may be involved, a psychiatrist or psychiatric NP joins the picture in either case.

Are subscription platforms like BetterHelp legitimate therapy?Yes — the clinicians on major platforms are licensed professionals, and for many people a platform is an accessible, effective way to start care. The honest caveats are structural rather than about legitimacy: you’re matched rather than choosing, therapist turnover is common, sessions may be shorter than a standard clinical hour, and platforms aren’t built for assessment or specialized treatment of complex situations. Legitimacy isn’t the question; fit is.

What questions should I ask before starting with an online therapist?At minimum: whether they’re licensed in your state, their specific experience with your concern, which approach they’d use and why, how progress will be measured, what happens if you need services they don’t provide, and whether their video platform is HIPAA-compliant. A quality clinician answers all of these readily. Defensiveness or vagueness in response to reasonable questions is the most reliable warning sign in the selection process.

## Skip the Matching Algorithm

Schedule a free consultation. I’ll give you an honest read on what your situation calls for — including whether a platform, a specialist referral, or my own practice is the right answer.

[Schedule a Free Consultation](https://www.picktime.com/scheduleaconsult)

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? ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Virtual

---

### [Is Virtual Therapy as Effective as In-Person?](https://dralanjacobson.com/is-virtual-therapy-as-effective-as-in-person/)

**Published:** April 6, 2024
**Author:** Dr. Alan Jacobson

**Content:**

It’s the question nearly every prospective client asks before their first video session — and it deserves a real answer, not a sales pitch. The short version: for most people and most concerns, yes, the research and my own caseload agree that virtual therapy works as well as meeting in an office. The longer version is more interesting, because the honest answer depends on who you are, what you’re working on, and — for children especially — a few factors worth thinking through before you start. This article covers the evidence, the situations where each format has the edge, and what I’ve seen across a practice that is now mostly virtual. (For the practical side — technology, privacy, fees, scheduling — see my [Complete Virtual Therapy Guide](https://dralanjacobson.com/virtual-therapy-guide/).)

## What the Research Shows

This question has been studied extensively, including head-to-head randomized trials. The [American Psychological Association’s summary of the telehealth research](https://www.apa.org/practice/telehealth-telepsychology) concludes that teletherapy produces outcomes similar to in-person treatment across a wide range of concerns, including anxiety, depression, PTSD, and adjustment difficulties. A [meta-analysis of randomized controlled trials](https://pubmed.ncbi.nlm.nih.gov/33539135/) comparing the two formats directly reached the same conclusion — and found video sessions notably more effective than telephone-only treatment, which is worth knowing if you’re comparing options.

My own experience matches the literature. Most of my practice is now virtual, and I see no difference in outcomes between the clients I treat online and those I see in person. What predicts success isn’t the format — it’s the strength of the therapeutic relationship and the fit between the approach and the problem.

**Sometimes virtual is actually better.** Exposure work is the clearest example: when we treat anxiety, OCD, or phobias, the feared situations live in your real environment — your kitchen, your commute, your driveway. Virtual sessions let us do exposure practice where the anxiety actually happens rather than imagining it from an office chair. The same logic applies to ADHD and executive functioning work: we can build systems in the actual space where your mornings fall apart, looking together at the real desk, the real calendar, the real pile.

## When Virtual Therapy Is Just as Effective

### Virtual treatment is likely to serve you fully if:

- You’re comfortable enough with technology that the screen disappears within a few minutes
- You have a private, reasonably quiet space for a confidential hour
- Your goals center on talk-based approaches — CBT, ACT, psychodynamic work, mindfulness-based therapy, and most other [evidence-based approaches adapt fully to video](https://dralanjacobson.com/therapy-online-approaches-techniques-and-outcomes/)
- You can engage without the structure of physically going somewhere
- Your concerns don’t require in-the-room intervention or hands-on techniques

### Virtual may actually be the stronger choice if:

- The best-matched specialist for your concern isn’t within driving distance
- Exposure practice in your real environment would accelerate the work
- Anxiety, health, mobility, or transportation would make consistent office attendance unlikely — the best format is the one you’ll actually show up for
- Your schedule means the choice is between virtual sessions and no sessions
- You want treatment to continue seamlessly through travel, relocation, or a return to college

## When In-Person Has the Edge

I’d be doing you a disservice to pretend the answer is always yes. In-person treatment is the better starting point when the method itself requires presence — standard-protocol EMDR, play therapy for young children, certain somatic approaches — or when a private space simply isn’t available in your life right now. And a minority of people never feel as connected through a screen; the relationship is the engine of therapy, so that feeling is disqualifying, not trivial. When that happens in my practice, I say so and refer to a well-matched in-person colleague. It’s rare, but the honest number isn’t zero.

## Is Virtual Therapy Effective for Children?

This is where the answer genuinely becomes “it depends,” and where parents are right to ask harder questions:

- **Age and developmental stage matter most.** Teens are often *more* forthcoming on video — it’s their native medium, and the slight distance can make hard topics easier to open. Younger children are more mixed: some engage beautifully, while others need the containment and novelty of a physical space.
- **The screen cuts both ways.** For some kids, especially those with attention difficulties, a device is an invitation to click elsewhere. A skilled clinician plans for this — shorter segments, interactive tools, movement built into sessions — but it’s a real variable.
- **Play therapy translates only partially.** If your young child needs play-based treatment, in-person is usually the stronger format, and I’ll tell you so at the consultation stage.
- **Parental involvement is easier virtually.** Check-ins, parent coaching, and family components are far simpler to schedule when nobody has to drive — which often means parents are more involved in virtual child treatment, not less.

## For Couples and Families

Effectiveness here should be evaluated per person, not per household — the format needs to work for each participant. When it does, virtual couples and family work has one advantage no office can match: members can join from different locations. Partners who travel, parents with children at college, adult siblings in different cities — the sessions happen because geography stops being a veto. If one member never warms to the screen, that’s a real limitation, and a hybrid or in-person referral is the right call.

## Frequently Asked Questions

What does the research say about virtual therapy’s effectiveness?Randomized controlled trials comparing video-based therapy directly with in-person treatment consistently find similar outcomes across anxiety, depression, PTSD, and related concerns, and the American Psychological Association’s research summaries reach the same conclusion. One consistent nuance: video sessions outperform telephone-only sessions, so if you’re choosing a remote format, video is the evidence-backed option.

Is virtual therapy as effective for children and teens?For teens, often yes — many are more comfortable and more forthcoming on video. For younger children it depends on age, attention, and the type of treatment needed: talk-based and parent-involved approaches translate well, while play therapy for young children usually favors in-person work. A good clinician assesses this per child rather than giving a blanket answer, and adapts sessions — shorter segments, interactive tools, built-in movement — when working virtually with kids.

When is in-person therapy clearly the better choice?When the method itself requires physical presence — standard-protocol EMDR, play therapy for young children, certain somatic techniques — when no private space is available for sessions, or when someone simply never feels connected through a screen. The therapeutic relationship is the strongest predictor of outcome, so if video genuinely interferes with that connection for you, that’s a valid reason to choose in-person care.

Can exposure therapy really work over video?Often it works better. Exposure and response prevention for anxiety, OCD, and phobias targets feared situations that exist in your real environment — home, car, workplace. Virtual sessions allow practice in the actual settings where symptoms occur rather than simulations of them, and research on remotely delivered exposure-based treatment supports its effectiveness for both adults and adolescents.

## Wondering Which Format Fits Your Situation?

Schedule a free consultation. I’ll give you a straight answer about whether virtual treatment suits your goals — including when it doesn’t, and what I’d recommend instead.

[Schedule a Free Consultation](https://www.picktime.com/scheduleaconsult)

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? ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Virtual

---

### [Best Types of Therapy for Depression: Finding Your Best Fit](https://dralanjacobson.com/best-types-of-therapy-for-depression/)

**Published:** July 20, 2025
**Author:** Dr. Alan Jacobson

**Content:**

When someone is struggling with persistent worry, panic, low mood, self-doubt, or emotional exhaustion, therapy is designed to work collaboratively to understand the root causes and tailor a treatment approach that is both evidence-based and deeply individualized. There are many different types of therapy for depression, including [Cognitive Behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT), [Acceptance and Commitment](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) (ACT), [psychodynamic](https://dralanjacobson.com/psychodynamic-therapy/), [existential](https://dralanjacobson.com/existential-therapy/), and [mindfulness methods](https://dralanjacobson.com/mindfulness-therapy/). Selecting the best type of therapy for depression depends on each client’s unique goals, values, and strengths. This post reviews the different kinds of therapy for depression from multiple perspectives.

## Different Types of Therapy for Depression

The different types of therapy for depression can be broken down into three broad Categories:

### Types of Therapy for Depression: Cognitive and Behavioral

#### Behavioral Activation (BA)

**Introduction:**
[Behavioral Activation](https://dralanjacobson.com/behavioral-activation/) is a straightforward, action-focused method that aims to increase engagement in activities that are both meaningful and rewarding. It’s based on the idea that withdrawing from life reinforces depression, and that structured activity scheduling can improve mood and functioning.

- **Best for:** Individuals with low motivation, fatigue, or anhedonia
- **What to expect:** Identifying values, setting behavioral goals, tracking activity and mood
- **Can be combined with:** CBT, group therapy

#### Cognitive Behavioral

**Introduction:**
Cognitive Behavioral Therapy is one of the most well-researched and widely used types of therapy for depression. It focuses on identifying and changing unhelpful patterns of thinking and behavior that contribute to emotional distress. [CBT for depression](https://dralanjacobson.com/cbt-for-depression/) is practical, goal-oriented, and typically time-limited, making it a top choice for many clients.

- **Best for:** Mild to moderate depression, negative thought patterns, goal-oriented individuals
- **What to expect:** Weekly sessions, structured exercises, homework, lasting 12–20 weeks
- **Can be combined with:** Behavioral Activation, [MBCT](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/)

#### [Mindfulness-Based Cognitive Therapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) (MBCT)

**Introduction:**
MBCT blends traditional CBT techniques with mindfulness meditation practices. It is one of the types of therapy for depression that is especially effective for individuals prone to recurrent depression, as it helps them observe thoughts and feelings without becoming entangled in them.

- **Best for:** Relapse prevention, residual symptoms, mindfulness-inclined clients
- **What to expect:** Group format, eight sessions, includes meditation, breathing exercises, and thought awareness
- **Can be combined with:** CBT, ACT

#### [Dialectical Behavior Therapy](https://dralanjacobson.com/dbt-for-teens/) (DBT)

**Introduction:**
Originally developed for borderline personality disorder, DBT is now widely used for mood disorders that involve emotional dysregulation. It combines validation and change, teaching clients how to manage intense emotions and reduce self-destructive behaviors.

- **Best for:** Depression with emotional instability, self-harm, or co-occurring personality disorders
- **What to expect:** Weekly individual sessions, skills group, and phone coaching; long-term commitment
- **Can be combined with:** EMDR, [trauma-informed therapy](https://dralanjacobson.com/trauma-informed-care/)

### Types of Therapy for Depression: Social

#### [Interpersonal Therapy](https://dralanjacobson.com/interpersonal-therapy/) (IPT)

**Introduction:**
IPT emphasizes the role of interpersonal relationships and life events in the development and maintenance of depression. It helps clients improve communication, navigate role transitions, and resolve grief or conflicts that may underlie depressive symptoms.

- **Best for:** Depression linked to grief, relationship issues, or life changes
- **What to expect:** Focused sessions (12–16 weeks), exploring key relationship patterns
- **Can be combined with:** [couples therapy](https://dralanjacobson.com/couples-therapy/), [family therapy](https://dralanjacobson.com/family-therapy/), group IPT

#### [Group Therapy](https://dralanjacobson.com/group-therapy/)

**Introduction:**
Group therapy provides a supportive environment where individuals can share their experiences, gain insight, and learn from others who have similar struggles. It’s especially helpful for combating isolation and shame, two common features of depression.

- **Best for:** Clients who feel isolated or stigmatized, or benefit from peer interaction
- **What to expect:** Weekly sessions in a structured or process-oriented format; often topic-specific
- **Can be combined with:** Individual therapy, medication, psychoeducation groups

#### Couples or Family Therapy

**Introduction:**
Depression doesn’t exist in a vacuum. Relational dynamics can trigger, worsen, or maintain depressive symptoms. Couples and family treatment can uncover systemic patterns that contribute to distress and enable family members to support the individual more effectively.

- **Best for:** Depression impacted by relationship conflict, family stress, or caregiving dynamics
- **What to expect:** Collaborative sessions, communication skill-building, exploration of family roles
- **Can be combined with:** Individual therapy, parenting support, IPT

### Different Kinds of Therapy for Depression: Combination Approaches

#### Psychodynamic

**Introduction:**
Psychodynamic therapy is a depth-oriented approach that explores unconscious conflicts, early life experiences, and internalized patterns of relationships. It helps individuals gain insight into the root causes of their depression, often making it suitable for chronic or complex presentations.

- **Best for:** Recurrent or long-term depression, unresolved childhood issues, self-reflective individuals
- **What to expect:** Exploration of past experiences and emotional patterns; duration can be short or long-term
- **Can be combined with:** CBT, medication

#### Acceptance and Commitment Therapy (ACT)

**Introduction:**
ACT focuses on helping clients develop psychological flexibility by accepting unpleasant emotions and thoughts while committing to values-based action. Rather than eliminating depressive symptoms, ACT encourages clients to live meaningfully in the presence of them.

- **Best for:** Depression with avoidance, chronic pain, or existential themes
- **What to expect:** Mindfulness, metaphor, values clarification, and experiential exercises
- **Can be combined with:** CBT, MBCT, exposure

#### Eye Movement Desensitization and Reprocessing ([EMDR](https://www.emdr.com/what-is-emdr/))

**Introduction:**
EMDR is a trauma-focused method that helps clients process distressing memories that may be contributing to depressive symptoms. Through bilateral stimulation, such as guided eye movements, clients reprocess unresolved trauma in a structured and safe environment.

- **Best for:** Trauma-related depression, comorbid PTSD, single-incident or developmental trauma
- **What to expect:** Phased protocol with history-taking, target memory processing, and stabilization
- **Can be combined with:** Psychodynamic therapy, DBT

### How These Different Types of Therapy for Depression Can Be Combined

Many different kinds of therapy for depression complement each other and can be blended to create a personalized treatment plan. Here are some **common pairings**:

**Combination****Purpose**CBT + MedicationStandard treatment for moderate/severe depressionCBT + BABuilds cognitive insight and action momentumPsychodynamic + ACTCombines deep emotional work with values-driven livingDBT + EMDRTargets both emotional regulation and trauma processingGroup + IndividualOffers both peer support and personalized attention## So, What is the Best Type of Therapy for Depression?

The best type of therapy for depression depends on a variety of factors, including the client’s needs, the nature and severity of their depression, and what kind of relationship and structure they respond to best. One crucial characteristic, then, is the therapist fit. Below is a breakdown of the ideal therapist characteristics by personality, therapeutic approach, and location considerations.

### Therapist Personality Traits

A therapist’s personality can significantly influence the client’s comfort, engagement, and openness. While preferences vary, clients with depression often benefit from therapists who are:

1. **Warm and Compassionate**

- Creates a safe, nonjudgmental space
- Validates pain without minimizing it
- Helps build trust and therapeutic alliance

2. **Patient and Steady**

- Understands that depression often causes slow progress and resistance
- Avoids pressuring or rushing change
- Consistently shows up as a grounding presence

3. **Insightful and Reflective**

- Helps clients connect present struggles to past patterns
- Offers interpretations that deepen self-understanding
- Encourages emotional exploration and provides psychoeducational about depression.

4. **Empowering and Strength-Based**

- Focuses on the client’s resilience and capabilities
- Challenges hopelessness with achievable goals
- Instills a sense of agency

5. **Flexible and Adaptable**

- Adjusts approach based on client feedback and evolving needs
- Open to integrating different techniques or pacing as needed

The [best therapist for depression](https://dralanjacobson.com/choosing-the-best-therapist-for-you/) for you will likely have many of these traits.

### Best Kinds of Therapy for Depression: List

As also listed above, strong candidates for the best type of therapy for depression include:

1. **Cognitive Behavioral (CBT)**

- Ideal for clients seeking structure and skill-building
- Focuses on changing negative thoughts and behaviors
- Often offers short-term, goal-focused work

2. **Psychodynamic**

- Ideal for clients who want deeper emotional insight
- Explores unconscious patterns, self-concept, and relational issues
- Often suitable for longstanding or treatment-resistant depression

3. **Interpersonal (IPT)**

- Ideal for depression rooted in relationships, grief, or role transitions
- Time-limited and structured
- Especially helpful for teens, new parents, and older adults

4. **[ Integrative](https://dralanjacobson.com/integrative-therapy/) or Holistic**

- Pull from multiple modalities to match the client’s unique needs
- May integrate somatic work, mindfulness, or spiritual practices
- Often good for clients who want to explore depression from a whole-person lens

5. **Trauma-Informed**

- Important if depression stems from adverse childhood experiences or PTSD
- Use EMDR, sensorimotor psychotherapy, or [trauma-focused CBT](https://pmc.ncbi.nlm.nih.gov/articles/PMC4396183/)
- Emphasizes safety, stabilization, and emotional regulation

### Best Location/Setting

Where and how therapy occurs can significantly impact outcomes, depending on the client’s accessibility needs, comfort level, and preferences.

1. **In-Person Kinds of Therapy for Depression**

- Best for clients who benefit from physical presence, structure, and routine
- Office environment can provide a change of scenery from isolating home environments
- Often preferred for trauma or complex cases needing deep relational work

2. **[ Teletherapy](https://dralanjacobson.com/telehealth-therapy-teletherapy/) (Online)**

- Best for those with mobility issues, transportation challenges, or rural access
- Offers flexibility, convenience, and comfort of one’s own environment
- Ideal for clients who might not attend consistently otherwise

3. **Walk-and-Talk or Nature-Based**

- Best for clients with somatic symptoms or restlessness
- Combines movement, nature, and therapeutic dialogue
- May reduce feelings of clinical formality and increase openness

4. [ **Community Mental Health Clinics**](https://www.thenationalcouncil.org/program/ccbhc-success-center/ccbhc-locator/)

- Accessible to low-income or uninsured individuals
- Often staffed by clinicians in training, supervised by licensed professionals
- Can offer consistent care for moderate to severe depression

5. **Private Practice**

- More flexibility in therapeutic style, frequency, and customization
- Often allows for longer sessions and deeper rapport
- Ideal for clients seeking consistency and a personalized experience

### Summary: Best Type of Therapy for Depression

**Characteristic****Ideal Trait or Option****Therapist Personality**Warm, patient, empowering, reflective, adaptable**Therapeutic Approach**CBT, psychodynamic, IPT, trauma-informed, integrative**Setting/Location**In-person (for structure), telehealth (for access), nature-based (for somatic regulation)**Client-Therapist Fit**Comfort, trust, and shared values matter mostIf you’re helping someone select a therapist, it’s helpful to explore whether they feel emotionally safe, understood, and empowered after a few sessions. Research shows that the **[therapeutic relationship](https://www.ncbi.nlm.nih.gov/books/NBK608012/),** not just the technique, is the strongest predictor of success in treating depression.

## In Session Work vs. Homework

### Types of Therapy for Depression that Include Homework

These approaches **emphasize skill-building and behavioral change,** often assigning structured exercises or tasks between sessions to reinforce learning and create momentum.

1. **Cognitive Behavioral (CBT)**

- **Homework Focus:** Thought records, mood tracking, behavioral experiments, cognitive restructuring
- **Best For:** Clients who like structure and goal-setting; those motivated to apply concepts independently
- **Style:** Teaches practical tools; often short to medium term
- **Goal:** Help clients become their own therapists

2. **Behavioral Activation (BA)**

- **Homework Focus:** Scheduling and completing pleasurable or value-based activities, tracking energy and enjoyment
- **Best For:** Clients with low motivation, fatigue, or anhedonia
- **Style:** Highly action-oriented and forward-moving

3. **Acceptance and Commitment (ACT)**

- **Homework Focus:** Mindfulness exercises, values identification, committed action plans
- **Best For:** Clients willing to sit with discomfort and engage in experiential tasks
- **Style:** Encourages active application of new habits in daily life

4. **Dialectical Behavior Therapy (DBT)**

- **Homework Focus:** Skills practice for emotion regulation, distress tolerance, interpersonal effectiveness, mindfulness
- **Best For:** Clients with emotional dysregulation or co-occurring conditions like borderline traits
- **Style:** Structured and skills-based, with built-in accountability

### Different Kinds of Therapy for Depression that Focus on In-Session Work

These different kinds of therapy for depression **emphasize insight, emotional processing, and the therapeutic relationship**, with most of the work occurring within the session itself. Reflection or journaling may be encouraged outside of the session, but formal homework is minimal or optional.

1. **Psychodynamic**

- **In-Session Focus:** Exploring unconscious patterns, emotional insight, attachment history, defense mechanisms
- **Best For:** Clients interested in understanding deeper causes of their depression, long-standing or recurrent depression
- **Style:** Relational and exploratory; often longer term

2. **Interpersonal (IPT)**

- **In-Session Focus:** Addressing grief, role transitions, and interpersonal conflicts
- **Best For:** Clients whose depression is linked to relationship patterns or social functioning
- **Style:** Structured, but experiential and dialog-driven in session

3. **[ Emotion-Focused](https://dralanjacobson.com/emotionally-focused-individual-therapy/) (EFT)**

- **In-Session Focus:** Processing difficult emotions and transforming emotional responses
- **Best For:** Clients stuck in self-criticism, shame, or unresolved emotional pain
- **Style:** Focus on emotional expression, not behavior change

4. **[ Humanistic](https://dralanjacobson.com/humanistic-therapy/) / [Person-Centered](https://dralanjacobson.com/client-centered-therapy/)**

- **In-Session Focus:** Providing a nonjudgmental, empathetic environment for self-discovery and growth
- **Best For:** Clients needing validation, self-acceptance, and empowerment
- **Style:** Therapist follows client’s lead; homework rarely emphasized

Choosing among the different kinds of therapy for depression often comes down to **client preference and motivation**. Some feel empowered by concrete tools and action steps (homework-oriented), while others heal best through **reflective conversation and emotional presence** (session-focused). A skilled therapist may integrate both styles or adjust the balance as therapy progresses.

### Treating Major Depression with Medications

It is a personal choice whether to pursue medication treatment, and I am happy to advise those who request it. Otherwise, I can provide information about the psychiatrists I trust to take a balanced approach. The types of medications commonly used to treat major depressive disorder include:

– [Selective Serotonin Reuptake Inhibitors](https://en.wikipedia.org/wiki/Selective_serotonin_reuptake_inhibitor) (SSRIs) include fluoxetine (Prozac) and sertraline (Zoloft). These are often the first ones that people try, given that doctors like that they have few side effects, have been mostly proven safe, and do what they set out to do. I cannot give specific advice or guidance about these or any medications.
– [Serotonin and Norepinephrine Reuptake Inhibitors](https://my.clevelandclinic.org/health/treatments/24797-snri) (SNRIs) include venlafaxine (Effexor) and duloxetine (Cymbalta). Many people try these if SSRIs do not work.
– [Atypical Antidepressants](https://screening.mhanational.org/content/atypical-antidepressants/) include bupropion (Wellbutrin) and mirtazapine (Remeron). Some people respond well to these, but again, you need to consult with a doctor who can review your history and needs and give you more specific advice.

Keep in mind that one of the [myths about depression](https://dralanjacobson.com/myths-about-depression/) is that it is due to a chemical imbalance; medications do not work for everyone.

### Lifestyle Modifications to Treat Major Depressive Disorder

Outside of psychotherapy for MDD, there are many things you can do as an adjunct to address your symptoms. For example:

– Regular physical activity can improve mood and reduce symptoms of depression. While exercise may not provide a cure, it can help as part of a comprehensive and multi-faceted approach.
– Balanced nutrition supports overall mental health. This is particularly true if an unhealthy diet reduces energy and motivation.
– Socializing to a comfortable degree can help lift depressive moods, especially if you are avoiding your normal degree of going out and being with and around people.
– Maintaining a regular sleep schedule is crucial. Sleeping too much or too little can affect your mood.

### Mindfulness and Relaxation Therapy for MDD

These techniques may not get to the root of the problem that is causing the depression, but some find that they address symptoms:

– [Mindfulness-Based Cognitive Therapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) for MDD (MBCT) combines mindfulness strategies with cognitive therapy. I like to mix mindfulness exercises to help people avoid automatic and irrational thoughts and find times of peacefulness and contentment. They also help people focus on the exceptions and extend them – the times that bring happiness.
– [Meditation and Yoga](https://www.livescience.com/yoga-and-meditation-similarities-differences) can help reduce stress and improve mood. These techniques are not my specialty, but I know good apps, virtual providers, and exercises to provide to interested people. Many people benefit greatly from these methods.

### Treating Major Depression: Alternatives

There are some other ways of treating major depression, including:

– Light Therapy can be especially useful for [Seasonal Affective Disorder](https://dralanjacobson.com/seasonal-affective-disorder-treatment/) (SAD). You can buy a reasonably inexpensive light to use for treating major depression at online retailers. They are easy to use
– Acupuncture can be beneficial for symptom relief. Many people have used acupuncture for a variety of mental health conditions with reported positive results. This is not an area of expertise for me.
Some noninvasive procedures use [magnetic fields to stimulate nerve cells in the brain](https://my.clevelandclinic.org/departments/neurological/depts/psychiatry-psychology/transcranial-magnetic-stimulation-clinic). They are often used when other treatments have failed.

New treatments are continuously being researched, including the use of ketamine and psychedelics. I stay informed about emerging therapies and am happy to discuss all your options. When an area is outside my expertise, I can refer you to someone who can help.

## Most Effective Treatment for Depression

Many people want to look to numbers and data to understand the most effective treatment for depression. While this is certainly close to asking about the “best” treatment, the “most effective” treatment for depression would suggest that the therapy works particularly quickly, reduces the most symptoms, and keeps a person free of symptoms longer.

In my experience, the most effective treatment for depression may actually not be the “best” treatment. For example, an effective treatment for depression may require more frequent meetings than are feasible, may include treatment techniques that will cause discomfort, or may lower symptoms without getting to underlying causes. The most effective treatment for depression may be one that lowers the symptoms now but does not prevent relapse.

### Instead of the Most Effective Treatment for Depression…

For the above reasons, I suggest that people look for the best therapy for depression for their unique needs, comfort, and depressive origins. If you want lasting and deep results from therapy, the best treatment may not be quite the most effective treatment for depression, but it may be the most lasting, deep, and comfortable course for you. Of course, in many cases, the most effective treatment for depression is also the best method!

## Choosing the Best Treatment for Depression: Example 1

Here’s a fictitious example that is typical and shows how I might select the most effective treatment for depression for a client:

Jane is a 35-year-old woman experiencing her first [major depressive](https://dralanjacobson.com/treating-major-depression/) episode. She has been feeling persistently sad, has lost interest in activities she used to enjoy, and has trouble sleeping and concentrating. Jane has no history of mental illness, but her mother had depression. Jane prefers to avoid medication if possible. I start with a comprehensive evaluation, including a detailed medical and psychological history. I use an empirical tool called the [Patient Health Questionnaire-9](https://www.apa.org/depression-guideline/patient-health-questionnaire.pdf) (PHQ-9) to gauge the severity of Jane’s depression. During this initial process, I also screen for other possible conditions, such as anxiety disorders, but there are no signs that this is a significant problem.

Some stress in her social life involving a relationship ending, some longstanding family issues, and challenges at work after a recent promotion may be causing her low mood.

#### Discussion of Treatment Options

Jane and I discussed various treatment options, and she felt that two of them resonated with her, and I agreed. For Jane, the best treatment for depression would combine two approaches:

- [Cognitive Behavioral Therapy](https://dralanjacobson.com/cbt-for-depression/) (CBT): Given that she feels that her underlying thoughts relative to self-esteem, work competence, and her future outlook are causing her distress, it seems that CBT would be the most effective treatment for depression. We will use it to identify and change negative thought patterns and behaviors.
- [Interpersonal Therapy](https://dralanjacobson.com/interpersonal-therapy/) (IPT): We will also mix in IPT, which focuses on improving Jane’s interpersonal relationships, nurturance needs, and communication patterns, which might be contributing to her depression.
- [ Sleep Hygiene](https://www.healthline.com/health/sleep-hygiene): Tips for improving sleep patterns will also be provided, as sleep disturbances are a significant part of Jane’s depressive symptoms.

#### Outcomes

After six weeks of CBT sessions, Jane notices an improvement in her mood and a reduction in her depressive symptoms. IPT is also helping her address some of the root causes of her symptoms. We decided to meet twice monthly to assess the effectiveness of the treatment plan, including coping strategies, stress management methods, and CBT techniques, and make necessary adjustments.

The above is a general example of how I find the best therapy for depression for each client. The techniques chosen by Jane may not be the ones that work best for you, and that’s why I make sure you are fully informed about [different possible approaches](https://dralanjacobson.com/best-types-of-therapy-for-depression/) so we can work together to find the more effective course. One of the common [depression myths](https://dralanjacobson.com/myths-about-depression/) is that it is similar in everyone who has i

## Choosing the Best Therapy for Major Depression: Example 2

Here’s an example of how I might provide therapy for major depression. This fictitious example gives a general idea of how my practice works.

Jane is 38 and has been suffering from major depressive disorder for the past 10 years. She has tried multiple antidepressants, including SSRIs and SNRIs, without significant improvement. She has also tried cognitive behavioral therapy (CBT) with limited success.

### Therapy for Major Depression: Planning

We start with a comprehensive assessment of Jane’s diagnosis, treatment history, and overall health. We’ll review what has worked and what hasn’t, as well as her current stressors and challenges. We’ll talk about her support network and daily schedule. We might discuss when she feels at her best and her worst. The end result will be a comprehensive treatment plan with meaningful, measurable, and clear goals.

### Psychotherapy for Major Depression

Our major goals of this [individual therapy](https://dralanjacobson.com/individual-therapy/) for treatment-resistant depression are reducing Jane’s symptoms’ intensity, helping her develop coping strategies, and helping her see and tap into her strengths. We’ll combine cognitive-behavioral therapy for MDD with narrative psychotherapy for MDD to help her develop new and more positive ways of thinking about her life and to re-write her feelings about how things will go. We’ll also use an interpersonal approach since some of her symptoms stem from concerns about her social life and self-esteem. Thus, we plan weekly sessions focusing on unconscious conflicts, negative and automatic thoughts, and current relational dynamics.

### Lifestyle and Holistic Approaches

To support her overall well-being and enhance treatment efficacy, she got regular physical exercise, such as a daily 30-minute walk or yoga. I also teach mindfulness meditation practices to reduce stress and improve emotional regulation. She also made an appointment with a Nutritionist to design a balanced diet rich in omega-3 fatty acids, vitamins, and minerals.

### Ongoing Therapy for Major Depression

We meet regularly and introduce new techniques and methods as needed. I sometimes measure her depressive symptoms using standardized scales such as the Beck Inventory. We will adjust the treatment plan based on her response and any emerging issues. The goal of therapy for major depression is to bring her relief, help her develop a toolkit of coping strategies, and eliminate some of what was maintaining her symptoms. This exploration might include exploring underlying emotional conflicts and how they relate to her depressive symptoms and addressing automatic negative thought patterns.

After eight weeks of this combined approach, Jane reports significant mood and daily functioning improvement. She continues with regular psychotherapy to pursue even greater improvement and to address some longer-standing issues now that the severity of her symptoms has lessened.

This multimodal approach aims to address both the biological and psychological aspects of depression, providing Jane with a comprehensive and individualized treatment plan. Jane feels she no longer needs therapy for major depression, though she is considering returning to work on some less urgent issues that may help her avoid a relapse.

## Different Types of Therapy for Depression: Conclusion

Therapy is not about achieving perfection or eliminating all discomfort; it’s about learning to face life’s challenges with greater resilience, presence, and self-compassion. With the right therapeutic relationship and approach, meaningful and lasting change is possible. If you are struggling, know that you don’t have to navigate it alone. There are many different kinds of therapy for depression available, and you don’t need to make the perfect choice. Instead, go with what you think will work and try things out. There may not actually be just one perfect choice, or you may be able to find a therapist with an integrative practice that can try different methods.

## My Work

An integrated approach with several proven therapy methods and supplemental and adjunctive approaches often works best. I am happy to talk to you about what the best treatment for depression might be for you. We will develop a personalized treatment plan addressing your needs and circumstances. [A combination of therapy](https://dralanjacobson.com/therapy-for-depression-and-anxiety/), medication, and lifestyle changes may be most effective in severe cases.

If you have questions about the different types of therapy for depression, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## FAQs

**What is the best type of therapy for depression?**
The best type depends on your individual needs, the nature and severity of your depression, and how you respond to different styles. CBT works well for negative thought patterns and goal-oriented people; psychodynamic therapy suits those with long-standing or recurrent depression; IPT is ideal when depression is linked to relationships or life transitions; and integrative approaches work well for those who benefit from a combination of methods.

**Does therapy for depression involve homework?**
Some approaches do and some don’t. CBT, Behavioral Activation, ACT, and DBT all include structured between-session exercises like thought records, mood tracking, and mindfulness practice. Psychodynamic, IPT, Emotion-Focused, and Person-Centered therapies focus primarily on in-session work, with minimal or optional homework.

**Can depression be treated without medication?**
Yes — psychotherapy alone is effective for many people, particularly those with mild to moderate depression. CBT, IPT, and psychodynamic therapy all have strong evidence bases independent of medication. For moderate to severe depression, a combination of therapy and medication is often most effective, but medication is always a personal choice.

**How long does therapy for depression take?**
It depends on the approach and the individual. CBT typically runs 12–20 weeks. IPT is usually 12–16 sessions. Psychodynamic therapy can be short or long-term depending on complexity. Behavioral Activation can show results in as few as 8–10 sessions. Chronic or treatment-resistant depression often benefits from longer-term work.

**What is the difference between CBT and psychodynamic therapy for depression?**
CBT focuses on identifying and changing unhelpful thought patterns and behaviors in a structured, skills-based format. Psychodynamic therapy explores unconscious patterns, early life experiences, and relational dynamics to uncover root causes of depression. CBT tends to be shorter-term and goal-oriented; psychodynamic work tends to be deeper and longer.

**Can therapy for depression be done online?**
Yes — telehealth therapy for depression is widely available and research shows it is as effective as in-person therapy for most presentations. It is particularly well-suited for busy professionals, people in rural areas, and those who prefer the comfort of their own environment. Sessions are conducted via secure video platform.

**What lifestyle changes help with depression alongside therapy?**
Regular physical activity, balanced nutrition, maintaining a consistent sleep schedule, and appropriate social engagement all support therapy outcomes. Mindfulness practices such as MBCT, meditation, and yoga can also help manage symptoms. These are not replacements for therapy but effective adjuncts to it.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Types of Therapy

---

### [Cognitive-Behavioral Therapy (CBT): Fast, Measurable Results](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/)

**Published:** May 21, 2023
**Author:** Dr. Alan Jacobson

**Content:**

**Cognitive-Behavioral Therapy** (CBT) is a widely used, proven, [evidence-based approach](https://www.hopkinsmedicine.org/nursing/center-nursing-inquiry/nursing-inquiry/evidence-based-practice) to psychotherapy that focuses on the connection between thoughts, feelings, and behaviors. **CBT treatment** operates under the principle that our thoughts influence our emotions and behaviors. Identifying and changing problematic or harmful thought patterns can alleviate stress and anxiety and improve overall well-being. One key feature of this approach is it’s structured and solution-focused, making it a [practical and effective treatment with clear results](https://dralanjacobson.com/therapy-for-depression-and-anxiety/). I use it as a core part of [my practice](https://dralanjacobson.com/). I cover specific strategies such as [CBT for ADHD](https://dralanjacobson.com/cbt-for-adhd/), [Cognitive-behavioral treatment for social anxiety](https://dralanjacobson.com/cbt-for-social-anxiety/) and [CBT-I for sleep](https://dralanjacobson.com/cbt-i-for-sleep-difficulties/) elsewhere in this blog.

## Cognitive-Behavioral Therapy Background

CBT has been extensively researched and has demonstrated effectiveness in treating a wide range of mental health conditions. This includes depression, anxiety disorders, phobias, [panic attacks,](https://dralanjacobson.com/panic-attack-treatment/) and general discontent. Cognitive-behavioral therapy is typically time-limited and structured, so you see results quickly. Sometimes, a quick course of cognitive-behavioral treatment can be done within a longer course of treatment so you can work on other issues and goals as well.

### Basic Tenets

Cognitive-behavioral therapy offers a practical, evidence-based approach that targets the connection between thoughts, feelings, and behaviors. If you are looking for a collaborative and goal-oriented approach that can have lasting effects and arms you with strategies you can use in many areas of your life. In that case, cognitive behavioral therapy is for you.

### Benefits of Cognitive-Behavioral Therapy

1. **Evidence-Based Effectiveness**: Cognitive-behavioral treatment is supported by a substantial body of research demonstrating its effectiveness in treating various diagnoses, including depression, anxiety disorders, panic disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and more.
2. **Short-Term and Focused**: This method is often considered a relatively short-term therapy. Compared to other therapeutic approaches that might require longer periods, many individuals start to experience positive changes within a limited number of sessions.
3. **Problem-Solving Skills**: Cognitive-behavioral treatment equips individuals with practical skills to identify, challenge, and reframe negative thought patterns contributing to emotional distress. This helps you develop healthier ways of thinking and responding to life’s challenges.
4. **Holistic Approach**: Cognitive-behavioral treatment addresses the interconnectedness of thoughts, emotions, and behaviors. By working on changing negative thought patterns, it can improve emotional regulation and behavioral responses.
5. **Relapse Prevention**: Cognitive-behavioral treatment often includes relapse prevention strategies. You will learn to recognize early signs of distress, which helps you apply them to coping skills you’ve acquired to prevent worsening symptoms.
6. **Customization**: CBT is adaptable and tailored to your needs and challenges. We will work to develop personalized strategies and goals.
7. **Skills for Life**: The coping skills and techniques learned in Cognitive-behavioral treatment can extend beyond the therapy sessions, enabling you to apply them to various situations.
8. **Wide Applicability**: Cognitive-behavioral therapy can treat various conditions beyond mental health disorders, such as managing stress, improving communication skills, enhancing self-esteem, and addressing sleep difficulties.
9. **Combination with Other Treatments**: CBT can be combined with [other therapeutic approaches](https://dralanjacobson.com/types-of-therapy/) or medication, enhancing overall treatment outcomes.
10. **Empowerment**: Cognitive-behavioral treatment empowers you by giving you tools to manage your mental health and well-being. This can increase self-awareness and greater control over your thoughts and emotions.
11. **Long-Term Benefits**: The skills learned can have lasting effects, helping you maintain your mental health and prevent relapse even after the therapy has concluded.

## CBT Uses

I use CBT in my practice for a wide range of mental health and general wellness issues. These are the most common:

### CBT for Anxiety Disorders

CBT effectively treats various anxiety disorders, including generalized anxiety disorder, [social anxiety disorder](https://dralanjacobson.com/therapy-for-social-anxiety/), panic disorder, and specific phobias. It helps you identify and challenge irrational or distorted thought patterns contributing to anxiety. CBT offers practical tools to manage the underlying stress that causes anxiety by teaching you how to reframe stressful situations, set realistic goals, and develop effective problem-solving skills.

[CBT is also a primary treatment for OCD](https://dralanjacobson.com/cbt-for-ocd/). It involves gradually exposing you to your obsessions and [preventing their usual compulsive responses,](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/) thereby reducing the impact of obsessions. Finally, cognitive behavioral therapy can be used to treat insomnia rooted in anxiety. It involves changing behaviors and thoughts that contribute to sleep disturbances.

### Cognitive-Behavioral Therapy and Depression

I use cognitive behavioral therapy to [treat depression](https://dralanjacobson.com/therapy-for-depression/) by helping you recognize and change negative thought patterns and behaviors that contribute to your feelings of sadness and hopelessness. This approach can help you build healthier self-esteem and self-confidence by challenging negative self-perceptions and developing positive self-beliefs. This can insulate you against future depressive episodes.

### Cognitive-behavioral Treatment for Insomnia

Cognitive-behavioral therapy can help with primary insomnia, the type of insomnia that persists even after the original cause of the problem subsides. This method is called CBTI, with the “I” standing for “Insomnia.” This area requires specific training, which I have. [CBT for insomnia](https://dralanjacobson.com/cbt-i-for-sleep-difficulties/) is time-limited, solution-focused, and powerful. This method can be delivered virtually.

### Cognitive-Behavioral Therapy for ADHD

I also use [CBT for ADHD](https://dralanjacobson.com/cbt-for-adhd/). While this approach is less known than other ways of managing an attention deficit, it can be quite effective, especially as an add-on method. CBT for ADHD gives you a toolkit to use to manage the racing thoughts, procrastination, and lack of focus that you might be experiencing. CBT for [ADHD in girls](https://dralanjacobson.com/therapy-for-girls-with-adhd/) is particularly effective.

### General Uses for Cognitive-behavioral Therapy

Cognitive behavioral techniques can benefit individuals seeking personal growth, [stress reduction,](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) and improved overall well-being, even if they don’t have a specific mental health diagnosis.

## Cognitive-Behavioral Therapy Process

In CBT, therapists work with clients to identify and challenge negative thoughts and beliefs contributing to emotional and behavioral difficulties. We look for exaggerated or irrational thinking that you may not even know. Through cognitive strategies, you’ll learn to recognize automatic negative thoughts and replace them with more realistic, positive, and adaptive ones. You’ll feel more in control and competent in creating positive moods and feeling empowered. This approach often involves homework assignments that encourage you to actively apply the skills and techniques learned in therapy to your daily life. Sometimes, you get to do fun experiments where you are the subject!

### Process Detail:

1. **Assessment and Goal Setting**: The process begins with our collaborative identification of the client’s concerns, symptoms, and goals. This helps establish a clear focus for the therapy and allows me to understand your unique challenges.
2. **Identifying Negative Thought Patterns**: You learn to recognize automatic negative thoughts and cognitive distortions contributing to emotional distress. These thoughts are often habitual and automatic, so our goal is to increase awareness.
3. **Challenging Negative Thoughts**: I help you challenge and question the accuracy and validity of their negative thoughts. This involves evaluating evidence for and against these thoughts and considering more balanced or realistic perspectives.
4. **Restructuring Thought Patterns**: We’ll work towards alternative, more balanced, and rational ways of thinking. This process is often referred to as cognitive restructuring. The aim is to replace irrational or negative thought patterns with healthier, more adaptive ones.
5. **Behavioral Techniques**: In addition to addressing thoughts, CBT also focuses on behaviors. You’ll learn to identify behaviors contributing to your difficulties and develop strategies to modify them. This might involve practicing new coping skills, facing feared situations gradually (exposure therapy), or implementing behavioral experiments. You’ll also learn “[behavioral activation](https://dralanjacobson.com/behavioral-activation/),” or what activities you can add to your daily routine to make you happier.
6. **Homework Assignments**: I often given homework assignments between sessions. These assignments might involve practicing new skills, challenging negative thoughts, or engaging in exposure exercises. Homework reinforces the learning process and helps you apply what you’ve learned in real-life situations.
7. **Gradual Progression**: The therapy sessions follow a structured progression, starting with foundational concepts and moving toward more complex challenges. As you build skills and confidence, you’ll tackle more difficult situations.
8. **Relapse Prevention**: Towards the end of therapy, you’ll learn strategies to prevent relapse and maintain your progress. This involves identifying triggers and creating plans for managing potential setbacks.

## CBT Treatment Resources

CBT treatment continues to be a prominent part of my practice due to its durable positive effects and wide range of potential benefits. You can read more about [my therapy approach](https://dralanjacobson.com/types-of-therapy/) and overall [training and preparation](https://dralanjacobson.com/my-bio/) or [schedule a call](https://dralanjacobson.com/contact/) to discuss whether cognitive-behavioral treatment is for you or whether my approach can help you with your unique goals. For more information on CBT treatment, there is a good overview of information from the [American Psychological Association](https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral) and the specific ways it is used from [Science Direct](https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral).

## Cognitive-Behavioral Treatment Example

The following example of [cognitive-behavioral treatment](https://dralanjacobson.com/) (CBT) is designed to help you decide whether this approach may suit you. The example is not based on any specific client, of course, but rather an example of how it might be used for a made-up client who is suffering from social anxiety. Please get in touch with me anytime to discuss how Cognitive-behavioral therapy or a [combination approach](https://dralanjacobson.com/integrative-therapy/) that includes CBT might help with your unique goals and challenges.

I also have an example in another post of [CBT for social anxiety](https://dralanjacobson.com/cbt-for-social-anxiety/).

### CBT Treatment Initial Steps

CBT treatment starts with steps designed to ensure that this is the best approach for you and then to design a treatment plan around your hopes and goals for therapy. This client, Julie, is a 25-year-old woman facing social anxiety, which affects her dating life, and some [fear of public speaking](https://dralanjacobson.com/public-speaking-fear/) in her new job.

#### Initial Assessment

We will begin by making sure I fully understand her concerns, symptoms, and triggers related to social anxiety. We reviewed specific situations that caused her social distress and how she hoped therapy would help. Next, we go over how she feels physically during these times, the anticipatory anxiety that prevents her from being fully social, and the negative thoughts associated with social interactions.

Given what she says in the initial conversation, we collaborate to set specific and achievable goals. These goals are not necessarily what she will do immediately but rather the longer-term goals that will show that therapy worked. They include attending casual social events without overwhelming anxiety, being able to engage in small talk on a date, giving feedback in work meetings, and presenting confidently in front of a small group.

#### Identifying Negative Thoughts

Once we have a solid treatment plan, it’s time to do the core task with CBT: Identifying and challenging negative thought patterns. These thoughts are often exaggerated or irrational, and they happen automatically. For Julie, we realize she has irrational thoughts of people evaluating her negatively about how she speaks and whether she is “up to the task” at her new job. She also fears embarrassing herself by saying something wrong or “unintelligent.”

Julie also has exaggerated thoughts when in social situations that the person or people she is with do not like something about her but do not say anything. She also fears saying the wrong thing and often leaves social situations obsessing about something she said.

#### CBT Treatment and Cognitive Reframing

It’s now time to help Julie more clearly see that these thoughts are irrational or exaggerated in real time. We start by having her do “behavioral experiments” to test the accuracy of negative thoughts. For Julie, this involves going as far as she is comfortable in social and work situations and noticing whether there is evidence to back her thoughts. Her homework will be to keep a thought journal to track negative thoughts and associated emotions and then see if there are signs that she was right about her fears.

### Cognitive-Behavioral Therapy Adjunctive Steps

Julie is enthusiastic but fearful about the above steps, and we want to make sure that therapy goes at a pace she is comfortable with. One way to help is by teaching her relaxation techniques to manage anxiety. We will also go over coping strategies like [deep breathing](https://positivepsychology.com/deep-breathing-techniques-exercises/), [progressive muscle relaxation](https://health.clevelandclinic.org/progressive-muscle-relaxation-pmr/), and [mindfulness](https://health.clevelandclinic.org/progressive-muscle-relaxation-pmr/) to manage anxiety symptoms in real time.

### CBT Treatment Later Steps

As Julie progresses in therapy, she will work on gradually exposing herself to feared social situations or practicing specific social skills. Her progress is continually assessed in treatment, and positive changes are reinforced while challenges are explored, focusing on comfortable solutions. We continually work together to evaluate what strategies are working and make adjustments as needed. For example, Julie found that CBT techniques were challenging at first because her mind was racing, so I taught her some basic meditation techniques that helped her clear her mind.

#### More Homework

As we get closer to ending the CBT treatment course, I will assign even more homework to ensure the gains will stick and give her a toolbox she can use as necessary going forward. We’ll discuss what exercises she can do to maintain her gains and continue practicing learned skills outside therapy sessions.

### Review and Progress Evaluation:

In the last few sessions, we will thoroughly review Julie’s progress toward her goals and what worked and what didn’t. We’ll talk about the stressors that may arise in the near term and how she can proactively use her new skills and knowledge to ensure she handles them well. We’ll focus on her new strengths and how she worked hard to overcome the barriers that were in place.

### Termination and Relapse Prevention:

In the last session, we will continue talking about relapse prevention strategies and ensure she has the tools to continue her progress independently. We’ll review everything again and focus on how she can maintain her progress in the future. I’ll ensure she has multiple ways to contact me should she want a reminder or boost. I’ll let her know there is no charge for quick contacts designed to help maintain progress.

## CBT Outcomes

Julie has made significant progress and can now quickly identify negative thoughts, challenge them, and fully believe they are inaccurate. This has led to her seeing improvements in her social life, work performance, and enjoyment. She is excited about taking even more steps forward, not that CBT has given her ideas and strategies. Specifically, she has found that CBT treatment helped with:

1. Symptom Reduction: CBT treatment reduced her anxiety by addressing irrational thoughts and gradually exposing her to feared situations. She now feels more comfortable socially and in public speaking.
2. Increased confidence: Julie’s gains in CBT treatment helped her feel more competent to make new and lasting improvements even after therapy concluded. She now has the general coping skills to deal with life stressors, difficult situations, and emotional challenges.
3. Increased self-awareness and understanding: CBT treatment helped her understand the connections between their thoughts, emotions, and behaviors, fostering self-awareness and insight.
4. Workplace performance: CBT treatment specifically helped Julie feel more competent and confident at work. She feels less stressed, more confident, and more able to use effective coping mechanisms.

This is a broad example of how this therapy might work on a fictitious person; [CBT is highly individualized and adaptable](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) to each person’s unique needs and circumstances. The ultimate goal is to empower individuals to manage their thoughts and behaviors more effectively, improving their mental health and well-being.

Your unique situation may feel similar to this one or quite different, but I hope this CBT treatment example shows you the power and flexibility of this type of treatment. I have used CBT as a standalone approach and in combination with other approaches to help people of all ages manage stress, feel more content, and improve performance.

[unconscious processes](https://www.simplypsychology.org/unconscious-mind.html), identity, freedom, and the search for meaning.

### Cognitive Behavioral Therapy Methods in Practice

Healing is not only about symptom reduction but also about fostering greater self-awareness, resilience, and an authentic connection to one’s values and purpose. I use [cognitive behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) methods in combination with other approaches to provide a powerful, effective treatment course.

## Specific CBT Techniques in Detail![CBT Techniques and Methods](https://dralanjacobson.com/wp-content/uploads/2025/04/maintenence.jpg "maintenence | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Here’s a detailed breakdown of **key cognitive behavioral therapy techniques**, with *detailed explanations*:

### [Cognitive Restructuring](https://dralanjacobson.com/cognitive-restructuring/) or Reframing CBT Techniques

**Goal**: Use CBT methods to identify and challenge negative thought patterns and replace them with more balanced ones.

- **How it works**: 
    - **Identify** the negative automatic thoughts (e.g., “I always fail.”)
    - **Examine** the evidence for and against these thoughts.
    - **Challenge** distortions like catastrophizing, black-and-white thinking, or mind reading.
    - **Replace** with a more realistic or compassionate thought.
- **Example**: 
    - Thought: “If I don’t do this perfectly, I’m a failure.”
    - New Thought: “Doing my best is enough, and mistakes help me learn.”

### CBT Techniques and [Behavioral Activation](https://dralanjacobson.com/behavioral-activation/)

**Goal**: Use CBT methods to increase engagement with positive and rewarding activities to combat depression and avoidance behaviors.

- **How it works**: 
    - Track daily activities and mood.
    - Identify avoidance patterns.
    - Schedule specific positive activities (even small ones).
    - Gradually increase participation in these activities, even if motivation is low.
- **Example**: Scheduling a 10-minute walk even when feeling low, to break the inactivity cycle.

### [Exposure and Response Prevention](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/) Cognitive Behavioral Techniques

**Goal**: Use CBT methods to reduce fear and avoidance by gradually facing feared objects, activities, or situations.

- **How these cognitive behavioral techniques work**: 
    - Develop a **fear hierarchy**: list fears from least to most scary.
    - Gradually **expose** yourself to these fears in a safe, controlled way.
    - Stay in the feared situation long enough to experience anxiety decrease.
    - Repeat exposures until the fear reduces (habituation).
- **Example**: Someone afraid of dogs might first look at pictures, then watch videos, then visit a dog park from a distance, and eventually pet a dog.

### Activity Scheduling and Planning

**Goal**: Structure the day to improve mood and productivity.

- **How it works**: 
    - Create a detailed schedule for the day or week.
    - Include pleasurable activities, mastery activities (building skills), and necessary tasks.
    - Helps counter procrastination, hopelessness, and lack of motivation.
- **Example**: Planning “clean kitchen for 10 minutes” at 5 PM and “call a friend” at 7 PM.

### [Solution-Focused](https://dralanjacobson.com/solution-focused-therapy/) CBT Therapy Techniques

**Goal**: Improve coping by teaching structured CBT methods to solve real-world problems.

- **How it works**: 
    - Clearly **define the problem**.
    - **Brainstorm** possible solutions without judging them.
    - **Evaluate** pros and cons.
    - **Choose** the best option and create an action plan.
    - **Review** outcome and revise if needed.
- **Example**: Deciding how to approach a conflict with a coworker by generating options and choosing a respectful conversation.

### [Mindfulness-Based](https://dralanjacobson.com/mindfulness-therapy/) CBT Methods

**Goal**: Increase awareness of the present moment and reduce judgment of thoughts.

- **How it works**: 
    - Practice [observing thoughts, feelings, and body sensations](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) without reacting.
    - Use breathing exercises, body scans, or meditation.
    - Learn to allow thoughts to come and go without clinging to them.
- **Example**: Notice anxiety rising before a presentation, acknowledge it without self-criticism, and refocus on breathing.

### Distortion Identification

**Goal**: Use CBT methods to recognize specific types of faulty thinking that maintain emotional distress.

- **Common cognitive distortions**: 
    - All-or-nothing thinking (“If I’m not perfect, I failed.”)
    - Overgeneralization (“I didn’t get this job; I’ll never succeed.”)
    - Mental filter (focusing only on the negatives).
    - Discounting the positive.
    - Jumping to conclusions (mind reading, fortune-telling).
- **Technique**: 
    - Catch the distortion.
    - Label it.
    - Reframe the thought.

### [Socratic Questioning](https://www.teachwithmrst.com/post/socratic-questioning) CBT Methods

**Goal**: Encourage critical thinking to challenge harmful beliefs using cognitive behavioral therapy methods.

- **How it works**: 
    - I (or you) ask open-ended, guiding questions to explore the validity of beliefs.
    - Examples of Socratic questions: 
        - “What evidence supports this thought and what evidence contradicts it?”
        - “What would I tell a friend in this situation?”
        - “Is there another way to look at this?”
- **Example**: If you believe “I’m worthless,” a series of questions might reveal many past successes that contradict that belief.

### Cognitive Behavioral Techniques for Relapse Prevention

**Goal**: Use cognitive behavioral therapy techniques to prepare for future challenges and setbacks after therapy ends.

- **How it works**: 
    - Identify early warning signs of relapse (e.g., increased isolation).
    - Develop a personal action plan (e.g., seeking support, using coping skills).
    - Normalize setbacks as part of growth.
- **Example**: A checklist of coping strategies ready to use when early signs of depression reappear.

### Thought Records

**Goal**: Use CBT methods to track situations, thoughts, emotions, and alternative thoughts.

- **How it works**: 
    - Fill out structured worksheets.
    - Typical columns: 
        - Situation
        - Emotion (intensity 0–100%)
        - Automatic thought
        - Evidence for/against
        - Alternative thought
        - Outcome (emotions after rethinking)
- **Example**: 
    - Situation: “Got critical feedback at work.”
    - Emotion: “Embarrassed (80%)”
    - Thought: “I’m incompetent.”
    - Evidence for: “I made some mistakes.”
    - Evidence against: “I usually do well; feedback is common.”
    - Alternative: “This is a learning opportunity.”
    - Outcome: “Less embarrassment (40%)”

## Case example: CBT Techniques for Anxiety

**Name**: Emma
**Age**: 16
**Presenting Problem**: Emma struggles with intense social anxiety. She worries constantly about being judged at school, avoids raising her hand in class, and recently started skipping social events like parties and group projects. She reports feeling nauseous and shaky when around peers. Her grades have dropped due to participation fears.

### Assessment:

- **Automatic Thoughts**: “Everyone will think I’m stupid.” “If I say something wrong, I’ll be humiliated.”
- **Core Beliefs**: “I am not good enough.” “I must be perfect to be liked.”
- **Behavioral Responses**: Avoids speaking in class, avoids social gatherings, pretends to be sick.

We decided that cognitive behavioral therapy methods would be one of the best [kinds of therapy for anxiety](https://dralanjacobson.com/best-types-of-therapy-for-anxiety/) to help address these symptoms. [Therapy for presentation anxiety](https://dralanjacobson.com/presentation-anxiety/) and social worries would be the focus.

### CBT Techniques for Anxiety Applied:

1. #### Psychoeducation about CBT Techniques for Anxiety

- **Explained** what anxiety is (fight/flight response) and how avoidance actually strengthens anxiety.
- **Normalized** that everyone feels judged sometimes, but avoidance keeps fears alive.
- **Introduced** CBT methods as a way to change how she thinks and acts to feel better.

2. #### Cognitive Restructuring CBT Techniques for Anxiety

- **Identified** Negative Thoughts: 
    - Example: Before a class discussion, Emma thinks: “If I say the wrong thing, people will laugh at me.”
- **Challenge/Restructure**: 
    - Evidence for: “Sometimes people giggle, but not always at me.”
    - Evidence against: “I’ve answered questions right many times before.”
    - New Thought: “Even if I stumble, most people won’t notice — and mistakes are normal.”

3. #### Exposure CBT Therapy Techniques (gradual exposure to feared situations)

- **Created a fear hierarchy**: 
    - 1/10: Saying “hi” to a classmate.
    - 4/10: Answering a question wrong in a small group.
    - 7/10: Speaking in front of the full class.
    - 10/10: Giving a formal speech.
- **Planned gradual exposures**: 
    - Start with saying “hi” daily to two people.
    - Progress to asking one question in a small group.
    - Then move to volunteering a short answer in class.
- **She stayed** in the feared situation long enough to let the anxiety naturally decrease (rather than escaping).

4. #### Behavioral Experiments

- **Set up experiments** to test beliefs.
- Example: Emma believes if she answers wrong, classmates will laugh.
- **Plan**: She volunteers a simple answer, even if unsure.
- **Outcome**: Nobody laughs. Some nod supportively.
- **Conclusion**: Her belief was inaccurate; most people aren’t focused on her.

5. #### Thought Records (CBT Techniques for Anxiety Daily Homework)

Emma keeps a journal:

**Situation****Feeling (0–100%)****Thought****Evidence For****Evidence Against****New Thought**Had to read in classAnxiety (90%)“I’ll mess up and everyone will mock me”I sometimes stutterPeople usually don’t react; others stumble too“Even if I stumble, I can continue calmly.”6. #### Relaxation and Coping Skills

- **Taught** breathing exercises (e.g., “4-7-8 breathing”: inhale 4 sec, hold 7 sec, exhale 8 sec).
- **Introduced Progressive muscle relaxation**: Tense and release muscles to lower physical anxiety symptoms.
- **Mindfulness moments**: She practiced focusing attention on the present (sounds, sensations) during anxious moments.

7. #### Problem-Solving Cognitive Behavioral Therapy Techniques

- Problem: Feeling lonely because she avoids parties.
- Steps: 
    - Identified the problem.
    - Brainstormed options (e.g., attend a party for just 20 minutes, bring a supportive friend).
    - Chose a doable action.
    - Evaluated the experience afterward.

8. #### Relapse Prevention Plan

- Taught Emma to notice early signs of rising anxiety (increased avoidance thoughts).
- Developed a mini-action plan of cognitive behavioral therapy techniques: 
    - Re-engage with exposures.
    - Revisit positive coping thoughts.
    - Use relaxation strategies early.

### Results after several months of CBT Therapy Techniques:

Cognitive behavioral therapy for anxiety resulted in:

- Emma gradually participates more in class discussions.
- She attended a school dance for the first time without leaving early.
- She reports moderate anxiety but no longer avoids social settings.
- Her self-confidence and mood significantly improve.

## Case example: CBT Techniques for Depression

**Name**: Lisa
**Age**: 34
**Presenting Problem**: Lisa reports persistent low mood, fatigue, hopelessness, and withdrawal from friends and hobbies over the past 6 months. She often thinks, “Nothing I do matters,” and “I’m a burden to everyone.” She has stopped exercising, spends most weekends in bed, and feels overwhelmed by small tasks.

### CBT Assessment:

- **Automatic Thoughts**: “I’m useless.” “Things will never get better.”
- **Core Beliefs**: “I’m a failure.” “I’m unlovable.”
- **Behavioral Responses**: Isolation, inactivity, avoidance of work and personal responsibilities.

We chose a treatment course centered on cognitive behavioral therapy techniques for depression.

### CBT Techniques for Depression Applied

1. #### Psychoeducation

- **Taught** Lisa about the cycle of depression: 
    - Negative thoughts → Low mood → Inactivity → Reinforced negative thoughts.
- **Introduced** cognitive behavioral therapy techniques for depression as a way to interrupt this cycle by changing thoughts and behaviors.

2. #### Behavioral Activation CBT Techniques for Depression (First priority)

- Depression often leads to withdrawal and inactivity, which worsens the mood.
- **Action Plan**: 
    - Identify activities Lisa used to enjoy or find meaningful (e.g., yoga, reading, coffee with friends).
    - Start very small: **One pleasurable or mastery task per day**, even if motivation is low.
    - **Use activity scheduling** with checkboxes to create a sense of accomplishment.
- **Example**: 
    - Monday: 5-minute stretch
    - Tuesday: Call sister for 5 minutes
    - Wednesday: Walk to mailbox
- **Outcome**: Completing small tasks builds momentum, boosting mood through real experiences.

3. #### Cognitive Restructuring CBT Techniques for Depression

- **Identify** negative automatic thoughts (e.g., after sleeping late: “I’m so lazy; I’ll never get better.”)
- **Challenge and Reframe**: 
    - Evidence for: “I overslept today.”
    - Evidence against: “I’ve been very tired; my body may need extra rest. I’ve completed other tasks this week.”
    - Alternative thought: “One day doesn’t define my progress.”
- **Introduce a “Thought Diary”**: Lisa records daily thoughts, feelings, evidence, and reframed thoughts.

4. #### Cognitive Distortion Identification

- Teach Lisa about **common distortions** she frequently uses, like: 
    - **All-or-nothing thinking** (“Either I’m successful or a total failure.”)
    - **Overgeneralization** (“This mistake means I always fail.”)
    - **Fortune telling** (“Things will never get better.”)
- **Technique**: 
    - Spot the distortion.
    - Label it.
    - Reframe the thought logically.

5. #### Problem-Solving Cognitive Behavioral Therapy Techniques for Depression

- **Address overwhelming tasks** (e.g., unpaid bills).
- **Steps**: 
    - Clearly define the problem.
    - Break it into small, specific parts.
    - Brainstorm possible steps (e.g., open bills, make a list, call the utility company).
    - Choose one small first step.
- **Example**: Opening the stack of unopened mail without having to act immediately.

6. #### Activity Scheduling and Monitoring Mood

- Lisa logs daily activities and rates her mood (0–10).
- **Goal**: Notice connections between activities and feelings.
- **Example**: Mood 2/10 after lying in bed all day, but 5/10 after a short coffee outing.
- **Insight**: Even small actions influence mood positively.

7. #### Behavioral Experiments (Challenging Beliefs with CBT Techniques for Depression)

- Belief: “If I reach out to my friends, they will be annoyed.”
- **Experiment**: Send a simple text (“Thinking of you — hope you’re well”).
- **Outcome**: Friends respond warmly.
- **Conclusion**: Her belief is not accurate; she’s valued.

8. #### Relapse Prevention Plan Using Cognitive Behavioral Therapy Techniques for Depression

- **Prepare for setbacks**: 
    - Identify early warning signs (e.g., stopping activities, increased negative thinking).
    - Create an action plan (restart activity scheduling, call therapist or supportive friend).
    - Normalize that setbacks are **not failures**, but chances to use skills.

### Results after 3–4 months of CBT Methods:

[CBT for depression](https://dralanjacobson.com/cbt-for-depression/) resulted in:

- Lisa steadily re-engages in life: short daily walks, occasional dinners with friends, pursuing a small side project.
- Her thoughts are more balanced.
- She reports feeling hopeful about the future and experiencing fewer “hopeless” days.

### Quick Summary of CBT Techniques Used:

**CBT Methods****How Applied as CBT Therapy Techniques**Behavioral ActivationScheduling small rewarding activitiesCognitive RestructuringChallenging negative automatic thoughtsDistortion IdentificationSpotting all-or-nothing thinking and fortune tellingProblem SolvingBreaking overwhelming problems into stepsBehavioral ExperimentsTesting negative beliefs about relationshipsRelapse PreventionPlanning for future difficult periods## Case example: CBT Techniques for ADHD

**Name**: Jordan
**Age**: 20
**Presenting Problem**: Jordan is a college sophomore struggling with focus, procrastination, missed deadlines, and emotional frustration. He often feels overwhelmed by large assignments, starts but rarely finishes projects, and calls himself “lazy” or “stupid” when he falls behind. He had [psychological testing for ADHD](https://psychologicalassessments.com/testing-for-adhd/) in high school, but he never received structured support.

### CBT Assessment:

- **Automatic Thoughts**: “I’ll never be able to manage this workload.” “Everyone else is better at this than me.”
- **Core Beliefs**: “I’m incapable.” “I’m not good enough.”
- **Behavioral Responses**: Procrastination, avoidance of large assignments, late-night cramming, perfectionism leading to shutdown.

Cognitive behavioral techniques seemed like a perfect fit.

### CBT Techniques for ADHD Applied:

1. #### Psychoeducation on CBT techniques for ADHD and Executive Function

- **Taught** Jordan about how ADHD impacts: 
    - Task initiation
    - Working memory
    - Planning and organization
    - Emotional regulation
- **Normalized** that his struggles are *brain-based* and not because he’s “lazy” or “stupid.”
- **Framed ADHD management** as a *skills training* process, not a personal flaw.

2. #### Cognitive Restructuring CBT Techniques for ADHD

- **Identify** Negative Automatic Thoughts: 
    - Example: “This project is too big. I can’t even start.”
- **Challenge/Restructure**: 
    - Evidence for: “It *feels* overwhelming.”
    - Evidence against: “I have completed large projects before, one step at a time.”
    - New Thought: “I don’t have to finish it all today. I can start with a small piece.”
- **Daily Reframing Practice**: Jordan writes down 1 negative thought a day and reframes it.

3. Behavioral Activation and Task Structuring

- **Break tasks into small, specific steps**. 
    - Instead of “Write research paper,” the task becomes: 
        - Open Word document
        - Write paper title
        - Find and save 3 journal articles
- **Use “micro-tasking”**: 5–10 minute work bursts with a clear goal.
- **Example**: 
    - Monday: Find sources (10 minutes).
    - Tuesday: Outline first two sections (15 minutes).
    - Wednesday: Write intro paragraph.

4. #### Implementation Intentions (“If-Then Planning”)

- ADHD brains benefit from **pre-deciding** actions: 
    - Example: “If I sit down at my desk after lunch, *then* I will open my laptop and work for 10 minutes.”
- Helps reduce reliance on willpower and increase automatic behavior.

5. #### Externalization of Memory and Planning

- ADHD often impacts **working memory**. Using cognitive behavioral therapy methods, Jordan is taught to: 
    - Use external reminders (whiteboards, sticky notes, phone alarms).
    - Set visible, immediate cues for actions (“When the phone alarm rings, time to switch subjects”).
    - Plan in visual blocks (color-coded calendars).

6. #### Time Management and “Time Anchoring”

- **Time Blindness** is common in ADHD: tasks seem endless or fleeting.
- Cognitive behavioral therapy methods: 
    - Use timers (Pomodoro technique: 25 mins focus, 5 min break).
    - Visibly block out time for tasks in calendar (e.g., “Study psych 3–3:30 PM”).
    - Celebrate micro-completions (e.g., “I studied 2 chapters!”).

7. #### Emotional Regulation Cognitive Behavioral Therapy Methods

- ADHD often comes with **intense frustration or shame**.
- Jordan learns CBT techniques, including: 
    - Self-soothing skills (e.g., grounding techniques when overwhelmed).
    - Coping statements (“It’s okay to feel frustrated — I can still take the next small step.”).
    - Naming feelings instead of reacting immediately (“I’m feeling stuck, not lazy.”).

8. #### Problem-Solving Cognitive Behavioral Therapy Methods

- Example Problem: “I never finish homework on weekends.”
- Steps: 
    - Define problem clearly.
    - Brainstorm options (e.g., study in a coffee shop, work with a friend, set morning alarms).
    - Choose one to try.
    - Evaluate results and adjust.

9. #### Relapse Prevention and Self-Compassion Using CBT Techniques for ADHD

- Jordan creates a **self-support plan** for bad days: 
    - Notice early signs (e.g., “I’m endlessly scrolling TikTok instead of starting homework”).
    - Use a “reset” routine (e.g., take a 5-minute walk, reset timer, reframe thought).
    - Emphasize **progress, not perfection**: missing one day doesn’t mean failure.

### Results after 3–4 months of Cognitive Behavioral Therapy Methods:

[CBT for ADHD](https://dralanjacobson.com/cbt-for-adhd/) resulted in:

- Jordan regularly uses a planner for deadlines.
- He gets [therapeutic tutoring](https://therapeutictutoring.com/) to get the academic help he needs, with an understanding of the challenges and [benefits of ADHD](https://psychologicalassessments.com/benefits-of-adhd/)
- He tackles assignments in smaller steps, reducing procrastination.
- CBT methods have made his inner dialogue more compassionate (“I’m working *with* my ADHD, not against it.”).
- GPA improves, and he feels more confident in managing college life, continuing to use cognitive behavioral techniques.

### Quick Summary of Cognitive Behavioral Therapy Methods Used:

**CBT Methods****How Applied**PsychoeducationNormalize ADHD struggles, teach brain-based strategiesCognitive RestructuringReframe self-critical thoughtsTask StructuringBreak down assignments into micro-stepsIf-Then PlanningAutomate task initiationExternal SupportsUse alarms, planners, visual remindersEmotional RegulationManage frustration and shameRelapse PreventionBuild flexible, forgiving recovery plansI amso use these methods in [ADHD treatment for teens](https://dralanjacobson.com/adhd-treatment-for-teens/).

## My Work With Cognitive Behavioral Therapy Methods

Using CBT methods, you’ll find structure and depth: concrete strategies to manage everyday challenges and space to explore the larger questions of who you are and how you want to live. Whether we are addressing anxious thoughts, navigating painful emotions, revisiting early relational patterns, or confronting existential uncertainty, my goal is to support you in building a life that feels both empowered and deeply true to you. Cognitive behavioral therapy methods are powerful and effective!

CBT techniques are not about becoming a “perfect” version of yourself — it’s about growing into a more compassionate, resilient, and self-accepting one. If you want to learn more about how cognitive behavioral therapy techniques for depression, anxiety, or ADHD might help you or a loved one, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult). You can also inquire about specialties like [therapy for teen girls with ADHD](https://dralanjacobson.com/teenage-girls-with-adhd/).

## My work

[Much of my work](https://dralanjacobson.com/types-of-therapy/) either centers around cognitive-behavioral treatment or at least borrows some of the techniques and strategies of this approach. I also offer [metacognitive therapy](https://dralanjacobson.com/metacognitive-therapy-mct/) which is a close cousin to CBT.

If you feel that CBT is an approach that might benefit you, feel free to [get in touch](https://dralanjacobson.com/contact/), and we can discuss this further. As with all [specific techniques](https://dralanjacobson.com/), we can also look at a [combination of therapies](https://dralanjacobson.com/types-of-therapy/) that will include cognitive-behavioral treatment but also a [humanistic](https://dralanjacobson.com/humanistic-psychology/) or [psychodynamic](https://dralanjacobson.com/psychodynamic-therapy/) approach to understand better how and why the anxiety started in the first place. [Contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) to see how **cognitive behavioral therapy** may be helpful to you.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Therapy Approaches

---

### [What is a Therapy Appointment Like?](https://dralanjacobson.com/what-is-a-therapy-appointment-like/)

**Published:** June 7, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Choosing to go to therapy is a crucial step toward enhancing emotional well-being, strengthening relationships, and promoting personal growth. A therapy appointment provides a safe and confidential space where individuals, couples, and families can explore their challenges, gain insight, and develop effective coping strategies. Whether you are grappling with mental health symptoms, navigating life transitions, or simply looking to deepen self-understanding, going to therapy can be incredibly valuable. Understanding when and how to engage in treatment — and how to support loved ones in doing so — can empower people to make informed decisions about their mental health care. This post covers questions such as, “Why do people go to therapy?”, “Should I go to therapy?”, and more.

Going to therapy—especially for the first time—can feel like stepping into the unknown. You might wonder: *What will I say? Will they judge me? Will it even help?* These are normal questions. The truth is: at a therapy appointment, it is not about being perfect or saying the right thing—it’s about being real, even if that means saying “I don’t know where to start.”

## What is a Therapy Appointment Like, and What is it Like to Go to Therapy

![What is it like to go to therapy, and what is a therapy appointment like](https://dralanjacobson.com/wp-content/uploads/2025/06/sunlight-path-300x200.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")Here’s a breakdown of what a typical therapy appointment is like and what it feels like to go to therapy.

### What Is a Therapy Appointment Like?

#### Therapy Appointment Length & Format

- Most sessions are 45–60 minutes.
- They can be in person, via video, or by phone.
- It’s just you and the therapist in a private, confidential setting.

#### The First Session

The first session is often more of an introduction and assessment:

- The therapist may ask about: 
    - Why do you seek treatment
    - Your current symptoms or concerns
    - Mental health history
    - Daily life (work, relationships, health)
- You’ll talk about goals: What do you want to change or feel better about?
- The therapist will explain confidentiality, their approach, and what the sessions will entail.

#### *You can ask questions too*, like:

- “How many people have you worked with who have anxiety/ADHD/trauma/etc?”
- “What kind of treatment approach do you use?”
- “How will we know if this is working?”
- “How long until I see measurable improvement?”

It’s okay to feel nervous or awkward at your therapy appointment—your therapist expects that.

#### Typical Sessions After That

After the first therapy appointment, sessions might include:

- Talking about what’s been going on that week (emotionally or situationally)
- Exploring your thoughts, patterns, or triggers
- Working on coping strategies or new perspectives
- Reflecting on past experiences that affect your current struggles
- Practicing skills (like grounding, communication, or boundary-setting)

The therapist won’t just sit silently or psychoanalyze you. Sound treatment is a collaborative process—you work together. This includes answering questions such as, “How often should you go to therapy?” “Can we work on other stuff?” and others.

### What Does It *Feel* Like to Be in Therapy

At first, it might feel:

- Awkward (“What do I say?”)
- Uncertain (“Am I doing this right?”)
- Emotionally raw (you might cry, or feel relief)
- New and strange—like learning a new language

But over time, when you go to therapy, it starts to feel more like:

- A safe space where you can say *anything*
- Empowering—you start to understand yourself better
- Relieving—you’re no longer holding everything in alone
- Grounding—you have someone helping you make sense of things

#### What You *Don’t* Have to Be in a Therapy Appointment:

- “Fixed” or put-together
- Polite or perfect
- Always talkative or expressive
- Sure of what you want

### Common Myths About Going to Therapy

MythReality“Therapy is only for people with serious problems.”It is for *anyone* who wants support, clarity, or change.“I won’t know what to say.”You don’t have to—your therapist will help guide you.“It’ll be uncomfortable forever.”It might be at first, but therapy gets easier and more meaningful over time.“Therapists just give advice.”They help you explore, understand, and grow—not just tell you what to do.### Why Do People Go to Therapy?

- You feel less alone
- You discover the roots of what you’ve been struggling with
- Untangling emotional knots becomes possible.
- You gain tools to manage life better
- You build self-understanding and self-compassion

#### Final Words

Why do people go to therapy? It doesn’t mean something’s “wrong” with you. Instead, it means you’re brave enough to take care of your mental and emotional well-being. It may feel hard at first, but over time, it often becomes a place of comfort, clarity, and deep personal growth. The reasons to go to therapy are varied but center on self-improvement and the desire to thrive.

## Glossary of Therapist Terms

Here’s a glossary of common therapist terms—designed to help you feel more confident and less confused in sessions. Whether you’re new to the process or want a refresher, this list breaks down psychological terms in plain, human language.

1. [Active Listening](https://hbr.org/2024/01/what-is-active-listening)

When the therapist listens carefully, repeats back what you’re saying (in their own words), and checks to make sure they understand you correctly. It helps you feel heard and helps them get it right.

2. Affect

This means your emotional expression—how you look or sound when talking (e.g., flat, sad, cheerful). A therapist might say, “Your affect seems low today.”

3. Coping Skills

Tools or strategies you use to handle stress, anxiety, sadness, etc. Examples: breathing techniques, journaling, taking breaks, reframing thoughts.

4. [Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT)

A standard method focuses on the idea that your thoughts, feelings, and behaviors are interconnected, so changing your thinking can help alter how you feel and act.

5. Insight

Understanding something new about yourself—like realizing why you react a certain way, or what triggers your emotions. This is one of the main reasons to go to any [insight oriented therapy](https://dralanjacobson.com/insight-therapy/) – to build deeper awareness over time.

6. [Grounding Techniques](https://www.therapistaid.com/worksheets/grounding-techniques)

Simple actions that help calm your body and mind, especially during anxiety, panic, or dissociation. Example: naming five things you can see in the room.

7. Validation

When the therapist acknowledges that your feelings are real and make sense, even if they’re difficult. Validation is key to feeling emotionally safe, and it is another key reason to go to therapy.

8. Projection

A defense mechanism where you attribute your feelings or thoughts to someone else. Example: thinking someone’s mad at you, when *you’re* mad at them.

9. Transference

When you unconsciously redirect feelings from someone in your past (like a parent) onto your therapist. It’s normal and can be helpful to explore.

10. Countertransference

When a therapist reacts emotionally to a client, it is often based on their own past or feelings. Good clinicians stay aware of this and use supervision to manage it.

11. [Trauma-Informed Care](https://dralanjacobson.com/trauma-informed-care/)

An approach that recognizes how past trauma affects current behavior and emotions, and ensures treatment is safe, respectful, and empowering.

12. Reframing

Looking at a situation in a different, more helpful way. For example: “I failed” → “I learned something important.”

13. Self-Regulation

Your ability to manage emotions, behaviors, and impulses, especially under stress. Treatment often helps improve this skill.

14. Boundaries

The limits you set to protect your well-being, emotional, physical, or social. Therapists may help you recognize and strengthen healthy boundaries.

15. Holding Space

When a therapist gives you room to feel what you feel without rushing, fixing, or judging. It’s quiet, accepting support.

16. [Psychoeducation](https://dralanjacobson.com/psychoeducation/)

When a therapist teaches you about mental health concepts, diagnoses, or brain function, you will gain a deeper understanding of yourself and your experiences.

17. [Somatic Therapy](https://dralanjacobson.com/somatic-therapy/)

Refers to the body’s role in emotions or trauma. Somatic treatment focuses on how feelings show up in the body (e.g., tension, pain, restlessness).

18. [Mindfulness](https://dralanjacobson.com/mindfulness-therapy/)

Paying attention to the present moment without judgment. Often used to help with anxiety, stress, and emotional regulation.

19. [DBT](https://dralanjacobson.com/dbt-for-teens/) (Dialectical Behavior Therapy)

A method that combines acceptance and change strategies. It teaches skills like mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness.

20. [EMDR](https://www.emdria.org/about-emdr-therapy/) (Eye Movement Desensitization and Reprocessing)

Used mainly for trauma and PTSD. It utilizes bilateral stimulation (similar to eye movements) to help the brain process distressing memories.

### Bonus Therapist Terms

TermWhat It MeansTriggerSomething that sets off an emotional reaction (especially from trauma or stress).DysregulationFeeling overwhelmed and unable to control emotions.[Attachment Style](https://dralanjacobson.com/attachment-therapy/)The way you relate to others, shaped by early relationships (secure, anxious, avoidant, etc.).[Inner Child](https://www.verywellmind.com/inner-child-work-how-your-past-shapes-your-present-7152929)The part of you that holds childhood emotions or unmet needs.ProcessingWorking through emotions, thoughts, or memories with the therapist—making sense of them over time.### Final Note About Therapist Terms

It’s okay to ask your provider what one of the therapist terms they use *means*—they’ll respect your curiosity. Therapy is a learning space, and part of the process is building a shared language that helps you grow.

## Reasons to go to Therapy

### [Individual Psychotherapy](https://dralanjacobson.com/individual-therapy/)

#### Mental Health & Emotional Challenges

- Depression, sadness, or emotional numbness
- Anxiety, panic attacks, or chronic worry
- Trauma or PTSD
- Grief and loss
- Anger issues or emotional regulation problems
- Self-harm or suicidal thoughts
- Feeling overwhelmed or “stuck”

#### Identity & Self-Esteem

- Low self-esteem or self-worth
- Identity issues (e.g., racial, cultural, gender, sexual orientation)
- Body image issues
- Difficulty asserting boundaries or saying no

#### Stress & [Life Transitions](https://dralanjacobson.com/life-transitions-therapy/)

- [Therapy for burnout](https://dralanjacobson.com/burnout-therapy/), work stress, or career uncertainty
- Life (e.g., divorce, relocation, new parenthood)
- Academic pressure or school-related difficulties
- Aging, chronic illness, or disability (where [life review therapy](https://dralanjacobson.com/life-therapy/) may work well)

#### Behavioral Concerns

- ADHD or [executive functioning challenges](https://dralanjacobson.com/executive-functioning-coaching/)
- Addiction or substance use
- [Eating disorders](https://www.healthline.com/nutrition/common-eating-disorders)
- [Compulsive behaviors](https://www.treatmyocd.com/what-is-ocd/info/ocd-stats-and-science/examples-of-compulsive-behavior-and-how-to-identify-the-signs) (e.g., internet, gambling, shopping)

#### Growth & Exploration

- Personal development
- Spiritual exploration
- Understanding the impact of childhood and past experiences
- Learning new coping or communication skills

### Couples’ Reasons to Go to Therapy

#### Communication & Conflict

- Frequent arguments or communication breakdown
- Stonewalling, criticism, or emotional withdrawal
- Mismatched conflict styles

#### Trust & Betrayal

- Infidelity, emotional affairs, or secrecy
- Rebuilding trust after betrayal

#### [Sex & Intimacy](https://dralanjacobson.com/fear-of-intimacy/)

- Mismatched sexual desire or dysfunction
- Disconnection or loss of physical affection
- Navigating kink, polyamory, or other relationship dynamics

#### Life Transitions

- [Preparing for marriage](https://dralanjacobson.com/premarital-counseling/) or managing early marital issues
- Infertility or decision-making about having children
- Transitioning to parenthood
- [Step parent counseling](https://dralanjacobson.com/blended-family-therapy-step-parent-counseling/) and support
- Coping with aging, illness, or caregiving responsibilities

#### Values & Goals

- Financial disagreements
- Differences in values or life goals
- [Deciding whether to stay together or separate](https://dralanjacobson.com/discernment-counseling-pre-engagement-counseling/)

### Families Going to Therapy Together

#### Parent-Child Relationships

- Behavioral issues in children or teens
- Communication struggles between parents and kids
- Navigating discipline, boundaries, or screen time
- [Co-parenting after separation or divorce](https://dralanjacobson.com/co-parenting-therapy/)

#### Family Stressors

- Coping with a loved one’s illness, addiction, or mental health issues
- Loss of a family member
- Adjustment to blended families or step-parenting

#### Systemic Challenges

- Intergenerational trauma
- Cultural or religious conflict within the family
- Impact of racism, immigration stress, or minority stress

#### Building Skills & Strength

- Improving family communication and cohesion
- Building empathy and reducing blame
- Learning how to support a struggling family member
- Creating healthier family rules, routines, or rituals

## Determining: Should I Go To Therapy?

Deciding whether to go to therapy can feel overwhelming, but a simple way to start is by asking yourself a few key questions about how you’re feeling, functioning, and connecting with others.

### Should I Go to Therapy?

Here’s a self-check to help you decide, “Should I go to therapy?”.

1. Are you feeling emotionally overwhelmed or stuck?

- You feel sad, anxious, irritable, or numb most days
- Your emotions feel out of control, or you find yourself shutting down
- You’re feeling hopeless or questioning the point of things

2. Are your daily responsibilities harder than usual?

- Trouble focusing, sleeping, or completing work/school tasks
- You feel burned out or exhausted all the time
- You’re withdrawing from people or avoiding responsibilities

3. Are your relationships struggling?

- Constant conflict with family, friends, or your partner
- Feeling lonely, even around people
- Struggles with boundaries, trust, or communication

4. Have you experienced something difficult or traumatic?

- A recent loss, breakup, accident, assault, or illness
- Childhood trauma or abuse that still affects you
- A significant life change that’s hard to adjust to

5. Are you using coping strategies that don’t feel healthy?

- Numbing out with food, alcohol, screens, or substances
- Avoiding emotions or isolating yourself
- Angry outbursts or harmful thoughts/behaviors

6. Are you looking to gain a deeper understanding of yourself or grow personally?

- Wanting to develop confidence or self-esteem
- Exploring identity (e.g., gender, sexuality, culture, religion)
- Hoping to break old patterns or improve decision-making

### Other Reasons to Go to Therapy

- You’re generally okay, but not feeling like yourself
- You’ve tried self-help, but it’s not enough
- You want things to change, but don’t know how
- You feel like a burden to others
- You’ve been told by someone who cares about you that it might help
- You keep thinking, “Should I go to therapy?” and feel like that’s a sign

### Common Misconceptions (That Might Be Holding You Back)

MythTruth“I’m not *sick enough*.”You don’t have to be in crisis to go. Many people go for support, clarity, and growth.“Therapy means I’m weak.”Asking for help is actually a sign of strength and self-awareness.“Therapists just listen—I can talk to my friends.”A trained therapist helps you dig deeper, notice patterns, and learn real tools for change.“It’s too expensive or time-consuming.”There are affordable options, and even a few sessions can be helpful. Think of it as investing in your well-being.## How Often Should You Go To Therapy?

Answering “How often should you go to therapy?” depends on your individual needs, goals, and situation. Here’s a general guide to help you understand what might work best for you:

### How Often Should You Go to Therapy? The Possibilities:

1. Weekly Sessions (Most Common)

- Typical for many people starting out.
- Helps build a strong therapeutic relationship.
- Provides regular support for ongoing issues like anxiety, depression, trauma, or relationship struggles.
- Allows steady progress with tools and coping skills.

2. Biweekly or Every Other Week

- Good if your challenges are less acute or you’re managing symptoms well.
- Helps maintain gains once you’re feeling more stable.
- Works if your schedule or budget doesn’t allow weekly visits.

3. Monthly Check-Ins

- For ongoing maintenance after significant progress.
- Helpful when treatment focuses on long-term growth, rather than crisis management.
- Useful for specific challenges, such as coping with chronic illness or significant life transitions.

4. Intensive or More Frequent Sessions

- Sometimes two or more times per week in severe cases (e.g., trauma, crisis, addiction).
- For specific point-in-time reasons like [fear of flying](https://dralanjacobson.com/fear-of-flying-therapy/) or fear of [public speaking anxiety](https://dralanjacobson.com/public-speaking-anxiety/) treatment
- Usually short-term and closely monitored.

5. As Needed / Drop-in

- Some people use sessions sporadically during stressful life events.
- Helpful if you’ve already done long-term treatment but want support during transitions.

You and your therapist will work together to answer the question, “How often should you go to therapy?” based on your goals and preferences.

### Factors Influencing Frequency

- Severity of symptoms: More intense struggles often need more frequent sessions.
- Goals: Working through trauma or deep issues may require weekly sessions; skill-building or maintenance might not.
- Budget and insurance: Practical considerations often shape frequency.
- Therapist recommendation: Your therapist can help tailor the frequency based on your progress.
- Your schedule and availability: Consistency is key, but sessions need to fit your life.

## How to Convince Someone To Go To Therapy

Convincing someone to go to therapy can be delicate because it involves their feelings, fears, and personal readiness. Here’s a thoughtful approach to encouraging someone gently and effectively:

### How to Convince Someone to Go to Therapy: A Guide

1. Choose the Right Moment

- Find a calm, private time to talk.
- Avoid bringing it up during arguments or stressful moments.
- Approach with empathy and patience.

2. Express Concern Without Judgment

- Use “I” statements to share your feelings:
    
    *“I’ve noticed you’ve been really struggling lately, and I care about you.”*
    
    *“I want to make sure you get support because you don’t have to go through this alone.”*
- Avoid blaming, criticizing, or making them feel weak.

3. Normalize the experience of a therapy appointment.

- Explain that behavioral health treatment is a common, helpful resource for many people, not just for “serious” problems.
- Share examples if comfortable: friends, family, or even yourself who benefited.
- Mention that therapy can help with stress, relationships, or [personal growth](https://dralanjacobson.com/therapy-faqs/).
- Answer, “Why do people go to therapy?” in a supportive, positive manner

4. Address Their Concerns

- Ask what worries them. Common concerns include stigma, cost, time, or fear of being judged.
- Provide information or solutions, if possible, such as affordable options, online approaches, or assurances of confidentiality.
- Reassure them it’s a safe space and therapists are there to help, not judge.

5. Offer Support

- Suggest helping them find a clinician or making the first appointment.
- Offer to go with them to their therapy appointment if it feels supportive.
- Let them know you’ll be there regardless of their decision.

6. Be Patient and Respect Boundaries

- Remember, they must want it for themselves for it to be effective.
- If they say no, respect that — keep the door open for future conversations.
- Continue showing care and support without putting pressure on them.

Knowing how to convince someone to go to therapy can be valuable and provide you with the motivation to help a friend or family member in need.

### Example Script

“Hey, I just wanted to say I’ve noticed you seem overwhelmed lately, and I’m worried about you. I think talking to a therapist could be a constructive way to get some support and tools to feel better. It’s something a lot of people do, and it doesn’t mean you’re weak or broken. If you’d like, I can help you find someone or even accompany you to the first session. I care about you, and I’m here no matter what.” This is the kind of script you can modify as you learn how to convince someone to go to therapy.

Many who have never tried psychotherapy wonder what talking to a therapist is like, and almost all find it much easier and more positive than they expected. Talking to a psychologist can be a unique and transformative experience. This post answers “What is therapy like?” and concludes with an example of how to talk to a therapist about depression. Of course, if you still have questions or want more information, you can talk to a psychologist very soon by [contacting me](https://dralanjacobson.com/contact/) or [scheduling a consultation](https://www.picktime.com/scheduleaconsult)!

## Talking to a Therapist, Overview ![Talking to a therapist](https://dralanjacobson.com/wp-content/uploads/2021/08/cropped-Office-228x300.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

The following is an overview of what talking to a psychologist like me is like, step by step:

### 1. Talking to a Therapist: Setting the Scene

- **Confidentiality:** We maintain a confidential and non-judgmental space where you can talk openly. They’ll explain the limits of confidentiality (e.g., if there’s an immediate risk of harm to yourself or others).
- **Comfortable Environment:** Sessions are usually held in a quiet, private space that feels safe and supportive.

### 2. Talking to a Therapist: First Session

- **Introduction:** The first session is often about getting to know each other. I may ask questions about your background, current concerns, and goals for therapy.
- **Empathy and Validation:** I listen attentively and work to validate your feelings, making sure you feel understood.

### 3. Guided Conversations

- **Open-Ended Questions:** I often ask questions like, “What’s been on your mind?” or “How does that make you feel?” to help you explore your thoughts and emotions. More specific or pointed questions may seem pushy, so I leave it up to you what you want to share.
- **Reflection:** I might repeat back what you’ve said in a way that helps you see your experiences from a new perspective.
- **Gentle Challenges:** Sometimes, I may gently challenge your thought patterns or beliefs to help you grow or uncover deeper truths.

### 4. Talking to a Therapist About Emotions

- **Processing Emotions:** Talking to a psychologist can bring up strong feelings, especially for the first time. It’s okay to cry, be frustrated, or even feel unsure—this is part of the healing process.
- **Supportive Presence:** I provide a calm, steady presence to help you navigate difficult emotions, and I work to understand how fast you want to move.

### 5. Tools and Strategies

- **Coping Skills:** I teach [techniques like mindfulness](https://dralanjacobson.com/mindfulness-therapy/), breathing exercises, or problem-solving strategies.
- **Homework:** Between sessions, you may be given tasks to try, such as journaling, practicing a skill, or reflecting on a specific topic.

### 6. Talking to a Therapist about Your Progress

- **Ongoing Review:** Over time, we will assess how therapy is going and adjust your approach as needed. I may ask, “What is therapy like for you?”
- **Empowerment:** The goal of talking to a psychologist is to help you build self-awareness and develop the tools to handle challenges independently. [Individual therapy](https://dralanjacobson.com/individual-therapy/) should be [solution-focused](https://dralanjacobson.com/solution-focused-therapy/) and relatively time-limited.

### 7. What Talking to a Therapist is Not

- **Not Judgmental:** Talking to a psychologist will not make you feel criticized or told what to do. Instead, it’s a collaborative process.
- **Not Always Easy:** Talking about tough topics can make you feel vulnerable, but it’s often necessary for growth, and we’ll go at a comfortable pace.

---

Every therapist has a unique style, and your experience may vary depending on the therapist’s approach (e.g., [cognitive-behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/), [psychodynamic](https://dralanjacobson.com/psychodynamic-therapy/), or [humanistic therapy](https://dralanjacobson.com/humanistic-therapy/)) and your personal needs. It’s okay to shop around for a therapist you feel comfortable with (we are never offended when someone says they are shopping around – in fact, we welcome it). I use an [integrative psychological approach](https://dralanjacobson.com/integrative-therapy/) that combines a variety of therapeutic methods and [types of therapy](https://dralanjacobson.com/types-of-therapy/), but if it turns out you feel I am not the right match, I’ll work with you to find someone who is if you’d like.

## What is Talking to a Psychologist Online Like?

Talking to a psychologist online is similar to in-person therapy in many ways but has some unique aspects due to the virtual format. Here’s an overview of the answer to “What is therapy like online?”:

---

### Before the Session

1. **Scheduling:**
    
    You typically book an appointment through a secure platform. I use a dedicated therapy platform with significant privacy and security enhancements. I offer an initial phone conversation, which is when many new to the process may ask, “What is therapy like online?” and I help them feel comfortable with the process.
2. **Preparation:**
    - You’ll receive a link to join the session.
    - You’ll need to complete intake forms electronically before your first meeting.
    - Ensure you have a private, quiet space for the session, with a stable internet connection.

---

### Talking to a Psychologist During the Session

1. **Setting the Scene:**
    - Depending on your preference, sessions are held via video, phone, or even chat.
    - I will greet you and ensure you feel comfortable with the technology.
    - I’ll explain confidentiality and its limits, just like in-person therapy.
2. **Building Rapport:**
    - I’ll ask your reasons for seeking help, background, and goals.
    - The interaction is usually relaxed and conversational, aimed at helping you feel at ease.
3. **Flexibility in Format:**
    - Video: We see each other, mimicking face-to-face interaction.
    - Phone: You can focus on talking without worrying about eye contact or appearance.
4. **Focus on Your Needs:**
    - I listen actively, provide feedback, and may guide the conversation with open-ended questions.
    - I may share tools like worksheets or coping strategies electronically during the session.

---

### Pros of Talking to a Psychologist Online

1. **Convenience:**
    - [Virtual psychotherapy](https://dralanjacobson.com/virtual-therapy-guide/) allows you to attend from home or any private location.
    - No travel time is required, making fitting into a busy schedule easier.
2. **Comfort:**
    - Many people feel more relaxed in their own space, making it easier to open up.
    - It’s accessible for those with mobility issues or living in remote areas.
3. **Flexibility:**
    - Online therapy often allows for evening or weekend appointments.
    - A major [advantage of online therapy](https://dralanjacobson.com/is-virtual-therapy-as-effective-as-in-person/) is that you can join from work or other places.
    - My platform offers asynchronous communication, like messaging your psychologist between sessions.
4. **Availability**
    - Online therapy allows you to choose among a much wider range of possible providers
    - Online therapy allows for more flexibility in having family members join

---

### Challenges of Talking to a Psychologist Online

1. **Technical Issues:**
    - Internet disruptions or software glitches can interrupt the session.
    - A backup plan is essential, like switching to a phone call if needed.
2. **Privacy Concerns:**
    - You need to ensure your space is private to talk freely without interruptions.
    - Use headphones to maintain confidentiality.
3. **Less Physical Presence:**
    - Some people miss the face-to-face connection of in-person therapy.
    - Non-verbal cues (e.g., body language) may be harder to pick up on through a screen.

---

### After the Session

1. **Follow-Up:**
    - I may email session notes, resources, or tasks to work on.
    - You can book your next appointment through the platform.
2. **Reflection:**
    - Like in-person therapy, you’ll have time to process the session and practice strategies discussed.

---

### Who Benefits Most from Talking to a Therapist Online?

- People with busy schedules or transportation challenges.
- Those who feel anxious about meeting in person or just more comfortable at home.
- People who find a good match in a therapist who lives far from them.
- Individuals living in areas with limited access to mental health services.

---

Online therapy can be just as effective as in-person therapy for many issues, allowing you to talk to a therapist about depression, anxiety, stress, and more in a flexible and accessible way to get support tailored to your needs.

## Talk to a Therapist About Depression: Case Example

Here’s an example of what it’s like to talk to a therapist about depression. This is a fictional scenario to help illustrate the process I might use:

---

For the past two months, Alex has felt sad, unmotivated, and isolated. She struggles to keep up with schoolwork and often feels like a failure. Before that, she was mostly happy and content. After an initial consultation, she felt that it would benefit her to talk to a therapist about depression and learn strategies for overcoming her recent frustrations.

---

### First Session: Building Rapport and Understanding

**Me:**
“Hi Alex, thanks for coming in today. What made you decide to reach out for support?”

**Alex:**
“I guess I’ve been feeling down lately, and it’s not improving. I feel like I’m stuck, and I don’t know how to fix it.”

**Me:**
“I hear you. Feeling stuck can be hard. Can you tell me more about what you’ve been experiencing?”

**Alex:**
“I just… I don’t feel like myself. I used to be excited about school and seeing friends, but now I can barely get out of bed. Even things I used to enjoy feel pointless.”

**Me:**
“That sounds exhausting. It’s clear this has been weighing on you. Have you noticed when these feelings started?”

**Alex:**
“Maybe a couple of months ago? I had a bad breakup, and since then, it’s like everything’s gone downhill.”

---

### Middle Sessions: Exploring and Addressing Depression

After a few sessions, I help Alex identify patterns and explore coping strategies.

**Me:**
“You mentioned feeling like a failure. Can we talk about that? What thoughts go through your mind when you feel that way?”

**Alex:**
“I just feel like I’m letting everyone down—my professors, family, even myself. I’ve missed so many deadlines and can’t catch up.”

**Me:**
“That sounds overwhelming. Our minds can easily spiral into self-criticism when we’re struggling. What would you say to a friend if they were going through the same thing?”

**Alex:**
“I’d probably tell them it’s okay to struggle sometimes and that they’re not a failure. But it’s hard for me to believe that.”

**Me:**
“Exactly—our inner critic can be harsh. Let’s work on developing some self-compassion. Would you be open to practicing grounding when those thoughts arise?”

---

### Talk to a Psychologist About Depression: Techniques

- **[Cognitive Restructuring](https://dralanjacobson.com/cognitive-restructuring/):** I help Alex challenge negative thought patterns and replace them with more balanced ones.
- **[Behavioral Activation](https://dralanjacobson.com/behavioral-activation/):** Alex creates a plan to gradually reintroduce activities that bring joy or a sense of accomplishment.
- **[Mindfulness-Based Stress Reduction](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/):** Alex learns simple breathing exercises to manage overwhelming emotions.

---

### Later Sessions: Tracking Progress

**Me:**
“You mentioned last week that you went for a walk with a friend. How did that feel?”

**Alex:**
“It was actually nice. I didn’t think I’d enjoy it, but I felt better afterward. It made me realize I’ve been isolating myself too much.”

**Me:**
“That’s a great insight, Alex. It sounds like connecting with others and getting outside help. How can we build more of those moments into your week?”

**Alex:**
“Maybe I can set a goal to text one friend and go to the gym once this week.”

**Me:**
“That’s a solid plan. Remember, small steps are key, and it’s okay to take things at your own pace.”

---

### After You Talk to a Therapist About Depression

Over time, Alex begins to feel more hopeful and develops tools to manage her depression. She is happy she decided to talk to a therapist about depression. She still has tough days but feels equipped to handle them and supported in their journey.

---

This example highlights how talking to a therapist about depression offers a safe space for exploration while offering practical strategies to improve well-being.

## What is Therapy Like? Summary and My Work

Therapy is a supportive, confidential process where you work with a trained and experienced professional to explore your thoughts, feelings, and behaviors. Here’s a quick summary of what it’s like:

1. **Safe Space:**
    
    Therapy provides a nonjudgmental and private environment to discuss challenges or personal growth. So, “What is therapy like?”: It is an emotionally comfortable space to explore your challenges and barriers and discover possibilities.
2. **Collaborative Process:**
    
    You and I work together to identify concerns, set goals, and develop strategies to address them. So, “What is therapy like?”: Working as a Team to address your concerns, find your strengths, and feel accepted and understood. You’ll have the pleasure of reaching meaningful goals and setting new ones if you want.
3. **Structured but Flexible:**
    
    Sessions may include open-ended discussions, guided exercises, or learning specific skills (e.g., managing anxiety or improving communication). So, “What is therapy like?” It is a place to build a toolbox that will help now and in the future after your sessions end.
4. **Emotionally Intense but Empowering:**
    
    Discussing personal struggles can feel vulnerable, but the process can help you gain clarity, resilience, and a sense of control. So, “What is therapy like?” It is a safe space to explore deep thoughts and feelings without feeling judged. I ensure we do not move faster than you want, and you’ll always be able to ask to slow the process if you wish.
5. **Tailored to You:**
    
    Therapy is adapted to your needs, whether you’re dealing with mental health conditions, relationship issues, or personal development. So, “What is therapy like?” It feels like you have a unique plan developed specifically for you.

---

### What is Talking to a Therapist Like With Me?

Talking to a therapist can sometimes be challenging, but it’s ultimately a space for healing, growth, and self-discovery. I ensure that you feel safe, accepted, and heard. We’ll progress at a pace that is comfortable for you and adjust the methods and approaches as needed. I’ll ensure that you are educated about the possible types of therapy we can use in my integrative practice. You can also read about [what it is like to go to therapy](https://dralanjacobson.com/what-is-a-therapy-appointment-like-go-to-therapy-feeling-confident-and-know-common-therapist-terms/).

## Summary and Conclusion

So, why do people go to therapy? A therapy appointment can be a flexible and accessible tool that can meet a wide range of needs, from crisis intervention to ongoing personal development. Deciding to begin going to therapy, determining the appropriate frequency of sessions, and encouraging others to seek help are deeply personal decisions that should be approached with compassion and respect.

Remember, the reasons to go to therapy do not have to do with weakness but rather are part of proactive choices toward greater resilience, deeper meaning, and healthier relationships. By fostering openness about mental health and support options, we can reduce stigma and create environments where everyone feels empowered to seek the care they deserve. I have another similar post that answers, “[Does therapy help?](https://dralanjacobson.com/does-therapy-help-what-form-of-therapy-works-best/)“

To set up a therapy appointment, learn more about how to convince someone to go to therapy, or discover my specific services or other [therapy resources](https://dralanjacobson.com/the-best-way-to-find-a-therapist-using-therapist-finders-word-of-mouth-and-other-therapy-resources/), please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Finding therapy

---

### [How to Find a Good Therapist that Fits You and Your Goals](https://dralanjacobson.com/how-to-find-a-good-therapist/)

**Published:** March 16, 2026
**Author:** Dr. Alan Jacobson

**Content:**

Whether you are dealing with persistent anxiety, low mood, relationship stress, life transitions, or simply feeling that you know life could be more meaningful, therapy can provide a structured space to understand what is happening internally and develop practical strategies for moving forward. Knowing how to find a good therapist is the first step in the process. This post is designed to help you find a good psychologist or other clinician who can help you gain clarity, strengthen coping skills, improve relationships, and develop a deeper understanding of yourself. What is the best way to find a therapist? Here you go:

---

### Ready to get started? 

I’d be happy to help you find a good therapist, whether it’s a colleague or me. Please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult#book/services) anytime. I’ll help you how to find the right psychologist or therapist.

---

Research consistently shows that [psychotherapy can significantly reduce symptoms](https://dralanjacobson.com/psychotherapy/) of **anxiety, depression, stress, and emotional distress** while improving overall well-being and life satisfaction. For example, the **[American Psychological Association](https://www.apa.org/topics/psychotherapy)** reports strong evidence that psychotherapy is effective across a wide range of conditions.

At its core, counselling provides three essential benefits:

- **Clarity** – understanding patterns, emotions, and underlying causes of distress
- **Tools** – learning evidence-based strategies for managing anxiety, depression, or stress
- **Support** – working with a trained professional who can help you navigate difficult experiences in a constructive way

For many people, the most difficult step is simply **getting started with therapy**. This post aims to help you learn how to find a good therapist who is the right fit for you.

---

## How to Find **a Good Therapist**: First Steps 

![How to find a good therapist](https://i0.wp.com/dralanjacobson.com/wp-content/uploads/2026/03/aioseo-ai-a-clipboard-with-steps-medium-auto-landscape-20260322-151845.png?fit=%2C&ssl=1 "A clipboard with steps - more abstract | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")If you are considering counselling, the process may feel unfamiliar at first. Fortunately, getting started with therapy is usually straightforward.

### How to Find a Good Therapist **Step 1: Identify Your Goals**

Understanding your goals helps you **find a therapist who fits you**.

The first step in finding a therapist is identifying your needs and what type would best fit. You should research and determine what [type of therapy](https://dralanjacobson.com/types-of-therapy/) you’re looking for (e.g., [cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/), psychoanalysis methods, etc.). You can browse [my blog](https://dralanjacobson.com/blog/) and other sources to understand the available therapy types. Your needs may be quite specific, such as [fear of flying](https://dralanjacobson.com/flying-anxiety-treatment/) or [public speaking anxiety](https://dralanjacobson.com/presentation-anxiety/), or more general, such as just not feeling satisfied with life or having a general sense of anxiety.

Then, consider specific preferences, such as gender, cultural background, or age. These considerations may not mean anything to you in your search to find a therapist, but some people feel more understood when they share the same gender as their clinician. In contrast, others prefer finding a therapist of a different gender to help them gain new perspectives. For many, gender is less important than the overall fit. Finding a good therapist involves listening to your gut about these issues.

### Tips For Step One:

1. Word of mouth is often the best way to find a good therapist, not just to get specific names. You can also use word of mouth to locate someone who offers a specific approach that works for someone you know or provides therapy in a certain way (virtual, for example). This is particularly true if the person shares some of the same reasons for pursuing therapy as you do.
2. As strange as it sounds, you may want to ask people you are close to what you need. You certainly know yourself best, but sometimes, other people may have ideas for what you could work on. This may be especially true if they’ve had therapy themselves before.
3. The psychologist or social worker may also have ideas about your needs that may initially sound counterintuitive. As they get to know you, she or he may be able to give you ideas of how therapy can help.

### How to Find a Good Therapist **Step 2: Qualifications**

Many ways exist to generate a list of possible clinicians when finding a therapist. You can start by asking your primary care physician for recommendations or seek referrals from friends, family, or colleagues who have had positive experiences. You can also use online [therapy resources](https://dralanjacobson.com/the-best-way-to-find-a-therapist-using-therapist-finders-word-of-mouth-and-other-therapy-resources/) like Psychology Today, Well respected [ZenCare](https://zencare.co/) , or [GoodTherapy](https://www.goodtherapy.org/) can help you find a psychologist or therapist. Browsing the web is an excellent idea to find a psychologist or social worker as well, but it is important if you do so to know how to read into their credentials (see next paragraph). Finally, consider logistics. For example, distance is important when finding a therapist for in-person therapy.

### A Deeper Look to Find a Therapist

Once you have your list, ensure the person is [licensed and accredited](https://dralanjacobson.com/what-is-a-clinical-psychologist/) by relevant professional associations in your country or state. In any state, this is an easy web search of, for example, “(your state), psychologists, licensure.” Look for membership in state and national organizations in their specialty. There are higher levels of accreditation as well – for psychologists, look for someone who is [Certified as a Health Service Provider](https://www.findapsychologist.org/), for example. Finding a psychologist involves knowing how many years they’ve been in practice and how many people they’ve seen.

### Tips for Step Two:

Weigh the length of the waitlist against the potential match. It may be worth waiting to find a psychologist or social worker you think is a perfect fit rather than someone who can see you quickly. Remember that a wait list means many people want to see that clinician!

When you set out to find a psychologist or social worker, pay attention to how much time they put into their online profiles. Look for those willing to share significant information and have kept it updated.

Years of experience may be a significant factor when finding a good therapist, but do not make it the only one. Clinicians go through many years of supervised training before they can practice, and even more to practice independently.

When searching for a therapist, consider professionals such as:

- Licensed psychologists
- Licensed clinical social workers
- Certified or Licensed mental health counselors
- Psychiatrists (if medication may be needed)

You can [search through directories](https://dralanjacobson.com/therapy-in-california/) such as:

National Register of Health Service Psychologists

Psychology Today Therapist Directory

National Institute of Mental Health (mental health information)

These resources can help you **find a therapist for anxiety**, **find a therapist for depression**, or locate someone who specializes in specific concerns.

### How to Find a Good Therapist **Step 3: Evaluate Fit**

One of the most important factors in the success of therapy is the **therapeutic relationship**.

In your search to find a good therapist, you are close! Now, you need to contact potential clinicians via phone or email to ask about their availability, fees, and approach to therapy. Schedule consultations with a few therapists to see who you feel most comfortable with – most of us offer a 10-15 minute consult. Make sure everything you’ve done in the initial steps rings true with that person, and then trust your gut! [Finding a therapist](https://dralanjacobson.com/how-to-find-a-good-therapist/) you feel comfortable talking to and who seems to understand your concerns is vital. My posts “[How to Choose the Right Therapist](https://dralanjacobson.com/how-to-choose-the-right-therapist/)” and “[Choosing the best therapist](https://dralanjacobson.com/choosing-the-best-therapist-for-you/)” have more information about this step.

### Tips for Step Three:

- [Psychological testing](https://www.psychologicalassessments.com) can be a helpful step if you want to clarify your challenges and needs. Find a psychologist who does testing if you think this would help.
- Many clinicians offer [sliding-scale fees or financial assistance](https://dralanjacobson.com/how-do-you-find-a-psychologist-offering-affordable-therapy/), so don’t hesitate to ask about this if cost is a concern. However, they cannot give you a break on co-insurance or co-pays.
- Geography may or may not be a problem – you need to decide if [online therapy](https://dralanjacobson.com/virtual-therapy-guide/) is for you. With the virtual option, you’ll have a much wider variety to find a good therapist.
- It is okay to be unsure of your therapist’s therapeutic approach. You can find a psychologist or two who offer different approaches and schedule consultations with them.

Research shows that the **fit between clinician and client** is often as important as the specific therapy technique being used.

When considering **how to find a good therapist that is right for you**, ask yourself:

- Do I feel comfortable speaking with this person?
- Are they listening carefully and responding thoughtfully?
- Do they explain their approach clearly?
- Do I feel respected and understood?

If the answer is yes, you may have found a strong therapeutic match. The following information may help you learn how to find the right psychologist or therapist for specific concerns.

---

### **How to Find a Therapist for Anxiety**

If anxiety is your primary concern, it can be helpful to look for providers who specialize in evidence-based treatments such as:

- Cognitive Behavioral Therapy (CBT)
- Exposure-based therapy
- [Acceptance and Commitment Therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) (ACT)
- Mindfulness-based interventions

The **[National Institute of Mental Health](https://www.nimh.nih.gov/health/topics/anxiety-disorders)** explains that therapy for anxiety often focuses on identifying patterns of thinking and behavior that maintain worry or fear.

A good therapist for anxiety will typically:

- help you identify anxiety triggers
- teach practical coping skills
- gradually reduce avoidance behaviors
- help you build confidence in managing difficult situations

---

### **How to Find a Therapist for Depression**

Depression can affect mood, energy, motivation, sleep, and concentration. When searching for **how to find a good therapist for depression**, consider those with experience in treatments such as:

- Cognitive Behavioral Therapy (CBT)
- [Interpersonal Therapy](https://dralanjacobson.com/interpersonal-therapy/) (IPT)
- Behavioral activation
- meaning-centered approaches

The **[Mayo Clinic](https://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression-treatment)** notes that psychotherapy can help individuals understand underlying issues contributing to depression and develop healthier thinking and behavior patterns.

If you are experiencing **both anxiety and depression**, it is often helpful to **find a therapist for depression and anxiety** who routinely works with both conditions.

---

## **How to Find a Therapist That Fits You**

People often ask **what is the best way to find a therapist**. Knowing find a therapist that fits you involves several factors:

#### Find a Therapist that Fits You: **Training and Credentials**

Ensure the person is licensed and trained in evidence-based methods.

#### Find a Therapist that Fits You: **Specialization**

Find a provider that fits you by looking for clinicians who regularly treat your specific concern (anxiety, depression, trauma, etc.).

#### How to Find a Therapist that Fits You: **Communication Style**

Some clinicians are more structured and skills-focused, while others emphasize exploration and insight. Find a therapist that fits you and your preference in this area

### **How to Find the Best Therapist for You**: Practical Considerations

In order to find the best therapist for you, you may also want to consider:

- location or telehealth availability
- scheduling flexibility
- insurance coverage or fees

Finding the right match can sometimes take more than one attempt, and that is completely normal. Knowing what the best way to find a therapist is is vital.

---

## Real-World Examples: How to Find the Best Therapist for You

The process of learning how to find the best therapist for you can look different for everyone. Below are three real-world style examples illustrating how people often find a therapist that fits them, how therapy can help with anxiety and depression, and how responsible clinicians sometimes recommend referral to ensure the best possible care. Knowing how to find the best therapist for you requires knowledge of real-world examples.

---

### Example 1: How to Find a Good Therapist for Anxiety

A professional in her early thirties contacted my practice after spending several weeks researching how to find a therapist for anxiety. She described experiencing escalating work-related stress that had gradually developed into persistent worry, racing thoughts at night, and difficulty sleeping. Although she was functioning well professionally, she felt constantly “on edge” and worried that the anxiety was beginning to affect her concentration and quality of life.

Before reaching out, she had tried several strategies on her own—exercise, meditation apps, and productivity techniques—but found that the underlying anxiety kept resurfacing. During her search, she came across several articles discussing how to find a good therapist for anxiety, which emphasized the importance of working with clinicians trained in evidence-based approaches such as cognitive behavioral therapy.

In our initial consultation, we discussed the specific patterns she was experiencing: anticipatory worry about upcoming work tasks, difficulty “turning off” her thoughts at night, and a tendency to mentally rehearse worst-case scenarios.

Therapy focused on several structured strategies:

- identifying the thinking patterns that were fueling chronic worry
- learning practical techniques to interrupt anxious thought loops
- developing more balanced ways of evaluating uncertainty
- improving sleep routines and stress regulation

Over the course of several months, she reported that her anxiety had become far more manageable. Instead of feeling overwhelmed by worry, she described feeling more capable of stepping back from anxious thoughts and responding in a calmer, more deliberate way.

One of the most important takeaways for her was realizing that finding a therapist who specializes in anxiety treatment can make a significant difference in how quickly meaningful progress occurs.

---

### Example 2: How to Find a Therapist for Depression and Anxiety

Another client reached out after searching online for how to find a therapist for anxiety and depression. He had been experiencing a combination of symptoms that had gradually developed over the previous year: persistent low mood, loss of motivation, difficulty concentrating, and increasing social withdrawal.

He initially assumed his symptoms were simply related to work burnout. However, as the months passed, he noticed that the combination of anxiety and depression was beginning to affect multiple areas of his life, including relationships and daily functioning.

Like many people, he felt unsure about how to find a therapist who is the right fit. There are many different therapy approaches, and it can be difficult to know which clinician might be the best fit.

During our early sessions, we focused on clarifying the patterns contributing to both his anxiety and depressive symptoms. These included:

- chronic self-critical thinking
- avoidance of activities that previously brought satisfaction
- increasing isolation from friends and supportive relationships

Treatment incorporated evidence-based strategies designed to address both conditions simultaneously. These included behavioral activation to gradually restore meaningful activities, cognitive restructuring to challenge negative thinking patterns, and structured goal setting to rebuild a sense of forward momentum.

Over time, he began reporting noticeable changes in energy, mood, and engagement with daily life. Activities that once felt overwhelming became more manageable, and he gradually reconnected with social supports and personal interests.

He later reflected that the most helpful step had been simply deciding to get started with therapy, even though he initially felt uncertain about the process.

---

### Example 3: How to Find a Good Therapist that is a Better Fit Than Me

Finding the right match sometimes means recognizing when another professional may be better suited to a particular situation.

For example, an individual once contacted my practice after searching for how to find a therapist who fits you following a recent traumatic event. They were experiencing intense symptoms, including intrusive memories, severe sleep disruption, and significant emotional distress.

During our consultation, it became clear that their needs would likely be best addressed by a clinician who specialized exclusively in trauma-focused therapies such as EMDR and intensive trauma treatment programs.

While I have experience working with trauma-related concerns, this particular case required a highly specialized level of care that another clinician in the region provides as the primary focus of their practice.

I explained the reasoning openly and connected the individual with that specialist. Within several weeks, they began working with the recommended provider and later reported that the focused trauma treatment approach was extremely helpful.

This example illustrates an important aspect of ethical clinical practice: helping individuals find the clinician who is truly the best fit, even when that means referring them elsewhere.

Ultimately, the goal is always the same—to ensure that people receive the most appropriate and effective care for their needs.

---

These real-world scenarios highlight a key point: finding the right therapist is less about choosing the first available provider and more about identifying someone whose training, experience, and approach align with your needs.

---

## What is the Best Way to Find a Therapist That: 7 Keys

When people search for a clinician, they often assume the answer lies only in credentials or therapy techniques. While training and experience matter, research consistently shows that the quality of the therapeutic relationship is one of the strongest predictors of successful outcomes in therapy.

According to the [American Psychological Association](https://www.apa.org/topics/psychotherapy), a strong collaborative relationship between therapist and client is one of the most important factors contributing to improvement in psychotherapy.

### Seven Signs You May Have Found a Therapist Who is a Good Fit for You.

---

#### **1. You Feel Comfortable Speaking Openly**

A good provider creates an environment where you feel safe discussing difficult topics, even those that may be uncomfortable or emotionally complex.

This does not mean therapy always feels easy. Many sessions involve discussing challenging experiences or confronting difficult emotions. However, you should generally feel respected, heard, and understood.

Feeling able to speak honestly is often one of the first indicators that you may have found a therapist who fits you.

---

#### **2. Your Provider Listens Carefully and Thoughtfully**

A strong clinician does more than simply ask questions. They listen carefully, reflect back what they hear, and help clarify patterns you may not have noticed before.

Many people seeking how to find a therapist for anxiety or how to find a therapist for depression are looking for someone who can help them understand their thoughts and emotions in a structured way.

Effective providers help translate complex emotional experiences into clear, understandable insights.

---

#### **3. Their Approach Makes Sense to You**

There are many [evidence-based therapy approaches](https://dralanjacobson.com/types-of-therapy/), including:

- Cognitive Behavioral Therapy (CBT)
- Acceptance and Commitment Therapy (ACT)
- Interpersonal Therapy
- Psychodynamic therapy
- Mindfulness-based approaches

A good provider should be able to explain how their approach works and why it may help your specific situation.

When considering how to find a good therapist for anxiety or depression, understanding the therapist’s method can help you feel more confident in the process.

---

#### **4. You Begin to Notice Small Changes Over Time**

Progress in therapy often occurs gradually. Early improvements may include:

- increased awareness of emotional patterns
- better coping strategies for stress
- improved communication with others
- A greater ability to manage anxiety or negative thinking

These small shifts can accumulate over time, eventually leading to significant improvements in overall well-being.

---

#### **5. The Therapist Encourages Collaboration**

[Therapy works](https://dralanjacobson.com/does-therapy-work/) best when it is collaborative rather than directive.

A skilled clinician will typically invite your input about:

- goals for therapy
- strategies that feel helpful
- areas you would like to explore further

This collaborative approach helps ensure that therapy remains aligned with your personal goals and values.

---

#### **6. You Feel Both Supported and Challenged**

Effective therapy involves a balance between emotional support and constructive challenge.

A good clinician will:

- validate your experiences
- offer empathy and understanding
- help you examine patterns that may be contributing to distress
- encourage new ways of thinking or responding

This balance often helps people grow in ways that would be difficult to achieve on their own.

---

#### **7. You Feel More Hopeful About the Future**

Perhaps the most meaningful sign that therapy is helping is a gradual shift toward greater hope and confidence about the future.

Even when life circumstances remain challenging, therapy can help individuals develop:

- stronger emotional resilience
- better coping strategies
- a clearer sense of direction and purpose

These changes often emerge slowly, but they can have a profound impact on overall quality of life.

---

### What is the Best Way to Find a Therapist: It Takes Time

Many people searching for how to find a therapist for anxiety and depression worry about choosing the wrong therapist.

It is important to remember that finding the right fit sometimes takes time. Meeting with one or two therapists before finding the right match is common and completely normal.

The goal is not simply to find *a* therapist, but to find a therapist whose expertise, communication style, and approach align with your needs and goals.

## How to Find a Good Therapist: More Details

Finding a therapist who is a good fit for your needs can be a crucial step in [improving your mental health and well-being](https://dralanjacobson.com/does-therapy-help-what-form-of-therapy-works-best/). Here’s a comprehensive guide on how to approach the process of finding a good therapist:

### Find a Psychologist or Social Worker with the Right Approach

**Types of Therapy**: Determine what kind of therapy or counseling you need. Finding a good therapist with the right approach is vital. Common major forms of therapy include:

- - **[Cognitive Behavioral Therapy](https://dralanjacobson.com/cbt-for-depression/) (CBT)**: Focuses on changing unhelpful thought patterns.
    - [**Psychodynamic Therapy**](https://dralanjacobson.com/psychodynamic-therapy/): Explores unconscious patterns rooted in past experiences.
    - [**Humanistic Therapy**](https://dralanjacobson.com/basic-tenets-of-humanistic-psychology/): Centers on self-growth and personal understanding.
    - **[Couples Treatment](https://dralanjacobson.com/couples-therapy/)/[Family Therapy](https://dralanjacobson.com/family-therapy/)**: Helps navigate relationship issues.
    - [**Trauma-Focused Therapy**](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/): Addresses PTSD, abuse, or significant traumas.
    - Art/Music Therapy: Combines creativity with therapeutic approaches.

Understanding what kind of help you seek can guide you to finding a therapist specializing in relevant approaches.

### Find a Therapist: Credentials and Licensing

- Common types of licensed professionals include: 
    - **Psychologists (PhD or PsyD):** Specialize in psychotherapy and psychological testing. They must first complete three years of schooling that include some supervised practice, two years of heavily supervised full-time practice, and another year of practice before they can be licensed.
    - **Licensed Clinical Social Workers (LCSW)**: Focus on psychotherapy and case management. LCSWs (and LISCSWs after they are licensed) have two years of school with some clinical practice and two years of supervised full-time practice before they can be licensed.
    - **Marriage and Family Therapists (MFT)**: Specialize in relational therapy, and have approximately the same schooling and supervision as social workers.
    - **Psychiatrists (MD)**: Medical doctors who can prescribe medication alongside therapy.

After you find a therapist you like, you may want to ensure the professional you choose holds a current license by checking their status with your state’s or country’s licensing board.

### Find a Therapist: Accessibility and Logistics

- **Location**: Decide whether you want to meet in-person or online. Some people prefer face-to-face sessions, while others are comfortable with online therapy, which can be more convenient and accessible. Finding a psychologist or therapist near you if you want in-person can be a challenge.
- **Availability**: Make sure the clinician’s hours align with your schedule. Some may offer evening or weekend appointments.
- **Language and Culture**: If relevant, seek a provider who understands your cultural, linguistic, or personal background, which may lead to a more effective therapeutic relationship.

### Find a Good Therapist By Interviewing

Before committing, contacting a few therapists to see if they are a good match for you is fine. When trying to find a good therapist consider asking questions like:

- **What’s your approach to therapy?**
- **What kind of experience do you have with my specific issues (e.g., anxiety, depression, trauma)?**
- **How long do you typically work with clients?**
- **What is your availability and how do you handle emergency situations?**

Many therapists offer free initial consultations so you can get a feel for their style and determine if you feel comfortable with them.

### Be Open to Change

If, after a few sessions, you feel that the clinician isn’t a good fit, it’s okay to switch. Therapy is most effective when you feel a strong connection with your provider, so don’t hesitate to try someone new if necessary.

By understanding your needs, researching your options, and taking the time to find a good therapist for you, you can greatly improve your therapy experience and the effectiveness of the treatment.

## Conclusions and My Work

The process to find a good therapist might take some time, and it’s okay to consult different therapists to see who best meets your needs. Unlike other fields, therapists have no competition – we want people to find a therapist that is the best fit for them, even if it is not us. We don’t take it personally when you choose someone else, and instead hope that you will find that person truly helps.

### If You Find a Psychologist and It’s Me

I am humbled and honored when people consider me to possibly be their therapist. I take that responsibility seriously because it is such an important decision. I always offer a free consultation where we can talk about the [integrative approaches](https://dralanjacobson.com/integrative-therapy/) I use and other possibilities that may be out there. I want you to find a therapist that is a perfect match!

If you’d like more information about [my therapeutic approaches](https://dralanjacobson.com/types-of-therapy/), [background](https://dralanjacobson.com/my-bio/), or anything else about me, please feel free to [contact me](https://dralanjacobson.com/contact/). If you just want to talk through how to find a good therapist, even if I may not be a fit, that is fine, too!

If a psychologist is asked, ‘Are you the best therapist I can find?’ The answer should be: ‘I am an excellent choice for some but not others.’ The “best psychotherapist” is not a static title one earns and keeps forever; it is a state of **relational and clinical alignment**. My primary ethical duty is to ensure that you receive the highest standard of care, which sometimes means acknowledging that my training, style, and methods may not be the best fit for you. A psychologist who claims they can be the “best mental health therapist” *for everyone* is ignoring the vast diversity of human psychology. What follows is an ‘insider’s map’ to finding the professional who will be the catalyst for your specific evolution.

## What Makes for the “Best Psychotherapist”? ![Best Therapist for anxiety and depression](https://dralanjacobson.com/wp-content/uploads/2025/12/Choices-2-300x203.jpg)

Beyond a license and a degree, “master” therapists (the top 10% of practitioners) demonstrate advanced competencies that extend beyond basic active listening.

### Best Therapist Personal Attributes

The following are some of the attributes that many consider essential when seeking the best [therapist for their needs and goals](https://dralanjacobson.com/how-to-find-a-good-therapist/).

#### [Metacognitive](https://dralanjacobson.com/metacognitive-therapy-mct/) Awareness

The best psychotherapist is constantly reflecting on how they think. They monitor their own biases, their emotional reactions to you ([countertransference](https://www.simplypsychology.org/countertransference.html)), and the “vibe” in the room. If they feel a session is stalling, they don’t blame your “resistance”; they look at their own technique and pivot.

#### The Ability to “Standardize” Flexibility

While they follow [evidence-based protocols](https://pmc.ncbi.nlm.nih.gov/articles/PMC10230988/) (such as [CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) or [DBT](https://dralanjacobson.com/dbt-for-teens/)), they don’t apply them as a rigid script. They understand the **spirit** of the intervention. For example, if you are grieving, they will not impose a “[cognitive restructuring](https://dralanjacobson.com/cognitive-restructuring/)” worksheet; they will hold space for the grief first, recognizing that technical work cannot proceed until emotional regulation is stabilized.

#### Verbal Fluency and “Aha!” Moments

A top-tier best psychotherapist candidate can take the “tangled ball of yarn” that is your internal world and pull out a single thread that makes sense of everything. They provide **insight**—that moment where you say, *“I never thought of it that way, but it explains everything.”*

#### The Mechanics of the “Best Fit” (The Alliance)

The “fit” is technically defined as the [**Therapeutic Alliance**](https://www.verywellmind.com/why-a-therapeutic-alliance-is-important-in-therapy-7503678). It is the [single most consistent predictor of success in psychotherapy](https://pubmed.ncbi.nlm.nih.gov/39383291/), more so than the specific [type of therapy](https://dralanjacobson.com/types-of-therapy/) used. It is composed of three “negotiable” pillars:

1. **Goal Consensus:** You and your provider are “pulling in the same direction.” If you want to stop drinking and the clinician wants to talk about your childhood trauma, the alliance is weak. The best therapist checks in: *“Does this feel like the most important thing for us to be talking about today?”*
2. **Task Collaboration:** You both agree on the “work.” If you hate “homework” but your therapist insists on it, you will likely drop out. A great clinician finds a way to do the work that fits your lifestyle.
3. **The Affective Bond:** the “liking” factor. Do you feel that this person genuinely cares about your well-being? Clients who feel liked by their clinicians usually recover more quickly.

### Best Therapist Clinical Skills

The best psychotherapist works across **six overlapping levels** at once.

#### Developmental Formulation

The best psychotherapist understands how your symptoms developed over time—not just what they are today.

They ask:

- What did you learn about safety early in life?
- What emotional roles did you have to play?
- How did your family handle fear, anger, success, and mistakes?

This creates a *coherent narrative rather than* a list of problems.

#### [Neurobiological](https://opentext.uoregon.edu/neurobiology/front-matter/what-is-neuroscience/) Literacy

The best psychotherapist understands your nervous system — not just your thoughts.

They explain:

- Why does your body react before your mind
- How trauma is stored procedurally
- Why insight alone often fails

This replaces self-blame with self-compassion.

#### Relational Precision

They notice how you show up in the room:

- Do you minimize pain?
- Over-explain?
- Hide anger behind politeness?

They don’t just talk about patterns — they see them happening live.

#### Strategic Intervention

The best psychotherapist won’t default to one method. They choose approaches based on:

- Whether distress lives primarily in cognition, emotion, body, or identity
- How well defended you are
- How much structure you need

#### Outcome Monitoring

The best psychotherapists constantly ask themselves:

- Is this helping?
- Are we moving?
- Is the client becoming freer, or is the client simply better adjusted?

#### Ethical Humility

They are willing to say, “This isn’t working — let’s rethink.”

## How to Find the Best Therapist: A Process

If you would like to take an active role in identifying the best therapist for your unique needs, background, and goals, this process may be helpful.

**Step 1 — Write Your Psychological Autobiography (1 page)**

Include:

- earliest memory of feeling unsafe or unseen
- recurring relationship conflicts
- moments you thought you had to change who you were to be accepted

This is the *real intake*.

**Step 2 — Analyze Their Language**

Therapists who say:

- “tools,” “skills,” “coping” → often symptom-focused (often the best therapist for anxiety)
- “patterns,” “attachment,” “meaning,” “identity” → depth-oriented (often the best therapist for depression and anxiety)

Choose based on your needs.

**Step 3 — Treat the First Three Sessions as Data**

Ask:

- Did I leave with a new language for my experience?
- Did something loosen inside me?

If not, don’t rationalize it — listen to it.

### How to Know if Your Provider is the “Best” for You

Use the **“First Month Review”**. After four sessions, ask yourself:

- **Do I feel “seen”?** (Does the clinician remember the names of the important people in my life?)
- **Is the “Vibe” right?** (Do I like their sense of humor? Is their office—or digital background—comforting or distracting?)
- **Is there a “Working Map”?** (If someone asked me, ‘What are you doing in therapy?’, could I answer them clearly?)
- **The Honesty Test:** (Am I starting to tell them things I’ve never told anyone else? If not, why?)

## Best Therapist Case Examples: The Path to Success

The following case examples show how different clients found the best psychotherapist for them.

### Case A: Find the Best Therapist for Anxiety (The Specialist Path)

**The Client:** “Sarah,” 28, suffering from Generalized Anxiety Disorder (GAD). She is “hooked” on a cycle of constant worry about her health, her job, and her family.

**The Search for the Best Therapist for Anxiety:** Sarah spent a year with a therapist who was very kind but mostly just validated her feelings. Sarah felt “better” for an hour after the session, but her anxiety returned by the time she reached her car.

**The Best Match:** She switched to a specialist in **[Metacognitive Therapy](https://dralanjacobson.com/metacognitive-therapy-mct/) (MCT)**, and that person turned out to be the best therapist for anxiety of her kind.

**The Process:** This psychologist didn’t focus on *what* Sarah was worried about; they focused on *how* Sarah thought about worry itself. They challenged her “meta-beliefs” (e.g., “I have to worry to be prepared”).

**The Result:** Sarah learned to treat her worries as “mental noise” rather than “urgent signals.” Her physical symptoms (headaches and insomnia) vanished because she stopped engaging with every anxious thought.

### Case B: Best Therapist for Depression and Anxiety (The Integrated Path)

**The Client:** “Marcus,” 45, who feels “trapped in a fog” (depression) but experiences sharp, terrifying panic attacks when he tries to engage with the world.

**The Search for the Best Therapist for Depression and Anxiety:** Marcus needed someone who could handle the “lows” and the “highs” of his nervous system.

**The Best Match:** An integrative therapist using **Behavioral Activation (BA)** and **[Interpersonal Therapy](https://dralanjacobson.com/interpersonal-therapy/) (IPT)** turned out to be the best therapist for depression and anxiety of the sort he has.

**The Process:** They used BA to help Marcus find “drops of joy” in his day and break the depressive cycle. For the panic, they used [**Interoceptive Exposure**](https://positivepsychology.com/interoceptive-exposure/), where Marcus purposefully mimicked panic symptoms (like breathing through a straw) to prove to his brain that the sensations weren’t fatal.

**The Result:** Marcus’s “social battery” recharged. He reconnected with his estranged brother and returned to work part-time. The best therapist for depression and anxiety for him was someone who could be a cheerleader and a coach simultaneously.

### Case C: Best Psychotherapist for Complex Trauma (The Somatic Path)

**The Client:** “Elena,” who grew up in an unpredictable household. She often feels “disconnected” from her body and has difficulty trusting anyone.

**The Search:** Elena found that “talk therapy” made her feel worse. Whenever she talked about the past, she would “freeze” or stop breathing properly.

**The Best Match:** A therapist certified in [**EMDR**](https://www.emdr.com/what-is-emdr/) and **[Internal Family Systems](https://dralanjacobson.com/internal-family-systems-therapy-ifs/) (IFS)**.

**The Process:** Instead of “telling the story” of her trauma, they used bilateral stimulation (EMDR) to desensitize the memories. They used IFS to talk to the “parts” of Elena that were trying to protect her by making her feel numb.

**The Result:** Elena learned to recognize her “triggers” before they became “explosions.” She reported feeling “solid” for the first time in her life.

### Case D: Best Therapist for Depression and Anxiety in an Adolescent (Social & Developmental Path)

**The Client:** “Leo,” 14, who has become withdrawn, plays video games for 10 hours a day, and says “I don’t know” to every question.

**The Best Match:** A therapist who uses **Gamification** and **[Narrative Therapy](https://dralanjacobson.com/narrative-therapy/)** ended up being the best therapist for depression and anxiety of this type.

**The Process:** Instead of sitting across from Leo in a chair, the therapist played a game with him while they talked. They treated his “social anxiety” as an external “villain” that Leo was learning to defeat.

**The Result:** By externalizing the problem, Leo stopped feeling like *he* was the problem. He eventually felt confident enough to join a school club.

### Case E: The College Student (Identity & Career Path)

**The Client:** “Maya,” 21, who is “perfect” on paper but feels like an imposter. She is terrified of graduating because she doesn’t know who she is outside of being a “student.”

**The Best Match:** A therapist trained in **[Acceptance and Commitment Therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) (ACT)**.

**The Process:** They focused on “Values.” Maya realized her “career goals” were actually her father’s goals. They used “[Cognitive Defusion](https://www.therapistaid.com/therapy-worksheet/thought-defusion-techniques)” to help her stop taking her “I’m a failure” thoughts so seriously.

**The Result:** Maya took a “gap year” to volunteer—a choice her “perfectionist” self would have never allowed. She found a sense of peace that wasn’t tied to her GPA.

## Best Mental Health Therapist for Virtual Services

Many people prefer online therapy for a multitude of reasons. This section is dedicated explicitly to finding the best mental health [therapist for virtual sessions](https://dralanjacobson.com/virtual-therapy-guide/).

### Best Mental Health Therapist Online: General Information

In the digital age, the “best therapist” might be 200 miles away. Here is how to ensure quality in a virtual setting:

1. **Clinical Presence:** Can the clinician “read” you through a screen? The best virtual clinicians notice if you are fidgeting with your hands, even if they can only see your face.
2. **Platform Reliability:** A therapist who uses a “glitchy” or non-secure platform is not providing “the best” care. Look for [**HIPAA-compliant**](https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html) portals.
3. **Emergency Protocols:** A high-quality virtual clinician will always know your exact physical address for every session and have a list of local emergency services in *your* area, not theirs.
4. **Specialized Directories:** Use filters on sites like [**Zencare**](https://zencare.co/) or [**Inclusive Therapists**](https://www.inclusivetherapists.com/) to find providers who specialize specifically in “Telehealth” and have mastered the digital medium.

### Finding the Best Mental Health Therapist for You

Finding a great clinician is a little like finding the right running shoes: on paper, lots of options look “good,” but the real test is how you feel after a few miles. Online therapy introduces a few additional variables, but the fundamentals remain the same. Here’s more about how to know whether the professional you’re seeing virtually is truly the best mental health therapist for you.

#### You Feel Safer, Not Smaller

A sign that you have the best mental health therapist for your needs is that after sessions, you don’t just feel “understood” — you feel more *grounded*.

Signs you’ve got a strong match:

- You’re willing to share things you usually avoid.
- You don’t feel rushed, judged, or subtly corrected.
- Hard topics can come up without the room (or Zoom room) feeling brittle.

Red flags:

- You censor yourself because you’re worried how they’ll react.
- You leave sessions feeling embarrassed, dismissed, or emotionally hungover without clarity.

The best mental health therapist doesn’t eliminate discomfort — they make it *usable*.

#### Sessions Create Momentum Between Appointments

Great therapy doesn’t end when you click “Leave meeting.”

Look for:

- New language for your experience (“Oh — that’s what I do when I panic.”)
- Small behavioral experiments you’re trying in real life.
- Insights that pop up on a Tuesday afternoon, not just in session.

If therapy feels like a weekly emotional vent with no after-effects, that’s more like emotional maintenance than growth.

#### The Best Mental Health Therapist Will Be Actively Thinking About *You*

In online work especially, it’s easy for therapy to become generic. The best mental health therapist for you online:

- Refers back to things you said weeks ago.
- Notices patterns in your relationships, work life, stress style.
- Adjusts how they work with you over time.

If every session feels interchangeable — same questions, same pacing, same vibe — that’s not depth, that’s a script.

#### The Work Has a Direction (Even When It’s Flexible)

You don’t need a rigid treatment plan, but you should have a sense of:

- What you’re working *toward*.
- How today’s conversation fits into the bigger arc of your life.

The best mental health therapist will periodically zoom out with you:

“Here’s what I think we’re circling… does that match your experience?”

That moment of shared direction is gold.

#### You’re Gently Challenged, Not Just Comforted

Support alone isn’t therapy — it’s emotional first aid.

The best psychotherapist online:

- Questions your assumptions with warmth.
- Invites you to look at blind spots.
- Helps you notice when you’re reenacting the same story in different settings.

If your therapist only validates and never stretches you, you may feel better — but you probably won’t change.

#### A Sign You Have the Best Mental Health Therapist for You: The Tech Disappears

In great online therapy, the platform fades into the background.

You’re not preoccupied with:

- Awkward silences caused by lag.
- Feeling watched, distracted, or unsure where to look.
- A sense that the therapist is half-present.

Instead, you feel *with* them — even through a screen.

#### You Feel More Like Yourself Over Time

One of the most evident signs you’ve found the best mental health therapist for you is subtle:

You begin reclaiming aspects of yourself you had forgotten you had.

- Your humor comes back.
- Your confidence feels less performative.
- You’re not just surviving your life — you’re steering it.

That doesn’t happen because someone gives good advice. It occurs because the relationship itself becomes a place where your nervous system learns something new.

### A Simple Check-In Question

Every few months, ask yourself:

*Am I becoming more honest, more flexible, and more alive since starting this therapy?*

If the answer is yes — even imperfectly — you’re probably in the right place.

And if the answer is no, that’s not a failure. It’s information. Sometimes, the most growth-oriented thing you can do is outgrow a therapist and intentionally choose your next chapter.

---

## How to Find a Good Therapist: FAQs

### How to Find a Good Psychologist, and H**ow Can They Help Me?**

A psychologist is specifically trained in complex psychological issues and can help you understand emotional patterns, develop coping strategies, improve relationships, and manage conditions such as anxiety, depression, or stress. A trained clinical psychologist provides a structured and supportive environment for exploring challenges and building practical skills.

### How to Find a Good Psychologist for Anxiety 

To find a psychologist for anxiety, look for licensed mental health professionals who specialize in evidence-based treatments such as cognitive behavioral therapy (CBT) or exposure therapy. Therapist directories and referrals from physicians or trusted professionals can help identify qualified providers.

### How Can I Find a Good Psychologist for Depression

When searching for a psychologist for depression, look for clinicians with experience treating mood disorders using evidence-based approaches such as CBT, interpersonal therapy, or behavioral activation. It is also important to find someone whose communication style feels comfortable and supportive.

### What is the Best Way to Find a Therapist that **is Right for Me?**

A therapist may be a good fit if you feel comfortable speaking openly, feel understood and respected, and believe the therapist is knowledgeable about your concerns. The therapeutic relationship is one of the strongest predictors of therapy success.

### **How to Find the Right Psychologist** and **get started with therapy?**

To get started with therapy, identify your goals, research qualified therapists, schedule an initial consultation, and discuss your concerns openly. The first session often focuses on understanding your background and determining how therapy can help.

---

### How to Find a Good Therapist: **Taking the First Step**

Deciding to seek counselling is often the hardest step. Many people wait months or even years before reaching out for support.

However, therapy can provide clarity, practical tools, and a supportive environment for navigating life’s challenges. Whether you are experiencing anxiety, depression, or simply feeling stuck, working with a qualified therapist can help you move toward a healthier and more fulfilling life.

---

#### **Schedule a Consultation**

If you are considering therapy and would like to [learn more about how counselling may help](https://dralanjacobson.com/therapy-faqs/), you are welcome to reach out.

A brief consultation can help determine whether therapy may be helpful and whether my approach is a good fit for your needs. I can help you know how to find the right psychologist or therapist, whether or not I am the best fit. My goal is to help you learn how to find the best therapist for you, and it does not have to be me!

Please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult#book/services) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.instagram.com/appliedpsychological) [ ![social network 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](https://www.linkedin.com/company/psychologicalscience/)

**Categories:** Therapy Approaches

---

### [What is a Private Practice?](https://dralanjacobson.com/what-is-a-private-practice/)

**Published:** March 15, 2025
**Author:** Dr. Alan Jacobson

**Content:**

As a licensed [clinical psychologist](https://dralanjacobson.com/what-is-a-clinical-psychologist/) with over 20 years of experience as a **private practice therapist**, I have worked with individuals, couples, and families to help them navigate life’s challenges and find new opportunities and contentment. My expertise spans a range of psychological concerns, including anxiety, depression, trauma, and relationship difficulties. I aim to create a supportive, nonjudgmental space where clients feel heard, understood, and empowered to make meaningful life changes. But what exactly is a “**private practice psychologist**?” Why do people pursue **private therapy**, and what does a **private counseling practice** offer that is unique?

### Private Practice Therapist Overview

A **private practice therapist** is a licensed mental health professional who operates independently or within a small group rather than being employed by a hospital, clinic, or other institution. We provide private counseling practice services directly to clients, often in their own offices or via telehealth.

## Why Choose a Private Practice Therapist:

Seeing a private practice therapist has several benefits, depending on what you’re looking for in therapy. Here are some key reasons why people make this choice:

#### 1. Personalized Care

A private practice therapist often has fewer clients than those working in clinics, allowing them to tailor treatment plans specifically to your needs and goals. We are careful to ensure that we feel we can help; there is no competition in our field, so we are happy to refer people to another professional with a different approach or method who may be able to serve you better.

#### 2. Greater control over who you see

Clients see the same therapist throughout treatment, fostering a stronger therapeutic relationship. In a private counseling practice, there is no risk of being assigned to a professional with openings rather than the person there who [best fits you](https://dralanjacobson.com/how-to-choose-the-right-therapist/).

#### 3. Greater Choice and Specialization

You can choose a professional who specializes in exactly what you need, whether it’s [treatment for ADHD](https://dralanjacobson.com/adhd-therapy-for-adults/), autism, trauma, anxiety, or other mental health concerns. You can also be seen for general concerns that may not carry a diagnosis, such as general malaise, a feeling of a [lack of meaningfulness](https://dralanjacobson.com/logotherapy/), or a life transition. Particularly with the growth of [teletherapy](https://dralanjacobson.com/telehealth-therapy-teletherapy/), you can often find someone with more niche expertise that fits your unique needs.

#### 4. More Flexibility in Scheduling

These professionals set their schedules so that you may have more options for appointment times, including evenings. (However, sometimes, a clinic will have more choices at the beginning of treatment.)

#### 5. Consistency and Long-Term Care

Unlike community clinics or school-based services with high turnover, a private practice therapist tends to stay in one place longer. This helps build a strong, ongoing therapeutic relationship.

#### 6. More Privacy in a Private Counseling Practice

Private therapy is often more confidential than therapy in a clinic or hospital, where multiple providers may access your records. Some clients feel more comfortable discussing personal matters privately than in a hospital or clinic. The office environment of a private counseling practice is usually more comfortable than a busy clinic.

#### 7. Less Restrictive Treatment Approaches

Therapists who open a private counseling practice often have more freedom to use [different therapy styles and approaches](https://dralanjacobson.com/integrative-therapy/) that work best for you rather than being bound by clinic policies or insurance limitations.

## Disadvantages of Seeing a Private Practice Therapist

#### 1. Higher Cost & Insurance Limitations

- Rates for therapy can be expensive (e.g., $180–$250 per session).
- Not all accept insurance, and out-of-pocket costs can be high.
- Clients may have to submit their insurance claims for reimbursement if the therapist is out-of-network.

#### 2. Limited Crisis Support

- Unlike hospitals or large clinics, private therapy may not offer 24/7 crisis support.
- If a client experiences a severe crisis (e.g., suicidal thoughts or psychotic episodes), they may need emergency care elsewhere.

#### 3. Less Access to Additional Services

- Hospitals and community mental health centers often offer extra services, such as case management, [group therapy](https://dralanjacobson.com/group-therapy/), or medication management, that a private counseling practice may not offer.
- Clients may need to find a separate psychiatrist for medication if their therapist is not licensed to prescribe.

#### 4. Availability & Wait Times

- Many sought-after professionals have long waitlists, sometimes taking months to get an appointment.
- Finding private therapy specializing in certain areas (e.g., [treatment for trauma](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/), autism, or ADHD) can be even more challenging.

#### 5. No Built-In Supervision or Collaboration

- Unlike those working in hospitals or agencies, these professionals don’t always have colleagues for direct collaboration or supervision, which can be a downside for complex concerns. (Note that many professionals, including myself, do pursue collaboration and supervision despite practicing independently.)

### Summary

What Makes Private Therapy Different from Other Options?

- **More personalized** – Private therapy is focused on your specific needs and goals.
- **More flexible** – You can choose your therapist, schedule, and approach.
- **Can be expensive** – May not accept insurance or have high out-of-pocket costs.
- **Less crisis support** – Unlike a hospital or clinic, they may not be available 24/7.

## Is a Private Counseling Practice Right for You?

**A private practice [therapist might be a good fit](https://dralanjacobson.com/how-to-find-a-good-therapist/) if you:**

- Prefer individualized, one-on-one therapy with the same provider long term.
- Need a specialist for a particular mental health condition (e.g., ADHD, autism, trauma). (This may be possible at clinics as well, but you need to ensure that this is the case.)
- Can afford to pay or have insurance that covers out-of-network providers.
- Want more flexibility in scheduling and session length.
- Value a personalized and often more private setting.
- Want to see a specific clinician with a certain approach or breadth of experience

**You may want to consider other options if you:**

- Would like more of a team approach, where you can see people with different specialties
- Need lower-cost services that take most insurances or offer sliding-scale fees.
- Require crisis intervention or 24/7 mental health support.
- Prefer a structured program with multiple services, such as group therapy or case management.

## My Journey to Becoming a Private Practice Psychologist

Becoming a private practice psychologist takes years of education, supervised experience, and licensing. Here’s a step-by-step breakdown of the required experience, education, and training I pursued before opening a private counseling practice:

### 1. Earned a Bachelor’s Degree (4 Years)

- **Field of Study:** I majored in Child Study at the [Eliot-Pearson Department at Tufts University](https://as.tufts.edu/epcshd/)**.** (Others major in Psychology, Neuroscience, or a related field).
- **Experience Gained:**
    - Introductory developmental psychology knowledge
    - Research experience to understand how different methods work
    - Internships and volunteer work in mental health settings

### 2. Earned a Doctoral Degree in Psychology (4 Years)

- Many of my colleagues earned a PhD **(Doctor of Philosophy in Psychology)** that focuses on research and clinical training.
- I earned a PsyD **(Doctor of Psychology)** which Focuses more on clinical practice than research.
- **Experience Gained:**
    - **Graduate coursework** (counseling techniques, diagnosis, ethics)
    - **Practicum** (two years of supervised clinical training with real clients)
    - **Research,** including a [Dissertation](https://www.scribbr.co.uk/thesis-dissertation/what-is-a-dissertation/)

### 3. Complete a Pre-Doctoral Internship (1 Year)

- **Experience Gained:**
    - Full-time supervised clinical training (I worked around 2,100 hours)
    - I worked in hospitals, a community mental health center, and schools
    - Direct therapy and psychological assessments under close supervision

### 5. Obtain Licensure for Private Therapy (Varies by State, Usually 1-2 Years of Postdoc Work)

- **Postdoctoral Supervised Hours (1 Year, 1,500-2,000 Hours Required in Most States)**
    - I work under a licensed psychologist’s close supervision and mentorship before practicing independently.
    - I gained experience diagnosing, treating, and evaluating a wide variety of clients.
- **Pass the Examination for Professional Practice in Psychology (EPPP)**
    - National licensing exam covering clinical knowledge and ethics. The exam is comprehensive and quite challenging.
- **Pass Any State-Specific Exams (If Required)**
    - Some states, like California, require additional ethics or jurisprudence exams.

### 6. Gain Experience Before Becoming a Private Practice Therapist

- Before becoming a full-time private practice psychologist, I worked in a large mental health clinic, three psychiatric hospitals, and on an emergency response team to gain experience with a wide variety of clients and therapeutic techniques before becoming fully independent.

### Starting a Private Counseling Practice

- After all the experience, education, and training above, I started my private counseling practice. 
    - **Business knowledge** (insurance billing, marketing, finance)
    - **Networking** (building a client base, professional referrals)
    - **Legal compliance** (HIPAA laws, contracts, record-keeping)Additional skills I built:

### Total Time to Become a Private Practice Psychologist:

- My education, training, supervision, and licensing took around 10 years before I felt ready to become a full-time private practice psychologist

## Conclusion and My Work:

If you have any questions about private counseling practice, what it’s like to see a private practice psychologist in general, or [how to find a psychologist](https://dralanjacobson.com/how-do-you-find-a-psychologist-offering-affordable-therapy/) or generally [how to find the best therapist](https://dralanjacobson.com/the-best-way-to-find-a-therapist-using-therapist-finders-word-of-mouth-and-other-therapy-resources/) for you, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime. There are also location-specific posts regarding how to find [therapy in NYC](https://dralanjacobson.com/how-to-find-therapy-in-new-york-or-anywhere-a-guide-to-getting-started/) or a [therapist in California](https://dralanjacobson.com/therapy-in-california/), which serves as a model for finding treatment anywhere.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.instagram.com/appliedpsychological) [ ![social network 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](https://www.linkedin.com/company/psychologicalscience/)

**Categories:** Types of Therapy

---

### [Therapist Finders Compared: Listings, Word-of-Mouth, and AI](https://dralanjacobson.com/therapist-finders-compared/)

**Published:** June 21, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Finding a therapist who is truly the right fit is one of the most important decisions you can make for your mental health — and one of the most confusing. Dozens of therapist finders exist, each with different strengths, filters, and blind spots. Word-of-mouth still works. AI-powered matching is emerging. And your insurance directory is… somewhere.

This page cuts through that noise. It is a practical guide to the *tools and resources* used to locate a therapist — how they work, how they compare, and which ones tend to produce the best results depending on what you need. If you are looking for guidance on evaluating fit once you have found a candidate, I cover that in detail in [How to Find a Good Therapist That Fits You and Your Goals](https://dralanjacobson.com/how-to-find-a-good-therapist/).

I want to be transparent about something upfront: when someone contacts me who is trying to figure out how to get therapy, my first goal is not to book a session. It is to help you land in the right place — whether that is with me or with a colleague who is a better match for your specific needs. Your fit with your provider is one of the strongest predictors of whether therapy actually works. This guide is written with that priority in mind.

**What this page covers:**

Two real case examples: finding the right fit, even when it wasn’t me

How the major therapist finders compare (Psychology Today, Zencare, TherapyDen, and others)

When word-of-mouth outperforms directories — and how to use it

How to use AI tools to narrow your search

What to say when you reach out to a therapist

Low-cost and self-guided therapy resources

## Best Way to Find a Therapist ![Best way to find a therapist: Therapy resources](https://dralanjacobson.com/wp-content/uploads/2025/06/checklist.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Here’s a structured guide to the best way to find a [therapist from start to finish, including how to use therapist finders, what to ask in the first call or session, and how to determine whether a therapist is the right fit](https://dralanjacobson.com/therapy-models-and-therapist-styles-a-complete-guide-to-finding-the-right-fit/). It also includes other self-help and **online therapy resources** for those exploring alternatives or supplements to therapy.

### Step-by-Step: Best Way to Find a Therapist Who Fits

#### How to Get Therapy Using Therapist Finders

##### These directories help you learn how to get therapy, including

- Insurance accepted
- Specialty (e.g., trauma, ADHD, couples, teens)
- Therapy approach (e.g., CBT, EMDR, [psychodynamic](https://dralanjacobson.com/psychodynamic-therapy/))
- Identity (e.g., LGBTQ+, BIPOC, faith-based)
- Languages spoken
- Virtual or in-person availability

##### Top Therapist Finders

- Psychology Today – The most widely used of the therapist finders, with very customizable options. One drawback is that no search feature indicates whether a practitioner is licensed or how many years of experience they have.
- [TherapyDen](https://www.therapyden.com/therapist/alan-jacobson-westwood-ma) – Inclusive and user-friendly with advanced identity filters
- [Open Path Collective](https://www.openpathcollective.org) – Affordable therapy ($40–$70/session)
- [Zencare](https://zencare.co/provider/therapist/alan-jacobson) – High-quality video introductions and vetted clinicians. One of the best therapist finders overall.
- [Inclusive Therapists](https://www.inclusivetherapists.com) – The best of the therapist finders for prioritizing marginalized identities
- **Your insurance provider’s website** – Find in-network therapists by plan

#### Contact a Few Therapists

Email or call 2–4 of the results from therapist finders with a brief message like:

“Hi, I’m looking for support with \[brief concern, e.g., anxiety, relationship issues\]. I’m hoping to find a therapist who uses \[CBT/trauma-informed/mindfulness\] approaches and accepts \[your insurance, or private pay\]. Do you have availability, and could we set up a short consultation?”

#### Questions to Ask a Therapist

Use a **free consultation (often 10–20 minutes – most therapist finders list whether these are offered)** to ask:

- What is your experience working with \[your issue\]?
- What is your general approach or philosophy of therapy?
- How do you structure sessions?
- Do you assign homework or do in-session work only?
- What experience do you have working with clients who are \[your identity/life context\]?
- What should I expect in the first few sessions?
- How do we track progress or know when therapy is working?

If you’re unsure what to ask, you can say:

“This is my first time learning how to get therapy. Can you walk me through what working together might look like?”

### How to Get Therapy that is the Best Fit

After your consultation or first few sessions, the best way to find a therapist is to ask yourself:

- Do I feel safe and heard in this space?
- Do I feel respected and not judged?
- Is the communication clear?
- Do they challenge me appropriately or just listen?
- Do I leave sessions feeling clearer or more overwhelmed?
- Am I noticing small shifts over time?

**Tip**: It’s okay to “shop” using different therapist finders. A good clinician will understand if you want to explore other fits.

### Other Online Therapy Resources

If you prefer [therapy online](https://dralanjacobson.com/therapy-online-approaches-techniques-and-outcomes/) or via text/chat. Keep in mind that there may be a significant range of experience and expertise with these services, and you may have less choice on which provider you get:

**Online Therapy Resources**

- **BetterHelp** – Text/video therapy resources with licensed professionals (not usually insurance-eligible)
- **Talkspace** – Similar to BetterHelp, with insurance coverage in some plans
- **Thriveworks** – National network, insurance-eligible, in-person, and online
- **Amwell / MDLIVE** – Offers therapy under telehealth, often through insurance

### Best Way to Find a Therapist for a Low Cost

**How to Get Therapy Resources Through Apps**

- **Insight Timer** (free) – Meditations, sleep tools, emotional wellness
- **MoodKit** (iOS) – CBT-based thought tracking and goal setting
- **Woebot** – AI-powered CBT chat for support
- **[CBT-i](https://dralanjacobson.com/cbt-i-for-sleep-difficulties/) Coach** – Gold-standard app for insomnia, developed by VA

**How to Get Therapy Through Self-Guided Programs**

- [**Centre for Clinical Interventions**](https://www.cci.health.wa.gov.au/) – Therapy resources through evidence-based modules (depression, anxiety, perfectionism, etc.)
- [**Therapist Aid**](https://www.therapistaid.com) – Free worksheets, coping tools, and psychoeducation
- [**Mindfulness-Based Cognitive Therapy Online**](https://oxfordmindfulness.org) – Self-paced course from Oxford

**How to Get Community Support**

- [**7 Cups**](https://www.7cups.com/) – Trained volunteer listeners and free peer support chat
- **Mental Health America** – Offers free screening tools and support guides: [mhanational.org](https://mhanational.org)

### Best Way to Find a Therapist: Final Tips

- **Therapy is a relationship**—it may take a few sessions to know if it feels right.
- **You are allowed to ask questions, change therapists, or take breaks. You are the customer.**
- **Good treatment makes you feel more understood and empowered over time, not confused, unsure, or belittled.**

## Case Example: How to Get Therapy for Test Anxiety and Sports Performance

When *Jenna*, a 15-year-old high school sophomore, came to me, she was juggling a multitude of responsibilities — competitive athletics, a demanding academic load, and the intense pressure to excel both on the field and in the classroom. Her parents described her as bright, determined, and hardworking, but lately she had begun experiencing intense **test-taking anxiety**, along with self-doubt that was starting to affect her **athletic performance**.

### How Jenna’s Family Found Me

Jenna’s mom had been asking around in a local parent Facebook group about therapists who specialize in [therapy for teens](https://dralanjacobson.com/therapy-for-teens/). A few parents mentioned they’d had positive experiences with therapists who also understood the **psychology of performance**. One name came up a couple times — mine.

Her mom then turned to therapist finders, including Zencare.co, a directory that lets you filter therapists by specialty, approach, and age group served. She searched for:

- Age: Adolescents
- Issues: [Test-taking anxiety](https://dralanjacobson.com/test-taking-anxiety/), [sports performance](https://dralanjacobson.com/sports-performance-psychology/), and stress
- Format: In-person and virtual
- Location: \[local city\]
- Approach: CBT + performance coaching

Again, she found my profile, watched my short video introduction, and read about how I blend [**CBT techniques**](https://dralanjacobson.com/cbt-techniques/) with **performance psychology** tools I’ve used with young athletes and high-achieving teens. She also liked that I am a psychologist and [life therapist](https://dralanjacobson.com/life-therapists/), so that she might continue beyond her college career.

### Reaching Out

She sent me a brief message through Zencare that said:

“Hi, I’m looking for someone who can help my daughter manage test anxiety and regain her confidence in sports. She’s a student-athlete who puts a lot of pressure on herself. I’d love to know if this is an area you work in.”

We set up a free 15-minute call where I explained my experience:

- Working with teens using **[cognitive behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT)** for anxiety
- Teaching **mental rehearsal and focus techniques** for athletes
- Helping students develop **coping strategies** for test environments (e.g., breathing tools, [mindset reframing](https://www.mobeforlife.com/blog/7-ways-to-reframe-your-mindset), time-buffer planning)

They appreciated the fact that I offered both **a structured plan** and space for Jenna to explore her feelings without judgment.

### What Treatment Looked Like

Over the next few months, Jenna and I worked together on:

- Identifying **thought patterns** that triggered her anxiety before tests
- Using **visualization and [anchoring techniques](https://inlpcenter.org/nlp-anchoring/)** for sports performance
- Practicing exposure to low-stakes “test simulations”
- Building a **compassionate inner voice** instead of harsh self-talk
- Strategizing time management to avoid burnout from trying to “do it all”

### Outcome

Jenna learned how to approach pressure situations with more **calm, confidence, and clarity**. She didn’t just improve her test scores and performance on the field. She also began to enjoy these challenges more, seeing them as opportunities rather than threats.

If you’re a parent looking for a therapist for your teen, especially one navigating **academic pressure**, **performance anxiety**, or **self-esteem issues,** you might consider therapy resources such as a platform like **Zencare** or asking your **community** who they trust. And if my approach resonates with you, I’d be happy to discuss whether I might be a good fit for your child.

## Case Example: Best Way to Find a Therapist – Even When It Wasn’t Me

I received a message from *David*, a man in his late 30s who was reaching out because he was feeling stuck. He’d been carrying the weight of past experiences, including childhood trauma, grief from a recent loss, and a growing sense of emotional numbness. He told me he was ready to start [individual therapy](https://dralanjacobson.com/individual-therapy/) but wasn’t sure where to begin or what kind of therapist he needed.

David had found my profile on **Psychology Today**, and what stood out to him was my clear focus on men’s mental health and anxiety. He appreciated my straightforward style and the fact that I offered a free consultation, so he reached out.

### The First Conversation

In our consultation, David shared some of his story. As he opened up, it became clear that his experiences were deeply trauma-related. He described vivid memories, emotional flooding, and a persistent feeling that the past was “still happening.”

While I do trauma-informed work, I recognized quickly that **he would benefit most from EMDR**, an evidence-based treatment specifically designed to help the brain process and rewire trauma memories.

I let David know:

“I think you’re doing something courageous by reaching out. Based on what you’ve shared, I want to make sure you connect with someone who’s not just good, but *specialized* in exactly what you need. EMDR is one of the most effective approaches for this kind of work, and while I don’t offer it myself, I know excellent colleagues who do.”

### Helping Him Connect to Therapy Resources that Fit

David was understandably unsure. He had taken a big step by reaching out to *me*. I assured him that finding the *right* therapeutic fit is part of the healing process.

I asked:

- Whether he preferred in-person or [online therapy](https://dralanjacobson.com/virtual-therapy-guide/) sessions
- If he wanted someone of a particular gender or cultural background
- What his schedule and insurance situation looked like

Then I searched my network for:

- **EMDR certified therapists**
- [**Trauma-informed approach**](https://dralanjacobson.com/trauma-informed-care/)
- Evening availability
- Culturally responsive clinicians (based on his preference)

I shared two recommendations, along with personal notes about each, and provided him with language to use when reaching out. I also called them myself to let them know he’d be calling.

### A Better Fit, A Better Start

David followed up with one of the referrals and started EMDR therapy within the month. A few weeks later, he sent me a short thank-you note:

“I didn’t know what I needed when I reached out, but I’m glad I landed in the right place. You made this less overwhelming.”

Sometimes the most therapeutic thing I can do is *not* start therapy, but help someone find the right doorway into it using my network of therapy resources. If you’re unsure where to start, I’m always happy to be a guide, not just a provider.

## How to use AI to find a therapist

Using **AI to find a therapist** can make the process faster, more personalized, and less overwhelming, especially if you’re not sure what kind of therapist you need. Here’s a breakdown of **how to use AI tools** effectively for this purpose, including platforms that utilize AI-powered matching and how to combine them with your own preferences to find the best way to find a therapist using technology.

### How AI Can Provide the Best Way to Find a Therapist

AI can assist in several ways:

- **Personalized matching**: AI can match you to therapy resources based on your symptoms, preferences, and therapy goals.
- **Chat-based guidance**: Some platforms offer chatbot assistants that guide you through the process and refine your search.
- **Symptom screening**: AI can help clarify what issues you’re dealing with through brief assessments, then suggest appropriate modalities or specialists.
- **Predictive filtering**: AI tools can analyze provider reviews, specialties, success rates, or availability to improve matches over time.

### Step-by-Step: Using AI to Find a Therapist

#### Describe Your Needs Clearly

AI matches work best when you include:

- **Presenting issues**: e.g., anxiety, burnout, trauma, ADHD
- **Preferences**: therapist gender, cultural background, identity alignment
- **Goals**: coping strategies, healing trauma, relationship improvement
- **Format**: virtual, in-person, hybrid

The more detail you provide, the more tailored your match will be.

#### Try AI Symptom Checkers (Optional)

If you’re unsure what you need help with, start with an AI-based mental health screener:

- **[Mind Diagnostics](https://www.mind-diagnostics.org/)** – Screens for depression, anxiety, trauma, etc.
- **[Ada Health](https://ada.com)** – AI symptom checker that includes mental health conditions
- **[Woebot](https://woebothealth.com/)** – AI-powered CBT chatbot (not therapy, but can guide you toward it)

You can use your screener results when filling out therapist matching forms.

#### Evaluate Your Matches Thoughtfully

Once AI gives you recommendations:

- Read therapist bios carefully
- Watch intro videos (Zencare, Alma, and others often include these)
- Check for keywords: CBT, trauma-informed, EMDR, [somatic therapy](https://dralanjacobson.com/somatic-therapy/), etc.
- Reach out with a short message and request a consultation

### Limitations of an AI Therapist Search

- AI doesn’t replace your **gut feeling** after meeting someone, which is a key aspect of how to get therapy that fits
- Algorithms may not account for **interpersonal chemistry**
- Not all therapists are listed on AI platforms, especially those in smaller practices or with full caseloads

#### Combine AI With Human Wisdom for the True Best Way to Find a Therapist

The best way to find a therapist using AI is by:

- Using AI platforms to narrow down 3–5 solid therapist options
- Reaching out to each with a message or scheduling a consult
- Use therapist finders as well
- Talking to trusted friends, doctors, or support groups for names
- Listening to how you feel in a session: **therapy is a relationship, not just a service**

## Conclusion

Knowing how to get therapy is not easy, and that’s a good thing. Whether you work with me or someone I help you find, what matters most is that you feel safe, meaningfully understood, and supported in the work. If you’re unsure where to start or the best way to find a therapist that is right for you, I’m always happy to help guide you through the process of how to get therapy. Even if our paths don’t align directly, I want you to [find a therapist](https://dralanjacobson.com/how-to-find-a-good-therapist/) who *gets* you and who can help you grow, heal, and move forward in measurable and meaningful ways.

Support is out there. If you have questions about how to get therapy that will match your unique needs and hopes or how to navigate therapist finders, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Finding therapy

---

### [Relational Life Therapy (RLT): Advanced Couples Treatment](https://dralanjacobson.com/relational-life-therapy-rlt/)

**Published:** November 9, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Relational Life Therapy (RLT) is a form of couples treatment developed by [**Terry Real**](https://terryreal.com/), a family therapist and author of *The New Rules of Marriage* and *Us: Getting Past You and Me to Build a More Loving Relationship*. Emerging in the 1990s, relational couples therapy was created in response to what Real saw as the limitations of traditional [marriage counseling](https://dralanjacobson.com/marriage-counseling/), especially its inability to address power imbalances, emotional disconnection, and gender-role conditioning in intimate partnerships. It remains a core relationship therapy approach for couples and dyads of family members.

Rooted in [feminist theory](https://www.simplypsychology.org/feminist-theory-sociology.html), [systems thinking](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/), and [attachment-based](https://dralanjacobson.com/attachment-therapy/) theory, relational life therapy integrates **blunt truth-telling**, **compassionate confrontation**, and **skills training** to foster connection, accountability, and authenticity. It is distinct for its direct, therapist-led style and its emphasis on both partners doing the work needed to transform their dynamic.

### Who is Relational Life Therapy Best For ![Relational Life Therapy](https://dralanjacobson.com/wp-content/uploads/2025/11/couple-on-beach-300x200.png "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

RLT couples therapy is beneficial for:

- Couples experiencing frequent conflict, emotional disconnection, or dissatisfaction
- Dyads affected by traditional gender role expectations or power struggles
- Partners who struggle with emotional expression or accountability (a common focus of RLT couples therapy)
- High-conflict partners with a history of blame, resentment, or defensiveness
- Individuals or couples who want both **personal growth** and **repair**
- Clients who feel traditional [couples therapy](https://dralanjacobson.com/couples-therapy/) is too passive or lacks direction

Relational life therapy is also used with individuals to help people become better relational partners by examining their family-of-origin issues, trauma, and internalized beliefs about love, power, and vulnerability.

### Techniques Used in Relational Life Therapy

RLT couples therapy is structured around three key phases: **Waking Up, Owning Up, and Growing Up**. Across these phases, we use a variety of techniques:

1. **Blunt, Loving Confrontation**: I directly challenge destructive behaviors without shaming, offering a mix of firmness and compassion.
2. **Relational Diagnosis**: Rather than pathologizing individuals, the focus is on identifying patterns that damage the partnership (e.g., grandiosity, avoidance, withdrawal).
3. **Trauma Work**: Exploring family-of-origin wounds that shaped each partner’s style.
4. **Relational Skill Building**: Teaching skills such as active listening, healthy self-expression, boundary setting, and [mutual empowerment](https://www.ourmental.health/love-sex/6-reasons-why-mutual-empowerment-is-key-in-a-healthy-partnership).
5. **Accountability and Repair**: Encouraging personal responsibility rather than blame; promoting apology, change, and follow-through.
6. [**Gender Role Deconstruction**](https://www.numberanalytics.com/blog/guide-to-deconstructing-gender): Challenging traditional masculinity/femininity scripts that prevent intimacy and equality.

Unlike many approaches that aim only to create understanding, this form of relationship therapy actively teaches **how to behave differently,** increasing both **insight and action**.

### Outcomes of Relational Life Therapy

Outcomes of RLT couples therapy include:

- Greater intimacy, vulnerability, and emotional connection
- Increased mutual respect, empathy, and fairness
- Enhanced communication and conflict resolution skills
- Reduction in power struggles and blame cycles
- A deeper understanding of each partner’s internal wounds and how they play out
- More substantial commitment to integrity and long-term repair

Many couples who have struggled for years report that relational life therapy provides clarity, movement, and tools that were missing from more passive or insight-focused approaches.

### Methods That Fit Well With Relational Couples Therapy

Relational Life Therapy (RLT) is an integrative, direct, and transformative model of relationship therapy. It blends **[psychodynamic](https://dralanjacobson.com/psychodynamic-therapy/), systems, feminist, [psychoeducational](https://dralanjacobson.com/psychoeducation/), [trauma-informed](https://dralanjacobson.com/trauma-informed-care/), and coaching methods**, all rooted in one guiding principle: *people thrive when people learn to live from their most mature, connected, and accountable selves.*

Here are the methods, techniques, and orientations that align most naturally with relational couples therapy:

1. #### Fierce Honesty and Loving Confrontation

A core relational couples therapy stance is to name problematic patterns clearly, compassionately, and without collusion.

**Fits well with:**

- [Motivational interviewing](https://dralanjacobson.com/motivational-interviewing/) (focus on ambivalence, change talk)
- [Gestalt two-chair dialogue](https://feelandhealtherapy.org/how-the-two-chair-technique-works-and-how-to-do-it-yourself/) (highlighting internal conflict and responsibility)
- Behaviorally specific feedback

**What it looks like:**
Therapist directly calls out entitlement, withdrawal, defensiveness, or contempt — *paired with validation and pathways for repair*.

2. #### Family-of-Origin Exploration

Relational couples therapy includes a strategic exploration of how childhood wounds shape present patterns.

**Fits well with:**

- [Attachment theory](https://www.simplypsychology.org/attachment.html)
- [Internal Family Systems](https://dralanjacobson.com/internal-family-systems-therapy-ifs/) (IFS) or parts work
- [Schema techniques](https://dralanjacobson.com/schema-therapy/) ([early maladaptive schemas](https://www.attachmentproject.com/blog/early-maladaptive-schemas/))

**What it looks like:**
Helping clients see how their “adaptive child” took over and overrides the “wise adult” in moments of stress.

3. #### Trauma-Aware Relational Reconstruction

Many adult issues arise from trauma that becomes relationally reenacted.

**Fits well with:**

- [Somatic tracking](https://dralanjacobson.com/somatic-therapy/)
- [EMDR](https://www.emdr.com/what-is-emdr/) principles of pairing activation with grounding
- [Narrative re-storying](https://positivepsychology.com/narrative-therapy/) of partnership ruptures

**What it looks like:**
Noticing body activation (tension, shutdown, rage), linking current reactions to old experiences, and teaching self-regulation before skills.

4. #### Skills-Building and Coaching

Relational couples therapy is more directive and instructional than typical couple therapies.

**Fits well with:**

- [Cognitive-behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) communication skills
- Assertiveness coaching
- [Emotional literacy training](https://positivepsychology.com/emotional-literacy/)
- Role-play with a therapist modeling new behaviors

**What it looks like:**
Teaching phrases such as “Here’s what I want… Here’s what I feel… Here’s what I need from you right now.”

5. #### Repair and Reconnection Practices

RLT emphasizes mature relational repair — not blame, justification, or passive apologies.

**Fits well with:**

- [Gottman repair](https://www.gottman.com/blog/r-is-for-repair/) attempts
- [EFT for couples](https://dralanjacobson.com/eft-therapy-for-couples/) cycle de-escalation
- [Compassion-focused](https://dralanjacobson.com/compassion-focused-therapy/) (CFT)

**What it looks like:**
Guided conversations in which each partner acknowledges their impact, expresses vulnerability, and outlines specific commitments.

6. #### Working With the Three Relationship Stances

RLT often locates people in one of three stances:

- **One-up (entitled, controlling, superior)**
- **One-down (collapsing, insecure, deferential)**
- **Healthy adult (connected, accountable, grounded)**

**Fits well with:**

- [Transactional analysis](https://www.simplypsychology.org/transactional-analysis-eric-berne.html)
- Schema modes (parent, child, adult)
- [Positive psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/) (strengths, values, mature self)

**What it looks like:**
Helping a client shift from dominance or appeasement into dignity.

7. #### Gender and Power Analysis

Relational couples therapy directly incorporates cultural narratives, socialization, and structural power differences.

**Fits well with:**

- [Feminist therapy](https://www.verywellmind.com/what-is-feminist-therapy-5204184)
- Sociocultural analysis of roles
- Boundary and assertiveness interventions

**What it looks like:**
Naming invisible labor, emotional caretaking expectations, and gendered entitlement patterns.

8. #### Quick Wins and Deep Repair

Relational couples therapy sessions often create rapid change by tackling acute patterns while also building deeper relational transformation.

**Fits well with:**

- [Solution-focused interventions](https://dralanjacobson.com/solution-focused-therapy/)
- Coaching models
- Psychoeducation on relational cycles

**What it looks like:**
Interrupting a destructive pattern in the relational couples therapy session, mapping out the deeper wounds beneath it.

When family of origin issues come up for one or both members of the couple, a course of [Short-Term Dynamic Psychotherapy](https://dralanjacobson.com/short-term-dynamic-psychotherapy/) can work well.

## Relational Couples Therapy Case Examples

Here are several RLT therapy case examples to give you an idea of how these techniques are used.

### Relationship Therapy for Couples: The Entitled Executive and the Exhausted Partner

Mark (48) and Dana (45) came to therapy after years of escalating resentment. Mark, a successful executive, was frequently criticized and had little patience for emotional conversations. Dana felt unseen, lonely, and increasingly shut down.

#### Relationship Couples Therapy Intervention Highlights

- **Fierce honesty with Mark:**
    I directly confronted Mark’s tone, sarcasm, and dismissiveness. The message: *“Your impact is harming your partner. This is not sustainable.”*
    Mark initially bristled but respected the clarity.
- **Family-of-origin work:**
    Mark had grown up with a domineering father and learned survival through overcontrol. Dana had grown up smoothing conflicts between parents.
- **Helping each move from adaptive child to wise adult:**
    Mark learned to pause before barking instructions; Dana practiced speaking her truth without collapsing.
- **Skill building:**

- “I statements”
- Mark practiced “softening starts”
- Dana practiced boundary-setting (“I won’t stay in a conversation where I’m dismissed.”)

- **Relationship couples therapy repair ritual:**
    Mark apologized not with excuses but with accountability:
    *“I dismissed your needs for years. I see the impact. I’m working every day to show up differently.”*

#### Relationship Therapy for Couples Outcome

Within months of relationship therapy, Mark’s tone softened dramatically. Dana became more expressive and less resentful. They rebuilt intimacy through weekly check-ins and agreed-on repair behaviors.

### RLT Couples Therapy and the Same-Sex Couple Stuck in Parallel Lives

Jordan (29) and Alex (31), together for 6 years, were functioning like roommates. Both avoided conflict and turned toward work and hobbies. They wanted a form of relationship therapy reconnection.

#### RLT Couples Therapy Intervention Highlights

- **Relational therapy cycle mapping:**
    *I* showed them their pattern:
    **Avoid → Distance → Loneliness → More Avoidance.**
- **Attachment and trauma-informed work:**
    Jordan had a chaotic childhood and learned to “stay invisible.”
    Alex feared being burdensome.
    Both were stuck in one-down stances.
- **Relationship Therapy [Parts work](https://www.choosingtherapy.com/parts-work/):**
    Their adaptive child selves were protecting them from vulnerability. The therapist taught them to access their wise adult voices.
- **Reconnection exercises:**

- Weekly gratitude ritual
- Five-minute vulnerability shares
- Practiced “bidding” for connection and responding warmly

- **Direct coaching:**
    The therapist modeled what “Direct yet loving” communication looks like, having them role-play in session until they could do it spontaneously.

#### RLT Couples Therapy Outcome

Emotional intimacy returned. They created more shared experiences, began initiating affection, and agreed on early-repair strategies rather than drifting into distance.

### Relational Therapy and the Single Mother and Her Teenage Daughter

Maria (39) sought RLT to address conflicts with her daughter, Sofia (16). They cycled between silent tension and explosive arguments.

#### Relational Couples Therapy Intervention Highlights

- **Naming the pattern:**
    I showed how Maria’s harsh tone triggered Sofia’s retreat, which provoked more criticism — a classic one-up/one-down loop.
- **Family-of-origin deep dive:**
    Maria saw she was replaying her mother’s controlling, fear-based parenting style.
    Sofia identified her adaptive child strategy: emotional shutdown.
- **[ Somatic grounding](https://betterme.world/articles/somatic-grounding-exercises/) for both:**
    Sessions included breathing, noticing activation, and pausing before reacting.
- **Mutual empathy work:**
    Through guided dialogues, they each shared childhood experiences of feeling misunderstood. They cried together for the first time in years.
- **RLT parenting skills:**

- Repair after rupture
- Direct but warm limits
- Personal accountability (“My tone crossed a line. I’m working on that.”)

#### Relational Couples Therapy Outcome

Arguments decreased drastically. Sofia began confiding more. Maria felt less overwhelmed and more emotionally connected.

### Relational Life Therapy and the Withdrawn Husband and the Critical Wife

James (47) and Elena (45) entered therapy after 15 years of accumulating emotional distance, escalating conflict, and chronic resentment. James tended to withdraw or simmer with anger, leaving Elena feeling abandoned and emotionally starved. In turn, Elena often criticized him for being “checked out.”
They had tried traditional couples therapy but felt it focused too heavily on talking about feelings without producing actual behavioral change. They chose Relational Life Therapy for its direct, skills-based approach.

#### Relational Life Therapy Intervention Highlights

- **Naming the pattern with fierce honesty:**
    I compassionately but firmly confronted James’s passive-aggressive withdrawal and emotional unavailability. Elena was helped to see that her criticism, although rooted in longing, often triggered more shutdown from James.
- **Family-of-origin exploration:**
    James grew up with a father who was emotionally distant, teaching him to retreat and avoid vulnerability.
    Elena came from a volatile home where emotional expression was inconsistent and unpredictable. Both were reenacting learned survival strategies.
- **Shifting from adaptive child to wise adult:**
    James learned to notice when his shutdown reflex took over and practiced staying present long enough to speak truthfully.
    Elena practiced noticing when her anxious frustration pushed her to attack, and learned to express her needs directly rather than in a critical way.
- **Relational skill-building:**
    James practiced emotional expression, empathy statements, and staying in difficult conversations.
    Elena practiced assertive communication without blame, softening her approach while still holding boundaries.
- **Accountability and mutual growth:**
    James increasingly took ownership of the distance he created.
    Elena realized that her tone, not her needs, was often the barrier to connection, and she actively changed her delivery.

#### Relational Life Therapy Outcome

Over the course of this relationship therapy approach, they reported a renewed sense of emotional connection, deeper mutual understanding, and dramatically reduced conflict. James became more present, communicative, and engaged. Elena felt less alone, more supported, and less driven to criticism. Their partnership transitioned from a cycle of attack–withdraw to a pattern of vulnerability, responsiveness, and shared repair.

## RLT Self-Help Methods

These strategies allow individuals to practice the heart of relational therapy without a therapist.

1. #### Identify Your Pattern: One-Up or One-Down?

Ask yourself:

- Do I often take control, criticize, or override? (**One-up**)
- Do I collapse, people-please, or silence my needs? (**One-down**)
- What would the **healthy adult** do here?

Write down examples from the week.

2. #### Track When Your Adaptive Child Takes Over

Notice moments when your reaction is bigger than the situation.

Ask:

- “How old do I feel right now?”
- “What am I protecting myself from?”
- “What would my wise adult say instead?”

3. #### Practice [Fierce Kindness](https://fiercekindness.com/start/) With Yourself

A signature RLT move:
**Be honest without being cruel, and be compassionate without making excuses.**

4. #### Use a Repair Script

RLT repair uses **ownership + empathy + commitment**.

Try:

1. *“Here’s what I did…”*
2. *“Here’s how I imagine that landed for you…”*
3. *“Now, here’s what I’m committed to doing differently.”*

Do not add “but.”

5. #### Strengthen Your Partnership Muscles

Daily exercises:

- 2 minutes of gratitude toward a partner/friend/family member
- One act of vulnerability per day (express a feeling, ask for comfort)
- Respond positively to bids for connection

6. #### Build Emotional Literacy

Practice naming feelings using more nuance: “hurt,” “overwhelmed,” “dismissed,” “lonely,” “afraid,” “not enough,” etc.
RLT frames emotional specificity as relational clarity.

7. #### Interrupt Distancing or Attacking in Real Time

When you feel escalation:

- Take 10 deep breaths
- Place a hand on your chest
- Say out loud: “Pause — my adaptive child is driving.”
    This disrupts ingrained cycles.

8. #### Establish Weekly Check-Ins

Recommended structure:

- Appreciation
- Something that felt hard
- A need or request
- One commitment for the coming week

Short, predictable, structured conversations build safety.

9. #### Practice Receiving Feedback Without Collapse or Defensiveness

Say:

- “Thank you for telling me.”
- “Let me sit with that.”
- “Here’s the part I can take responsibility for.”

This is deep RLT maturity work.

10. #### Reclaim Joy and Connection

RLT couples therapy emphasizes not just reducing harm but increasing vitality.

Self-help options:

- Micro-moments of delight
- Shared rituals
- Reawakening play, touch, humor
- Designing a “relationship vision” for the future

### Conclusion

Relational Life Therapy offers a powerful, transformative approach for individuals and couples who are ready to confront difficult truths, take responsibility, and actively develop healthier patterns. By blending directness with deep compassion and focusing equally on inner healing and skill development, relational life therapy stands out as a relationship therapy model for sustainable change that emphasizes action-oriented approaches. RLT couples therapy is especially well-suited for couples in crisis or those who feel stuck despite prior attempts at treatment.

If you have any questions about the work of a [life therapist](https://dralanjacobson.com/life-therapists/), Relational Life Therapy, Quality of Life Therapy, or Life Review Therapy, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Frequently Asked Questions: Relational Life Therapy (RLT)

Common questions about RLT couples therapy, what to expect, and whether it’s the right fit for you.

 ### What makes Relational Life Therapy different from traditional couples therapy?

Most couples therapy models prioritize reflection, empathy, and understanding — which are valuable but can feel passive. RLT, developed by [Terry Real](https://terryreal.com/), is more directive: the therapist actively names destructive patterns, challenges both partners when warranted, and coaches new behaviors directly in session. Rather than simply facilitating conversation, RLT teaches couples *how to behave differently* — combining insight with concrete skill-building. This makes it especially effective for couples who have tried other approaches and feel stuck.

 ### Who is RLT couples therapy best suited for?

RLT is a strong fit for couples dealing with chronic conflict, emotional disconnection, power imbalances, or patterns of blame and resentment. It also works well for partners affected by traditional gender-role conditioning that creates inequality or emotional distance. Individuals who struggle to express vulnerability or take accountability — or who feel that previous therapy was too passive — often respond particularly well to RLT’s direct, structured approach. It is also used effectively with parent-child dyads experiencing high conflict, as described in the case examples on this page.

 ### What does “compassionate confrontation” mean in practice?

Compassionate confrontation is a defining feature of RLT. It means the therapist will name what is happening clearly and directly — including harmful behaviors like dismissiveness, withdrawal, or contempt — without shaming either partner. The goal is not to assign blame but to interrupt patterns that are damaging the relationship and open pathways to repair. Many clients initially find this directness jarring, but most quickly recognize it as the honest, caring intervention they needed. It is always paired with warmth, validation, and a clear focus on what change looks like.

 ### How does RLT incorporate family-of-origin work?

A significant portion of RLT involves exploring the childhood wounds and family patterns that each partner brings into the relationship. RLT draws on [attachment theory](https://dralanjacobson.com/attachment-therapy/), [Internal Family Systems (IFS)](https://dralanjacobson.com/internal-family-systems-therapy-ifs/), and [schema therapy](https://dralanjacobson.com/schema-therapy/) concepts to help clients understand how their “adaptive child” — the survival strategies developed in response to early experiences — overrides their “wise adult” in moments of relational stress. Understanding these roots creates both compassion for oneself and accountability for how those patterns affect a partner.

 ### How does RLT relate to other couples therapy approaches like EFT or Gottman?

RLT is complementary to — and often integrated with — other evidence-based models. [Emotionally Focused Therapy (EFT)](https://dralanjacobson.com/eft-therapy-for-couples/) and [Gottman Method](https://www.gottman.com/) approaches share RLT’s emphasis on de-escalating conflict cycles and building secure connection. RLT adds a more confrontational and coaching-oriented layer, making it useful when insight alone hasn’t produced change. Dr. Jacobson draws on all three frameworks, tailoring the blend to each couple’s needs and readiness for direct feedback.

 ### Can RLT be done online, or does it require in-person sessions?

RLT is fully compatible with online therapy. Dr. Jacobson provides RLT-informed [couples therapy](https://dralanjacobson.com/couples-therapy/) via secure video sessions, which allows partners in different locations — or couples who prefer the flexibility of virtual appointments — to participate without interruption. The direct, skills-based format of RLT translates well to video sessions, and many couples find that meeting from home reduces the logistical barriers that often delay starting treatment. Dr. Jacobson is licensed in 44 states through PSYPACT.

 ### What results can couples realistically expect from RLT?

Outcomes vary depending on each couple’s starting point and commitment to doing the work between sessions. However, RLT consistently produces gains in emotional intimacy, mutual accountability, communication quality, and reduction of destructive conflict patterns. Many couples who have felt stuck for years report meaningful movement within a few months of RLT work. As illustrated in the case examples on this page, change often shows up first as a shift in tone — less contempt, more vulnerability — followed by deeper structural changes in how partners relate to each other. Research on [couples therapy outcomes](https://www.apa.org/topics/relationships/marriage) broadly supports the effectiveness of active, skills-based approaches.

 ### How do I know if RLT is the right approach for my relationship?

The best way to find out is through a free consultation. In that conversation, you can describe what you’ve been experiencing, ask questions about the RLT framework, and get a candid sense of whether this approach fits your situation. RLT tends to resonate most with couples who want an active, structured experience rather than open-ended exploration — and who are ready to be challenged as well as supported. If you’ve tried other forms of [marriage counseling](https://dralanjacobson.com/marriage-counseling/) without lasting results, RLT is often worth exploring. You can also review the [guide to choosing a couples therapy approach](https://dralanjacobson.com/which-type-of-family-therapy-is-right-for-you/) for additional context.

 Wondering if RLT is right for your relationship?

Schedule a free 20-minute consultation with Dr. Jacobson. No pressure, no commitment — just an honest conversation about where you are and what might help.

 [ Schedule a Free Consultation ](https://www.picktime.com/scheduleaconsult) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Couples Therapies

---

### [How Do You Find a Psychologist Offering Affordable Therapy?](https://dralanjacobson.com/how-do-you-find-a-psychologist-offering-affordable-therapy/)

**Published:** March 22, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Access to clinical psychology services is essential but can be financially challenging. In my practice, most people pay me out-of-pocket while sometimes getting reimbursed through a flexible spending account or their insurance company. I also discount my fee in some cases for those facing financial constraints and provide a superbill for those seeking reimbursement through their insurance. Finally, I provide deeply discounted rates for some services due to my desire to give back to the field, such as helping people who need an evaluation for military service or accommodations for work or college. Despite all this, sometimes I cannot discount my fee enough to serve everyone who calls; other times, I am not the best fit for the person inquiring. So, how do you find a psychologist offering affordable therapy?

## What are Clinical Psychology Services?

Before answering the question, “How do you find a psychologist?” It’s important to define clinical psychology services, which focus on assessing, diagnosing, and treating mental health conditions. They are provided by [clinical psychologists](https://dralanjacobson.com/what-is-a-clinical-psychologist/) and trained professionals specializing in therapy, [psychological testing](https://psychologicalassessments.com/), and intervention.

### Types of Clinical Psychology Services

#### Psychological Assessment & Diagnosis

- **Comprehensive [Mental Health Evaluations](https://psychologicalassessments.com/mental-health-testing/)** – Used to diagnose anxiety, depression, bipolar disorder, PTSD, etc.
- [**Neuropsychological Testing**](https://psychologicalassessments.com/neuropsychological-testing/) – [Assesses cognitive functions](https://psychologicalassessments.com/iq-testing/) for ADHD, autism, learning disabilities, or brain injuries.
- [**Personality Assessments**](https://psychologicalassessments.com/personality-testing/) – Evaluates personality traits and emotional functioning.

#### Therapy & Counseling

- [**Individual Therapy**](https://dralanjacobson.com/individual-therapy/) – One-on-one therapy for managing emotions, trauma, anxiety, depression, etc. Some examples: 
    - **[Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT)** – Helps with thought patterns and behavior change.
    - **[Dialectical Behavior Therapy](https://dralanjacobson.com/dbt-for-teens/) (DBT)** – Supports emotional regulation.
    - **[Acceptance and Commitment Therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) (ACT)** – Focuses on accepting thoughts and emotions while making positive changes.
- [**Couples Therapy**](https://dralanjacobson.com/couples-therapy/) – Work with partners wanting to improve their relationship including communication, understanding, and closeness. Some examples: 
    - **[Emotionally Focused Couples Therapy](https://dralanjacobson.com/eft-therapy-for-couples/) (EFCT)**: Focuses on emotions and attachment styles to improve connection.
    - [**Narrative Couples Therapy**](https://dralanjacobson.com/narrative-couples-therapy/): Couples have formed an unhelpful or dated narrative of their relationship, and this therapy helps them rewrite it.
    - **[Integrative Behavioral Couples Therapy](https://dralanjacobson.com/integrative-behavioral-couples-therapy/) (IBCT)**: Couples learn to manage differences that can benefit them.
- [**Family Therapy**](https://dralanjacobson.com/family-therapy/) – One-on-one therapy for managing emotions, trauma, anxiety, depression, etc. Some examples: 
    - [**Strategic family therapy**](https://dralanjacobson.com/strategic-family-therapy-powerful-positive-time-limited/): Emphasizes problem-solving and goal-oriented strategies based on family history and how roles have evolved.
    - [**Narrative family therapy**](https://dralanjacobson.com/narrative-family-therapy/): Encourages members to reframe their stories and narratives about their lives together and how they perceive their relationships.
    - [**Solution-focused family therapy**](https://dralanjacobson.com/solution-focused-family-therapy-focusing-on-positive-change/): Identifies and implements solutions rather than dwelling on problems.

#### [Group Therapy](https://dralanjacobson.com/group-therapy/) & Support Groups

- Peer-based therapy sessions for specific mental health concerns (e.g., anxiety, trauma, ADHD, autism).
- Often used in addiction recovery, social skills training, and emotional regulation.

#### Crisis Intervention & Suicide Prevention

- Immediate support for individuals in crisis.
- Often provided through hospitals, mental health clinics, or hotlines.

#### Specialized Clinical Psychology Services

- **Trauma Therapy** – Includes [EMDR](https://www.emdr.com/what-is-emdr/) (Eye Movement Desensitization and Reprocessing) and [somatic therapy](https://www.health.harvard.edu/blog/what-is-somatic-therapy-202307072951).
- **Addiction Treatment** – Therapy for substance use disorders and behavioral addictions.

#### Workplace & Academic Accommodations

- [**Psychoeducational Evaluations**](https://psychologicalassessments.com/psychoeducational-testing-benefits/) – Determines eligibility for [academic accommodations for ADHD](https://psychologicalassessments.com/testing-for-adhd-accommodations-for-school-and-work/), autism, or learning disabilities.
- **Workplace Mental Health Support** – Helps individuals request [work accommodations](https://psychologicalassessments.com/psychological-testing-for-workplace-accommodations/) under disability laws.

#### Behavioral Interventions

- **[Applied Behavior Analysis](https://www.abacenters.com/?utm_source=bing&utm_medium=cpc&utm_campaign=ABACOA+%7C+Milford+%7C+ABA+Therapy+%7C+Autism+Therapy&utm_term=applied%20behavior%20analysis&utm_adgroup=ABA%20Therapy%20-%20Milford,%20MA&msclkid=2167de829beb1af3bae7b962939ceabf) (ABA)** – Used for autism and developmental disabilities (controversial in neurodivergent communities).
- **Parent Training** – Helps parents support children with ADHD, autism, or behavioral challenges.

#### Psychiatric Referrals & Medication Management

- Clinical psychology services do not include medication but can refer patients to psychiatrists.
- Work in collaboration with medical professionals for holistic treatment.

### Where to Access Clinical Psychology Services

- [**Private Practice Psychologists**](https://dralanjacobson.com/finding-a-private-practice-therapist/) Offer therapy and assessments. These professionals are often quite experienced, but their fees tend to be highest, and access to affordable therapy is lower.
- **Hospitals & Mental Health Clinics** – Provide specialized, crisis, and lower-cost therapy services.
- **University Counseling Centers** – Often offer free or low-cost clinical psychology services. While you may see a student in training, they are closely supervised and use some of the newest techniques.
- **Community Mental Health Centers—**These offer sliding-scale or free clinical psychology services for low-income individuals, and there is often a wide range of available clinicians.

## How Do You Find a Psychologist: Process Overview

How do you find a psychologist who is a perfect fit for you? This involves understanding different therapy types and approaches. Here’s a step-by-step guide with specifics:

### How Do You Find a Psychologist with a Specialization

Psychologists can have different specializations. Based on your needs, you might look for one of these:

- **Clinical Psychologist** – Focuses on diagnosing and treating mental health conditions like anxiety, depression, ADHD, or autism.
- **Neuropsychologist** – Specializes in brain function, often useful for ADHD and autism assessments.
- **Counseling Psychologist** – Helps with emotional and life challenges, often less clinical.
- **Educational/School Psychologist** – Specializes in learning differences, accommodations, and academic struggles.

### Understand Therapy Types and Approaches

How do you find a psychologist with clinical psychology services that best fit you? Here is some advice:

**How do you Find a Psychologist for ADHD & Learning Differences:**

- **Cognitive Behavioral Therapy (CBT)** – Helps with managing impulsivity, emotional regulation, and executive function challenges.
- **Dialectical Behavior Therapy (DBT)** – Good for emotional regulation and distress tolerance, often used for autistic individuals who struggle with emotional overwhelm.
- [**Executive Function Coaching**](https://dralanjacobson.com/executive-functioning-coaching/) – Helps with organization, time management, and planning (especially for ADHD).
- **Social Skills Training** – Often helpful for autistic individuals working on communication and interaction strategies.

**How do you Find a Psychologist for Anxiety, Depression, or Emotional Support:**

- **Acceptance and Commitment Therapy (ACT)** – Focuses on accepting emotions rather than fighting them, useful for anxiety and neurodivergence.
- **[Mindfulness-Based Cognitive Therapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) (MBCT)** – Combines mindfulness and CBT to help with stress and mood regulation.
- [**Psychodynamic Therapy**](https://dralanjacobson.com/psychodynamic-therapy/) – Explores past experiences and unconscious patterns affecting current behavior.
- [**Person-Centered Therapy**](https://dralanjacobson.com/client-centered-therapy/) – A more supportive, non-directive approach that helps with self-exploration and self-acceptance.

**How do you Find a Psychologist for Trauma or Emotional Dysregulation:**

- **Eye Movement Desensitization and Reprocessing (EMDR)** – Helps process trauma, sometimes beneficial for those with past medical or educational trauma.
- [**Somatic Therapy**](https://dralanjacobson.com/somatic-therapy/) – Focuses on bodily responses to stress and trauma, helpful for sensory-sensitive individuals.
- **[Internal Family Systems](https://dralanjacobson.com/internal-family-systems-therapy-ifs/) (IFS)** – Helps individuals navigate different “parts” of their mind, useful for trauma and self-awareness.

### How Do You Find a Psychologist by Therapy Approach

Once you know what kind of therapy might work for you, use these resources to find a specialist:

- **Psychology Today** (www.psychologytoday.com) – Filters by therapy type, insurance, and conditions.
- **Therapy Den** ([www.therapyden.com](https://www.therapyden.com)) – Lists neurodivergent-affirming therapists.
- **International OCD Foundation Therapist Directory** ([iocdf.org](https://iocdf.org)) – If OCD is a concern.
- **Open Path Collective** ([www.openpathcollective.org](https://www.openpathcollective.org)) – For lower-cost therapy options.

### How Do You Find a Psychologist: Questions to Ask

When contacting a psychologist, consider asking:

- What therapy modalities do you use?
- Do you have experience working with \[your challenge, barrier, or diagnosis\]?
- How do you accommodate your clients (e.g., flexible scheduling, communication preferences)?
- Do you offer virtual or in-person clinical psychology services?
- Do you provide diagnostic evaluations before we start
- What’s your experience with \[something about your culture, identity, or background\]?

Aside from psychologists, I also explore the various [types of therapists](https://dralanjacobson.com/does-therapy-help-what-form-of-therapy-works-best/).

## How do you Find Affordable Therapy? ![How do you find a psychologist who offers affordable therapy](https://dralanjacobson.com/wp-content/uploads/2025/03/Invest.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Finding affordable therapy can be challenging, but there are several ways to access mental health care without breaking the bank. Here are some options:

### The Most Affordable Therapy Option: Insurance Coverage

- If you have health insurance, check your provider’s website for in-network therapists. This is the best way to find affordable therapy. Then, you can cross-reference what you find with one of the directories listed above or websites like mine to get more information about the clinician’s approach.
- Call therapists directly to ask if they accept your insurance.
- Ask about **“out-of-network” benefits**—some insurers reimburse part of the cost as long as you provide a “superbill,” which provides another avenue to getting affordable therapy. I most commonly do this since I do not take many insurance plans directly, given the number of states I serve.

### Sliding Scale Affordable Therapy

Many therapists offer a **sliding scale**, adjusting fees based on income to provide affordable therapy. You may have to balance the therapist’s experience and expertise with how deeply they are willing to discount their fee. For example, I discount my fee up to 30% (or more for certain specialties – see next section), but there may be psychologists who are earlier in their career or in locations with lower costs of living whose rates are lower. You can also:

- Search **[Open Path Collective](https://www.openpathcollective.org/).**
- Use a platform such as **[Therapy Den](https://www.therapyden.com/)** to filter for low-cost therapists.

### Affordable Therapy For Specific Needs

Many psychologists offer affordable therapy for certain aspects of their practice and areas in which they want to give back to the field. For example, I discount my usual fees by 50% for those who need an evaluation to help them join the military, [emotional support animals](https://dralanjacobson.com/emotional-support-animals-esa/), accommodations at work or school, and some clinical specialties that are hard to find otherwise (such as therapy for adolescents and young adults who have ADHD that was undiagnosed or diagnosed late).

### Affordable Therapy at Community Mental Health Centers

I am happy to help people find a CMHC that meets their needs, and I have many highly talented colleagues who work at these agencies, for example:

- Many cities have **nonprofit mental health centers** offering therapy on a pay-what-you-can basis.
- Look for **[federally qualified health centers](https://data.hrsa.gov/data/reports/datagrid?gridName=FQHCs) (FQHCs)** which provide services based on income.

### Affordable Therapy at University Counseling Clinics

- Universities with **psychology or counseling programs** often have low-cost clinics where graduate students provide therapy under supervision.
- Search for **“university psychology clinic near me.”**

### Local Support Groups & Hotlines

If your concern is situational, or might be served through more informal conversation or connection, there are other options, such as

- **NAMI ([National Alliance on Mental Illness](https://www.nami.org/))** offers free peer support groups.
- Many therapists run **free or low-cost group therapy** sessions.
- Crisis hotlines (988 in the U.S.) provide free support.

## Finding a Good Psychologist – Does Experience Matter?

For several reasons, finding a good psychologist means paying for their experience. This can be a worthwhile investment in your mental health. Here’s why experience matters:

1. **Specialized Expertise & Accurate Diagnosis**

- Experienced psychologists have worked with many clients and can quickly identify **patterns, symptoms, and underlying issues**.
- For complex conditions like **ADHD, autism, trauma, or mood disorders**, an experienced psychologist is **less likely to misdiagnose** and more likely to tailor a **personalized treatment plan**.

2. **More Effective Treatment Approaches**

- A seasoned psychologist has **years of practice refining therapy techniques** and adjusting them based on individual needs. We all have certain continuing education requirements.
- They are skilled at **adapting therapy methods** (CBT, DBT, ACT, EMDR, etc.) to fit **neurodivergent individuals or those with multiple diagnoses**.

3. **Better Problem-Solving & Crisis Management**

- When therapy gets tough, an experienced psychologist knows how to **guide you through resistance, emotional breakdowns, or trauma responses**.
- We have handled **a wide range of cases so that** we can provide **practical, real-world strategies** rather than generic textbook advice.

4. **Stronger Therapeutic Relationship & Communication**

- A seasoned psychologist **understands neurodivergent communication styles** and sensory needs, making sessions more comfortable.
- They know how to build **trust and rapport** faster, leading to **deeper, more meaningful therapy**.

5. **Saves Time & Money in the Long Run**

- A highly skilled psychologist may **help you progress faster**, reducing the overall number of sessions needed.
- A less experienced therapist may **struggle with complex cases**, requiring more sessions (or even switching therapists) before real progress is made.

6. **Ethical & Evidence-Based Practice**

- Experienced psychologists are **up to date on research, ethical standards, and best practices**.
- They are **less likely to use outdated or harmful approaches**, ensuring a **safe, supportive therapy experience**.

### Finding a Good Psychologist with Less Experience

- If budget is a concern, newer therapists (e.g., graduate students in training) can still provide **quality therapy under the supervision of a highly experienced person**.
- When clinicians are just starting, they learn about the latest and most innovative techniques and methods, which can be an advantage.
- If your needs are **mild (stress, life transitions, general support)**, you may not need to pay the highest fees. Remember that even when they are just starting out, a psychologist has already had three years of school, two years of part-time training, two years of full-time closely supervised training, and passed an intensive and challenging exam. Finding a good psychologist early in their career is quite possible.

## I’ll Help with Finding a Good Psychologist

Your mental health and well-being are essential to all aspects of your life, and financial limitations shouldn’t hinder receiving the clinical psychology services you deserve. Whether you need therapy for a specific diagnosis such as ADHD, more general anxiety or malaise, or life transitions, there are many clinicians committed to providing accessible, professional, and effective support. In my practice, I discount my fee when needed, quite deeply for certain services to give back to my field, and help people get reimbursed through their insurance when possible. I also help people find lower-cost options when my practice is not a fit, or my discount is not deep enough. In another post, I use [therapy in NYC](https://dralanjacobson.com/how-to-find-therapy-in-new-york-or-anywhere-a-guide-to-getting-started/) as an example of how to search for a therapist that is a perfect fit, and I also have information about using [therapist finders](https://dralanjacobson.com/the-best-way-to-find-a-therapist-using-therapist-finders-word-of-mouth-and-other-therapy-resources/).

If you have questions about sliding-scale fees, using a superbill for insurance reimbursement, or finding a good psychologist or therapist (see my other post for information about terms, such as [therapist vs. psychotherapist](https://dralanjacobson.com/therapist-vs-psychologist-therapist-vs-psychotherapist/) or [therapist vs. clinical psychologist](https://dralanjacobson.com/what-is-a-clinical-psychologist/)) who matches your needs, I’m happy to help. Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.facebook.com/appliedpsychologicalscience) [ ![social network 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](https://www.linkedin.com/company/psychologicalscience/)

**Categories:** Types of Therapy

---

### [Academic Coaching](https://dralanjacobson.com/academic-coaching/)

**Published:** May 29, 2023
**Author:** Dr. Alan Jacobson

**Content:**

I offer **Academic Coaching** as a compliment to [Sports Psychology](https://dralanjacobson.com/sports-psychology/), [College Admissions](https://dralanjacobson.com/college-admissions-counseling/), [Individual Therapy](https://dralanjacobson.com/), and other services. Not every client who receives these core services will want or need **Academic Success Coaching**, but for some, the combination is a great fit. In fact, there is an emerging field called [Therapeutic Tutoring](https://therapeutictutoring.com/) where academic coaching is interwoven with traditional therapy.

Academic Coaching services aim to ensure that you meet academic goals while achieving and being content in other areas. This service is most commonly used to serve high school students, but it might also be used for college and graduate students who want to be sure their academic achievement matches their potential. [You can visit here](https://pubmed.ncbi.nlm.nih.gov/24646930/) is a nice article from the National Institute of Health about how important academic performance is in a student’s well-being and ability to manage stress.

## How Academic Coaching Works

Academic Coaching is designed to look at school as a series of performance tasks. The most common performance aspects of school are tests. I often help students [overcome test anxiety](https://dralanjacobson.com/test-taking-anxiety/), develop confidence in their test-taking ability, and learn strategies to tap into “flow” to successfully and effectively get through each test.

Beyond test taking, however, Academic Success Coaching works to help a student also perform at their best when taking in information, doing homework, and presenting or participating in class. Many of the tenets of Performance Psychology usually associated with sports can help students in the classroom and with homework. For example:

- Homework: Homework for school is similar to the visualization and off-field learning an athlete does before an athletic contest. The more the athlete prepares by ensuring they are fully prepared, the better; this is the same function homework provides.
- Classroom Participation: If tests are like game-day performance, then class participation is similar to practice and scrimmage performance. Class participation also leads to confidence in one’s abilities, just as practice in front of a coach does for an athlete.
- [Attention and Concentration](https://dralanjacobson.com/adhd-coaching-for-adults-help-for-focus-and-concentration/): Sports psychologists work with athletes to expand the amount of information they are taking in during their performance. Many athletes who have felt like they achieved “flow” will say that everything slowed down, allowing them to be hyper-aware. This is the same goal we have for learning, whether through classroom work or at-home study.

In summary, Academic Coaching can also ensure that confidence and the feeling of flow can positively affect schoolwork.

## Academic Coaching Process

The actual methods I use in Academic Coaching will depend on the unique needs and skills of the student – Academic Success Coaching is always uniquely tailored, given that every student comes in with certain strengths and weaknesses. A treatment plan will be designed that describes the following:

1. The challenges the student faces in school
2. The pre-treatment effects of those challenges on achievement and, if relevant, post-secondary goals
3. Specific, measurable goals for improvement in each indicated area
4. Methods to be employed
5. Timelines that point to specific outcomes

After designing the treatment plan, I choose techniques to help clients reach their goals. [My approach](https://dralanjacobson.com/types-of-therapy/) is what is called integrative, meaning that I choose from a wide variety of techniques so that the client’s unique needs are met. Everything is wrapped up in a positive, solution-focused, and client-centered mindset. The specific techniques might borrow from different theories.

We will then review that treatment plan at certain intervals during treatment to ensure goals are met. As the student reaches goals, new ones might be set. Treatment ends when the student feels comfortable that they’ve made the gains they are looking for. The student now has a toolkit to use should challenges arise.

## Academic Success Coaching Example

Jeremy is a high school student who is experiencing anxiety when facing pressure. He is an outstanding lacrosse goalie and is being actively recruited by colleges. Still, his anxiety before and during each game interferes with his love of the sport and excitement about playing in college. Thus, Jeremy has started [Sports Psychology](https://dralanjacobson.com/sports-psychology/) services with me.

Jeremy also finds that this anxiety also appears when doing other high-level tasks. He is particularly concerned with how it affects his ability to perform at his best on the SATs.

Regarding the SATs, Jeremy did okay the two times he took them before. However, he felt that anxiety kept him from doing his best, especially when he got to a series of challenging questions. He needs to raise his scores just a bit to increase his admission chances. He has been taking small group lessons at a private SAT tutoring center.

### Academic Success Coaching Treatment Plan

The treatment plan for Jeremy looked something like this:

1. Overview: Overcome anxiety and develop positive and effective test-taking habits
2. Concern: Test-taking anxiety may be interfering with positive achievement on SATs and other school tests
3. Goal: Take the SATs (and other tests) with minimal anxiety so that scores match achievement, knowledge, and skill
4. Cognitive Psychology and Performance Psychology within a positive framework to reduce test-taking anxiety
5. Significant improvement before the next test, scheduled for approximately 60 days from now

We would add to the treatment plan as goals are met, or new challenges arise. After the treatment plan was devised, I would explain to Jeremy the types of approaches we could use to meet the goals, so he is fully informed and can give feedback. I would tell him that homework will likely be between sessions, and I ask how he would like his parents involved.

### Academic Coaching Treatment

My academic coaching process mixes actual help with certain school tasks with psychological processes. In this case, we used cognitive-behavioral techniques to lower stress and anxiety by noticing and targeting irrational and exaggerated negative thoughts. His homework after each session was to do SAT prep, including taking practice tests, and make sure to integrate the techniques we had gone over. We also reviewed some brief relaxation and positive self-talk techniques that he would begin using.

We also wanted to ensure that the stress he felt under pressure did not affect interview situations. Thus, we used some of the same techniques while having him practice for interview situations in session. He used visualization outside each session to imagine himself confident and compelling in [college interview situations](https://dralanjacobson.com/college-admission-help/).

## Academic Coaching Conclusions and My Work

Academic Success Coaching is a perfect stand-alone or add-on service that therapists offer. Sometimes, it is a time-limited course of treatment, while at others, it underlies the entire scope of work. Academic Coaching can be done with high school, college, and graduate students, and even can help those going back for adult learning. This approach can be combined with other clinical services or can stand alone. It can be delivered to small groups who share the same challenges.

### My Work

I have found this work helpful and successful, so I have integrated it into my practice. I usually offer an add-on service for those who are also receiving [My clinical specialties](https://dralanjacobson.com/intensive-therapy-and-specialty-services/) because there is some synergy and a fit with what we’d be working on there. However, I do sometimes offer **Academic Success Coaching** as a stand-alone, and I also offer related services such as [ADHD coaching for college students](https://dralanjacobson.com/adhd-coaching-for-college-students-effective-enduring/). If you or your child (high school and older) would potentially benefit from the type of service listed above, or you have questions or would like more information about **Academic Coaching** or [Therapeutic Tutoring](https://therapeutictutoring.com/), please feel free to [contact me](https://dralanjacobson.com/contact/).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.instagram.com/appliedpsychological) [ ![social network 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](https://www.linkedin.com/company/psychologicalscience/)

**Categories:** Therapy Specialties

---

### [College Admissions Self-Help](https://dralanjacobson.com/college-admissions-self-help/)

**Published:** June 27, 2023
**Author:** Dr. Alan Jacobson

**Content:**

**College admissions self-help** is designed to help you jump-start the process and ensure you know what you need to know to put your best foot forward. The process can be challenging and overwhelming, but you can increase your chances of success with the right approach and preparation. [I can help](https://dralanjacobson.com/college-admissions-counseling/) tailor your program to you and offer [more specific advice and guidance](https://dralanjacobson.com/college-admission-help/) based on their experience and connections. They can also keep you on track and on time along the way. As you embark on your journey, it will become clear whether you need the types of [My clinical specialties](https://dralanjacobson.com/intensive-therapy-and-specialty-services/) I offer.

## College Admissions Self-Help: Research

The first step in the college admissions process is fully understanding what college admissions officers are typically looking for. They consider a combination of factors when evaluating applications to determine which students they should admit. While the specific criteria and their weight may vary from one college to another, here are some of the critical factors that admissions officers consider:

### Academic Performance and Test Scores

Admissions officers often place a strong emphasis on an applicant’s high school academic record, including their GPA, class rank, and the rigor of their course load. They want to see that a student has performed well in challenging courses and has a strong foundation in core subjects. Many colleges still consider standardized test scores like the SAT or ACT, although many schools have moved toward test-optional or test-flexible policies in recent years. Good test scores can help demonstrate a student’s academic aptitude. So, one crucial part of a college admissions self-help plan is to focus on grades and studying for the SATS or ACT.

### Extracurricular Activities, Special Talents or Achievements

Admissions officers seek involvement in extracurricular activities, such as clubs, sports, community service, and leadership roles. They want to see well-rounded individuals who contribute to their communities and have a passion outside the classroom. Exceptional talents, such as in the arts, athletics, or other areas, can be a significant factor in the admissions process. Demonstrating unique skills and achievements can set an applicant apart. THus as part of any college admissions self-help plan, beef up your resume in these areas.

### Essays, Personal Statements, and Demonstrated Interest

Personal essays and statements allow applicants to showcase their personality, experiences, and writing skills. Admissions officers use these to understand an applicant’s motivations, values, and how they would contribute to the college community. Some colleges consider an applicant’s demonstrated interest in the institution, such as campus visits, interviews, and engagement with the college’s resources and events. This can signal genuine interest in attending the school.

### Letters of Recommendation

Strong letters of recommendation from teachers, counselors, or other individuals who know the applicant well can provide insight into a student’s character, work ethic, and potential for success in college. Make sure you connect with the people you think would be willing to write in-depth about you, your potential, and your character.

### Fit with the College and Interviews

Admissions officers want to admit students who are a good fit for their institution. This includes considering the alignment between the applicant’s academic and career goals and what the college can offer. Research each school in depth so you have an idea about these factors. Some [colleges conduct interviews as part of the admissions](https://dralanjacobson.com/college-admissions-counseling/) process. These interviews allow admissions officers to get to know the applicant better and assess their communication skills and interpersonal qualities. They use these factors to assess fit.

It’s important to note that each college has its unique selection criteria, and the relative importance of these factors can vary widely. Additionally, the admissions process may be influenced by other external factors like application volume, institutional goals, and policies. These are areas where my services can help.

## College Admissions Self-Help: Tips

Here are some self-help tips to navigate the college admissions process:

### Early Stages in the Process:

1. Start early: Begin your college admissions journey before the summer of your senior year. By then, you should have researched colleges, understood their admission requirements, and familiarized yourself with the application deadlines. The process should be mapped out – you’d be surprised by how fast everything moves and how easy it is to miss deadlines (when you need to schedule an interview, for example).
2. Visit some schools: You can’t go to all of them, but you can go to all of the ones on your list if top choices emerge, go to them, and otherwise, make sure you go to several different types (small, large, city, suburban, state, private, etc.)
3. Set realistic goals: Assess your academic strengths, interests, and career aspirations. Look up the admissions history of the schools you are interested in and be realistic about whether you can get in. Begin compiling a list that includes reaches, realistic (schools you have about a 50-50 chance), and safeties.
4. Research financial aid and scholarships: Understand the financial aspects of college education and explore scholarship opportunities. Investigate grants, loans, work-study programs, and merit-based scholarships from colleges and external organizations.

### College Admissions Self-Help: Outside the Application:

1. [Build a solid academic profile](https://dralanjacobson.com/academic-coaching/): Focus on achieving excellent grades throughout high school. Take challenging courses, especially in subjects that interest you or relate to your intended major. Seek opportunities to enhance your academic profile, such as advanced placement (AP) or [International Baccalaureate](https://en.wikipedia.org/wiki/International_Baccalaureate) (IB) courses.
2. Prepare for standardized tests: Standardized tests like the SAT or ACT may not be as commonly required for college admissions anymore, but they can help if you do well. Familiarize yourself with the test format, practice sample questions, and consider taking preparatory courses or utilizing online resources to improve your scores.
3. Get involved in extracurricular activities: Colleges value well-rounded students. Engage in extracurricular activities that genuinely interest you and showcase your talents, skills, and leadership abilities. Join clubs, participate in community service, play sports, or pursue hobbies. Aim high – colleges know that anyone can join a club, but the people who emerge as leaders of the club, start a new one, or do something particularly outstanding that gets noticed.
4. Seek out meaningful experiences: Explore internships, volunteer opportunities, [summer programs](https://summer.harvard.edu/blog/summer-activities-that-will-boost-a-college-application/), or research projects in areas of your interest. These experiences can demonstrate your commitment, passion, and initiative to college admissions officers.
5. Cultivate strong relationships with teachers and mentors: Request letters of recommendation from teachers who know you well and can speak to your abilities and character. Maintain a positive rapport with them throughout high school, even after you are not in their class.

### College Admissions Self-Help: The Application:

1. Craft a compelling personal statement: Spend time brainstorming and drafting your college essay. Reflect on personal experiences, challenges, or moments that have shaped your identity and aspirations. Share your unique perspective and voice while highlighting your strengths and growth. Do not fall into [known traps](https://collegespecific.com/pages/5-college-essay-flaws).
2. [Stay organized and meet deadlines](https://dralanjacobson.com/executive-functioning-coaching/): Create a calendar to keep track of application deadlines, standardized test dates, and required documents. Start working on applications well in advance to avoid last-minute stress.
3. Seek guidance and support: Reach out to your school’s college counseling office or seek advice from trusted mentors, teachers, or family members who have experience with the college admissions process. They can provide valuable insights and support.

## College Admissions Self-Help Summary

Remember, college admissions are not solely about getting into a prestigious institution. It’s about finding the right fit for your goals, interests, and personal growth. Stay focused, be authentic, and put your best foot forward. Present yourself authentically and compellingly, one that you feel the admissions committee will take a liking to as far as your fit with their school.

Look forward to the point where things flip, and the colleges you get into will fight over who gets to have you as a member of their community the following year.

### How I can help

I have a [unique approach to the college admissions process](https://dralanjacobson.com/college-admissions-counseling/) that combines traditional college admission counseling with psychological methods. In other words, [I can help](https://dralanjacobson.com/college-admissions-counseling/) with many aspects of the process while helping you reduce stress and anxiety at the same time. I can also make sure that you present yourself most compellingly and convincingly by factoring in the psychology involved on the other side during the process. And we can [work on areas](https://dralanjacobson.com/) such as reducing procrastination, increasing confidence, and uncovering strengths. I have two examples of [college admissions consulting](https://dralanjacobson.com/college-admissions-consulting/) in this blog.

I have provided [College admission services](https://dralanjacobson.com/college-admissions-consulting/) of these services in my blog. Feel free to [contact me](https://dralanjacobson.com/contact/) to discuss all of this further.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.instagram.com/appliedpsychological) [ ![social network 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](https://www.linkedin.com/company/psychologicalscience/)

**Categories:** College Admissions Services

---

### [Virtual Couples Therapy](https://dralanjacobson.com/virtual-couples-therapy/)

**Published:** March 22, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Virtual couples therapy**, also known as **online couples therapy,** **online couples counseling**, and **virtual marriage counseling**, involves providing therapy and support to couples through secure online platforms. I provide this therapy in 41 states, allowing me to serve couples from all over the country and couples who may not be in the same place at the same time each week.

Virtual couples therapy can be helpful when two people want to improve their relationship, see signs of difficulty in a previously solid bond, or when something specific has happened that creates a crisis. It can be helpful in all stages of a relationship, whether the two people are considering a new level of commitment, are facing a [life transition](https://dralanjacobson.com/life-transitions-therapy/) that affects them, or have been together a long time and are managing a new stress.

I differentiate online *couples* counseling from virtual *marriage* counseling because the former can involve any two people in an important relationship, while the latter specifically refers to people who have already committed to each other for the long term. There is no huge difference in practice, so I use the terms mostly interchangeably. The following covers virtual marriage counseling methods, benefits, and drawbacks to help you become an informed consumer. Of course, you can also [get in touch](https://dralanjacobson.com/contact/) with me anytime to discuss this type of therapy and how it might work for you.

## Benefits of Virtual Couples Therapy

In general, I have found virtual marriage counseling [just as effective as in person](https://dralanjacobson.com/virtual-therapy-guide/). I have even found there to be a variety of important advantages of online couples therapy, including:

### Accessibility of Online Couples Counseling

Virtual couples therapy can be more accessible for couples with difficulty attending in-person sessions due to scheduling conflicts, transportation issues, or other scheduling limitations. It allows the two members to connect with a therapist from the comfort of their homes or other places, even when apart. Busy work schedules, childcare issues, and frequent travel do not disrupt virtual couples therapy as much as they do in person. In addition, virtual marriage therapy is ideal for those situations where one member travels a lot or work schedules sometimes do not coincide, allowing the treatment to continue without interruption.

### Virtual Couples Therapy and Choices

Virtual couples therapy eliminates the need for travel time. It can be more convenient for those living in remote areas with limited access to therapy. It is also helpful for those who have trouble finding a good match in therapists regarding [clinical approach and personality](https://dralanjacobson.com/how-to-choose-the-right-therapist/). Virtual marriage counseling opens up many more options for you as the consumer. You need to ensure that the practitioner is licensed in your state and any other state you might be in when the services are delivered.

### Privacy and Comfort

Some members of a relationship may feel more comfortable discussing sensitive topics in the privacy of their own homes rather than in a therapist’s office. Virtual couples therapy can provide a more comfortable environment for open and honest communication. It can also help overcome issues such as poor weather, making it difficult to go to an office. For those who have split or are otherwise currently uncomfortable being in the same office, virtual [marriage counseling](https://dralanjacobson.com/marriage-counseling/) can allow them to be in different places comfortably.

### Security and Confidentiality

I use a secure platform for virtual couples therapy sessions to ensure confidentiality and privacy. Even though I work at home, I ensure that I am in a private area where no one can see my screen or hear what is being said. Online couples therapy also allows you to avoid going to an office and waiting in a waiting room where you could potentially run into people you know.

## Online Couples Therapy Drawbacks

The following are the challenges that can come with online couples counseling.

### Virtual Couples Therapy Technology Requirements

You and your partner will need a reliable internet connection and access to a device with a camera and microphone, such as a computer, smartphone, or tablet. Of course, that means the connection could be interrupted, or there could be other technical problems. With virtual marriage therapy, the chances of problems may be multiplied by two if the two of you are seen in different places. As an aside, like many therapists, I prefer to see both members of the partnership together unless we have planned separate meetings for a clinical reason. Thus, if one person’s technology cuts out, we may be unable to meet.

### Engagement and Interaction

While I have been trained in techniques to ensure that partners effectively engage in a virtual setting, some people are just not as comfortable in this type of treatment; in that case, I can refer you to someone who provides more [traditional couples therapy](https://dralanjacobson.com/couples-therapy/). You need to decide if you are both comfortable with this type of service delivery. That is why I and many of my colleagues offer a [free consultation](https://www.picktime.com/scheduleaconsult) that allows you to see what the experience might be like.

### Establishing Boundaries During Online Couples Therapy

Partners need to establish boundaries to create a therapeutic space during virtual sessions. This involves finding a quiet, private area for sessions and minimizing distractions to focus on the therapy process. This can be more challenging at home if there are kids, pets, deliveries, etc.

## Virtual Couples Therapy Techniques

Virtual couples therapy, like in-person therapy, involves various techniques to improve communication, resolve conflicts, and [strengthen the relationship](https://dralanjacobson.com/relationship-therapy/). I generally use a [strengths-based approach](https://dralanjacobson.com/humanistic-psychology/) to identify and build upon the relationship’s strengths. I encourage partners to reminisce about positive experiences and highlight areas where they work well together. I use specific techniques such as [Integrative Behavioral Couples Therapy](https://dralanjacobson.com/integrative-behavioral-couples-therapy/) and [EFT Couples Therapy](https://dralanjacobson.com/eft-therapy-for-couples/).

Here are some specific effective therapeutic techniques I use that are tailored for virtual couples therapy:

### Establishing a Safe Virtual Environment

I begin the first session by setting ground rules for communication and ensuring confidentiality. I emphasize the importance of creating a safe space where both partners feel comfortable expressing themselves. This is particularly important if each person joins from a different place. We’ll go over how we might utilize [various technological tools](https://dralanjacobson.com/therapy-online-approaches-techniques-and-outcomes/) to enhance online couples counseling therapy sessions, such as virtual whiteboards, screen sharing for visual aids, and secure messaging platforms for communication outside of sessions.

### Active Listening in Virtual Couples Therapy

I encourage [active listening skills](https://www.verywellmind.com/what-is-active-listening-3024343) by having one partner speak while the other listens without interruption. Then, we can use techniques like paraphrasing and summarizing to ensure the other person fully understands before responding. This is essential in virtual couples counseling, where the lack of being in person can limit how much nonverbal skills are noticed. Developing an understanding of the other person’s thoughts and perspective is

### Reflective Communication in Virtual Marriage Counseling

During online couples counseling, I teach couples to reflect on their own feelings and thoughts before expressing them to their partner. This helps avoid blame and criticism and promotes understanding. Delay in conversations becomes an effective strategy.

We’ll also work on effective conflict resolution techniques, such as using [“I” statements](https://www.therapistaid.com/therapy-worksheet/i-statements), staying focused on the present issue, and seeking compromise rather than trying to “win” arguments. I also engage couples in role-playing exercises to help them better understand each other’s perspectives and practice new communication techniques in a controlled setting. For example, we might replay a recent disagreement with each person taking the other’s role.

### Emotion Regulation and Techniques

Online couples counseling can lead to strong emotions. We might discuss [mindfulness and relaxation techniques](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7003166/), such as deep breathing and taking breaks, which can be helpful in de-escalating conflicts. These techniques become useful outside of sessions and are part of how the partnership manages day-to-day stress and conflict.

### Cognitive Restructuring in Virtual Couples Therapy

In online couples counseling, you’ll learn to identify and [challenge negative thought patterns](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) contributing to relationship problems. You’ll also reframe your perspective and focus on more constructive interpretations of situations. These virtual marriage counseling techniques work well within virtual marriage counseling sessions, helping partners navigate challenges, improve communication skills, and cultivate a healthier relationship dynamic. We may look to understand how your unique histories affect the relationship and how you can learn to navigate all of that.

## Online Couples Counseling Case Example

Here is a fictitious case example of virtual couples therapy, showcasing the process, interventions, and outcomes.

### “Rebuilding Trust After Infidelity”

**Couple:** Sarah (29) and John (31)
**Length of Relationship:** 5 years, married for 2
**Presenting Issue:** Sarah discovered that John had an emotional affair with a coworker. They’re seeking therapy to rebuild trust and improve communication.
**Format:** Weekly, 45-minute online couples counseling sessions via a secure video platform

#### Initial Assessment

In the first online couples therapy session, I met with both partners and briefly individually to better understand their perspectives. Key issues identified:

- **Sarah’s feelings:** Hurt, betrayal, and anxiety about their future.
- **John’s feelings:** Guilt, remorse, and frustration about his inability to communicate his needs earlier.
- **Relationship dynamic:** Communication issues, with a pattern of avoidance and defensiveness.

#### Online Couples Therapy Treatment Goals

1. Establish a safe and non-judgmental space for both partners.
2. Rebuild trust and address the impact of the emotional affair.
3. Improve communication skills and emotional intimacy.

#### Online Couples Counseling Intervention Plan

1. **[Emotionally Focused Therapy](https://dralanjacobson.com/eft-therapy-for-couples/) (EFT):** To address the underlying attachment issues and fears, focusing on creating a secure emotional bond.
2. **[Gottman Method Techniques](https://www.psychologytoday.com/us/therapy-types/the-gottman-method?msockid=1686e8c22e816b8a1935fc532fc26a1c):** Including “[Love Maps](https://www.gottman.com/blog/build-love-maps/)” exercises to rebuild emotional connection and structured conflict discussions to manage arguments effectively.
3. **[Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT):** To address individual thought patterns contributing to trust issues and anxiety, particularly for Sarah.

#### Virtual Marriage Counseling Session Highlights

**Session 1-2:** Establishing Safety and Ground Rules

- I emphasized confidentiality and the importance of honesty, even in difficult discussions.
- The initial focus was on creating safety in the virtual space, acknowledging the potential challenges of remote communication.
- The couple was asked to avoid discussing the affair outside of sessions initially to prevent unproductive conflict.

**Session 3-5:** Addressing the Affair and Its Impact

- Using EFT techniques, I guided John in expressing his genuine remorse and understanding of Sarah’s pain.
- Sarah shared her emotional turmoil, facilitated by the therapist’s reflective listening and validation.
- I introduced a “[Trust Bank](https://www.gallup.com/cliftonstrengths/en/390386/building-trust-bank-lessons-individual-team-success.aspx)” exercise: Small, consistent actions to rebuild trust, like sharing daily check-ins and setting clear expectations.

**Session 6-8:** Improving Communication

- I introduced the “Four Horsemen” (criticism, contempt, defensiveness, stonewalling) from the Gottman Method, and the couple identified which behaviors were present in their conflicts.
- Role-play exercises helped them practice softened startups (gentle ways to bring up issues) and active listening.
- Sarah wanted transparency about John’s interactions with the coworker. I facilitated a conversation about setting new boundaries that felt fair and reasonable for both.

**Session 9-12:** Reconnecting Emotionally

- “Love Maps” exercises helped the couple rediscover what they valued and admired about each other.
- I used guided visualization to help the couple imagine a positive future together, focusing on shared goals and dreams.
- By the end of the 12th session, John and Sarah reported improved emotional closeness and fewer arguments.

### Virtual Marriage Counseling Outcome

- The couple demonstrated a significant improvement in communication, with fewer defensive and critical exchanges.
- Sarah’s anxiety about the affair decreased as John consistently followed through on agreed-upon actions to rebuild trust.
- Both partners expressed increased satisfaction in the relationship and decided to continue with bi-weekly sessions for ongoing support.

#### Reflections

This case highlights how virtual couples therapy can still create a meaningful healing space despite potential barriers like technological issues. The structured approach of integrating EFT, the Gottman Method, and CBT helped address the couple’s challenges’ emotional and cognitive aspects.

## Final Thoughts

Almost all insurance providers may cover virtual couples counseling sessions—some even encourage them with lower copays. However, you must check with your insurance company to understand coverage options and any limitations related to online couples counseling [teletherapy services](https://dralanjacobson.com/telehealth-therapy-teletherapy/).

### Effectiveness of Virtual Couples Therapy

Research suggests that online couples therapy can be [as effective as in-person therapy](https://dralanjacobson.com/is-virtual-therapy-as-effective-as-in-person/) for addressing relationship issues and improving communication and satisfaction. Of course, the effectiveness of virtual couples counseling may vary depending on your needs and comfort with this treatment.

Overall, online couples therapy can be convenient and effective for couples seeking support and guidance to improve their relationships. By leveraging technology, couples can access therapy services from anywhere while receiving the same quality of treatment. I have found this type of treatment as effective as in-person [couples therapy](https://dralanjacobson.com/couples-therapy/) and, for some, even more effective. It works well with all of my couples therapy methods, including EFT and [Imago Relationship Therapy](https://dralanjacobson.com/imago-relationship-therapy/).

### Online Couples Therapy in My Practice

I have been trained to adapt clinical techniques and interventions to suit the unique needs and circumstances of each couple I serve. Flexibility is crucial in online therapy, where technical issues or external distractions may arise. I’ll regularly solicit your feedback about your treatment experience and progress towards your goals. We might use outcome measures or assessments to track changes in relationship satisfaction over time. I also do virtual [premarital counseling](https://dralanjacobson.com/premarital-counseling/) and [discernment therapy](https://dralanjacobson.com/discernment-counseling-pre-engagement-counseling/) for couples who are unsure whether to commit.

You may be asked to do homework tasks between sessions to practice newly learned skills and reinforce therapy goals. This could include communication exercises, collaborative problem-solving tasks, or activities to increase intimacy.

Please also see my page about [online therapy](https://dralanjacobson.com/virtual-therapy-guide/) in general or my post about finding online counseling services. If you have any questions about online couples therapy or would like to possibly see me for virtual couples therapy, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Types of Therapy, Virtual

---

### [The Athletic Flow State](https://dralanjacobson.com/flow-state/)

**Published:** May 28, 2023
**Author:** Dr. Alan Jacobson

**Content:**

The **athletic flow state** is powerful yet elusive. Most athletes have felt it at some point – that feeling of being “on,” where things come quickly, and it all falls into place. Basketball players find that they are hitting shots with little effort, baseball players see the ball more clearly than ever, figure skaters hit every jump flawlessly, soccer players control the ball effortlessly, etc. It’s called “achieving flow state.” This state of mind has been [thoroughly researched](https://www.cwilsonmeloncelli.com/neuroscience-flow-state-effects-sports-athletes/) and is real, yet sometimes very elusive!

This feeling of flow state usually does not last – athletic flow might last for a few series, a game, or even a short series of games.

The trick to sustaining flow is not overthinking during and then thinking a lot afterward. In other words, when everything is “on,” let it be, enjoy it, and don’t overthink. Overthinking can be distracting and open the door to doubts. The more the athlete thinks about the uncommon results, the more likely they are to plant seeds of doubt.

## Tracking Athletic Flow State of Mind

The athletic flow state of mind will subside at some point; at that time, it is worth thinking about what happened. I suggest keeping a “flow state diary.” The athlete should ask her or himself what the circumstances were when it appeared, with items in four categories:

1. The recent past events leading to peak performance and flow state:
    – How busy have you been from a physical exertion standpoint (has it been an easy few days, or have your days been filled with practices and games)?
    – How have you slept lately
    – What has your diet been lately (generally – have you been eating healthy, and has any particular food group been prominent)?
    – How much stress have you been experiencing outside of athletics?
2. Specific to the past 24 hours:
    – How did you sleep last night, including how well and how long?
    – What did you eat in the 2-3 meals that preceded the experience of peak athletic performance and flow?
    – What was your mood like over the past 24 hours?
3. Immediately preceding:
    – How has your game gone so far?
    – What was your warmup like – anything different than usual?
    – How was your mood immediately preceding the event?
    – What was on your mind – were there any outside distractions, and how did you “psych up” for the event?
4. During an athletic flow state
    – What were you thinking?
    – How did your body feel?
    – When did it subside?

## Athletic Flow State of Mind and Coaching

Some athletes report that peak performance occurs independently of coaching. It’s certainly not that these athletes do not appreciate their coach. In fact, in most cases, they credit their coach significantly for helping them achieve their ability at their sport. However, they feel that the occurrence of flow and the resulting peak performance are so unpredictable and, in many cases, rare that they seem independent of any outside factor.

So, is it true that flow and the [peak athletic performance](https://dralanjacobson.com/sports-performance-improvement-innovations/) it drives are truly independent of coaching? That depends on how you look at it. The athlete is likely correct that flow comes on spontaneously, and the factors that led to it can be fleeting despite the athlete’s best attempt to track them. But that does not mean the coach truly did not contribute.

### Advice to Coaches about Flow

If you are a coach or you are an athlete who would like to give your coach some feedback or advice, here are some ways you can influence peak performance flow:

– Help the athlete resist overthinking things during flow. Athletes who get too caught up in thinking “about why this is happening” often distract themselves enough that it stops. This is magnified when the athlete begins to doubt it can continue. A good coach will help the athlete stay focused on the game, match, or event, allowing peak performance without thinking about why or how.
– Help the athlete try to understand why it happened afterward. Any good coach should develop a deep and detailed understanding of what makes the athlete tick. The coach might ask the above questions and more.
– Gather information across all your athletes – what common factors led to flow?
– Most of all, perhaps, make sure the athlete does not rely on these episodes – they may be fleeting or at least hard to predict, but top performance does not have to rely on these instances.

## Self-Help Tips for Reaching Flow

Here are some [strategies to help you reach an athletic flow state](https://dralanjacobson.com/athletic-performance-improvement/):

### Set Clear Goals and Confidence

Clearly define your goals for the activity or sport you’re participating in. A clear sense of purpose and direction can help you stay focused and motivated. Ensure you have the skills and training to perform well in your chosen sport. Confidence in your abilities is a key component of achieving flow. Maintain a positive attitude and self-belief. Negative thoughts and self-doubt can disrupt your flow state. Use affirmations and visualization to boost your confidence.

### Concentration, Focus, and Stress Management

Concentrate on the task at hand. Avoid distractions and stay in the present moment. Pay attention to your surroundings, your body, and your actions. High levels of anxiety and stress can hinder your ability to achieve peak athletic performance. Practice relaxation techniques such as deep breathing, visualization, or meditation to stay calm and centered.

### Develop a Routine and Embrace the Process

Create a [pre-performance routine](https://dralanjacobson.com/counseling-for-athletes/) that helps you get into the right mindset. This routine can include warm-up exercises, mental preparation, and positive self-talk. Focus on the process of the activity rather than the outcome. Enjoy the journey and the sensations of being in the moment. Mindfulness: [mindfulness practice](https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/mindfulness-exercises/art-20046356), such as mindfulness meditation, can help you become more aware of your thoughts and feelings, allowing you to control them during your athletic performance better.

### Day of the Event Flow State Activities

Pay attention to feedback from your body and the environment. Use this information to make real-time adjustments to your performance. Minimize external distractions, whether noise, spectators, or electronic devices. Create a quiet and focused environment. Understand that achieving peak athletic performance may take time and practice. Be patient with yourself, and keep working on your mental skills.

Remember that achieving peak athletic performance is a highly individualized experience, and it may take time to reach this state consistently. Experimenting with different strategies and techniques is important to find what works best for you. Flow states often come and go, but incorporating these principles into your athletic routine increases your chances of experiencing them more frequently and enhances your overall performance. I would look forward to working with you on all of this.

## Achieving Athletic Flow State and My Work

I help athletes try to develop a deeper and more meaningful peak athletic performance experience through data collection and implementing a specific plan. I use proven and established cognitive [sports psychology](https://dralanjacobson.com/sports-psychology/) techniques to open the door to more instances and longer duration of a flow state. We will set measurable and realistic goals so you know your hard work in our sessions is working.

The athletic flow state of mind will not always occur, but we’ll try to get it to emerge at the perfect times [in our work together](https://dralanjacobson.com/sports-performance-psychology/). When it does, we’ll explain why it might have occurred and learn how to increase the chances it can happen again.

[Contact me](https://dralanjacobson.com/contact/) if you’d like to discuss this information about the athletic flow state.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Sports Psychology

---

### [Solution-Focused Therapy](https://dralanjacobson.com/solution-focused-therapy/)

**Published:** October 2, 2023
**Author:** Dr. Alan Jacobson

**Content:**

**Solution-focused therapy** is a goal-oriented and collaborative approach to psychotherapy that focuses on helping you identify and work towards solutions to your problems rather than dwelling on them. We explore the underlying causes using solution focused therapy techniques, but only if and when we believe that understanding them better will lead to solutions in the present. At the end of this post, I present some solution-focused therapy questions we might use and an example of **solution-focused brief therapy**.

Solution-focused therapy is considered a strengths-based approach, often in the [Humanistic](https://dralanjacobson.com/humanistic-psychology/) realm. It is often [my approach](https://dralanjacobson.com/types-of-therapy/) of choice when a client wants a more short-term intervention, but it can be a facet of longer-term treatment as well. A subset of this approach is [brief supportive psychotherapy](https://dralanjacobson.com/supportive-psychotherapy/).

Please [reach out](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you have questions about **solution-focused therapy** and how it might help you or a loved one.

## Principles of Solution-Focused Therapy

Key principles and techniques of Solution-Focused Brief Therapy include:

### Solution-Focused Therapy is Future-Oriented

Solution-focused therapy is future-oriented, meaning it focuses on helping you create a vision of the future you want to achieve and develop a plan to get there rather than dwelling on past problems or traumas. As the name suggests, solution-focused therapy is typically short-term and emphasizes achieving quick and practical results.

### Solution-Focused Therapy is Collaborative

We will work together as partners in the therapeutic process. I see you as the expert in your own life, and we’ll explore positive resolutions to challenges rather than having me impose advice or interpretations. We’ll set clear, concrete, and achievable goals that are specific, measurable, attainable, relevant, and time-bound ([SMART goals](https://www.atlassian.com/blog/productivity/how-to-write-smart-goals)). You will be actively involved in the therapeutic process, and your feedback will be valued.

### Minimal Emphasis on Diagnosis

Unlike other [therapeutic approaches](https://dralanjacobson.com/types-of-therapy/) focusing on diagnosing and treating specific mental health disorders, solution-focused therapy is less concerned with the diagnosis and more about helping you achieve your desired outcomes. It encourages you to set specific, realistic, and measurable goals. These goals serve as a roadmap for therapy and provide a sense of direction.

### Change Is Possible

Solution-focused therapy assumes that change is possible, even if it appears difficult or unlikely. Solution focused therapy techniques encourage hope and optimism by helping clients imagine and work towards positive outcomes. You will be encouraged to take small, manageable steps toward your goals. These incremental changes can lead to bigger transformations over time. This is why solution-focused therapists use positive and constructive language in client interactions. We ask questions, encouraging clients to explore their strengths, resources, and potential solutions.

### Solutions Focused Therapy Techniques Focus on Exceptions

We will likely spend time focusing on periods when the problem is less severe or not present (exceptions). By exploring these exceptions, you can gain insights into what works and how you can replicate positive experiences. This fits the fact that solution-focused therapy avoids labeling people with psychiatric diagnoses; instead, it focuses on helping you work toward their preferred outcomes.

### Amplification of Success

I will use solution focused therapy techniques to amplify successful moments and progress by highlighting your achievements and helping you see the positive impact of your efforts. This reinforces motivation and confidence. I may use scaling questions to help you measure their progress and gain insight into the severity of their issues. This scaling helps you see your success and set realistic new expectations.

## Solution Focused Therapy Techniques

This is a brief outline of some of the solution focused therapy techniques I use:

### Solution-Focused Therapy Questions Initially

I will use a series of questions to help you clarify your goals and identify what is already working in your life. These questions reveal your strengths, resources, and past successes. I may ask you to rate their current situation on a scale from 0 to 10, with 0 being the worst and 10 being the best. This scaling helps you assess your progress and identify what it would take to move closer to your preferred outcome.

### Solution-Focused Therapy Questions Follow-Up

After the initial questions, I often ask you about times when your problems were less severe or absent. This helps you identify exceptions to your difficulties and explore what they did differently during those times. We will also discuss the “Miracle Question,” where you will be asked to imagine a miracle that happened overnight and solved your problem. We’ll then explore their life and the steps they could take to move in that direction. Questioning like this is a core part of solution focused therapy techniques.

### Compliments and Reinforcement

You’ll hear genuine positive feedback and compliments when you share their strengths, successes, and progress. This helps reinforce your decisions that are moving you toward improvement. Of course, barriers and challenges will not be ignored, but they will covered in the context of hope and strength.

### Solution Focused Therapy Techniques and Homework

I often assign homework, encouraging clients to practice new behaviors or strategies outside sessions. This helps you actively work toward your goals as much as you want and in a way that allows you to get feedback on the process. These homework assignments open up conversations on what is working and what could be improved.

### Exception Amplification

When discussing exceptions to the problem, I often ask clients to describe the circumstances, thoughts, and feelings that contributed to those exceptions. This can help you replicate these positive experiences in the future.

### Coping Cards

Some clients create coping cards that contain reminders of their strengths, resources, and coping strategies. They can carry these cards with them and use them in challenging situations.

These solution focused therapy techniques help clients shift their focus from problems to the answers and resources they possess to make positive life changes. Solution-focused therapy is often used relatively short-term and structured, making it a practical approach for addressing specific issues.

## How Can Solution-Focused Therapy Help

Solution-focused therapy can be helpful in various situations and for individuals of all ages. It is particularly effective in addressing various emotional and psychological challenges and helping individuals improve their well-being and relationships. Here’s how solution-focused therapy can be of assistance:

1. Problem Resolution: Solution focused therapy techniques help you identify and work toward practical ways to address to your challenges. By focusing on resolutions rather than problems, you can break issues down into manageable steps and take action to address them.
2. Goal Achievement: This approach assists clients in setting and achieving specific, realistic goals. I will work with you to define clear, measurable, and achievable objectives and help you develop strategies for reaching these goals.
3. Positive Change: Solution focused therapy techniques emphasize amplifying and building upon positive change and progress. This can [boost confidence and motivation](https://dralanjacobson.com/therapy-for-self-esteem-and-resilience-training/), leading to further improvement. By focusing on positive change, this approach can reduce rumination and negative thinking patterns, potentially alleviating symptoms of [depression and anxiety](https://dralanjacobson.com/therapy-for-depression-and-anxiety/).
4. Empowerment: Solution focused therapy techniques empower you by highlighting your strengths, abilities, and past successes. It encourages self-efficacy and a sense of control over your life. Clients can learn effective coping strategies and skills to handle [life’s transitions](https://dralanjacobson.com/life-transitions-therapy/) and challenges more resiliently and adaptively.
5. Improved Communication: In [couples treatment](https://dralanjacobson.com/couples-therapy/) or [family therapy](https://dralanjacobson.com/family-therapy/), solution-focused techniques can enhance communication, understanding, and problem-solving skills. This can help resolve conflicts and improve relationships.

## Solution-Focused Therapy Questions

Here are common types of solution-focused therapy questions that might be the scaffolding around which we’ll build your therapy:

---

### 1. Miracle Question in SFT

- *“Imagine that tonight, while you’re asleep, a miracle happens, and the problem that brought you here is solved. When you wake up, what will be the first sign that the miracle happened?”*
- *“What will you notice that’s different?”*
- *“How will others notice that the miracle happened?”*

---

### 2. Exception Solution-Focused Therapy Questions

- *“Tell me about a time when this problem didn’t happen. What was different then?”*
- *“What were you doing differently during that time?”*
- *“Who else noticed things were better then?”*

---

### 3. Scaling Solution-Focused Therapy Questions

- *“On a scale of 1 to 10, where 10 means the problem is completely solved, and 1 means it’s at its worst, where are you right now?”*
- *“What would it take to move one step higher on the scale?”*
- *“What’s helping you stay at your current number and not lower?”*

---

### 4. Coping Solution-Focused Therapy Questions

- *“How have you managed to keep going despite the challenges?”*
- *“What has helped you cope so far?”*
- *“What strengths have you relied on during this time?”*

---

### 5. Future-Oriented Solution-Focused Therapy Questions

- *“What would be different in your life if this issue were resolved?”*
- *“What small step could you take this week to move closer to your goal?”*
- *“If things improved slightly, what would you notice first?”*

---

### 6. Resource Solution-Focused Therapy Questions

- *“Who supports you when you’re facing challenges?”*
- *“What personal strengths have helped you overcome past difficulties?”*
- *“What resources (people, tools, habits) can you rely on?”*

---

### 7. Goal-Setting Solution-Focused Therapy Questions

- *“What would you like to achieve from our sessions together?”*
- *“How will you know when you’re making progress?”*
- *“What will success look like for you?”*

---

Of course, the solution-focused therapy questions I might use change depending on your circumstances and goals, but these are some of the more common choices. Often, solution-focused therapy questions become part of homework I might assign you to think about or discuss with a loved one between sessions.

## Solution-Focused Brief Therapy Example

Solution-Focused Brief Therapy (SFBT) focuses on a client’s present and future circumstances and goals rather than past experiences. We work together to identify what you want to achieve through therapy and how to achieve these goals. Here is a fictitious example of how solution-focused brief therapy might work in my practice. It’s a simple description and only the first step in multiple sessions, with new solution-focused brief therapy techniques added each time. Still, it is designed to give you a general idea about the approach.

### Solution-Focused Brief Therapy Scenario

A 35-year-old woman, Lilly, comes in feeling overwhelmed by stress at work. She feels stuck in her career and is unsure how to move forward. Lilly describes feeling like she’s not good enough and worries that she might fail if she tries to advance in her job.

### Solution-Focused Brief Therapy Session

Me: “Lilly, it’s clear that work has been really stressful for you lately. Can you tell me what would be different if this stress were less of a problem for you?”

LIlly: “I think I’d feel more confident and maybe even enjoy going to work again. I wouldn’t feel so drained all the time.”

Me: “That sounds like a great place to be. Let’s imagine for a moment that you wake up tomorrow and the stress is gone. What would be the first thing you notice that tells you things are better?”

Lilly: “I think I’d feel more relaxed getting ready for work. I might even look forward to some of the tasks I have to do.”

Me: “It sounds like you’re saying you’d notice a change in your mood and outlook. What small steps you could take right now that might help you feel a bit more relaxed in the mornings?”

Lilly: “Maybe I could start with something simple, like setting my clothes out the night before or having a more calming morning routine.”

Me: “Those sound like great ideas. What do you think might happen if you tried that this week?”

Lilly: “I think it would make my mornings a little easier, and maybe I’d start the day feeling less stressed.”

Me: “That sounds promising. Let’s try that for the next week and see how it goes. When we meet again, we can discuss what worked well and what else we might add to your routine to keep building on that progress.”

### Key Techniques in the Example

1. **Miracle Question:** I asked Lilly to imagine how her life would be different if her problem were solved. This helps her envision a positive future and set goals.
2. **Scaling Questions:** I might later ask Lilly to rate her current stress level from 0 to 10 and explore what would happen if she moved up one point on that scale.
3. **Identifying Strengths and Resources:** I help Lilly recognize the small steps she can take and the strengths she already possesses.
4. **Setting Small, Achievable Goals:** I encouraged Lilly to make small changes, such as adjusting her morning routine, which can lead to larger improvements over time. This is at the core of solution-focused brief therapy.

This solution-focused brief therapy approach focuses on Lilly’s goals, resources, and potential for change rather than dwelling on her problems.

## Conclusions and My Work

Solution-focused therapy can be particularly useful for individuals with specific situational problems and those looking for a pragmatic and strengths-based [positive psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/) approach to change. I use it to include [individual treatment](https://dralanjacobson.com/individual-therapy/), [couples therapy](https://dralanjacobson.com/couples-therapy/), and, of course, [solution-focused family therapy](https://dralanjacobson.com/solution-focused-family-therapy-focusing-on-positive-change/). It can also be used in organizations and educational settings with small groups. I often integrate it into Executive Coaching, [Sports Psychology](https://dralanjacobson.com/sports-psychology/), and [College Admissions](https://dralanjacobson.com/college-admissions-counseling/) [specialty services](https://dralanjacobson.com/intensive-therapy-and-specialty-services/), as well as specific situations such as [holiday anxiety](https://dralanjacobson.com/holiday-anxiety/) treatment. Solution-focused brief therapy is a subset that involves fewer sessions.

Please [reach out](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you have questions about **solution-focused therapy** and how we might use it to help you overcome barriers and achieve success.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Athletic Performance Improvement Self Help](https://dralanjacobson.com/athletic-performance-improvement/)

**Published:** June 24, 2023
**Author:** Dr. Alan Jacobson

**Content:**

While therapy for **athletic performance improvement** is potent, proven, and effective, some athletes may choose to pursue their goals on their own. Maybe they are close to peak performance and need a slight boost, or perhaps they find themselves so busy that scheduling a treatment course is not feasible. Athletes sometimes want to try athletic performance psychology techniques independently before deciding if [working with a psychologist](https://dralanjacobson.com/fear-of-public-speaking-therapy-process/) will help. In any of these cases, I am happy to provide these sports performance psychology self-help tips, with the caveat that the most potent effects usually seem when you work directly with a psychologist who can choose and [tailor techniques](https://dralanjacobson.com/sports-psychology/) to your unique needs and athletic background.

## The Pillars of Sports Performance

Exploring how you can achieve athletic performance improvement on your own starts with pulling apart the basics of what contributes to success. Various factors influence athletic performance, and while different experts might categorize them differently, some commonly acknowledged pillars include:

- Physical Strength and Conditioning: This pillar of athletic performance psychology encompasses muscular strength, endurance, flexibility, agility, speed, and cardiovascular fitness. Training programs often focus on improving these physical attributes to enhance athletic performance.
- Nutrition and Hydration: Proper nutrition and hydration are crucial for providing the body with the necessary fuel, nutrients, and hydration for optimal performance, endurance, and recovery.
- Mental Conditioning: Mental aspects, including focus, confidence, mental toughness, resilience, and the ability to handle pressure, play a significant role in athletic performance psychology. Techniques like visualization, goal-setting, and [mindfulness](https://dralanjacobson.com/mindfulness-therapy/) are often employed to enhance mental conditioning.
- Skill Development and Technique: Mastery of specific skills and techniques relevant to the sport is fundamental for success. Athletes often refine their technical abilities and tactics to perform at their best.
- Rest and Recovery: Adequate rest and recovery allow the body to repair, adapt, and grow stronger after training or competition. This includes sleep, [active recovery](https://www.medicalnewstoday.com/articles/active-recovery#:~:text=Active%20recovery%20simply%20means%20that%20people%20work%20muscle,after%20a%20workout%20leads%20to%20overall%20performance%20improvement.), and strategies like massage, stretching, and proper rest periods.
- Injury Prevention and Rehabilitation: Avoiding and effectively rehabilitating injuries is crucial for consistent performance. This pillar involves techniques, exercises, and strategies for preventing injuries and properly rehabilitating them when they occur.
- Consistency and Periodization: Consistent athletic performance psychology training and structured periodization (strategic planning and cycling of training phases) help athletes optimize their performance and [prevent burnout](https://theathleteblog.com/athlete-mental-health-burnout-in-sports/#:~:text=Top%20strategies%20to%20maintain%20athlete%20mental%20health%20%28and,to%20prevent%20burnout%20in%20sports%20...%20More%20items) or overtraining.

These pillars aren’t standalone factors; they often intersect and influence each other. Successful athletes often focus on developing these aspects to achieve peak performance and maintain long-term athletic success. These help guide the self-help tips I suggest.

## Athletic Performance Improvement Self-Help Tips

Athletic performance improvement requires physical training, mental preparation, and overall well-being. Here are some self-help strategies to improve the mental side of your game:

### Pre-Season Athletic Performance Improvement

At the beginning of each season, there are steps you should take to maximize your performance:

1. Set Clear Goals: Define specific, measurable, attainable, relevant, and time-bound (SMART) goals. These athletic performance psychology goals should be clear and realistic, and you should have a system to review your progress regularly. This simple step can keep you motivated throughout your training and help you assess your routines.
2. Practice Proper Nutrition: Yes, this is a mental health tip since a well-balanced diet rich in whole foods, including lean proteins, complex carbohydrates, and healthy fats, also contributes to mental health and the cognitive aspects of sports performance. You may want to consult with a sports nutritionist for tailored advice.

### Pre-Game Athletic Performance Improvement

Before any competition, there are certain athletic performance improvement steps you can take.

1. Mental Rest and Recovery: You likely already know that you should allow sufficient rest and recovery between training sessions to prevent overtraining and reduce the risk of injuries. However, you should also ensure you are recovering effectively from the stress of competition and the mental effort involved. This involves changing the subject in your mind – taking a break, even if short, from thinking about your sport, plans, and performance.
2. Mental Preparation: Develop mental toughness and resilience through sports performance psychology by practicing visualization, positive self-talk, and relaxation techniques. These techniques can help you maintain focus, manage stress, and stay confident. Build them into your routine. Here’s an article from the New York Times about powerful visualization and an excellent article from the National Federation of Professional Trainers about a popular relaxation technique.
3. Manage Pressure and Stress: Learn sports performance psychology techniques to cope with pressure situations effectively. Deep breathing exercises, [mindfulness-based stress reduction](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/), and visualization can help you stay calm and perform at your best under pressure.

### Post-Competition Athletic Performance Improvement

Developing a post-game routine is often overlooked but is an essential step toward athletic performance improvement. Here are some specifics:

1. Analyze and Learn: Reflect on your performances, identifying strengths and areas for improvement. Seek feedback from coaches, teammates, or video analysis to gain valuable insights and adjust your training accordingly. Then, use that information to guide your athletic performance psychology visualization strategies and goal-setting.
2. Set a Mental Routine: Establish pre-game or pre-competition mental rituals that help you develop a focused and confident mindset. This could include self-talk, visualization, listening to specific music, or reviewing notes. Keep track of what works.
3. Seek Support: Surround yourself with a supportive network of coaches, teammates, and mentors who can provide guidance, motivation, and constructive feedback. Doing any of the above steps with teammates or others in your sport can enhance their effects and give you new ideas. Sharing these steps with your coach can also be helpful.

### The Importance of a Diary

No matter which of the above sports performance psychology self-help methods you choose to do, a helpful addition is an athletic performance improvement diary or journal. Using your phone, computer, or an old-fashioned piece of paper, you should track which of the above you do, what effect it has on your performance, and which combinations seem most potent. You may want to combine this with tracking other variables such as sleep, stress, diet, and other activities. A good journal will help you play a scientist in the same way a sports psychologist can.

## Sports Performance Psychology Examples

[Sports performance psychology](https://dralanjacobson.com/sports-performance-psychology/) focuses on mental strategies that enhance athletic performance by improving confidence, focus, resilience, and emotional regulation. Below is a detailed example and a self-help approach to athletic performance psychology that athletes can apply to their training and competition.

1. ### Sports Performance Psychology: Basketball

Jake, a college basketball player, performs well in practice, making 85% of his free throws. However, during high-pressure game situations, he struggles—his heart races, his hands feel shaky, and negative thoughts creep in, leading to missed shots. He feels frustrated and doubts his ability to perform under pressure.

### Sports Performance Psychology Analysis:

Jake’s struggle is a classic case of performance anxiety and mental interference. The pressure of the game activates his [fight-or-flight response](https://www.verywellmind.com/what-is-the-fight-or-flight-response-2795194), making it harder to execute movements with precision. His mind shifts from automatic execution (which he does in practice) to overthinking the mechanics, disrupting his [athletic flow](https://dralanjacobson.com/flow-state/).

### Sports Performance Improvement Strategies

Here is the type of athletic performance psychology plan that might work for an athlete like Jake:

1. **Visualization (Athletic Performance Psychology Mental Rehearsal)**

- What It Is: Imagining successful performance in vivid detail before actually doing it.
- How to Do It: 
    - Close your eyes and take a deep breath.
    - Imagine stepping up to the free-throw line in a real game.
    - Picture yourself feeling confident, taking a deep breath, and sinking the shot smoothly.
- Use all five senses—hear the crowd, feel the ball, see it swish through the netWhy It Works: Visualization trains your brain to execute the skill confidently in real situations. Athletic performance psychology studies show that mental practice can be almost as effective as physical practice.

2. **Breathing and Relaxation Techniques**

- What It Is: Deep breathing lowers heart rate and reduces anxiety.
- How to Do It: 
    - Before a free throw, inhale deeply for 4 seconds, hold for 2 seconds, and exhale for 6 seconds.
    - Focus on the breath instead of the outcome of the shot.
    - Pair deep breathing with a calming word like “relax” or “smooth” before shooting.
- Why It Works: Slow breathing activates the parasympathetic nervous system, reducing tension and promoting focus.

3. **Self-Talk and Confidence Building**

- What It Is: Using positive, constructive thoughts to replace self-doubt.
- How to Do It: 
    - Identify negative thoughts: *“I always choke under pressure.”*
    - Replace them with positive affirmations: *“I am calm, prepared, and in control.”*
    - Create a power phrase (mantra) to repeat before each free throw, e.g., *“Smooth and easy.”*
- Why It Works: Thoughts directly influence emotions and performance. [Positive self-talk](https://dralanjacobson.com/positive-psychology-powerful-benefits/) builds confidence and reduces self-sabotage.

4. **Developing a Pre-Shot Routine**

- What It Is: A consistent, repeatable routine before every shot to create familiarity and confidence.
- How to Do It: 
    - Establish a step-by-step routine: e.g., dribble twice, spin the ball, take a deep breath, focus on the target.
    - Stick to this routine every time, in practice and games.
    - Use a cue word (e.g., “focus”) to trigger automatic execution.
- Why It Works: Routines provide predictability and stability, which help athletes perform under stress.

5. **Simulating Pressure in Practice**

1. What It Is: Athletic performance psychology training to build mental toughness under game-like conditions.
2. How to Do It: 
    - Replicate game situations by adding distractions (e.g., teammates yelling, countdown timers).
    - Keep score and set pressure-based challenges (e.g., “Make 8/10 free throws or run sprints”).
    - Practice with a pressure mindset—imagine each shot as a game-winning moment.
3. Why It Works: The more you expose yourself to game-like pressure, the less overwhelming it becomes in actual competition.

### Putting It All Together: Game-Day Strategy

1. Before the Game: 
    - Use athletic performance psychology visualization to rehearse making free throws mentally.
    - Do deep breathing exercises to stay calm.
2. During the Game: 
    - Stick to your pre-shot routine every time.
    - Take a deep breath before each shot.
    - Repeat your power phrase to block out doubt.
    - Focus on the process, not the outcome.
3. After the Game: 
    - Reflect on what worked and what can be improved.
    - Keep practicing under pressure.

### Sports Performance Improvement Conclusion: Train Your Mind Like Your Body

- Just as you train your physical skills, mental skills require consistent practice.
- Sports psychology techniques work for all athletes in any sport, from runners to golfers to soccer players.
- Developing mental resilience can give you the edge over competitors who only train physically.

2. ## Sports Performance Psychology: Field Hockey

Emma is a talented midfielder and a key playmaker for her team. However, she becomes frustrated when she makes a bad pass or loses possession and starts overthinking her next moves. This hesitation slows her reactions, and she loses confidence throughout the game. She also struggles to stay focused when tired late in the second half.

### Athletic Performance Improvement Analysis

Emma’s challenge combines perfectionism, self-doubt, and difficulty refocusing after mistakes. Her inner critic takes over when she makes an error, causing her to dwell on past plays instead of staying in the present moment. In sports performance psychology this is known as choking under pressure or mental interference—her emotions are blocking her ability to play freely.

### Sports Performance Psychology for Mental Toughness in Field Hockey

Here is the type of sports performance psychology plan that might work for an athlete like Emma:

1. **Managing Mistakes and Building Resilience**

- What It Is: Learning to let go of mistakes and refocus quickly.
- How to Do It: 
    - Use the “Flush It” Technique—after a mistake, imagine pressing a mental reset button or flushing the mistake away like water down a drain.
    - Set a 3-Second Rule—allow yourself 3 seconds to be frustrated, then shift your focus to the next play.
    - Use a cue word (e.g., “Next!” or “Reset”) to train your brain to move forward instead of dwelling on mistakes.
- Why It Works: The best players don’t avoid mistakes—they just recover from them faster than others.

2. **Staying Focused Under Fatigue**

- What It Is: Using sports performance psychology to train your brain to stay sharp in the final minutes of a match.
- How to Do It: 
    - Use breathing techniques during breaks (inhale for 4 seconds, hold for 2, exhale for 6).
    - Break the game into small mental segments (e.g., “Win the next 5 minutes” instead of thinking about the whole match).
    - Focus on what you can control—body language, effort, and decision-making.
    - Use “trigger words” like “Fast feet” or “Stay sharp” to keep energy high.
- Why It Works: When your body is tired, your mind takes over. Training your focus prevents costly mistakes in crunch time.

3. **Confidence Building Through Positive Self-Talk**

- What It Is: Replacing negative thoughts with empowering ones.
- How to Do It: 
    - Write down three strengths you bring to the game (e.g., “I have great vision,” “I work hard,” “I’m a strong passer”).
    - Use affirmations before and during games: “I am composed under pressure,” “I make smart plays.”
    - When negative thoughts creep in, flip the script:
        *“I always mess up under pressure.”* to *“I learn from every mistake and bounce back stronger.”*
- Why It Works: The brain believes what you tell it repeatedly. The more positive reinforcement you give yourself, the more confident you’ll feel in games.

4. **Handling Pressure in Key Moments (Penalty Corners, 1v1s, Last-Minute Plays)**

- What It Is: Training your mind to stay calm and perform under pressure.
- How to Do It: 
    - Use visualization before a game—close your eyes and imagine executing a perfect penalty corner shot or a clean defensive tackle.
    - Develop a pre-shot routine before a big play (e.g., deep breath, reset stance, focus on the ball).
    - Think process, not outcome—focus on proper technique rather than “I have to score.”
    - Stay present—don’t think about the scoreboard or what happens if you miss.
- Why It Works: The best players aren’t fearless; they just train their response to pressure to stay composed in big moments.

5. **Mental Preparation Before a Match**

- What It Is: Using sports performance psychology to get into the right mindset before stepping on the field.
- How to Do It: 
    - Pre-Game Visualization: Picture yourself executing your best skills—winning tackles, accurate passes, scoring goals.
    - Music & Pre-Game Rituals: Listen to a pump-up playlist or do a specific warm-up routine to get in the zone.
    - Goal-Setting: Set small, controllable goals for the game: 
        - “Win 80% of my duels.”
        - “Keep my passes sharp and simple.”
        - “Stay vocal and support my teammates.”
    - Why It Works: The more prepared you feel, the more confident and focused you’ll be at the start of the game.

6. **Handling Nerves Before a Game**

- What It Is: Turning nervous energy into fuel for peak performance.
- How to Do It: 
    - Recognize that nerves are normal—even elite athletes feel them!
    - Instead of saying, “I’m nervous,” say, “I’m excited.” (Your body reacts the same way to both.)
    - Shift your focus from fear of failure to playing freely and aggressively.
    - Take slow, deep breaths to calm your body before the first whistle.
- Why It Works: Nervousness and excitement feel the same physiologically—reframing nerves as excitement keeps your mind in a high-performance state.

### Putting It All Together: Athletic Performance Improvement Game-Day Strategies

1. Practice Mental Skills Like Physical Skills – Just like dribbling and shooting, confidence and focus are trainable with repetition.
2. Control What You Can Control – You can’t control referees, the weather, or the opponent, but you can control your mindset, effort, and attitude.
3. Make Mental Training Part of Your Routine – Spend 5 minutes before practice visualizing success, working on deep breathing, or setting game-day goals.
4. Mistakes Are Part of the Game – The best players don’t play perfectly; they recover quickly and stay mentally strong.

## Summary and Conclusions

Athletic performance improvement takes time and dedication, and making any of the above steps part of your routine can help. Be patient with yourself, stay consistent, and continuously strive for improvement. Also, always remember why you are competing in the first place – make sure your planning always involves getting joy from competition and learning lessons applicable to other aspects of your life.

Doing some of the above with teammates or friends who may play another sport may be helpful. Often, the insights you can gain through athletic performance improvement techniques can be enhanced by doing them with others and sharing your thoughts afterward. Similarly, if something works for you, you may want to share that information with your coach, who can also pass it along to others.

### When to Call Me

Athletic performance psychology can provide a more specific plan tailored to your unique needs and goals. If you ever feel that your progress has stalled, or you know you can perform higher, you may want to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) for my specialty [sports psychology](https://dralanjacobson.com/sports-psychology/) services. I can do traditional once-weekly athletic performance improvement sessions or more [my clinical specialties](https://dralanjacobson.com/intensive-therapy-and-specialty-services/). Another post gives you an idea of the usual [sports psychotherapy outcomes](https://dralanjacobson.com/sports-psychotherapy-outcomes/).

I can also meet with groups, whether an entire team or a smaller group (like the captains). My work also includes working with coaches to incorporate athletic performance psychology methods and the latest [athletic performance innovations](https://dralanjacobson.com/sports-performance-improvement-innovations/) into their work.

Best of luck in your **athletic [performance improvement](https://dralanjacobson.com/sports-performance-improvement-innovations/)** journey!

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Sports Psychology

---

### [Basic Tenets of Humanistic Psychology](https://dralanjacobson.com/basic-tenets-of-humanistic-psychology/)

**Published:** January 19, 2024
**Author:** Dr. Alan Jacobson

**Content:**

I am a humanistic psychologist, meaning I follow the humanistic perspective in my work, which can be woven through many approaches and methods. Although I integrate many other approaches, this approach is [central to my practice](https://dralanjacobson.com/types-of-therapy/). Thus, I wanted to present this overview. The humanistic approach, also known as humanistic psychology or humanism, is an approach to psychotherapy that emerged in the mid-20th century as a reaction to psychology’s more deterministic and behavioristic models. Humanistic theory emphasizes a person’s inherent capacity for personal growth, self-awareness, and self-determination. It focuses on the individual’s subjective experience and views each person as unique, with the potential for positive growth and fulfillment.

The humanistic perspective is often used to address a wide range of issues, including personal development, self-esteem, relationships, and [existential concerns](https://dralanjacobson.com/existential-therapy/). It is particularly well-suited for individuals seeking personal growth and self-discovery. While it may not be the primary choice for all mental health issues, the humanistic perspective can complement other [therapeutic approaches](https://dralanjacobson.com/types-of-therapy/) and provide valuable insights into an individual’s inner experience. Later in this post, I provide a humanistic psychology example so you can see how this method works in practice.

## What Does Humanistic Psychology Focus On?

This approach emphasizes the study of the whole person and individuals’ unique qualities and potential. It focuses on understanding human experience, consciousness, and self-awareness. The basic tenets include:

1. Self-Actualization: A humanistic psychologist emphasizes individuals’ innate drive to achieve their fullest potential and become their best version. This concept is known as self-actualization.
2. Holism: The humanistic approach focuses on each individual, considering the interconnectedness of mind, body, and spirit. We emphasize the importance of understanding the complete human experience.
3. Personal Responsibility: Humanism encourages individuals to take responsibility for their actions and choices. It emphasizes the idea that individuals have the power to shape their destinies. The focus is on personal growth, self-improvement, and realizing one’s unique abilities. A humanistic psychologist emphasizes potential and engagement in self-discovery.
4. Subjective Experience: A humanistic approach emphasizes the value of individuals’ subjective experiences, including emotions, perceptions, and personal meanings attached to events. It is a highly nonjudgmental approach.
5. Rejecting Determinism: One of the basic tenets of this method is that it rejects strict determinism and the idea that external factors solely determine behavior. It emphasizes free will and the ability of individuals to make choices.

### Summary of the Basic Tenets

Overall, humanistic psychology emphasizes individuals’ subjective experiences, personal growth, and the pursuit of one’s full potential. It stands in contrast to more behaviorist or psychodynamic perspectives that might focus more on observable behaviors or [unconscious processes](https://www.simplypsychology.org/unconscious-mind.html). What I like about the humanistic perspective is that the basic tenets of humanism allow me to weave in other methods, even if they do not follow them. This is key in an [integrative psychology practice](https://dralanjacobson.com/integrative-therapy/) like mine and many others.

## Humanistic Approach Examples

The humanistic psychology focus approach is broad and encompassing, but some examples of the humanistic perspective and philosophy help show the approach. It often refers to any form of therapy that is future-oriented, client-centered, and more focused on current dynamics than past experiences’ effects. These approaches share a common belief in the importance of understanding an individual’s subjective experience, fostering self-awareness, and promoting personal growth. At the same time, their techniques and emphases differ, but they share a holistic perspective that values the uniqueness and potential of each person.

1. [Positive Psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/): While not exclusive to humanistic psychology, the field often aligns with the positive psychology movement, which seeks to understand and enhance human strengths, virtues, and overall well-being. The work of positive psychologists provides a core humanistic psychology example that can be combined with other approaches.
2. [Client-centered therapy](https://dralanjacobson.com/client-centered-therapy/): Carl Rogers, one of the influential figures in humanism, developed client-centered therapy. This therapeutic approach emphasizes [empathy, unconditional positive regard](https://dralanjacobson.com/compassion-focused-therapy/), and active listening to help individuals explore and understand themselves.
3. [Gestalt Therapy](https://dralanjacobson.com/gestalt-therapy/): This method is a great example of a humanistic perspective. It emphasizes the importance of the present moment and your current subjective inner experience. This approach asks clients to understand their experiences as an integrated entity rather than a collection of smaller, separate parts.
4. [Existential Therapy](https://dralanjacobson.com/existential-therapy/) and [Logotherapy](https://dralanjacobson.com/logotherapy/): Based on the theories of [Viktor Frankl](https://en.wikipedia.org/wiki/Viktor_Frankl), [Rollo May](https://en.wikipedia.org/wiki/Rollo_May), and [Irvin D. Yalom](https://en.wikipedia.org/wiki/Irvin_D._Yalom), these methods focus on existential concerns such as freedom, choice, responsibility, and the search for meaning in life. It encourages clients to confront the anxieties and uncertainties of human existence. This approach follows the humanistic theory and involves philosophical dialogue, exploring life choices, and examining the client’s responsibility for their own actions.

### Humanistic Psychology Example in Practice

A young professional named Sarah feels unfulfilled in her career despite achieving external success. She experiences anxiety, a lack of motivation, and a sense of disconnection from her true self. Sarah decides to seek therapy to explore these feelings. Sarah and I decided on the [client-centered approach](https://dralanjacobson.com/client-centered-therapy/) (also known as person-centered therapy), a humanistic approach developed by [Carl Rogers](https://en.wikipedia.org/wiki/Carl_Rogers). This humanistic psychology example is general and brief but designed to give you an idea of how it works.

#### A Humanistic Psychologist Approach

I will provide a [non-judgmental, empathetic, and supportive environment](https://dralanjacobson.com/talking-to-a-therapist/), allowing Sarah to express her thoughts and emotions freely. I will practice the humanistic perspective of **unconditional positive regard**, meaning I accept Sarah without judgment, regardless of what she shares. Instead of directing the conversation, I actively listen, reflecting on Sarah’s feelings and helping her explore her experiences more deeply.

I encourage Sarah to [explore her values](https://dralanjacobson.com/values-clarification-therapy/), desires, and what truly matters to her. This helps her identify the disconnect between her career and her sense of self. This is called self-actualization.

#### Humanistic Psychology Example Results

Through this process and the humanistic perspective, Sarah begins to recognize that her current job, though successful, does not align with her deeper passions or purpose. Over time, Sarah gains clarity about what she truly wants in life, such as pursuing a career that aligns with her passion for helping others. I support Sarah in exploring potential career changes, emphasizing that the decision should come from within her, reflecting her authentic self.

With my support, Sarah decided to shift her career toward a field that feels more meaningful to her. She begins to feel more fulfilled, motivated, and connected to her sense of purpose, reflecting the goal of self-actualization.

### Humanistic Psychology Example Summary

As you can see from that brief humanistic psychology example, this [therapy method](https://dralanjacobson.com/humanistic-therapy/) is based on the following principles:

- **Empathy and Compassion:** I deeply understand Sarah’s feelings and perspectives, helping her feel heard and validated.
- **Unconditional Positive Regard:** I accept Sarah as she is, fostering a safe self-exploration environment.
- **Self-Actualization:** I focus on helping Sarah realize her potential and align her life with her true self.

This humanistic psychology example exemplifies how humanistic theory can be applied in therapy to help individuals achieve personal growth and a [deeper understanding of themselves](https://dralanjacobson.com/insight-therapy/).

## What Drives Humanistic Theory

Humanistic theory is driven by a set of core beliefs and principles. These principles emphasize the importance of understanding and promoting individuals’ well-being and potential.

### Humanistic Theory Tenets

1. Belief in Human Potential: Humanistic Theory believes in individuals’ inherent potential for growth, self-improvement, and self-actualization. It is motivated by the idea that people can strive to become their best selves.
2. Nonjudgement and Humanistic Theory: Emphasizing subjective experience, including emotions, perceptions, and personal meanings, drives a humanistic psychologist. This means they believe in being fully nonjudgmental and find it important for the client to realize that.
3. Promotion of Personal Responsibility: One of the basic tenets of this approach is empowering individuals to take responsibility for their own lives. Thus, humanistic theory is motivated to help people recognize their agency and make choices that align with their values and goals.
4. Positive Approach: Many psychologists align with the positive psychology movement, focusing on strengths, virtues, and well-being. They are motivated to contribute to individuals’ positive experiences and to enhance overall life satisfaction.
5. Rejecting Determinism: The humanistic perspective rejects strict determinism. It advocates for the importance of free will and the capacity of individuals to make meaningful choices that shape their lives. The example above illustrates this.
6. Cultural Sensitivity: A humanistic psychologist often emphasizes cultural sensitivity and recognizes the importance of understanding individuals within their cultural context. They are motivated to appreciate diversity and promote inclusivity.

### Humanistic Perspective on Human Nature

Overall, a humanistic psychologist is motivated by a deep concern for the well-being and fulfillment of individuals. Their approach is characterized by a positive and empowering perspective on human nature, valuing the richness of personal experiences and the potential for growth and self-realization. It’s not that we ignore barriers and challenges, but rather that we see you as having the potential to overcome them or find ways around them. We don’t focus on the past, but that does not mean we ignore it or how it influences us in the present time.

## Summary and My Work

While I consider myself a humanistic psychologist, my practice is quite integrative. Thus, I do braid in other theories, even some that, on the surface, contradict the focus. Some examples include [psychodynamic therapy](https://dralanjacobson.com/psychodynamic-therapy/) and [cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/). I also use [supportive psychotherapy techniques](https://dralanjacobson.com/supportive-psychotherapy/) when a client has a specific issue to work through. I firmly believe that the basic tenets can hold true even when other techniques are used – just because we explore the past does not mean we are embracing determinism, for example.

### How I Use This Approach

In my practice, I am a humanistic psychologist, and this carries over into some of my [specialty areas](https://dralanjacobson.com/intensive-therapy-and-specialty-services/), including assessing people for emotional [support animals](https://dralanjacobson.com/emotional-support-animals-esa/). I use it for [individual therapy](https://dralanjacobson.com/individual-therapy/), [couples therapy](https://dralanjacobson.com/couples-therapy/), and [family therapy](https://dralanjacobson.com/family-therapy/). I hope the humanistic psychology example above helps you see how this method works, but I welcome more specific questions.

Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) to discuss humanistic psychology and what it might mean for your therapy.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Psychodynamic Therapy](https://dralanjacobson.com/psychodynamic-therapy/)

**Published:** October 22, 2023
**Author:** Dr. Alan Jacobson

**Content:**

Rounding out [my approach](https://dralanjacobson.com/types-of-therapy/) is Psychodynamic Therapy. This form of psychotherapy emphasizes the importance of the unconscious mind and the influence of early life experiences on an individual’s psychological and emotional functioning. This therapeutic is related to the [treatment approach](https://www.simplypsychology.org/psychoanalysis.html) developed by [Sigmund Freud](https://en.wikipedia.org/wiki/Sigmund_Freud). Still, it has evolved and been adapted to allow for more growth, change, and evolution than the original approaches. The psychodynamic therapy techniques I use are powerful and effective when there is a good fit between what my client is looking for and this approach. This post goes over psychodynamic treatment to help you become an informed consumer.

Psychodynamic Therapy is not for everyone. It is usually a longer-term exploration, not as scientifically based, and specifically [solution-focused](https://dralanjacobson.com/solution-focused-therapy/). However, many people find psychodynamic treatment quite powerful and effective. I use it in my practice as a stand-alone therapy, and, more commonly, I use techniques like the ones in the psychodynamic therapy examples below as a part of an [eclectic mix](https://dralanjacobson.com/integrative-therapy/) of approaches.

## What is Psychodynamic Therapy

The following are the basic tenets of Psychodynamic Treatment:

### Unconscious Processes in Psychodynamic Therapy

Psychodynamic treatment explores the unconscious aspects of a person’s thoughts, feelings, and behaviors. It assumes that many psychological issues and conflicts originate in the unconscious mind. Issues may get stuck there, out of awareness, but still affect your mood and thoughts, and uncovering these motivations can be key to feeling more content.

### The Role of the Past in Psychodynamic Therapy

Psychodynamic therapy techniques are based on the assumption that a person’s past, particularly [early childhood experiences](https://dralanjacobson.com/family-of-origin-therapy/) and relationships, is crucial for understanding their current emotional and interpersonal difficulties. While modern psychodynamic therapy does not get stuck in the past and allows for the possibility of overcoming difficult experiences, it still relies on exploring the past to understand the present.

### Transference and Countertransference

These are essential concepts in psychodynamic therapy. Transference refers to your unconscious feelings and attitudes toward the therapist, which can shed light on their past relationships. Countertransference is the therapist’s emotional reactions and responses to the patient, which can also provide insights.

### Defense Mechanisms

Psychodynamic treatment explores individuals’ [defense mechanisms](https://www.verywellmind.com/defense-mechanisms-2795960) to protect themselves from anxiety and emotional distress. Common defense mechanisms include repression, denial, projection, and displacement. Knowing the defense mechanisms you use can be vital in decreasing stress and conflict in your life.

### Psychodynamic Treatment is Open-Ended

Sessions in psychodynamic therapy are typically open-ended and exploratory, while I provide a non-directive, empathetic, and supportive environment in which you can freely express your thoughts and emotions. Other [types of therapy](https://dralanjacobson.com/types-of-therapy/) have more structure and direction.

## What is Psychodynamic Therapy Used For?

The following outlines the primary ways I use psychodynamic therapy in my [integrative practice](https://dralanjacobson.com/integrative-therapy/), whether mixed with other methods or as a primary approach.

### Insight and Self-awareness

Psychodynamic therapy aims to help you gain insight into your unconscious processes and how they impact your thoughts, emotions, and behaviors. This self-awareness can lead to personal growth and more adaptive ways of coping with life’s challenges. Psychodynamic treatment helps individuals gain insight into their [unconscious thoughts and feelings](https://www.scientificamerican.com/article/how-unconscious-thought-and-perception-affect-our-every-waking-moment/). This can be particularly useful for uncovering repressed emotions, unresolved conflicts, and deep-seated motivations contributing to current issues.

### Treatment of Longer-Term Issues

Some issues have been around for a long time and may require a more extended approach like psychodynamic therapy. These disorders include dysthymia (long-term mild depression) and social anxiety. This treatment can also help you improve your self-esteem by addressing underlying issues contributing to low self-worth.

### Psychodynamic Therapy for Resolving Past Trauma

Psychodynamic therapy is often used to help you [process and heal from past traumatic experiences](https://dralanjacobson.com/trauma-informed-care/). By delving into the roots of trauma, clients can work through unresolved feelings and achieve a greater sense of closure. This can be beneficial for individuals [coping with grief and loss](https://dralanjacobson.com/grief-therapy/). It allows them to explore their grief and understand the impact of the loss on their emotional well-being.

### Exploring Interpersonal Relationships

Psychodynamic treatment can be effective in examining the dynamics of personal relationships. By understanding how past experiences influence current patterns of relating to others, you can work on improving their interactions and forming healthier connections. For this reason, this method can be used in [couples therapy](https://dralanjacobson.com/couples-therapy/) and [family treatment](https://dralanjacobson.com/family-therapy/).

### Managing Emotions and Stress with Psychodynamic Therapy

Psychodynamic therapy can help you learn to manage and regulate your emotions more effectively. This is particularly valuable for anxiety, depression, and stress-related issues. By addressing and processing deep-seated emotional issues, psychodynamic therapy techniques can help you become more [emotionally resilient](https://dralanjacobson.com/therapy-for-self-esteem-and-resilience-training/) and better equipped to cope with life’s challenges.

### Psychodynamic Therapy to Build Self-Awareness

These methods aim to gain insight into the unconscious and promote personal growth and emotional well-being. Self-exploration can help you better understand your personality, desires, and values. This increased self-awareness can lead to personal growth and positive changes. Many people find that this approach is empowering and creates lasting change.

## Psychodynamic Therapy Techniques

This treatment is a form of depth psychology that focuses on the unconscious processes manifest in a person’s behavior. Psychodynamic therapy techniques aim to help clients gain insight into their unconscious conflicts and motivations, often stemming from childhood experiences, to resolve them and achieve personal growth. Here are some key psychodynamic therapy techniques:

### Major Psychodynamic Therapy Techniques

The main methods I use include:

#### 1. Free Association

- You are encouraged to speak freely about whatever comes to mind without censorship or judgment. This process allows unconscious thoughts and feelings to emerge, providing insights into your inner world.

#### 2. Interpretation

- I help you interpret your thoughts, feelings, behaviors, and dreams. These interpretations aim to make unconscious material conscious and help you understand the underlying meaning of their experiences.

#### 3. Dream Analysis

- Dreams are considered to be a window into the unconscious. You and I work together to explore the symbolism and meaning of your dreams, which can reveal hidden conflicts and desires.

#### 4. Transference and Countertransference

- Transference: You naturally project feelings and attitudes from past relationships onto me. This can provide valuable insight into your relational patterns and unresolved issues.
- Countertransference: My emotional reactions to you can provide important information about your dynamics and can be used to further the therapeutic process.

#### 5. Exploration of Defenses

- I help you understand your defense mechanisms (e.g., denial, repression, projection) that protect them from uncomfortable feelings and thoughts. Understanding these defenses can help you develop healthier ways of coping.

#### 6. Resistance Analysis

- Resistance occurs when you unconsciously avoid discussing certain topics or feelings. I identify and interpret these resistances to help you understand what they might be avoiding and why.

### Less Common Methods

Depending on your needs, I might also provide:

#### 1. Working Through

- This involves revisiting and reinterpreting the same issues multiple times from different angles. The process helps you integrate new insights into your everyday lives and make lasting changes.

#### 2. Catharsis

- The release of pent-up emotions through talking about past traumatic experiences. This can lead to emotional relief and a deeper understanding of the impact of these experiences.

#### 3. Confrontation

- I might challenge your thoughts, feelings, or behaviors, helping you face difficult truths about yourself. This is done in a supportive way to encourage self-exploration and growth.

These psychodynamic therapy techniques are often combined and tailored to the client’s needs. The therapeutic relationship is also key, providing a safe space to explore deep-seated issues.

## Who Benefits from Psychodynamic Treatment

Psychodynamic therapy techniques have benefited a range of individuals facing barriers and challenges. It is usually a longer-term approach, so I do not typically use it for brief solution-focused needs or when you seek fast results. The results of psychodynamic treatment can be profound and significant, but they may be less measurable than with other approaches. I can borrow from psychodynamic treatment with [families with older children](https://dralanjacobson.com/family-therapy/) and in [couples approaches](https://dralanjacobson.com/couples-therapy/), though it is not likely to be my primary method.

### Psychodynamic Therapy in Practice

Psychodynamic therapy may be particularly helpful for:

1. Individuals with Long-standing Issues: Psychodynamic therapy is often used for people dealing with long-standing psychological issues, such as chronic anxiety, depression, or interpersonal difficulties that have roots in early life experiences.
2. Exploring Unconscious Processes: This approach is suitable for those interested in delving into unconscious processes and gaining insight into how past experiences shape present thoughts and behaviors.
3. Complex Issues: Psychodynamic therapy is effective for complex psychological issues that may have multiple layers and roots. It allows individuals to explore and understand the deeper meanings behind their thoughts and actions.
4. People Open to Self-Exploration: Individuals open to self-reflection and introspection may find this method beneficial. The therapeutic process involves exploring one’s inner world and connecting current struggles and past experiences.
5. Improving Interpersonal Relationships: This approach can be valuable for those who want to enhance their interpersonal relationships by understanding patterns of behavior and communication learned in early relationships.
6. Personality Disorders: It is often used in the treatment of specific personality disorders, such as [borderline personality disorder](https://www.mayoclinic.org/diseases-conditions/borderline-personality-disorder/symptoms-causes/syc-20370237).
7. Addressing Repressed Emotions: For individuals who may have repressed or unresolved emotions from the past, psychodynamic treatment provides a space to bring these emotions to light and work through them.
8. Developing Self-awareness: This approach can help individuals develop a deeper understanding of themselves, fostering increased self-awareness and self-acceptance.

#### Effectiveness

The effectiveness of any therapeutic approach can vary from person to person. Some individuals may prefer and respond better to other methods, such as [cognitive-behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) (CBT) or [Solution-Focused](https://dralanjacobson.com/solution-focused-therapy/) approaches. Treatment choice depends on your preferences, so we will go over [this approach and others](https://dralanjacobson.com/types-of-therapy/) when we first meet to see which one, or what combination, will be most helpful. What is psychodynamic therapy going to be like for you? That is a question with a different answer for every client.

## Psychodynamic Therapy Examples

Here are some **psychodynamic therapy examples** that point out the **general techniques** and how they might be used in practice. This approach is based on the idea that unconscious thoughts and past experiences—especially from childhood—influence current behavior.

### 1. Free Association

**Example:**
A client is encouraged to say whatever comes to mind without filtering or censoring.
**Client:** “I was talking to my boss and suddenly thought about my father yelling at me as a kid… I don’t know why.”
**Me:** “Let’s explore that connection—how might your relationship with your father affect how you respond to authority figures?”

### 2. Exploring Defense Mechanisms

**Example:**
A client avoids talking about a painful breakup and instead jokes about it.
**Me:** “I notice you tend to laugh when we bring up the breakup—do you think humor might be a way of protecting yourself from feeling the pain more deeply?”

### 3. Childhood Experience Exploration

**Example:**
A client who fears abandonment discusses being left at daycare for long hours as a child.
**Me:** “Do you think some of those early experiences shaped how you now react when people pull away from you?”

### 4. Working Through Transference

**Example:**
A client becomes angry with the me, feeling they are being judged.
**Me:** “I wonder if you might be reacting to me as you might have reacted to someone else in your past—does this feel similar to other relationships?”

### 5. Identifying Repetitive Patterns

**Example:**
A client repeatedly chooses emotionally unavailable partners.
**Me:** “Let’s think about where this pattern might come from. Was there someone in your early life who you had to work hard to get attention from?”

I could give many other psychodynamic therapy examples, so please feel free to call me and we can discuss your unique situation and goals.

## Psychodynamic Therapy vs. CBT

What is psychodynamic therapy like compared to other approaches? Here’s a breakdown of **Psychodynamic Therapy vs. CBT (Cognitive Behavioral)**—how they differ in approach, goals, techniques, and more:

### Core Philosophy of Psychodynamic Therapy vs. CBT

#### Psychodynamic Therapy:

- Focuses on unconscious processes and how past experiences (especially childhood) influence present behavior.
- Aims for deep emotional insight and long-term change.
- Emphasizes the therapeutic relationship, transference, and emotional exploration.

#### [CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (Cognitive Behavioral):

- Focuses on current thoughts, beliefs, and behaviors.
- Aims for practical solutions to current problems.
- Works to identify and change negative thought patterns and behaviors.

### Techniques

#### Psychodynamic Techniques:

- Free association
- Dream analysis
- Exploring childhood memories
- Identifying defense mechanisms
- Working through transference

#### CBT Techniques:

- Thought records
- [Cognitive restructuring](https://dralanjacobson.com/cognitive-restructuring/) (challenging distorted thinking)
- Behavioral experiments
- Exposure (for anxiety/phobias)
- Homework assignments

### What is Psychodynamic Therapy Like vs. CBT: Time Frame

#### Psychodynamic Therapy:

- Can be long-term (months to years)
- Focused on personality change and emotional insight

#### CBT:

- Often short-term (6–20 sessions)
- Focused on symptom reduction and skill-building

### Psychodynamic Therapy vs. CBT Goals

#### Psychodynamic Therapy:

- Increase self-awareness and emotional understanding
- Uncover root causes of distress

#### CBT:

- Identify and change unhelpful thinking/behavior
- Teach coping strategies to manage symptoms

### Example Issue: Social Anxiety

**Psychodynamic Therapy Techniques:** Explore how early relationships (e.g., a critical parent) led to internalized shame and fear of judgment. Work through these feelings in the therapeutic relationship.

**CBT Techniques:** Identify anxious thoughts like “People will think I’m stupid,” challenge them with evidence, and practice exposure to social situations to reduce fear.

## Conclusions and My Work

Psychodynamic therapy techniques often take longer than other approaches like [cognitive-behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) or [Solution-Focused Therapy](https://dralanjacobson.com/solution-focused-therapy/). While these short-term, symptom-focused therapies have become more prominent in recent decades, psychodynamic therapy still has a place in contemporary [psychotherapy](https://dralanjacobson.com/). It can benefit individuals seeking a deeper understanding of their emotional and psychological issues and pairs well with other methods, such as [emotion-focused therapy interventions](https://dralanjacobson.com/emotionally-focused-individual-therapy/) and [relational psychotherapy](https://dralanjacobson.com/relational-therapy/).

If you want to discuss how this approach might benefit you, you want more psychodynamic therapy examples similar to your unique needs, or learn more about how a [mix of this approach and others](https://dralanjacobson.com/types-of-therapy/) might work for you, please [contact me](https://dralanjacobson.com/contact/) for a free consultation. You can also see my other post about [short-term dynamic psychotherapy](https://dralanjacobson.com/short-term-dynamic-psychotherapy/).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Therapy Techniques for Depression, Anxiety, and Phobias](https://dralanjacobson.com/therapy-techniques-for-depression-anxiety-and-phobias/)

**Published:** April 19, 2025
**Author:** Dr. Alan Jacobson

**Content:**

My [integrative psychological practice](https://dralanjacobson.com/integrative-therapy/) blends evidence-based psychotherapy techniques, drawing from [cognitive-behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT), [acceptance and commitment](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) (ACT), [person-centered](https://dralanjacobson.com/client-centered-therapy/), and [existential approaches](https://dralanjacobson.com/existential-therapy/) like [logotherapy](https://dralanjacobson.com/logotherapy/), to create a personalized path toward healing and growth. I see therapy as a collaborative space where clients are supported in exploring their experiences, gaining insight, building resilience, and reconnecting with their sense of purpose and identity. At the heart of my work is the belief that **therapy techniques** should meet clients where they are—emotionally, cognitively, and spiritually—and guide them toward the life they want to live. This post covers **therapy techniques for anxiety** and **therapy techniques for depression**, with case examples of both.

## Therapy Techniques Overview ![Therapy techniques for depression and anxiety](https://dralanjacobson.com/wp-content/uploads/2025/04/office-2-300x157.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Here’s a breakdown of **common therapy techniques**, **how they help**, and **what you can expect** from them. This can apply across a range of mental health concerns like anxiety, depression, trauma, ADHD, general malaise, [life transitions](https://dralanjacobson.com/life-transitions-therapy/), and more:

### 1. [Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) Techniques

**How it helps:**
[CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) is one of the core [types of therapy for depression](https://dralanjacobson.com/best-types-of-therapy-for-depression/). It focuses on identifying and changing negative thought patterns and behaviors. It helps people challenge and replace distorted thinking with more realistic, helpful thoughts. A subset of CBT is called [Rational Emotive Behavior Therapy](https://dralanjacobson.com/rational-emotive-behavior-therapy-rebt/).

**What to expect:**

- Structured sessions with specific goals
- Homework like journaling or thought records
- Learning skills to cope with distress in real time

### 2. [Dialectical Behavior Therapy](https://dralanjacobson.com/dbt-for-teens/) Techniques

**How it helps:**
Originally designed for borderline personality disorder, [DBT](https://dralanjacobson.com/dbt-for-teens/) teaches emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness. It’s especially helpful for people with intense emotions.

**What to expect:**

- Individual and group sessions
- Skills training and worksheets
- Crisis coping techniques

### 3. [Psychodynamic Therapy](https://dralanjacobson.com/psychodynamic-therapy/) Techniques

**How it helps:**
This and related forms of [insight therapy](https://dralanjacobson.com/insight-therapy/) focus on unconscious processes and past experiences (often from childhood) that affect current behavior. It can help uncover deep-rooted emotional issues.

**What to expect:**

- Talking through life history, dreams, and relationships
- A therapist who listens more than gives advice
- Insights that gradually surface over time

### 4. [Humanistic](https://dralanjacobson.com/humanistic-therapy/) / [Client-Centered](https://dralanjacobson.com/client-centered-therapy/)

**How it helps:**
Emphasizes self-growth, self-awareness, and personal responsibility. The therapist provides a nonjudgmental space for you to explore your thoughts and feelings.

**What to expect:**

- A lot of open-ended dialogue
- A strong, empathetic therapist-client relationship
- Less structured, more self-led conversations

### 5. Existential and [Logotherapy Techniques](https://dralanjacobson.com/logotherapy/)

**How it helps:**
Used to help people searching for more meaning in their lives, feel generally disconnected from others, or experience a general sense of malaise.

**What to expect:**

- Focusing on building a greater sense of meaningfulness and deeper connections
- Often takes longer than other therapies, but results can be profound
- Exploration of major life questions requires focus and homework

### 6. Acceptance and Commitment

**How it helps:**
Encourages accepting uncomfortable thoughts rather than fighting them, while committing to values-based action. Helps reduce avoidance behavior.

**What to expect:**

- Mindfulness exercises
- Clarifying personal values
- Techniques to create psychological flexibility

### 7. [Solution-Focused Brief Therapy](https://dralanjacobson.com/solution-focused-therapy/) Techniques

**How it helps:**
SFBT psychotherapy techniques for anxiety focus on finding solutions rather than analyzing problems. This [brief therapy](https://dralanjacobson.com/brief-therapy/) approach is great for people who want to address a specific issue quickly.

**What to expect:**

- Short-term (often under 10 sessions)
- Goal-oriented questions
- Focus on strengths and future actions

## Therapy Techniques for Depression

When it comes to **therapy techniques for depression**, several techniques have strong evidence behind them. Here’s a list of the **most commonly used therapy approaches**, **how they [treat depression](https://dralanjacobson.com/therapy-for-depression/)**, and **what you can expect** from each:

### 1. Cognitive Behavioral Therapy Techniques for Depression

**How it helps:**
CBT helps identify and challenge negative thoughts (like “I’m worthless” or “nothing will ever get better”) and replace them with more balanced, realistic ones. It also addresses behaviors that maintain depression (like withdrawal or avoidance).

**What to expect:**

- Structured sessions with homework (e.g., mood tracking, thought records)
- Practicing new ways to respond to triggering situations
- Skill-building for problem-solving, motivation, and goal-setting

### 2. [Interpersonal Therapy](https://dralanjacobson.com/interpersonal-therapy/) Techniques for Depression

**How it helps:**
Focuses on improving relationships and social functioning, which often deteriorate when someone is depressed. It addresses grief, role transitions (like becoming a parent or retiring), disputes, or social isolation.

**What to expect:**

- Exploration of recent life events and relationships
- Learning communication and conflict-resolution skills
- Time-limited treatment (often 12–16 weeks)

### 3. [Behavioral Activation](https://dralanjacobson.com/behavioral-activation/) (BA)

**How it helps:**
Depression often leads to withdrawing from pleasurable or meaningful activities. BA focuses on re-engaging with these activities to lift mood.

**What to expect:**

- Activity scheduling
- Tracking how activities affect your mood
- Gradually increasing engagement with positive routines

### 4. [Mindfulness-Based Cognitive Therapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) Techniques for Depression

**How it helps:**
[MBCT](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) combines CBT with mindfulness meditation. It’s especially helpful for preventing relapse in people who’ve had multiple episodes of depression.

**What to expect:**

- [Mindfulness practices like body scans](https://dralanjacobson.com/mindfulness-therapy/) and breathing exercises
- Learning to observe thoughts without judgment
- Group sessions (often in an 8-week format)

### 5. Psychodynamic Therapy Techniques for Depression

**How it helps:**
Explores underlying emotional conflicts and unresolved past issues (often from childhood). Helps increase insight into patterns that may fuel depression.

**What to expect:**

- Talking freely about relationships, dreams, and memories
- Gaining insight into self-concept and emotional triggers
- Gradual progress with deeper emotional work

### 6. Acceptance and Commitment Therapy Techniques for Depression

**How it helps:**
Instead of trying to eliminate negative thoughts, ACT encourages accepting them and choosing to act in line with your values. It reduces the struggle with internal experiences.

**What to expect:**

- Exercises to build mindfulness and “defusion” from thoughts
- Values clarification (what really matters to you)
- Focus on committed action, even in the presence of pain

### 7. [Group Psychotherapy](https://dralanjacobson.com/group-therapy/) Techniques for Depression

**How it helps:**
Provides support, reduces isolation, and allows for shared experiences. Some group therapies follow CBT or IPT models.

**What to expect:**

- Safe space to share and hear others’ stories
- Guided discussions by a trained therapist
- Can help normalize and reframe depressive experiences

### What’s Best for You?

The best therapy techniques for depression often depend on:

- Whether this is your first episode or a recurring one
- If you have co-occurring issues (like anxiety, trauma, ADHD)
- Your preferences for structure, insight, or skill-building

## Therapy Techniques for Anxiety

Anxiety is one of the most common issues therapy addresses, and several evidence-based psychotherapy techniques for anxiety can help. Here’s a rundown of the top ones, **how they work**, and **what you can expect**:

### 1. Cognitive Behavioral Therapy Techniques for Anxiety

**How it helps:**
CBT is the gold standard among therapy techniques for anxiety. It targets anxious thought patterns (“What if something bad happens?”), teaches realistic thinking, and reduces avoidance behaviors.

**What to expect:**

- Identifying and challenging anxious thoughts
- Exposure to feared situations (gradual and controlled)
- Tools like thought logs, breathing techniques, and reframing

**Good for:** [Generalized Anxiety Disorder](https://www.nimh.nih.gov/health/publications/generalized-anxiety-disorder-gad) (GAD), [panic disorder](https://dralanjacobson.com/panic-attack-treatment/), social anxiety, phobias, health anxiety, and more. See my other post about [CBT for social phobia](https://dralanjacobson.com/cbt-for-social-anxiety/).

### 2. [Exposure Therapy](https://dralanjacobson.com/exposure-therapy-for-anxiety/) Techniques for Anxiety

**How it helps:**
Avoidance fuels anxiety. [Exposure therapy gently helps you face fears](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/) in a safe, planned way so your brain learns they’re not as dangerous as they feel.

**What to expect:**

- Creating a fear hierarchy (from least to most scary)
- Gradual, repeated exposure to triggers
- Reduced fear response over time

**Good for:** Phobias, social anxiety, OCD, panic disorder, PTSD

### 3. Acceptance and Commitment Therapy Techniques for Anxiety

**How it helps:**
Instead of fighting anxiety, ACT teaches you to *accept* it and still move toward the life you want. It builds psychological flexibility.

**What to expect:**

- Mindfulness and grounding exercises
- Identifying core personal values
- Learning to “unhook” from anxious thoughts

**Good for:** GAD, social anxiety, OCD, and chronic anxiety

### [Mindfulness-Based Stress Reduction](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) (MBSR)

**How it helps:**
This technique emphasizes living in the present and observing thoughts non-judgmentally. Mindfulness reduces reactivity and overthinking.

**What to expect:**

- Meditation, body scans, mindful breathing
- Practicing awareness in daily life
- Often done in 8-week group programs

**Good for:** GAD, panic, stress-related anxiety

### 5. Psychodynamic Therapy Techniques for Anxiety

**How it helps:**
These therapy techniques for anxiety explore unconscious roots of anxiety—like unresolved conflicts, relationship patterns, or early life experiences. This builds long-term insight and emotional processing.

**What to expect:**

- Talking about recurring fears, dreams, past experiences
- Uncovering emotional triggers
- Slower pace, but deep inner work

**Good for:** Chronic anxiety, anxiety tied to self-esteem, relationship/family issues

### 6. Dialectical Behavior Therapy Techniques for Anxiety

**How it helps:**
Originally developed for intense emotions, DBT is one of the [best types of therapy for anxiety](https://dralanjacobson.com/best-types-of-therapy-for-anxiety/) because it improves emotion regulation and distress tolerance through specific skills.

**What to expect:**

- Structured modules: mindfulness, emotion regulation, interpersonal effectiveness, distress tolerance
- Both individual and group work
- Learning to cope without avoidance or impulsivity

**Good for:** Anxiety with emotional dysregulation, panic, social anxiety, trauma

## Psychotherapy Techniques for Phobias

When it comes to **phobias**—which are intense, irrational fears of specific objects, situations, or experiences—psychotherapy can be incredibly effective. Here are the most well-supported psychotherapy techniques for treating phobias, how they work, and what you can expect:

### Exposure Therapy (The Gold Standard)

**How it helps:**
This is the most effective treatment for phobias. It works by helping you gradually and repeatedly face the thing you’re afraid of in a safe, controlled way. Over time, your brain learns it’s less dangerous than it feels, and the fear fades.

**What to expect:**

- Creating a fear ladder (from least to most scary)
- Gradual exposure, starting with easier steps (imagining the fear, looking at pictures)
- Eventually moving to real-life exposure
- Practice until the anxiety response drops

**Good for:** All specific phobias (spiders, flying, needles, driving, etc.)

### Cognitive Behavioral Psychotherapy Techniques for Phobias

**How it helps:**
CBT helps you understand and change the thought patterns that make your phobia worse. It’s often combined with exposure therapy.

**What to expect:**

- Identifying catastrophic thoughts (like “If I fly, the plane will crash”)
- Learning to challenge and reframe them
- Behavioral experiments to test your fears

**Good for:** Specific phobias, social phobia, agoraphobia

### Systematic Desensitization for Phobias

(A gentle version of exposure therapy, often with relaxation techniques)

**How it helps:**
Combines gradual exposure with relaxation (like deep breathing or progressive muscle relaxation) so your body learns to stay calm while facing fears.

**What to expect:**

- Relaxation training first
- Slowly imagining or confronting fears while staying relaxed
- Practicing until fear fades

Good for: People who feel overwhelmed by fast exposure work

### [Virtual Reality Exposure](https://www.verywellmind.com/virtual-reality-exposure-therapy-vret-2797340) (VRET)

**How it helps:**
Uses virtual simulations (like flying in a plane or standing on a tall building) to expose you to fears without needing to face them in real life first.

**What to expect:**

- Wearing a headset and being guided through simulations
- I monitor your response and helps you stay grounded
- Useful when real-world exposure is hard to arrange

**Good for:** Fear of flying, heights, public speaking, driving

### Acceptance and Commitment Therapy Techniques for Phobias

**How it helps:**
Rather than fighting the fear, ACT helps you accept the discomfort and move forward anyway—especially useful if the phobia limits your life in important ways.

**What to expect:**

- Mindfulness and acceptance strategies
- Clarifying what really matters to you
- Learning to take action even while feeling fear

**Good for:** People with long-standing or life-disrupting phobias

**Ready to Conquer a Phobia?**

If you want help figuring out a plan based on your specific phobia (like fear of flying, driving, animals, etc.), I can help break it down into manageable steps.

## Case example: Psychotherapy Techniques for Depression in a Teenager

It’s very common—and often most effective—to combine psychotherapy techniques in real-life cases, especially with teens, since their needs are unique and changeable. Here’s a case example that blends multiple therapy approaches for a teenager dealing with depression:

### Case Example: Maya, 16-Year-Old with Depression

**Presenting Issues:**

- Low mood, lack of motivation, withdrawal from friends
- Poor sleep and appetite
- Trouble concentrating in school
- Negative self-talk (“I’m useless”)
- Increased irritability at home

**Background:**

- Parents recently divorced
- Was previously a high-achieving student
- Now skipping classes and isolating in her room

### Integrated Treatment Plan Using Mixed Psychotherapy Techniques for Depression

#### 1. Cognitive Behavioral Therapy (CBT) – Restructuring Thoughts

**Focus:** Identify and challenge Maya’s negative self-talk and distorted thinking.

**Approach:**

- Use a thought log to capture negative automatic thoughts like “I’ll never feel better.”
- Teach cognitive reframing: “This is a hard time, but it doesn’t define me.”
- Problem-solving sessions for school-related stress.

*CBT gives Maya tools to interrupt the cycle of depression and self-defeating thoughts.*

#### 2. Behavioral Activation – Increasing Positive Reinforcement

**Focus:** Reintroduce enjoyable and meaningful activities to combat withdrawal and low motivation.

**Approach:**

- Schedule small, manageable activities Maya used to enjoy (like painting or going on walks).
- Track her mood before and after activities to show the connection.
- Gradual goals: texting one friend per week → attending a club meeting → short hangouts.

*Helps rebuild motivation and improve mood through action, not waiting to “feel like it.”*

#### 3. [Interpersonal Therapy](https://dralanjacobson.com/interpersonal-therapy/) (IPT) – Navigating Relationships and Grief

**Focus:** Address the emotional impact of her parents’ divorce and feelings of isolation.

**Approach:**

- Explore Maya’s feelings of abandonment and how the divorce changed family dynamics.
- Practice communication strategies for expressing needs to her mom and friends.
- Normalize grief and emotional fluctuation post-divorce.

*Supports Maya’s emotional processing and helps her rebuild connection and trust.*

#### Mindfulness-Based Psychotherapy Techniques for Depression – Managing Emotional Overwhelm

**Focus:** Increase emotional regulation and reduce rumination.

**Approach:**

- Teach grounding exercises (like 5-4-3-2-1) and mindful breathing.
- Practice short mindfulness meditations or body scans.
- Use “noticing thoughts” techniques to reduce fusion with depressive thinking.

*Builds resilience and gives Maya tools to calm herself in moments of distress.*

### Outcome Goals:

- Improved mood and energy
- Re-engagement in school and hobbies
- Healthier self-talk and coping tools
- Stronger family communication
- Renewed sense of identity and hope

#### Why Integration Works:

- **Teens need flexibility**—some days require more problem-solving (CBT), others more emotional validation (IPT or mindfulness).
- Combining **action-based**, **relational**, and **insight-building** therapy techniques for depression helps target symptoms from all sides.

## Case example: Psychotherapy Techniques for Anxiety During a Life Transition

Combining **Logotherapy**, **ACT (Acceptance and Commitment Therapy)**, and **Client-Centered Therapy** can be a powerful approach for an adult facing a major **life transition**, like divorce, career change, or loss of identity. These psychotherapy techniques for anxiety all emphasize meaning, personal values, and authentic self-expression, making them a great mix.

### Daniel, a 42-Year-Old Facing a Major Life Transition

**Presenting Issues:**

- Recently laid off after 18 years at the same company
- Struggling with identity (“Who am I without this job?”)
- Low mood, sense of purposelessness
- Anxiety about the future
- Feels disconnected from others, unsure of next steps

**Personal Background:**

- Always saw himself as a “provider” and “hard worker”
- Was planning to advance in his company before the sudden restructuring
- Married, two kids, generally high-functioning before this event

### Integrated Psychotherapy Techniques for Anxiety

#### 1. Client-Centered Therapy – Creating Psychological Safety

**Focus:** Build trust, offer unconditional positive regard, and allow Daniel to process his emotions at his own pace.

**Approach:**

- Provide a nonjudgmental space for Daniel to express grief, anger, and confusion.
- Use reflective listening and emotional validation to help Daniel feel understood.
- Ask open-ended questions like, “What does this transition mean to you?” or “What parts of you feel lost right now?”

*Lays the emotional groundwork so Daniel can explore deeper meaning and direction later.*

#### Logotherapy – Finding Meaning Through Suffering and Purpose

**Focus:** Explore Daniel’s beliefs about purpose and how to find meaning even during loss.

**Approach:**

- Help Daniel reflect on existential questions: “What can I still contribute?” “What matters most now?”
- Discuss **freedom of attitude**: while he can’t control what happened, he can control how he responds.
- Explore **legacy** and **values-driven meaning** beyond his career (e.g., fatherhood, creativity, mentorship).
- Introduce Viktor Frankl’s idea: “Suffering ceases to be suffering at the moment it finds meaning.”

*Helps Daniel see that his worth and purpose aren’t tied solely to work, and that life still holds potential.*

#### Acceptance and Commitment Therapy (ACT) – Clarifying Values and Taking Committed Action

**Focus:** Shift Daniel’s focus from avoiding pain to moving toward what truly matters.

**Approach:**

- Teach mindfulness and “defusion” skills to help Daniel observe painful thoughts (“I’m a failure”) without letting them control him.
- Use values-clarification exercises to help identify areas of meaning: e.g., connection, contribution, learning.
- Set small, values-aligned goals (volunteering, networking, spending meaningful time with family).
- Emphasize the ACT principle: **“Move toward what matters, even in the presence of discomfort.”**

*Reorients Daniel toward purposeful living, even while uncertainty remains.*

### Outcome Goals:

- Greater acceptance of the life change
- Rediscovered sense of purpose not dependent on career success
- Emotional resilience and clarity on personal values
- Renewed motivation for intentional action

#### Why This Combo Works:

**Therapy Techniques for Anxiety****What They Bring**Client-CenteredSafety, empathy, and emotional validationLogotherapyExploration of purpose, meaning in sufferingACTPractical tools for accepting discomfort and moving forwardTogether, these therapy techniques for anxiety help someone like Daniel feel **seen**, **empowered**, and **capable** of building a life that still feels meaningful, even in the aftermath of change.

## Summary and My Work

Integrative therapy allows us to honor your uniqueness and the complexity of the human experience. Whether you are navigating anxiety, depression, trauma, life transitions, or existential questions, this approach offers flexibility, depth, and structure. By [combining tools that address thought patterns](https://dralanjacobson.com/types-of-therapy/), emotional regulation, values, relationships, and meaning, I aim to help each person move from surviving to thriving. Healing is not one-size-fits-all; through an integrative lens, therapy becomes a dynamic, compassionate, and empowering journey.

If you want to learn more about psychotherapy techniques for depression, anxiety, or any other barriers, or want more information about my services, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Therapy Approaches

---

### [Relational Therapy and Object Relations Therapy](https://dralanjacobson.com/relational-therapy/)

**Published:** February 3, 2025
**Author:** Dr. Alan Jacobson

**Content:**

**Relational therapy**, or **relational psychotherapy**, is a treatment that focuses on the role of social connections in a person’s emotional well-being. It is based on the idea that our connections with others shape our sense of self and that emotional distress often stems from difficulties in forming and maintaining healthy connections. These approaches are often central in [trauma-informed care](https://dralanjacobson.com/trauma-informed-care/). This post goes over the principles and techniques used in this method, followed by two case examples: **Object Relations Therapy** and [**Relational Life Therapy**](https://dralanjacobson.com/relational-life-therapy-rlt/).

This post aims to provide a general backdrop so you can get a sense of this approach. However, if you have specific questions, including how it might benefit you or a loved one or what treatment might be like, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

### Relational Therapy Referrals

If you have any remaining questions about relational psychotherapy, how it might work for you or a loved one, or what other treatments I could pair for your unique treatment plan, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Relational Therapy Overview

### Core Principles of Relational Therapy

1. **Interactions Shape Identity**
    - We develop our sense of self through interactions with others.
    - Early experiences (e.g., with caregivers and family) create internal models that influence future connections.
2. **Emotional Healing Happens in Connection**
    - [Individual Therapy](https://dralanjacobson.com/individual-therapy/) serves as a safe, supportive space where healing can occur.
    - Clients learn to engage with more trust, openness, and vulnerability.
3. **Mutual Empathy and Authenticity**
    - You and I engage in a real, emotionally attuned connection.
    - I model healthy social behaviors, such as active listening and emotional validation.
4. **Recognizing and Changing Relational Patterns**
    - You’ll examine recurring difficulties (e.g., [fear of intimacy](https://dralanjacobson.com/fear-of-intimacy/), trust issues).
    - Therapy helps break unhelpful patterns and replace them with healthier ways of connecting.

### Who Can Benefit from Relational Therapy?

#### 1. People with Social Challenges

- Struggles with intimacy, trust, or communication.
- Difficulty forming or maintaining friendships.
- Those who need to [break free from codependency](https://dralanjacobson.com/codependency-therapy/) or unhealthy attachment patterns.

#### 2. Individuals with Low Self-Esteem or Identity Issues

- People who derive their self-worth from others’ approval.
- Those who struggle with feelings of inadequacy or self-doubt.
- Individuals who feel disconnected from their true selves due to past experiences.

#### 3. Survivors of Trauma or Emotional Neglect

- People who have experienced emotional, physical, or abuse.
- Those with attachment trauma (e.g., neglectful or inconsistent caregivers).
- Survivors of betrayal or abandonment.

#### 4. Individuals with Mental Health Struggles

- People with anxiety or depression linked to social connections.
- Those struggling with emotional regulation in social contexts.
- Individuals with [borderline personality disorder](https://www.nimh.nih.gov/health/topics/borderline-personality-disorder) (BPD), which often involves social difficulties.

#### 5. Those Seeking Personal Growth

- People who want to understand their social patterns and improve [emotional intelligence](https://psychologicalassessments.com/emotional-intelligence-testing/).
- Individuals interested in fostering deeper, more meaningful connections.
- Those looking to break free from toxic cycles.

Relational therapy is based on the idea that our emotional well-being is deeply connected to our connections. It focuses on how the past and present shape our sense of self, emotional patterns, and ways of interacting with others. Relational psychotherapy aims to help individuals develop healthier, more fulfilling connections by fostering [self-awareness](https://dralanjacobson.com/insight-therapy/), emotional growth, and secure connections.

---

### The Relational Psychotherapy Process

1. **Building a Therapeutic Connection**
    - I start relational psychotherapy by creating a safe, supportive space where you feel heard and understood.
    - Your history is explored to identify recurring themes and struggles.
2. **Identifying and Understanding Patterns**
    - You reflect on past connections and how they shaped their love, trust, and self-worth beliefs.
    - I help you recognize unhealthy patterns (e.g., avoidance, codependency, fear of abandonment).
3. **Exploring Emotional Wounds and Internalized Beliefs**
    - Many struggles stem from unresolved emotional wounds from childhood or past experiences.
    - Relational psychotherapy helps clients heal from these wounds while developing healthier self-perceptions.
4. **Using the Therapist-Client Connection as a Model**
    - The therapeutic relationship with a [clinical psychologist](https://dralanjacobson.com/what-is-a-clinical-psychologist/) serves as a corrective emotional experience.
    - You learn to trust, communicate openly, and develop [self-compassion](https://dralanjacobson.com/compassion-focused-therapy/).
5. **Practicing New Relational Skills**
    - You work on expressing emotions, setting boundaries, and engaging in healthier interactions.
    - I may use role-playing or guided conversations to help you practice new ways of relating.
6. **Integrating Change into Everyday Relationships**
    - You apply insights and skills from therapy to real-life relationships.
    - Relational psychotherapy helps maintain long-term change by reinforcing healthier behaviors.

Relational therapy can help a wide range of people, particularly those who struggle with social connections, emotional distress, and self-identity. It is especially beneficial for individuals who have experienced social wounds or difficulty forming healthy connections with others.

### Relational Psychotherapy Techniques

Relational therapy uses various techniques to help clients build self-awareness, improve connections, and heal emotional wounds. Here are some key techniques used in this approach:

#### 1. Initial Inquiry

- I explore your connections, both past and present, to identify patterns.
- Questions focus on how they shape your emotions and self-perception.

#### 2. Mutual Empathy

- I actively engage with you, expressing genuine care and understanding.
- This models healthy dynamics and fosters emotional safety.

#### 3. Attunement

- I carefully observe your emotions, body language, and speech patterns to respond to your needs.
- This helps you feel heard and validated.

#### 4. Exploration of Patterns

- You examine how you relate to others and identify recurring issues, such as fear of intimacy or difficulty setting boundaries.
- I help you recognize unhealthy patterns and develop healthier ways of connecting.

#### 5. Reframing Negative Beliefs

- Many people develop negative self-perceptions from past connections.
- I work with you to [challenge and reshape these beliefs](https://dralanjacobson.com/cognitive-restructuring/) into more constructive and compassionate self-views.

#### 6. Processing Wounds

- You revisit past negative experiences, including trauma, rejection, or abandonment.
- You can heal and build healthier connections by working through these experiences in a safe environment.

#### 7. Role-Playing and Experiential Techniques

- You practice new ways of interacting, such as assertive communication or expressing vulnerability and [intimacy fears](https://dralanjacobson.com/fear-of-intimacy/).
- This helps you feel more confident in real life.

#### 8. Mindfulness and Emotional Regulation

- Clients learn to recognize emotional triggers and develop strategies to manage them, sometimes through [creative counseling](https://dralanjacobson.com/creative-counseling/) techniques.
- [Mindfulness techniques](https://dralanjacobson.com/mindfulness-therapy/) help increase self-awareness and reduce emotional reactivity.

## Subsets of This Approach:

### Object Relations Therapy

A subset of relational psychotherapy is Object Relations Therapy. This psychodynamic approach focuses on how early connections, particularly with caregivers, shape a person’s emotional world and interpersonal dynamics. Object relations therapy suggests that our mental representations (or “objects”) of past connections influence how we relate to others in adulthood.

#### Key Concepts of Object Relations Therapy:

1. **Objects:** In this context, “objects” refer to people (especially caregivers) or mental representations of them.
2. **Internalized Relationships:** Early experiences with caregivers become internalized and serve as templates for future connections.
3. **Splitting:** A defense mechanism where people or objects are seen as entirely good or bad.
4. **Transference:** The projection of feelings and expectations from the past connections onto the current.
5. **Attachment & Dependency:** Examines how early bonds influence current relational patterns.

#### Goals of Object Relations Therapy:

- I help clients recognize and change maladaptive patterns.
- Object relations therapy addresses unresolved childhood conflicts affecting present connections.
- It encourages the integration of conflicting emotions (moving away from black-and-white thinking).
- Object relations therapy improves self-awareness and emotional regulation.

### Relational Therapy

This form of [couples therapy](https://dralanjacobson.com/couples-therapy/), developed by [**Terry Real**](https://terryreal.com/), focuses on helping individuals and partners build deeper, more authentic emotional connections. RLT is unique in its **direct, no-nonsense approach**, often challenging clients to take responsibility for their behaviors while addressing societal and familial influences on their social patterns.

#### Core Principles of RLT:

1. **Empowerment** – Encourages both partners to move beyond traditional gender roles and societal conditioning that may hinder intimacy.
2. **Full-Respect Living** – Emphasizes mutual respect, accountability, and emotional integrity.
3. **Radical Honesty with Compassion** – Encourages open communication, even when discussing difficult truths, but in a way that fosters connection rather than conflict.
4. **Breaking Destructive Cycles** – Helps individuals identify and change dysfunctional patterns learned from family dynamics.
5. **Three Phases of Relational Therapy:**
    - **Waking Up:** Identifying destructive behaviors and breaking denial.
    - **Taking Action:** Teaching clients new skills.
    - **Creating Change:** Integrating changes into daily life for long-term health.

## Object Relations Therapy Case Example

Sarah, a 30-year-old woman, seeks [psychotherapy](https://dralanjacobson.com/psychotherapy/) due to struggles with intimacy and trust. She reports a pattern of pushing partners away when they get too close and experiencing intense fear of abandonment when they pull away. She also has difficulty expressing her needs and often feels unworthy of love.

### Early Life & Object Relations Theory Perspective:

Through therapy, Sarah reveals that she had a distant and emotionally unavailable mother. As a child, she learned that expressing her emotions led to rejection, so she suppressed them to maintain a sense of connection. Her father was physically present but uninvolved in her emotional life.

From an [**object relations**](https://en.wikipedia.org/wiki/Object_relations_theory) perspective, Sarah internalized an early mental representation where love felt conditional and unpredictable. She unconsciously carries this “internal object” into her adult connections, expecting partners to be distant or rejecting, which fuels her fear and avoidance.

### Relational Therapy Process & Techniques

1. **Exploring Early Object Relations:**
    - I help Sarah reflect on her childhood experiences and how they shaped her relational patterns.
    - Through guided exploration, Sarah recognizes that she unconsciously expects rejection, even when not warranted.
2. **Transference in Object Relations Therapy**
    - Sarah starts projecting her fears onto me, feeling at times that I am uninterested in her struggles.
    - I gently address this transference, helping Sarah see she is replaying old patterns in new situations.
3. **Restructuring Internal Objects:**
    - I encourage Sarah to challenge her negative self-perceptions (e.g., “I’m unlovable”) and develop a new internal sense of self.
    - Through consistent, empathic responses, Sarah has a corrective emotional experience, which helps her build trust.
4. **Developing Healthier Patterns:**
    - Sarah practices expressing her needs and learns that emotional vulnerability does not always lead to rejection.
    - She applies these skills outside sessions, gradually allowing herself to trust and communicate more openly.

### Object Relations Therapy Outcome

Over time, Sarah develops a healthier internal representation of social connections, realizing that love can be secure and reliable. She becomes more comfortable with emotional closeness and learns to manage fears of abandonment without self-sabotaging.

## Relational Therapy Case Example

John (42) and Lisa (39) have been married for 12 years and are struggling with constant arguments, emotional distance, and a lack of intimacy. John often shuts down during conflicts, while Lisa feels unheard and increasingly frustrated. They seek relational therapy because they fear their marriage is falling apart.

### Relational Therapy Perspective on the Problem:

In this case, John’s withdrawal and Lisa’s frustration create a negative cycle. Through a relational life therapy lens:

- **John’s Avoidance**: Likely learned from childhood, where emotions were dismissed, causing him to disengage during conflict.
- **Lisa’s Pursuit**: She grew up in a household where she had to fight to be heard, which led her to escalate when she felt ignored.

Both contribute to the unhealthy dynamic, but this therapy emphasizes **taking personal responsibility** rather than blaming each other.

### Therapeutic Process & Techniques:

1. **Identifying Patterns & Accountability:**
    - I help both partners see how they contribute to the disconnection.
    - John acknowledges that shutting down increases Lisa’s frustration.
    - Lisa realized that her escalating anger made John withdraw further.
2. **Challenging Dysfunctional Behaviors:**
    - I directly but compassionately challenge John’s emotional avoidance, helping him understand that disengagement harms the connection.
    - As homework, Lisa is encouraged to express her frustration in a way that invites connection rather than pushing John away.
3. **Teaching Relational Skills:**
    - John practices **staying engaged** in conversations even when uncomfortable, learning to express his emotions instead of withdrawing.
    - Lisa learns **regulated communication**, expressing needs without attacking or criticizing.
4. **Establishing Healthy Boundaries & Connection:**
    - Both partners work on **“fierce intimacy”**—being honest, vulnerable, and emotionally present.
    - They practice **repair strategies** after conflicts, acknowledging mistakes without defensiveness.

### Relational Therapy Outcome:

Over time, John became more emotionally available, and Lisa learned to communicate her needs in a way that fostered closeness. Their fights become less destructive, and intimacy improves as they reconnect through the **mutual respect, accountability, and conscious** connection-building that this therapy brings

## Summary and My Work

I provide relational psychotherapy for individuals and couples, including methods such as object relations therapy described above. This [type of therapy](https://dralanjacobson.com/types-of-therapy/) can be [effectively delivered virtually](https://dralanjacobson.com/virtual-therapy-guide/), so I provide it for most of the United States. Relational therapy pairs well with many other techniques, particularly [psychodynamic therapy](https://dralanjacobson.com/psychodynamic-therapy/), [narrative treatment](https://dralanjacobson.com/narrative-therapy/), and some [third-wave therapies](https://dralanjacobson.com/third-wave-psychotherapy/). It also often crosses over to [family of origin therapy](https://dralanjacobson.com/family-of-origin-therapy/). Sometimes, [psychological testing](https://www.psychologicalassessments.com/) can be a helpful first step to deeply understanding the issues involved in your personality and social functioning.

If you have any questions about relational psychotherapy, how it might benefit you or a loved one, or what treatment might be like, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Burnout Therapy: Prevention, Treatment, and Recovery](https://dralanjacobson.com/burnout-therapy/)

**Published:** September 8, 2025
**Author:** Dr. Alan Jacobson

**Content:**

As a psychologist specializing in burnout therapy and prevention, I work with individuals who feel depleted by the constant demands of work, school, caregiving, or life transitions. This condition is not simply “being tired.” It is a complex psychological state that can erode motivation, joy, and health. My approach to therapy for burnout emphasizes both immediate relief and long-term strategies, enabling clients to regain balance, rebuild resilience, and prevent recurrence. I offer burnout counseling and therapy to individuals, couples, and groups.

## Causes and Symptoms of Burnout ![Burnout Therapy](https://dralanjacobson.com/wp-content/uploads/2025/09/paperwork-238x300.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Recognizing the symptoms of burnout early is key to preventing its more serious effects. Knowing the causes and symptoms is the best place to start.

### Causes

Burnout is usually the result of **chronic, unrelieved stress**, often from multiple sources that accumulate over time. Common causes include:

- **Workplace Factors:** Excessive workload, long hours, lack of control, unclear expectations, or toxic work environments.
- **Role Overload:** Balancing too many responsibilities (career, parenting, caregiving, academics) without adequate support.
- **Perfectionism and Personality Traits:** High personal standards, fear of failure, or difficulty delegating.
- **Lack of Recovery Time:** Insufficient sleep, limited rest periods, or absence of leisure activities.
- **Isolation:** Minimal emotional or social support, leading to feeling disconnected.
- **Value Conflicts:** When personal values clash with workplace or societal demands (e.g., being pressured to prioritize profit over well-being).
- **Unresolved Trauma or Stress History:** Previous adverse experiences that lower resilience to ongoing stress.

### Symptoms

Symptoms typically emerge gradually and worsen if left unaddressed. They often affect emotional, cognitive, physical, and social functioning:

- **Emotional Symptoms:** Irritability, sadness, apathy, cynicism, feeling trapped or helpless.
- **Cognitive Symptoms:** Difficulty concentrating, forgetfulness, decision fatigue, reduced creativity.
- **Physical Symptoms:** [Chronic fatigue](https://www.healthline.com/health/chronic-fatigue-syndrome), headaches, muscle tension, insomnia, gastrointestinal distress, lowered immunity.
- **Behavioral Symptoms:** Withdrawal from social or work activities, procrastination, avoidance, reliance on unhealthy coping mechanisms (alcohol, overeating, screen time).
- **Work/Performance Symptoms:** Reduced productivity, frequent mistakes, absenteeism, or presenteeism (being physically present but mentally disengaged).

Burnout is distinct from ordinary stress: while stress often feels urgent and high-energy, burnout tends to bring exhaustion, detachment, and a sense of “running on empty.”

Those most susceptible are professionals in high-demand fields (healthcare, education, corporate leadership), caregivers (both personal and professional), perfectionists, and individuals with limited support systems. Students, entrepreneurs, and employees in rapidly changing industries are also at elevated risk.

## Burnout Therapy Approaches

Burnout therapy is tailored, but often [integrates several evidence-based approaches](https://dralanjacobson.com/integrative-therapy/):

1. **[Cognitive-Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT):** Identifying and restructuring unhelpful thoughts (“If I don’t do this perfectly, I’ll fail”), replacing them with balanced perspectives, and building practical coping skills.
2. **[Mindfulness-Based Stress Reduction](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) (MBSR):** Structured meditation and body-awareness practices to calm the stress response, improve focus, and reduce rumination.
3. **[Acceptance and Commitment Therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) (ACT)** and [Values Clarification Therapy](https://dralanjacobson.com/values-clarification-therapy/): Clarifying values and building flexibility, so clients can live a meaningful life without being paralyzed by stress.
4. **Behavioral Interventions and [resiliency training](https://dralanjacobson.com/therapy-for-self-esteem-and-resilience-training/):** Scheduling rest, practicing sleep hygiene, balancing work-rest cycles, and creating healthier boundaries.
5. **[Psychodynamic](https://dralanjacobson.com/psychodynamic-therapy/)/[Insight-Oriented Therapy](https://dralanjacobson.com/insight-therapy/) for Burnout:** Exploring underlying personality traits, family dynamics, or unresolved conflicts that may contribute to overwork or difficulty saying “no.”
6. **Supportive/[Group Interventions](https://dralanjacobson.com/group-therapy/):** Normalizing experiences, creating accountability, and reducing isolation.
7. **Preventive Coaching:** Equipping clients with long-term tools to prevent recurrence, such as leadership skills, communication training, and proactive stress management.

### Risks of Not Seeking Therapy for Burnout

If this condition is left untreated, the consequences can be wide-ranging:

- **Psychological Risks:** Chronic conditions can evolve into major depression, generalized anxiety, panic attacks, or substance misuse. Clients may also develop [learned helplessness](https://www.simplypsychology.org/learned-helplessness.html), feeling that no matter how much effort they put in, it makes no difference.
- **Physical Health Risks:** Prolonged stress increases inflammation, impairs the immune system, and raises the risk of cardiovascular disease, hypertension, and gastrointestinal problems. Sleep disruption can worsen fatigue and compromise cognitive function.
- **Professional Risks:** Burnout leads to absenteeism, presenteeism (showing up but being disengaged), decreased productivity, and professional mistakes that may jeopardize careers. Over time, this can cause job loss or stalled growth.
- **Relationship Risks:** Emotional withdrawal, irritability, and exhaustion often strain family, friendships, and romantic relationships. Loved ones may feel neglected, which can create cycles of conflict and further stress.
- **Identity Risks:** Untreated burnout can erode one’s sense of self. People who once identified strongly with their work or caregiving roles may feel a sense of purposelessness, hopelessness, or directionlessness.

## Burnout Counseling for Groups

Burnout counseling in group settings offers participants the opportunity to share their experiences, normalize challenges, and learn effective coping strategies collectively. The group format fosters peer support, accountability, and the reduction of isolation, common barriers when dealing with chronic stress or emotional exhaustion.

### Why Burnout Counseling Groups Work

- **Shared Experience**: Burnout counseling helps normalize things by showing individuals they are not alone.
- **Collective Insight**: Different perspectives can spark problem-solving and new coping methods.
- **Modeling and Support**: Participants in burnout counseling observe others’ resilience strategies and feel supported.
- **Cost-Effectiveness**: Organizations can provide group interventions more widely than individual therapy.

**Risks of Not Addressing Burnout**

- Escalation to depression, anxiety, or physical health issues.
- Increased absenteeism and turnover in organizations.
- Strained relationships and diminished quality of life.

### Typical Group Formats

1. **Traditional Burnout Counseling Groups**
    - Led by a psychologist or counselor.
    - Focus on emotional expression, self-reflection, and processing work-related stress.
2. **[Psychoeducational](https://dralanjacobson.com/psychoeducation/) Groups**
    - Blend teaching with skill-building (stress management, mindfulness, time management).
    - Often structured, with handouts and practice exercises.
3. **Workplace or Peer Support Groups**
    - Facilitated but less clinical.
    - Encourage peer accountability, peer-led solutions, and open discussions about workplace culture.

#### Core Themes and Activities

- **Understanding**: Education on symptoms, causes (workload, lack of control, value conflicts, etc.), and risks if untreated.
- **Coping and Recovery Skills**: Stress reduction techniques, [cognitive restructuring](https://dralanjacobson.com/cognitive-restructuring/), mindfulness, boundaries, and rest strategies.
- **Role of Values and Purpose**: Helping members realign work/life with personal meaning and goals.
- **Building Resilience**: Focus on social support, self-care, and flexible problem-solving.
- **Action Planning**: Group members set practical goals and check in on progress.

#### Clinical Approaches Often Used in Burnout Counseling

- **[Cognitive-Behavioral Group Therapy](https://www.choosingtherapy.com/cbt-group-therapy/) (CBGT)**: Identifying thought distortions and developing healthier thinking patterns.
- **Mindfulness-Based Stress Reduction ([MBSR](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/))**: Practicing awareness, breathing, and meditation.
- **Acceptance and Commitment Therapy (ACT)**: Focusing on values-based living even amid stress.
- **Interpersonal Process Groups**: Exploring relational dynamics that are contributing.

## Burnout Therapy Case Examples

The following case examples illustrate the various reasons burnout therapy might be used, as well as the differences in approach for each reason.

### Burnout Therapy Case Example 1: Healthcare Professional (Nurse)

**Background:** A nurse in her late 30s came to therapy reporting chronic fatigue, emotional numbness, and dread before every shift. She worked in a high-stress hospital unit with long hours and frequent exposure to trauma.

**Burnout Therapy Process:** We began by validating her experiences and teaching grounding techniques to reduce daily overwhelm. Through [CBT techniques](https://dralanjacobson.com/cbt-techniques/), she reframed unrealistic self-demands (“I must always be available for my patients”) and practiced boundary-setting with colleagues. Together, we also developed a sustainable self-care plan including restorative sleep, exercise, and brief “micro-breaks” at work.

**Outcome:** Over several months of therapy for burnout, she regained energy, improved her ability to leave work stress at work, and negotiated with her supervisor for a more balanced schedule. She began to enjoy her profession again and reported feeling “human” rather than “just a machine.”

### Burnout Therapy Case Example 2: Graduate Student

**Background:** A doctoral student in his mid-20s presented with insomnia, racing thoughts, and difficulty concentrating on research. He struggled with perfectionism, isolation, and the pressure to secure academic success.

**Burnout Therapy Process:** Using ACT, we clarified his values beyond academics—such as relationships, creativity, and personal growth—so he could place setbacks in perspective. We integrated mindfulness meditation to calm his stress response and added structured scheduling to prevent overwork. He also joined a peer support group that normalized the struggles of graduate school.

**Outcome:** After therapy for burnout, he learned to separate his identity from academic performance, reduced nightly rumination, and developed a healthier daily routine. Ultimately, he completed his dissertation without the collapse he once feared, and reported greater life satisfaction than before burnout symptoms began.

### Therapy for Burnout Case Example 3: Entrepreneur and Parent

**Background:** A 42-year-old single parent running a start-up reported feeling emotionally flat, disconnected from her children, and unable to make clear decisions. She described working late into the night and experiencing guilt about neglecting both family and business.

**Therapy for Burnout Process:** Our work combined CBT to challenge guilt-driven thoughts (“If I’m not always working, I’ll fail as a provider”), supportive therapy to address loneliness, and coaching strategies for time management. Lifestyle interventions included technology-free family meals, scheduled downtime, and exercise routines. We also explored identity themes—what success meant to her and how she wanted her children to view resilience.

**Outcome:** Within six months of therapy for burnout, she rebuilt energy, strengthened her relationship with her children, and created healthier work-life boundaries. Her business became more stable as she delegated tasks effectively, and she began to feel both present as a parent and effective as a leader.

### Therapy for Burnout Case Example 4: Athlete Experiencing Sports Burnout

**Background:** A 17-year-old competitive soccer player came to therapy after months of declining performance, frequent injuries, and loss of enjoyment in a sport she once loved. She reported intense pressure from coaches, parents, and college recruiters. Practices and games consumed nearly all her free time, leaving little room for rest, socializing, or academic focus. She described feeling “trapped,” noting that her identity was so tied to soccer that she no longer knew who she was outside the sport.

**Therapy for Burnout Process:** We began with psychoeducation about burnout in athletes, normalizing her experience and helping her understand the difference between healthy discipline and destructive overtraining. Cognitive-Behavioral Therapy for burnout (CBT) targeted perfectionistic thoughts (“If I don’t perform perfectly, I’ll lose my scholarship chances”). In contrast, Acceptance and Commitment Therapy for burnout (ACT) helped her clarify values beyond athletic achievement. Together, we developed a recovery plan that included structured rest days, mindfulness techniques for body awareness, and gradual exposure to alternative activities she once enjoyed, such as art and spending time with friends. [Family therapy](https://dralanjacobson.com/family-therapy/) sessions provided space to renegotiate parental expectations and support her broader well-being.

**Outcome:** Within several months, the athlete reported improved energy, mood, and enjoyment in playing soccer. She regained perspective on her long-term goals, understanding that athletic success should enhance, not consume, her life. With a healthier training schedule, she reduced injuries and began performing at a higher level again. Most importantly, she discovered an identity beyond sports, which gave her confidence that her worth extended far past the soccer field.

### Case Example 5: Burnout Counseling for Couples When One Partner is Burned Out

**Background:** A married couple in their early 40s sought therapy after months of growing tension. The husband worked long hours in a demanding corporate role and began showing signs of burnout—emotional withdrawal, irritability, exhaustion, and lack of interest in family activities. His partner felt neglected, resentful, and overwhelmed by taking on more household and parenting responsibilities. Arguments escalated, and both worried their relationship was unraveling.

**Burnout Counseling Process:** The therapeutic work combined individual and couples sessions. Individually, the burned-out partner learned to identify signs of emotional exhaustion and practiced stress management skills, including mindfulness and [setting work boundaries](https://dralanjacobson.com/therapy-for-work-life-balance/). Together, in couples sessions, we used [Emotionally Focused Family Therapy](https://dralanjacobson.com/emotionally-focused-family-therapy/) (EFT) and communication training to help both partners express needs without blame. We explored how burnout was a shared stressor rather than a personal failure. The couple also created a joint “wellness contract,” where both committed to more balanced routines—such as scheduled family time, shared responsibilities, and mutual support for rest and self-care.

**Outcome:** As a result of burnout counseling, the husband gradually reduced work hours and reclaimed time for rest and connection. His partner reported feeling seen and supported again, and the resentment began to fade. The couple reestablished intimacy and a sense of teamwork, shifting from a pattern of criticism and withdrawal to one of empathy and collaboration. Both partners described feeling hopeful about their future and confident that they now had tools to prevent burnout from undermining their relationship again.

## Prevention: Self-Help and Holistic Approaches

While burnout therapy is often essential for recovery, many holistic and self-help practices can help prevent burnout or sustain progress:

- **Physical Wellness:** For many, prioritizing regular exercise, balanced nutrition, adequate sleep, and hydration is essential in burnout prevention.
- **Mind-Body Practices:** Yoga, tai chi, breathwork, and meditation reduce stress hormones and build resilience that becomes burnout prevention.
- **Time and Energy Management:** Break large tasks into manageable steps, use scheduling tools, and practice saying “no” when commitments exceed capacity.
- **Workplace Strategies:** Seek social support, request reasonable [workplace accommodations](https://psychologicalassessments.com/psychological-testing-for-workplace-accommodations/), rotate duties when possible, and advocate for wellness policies.
- **Creative Outlets:** Writing, art, or music can restore energy and provide emotional release.
- **Social Connection:** Regular time with supportive friends and family helps counteract isolation and strengthens one’s perspective.
- **Nature Exposure:** Even short daily walks outdoors can reduce stress and improve mental clarity.
- **[Self-Compassion](https://positivepsychology.com/how-to-practice-self-compassion/):** Practicing kindness toward oneself—acknowledging limits, accepting imperfection, and celebrating small wins—creates resilience against chronic stress.

## Burnout Therapy in My Practice

Burnout is a signal, not a weakness. It is the body and mind’s way of saying that change is needed. With professional guidance and self-directed prevention strategies, recovery is not only possible—it can become a turning point toward greater resilience, balance, and fulfillment. Burnout therapy provides tools to heal, but also to thrive in new ways: to rediscover meaning, deepen relationships, and live a life aligned with values rather than demands. With the right support, burnout can transform from a breaking point into a breakthrough.

If you have any questions about individual therapy for burnout or burnout counseling for couples or groups, please do not hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a free consultation](https://www.picktime.com/scheduleaconsult#services/service) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Types of Therapy

---

### [Somatic Therapy Exercises and Somatic Experiencing Techniques](https://dralanjacobson.com/somatic-therapy/)

**Published:** May 4, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Healing can be a whole-person process, involving the mind, body, and more profound existential questions that shape our lives. Combining somatic therapy exercises with [third-wave cognitive-behavioral therapies](https://dralanjacobson.com/third-wave-psychotherapy/) (such as [Acceptance and Commitment Therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) and [mindfulness-based strategies](https://dralanjacobson.com/mindfulness-therapy/)) and the existential tradition allows for a more integrated and robust path to change. Somatic awareness can provide a helpful and effective boost to many of these other [types of therapy](https://dralanjacobson.com/types-of-therapy/). A subtype specifically for trauma is called somatic experiencing, which is covered toward the end of this post.

Many clients come to therapy feeling disconnected—not just from others but also from their values, or sense of purpose. Somatic therapy exercises help ground them in the present moment through body awareness and nervous system regulation. Third-wave therapies help them relate differently to thoughts, emotions, and behaviors without becoming entangled. [Existential therapy](https://dralanjacobson.com/existential-therapy/) provides a space to explore meaning, responsibility, freedom, and identity in life’s inherent uncertainties. I braid all of it into an effective, lasting approach.

Healing occurs not just through insight, but through embodied experience, authentic connection, and the freedom to live in alignment with one’s values—even in the face of pain. So, what is somatic therapy, and how might it help you or a loved one? I hope this post helps answer those questions.

## What Is Somatic Therapy? ![Somatic Therapy Exercises and Somatic Experiencing Techniques](https://dralanjacobson.com/wp-content/uploads/2025/05/dreaming-in-field-300x220.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Somatic therapy is a form of body-centered therapy that integrates traditional talk therapy with physical techniques to help individuals process trauma, stress, and emotional pain. The word “somatic” comes from the Greek word *soma*, meaning “body.” This therapy is based on the idea that emotions and traumatic experiences are stored not only in the mind but also in the body.

Unlike traditional [psychotherapy](https://dralanjacobson.com/psychotherapy/), which focuses mostly on thoughts and emotions, this therapy incorporates awareness of bodily sensations, movements, and patterns (“somatic awareness”) to help people heal. It combines principles from psychology, neuroscience, and physical practices like yoga, dance, and breathing techniques.

### What Is Somatic Therapy Used For?

Somatic therapy exercises are particularly effective for people who have experienced:

- Trauma or PTSD (including complex or developmental trauma)
- Chronic stress or anxiety
- Depression
- Grief and loss
- Dissociation or feeling “numb” or disconnected from the body
- Physical symptoms without clear medical causes (e.g., chronic pain, fatigue)
- Addiction or substance use
- Eating disorders

Somatic awareness can be helpful for both individuals and groups, and is increasingly used with veterans, survivors of abuse, first responders, and others dealing with long-term stress or trauma.

## Somatic Therapy Exercises

Common techniques used include:

- **Body Awareness**: Noticing physical sensations (tightness, warmth, tingling) as they arise in the body.
- **Grounding**: Techniques like feeling your feet on the floor or connecting to the present through the five senses.
- **Breath Work**: Controlled breathing to regulate the nervous system.
- **Touch Therapy**: In some modalities, gentle physical touch may help clients reconnect with areas of the body holding tension or trauma.
- **Movement Exercises**: This might include stretching, shaking, or guided movement to release held stress or emotion.
- **Visualization**: Imagining a safe space or using imagery to support bodily regulation.
- **Pendulation and Titration** (from Somatic Experiencing): Gradually moving between sensations of discomfort and comfort to build resilience and reduce overwhelm.

### How Somatic Therapy Exercises Help

Somatic therapy exercises help by:

- Releasing stored trauma from the body: Traumatic experiences often get “stuck” in the nervous system, leading to chronic tension or [emotional dysregulation](https://psychologicalassessments.com/emotional-dysregulation-testing/). Somatic therapy exercises allow the body to complete the fight/flight/freeze response.
- Regulating the nervous system: Through breath work and movement, clients learn to calm hyperarousal and increase their window of tolerance.
- Reconnecting mind and body: Many people become disconnected from their bodily sensations due to trauma. Somatic therapy helps restore a sense of embodiment and presence.
- Improving emotional resilience: Clients become better able to feel and tolerate emotions without becoming overwhelmed.
- Enhancing self-awareness and self-regulation: Somatic awareness involves learning how physical sensations relate to emotions, which helps clients better manage triggers.

Here’s a deeper look at how somatic therapy exercises help, especially in terms of healing trauma, regulating emotions, and improving overall well-being:

#### 1. Somatic Therapy Exercises Rewire the Nervous System

Somatic therapy directly engages the [autonomic nervous system](https://en.wikipedia.org/wiki/Autonomic_nervous_system) (ANS), which governs our fight/flight/freeze responses. Trauma can cause the nervous system to become “stuck” in survival states—hypervigilance, numbness, or panic.

Somatic awareness techniques help by:

- Teaching the body how to *come back to safety* after a threat.
- Supporting *neuroplasticity*—the brain’s ability to rewire itself.
- Helping the client shift from survival modes to calm (rest and digest).

Example: A person with PTSD might experience constant anxiety; through breath work and body awareness, they begin to feel moments of calm that grow with practice.

#### 2. Bridges the Gap Between Body and Mind

Many people with trauma or anxiety experience disconnection—feeling out of touch with their bodies, or not knowing how they feel physically or emotionally.

Somatic therapy exercises help by:

- Reestablishing a mind-body connection.
- Teaching clients to identify emotions *through physical cues* (e.g., “I notice my chest tightens when I’m anxious”).
- Promoting embodiment—feeling present and whole within one’s body.

Example: Someone might realize they clench their jaw when suppressing anger—this awareness can lead to emotional insight and healing.

#### 3. Supports Emotional Regulation

Emotions are not just mental—they appear physically (e.g., racing heart, clenched fists). This therapy helps people *feel* emotions safely and *release* them without becoming overwhelmed.

Somatic therapy exercises promote:

- Emotional processing instead of repression.
- Increased capacity to tolerate strong feelings without shutdown.
- A larger “window of tolerance” (the ability to stay regulated in the face of stress).

Example: Instead of numbing out during conflict, clients learn grounding tools to stay calm and express themselves effectively.

#### 4. Releases Chronic Tension and Pain

Trauma often lodges in the body as chronic muscular tension, pain, or fatigue, especially if fight or flight energy was never discharged.

Somatic therapy can help by:

- Releasing that stored tension through movement or breath.
- Reducing psychosomatic symptoms like headaches, gut issues, or fibromyalgia.
- Increasing physical vitality and ease in the body.

Example: A survivor of childhood trauma might find that their posture improves and pain decreases after regularly practicing somatic movement and body awareness.

#### 5. Builds Resilience and Empowerment

Healing is not just about feeling better but reclaiming control and confidence in one’s body and life.

Through developing somatic awareness, clients often report:

- A greater sense of agency (“I can calm myself down”).
- Trust in their body’s signals.
- More energy and motivation to engage in life.

Example: Someone who used to shut down during stress may learn to stay present and grounded using somatic awareness tools like breath or grounding.

### Summary:

What is somatic therapy? It’s a form of treatment that doesn’t just talk about what happened—it helps people feel and release the effects of what happened in a safe, body-centered way. Somatic awareness brings emotional relief, physical ease, and a renewed sense of self.

## Case example: Somatic Therapy for Sports Anxiety

Client Background:

- Name: Alex (15 years old)
- Issue: Intense performance anxiety during soccer games
- Symptoms: Racing heart, sweaty palms, stomachaches before games, negative self-talk (“I’m going to mess up”), freezing or zoning out under pressure
- History: No major trauma, but high expectations from a coach and perfectionistic tendencies. He had one incident where he missed a key goal and felt humiliated.

### Somatic Therapy Goals:

- Help Alex become aware of how anxiety shows up in his body (somatic awareness building).
- Teach regulation tools to manage stress in the moment.
- Build confidence and trust in their body’s responses (somatic awareness responses).
- Unpack and release any stuck stress or shame from past experiences.

### Therapy Process:

#### Session 1: Building Somatic Awareness

- Establish safety and rapport.
- Explore how Alex experiences anxiety physically (“Where do you feel it when you’re nervous?”)
- Introduce somatic therapy exercises, such as body scans, to notice tension without judgment.

#### Session 2: Grounding and Regulation

- Teach grounding techniques (e.g., feet on the floor, naming five things they see).
- Practice calming breathwork (like box breathing).
- Role-play a game day scenario using grounding tools during the session.

#### Session 3: Movement and Release

- Explore simple movement-based techniques (e.g., shaking out limbs to discharge tension).
- Alex notices he clenches his fists before games, and practices loosening and stretching them.
- Introduce “pendulation”: moving between comfort and anxiety in small, manageable ways.

#### Session 4: Working with a Stuck Memory

- Gently revisit the somatic awareness memory of missing the goal.
- Use tracking (noticing how it feels in the body when thinking about the moment).
- Invite a physical shift: “What movement or posture would help you feel more powerful right now?”

#### Session 5: Rehearsal and Resilience

- Use visualization to mentally rehearse staying grounded during a stressful moment on the field.
- Combine imagery with breathing and posture cues (e.g., chest open, eyes focused).
- Build a “regulation toolkit” that Alex can use before and during games.

#### Session 6: Reflection and Integration

- Review progress and what tools feel most effective.
- Celebrate moments when Alex used skills (e.g., took deep breaths before the last game and felt calmer).
- Discuss applying these tools outside sports (e.g., tests, social pressure).

### Outcomes:

- Alex reports fewer physical symptoms before games.
- Uses breathwork and grounding regularly.
- Feels more in control of his response to pressure.
- Regains enjoyment in playing soccer instead of fearing failure.

We then moved into more traditional [sports psychology](https://dralanjacobson.com/sports-psychology/) treatment, with refreshers on the mind-body connection mixed in.

## Case Example: Somatic Awareness and Fear of Flying

Here’s a case example of how somatic therapy might help an adult with a [fear of flying](https://dralanjacobson.com/fear-of-flying-therapy/):

**Client Background:**

- Name: Maria (38 years old)
- Issue: Severe anxiety about flying
- Symptoms: Nausea, racing heart, muscle tension, sweating, intrusive thoughts of crashing
- Behavior: Avoids travel altogether or experiences panic during flights (grips armrests, can’t eat or sleep, sometimes cries)
- History: No plane-related trauma, but experienced a [panic attack](https://dralanjacobson.com/panic-attack-treatment/) on a turbulent flight 5 years ago and has been afraid to fly since.

### Somatic Therapy Goals:

- Help Maria track and regulate the physical sensations tied to her fear.
- Teach tools to manage anxiety before and during flights.
- Reprocess the stored traumatic memory of the panic attack.
- Build a new association between flying and a sense of safety or control.

### Somatic Therapy Exercises Used for [Flight Anxiety](https://dralanjacobson.com/flight-anxiety-self-help/):

#### Session 1: Using Somatic Awareness to Map the Fear Response

- Establish trust and safety in the therapeutic relationship.
- Begin tracking sensations: “What happens in your body when you *think* about flying?”
- Maria notices her chest tighten and shoulders rise—introduce body scanning and naming sensations.

#### Session 2: Somatic Awareness for Grounding and Body Regulation

- Introduce grounding techniques (e.g., pressing feet into the floor, orienting by looking around the room).
- Practice slow, diaphragmatic breathing to reduce heart rate.
- Work on resourcing: developing a calming mental image (e.g., being on the beach or being hugged by a loved one) to which she can return.

#### Session 3: Processing the Panic Memory

- Invite Maria to recall the moment of panic on the plane—but only to the degree she can tolerate (titration).
- Use tracking: “Notice what’s happening in your body as you recall that moment.”
- Begin pendulation: shift between recalling the anxiety and returning to grounding/safety to build nervous system resilience.

#### Session 4: Reclaiming Agency Through Movement

- Maria notices she freezes and grips the armrests during flights—explore how her body wants to respond differently.
- Introduce subtle movements (e.g., stretching arms, uncurling fists) to simulate empowerment.
- Practice a mock flight sequence in session (e.g., imagining boarding the plane and taking off) while using grounding tools.

#### Session 5: Future Planning and Practice

- Co-create a “flight toolkit”: breathwork, grounding, calming playlist, comfort object.
- Role-play using these tools in imagined flight scenarios.
- Maria begins to feel more capable, even excited, about an upcoming short flight.

### Outcomes:

- Maria successfully boards a flight with reduced anxiety, using breathwork and visualization.
- No panic attack occurs—she reports being nervous, but *in control*.
- She expresses hope about traveling more and feels “reconnected” to the part of herself that loved travel.

## Somatic Experiencing Therapy

Somatic Experiencing Therapy (SE) is a body-oriented therapeutic approach specifically developed to help individuals heal from trauma and chronic stress. It was created by [Dr. Peter Levine](https://www.somaticexperiencing.com/about-peter), who based it on the observation that wild animals, though constantly exposed to life-threatening situations, rarely develop trauma like humans do. He theorized that trauma is not caused solely by the event itself, but by the incomplete processing of the body’s natural survival responses (fight, flight, freeze).

### Core Principles of Somatic Experiencing (SE):

1. Trauma is stored in the body, not just the mind.
    Somatic experiencing focuses on helping the body complete the natural defense response interrupted or frozen during a traumatic event.
2. The nervous system can heal with gentle support.
    Somatic experiencing supports regulation of the autonomic nervous system (ANS), guiding clients toward safety and balance (away from hyperarousal or shutdown).
3. Slow is fast.
    Somatic experiencing works slowly and mindfully to avoid retraumatization. It often involves “titration”—touching a little bit of distress at a time, then returning to safety.
4. The body holds the key to resolution.
    Somatic experiencing practitioners help clients notice internal sensations (“interoception”) to discharge stored survival energy and return to equilibrium.

### Key Techniques in Somatic Experiencing:

- Sensation Tracking (Interoception): Paying attention to body sensations (e.g., tightness, heat, tingling) as a way to access and release trauma.
- Titration: Introducing small pieces of traumatic material very gradually to avoid overwhelm and allow integration.
- Pendulation: Moving back and forth between distressing sensations and feelings of safety or neutrality in the body.
- Discharge: Supporting the body in releasing stuck survival energy through trembling, sighing, crying, or subtle movement.
- Resourcing: Identifying internal and external sources of comfort or stability (e.g., safe people, calming imagery, a supportive memory).
- Boundary Repair: Helping individuals restore a sense of physical and emotional boundaries that may have been violated during trauma.

### Who Is SE Therapy For?

Somatic Experiencing is effective for individuals who have experienced:

- PTSD and complex trauma
- Shock trauma (car accidents, medical procedures, natural disasters)
- [Childhood abuse or neglect](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/)
- Sexual assault or violence
- Chronic stress or anxiety
- Dissociation or emotional numbness
- Somatic symptoms (like chronic pain, migraines, IBS)

Somatic experiencing is used with children, adults, veterans, survivors of violence, and others who struggle with nervous system dysregulation.

### How It Helps:

Somatic Experiencing helps by:

- Restoring a sense of safety in the body
- Supporting emotional regulation
- Reducing hypervigilance, dissociation, or shutdown
- Releasing the stored tension and energy of unprocessed trauma
- Increasing a person’s resilience, presence, and sense of agency

### Example:

A person who was in a car accident might have no major physical injuries but still avoids driving, feels panicked when hearing brakes screech, and has trouble sleeping. In somatic experiencing, they may track sensations that arise when recalling the accident, work slowly with pendulation, and eventually experience a discharge (e.g., a tremor or sigh). This helps their body “complete” the fight/flight response that was frozen in place, leading to lasting relief.

## Conclusion and My Work

By blending approaches, I aim to help clients reduce suffering and build meaningful, embodied, and true lives. Therapy becomes a space not just for managing symptoms but for deep listening—both to the wisdom of the body and emotional experiences. This is the core answer to “What is somatic therapy?”

#### Blending Somatic Therapy Exercises

Somatic therapy can be blended with many other therapeutic approaches to create a more holistic and personalized experience for clients. Below are several types of therapy it can integrate with, along with how they can be combined:

1. ####  **Cognitive Behavioral Therapy ([CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/))**

- How it blends:
    While CBT focuses on changing unhelpful thoughts and behaviors, somatic therapy exercises add a body-based layer by helping clients recognize how those thoughts appear physically (e.g., muscle tension, heart rate).
- Example:
    A client identifies a negative thought like “I’m a failure,” and notices it causes tightness in their chest. Tools like breathwork or movement soften that reaction, while CBT addresses the thought pattern.

2. ####  **Acceptance and Commitment Therapy (ACT)**

- How it blends:
    ACT emphasizes psychological flexibility and values-based action. Somatic therapy supports the ACT principle of “being present” by anchoring awareness in bodily sensations, which deepens mindfulness.
- Example:
    A client practicing ACT might learn to “sit with discomfort” using grounding, which can help them manage difficult emotions while choosing valued actions.

3. ####  **Dialectical Behavior Therapy ([DBT](https://dralanjacobson.com/dbt-for-teens/))**

- How it blends:
    DBT teaches skills for emotion regulation, distress tolerance, and mindfulness. Somatic therapy exercises enhance these skills by helping clients feel emotions in the body and use regulation techniques like breath and posture to stay grounded.
- Example:
    During a distressing moment, a client uses DBT’s “TIP” skill and pairs it with physical tracking (e.g., “I feel a knot in my stomach—I’ll focus on breathing there”).

4. ####  **Mindfulness-Based Therapies (MBCT, [MBSR](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/))**

- How it blends:
    Both mindfulness and somatic therapy emphasize present-moment awareness. Somatic therapy brings mindfulness into the felt experience of the body, not just the breath or thoughts.
- Example:
    Instead of simply noticing thoughts, a client might be guided to feel the physical sensations those thoughts evoke, leading to deeper insight and regulation.

5. #### **[ Internal Family Systems](https://dralanjacobson.com/internal-family-systems-therapy-ifs/) (IFS)**

- How it blends:
    IFS involves working with internal “parts” (e.g., anxious part, inner critic). Somatic therapy complements this by noticing where parts are felt in the body (e.g., tension in the throat, pressure in the chest).
- Example:
    A client talks to a fearful part while placing a hand on their stomach, helping to soothe and connect somatically to that part.

6. ####  **Eye Movement Desensitization and Reprocessing ([EMDR](https://www.emdr.com/what-is-emdr/))**

- How it blends:
    Both EMDR and somatic experiencing help clients process trauma. Somatic tools can be used before, during, or after EMDR sessions to regulate arousal or enhance grounding.
- Example:
    If clients become overwhelmed during EMDR, I may guide them to notice their feet on the floor or slow their breath to return to safety.

7. #### [ **Existential Therapy**](https://dralanjacobson.com/existential-therapy/)

- How it blends:
    Existential therapy explores meaning, death, freedom, and identity. Somatic therapy helps clients stay present with the discomfort these questions can evoke.
- Example:
    When a client explores fear of death, the therapist might invite them to feel where that fear lives in the body and use movement or breath to stay connected rather than dissociate.

8. #### Psychoanalytic or [Psychodynamic Therapy](https://dralanjacobson.com/psychodynamic-therapy/)

- How it blends:
    Traditional talk therapy explores the unconscious and past. Somatic therapy can access nonverbal trauma or emotional memory stored in the body, which might not be accessible through words alone.
- Example:
    A client may uncover early attachment wounds not through a story, but through chronic shoulder tension or collapsing posture that reflects an internalized sense of shame.

9. #### [Trauma-Informed](https://dralanjacobson.com/trauma-informed-care/) Yoga or Movement Therapy

- How it blends:
    Somatic therapy shares many goals with trauma-sensitive yoga: reconnecting with the body, creating choice, and moving out of freeze states.
- Example:
    I might integrate gentle movement, breath, or stretching to release trauma energy stored in the muscles. This is often paired with even deeper somatic experiencing.

10. #### Art or [Expressive Therapies](https://dralanjacobson.com/supportive-expressive-therapy/)

- How it blends:
    While expressive therapies allow for nonverbal expression through art or music, somatic therapy helps ground that expression in bodily experience.
- Example:
    A client painting a chaotic image of their anxiety might be guided to notice what sensations arise, and then use grounding techniques to process those feelings.

### Why Use an [Integrative Practice](https://dralanjacobson.com/integrative-therapy/)

The example explored here combines somatic awareness with many other techniques and approaches I use. It helps point out the reasons for using an integrative practice like mine. In addition:

- It respects the **complexity of human experience**—mental, emotional, physical, and existential.
- Clients often benefit from **multiple access points**: some heal through insight, others through movement, presence, or values alignment.
- Multiple approaches foster **regulation and resilience** by meeting clients where they are—whether in crisis, chronic stress, or deep reflection.

### Conclusion

Many people cultivate resilience, self-compassion, and a greater sense of agency by learning to stay present and build somatic awareness when stress arises including physical tension, intrusive thoughts, or existential doubt. From this place, growth becomes more than possible; it becomes personal, purposeful, and lasting. If you still want to understand somatic therapy or somatic experiencing or learn more about the somatic therapy exercises that might benefit you, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Types of Therapy

---

### [Teletherapy Groups](https://dralanjacobson.com/teletherapy-groups/)

**Published:** March 6, 2024
**Author:** Dr. Alan Jacobson

**Content:**

I offer **teletherapy groups** for specific purposes that work well in the group format. The **virtual group therapy** I offer is open, meaning that new people can join any time, and all virtual, meaning there will not be some people meeting in person and others joining virtually. Right now, I have three online group therapy programs running:

1. [Fear of flying](https://dralanjacobson.com/fear-of-flying-group/)
2. [Fear of public speaking](https://dralanjacobson.com/fear-of-public-speaking-groups/)
3. [Young adults](https://dralanjacobson.com/group-therapy-for-young-adults/)

Feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime about these offerings, but here is some general information. There is also a page about [online therapy](https://dralanjacobson.com/virtual-therapy-guide/) in general.

## More About My Teletherapy Groups

Right now, I am running the following online group therapy services:

#### Fear of Flying Teletherapy Groups

This online group therapy experience comprises adults with significant [anxiety about flying](https://dralanjacobson.com/fear-of-flying-therapy/). Most members either don’t fly at all or seriously limit their flying. Many suffer from both anticipatory anxiety and fears the day of the flight. Most have never experienced a problem aboard an aircraft but developed flight anxiety anyway. The format is ideal for a fear-of-flying group because you feel understood, supported, and connected without pressure to move faster than you are comfortable. Your hopefulness and confidence will increase as fellow members succeed.

#### Fear of Public Speaking Teletherapy Groups

This one is made up of adults who face fear and anxiety when they need to speak in front of people. For some, part of their work requires them to speak in front of others, while others get [nervous when speaking in front of a small number](https://dralanjacobson.com/public-speaking-anxiety/) in an informal situation. This experience is innovative and unique in that we review [public speaking](https://dralanjacobson.com/public-speaking-fear/) lessons and anxiety treatment strategies. In other words, no matter what your fears are, you will [learn ways to be a better public speaker](https://professional.dce.harvard.edu/blog/10-tips-for-improving-your-public-speaking-skills/), and that, along with specific therapeutic techniques, will help you overcome your fears.

#### Young Adults Virtual Group Therapy

Young adulthood is a time of significant change, with a lot of important decision-making about careers, social life, and family relationships. It is an exciting time, but the pressure and worry can lead to a lack of contentment and a feeling that there is not enough meaning in life. My young adult [teletherapy service allows you to share your fears,](https://dralanjacobson.com/fear-of-public-speaking-groups/) hopes, worries, and expectations with others who fully understand. You’ll learn a lot from each other, and we’ll go over ways to increase coping strategies, confidence, meaningfulness, and existential comfort.

## Therapeutic Approaches

I use a combination of the following approaches in online group therapy:

#### Psychoeducational Group Teletherapy

This approach provides members with information about mental health conditions, solutions, coping strategies, and communication skills. Psychoeducation aims to enhance understanding, give you a toolkit to use outside of sessions, and ensure you take away concrete ideas and strategies you may not have thought of.

#### Cognitive-Behavioral Online Group Therapy

[CBT in a virtual group therapy setting](https://dralanjacobson.com/therapy-online-approaches-techniques-and-outcomes/) involves identifying and challenging negative thought patterns and maladaptive behaviors. Members learn to [recognize cognitive distortions](https://dralanjacobson.com/cbt-for-social-anxiety/) (for example irrational and exaggerated worries) and develop healthier coping mechanisms through exercises, discussions, and homework.

#### Supportive Group Teletherapy

This approach emphasizes empathy, validation, and mutual support among members. It provides a safe space for members to express their emotions, share experiences, and receive validation from others facing similar challenges. You can participate as much or as little as you’d like, and no matter what you will likely feel understood and validated.

#### Mindfulness-Based Approaches

[Mindfulness-based approaches](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) integrate mindfulness meditation practices with cognitive and behavioral techniques. Members learn to cultivate [present-moment awareness, self-compassion, and acceptance](https://dralanjacobson.com/mindfulness-therapy/) to manage stress, anxiety, and depression.

#### Existential Group Teletherapy

[Existential therapy](https://dralanjacobson.com/existential-therapy/) focuses on exploring existential themes such as freedom, meaning, and isolation. Members reflect on their values, beliefs, and life purpose to confront existential anxiety and find deeper meaning in their experiences. This approach is most common in my [young adults groups](https://dralanjacobson.com/group-therapy-for-young-adults/)

I tailor these clinical approaches to the specific needs of the individuals involved.

## Benefits of Teletherapy Groups

The benefits of teletherapy groups include:

### Accessibility of Teletherapy Groups

Virtual group therapy offers increased accessibility for individuals with difficulty attending in-person sessions due to geographical constraints or scheduling conflicts. You can join one of your choice that has a good reputation or uses the approach you are looking for, even if the psychologist is not near where you live. The convenience is particularly attractive to those with busy schedules or hurdles such as childcare, making going to an office difficult.

### Comfort and Relative Anonymity

Teletherapy groups can offer a sense of anonymity and comfort for participants who may feel more at ease discussing sensitive topics from the privacy of their own homes. Most of the services I offer revolve around topics that may be sensitive, such as anxieties and fears. For some, the comfort of the virtual experience means a lot. While you cannot guarantee that you will not see someone you know, it is unlikely that the ones I offer brings in people from 42 states. You do not have to go to an office where people might see you entering with virtual group therapy.

## Challenges with Online Group Therapy

It’s important to note that teletherapy groups may present certain challenges compared to traditional in-person, including:

### Technological glitches and Virtual Group Therapy

While technological issues such as “freezing” and temporary Wi-Fi losses can easily be overcome in [online individual treatment](https://dralanjacobson.com/is-virtual-therapy-as-effective-as-in-person/), the problem is multiplied in group teletherapy because of the number of people involved. It is vital that people work as hard as they can to be in a place where the Wi-Fi signal is strong and the potential for interruption is low.

### Teletherapy Groups and Nonverbal Cues

A virtual meeting presents some challenges with picking up [nonverbal cues](https://positivepsychology.com/nonverbal-communication-cues/) and communication. Body language can be harder to read, for example. This is why I ask that anyone participating in my teletherapy groups leave their camera and microphone on throughout the time.

### Privacy and Confidentiality

I take steps to ensure the security of the online platform, so much of the challenge in this area requires the participants to follow certain guidelines for confidentiality and participation. Most of these instructions are easy, such as ensuring your screen is facing away from any direction where another person could see it, not repeating any names of people outside the session, and being in a private place during the session.

## Virtual Group Therapy Example

Online group therapy planning involves structuring sessions that promote interaction, connection, and personal growth, while ensuring privacy and ethical considerations in an online format. Below is an example structure focused on stress management—samples of my offerings are on their respective pages on my [Group Therapy](https://dralanjacobson.com/group-therapy/) options page.

#### Online Group Therapy Overview:

- Duration: 6 weeks, 1 session per week
- Session Length: 60-90 minutes
- Platform: My [HIPAA-compliant video platform](https://dralanjacobson.com/telehealth-therapy-teletherapy/)
- Size: 6-8 participants
- Goal: To teach participants healthy coping mechanisms, foster support among members, and provide tools for managing stress in daily life.

### Virtual Group Therapy Sessions

Online group therapy sessions in my practice might unfold as follows:

#### Virtual Group Therapy Session 1: Introduction and Establishing Trust

- **Objective**: Set the tone, discuss confidentiality, establish rules, and get to know each other.
- **Activities**: 
    - Welcome & Ground Rules: I explain the group’s purpose and the importance of confidentiality.
    - Icebreaker: Each participant shares their name, a brief introduction, and a current stressor.
    - Agreement: Create an agreement on confidentiality, respect, and participation.
    - Psychoeducation: I briefly introduce the concept of stress and its effects on the body and mind.
    - Homework: Reflect on personal stress triggers and coping mechanisms.

#### Session 2: Understanding Stress and Its Impact

- **Objective**: Help participants recognize their stress triggers and the physical/emotional impact of stress.
- **Activities**: 
    - Check-in: Participants share how they are feeling today.
    - Discussion: I facilitate a discussion about common stressors and their impact on health.
    - Activity: Guided visualization or body scan to help participants notice where they hold stress.
    - Group Discussion: Participants share insights about how stress manifests in their body/mind.
    - Homework: Journaling exercise to track stress triggers throughout the week.

#### Session 3: Coping Strategies for Managing Stress

- **Objective**: Teach participants healthy ways to cope with stress.
- **Activities**: 
    - Check-in: Participants discuss their experiences from the journaling exercise.
    - Psychoeducation: I introduce to coping strategies such as [mindfulness strategies](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/), breathing techniques, and time management.
    - Practice: Practice deep breathing and mindfulness exercises together.
    - Discussion: How can these techniques be applied to real-life situations?
    - Homework: Practice one new coping technique daily and note any changes in stress levels.

#### Session 4: Cognitive Restructuring for Stressful Thoughts

- **Objective**: Teach participants how to identify and reframe negative or stressful thoughts.
- **Activities**: 
    - Check-in: Share successes and challenges using coping techniques.
    - Psychoeducation: I introduce [cognitive-behavioral techniques](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) for identifying negative thought patterns.
    - Activity: Each participant identifies a recent stressful situation and works through reframing it with the help of other members.
    - Homework: Continue practicing cognitive restructuring in daily situations.

#### Session 5: Building Resilience and Preventing Burnout

- **Objective**: Focus on long-term strategies for managing stress and avoiding burnout.
- **Activities**: 
    - Check-in: Discuss how cognitive restructuring exercises have worked.
    - Psychoeducation: I introduce to resilience-building techniques and self-care practices.
    - Activity: Group discussion on personal boundaries, saying “no,” and self-care routines.
    - Homework: Create a personalized self-care plan for the next week.

#### Session 6: Wrap-Up and Future Planning

- **Objective**: Reflect on the progress made and create a plan for continued stress management.
- **Activities**: 
    - Check-in: Reflect on progress and how stress management techniques have been helpful.
    - Group Reflection: Share personal growth and key takeaways from the experience.
    - Action Planning: Each participant creates a stress management action plan for the future, incorporating lessons learned.
    - Goodbye Ritual: Facilitator leads a brief closing ritual (e.g., sharing one word for the experience, or a closing meditation).

### Online Group Therapy Rules/Guidelines:

- Respect confidentiality.
- Allow everyone time to speak.
- Be open and supportive.
- Attend all sessions if possible.
- Commit to active participation and engagement.

This example offers a well-rounded online group therapy experience, focusing on stress management and personal growth.

## Summary and My Current Teletherapy Groups

Overall, teletherapy groups can be a valuable and effective option for those seeking mental health support, and I choose topics that work well in this format. I use state-of-the-art portals for this work to assure your [privacy and confidentiality](https://www.apa.org/topics/psychotherapy/confidentiality). Right now, I have the virtual group therapy opportunities listed on this post, and you can learn about new groups by going to the [Group Therapy](https://dralanjacobson.com/group-therapy/) page.

I use an open format, meaning that new members can join at any time. They are fully virtual.

Don’t hesitate to [contact me](https://dralanjacobson.com/contact/) anytime if you want to learn more about virtual group therapy, are interested in joining one of my teletherapy groups, or just have general questions.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Virtual

---

### [CBT for Fear of Public Speaking](https://dralanjacobson.com/cbt-for-fear-of-public-speaking/)

**Published:** January 21, 2024
**Author:** Dr. Alan Jacobson

**Content:**

I provide **CBT for Fear of Public Speaking** as a core service in my practice. [Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) is a highly effective approach for this anxiety, having been [proven over decades](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5797481/). I wanted to provide a post describing a specific approach to a specific challenge, and this is a good example. Cognitive-behavioral therapy for speech anxiety is often time-limited, with powerful and effective results. With CBT for public speaking anxiety, you’ll end up with a toolkit you can use should your fears return or even to use on other anxieties.

Even in my [integrated practice](https://dralanjacobson.com/integrative-therapy/), I often start with primarily cognitive-behavioral therapy for fear of public speaking because of the results I have seen. We can certainly mix in other methods if you want to address other challenges or barriers or if, after conquering your fear, you want to explore what caused it in the first place.

You are welcome to contact me or schedule a consultation about CBT for speech anxiety. Still, first, I wanted to provide an overview of how this method works in individual therapy and specialties such as [college admissions counseling](https://dralanjacobson.com/college-admissions-counseling/) and executive coaching.

## CBT for Fear of Public Speaking Techniques

CBT for speech anxiety follows a clear and well-defined set of steps, which works for many people because you begin to see results quickly. Reaching goals can be motivating and can increase confidence. The following are the steps in [individual therapy](https://dralanjacobson.com/individual-therapy/) for public speaking fear:

### Initial CBT for Fear of Public Speaking Steps

- Identify Negative Thoughts: We start by identifying your negative thoughts related to public speaking. What specific fears or beliefs contribute to your anxiety? We will try to notice any exaggeration or irrationality in those thoughts.
- Challenge Negative Thoughts: Next, we’ll start to question the accuracy of these negative thoughts. Are they based on facts or distorted perceptions? That will lead us to challenge irrational beliefs and replace them with more realistic thoughts.
- Positive Visualization: Our final step in this phase is practicing [positive visualization](https://psychcentral.com/lib/imagery-in-everyday-life). I’ll ask you to imagine yourself speaking confidently and successfully in front of an audience. Your homework from the initial sessions will be to repeat this visualization regularly to reinforce positive associations.

### Cognitive-Behavioral Therapy for Speech Anxiety Next Steps

- Gradual Exposure: After we’ve done some of the work above, you’ll [gradually expose yourself](https://dralanjacobson.com/fear-of-public-speaking-therapy-process/) to public speaking situations. You’ll start with small and less intimidating settings, then progressively move to larger audiences. This will help desensitize you to the fear. We’ll never move faster than you’re comfortable unless, of course, you don’t have control over that because of work responsibilities.
- Systematic Desensitization: In this step, we will break down the public speaking process into smaller steps. This will allow you to gradually expose yourself to each step, starting with less anxiety-provoking tasks. This systematic approach helps build confidence over time.
- Mindfulness and Relaxation Techniques: I’ll teach you [mindfulness techniques](https://dralanjacobson.com/mindfulness-therapy/) and relaxation exercises to manage anxiety during this phase. [Deep breathing, progressive muscle relaxation, and mindfulness meditation](https://dralanjacobson.com/panic-attack-treatment/) can help you stay calm and focused.

### As CBT for Fear of Public Speaking Starts to Work

- Focus on Skills: As you begin to feel more confident and less anxious, we’ll work to shift your focus from fear to developing and improving your [public speaking skills](https://professional.dce.harvard.edu/blog/10-tips-for-improving-your-public-speaking-skills/). The more competent you feel, the less anxious you may become. I’ll help you learn new skills and may even [refer you to a trusted program](https://dralanjacobson.com/fear-of-public-speaking-groups/) if you’d like.
- Rehearse: You’ll also learn the best ways to review your speech multiple times, either in front of a mirror or with a trusted friend. Familiarity with your material boosts confidence and reduces anxiety. I’ll show you how to get the most out of that process and how to mix cognitive-behavioral therapy for speech anxiety techniques into this step.
- Self-Compassion: As part of my overarching [humanistic approach](https://dralanjacobson.com/basic-tenets-of-humanistic-psychology/), we’ll work on ensuring that you are being kind to yourself. You’ll learn to acknowledge that everyone experiences nervousness before public speaking. Treating yourself with compassion can help you avoid self-critical thoughts.

## CBT for Fear of Public Speaking Results

The effectiveness of CBT for fear of public speaking often depends on your commitment to the therapy process, the severity of your fear, and your opportunities to challenge your fears. In most cases, the speed at which you tackle your fears is up to you, and I don’t push you to work any faster than you are comfortable. Here are some potential outcomes and results you can expect from CBT for public speaking anxiety:

### CBT for Fear of Public Speaking Reduces Anxiety Levels

CBT for public speaking anxiety aims to identify and challenge negative thought patterns associated with public speaking fears. By changing these thought patterns, you can experience a reduction in anxiety levels related to public speaking. This is often the first thing people notice as treatment progresses.

### Improved Coping Strategies Through CBT for Speech Anxiety

Cognitive-behavioral therapy for public speaking anxiety equips you with practical coping strategies to manage anxiety and stress associated with public speaking. This might include relaxation techniques, positive self-talk, and exposure exercises to desensitize fear gradually. You will get to challenge yourself at a comfortable pace, and as things get better, you’ll likely feel quite proud.

### Increased Self-Confidence Through Cognitive Techniques

As individuals progress through cognitive-behavioral therapy for speech anxiety, they often develop a more positive self-perception and increased self-confidence. This can translate into feeling more capable and less fearful when facing public speaking situations and, more generally, situations where they feel under a spotlight of some sort.

### Behavioral Changes that Are Generally Helpful

Cognitive-behavioral therapy for speech anxiety encourages individuals to confront and change maladaptive behaviors associated with their fear. This might involve gradual exposure to public speaking situations and other social activities, allowing them to build confidence over time beyond just the public speaking arena. Successfully overcoming the fear of public speaking can contribute to overall personal growth. Individuals may find themselves more open to new challenges, more willing to take on leadership roles, and more adept at handling stress in various areas of life.

### Enhanced Communication Skills

Beyond just reducing fear, CBT for fear of public speaking can help individuals improve their overall communication skills. This includes learning effective ways to convey messages, engage with an audience, and handle unexpected challenges during public speaking.

It’s important to note that the effectiveness of CBT for public speaking anxiety can vary from person to person. Some people experience significant improvements relatively quickly, while others require more time and consistent effort. One thing is quite true: Public speaking anxiety is treatable, and CBT is a great fit.

## Cognitive-behavioral Therapy for Speech Anxiety Example

Here is how I might use cognitive-behavioral therapy for speech anxiety in my practice:

Jennifer is a 30-year-old woman who works in public relations and frequently has to speak in front of people. When she received her latest promotion, she suddenly developed a fear of speaking in front of groups. She had always had some anxiety, but in the new role, she has become much more nervous about not being seen as competent or effective when she speaks in front of others.

### Cognitive-Behavioral Therapy for Speech Anxiety Step One

First, we identify the automatic, though sometimes hard to perceive, negative thoughts that Jennifer has developed associated with public speaking. These thoughts include:

– “I’m going to embarrass myself in front of everyone. They will wonder how I got this position.”
– “People will judge me harshly if I make a mistake.”
– “I’ll forget what I want to say and freeze up.”

### CBT for Public Speaking Anxiety Step Two

Now that we’ve identified these automatic negative thoughts, we must challenge their accuracy and validity with the next step in CBT for public speaking anxiety. For example:

– “Is there any evidence that supports the idea that I’ll embarrass myself? Have I spoken publicly before without any issues?”
– “Even if I make a mistake, is it realistic to think everyone will judge me harshly? Most people are understanding and empathetic.”
– “What’s the worst that could happen if I forget what I want to say? It’s unlikely to be catastrophic, and I can always recover. I’ve seen plenty of people I respect recover and do fine.”

### Step Three: Replacing Negative Thoughts with Realistic Ones

The next step in CBT for public speaking anxiety involves replacing the negative thoughts with more realistic and helpful ones:

– “I’ve prepared for this presentation and have experience speaking in public. I can handle this.”
– “Everyone makes mistakes occasionally, and it’s okay. People are generally supportive and understanding.”
– “Even if I forget something, I can improvise or refer to my notes. It’s not the end of the world.”

Between therapy sessions, she’ll continue to think more about these positive thoughts and try to replace anticipatory thoughts and fears with them.

During cognitive-behavioral therapy for speech anxiety, we will also work to reduce the impact of these thoughts. She plans to gradually expose herself to public speaking situations in more intimidating settings, practice relaxation techniques, such as deep breathing or progressive muscle relaxation, and use visualization or imagery exercises to rehearse successful public speaking experiences mentally.

By systematically addressing both the cognitive and behavioral aspects of public speaking anxiety, CBT for public speaking anxiety can empower individuals to gradually overcome their fears and develop more adaptive ways of thinking and behaving in public speaking situations.

## Cognitive-Behavioral Therapy for Speech Anxiety in My Practice

Overcoming the [fear of public speaking](https://dralanjacobson.com/public-speaking-anxiety/) is gradual, and taking small steps is okay. Consistent practice and a positive mindset can contribute to significant improvement over time. CBT for fear of public speaking will speed up the process clearly and clearly. CBT addresses immediate concerns and provides you with tools and skills to manage your fear of public speaking in the long term. This may involve ongoing self-monitoring and applying learned strategies independently.

I provide CBT for public speaking anxiety as part of [individual therapy](https://dralanjacobson.com/individual-therapy/) and also in [specialty services](https://dralanjacobson.com/intensive-therapy-and-specialty-services/) such as [college admissions counseling](https://dralanjacobson.com/college-admissions-counseling/) and executive coaching. CBT for speech anxiety can be delivered quite effectively through [online therapy](https://dralanjacobson.com/virtual-therapy-guide/).

If you want to understand how this approach might help you or have general questions about **CBT for fear of public speaking**, don’t hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.linkedin.com/company/psychologicalscience/)

**Categories:** Symptom Relief

---

### [Examples of Counseling for Athletes](https://dralanjacobson.com/counseling-for-athletes/)

**Published:** May 8, 2023
**Author:** Dr. Alan Jacobson

**Content:**

I provide **counseling for athletes** of all ages and levels. The following are two examples of the types of athlete therapy I provide, using the psychology of sports performance as a base to improve things both on and off the field of play. If you’d like information or to discuss how these methods may benefit you or a loved one, please [schedule a consultation](https://www.picktime.com/scheduleaconsult) or [contact me](https://dralanjacobson.com/contact/) anytime.

## Psychology of Sports Performance

Performance in sports is influenced not just by physical ability but also by mental factors such as confidence, focus, motivation, and resilience. Athletes who train their minds and bodies often gain a competitive edge.

---

### Key Factors in the Psychology of Sports Performance

1. **Psychology of Sports and Confidence**
    - Athletes with high confidence perform better under pressure.
    - Self-doubt can lead to hesitation and mistakes.
    - Confidence can be built through preparation, positive self-talk, and past successes.
2. **Psychology of Sports and Focus** 
    - The ability to stay present and block out distractions is critical.
    - Athletes use techniques like [mindfulness](https://dralanjacobson.com/mindfulness-therapy/) and visualization to improve focus.
    - Losing focus can lead to errors and missed opportunities.
3. **Psychology of Sports and Motivation**
    - Two types of motivation: 
        - **Intrinsic Motivation:** Driven by love for the sport, personal growth, and enjoyment.
        - **Extrinsic Motivation:** Driven by rewards, recognition, or external pressures.
    - Highly motivated athletes are more likely to push through challenges.
4. **Psychology of Sports and Anxiety**
    - A moderate level of stress can enhance performance (known as the [**Yerkes-Dodson Law**](https://www.simplypsychology.org/what-is-the-yerkes-dodson-law.html)).
    - Too much anxiety can lead to muscle tension, poor decision-making, and reduced performance.
    - Strategies like breathing exercises, progressive muscle relaxation, and reframing negative thoughts help manage anxiety.
5. **Psychology of Sports and Resilience**
    - The ability to bounce back from failure, setbacks, or injury.
    - Mentally tough athletes stay focused and perform under pressure.
    - Techniques like goal setting, mindfulness, and cognitive restructuring help build resilience.
6. **Psychology of Sports and Visualization**
    - Athletes mentally rehearse successful performances before competing.
    - Helps with muscle memory, confidence, and stress reduction.
    - Used by elite athletes in all sports to prepare for high-pressure situations.
7. **Psychology of Sports and Mindfulness**
    - **[Athletic Flow State](https://dralanjacobson.com/flow-state/):** A mental state where athletes feel fully immersed in their performance, leading to peak performance.
    - Achieved by balancing challenge and skill level, eliminating distractions, and staying in the moment.

---

### Strategies in Counseling for Athletes

- **[Cognitive-Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT):** Helps athletes reframe negative thoughts and develop confidence.
- **Goal Setting:** Setting specific, measurable, achievable, relevant, and time-bound (SMART) goals improves motivation and focus.
- **Routine Development:** Pre-game routines help athletes get into the right mindset before competition.
- **Breathing & Relaxation Techniques:** Helps manage anxiety and keep the body relaxed under pressure.
- **Positive Self-Talk:** Replacing negative thoughts (“I’m going to fail”) with constructive ones (“I’ve trained for this, I am ready”).

---

The mental side of sports is just as important as the physical. Athletes who develop strong psychological skills tend to perform better, recover faster from setbacks, and enjoy their sport more. By training the mind and body, athletes can reach their full potential.

---

## Counseling for Athletes Example: D1 College Student-Athlete

Taylor is a Division I college athlete at a high-level school looking for **sports psychotherapy** before her second year. She plays varsity softball and is getting excellent grades. As a sophomore, she hopes to improve her performance even further and increase the joy she feels in her sports.

Taylor is doing well on the diamond but is finding that two challenges have arisen: First, she is not experiencing the same periods of being “in the zone” at the plate that she once had, leading to a lower batting average than she is used to; and second, she is not enjoying the sport as much as she once did. In both cases, she found that the problems started shortly into her first year, but she is unsure why. She has chosen my [sports psychology intensive therapy](https://dralanjacobson.com/sports-psychology/).

The following outlines the path we might take, the expected outcomes, and then a description of how [my services](https://dralanjacobson.com/types-of-therapy/) can help you.

### Counseling for Athletes First Step: Collect a History

Counseling for athletes has a [specific therapeutic process](https://dralanjacobson.com/sports-performance-psychology/). We start with a detailed athletic history from the beginning of her competitive softball career. We talk about the times when she experienced “[feelings of flow](https://www.sciencealert.com/the-science-of-why-flow-states-feel-so-good-according-to-a-cognitive-scientist),” times when she struggled, and everything in between. With this information, we work to paint a picture of when she garnered the most enjoyment from her sport and what factors contributed. Taylor talked to her parents and her former coaches in this exploration, seeing what input they had from their years of knowing her as an athlete.

#### Barriers and Challenges

We were able to generate a detailed history that included many factors that may have affected her along the way – everything from how challenging other aspects of her life were at those times, what role she had on each team, the type of seasons her teams were having and her overall schedule. Taylor began to realize that she did better historically when her role on a team was clear, she had time to work on her craft, and her teammates were supportive but not critical. She didn’t mind tough coaching but did better when she developed a relationship with the coach that allowed her to read her moods and not take feedback too personally.

#### Opportunities with Counseling for Athletes

Our first goal is to help Taylor improve her mindset and find additional success on the playing field. We also want to increase her confidence, stress management, and coping strategies. The hope is that these improvements from counseling for athletes carry over into other aspects of her life, including school performance, her achievements at her upcoming internship, and her social life. Sports psychology is rarely done in a vacuum, so we want to work together to help her [improve her outlook and performance](https://dralanjacobson.com/sports-performance-improvement-innovations/) in a wide number of areas.

### Counseling for Athletes: Next Steps

We temporarily leave history behind to explore what is going on now. Taylor watches video sessions that she edited involving some recent at-bats. We watched the video and reviewed her thoughts and feelings at each point. We look for patterns and other clues to what might get in the way of “flow.” We also discuss her general anxieties and the automatic, often exaggerated, and even irrational thoughts that bring her down. Finally, we discuss the imagery her mind is conjuring that is negative and unhelpful and work to replace it with positive images.

Now, we compare this with her history to see what was different during periods of flow and being in the zone. We are not just looking for the automatic thoughts but also for the ways they differ from her more positive thought patterns.

#### Counseling for Athletes Toolkit

Throughout our work together, Taylor builds a toolkit of strategies to reduce irrational and exaggerated thoughts and build confidence. These powerful and proven cognitive-behavioral techniques can be paired with quick relaxation and stress management techniques. We also work on [visualization methods](https://www.forbes.com/sites/lidijaglobokar/2020/03/05/the-power-of-visualization-and-how-to-use-it/), choosing among many options to see which techniques work best for her. Finally, we work on self-talk and how she can mirror the positive feedback she continually receives from coaches and her teammates, as well as her growing confidence, to develop positive trains of self-talk.

#### Homework Assignments

Homework assignments often include incorporating something we discussed in session, such as a phrase she will use, an image she will bring to mind, or a specific technique she will incorporate into practices or games. During treatment, we also discuss what she loves about her sport and what sometimes gets her down. We also talk about many other aspects of her life and how they all fit together for her as a college student-athlete. Part of the homework is to track all aspects of her life, how much joy she derives, and how sports fit in.

#### Day of game homework

We also discussed things that Taylor could do on the day of her games as part of her counseling for athletes’ homework. Much of this involves remembering to use the techniques she learned in sessions- the toolbox. She’s also instructed to remember certain things, like how she felt at each at-bat or when she fielded a ball. She might also think about the feedback she received directly or perceived from her teammates and coaches. Finally, she might be asked to write in a journal-style fashion what she ate before the game, how she slept, and generally what her stress level was.

### Counseling for Athletes Outcomes

Through counseling for athletes, Taylor has learned much about herself and her game. She makes the following changes in her routine:

1. Talking more with her college coach and assistant coaches to better understand their styles and how they like giving feedback.
2. She changed her college routine overall so she has some time to work independently on her sport without giving up too much of the overall college experience.
3. She developed closer relationships with her Captains, asking them for feedback and advice.
4. These insights led to learning exactly what type and timing of visualization works best for her and [improved and refined her self-talk](http://www.sportpsychologytoday.com/youth-sports-psychology/using-positive-self-talk-to-improve-performance/).
5. She used effective relaxation and mindfulness techniques that helped her focus.
6. She was also to recognize even fleeting irrational and exaggerated negative thoughts and shut them down.

Taylor found that she could change her mental approach and see the keys to getting in a groove more often. She also finds ways to magnify what she loves about her sport while finding the balance she seeks. She felt renewed motivation and drive, looking forward to using these new [sports psychology](https://dralanjacobson.com/sports-psychology/) techniques.

## High School Athlete Therapy Example

Jake is a 17-year-old pitcher with performance anxiety and fear of failure after a recent slump. He enters athlete therapy to regain confidence and improve mental resilience on the mound.

Jake has been a starting pitcher for his high school baseball team for the past two years. Recently, he has struggled with performance anxiety after giving up several runs in a key game. Since then, he has felt increasingly nervous before games, overthinks his pitches, and has trouble sleeping the night before a start. His coach and parents have noticed a drop in his confidence, and Jake reports that he feels like he’s “letting the team down.”

---

### Phase 1: Counseling for Athletes Assessment & Goal Setting

- **Athlete Therapy Sessions:** Initial intake and psychological assessment
- **Findings:**
    - High levels of pre-game anxiety (reported 8/10 anxiety on game days)
    - Negative self-talk (“I’m going to mess up again”)
    - Difficulty focusing under pressure
    - Avoidance behaviors (hesitating to throw inside fastballs, relying on off-speed pitches too much)
- **Athlete Therapy Goals Set:**
    - Reduce pre-game anxiety to a manageable level (4/10 or lower)
    - Improve focus and confidence in high-pressure situations
    - Develop a mental routine to handle setbacks

---

### Phase 2: Athlete Therapy Mental Skills Training

- **Cognitive Restructuring:**
    - Identified and replaced negative self-talk (“I can’t do this”) with affirmations (“I have prepared for this moment”)
    - Practiced thought-stopping techniques when overthinking during games
- **Breathing & Relaxation Techniques:**
    - 4-7-8 breathing exercises before games
    - Progressive muscle relaxation on the night before a start to improve sleep
- **Athlete Therapy Visualization Training:**
    - Spend 10 minutes before each practice visualizing himself executing perfect pitches under pressure
    - Watch past highlights of his best performances to reinforce confidence

---

### Phase 3: Resilience & Emotional Regulation

- **Pre-Game Routine Development:**
    - Created a step-by-step mental warm-up (breathing exercises, listening to music, reviewing a confidence-boosting statement)
    - Practiced focusing on one pitch at a time instead of worrying about the whole game
- **Managing Setbacks:**
    - Reframed mistakes as learning opportunities rather than failures
    - Used a quick reset routine (deep breath + positive self-talk) after a bad pitch
- **Team & Coach Communication:**
    - Discuss concerns with his coach, who provided reassurance and encouragement
    - Practice asking teammates for support rather than isolating himself after a rough game

---

### Phase 4: Performance Optimization & Long-Term Strategies

- **Athlete Therapy Outcome:**
    - Jake reports feeling much calmer before games (anxiety reduced to 3-4/10)
    - Performance improved as he regained confidence in his pitching
    - Continues using visualization and breathing techniques to stay focused
    - No longer avoids aggressive pitching strategies due to fear of failure
- **Athlete Therapy Ongoing Plan:**
    - Periodic mental health check-ins
    - Maintain a strong pre-game routine to reinforce confidence
    - Continue using mindfulness techniques to manage stress

---

### Athlete Therapy Conclusions

Jake successfully overcame his performance anxiety by developing mental resilience, improving his self-talk, and using relaxation techniques. He can sustain these mental skills throughout his baseball career with continued practice.

## Summary and My Work

These treatment examples are not based on a specific person but is a braiding of many courses of treatment based on the psychology of sports performance. They are examples of [what sports therapy entails and its process](https://dralanjacobson.com/sports-performance-psychology/). Every client I see for sports psychotherapy charts their unique path, determined by their background, experiences, goals, and the specific sport they play. We also ensure we set goals to carry over into other aspects of the athlete’s life. The goals of athlete therapy are clear from the start and as measurable as possible, and we continually follow up to ensure we’re progressing.

Please [contact me](https://dralanjacobson.com/contact/) to review your situation and discuss the **sports psychology therapy** techniques and approaches that may work for you. You can also check out our [sports psychology self-help](https://dralanjacobson.com/athletic-performance-improvement/) and [sports performance innovations](https://dralanjacobson.com/sports-performance-improvement-innovations/) pages as well.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Sports Psychology

---

### [Fear of Flying Treatment Example](https://dralanjacobson.com/fear-of-flying-treatment/)

**Published:** June 29, 2023
**Author:** Dr. Alan Jacobson

**Content:**

This **fear of flying treatment** example is typical of many people who come to therapy – a sudden onset in adulthood, no apparent precipitant, intense anxiety that does not happen with anything else, and a person knowing that their thoughts are at least somewhat irrational but not making a difference. **Therapy for fear of flying** can be very helpful and effective.

Sue is a young woman who entered therapy for fear of flying after becoming very fearful of flying soon after her first child was born. She is quite worried because her job requires travel every once in a while, and she has family in other parts of the country whom she enjoys seeing. She has no idea why this fear developed, but it has become severe, with significant [anticipatory anxiety](https://en.wikipedia.org/wiki/Anticipatory_anxiety). Her symptoms include intense anxiety, [mild panic](https://dralanjacobson.com/panic-attack-treatment/), rumination, and pervasive worry.

## Fear of Flying Treatment Initial Steps

There are two initial steps of a fear of flying treatment course:

### Fear of Flying Treatment Step One: Gathering History

We start our fear of flying treatment by gathering Sue’s history. She tells me when the symptoms started and what was happening in her life. We discuss how the fears have evolved, including the thoughts that accompany them, the evolution of her anticipatory anxiety, and what she has done in response to the fear. Understanding the origins of the fear can be helpful as treatment moves along, however it can be elusive and understanding it is often not imperative.

### Fear of Flying Treatment Step Two: Setting Goals

We continue our fear of flying treatment by setting our goals. We break the fear of flying into its component chronological parts: anticipatory anxiety, feelings that day, and sensations and thoughts aboard the aircraft. Our overarching goal is to reduce the anxiety enough not to cause undue stress, anxiety, and distraction. Our treatment method will be [Cognitive-Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) (CBT), a widely used and effective treatment for many phobias, including fear of flying. Goals at this stage may include reducing (for example, on a scale of 1-10) the anticipatory anxiety and during flight anxiety, not hesitating to travel, and learning new coping strategies.

We aim to identify and challenge negative thoughts and beliefs related to flying and replace them with more realistic and positive ones. We will investigate what her particular worries are. For example, she lists worries that turbulence could bring the plane down and that something unexpected will happen like she’s read about happening to other aircraft.

## Fear of Flying Treatment Course

It’s time to dive in and begin since Sue has set a goal of being able to fly to an important conference that is occurring in 6 weeks, so we start with three initial fear of flying treatment strategies:

### Challenging Irrational Thoughts

We look at each automatic and irrational thought she has about flying so we can later challenge them individually. We talk about why her anxiety exists in the first place (in her case, because she has a greater sense of responsibility now that she is a mom and because she is much more aware of her mortality than she was when she was younger). Then we take measurements, such as how much time she dreads flying daily. These measurements will help Sue see how she is progressing in therapy for fear of flying in a measurable and therefore motivating way.

### Cognitive Restructuring

The second step is using the information captured in step one to begin [cognitive restructuring](https://www.medicalnewstoday.com/articles/cognitive-restructuring). She will learn to challenge her irrational and exaggerated thoughts by using flight safety data, reminding herself of the real reason she is scared, and finding ways to practice distraction. Our goal at first is not to eliminate the anxiety but to show measurable progress in reducing the time she is anxious each day.

### Fear of Flying Treatment Through Gradual Exposure

We begin to [expose her to flying-related stimuli](https://dralanjacobson.com/exposure-therapy-for-anxiety/), starting with less anxiety-provoking situations (such as watching videos of airplanes safely taking off and landing, using virtual reality to simulate flights, and even having her go to the airport to watch flights taking off and landing safely). She also goes to websites where she can see a diagram of all the planes safely in the air.

### Conquering the Fear

The next step is actually flying. I do not push this step until Sue feels ready, but it becomes quite essential when she does. Since she does not have actual travel planned, she volunteers to take a short trip from Boston to New York for her work to go to a convention. This is ideal because the flight is short, and others from her work are going, which will provide distraction. She can also get support from a close friend who she will sit next to.

These three steps may be mixed and matched as treatment progresses, as we may return to steps one and two after she progresses in steps three and four.

### Fear of Flying Treatment Adjunctive Steps

As an additional step for her fear of flying treatment, Sue [joins an online support group](https://dralanjacobson.com/fear-of-flying-group/) to interact with others who share similar fears. This can provide a sense of understanding, validation, and encouragement. Sharing experiences, coping strategies, and success stories can help alleviate anxiety and build confidence. She also learned various self-help techniques to complement our formal treatment to build a toolkit she could use before and during the flight. These include [deep breathing exercises](https://positivepsychology.com/deep-breathing-techniques-exercises/), [progressive muscle relaxation](https://positivepsychology.com/progressive-muscle-relaxation-pmr/), [easy visualization](https://www.wikihow.health/Overcome-Your-Fears-Through-Visualization), and [the practice of mindfulness](https://mindfulminutes.com/flight-mindfulness-5-meditations-try-youre-traveling/) meditation.

## The Results and Other Possibilities

In the end, Sue’s anxiety did not completely disappear. We expected this from the beginning because taking actual flights and experiencing the relief and validation of landing safely each time is usually needed to overcome the fear entirely. Most people find that fear of flying goes away in steps, where the person realizes that the flight they are taking next is not causing as much anxiety as the last flight did. Sue will likely be no exception. She did get enough relief to make sure she did not miss a family event and a work conference, and she called after these two flights to say that getting on those airplanes accelerated her reduction in fear.

While this client decided that she could address her fear of flying without medication, she could have gone to her doctor for advice and information since medication, in some cases, can help manage anxiety symptoms associated with flight. Anti-anxiety medications, personal or short-acting sedatives, can help reduce anxiety and promote relaxation during flight decisions that should always be made with the advice and guidance of an MD.

This client also wanted to work on her difficulty in her individual fear of flying treatment, even though some think group treatment can be powerful. I have some trusted groups I refer to for those who I think would do better in group treatment. This type of treatment can also adjunct individual flying anxiety treatment.

## Therapy for Fear of Flying Conclusions

[Flying anxiety](https://dralanjacobson.com/flying-anxiety-treatment/), also known as aviophobia, can be a challenging and distressing issue for many people, such as our fictitious client described above. [Therapy for fear of flying](https://dralanjacobson.com/fear-of-flying-therapy/) can be a helpful and effective way to address and overcome this fear. The approaches listed above are often beneficial. In addition, therapy for fear of flying might also include:

### Virtual Reality Therapy for Fear of Flying

I sometimes use virtual reality technology to simulate experiences in a controlled environment. This allows cluents to gradually face their fear and become more comfortable with the idea of flying. VR therapy does require additional technology, but it can be quite effective. VR therapy for fear of flying works particularly well when a client needs a little more help with gradual exposure before actually going on a plane.

### Hypnosis as a Therapy for Fear of Flying

Hypnotherapy involves guided relaxation and focused attention to help individuals access their subconscious mind. Therapists may use suggestions to reframe negative beliefs and associations related to flying. I do not provide hypnosis as a therapy for fear of flying, but I can refer you to someone who does. In fact, this is one case where two therapists can work well, with one providing hypnotherapy and me providing the CBT structure around that approach.

It’s important to note that the effectiveness of therapy can vary from person to person, and a combination of approaches that may or may not be similar to the above may be best for you. My experience in treating phobias and anxiety disorders helps me develop a personalized treatment plan tailored to your specific needs.

## My Fear of Flying Treatment Services

Please note that this and all examples on my website involve fictitious people – they describe a general treatment course, and your [flying anxiety treatment](https://dralanjacobson.com/flying-anxiety-treatment/) may differ depending on your unique needs, circumstances, and etiology of symptoms. The steps outlined above are generally what we do in therapy for fear of flying, but we take each step at the pace with which you are comfortable. In some cases, there is a specific goal – an upcoming flight that cannot be avoided, for example – and we will discuss how to proceed to meet that goal.

Therapy for fear of flying can be interwoven with other approaches and specialties or stand-alone. It is not uncommon for executive coaching or [college admissions consulting](https://dralanjacobson.com/college-admissions-counseling/) to include this form of treatment because these people often have to do some traveling.

I hope this helps give an example of what **fear of flying treatment** would be like. Of course, feel free to [contact me](https://dralanjacobson.com/contact/) to review your situation and how I might help.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Fear of Flying Services

---

### [Forgiveness Therapy Steps and Integrations](https://dralanjacobson.com/forgiveness-therapy-steps-and-integrations/)

**Published:** April 2, 2025
**Author:** Dr. Alan Jacobson

**Content:**

**Forgiveness therapy**, or **acceptance and forgiveness therapy**, is a psychological approach that helps individuals process and release resentment, anger, and emotional pain caused by past hurts. Developed by [Dr. Robert Enright](https://internationalforgiveness.com/team/) and influenced by researchers such as [Dr. Everett Worthington](https://www.evworthington-forgiveness.com/), this therapy promotes emotional healing by guiding people through a structured process of acknowledging pain, reframing perspectives, and ultimately finding peace. Unlike traditional [types of therapy](https://dralanjacobson.com/types-of-therapy/) that focus on symptom management, **therapy for forgiveness** aims at deep emotional resolution, enabling people to regain control over their emotional well-being.

## Forgiveness Therapy: An In-Depth Exploration ![Acceptance and forgiveness therapy](https://dralanjacobson.com/wp-content/uploads/2025/04/path4-300x200.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

### History of the Forgiveness Therapy Model

Forgiveness therapy emerged from psychological and philosophical traditions, integrating elements of moral philosophy, religious teachings, and psychological healing. Dr. Robert Enright pioneered the modern psychological approach in the 1980s. He developed a structured therapeutic model based on cognitive and emotional processes, emphasizing that letting go can be a deliberate choice rather than a passive experience.

Other significant contributors include Dr. Everett Worthington, who introduced the [**REACH** therapy model](https://neurolaunch.com/reach-therapy/) for forgiveness, and various [positive psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/) researchers who explored its benefits for mental health and well-being. Acceptance and forgiveness therapy has been widely used in clinical psychology, trauma therapy, and conflict resolution.

### Who Is the Forgiveness Therapy Model Used For?

Forgiveness therapy is beneficial for individuals struggling with unresolved emotional pain, resentment, or trauma. It is applied across various psychological and relational challenges, including personal trauma, interpersonal conflicts, and mental health issues. Below are the primary groups of people who benefit from the forgiveness therapy model:

1. **Survivors of Trauma and Abuse**

- People who have experienced [**emotional, physical, or sexual abuse** in childhood](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/) or adulthood.
- Victims of **domestic violence** who are working through anger, betrayal, and self-blame.
- People with **PTSD** from violent crimes, war, or severe personal betrayals.
- Acceptance and forgiveness therapy helps them process their pain, release self-blame, and regain a sense of emotional control.

2. **People with [Family Estrangement](https://dralanjacobson.com/family-estrangement-therapy/) or Dysfunctional Upbringings**

- People who were neglected or abandoned by parents (e.g., raised by a young single parent, adopted children with [attachment issues](https://dralanjacobson.com/attachment-therapy/)).
- Siblings who have been in long-term conflict.
- Adult children with unresolved resentment toward parents.
- Acceptance and forgiveness therapy helps improve emotional well-being, even if reconciliation is impossible.
- It [treats parent-child codependency](https://dralanjacobson.com/codependency-therapy/)

3. **Individuals with Betrayal or Relationship Trauma**

- Spouses or partners dealing with **infidelity** or broken trust.
- Friends who have been deeply betrayed.
- As part of [separation or divorce counseling](https://dralanjacobson.com/divorce-counseling/).
- Acceptance and forgiveness therapy helps rebuild self-worth and trust, whether or not reconciliation occurs.

4. **People Struggling with Resentment or Anger Issues**

- People who hold grudges that affect their mental well-being.
- Those who struggle with **chronic anger, bitterness, or revenge-seeking behaviors**.
- Acceptance and forgiveness therapy helps reduce emotional distress and improve interpersonal relationships.

5. **Individuals with Depression, Anxiety, or Stress-Related Conditions**

- People whose resentment contributes to **chronic stress, anxiety, or depression**.
- Those experiencing emotional exhaustion from holding onto past pain.
- Acceptance and forgiveness therapy helps by promoting emotional release and reducing psychological distress.

6. **People with Grief and Loss Issues**

- People who are grieving the loss of a loved one but struggling with anger toward the deceased (e.g., feeling abandoned and resentful over past conflicts).
- Those angry at **circumstances or fate** (e.g., feeling wronged by life events).
- Acceptance and forgiveness therapy helps reframe loss and find emotional peace.

7. **Patients with Chronic Illness or Terminal Conditions**

- People dealing with chronic pain, cancer, or terminal illness who feel resentment toward life, caregivers, or themselves.
- People who are experiencing **guilt over past mistakes** or unresolved emotional burdens.
- Acceptance and forgiveness therapy helps alleviate emotional suffering and promote inner peace.

8. **Couples and Families in Conflict**

- Couples in [**marriage counseling**](https://dralanjacobson.com/marriage-counseling/) who are working through resentment and past wounds.
- Families dealing with **long-standing conflicts, estrangement, or deep misunderstandings**.
- Acceptance and forgiveness therapy helps rebuild relationships or find personal healing even if reconciliation is impossible.

9. **People in Religious or Spiritual Settings**

- People seeking [**faith-based healing**](https://neurolaunch.com/faith-based-therapy/).
- Those struggling with **spiritual guilt, moral injury, or resentment toward religious institutions or figures**.
- Acceptance and forgiveness therapy helps integrate forgiveness within spiritual and moral frameworks.

10. **People Navigating Workplace or Community Conflicts**

- People dealing with workplace injustices, discrimination, or unfair treatment.
- Community members working through **historical grievances or cultural conflicts**.
- Acceptance and forgiveness therapy helps foster reconciliation and improve workplace or social dynamics.

### Does the Person Need to Reconcile?

**No**— the forgiveness therapy model is about **emotional release**, not reconciliation. Some people reconnect with the person they are forgiving, while others use it as a personal healing process without direct contact.

### Who Uses Forgiveness Therapy?

Forgiveness therapy is utilized by:

- **[Clinical psychologists](https://dralanjacobson.com/what-is-a-clinical-psychologist/) and therapists** – use therapy for forgiveness to help clients struggling with trauma, resentment, and emotional wounds.
- **Counselors specializing in trauma and abuse** – use therapy for forgiveness to aid survivors in healing from past betrayals and injustices.
- **Marriage and family therapists** – use therapy for forgiveness to assist couples and families in overcoming conflict, infidelity, and estrangement.
- **Religious and spiritual counselors** – use these techniques as a moral and emotional practice.
- **[Life coaches](https://www.verywellmind.com/what-is-a-life-coach-4129726) and self-help practitioners** – use therapy for forgiveness to guide individuals toward emotional growth and resilience.
- **Medical professionals** – particularly in palliative care and chronic illness management, forgiveness therapy steps are used to support emotional healing and reduce stress-related conditions.

### Therapeutic Forgiveness Techniques

1. [**Cognitive Restructuring**](https://dralanjacobson.com/cognitive-restructuring/) – Changing negative thought patterns about the offender or event
2. **Empathy Development** – Encouraging understanding of the offender’s perspective (without justifying their actions)
3. **Emotional Processing** – Acknowledging and expressing anger, grief, and pain
4. **Guided Imagery & Letter Writing** – Writing unsent letters to the offender to process emotions
5. **Behavioral Commitments** – Engaging in acts of kindness or symbolic gestures of release
6. [**Mindfulness & Meditation**](https://dralanjacobson.com/mindfulness-therapy/) – Using techniques to manage anger and promote acceptance
7. **Role-Playing & Storytelling** – Reframing the experience through guided narratives
8. **Religious or Spiritual Approaches** – Using prayer, scripture, or moral teachings

### Acceptance and Forgiveness Therapy Steps

Dr. Robert Enright’s model outlines the forgiveness therapy steps as a **four-phase process**:

1. **Therapeutic Forgiveness Uncovering Phase**
    - Identifying the hurt and resentment
    - Recognizing how the offense affects emotions and behaviors
    - Understanding the consequences of holding onto anger
2. **Decision Phase**
    - Acknowledging that forgiveness is a choice
    - Deciding to commit to the process
3. **Work Phase**
    - Developing empathy and understanding toward the offender
    - Reframing the situation in a way that reduces emotional distress
    - Engaging in acts that symbolize letting go (e.g., journaling, writing a letter)
4. **Deepening Phase**
    - Finding meaning in the pain and personal growth
    - Recognizing personal benefits (e.g., emotional freedom, improved relationships)
    - Solidifying forgiveness as a long-term emotional stance

### Does Therapy for Forgiveness Work?

Numerous studies suggest that therapy for forgiveness is effective in improving mental health, reducing stress, and enhancing overall well-being. Some benefits include:

- Reduced **depression, anxiety, and PTSD** symptoms
- Lower **blood pressure and improved heart health**
- Stronger **interpersonal relationships** and greater emotional resilience
- Decreased **anger and hostility**
- Increased **self-esteem and life satisfaction**

However, therapy for forgiveness is **not about excusing or forgetting** but rather about releasing emotional burdens. It may not be suitable for everyone, especially in cases where ongoing harm or danger is present.

## Case Example 1: Forgiveness Therapy for an Adolescent

### Client Background

- **Name:** Sarah (fictional)
- **Age:** 16
- **Presenting Issues:** Anxiety, anger, trust issues, low self-esteem
- **Family History:** Her parents divorced when she was 8, and she has had limited contact with her father since then. He made promises to visit but rarely followed through. Sarah feels abandoned and unworthy and struggles with relationships due to fear of rejection.

### Forgiveness Therapy Steps

1. **Therapeutic Forgiveness Uncovering Phase (Exploring the Hurt)**

- Sarah works with me to recognize and express her emotions—anger, sadness, and resentment toward her father.
- She journals about broken promises and missed milestones (e.g., birthdays, school events).
- I help Sarah identify how her pain affects her daily life—lack of trust in others, emotional withdrawal, and self-doubt.

2. **Decision Phase (Choosing to Forgive)**

- Sarah explores that forgiveness is for her healing, not necessarily for her father.
- She doubts: “Why should I forgive someone who doesn’t care?”
- I help her understand that forgiveness doesn’t mean excusing his actions but freeing herself from emotional pain.
- She agrees to try the therapy for forgiveness process, knowing she can take her time.

3. **Work Phase (Building Empathy & Letting Go)**

- Sarah learns about her father’s past—his struggles with financial insecurity and emotional unavailability due to his own childhood trauma.
- She imagines him as a flawed person rather than just “the father who abandoned me.”
- Through guided exercises, she writes an unsent letter expressing her hurt and her desire to let go of the resentment.
- She practices self-compassion, realizing she is not to blame for his absence.

4. **Deepening Phase (Finding Meaning & Moving Forward)**

- Sarah acknowledges her pain but also recognizes her strength in overcoming it.
- She sets boundaries—she may choose to reconnect with her father in a limited way, or she may decide to emotionally move on without contact.
- She engages in a symbolic act of release (e.g., tearing up the letter, releasing a balloon, or a small personal ritual).
- Over time, she experiences reduced anger and greater self-worth.

### Outcome

- Sarah no longer lets her father’s absence define her self-worth.
- She still feels moments of sadness but is no longer consumed by resentment.
- She builds healthier relationships, trusting that she is valuable even if some people let her down.

## Case Example 2: Acceptance and Forgiveness Therapy for an Adult

### Client Background

- **Name:** Lisa (fictional)
- **Age:** 32
- **Presenting Issues:** Anxiety, difficulty in relationships, low self-worth, deep-seated resentment toward her mother
- **Family History:** Lisa was raised by her teenage mother, who was emotionally unavailable and often left her alone for long periods while working or socializing. Lisa experienced neglect—she lacked emotional support, stability, and sometimes even basic care.

### Forgiveness Therapy Process

1. **Uncovering Phase of Therapy for Forgiveness (Exploring the Hurt & Consequences)**

- Lisa acknowledges the depth of her resentment toward her mother.
- Through guided journaling and our sessions, she reflects on painful childhood memories—feeling invisible, longing for affection, and learning to care for herself too early.
- She realizes how this pain affects her adult life—difficulty trusting others, fear of abandonment, and a tendency to overcompensate in relationships.
- She expresses anger, sadness, and disappointment, recognizing that these emotions are valid.

2. **Decision Phase (Choosing to Forgive for Herself)**

- Lisa struggles with letting go—”Why should I forgive someone who never really showed up for me?”
- I explain that acceptance is not about excusing neglect but freeing herself from the emotional burden.
- Lisa decides to begin the process, knowing she can do it on her own terms and at her own pace.

3. **Work Phase (Building Empathy & Letting Go of Resentment)**

- Lisa explores her mother’s perspective—not to justify the neglect but to understand the circumstances.
- She learns that her mother was overwhelmed as a teenager, lacked support, and had her own unresolved traumas.
- Through guided imagery, she imagines her mother as a young, scared girl rather than “the mother who failed me.”
- She writes an unsent letter expressing both her pain and her acknowledgment that her mother was struggling, too.
- Lisa also works on self-compassion—realizing that her childhood neglect was not her fault and that she is worthy of love.

4. **Deepening Phase (Finding Meaning & Moving Forward)**

- Lisa recognizes her resilience—how she became independent and emotionally aware despite her past.
- She decides on healthy boundaries—she may choose limited contact with her mother, an honest conversation, or simply an internal shift toward peace.
- She engages in a symbolic act of release (e.g., burning the letter, planting a tree, or practicing a mindfulness ritual).
- Over time, Lisa experiences emotional relief, less resentment, and a greater sense of control over her life.

### Forgiveness Therapy Model Results

- Lisa no longer allows her past to dictate her present relationships and self-worth.
- She acknowledges the hurt but does not carry the weight of resentment daily.
- She builds healthier relationships, learning to trust and receive love without fear of abandonment.

## Therapies That Can Be Integrated with Therapy for Forgiveness

I combine forgiveness therapy with several [other therapeutic approaches](https://dralanjacobson.com/integrative-therapy/) to enhance emotional healing and address underlying psychological issues. Some of the most effective integrations include:

1. **[ Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT) and Therapeutic Forgiveness**

- Helps individuals identify and reframe negative thought patterns about the offender.
- Reduces cognitive distortions (e.g., “I’m unworthy because they hurt me”).
- Uses behavioral strategies to cope with anger and resentment.
- Can be combined as [mindfulness based cognitive therapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/).

2. **[ Trauma-Focused Therapy](https://dralanjacobson.com/cbt-for-trauma/) (e.g., EMDR, [TF-CBT](https://dralanjacobson.com/cbt-for-trauma/))**

- **Eye Movement Desensitization and Reprocessing (EMDR):** Helps process traumatic memories associated with betrayal or neglect.
- **Trauma-Focused CBT (TF-CBT):** Addresses PTSD symptoms while incorporating forgiveness as a step in emotional recovery.

3. **[ Acceptance and Commitment Psychotherapy](https://dralanjacobson.com/act-psychotherapy/) (ACT)**

- Encourages acceptance of painful emotions without letting them control behavior.
- Uses mindfulness techniques to help individuals detach from resentment and focus on personal values.

4. [ **Psychodynamic Therapy**](https://dralanjacobson.com/psychodynamic-therapy/)

- Explores deep-seated emotional wounds and unresolved conflicts.
- Examines how past relationships influence current emotional responses to hurt.
- Like therapy for forgiveness, it helps individuals gain insight into unconscious patterns of resentment and anger.

5. **[ Compassion-Focused Therapy](https://dralanjacobson.com/compassion-focused-therapy/) (CFT)**

- Encourages self-compassion as part of the forgiveness process, similar to therapy for forgiveness.
- Uses exercises to develop empathy toward oneself and the offender without minimizing harm.

6. **[ Mindfulness-Based Stress Reduction](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) (MBSR) & Meditation**

- Uses mindfulness techniques to reduce anger and emotional distress.
- Encourages non-judgmental awareness of thoughts and emotions related to past harm.

7. [ **Narrative Therapy**](https://dralanjacobson.com/narrative-therapy/)

- Helps individuals reframe their personal stories in a way that promotes empowerment and healing.
- Encourages externalizing the problem (e.g., “resentment is something I can change” rather than “I am resentful”).

8. **[ Interpersonal Therapy](https://dralanjacobson.com/interpersonal-therapy/) (IPT)**

- Focuses on how interpersonal relationships contribute to emotional distress.
- Helps individuals set healthy boundaries with those who have hurt them.

9. [ **Positive Psychology Approaches**](https://dralanjacobson.com/positive-psychology-powerful-benefits/)

- Uses gratitude and strengths-based techniques to shift focus from pain to growth.
- Encourages therapeutic forgiveness practices like journaling about personal resilience.

## Conclusion and My Work

Forgiveness therapy is a powerful approach that offers individuals a path to healing by addressing deep-seated emotional wounds. It does not require excusing harmful actions but instead empowers people to release the burden of resentment for their own well-being and strength. We can work to rebuild emotional resilience, improve relationships, and lead healthier, more fulfilling lives.

If you have any questions about therapy for forgiveness, or the unique acceptance and forgiveness therapy steps that might work for you or a loved one, don’t hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Types of Therapy

---

### [Therapy for Self-Esteem and Resilience Training](https://dralanjacobson.com/therapy-for-self-esteem-and-resilience-training/)

**Published:** October 14, 2025
**Author:** Dr. Alan Jacobson

**Content:**

**Self-esteem therapy** is a therapeutic process designed to strengthen an individual’s sense of worth, acceptance, and emotional stability. Rather than focusing solely on positive affirmations, effective therapy for self-esteem addresses the *roots* of self-doubt, examining early experiences, social influences, and internalized beliefs that may have distorted one’s self-view. I often integrate **emotional resilience training** into self-esteem counseling work because these two domains are deeply intertwined. Resiliency training teaches clients to stay grounded during life’s inevitable challenges, while therapy helps them feel inherently capable of facing those challenges. When combined, they create a mindset of “I can handle what comes my way, and I’m still worthy even when things go wrong.”

From a psychological standpoint, self-esteem is built upon **efficacy** (the belief that one can make a difference), **compassion**, and **resilience,** which is the ability to recover and grow from adversity. My role is to help clients build this internal foundation, transforming self-criticism into constructive inner reflection and helping them experience mastery, belonging, and agency.

Common emotional targets include chronic doubt, perfectionism, people-pleasing, social anxiety, and the lingering effects of trauma or neglect. The overarching goal of therapy for self-esteem is not just to make clients feel better about themselves, but to help them **feel solid in who they are, even when life tests them.**

### Who Self-Esteem Therapy and Resiliency Training Are For ![therapy for self-esteem and resiliency training](https://dralanjacobson.com/wp-content/uploads/2025/07/risk-24-300x84.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Self-esteem therapy can benefit individuals across many life stages and circumstances. It is particularly valuable for those who:

- **Struggle with self-criticism or negative inner talk**, often rooted in early invalidation or comparison.
- **Have experienced trauma, bullying, or family dysfunction**, leading to internalized shame or learned helplessness.
- **Experience [imposter syndrome](https://www.verywellmind.com/imposter-syndrome-and-social-anxiety-disorder-4156469)**, doubting their competence despite evidence of success.
- **Face chronic stress or burnout**, where perfectionism and overachievement mask deeper issues with worth.
- **Navigate identity transitions**, including adolescence, divorce, career changes, and aging.
- **Live with anxiety or depression**, where inner perception is closely linked to mood regulation.
- **Are high-functioning but feel empty or undeserving**, seeking a more authentic sense of value beyond achievement.

Because self-esteem influences motivation, relationships, and mental health, improving it often enhances functioning in virtually every domain, such as emotional regulation, productivity, and interpersonal connection.

### Therapy for Self-Esteem Techniques

Self-esteem therapy is integrative by nature, drawing from multiple [evidence-based](https://en.wikipedia.org/wiki/Evidence-based_practice) modalities. Below are the primary techniques and how they are applied in practice:

#### [Cognitive-Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) for Self-Esteem

In CBT therapy for self-esteem, clients learn to identify core beliefs such as *“I’m a failure”* or *“I don’t deserve love”* and replace them with more balanced, reality-based perspectives. [Behavioral experiments](https://www.verywellmind.com/how-to-perform-behavioral-experiments-4779864) test these new beliefs in daily life, reinforcing confidence through experience.

#### Emotional Resilience Training

Resiliency training builds psychological endurance through structured methods:

- **Stress inoculation resiliency training** teaches individuals to anticipate and manage difficult situations rather than avoid them.
- **Coping flexibility** encourages adaptive problem-solving instead of rigid reactions.
- **Strengths-based reflection** identifies previous examples of persistence and courage, helping clients see themselves as capable survivors rather than victims.

#### [Compassion-Focused Therapy](https://dralanjacobson.com/compassion-focused-therapy/) for Self-Esteem

For those with deep-seated shame, self-compassion becomes a powerful corrective experience. In self-esteem therapy, clients learn to relate to themselves with warmth and understanding, replacing harsh inner judgment with curiosity and care.

#### [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/) for Self-Esteem

Therapists help clients “re-author” their life stories in therapy for self-esteem, shifting from “I’ve always failed” to “I’ve learned from every challenge.” This method externalizes problems, making them something the person *has*, not something they are*.*

#### Mindfulness and [Acceptance-Based Practices](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/)

These self-esteem therapy approaches teach clients to observe self-critical thoughts without fusing with them. [Mindfulness develops the meta-cognitive awareness](https://dralanjacobson.com/mindfulness-therapy/) that “thoughts are not facts,” and acceptance training builds tolerance for discomfort without avoidance.

#### [Behavioral Activation](https://dralanjacobson.com/behavioral-activation/) and Exposure

In self-esteem therapy, Clients rebuild confidence through incremental mastery experiences, such as public speaking, creative projects, and social engagement, gradually retraining the brain to associate risk with growth instead of threat.

#### [Positive Psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/) Interventions

In therapy for self-esteem, gratitude journaling, strengths identification, and savoring exercises enhance positive affect, which stabilizes self-esteem and broadens coping resources.

### Integrative Combinations

Self-esteem therapy and emotional resilience training often benefit from integration with complementary modalities and supports:

- **ADHD or [executive function coaching](https://dralanjacobson.com/executive-functioning-coaching/)**, to reinforce goal completion and accountability.
- **[Dialectical Behavior Therapy](https://dralanjacobson.com/dbt-for-teens/) (DBT)** modules focus on emotion regulation and distress tolerance.
- **[Group therapy](https://dralanjacobson.com/group-therapy/) or workshops**, providing social modeling, validation, and peer encouragement.
- **[Family treatment](https://dralanjacobson.com/family-therapy/) or [couples therapy](https://dralanjacobson.com/couples-therapy/)**, when relational patterns contribute to low worth.
- **Career or performance psychology** aligns worth with authentic competence rather than external validation**.**

Of course, all of these therapies are even stronger with a but of [psychoducation](https://dralanjacobson.com/psychoeducation/) so you can understand not just what but why we are choosing each technique.

---

## Therapy for Self-Esteem Resiliency Training Case Examples

The following are three examples of self-esteem therapy and resiliency training. Of course, your own unique needs and hopes will guide your own treatment plan and course.

### Self-Esteem Counseling: High School Student Facing Academic Pressure

Maria, a high-achieving but anxious student, entered self-esteem counseling after developing panic attacks during college entrance exams. Her self-esteem was tied almost entirely to grades, and she often said, “If I don’t get straight A’s, I’m worthless.”

**Self-Esteem Counseling Process:**
Early self-esteem counseling sessions focused on understanding how parental expectations and school comparisons had reinforced perfectionism. Through CBT, Maria learned to challenge “all-or-nothing” thinking and recognize effort as an indicator of worth. [Mindfulness and breathing exercises](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) were introduced for exam-related anxiety.

Resiliency training helped her view academic stress as a challenge rather than a threat. Her therapist guided her in journaling about previous obstacles she had overcome, such as injuries, difficult teachers, and friendship issues, to build a personal narrative of strength. Over time, Maria began to see herself as a capable, multi-dimensional person beyond her grades.

**Self-Esteen Counseling Outcome:**
By graduation, Maria maintained strong academic performance but described herself as “happier and freer.” She joined a peer mentoring group, helping younger students with test anxiety, transforming her struggles into empathy and leadership.

### Self-Esteem Therapy Case 2: 35-Year-Old Professional Experiencing Imposter Syndrome

Ethan, a financial analyst, came to self-esteem therapy after a promotion triggered overwhelming inner doubt. Despite positive feedback from supervisors, he was convinced he would soon “be found out.” He overworked himself, avoided delegation, and suffered frequent insomnia.

**Self-Esteem Therapy Process:**
I began with cognitive restructuring to challenge catastrophic thinking (“I’ll ruin everything”) and helped Ethan document objective evidence of competence. Through guided journaling, he explored how early family messages about humility and comparison fueled his feelings of impostorship.

Resiliency training focused on redefining failure: instead of seeing mistakes as proof of inadequacy, Ethan learned to view them as feedback for growth. Using behavioral experiments, he intentionally delegated tasks and monitored outcomes, learning that others’ success did not diminish his own.

**Self-Esteem Therapy Outcome:**
Ethan’s doubt and worry stabilized as he internalized his worth from performance outcomes to identity. He became a mentor to junior analysts, emphasizing learning over perfection. His sleep and work-life balance improved, and he reported feeling “proud, not pressured.”

### Self-Esteem Therapy Case 3: 52-Year-Old Woman Rebuilding Identity After Divorce

Asha sought therapy for self-esteem and resiliency training after a painful divorce ended a 25-year marriage. She described herself as “invisible” and unsure who she was without the role of caregiver. She expressed guilt for prioritizing herself and felt uncertain about re-entering the workforce.

**Self-Esteem Therapy Process:**
Therapy began with compassionate exploration of loss and grief, using **narrative therapy** to reframe her story from “abandoned” to “rediscovering independence.” The clinician incorporated **compassion-focused exercises**, teaching Asha to nurture herself as she would a close friend.

Resiliency training centered on small mastery experiences: updating her résumé, attending a community class, and reconnecting with friends. Through mindfulness, she learned to tolerate moments of loneliness without collapsing into inner blame. Asha gradually identified strengths, such as empathy, persistence, and organization, that had been hidden behind her caregiving role.

**Self-Esteem Therapy and Resiliency Training Outcome:**
Over the course of self-esteem therapy and resiliency training, Asha regained a strong sense of agency. She began consulting for nonprofits, describing her new role as “an opportunity to make meaning, not just money.” She no longer measured her worth by relationship status, but by her capacity to live authentically and give back with strength.

---

## Self-Esteem Counseling for Teens

Adolescence is one of the most vulnerable and formative periods for developing identity. Rapid changes in identity, social belonging, and body image make teens particularly susceptible to internalizing criticism and comparison.

**Self-esteem counseling goals for teens** include:

- Teaching **healthy inner talk** to challenge negative internal dialogue (“I’m not popular enough” → “I’m still valuable even if I’m different”).
- Building **resilience through graded exposure** to challenges—public speaking, sports tryouts, or peer conflict resolution.
- Reinforcing a **growth mindset**, as self-esteem counseling helps teens see mistakes as part of learning rather than proof of failure.
- Involving **parents or guardians** in supportive coaching roles, promoting praise for effort and emotional openness rather than perfectionism.
- Addressing [**social media literacy**](https://pmc.ncbi.nlm.nih.gov/articles/PMC9325204/), helping teens critically interpret online comparisons.
- Integrating **creative expression,** art, journaling, music, to help them externalize emotions and celebrate individuality.

Self-esteem counseling often includes group or peer components, allowing adolescents to witness shared experiences of insecurity and mutual validation. The result is not only greater confidence but also emotional maturity and empathy.

---

## Emotional Resilience Training

Emotional resilience is the ability to adapt, recover, and grow from life’s challenges while maintaining a sense of inner balance. It’s not about avoiding stress or pretending everything is fine. Instead, it’s about building the internal capacity to face adversity with flexibility, confidence, and composure.

Resilience can be learned and strengthened, much like a muscle. Through emotional resilience training, whether on your own or with a professional, you can train your brain and body to respond to setbacks with calmness, curiosity, and a sense of control rather than panic or self-blame.

### The Core Components of Emotional Resilience

Resilience isn’t a single skill. It’s a set of habits and mindsets that work together.

1. **Self-Awareness**: Recognizing your emotions, thoughts, and physical responses in the moment.
2. **Cognitive Flexibility**: The ability to reframe challenges, find alternative solutions, and shift perspectives.
3. **Emotional Regulation**: Managing intense emotions so they inform, rather than overwhelm, decision-making.
4. **Optimism and Realistic Hope**: Maintaining faith in your ability to handle difficulty and recover.
5. **Self-Efficacy**: Believing your actions can influence outcomes, even when you can’t control everything.
6. **Connection**: Building supportive relationships that buffer stress and promote accountability.
7. **Meaning and Purpose**: Seeing challenges as part of a larger personal growth process.

#### The Science Behind Emotional Resilience Training

Research in positive psychology, neuroplasticity, and stress physiology shows that successful emotional resilience training involves both mental and physical exercises.

- When you practice stress-tolerance techniques in emotional resilience training, your amygdala (threat center) becomes less reactive.
- Your [prefrontal cortex](https://en.wikipedia.org/wiki/Prefrontal_cortex) (the decision-making center) becomes stronger, enabling clearer thinking under pressure.
- Emotional regulation rewires neural pathways toward calm and confidence instead of panic and avoidance.

Resilience doesn’t mean you stop feeling. It means you feel and recover more efficiently.

### Self-Help Emotional Resilience Training Techniques

Below are practical, step-by-step strategies you can apply independently or alongside therapy or coaching.

1. **Build Awareness of Stress Signals**

Emotional resilience training begins with noticing when your system is under pressure.

- Identify early warning signs: racing thoughts, irritability, tight chest, or fatigue.
- Keep a brief stress log for a week to track triggers and responses.
- Ask yourself: *“What am I feeling right now?”* and *“What do I need?”*

Awareness is the foundation for change. You can’t manage what you don’t recognize.

2. **Use [Grounding and Centering Techniques](https://health.clevelandclinic.org/grounding-techniques)**

When stress spikes, your nervous system needs quick tools to reset.
Try:

- [Box Breathing](https://www.verywellhealth.com/box-breathing-8423967) (4-4-4-4): Inhale for 4, hold for 4, exhale for 4, hold for 4.
- 5-4-3-2-1 [Sensory Grounding](https://psychcentral.com/anxiety/using-the-five-senses-for-anxiety-relief): Identify 5 things you see, 4 feel, 3 hear, 2 smell, 1 taste.
- [Progressive Muscle Relaxation](https://www.healthline.com/health/progressive-muscle-relaxation): Tense and release muscle groups slowly, noticing the contrast between tension and calm.

These emotional resiliency training methods activate the parasympathetic nervous system, reducing cortisol and helping the body exit fight-or-flight mode.

3. **Reframe Negative Thinking**

Resilient people interpret setbacks differently. Instead of “This is a disaster,” try:

- “This is difficult, but I can handle it.”
- “What can I learn from this?”
- “Who or what can help me right now?”

Practice writing down one difficult event each week, followed by three possible interpretations in emotional resilience training, from catastrophic to constructive. Over time, your brain learns to choose more adaptive perspectives automatically.

4. **Develop Emotional Regulation Routines**

Emotions are information, not instructions. In emotional resilience training, use daily micro-practices to manage them before they escalate:

- Take a brief pause before responding to emotional triggers.
- Use journaling to externalize frustration or disappointment.
- Label emotions precisely (“I feel discouraged,” not just “bad”) — naming helps contain them.
- Engage in physical regulation through movement, stretching, or deep breathing.

This helps train emotional “muscle memory,” allowing you to recover faster from distress.

5. **Practice Self-Compassion Instead of Harsh Self-Talk**

Self-criticism drains resilience. When you make mistakes, ask:

- “If a friend experienced this, what would I say to them?”
- Then say the same to yourself.
- Try this 3-step self-compassion check-in: 
    1. Notice the suffering: “This is really hard right now.”
    2. Normalize it: “Struggle is part of being human.”
    3. Offer kindness: “I can give myself understanding and patience while I figure this out.”

This emotional resilience training approach, developed in *Compassion-Focused Therapy* and *Mindful Self-Compassion (MSC)*, rewires shame-based responses into care-based ones.

6. **Strengthen Cognitive Flexibility Through Perspective Exercises**

When stuck in black-and-white thinking, intentionally widen the lens:

- Ask: *“What else might be true here?”*
- Try viewing the problem from a mentor’s or friend’s perspective.
- Write a “resilient response” letter to yourself — what would your stronger self say about this challenge?

Practicing mental flexibility teaches your brain that distress is tolerable and solvable.

7. **Create a Resilience Routine**

Consistency turns coping into a habit. Try integrating daily emotional resilience training rituals:

- Morning: Set one small intention (“I will approach challenges calmly”).
- Midday: Take a mindful reset break — 2 minutes of breathing or gratitude reflection.
- Evening: Reflect on three things you handled well that day, no matter how small.

Over time, these moments train your nervous system to default toward calm internal regulation rather than reactivity.

8. **Foster Connection and Support**

Resilience thrives in community. Humans are wired for co-regulation — our nervous systems calm each other.

- Reach out to trusted people before crises arise.
- Practice vulnerability: share how you feel rather than hiding it.
- Participate in groups (support, creative, volunteer, or hobby-based) that foster belonging and purpose.

If available, professional spaces such as therapy, coaching, or group workshops can deepen these skills with guidance and feedback.

9. **Rebuild Meaning After Adversity**

Resilience grows strongest after reflection. Ask yourself:

- *“What did I learn about myself through this?”*
- *“How did this challenge shape my priorities or strengths?”*
- *“How might this experience help me support others?”*

This meaning-making process transforms pain into wisdom, fostering what psychologists call post-traumatic growth or the ability to become stronger, more compassionate, and more aware after hardship.

10. **Nourish Your Physical Foundation**

Emotional regulation is strongly linked to body regulation.

- Sleep: Aim for 7–8 hours consistently.
- Movement: Regular exercise increases resilience chemicals (dopamine, serotonin, endorphins).
- Nutrition: Steady blood sugar supports emotional stability.
- Relaxation: Yoga, stretching, nature walks, or creative hobbies all help maintain equilibrium.

Your body is your emotional anchor; treating it well supports your mental recovery.

### Building Long-Term Resilience

Resilience is built *gradually*, through repetition and reflection. Expect small, steady gains rather than sudden transformation. A helpful progression of emotional resilience training looks like this:

1. Awareness: You notice stress earlier.
2. Response: You recover faster after difficulty.
3. Mastery: You approach future challenges with calm confidence.
4. Integration: Resilience becomes a lifestyle, part of how you move through the world.

#### When to Seek Professional Guidance

Self-help tools can go a long way, but if you’re feeling stuck and repeating the same patterns of burnout, anxiety, or doubt, guided resilience training with a therapist can help. A clinician can personalize strategies for your unique challenges, provide structure, and help you practice until resilience becomes second nature.

---

## Therapy for Self-Esteem in My Practice

True self-esteem is not inflated confidence or blind positivity. Instead, it is **the quiet assurance that one’s worth is constant, even in the face of change or adversity.** When paired with resiliency training, therapy for self-esteem becomes more than a path to inner acceptance; it becomes a training ground for life.

Every individual, whether a teenager navigating identity, an adult facing new challenges, or someone rebuilding after loss, can learn to stand on a foundation of internal trust. Through understanding, compassion, and practice, people rediscover what was true all along: they are capable, resilient, and worthy of a life defined by confidence and connection.

Therapy for self-esteem and resiliency training can provide the support and lasting change you are looking for. If you have any questions about how these techniques might help you or how self-esteem counseling might help your teen, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult#services/service) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Therapy Approaches

---

### [Imago Relationship Therapy](https://dralanjacobson.com/imago-relationship-therapy/)

**Published:** October 14, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Imago Relationship Therapy** (IRT) is a form of couples therapy developed by [Dr. Harville Hendrix and Dr. Helen LaKelly Hunt](https://harvilleandhelen.com/about/). The word “imago” is Latin for “image,” and in this context, it refers to an unconscious image we carry of our ideal partner, often shaped by early experiences with caregivers. The central idea of i**mago therapy** is that people are drawn to partners who reflect both the positive and negative traits of their primary caregivers. In romantic relationships, unresolved childhood wounds can surface, and these dynamics can cause conflict. This is where **imago couples therapy** can help.

### My Work with Imago Relationship Therapy (IRT)

I provide Imago couples therapy in my practice, often combined with other approaches such as [Emotionally Focused Therapy](https://dralanjacobson.com/eft-therapy-for-couples/) or [supportive-expressive therapy](https://dralanjacobson.com/supportive-expressive-therapy/). It is a form of [couples treatment that can be delivered virtually](https://dralanjacobson.com/virtual-couples-therapy/). The following post reviews Imago relationship therapy in detail, but if you want information about how it might benefit you or a loved one, feel free to [reach out anytime](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

## Imago Relationship Therapy Process

Imago Relationship Therapy aims to help couples understand the underlying causes of their conflicts and create a deeper emotional connection. It focuses on transforming conflicts into opportunities for healing and growth. The process includes:

1. **Imago Dialogue**: A structured communication tool where partners take turns speaking and listening with empathy. It involves three main steps: 
    - **Mirroring**: The listener repeats back what the speaker said to ensure understanding.
    - **Validation**: The listener validates the speaker’s feelings by acknowledging their perspective.
    - **Empathy**: The listener tries to empathize with the speaker’s emotions.
2. **Understanding Childhood Wounds**: In Imago Relationship Therapy, couples explore how past experiences, especially from childhood, influence their current behavior and emotional reactions. The idea is that unresolved childhood wounds often lead to unmet needs in adult relationships. This is why imago therapy works best when one or both members of the couple suspect that events or relationships from childhood are casting a shadow on the current situation.
3. **Shifting from Conflict to Connection**: Instead of seeing conflict as a problem, Imago therapy encourages couples to see it as an opportunity for healing. By understanding each other’s triggers and needs, couples can create a conscious, loving relationship.
4. **Intentionality**: Imago couples therapy emphasizes being intentional in communication and behavior. Partners are encouraged to actively create a safe and nurturing space for each other, promoting a positive, growth-oriented relationship dynamic.

Imago Relationship Therapy is used for couples who want to deepen their connection, heal emotional wounds, or overcome persistent conflict patterns. It is often viewed as a highly structured yet empathic form of [couples counseling](https://dralanjacobson.com/couples-therapy/).

## Imago Couples Therapy Techniques

Imago Relationship Therapy uses various techniques to help couples improve communication, deepen emotional intimacy, and heal unresolved wounds from childhood that manifest in adult relationships. Here are some of the core techniques of IRT that I choose from:

### 1. Imago Therapy Dialogue

This is the cornerstone of Imago therapy. It provides a structured framework for couples to communicate, fostering understanding, empathy, and connection. The dialogue consists of three steps:

- **Mirroring**: One partner speaks while the other mirrors or repeats back what was said. This ensures the speaker feels heard and understood. For example, “What I hear you saying is…”
- **Validation**: The listener validates the speaker’s perspective, even if they don’t agree with it, by saying something like, “That makes sense to me because…”
- **Empathy**: The listener tries to empathize with the speaker’s emotions, saying something like, “I imagine you might be feeling…”

This structured communication helps both partners feel acknowledged, reducing defensiveness and increasing emotional safety.

### 2. IRT Parent-Child Dialogue

This imago therapy technique explores how unresolved childhood issues may contribute to current conflicts. Partners discuss their early childhood experiences with their primary caregivers and the emotional wounds they may still carry. By understanding the “Imago” (the image of their [caregivers they carry into relationships](https://dralanjacobson.com/attachment-therapy/)), partners can recognize how these unresolved issues play out in their current relationship dynamics.

### 3. Behavior Change Requests

This imago relationship therapy technique focuses on making specific, actionable requests for change. Partners are encouraged to identify one or two behaviors from their partner that trigger frustration or emotional pain. They then express these requests in a non-judgmental, non-demanding way, and the partner is asked to agree to meet the request. This encourages couples to move from vague complaints to concrete steps toward change.

### 4. Imago Relationship Therapy and Caring Behaviors

Couples are asked to identify simple, caring behaviors that make them feel loved and appreciated by their partner. These can be small, thoughtful actions like giving a hug, making coffee in the morning, or leaving a kind note. The goal is to nurture emotional connection through daily acts of love and consideration.

### 5. The Imago Relationship Therapy Stretching Exercise

### This imago couples therapy technique encourages partners to step outside of their comfort zones to meet their partner’s needs. The idea is to “stretch” oneself by doing something that may not come naturally but is important for one’s partner’s emotional well-being. For example, if one partner values quality time and the other finds it difficult to prioritize, the latter might stretch by spending more focused time together.

### 6. Re-Imaging Your Partner

This imago therapy exercise helps partners move away from negative perceptions by focusing on their partner’s positive qualities. Partners are asked to consciously reframe their thinking, focusing on what attracted them to their partner and appreciating their strengths. This helps counteract negative thoughts and fosters a more positive emotional climate in the relationship.

### 7. IRT for Healing Old Wounds

A crucial part of Imago therapy is recognizing how [childhood wounds](https://dralanjacobson.com/family-of-origin-therapy/) manifest in adult relationships. Partners are guided through exercises that help them heal these old wounds by providing each other with what was missing in childhood (such as emotional validation, affection, or attention). The goal is to foster a more nurturing and emotionally supportive relationship.

### 8. The Intentional Imago Relationship Therapy Dialogue

This is a more advanced version of the Imago Dialogue, where couples practice talking intentionally and deliberately. It emphasizes active listening, empathy, and understanding, and encourages couples to be fully present during conversations. Intentional dialogue also emphasizes avoiding reactive or defensive behavior, instead focusing on openness and connection.

### 9. IRT Vision of the Relationship

In this IRT technique, couples are guided to create a shared vision of their ideal relationship. By articulating what kind of relationship they want to build, they can align their goals and take conscious steps toward achieving that vision together.

### 10. IRT and Daily Gratitudes

Couples are encouraged to express daily gratitude toward each other. They may begin or end their day by sharing three things they appreciate about their partner. This simple practice fosters appreciation and helps maintain a positive emotional atmosphere in the relationship.

### 11. Conflict as Growth Opportunity

Imago Therapy reframes conflict not as something to be avoided but as an opportunity for growth. Couples are guided to explore the deeper issues underlying their conflicts and to use these moments as opportunities for healing and understanding.

When practiced consistently, these IRT techniques aim to transform relationships by deepening emotional connection, improving communication, and fostering mutual growth and healing.

## Imago Therapy Example

Here’s a fictitious example of how Imago Relationship Therapy might play out with a couple, using one of its core techniques, the Imago Dialogue.

### Imago Therapy Scenario:

Sarah and John are a couple experiencing recurring conflicts over John’s long work hours. Sarah feels neglected and unimportant, while John feels pressured and misunderstood because he’s working hard to support the family.

### Imago Relationship Therapy Steps

In each of these steps in Imago Couples Therapy, my role would be to guide the conversation. Over a few sessions, I would work to fade back and let them use newly acquired techniques and approaches.

#### Step 1: Imago Couples Therapy Mirroring

Sarah: “When you come home late from work every night and don’t text me to let me know, I feel really hurt. It feels like your job is more important than our relationship, and I start feeling like I don’t matter to you.”

John: “What I hear you saying is that when I come home late and don’t text you, it makes you feel hurt, like my job is more important than our relationship, and it makes you feel like you don’t matter to me. Did I get that right?”

Sarah: “Yes.”

This mirroring step helps Sarah feel heard and acknowledged, which can defuse some of the emotional charge.

#### Step 2: Imago Couples Therapy Validation

John: “It makes sense to me that you would feel that way. I can see how my not communicating makes you feel like you’re not a priority, especially because you’ve told me before how important time together is for you.”

By validating Sarah’s feelings, John shows that he understands her perspective, even if he doesn’t entirely agree. This validation helps Sarah feel less defensive and more open to further conversation.

#### Step 3: Imago Couples Therapy Empathy

John: “I imagine that when I come home late without letting you know, you might feel lonely or unimportant, and that’s painful for you.”

Here, John empathizes with Sarah’s feelings, going beyond just repeating her words to acknowledge the emotional impact. This empathy creates emotional closeness and trust, helping Sarah feel connected to John.

#### Step 4: Sarah’s Response

Sarah: “Yes, I do feel lonely sometimes, and it reminds me of when I was a child. My dad worked long hours too, and I rarely saw him. So when you come home late without telling me, it brings up those same feelings of neglect.”

At this point, Sarah can share how her childhood wound is being triggered. She recognizes that her deep emotional reaction isn’t only about John’s actions, but also about unresolved feelings from her past.

#### Step 5: John’s Response (Using Empathy Again)

John: “I didn’t realize that my behavior reminded you of that painful time with your dad. That must be really hard for you. I can see how that would make you feel even more upset when I come home late.”

John now understands the deeper emotional connection behind Sarah’s frustration and can approach the situation with more sensitivity.

#### Step 6: Behavior Change Request

Sarah: “I would really appreciate it if you could text me when you know you’ll be home late. That way, I won’t worry as much, and it will help me feel like you’re thinking about me.”

John: “I can do that. I’ll text you if I’m going to be late. I can also try to finish up earlier so we can have more time together.”

By the end of this exercise, John has a concrete action he can take to ease Sarah’s concerns, and Sarah feels more understood and emotionally connected to John.

### Imago Couples Therapy Outcome

Through this Imago Dialogue, Sarah and John transform what could have been a hurtful argument into a healing conversation. Sarah feels heard and validated, and John better understands why Sarah reacts like she does. This leads to an opportunity for both partners to grow, both individually and together, as a couple.

By recognizing how childhood wounds and unmet emotional needs influence their reactions in the relationship, both partners can use conflict as a path to deeper connection and healing.

## Summary and My Work with IRT

Imago therapy is not for every couple. It is best used when you are willing and motivated to dive into the past to see how it is affecting your relationship, particularly if you sense that past relationships in your family may be having a profound effect today (such as when there is a [sudden fear of intimacy](https://dralanjacobson.com/fear-of-intimacy/)). This form of couples or [marriage counseling can be delivered online](https://dralanjacobson.com/marriage-counseling/). It is an excellent approach for [premarital counseling](https://dralanjacobson.com/premarital-counseling/) in many cases and a core part of the [relationship therapy](https://dralanjacobson.com/relationship-therapy/) I provide to married couples. When you have children and parenting stress arises, it can be a part of [parent coaching](https://dralanjacobson.com/parent-coaching/) or therapy.

If you’d like to discuss any of this and how it might benefit you and your partner, feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Couples Therapies

---

### [Adlerian Therapy: Meaning, Goals & Key Techniques](https://dralanjacobson.com/adlerian-therapy/)

**Published:** August 11, 2025
**Author:** Dr. Alan Jacobson

**Content:**

## **What Is Adlerian Therapy? (Quick Overview)**

Adlerian therapy is a goal-oriented, collaborative approach that helps people understand how their beliefs, early experiences, and sense of belonging shape their lives. It focuses on overcoming feelings of inferiority, building confidence, and creating a more meaningful, socially connected life.

### Key elements include:

- Understanding lifestyle patterns shaped by early experiences
- Identifying and changing discouraging beliefs
- Building a stronger sense of belonging and purpose
- [Encouragement-based strategies to support growth](https://dralanjacobson.com/motivational-interviewing/) and resilience

## **When Is Adlerian Therapy Used?**

- Low self-esteem or self-doubt
- Relationship or family difficulties
- Feeling stuck, discouraged, or lacking direction
- Personal growth, identity, or life transitions

## Introduction to this Powerful Form of Therapy

I often meet clients who are intelligent, resourceful, and motivated but feel stuck repeating patterns that no longer serve them. Adlerian Therapy offers a powerful, encouraging framework to help people understand where these patterns come from, why they persist, and how to reshape them into healthier, more purposeful ways of living. Unlike approaches that focus only on symptom relief, Adlerian techniques seek to uncover the unique “life style” each person has developed, the beliefs, strategies, and goals that guide their choices so that they can rewrite their own story. This post reviews the underlying Adlerian Theory and how it shapes this powerful clinical approach.

---

### Learn More and Get Started

If you’re interested in developing greater clarity, confidence, and direction through Adlerian therapy, [schedule a consultation](https://www.picktime.com/scheduleaconsult) can help determine whether this approach may be a good fit for your goals and concerns.

---

## What Is Adlerian Therapy?

Adlerian therapy is a goal-oriented, strengths-based approach that helps individuals understand how early experiences shape beliefs, habits, and patterns that influence current decisions and emotional reactions. Rather than focusing only on symptoms, Adlerian therapy helps you examine your unique “lifestyle” — the assumptions and private logic you developed about yourself, other people, and the world — and determine whether those patterns are helping you move toward your goals or holding you back.

Through this process, therapy focuses on building insight, increasing flexibility in thinking, strengthening relationships, and developing a clearer sense of purpose and direction in daily life.

### What Issues Can Adlerian Therapy Help With?

Adlerian therapy is commonly used to help individuals who are experiencing:

- Anxiety or chronic worry
- Depression or discouragement
- Low self-confidence
- Difficulty with relationships
- Life transitions
- Identity concerns
- Work or performance stress
- Feelings of inferiority or self-doubt
- Lack of direction or meaning

It is especially helpful for individuals who feel stuck in recurring emotional or behavioral patterns and want to understand *why* they react the way they do — and how to change it.

### What Happens in Adlerian Therapy Sessions?

Adlerian therapy typically includes:

- Exploring early memories and formative experiences
- Identifying recurring beliefs or themes
- Understanding relationship patterns
- Clarifying personal goals and values
- Challenging unhelpful assumptions
- Developing more flexible ways of thinking and responding
- Building new strategies for connection, confidence, and growth

Sessions are collaborative, practical, and focused on applying insights to everyday life so that changes are noticeable both internally and externally.

## Adlerian Theory

Adlerian theory, developed by [Alfred Adler](https://en.wikipedia.org/wiki/Alfred_Adler) in the early 1900s, rests on the belief that human beings are inherently social, creative, and purposeful. People are not driven solely by unconscious forces ([as Freud emphasized](https://pmc.ncbi.nlm.nih.gov/articles/PMC10575551/)) or by [deterministic conditioning](https://psychology.tips/behaviorism-determinist-perspective/) (as behaviorists proposed). Instead, they are motivated by goals, often unconscious, that shape their perceptions, emotions, and actions.

Adlerian theory proposes that each person develops a “life style” (not in the modern sense of fashion or hobbies, but as an internally consistent pattern of beliefs, behaviors, and goals) by around age 5–6. This life style reflects how a person interprets the world and their place within it, shaped by early experiences, birth order, and family dynamics.

### Key Principles of Adlerian Theory

1. Holism in Adlerian Theory 
    - The person is an indivisible whole. Mind, body, emotions, and social context are interconnected.
    - Symptoms cannot be fully understood in isolation from the person’s relationships and environment.
2. Social Interest ([Gemeinschaftsgefühl](https://de.wikipedia.org/wiki/Gemeinschaftsgef%C3%BChl)) 
    - A measure of mental health is the degree to which a person feels connected to, and responsible for, the welfare of others.
    - Psychological distress often stems from feeling disconnected, inferior, or unable to contribute.
3. Goal Orientation 
    - All behavior is purposeful, aimed toward achieving perceived goals.
    - These goals are often future-oriented, even if rooted in past experiences.
4. Subjective Perceptions 
    - Reality is experienced through a personal lens shaped by beliefs, interpretations, and assumptions.
    - What matters in therapy is not objective truth, but the client’s subjective truth.
5. Inferiority and Compensation 
    - Feelings of inferiority are universal; they can motivate growth or cause maladaptive compensations.
    - “[Striving for superiority](https://link.springer.com/rwe/10.1007/978-3-319-28099-8_1428-1)” in Adler’s sense means striving toward mastery, competence, and contribution, not dominance over others.
6. Creative Self 
    - Individuals actively construct their lifestyle and can choose new directions.
    - This agency is central to change.
    - The creative self can be directly accessed through art ( as in Adlerian art therapy)

## Overview of Adlerian Therapy

Adlerian Therapy is a **goal-oriented, socially conscious, and holistic** approach to psychotherapy. It is based on the premise that all human behavior is purposeful and directed toward finding significance, belonging, and meaning. Clients are seen as creative problem-solvers whose challenges arise when mistaken beliefs or discouragement lead to unhelpful strategies. Adlerian techniques focus on encouraging clients, building insight, and guiding them toward socially beneficial goals that promote both self-respect and connection with others.

### Who Is Best Suited for Adlerian Therapy

Adlerian counseling or therapy is especially effective for:

- **Young adults** who are exploring identity, purpose, and career direction.
- Adults making **[life transitions](https://dralanjacobson.com/life-transitions-therapy/) or significant decisions** (e.g., relocation, career changes, [relationship discernment](https://dralanjacobson.com/discernment-counseling-pre-engagement-counseling/)).
- Individuals struggling with **low self-esteem, social anxiety, or perfectionism**.
- People seeking **insight into recurring relational patterns**.
- Clients who value **collaboration and active participation** in therapy.

### How It Works

Adlerian techniques unfold in **four overlapping phases**:

1. **Engagement** – Building trust, safety, and a collaborative relationship.
2. **Assessment** – Gathering life story, early memories, and family constellation to identify recurring themes and beliefs.
3. **Insight** – Helping clients understand the purpose of their behaviors and reframe mistaken beliefs.
4. **Reorientation** – Encouraging action steps, new behaviors, and an expanded sense of social contribution.

### Specific Adlerian Techniques

1. **Lifestyle Assessment** – In-depth exploration of early recollections, family roles, and pivotal life experiences to identify core beliefs.
2. **Family Constellation Analysis** – Examining how birth order and perceived family dynamics influenced the client’s life style.
3. **Early Recollections Technique** – Eliciting first memories to reveal symbolic themes.
4. **Encouragement** – Reinforcing strengths, effort, and potential rather than focusing solely on deficits.
5. **Identifying and [Challenging Mistaken Beliefs](https://positivepsychology.com/core-beliefs-worksheets/)** – Replacing unhelpful private logic with more flexible, reality-based perspectives.
6. **The Question** – Asking, “What would be different if the problem were gone?” to reveal the function of symptoms.
7. [**Acting ‘As If’**](https://thegoalchaser.com/act-as-if/) – Practicing desired qualities or roles before they feel natural.
8. [**Spitting in the Soup**](https://www.lifeworksystems.com/spitting-in-the-soup/) – Highlighting the hidden payoff of unhelpful behaviors to reduce their appeal.
9. **Push-Button Technique** – Training clients to switch emotional states intentionally.
10. **Reframing in Social Context** – Viewing personal struggles as part of a larger need for connection and purpose.

There are also techniques specific to Adlerian art therapy, which are detailed in the case example below.

### Therapeutic Goals

- Adlerian techniques foster insight into mistaken beliefs and unhelpful patterns.
- Adlerian techniques encourage the client to develop social interest and a sense of belonging.
- They support clients in adopting more flexible and constructive life goals.
- Adlerian techniques cultivate the courage to face life’s challenges and embrace imperfection.

## Adlerian Therapy Case Example: College Student

Emily, 20, is a sophomore majoring in liberal arts. She came to therapy reporting chronic procrastination, extreme anxiety over grades, and indecision about choosing a major. She frequently avoided starting assignments, only to work frantically at the last minute, producing work she never felt was “good enough.” She worried her professors and peers would think less of her if she made mistakes.

### Assessment Using Adlerian Theory:

- **Early recollections:** Helping her younger siblings with homework and receiving praise for being “the smart one.”
- **Birth order:** Oldest of three, felt responsible for modeling success and keeping peace at home.
- **Life style theme:** Worth and belonging are tied to flawless performance and others’ approval.
- **Mistaken belief:** “If I’m not perfect, I’ll let everyone down and lose their respect.”

### Adlerian Therapy Insight Phase:

Through Adlerian techniques, Emily saw that her procrastination was a protective strategy. It gave her an excuse if her work fell short (“I didn’t have enough time”) rather than risking full effort and potential criticism. She recognized this fear-driven pattern as a continuation of her childhood role of “the dependable achiever.”

### Reorientation Strategies:

- Practiced **Acting As If** she could turn in imperfect work without rejection.
- Used the **Push-Button Technique** before study sessions, recalling times she felt calm and capable.
- Began setting micro-deadlines to reduce overwhelm.
- Joined a student environmental group, shifting some focus from achievement to contribution.

### Adlerian Therapy Outcome:

Over several months of using Adlerian techniques, Emily declared a biology major, accepted B grades without spiraling into self-criticism, and began seeing herself as valuable beyond academic achievement. Her confidence grew as she diversified her identity from “the smart one” to “a capable, multifaceted person.”

## Adlerian Counseling Case Example: A Personal Decision

Sarah is 36 and works as a marketing manager. She is currently torn between accepting a job abroad with her partner or staying near her aging parents. She described feeling “frozen” in indecision, plagued by guilt about leaving her family and anxiety about regretting either choice.

### Assessment Using Adlerian Theory

- **Early recollections:** Mediating arguments at family dinners and being praised for “keeping the peace.”
- **Birth order:** Middle child, often positioned as the mediator between siblings.
- **Lifestyle theme:** Maintaining harmony and others’ happiness is her responsibility, even at personal cost.
- **Mistaken belief:** “If I put my needs first, I’m being selfish and will hurt the people I love.”

### Insight Phase:

Sarah realized her difficulty deciding was rooted in a lifelong pattern of over-responsibility for others’ well-being. She recognized that she had been avoiding choices that could create disappointment, even if they aligned with her personal growth.

### Adlerian Counseling Reorientation Strategies:

- Used **Reframing**: “Caring for myself allows me to be more present for others.”
- Applied **The Question** to imagine her life if the indecision vanished, clarifying her true preference.
- Engaged in a two-week “Acting As If” experiment, journaling each day as though she had made each possible decision, noting changes in energy, mood, and motivation.

### Adlerian Counseling Outcome:

Sarah chose the overseas job, developing a plan for regular visits and virtual check-ins with her parents. The decision, once paralyzing, became a source of empowerment. She reported excitement about professional opportunities and a sense of agency in shaping her own future.

## Case Example: Adlerian Art Therapy

Laura is 28 and a graduate art student. She sought Adlerian Art Therapy for self-doubt, creative block, and difficulty forming close friendships. She described feeling “invisible” in social settings and believed her art was “never original enough.” She had recently withdrawn from her art collective, fearing her work didn’t measure up.

### Assessment:

- Early recollections: Drawing alone in her room as a child while her older siblings played outside together.
- Birth order: Youngest of three, often left out of group activities.
- Life style theme: To be accepted, she must stand out through unique talent—but she also fears scrutiny.
- Mistaken belief: “If I am truly seen, I will be judged and rejected.”

### Adlerian Art Therapy Integration:

I used Adlerian art therapy as both a means of expression and a diagnostic/insight tool.

1. **Adlerian Art Therapy [Projective Drawing](https://psychologicalassessments.com/house-tree-person-and-draw-a-person-tests/) for Early Memories**
    - Laura was asked to create a drawing of her earliest memory. She drew herself in a corner, coloring, while her siblings laughed together on the other side of the page.
    - Discussion revealed her interpretation that she was “different” and “on the outside,” reinforcing her belief that safety comes from remaining unseen.
2. [**Metaphor-Based Art**](https://jerwoodvisualarts.org/art-education-and-methodologies-glossary/metaphorical-thinking-in-art/)
    - Laura created an image of a bird in a cage, painted in vivid colors but surrounded by gray space.
    - This became a visual metaphor for her life style, possessing vibrant creativity but self-contained and hidden.
3. **Acting “As If” Through Adlerian Art Therapy**
    - Laura was invited to create a series of paintings as if she had no fear of judgment.
    - She experimented with bolder colors, unfinished textures, and more personal subject matter.
    - This paralleled Adlerian behavioral experiments in the verbal therapy space, where she began initiating conversations with peers without overthinking.
4. **Social Interest in Artistic Context**
    - I encouraged Laura to submit a collaborative piece to a community art show, reframing it as a way to contribute rather than to prove herself.
    - This directly addressed her need for belonging and her mistaken belief that she must stand apart to be valued. Adlerian art therapy became a way to infuse behavioral activation.

### Adlerian Art Therapy Outcome:

Over several months of Adlerian art therapy, Laura began sharing more of her work publicly and rejoined her art collective. She reported less perfectionism, greater enjoyment of the creative process, and increased comfort connecting with peers. In verbal sessions, she acknowledged that “being seen” could mean acceptance rather than criticism.

## Case Example: Brief Adlerian Therapy for a Teen

Marcus is a high school sophomore referred by his school counselor for frequent class absences, declining grades, and a recent suspension for skipping detention. He appeared withdrawn at the first session but admitted feeling “pointless” about school and unmotivated. His parents described him as bright but easily discouraged.

### Brief Adlerian Therapy Format:

Brief Adlerian Therapy (BAT) – 6 sessions over 8 weeks, focused on clarifying goals, identifying mistaken beliefs, and initiating action steps.

#### Session 1 – Engagement

- Built rapport through collaborative goal-setting.
- I expressed genuine respect for Marcus’s perspective, avoiding lecture-style interventions.
- Agreed therapy goal: “Figure out what makes school worth showing up for.”

#### Session 2 – Assessment

- Explored family constellation: Marcus is the youngest of three, with two high-achieving older sisters.
- Early recollection: Sitting at the dinner table, parents praising his sisters’ grades while he remained silent.
- Emerging life style theme: “No matter what I do, I can’t measure up—so why try?”

#### Session 3 – Insight-Oriented Adlerian Techniques

- I shared an interpretation: Marcus’s withdrawal might be a strategy to avoid inevitable comparison.
- Used **“Spitting in the Soup”** to make the hidden payoff of disengagement clear: “If you don’t try, you can always say it’s because you didn’t care—not because you couldn’t do it.”
- Marcus acknowledged this matched his thinking and felt “called out in a good way.”

#### Session 4 – Reorienting Adlerian Techniques

- Practiced **Acting As If**: Marcus chose one subject (history) to attend consistently for two weeks, even on bad days.
- Introduced **Push-Button Technique**—focusing on energizing memories before class.
- Reframed “being measured” into “being different” by identifying personal strengths outside academics (mechanical skills, problem-solving).

#### Session 5 – Social Interest Activation

- Encouraged Marcus to join the school’s robotics club to connect his mechanical strengths to a group setting.
- Discussed contribution, not competition, as a new measure of worth.

#### Session 6 – Consolidation

- Reviewed progress: Marcus had attended all history classes for two weeks, raised his grade from 62% to 75%, and enjoyed the robotics club.
- Identified ongoing plan: Build consistency in other subjects, maintain club participation, and check in with the school counselor monthly.

### Outcome:

Marcus’s attendance improved, his teachers noted increased engagement, and he reported feeling “more in control.” The brief format helped focus on **specific, actionable change** without overwhelming him with long-term therapy expectations. This is why brief Adlerian techniques are often a part of [therapy for teens](https://dralanjacobson.com/therapy-for-teens/).

## Conclusion and My Work ![Adlerian Therapy](https://dralanjacobson.com/wp-content/uploads/2024/12/sunlight-path-300x200.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Adlerian therapy invites clients to see themselves as the authors of their lives, capable of identifying unhelpful patterns, reinterpreting their experiences, and adopting new ways of living that honor both personal needs and social connection. With its blend of insight, encouragement, and actionable strategies, it serves people at many stages of life, from young adults charting their course to seasoned professionals facing pivotal decisions. The goal of Adlerian techniques is not simply to solve a problem, but to help clients cultivate the courage, clarity, and confidence to meet life’s challenges with purpose. It is not surprising that Adlerian techniques are often used in Executive Coaching. They also complement many [insight therapies](https://dralanjacobson.com/insight-therapy/) and can even be used with [short-term psychodynamic psychotherapy](https://dralanjacobson.com/short-term-dynamic-psychotherapy/).

### Is Adlerian Therapy Right for You?

Many people consider therapy when they notice recurring patterns in relationships, motivation, or emotional reactions that don’t seem to change despite their best efforts. Adlerian therapy may be especially helpful if you are seeking not only symptom relief but also a [clearer sense of purpose](https://dralanjacobson.com/logotherapy/), direction, or personal meaning.

### Learn More

If you have any questions about how Adlerian counseling or therapy might benefit you or a loved one, or would like more information about specific approaches such as Adlerian art therapy, please do not hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

## FAQs about Adlerian Therapy

### What is Adlerian therapy used for?

Adlerian therapy is used to help individuals better understand how their beliefs, habits, and emotional reactions developed over time and how those patterns may influence current relationships, confidence, motivation, and mental health. It is commonly used to address anxiety, depression, self-doubt, life transitions, and interpersonal difficulties.

### How is Adlerian therapy different from CBT?

While [Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) focuses primarily on identifying and changing current thoughts and behaviors, Adlerian therapy places additional emphasis on understanding how early experiences shaped long-standing beliefs about oneself and others. This broader perspective can help individuals make deeper and more sustainable changes.

### Is Adlerian therapy evidence-based?

Adlerian therapy incorporates principles that are consistent with modern strengths-based, cognitive-behavioral, and solution-focused approaches. Many contemporary therapeutic models draw from Adlerian concepts such as goal orientation, social connectedness, and meaning-making.

### How long does Adlerian therapy take to work?

The timeline for progress varies based on individual goals and challenges. However, many people begin to notice increased clarity, improved confidence, or better emotional regulation within the first several sessions as they gain insight into recurring patterns.

### Can Adlerian therapy help with anxiety?

Yes. Adlerian therapy can help reduce anxiety by identifying underlying beliefs or assumptions that contribute to worry, avoidance, or perfectionism, and by helping individuals develop more adaptive goals and coping strategies.

### Who is a good fit for Adlerian therapy?

Adlerian therapy may be a good fit for individuals who:

Want to improve relationships or confidence

Want to better understand their emotional reactions

Feel stuck in recurring patterns

Are navigating major life changes

Are seeking greater purpose or direction

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

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### [Short-Term Dynamic Psychotherapy (STDP): Powerful, Enduring](https://dralanjacobson.com/short-term-dynamic-psychotherapy/)

**Published:** November 22, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Unlike supportive or insight-only therapies, Short-Term Dynamic Psychotherapy (STDP), sometimes called time-limited dynamic psychotherapy, works to mobilize deep emotional change by uncovering unconscious patterns, bringing them into the present moment, and helping clients fully experience and integrate feelings they have historically avoided. The work is active, focused, relational, and experiential. Sessions often involve tracking micro-shifts in emotion, tension, anxiety, defenses, and the therapeutic relationship. A cousin of STDP is Intensive Short-Term Dynamic Psychotherapy (ISTDP), which is used when there is more urgency.

I often meet clients who intellectually understand their problems but feel powerless to change them. They might say things like:

- *“I know I shouldn’t get triggered, but I can’t stop it.”*
- *“I know this relationship is unhealthy, but I keep repeating the same pattern.”*
- *“I’m not sure why I react like this, but I can’t control it.”*

This gap between cognitive understanding and emotional transformation is precisely where Short-Term Dynamic Psychotherapy (STDP) excels. Many clients describe STDP as the first therapy that helps them feel the root of their difficulties shifting — not just their coping strategies.

## Short-Term Dynamic Psychotherapy Overview ![Short-term dynamic psychotherapy](https://dralanjacobson.com/wp-content/uploads/2025/11/2-paths-300x200.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

STDP is not one therapy but a *family* of accelerated [psychodynamic treatments](https://dralanjacobson.com/psychodynamic-therapy/) developed in reaction to the long, open-ended nature of [classical psychoanalysis](https://pmc.ncbi.nlm.nih.gov/articles/PMC10575551/).

### Key Principles of Short-Term Dynamic Psychotherapy

Here are several key principles of short-term dynamic psychotherapy:

1. Psychopathology arises from conflicts around emotions.

Unresolved feelings — often anger, grief, fear, longing, or shame — become warded off because they were overwhelming, dangerous, or forbidden in early life.

2. Avoidance of emotion produces symptoms.

Defenses such as [intellectualization](https://neurolaunch.com/intellectualization-psychology/), people-pleasing, substance use, withdrawal, perfectionism, or [somatization](https://en.wikipedia.org/wiki/Somatization\) keep emotions out of awareness but create psychological and physical distress.

3. Real change occurs through emotional experience, not insight alone.

Clients must *feel* emotions in a contained, regulated way, not simply understand them cognitively.

4. The therapeutic relationship is a live laboratory.

[Transference and countertransference](https://positivepsychology.com/countertransference-and-transference/) illuminate past relational templates that are re-enacted with the therapist.

5. Time limitation drives focus and motivation.

STDP is usually structured between 12 and 40 sessions, although ISTDP can be longer for complex cases.

### Who Benefits Most From STDP

Though not an exhaustive list, here are some individuals who might benefit most from short-term dynamic psychotherapy:

1. Individuals With Chronic Anxiety and Inner Conflict

People who “think too much,” overanalyze, or fear making mistakes. Their anxiety often spikes when angry, sad, or vulnerable feelings surface.

2. Clients with Depression Rooted in [Relational Trauma](https://psychcentral.com/ptsd/what-is-relational-trauma)

Especially those who turn feelings inward, experience guilt or self-blame, or carry unresolved grief.

3. Adults With Longstanding Relationship Patterns

Including:

- [fear of intimacy](https://dralanjacobson.com/fear-of-intimacy/)
- choosing unavailable partners
- avoidance of closeness
- repeated conflict cycles
- passive or submissive roles

4. People Experiencing [Somatic Symptoms](https://dralanjacobson.com/somatic-therapy/)

Including:

- migraines
- IBS
- non-specific chronic pain
- muscle tension
- [psychosomatic fatigue](https://my.clevelandclinic.org/health/diseases/21521-psychosomatic-disorder)
- autonomic dysregulation

5. [Trauma Survivors Who Are Emotionally Stable](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/) Enough for Affective Work

Those who avoid feelings because emotions historically led to danger, invalidation, or unpredictability.

6. “High-functioning but stuck” individuals

Those who succeed professionally but struggle internally — often perfectionists, over-responsible caregivers, or conflict-avoidant people.

### Techniques Used in Time-Limited Dynamic Psychotherapy

The following are the core techniques used in time-limited dynamic psychotherapy:

1. Inquiry and Pressure

The therapist helps narrow the focus onto emotional problems by asking:

- “What is the feeling toward that person in this moment?”
- “What happens in your body as you talk about this?”

This “pressure” is not coercive — it encourages emotional contact.

2. Identifying and Blocking Defenses

Defenses are spotted in real time:

- smiling when talking about pain
- intellectualizing
- humor
- dismissiveness
- minimalizing
- excessive detail to avoid emotional core themes
- caretaking the therapist

The therapist names them:
*“You shifted to describing events instead of talking about the feeling. Do you notice that?”*

3. Regulation of Anxiety

In time-limited dynamic psychotherapy anxiety is monitored at three levels:

- Cognitive-perceptual disruption (confusion, tunnel vision)
- Muscular tension (tight jaw, chest pressure, sighing)
- [Smooth-muscle anxiety](https://www.goodtherapy.org/blog/self-criticism-smooth-muscle-anxiety-how-istdp-helps-0713165) (GI symptoms, nausea)

When anxiety rises too high, the therapist slows down or grounds the client.

4. Direct Access to Emotion

Clients are guided into *experiencing* emotions:

- exploring bodily sensations
- naming impulses (“What does the anger want to do?”)
- witnessing images or memories
- tracking shifts in posture and facial expression

5. Transference Work in Time-Limited Dynamic Psychotherapy

Old relational patterns emerge between client and therapist:

- fear of judgment
- pleasing the therapist
- withholding anger
- expecting disappointment

The therapist uses these moments to deepen emotional understanding.

6. Reorganization and New Meaning-Making

After emotional expression, the therapist helps integrate:

- a more coherent narrative
- new internal models
- shifts in identity and self-compassion
- changes in interpersonal behavior

### Integration with Other Methods

Although STDP is a powerful stand-alone therapy, integrating it with other modalities often improves outcomes — especially when clients struggle with emotional tolerance, chronic dysregulation, trauma, or entrenched cognitive distortions.

Below is a deeper, more clinically nuanced look at how time-limited psychodynamic psychotherapy interacts with other treatments.

1. #### [Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT)

CBT and short-term dynamic psychotherapy complement each other exceptionally well, despite being rooted in different traditions.

How CBT Supports STDP

- Builds coping capacity: Many clients arrive with overwhelming anxiety or depression, making emotional exploration difficult. CBT tools (thought records, behavioral activation, exposure hierarchies) strengthen their ability to manage symptoms.
- Reduces global avoidance: STDP targets *emotional* avoidance; CBT targets *behavioral* avoidance. Addressing both forms accelerates recovery.
- Supports homework and practice: STDP insights can be translated into concrete action steps through CBT strategies.
- Bridges the gap between insight and behavior change: Clients often understand their emotional patterns after STDP sessions but need help turning these insights into new habits.

How Short-Term Dynamic Psychotherapy Supports CBT

- STDP targets the *origin* of maladaptive thoughts (e.g., “I’m unlovable”) by accessing the underlying emotional wounds, which CBT alone may not fully resolve.
- Emotional breakthroughs in STDP can reduce the cognitive distortions CBT has been working to restructure.

Example of Integration of CBT and Intensive Short-Term Dynamic Psychotherapy

A client learns in STDP that their anxiety spikes when they feel anger toward a parent. CBT then helps them challenge catastrophic thoughts (“If I express anger, I’ll be rejected”) and practice graded exposure to assertiveness.

2. #### [EMDR](https://www.emdr.com/what-is-emdr/) and Trauma-Focused Therapies

Trauma therapies integrate extremely well with STDP, especially when emotions tied to trauma memories surface.

How EMDR Supports STDP

- Helps process trauma memories that STDP has uncovered through affect-focused exploration.
- Regulates emotional intensity when trauma threatens to overwhelm the client.
- Allows integration of stored body-based trauma reactions, supporting deeper emotional freedom.

How Short-Term Psychodynamic Psychotherapy Supports EMDR

- STDP identifies the emotional conflicts and attachment wounds that fuel trauma symptoms.
- It clarifies which memories or themes are primary EMDR targets.
- It strengthens emotional connection so EMDR work can unfold with deeper coherence.

Clinical Pattern

STDP → mobilizes core emotions
EMDR → processes trauma memory
STDP → integrates new relational models and self-perception

This loop often produces profound change.

3. #### [Mindfulness-Based Therapies](https://dralanjacobson.com/mindfulness-therapy/) ([MBSR](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/), [MBCT](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/), ACT)

These therapies are powerful adjuncts because STDP relies heavily on internal awareness.

How Mindfulness Supports Intensive Short-Term Dynamic Psychotherapy

- Enhances interoceptive awareness (tracking breath, sensations, emotions).
- Strengthens tolerance for emotional activation.
- Helps clients identify early defense activation (“I can notice myself pulling away”).
- Creates a more compassionate and observing stance toward internal experience.

How ACT Specifically Helps

- Defusion skills help clients recognize thoughts as thoughts, freeing attention for emotional work.
- Values clarification strengthens motivation for confronting long-avoided feelings.

Example

A client notices tightness in their chest when discussing conflict with a partner — mindfulness training helps them stay with that sensation instead of shutting down.

4. #### [DBT Skills](https://dralanjacobson.com/dbt-for-teens/) (Distress Tolerance, Emotion Regulation, Interpersonal Effectiveness)

DBT is extremely synergistic with STDP when clients struggle with:

- affective instability
- intense relational reactions
- impulsive behaviors
- self-harm

Why DBT Helps

DBT gives clients tools to remain stable enough to engage in deeper emotional work, including:

- grounding
- self-soothing
- crisis survival strategies
- emotional labeling
- distress tolerance strategies
- interpersonal boundaries

How It Improves Short-Term Psychodynamic Psychotherapy Outcomes

Clients become more capable of:

- holding emotional activation without panic
- seeing defenses in action
- tolerating vulnerability in the therapeutic relationship
- differentiating emotion from impulse

Intensive Short-Term Dynamic Psychotherapy then builds on this foundation by helping clients contact underlying core affects.

5. #### AEDP ([Accelerated Experiential Dynamic Psychotherapy](https://aedpinstitute.org/))

AEDP and STDP share many foundations.

How They Complement Each Other

- AEDP emphasizes fostering emotional safety and positive attachment experiences.
- STDP emphasizes identifying and challenging defenses that block emotional access.
    Used together:
- STDP breaks down barriers.
- AEDP deepens the healing experience with compassion and co-regulation.

Clients often move fluidly between STDP’s active, focusing approach and AEDP’s gentle processing of core experiences.

6. #### Medication Support (Psychiatry) and Short-Term Psychodynamic Psychotherapy

Medications often improve the effectiveness of ISTDP and STDP.

Why Medication Helps

- Lowers anxiety to manageable levels.
- Improves sleep, emotional regulation, and cognitive clarity.
- Allows clients to stay emotionally present for affect-focused work.

When Medication Is Especially Helpful

- chronic depression
- obsessive rumination
- panic disorder
- trauma with high autonomic arousal
- somatic symptom disorders

Medication does not replace STDP but amplifies emotional access.

7. #### Skills-Based Therapies (Coaching, [Executive Function Support](https://dralanjacobson.com/executive-functioning-coaching/), Behavioral Plans)

These supports are most useful when emotional issues interfere with functioning.

Examples

- [ADHD coaching](https://dralanjacobson.com/adhd-coaching-for-adults-help-for-focus-and-concentration/) for clients who repeatedly sabotage progress because of emotional avoidance.
- Executive functioning supports for clients who shut down under emotional stress.
- Sleep and lifestyle interventions that reduce physiologic overwhelm.

These therapies provide clients with stability, enabling Intensive Short-Term Dynamic Psychotherapy to access deeper layers.

### Expected Outcomes

Below are the outcomes supported by research and clinical observation across multiple STDP and ISTDP traditions.

1. #### Significant Reduction in Anxiety Symptoms

Short-term dynamic psychotherapy reduces both:

- *Symptom anxiety* (the anxiety clients feel when emotions surface)
- *characterological anxiety* (anxiety tied to lifelong emotional conflicts)

Clients often report:

- decreased panic
- less rumination
- reduced somatic tension
- improved bodily awareness
- less anticipatory anxiety

Why This Happens with Intensive Short-Term Dynamic Psychotherapy

Once suppressed emotions become accessible and tolerable, the need for anxiety as a signal or defense decreases dramatically.

2. #### Reduction in Depression and Chronic Sadness

Depression in STDP is often conceptualized as:

- anger turned inward
- grief that was never processed
- emotional suppression
- hopelessness about unmet needs

As these emotions surface and resolve, clients generally experience:

- improved motivation
- energy returning
- greater pleasure in daily life
- decreased self-criticism
- an expanded emotional range

3. #### Improved Emotional Regulation

Clients become able to:

- track emotional activation earlier
- differentiate primary emotions (anger, sadness, fear) from secondary reactions (anxiety, guilt, shame)
- remain present in distress
- express emotions safely
- repair conflicts without collapsing or exploding

This leads to:

- fewer emotional shutdowns
- fewer emotional outbursts
- increased tolerance for vulnerability

4. #### Dramatic Improvement in Relationship Patterns

STDP deeply affects attachment and relational functioning.

Clients often begin to:

- choose healthier partners
- communicate needs clearly
- stop caretaking or over-functioning
- set boundaries confidently
- reduce conflict cycles
- tolerate closeness and authenticity
- stop pursuing unavailable or rejecting partners

The therapeutic relationship becomes a template for new relational possibilities.

5. #### Reduction or Resolution of Somatic Symptoms

Through Intensive Short-Term Dynamic Psychotherapy many clients report improvement in:

- chronic pain
- headaches
- jaw tension
- gastrointestinal issues
- muscle contractions
- fatigue
- vague medical symptoms with no clear cause

Mechanism

When emotional activation is no longer being converted into physical tension or autonomic arousal, the body relaxes.

6. #### Increased Self-Esteem and Internal Coherence

Through Intensive Short-Term Dynamic Psychotherapy clients feel:

- more grounded in who they are
- more compassionate toward themselves
- less self-critical
- more assertive
- more authentic

They move from:
“Something is wrong with me” → “I understand why I am this way, and it’s changing.”

7. #### Permanent Shifts, Not Temporary Relief

One of the most striking outcomes of time-limited psychodynamic psychotherapy is the durability of gains.

Research shows:

- clients continue improving *after therapy ends*
- relapse rates are lower than in many other modalities
- clients become more aware of defenses and can self-correct

Because STDP resolves underlying emotional conflicts instead of only treating symptoms, improvements tend to last.

8. #### Identity Transformation and Increased Freedom

STDP often produces deep existential change.

Clients move from living in:

- fear
- self-protection
- suppression
- people-pleasing
- perfectionism
- emotional numbness

to living with:

- authenticity
- clarity
- choice
- emotional vitality
- a sense of embodiment

Clients often say:

- *“I’m finally feeling like myself.”*
- *“I don’t react out of fear anymore.”*
- *“I feel alive.”*

## STDP and ISTDP Case Examples

The following case examples illustrate how Short-Term Intensive Dynamic Psychotherapy works:

### Short-Term Dynamic Psychotherapy with the Anxious High-Achiever

Emma, a 24-year-old law student, presented with:

- severe test anxiety
- panic attacks
- perfectionism
- chronic neck and jaw tension
- fear of disappointing others

She described herself as “very successful on paper but falling apart internally.”

#### Course of short-term dynamic psychotherapy

In early sessions, Emma intellectualized everything. When asked about emotions, she responded with achievements, statistics, or timelines. Defenses became a central focus.

As emotional pressure increased, her anxiety rose into smooth muscle activation (stomach pain, nausea). The therapist slowed down and regulated, helping her stay in contact with the feeling.

She eventually developed anger toward a hypercritical father who equated worth with accomplishment. Underneath this was grief about never feeling emotionally supported.

**Time-limited dynamic psychotherapy breakthrough**

Around session 12, Emma experienced a visceral wave of anger — fists tight, voice strong — followed by uncontrollable crying. She said:

*“I worked so hard because I thought maybe finally he’d love me.”*

**By session 20 of time-limited dynamic psychotherapy:**

- Panic attacks ceased.
- She reduced work hours and still performed well academically.
- She challenged her inner critic.
- Her relationships became more authentic and less driven by approval-seeking.

She described feeling “lighter, real, and no longer terrified of failing.”

### Intensive Short-Term Dynamic Psychotherapy (ISTDP) and Emotionally Unavailable Partners

David, 41, repeatedly entered relationships with distant or avoidant partners. He sought validation through caretaking and resented being unappreciated. He experienced depression after breakups.

#### Course of ISTDP

In sessions, David joked whenever feelings surfaced, especially around vulnerability or anger. The therapist identified humor as a defense.

When asked about feelings toward past partners, he said:

*“It’s fine, I just move on.”*

Under pressure and clarification, David contacted deep longing and unexpressed anger toward a mother who was loving but inconsistently present due to depression. He feared becoming “too needy,” mirroring a childhood narrative.

**Transference**

He initially feared the therapist would pull away if he showed disappointment or anger. Working through this became foundational.

**ISTDP Breakthrough**

Around session 18, he expressed anger clearly:

*“I always choose people who won’t choose me back because I’m terrified of being seen.”*

**ISTDP Outcome**

By session 30:

- He recognized red flags earlier.
- He entered a relationship with someone emotionally available.
- His depressive symptoms decreased.
- He described feeling more stable and less frantic in love.

### Intensive Short-Term Dynamic Psychotherapy (ISTDP) and Somatization and Chronic Pain

Marisol, 53, experienced:

- chronic back pain
- migraines
- emotional flatness
- avoidance of conflict
- years of suppressing anger

She never cried, never yelled, and rarely expressed needs.

#### Course of ISTDP

In early intensive short-term dynamic psychotherapy sessions, discussing emotions caused sharp increases in muscular tension. She often dissociated slightly (staring off, slowed speech). The therapist intervened with grounding.

As defenses dropped, images surfaced of childhood physical punishment whenever she showed anger. Therefore, she had an internal rule:
“Anger = danger.”

**Intensive Short-Term Dynamic Psychotherapy Breakthrough**

Session 15: Marisol experienced her first emotional expression — shaking with anger toward her father, followed by grief.

Her back pain subsided for several days afterward.

**Intensive Short-Term Dynamic Psychotherapy Reorganization**

Over time, she:

- learned to identify anger early
- set boundaries with family
- experienced deeper emotional range
- cut painkiller use in half
- resumed physical activities she had abandoned

**Intensive Short-Term Dynamic Psychotherapy Outcome**

By session 32, her chronic pain episodes were rare and manageable. She described feeling:

- “awake,”
- “connected,”
- and “no longer afraid of my own emotions.”

## When Short-Term Psychodynamic Psychotherapy Is *Not* the Right Choice

There are times when short-term psychodynamic psychotherapy is not a good choice, at least until specific symptoms clear:

1. Acute crises

Active suicidality, severe trauma exposure, or current abuse require stabilization first.

2. Severe dissociation

Clients who cannot stay within the therapeutic window need grounding and trauma methods before affect-focused work.

3. Psychosis or mania

Insight-oriented emotional work is ineffective or destabilizing in these states.

4. Severe substance use

Avoidance via substances blocks emotional presence.

5. Clients who explicitly do *not* want deep emotional work

Some prefer skills-based or solution-focused therapy. Consent and readiness matter.

6. Clients with extremely fragile defenses

If even minor emotional exploration leads to panic, collapse, or fragmentation, therapies like DBT, stabilization, or sensorimotor psychotherapy are better entry points.

## Conclusion

Short-Term Dynamic Psychotherapy offers a powerful path for people ready to experience significant emotional change. By focusing on core affect, real-time relational patterns, and defenses that block emotional truth, STDP can lead to rapid breakthroughs that create long-lasting transformation. When used with the right clients — and at the right time — it can shift lifelong patterns, reduce symptoms, expand emotional range, and help people live with greater authenticity, freedom, and internal stability. Intensive Short-Term Dynamic Psychotherapy (ISTDP) can have an even more profound effect.

### My Work with Short-Term Psychodynamic Psychotherapy

STDP and ISTDP are ultimately about helping clients reclaim the parts of themselves they had to bury for survival. And when those emotional truths finally emerge, profound healing becomes possible. If you would like more information about short-term psychodynamic psychotherapy and how it might benefit you or a loved one, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a free consultation](https://www.picktime.com/scheduleaconsult#services/service).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Types of Therapy

---

### [Panic Attack Treatment](https://dralanjacobson.com/panic-attack-treatment/)

**Published:** July 20, 2021
**Author:** Dr. Alan Jacobson

**Content:**

**![Panic attack treatment](https://dralanjacobson.com/wp-content/uploads/2018/07/panic-attack.jpg "panic attack | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")**The following is a self-help guide, but I can provide options for **panic attack treatment** at home and in my office if you need more. These symptoms are [more common](https://www.nimh.nih.gov/health/statistics/panic-disorder) than many people realize. Given that a definition that describes the symptoms precisely is hard to pin down, estimates of the incidence and prevalence vary widely. However, one thing that can be inferred from the data is that many people will experience them sometime in their lives. **Therapy for panic attacks** can help! I offer **cognitive-behavioral therapy for panic disorder**, as well as other types of **therapy for panic attacks**.

These symptoms can be unsettling and scary and can interfere with social, academic, and work functioning in two crucial ways: First, they can [make a presentation at work](https://dralanjacobson.com/presentation-anxiety/), a social introduction, or a class presentation less effective and certainly less comfortable; Second, they can create overwhelming anticipatory anxiety afterward that creates an avoidance of any activities that are perceived as having the potential to cause another one. The good news is that treatment for panic attacks can be very powerful! [Contact me](https://dralanjacobson.com/contact/) or [schedule a free consultation](https://www.picktime.com/scheduleaconsult) to discuss any of this anytime.

## Panic Attack Treatment Works!

There is good news when it comes to treatment for panic attacks:

1. *These episodes are usually transitory* – people often develop them at a certain life transition point or during general stress. Still, they often resolve as the transition passes or overall anxiety lessens.
2. *They are relatively easy to address* within and outside the therapist’s office. In other words, they are symptoms you can work on yourself with a therapist.
3. *The fears and anxieties that come with these episodes are almost always unfounded or at least irrational.* You may [fear that your plane will crash](https://dralanjacobson.com/fear-of-flying-therapy/), that people you are speaking in front of are judging you unfairly, or that you will crash your car if you have one, but none of these is likely to happen.

One focus of treatment for panic attacks revolves around [cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) to help you see the irrational or exaggerated fears you have that cause them or make you suffer from anticipatory anxiety about having one. You will quickly see how the disruption they cause is not nearly what you worry it will be, and the worries about having one are often much worse than the actual experience.

Therapy for panic attacks has a high rate of helping and often gives more general tips and advice that can help with other forms of anxiety. This post explores therapy for panic attacks from several angles.

## Techniques Used in Therapy for Panic Attacks

So, how can you address all of this? Here is a start, with some information about what we can do in a session that focuses on treatment for panic attacks.

### Panic Attack Treatment Quick Start

These episodes are worsened when we fight against them. Pushing back often makes them more intense or at least more anxiety-producing. But realizing they are common, will not hurt you, and will pass can help a lot. Think of being at the beach on a day when the waves are high. What causes relaxation and comfort: Jumping into the waves or riding them to shore?

Given all that, one technique we start with in therapy for panic attacks involves simply treating them like waves (or a strong breeze that occurs when walking or running, if you prefer). Go with it. Allow the anxiety to set in, know it is time-limited, and feel how it reduces in intensity. (Spoiler alert: While it may seem that you are merely waiting out the episode – a good thing in itself – you are also likely reducing its intensity by not mixing in any more anxiety.)

Consulting with a psychologist like me may be helpful if you haven’t been able to reduce the frequency and intensity on your own. We can tailor your approach to treatment for panic attacks to your specific needs and circumstances. In therapy for panic attacks, we use some of the following techniques and approaches:

### 1. Cognitive-behavioral Therapy for Panic Disorder (CBT)

- **Identifying and Challenging Negative Thoughts:** Cognitive-behavioral psychotherapy for panic disorder helps clients identify irrational thoughts (like “I’m going to die” or “I’m losing control”) that may trigger or intensify symptoms. Replacing these with more balanced thoughts reduces anxiety.
- **Exposure Therapy:** This is a cognitive-behavioral therapy for panic disorder in which clients are gradually exposed to situations or sensations that can trigger episodes, such as feeling dizzy or having a racing heart. Over time, this exposure helps reduce the fear response.
- **Interoceptive Exposure:** This treatment for panic attacks involves deliberately triggering mild physical sensations associated with these episodes (such as hyperventilating to cause dizziness), helping clients learn that these sensations are safe and manageable.

### 2. Mindfulness-Based Panic Attack Treatment

- **Mindfulness Training:** [Mindfulness psychotherapy](https://dralanjacobson.com/mindfulness-therapy/) for panic disorder teaches clients to observe their thoughts and sensations non-judgmentally and accept them without fear. This can be especially helpful for managing the physical sensations.
- **Breathing and Grounding Techniques:** Mindfulness exercises like deep breathing, grounding, and body scans help people center themselves, reducing physical and mental distress.

### 3. Acceptance and Commitment Therapy for Panic Attacks

- **Acceptance of Symptoms:** Acceptance and Commitment Therapy for panic attacks helps people accept uncomfortable sensations and emotions rather than trying to avoid or escape them. The [acceptance and commitment therapy](https://dralanjacobson.com/act-psychotherapy/) approach reduces the power panic has over their lives.
- **Values-Based Living:** Acceptance and Commitment Therapy for Panic Attacks encourages clients to focus on their personal values and engage in meaningful activities, even when they feel anxious. This helps individuals move forward without letting symptoms dictate their actions.

### 4. Exposure and Response Prevention (ERP)

- **Gradual Exposure to Feared Situations:** In ERP panic attack treatment, clients are gradually exposed to situations that trigger their anxiety, learning to tolerate their anxiety without engaging in safety behaviors or avoidance.
- **Building Resilience to Triggers:** Through repeated [exposure and response prevention](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/), clients gain confidence and see that feared outcomes (like losing control) do not actually occur.

### 5. Psychoeducation and Self-Management Techniques

- **Education on Anxiety:** Understanding what happens in the body during an episode can be empowering, helping individuals realize that symptoms are uncomfortable but not dangerous. This is a perfect adjunct to psychotherapy for panic disorder.
- **Coping Skills Training:** Self-soothing techniques like deep breathing, muscle relaxation, visualization, and using positive affirmations help clients manage symptoms before they escalate.

### 6. Relapse Prevention

- **Developing a Coping Plan:** Many forms of therapy for panic attacks include a focus on long-term management, helping clients recognize early signs of anxiety, and applying learned techniques to prevent full-blown episodes.
- **Lifestyle Adjustments:** Stress management, regular exercise, healthy eating, and consistent sleep routines can all reduce overall anxiety levels, helping prevent relapse and enhancing the power of psychotherapy for panic disorder.

### Therapy for Panic Attacks and Homework

Beyond therapy for panic attacks, we make several suggestions related to symptoms, including:

1. **Lifestyle Changes:** Healthy lifestyle changes can help. Regular exercise, maintaining a balanced diet, getting adequate sleep, and avoiding substances like caffeine and alcohol can all reduce anxiety.
2. **Support Groups:** Joining a support group for individuals with similar symptoms can provide a sense of community and a platform to share experiences and coping strategies. This is a great adjunct to individual therapy for panic disorder.
3. **Stress Management:** Learning to manage stress through time management, setting realistic goals, and practicing good self-care can help prevent them.
4. **Limit Stimulants**: Reduce or eliminate stimulants like caffeine and nicotine, as they can exacerbate anxiety symptoms.

## Panic Attack Treatment At Home

Whether you pursue structured treatment for panic attacks that psychologists like me provide or not, there are things you can do at home outside of sessions. Here are several techniques you can try at home to manage symptoms:

### Pain Attack Treatment At Home Through Deep Breathing

Practice deep breathing exercises to help calm your body’s physiological response to anxiety. Inhale deeply through your nose for a count of four, hold your breath for a count of four, and then exhale slowly through your mouth for a count of four.

### Progressive Muscle Relaxation as Panic Attack Treatment at Home

Tense and then relax each muscle group in your body, starting from your toes and working your way up to your head. This can help release tension and reduce feelings of anxiety.

### Mindfulness, Affirmations, and Meditation

Engage in [mindfulness practices](https://dralanjacobson.com/mindfulness-therapy/) or meditation to bring your focus to the present moment and reduce racing thoughts. There are many [guided meditation apps](https://www.nytimes.com/wirecutter/reviews/best-meditation-apps/) or videos available that can assist with this. While you do this, repeat positive affirmations to yourself, such as “I am safe,” “This feeling will pass,” or “I can handle this.” Repeating these affirmations can help shift your mindset during an episode.

### Grounding Techniques for Panic Disorder Treatment at Home

Use [grounding techniques](https://www.healthline.com/health/grounding-techniques) to bring your focus back to the present moment. This can include focusing on sensory experiences like touch, sight, sound, taste, or smell. Designate a specific area in your home where you feel calm and safe. Spend time in this space when you’re feeling overwhelmed or anxious.

### Reach Inward and Outward

Write down your thoughts and feelings during and after an episode. This can help you identify triggers and patterns and provide a sense of release. Also, stay connected with friends, family, or support groups who can offer understanding and encouragement during difficult times.

Remember, while these techniques for panic attack treatment at home can be helpful, they may not be sufficient. If you experience frequent or severe symptoms, you may want to seek more formal therapy.

## Cognitive-Behavioral Psychotherapy for Panic Disorder

Cognitive-behavioral therapy for Panic Disorder is one of the most effective treatments. It focuses on identifying, understanding, and modifying the thoughts and behaviors that contribute to panic attacks and their physical symptoms. Here’s how cognitive-behavioral therapy for panic disorder is typically used to treat panic disorder:

### 1. CBT for Panic Attacks and Psychoeducation

- **Learning about the Disorder:** In CBT for panic attacks, understanding the physical, mental, and emotional aspects helps reduce fear and anxiety. Clients learn that these episodes are not harmful and that their uncomfortable symptoms are temporary and manageable.
- **Anxiety Cycle Education:** In CBT for panic attacks, clients learn how thoughts, feelings, and behaviors contribute to the maintenance of anxiety, which empowers them to break this cycle.

### 2. Cognitive Restructuring

- **Identifying Negative Thought Patterns:** Cognitive-behavioral treatment for panic disorder helps individuals identify distorted or catastrophic thoughts that often trigger or intensify panic, like “I’m having a heart attack” or “I’m going to lose control.”
- **Challenging and Reframing Thoughts:** In cognitive-behavioral therapy for panic disorder, I work with clients to challenge these unhelpful beliefs and replace them with more realistic, balanced thoughts. For example, instead of “I am going to faint,” a new thought might be, “This is uncomfortable but not dangerous, and I can handle it.”

### 3. Exposure Therapy for Panic Attacks

- **Interoceptive Exposure:** This treatment for panic attacks involves intentionally bringing on physical sensations similar to those of an episode (like increased heart rate or dizziness) in a controlled setting, helping clients learn that these sensations are not harmful.
- **Situational Exposure:** In [exposure therapy for anxiety](https://dralanjacobson.com/exposure-therapy-for-anxiety/), clients gradually face situations they have avoided (like crowded places or public transportation) to reduce fear over time, building confidence that they can handle these experiences without distress.
- **Graded Exposure:** Exposure therapy for panic attacks is often done gradually, starting with less intimidating situations and progressing to more challenging ones as comfort increases.

### 4. Behavioral Panic Attack Treatment Techniques

- **Relaxation Training:** CBT for panic attacks techniques like deep breathing, progressive muscle relaxation, and mindfulness help manage physical symptoms of anxiety and promote calmness, and thus, they are used as adjunctive approaches in cognitive-behavioral therapy for panic disorder.
- **Activity Scheduling and Avoidance Reduction:** Cognitive-behavioral therapy for panic disorder helps individuals gradually re-engage in daily activities they may have been avoiding due to fear, encouraging a balanced, fulfilling lifestyle.

### 5. CBT for Panic Attacks and Relapse Prevention

- **Planning for Future Triggers:** As treatment for panic attacks progresses, clients develop a plan for managing future anxiety triggers or potential relapses, which is especially valuable in long-term maintenance.
- **Self-Monitoring Skills:** Clients learn to recognize early signs of anxiety and apply coping strategies proactively as treatment for panic attacks.

Through these steps, cognitive-behavioral therapy for panic disorder helps individuals with panic disorder reduce the intensity and frequency of symptoms and live with greater confidence and less anxiety. Therapy is often structured over several sessions, and a significant improvement is usually noticeable within 12-20 sessions, though this can vary by individual.

## Treatment for Panic Attacks in My Practice

I welcome inquiries about how therapy for panic attacks can help reduce the frequency and intensity of attacks. For example, cognitive-behavioral treatment for panic disorder has a high rate of success. Often, people leave therapy with a toolkit that can help them should they recur, and sometimes, just having that toolkit alone helps reduce the chances. Feel free to try the techniques for panic attack treatment at home first, but I hope you’ll be in touch if they are not enough.

### Reduce the Chance of Having One

You can also work on reducing the chances or severity of these symptoms, including visualizing, handling them well, and paying closer attention to what triggers them. For many people, the latter exercise proves essential—it can be hard to figure out what causes one, but if you can figure it out, you may be able to address that trigger.

### Anticipatory Anxiety

*Unfortunately, [anticipatory anxiety](https://www.medicalnewstoday.com/articles/anticipatory-anxiety) becomes the central problem* in many cases. While these incidents may be a transient problem, likely to resolve over time, worry about having one can persist for a long time. A person experiencing anticipatory anxiety may avoid many social situations or interrupt their career or academic path to ensure that any number of fears, including flying, speaking in front of others, and working under pressure, are not required.

### When Should You Seek Panic Attack Treatment?

If, at some point, you find yourself avoiding certain activities due to your fear or despite your efforts to reduce the frequency and intensity, meeting with a therapist like me for treatment for panic attacks may help. You will do much of the work and likely see that the work pays off. But we are there to suggest ideas, modify them as needed, give encouragement, and help you understand why they happen. We know what has worked for people with symptoms and triggers similar to yours!

[Contact me](https://dralanjacobson.com/contact/) or [schedule a free consultation](https://www.picktime.com/scheduleaconsult) about panic attack treatment anytime. We can explore cognitive-behavioral therapy for panic disorder and other methods, and I’d also be happy to give you some tips for your unique situation. I provide general **treatment for panic attacks** and specific services related to [public speaking](https://dralanjacobson.com/public-speaking-anxiety/) and [airplane flying](https://dralanjacobson.com/fear-of-flying-treatment/).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Symptom Relief

---

### [Cognitive Restructuring Techniques: Fast, Positive Results](https://dralanjacobson.com/cognitive-restructuring/)

**Published:** December 14, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Cognitive restructuring** is one of the pillars of cognitive behavioral therapy. I use **cognitive restructuring techniques** with many clients, whether we are focused on [cognitive behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) or [humanistic methods](https://dralanjacobson.com/basic-tenets-of-humanistic-psychology/) such as [narrative therapy](https://dralanjacobson.com/narrative-therapy/) or [ACT psychotherapy](https://dralanjacobson.com/act-psychotherapy/). These methods are effective both virtually and in person. In this post, I provide a **cognitive restructuring example** that includes how a client used a **cognitive restructuring worksheet** to get significant results. Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you have any questions or want to pursue this treatment.

## Cognitive Restructuring Overview

Cognitive restructuring techniques target **unhelpful or distorted thoughts** contributing to negative emotions and behaviors. In brief, this is how cognitive restructuring works:

- **Goal**: Use cognitive restructuring techniques to identify, challenge, and replace maladaptive thoughts with more balanced and realistic ones.
- **Cognitive Restructuring Techniques**: 
    - Recognize [automatic negative thoughts](https://www.healthline.com/health/mental-health/stop-automatic-negative-thoughts) (e.g., “I’m a failure,” “No one likes me”).
    - Challenge these thoughts by evaluating evidence for and against them.
    - Replace the negative thought with a healthier, more balanced one (e.g., “I made a mistake, but that doesn’t mean I’m a failure”).
- **Cognitive Restructuring Example**:
    *Situation*: You failed an exam.
    *Thought*: “I’m completely useless.”
    *Revised Thought*: “I didn’t do well on this exam, but I can study differently next time and improve.”

Cognitive restructuring techniques help individuals reduce **cognitive distortions** like catastrophizing, overgeneralization, or all-or-nothing thinking.

---

### Cognitive Restructuring Example List

Each **cognitive restructuring example** covers a common distortion and highlights how to challenge and replace unhelpful thoughts with balanced alternatives:

---

#### 1. Cognitive Restructuring Example: All-or-Nothing Thinking

- Negative Thought: “If I can’t do this perfectly, I’m a total failure.”
- Challenged Thought: “It’s okay if I don’t get everything right. Progress is still progress, and I can learn from mistakes.”

---

#### 2. Catastrophizing

- Negative Thought: “If I mess up this presentation, my boss will fire me, and my career will be over.”
- Challenged Thought: “If the presentation doesn’t go perfectly, I’ll be disappointed, but I can use the feedback to improve. One presentation won’t ruin my career.”

---

#### 3. Overgeneralization

- Negative Thought: “I failed this exam. I’m going to fail at everything I try in life.”
- Challenged Thought: “I struggled with this exam, but it doesn’t mean I’ll always fail. I can study differently next time and do better.”

---

#### 4. Labeling

- Negative Thought: “I’m such an idiot for forgetting my friend’s birthday.”
- Challenged Thought: “Forgetting a birthday doesn’t make me an idiot. It was a mistake, and I can make it up by reaching out and apologizing.”

---

#### 5. Mind Reading

- Negative Thought: “She didn’t reply to my text. She must be mad at me.”
- Challenged Thought: “There could be many reasons she hasn’t replied yet. She might be busy or preoccupied. I shouldn’t assume the worst.”

---

#### 6. Fortune Telling

- Negative Thought: “I’ll never get this job, so there’s no point in applying.”
- Challenged Thought: “I don’t know what will happen. I have a chance if I apply, and not trying guarantees failure.”

---

#### 7. Personalization

- Negative Thought: “My friends didn’t laugh at my joke. I must be boring or annoying.”
- Challenged Thought: “Just because they didn’t laugh doesn’t mean they think I’m boring. Maybe they didn’t find it funny, and that’s okay.”

---

#### 8. Emotional Reasoning

- Negative Thought: “I feel useless, so I must be useless.”
- Challenged Thought: “Just because I feel this way doesn’t mean it’s true. Feelings aren’t facts, and I’ve accomplished things before.”

---

#### 9. Discounting the Positive

- Negative Thought: “Sure, I did well on the project, but anyone could have done that.”
- Challenged Thought: “I worked hard and succeeded on this project. My effort and skills played a role in that success.”

---

#### 10. Should Statements

- Negative Thought: “I should always be strong and never ask for help.”
- Challenged Thought: “It’s okay to ask for help when I need it. Everyone has limits, and seeking support shows strength, not weakness.”

---

### General Cognitive Restructuring Steps

1. **Identify the Thought**: Recognize the unhelpful thought causing distress.
2. **Examine Evidence**: Ask, “What proof do I have that this thought is true or false?”
3. **Challenge the Thought**: Look for alternatives that are more balanced or realistic.
4. **Replace the Thought**: Create a healthier, more positive thought.

### Cognitive Restructuring Techniques

You can use cognitive restructuring techniques to identify, challenge, and replace unhelpful thoughts:

#### 1. Identify Automatic Negative Thoughts (ANTs)

Automatic negative thoughts occur instantly in response to situations. The first step is recognizing them.

- Example: “I failed this test. I’m stupid.”
- Action: Write down your thoughts as they arise to catch patterns of negativity.

---

#### 2. Cognitive Restructuring Worksheet

[Thought records](https://positivepsychology.com/thought-records/), or cognitive restructuring worksheets, help you analyze your thoughts systematically. Break the process into steps:

SituationAutomatic ThoughtEmotionsEvidence ForEvidence AgainstNew Balanced ThoughtFailed a test“I’m a failure.”Sad, hopelessI got a low gradeI passed other tests before“I didn’t do well this time, but I can learn and improve.”- Why they work: Cognitive restructuring worksheets help you evaluate thoughts objectively and replace them with more realistic ones.

---

#### 3. Socratic Questioning

Use open-ended questions to challenge unhelpful thoughts:

- What evidence supports this thought? What evidence contradicts it?
- Am I jumping to conclusions or assuming the worst?
- How would I view this situation if it happened to someone I care about?
- Will this matter a month or a year from now?
- Am I basing this thought on facts or feelings?

Example:

- *Thought*: “Everyone hates me.”
- *Questions*: “What evidence do I have for this? Did someone say that? Are there friends who enjoy my company?”

---

#### 4. Reframing

Reframe negative thoughts into more constructive ones by looking for alternative perspectives.

- Negative Thought: “I’m terrible at public speaking.”
- Reframe: “I have [public speaking anxiety](https://dralanjacobson.com/public-speaking-anxiety/), but I can practice and get better with time.”

---

#### 5. Distinguish Thoughts from Facts

Remember that thoughts are not always facts. Treat them as opinions you can question.

- Example: “I’ll never succeed.”
- Ask yourself: “Is this a fact, or is this just a belief I’ve created based on fear?”

---

#### 6. Label Cognitive Distortions

Identify and name the cognitive distortion (e.g., all-or-nothing thinking, catastrophizing). Once labeled, it’s easier to challenge.

- Example: “I failed once, so I’m useless.” → *Overgeneralization*.
- Cognitive restructuring example: “Failing once doesn’t define me. I can try again.”

---

#### 7. Use a Thought Diary

Keep a journal to log negative thoughts, their triggers, and restructured thoughts, and then transfer them to your cognitive restructuring worksheet.

- Format: 
    - Trigger/Situation
    - Negative Thought
    - Emotion (rate intensity: 1–10)
    - Balanced Thought
    - Outcome (emotion intensity after restructuring)
- Cognitive Restructuring Example Entry: 
    - Trigger: Got critical feedback at work.
    - Negative Thought: “I’m terrible at my job.”
    - Emotion: Sadness, 8/10.
    - Balanced Thought: “Feedback helps me improve; it doesn’t mean I’m bad at my job.”
    - Outcome: Sadness reduced to 4/10.

---

#### 8. Positive Affirmations

Counteract negative thoughts with intentional, realistic affirmations.

- Negative Thought: “I’m going to fail.”
- Affirmation: “I’m prepared, and I’ll do my best. That’s enough.”

---

#### 9. Behavioral Experiments

Test whether your negative thoughts are accurate by taking action.

- Example: 
    - Thought: “If I ask for help, people will think I’m weak.”
    - Experiment: Ask a colleague for help on a small task and observe their reaction.
    - Result: Most people are willing to help and don’t judge you negatively.

---

#### 10. Scaling the Problem

Put your problems or thoughts on a scale from 1 to 10 to gain perspective.

- Example: “This is the worst thing ever!”
- Ask: “On a scale of 1–10, how bad is this really? Is it a 10 like a serious illness, or more like a 4 because it’s just temporary?”

---

#### 11. The Double-Standard Method

Treat yourself with the same kindness you’d give a friend.

- Example: 
    - *Thought*: “I’m so dumb for making this mistake.”
    - *Question*: “If my friend made this mistake, would I say that to them? No. I’d remind them that everyone makes mistakes.”

---

#### 12. Decatastrophizing

Imagine the “worst-case scenario” and how you’d realistically cope with it.

- Thought: “If I fail this interview, my life is ruined.”
- Challenge: “Even if I fail, I can try again. It’s disappointing, but it won’t ruin my life.”

---

By consistently practicing these cognitive restructuring techniques, you can rewire unhelpful thought patterns and develop a healthier, more balanced mindset.

## Cognitive Restructuring Example in Practice

Here is a fictitious **cognitive restructuring example** to illustrate how it works in practice:

---

### Case Scenario

**Client**: Sarah, a 23-year-old college student
**Issue**: Sarah has been feeling anxious and overwhelmed about her academic performance. She recently scored lower than expected on an exam and has started to think she is “a failure” and “not smart enough to succeed.” This thought has led her to procrastinate on studying for her upcoming exams.

---

### Step 1: Identify the Automatic Thought

- **Situation**: Scoring a low grade on an exam.
- **Automatic Thought**: “I’m a total failure. I’m not smart enough to be in college.”
- **Emotion**: Anxiety, sadness, hopelessness.
- **Behavior**: Avoids studying, procrastinates, isolates herself.

---

### Step 2: Identify the Cognitive Distortion

- Sarah’s thought contains **cognitive distortions**: 
    - **All-or-Nothing Thinking**: “I’m a total failure” (labeling herself entirely based on one event).
    - **Overgeneralization**: “I’m not smart enough to succeed” (generalizing one exam to her overall abilities).
    - **Fortune Telling**: Assuming she will fail future exams without evidence.

---

### Step 3: Challenge the Thought Using Socratic Questions

Sarah works with me to question and challenge the automatic thoughts. I ask her:

1. **What evidence supports this thought?**
    - Sarah: “I did poorly on this one exam.”
2. **What evidence contradicts this thought?**
    - Sarah: “I’ve done well on previous exams and assignments in other subjects.”
    - “I studied less for this exam because I was busy last week.”
3. **Am I jumping to conclusions or assuming the worst?**
    - Sarah: “Yes, I’m assuming that one poor grade means I’ll fail everything.”
4. **If a friend were in my position, what would I say to them?**
    - Sarah: “I’d tell them that one bad grade doesn’t define them and they can still improve.”
5. **Is this thought helping or harming me?**
    - Sarah: “It’s making me feel hopeless and preventing me from studying.”

---

### Step 4: Create a Balanced Thought

Sarah works on replacing the negative thought with a more balanced, realistic thought:

- **Old Thought**: “I’m a total failure. I’m not smart enough to succeed.”
- **New Balanced Thought**: 
    - “I didn’t do well on this exam, but one grade doesn’t define my abilities. I’ve done well before, and I can use this experience to study more effectively next time.”

---

### Step 5: Use a Cognitive Restructuring Worksheet to Observe Change

- **Emotion**: 
    - Old thought noted on cognitive restructuring worksheet: Anxiety and hopelessness (intensity: 8/10).
    - New Thought: Disappointment but hopefulness (intensity: 4/10).
- **Behavior**: 
    - Sarah feels motivated to create a study plan for her next exam instead of procrastinating.

---

### Cognitive Restructuring Example Outcome

In this cognitive restructuring example:

- Sarah recognizes that one poor grade does not reflect her overall intelligence or ability to succeed.
- She feels less anxious and begins studying in a structured way, which helps her feel more in control.

This example highlights how cognitive restructuring techniques can help break the cycle of negative thinking, improve emotional regulation, and encourage positive action.

---

## Cognitive Restructuring Worksheet

The above cognitive restructuring shows how a worksheet can be created and used. In this case, Sarah’s cognitive restructuring worksheet would have looked something like this:

**Step****Details**Identify Automatic Thought“I’m a total failure. I’m not smart enough to succeed.”Identify Cognitive DistortionAll-or-nothing thinking, overgeneralization, fortune telling.Challenge the ThoughtUse Socratic questioning to evaluate the evidence.Replace with Balanced Thought“One bad grade doesn’t define me. I can improve next time.”Observe the OutcomeReduced anxiety, increased motivation, and productive behavior.Many people with milder symptoms can create their own cognitive restructuring worksheet like the one above. However, in many cases, it is often still helpful to meet with a therapist, at least at first, to ensure you follow the most effective path to implementing it.

---

## Summary and My Work

Cognitive restructuring techniques are a large part of my work, particularly when I use cognitive behavioral therapy as a treatment method. Cognitive restructuring techniques also work well with other approaches, particularly [behavioral activation](https://dralanjacobson.com/behavioral-activation/), but also [narrative therapy](https://dralanjacobson.com/narrative-therapy/), [acceptance and commitment therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/), and [schema-based methods](https://dralanjacobson.com/schema-therapy/). It can be used in [couples therapy](https://dralanjacobson.com/couples-therapy/) and [family treatment](https://dralanjacobson.com/family-therapy/), especially when distortion is shared or an open person’s distortions affect others (such as with [psychotherapy for anxiety about politics](https://dralanjacobson.com/therapy-for-political-anxiety/)). It is often part of my clinical specialties, such as [fear of public speaking therapy](https://dralanjacobson.com/fear-of-public-speaking-therapy-process/). These [therapy techniques](https://dralanjacobson.com/therapy-techniques-for-depression-anxiety-and-phobias/) can be effectively delivered virtually.

If you have any questions about cognitive restructuring, how this method could benefit you or a loved one, or if you want a jump-start on creating your cognitive restructuring worksheet, feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Advice for Youth Sports Parents](https://dralanjacobson.com/youth-sports-parents/)

**Published:** June 13, 2023
**Author:** Dr. Alan Jacobson

**Content:**

**Youth sports parents** can be helpful in the sports psychology process. Sports psychology is designed to help athletes look to achieve their highest potential in athletic competition. It includes offshoots such as assisting them to overcome anxiety, get out of a slump, or fix a specific challenge. Parents often ask me what they can do to benefit their youth athletes. Here is my primary advice for youth sports parents:

## Expectations and the Youth Athlete

There is a delicate balance between expectations and the youth athlete. On the one hand, your high expectations show you have confidence in the child and, assuming they are accurate, they provide them with a model of setting high but achievable goals. However, parents and coaches must ensure their expectations resonate with the youth athlete. If the child feels unrealistically high, they may tune you out or develop anxiety about reaching them. The latter is a problem because it can work against the athlete by creating anxiety.

As a youth sports parent, your best approach is to let the athlete set their own goals, and even when you feel that they are setting the bar too low, tell them you’ll be proud if they accomplish that. Let them learn that they can outperform their goals.

## Youth sports parents: What to Say and Do

Here’s the short version: Do not prescribe an expectation. From a youth sports psychology perspective, you want your child to strive for their goals. By prescribing an expectation, the goal becomes your goal, and there is added anxiety about living up to your standards.

More to the point: Focus on the journey!

In other words, motivate them to practice, learn new things, and use whatever techniques work for them to relax and focus. You do not need to be involved in sport-specific goal setting. That is the job of the coach. Many youth athletes want to do extra training outside of their organized practices and games, and you can provide the information but do not pressure them.

Here is some excellent advice from [The Association of Applied Psychology](https://appliedsportpsych.org/resources/resources-for-parents/dos-and-donts-for-parents-of-young-athletes/).

### Advice for Youth Sports Parents: A Checklist

Here is a checklist you can use so that you play an effective and influential role in your child’s sports journey:

1. **Be supportive no matter the outcome**. Focus on how much s/he enjoyed the competition. Stay positive. In almost every case, your child knows what s/he did right and wrong, and if not, you need to be sure you trust the coach to communicate that.
2. **Do not ask leading questions**, such as “Did you reach your goals” and “How do you think you did.” These questions can inadvertently have a tone that can be read as disappointment or pressure. Instead, you can ask whether the coach gave feedback.
3. **Give feedback that is not specific to the sport**, such as “You looked like you were working hard out there” or “I saw you pat {another player} on the back after a good play. As a parent, you are there to notice and talk about the life lessons but leave the coaching to the coach.
4. Make sure you **look attentive and interested but relaxed** and comfortable on the sideline. Kids pick up on any bit of anxiety or disappointment.
5. As soon as s/he is old enough, **have them communicate with the coach**, and be careful not to dictate too much of what is said. Until then, **your communications with the coach should be designed to learn and inform,** not to influence or complain.
6. **Be careful about cheering**. We do not want to suggest that you don’t cheer at all, but remember that your child will assess your cheering – did you seem quieter this time, or were your words of encouragement motivated by disappointment?

## Youth Sports Parents and My Services

Please note that I only provide Youth [Sports Psychology services](https://dralanjacobson.com/sports-psychology/) when there is a clear synergy between parents’ hopes and goals and the child’s hopes and goals. There also needs to be an agreement between the parents and child about the intensity of sports involvement and, as they get older, the sacrifices necessary. We know that a child’s motivation and confidence may wax and wane, but we make sure that overall the child is happy and on board with the directions that are being chosen when it comes to their sports career. In other words, just because a parent or coach pushes for [Sports Psychology](https://dralanjacobson.com/sports-performance-psychology/) does not mean my services are warranted. I have to see genuine motivation from the child or teen.

Performance Psychology should only be used by youth who want to integrate its concepts into other essential aspects of their life, particularly school. I feel that athletes must be students first. Sports can provide tremendous education regarding life lessons, strategy, and teamwork, but formal education is still paramount.

In summary, as a parent of youth athletes, I greatly respect other **youth sports parents** who support their kids’ hopes and dreams. I know how powerful and wonderful youth sports can be in your child’s life and your family’s experience. I hope I can play a part in making it all more enjoyable, productive, and successful!

[Contact me](https://dralanjacobson.com/contact/) to hear more or see if I might be a fit.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Sports Psychology

---

### [Psychotherapy for Childhood Trauma](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/)

**Published:** June 23, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Psychotherapy for childhood trauma** is an important and sensitive area of mental health treatment. Their experiences in childhood can have long-lasting effects on a person’s emotional, psychological, and social well-being. I provide several approaches to psychotherapy that are effective in treating the effects of negative childhood experiences on adults. This post goes over some of the most widely recognized **childhood trauma therapy** techniques, including early **trauma-focused cognitive therapy**. I offer early **trauma-focused CBT** to adolescents and adults. I do not see children who have experienced trauma, but I can help you [find a therapist](https://dralanjacobson.com/how-to-find-a-therapist/) who does.

## Psychotherapy for Childhood Trauma: Techniques

There are three major methods of childhood trauma therapy. Keep in mind that in my [integrated practice](https://dralanjacobson.com/types-of-therapy/) that provides [trauma-informed care](https://dralanjacobson.com/trauma-informed-care/), we might use these core techniques while mixing in other, more general methods.

### Trauma-Focused CBT

The method I use most commonly is [CBT for trauma](https://dralanjacobson.com/cbt-for-trauma/). This approach helps adolescents and adults understand the connection between their thoughts, feelings, and behaviors. It aims to change negative thought patterns and behaviors resulting from negative experiences. Techniques might include [cognitive restructuring](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/), which aims to identify and challenge distorted thoughts; [exposure therapy](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/), which provides gradual exposure to painful memories or situations in a controlled way to reduce fear and anxiety; and skills training, which involves teaching [coping skills and relaxation techniques](https://blog.calm.com/blog/coping-strategies). This also involves helping people process and talk about their past experiences.

Note that trauma-focused cognitive therapy is also often delivered to children soon after their trauma experience. However, I do not deliver this service because children are more effectively served in person. I would be happy to refer you to someone who does trauma-focused CBT for children. This type of [individual therapy](https://dralanjacobson.com/individual-therapy/) often involves caregivers supporting the child and reinforcing skills learned in therapy.

### Eye Movement Desensitization and Reprocessing (EMDR)

[EMDR is a therapy](https://www.apa.org/topics/psychotherapy/emdr-therapy-ptsd) that involves recalling painful memories while simultaneously focusing on an external stimulus (like the therapist’s finger moving side to side). This is thought to help reprocess the memory and reduce its emotional impact. EMDR can be a powerful technique, though it is not part of my practice.

### Childhood Trauma Therapy for Couples

Involving a partner in therapy can help address dynamics that contribute to or result from the painful memories and their effects. Thus, [Couples therapy](https://dralanjacobson.com/couples-therapy/) aims to improve communication and support within the relationship.

### Dialectical Behavior Therapy for Trauma

Originally developed for [borderline personality disorder](https://en.wikipedia.org/wiki/Borderline_personality_disorder), DBT has been adapted for use with adolescents and adults who have experienced stressful childhood situations. It focuses on teaching mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.

## Childhood Trauma Therapy Considerations

Each person’s experience of negative past occurrences is unique. Thus, therapy should be tailored to their specific needs. A strong, trusting relationship between the therapist and client is essential for effective treatment. I remain aware of and sensitive to the client’s cultural background and how it might influence their experiences and healing.

## Psychotherapy for Childhood Trauma in My Practice

Using psychotherapy for childhood trauma effectively requires a multifaceted approach that considers the unique needs of each client. [combination of different therapies](https://dralanjacobson.com/integrative-therapy/) might be used to help people process their past, develop healthy coping mechanisms, and lead healthier, more fulfilling lives.

### Trauma-Focused Cognitive Therapy for Adolescents Example

Here is a fictitious example of how trauma-focused cognitive therapy might be applied in my practice:

Sarah is a 16-year-old adolescent who was involved in a car accident when she was a child. Since the accident, she has been experiencing occasional nightmares, anxiety, and fear when riding in cars. Now, she is hoping to get her license and has experienced significant stress.

#### Psychoeducation and Coping Skills

I explain to Sarah about past experiences and their common effects. This helps normalize Sarah’s reactions and reduces stigma or blame. Through trauma-focused cognitive therapy, Sarah learns that her symptoms are a common response to those types of events and that a new change in her life. For her, this includes becoming eligible to get her license.

In addition to trauma-focused cognitive therapy, I teach Sarah relaxation techniques such as deep breathing, [progressive muscle relaxation](https://blog.calm.com/blog/progressive-muscle-relaxation), and guided imagery. These psychotherapy for childhood trauma techniques help Sarah manage her anxiety symptoms when they arise since she will soon be attending driver’s ed.

#### Affective Expression and Regulation

The next phase of trauma-focused CBT involves helping Sarah identify and express her feelings related to the painful event. She uses [feeling charts](https://liveboldandbloom.com/03/self-improvement/feelings-charts-adults) and creative writing to explore and discuss her emotions. This helps Sarah understand and manage her emotional responses.

#### Cognitive Coping and Processing

A core part of trauma-focused cognitive therapy is introducing cognitive coping skills, helping Sarah identify and challenge unhelpful thoughts related to the event. For example, Sarah might believe, “The accident was my fault.” I helped her reframe this thought to something more realistic, such as, “The accident was not my fault. It was an accident.”

#### Trauma Narrative Development

Sarah creates a past narrative, a detailed account of the event. This can be done through writing, drawing, or storytelling. She gradually shares her narrative with me, which helps desensitize her to the memories. I help Sarah process her feelings and correct any cognitive distortions related to the event.

#### In Vivo Mastery of Trauma Reminders

Sarah is gradually exposed to reminders of the event in a controlled and safe way. For example, she might start by sitting in a stationary car and visualizing driving safely, then driving for short distances. This helps reduce her fear and avoidance behaviors.

By the end of the therapy, Sarah has shown significant improvement. Her nightmares have reduced, she no longer avoids car rides, and she has regained interest in her usual activities. Her anxiety levels are more manageable. She has developed effective coping strategies to deal with her emotions. Her parents feel more equipped to support her and manage her symptoms if they reoccur.

### Childhood Trauma Therapy for Adults Example

Here is a fictitious example of a different type of approach, this one regarding childhood trauma therapy for adults. Trauma-focused cognitive therapy is the most common way I work with adults who experienced trauma when they were children.

Jean is a 26-year-old woman who experienced significant bullying when she was a young adolescent. Now, as an adult, she has lower self-esteem, social anxiety, and fears when she has to present in front of people at work. She just got a new job that she’s excited about, but it will involve making presentations and attending more social gatherings.

#### Psychoeducation and Coping Skills

I explained to Jean how childhood trauma can have significant effects in adulthood. We review how the effects can differ in different people and how her symptoms likely emerged. This helps normalize Jean’s reactions, reduces stigma or blame, and helps show that her fears may feel real, but there is no real threat.

As an adjunct to trauma-focused cognitive therapy, I teach Jean relaxation and mindfulness techniques such as on-the-spot meditation, deep breathing, progressive muscle relaxation, positive affirmations, and guided imagery. These techniques help Jean manage her anxiety symptoms, both anticipatory symptoms that she has at home and while driving to work, and the actual symptoms when they arise.

#### Affective Expression and Regulation

The next phase of childhood trauma therapy involves helping Jean talk about those early experiences in an open, non-judgmental, and confidential way, allowing her to express her feelings related to the trauma freely. She explores her emotions, realizing how powerful and just under the surface they are even this many years later. Trauma-focused CBT also helps Jean see that there is no real threat now and that her fight-or-flight responses are actually related to the past.

#### Cognitive Coping and Processing

I now introduce cognitive coping and processing skills, helping Jean identify and challenge irrational and exaggerated thoughts related to the bullying. For example, Jean believed that those who were bullying her were “right” about what they were saying and that they were accurately pointing out her weaknesses. Trauma-focused CBT helps her reframe these thoughts, and she realizes that the bullies were merely insecure and likely bullying her to avoid being bullied themselves.

#### Trauma Narrative Development

The next phase of trauma-focused CBT involves having Jean create [a new trauma narrative](https://dralanjacobson.com/narrative-therapy/), a detailed account of the bullying events that reframes what was actually going on. She tells stories from the point of view of the bullies, exploring their own insecurities and needs to bully, separating them from any actual reality of Jean’s traits. This narrative helps her develop a new perspective to replace the one she has been carrying, and it generally works to desensitize her to the painful memories.

#### In Vivo Mastery of Trauma Reminders

Through storytelling, role plays, and conversation in sessions, Jean is gradually exposed to reminders of the bullying in session. This provides a safe way to get relief. Then, as homework, she also starts exposing herself to challenging situations at work, eating lunch more socially, joining in on conversations, and volunteering to present. During these times, she reminds herself of her chosen new narratives.

About two months into psychotherapy for childhood trauma, Jean is very happy with her progress. While presenting to large groups is still not easy, she finds herself having less anticipatory anxiety. She’s also generally feeling better socially. Her anxiety levels are down, and she feels more hopeful.

These examples illustrate childhood trauma therapy is structured and applied in a real-world scenario. Individual psychotherapy for childhood trauma is designed to be flexible and adapted to each client’s specific needs and circumstances. Through a combination of education, skill-building, cognitive processing, and gradual exposure, childhood trauma therapy helps people heal from the effects of those past experiences.

### Psychotherapy for Childhood Trauma in My Practice

My practice may be a good fit if you are specifically looking for trauma-focused cognitive therapy or a more integrated approach, such as an integration with [emotionally focused individual therapy](https://dralanjacobson.com/emotionally-focused-individual-therapy/) to more deeply process the emotional impact. For more information about trauma-focused CBT and how I use it in my practice or general information about possible approaches to psychotherapy for childhood trauma for you or a loved one, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Types of Therapy

---

### [Strength Based Therapy Techniques: Positive Outcomes that Last and Grow](https://dralanjacobson.com/strength-based-therapy/)

**Published:** May 18, 2025
**Author:** Dr. Alan Jacobson

**Content:**

I take an integrative approach that draws from [positive psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/), strength based therapy, and evidence-based modalities to help clients reduce distress and move toward a more fulfilling and authentic life. I focus on what’s right with you, not to ignore challenges, but to empower your capacity for resilience, purpose, and growth. Whether you’re navigating anxiety or depression, [life transitions](https://dralanjacobson.com/life-transitions-therapy/), a general lack of meaningfulness, burnout, or identity concerns, we’ll use a strength based approach to identify the inner resources, values, and fortitude that can guide your healing and direction. In my practice, I use strength based therapy techniques not to fix what’s broken, but rather to illuminate and expand what’s already working.

Together, we explore your story, reconnect with your fortitude, and cultivate the mindset, habits, and meaning that support long-term well-being.

## What Is Strength Based Therapy? ![Strength based therapy](https://dralanjacobson.com/wp-content/uploads/2025/05/up-300x240.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

**Strength based therapy** is a positive, collaborative approach to psychotherapy that emphasizes clients’ existing potential, resources, and resilience, rather than focusing primarily on their deficits, problems, or pathologies. It aims to empower individuals by helping them recognize and build upon what they already do well.

The strength based therapy operates on the belief that:

- Every person has fortitude, power, and resources.
- Change is more likely when people focus on what is working.
- Empowerment fosters resilience and improved well-being.

#### Populations and Settings

Strength based therapy is widely used across:

- Youth and [family therapy](https://dralanjacobson.com/family-therapy/)
- Trauma recovery
- [Career assessment](https://psychologicalassessments.com/career-testing/) and counseling
- Job stress and [burnout therapy](https://dralanjacobson.com/burnout-therapy/)
- Substance use treatment
- Education and executive coaching
- Community mental health
- [Therapy for Self-Esteem](https://dralanjacobson.com/therapy-for-self-esteem-and-resilience-training/)

### Origins of Strength Based Therapy

The strength based approach emerged as a response to traditional therapy models that focused largely on pathology, problems, and dysfunction. Key historical milestones include:

- **Social Work Roots**: The strength based approach gained traction in social work during the 1980s and 1990s. It was notably advanced by [**Dennis Saleebey**](https://en.wikipedia.org/wiki/Dennis_Saleebey), who argued for viewing clients through a lens of competence and capability rather than deficiency.
- **Influence from Positive Psychology**: The field of **positive psychology**, spearheaded by [**Martin Seligman**](https://en.wikipedia.org/wiki/Martin_Seligman) and [**Mihaly Csikszentmihalyi**](https://en.wikipedia.org/wiki/Mihaly_Csikszentmihalyi), also contributed significantly. Positive psychology shifted focus toward human flourishing, happiness, and meaning.
- **Narrative and [Solution-Focused Therapies](https://dralanjacobson.com/solution-focused-therapy/)**: Strength-based therapy draws from these practices by encouraging clients to tell stories of resilience and success, and envision preferred futures.

### Common Strength-Based Therapy Techniques

Each of the following is a strength based approach:

1. **Strengths Assessment**
    - Clients identify personal, relational, cultural, and community fortitude.
    - Tools like the *VIA Character Strengths Survey* may be used.
2. **Exception-Finding**
    - Identifying times when problems were absent or less intense, to explore what was different and effective.
3. **Reframing**
    - Helping clients reinterpret difficulties as opportunities or indicators of (e.g., seeing “stubbornness” as determination).
4. [**Narrative Techniques**](https://dralanjacobson.com/narrative-therapy/)
    - Encouraging clients to tell stories highlighting their resilience, achievements, and problem-solving abilities.
5. **Goal Setting**
    - Creating actionable goals aligned with what clients are naturally good at or passionate about.
6. **Gratitude and Power Journals**
    - Keeping track of positive experiences and moments when personal power was used positively and successfully.
7. **Positive Affirmations and Visualization**
    - Practicing affirming beliefs and imagining future successes.

### What is the Strength Based Therapy Success Rate

Research and clinical observation show several positive outcomes from strength based therapy:

- **Increased Self-Esteem and Confidence**: Clients feel more capable and empowered to handle challenges.
- **Improved Coping and Resilience**: Focus on past successes builds confidence in future problem-solving.
- **Greater Motivation and Engagement**: Positive reinforcement enhances engagement in the therapeutic process.
- **Enhanced Relationships**: Recognizing positive potential can improve empathy and communication in relationships.
- **Reduction in Symptoms of Anxiety and Depression**: Especially when combined with [cognitive-behavioral techniques](https://dralanjacobson.com/cbt-techniques/).

### Conclusion

Strength based therapy shifts the narrative from “what’s wrong” to “what’s strong.” Empowering individuals to tap into their inner resources offers a hopeful, energizing path to growth, healing, and well-being. It’s particularly effective when clients feel stuck or overwhelmed by problems or when traditional pathology-focused approaches feel disempowering.

## Strength Based Therapy Techniques

Here’s a **deeper breakdown of strength based therapy techniques**, how they’re used, and why they’re effective. This section answers the question, “What is strength based therapy used for?”

1. ### Strength Based Therapy Assessment

**Purpose:** To identify and validate the client’s internal and external resources.

**How it works:**

- Clients explore positive aspects of character traits, skills, relationships, values, achievements, and coping strategies.
- I use structured tools like: 
    - **VIA Character Survey**
    - **StrengthsFinder by Clifton**
    - **Resilience scales**
- Informal methods include asking: 
    - *“What are you proud of?”*
    - *“How have you gotten through tough times before?”*

**Why it works:** People often overlook their fortitude. Naming them increases self-efficacy and builds a foundation for change.

2. ### Exception-Finding in Strength Based Therapy

**Purpose:** To uncover times when problems did not occur or were less severe, revealing potential solutions.

**How it works:**

- I might ask: 
    - *“Can you think of a time when the problem wasn’t happening?”*
    - *“What was different then?”*
    - *“What did you do that helped?”*

**Why it works:** This technique, borrowed from solution-focused therapy, helps clients realize they already possess the tools to succeed, even if they use them inconsistently.

3. ### Reframing Weaknesses

**Purpose:** To challenge negative self-perceptions by reframing them in a positive light.

**How it works:**

- Examples: 
    - “You say you’re too sensitive. That sensitivity also helps you empathize with others.”
    - “Being stubborn could be a sign of determination.”

**Why it works:** Reframing helps clients shift from shame or self-criticism to self-acceptance and pride.

4. ### Strength-Based Therapy Goal Setting

**Purpose:** To help clients set achievable, motivating goals rooted in their values and fortitude.

**How it works:**

- Instead of asking *“What’s wrong?”* I might ask: 
    - *“What would you like more of in your life?”*
    - *“How can you use your creativity or persistence to reach that goal?”*
- Goals are framed positively (what to build, not avoid).

**Why it works:** Aligning goals with positive attributes makes them more engaging and sustainable.

5. ### Narrative Strength Based Therapy and Storytelling

**Purpose:** To help clients author new versions of their life stories.

**How it works:**

- Clients describe: 
    - Successes and the traits they used to achieve them.
    - Key turning points where resilience was shown.
- Techniques: 
    - “Re-authoring” problem-saturated stories
    - Identifying “sparkling moments” (times of success or empowerment)
    - Writing a “heroic” or growth narrative

**Why it works:** Retelling life through a positive lens can help rewire self-identity and boost hope.

6. ### Strength Based Approach to Journaling

**Purpose:** To promote positive emotion and highlight strengths in action.

**How it works:**

- Daily or weekly entries where clients: 
    - Reflect on a positive aspect of their day.
    - Express gratitude for their efforts or for others.
- Prompts may include: 
    - *“Today I showed courage when…”*
    - *“I’m grateful for my persistence because…”*

**Why it works:** Consistent focus on positives increases self-awareness, mood, and motivation.

7. ### Scaling Questions

**Purpose:** To help clients assess progress and confidence.

**How it works:**

- I ask: 
    - *“On a scale of 1 to 10, how confident are you in using your positive quality of patience this week?”*
    - *“What would make it a 7 instead of a 5?”*

**Why it works:** Encourages realistic self-assessment and fosters small, attainable improvements.

8. ### Strengths Based Therapy Mind Mapping

**Purpose:** To visually organize a person’s fortitude and connect them to life goals.

**How it works:**

- The client creates a visual map with a core goal at the center (e.g., “Better relationships”).
- Branches represent strengths like empathy, patience, listening skills, etc., and how each can support the goal.

**Why it works:** Seeing things mapped out reinforces clarity and confidence in how to move forward.

9. ### Strengths Based Therapy Role Play and Visualization

**Purpose:** To mentally rehearse using a strength in a challenging scenario.

**How it works:**

- I guide the client to: 
    - Visualize a future situation (e.g., a job interview).
    - Identify success (e.g., confidence, preparation).
    - Role-play or imagine it going successfully.

**Why it works:** Builds neural pathways and reduces anxiety about real-life execution.

10. ### Strengths Based Therapy Affirmations

**Purpose:** To help rewire internal dialogue.

**How it works:**

- Clients develop personalized affirmations such as: 
    - *“I bring calm to chaos.”*
    - *“I overcome by adapting.”*

**Why it works:** Repetition of positive beliefs helps shift inner narratives.

## Case Example: Strength Based Approach for a Student Athlete

Here’s a **case example** of how I might use the **strengths based approach** with an adolescent student athlete experiencing a dip in confidence.

**Client Background**

- **Name:** Maya (fictional)
- **Age:** 15
- **Context:** Maya is a high school sophomore and a competitive soccer player.
- **Presenting Issue:** Her coach recently benched her for a few games. Since then, Maya reports feeling “not good enough,” struggles with motivation, and is pulling back socially and academically. She came to me for [sports psychology](https://dralanjacobson.com/sports-psychology/) treatment.

### Strengths Based Therapy Goals

1. Restore Maya’s self-confidence.
2. Help her reconnect with her identity and resilience beyond recent setbacks.
3. Promote a growth mindset and emotional fortitude.

### Strength Based Therapy Techniques Used

1. #### Discovery Session

**Technique:** *Interview + Strengths Cards*

- **What I do**
    Ask Maya to describe moments when she felt proud of herself, both in and outside of soccer. We identify qualities like determination, leadership, teamwork, and discipline.
- **Outcome:**
    Maya begins to reframe herself not just as a “benched player,” but as someone who worked hard to earn a starting position previously. She also identifies how those attributes show up academically and socially.

2. #### Exception-Finding

**Technique:** *Identifying “good games” and “confident days”*

- **Prompt:**
    “Tell me about a time this season when you felt really confident—what was different that day?”
- **Maya’s Reflection:**
    She recalls a tournament where she felt “on fire” because she played with friends, slept well, and remembered her parents’ encouragement.
- **Outcome:**
    Maya begins noticing the link between emotional support, preparation, and performance. These become actionable levers.

3. #### Journaling

**Technique:** *3 entries per week*

- **Homework:**
    Each week, Maya writes about three ways she used her abilities (not just on the field). Example: “Used persistence to finish a hard history project.”
- **Outcome:**
    Maya becomes more aware of her non-soccer abilities and sees her value beyond one role.

4. #### Visualization & Role Rehearsal

**Technique:** *Guided imagery of future performance*

- **Session Activity:**
    I guide Maya through imagining an upcoming game in which she plays confidently, focusing on breathing, positive self-talk, and using her “resilience” and “focus.”
- **Outcome:**
    Maya starts training her mindset, not just her skills. It helps her manage nerves and prepare mentally.

5. #### Strengths-Based Goal Setting

**Technique:** *Process over outcome*

- **Goal:**
    Rather than “get back in the starting lineup,” Maya sets goals like: 
    - “Stay focused during practice.”
    - “Show leadership by encouraging teammates.”
    - “Track my effort, not just stats.”
- **Outcome:**
    These goals are internal and within her control, boosting her autonomy and confidence.

6. #### Reframing Setbacks

**Technique:** *Reframe “benched” as “opportunity”*

- **Conversation:**
    I help Maya reframe the coach’s decision as a chance to grow her game, observe team dynamics, and focus on her mental preparation.
- **Outcome:**
    Maya stops viewing the bench as punishment and starts viewing it as part of her development arc.

### Therapeutic Outcome

Throughout 8–10 sessions:

- Maya’s self-talk shifts from “I’m not good enough” to “I’m still growing.”
- She re-engages in both her academic and athletic life.
- She reports feeling “like myself again,” with more tools to manage future dips in confidence.

#### Takeaway

Strength-based therapy helped Maya reconnect with her identity beyond temporary setbacks. Rather than fixing a “problem,” I amplified Maya’s resilience and built confidence from the inside out.

## Case Example: Strength Based Therapy for an Adult in Life Transition

Here’s a **comprehensive case example** of a strength-based therapy approach for an **adult [navigating a major life transition](https://dralanjacobson.com/life-transitions-therapy/)**.

**Client Profile**

- **Name:** James (fictional)
- **Age:** 42
- **Background:** James recently left a 15-year corporate career. He’s uncertain about his next steps and feels a loss of identity, purpose, and structure.
- **Presenting Concerns:**
    - Low motivation
    - Anxiety about the future
    - Difficulty seeing his value beyond work identity

### Overall Framework

#### Primary Approach:

- **Strength-Based Therapy**
- **Integrated with:**
    - [**Logotherapy**](https://dralanjacobson.com/logotherapy/) ([Viktor Frankl](https://en.wikipedia.org/wiki/Viktor_Frankl)’s meaning-centered therapy)
    - [**Narrative Therapy**](https://dralanjacobson.com/narrative-therapy/)
    - **Positive Psychology Exercises**

### Phase-by-Phase Breakdown of Strengths Based Therapy Techniques

#### Phase 1: Grounding in Strengths and Identity

**Assessment**

- **Tools Used:** VIA Character Strengths Survey + narrative prompts
- **Goal:** Help James rediscover and name his enduring strengths (e.g., leadership, curiosity, fairness, perseverance).
- **I Prompt:**
    - *“What personal qualities helped you succeed in your last role?”*
    - *“Which of these are still alive in you now?”*

**Outcome:** James begins to see that while his job role has ended, his core identity as a mentor, problem-solver, and visionary remains intact.

#### Phase 2: Meaning-Making with Logotherapy

 **Meaning-Oriented Dialogue**

- **Technique:** Frankl-inspired Socratic questioning
- **I Ask:**
    - *“What values guided your work all those years?”*
    - *“What kind of pain are you willing to endure if it meant doing something meaningful?”*
    - *“Why are you uniquely positioned to contribute now?”*

**Outcome:** James identifies that mentoring others and creative problem-solving gave him a deep sense of purpose, which can extend beyond corporate life.

 **Discovering Meaning Through Three Logotherapy Pathways**

- **Creative Values:** What can James give or create (e.g., consulting, writing, teaching)?
- **Experiential Values:** What experiences bring James meaning (e.g., travel, relationships)?
- **Attitudinal Values:** How can James grow through adversity?

**Outcome:** James begins reframing this transition as a challenge rather than a void.

#### Phase 3: Narrative Re-Authoring and Reframing

 **Timeline of Strengths**

- **Activity:** I help James create a life map, marking key moments where his fortitude helped him overcome or contribute.
- **I Ask:**
    - *“What does this map say about the kind of person you are?”*

**Outcome:** James builds continuity between his past and his emerging identity, reducing fear of the unknown.

 **Story Re-Authoring**

- **Technique:** Narrative therapy-style rewriting
- **Exercise:** James writes a letter to his “future self,” describing how he navigated this phase with courage, creativity, and meaning.

**Outcome:** James sees himself as an active author of his life, not a passive victim of circumstance.

#### Phase 4: Forward Action and Strengths in Motion

 **Strengths-Based Goal Setting**

- **Method:** Aligning goals with core strengths and values.
- **Example Goals:**
    - Use of leadership qualities in a volunteer role.
    - Create a professional blog to share lessons learned from the transition.
    - Network with the intention to mentor or collaborate.

**Outcome:** Action reduces paralysis. James feels engaged and hopeful again.

 **Gratitude and Meaning Journal**

- **Prompt:** Daily reflection on moments of meaning or strength in use.
- *“Today I acted with courage when…”*
- *“I found meaning in…”*

**Outcome:** Rewires attention toward growth, not loss.

### Results After 12 Sessions

Strength based therapy techniques led to:

- James reports a renewed sense of **identity and purpose**.
- He begins **consulting** part-time and develops a **mentoring program** for younger professionals.
- He no longer views his corporate exit as a failure, but as a **pivot toward deeper meaning**.
- Anxiety decreases; agency increases.

#### Takeaway

By integrating **strength-based therapy** techniques with **logotherapy**, the therapeutic process:

- Honors the past without getting stuck in it
- Focuses on identity through inner resources, not external roles
- Uses **meaning** as a compass and **strengths** as the fuel for forward movement

## Summary and My Work

A strength-based approach can be integrated with many therapeutic models, especially those emphasizing collaboration, empowerment, growth, and positive identity development. Here’s a list of therapies that work especially well with strength based therapy techniques, along with how they align:

### Therapies That Integrate Well with a Strength Based Approach

1. #### Positive Psychology

- Why it fits: This is the foundation of many strength based approaches. It cultivates well-being, optimism, flow, gratitude, and meaning.
- Key Tools: VIA Character, gratitude journaling, savoring, strengths spotting, best possible self exercises.

2. #### [Solution-Focused Brief Therapy](https://dralanjacobson.com/solution-focused-therapy/) (SFBT)

- Why it fits: This form of [brief therapy](https://dralanjacobson.com/brief-therapy/) emphasizes what’s working rather than what’s wrong. It uses “exceptions to the problem” and goal-oriented language to build on success.
- Techniques: Miracle questions, scaling questions, identifying past successes.

3. #### Narrative Strengths Based Therapy

- Why it fits: Encourages clients to “re-author” their stories by highlighting moments of power, resistance, and capability.
- Techniques: Externalizing problems, identifying sparkling moments, writing alternative life narratives.

4. #### [Acceptance and Commitment Therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) (ACT)

- Why it fits: It helps clients clarify values and take action from a place of meaning rather than avoidance. It is a strength based approach emphasizing psychological flexibility and resilience.
- Techniques: Values clarification, committed action, mindfulness exercises.

5. #### Cognitive Behavioral Therapy (CBT)

- Why it fits: While traditionally problem-focused, [CBT can be modified](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) to focus on identifying and reinforcing helpful thoughts and behaviors.
- Techniques: Thought records with strength-based reframing, behavioral activation using core strengths.

6. #### Logotherapy (Viktor Frankl)

- Why it fits: A strength based approach centering around finding meaning in suffering and life’s challenges, it encourages action based on purpose and inner fortitude.
- Techniques: Meaning-centered dialogue, exploration of creative, experiential, and attitudinal values.

7. #### [Humanistic](https://dralanjacobson.com/humanistic-therapy/)/Person-Centered Strengths Based Therapy

- Why it fits: Emphasizes unconditional positive regard, self-actualization, and the belief that people are inherently resourceful.
- Core Values: Empathy, authenticity, client-led growth.

8. #### Coaching-Oriented Therapies

- Why it fits: Life coaching, career coaching, and mental fitness models often assume that clients can generate their own solutions with the right support, and thus, they use a strength-based approach.
- Techniques: [Goal setting, motivational interviewing](https://dralanjacobson.com/motivational-interviewing/), future self visualization.

9. #### [Mindfulness Therapies](https://dralanjacobson.com/mindfulness-therapy/)

- Why it fits: Mindfulness cultivates present-moment awareness and self-compassion, both of which help people notice and build on their existing power.
- Examples: [Mindfulness-Based Stress Reduction](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) (MBSR), Mindfulness-Based Cognitive Therapy ([MBCT](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/)).

10. #### [Trauma-Informed Therapies](https://dralanjacobson.com/trauma-informed-care/) *(e.g., [Internal Family Systems](https://dralanjacobson.com/internal-family-systems-therapy-ifs/), EMDR)*

- Why it fits: It’s a strength based approach that supports resilience-building and post-traumatic growth when integrated with trauma healing.
- Note: Always balanced with sensitivity to survivor safety and pacing.

### My [Integrative Practice](https://dralanjacobson.com/integrative-therapy/)

A strength based approach is not a standalone model, but a powerful lens that can enhance many therapies by:

- Shifting focus from pathology to possibility
- Empowering clients to build on what already works
- Fostering lasting change by rooting growth in identity, values, and capacity

At the heart of this work is the belief that everyone has untapped strength and potential, even in their most uncertain moments. My goal is to use strengths based therapy to help you rediscover and activate compassion, curiosity, and practical tools. Healing doesn’t always start with what hurts. Sometimes, it begins by remembering what gives you life.

Move forward, away from pain and toward purpose, joy, and self-trust. [Contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime to learn more.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Therapy Approaches

---

### [Insight Therapy for Deep, Meaningful, Lasting Change](https://dralanjacobson.com/insight-therapy/)

**Published:** September 5, 2025
**Author:** Dr. Alan Jacobson

**Content:**

As a psychologist who practices insight oriented therapy, my work focuses on helping individuals gain a deeper understanding of the underlying forces that shape their thoughts, emotions, and behaviors. Often, our present struggles are linked to unresolved experiences, patterns, or beliefs from earlier in life. By bringing these into awareness, insight therapy provides the space for reflection, meaning-making, and growth. I see my role as both guide and collaborator, helping clients uncover their inner truths so they can move toward greater freedom, self-acceptance, and fulfillment.

## Overview of Insight Therapy

![Insight Therapy](https://dralanjacobson.com/wp-content/uploads/2025/09/lucid-dreams-2-300x200.jpg "Insight therapy | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Insight therapy refers to a broad category of psychotherapies that focus on increasing a person’s self-awareness and understanding of how past experiences, [unconscious processes](https://www.simplypsychology.org/unconscious-mind.html), and internal conflicts influence their current functioning. Unlike symptom-focused or skills-only approaches, insight therapies explore the “why” beneath a person’s distress, with the belief that understanding fosters long-term change.

### Key Goals of Insight Oriented Therapy

1. #### Developing Awareness of Underlying Thoughts, Feelings, and Patterns

Many of our daily reactions happen automatically, outside of conscious awareness. For example, a person might consistently feel anxious when receiving feedback at work, without realizing it is linked to an early pattern of harsh criticism at home. Insight oriented therapy helps clients *slow down and notice* these automatic thoughts and emotions, revealing patterns that drive behavior.

- **Example:** Using insight oriented therapy, a client learns to recognize that their recurring self-doubt isn’t simply “who they are,” but a learned internal script shaped by earlier experiences.
- **Why it matters:** Awareness is the foundation of choice. Once patterns are visible, they can be evaluated rather than blindly repeated.

2. #### Making Connections Between Past Experiences and Present Behaviors

A hallmark of insight oriented therapy is drawing a bridge between past and present. Early relationships, cultural expectations, or unresolved traumas often shape our responses today. By tracing current struggles back to their origins, clients gain clarity about why they respond in certain ways.

- **Example:** A man who avoids intimacy realizes this stems from growing up in a household where vulnerability was unsafe. Understanding this connection allows him to approach closeness differently in adulthood.
- **Why it matters:** Recognizing origins helps reduce shame. Clients often feel relieved when they understand that their reactions aren’t personal failings, but learned adaptations that once served a purpose.

3. #### Resolving Internal Conflicts that Drive Symptoms

Symptoms like anxiety, depression, or irritability are often signals of unresolved inner conflict. For example, a person may simultaneously long for independence but fear abandonment, creating tension that shows up as panic or indecision. Insight therapies help clients explore these conflicting drives, name them, and integrate them into a more balanced self.

- **Example:** A young adult discovers that procrastination isn’t laziness but a conflict between wanting to succeed (to gain approval) and fearing failure (which feels catastrophic).
- **Why it matters:** Resolving inner conflicts leads to relief, more coherent decision-making, and fewer self-sabotaging behaviors.

4. #### Strengthening One’s Capacity for Reflection, Self-Acceptance, and Healthier Choices

Insight therapy doesn’t end with awareness; it cultivates a reflective stance toward life. Clients learn to pause, consider their motivations, and make deliberate choices rather than reacting impulsively. With time, this reflective capacity fosters compassion for oneself and the ability to live in ways that feel authentic and intentional.

- **Example:** Instead of automatically saying “yes” to every request (a habit rooted in fear of rejection), a client begins to reflect: *Do I truly want to do this? What are my limits?* This reflective stance allows for healthier boundaries.
- **Why it matters:** Reflection creates freedom. Clients become less bound by old patterns and more able to build lives aligned with their values, leading to lasting change.

Put together, these four goals form the **core engine of insight therapies**: moving from unconscious repetition to conscious choice, from shame to self-compassion, and from unresolved conflict to integrated living.

### Who Does Insight Therapy Help and Why

Insight oriented therapy benefits a wide range of individuals, including:

- **Adolescents** who are developing identity, grappling with self-esteem, or struggling with anxiety/depression rooted in family or peer dynamics.
- **Young adults** facing career, relationship, or identity decisions, especially those who feel “stuck” repeating family patterns or unclear about who they truly are.
- **Adults** experiencing chronic dissatisfaction, looking for [burnout therapy](https://dralanjacobson.com/burnout-therapy/), or recurring relationship conflicts that skills-based therapies alone haven’t resolved.
- **Older adults** reflecting on life transitions, unresolved grief, or questions of meaning and legacy.
- **People with trauma histories** who find that surface-level coping skills don’t fully resolve their distress.
- **Individuals with [psychosomatic symptoms](https://www.verywellmind.com/depression-can-be-a-real-pain-1065455)** (e.g., chronic pain, headaches, stomachaches linked to stress) where unconscious conflicts may be manifesting physically.
- **High-functioning but distressed professionals/students** who outwardly succeed yet internally struggle with perfectionism, emptiness, or imposter feelings.

### Types of Insight Therapies

1. #### [Psychoanalysis](https://en.wikipedia.org/wiki/Psychoanalysis)

- **Use:** Long-term, intensive therapy to explore unconscious conflicts rooted in early development.
- **Insight Therapy Techniques:**
    - **[Free Association](https://en.wikipedia.org/wiki/Free_association_(psychology)):** The client says whatever comes to mind, uncovering unconscious thoughts.
    - **[Dream Analysis](https://www.dreamdictionary.org/):** Interpreting dreams as symbolic representations of unconscious material.
    - **[Transference Analysis](https://www.simplypsychology.org/psychoanalytic-theory-of-transference.html):** Exploring how feelings toward early figures are projected onto the therapist.
    - **Resistance Analysis:** Identifying avoidance behaviors that protect against painful insights.

2. #### [Psychodynamic Therapy](https://dralanjacobson.com/psychodynamic-therapy/) (including [Intensive Short-Term Dynamic Psychotherapy](https://dralanjacobson.com/short-term-dynamic-psychotherapy/))

- **Use:** Focused exploration of unconscious patterns that influence current relationships and mood.
- **Insight Therapy Techniques:**
    - **Interpretation:** The therapist helps link present struggles to past experiences or defenses.
    - **Identifying [Defense Mechanisms](https://www.verywellmind.com/defense-mechanisms-2795960):** Bringing awareness to strategies (e.g., denial, projection) used to avoid distress.
    - **Use of the Therapeutic Relationship:** The therapist-client bond is used as a “here-and-now” model for exploring relational dynamics.

3. #### [Jungian/Analytical Therapy](https://www.thesap.org.uk/articles-on-jungian-psychology-2/about-analysis-and-therapy/analytical-psychology/)

- **Use:** Promotes individuation—becoming one’s fullest, authentic self—by integrating conscious and unconscious aspects.
- **Insight Therapy Techniques:**
    - **Active Imagination:** Dialoguing with inner images or figures that emerge in dreams or fantasy.
    - **[Archetypal Exploration](https://realitypathing.com/8-essential-archetypal-journeys-for-self-discovery/):** Identifying universal symbols (hero, shadow, anima/animus) and their role in the client’s life story.
    - **Symbol and Myth Analysis:** Using cultural stories and personal symbols to interpret life meaning.

4. #### [Adlerian Therapy](https://dralanjacobson.com/adlerian-therapy/)

- **Use:** Helps individuals understand how early childhood experiences, goals, and feelings of inferiority shape behavior.
- **Insight Therapy Techniques:**
    - **Early Recollections:** Analyzing key memories to reveal guiding beliefs and attitudes.
    - **Lifestyle Assessment:** Mapping out core assumptions about self, others, and the world.
    - **Encouragement and Reframing:** Building self-confidence and offering alternative interpretations of setbacks.

5. #### [Humanistic Existential](https://dralanjacobson.com/humanistic-existential-therapy/) Insight Therapy

- **Use:** Focuses on self-acceptance, authenticity, personal choice, and responsibility for meaning-making.
- **Insight Therapy Techniques:**
    - **Phenomenological Exploration:** The therapist invites clients to describe experiences as they perceive them.
    - **[Existential Questioning](https://liveboldandbloom.com/06/passion-in-life/existential-questions):** Examining issues such as freedom, mortality, isolation, and meaning.
    - **Reflection and Empathic Understanding:** The therapist mirrors the client’s inner experience with warmth and acceptance.

6. #### [Interpersonal Therapy](https://dralanjacobson.com/interpersonal-therapy/) (IPT)

- **Use:** Time-limited therapy emphasizing how interpersonal relationships influence emotional health.
- **Insight Therapy Techniques:**
    - **Communication Analysis:** Examining how messages are sent and received in relationships.
    - **Role-Playing:** Practicing new relational skills in-session.
    - **Linking Mood to Relationship Events:** Helping clients see how changes in relationships affect emotional states.

### Methods that Insight Therapy Techniques Combine Well With

- - **[Cognitive-Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT):**
        CBT provides practical tools to change distorted thoughts and maladaptive behaviors. When combined with insight oriented therapy, clients not only *understand* the origins of their patterns but also acquire concrete skills to challenge and change them. For example, a client who recognizes perfectionism as a defense mechanism (insight) can use [CBT techniques](https://dralanjacobson.com/cbt-techniques/) to actively reframe “I must be perfect” into healthier self-talk.
    - **Mindfulness-Based Therapies ([MBCT](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/), [MBSR](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/)):**
        Mindfulness strengthens [present-moment awareness and acceptance](https://dralanjacobson.com/mindfulness-therapy/). Insight therapy techniques often bring unconscious material to the surface, and mindfulness practices help clients observe these insights without judgment. This combination supports emotional regulation and prevents overwhelm when difficult insights arise.
    - **[Family Treatment](https://dralanjacobson.com/family-therapy/) or [Couples Therapy](https://dralanjacobson.com/couples-therapy/):**
        Individual insights often affect relationships. By integrating insight oriented therapy with [relational work](https://dralanjacobson.com/relational-therapy/), patterns identified in individual therapy (e.g., fear of abandonment) can be addressed in real interactions with partners or family. This creates a bridge between internal awareness and external change.
    - **[Acceptance and Commitment Psychotherapy](https://dralanjacobson.com/act-psychotherapy/) (ACT):**
        ACT emphasizes [living in alignment with one’s values](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/), despite any discomfort. Insight therapy techniques help clarify what values truly matter, and ACT provides the framework to take action. Together, they help clients transition from understanding to making meaningful choices. This includes the subset of ACT called [Values Clarification Therapy](https://dralanjacobson.com/values-clarification-therapy/).
    - **[Expressive Arts](https://dralanjacobson.com/creative-counseling/) or [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/):**
        Insight oriented therapy sometimes requires symbolic processing. Expressive arts (drawing, movement, writing) allow unconscious material to surface creatively. Narrative therapy helps re-author life stories once old patterns are understood and recognized. Both approaches deepen and expand the impact of insight work.
    - **Trauma-Focused Approaches ([EMDR](https://psychcentral.com/health/emdr-therapy), [Somatic Experiencing](https://dralanjacobson.com/somatic-therapy/)):**
        Insight therapy techniques help identify the origins of [trauma responses](https://dralanjacobson.com/trauma-informed-care/), while trauma-specific modalities provide tools to reprocess traumatic memories safely. This combination ensures both intellectual understanding and nervous system healing.

## Insight Oriented Therapy Case Examples

### Insight Therapy for an Adolescent with Anxiety

*Case:* Sarah, a 15-year-old, presented with persistent anxiety about school performance and friendships. She described frequent stomachaches and panic before exams, and felt she “never measured up.”

*Therapeutic Process:* Insight therapy revealed that Sarah’s anxiety was rooted in early experiences of perfectionistic expectations from her parents, who praised achievement more than effort. She internalized a fear of failure and equated mistakes with rejection. By exploring these themes, Sarah gained awareness that her critical inner voice was not her own but an internalized echo of parental pressure.

*Outcome:* With insight, she began to challenge these beliefs, appreciate her strengths, and accept mistakes as part of growth. Her anxiety reduced, and she gained confidence in both academics and friendships.

### Insight Therapy for a Young Adult Facing Career Choices

*Case:* Daniel, age 24, sought insight oriented therapy because he felt “paralyzed” about choosing a career path after college. He had strong grades but drifted between internships, never satisfied.

*Therapeutic Process:* Through exploration using insight therapy techniques, Daniel realized he was unconsciously trying to please his father, a corporate executive who valued prestige. Daniel’s own passion, creative writing, was something he had buried, fearing it wouldn’t bring approval. Therapy helped him recognize this conflict between external expectations and internal desires.

*Outcome:* Daniel gained clarity that fulfillment mattered more than conformity. With support, he pursued graduate studies in creative writing, while also finding practical ways to support himself. His self-understanding gave him both direction and a sense of empowerment.

### Older Adult Seeking Contentment

*Case:* Margaret, a 62-year-old recently retired teacher, felt restless and dissatisfied. Despite financial stability and close family, she struggled with a sense of emptiness.

*Therapeutic Process:* Insight therapy revealed unresolved grief: Margaret had lost her younger sister as a teen, an event her family rarely spoke about. Much of her life’s energy went into caretaking and achievement, unconsciously trying to “make up” for the loss. Retirement removed her sense of identity as a giver and achiever, leaving the underlying grief exposed.

*Outcome:* Processing this loss allowed Margaret to honor her sister’s memory and recognize her own needs. She began pursuing art classes and volunteer work, which added richness to her life. She reported newfound peace and contentment, as therapy helped her integrate the past and embrace the present.

### Couples Case Example

*Case:* Maya (32) and Alex (34) sought couples therapy due to frequent arguments about finances and intimacy. They felt stuck in a cycle where Maya criticized Alex for not being responsible, and Alex withdrew to avoid conflict.

*Therapeutic Process:* Insight oriented couples therapy uncovered that Maya’s fears stemmed from growing up with an unreliable father, leading her to equate financial lapses with betrayal. Alex’s withdrawal traced back to a childhood where expressing anger led to punishment, so he learned to “shut down” to keep the peace.

By making these unconscious patterns explicit, both partners began to see their conflicts not as “the other person’s fault” but as reenactments of old wounds. The therapist guided them to communicate with greater empathy and helped them practice new ways of engaging, such as expressing needs directly rather than through criticism or withdrawal.

*Outcome:* The couple reported less reactivity and more understanding. Their intimacy improved once they felt safer sharing vulnerable emotions without triggering old defenses.

### Insight Therapy Techniques with [Family Therapy with Adult Children](https://dralanjacobson.com/adult-family-therapy/)

*Case:* A family with three adult siblings (ages 28, 32, and 35) came to therapy with their mother, Linda, age 60. Tension centered on caregiving responsibilities for the aging grandmother. The siblings accused each other of “checking out,” while Linda felt guilty and overwhelmed, often taking on too much herself.

*Therapeutic Process:* Insight oriented therapy revealed unspoken dynamics: Linda had grown up in a family where sacrifice was equated with love, and she unconsciously modeled this for her children. The oldest sibling felt pressured to be “the responsible one,” while the youngest often withdrew to avoid conflict. These roles, rooted in family history, shaped the current imbalance in caregiving.

In insight therapy, family members explored how these patterns had been passed down across generations. By bringing awareness to their roles and the guilt that fueled them, the family began renegotiating expectations more openly. The therapist encouraged each sibling to articulate their actual capacity, rather than act out unconscious roles.

*Outcome:* The family developed a shared caregiving plan that felt equitable. More importantly, the adult children began relating to each other less as “assigned roles” and more as equals, while Linda learned to set healthier boundaries. The atmosphere shifted from blame to collaboration.

## Conclusion and My Work

Insight therapy is not about staying stuck in the past, but about freeing ourselves from its unconscious hold. When we understand the roots of our patterns, we gain the power to choose differently. Whether it’s a teenager learning to accept themselves, a young adult embracing authenticity, or an older adult rediscovering joy, the process of self-discovery brings about lasting transformation. My role is to offer compassion, curiosity, and guidance as they uncover the more profound truths that lead to healing and fulfillment.

If you have questions about insight priented therapy and how it might work for you, or any one of the insight therapies available, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a free consultation](https://www.picktime.com/scheduleaconsult#services/service) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Logotherapy: Finding Meaning, Purpose & Direction](https://dralanjacobson.com/logotherapy/)

**Published:** May 24, 2024
**Author:** Dr. Alan Jacobson

**Content:**

## What Is Logotherapy? (Quick Overview)

**Logotherapy is a meaning-centered form of psychotherapy developed by Viktor Frankl that helps individuals discover purpose in their lives—even in the face of suffering. It is based on the idea that the primary human motivation is the search for meaning, not just pleasure or power.**

**Key elements include:**

- **Identifying personal meaning and life purpose**
- **Recognizing freedom of choice in how you respond to challenges**
- **Building resilience by reframing suffering and adversity**
- **Aligning actions with values and what truly matters**

### **When Is Logotherapy Used?**

- **Feeling stuck, empty, or lacking purpose**
- **Depression, burnout, or existential distress**
- **Major life transitions or identity questions**
- Coping with loss, suffering, or difficult circumstances

Logotherapy is often used when people are struggling with meaning or direction in life, sometimes called an “existential vacuum.”

### Key Techniques in Logotherapy

- Dereflection (shifting focus away from problems)
- Paradoxical intention (facing fears directly)
- Socratic dialogue (guided self-discovery of meaning)

These techniques help individuals reconnect with purpose and reduce distress by changing how they relate to their experiences.

## Introduction to this Therapeutic Technique

**Logotherapy**, developed by psychologist [Viktor Frankl](https://en.wikipedia.org/wiki/Viktor_Frankl), is a form of existential analysis focusing on the search for meaning in life. Unlike other psychologists who emphasize exploring past experiences or analyzing unconscious drives, a logotherapist emphasizes that humans’ primary motivational force is to find a purpose or meaning in life. Many times, I use logotherapy techniques within the context of other approaches, including [narrative therapy](https://dralanjacobson.com/narrative-therapy/) and [gestalt therapy](https://dralanjacobson.com/gestalt-therapy/). The post concludes with some logotherapy examples to illustrate what the therapy would be like.

Jump to [logotherapy FAQs](#logotherapy-faq)

## What is Logotherapy?

In sessions, I help my clients clarify what genuinely matters to them, and create practical plans to help them cultivate what really matters to them in their lives.

## ![Logotherapy](https://dralanjacobson.com/wp-content/uploads/2024/05/Meaning-300x200.png "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

1\. [Will to Meaning](https://www.panarchy.org/frankl/meaning.html): This is the fundamental drive in humans to find meaning and purpose. Frankl believed that even in the most challenging circumstances, individuals can find meaning in their lives, thereby overcoming suffering.

2\. Freedom of Will: Logotherapy asserts that individuals can choose their attitudes and responses to life’s situations, even when faced with unavoidable suffering.

3\. Meaning in Life: According to Frankl, meaning can be found in every situation, whether through creating work or deeds, experiencing something or encountering someone, or by our attitude towards unavoidable suffering.

4\. Existential Vacuum: This term describes a sense of emptiness and meaninglessness, often seen in individuals who lack a sense of purpose. This can lead to feelings of boredom, apathy, and depression.

### Viktor Frankl’s Contributions

Viktor Frankl was an Austrian neurologist and psychiatrist, as well as a Holocaust survivor. His experiences in Nazi concentration camps profoundly influenced his development of logotherapy. Frankl documented his theories and personal experiences in his seminal book, “[Man’s Search for Meaning](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5111395/),” which has inspired countless individuals worldwide. If logotherapy sounds meaningful to you, read that book, which is quite short and very moving.

### **Who Logotherapy Is Helpful For**

Logotherapy can be especially valuable if you’re feeling stuck, lacking direction, or wrestling with existential questions — whether you’re navigating life transitions, career dissatisfaction, burnout, or a sense of meaninglessness. In my clinical practice, I help adolescents and adults explore values and purpose and integrate logotherapy with evidence-based techniques for deeper, sustainable growth.

## What are the Core Logotherapy Techniques?

Logotherapy employs several techniques to help individuals find meaning and purpose in their lives. These feelings may arise during periods of transition or more generally as we age. Here are some key techniques used in logotherapy:

### Dereflection in Logotherapy

Dereflection shifts the individual’s focus away from their symptoms or problems and towards something more meaningful. This technique is particularly useful for addressing issues like [general anxiety](https://dralanjacobson.com/therapy-for-generalized-anxiety-disorder/) and [obsessive thoughts](https://dralanjacobson.com/therapy-for-ocd/). By diverting attention from the problem and towards positive goals and values, individuals can reduce the intensity of their symptoms.

Example: If someone is overly focused on fear of failure, the therapist might encourage them to engage in a meaningful and fulfilling activity, thereby redirecting their attention. This is a technique that can be used with [cognitive behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) to deepen its impact and imbue it with greater meaning.

### Paradoxical Intention

Paradoxical intention involves encouraging individuals to engage in or embrace the very thing they fear. This technique helps reduce the power of the fear or anxiety through humor and detachment.

Example: If a person experiences insomnia due to fear of not falling asleep, the logotherapist might suggest that they try to stay awake as long as possible. This often leads to relaxation and, eventually, sleep because the pressure to fall asleep is removed.

### Socratic Dialogue in Logotherapy

[Socratic dialogue](https://en.wikipedia.org/wiki/Socratic_dialogue) asks open-ended, thought-provoking questions that help individuals explore and reflect on their beliefs, values, and attitudes. This technique encourages self-discovery and the identification of personal meaning.

Example: I might ask you, “What gives your life meaning?” or, if you’re facing a challenge, “How can you turn this into an opportunity for growth?” This technique works well with [positive psychology approaches](https://dralanjacobson.com/positive-psychology-powerful-benefits/), which also emphasize cultivating a positive outlook even in the face of challenges.

### Attitude Modifying Logotherapy Techniques

This technique focuses on helping individuals change their attitudes towards unchangeable situations. By adopting a new perspective, individuals can find meaning even in suffering.

Example: I might encourage clients facing a long-term illness or diagnosis to find meaning in their experiences by focusing on the love and support they give and receive during this challenging time.

### Value Clarification Logotherapy Techniques

Value clarification helps individuals identify and affirm their personal values. This process involves exploring what is truly important to them, which can guide their decisions and actions. This can be quite important during transitions or crises.

Example: Through guided discussions with their logotherapist, clients may recognize the value of creativity and decide to pursue a career in the arts, leading to a more fulfilling life. The example below elucidates this technique.

### Existential Reflection

This technique involves reflecting on [life’s existential questions](https://dralanjacobson.com/existential-therapy/), such as the meaning of life, the inevitability of death, and the individual’s role in the world. Reflecting on these questions can lead to a deeper understanding of oneself and one’s purpose.

Example: I might facilitate a discussion on how facing mortality can inspire you to live more authentically and fully. I often use this technique with people facing life transitions, when feelings of mortality frequently arise. I also use logotherapy techniques like this in my [fear of flying treatment](https://dralanjacobson.com/fear-of-flying-therapy/), which also often involves feelings of mortality.

## Applications of Logotherapy Techniques

Logotherapy has been applied in various contexts, including psychotherapy, counseling, and coaching. It is beneficial for individuals facing existential crises, such as those dealing with loss, trauma, or long-term illness. It is also effective in enhancing personal growth and development by helping individuals clarify their life goals and values, especially when they feel a lack of meaning or purpose. Within the Foresight Psychological Institute, I maintain a model of the basic application of these proven techniques.

### Specific Uses

– [Treatment for Anxiety and Depression](https://dralanjacobson.com/therapy-for-depression-and-anxiety/): Logotherapy techniques like dereflection and paradoxical intention can help individuals manage and reduce symptoms.
– Crisis Intervention: Attitude modification and existential reflection can provide individuals with new perspectives during times of crisis.
– [Life transition therapy](https://dralanjacobson.com/life-transitions-therapy/): For expected and unexpected changes in the path of your life
– [Personal Growth Counseling](https://dralanjacobson.com/personal-growth-counseling/\): Socratic dialogue and value clarification are logotherapy techniques that can guide individuals towards self-discovery and fulfillment.

Logotherapy techniques are versatile and adaptable to various therapeutic settings. They help individuals find meaning and purpose in diverse aspects of their lives.

## What is a Logotherapist?

A **logotherapist** is a clinician trained in **Logotherapy**, the meaning-centered therapy developed by psychiatrist Viktor Frankl, author of *Man’s Search for Meaning*.

At its core, logotherapy rests on three ideas:

1. **Life has meaning under all circumstances** — even painful ones.
2. **We are motivated by a “[will to meaning](https://www.litcharts.com/lit/man-s-search-for-meaning/logotherapy-in-a-nutshell-the-will-to-meaning),”** not just pleasure or power.
3. **We always retain the freedom to choose our attitude**, even when we cannot change our situation.

So a logotherapist isn’t primarily hunting symptoms — they’re helping people reconnect with purpose, values, responsibility, and dignity.

### What Does a Logotherapist Actually Do?

Logotherapists work with:

- Burnout
- Midlife and other transitions
- [Existential anxiety](https://www.medicalnewstoday.com/articles/existential-anxiety)
- Depression tied to emptiness or loss of direction
- Trauma survivors who feel life no longer “makes sense”
- High-functioning professionals who feel hollow despite success

#### In sessions, a logotherapist might:

- Explore what feels missing in the client’s life
- Identify blocked or abandoned values
- Use **Socratic dialogue** to surface meaning gently
- Apply **paradoxical intention** to loosen anxiety’s grip
- Help clients reframe suffering into purposeful action
- Guide life-review or legacy-building work
- Anchor decisions in responsibility rather than avoidance

The question slowly shifts from:

“How do I get rid of this pain?”
to
“What is life asking of me right now?”

### How Is a Logotherapist Trained?

Most logotherapists are already [clinical psychologists](https://dralanjacobson.com/what-is-a-clinical-psychologist/), counselors, social workers, physicians, or spiritual care professionals who pursue specialized training thereafter.

Training usually includes:

- Graduate-level coursework in Frankl’s theory
- Supervised clinical application
- Instruction in existential phenomenology
- Ethics of meaning-centered care
- Formal certification programs (e.g., Viktor Frankl Institute programs)
- Personal meaning-centered development work

It’s not something you memorize — it’s something you **internalize**.

### What Is It Like to Be a Logotherapist?

It’s a deeply human role, as you’ll see in the logotherapy examples below.

You sit with people at:

- the collapse of old identities
- the edge of grief
- the terror of wasted potential
- the ache of quiet dissatisfaction
- the shock of unexpected life turns

But instead of patching holes, you help them *rebuild a compass*.

Logotherapists don’t rescue — they **stand beside**.

They don’t tell people what their meaning is — they help them **remember how to find it themselves**.

It’s not flashy work.
It’s sacred work.

For many clinicians, it becomes not just a method but a way of living: choosing responsibility over comfort, purpose over avoidance, and courage over despair, one session at a time. This work is grounded in empirically supported principles.

## Logotherapy Examples

Logotherapy techniques offer a unique approach to psychotherapy that emphasizes the human capacity to find meaning and purpose in life, regardless of the circumstances. This focus on meaning can lead to profound psychological healing and personal growth. The following logotherapy examples should help you get a feel for what the therapy would be like.

### Logotherapy Example: Adult

Here is a fictitious example of logotherapy to illustrate how I might apply logotherapy in my practice:

Maria, a 45-year-old woman, has been feeling lost and depressed since her children left for college. She has dedicated her life to being a strong and connected mother, and now she feels that some of her sense of purpose and meaningfulness has disappeared. She works at a fitness club and enjoys her work, but it has always been secondary to raising her children.

I start by understanding Maria’s background, her feelings of emptiness, and her sense of purpose being tied to her children. I acknowledge the significant life change Maria is experiencing and encourage her to reflect on the times when she felt most fulfilled. Together, we identify what made those moments meaningful. Maria recalls volunteering at a local shelter before her children were born, which gave her a sense of community and a sense of contribution.

#### Recognizing Current Sources of Meaning

I help Maria see that her role as a mother was meaningful, but it was not the only source of meaning in her life. We discuss other aspects of her life that could provide fulfillment, such as pursuing a job promotion, a new job that may be more fulfilling now that she has a less demanding home schedule, her hobbies, relationships, and potential new roles.

#### Future-Oriented Perspective

I ask Maria to envision a meaningful life for herself now that her children are grown. I introduce the concept of “self-transcendence,” in which finding meaning entails reaching beyond oneself. We explore possibilities such as volunteering, pursuing a passion, or considering a new career. Many logotherapy techniques strive to remain future-oriented, as does my overall humanistic approach and its positive-psychology underpinnings.

Maria expresses her fear of starting something new and the potential for failure. I propose that suffering can be given meaning by how one responds to it. I suggest that her current struggles can be viewed as opportunities for growth and self-discovery.

#### Logotherapy Action Plan

Together, Maria and I create a plan for her to start with small, achievable steps toward rediscovering her sense of purpose. This includes:

- Reconnecting with the shelter to explore volunteer opportunities.
- Attending community events to meet new people.
- Setting aside time each week for a hobby she enjoys.
- Talking to her boss about additional challenges she can take on

At the same time, she will explore the changing relationships she has with her children, realizing that they still need her but just in different ways and knowing that they will still be home a decent amount. She will cherish the time even more and be proud of their growing into wonderful young adults.

#### Logotherapy Follow-Up

Over subsequent sessions, I continue to support Maria as she takes these steps, reinforcing her efforts and helping her reflect on meaningful experiences. We explore her feelings and adjust the plan to align with her evolving sense of purpose.

Through logotherapy techniques, Maria comes to view her life transition not as an end but as a new chapter, offering opportunities to find meaning in different ways. By focusing on what brings her fulfillment and how she can contribute to others, Maria starts to rebuild a sense of purpose and direction in her life.

### Logotherapy Example: Teen

When working with adolescents, who often face unique challenges as they develop their identity and purpose, logotherapy techniques can be empowering. Here’s a logotherapy example of how I might use this method with a teenage client:

**Background**
Alex is a 16-year-old high school student struggling with emptiness and purposelessness. She has been experiencing anxiety, mild depression, and a lack of motivation, especially regarding school and social life. Alex reports feeling that “nothing matters” and often questions the purpose of life. She has supportive parents, but feels they don’t fully understand these internal struggles.

In the first few sessions of this logotherapy example, I used [empathic listening](https://www.berkeleywellbeing.com/empathic-listening.html) to create a safe space for Alex to express their thoughts and feelings. I introduce the concept of logotherapy, emphasizing that it’s about finding personal meaning and purpose, not necessarily immediate happiness.

#### Logotherapy Techniques Used

1. **Exploring Values and Interests**
    I ask Alex about activities, people, or experiences that have felt fulfilling or meaningful in the past. Alex reflects on her love for drawing and meaningful conversations with close friends. Through these discussions, I helped Alex realize that even if life feels meaningless at times, she can still connect to small moments of purpose.
2. **Addressing Existential Frustration**
    Alex expresses frustration with the pressure to achieve high grades, attend college, and develop future career plans. Through a logotherapeutic lens, I encourage Alex to look beyond societal expectations and consider what personally resonates as meaningful. This reframing logotherapy technique helps Alex feel less pressured by external standards and more curious about exploring her own path.
3. **Purpose and Legacy Exploration**
    I introduce the idea of contributing to something beyond oneself. I explored with Alex how her interest in art could be used to bring joy or insight to others, such as by drawing comics that address teenage mental health challenges. This helps Alex envision ways to express themselves and possibly help others who feel the same way.
4. **Logotherapy and Paradoxical Intention**
    Alex often worries about failing or not finding a purpose, which leads to a cycle of anxiety. I use [paradoxical intention](https://en.wikipedia.org/wiki/Paradoxical_intention), encouraging Alex to humorously “try” to feel anxious on purpose. This logotherapy technique often reduces the grip of anxiety and helps Alex gain a sense of control over her emotional reactions.
5. **Meaning in the Moment**
    As sessions progress, Alex identifies small ways to find meaning daily, such as doing artwork, being present with friends, and trying new activities. This step-by-step approach to finding immediate meaning becomes a foundation for Alex to build a deeper sense of purpose.

#### Outcome

Over time, Alex starts to feel more engaged with life. While [existential questions](https://dralanjacobson.com/existential-therapy/) still arise, they don’t cause as much distress. Alex realizes that while the big picture might still be unclear, small, meaningful actions can create a sense of purpose. Alex also feels more empowered to explore future possibilities without the burden of needing to have it all figured out.

## Summary and My Work

The above are just fictitious logotherapy examples. This [type of psychological treatment approach](https://dralanjacobson.com/types-of-therapy/) can be useful in many circumstances and with a wide variety of presenting concerns. I use logotherapy in my work with individuals, in [couples therapy](https://dralanjacobson.com/couples-therapy/), and even in [family treatment](https://dralanjacobson.com/family-therapy/) (especially when the children are now adults). It can be combined with other techniques, such as [metacognitive therapy](https://dralanjacobson.com/metacognitive-therapy-mct/). I also use it in some of my specialty areas, including executive coaching and [fear of flying](https://dralanjacobson.com/fear-of-flying-therapy/).

### Who I Work With

I work with adolescents and adults who are thoughtful, capable, and often high-functioning — but feel internally unsettled, disconnected, or uncertain about direction.

Many of the people who seek logotherapy are:

- Navigating life transitions (empty nest, career shifts, identity changes)
- Experiencing burnout despite outward success
- Wrestling with existential anxiety or a loss of meaning
- Facing grief, illness, or unexpected life turns
- Feeling “stuck” even though nothing is dramatically wrong

You may not be in crisis. You may simply feel that something important is missing.

In my work, we focus not only on reducing distress, but on rebuilding clarity, purpose, and alignment with your values. Meaning-centered therapy can be especially helpful when you want deeper direction — not just symptom relief.

If you’re unsure whether this approach fits your situation, a consultation can help clarify next steps.

If you have any questions about logotherapy or how choosing a logotherapist might benefit you, don’t hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

## FAQ

### **What is Logotherapy, and how is it different from other therapy approaches?**

Logotherapy is a meaning-centered therapy developed by Viktor Frankl. It focuses on helping individuals reconnect with purpose, values, and responsibility — particularly during periods of transition, loss, or existential uncertainty.

Unlike approaches that focus primarily on symptom reduction or past experiences, logotherapy explores how meaning can be discovered even in difficult circumstances. In my practice, I often integrate logotherapy techniques with cognitive, insight-oriented, and strengths-based methods to ensure both emotional relief and deeper clarity.

### **Who is Logotherapy most helpful for?**

Logotherapy can be especially helpful for:

- Adults experiencing midlife or identity transitions
- Individuals who feel successful but internally unfulfilled
- People navigating grief, loss, or unexpected life changes
- High-functioning professionals facing burnout
- Adolescents struggling with purpose or direction

If you feel stuck, disconnected, or uncertain about what gives your life meaning, this approach can provide a structured way to explore those questions safely and constructively.

### **What happens in a Logotherapy session?**

In a session, we explore values, identity, and responsibility in practical terms. Techniques may include:

- Socratic dialogue to clarify beliefs and meaning
- Value clarification exercises
- Paradoxical intention to reduce anxiety
- Reframing suffering in ways that restore agency

The goal is not abstract philosophy, but concrete shifts in how you relate to your experiences and decisions.

### **How do you integrate Logotherapy into your clinical work?**

As a licensed psychologist, I use logotherapy as part of an integrative framework. That means it is blended thoughtfully with evidence-based approaches such as cognitive-behavioral techniques and insight-oriented therapy when appropriate.

The emphasis remains practical and grounded. The goal is to help you build a stronger internal compass — not just reduce distress, but increase direction and purpose.

### **How do I know if Logotherapy is right for me?**

If you find yourself asking questions like:

- “What is the point of this?”
- “Why does this feel empty even though things look fine?”
- “What is life asking of me right now?”

then meaning-centered therapy may be worth exploring.

A consultation can help clarify whether this approach aligns with your goals and whether it fits within a broader treatment plan.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Rational Emotive Behavior Therapy (REBT): Fast, Enduring Results](https://dralanjacobson.com/rational-emotive-behavior-therapy-rebt/)

**Published:** August 30, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Experience and training in Rational Emotional Behavioral Therapy have reinforced my conviction that people can transform their lives by discovering and taking more control over their thought patterns. REBT empowers clients to take an active role in recognizing how their own beliefs fuel emotions and behaviors. It is both efficient and deeply philosophical, designed to help people become their own mentors over time. Clients leave with Rational Emotive Behavior Therapy techniques and tools they can use for the rest of their lives, long after their treatment has ended. This post provides information about this approach, followed by three case examples of Rational Emotional Behavior Therapy in practice.

### Origins of Rational Emotive Behavior Therapy

REBT was developed in the mid-1950s by [Dr. Albert Ellis](https://en.wikipedia.org/wiki/Albert_Ellis), who found [psychoanalysis](https://en.wikipedia.org/wiki/Psychoanalysis) too slow and passive. He argued that emotional distress is not directly caused by external events, but rather by the beliefs people hold about those events. His [**ABC Model**](https://www.healthline.com/health/abc-model) (Activating event → Beliefs → Consequences) became the cornerstone of Rational Emotional Behavioral Therapy. Later refinements introduced the disputation of beliefs and the practice of developing philosophies of life that emphasize acceptance, flexibility, and resilience.

## Who REBT Works Best For, and Why

Rational Emotive Behavior Therapy techniques are particularly suited for individuals who:

1. **Experience anxiety and worry** – such as students with [test anxiety](https://dralanjacobson.com/test-taking-anxiety/), professionals with performance fears, or socially anxious individuals. REBT helps them challenge catastrophizing, perfectionistic beliefs, and “musts” that fuel anxiety.
2. **Struggle with depression** – especially when depression stems from rigid self-demands (“I must succeed or I’m worthless”) or from placing conditional worth on external approval. Rational Emotional Behavior Therapy helps by promoting unconditional self-acceptance and reframing rigid, negative beliefs.
3. **Have anger or frustration issues** – when people tell themselves, “Others must treat me fairly, and if they don’t, they’re terrible and deserve punishment.” REBT reduces anger by fostering unconditional other-acceptance and realistic expectations.
4. **[Therapy for young adults](https://dralanjacobson.com/therapy-for-college-students/) and teens** – because they often develop rigid standards about achievement, appearance, and peer acceptance. Early REBT work teaches them resilience before harmful patterns harden.
5. **Adults [facing life transitions](https://dralanjacobson.com/life-transitions-therapy/)** – retirement, divorce, career changes, parenthood, or health challenges. These moments often trigger identity-based beliefs (“Without my job, I am nothing”), which Rational Emotional Behavior Therapy directly addresses.
6. **Clients open to structured, active, skills-based work** – Rational Emotive Behavior Therapy techniques are not for someone who only wants supportive listening. It’s most effective when clients are willing to practice disputation, complete homework, and confront their beliefs between sessions.
    ## ![Rational Emotive Behavior Therapy](https://dralanjacobson.com/wp-content/uploads/2025/08/true-or-false-300x200.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## Core Rational Emotive Behavior Therapy Techniques

The following are the usual Rational Emotive Behavior Therapy techniques:

1. **ABC Model:** This is at the core of all Rational Emotive Behavior Therapy techniques, breaking down problems into Activating Event (A), Belief (B), and Consequence (C) to illustrate how beliefs, not events, cause distress.
2. **Disputation of Irrational Beliefs (D):**
    - *Logical disputation:* “Does this belief make sense?”
    - *Empirical disputation:* “Where’s the evidence that this must be true?”
    - *Pragmatic disputation:* “Is this belief helping me or hurting me?”
3. **Effective New Philosophy (E):** Clients adopt flexible, productive beliefs: *“I’d prefer things to go well, but if they don’t, I can still be okay.”*
4. **Homework & Self-Help Assignments:** Daily disputation worksheets, thought records, or behavioral experiments.
5. **Imagery & Visualization:** Mentally rehearsing responding with balanced beliefs in situations that trigger anxiety, sadness, or anger.
6. **Behavioral Rehearsal & Role-Play:** Practicing assertive communication, exposure to feared situations, or practicing new thinking patterns aloud.
7. **Philosophical Reframing:** Promoting [unconditional self-acceptance](https://exploringyourmind.com/unconditional-self-acceptance-according-to-albert-ellis/) (USA), unconditional other-acceptance (UOA), and unconditional life-acceptance (ULA).

### Therapies and Approaches That Work Well With REBT

**Rational Emotional Behavioral Therapy** is a structured, philosophical, and skills-based approach. While effective on its own, it integrates well with a wide range of therapeutic strategies. Combining modalities enables clients to benefit from Rational Emotional Behavior Therapy’s rational belief restructuring while also addressing emotional processing, relational dynamics, and behavioral change. This makes Rational Emotive Behavioral Therapy not only a standalone treatment but also a **powerful core framework** that integrates into many clinical and developmental approaches.

1. **[ Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT)**

- **Why it works with Rational Emotive Behavior Therapy:** Both share cognitive-behavioral foundations. CBT focuses on identifying and restructuring negative automatic thoughts, while Rational Emotive Behavior Therapy techniques emphasize deep philosophical change (from rigid “musts” and “shoulds” to flexible preferences).
- **Benefit:** Clients gain practical short-term tools (CBT) and long-term mindset shifts (Rational Emotional Behavior Therapy).

2. **Mindfulness-Based and [Acceptance-Based Approaches](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) (ACT, [MBCT](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/))**

- **Why it works with Rational Emotive Behavior Therapy:** [Mindfulness increases awareness](https://dralanjacobson.com/mindfulness-therapy/) of irrational thoughts before disputation begins, while Acceptance and Commitment Therapy (ACT) encourages acceptance of uncomfortable emotions. Rational Emotional Behavioral Therapy’s disputation then helps reframe and replace rigid beliefs.
- **Benefit:** Combines nonjudgmental acceptance with rational disputation, reducing both avoidance and rigidity.

3. **[ Behavioral Activation](https://dralanjacobson.com/behavioral-activation/) (BA)**

- **Why it works with Rational Emotive Behavior Therapy:** Depression often involves withdrawal. Rational Emotive Behavior Therapy techniques help dispute the beliefs fueling withdrawal (“I can’t do anything unless I feel motivated”), while BA provides concrete steps to re-engage in life.
- **Benefit:** Clients challenge depressive thinking while taking behavioral steps that reinforce balanced beliefs.

4. **Exposure Methods ([ERP](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/), systematic desensitization)**

- **Why it works with Rational Emotive Behavior Therapy:** In anxiety treatment, exposure reduces fear by experience, while REBT challenges catastrophic beliefs driving the fear (“I must not feel anxious, or I’ll lose control”).
- **Benefit:** Rational Emotional Behavior Therapy prepares clients cognitively for exposure, making them more willing to face feared situations.

5. **[ Solution-Focused Brief Therapy](https://dralanjacobson.com/solution-focused-therapy/) (SFBT)**

- **Why it works with Rational Emotional Behavioral Therapy:** REBT looks backward at beliefs that cause distress, while SFBT emphasizes building future-oriented solutions. Together, they balance philosophical restructuring with goal-driven action.
- **Benefit:** Clients not only dispute unreasonable beliefs but also envision and create specific future changes.

6. **[ Motivational Interviewing](https://dralanjacobson.com/motivational-interviewing/) (MI)**

- **Why it works with Rational Emotional Behavioral Therapy:** MI increases readiness to change, which is essential for REBT homework and disputation to be effective. MI addresses ambivalence, while REBT provides the tools for long-term change.
- **Benefit:** Helps resistant or ambivalent clients commit to doing the active work of REBT.

7. **Dialectical Behavior Therapy ([DBT](https://dralanjacobson.com/dbt-for-teens/)) Skills Training**

- **Why it works with Rational Emotional Behavioral Therapy:** DBT’s emotion regulation and distress tolerance skills complement REBT’s disputation of unbalanced thoughts. When clients are highly dysregulated, DBT skills help stabilize them so they can apply REBT techniques.
- **Benefit:** Provides both philosophical reframing (REBT) and moment-to-moment coping tools (DBT).

8. **[ Interpersonal Therapy](https://dralanjacobson.com/interpersonal-therapy/) (IPT)**

- **Why it works with Rational Emotional Behavioral Therapy:** IPT focuses on role transitions, interpersonal disputes, grief, and social deficits. REBT helps address the irrational beliefs underlying interpersonal struggles, such as “People must always treat me fairly” and “I must always be liked.”
- **Benefit:** IPT strengthens relationships, while REBT reduces the rigid beliefs that make relationships fragile.

9. **[ Psychodynamic](https://dralanjacobson.com/psychodynamic-therapy/) / Insight-Oriented Approaches**

- **Why it works with Rational Emotional Behavior Therapy:** Psychodynamic techniques explore the origins of unbalanced beliefs (family history, attachment experiences). REBT then helps the client actively challenge and replace those beliefs in the present.
- **Benefit:** Deeper self-understanding paired with practical, philosophical tools for change.

10. **[ Strength-Based](https://dralanjacobson.com/strength-based-therapy/) & [Positive Psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/) Approaches**

- **Why it works with Rational Emotional Behavior Therapy:** Positive psychology emphasizes cultivating strengths, gratitude, and meaning. REBT dovetails by helping clients dispute beliefs that block optimism and resilience.
- **Benefit:** Builds both resilience (REBT) and flourishing (positive psychology).

11. **[ Family Treatment](https://dralanjacobson.com/family-therapy/) and [Couples Therapy](https://dralanjacobson.com/couples-therapy/) (including Structural and [Systems Approaches](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/))**

- **Why it works with Rational Emotional Behavioral Therapy:** Family and couples therapy address relationship patterns. At the same time, REBT helps each member dispute rigid relational beliefs, such as “My partner must always agree with me.”
- **Benefit:** Reduces relational conflict by fostering acceptance, flexibility, and rational communication.

12. **Coaching Models (Life, Academic, or Executive Coaching)**

- **Why it works with Rational Emotional Behavior Therapy:** Coaching emphasizes setting goals, improving performance, and maintaining accountability. Rational Emotional Behavior Therapy is an excellent fit because it challenges performance-blocking beliefs (“I must never fail” / “I can’t tolerate setbacks”).
- **Benefit:** Creates lasting performance improvements by addressing both behavior (coaching) and belief systems (REBT).

#### Summary:

Rational Emotive Behavior Therapy techniques blend seamlessly with therapies that:

- **Provide emotional regulation (DBT, mindfulness).**
- **Encourage behavioral change (BA, exposure).**
- **Strengthen motivation (MI, SFBT).**
- **Deepen insight (psychodynamic, IPT).**
- **Promote growth (positive psychology, coaching).**

In the following section, I cover fictitious examples of rational emotive behavior therapy in practice.

## Rational Emotive Behavior Therapy Example 1: Teen with Anxiety

In the first of our examples of rational emotive behavior therapy, we have Anna, 15, who has struggled with severe test anxiety. She often cried before exams, telling herself, *“I must get a perfect grade. If I don’t, my parents will be disappointed, and I’ll never get into a good college. That would be a disaster.”*

### Rational Emotive Behavior Therapy Techniques Used:

- **ABC Model:** We mapped her Activating event (upcoming test), Belief (“I must get 100% or my future is ruined”), and Consequence (panic, avoidance).
- **Disputation:** We practiced questioning the belief. Logical disputation: *“Is it true that one test defines your future?”* Empirical disputation: *“Have you ever done less than perfect and still done well overall?”* Pragmatic disputation: *“Is this belief helping you focus, or making you too anxious to study?”*
- **Effective Belief Replacement:** She practiced saying, *“I want to do well, but I don’t have to. Even if I get a lower grade, it doesn’t ruin everything—I can still succeed.”*
- **Rational Emotional Behavioral Therapy Homework:** She completed “belief logs” before each test, writing down unbalanced thoughts and their rational alternatives.
- **Imagery:** We employed positive imagery, where she visualized feeling anxious before a test but then responded calmly, utilizing her new beliefs.
- **Behavioral Rehearsal:** We role-played test scenarios in session, where she practiced calming self-talk.

### Outcome

Over several weeks of Rational Emotional Behavioral Therapy, Anna’s panic before tests dropped significantly. She began to view exams as important but not catastrophic, which allowed her to perform more confidently and effectively.

## Rational Emotional Behavior Therapy Example 2: Young Adult with Depression

Case: Marcus, 24, experienced depression following a breakup. His core thought: *“I must be loved by my partner. If I’m rejected, it proves I’m unworthy, and life is meaningless.”*

### Rational Emotive Behavior Therapy Techniques Used:

- **ABC Model:** Activating event = breakup; Belief = “I must be loved to have worth”; Consequence = sadness, withdrawal, loss of motivation.
- **Disputation:**
    - Logical: *“Does every human’s worth depend on someone else’s approval?”*
    - Empirical: *“Are there people who are single and still lead meaningful lives?”*
    - Pragmatic: *“Is holding this belief helping you recover, or trapping you in depression?”*
- **New Belief:** *“I want love, but I don’t have to have it to be worthwhile. I can still live a meaningful life on my own.”*
- **Homework:** Marcus wrote positive and balanced responses to his daily automatic thoughts and began journaling examples of times when he contributed value independently of relationships.
- **Behavioral Activation:** He scheduled enjoyable activities (such as music, exercise, and volunteering) to reinforce rational beliefs through real-life action.
- **Philosophical Shift:** We focused on unconditional self-acceptance, emphasizing that worth is not contingent upon success or approval.

**Outcome:** Marcus gradually re-engaged with friends, applied for jobs, and began dating again, no longer equating rejection with worthlessness. His depression symptoms lifted as his thinking became more flexible.

## REBT Example 3: Older Adult Facing Transition

**Case:** *Linda, 62,* recently retired and told herself, *“Without my job, I am useless. My life no longer has meaning.”* She experienced anxiety, sadness, and emptiness.

### Rational Emotive Behavior Therapy Techniques:

- **ABC Model:** A = retirement; B = “Without work, I’m useless”; C = despair, lack of purpose.
- **Disputation:**
    - Logical: *“Does usefulness only come from paid employment?”*
    - Empirical: *“Have you ever known retirees who still lived fulfilling lives?”*
    - Pragmatic: *“Is this belief helping you, or making you feel hopeless?”*
- **New Belief:** *“Work was important, but my worth is not limited to it. I can live meaningfully through family, hobbies, volunteering, and personal growth.”*
- **Homework:** Linda listed meaningful contributions outside of work each week, like mentoring, community activities, and spending time with grandchildren.
- **Rational Emotional Behavioral Therapy Imagery:** She visualized herself thriving in new roles, reinforcing the belief that life can remain purposeful.
- **Behavioral Rehearsal:** She practiced telling others about her new pursuits with pride, rather than shame.
- **Philosophical Reframing:** We emphasized unconditional life acceptance, embracing aging and transitions as part of the human experience.

**Outcome:** Linda began mentoring younger colleagues, joined a community theater group, and started traveling with her partner. She reframed retirement as an opportunity to expand rather than diminish her identity.

REBT is highly customizable and can be beneficial for a wide range of individuals. However, I hope these brief examples of rational emotive behavior therapy have given you an idea of how it might work for you or a loved one.

## Conclusion and My Work

Rational Emotive Behavior Therapy is more than a set of techniques; it’s a way of living. It teaches us that we cannot always control what happens, but we can control what we believe about it, and therefore how we feel and act. I have seen teens overcome severe anxiety, young adults rise from depression, and older adults [find new meaning after transitions](https://dralanjacobson.com/existential-therapy/). REBT is powerful because it equips people with lifelong skills: the ability to dispute harmful thoughts, replace them with balanced alternatives, and [accept themselves and life unconditionally](https://dralanjacobson.com/humanistic-therapy/). That, in my experience, is the foundation of resilience, freedom, and hope.

I hope that the examples of rational emotive behavior therapy described above help you understand how the method works. However, feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a free consultation](https://www.picktime.com/scheduleaconsult#services) if you would like more information about how REBT might benefit you.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Flight Anxiety Self-Help](https://dralanjacobson.com/flight-anxiety-self-help/)

**Published:** June 26, 2023
**Author:** Dr. Alan Jacobson

**Content:**

Overcoming **flight anxiety** can be challenging, but there are self-help strategies that can help you manage and reduce your fear. Below are some self-help strategies to help you reduce your anxiety on flights. These tips on how to get over flight anxiety should be helpful for those whose symptoms are not severe or who want to try things on their own before pursuing therapy.

If your fear is severe and you would prefer to work on things with a professional who can tailor techniques to your specific background, or if you feel that a set time to work on this anxiety would be a good fit, feel free to [contact me](https://dralanjacobson.com/contact/) or schedule a consultation. Here is a start to conquer your anxiety on flights alone.

## How to Get Over Flight Anxiety: Tips

Here are some steps you can take to help you learn how to get over flight anxiety. If you do not experience this phobia but have a companion that does, these can also be helpful.:

### Flight Anxiety Before the Flight:

For many people, the worst part about anxiety on flights is the anticipation. These tips will help you get to the day of your flight without too much distress.

1. **Identify Your Triggers**: Identify the aspects that trigger your fear. It could be turbulence, takeoff, landing, claustrophobia, or a fear of heights. Once you pinpoint your triggers, you can address them more effectively in the following steps.
2. **Educate Yourself**: Learn about the incredible amount of duplicative safety measures and procedures involved in air travel. Understanding how airplanes work and the safety protocols in place can help alleviate some fears. Seeing [flight safety statistics](https://lifehacker.com/six-airplane-facts-to-cure-your-fear-of-flying-1788654431) can also be comforting. Going to a site that shows [all the planes currently in the air](https://flightaware.com/live/) can also be reassuring.
3. **Gradual Exposure**: Start with small steps to [gradually expose yourself](https://dralanjacobson.com/exposure-therapy-for-anxiety/) to flying. This could involve visiting an airport without boarding, watching videos, or taking short domestic trips before attempting longer international ones.
4. **Join Support Groups**: Consider joining support groups or online communities where you can connect with others who share similar fears. Sharing experiences and coping strategies can provide valuable support and encouragement.
5. **Stay Healthy**: Prioritize self-care leading up to your trip. Get enough rest, eat nutritious meals, and avoid excessive caffeine or alcohol, which can exacerbate anxiety.

### Flight Anxiety During the Flight:

Congratulations if you experience flight anxiety but have gotten on the plane. These self-help tips will help you get through.

1. **Use Breathing and Relaxation Techniques**: Practice deep breathing exercises and relaxation techniques to help you learn how to get over flight anxiety by managing fear. This can include [progressive muscle relaxation](https://www.anxietycanada.com/articles/how-to-do-progressive-muscle-relaxation/), meditation, or [the practice of mindfulness](https://mindfulminutes.com/flight-mindfulness-5-meditations-try-youre-traveling/) techniques.
2. **Visualize Positive Outcomes**: Use visualization techniques to imagine yourself having a calm and enjoyable airplane ride. Visualize the entire journey, including takeoff, cruising, and landing, while focusing on feelings of relaxation and comfort.
3. **Distract Yourself**: Engage in activities that divert your attention. Bring a book, listen to music, watch a movie, or converse with your travel companion to keep your mind occupied.
4. **Communicate with the Flight Crew**: Inform the attendants about your anxiety. They are trained to handle anxious passengers and may be able to provide reassurance or guidance. Even saying “hello” to the pilots when you board can bring relief.

### After the Flight:

While some people experience relief after they deboard, others experience residual anxiety and stress. For the latter, I suggest the following how to get over flight anxiety self-help tips:

1. **Address lingering stress** by practicing self-care afterward. Get enough rest, enjoy activities, and spend time with loved ones. Engage in relaxation exercises to help reduce residual stress. Practice grounding techniques, such as focusing on your breath or using sensory objects, to help reconnect with the present moment and reduce any feelings of overwhelm.
2. **Reassess the Experience**: Sometimes, people replay the experience, dissecting every detail and worrying about what could have gone wrong. Instead of dwelling on this, focus on the positive aspects of your trip or the sense of accomplishment you gained from facing your fear.
3. **Get Professional Support**: If the anxiety persists and interferes with your daily life, self-help may not be enough. A therapist can help you process your feelings, provide coping strategies, and work with you to develop a plan for managing anxiety related to flying.

## Self-Help FAQs

Here are the answers to some common inquiries I receive from people with this phobia:

### Do I need to figure out what is causing my anxiety on flights?

No. While for some, the causes of their symptoms are obvious, such as pre-existing claustrophobia, a bad experience on a prior trip, or a fear of heights, many people don’t know why their fear started. In that case, you may be quite curious about why you developed this phobia, and therapy can often help uncover the reasons. Still, there is a lot you can do, including the tips on this page, that do not necessitate knowing why the phobia started in the first place.

### Does anxiety on flights sometimes go away on its own?

In some cases, it does go away on its own, but self-help techniques or formal therapy can usually speed up that process. This is particularly true if you don’t fly a lot, so you have few opportunities to challenge your irrational or exaggerated beliefs. It is important to note that flight anxiety is much less likely to go away if you avoid flying altogether,

### Can I take a short practice flight with others who have anxiety on flights?

Yes, I can refer you to some programs where you can go on a short trip to challenge your fear and others experiencing the same thing and want to learn how to get over flight anxiety. This can feel comforting and allows you to challenge your fear but for a controlled time. You should also realize that on any given airplane, a [significant number of people](https://my.clevelandclinic.org/health/diseases/22431-aerophobia-fear-of-flying) experience flight anxiety.

### Are self-help techniques enough?

Many people can conquer their anxiety on flights through self-help techniques. However, it depends on the severity of your symptoms, how long you’ve had them, and, to some degree, what is causing them. Usually, therapy speeds the process, and sometimes, therapy is necessary to help you learn how to get over flight anxiety.

These are some common questions people ask about anxiety on flights, but remember that you can contact me any time if you have other questions. Initial consultations are always free.

## How to Get Over Flight Anxiety: Summary

Overcoming flight anxiety, also known as aviophobia, involves a [combination of cognitive strategies](https://dralanjacobson.com/best-types-of-therapy-for-anxiety/), relaxation techniques, and gradual exposure to flying. Here is a summary of the information in this post and elsewhere in this site:

### 1. Educate Yourself About Flying

- Understand How Planes Work: Learning about the mechanics of flying, how planes are built for safety, and how turbulence is expected can help reduce irrational fears and anxiety on flights.
- Read About Airline Safety: Commercial air travel is one of the safest modes of transportation. Reminding yourself of this fact may help ease your anxiety on flights.

### 2. Cognitive Behavioral Therapy for Flight Anxiety

- [CBT is highly effective](https://dralanjacobson.com/fear-of-flying-therapy/) for anxiety disorders. I can help you challenge irrational fears and teach you coping mechanisms to manage anxiety on Flights.
- Exposure Therapy: [Gradual exposure to flying](https://dralanjacobson.com/flying-anxiety-treatment/) (e.g., visiting the airport, sitting in a plane while on the ground, etc.) can desensitize you to the fear over time.

### 3. Practice Relaxation Techniques

- Deep Breathing: Practice slow, deep breathing to calm your nervous system when anxiety arises. Inhale deeply for 4 seconds, hold for 4, and exhale for 4.
- Progressive Muscle Relaxation: Tense and release each muscle group in your body to alleviate physical tension caused by anxiety.
- Visualization: To distract your mind from anxious thoughts, imagine a peaceful scenario, like being on a quiet beach or walking in a calm forest.

### 4. Mindfulness and Grounding Techniques

- Stay in the Present: [Mindfulness practices](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/), such as focusing on sensations (what you can see, hear, and feel) during the flight, can keep you grounded and prevent anxious spiraling.
- 5-4-3-2-1 Grounding Technique: Identify 5 things you see, 4 things you can touch, 3 things you hear, 2 things you smell, and 1 thing you taste to refocus your mind.

### 5. Distraction

- Entertainment: Bring books, movies, music, or puzzles to occupy your mind during the flight. For some, distraction plays a key role in overcoming flight anxiety.
- Engage with Fellow Passengers: Talking to someone can help distract you from your anxiety and make the flight more comfortable.

### 6. Prepare for the Flight

- Arrive Early: Avoid the added stress of rushing by giving yourself plenty of time to get to the airport and settle in before your flight.
- Choose Your Seat: Sit where you feel most comfortable, such as an aisle seat (for easy movement) or a window seat (to see outside).
- Bring Comfort Items: Having something familiar, like a travel pillow, blanket, or calming essential oils (lavender), can make you feel more at ease.

### 7. Limit Caffeine and Alcohol

- Avoid Stimulants: Caffeine can increase anxiety and make it harder to relax.
- Limit Alcohol: While a drink might seem like it will help calm your nerves, alcohol can actually heighten anxiety and lead to dehydration.

### 8. Enroll in a Fear of Flying Course

- Many airlines and organizations offer [fear-of-flying courses](https://dralanjacobson.com/fear-of-flying-group/) that provide education, exposure, and therapeutic support. These courses often include simulated flights and expert advice to help you overcome anxiety on flights

### 9. Focus on the Destination

- Remind yourself why you’re flying. Focus on the excitement of reaching your destination—whether it’s a vacation, visiting family, or an important work trip. Keeping the end goal in mind can shift your focus from fear to anticipation, a key to how to get over flight anxiety.

## Overcoming Flight Anxiety: Case Example

Emily, a 28-year-old marketing professional, had struggled with flying anxiety for years. Her fear stemmed from a turbulent flight she experienced as a teenager, leading to avoidance behaviors such as opting for long road trips instead of flying. However, when she was promoted to a role that required frequent travel, she realized she needed to confront her fear.

### Challenges

- Racing heart, nausea, and sweating before and during airplane trips.
- [Panic attacks](https://dralanjacobson.com/panic-attack-treatment/) when experiencing turbulence.
- Avoidance of air travel, leading to missed opportunities.

### Self-Help Strategies for Overcoming Flight Anxiety

1. **Cognitive Behavioral Therapy (CBT) Techniques for Overcoming Flight Anxiety**
    - Emily identified negative thought patterns, such as “The plane will crash,” and replaced them with facts like “[Air travel is statistically the safest mode of transport](https://turbli.com/blog/the-safest-transport-modes-ranked-by-statistics-from-10-years-of-data/).”
    - She used cognitive restructuring to shift her mindset from fear-based to rational thinking.
2. **Gradual Exposure Therapy**
    - Started by watching videos to desensitize herself.
    - Visited the airport without flying to familiarize herself with the environment.
    - Took short airplane trips to build confidence, a key to overcoming flight anxiety.
3. **Breathing & Relaxation Techniques for Overcoming Flight Anxiety**
    - Practiced diaphragmatic breathing before and during.
    - Used progressive muscle relaxation to reduce physical tension.
4. **Distraction & Mindfulness**
    - She listened to calming music and podcasts to divert her focus.
    - She practiced mindfulness by concentrating on her senses instead of worrying.
5. **Education on Aviation Safety**
    - She spoke with a pilot to [understand turbulence](https://www.nationalgeographic.com/travel/article/what-is-turbulence-explained) and airplane mechanics.
    - Read materials on how airplanes are designed to withstand turbulence.
6. **Medication & Natural Remedies** (as needed) 
    - Consulted a doctor about using anti-anxiety medication for overcoming flight anxiety.
    - Used lavender oil and herbal teas to promote relaxation.

### Results and Conclusion

After consistently applying these self-help techniques, Emily successfully reduced her anxiety. Over time, she could fly without panic and even started enjoying the experience. Her quality of life and career opportunities improved significantly.

This case highlights how a combination of cognitive strategies, exposure therapy, relaxation techniques, and education can help individuals overcome flight anxiety.

## How to Get Over Flight Anxiety with My Help

Remember that learning how to how to get over flight anxiety is a gradual process, and it’s normal to experience setbacks. Be patient with yourself and celebrate small victories. With persistence and the right strategies, overcoming flight anxiety is possible, and air travel can become a more comfortable experience.

You’ll need to challenge yourself with the techniques above and use gradual exposure (including flying) to see if they are working. One thing we can do in my office that may be hard to do on your own is guided visualization, a form of exposure that can help with overcoming flight anxiety. [Individual therapy](https://dralanjacobson.com/individual-therapy/) can also help you gain new insights related to your flight anxiety and help you in other areas.

Please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you find these and other flight anxiety self-help strategies insufficient or want to speed up the process. I can design treatment around your specific fears and triggers, and if you would like, I can be available to help with **flight anxiety** when you need me through [my clinical specialties](https://dralanjacobson.com/intensive-therapy-and-specialty-services/).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Fear of Flying Services

---

### [Treating Major Depression](https://dralanjacobson.com/treating-major-depression/)

**Published:** May 31, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Treating major depression** is a challenge, but with the right combination of approaches, it is quite possible. I provide therapy for major depression (or major depressive disorder – MDD), which typically involves a combination of methods tailored to the individual’s needs. This post goes over the primary ways I treat major depressive disorder, followed by a fictitious example of therapy for MDD. Of course, every client’s needs are unique, so you may want to do other research, such as reading [my therapy blog](https://dralanjacobson.com/blog/) posts about my other treatment approaches, and for specific concerns such as [seasonal affective disorder treatment](https://dralanjacobson.com/seasonal-affective-disorder-treatment/).

If you would like to discuss your own needs or the needs of a loved one, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime for more information about my services or psychotherapy for MDD in general.

## Methods for Treating Major Depression

The following are the basic methods used in combination to treat major depressive disorder:

### Psychotherapy for Major Depression (Therapy for MDD)

These are the more common forms of [therapy for MDD](https://dralanjacobson.com/therapy-for-depression/).

– [Cognitive Behavioral Therapy](https://dralanjacobson.com/cbt-for-depression/) for MDD (CBT) focuses on identifying and changing negative thought patterns and behaviors. CBT is often the first line of treatment for major depression because it is focused and proven, and results can come quickly. I often start with cognitive-behavioral therapy while looking to mix in other techniques depending on each client’s needs and goals.
[Interpersonal Psychotherapy](https://dralanjacobson.com/interpersonal-therapy/) for MDD (IPT) addresses problems in personal relationships and social functioning. This is a good example of how I add a new method based on the individual’s unique needs when treating major depression. When it appears that [social issues are either causing](https://dralanjacobson.com/therapy-for-social-anxiety-disorder/) or maintaining the depressive state, IPT is an excellent add-on.
Dialectical Behavior Therapy for MDD (DBT) is a form of CBT that emphasizes psychosocial aspects to treat major depressive disorder. It is often used for individuals with severe symptoms. DBT is also a good add-on when social issues are involved and when a person may need more than one weekly session.
– [Psychodynamic Psychotherapy](https://dralanjacobson.com/psychodynamic-therapy/) for MDD explores unconscious feelings and thoughts and how they influence current behavior. I use Psychodynamic approaches when the roots of the current depressive state reach into the past and when developing new insights into these roots may help speed treatment.

Other approaches can also be helpful, depending on what is causing your symptoms. These include [existential psychotherapy](https://dralanjacobson.com/existential-therapy/) and [narrative therapy](https://dralanjacobson.com/narrative-therapy/). In an integrated practice like mine, we will continually explore new methods and techniques that could be helpful as add-ons.

### Treating Major Depression with Medications

It is a personal choice whether to pursue medication treatment, and I am happy to advise those who request it. Otherwise, I can provide information about the psychiatrists I trust to take a balanced approach. The types of medications commonly used to treat major depressive disorder include:

– [Selective Serotonin Reuptake Inhibitors](https://en.wikipedia.org/wiki/Selective_serotonin_reuptake_inhibitor) (SSRIs) include fluoxetine (Prozac) and sertraline (Zoloft). These are often the first ones that people try, given that doctors like that they have few side effects, have been mostly proven safe, and do what they set out to do. I cannot give specific advice or guidance about these or any medications.
– [Serotonin and Norepinephrine Reuptake Inhibitors](https://my.clevelandclinic.org/health/treatments/24797-snri) (SNRIs) include venlafaxine (Effexor) and duloxetine (Cymbalta). Many people try these if SSRIs do not work.
– [Atypical Antidepressants](https://screening.mhanational.org/content/atypical-antidepressants/) include bupropion (Wellbutrin) and mirtazapine (Remeron). Some people respond well to these, but again, you need to consult with a doctor who can review your history and needs and give you more specific advice.

Keep in mind that one of the [myths about depression](https://dralanjacobson.com/myths-about-depression/) is that it is due to a chemical imbalance; medications do not work for everyone.

### Lifestyle Modifications to Treat Major Depressive Disorder

Outside of psychotherapy for MDD, there are many things you can do as an adjunct to address your symptoms. For example:

– Regular physical activity can improve mood and reduce symptoms of depression. While exercise may not provide a cure, it can help as part of a comprehensive and multi-faceted approach.
– Balanced nutrition supports overall mental health. This is particularly true if an unhealthy diet reduces energy and motivation.
– Socializing to a comfortable degree can help lift depressive moods, especially if you are avoiding your normal degree of going out and being with and around people.
– Maintaining a regular sleep schedule is crucial. Sleeping too much or too little can affect your mood.

### Mindfulness and Relaxation Therapy for MDD

These techniques may not get to the root of the problem that is causing the depression, but some find that they address symptoms:

– [Mindfulness-Based Cognitive Therapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) for MDD (MBCT) combines mindfulness strategies with cognitive therapy. I like to mix mindfulness exercises to help people avoid automatic and irrational thoughts and find times of peacefulness and contentment. They also help people focus on the exceptions and extend them – the times that bring happiness.
– [Meditation and Yoga](https://www.livescience.com/yoga-and-meditation-similarities-differences) can help reduce stress and improve mood. These techniques are not my specialty, but I know good apps, virtual providers, and exercises to provide to interested people. Many people benefit greatly from these methods.

### Treating Major Depression: Alternatives

There are some other ways of treating major depression, including:

– Light Therapy can be especially useful for [Seasonal Affective Disorder](https://dralanjacobson.com/seasonal-affective-disorder-treatment/) (SAD). You can buy a reasonably inexpensive light to use for treating major depression at online retailers. They are easy to use
– Acupuncture can be beneficial for symptom relief. Many people have used acupuncture for a variety of mental health conditions with reported positive results. This is not an area of expertise for me.
Some noninvasive procedures use [magnetic fields to stimulate nerve cells in the brain](https://my.clevelandclinic.org/departments/neurological/depts/psychiatry-psychology/transcranial-magnetic-stimulation-clinic). They are often used when other treatments have failed.

New treatments are continuously being researched, including the use of ketamine and psychedelics. I stay informed about emerging therapies and am happy to discuss all your options. When an area is outside my expertise, I can refer you to someone who can help.

## Therapy for Major Depression: Example

Here’s an example of how I might provide therapy for major depression. This fictitious example gives a general idea of how my practice works.

Jane is 38 and has been suffering from major depressive disorder for the past 10 years. She has tried multiple antidepressants, including SSRIs and SNRIs, without significant improvement. She has also tried cognitive behavioral therapy (CBT) with limited success.

### Therapy for Major Depression: Planning

We start with a comprehensive assessment of Jane’s diagnosis, treatment history, and overall health. We’ll review what has worked and what hasn’t, as well as her current stressors and challenges. We’ll talk about her support network and daily schedule. We might discuss when she feels at her best and her worst. The end result will be a comprehensive treatment plan with meaningful, measurable, and clear goals.

### Psychotherapy for Major Depression

Our major goals of this [individual therapy](https://dralanjacobson.com/individual-therapy/) for treatment-resistant depression are reducing Jane’s symptoms’ intensity, helping her develop coping strategies, and helping her see and tap into her strengths. We’ll combine cognitive-behavioral therapy for MDD with narrative psychotherapy for MDD to help her develop new and more positive ways of thinking about her life and to re-write her feelings about how things will go. We’ll also use an interpersonal approach since some of her symptoms stem from concerns about her social life and self-esteem. Thus, we plan weekly sessions focusing on unconscious conflicts, negative and automatic thoughts, and current relational dynamics.

### Lifestyle and Holistic Approaches

To support her overall well-being and enhance treatment efficacy, she got regular physical exercise, such as a daily 30-minute walk or yoga. I also teach mindfulness meditation practices to reduce stress and improve emotional regulation. She also made an appointment with a Nutritionist to design a balanced diet rich in omega-3 fatty acids, vitamins, and minerals.

### Ongoing Therapy for Major Depression

We meet regularly and introduce new techniques and methods as needed. I sometimes measure her depressive symptoms using standardized scales such as the Beck Inventory. We will adjust the treatment plan based on her response and any emerging issues. The goal of therapy for major depression is to bring her relief, help her develop a toolkit of coping strategies, and eliminate some of what was maintaining her symptoms. This exploration might include exploring underlying emotional conflicts and how they relate to her depressive symptoms and addressing automatic negative thought patterns.

After eight weeks of this combined approach, Jane reports significant mood and daily functioning improvement. She continues with regular psychotherapy to pursue even greater improvement and to address some longer-standing issues now that the severity of her symptoms has lessened.

This multimodal approach aims to address both the biological and psychological aspects of depression, providing Jane with a comprehensive and individualized treatment plan. Jane feels she no longer needs therapy for major depression, though she is considering returning to work on some less urgent issues that may help her avoid a relapse.

## Treating Major Depression in My Practice

[In my integrated practice](https://dralanjacobson.com/integrative-therapy/), I treat major depressive disorder, including [treatment-resistant depression](https://dralanjacobson.com/treatment-resistant-depression/), using many of the same [types of therapy for depression](https://dralanjacobson.com/best-types-of-therapy-for-depression/) I use with less severe symptoms and related issues such as existential crises and life transitions. Often, clients who come in for psychotherapy for MDD with a major episode stay in treatment to work on some less severe but still meaningful issues after the depressive symptoms subside a bit. The approach I use to treat major depressive disorder involves urgency, and it is treated as a time-limited intervention to get you relief from severe symptoms.

I sometimes treat major depressive disorder with a [family therapy](https://dralanjacobson.com/family-therapy/) or [couples treatment](https://dralanjacobson.com/couples-therapy/) approach, where others who are important to the client join in treatment at times if the client feels that this would be helpful. There are also groups I can refer you to. Treating major depression [can be effective virtually](https://dralanjacobson.com/virtual-therapy-guide/) or in person, and I offer both.

### Questions about Treating Major Depression?

This post was designed to provide an overview and answer some general questions about therapy for MDD, but every client is unique, so you may want to learn more. If you have any questions about how I treat major depressive disorder, therapy for treatment-resistant depression, or what a [therapy course](https://dralanjacobson.com/individual-therapy/) might look like for you or a loved one, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Mental Health Diagnoses

---

### [Brief Therapy](https://dralanjacobson.com/brief-therapy/)

**Published:** August 14, 2024
**Author:** Dr. Alan Jacobson

**Content:**

I offer brief therapy in several forms, each designed for those looking for rapid change. Brief psychotherapy is time-limited and focused on addressing specific problems or goals that will respond quickly. In this post, I go over the short-term forms of treatment I use, including brief psychodynamic therapy, brief CBT, and [strategic family therapy](https://dralanjacobson.com/strategic-family-therapy-powerful-positive-time-limited/). These methods are not for everyone; when you have challenges and barriers that have deep roots or have been difficult to address in prior treatment, short-term approaches may not be enough. However, there are many instances where highly focused, short-term treatment can work quite well.

Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you’d like to learn more about how one of these approaches might help you or a loved one.

## Brief Therapy Overview ![Brief Therapy](https://dralanjacobson.com/wp-content/uploads/2024/08/obstacles-300x226.jpg "obstacles | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

The main characteristics of brief therapy include:

1. Time-Limited: Sessions are typically limited to a short period, ranging from 6 to 20 sessions, depending on the approach chosen and your specific needs.
2. Goal-Oriented: These methods center around clearly defined goals. We work together to identify the issues to be addressed and set specific, achievable goals for the treatment process.
3. Focus on the Present: Unlike some [traditional forms of treatment](https://dralanjacobson.com/types-of-therapy/) that delve deeply into past experiences, brief psychotherapy focuses more on the present and immediate issues.
4. Active and Directive: I often take a more active role, guiding the sessions to stay focused on the goals and helping you develop practical strategies for change.
5. Empowerment: Brief psychotherapy empowers you to use your resources and strengths to resolve your issues, emphasizing self-efficacy.

### Brief Psychotherapy Approaches

Several therapeutic approaches can be used within the brief therapy model, including Brief CBT, Brief Strategic Family Therapy, and Brief Psychodynamic Therapy. Each approach shares the common elements of brevity and focus but [differs in techniques and underlying theories](https://dralanjacobson.com/integrative-therapy/). Here is more information about those approaches:

## Brief Psychodynamic Therapy

One of the more common short-term approaches I use is Brief Psychodynamic Therapy (BPT). This method focuses on helping clients gain insight into their emotions, thoughts, and behaviors. It draws on the principles of traditional [psychodynamic treatment](https://dralanjacobson.com/psychodynamic-therapy/) but is designed to be shorter and more focused. BPT aims to achieve a meaningful therapeutic change relatively quickly, helping you gain insight, resolve specific emotional conflicts, and develop healthier ways of relating to yourself and others.

Here are the tenets of Brief Psychodynamic Therapy:

### Key Features of BPT:

1. Time-Limited: Brief Psychodynamic Therapy typically involves a set number of sessions, usually between 10 and 16, depending on the specific approach we choose and your needs.
2. Focus on Core Issues: The treatment centers on identifying and working through core emotional conflicts, often related to past experiences, relationships, or unresolved issues impacting your current life.
3. Insight-Oriented: Brief Psychodynamic Therapy emphasizes helping you gain insight into unconscious processes and how these affect your thoughts, feelings, and behaviors. The goal is to bring unconscious material to consciousness, facilitating self-understanding and change.
4. Transference and Countertransference: The therapeutic relationship is a key component of Brief Psychodynamic Therapy. I pay attention to transference (how you project feelings about important figures from your past onto me) and countertransference (my emotional responses to you), using these dynamics to explore your internal world.
5. Active Therapist Role: In Brief Psychodynamic Therapy, I am often more active and engaged than in traditional psychodynamic treatment, helping to keep the sessions focused on the core issues and the therapeutic goals.
6. Focus on Present Relationships: While past experiences are explored, BPT also focuses on how these past experiences influence current relationships and behaviors. The goal is to help you understand and change problematic patterns.
7. Use of Interpretation: Interpretation is a key technique in this form of brief psychotherapy. I help you make connections between your past experiences, unconscious processes, and current difficulties.

### Psychodynamic Brief Therapy Indications and Limitations:

Brief Psychodynamic Therapy can be particularly effective for those dealing with specific, identifiable issues such as relationship problems, [anxiety](https://dralanjacobson.com/best-types-of-therapy-for-anxiety/), depression, or work-related stress. It is suitable for motivated clients to explore their internal world and understand the deeper causes of their difficulties.

Due to its focused and time-limited nature, BPT may not be suitable for individuals with more complex or chronic psychological issues that require long-term treatment. It also relies on your ability to assertively engage in [introspection and self-reflection](https://positivepsychology.com/introspection-self-reflection/), which may not be comfortable for everyone in a short-term model.

## Brief CBT

A more traditional form of short-term treatment is Brief CBT, a structured course that focuses on the relationship between thoughts, emotions, and behaviors. It aims to help clients identify and change negative thought patterns and behaviors that contribute to psychological distress. This approach aims to equip clients with the tools to manage their symptoms and make lasting changes in their thoughts and behaviors. Research has shown that this form of Brief Psychotherapy can significantly improve in a relatively short period, and the skills learned can continue to benefit clients long after treatment ends.

Here are the basic tenets of Brief CBT:

### Key Features:

1. Time-Limited: Brief CBT is designed to be completed within a specific number of sessions, often between 6 and 16, depending on your needs and the nature of the issues being addressed.
2. Structured and Goal-Oriented: The treatment is highly structured, with each session typically following a specific agenda. We will set clear, measurable goals that guide the process.
3. Focus on the Present: While past experiences may be discussed, this approach primarily focuses on current problems and how they are maintained by dysfunctional thinking and behavior patterns.
4. Identification of [Cognitive Distortions](https://psychcentral.com/lib/cognitive-distortions-negative-thinking): You will learn to identify and challenge cognitive distortions—unrealistic, negative thoughts contributing to emotional distress and maladaptive behaviors. Common cognitive distortions include overgeneralization, catastrophizing, and black-and-white thinking.
5. Behavioral Interventions: This approach includes [cognitive restructuring](https://en.wikipedia.org/wiki/Cognitive_restructuring) and behavioral techniques to help you change problematic behaviors. These might involve exposure therapy for anxiety, activity scheduling for depression, or skills training for assertiveness.
6. Skill Development: In this form of brief psychotherapy, you are taught practical skills to manage your symptoms and cope with challenges. These skills might include relaxation techniques, problem-solving strategies, and communication skills.
7. Homework Assignments: Between sessions, you’ll often be given homework assignments to practice the skills you’ve learned in therapy. This might involve keeping thought records, engaging in behavioral experiments, or practicing relaxation techniques.
8. Collaborative Approach: In Brief CBT, we’ll work together as a team. I’ll provide guidance and support, but you play an active role in the process, learning to become your own therapist.

### Brief Therapy Using CBT: Indications and Limitations

Brief CBT is effective for a wide range of psychological issues, including anxiety disorders, depression, [specific phobias](https://dralanjacobson.com/therapy-for-phobias/), obsessive-compulsive disorder (OCD), [holiday stress](https://dralanjacobson.com/holiday-anxiety/), insomnia (called [CBT-i](https://dralanjacobson.com/cbt-i-for-sleep-difficulties/)), and post-traumatic stress disorder (PTSD). This form of Brief Psychotherapy is also used for stress management, insomnia, and chronic pain.

While this treatment is effective for many, it may not suit those with more complex or severe symptoms requiring long-term, in-depth treatment. Some clients may also find engaging with [cognitive-behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) treatment’s structured, homework-focused nature challenging.

## Brief Strategic Family Therapy (BFST)

Brief Strategic Family Therapy (BSFT) (or brief strategic [marriage therapy](https://dralanjacobson.com/marriage-counseling/)) is a time-limited, problem-focused therapeutic approach designed to address issues within [family systems](https://dralanjacobson.com/family-therapy/). This form of Brief Psychotherapy is based on the belief that dysfunctional family interactions often maintain problems within a family and that changing these interactions can lead to the resolution of the issues. Brief Strategic Family Therapy aims to create positive changes in family interactions that reduce or resolve the presenting problems. This form of brief psychotherapy aims to foster a healthier and more supportive family environment by improving communication, strengthening relationships, and altering dysfunctional patterns.

Here are the key features of Brief Strategic Family Therapy:

### Key Features of BFST:

1. Time-Limited: Brief strategic family therapy is typically 8 to 20 sessions. The exact number of sessions can vary depending on the complexity of the issues and your family’s progress.
2. Systemic and Interactional Focus: Brief Strategic Family therapy views problems as rooted in family dynamics rather than within an individual. It focuses on how family members interact and how these interactions contribute to the problems.
3. Goal-Oriented: Brief strategic family therapy is highly goal-directed, with you and I identifying specific issues. The goals are often related to improving communication, resolving conflicts, and changing problematic behaviors within the family.
4. Directive and Active Therapist Role: I take an active, directive role in guiding the treatment. This includes identifying dysfunctional patterns, offering strategies for change, and sometimes intervening directly in family interactions during sessions.
5. Focus on Family Strengths: I help the family to recognize and build on their strengths while addressing weaknesses. The aim is to empower you to resolve your problems using their existing resources.
6. Intervention at Multiple Levels: BSFT often involves working on multiple levels, including addressing individual family members’ behaviors, improving communication between members, and modifying the family structure.
7. Strategic Interventions: I use strategies to disrupt dysfunctional patterns and promote healthier interactions. These interventions are tailored to your family’s unique dynamics and may involve tasks or assignments outside therapy sessions.
8. Emphasis on Flexibility: I adapt the approach to fit the family’s cultural background, values, and specific situation. Flexibility ensures the treatment is effective and relevant to the family’s needs.

### Indications and Limitations:

Brief Strategic Family Therapy is particularly effective for families dealing with communication breakdowns, conflicts, or transition difficulties (e.g., divorce, remarriage, transition to adulthood) that are new, have reasonably known reasons, or are likely transient.

Brief Strategic Family Therapy may be less effective in situations where family members are unwilling to participate or where there are severe mental health issues that require intensive [individual therapy](https://dralanjacobson.com/individual-therapy/). It also requires high commitment from all family members to achieve the desired outcomes. In some cases, a longer-term option, such as [emotionally focused family treatment](https://dralanjacobson.com/emotionally-focused-family-therapy/) or traditional [family systems](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/) approaches, may be best.

## Brief Therapy Case Example

In this fictitious example, Maria, a 28-year-old graphic designer, is experiencing increased anxiety, especially about her job and social interactions. She describes a pattern of worrying thoughts and avoidance behaviors, which are starting to interfere with her work and social life. She has been having difficulty focusing on her work and experiences a racing heart and tense muscles whenever she has to present or meet with clients. This has led her to avoid these situations whenever possible, which has begun to [affect her professional performance and social connections](https://dralanjacobson.com/therapy-for-work-life-balance/).

### Brief Psychotherapy Goal

Our goal is to reduce Maria’s anxiety symptoms in situations that previously caused her distress and increase her engagement at work and socially. With the holidays and several work functions also approaching, she hopes to gain some relief fairly quickly. In the end, she will have a toolkit to manage these and future stresses.

### Therapeutic Approach: Brief CBT

We will plan to meet for 6–8 sessions focused on reducing anxiety and avoidance behaviors, changing unhelpful thoughts, and building coping skills.

**Intervention Techniques**:

1. **Psychoeducation**: In the first session, Maria is educated on the nature of anxiety, how it impacts her mind and body, and how avoidance reinforces her anxiety.
2. [**Cognitive Restructuring**](https://dralanjacobson.com/cognitive-restructuring/): Maria is guided to identify her automatic thoughts (“I’ll embarrass myself,” “They’ll think I’m incompetent”) and challenge their accuracy.
3. [**Exposure Therapy**](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/): Over a few sessions, Maria gradually exposes herself to anxiety-provoking situations, such as presenting in small meetings, to reduce her avoidance.
4. **Relaxation Techniques**: She learns breathing exercises and progressive muscle relaxation to manage her physiological symptoms of anxiety.

**Outcome**: By the end of this treatment, Maria reports feeling more in control of her anxiety. She is more comfortable in work meetings, has reduced her avoidance behaviors, and has learned strategies to manage her thoughts and physical symptoms when anxiety arises.

This example illustrates a short-term, targeted intervention focused on reducing Maria’s symptoms and equipping her with coping skills rather than exploring deeper underlying issues. In this fictitious example, Maria might return for another round, in this case, brief psychodynamic therapy, to understand where these feelings stem from.

## Brief Therapy Q&A

### Q: What is brief therapy?

**A:** Brief therapy is a short-term, goal-oriented approach to psychotherapy. It focuses on achieving meaningful change in a limited number of sessions, typically between 6 and 20. Rather than exploring every aspect of a person’s history, these approaches emphasize present concerns, solutions, and building on client strengths. Examples include brief CBT and brief psychodynamic therapy, which are covered above.

### Q: What is brief dynamic therapy?

**A:** Brief psychodynamic therapy is a time-limited treatment that focuses on unconscious patterns, unresolved conflicts, and emotional insight. While traditional psychodynamic methods can be long-term, this approach condenses treatment into 12–20 sessions, helping clients gain awareness and resolve internal struggles more efficiently.

### Q: What is brief strategic therapy?

**A:** Brief strategic treatment focuses on identifying and disrupting problematic behavioral patterns rather than analyzing their origins. It often involves specific, sometimes unconventional interventions to provoke change quickly. Techniques like reframing, prescribing the symptom, or using paradoxical tasks are common.

### Q: What is brief family therapy?

**A:** Brief family therapy is a short-term approach to addressing issues within the family system. It typically involves several family members and focuses on improving communication, shifting roles, and resolving conflicts. Sessions are structured and aim to generate positive change in a limited timeframe, usually 6–12 sessions. The most common form is brief strategic family therapy, which is covered above.

### Q: What is the best brief therapy model?

**A:** The “best” brief therapy model depends on your unique situation and goals. For example:

- **Brief CBT** is highly effective for anxiety, depression, and behavior change.
- **Solution-focused** is ideal for clients seeking fast, practical outcomes.
- **Brief Dynamic Therapy** may be best for exploring deeper emotional or relational patterns.
- **Brief Strategic Family Therapy** works well for relationship or system-level problems.

I can help you determine which approach fits best based on your needs and preferences.

## Summary and My Work

I provide all of the solution-focused short-term methods listed here and am happy to discuss how one of these approaches might benefit you, a loved one, or your family. I can weave these techniques into specialty areas, such as Brief CBT for [Fear of Flying](https://dralanjacobson.com/fear-of-flying-therapy/) and [Public Speaking](https://dralanjacobson.com/public-speaking-anxiety/). It can be a part of time-limited methods, such as for [holiday anxiety](https://dralanjacobson.com/holiday-anxiety/) and supportive treatments. I help clients achieve fast, measurable, and lasting results through these and other evidence-based models. Whether you’re facing anxiety, relationship challenges, life transitions, or emotional patterns you’d like to shift, there’s a focused approach that can work for you.

The goal is to empower you to feel better, think more clearly, and move forward efficiently and effectively. You don’t have to stay stuck. With the right support and strategy, lasting change can happen sooner than you think. Together we’ll find the brief therapy model that’s right for you.

### Connecting for Treatment

I am available to see individuals for brief CBT, psychodynamic, or brief strategic family therapy virtually in most US states. I also offer less intensive [supportive therapy](https://dralanjacobson.com/supportive-psychotherapy/) as well. While in-person treatment might sometimes work better, a [virtual approach is usually as effective](https://dralanjacobson.com/virtual-therapy-guide/) for the abovementioned treatment. Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you’d like to learn more about how brief therapy might help you.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Types of Therapy

---

### [Client-Centered Therapy](https://dralanjacobson.com/client-centered-therapy/)

**Published:** October 6, 2023
**Author:** Dr. Alan Jacobson

**Content:**

**Client-centered therapy**, or **person-centered therapy**, is a [humanistic](https://dralanjacobson.com/humanistic-psychology/) approach to psychotherapy that I use as a central tenet of my work. This approach was developed by the American psychologist [Carl Rogers](https://www.simplypsychology.org/carl-rogers.html) in the 1940s and 1950s (and thus, it is sometimes called “**Rogerian**“). It is based on the belief that you have the capacity for self-awareness and personal growth and are the expert on your own experiences. One of the core concepts, **self-actualization in person-centered therapy**, is covered at the end of this post.

In my work, I generally use client-centered therapy as a technique that is combined with others, such as [cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/), [positive psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/), and [Solution-Focused Therapy](https://dralanjacobson.com/solution-focused-therapy/). Person-centered therapy provides a back-drop, and those other therapies provide structure.

## Key Principles of Client-Centered Therapy

This form of treatment has a core premise to provide a supportive and empathetic environment for individuals seeking treatment, allowing them to explore and better understand themselves while promoting personal growth and self-actualization. It uses the following basic principles of care:

### Unconditional Positive Regard

When using person-centered therapy, I provide a non-judgmental and accepting environment for the client. This means I offer genuine empathy, understanding, and support without criticizing or evaluating your thoughts, feelings, or actions. You will trust me to hear your thoughts, opinions, and feelings without jumping in with advice or direction that may disregard or shine a negative light. Instead, I want you to feel safe in sharing anything on your mind.

### Client-Centered Therapy and Empathetic Understanding

I actively listen to you, striving to understand your perspective and emotions deeply. Empathic understanding involves reflecting on what you are saying and feeling, ensuring you feel heard and validated. Sometimes, I may even ask you to clarify or add details to be sure I truly heard you and understood what you were relating.

### Congruence or Genuineness in Client-Centered Therapy

I am [authentic and transparent](https://societyforpsychotherapy.org/reflections-on-authenticity-in-psychotherapy/) in my interactions with the client. I aim to be myself in the therapeutic relationship, hopefully building trust between us. This does not mean that I will not use proven therapeutic techniques that can help you, but rather that I will be a real person in our treatment. I may not be able to answer all your questions about my life, but I will share enough so you know you are working with a unique person.

### You Direct Your Client-Centered Therapy

The treatment is client-directed, meaning that you take the lead in discussing what you want to discuss and what issues you want to address. I do not impose an agenda or solutions; I help you explore their thoughts, feelings, and experiences, facilitating self-discovery and personal insight.

## Rogerian Client-Centered Therapy Uses

Client-centered therapy has been used effectively in various therapeutic settings and with individuals of all ages. It can be useful for helping clients with low self-esteem and relationship problems and personal growth and development. This approach relies on the client’s inherent self-healing and personal growth capacity. The main goal of client-centered therapy is to create a safe and supportive space. This way, you can explore your thoughts and feelings, better understand yourself, and make positive changes in your life. I facilitate this process by providing [empathetic listening](https://www.mindtools.com/a8l9j08/empathic-listening) and unconditional support.

This approach is also quite useful for those who have a sense that despite many positive aspects of their current lives, everything is not adding up to a sense of fulfillment, contentment, or meaning. In this case, we’ll focus on self-actualization in person-centered therapy, which I will cover later in this post.

### Client-Centered Therapy for Individuals

Client-centered therapy is commonly used for individual counseling. It can help individuals struggling with various issues, including depression, anxiety, stress, self-esteem problems, and personal growth. For example, client-centered therapy can help individuals who have [experienced trauma](https://dralanjacobson.com/trauma-informed-care/). This includes survivors of abuse, accidents, or other traumatic events. The non-directive, empathetic approach can provide a [safe space](https://dralanjacobson.com/supportive-psychotherapy/) for individuals to process their experiences.

People experiencing grief and loss, such as the death of a loved one or the end of a significant relationship, can also benefit from client-centered therapy. It allows them to express their feelings and work through their grief at their own pace. It can also help individuals develop better emotional regulation skills, understand and manage their emotions, and reduce impulsive behavior.

### Rogerian Relationship and Family Counseling

I also apply this approach in [relationship](https://dralanjacobson.com/couples-therapy/) and family counseling to facilitate better communication and understanding between family members or couples. It can be useful in resolving conflicts and improving relationships. It can be quite effective for families who have gone through a crisis or period of change.

### Person-Centered Therapy for Groups

[Group therapy](https://dralanjacobson.com/group-therapy/) can use client-centered therapy to explore their thoughts, feelings, and values and work on interpersonal growth and improvement. Client-centered therapy can assist groups in identifying the sources of stress in their relationships. It can also help individuals and groups resolve conflicts non-confrontationally and empathetically.

### Person-Centered Therapy and Substance Abuse

In addiction treatment, client-centered therapy can be helpful in a comprehensive treatment plan. It helps individuals explore the underlying issues that contribute to their addiction. Those with substance abuse must get active treatment designed to reduce their reliance on substances. However, combined with these treatments, they can understand how it all started and what kept it going.

### Career Counseling and Executive Coaching

Client-centered treatment can be used in career counseling and executive coaching to help individuals explore their values, interests, and motivations to make more informed decisions about their careers and life paths. Each executive is unique in their style and personality, and executive coaching that uses person-centered treatment as a backdrop helps ensure that you maintain and enhance the positive underlying aspects that got you to where you are.

### Crisis Intervention with Client-Centered Treatment

Client-centered therapy can be applied during crises to provide immediate emotional support and help individuals process traumatic events.

## Client-Centered Treatment Results

Here are some potential results and benefits of Rogerian client-centered treatment:

1. Increased self-awareness: Clients in person-centered therapy often become more self-aware, gaining [insight into their emotions](https://dralanjacobson.com/insight-therapy/), behaviors, and thoughts. This self-awareness can be a foundation for personal growth and change. You’ll learn to understand better and manage your emotions, reducing the intensity of distressing feelings and increasing emotional resilience.
2. Improved self-esteem: The [unconditional positive regard](https://positivepsychology.com/unconditional-positive-regard/) and empathy you’ll receive can help you develop a more positive self-concept and higher self-esteem.
3. Personal growth and self-acceptance: You may experience personal growth and self-acceptance as you explore your inner experiences and work through issues in a nonjudgmental and supportive environment. This approach emphasizes the client’s self-determination and autonomy, fostering a sense of empowerment and control over one’s life.
4. Stress reduction: Accepting and understanding one’s feelings can reduce stress and anxiety. You’ll become better equipped to cope with life’s challenges.
5. Improved relationships: This treatment can lead to more authentic and fulfilling relationships as you become more self-aware and capable of expressing your needs and emotions.
6. Long-term well-being: The insights and skills gained in client-centered treatment can have long-lasting effects. They can contribute to overall well-being and a more fulfilling life.

## Self-actualization in Person-Centered Therapy

Self-actualization is one of the key components of client-centered therapy. Here is more specific information about this core concept.

### What is Self-Actualization?

Self-actualization refers to realizing one’s full potential, talents, and abilities. It’s the highest level in psychologist [Abraham Maslow’s hierarchy of needs](https://www.simplypsychology.org/maslow.html), representing the culmination of personal growth and fulfillment. According to Maslow, individuals are motivated to pursue personal development, creativity, and self-improvement after satisfying basic needs like food, safety, love, and esteem.

In essence, self-actualization is about becoming the best version of yourself, achieving personal goals, and living a life that aligns with your values and aspirations. It can involve pursuing creative activities, gaining deeper self-understanding, achieving personal goals, or making a meaningful impact on the world.

### The Goal of Self-Actualization in Person-Centered Therapy

Self-actualization plays a central role in person-centered therapy, developed by [Carl Rogers](https://www.apa.org/about/governance/president/carl-r-rogers). Rogerian therapy believes that every individual has an inherent tendency to move toward personal growth, fulfillment, and self-realization, which he called the actualizing tendency. This tendency is a drive toward becoming one’s best self and achieving individual potential.

It follows that self-actualization in person-centered therapy becomes a vital goal. Becoming more authentic and congruent by aligning one’s real self (how one truly is) with one’s ideal self (how one wants to be) is an ongoing, lifelong process rather than a single achievement. Self-actualization in person-centered therapy is done in steps and may never be fully reached, leaving room for continued progress and improvement after treatment ends.

### Key Concepts of Self-Actualization in Person-Centered Therapy

1. **Actualizing Tendency**: This is the innate drive within every person to grow, improve, and fulfill their potential. It is a natural process of striving to become the best version of oneself.
2. **Unconditional Positive Regard**: One of the core conditions for fostering self-actualization in person-centered therapy is experiencing unconditional positive regard from others, especially from me. This means being accepted and valued without conditions, allowing you to explore your true self without fear of judgment.
3. **Congruence**: Self-actualization is closely related to congruence, which is the alignment between a person’s self-concept (how they see themselves) and their actual experiences. When there is congruence, you are more authentic and self-accepting, which allows for greater self-actualization.
4. **Empathy and Understanding**: My empathy is critical in helping you access your self-actualizing tendencies. By understanding and reflecting on your feelings, I help you become more aware of your inner experiences, facilitating growth.
5. **Self-Concept**: Self-actualization involves developing a more accurate and positive self-concept. As you become more congruent, you become more self-aware, accepting your strengths and weaknesses, allowing you to grow and change meaningfully.

My role is to create a supportive, non-judgmental environment that allows you to tap into their natural potential for self-actualization in person-centered therapy. Given the right conditions, Rogers believed people would move toward greater health, personal growth, and fulfillment.

### Self-Actualization in Person-Centered Therapy Case Example

Presenting Issue: Maria, a 32-year-old graphic designer, feels stuck in her career and experiences a persistent sense of dissatisfaction in her personal life. She reports low self-esteem and feels disconnected from her passions.

#### Client-Centered Therapeutic Process:

1. **Creating a Safe Environment:** I treat Maria with unconditional positive regard, actively listening and showing empathy for her struggles. I avoid giving advice or making judgments, encouraging Maria to explore her feelings. 
    - Example: Maria expresses doubt about her abilities. I reflect, “It sounds like you feel uncertain about your value, even though you’ve worked hard and are recognized by others. That must feel heavy.”
2. **Encouraging Authenticity:** I help Maria identify her goals through open-ended questions rather than imposing external standards. 
    - Example: “When you imagine a life that feels fulfilling to you, what comes to mind?”
    
    Maria begins to share that her passion lies in creating art for mental health advocacy but fears taking risks.
3. **Exploring Barriers:** As Maria feels heard and understood, she starts to explore internal conflicts. She realizes that societal pressures and fear of failure have held her back from pursuing what she truly values. 
    - Example: “I’ve always felt like I had to choose stability over creativity, but I miss feeling connected to my work.”
4. **Fostering Growth:** Maria has become more self-aware and confident over several sessions. She starts making small changes by taking on freelance projects aligned with her passions. 
    - Example: Maria shares, “I’ve started painting again, and it feels like a part of me that I lost is coming back.”
5. **Achieving Self-Actualization:** Maria continues to grow, embracing her authentic self. She decides to transition her career toward art that aligns with her values. She describes feeling more alive and purposeful. 
    - Example: “For the first time in years, I feel like I’m living the life I want, not the life I thought I should have.”

#### Key Elements of Rogerian Self-Actualization in the Case:

- **Empathy:** My understanding helps Maria feel safe to explore her true self.
- **Congruence:** I model authenticity, encouraging Maria to align her inner experiences with her external life.
- **Unconditional Positive Regard:** Maria feels valued, which helps her develop self-worth and confidence.
- **Self-Discovery:** Maria identifies her goals and overcomes barriers at her own pace, leading to personal growth.

This case involving self-actualization in person-centered therapy illustrates how the principles of client-centered therapy create a fertile ground for self-actualization.

## Summary and My Work

I provide client-centered therapy when it is a good fit for what you are coming in for and the goals you hope to accomplish. Some clients prefer more directive approaches, such as [cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/). It is possible to mix the two, though, as the treatment plan we design together can include one approach for some goals and another for others. Client-centered therapy can also be integrated with [third-wave therapies](https://dralanjacobson.com/third-wave-psychotherapy/), [existential therapy](https://dralanjacobson.com/existential-therapy/), and [psychodynamic approaches](https://dralanjacobson.com/psychodynamic-therapy/). It can be used in [family therapy](https://dralanjacobson.com/family-therapy/) as well.

These Rogerian approaches can be used with [individuals, couples, and even families](https://dralanjacobson.com/) where children are older. Person-centered therapy can also be used with groups, including groups of people who work together. If you have any questions about this approach and how it might help you, please don’t hesitate to [reach out](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Compassion Focused Therapy](https://dralanjacobson.com/compassion-focused-therapy/)

**Published:** September 25, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Compassion Focused Therapy** (CFT) is a form of psychotherapy that integrates principles from [evolutionary psychology](https://en.wikipedia.org/wiki/Evolutionary_psychology), neuroscience, and [cognitive behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT), focusing specifically on the role of empathy in emotional regulation and mental well-being. [British psychologist Paul Gilbert](https://en.wikipedia.org/wiki/Paul_Gilbert_(psychologist)) developed CFT therapy techniques, and it is designed to help individuals who struggle with high levels of shame, self-criticism, and difficulties with self-empathy. This post seeks to answer the question, “What is compassion focused therapy?” and how does it work, but please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime if you want more specific information.

## What Is Compassion Focused Therapy?

1. **Evolutionary Basis**: CFT therapy techniques are based on the idea that our brains have evolved to manage survival and social relationships and that emotions like fear, shame, and anger are normal responses to perceived threats.
2. **Three Emotion Regulation Systems**: CFT therapy proposes that humans have three primary systems that regulate emotions: 
    - Threat Protection System: This system focuses on detecting and responding to danger, often triggering fear, anger, or anxiety.
    - Drive/Excitement System: This system motivates us toward goals, achievements, and rewards and is linked to feelings of pleasure.
    - Soothing System: Helps us feel safe, content, and cared for. It is linked to self-empathy and empathy for others.
    
    In many people, the threat system is overactive, while the soothing system is underdeveloped, leading to excessive anxiety, shame, or self-criticism.\]
3. **The Role of Compassion**: This wonderful emotion motivates one to care for oneself and others to alleviate suffering. Using CFT therapy techniques, you are encouraged to develop compassion for yourself and others to balance the emotional systems and reduce distress.
4. **Self-Compassion Exercises**: Compassion Focused Therapy techniques involve imagery, breathing exercises, and mindful attention to foster a sense of warmth, safety, and kindness toward oneself. These CFT therapy techniques help cultivate the soothing system, which can regulate negative emotions.

### Who Can Benefit from CFT Therapy?

Compassion Focused Therapy techniques are particularly helpful for people who:

- Struggle with self-criticism or feelings of inadequacy.
- Have [experienced trauma](https://dralanjacobson.com/trauma-informed-care/) or complex emotional distress.
- Suffer from depression, anxiety, eating disorders, or personality disorders.
- Feel disconnected from others or have difficulty developing self-empathy.

### Compassion Focused Therapy Techniques in Brief

- **Mindful awareness**: Cultivating a non-judgmental awareness of one’s thoughts and feelings.
- **Imagery**: Visualization exercises that foster a sense of care and safety.
- **Letter writing**: Writing letters to oneself from an empathic perspective.
- **Soothing rhythm breathing**: Breathing exercises designed to stimulate the soothing system.

Overall, Compassion Focused Therapy techniques aim to help individuals learn to be more empathy toward themselves and others, leading to a greater sense of emotional balance and well-being.

## CFT Therapy Techniques

Compassion Focused Therapy techniques are designed to help individuals develop self-compassion, regulate emotions, and reduce self-criticism. Below are some key CFT therapy techniques I use:

### 1. Compassionate Mind Training (CMT)

CMT is central to CFT therapy and involves exercises that help individuals develop compassionate thinking and behavior. This helps balance the three emotion regulation systems (threat, drive, and soothing systems) and fosters a sense of safety and calm. Techniques include:

- **Soothing Rhythm Breathing**: A breathing exercise that encourages slow, rhythmic breathing to activate the soothing system. It helps regulate emotions and create a sense of calm and safety.
- **Imagery**: Guided visualizations that evoke feelings of warmth, and care. You might imagine yourself in a safe place or a caring figure offering you kindness and support.

### 2. CFT Therapy and Self-Talk

This technique helps you become aware of your internal self-critical dialogue and replace it with more care and understanding self-talk. This self-talk teaches you to respond to your needs with kindness rather than harsh criticism.

### 3. Letter Writing

Writing a letter to oneself from a caring and non-judgmental perspective helps individuals practice self-empathy. The letter may address personal difficulties, mistakes, or feelings of shame but in a tone of warmth and support. This exercise can help soften self-criticism and build emotional resilience.

### 4. Focused Therapy Imagery

In Compassion Focused Therapy imagery exercises, you visualize yourself or others in an empathic and supportive manner. This might involve imagining:

- A figure offering care and support.
- A time when they felt truly loved and cared for.
- Offering assistance to someone else who is suffering.

These visualizations help activate the soothing system and create positive emotional experiences associated with empathy.

### 5. Caring Attention

Caring attention involves focusing attention on areas of life that evoke kindness. It encourages you to notice caring acts from others, moments of kindness they show to yourself, and situations where you feel cared for.

### 6. Focus on Emotions

This technique helps you approach difficult emotions (e.g., shame, anger, anxiety) with compassion. Rather than avoiding or suppressing negative emotions, you learn to be present with their feelings and respond to them with understanding and kindness.

### 7. Compassion Focused Therapy Chair Work (or Two-Chair Dialogue)

You are asked to sit in different chairs and act out different parts of yourself. For example, one chair may represent the critical self, and another may represent the caring self. This dialogue helps you develop a more compassionate response to self-criticism.

### 8. CFT Therapy Affiliative Focusing

Compassion focused therapy techniques emphasize building affiliative emotions—feelings of connection and warmth. Affiliative focusing involves practices that help you experience these emotions, such as reflecting on moments of kindness from others or engaging in mindfulness exercises that evoke a sense of connection with others.

### 9. Developing a Compassionate Self-Identity

You are encouraged to cultivate a caring self, a part of you that is kind, understanding, and supportive. This self is developed through exercises such as:

- Imagining what it would be like to be the most caring version of oneself.
- Embodying the qualities of this self in daily life.

### 10. Mindfulness and Self-Awareness

This is one of the compassion focused therapy techniques that integrates [mindfulness techniques](https://dralanjacobson.com/mindfulness-therapy/). [Mindfulness involves being present](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) with one’s thoughts and feelings without judgment. Mindfulness helps individuals [recognize and accept their emotional experiences](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) while fostering a caring response to those experiences.

### 11. Compassion Focused Therapy Behavior Activation

This technique encourages you to act in ways that align with caring values, such as self-care, helping others, or practicing kindness. Acting in these ways can reinforce the development of deep caring both toward oneself and others.

### 12. Understanding and Rebalancing the Emotional Systems

In compassion focused therapy, you learn about the three major emotion regulation systems:

- **Threat System** (linked to fear, anxiety, and self-criticism).
- **Drive System** (associated with achievement and reward-seeking behavior).
- **Soothing System** (associated with feelings of calm, safety, and contentment).

Many CFT Therapy techniques focus on reducing the dominance of the threat system and strengthening the soothing system through caring practices.

### 13. Imagery of Caring Others

You may be guided to imagine receiving empathy from an ideal figure—someone who embodies wisdom, warmth, and strength. This figure could be real, imaginary, or symbolic. The exercise is designed to help you feel supported and cared for, especially in difficult moments.

### 14. Self-Care Breaks

In moments of distress, you are encouraged to take a “self-care break” by:

- Acknowledging your pain (“This is a moment of suffering”).
- Recognizing suffering is a common human experience (“I’m not alone in this”).
- Offering yourself kindness (“May I be kind to myself in this moment”).

These CFT therapy techniques aim to create a safe, caring internal environment that encourages emotional regulation, reduces self-criticism, and fosters mental well-being.

## What is Compassion Focused Therapy Like?

Here’s a fictitious example of how compassion focused therapy techniques might be used in my practice, particularly for someone struggling with self-criticism and shame.

### Sarah’s Background:

Sarah is a 30-year-old woman who frequently experiences intense self-criticism, particularly when she makes mistakes at work or in social situations. She feels overwhelmed by guilt and shame, believing that she is “never good enough.” As a result, Sarah often feels anxious and withdraws from others when she feels she’s failed or let them down.

### Initial CFT Therapy Session:

#### 1. Identifying the Problem

I begin by discussing Sarah’s feelings of self-criticism and shame. Sarah explains how she often feels worthless and believes she is constantly letting others down.

#### 2. Psychoeducation about Emotional Systems

I introduce the idea of the three emotional regulation systems that CFT therapy is based on:

- Threat System: Activated when Sarah feels anxious or scared of being judged or failing.
- Drive System: When she’s working hard to achieve goals, often trying to prove herself.
- Soothing System: Where compassion, calm, and safety reside—but Sarah finds it difficult to access this system.

I explain that Sarah’s threat system is overactive, especially when she makes mistakes, and that CFT therapy techniques will help her strengthen her soothing system by cultivating self-compassion.

#### 3. Soothing Rhythm Breathing

To help Sarah regulate her emotional state, I introduce her to soothing rhythm breathing.

- Sarah is encouraged to take slow, steady breaths, focusing on the rhythm of her breathing.
- I explain how this can activate the soothing system, creating feelings of calm and safety.

Sarah notices that even after a few minutes of slow, mindful breathing, she feels a bit more grounded and less tense.

### Middle CFT Therapy Sessions:

After the initial sessions, we move into developing Sarah’s CFT Therapy Techniques toolkit:

#### 4. Recognizing Self-Criticism

In subsequent sessions, I help Sarah become more aware of her inner critical voice. We explore how this self-critical part of Sarah is rooted in her fear of failure and her belief that she must be perfect to be accepted.

#### 5. Compassionate Imagery

I guide Sarah through an imagery exercise:

- Sarah closes her eyes and is asked to imagine a caring figure—someone or something that embodies warmth, strength, and understanding. This figure could be real or imaginary, and it is entirely non-judgmental and supportive.
- Sarah imagines this figure speaking kindly to her, offering words of encouragement like, “It’s okay to make mistakes. You are worthy of love and kindness, no matter what.”

After this exercise, Sarah feels emotional but more comforted, as if she has an internal ally to turn to when she feels vulnerable.

#### 6. Challenging Self-Critical Thoughts

I then help Sarah challenge some of her self-critical thoughts:

- When Sarah says, “I’m such a failure because I messed up that project,” I encourage her to reframe the thought through an empathic lens. She practices saying, “I made a mistake, but that doesn’t define me. I’m learning and trying my best.”
- This helps Sarah recognize that she can be imperfect and still deserving of kindness.

#### 7. Compassionate Letter Writing

As homework, I ask Sarah to write a caring letter to herself. In this letter, Sarah writes from the perspective of her empathic figure, responding to her current struggles with understanding and kindness. Sarah might write something like:

- “I know you’re feeling down about your performance at work, but it’s okay to make mistakes. You’re still learning, and you’re doing the best you can. I’m proud of you for showing up, even when things are tough.”

This exercise helps Sarah internalize that care and recognize that she can be supportive toward herself, just as she would be to a friend in a similar situation. Many compassion focused therapy techniques use this third person approach.

### CFT Therapy Techniques in Later Sessions:

As Sarah begins to improve, we work on more advanced compassion focused therapy techniques:

#### 8. Behavior Activation

I encourage Sarah to engage in behaviors that align with caring toward herself. We create a plan where Sarah practices self-care:

- Setting boundaries at work to avoid burnout.
- Engaging in activities that bring her joy, like reading and spending time with friends.
- Taking breaks when she feels overwhelmed, without guilt.

#### 9. Mindful Self-Care Breaks

Whenever Sarah starts to feel overwhelmed by shame or criticism, I teach her to take a self-compassion break:

- Acknowledge the pain: “This is a hard moment.”
- Remember common humanity: “Other people feel this way too; I’m not alone in this.”
- Offer herself kindness: “May I be kind to myself right now.”

Over time, Sarah learns to respond to her inner struggles with less harshness and more self-care, helping her regulate her emotions better.

### Compassion Focused Therapy Outcome:

After several months of CFT therapy techniques, Sarah feels more equipped to manage her self-critical thoughts. She no longer avoids situations out of fear of failure and can face challenges with greater self-compassion. Her shame and anxiety have significantly reduced, and she feels more connected to others, having learned that everyone experiences difficulty and that being kind to herself in those moments is a strength, not a weakness.

This example helps answer the question, What is compassion focused therapy?” by showing how it helps individuals like Sarah replace self-criticism with self-compassion, enabling them to develop emotional resilience and healthier relationships with themselves.

## Summary and My Work

CFT Therapy techniques are part of the [Third-wave of CBT](https://dralanjacobson.com/third-wave-psychotherapy/) along with [Acceptance and Commitment Therapy](https://dralanjacobson.com/act-psychotherapy/), [Gestalt approaches](https://dralanjacobson.com/gestalt-therapy/), and others. In my [integrative practice](https://dralanjacobson.com/integrative-therapy/), I provide Compassion focused therapy techniques, often mixed with similar methods for a unique and powerful treatment approach for each client. This post was designed to generally answer the question, “What is compassion focused therapy?” but please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime if you want more specific information about how it might work for you.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Therapy Approaches

---

### [Family of Origin Therapy: Impactful, Actionable Insights](https://dralanjacobson.com/family-of-origin-therapy/)

**Published:** February 16, 2025
**Author:** Dr. Alan Jacobson

**Content:**

As a psychologist specializing in Family of Origin Therapy, I help people explore how their early experiences shape their emotions, relationships, and sense of self. Many of the challenges we face in adulthood—such as difficulties with boundaries, self-doubt, anxiety, or repeating unhealthy relationship patterns—can often be traced back to the beliefs and dynamics we internalized as children. Through a compassionate and structured approach that starts with a long and enlightening list of “family of origin therapy questions,” family of origin counseling allows you to uncover these deep-rooted influences, heal past wounds, and develop healthier ways of relating to yourself and others.

Of course, everyone’s family of origin therapy experience is highly unique, so I welcome you to [call me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you’d like to learn more about how this approach could benefit you. While often for individuals, this form of treatment can also be used in [couples therapy](https://dralanjacobson.com/couples-therapy/) when issues from the past are affecting the relationship. It pairs well with many third-wave approaches, such as [acceptance and commitment therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/), and is an integral part of [trauma-informed care](https://dralanjacobson.com/trauma-informed-care/).

## What is Family of Origin Therapy?

Family of Origin Therapy is a form of psychotherapy that explores and understands how a person’s early experiences shape their beliefs, behaviors, emotional patterns, and relationships. It is rooted in systems theory and is commonly used in [Bowenian treatment](https://dralanjacobson.com/bowenian-family-therapy/) approaches.

### Key Concepts of Family of Origin Therapy:

- Patterns & Dynamics: Examines how roles, communication styles, and relational dynamics affect present-day functioning.
- Emotional Inheritance: Identifies emotional wounds, unspoken rules, and generational patterns passed down through families.
- Differentiation of Self: Helps individuals develop emotional independence while maintaining healthy connections with family members.
- Unresolved Childhood Issues: Works through past conflicts, trauma, or unmet emotional needs that impact current relationships.
- Intergenerational Transmission: Recognizes how behaviors, trauma, and coping strategies are unconsciously transferred between generations.

### Goals of Family of Origin Therapy:

- Understanding Past Influences – Identifying how early family dynamics, roles, and relationships shape present behaviors, emotions, and thought patterns.
- Breaking Dysfunctional Cycles – Recognizing and changing negative patterns inherited from childhood to foster healthier relationships and self-growth.
- Healing Unresolved Trauma – Processing past wounds, including neglect, abuse, or emotional struggles, to promote healing and resilience (Similar to [forgiveness therapy](https://dralanjacobson.com/forgiveness-therapy-steps-and-integrations/)).
- Developing Healthier Relationships – Improving communication, emotional regulation, and interpersonal skills to build stronger personal and professional relationships.
- Increasing Self-Awareness – Gaining insight into subconscious beliefs, triggers, and attachment styles to better navigate life’s challenges.
- Reframing Core Beliefs – Challenging limiting or harmful beliefs instilled during childhood that may contribute to anxiety, low self-esteem, or other struggles.
- Setting Boundaries – Learning to establish and maintain healthy boundaries with family members and others.
- Enhancing Emotional Regulation – Understanding emotional responses rooted in childhood experiences and learning healthier coping strategies.
- Empowering Personal Growth – Gaining tools to make conscious choices rather than being unconsciously driven by past conditioning.
- Improving Parenting Approaches – Helping individuals break generational cycles and parent in a way that fosters emotional security and well-being in their children.

Family of origin counseling is often used to address issues like relationship difficulties, anxiety, depression, attachment problems, and self-esteem struggles. It can benefit anyone seeking to understand themselves better and improve their interpersonal relationships.

### Family of Origin Counseling Process

In the family of origin counseling sessions, I guide you through exploring your early experiences to uncover patterns, wounds, and beliefs that influence your current emotions and relationships. Here’s how it typically works:

1. Assessment & Exploration

- I gather information about your history, relationships, and upbringing using family of origin therapy questions and worksheets.
- A genogram (a detailed family tree) may be created to map out patterns, roles, and intergenerational influences.
- We discuss childhood experiences, including rules, communication styles, and emotional dynamics.

2. Identifying Patterns & Beliefs

- I help you recognize recurring themes, such as emotional neglect, [enmeshment](https://en.wikipedia.org/wiki/Enmeshment), or unhealthy conflict styles.
- You examine how these patterns affect your current relationships, self-perception, and emotional well-being.

3. Processing Unresolved Emotions

- You explore unresolved childhood emotions, such as unmet needs, abandonment, or trauma.
- Techniques like [inner child work](https://psychcentral.com/health/how-to-heal-your-inner-child), guided visualization, or expressive writing may be used to process past experiences.
- You learn to validate your emotions and develop self-compassion.

4. Differentiation & Boundary Work

- You practice differentiation of self, meaning you learn to balance emotional independence with current connections.
- Boundaries are explored—understanding when to set limits and how to maintain a sense of self in relationships.

5. Rewriting the Narrative & Healing

- You work on [reframing past experiences](https://dralanjacobson.com/narrative-therapy/) and shifting limiting beliefs.
- Therapy may involve forgiveness work, grief processing, or reparenting techniques (learning to give oneself the care one didn’t receive).
- You develop healthier communication methods, resolve conflict, and build fulfilling relationships.

6. Applying Insights to Present Life

- I help you integrate new patterns of thinking and behavior into everyday life.
- You learn emotional regulation strategies, self-care practices, and tools for improving relationships.

### Who Can Benefit?

- People struggling with relationship patterns (e.g., repeating unhealthy dynamics).
- Those dealing with childhood trauma, neglect, or dysfunctional experiences.
- Individuals who feel stuck due to past emotional wounds.
- Anyone wanting to understand themselves on a deeper level and break generational cycles.
- Couples – Helps partners understand how their upbringing influences their current relationship.
- Parents – Encourages breaking unhealthy generational patterns to raise children differently.
- Those with anxiety, depression, or low self-esteem – Explores early influences on mental health and self-worth.
- Siblings – Improves strained relationships by addressing shared childhood experiences.

## Family of Origin Therapy Questions

These family of origin therapy questions help my clients explore their early experiences, uncover patterns, and understand how their upbringing shapes their current emotions and relationships.

1. Family of Origin Therapy Questions about Structure & Dynamics

- Who were the most influential people in your upbringing?
- What were the roles of each member?
- How were decisions made? Who had the most authority?
- Were there any unspoken rules?
- How did members handle conflict? Was it openly discussed or avoided?

2. Family of Origin Therapy Questions about Emotional Environment

- How did your family express love and affection?
- Were emotions openly discussed, or were they suppressed?
- What happened when you were sad, angry, or upset as a child?
- Did you feel emotionally safe with your caregivers?
- Were there certain emotions that were discouraged or seen as unacceptable?

3. Family of Origin Therapy Questions about Childhood Experiences & Core Beliefs

- What messages did you receive about yourself growing up?
- Did you feel like you had to earn love through achievements or behavior?
- Were you encouraged to be independent, or did you feel overly dependent?
- Were there any childhood experiences that felt particularly painful or significant?
- What were your biggest fears as a child? Do they still affect you today?

4. Family Patterns & Generational Influences

- Do you see any repeating patterns (e.g., relationship struggles, emotional avoidance, addiction, perfectionism)?
- How did your parents’ upbringing influence the way they raised you?
- Were there secrets or topics that were not allowed to be discussed?
- Did your parents model healthy relationships, or did you witness dysfunction?
- What values or beliefs were passed down through generations?

5. Current Impact & Healing

- How do your early experiences influence your relationships today?
- Do you struggle with boundaries because of your upbringing?
- What parts of your childhood do you need to heal from?
- How do you want to parent differently (if applicable) or break generational cycles?
- What beliefs do you want to keep, and which ones do you want to let go of?

Bonus: Family of Origin Therapy Inner Child Work Questions

- If you could talk to your younger self, what would you say?
- What did you need as a child that you didn’t receive?
- How can you give yourself that care, love, or validation now?

These family of origin therapy questions help guide reflection and discussion in therapy.

## Family of Origin Therapy Worksheets

These helpful tools elaborate and provide detail to the family of origin therapy questions above. They explore the dynamics, patterns, and relationships within one’s family. Family of origin therapy worksheets often guide individuals in identifying emotional issues, unresolved conflicts, and patterns that may influence current behaviors and relationships.

Here are some examples of what family of origin therapy worksheets might include:

1. Family Genogram: This worksheet allows you to map out your history, showing relationships, patterns, and key events across generations. It can help identify repeating behavioral patterns or other dynamics.
2. Family Roles Worksheet: This worksheet helps you identify your and other members’ roles and explores how these roles may have shaped your current relationships and behavior.
3. Communication Patterns Worksheet: This worksheet examines communication, focusing on unhealthy patterns like passive-aggressive behavior, avoidance, or conflict escalation.
4. Emotional Triggers Worksheet: This worksheet helps you identify situations where you feel triggered and explores whether these triggers originate from unresolved issues.
5. Boundaries Worksheet: This focuses on identifying healthy and unhealthy boundaries, allowing individuals to explore how to set more appropriate boundaries in their relationships.
6. Conflict Resolution Worksheet: This worksheet explores how conflict was handled and offers strategies for resolving conflicts more constructively in the present.
7. Values Worksheet: This worksheet helps explore the values and beliefs that were emphasized and how they impact your current worldview and behavior.

We often use a combination of questions and worksheets in family of origin therapy counseling.

## Case Example: Family of Origin Counseling for a Young Woman

- Name: Sarah
- Age: 25
- Presenting Issues: Struggles with low self-worth, difficulty setting boundaries, and anxiety in romantic relationships.
- Background: Grew up in a home where her parents had high expectations and rarely expressed affection. She often felt unseen and only received praise for academic achievements. Conflict was avoided, and emotions were not openly discussed.

### Family of Origin Counseling Process

1. Initial Assessment & Exploration (Family of Origin Therapy Questions)

During the first few sessions, I used family of origin therapy questions to help Sarah map out dynamics using a genogram. Through discussion, Sarah realizes:

- She was a “parentified child,” often mediating conflicts between her parents.
- She developed people-pleasing tendencies to gain approval.
- Now, she struggles to express her needs in relationships for fear of rejection.

2. Identifying Core Beliefs & Patterns

In early family of origin counseling sessions, Sarah and I identify irrational beliefs rooted in childhood, such as:

- “I have to be perfect to be loved.”
- “My emotions are a burden.”
- “If I disappoint people, they will leave me.”

These beliefs manifest in her adult life, causing her to overextend herself at work and in relationships, leading to burnout and resentment.

3. Processing Unresolved Emotions

Sarah does inner child work by writing a letter to her younger self, acknowledging the love and validation she never received.

- She expresses anger and sadness about feeling unseen by her parents.
- She practices self-compassion, learning to give herself the validation she craved as a child.

Through guided visualization, she imagines comforting her younger self, reinforcing that she is worthy of love regardless of achievements.

4. Boundary Setting & Differentiation

Sarah begins setting small boundaries with her family:

- She starts saying “no” without guilt.
- She practices expressing her needs instead of suppressing them.
- When feeling uncomfortable, she acknowledges that this discomfort is temporary, but boundaries lead to healthier relationships.

5. Rewriting the Narrative

As family of origin counseling progresses, I help Sarah challenge old beliefs and replace them with new affirmations:

- “I am lovable just as I am.”
- “My emotions deserve to be heard.”
- “I don’t have to earn love—I deserve it naturally.”

6. Applying Insights to Relationships

Sarah starts dating again with an awareness of her patterns. Instead of prioritizing a partner’s needs over her own, she practices:

- Communicating openly about her feelings.
- Recognizing red flags (e.g., partners who dismiss her emotions).
- Choosing relationships that feel safe and supportive rather than ones that reinforce her childhood wounds.

### Family of Origin Therapy Outcome:

After several months of family of origin counseling, Sarah reports:

- Increased self-esteem and self-acceptance.
- Better emotional regulation and self-awareness.
- Stronger boundaries with family and work.
- Healthier, more fulfilling relationships.

This case illustrates how family of origin counseling helps individuals break free from unhealthy patterns, heal childhood wounds, and build a stronger sense of self.

## Conclusion and My Work

Healing from the past doesn’t mean blaming your family—it means understanding, growing, and reclaiming your emotional well-being. Family of Origin Therapy provides a pathway to greater self-awareness, emotional freedom, and fulfilling relationships. If you’re ready to explore your past to create a healthier future, I invite you to begin this journey. Together, we can break negative cycles, strengthen your sense of self, and help you build the life and relationships you deserve.

I provide family of origin therapy mostly to individuals, but it can also be used in couples therapy when issues are affecting the relationship and in other [family therapy](https://dralanjacobson.com/family-therapy/) areas, such as with [estranged adult siblings](https://dralanjacobson.com/family-estrangement-therapy/). It can be easily interwoven with other techniques, such as [interpersonal therapy](https://dralanjacobson.com/interpersonal-therapy/), [emotion-focused therapy](https://dralanjacobson.com/emotionally-focused-individual-therapy/), [acceptance and commitment](https://dralanjacobson.com/act-psychotherapy/) (ACT), and other [third-wave approaches](https://dralanjacobson.com/third-wave-psychotherapy/).

Every course of family of origin counseling is highly unique and specifically designed around your history and goals, so please [call me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) any time if you have questions or want to learn more.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Structural Family Therapy](https://dralanjacobson.com/structural-family-therapy/)

**Published:** March 8, 2025
**Author:** Dr. Alan Jacobson

**Content:**

[Salvador Minuchin](https://en.wikipedia.org/wiki/Salvador_Minuchin) developed Structural Family Therapy techniques in the **1960s**. They address dysfunctional dynamics and interactions to promote healthier relationships and improved family functioning. Helping families reshape their relational patterns to promote positive interactions and stronger bonds starts with a therapist observing and understanding their structure, including their subsystems, roles, and power dynamics. Then, through boundary-making, enactment, and structural family therapy mapping techniques, we help families reorganize themselves to foster clearer communication, healthier relationships, and balanced power dynamics. Structural family therapy interventions are grounded in the belief that positive change naturally follows when families shift their structure.

## What is Structural Family Therapy? ![Structural Family Therapy](https://dralanjacobson.com/wp-content/uploads/2025/03/conversation-300x201.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

### Key Concepts of Structural Family Therapy

1. **Family Structure**

- **Definition:** The organized pattern of relationships and interactions (displayed by structural family therapy mapping).
- Families operate according to implicit rules and roles, such as **who is in charge**, **who is close to whom**, and **who has power** in decision-making.

2. **Subsystems**

- Families naturally divide into **subsystems** evidenced on structural family mapping based on **generation, role, and function**.
- Common subsystems include: 
    - **Parental subsystem** (parents or guardians)
    - **Sibling subsystem** (children)
    - **Spousal subsystem** (married or cohabitating partners)
- **Goal:** Ensure healthy boundaries between subsystems.

3. **Boundaries**

- **Definition:** Invisible lines that define **who participates** in a particular relationship and **how much influence** they have.
- **Types of Boundaries:**
    1. **Clear Boundaries** – Healthy; allow members to maintain their roles while staying emotionally connected.
    2. **Rigid Boundaries** – Distant relationships; little emotional connection or support.
    3. **Enmeshed Boundaries** – Overly involved relationships; lack of personal space and autonomy.

4. **Structural Family Therapy Techniques: Enactment**

- **Structural family therapy interventions** may include asking family members to **act out a conflict** or interaction during a session.
- **Purpose:** I can observe family dynamics in real time and help restructure them.

5. **Structural Family Therapy Techniques: Joining**

- I work to **“join” the system** by establishing trust and rapport.
- This helps me gain **insider access** to the dynamics and enables effective intervention.

6. **Structural Family Therapy Techniques: Restructuring**

- **Main Goal:** To use structural family therapy interventions to **reorganize the family structure** to promote healthy functioning (again, often starting with structural family therapy mapping).
- This can involve shifting power dynamics, changing roles, or setting clearer boundaries.

### Goals of Structural Family Therapy Techniques

1. **Strengthen parental authority** and restore hierarchy if necessary.
2. **Clarify boundaries** between subsystems to [reduce enmeshment](https://www.simplypsychology.org/what-is-enmeshment.html) or rigidity.
3. **Promote autonomy** among members while maintaining healthy connections.
4. **Rebuild interaction patterns** to improve overall functioning.

### Brief Example of Structural Family Therapy in Practice

**Scenario:**
A 15-year-old teenager is acting out and skipping school. The mother feels helpless, and the father is disengaged. The parents often undermine each other in front of him.

**My Role:**

- **Join the family** to observe their dynamic.
- Notice that the mother and child have an **enmeshed relationship** (overly close), and the father is disengaged.
- Structural family therapy interventions: 
    - **Empowering the father** to take a more active role in discipline.
    - **Reinforcing clear boundaries** between parent and child.
    - Helping the mother step back and reduce enmeshment.

Why are Structural Family Therapy Techniques Effective?

- Structural family therapy techniques target the **root cause** of conflict: dysfunctional relationship mapping and boundaries.
- They emphasize **action and change** rather than simply talking about feelings.
- They provide **clear and practical solutions** for families to improve their dynamics.

- 

## Structural Family Therapy Techniques

Here are the **Structural Family Therapy (SFT) techniques** that I commonly use

### Structural Family Therapy Joining Techniques

**Definition:**

- **Joining** means intentionally becoming **part of the system** to understand its dynamics and build trust.
- I do not remain a distant observer but **actively engage** with the family.

**Purpose:**

- Gain **trust**.
- Understand the unspoken rules and roles.
- Help members feel comfortable in therapy.

**How It Works:**

- **Mimic their communication style.**
- Match their **energy**, humor, or tone.
- If they are formal, I become formal.
- If they are loud or playful, I may match their tone to blend in.

**Example:**

- If they uses humor to cope, I may also use humor to connect with them.
- If the father is very formal, I may initially engage him in a formal tone to build trust.

### Enactment (Acting Out Family Dynamics)

**Definition:**

- **Enactment** involves asking members to **act out a conflict or interaction** in therapy.
- Instead of just talking about problems, they demonstrate them.
- This allows me to **observe the structure in real time.**

**Purpose:**

- **See the family dynamics** in action.
- Identify **coalitions, enmeshment, rigid boundaries, and power imbalances.**
- Provide an opportunity for **immediate intervention.**

**How It Works:**

- I say:

*“Can you show me what happens when you two argue at home?”*

- Members reenact the argument, allowing me to observe: 
    - Who has power?
    - Are there clear or blurred boundaries?
    - Is anyone disengaged or overinvolved?

**Example:**

- **Mother and daughter** fight constantly.
- I ask them to **reenact** a recent argument.
- During the enactment, the mother **talks over the daughter**, and the father remains **silent**.
- I now **see the enmeshment between mother-daughter** and **disengagement of the father**.
- This leads to targeted intervention.

### Boundary Making in Structural Family Therapy

**Definition:**

- **Boundary-making** is the process of **strengthening, loosening, or clarifying boundaries** between members.
- Families can have three types of boundaries: 
    - **Clear boundaries** → Healthy.
    - **Rigid boundaries** → Disengagement.
    - **Enmeshed boundaries** → Overinvolvement.

**Purpose:**

- **Address boundaries** to promote healthy autonomy and closeness.
- Prevent overinvolvement (enmeshment) or excessive distance (disengagement).

**How It Works:**

- If a **parent and child are enmeshed**, I may encourage the parent to: 
    - Allow the child to solve their own problems.
    - Avoid speaking on behalf of the child.
- If members are **disengaged**, I may: 
    - Encourage more shared activities.
    - Promote more direct communication.

**Example:**

- **Mother and daughter are enmeshed.**
- Daughter says: *“I can’t make any decisions without my mom.”*
- I intervene: 
    - *“Mom, could you let her answer for herself?”*
    - *“Daughter, could you practice making this decision without your mom?”*
- This **creates space (clear boundaries)** for the child to develop independence.

### Unbalancing (Shifting Power Dynamics)

**Definition:**

- **Unbalancing** means I **temporarily support one member** to **shift the power balance**.
- This is often done when one person has **too much power** or another is **disempowered.**

**Purpose:**

- **Empower the marginalized members.**
- **Reduce the dominance** of a powerful member.
- Reform the hierarchy.

**How It Works:**

- If a **father dominates**, I may intentionally **side with the mother or child**.
- This **shifts the power balance** and helps the weaker member find their voice.

**Example:**

- Father constantly interrupts his wife and children.
- I say:

*“Let’s hear from your wife for a moment without interruption.”*

- I then **validate the wife’s input**, disrupting the power balance.
- This promotes a more **balanced dynamic.**

### Restructuring

**Definition:**

- This is the **core goal** of Structural Family Therapy interventions.
- It involves **actively changing roles, boundaries, and power dynamics** to promote healthier functioning.

**Purpose:**

- Reduce enmeshment or disengagement.
- Restore a clear parental hierarchy.
- Encourage independence in children.

**How It Works:**

- I may: 
    - Shift decision-making power to parents.
    - Encourage children to take responsibility.
    - Break unhealthy coalitions (like mother-child vs. father).

**Example:**

- **Problem:** Father is disengaged; mother and child are enmeshed.
- **Intervention:**
    - I instruct the father to **take a more active role in discipline**.
    - Mother steps back and allows the father to lead.
    - Child learns to operate independently.
- This **reforms the hierarchy.**

### Using Structural Family Therapy Interventions to Reframe

**Definition:**

- **Reframing** means **changing the interpretation of a behavior** so it seems less negative or more manageable.
- This reduces **defensiveness** and encourages change.

**Purpose:**

- Help members **see each other differently.**
- Reduce blame and increase empathy.
- Promote **problem-solving** rather than conflict.

**How It Works:**

- If a child is acting out, instead of labeling them as “bad,” I may say:

*“Maybe your child is trying to get your attention because they feel disconnected.”*

- This **shifts perception** and promotes empathy.

**Example:**

- **Mother says:** *“My son is lazy.”*
- **I reframe:** *“Maybe your son lacks motivation because he feels disconnected.”*
- This reduces blame and increases understanding.

### Challenging the Family Myth (Disrupting False Beliefs)

**Definition:**

- Family myths are **false beliefs** families create to explain their problems.
- These myths often maintain dysfunction.

**Purpose:**

- Expose and disrupt false beliefs.
- Create a new, healthier narrative.

**Example:**

- **Myth:** *“Dad doesn’t care about us.”*
- **Me:** *“Could it be that Dad expresses care differently?”*
- This **breaks the myth** and helps them see new possibilities.

### Shaping Competence (Reinforcing Positive Change)

**Definition:**

- I **praise and reinforce** positive changes in the dynamic.
- This helps them gain confidence in their ability to change.

**Purpose:**

- Strengthen new, healthier patterns.
- Help families maintain positive changes after therapy ends.

**Example:**

- Child speaks up confidently for the first time.
- I say:

*“Wow! That was amazing! You expressed yourself clearly. Keep doing that!”*

- This **reinforces new, healthy behavior**.

## Case Example of Structural Family Therapy

- **Client:** 14-year-old girl named **Emily**.
- **Presenting Issues:**
    - Frequent **arguments with her mother (Lisa)**.
    - Emily has **become defiant**, refusing to follow household rules.
    - Emily spends **most of her time isolated** in her room.
    - **Father (John)** remains distant and uninvolved.
- **Family Structure:**
    - Mother (Lisa) is **overinvolved (enmeshed)** with Emily.
    - Father (John) is **disengaged** and rarely disciplines Emily.
    - Emily has **no clear boundaries** and feels smothered by her mother.

### Session 1: Structural Family Therapy Techniques for Joining

**Goal:**

- Use structural family therapy techniques to build rapport with the family.
- Observe family dynamics.
- Identify power structure, boundaries, and subsystems.

**What I Observe:**

**Family Member****Behavior Observed****Mother (Lisa)**Constantly speaks for Emily and interrupts her.**Father (John)**Quiet, avoids conflict, disengaged.**Emily (Daughter)**Defiant, avoids eye contact, stays silent.**Enactment (Technique):**

- **Me:** *“Can you show me what happens when you two argue?”*
- **Emily (defiant):** *“She never listens to me anyway.”*
- **Mother (angry):** *“You just lock yourself in your room and ignore me!”*
- **Father:** *silently watches*.

**Structural Family Therapy Mapping Analysis:**

- **Enmeshment:** The mother is overly involved in Emily’s life, smothering her.
- **Disengagement:** The father remains uninvolved, leaving parenting to the mother.
- **Power Imbalance:** The mother holds all the power, while the father is passive.

### Session 2: Boundary Making (Restructuring Enmeshment)

**Goal:**

- Use structural family therapy techniques to begin separating the mother from the daughter (reduce enmeshment).
- Encourage the father to take a more active role.

**Structural Family Therapy Interventions to Stop the Enmeshment**

- **Me:** *“Lisa, I notice you answer a lot for Emily. Can I ask you to let Emily answer for herself?”*
- **Mother (hesitant):** *“But she never talks!”*
- **Me:** *“Let’s try. Emily, how do you feel when your mom speaks for you?”*
- **Emily:** *“Like I don’t matter.”*
- **Me:** *“Lisa, what’s it like hearing that?”*
- **Mother (tearful):** *“I thought I was protecting her.”*

**Purpose:**

- This helps **establish clear boundaries** between mother and daughter.
- It forces Emily to **speak for herself**.

**Structural Family Therapy Interventions to Engage the Father (Unbalancing)**

- **Me (to father):** *“John, I noticed you stay quiet during these conflicts. Why is that?”*
- **Father:** *“Lisa handles it better.”*
- **Me:** *“But Emily also needs you. Could you step in when conflict arises?”*
- **Father:** *“I guess I could try.”*
- **Me:** *“Lisa, can you step back and let John take the lead sometimes?”*
- **Mother (hesitant):** *“I don’t know if he will.”*
- **Me:** *“Let’s give it a try this week.”*

**Purpose:**

- **Unbalance the power dynamic** by shifting some parental responsibility to the father.
- This **reduces enmeshment** between mother and daughter.

### Session 3: Structural Family Therapy Mapping, Part 1

**Goal:**

- Use structural family therapy mapping to show current dynamics
- Shift power from child → parents.
- Strengthen the parental hierarchy.

**Structural Family Therapy Interventions: Restructure the Hierarchy**

- **Me:** *“Emily has been the one controlling the dynamic by withdrawing or becoming defiant. We need to shift that control back to the parents.”*
- **Father:** *“What do we do?”*
- **Me:** *“John, you need to start setting clear rules and following through with consequences.”*
- **Me (to mother):** *“Lisa, you need to let John step in without interfering.”*
- **Mother (hesitant):** *“But what if he’s too harsh?”*
- **Me:** *“You’ll have to trust his parenting. Emily needs to see you two as a team.”*

**Purpose:**

- This **restores the parental hierarchy**.
- Emily stops having power by controlling conflict and withdrawal.
- The father becomes **more engaged**, reducing mother-daughter enmeshment.

### Session 4: Structural Family Therapy Mapping, Part 2

**Goal:**

- Use structural family therapy mapping to create a new, healthier map
- Solidify new roles.
- Ensure boundaries remain clear.

**Structural Family Therapy Interventions: Boundary Making**

- **Me (to mother):** *“Lisa, I noticed you didn’t interrupt Emily today. How did that feel?”*
- **Mother:** *“Hard, but I see her speaking up more.”*
- **Me:** *“That’s exactly the goal. She’s reclaiming her space.”*
- **Me(to father):** *“John, you’ve stepped in a lot more lately. What’s changed?”*
- **Father:** *“I realized my daughter needed me.”*
- **Me (to Emily):** *“How has that been for you?”*
- **Emily:** *“Weird… but better.”*

✅ **Purpose:**

- The **boundaries have shifted** from enmeshment to clear roles.
- Emily no longer controls the family with defiance.
- Parents now work as a team.

### Session 5: Structural Family Therapy Techniques to Prevent Relapse

**Goal:**

- Prevent them from falling back into old patterns.

**Structural Family Therapy Interventions: Shaping Competence (Reinforcing Positive Change)**

- **Me:** *“I’ve noticed a huge difference in how you all relate to each other.”*
- **Mother:** *“Yeah, I’m letting John lead more.”*
- **Father:** *“And Emily listens more now.”*
- **Me:** *“That’s because the structure has changed. Keep it up.”*
- **Emily:** *“It feels better now.”*

**Purpose:**

- Reinforce the **new structure**.
- Prevent regression into enmeshment or disengagement.

### Final Structural Family Mapping After Therapy

**Family Member****Before Therapy (Unhealthy)****After Therapy (Healthy)****Mother (Lisa)**Overinvolved, controlling Emily.Allows Emily independence, supports her growth.**Father (John)**Disengaged, avoids conflict.Actively involved, sets boundaries.**Emily (Daughter)**Defiant, isolated, controlling conflicts.Communicates openly, less defiant.**Therapeutic Outcome (Success)**

**Structural Family Therapy Mapping Before****Structural Family Therapy Mapping After****Enmeshment**Clear parent-child boundaries.**Disengaged father**Active, authoritative father.**Defiant adolescent**Increased responsibility, less conflict.**Parent power imbalance**Balanced parental power.## Summary and My Work

### Integrative Structural Family Therapy

**The best use of Structural Family Therapy** involves [**integrating complementary approaches** ](https://dralanjacobson.com/integrative-therapy/)and modifying techniques. Below are the strategies I use:

#### 1. To Ensure Individual Mental Health Issues are taken into consideration

- Structural family therapy techniques primarily focus on **structure and dynamics**, often **neglecting individual mental health issues** like: 
    - Depression
    - Anxiety
    - Trauma
    - Substance abuse
- This can make the client feel like their **personal struggles are being ignored**.

**How to Manage:**

- Combine structural family therapy Interventions with [**individual therapy**](https://dralanjacobson.com/individual-therapy/) (such as CBT or trauma-informed care) alongside SFT.
- Allow certain members to **receive individual sessions** if their mental health is significantly impacting dynamics.
- Educate them about how **mental health** conditions affect behavior, communication, and interaction patterns.
- Example: If a child has **anxiety**, help them understand how anxiety may influence the child’s behavior.
- When mental health issues are evident, I pause and provide some direct mental health intervention (like [mindfulness-based stress reduction](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/), etc.) before continuing with SFT.

#### 2. If One Member is Unwilling

- Structural family therapy techniques assume **all members** will participate in therapy.
- However, **one or more members** may refuse to join, making it hard to restructure the dynamic.

**How to Manage:**

- If a member refuses to attend, begin therapy with the **willing members**.
- Gradually work towards **bringing the resistant member in** once positive changes are evident.
- Even if a member does not attend, their influence still exists in the dynamic so I help the attending members change **how they respond** to the absent member’s behavior. This can indirectly influence the absent member’s behavior.
- If the resistant member attends but refuses to engage, I use [**Motivational Interviewing**](https://dralanjacobson.com/motivational-interviewing/) to explore their resistance.
- Ask questions like: 
    - *“What would need to change for you to feel comfortable participating?”*
    - *“What do you think would happen if you don’t engage in therapy?”*

#### 3. Address Past Trauma

- Structural family therapy interventions are **present-focused**.
- This often **ignores past trauma**, which may be the root cause of dysfunction.
- Example: 
    - If a child was abused in the past, the dysfunctional structure may have developed as a **response to trauma**.
    - Simply restructuring the family will not resolve the trauma itself.

**How to Manage:**

- Combine s**tructural family therapy interventions with trauma-informed care**, where I: 
    - Acknowledge the trauma history.
    - Help them understand how trauma shaped their current relationships.
    - Provide **healing techniques** like grounding, trauma-processing, or mindfulness.
- Introduce **genograms** to help uncover trauma patterns across generations. 
    - Example: If the mother experienced abuse in her childhood, she may unconsciously **overprotect her child**, leading to **enmeshment**.
    - Uncovering these patterns allows me to act with compassion and trauma-awareness.
- If a trauma memory surfaces, temporarily **shift the focus** to trauma processing.
- Resume SFT once the trauma has been addressed.

#### 4. Cultural Differences

- Structural family therapy interventions assume that **clear boundaries** and **hierarchical structures** are ideal for all families.
- However, dynamics **differ across cultures**; some may thrive in **non-traditional structures**.
- Example: 
    - In some **collectivist cultures**, enmeshed boundaries are seen as a sign of **care** rather than dysfunction.

**How to Manage:**

- Acknowledge cultural influence.
- I do not force a “Western” family structure on clients from different cultural backgrounds.
- Instead of imposing clear boundaries, ask: 
    - *“What would a healthy dynamic look like to you?”*
    - *“Would you like to create more space between members or maintain closeness?”*
- If they prefer to maintain **enmeshed boundaries**, **focus on making the enmeshment healthy** rather than eliminating it.
- Example: 
    - Promote **mutual respect** and **balanced communication** rather than forcing distance.

#### 5. Focuses on Behavior, Not Emotion

- Structural family therapy interventions **focus heavily on behavior and structure** but often ignore **emotional experiences**.
- This can leave members feeling emotionally invalidated.

**How to Overcome It:**

- Combine structural family therapy interventions with **[Emotion-Focused Family Therapy](https://dralanjacobson.com/emotionally-focused-family-therapy/) (EFFT)**
- **Pause for Emotional Processing**: 
    - When a deep emotion surfaces during SFT, pause and say:
    - *“Can we slow down and sit with what just came up emotionally?”*
    - This validates emotions while still promoting change.
- Help members label their emotions during interactions.
- Example: 
    - *“It sounds like you feel unheard when your son ignores you.”*
    - *“Can you express that feeling directly to him?”*
- This promotes **both emotional connection and structural change**.

## Summary and My Work

Structural Family Therapy does not assign blame but understands how the system maintains the presenting problem. Families can break free from dysfunctional patterns and build healthier connections by shifting boundaries, addressing power dynamics, and strengthening the parental hierarchy. Witnessing families gain a renewed sense of balance and understanding through these changes is always rewarding. I use structural family therapy techniques to guide families toward healthier functioning, where each member can thrive individually while remaining deeply connected as a unit. SFT ultimately empowers families to discover their solutions, fostering resilience and long-term positive change.

I often mix SFT with other forms of treatment, including [therapy for estrangement](https://dralanjacobson.com/family-estrangement-therapy/) and [solution-focused family therapy](https://dralanjacobson.com/solution-focused-family-therapy-focusing-on-positive-change/). With older children, we can do this [treatment virtually](https://dralanjacobson.com/virtual-therapy-guide/).

If you have any questions about structural family therapy techniques, we might use together and how they might benefit your family, or any other questions, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Family therapies

---

### [Supportive Psychotherapy](https://dralanjacobson.com/supportive-psychotherapy/)

**Published:** November 8, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Supportive psychotherapy** is a form of treatment aimed at helping individuals manage their symptoms and improve their emotional well-being. It focuses less on deep insight or uncovering unconscious conflicts (as seen in [psychodynamic treatment](https://dralanjacobson.com/psychodynamic-therapy/) methods) and more on offering practical support, guidance, and validation. **Supportive psychotherapy techniques** are commonly used across a range of conditions, especially when new clients want to try things out before engaging in more intensive or exploratory forms of treatment. When something significant arises, **brief supportive psychotherapy** can be done within any longer-term therapy course.

## Supportive Psychotherapy Overview

The following is an overview of supportive psychotherapy, including its goals, techniques, therapist role, and when it is used.

### Goals of Supportive Psychotherapy

- **Symptom Relief**: Supportive psychotherapy techniques help reduce distress and manage symptoms.
- **Enhance Coping**: Strengthen adaptive coping mechanisms and resilience.
- **Build Self-Esteem**: Offer encouragement to bolster self-worth and esteem.
- **Provide Stability**: Offer a consistent, safe therapeutic environment.
- **Promote Insight**: Facilitate self-awareness when appropriate.

### Techniques in Supportive Psychotherapy

1. **Empathy and [Active Listening](https://positivepsychology.com/active-listening-techniques/)**: Establishing a strong therapeutic alliance through compassionate understanding.
2. **Reassurance**: Offering comforting and realistic encouragement to help you feel supported.
3. **Advice and Guidance**: Providing practical suggestions and problem-solving strategies tailored to your needs.
4. **Reality Testing**: Helping you differentiate between your thoughts and reality, particularly useful for those experiencing distortions in thinking.
5. **Clarification and Reflection**: Helping you articulate your thoughts and feelings more clearly.
6. **Encouragement of Adaptive Behaviors**: Reinforcing positive coping strategies and adaptive responses.

### Indications for Supportive Psychotherapy

- [**Adjustment Disorders**](https://en.wikipedia.org/wiki/Adjustment_disorder): Help you cope with life stressors, times that will pass but cause distress and anxiety when they happen.
- [**Life Transitions**](https://psychologicalassessments.com/life-transitions-testing/): Where a place to talk through decisions and pathways can reduce stress and increase insight
- [**Depression and Anxiety**](https://dralanjacobson.com/therapy-for-depression-and-anxiety/): When individuals need a non-judgmental space to express themselves.
- [**Learning Disorders and ADHD**](https://dralanjacobson.com/adhd-therapy-for-adults/): Maintaining a consistent, validating, mentoring environment is key to help people [overcome a learning disability](https://dralanjacobson.com/therapy-for-people-with-learning-disorders/) or the effects of ADHD.
- **Medical Illness**: Supportive therapy can help those dealing with chronic pain or other serious health issues.

### Therapist’s Role

In supportive psychotherapy, I am an active and empathetic participant. Unlike purely analytical therapies, I may offer more direct advice, cheerlead for your progress, and work collaboratively to reinforce your strengths and potential.

### Differences from Other Forms of Therapy

- **Compared to [Cognitive-Behavioral Therapy](https://dralanjacobson.com/cbt-for-depression/) (CBT)**: Supportive psychotherapy is less structured and directive. It does not typically involve homework or specific behavioral techniques but may include them if useful.
- **Compared to [Psychodynamic Therapy](https://dralanjacobson.com/psychodynamic-therapy/)**: Brief supportive psychotherapy techniques focus more on here-and-now issues rather than exploring deep-seated unconscious conflicts from childhood.
- **Compared to [Psychoanalysis](https://en.wikipedia.org/wiki/Psychoanalysis)**: It is less intense, less frequent, and more oriented toward practical support rather than free association and transference analysis.

### Effectiveness of Supportive Psychotherapy

Research has shown supportive psychotherapy to be effective in various contexts, especially as part of a broader, integrated treatment plan. It can help with:

- Reducing distress, building strength and resilience, and enhancing the quality of life.
- Improving awareness of self-help strategies and other holistic forms of wellness and treatment.
- Providing a therapeutic anchor, especially when you are dealing with overwhelming external stressors.

## Example of Brief Supportive Psychotherapy

The following is a short example of what a brief supportive psychotherapy session might be like.

**Scenario:** A 40-year-old woman recently lost her job and is experiencing feelings of loneliness and self-doubt. She has come to therapy looking for help with managing her emotions and finding ways to cope. We decided to start with brief supportive psychotherapy, and we may move to a different approach when she feels a bit better.

---

**Me:** “It sounds like you’re feeling very alone right now, and it’s hard to adjust after such a big change in your life. That’s a lot to carry. I’m here to support you through this process.”

**Client:** “Yes, it’s been really difficult. I keep thinking I should have done more to make the job work. I just feel like I failed.”

**Me:** “I hear you. It’s normal to have those thoughts after a job loss, but it’s important to remember that many factors were behind this change. It sounds like you’re placing all the blame on yourself, even though you tried very hard.”

**Client:** “Maybe, but it’s hard not to feel like I’m the problem.”

**Me:** “I can understand why you feel this way. Be kind to yourself; you’ve gone through a big loss. Let’s focus on what you need right now to start healing. What are some things that have helped you feel better, even for a moment, over the past few weeks?”

**Client:** “Talking with friends has helped, and I’ve been trying to get out of the house for walks, but it’s hard to find the energy.”

**Me:** “It’s great that you’ve been reaching out to friends and getting some fresh air. Those are positive steps, even when they feel small. You’re showing a lot of resilience, even in the face of all this pain. Maybe we can think of one more small step you could take this week to build on that.”

---

### Techniques Used

1. **Empathy and Validation:** I acknowledge her emotions without judgment.
2. **Normalizing Feelings:** Helps her understand that her thoughts and feelings are common after a major life event like divorce.
3. **Support and Encouragement:** Reinforces her existing strengths and efforts.
4. **Practical Advice:** Collaborates on setting a small, achievable goal to help her feel a sense of progress.
5. **Reframing Negative Thoughts:** Gently challenges self-blame and encourages a more balanced perspective.

This brief supportive psychotherapy approach helps you feel heard, supported, and empowered to take small steps toward recovery. Brief supportive psychotherapy focuses on emotional support and practical strategies rather than deep analysis, which may come later in longer-term approaches.

## Supportive Psychotherapy Techniques for Teenagers

Brief supportive psychotherapy techniques for teenagers are tailored to consider their developmental stage, unique challenges, and need for autonomy. Adolescents often face issues like identity formation, peer pressure, academic stress, family dynamics, and emerging mental health concerns. Supportive psychotherapy techniques with teens aim to establish trust, provide a safe space for expression, and offer practical coping strategies.

### Supportive Psychotherapy Techniques for Teenagers

#### 1. Active Listening and Validation

- Supportive Psychotherapy Techniques Example: “I can see that this situation with your friends has been really tough for you. It makes sense that you’d feel upset about this.”
- Why It Works: Teenagers often feel misunderstood or invalidated by adults. Active listening and validating their feelings build rapport and trust, making them more likely to open up.

#### 2. Normalizing and Reassurance

- Example: “Feeling anxious about school and fitting in is normal. Many teens go through this phase, and it’s okay to talk about what’s worrying you.”
- Why It Works: Teens often feel isolated in their struggles. Normalizing helps them understand that their experiences are common and not alone.

#### 3. Encouragement and Positive Reinforcement

- Example: “You’ve shown great strength in dealing with this conflict. It’s impressive that you reached out instead of keeping it all in.”
- Why It Works: Adolescents are developing their self-esteem, and positive reinforcement can help boost their confidence and encourage adaptive behaviors.

#### 4. Problem-Solving and Decision-Making Support

- Example: “Let’s brainstorm some options together for how you might handle the situation with your teacher. What do you think could be a good first step?”
- Why It Works: Teens are learning to navigate complex social and academic situations. Collaborative problem-solving empowers them and builds their decision-making skills.

#### 5. Psychoeducation

- Example: “Feeling sad or anxious sometimes doesn’t mean something is wrong with you—it’s part of being human, especially during the teenage years when so much is changing.”
- Why It Works: Educating teens about everyday emotional experiences and mental health can reduce stigma, increase self-awareness, and help them make sense of their feelings.

#### 6. Supportive Psychotherapy Techniques and Reality Testing

- Example: “You mentioned that everyone at school hates you because of what happened. Let’s take a step back—can we think of some friends or classmates who have been supportive of you?”
- Why It Works: Teenagers may experience cognitive distortions, like all-or-nothing thinking. Reality testing helps them see the situation more objectively and reduces catastrophizing.

#### 7. Supportive Exploration of Identity

- Example: “It’s okay to feel unsure about who you are right now. Exploring different interests and styles is part of figuring out what’s important to you.”
- Why It Works: Adolescence is a critical time for identity formation. Providing a non-judgmental space for teens to explore their interests and values can help them feel more secure in their sense of self.

#### 8. Encouraging Healthy Coping Strategies

- Example: “You said listening to music and drawing have helped you calm down when overwhelmed. Those sound like great ways to take care of yourself. Are there any other activities you might want to try?”
- Why It Works: Many teens struggle with regulating emotions. Encouraging healthy coping strategies helps them develop skills they can use throughout life.

#### 9. Establishing Boundaries and Setting Limits

- Example: “I want to support you, but I must also ensure you’re safe. If you ever feel like harming yourself, we must involve a trusted adult who can help you through it.”
- Why It Works: Setting clear boundaries is crucial for maintaining a safe and effective therapeutic relationship with teens while also modeling healthy boundaries for them.

#### 10. Use of Humor and Relatability

- Example: “High school can feel like a rollercoaster, right? One minute, everything’s great, and the next, it feels like the end of the world. We can work on making those ups and downs a bit easier to handle.”
- Why It Works: Appropriate use of humor can help break the ice, reduce tension, and make the therapist seem more relatable, which can be especially important for building rapport with adolescents.

### Supportive Psychotherapy For Teens Case Example

Emma is a 15-year-old high school sophomore referred to therapy by her school counselor due to persistent anxiety, feelings of inadequacy, and withdrawal from peers. Her parents report that Emma has become more irritable at home and avoids social situations, including school activities. She experiences difficulty concentrating in class and often criticizes herself for minor mistakes.

#### Initial Assessment:

Emma is a bright student who struggles with perfectionism and worries about being judged by others. She reports feeling “not good enough” compared to her peers. During the initial sessions, Emma expressed discomfort opening up but appreciated having a safe space to share her thoughts.

#### Supportive Psychotherapy Goals:

1. Reduce feelings of anxiety and self-criticism.
2. Improve self-esteem and resilience.
3. Encourage healthy peer interactions.

#### Supportive Psychotherapy Techniques Chosen

1. **Establishing Rapport:**
    I created a warm and non-judgmental environment, emphasizing Emma’s strengths, such as her creativity and empathy. Trust-building exercises included discussing her favorite hobbies (drawing and reading) and validating her emotions.
2. **Emotion Regulation Techniques:**
    I introduced grounding exercises, such as deep breathing and [mindfulness-based stress reduction](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) activities, to help Emma manage her anxiety in stressful situations. Role-playing scenarios, like presenting in class or handling peer conflict, helped Emma rehearse responses in a safe space.
3. **Addressing Negative Self-Talk Through [Cognitive Restructuring](https://dralanjacobson.com/cognitive-restructuring/):**
    Through gentle questioning, I guided Emma to identify and [challenge her automatic negative thoughts](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/). For example, Emma often said, “I’ll never be as good as my friends.” I helped her reframe these thoughts: “I have different strengths, and that’s okay.”
4. **[Strength-Based Approach](https://positivepsychology.com/strengths-based-interventions/):**
    I encouraged Emma to focus on her achievements, like completing a challenging art project. Positive reinforcement helped Emma recognize her capabilities, boosting her confidence.
5. **Encouraging Social Connection:**
    Emma was supported in setting small, achievable social goals, such as inviting a friend to lunch or joining an art club. I provided coaching on initiating and maintaining conversations.

#### Progress:

Over several months, Emma reported feeling more comfortable expressing her emotions. She started participating in group activities at school and reported fewer episodes of self-criticism. While still facing challenges, Emma began to view herself more compassionately and showed an improved ability to manage her anxiety.

#### Conclusion:

Brief supportive psychotherapy helped Emma develop coping skills, build self-esteem, and navigate her social world more effectively. Regular check-ins and booster sessions ensured sustained progress.

### Final Thoughts

Brief supportive psychotherapy techniques for teenagers require flexibility, patience, and a strong focus on building trust. By offering empathy, practical support, and a safe space for self-expression, I can provide [therapy for teens](https://dralanjacobson.com/therapy-for-teens/) to help them navigate their challenges and foster resilience.

## Conclusions and My Work

Supportive psychotherapy is flexible and adaptable, emphasizing a strong therapeutic relationship, validation, and practical support. It can be particularly valuable for clients who need a safe space to express themselves, are dealing with chronic conditions, or may not yet be ready for more intensive [types of therapy](https://dralanjacobson.com/types-of-therapy/). It meets clients where they are and helps them build on their existing strengths. A more intensive treatment course can follow brief supportive psychotherapy, or a deeper course would be [supportive-expressive therapy](https://dralanjacobson.com/supportive-expressive-therapy/). A great example of how this approach might be used is in [counseling for single moms and dads](https://dralanjacobson.com/therapy-for-single-moms-and-dads/).

If you have specific questions or want to discuss how supportive psychotherapy might work for you or a loved one, don’t hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Therapy for Generalized Anxiety Disorder](https://dralanjacobson.com/therapy-for-generalized-anxiety-disorder/)

**Published:** December 24, 2023
**Author:** Dr. Alan Jacobson

**Content:**

I offer **therapy for Generalized Anxiety Disorder** (GAD). This challenge can be difficult to overcome, but **therapy for GAD** can effectively manage it. The following describes **generalized anxiety disorder treatment**, including the approaches I use to treat it and the results you can expect. Of course, you are also welcome to [schedule a consultation](https://www.picktime.com/scheduleaconsult) or [contact me](https://dralanjacobson.com/contact/) to hear more about how therapy for GAD could help you.

### What is Generalized Anxiety Disorder?

Generalized Anxiety Disorder (GAD) is a mental health condition characterized by excessive and persistent worry or anxiety about a variety of everyday situations. People with GAD often find it challenging to control their worry, and it can interfere with their daily life. The anxiety associated with GAD is not necessarily focused on specific events or situations but is more vague but powerful.

Common symptoms of GAD include:

1\. Excessive worry: Constant, pervasive worry about various aspects of life, such as work, health, family, or other issues.
2\. Restlessness: Feeling on edge, irritable, or easily fatigued.
3\. Muscle tension: Physical symptoms like muscle tension or headaches are common as anxiety seeks an outlet.
4\. Difficulty concentrating: Finding it hard to focus or experiencing the mind going blank.
5\. Sleep disturbances: Problems with falling, staying, or having restless sleep.

The [exact cause of GAD](https://adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad) is not well understood, but a combination of genetic, biological, environmental, and psychological factors may contribute to its development. Generalized anxiety disorder treatment is often effective, and it is a common referral reason for clients I see in my practice.

## Therapy for GAD Therapeutic Approaches

Here are some common therapeutic approaches I use for GAD, often braided together as part of my [integrative therapy practice](https://dralanjacobson.com/integrative-therapy/):

### Cognitive Behavioral Therapy for GAD

CBT, as a generalized anxiety disorder treatment, helps identify and challenge negative thought patterns and beliefs that contribute to anxiety. It involves learning coping skills, relaxation techniques, and gradual exposure to worry-provoking situations. This is often my first approach when I am choosing a therapy for GAD that can have relatively fast effects on increasing motivation and excitement about treatment prospects. People with GAD often have many irrational and exaggerated negative thoughts, and a [CBT approach](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) is perfect for reducing the intensity and frequency of this thinking.

### Mindfulness-Based Stress Reduction (MBSR)

This therapy for generalized anxiety disorder involves [mindfulness meditation](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) and yoga to help increase awareness of the present moment. It teaches individuals to observe their thoughts and feelings without judgment. While this therapy does not do as much to reduce symptoms as CBT – which is why I often weave them together – it does bring a different kind of relief. MBSR provides a toolkit to help people manage stress and anxiety and thus can have lasting results.

### Acceptance and Commitment Therapy for Generalized Anxiety Disorder

[ACT psychotherapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) combines mindfulness strategies with the acceptance of uncomfortable thoughts and feelings. It helps individuals clarify their values and commit to a meaningful life. It is very similar to MBSR in that it does not reduce the frequency of symptoms as much as it reduces their effect. People with GAD need to accept who they are, and that worry is part of their experience, even as we work to reduce that anxiety. ACT can have fast results that prove to be motivating for continued treatment

### Dialectical Behavior Therapy for GAD

Originally developed to treat borderline personality disorder, [Dialectical Behavior Therapy](https://www.yalemedicine.org/conditions/dialectical-behavior-therapy-dbt) has components useful as a GAD treatment. It focuses on emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness. I borrow from DBT in my work, but if you feel like this is an approach you would like as a primary treatment, I can refer you.

### Exposure Therapy for Generalized Anxiety Disorder

[Exposure therapy](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/) for GAD involves gradually exposing oneself to anxiety-provoking situations or objects in a controlled and safe environment. Over time, this helps reduce worry responses. In this case, the treatment involves a lot of homework, where you go at your own pace and try to do more as time progresses. This treatment approach is suited to those with general fears grounded in constant worry about specific situations.

### Psychodynamic Therapy for Generalized Anxiety Disorder

This form of therapy for generalized anxiety disorder explores how past experiences and [unconscious thoughts](https://en.wikipedia.org/wiki/Unconscious_mind) influence current behavior and feelings. It aims to uncover and address underlying issues contributing to symptoms. I rarely use [psychodynamic therapy](https://dralanjacobson.com/psychodynamic-therapy/) for GAD as a standalone treatment, but I do commonly mix it in.

## Therapy for Generalized Anxiety Disorder Results

I have seen therapy for Generalized Anxiety Disorder yield various positive outcomes for individuals, including:

### Symptom Reduction through Therapy for GAD

Effective therapy for generalized anxiety disorder can significantly reduce the intensity and frequency of symptoms. Techniques listed in the prior section, such as cognitive restructuring, mindfulness, and exposure therapy, help manage anxious thoughts and behaviors.

Therapy for GAD equips clients with practical tools and coping mechanisms to deal with triggers. This includes relaxation techniques, problem-solving skills, and stress management strategies.

### Enhanced Self-Awareness

Through therapy for generalized anxiety disorder, clients gain a deeper understanding of their thoughts, emotions, and behaviors related to anxiety. This self-awareness can empower them to recognize and address triggers more effectively. This awareness can also help people accept some anxiety as normal and learn to recognize and embrace the positives in their lives they may have been overlooking.

### Better Quality of Life Through Therapy for Generalized Anxiety Disorder

Managing GAD through therapy often leads to an overall improvement in quality of life. As symptoms diminish, individuals can engage more fully in work, relationships, and daily activities without being hindered by excessive worry.

Learning and practicing techniques in therapy can provide long-term relief from GAD. While it might not eliminate symptoms entirely, therapy for GAD can offer tools to manage it effectively, reducing its impact on daily life.

### Prevention of Escalation

Effective therapy can prevent anxiety from escalating into more severe mental health conditions. Learning to manage GAD early can reduce the risk of other related disorders developing. For example, people with GAD are prone to depression when the symptoms begin to feel unmanageable and hopelessness develops.

## Generalized Anxiety Disorder Treatment Example

Here is a sample of generalized anxiety disorder treatment I provide; of course, this is a made-up sample, but it follows the typical procedure and course.

Julie is 32 and is looking for generalized anxiety disorder treatment to help her manage her symptoms so she can [be more social in general](https://dralanjacobson.com/therapy-for-social-anxiety-disorder/), become less isolated, and feel more comfortable at work, where she likes her colleagues a lot but tends to withdraw from group situations. She will also worry less in general and find new levels of optimism.

### Generalized Anxiety Disorder Treatment Goals

Together, Julie and I design the following goals for her therapy for GAD:

1. Reduce Symptoms: Julie will achieve a significant reduction in the intensity and frequency of anxiety symptoms. She will use self-ratings on a scale of 1-10 to measure her emotional reactions in specific situations.
2. Improve Daily Functioning: Julie will be less isolated and more willing to engage with others in daily activities and responsibilities without excessive worry. She will also reduce the amount of negative thinking she does.
3. Enhance Coping Strategies: Julie will develop a toolbox to help her develop effective coping mechanisms to manage symptoms.

### Generalized Anxiety Disorder Treatment Components

I will use cognitive behavioral therapy for generalized anxiety disorder as a primary approach while also mixing in some mindfulness therapy techniques. We will meet weekly, at least at first, and Julie agrees that she will do homework in between sessions.

Julie’s therapy for GAD will center around three steps:

1. [Cognitive Restructuring](https://www.healthline.com/health/cognitive-restructuring): Julie will learn to Identify and challenge irrational thoughts related to worry and social fears.
2. Exposure Therapy: At a pace she is comfortable with, Julie will gradually expose herself to anxiety-provoking situations to reduce avoidance behaviors.
3. Mindfulness Training: We incorporate mindfulness and relaxation techniques into Julie’s therapy for generalized anxiety disorder to help her manage physical symptoms.

She will keep a daily journal to record worry levels, triggers, and coping strategies used so I can provide guidance and coaching.

### Lifestyle Changes

Julie will also pursue some lifestyle changes, including:

1. Exercise: She will engage in physical activity, including aerobic exercise (e.g., brisk walking, jogging), five days per week.
2. Diet: She will follow a balanced diet rich in fruits, vegetables, whole grains, and lean proteins; limit caffeine and sugar intake
3. Sleep Hygiene: She will establish a regular sleep schedule and create a restful sleep environment (cool, dark, and quiet).

### Therapy for Generalized Anxiety Disorder Results

After two months, Julie feels a reduction in the frequency and intensity of anxiety episodes, has improved sleep quality, and has enhanced social functioning at work. She generally feels more hopeful. We move our sessions to twice monthly. After five months, she has sustained a reduction in symptoms, developed effective coping mechanisms, and improved overall quality of life. We move back to once monthly.

## Summary and My Work with GAD

Therapy for generalized anxiety outcomes can vary from person to person. Factors such as your commitment to therapy, the severity of the disorder, the therapeutic relationship, and consistency in applying learned techniques can all impact the results. Additionally, combining therapy with other supportive practices, such as [healthy lifestyle changes](https://www.health.harvard.edu/blog/long-lasting-healthy-changes-doable-and-worthwhile-202109142594), social support, and, if necessary, medication, can further enhance the outcomes of the generalized anxiety disorder treatment I provide.

Everyone responds differently to treatment, so finding the right approach may take some time. Congratulations on considering therapy for GAD; it’s a positive step toward managing your anxiety. Whether you choose me or someone else, you are on your way to finding relief.

I provide [individual therapy](https://dralanjacobson.com/individual-therapy/) for GAD and couples and [families with older children](https://dralanjacobson.com/family-therapy/). In the latter two cases, it may be that only one member has GAD, and the others want to learn how to support them, including being part of any homework. **Therapy for generalized anxiety disorder** can be delivered as [virtual treatment](https://dralanjacobson.com/virtual-therapy-guide/) or in person. Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you have questions about **therapy for GAD** or want to know more about how my services might be helpful.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Mental Health Diagnoses

---

### [Telehealth Therapy (Teletherapy): Power and Effectiveness](https://dralanjacobson.com/telehealth-therapy-teletherapy/)

**Published:** January 20, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Telehealth therapy**, or **teletherapy**, has been around for a long time, but it expanded rapidly during the time of [COVID-19 pandemic](https://en.wikipedia.org/wiki/COVID-19). Clients and professionals discovered this approach’s [power, effectiveness, and convenience](https://dralanjacobson.com/virtual-therapy-guide/) during that time. I was no exception, as I found that I could reach more people for whom I was a good match this way. If you are a prospective client of mine or anyone else, you now have a much wider range of choices! In this post, I’ll cover the advantages and effectiveness of telehealth therapy and then end with some advice on making the teletherapy experience work best for you.

## Advantages of Teletherapy

Teletherapy offers several advantages that contribute to its growing popularity and effectiveness, all of which I’ve seen quite clearly in my own work:

### Telehealth Therapy and Accessibility

Teletherapy makes mental health [services more accessible to individuals facing barriers to traditional](https://dralanjacobson.com/psychotherapy/) in-person therapy. People in remote or rural areas, those with physical disabilities, or individuals with transportation challenges can benefit from its convenience. Aside from these groups, parents with young children at home or whose children have very busy schedules often benefit from the added accessibility. This also comes into play if you travel and do not want to miss your sessions.

### Teletherapy and Therapist Match

I am [licensed in 40 states](https://dralanjacobson.com/) to serve many more people than those near my office. You need to ask any prospective therapist if they are [licensed in your state](https://dralanjacobson.com/locations/), and if they are, they are a potential match. This opens up many therapists whose clinical approaches and personal bios are potential matches for interested people. I hope the information on this website and [in my blog](https://dralanjacobson.com/blog/) is helpful to you as you determine what therapeutic approaches might work best.

### Convenience and Telehealth Therapy

Clients can engage in sessions from home, eliminating the need to commute to a therapist’s office. This is particularly advantageous for individuals with busy schedules or those who prefer the flexibility of scheduling sessions around their daily activities. I see many [college students](https://dralanjacobson.com/therapy-for-college-students/) who can schedule sessions around their class schedules and young parents who do not want to pack up their infants, for example. I also see many couples and families whose members are not in the same place at the same time at an otherwise convenient time.

### Flexibility of Teletherapy

Telehealth therapy provides more flexible scheduling options. My clients and I can find mutually convenient time slots with online platforms, including evenings. I may have a free hour for you during a time when I would not have been able to get to my office. This flexibility has been especially beneficial for working professionals or parents. It also works well with my specialty services, where I provide some help at a particularly beneficial time.

### Confidentiality and Privacy

Some individuals may feel more comfortable discussing sensitive or personal issues in the privacy of their own space. Teletherapy allows clients to choose a secure and confidential environment for their sessions. While my in-person office is soundproof and private, I cannot guarantee that you wouldn’t see someone you know on the way in or out of the building.

### Teletherapy is Cost-Effective

Teletherapy can be cost-effective for both clients and therapists. Clients save on travel expenses and time, while therapists like me have lower overhead costs associated with maintaining a physical office. This is why my self-pay fee is lower for telehealth therapy. Other cost savings include allowing couples with infants not to secure a babysitter if they are reasonably comfortable that the baby will sleep and [college students](https://dralanjacobson.com/therapy-for-college-students/) not to have to Uber to an appointment.

### Continuity of Care

Teletherapy ensures continuity of care, allowing individuals to receive mental health support even during situations that may disrupt in-person services, such as inclement weather, health crises, or when traveling (as long as their travel is to a state that the therapist is licensed in). I’ve always had an office in the northeast, and there were times during the winter when in-person treatment could be quite affected.

### Telehealth Therapy Technology Integration

Modern teletherapy platforms often incorporate advanced features such as [secure messaging](https://en.wikipedia.org/wiki/Secure_messaging), screen sharing, and other virtual tools that enhance the therapeutic experience. These technological advancements can contribute to a more engaging and effective therapeutic process. You or I can share our screens if there is information that might be useful, for example. I can also easily send links to websites or other resources that benefit you.

## Telehealth Therapy Caveats

It’s important to note that while teletherapy has numerous advantages, it may not be suitable for everyone. Here are some issues to consider:

### Teletherapy and Interruptions

Telehealth therapy is prone to more interruptions than in-person treatment. These interruptions can include technological problems, such as a loss of signal or power failures, and personal disruption, such as kids needing a parent or a roommate unexpectedly coming home. Most of these interruptions are not enough to affect the [treatment process](https://dralanjacobson.com/flying-anxiety-treatment/), but they are worth discussing if they happen repeatedly.

### Telehealth Therapy and Nonverbal Cues

As a therapist, it is often important to pick up [nonverbal cues](https://positivepsychology.com/nonverbal-communication-cues/) such as body posture and gestures, and using video cuts down on my ability to see these. It may also reduce your ability to see those things in me when I am making a point or lending support. In my opinion, I don’t lose enough of this to make it not worthwhile, and in fact, there is a lot to learn by my being able to see you at your home where you are completely comfortable.

### Your Comfort with Virtual Meetings

Finally, treatment may be affected by your comfort with virtual meetings. While many people have become more comfortable and accustomed to virtual meetings during the pandemic, some still prefer in-person meetings with a therapist. I completely respect that and can refer you to someone who does in-person appointments in your area.

I am confident that telehealth therapy can be as effective and powerful as in-person, but it is not for everyone. We will discuss the fit when we first meet.

## Is Virtual Therapy as Powerful as In-Person?

Given all the above, it is natural to ask, “**Is online therapy as powerful as in-person?**” and the results boil down to your preferences. The [effectiveness of online therapy](https://dralanjacobson.com/telehealth-therapy-teletherapy/) compared to in-person depends on various factors, and I have seen it vary from person to person. Both modalities have their advantages and challenges. Broken down similarly to the above:

1. Accessibility: Virtual therapy is more accessible, allowing you to receive mental health support from the comfort of your own home. So, the answer to the question, “Is online therapy as powerful as in-person therapy?” is likely yes if you feel more comfortable at home in general, have mobility issues, live in a remote area, or have transportation limitations.
2. Convenience and Comfort: Virtual therapy eliminates the need for travel, making it more convenient for people with busy schedules. It also reduces the time and effort required to attend appointments. In addition, some people feel more comfortable opening up in their familiar environment, leading to more honest and open communication during virtual sessions. If any of that resonates with you, you may prefer virtual.
3. Continuity of Care: Virtual therapy can provide a continuous therapeutic relationship even during situations like travel, relocation, or unexpected events that might disrupt in-person sessions. For this reason, I have found that online therapy is powerful and effective for college students who live in a different state, people who travel a lot, or people who have homes in other states.
4. Technological Issues and Privacy Concerns: Technical glitches, such as poor internet connection or software malfunctions, can disrupt the flow of a session and may lead to frustration for both the therapist and the client. Also, maintaining privacy during virtual sessions can be a concern, especially if individuals live in shared spaces or have limited privacy at home. On the other hand, some people feel they have enhanced privacy at home where they are not seen walking into my building. These issues must be considered to answer the question, “Is online therapy as powerful as in-person?”

### Research Related to “Is Virtual Therapy as Powerful as In-Person?”

Research on the efficacy of [online therapy has shown that it can be as effective](https://dralanjacobson.com/virtual-therapy-guide/) as in-person for certain people and conditions. I have found it to be a valuable and viable alternative, with many clients who live near my office choosing online therapy. I have seen no difference in outcomes in my online therapy practice.

Ultimately, the effectiveness of treatment, whether [virtual or in-person](https://dralanjacobson.com/is-virtual-therapy-as-effective-as-in-person/), depends on the quality of the therapeutic relationship, the match between my approaches and your needs, and your individual needs and preferences. We will discuss all of this at the start, and I will provide a well-rounded overview. I can always refer you to a trusted colleague in your area if you prefer in-person and do not live near my office.

So, “Is online therapy as powerful as in-person?” Yes, it can be, and we’ll ensure it is the best fit for you before we start

## Teletherapy in My Practice

Most of my practice is telehealth therapy, allowing me to [serve people in 40 states](https://dralanjacobson.com/) who feel that I am a good fit for what they are looking for. I have found it helpful for [individual treatment](https://dralanjacobson.com/individual-therapy/), [couples counseling](https://dralanjacobson.com/couples-therapy/), and [families with older children](https://dralanjacobson.com/family-therapy/), the latter two particularly when people may be in different places during convenient times to meet. I use virtual approaches in all of my specialty services as well, which allows me to provide a booster when needed, such as with [fear of flying](https://dralanjacobson.com/fear-of-flying-therapy/) and [fear of public speaking](https://dralanjacobson.com/public-speaking-anxiety/) before an event that causes anxiety.

All of the approaches I commonly use, from [humanistic approaches](https://dralanjacobson.com/humanistic-psychology/) to [psychodynamic methods](https://dralanjacobson.com/psychodynamic-therapy/) to [cognitive-behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/), all work well with teletherapy. I haven’t noticed any difference in the power and potential of treatment since my practice moved to telehealth therapy.

In addition to this post, there is a full page about [virtual psychotherapy](https://dralanjacobson.com/virtual-therapy-guide/). If you have any questions about teletherapy or how a telehealth therapy approach might work for you, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) at any time.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.linkedin.com/company/psychologicalscience/)

**Categories:** Virtual

---

### [Emotionally Focused Individual Therapy](https://dralanjacobson.com/emotionally-focused-individual-therapy/)

**Published:** January 26, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Emotionally **Focused Individual Therapy** (**EFIT**) focuses on helping individuals process and understand their deep-seated feelings to improve their well-being and relationships. It was originally developed for [couples therapy](https://dralanjacobson.com/couples-therapy/) but has also been adapted to become emotion-focused therapy for individuals. The core idea is that emotions are central to how we experience the world and relate to others. EFT Therapy interventions work to explore and transform emotional responses that may be getting in the way of healing or growth.

In EFIT, I help clients become more aware of their feelings and how they are connected to their behaviors, thoughts, and relationships. The goal of emotion-focused therapy for individuals is to help the client create new inner experiences, promote self-compassion, and build stronger resilience.

## Emotionally Focused Individual Therapy Overview ![Emotionally focused individual therapy](https://dralanjacobson.com/wp-content/uploads/2025/01/faces-300x202.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Some key principles of EFIT include:

1. **Awareness**: EFT therapy interventions help clients become more aware of their inner experiences, especially those that may be suppressed or unprocessed.
2. **Expression**: Emotion-focused therapy for individuals encourages clients to express their feelings in a healthy, constructive way rather than avoiding or suppressing them.
3. **Validation**: Emotion-focused therapy for individuals helps the client feel understood and validated, which can be incredibly healing, especially for those who have felt dismissed or ignored in the past.
4. **Creating New Emotional Experiences**: EFT therapy interventions create new experiences that promote healing and growth.

EFIT is often especially helpful for people [struggling with childhood trauma](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/), [attachment issues](https://dralanjacobson.com/attachment-therapy/), anxiety, depression, or difficulty with relationships, as it helps people process their emotions in a safe and supportive environment.

### EFT Therapy Interventions

Emotionally Focused Individual Therapy (EFIT) uses various techniques to help clients understand and process their feelings to foster healing and growth. These EFT therapy interventions aim to create awareness, facilitate expression, and shift patterns of responses. Here are some of the key techniques used in EFIT:

#### 1. Empathic Attunement

- In emotionally focused individual therapy, I pay close attention to my client’s inner state, body language, tone, and words. This helps me understand the client’s inner experience and reflect it back to them. This technique builds trust and helps the client feel deeply understood and validated.
- For example, if a client expresses sadness, I might respond, “It sounds like you’re overwhelmed by deep sadness. Can you tell me more about what’s behind that feeling?”

#### 2. Focused Exploration

- This involves exploring my client’s feelings, especially those that might not have been fully acknowledged or processed. In emotion-focused therapy for individuals, I help clients explore these emotions in depth, identifying their origins and impact on current behavior and thoughts.
- The goal is to identify the root of these experiences and how they relate to the client’s past experiences, particularly attachment or relationship patterns (which is why this approach partners well with [family of origin counseling](https://dralanjacobson.com/family-of-origin-therapy/))

#### 3. Reflective Listening in Emotion-focused Therapy for Individuals

- In emotion-focused therapy for individuals, I reflect back on what my client has said, paraphrasing or restating it to ensure they are being heard correctly. This helps the client gain clarity about their feelings and thoughts.
- For example, I might say, “You seem to be feeling really conflicted about how to handle this situation—on the one hand, you want to avoid conflict, but on the other hand, you feel like your needs aren’t being met. Is that accurate?”

#### 4. Validating Emotions

- I validate my client’s feelings by acknowledging that their responses are understandable and make sense in the context of their experiences.
- Validation can be especially powerful for people who have experienced emotional neglect or invalidation in the past. For example, “It’s completely understandable that you would feel anxious given everything that’s happened. It makes sense that your fear would show up in these situations.”

#### 5. Emotion Reprocessing

- I help my client reframe or shift negative or unproductive responses. This can involve breaking down their automatic reactions and replacing them with more adaptive, flexible responses.
- For example, if a client reacts to a stressful situation with intense anger, I might help the client explore the underlying fear or vulnerability driving that anger.

#### 6. Creating New Experiences

- EFIT aims to help clients have new emotional experiences that can lead to healing. This could involve reframing a past traumatic event, processing the feelings tied to that event, or having a new emotional experience in the present moment that helps reshape their response.
- I might guide the client to have more positive, connected experiences with others or themselves that shift old response patterns.

#### 7. Attachment-Focused EFT Therapy Interventions

- EFIT often draws from attachment theory, which emphasizes the role of emotional bonds in human development. I may help my clients explore how their early attachments (e.g., with caregivers or significant others) shaped their responses and interpersonal patterns.
- In the therapeutic space, I can act as a secure emotional base, providing the client with the support needed to explore difficult feelings and challenge old behavior patterns.

#### 8. Interventions to Promote Self-Compassion

- In emotion-focused therapy for individuals, clients are encouraged to cultivate compassion for themselves, particularly when struggling with complicated feelings. This helps them break free from self-criticism or shame and create a healthier relationship with themselves.
- I may guide clients in recognizing their pain, validating it, and practicing self-kindness rather than self-judgment.

#### 9. Processing and Integration

- After exploring patterns, I help the client integrate the insights they’ve gained into their everyday lives. This involves applying the work done in [psychotherapy](https://dralanjacobson.com/psychotherapy/) to current life situations, helping the client make healthier emotional choices in the future.
- I might ask questions like, “How can you use what we’ve discussed today when you normally feel overwhelmed or stuck?”

Emotionally focused individual therapy is a deeply emotional and experiential process. The EFT therapy interventions aim to help the client move through intense feelings, break free from old patterns, and create more secure experiences in relationships and within themselves.

## Emotion-Focused Therapy For Individuals: Adolescent Case Example:

Here’s a case example that illustrates how Emotionally Focused Individual Therapy (EFIT) might be used with an adolescent girl.

---

Emma is 15 and has been struggling with intense feelings of sadness, anxiety, and a sense of disconnection from her family and peers. She recently experienced a major falling-out with her best friend, which triggered feelings of rejection and abandonment. Emma also feels misunderstood by her parents, who have been concerned about her lack of communication and social withdrawal.

### Emotionally Focused Individual Therapy Goals:

- First, emotion-focused therapy for Individuals will help Emma understand and process the underlying feelings driving her [sadness and anxiety](https://dralanjacobson.com/therapy-for-depression-and-anxiety/).
- Then, emotion-focused therapy for Individuals will build awareness and expression in a safe, supportive environment.
- Finally, emotion-focused therapy for Individuals will strengthen Emma’s connection with her family, especially her parents, and help her communicate her needs more effectively.

---

### EFT Therapy Interventions: Adolescent

#### Session 1: Building Trust and Awareness

I start EFIT by creating a safe, nonjudgmental space where Emma can feel heard and understood. Emma is initially hesitant and guarded, not wanting to open up fully about her feelings.

I use **empathic attunement** and reflective listening to build rapport gradually. For example, Emma mentions feeling “down all the time,” and I reflect, “It sounds like you’re feeling stuck in sadness, and it’s hard to shake it off. Can you tell me more about what’s been weighing on you lately?”

As Emma begins to speak more about her recent falling out with her best friend, I help her explore the feelings of rejection and abandonment. I use **emotion-focused exploration**, asking Emma to identify how those emotions feel in her body and how they influence her thoughts and behaviors.

#### Session 2: EFT therapy Interventions to Validate Emotions and Explore Attachment

Emma begins to feel understood, and I encourage her to explore the deeper layers behind her sadness. I use [**validating emotions**](https://www.verywellmind.com/what-is-emotional-validation-425336), acknowledging how hurtful it must be to feel abandoned by a close friend and how that may trigger fears of being unloved or unimportant.

I connect Emma’s feelings of rejection to her early attachment experiences, helping her understand that these feelings might stem from her fear of not being valued by others, which ties back to her past experiences with her parents. For example, Emma’s parents, though loving, have had a difficult time attuning to her needs, leading Emma to develop a sense of insecurity about her worth.

#### Session 3: Reprocessing and Developing New Experiences

Emma begins to identify how her anxious and withdrawn behaviors are attempts to protect herself from feeling vulnerable, but they also reinforce her sense of loneliness and disconnection. I use **emotion reprocessing** to help Emma understand the cycle of emotional avoidance and encourage her to express these feelings openly.

I gently encourage Emma to practice opening up in a safe way—whether it’s through journaling, talking to her parents, or expressing herself in a creative outlet like drawing. For example, we role-play how Emma might express her feelings to her mom, saying, “Mom, I feel like I’m not being seen or understood, and it makes me anxious. I need your help to feel more connected.” This process helps Emma recognize her needs and become more comfortable with vulnerability.

#### Session 4: EFT Therapy Interventions for Strengthening Connection with Parents

Emma desires to improve her relationship with her parents but feels stuck because she cannot communicate her feelings. I worked with Emma to create new inner experiences by helping her set up conversations with her parents in which she could share her emotions honestly and directly.

I help Emma frame her feelings in a way that is less likely to provoke defensiveness from her parents. For example, Emma might say, “I’ve been feeling really sad and anxious lately, and sometimes I feel like you don’t see it. I need you to listen and help me through it, even if you don’t have all the answers.”

I provide ongoing support and validation as Emma navigates this conversation with her parents, help her reframe any responses that may arise during the conversation, and encourage her to stay present with her feelings.

#### Session 5: Self-Compassion and Integration

By this point in EFIT, Emma is becoming more aware of her emotions and how to express them without shutting down or acting out. I focus on helping Emma develop **self-compassion** and recognize that feeling vulnerable and unsure is sometimes okay. Emma can show kindness to herself through [mindfulness-based stress reduction](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) techniques, self-affirmation, or engaging in activities that nurture her well-being ([behavioral activation](https://dralanjacobson.com/behavioral-activation/)).

---

### EFIT Outcomes:

- Through emotionally focused individual therapy, Emma becomes more aware of her inner patterns and understands how past attachment experiences influence her current relationships.
- She learns to express herself in healthier ways, particularly with her family and friends, which leads to more connected and understanding relationships.
- Emma feels more capable of self-regulating and managing anxiety while also building greater self-compassion.
- She develops a more secure attachment to her family, especially after successfully communicating her needs to her parents, which significantly reduces her feelings of isolation and sadness.

---

This example shows how EFIT can help an adolescent like Emma process and transform her emotions, break free from negative patterns, and develop healthier relationships with herself and others. EFT therapy interventions foster awareness, expression, and connection, all key healing components.

## Emotionally Focused Individual Therapy: Adult Case Example

Here’s an example of how Emotionally Focused Individual Therapy (EFIT) might be used with an adult client.

---

**Presenting Issues:** Sarah, a 34-year-old woman, comes to therapy reporting ongoing struggles with anxiety, loneliness, and self-criticism. She has a history of difficulty forming close, trusting relationships and feels that she often sabotages her happiness. Sarah also has recurring thoughts of not being good enough, stemming from her childhood, where she often felt neglected by her parents, particularly her mother. She has been in a relationship for two years but is increasingly distancing herself, fearing that her partner will eventually abandon her.

### Emotion-Focused Therapy Goals

- First, emotion-focused therapy for Individuals will help Sarah understand and process her responses, particularly those tied to her feelings of inadequacy and fear of abandonment.
- Then, emotion-focused therapy for individuals will increase emotional awareness and expression so that Sarah can better communicate her needs to her partner and others.
- Finally, emotion-focused therapy for Individuals will strengthen Sarah’s sense of self-worth and help her feel more connected to her feelings and relationships.

---

### Adult EFT Therapy Interventions

#### Session 1: Establishing a Safe Space and Emotional Awareness

In the first emotionally focused individual therapy session, Sarah is somewhat guarded and unsure of how to approach her feelings. She talks about feeling anxious in her relationships but finds it difficult to pinpoint why she feels so disconnected from others. She describes her relationship with her mother as distant, where she often had to “take care of herself” due to her mother’s preoccupation with her issues.

I use **empathic attunement** to make Sarah feel heard and seen. For example, when Sarah talks about her fears of not being enough, I reflect, “It sounds like there’s a deep fear that you might not be worthy of love or attention, and that feeling of not being enough seems to show up in your relationships.”

As Sarah opens up more, I encourage her to explore the feelings that come up when she thinks about her childhood experiences and how they might influence her current relationship behaviors. This is a key example of **emotion-focused exploration**.

#### Session 2: Validating Emotions and Exploring Attachment

In the second emotionally focused individual therapy session, I validate Sarah’s emotional experiences. I reflect, “It makes sense that you would feel anxiety and doubt about yourself given your history of not feeling nurtured. Those early experiences with your mother may have led you to feel like you’re always waiting for someone to pull away or reject you.”

I explore Sarah’s attachment style, explaining how her childhood experiences may have led to [anxious attachment](https://www.simplypsychology.org/anxious-attachment-style.html), where Sarah tends to fear abandonment in relationships and struggles to feel secure. Sarah starts to realize that her anxiety in her current romantic relationship may be linked to these deep-seated attachment fears.

I help Sarah name and understand the feelings behind her anxious reactions and self-doubt, fostering a greater sense of **inner awareness**.

#### Session 3: Reprocessing Emotions and Addressing the Fear of Abandonment

As emotionally focused individual therapy deepens, Sarah and I begin to work on **reprocessing emotions**. Sarah talks about her pattern of pushing her partner away when she feels vulnerable, as though pulling back will protect her from potential hurt. I gently guide Sarah to explore these patterns and how they are rooted in her fear of abandonment.

For instance, when Sarah describes an argument with her partner, I might say, “It sounds like when you felt your partner pulling away, it triggered a deep fear of abandonment for you. That fear led to shutting down and pushing him away before he could leave you.”

Through this exploration, Sarah begins to connect the dots between her childhood experiences of neglect and her current relationship patterns. This **reprocessing** helps Sarah see that her partner is not a threat but that her fears are deeply rooted in past experiences.

#### Session 4: Strengthening Self-Compassion and Building Communication Skills

By this point, EFT therapy interventions have helped Sarah better understand her inner patterns and their origins. I work with her to build **self-compassion**, helping her recognize that it’s okay to have emotional needs and to express them in her relationships. Sarah practices reframing her inner dialogue, challenging her automatic thoughts of being “not enough” or “too much.”

I also help Sarah develop **communication skills** to express her needs to her partner without feeling ashamed or afraid of rejection. For example, instead of withdrawing or becoming defensive, Sarah learns to say, “I feel really scared when I sense a distance between us. It makes me worry that you might leave me, and I’m working on trusting that you won’t.”

I role-play scenarios with Sarah, helping her practice new ways of responding to her partner and expressing her feelings. This process is about learning to be emotionally vulnerable in a safe, constructive way.

#### Session 5: Integrating New Emotional Responses and Strengthening Relationships

Through EFT therapy interventions, Sarah feels more confident expressing her emotions to her partner and others. She is beginning to break out of old patterns of withdrawal and self-criticism. I helped Sarah integrate these changes into her daily life, checking how she applied her newfound awareness in her relationship.

For example, Sarah reports that she could share her fears after a recent disagreement with her partner without withdrawing. This led to a deeper, more honest conversation with her partner and a sense of closeness that Sarah hadn’t felt before.

I reinforce that these small victories—being vulnerable and expressing needs—are important steps in breaking the cycle of fear and disconnection. They continue to explore how Sarah can sustain these changes and deepen her connection with others.

---

### Emotionally Focused Individual Therapy Outcomes:

- Through EFT therapy interventions, Sarah understands how her past experiences influence her current relationships and responses.
- In emotionally focused individual therapy, she learns to express her emotions more openly and authentically, particularly in her romantic relationship, reducing her fear of abandonment.
- Through **self-compassion** and expression, Sarah begins to heal her relationship with herself, decreasing her anxiety and self-criticism.
- Sarah feels more emotionally connected to her partner, as she can communicate her needs and vulnerabilities more effectively, leading to a more secure, trusting relationship.

---

This example illustrates how EFIT can be used with adults like Sarah to help them understand and process their emotions, transform negative patterns, and build healthier relationships with themselves and others. EFT therapy interventions focusing on emotional validation, attachment patterns, and vulnerability help Sarah break free from old emotional habits and develop more secure and fulfilling connections.

## Summary and My Work

I provide emotionally focused individual therapy. EFT therapy interventions provide powerful and effective relief for deep-seated emotional struggles. I also provide [emotionally focused family therapy](https://dralanjacobson.com/emotionally-focused-family-therapy/) for couples and families that would benefit from doing this work together. This approach pairs well with other forms of treatment, such as [interpersonal therapy](https://dralanjacobson.com/interpersonal-therapy/), [psychodynamic therapy](https://dralanjacobson.com/psychodynamic-therapy/), [object relations therapy](https://dralanjacobson.com/relational-therapy/), and [schema-based therapy](https://dralanjacobson.com/schema-therapy/). It often works well with [creative counseling](https://dralanjacobson.com/creative-counseling/) methods.

EFIT, or emotion-focused therapy for individuals, is a core part of my [integrative practice](https://dralanjacobson.com/integrative-therapy/), and I’d be happy to answer any questions you have. Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Types of Therapy

---

### [Codependency Therapy: Overcome and Heal from Codependency](https://dralanjacobson.com/codependency-therapy/)

**Published:** April 24, 2025
**Author:** Dr. Alan Jacobson

**Content:**

I help people break free from patterns of impaired relationships and rediscover who they are, apart from what they do for others. Codependency often hides behind love, loyalty, and responsibility. You might be the one who always fixes, supports, or sacrifices—yet feel unseen, emotionally drained, or stuck in one-sided relationships. Maybe you’re unsure where others end and you begin. Through in-person or online therapy for codependency, I work with individuals, couples, and parents to build healthier boundaries, reconnect with their own needs, and create balanced relationships grounded in mutual respect, not control or guilt. Codependency therapy is powerful and effective.

You don’t have to keep losing yourself to keep others close. Overcoming dependency and healing is possible, even if it initially feels unfamiliar.

## Codependency Therapy Overview

Here’s a comprehensive overview of **codependency therapy**, including what codependency is, therapeutic techniques used to address it, who benefits from this kind of therapy, and how it helps, especially for **couples and families**.

### What Is It?

**Codependency** is a behavioral and emotional condition where a person consistently prioritizes the needs, feelings, or problems of others over their own, often to the detriment of their own well-being. It’s most commonly seen in relationships where one person enables another’s poor mental health, addiction, irresponsibility, or underachievement.

#### Common Traits of Codependency:

- Low self-esteem or lack of identity outside the relationship
- A need to “fix” or rescue others
- Difficulty setting or respecting boundaries
- Fear of abandonment or rejection
- Excessive caretaking or people-pleasing
- Guilt when prioritizing oneself

## How I Treat Codependency

Here are some detailed descriptions of the methods I use in online therapy for codependency

#### [Cognitive Behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) Codependency Therapy

**Goal:** Identify and reframe negative beliefs that fuel codependent behavior.

**Standard Techniques to Treat Codependency:**

- **[Cognitive restructuring](https://dralanjacobson.com/cognitive-restructuring/):** Challenge core beliefs like “I’m only valuable if I help others.”
- **Behavioral experiments:** Test new ways of interacting (e.g., saying “no” and observing outcomes).
- **Thought journaling:** Track situations that trigger codependent thoughts and analyze patterns.

**In Practice ([Individual Therapy](https://dralanjacobson.com/individual-therapy/)):** People might explore how childhood experiences taught them to gain approval through sacrifice. [Online therapy](https://dralanjacobson.com/virtual-therapy-guide/) for codependency helps them recognize these patterns and replace them with healthier self-concepts.

**In Practice ([Couples Therapy](https://dralanjacobson.com/couples-therapy/)):** CBT helps each partner identify beliefs that cause over-functioning (e.g., “I must fix my partner’s problems”) and replace them with mutual responsibility.

#### [Family Systems](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/) Codependency Therapy

**Goal:** Understand how family roles, rules, and dynamics maintain codependency.

**Standard Techniques to Treat Codependency:**

- **Genograms:** A visual map of family relationships and dynamics to spot generational patterns.
- **Role exploration:** Identifying and dismantling roles like “the rescuer,” “the enabler,” or “the lost child.”
- **Structural interventions:** Restructuring how family members relate (e.g., encouraging independence in a [parentified child](https://www.healthline.com/health/parentification)).

**In Practice (Families):** Therapy might reveal that a parent’s emotional needs were met through a child’s caretaking. It then helps realign roles and encourages appropriate emotional boundaries.

#### [Emotionally Focused](https://dralanjacobson.com/emotionally-focused-family-therapy/) Codependency Therapy

**Goal:** Repair attachment injuries and develop secure, balanced emotional bonds.

**Standard Techniques to Treat Codependency:**

- **Cycle de-escalation:** Identify the reactive behaviors reinforcing disconnection (e.g., clinginess vs. withdrawal).
- **Emotion coaching:** Help partners/family members express vulnerability without blame.
- **Attachment reframing:** View behaviors as protective rather than malicious to foster empathy.

**In Practice (Couples):** A partner may rely too heavily on the other for validation. EFT helps each partner express deeper emotions (e.g., fear of rejection) and meet those needs together in a healthier, less dependent way.

#### Inner Child Work

**Goal:** Heal early emotional wounds that drive adult codependency.

**Standard Techniques to Treat Codependency:**

- **Guided visualizations:** Connect with and comfort the “inner child” who felt abandoned, unworthy, or overly responsible.
- **Reparenting exercises:** Provide emotional support the client didn’t receive as a child (e.g., affirmations, journaling, self-care rituals).
- **Dialoguing:** Have the adult self communicate directly with the inner child to understand unmet needs.

**In Practice (Individual):** Someone praised only for helping others might explore how that shaped their identity. Therapy helps them find worth outside of pleasing.

#### Assertiveness and Boundary Training

**Goal:** Help clients advocate for themselves without guilt or fear.

**Standard Techniques To Treat Codependency:**

- **Role-playing:** Practice saying “no,” asking for space, or expressing needs clearly.
- **Boundary mapping:** Visual tools to define emotional, physical, and time boundaries with others, similar to [Structural Family Therapy](https://dralanjacobson.com/structural-family-therapy/).
- **Scripts:** Use sentence starters like “I feel \_\_\_ when \_\_\_, and I need \_\_\_” to assert needs constructively.

**In Practice (Couples/Families):** The therapist may coach family members on how to set respectful limits around emotional caretaking or dependency, helping them shift from fusion to mutual respect.

### Integrative Codependency Therapy Methods

- **Mindfulness-Based Stress Reduction (MBSR):** Teaches clients to stay present with their feelings rather than reacting automatically.
- **[Somatic Therapy](https://dralanjacobson.com/somatic-therapy/):** Helps track body sensations to identify stress and boundary violations early.
- **Narrative Therapy:** Encourages clients to re-author their life story from one of sacrifice to one of self-agency and balance.

### Who Benefits From Codependency Therapy?

- **Individuals** with a pattern of one-sided or draining relationships
- **Couples** where one or both partners feel overly responsible for the other’s emotions or actions
- **Families** dealing with enabling dynamics, especially around addiction, illness, or mental health
- **Adult children** of alcoholics or dysfunctional households

### How Codependency Therapy Helps

**For Individuals:**

- Online therapy for codependency helps them develop a stronger sense of identity and self-worth
- It builds autonomy and emotional resilience, thus assisting people to heal from codependency
- Individual therapy improves emotional regulation and stress management
- It enhances relationship satisfaction by promoting healthier dynamics

**For Couples:**

- Online therapy for codependency encourages equal responsibility and [mutual emotional support](https://dralanjacobson.com/relationship-therapy/).
- It improves communication and conflict resolution.
- Couples therapy helps partners understand and support each other’s growth without overfunctioning
- It promotes overcoming codependency and developing secure attachment and balanced intimacy

**For Families:**

- Online therapy for codependency breaks cycles of enabling and emotional fusion
- It clarifies roles and responsibilities in the family system
- [Family therapy](https://dralanjacobson.com/family-therapy/) creates space for healthier interdependence and eventual healing from codependency
- It strengthens family communication and mutual respect

### Summary

Codependency therapy is a powerful tool for healing deeply rooted emotional patterns and fostering healthier, more fulfilling relationships. Whether working individually, as a couple, or with a family, codependency therapy offers practical tools and emotional insight to cultivate autonomy, set boundaries, and form secure, supportive connections.

## Case example: Therapy to Heal from Codependency in a Marriage

Here’s a case example that weaves together multiple therapeutic methods to show how a person might heal from codependency. This example is fictional but based on real-world patterns often seen in online therapy for codependency.

### “Emily’s Journey to Self-Worth”

**Background:**

**Emily**, a 38-year-old woman, sought therapy after years of feeling emotionally exhausted in her marriage. She described herself as the “glue” of the household—managing the home, supporting her husband through his career ups and downs, and suppressing her own needs to avoid conflict.

She often said things like:

- “If I don’t do it, it won’t get done.”
- “I feel selfish when I think about what I want.”
- “I just want peace.”

Emily grew up with an alcoholic father and a mother who relied heavily on her for emotional support, even as a child. She unconsciously adopted the role of “caretaker” from an early age.

### Codependency Therapy Methods Used

#### Cognitive Behavioral Therapy (CBT): Restructuring Beliefs

In early sessions, I helped Emily identify limiting beliefs, such as:

- “My worth comes from being needed.”
- “If I stop helping, they’ll leave me.”

Through journaling and thought records, she began healing from codependency by challenging these beliefs and replacing them with healthier thoughts like:

- “My needs are just as important as others’.”
- “Love doesn’t have to be earned through sacrifice.”

#### Inner Child Work: Reparenting the Wounded Self

Emily was guided through visualization exercises, during which she imagined comforting her 8-year-old self, the little girl who was terrified to disappoint her mother.

She began writing letters to her inner child, validating her feelings, and creating self-care rituals (like morning walks and reading for pleasure) as acts of reparenting.

Emily cried during her first inner child session—she hadn’t realized how long she’d been neglecting herself. This became a major turning point in her desire to overcome codependency.

#### Boundary and Assertiveness Training

I introduced the **“Broken Record” technique** to help Emily repeat firm but respectful boundaries without over-explaining.

**Practice Scenario:**

- Husband: *“Why are you going out tonight? We had dinner plans.”*
- Emily: *“I understand you’re disappointed. I need this time for myself, and I hope we can reschedule.”*

Over time, Emily practiced these scripts in session, role-playing how to say no without guilt or emotional collapse. She also began setting boundaries with extended family.

#### Family Systems Work

Emily and I mapped out a **genogram**, which helped her see a generational pattern of female caretakers and emotionally unavailable men. This awareness empowered her desire to overcome codependency by breaking the cycle.

We explored how her role in the family mirrored her marriage, and how stepping out of that role didn’t mean she was betraying anyone—it meant healing the family legacy.

#### Emotionally Focused Online Therapy for Codependency (EFT)

After about 4 months of individual therapy, Emily invited her husband to join. In EFT sessions:

- The couple identified their **negative cycle**: Emily overfunctioned → husband withdrew → Emily chased harder.
- Emily learned to express her underlying emotions (“I feel unseen and scared when I do everything alone”) rather than blame.
- Her husband, in turn, began to show more emotional engagement once the pressure dynamics shifted.

#### [Mindfulness](https://dralanjacobson.com/mindfulness-therapy/) & Somatic Awareness

Emily also learned to listen to her body when she felt overwhelmed. Tension in her chest and shoulders became signals that she was ignoring her needs.

Mindful breathing and grounding exercises helped her pause before reacting out of old patterns and heal from codependency.

### How She Learned to Heal from Codependency

- Emily no longer over-identified with the caretaker role.
- She enjoyed hobbies, friendships, and solo routines without guilt.
- Her marriage improved—not because her husband changed dramatically, but because Emily changed how she engaged.
- Most importantly, she felt whole on her own.

“I finally feel like I’m living *with* my husband, not *through* him.”

## Case example 2: Working with a Parent on Overcoming Codependency

Here’s a **case example** of a parent who worked with me on overcoming codependency related to their adult child. This case illustrates how codependency can manifest in parent-child relationships and how online therapy for codependency can help reestablish healthy boundaries, identity, and trust.

### “Mark Letting Go with Love”

**Background:**

**Mark**, a 62-year-old father, sought therapy for overcoming dependency after years of emotional exhaustion and conflict with his 28-year-old son, **Jason**. Jason had struggled with substance use, unstable employment, and depression since his early 20s. Though Jason lived independently, Mark provided regular financial support, managed his son’s responsibilities (like calling about bills or appointments), and constantly worried.

Mark described his role as:

- “If I don’t help him, who will?”
- “He needs me to keep his life together.”
- “I feel like I’m walking on eggshells around him.”

His wife had gently suggested online therapy for codependency after Mark drained part of their retirement savings to bail Jason out of a rental dispute, for the third time.

### Online Therapy for Codependency: Methods Used

#### Cognitive Behavioral Therapy (CBT): Challenging Thought Patterns

Mark worked with me to identify his **core beliefs**, such as:

- “Good parents always help, no matter what.”
- “If I stop helping, Jason will fall apart—and it’ll be my fault.”

He explored **cognitive distortions**, like catastrophizing (“If I don’t pay this bill, he’ll end up homeless”), and learned to **reframe** them:

- “Jason is an adult. He is capable of learning from consequences.”
- “Supporting doesn’t always mean rescuing.”

We used a **thought log** to track triggering situations and shift from automatic guilt to intentional reflection.

#### Family Systems Therapy: Redefining Roles

I used [**Bowen Family Systems Theory**](https://dralanjacobson.com/bowenian-family-therapy/) to help Mark understand **enmeshment** and how family anxiety gets passed down.

- Together, we mapped out a **genogram**, revealing that Mark’s father was emotionally distant and Mark had vowed to “never be that kind of parent.”
- This created a **reactive overcorrection** in Mark’s parenting, leading to overinvolvement with Jason.

We discussed the difference between **helping** and **enabling,** and how Jason felt unable to take responsibility because Mark always stepped in.

#### Boundary and Communication Skills

Mark learned to set **loving, firm boundaries** without withdrawing emotionally. We used role-playing to practice phrases like:

- “I trust that you’ll figure this out. I’m here to talk, but I won’t take this on for you.”
- “I’m not comfortable giving money again. Let’s talk about other options.”

We also worked on **non-defensive communication**, so Mark could express love and concern without lecturing or fixing.

#### Inner Child Work

Though Mark was skeptical at first, I gently introduced **inner child journaling**. Mark uncovered a deep fear: if he didn’t overperform as a dad, he would be as “neglectful” as his own father.

Through visualization exercises, he began to comfort and support his younger self, giving himself permission to be enough **without saving others**.

#### Detachment with Love for Overcoming Codependency

I introduced the concept of **“detachment with love”**, often used in [Al-Anon](https://al-anon.org/) and [CoDA](https://coda.org/) to heal from codependency. Mark learned that:

- Detachment is not coldness—it’s trusting others to manage their own life.
- Love doesn’t require rescuing—it can mean holding space, listening, and stepping back.

Mark started attending a [**CoDA support group**](https://coda.org/), where he found solidarity with other parents of adult children. This normalized his experience and encouraged him to keep holding boundaries.

#### Mindfulness and Emotional Regulation

Mark practiced short **breathing exercises and body scans** to manage anxiety when Jason called in distress. This gave him the space to pause before reacting or offering solutions.

He also started a regular **journaling practice**, where he explored his emotions without judgment and tracked progress.

### Online Therapy for Codependency Results

- Mark stopped providing financial support unless it aligned with clearly stated boundaries.
- He and Jason began having more honest, emotionally grounded conversations, not centered on fixing.
- Mark felt more connected to his wife, who had long felt pushed aside in Mark’s attempts to rescue Jason.
- He reported sleeping better, having fewer stomach issues, and feeling “lighter.”

“For the first time in years, I don’t feel responsible for Jason’s choices. And I still love him.”

## Summary and My Work

The need to overcome dependency is not based on a weakness—it stems from a pattern, often rooted in survival and shaped by early relationships. But patterns can change.

In therapy to treat codependency, we’ll create space for you to:

- Understand your emotional wiring
- Practice new boundaries without guilt
- Reclaim your identity, voice, and joy
- Build relationships where your needs matter, too

Whether you’re navigating a difficult dynamic with a partner, parent, or adult child, codependency therapy gives you a safe, private space to explore and grow, from wherever you are. If you’re ready to stop overfunctioning and start reconnecting with yourself, I’d be honored to help. Don’t hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) about online therapy for codependency anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Symptom Relief

---

### [Integrative Behavioral Couples Therapy](https://dralanjacobson.com/integrative-behavioral-couples-therapy/)

**Published:** October 20, 2024
**Author:** Dr. Alan Jacobson

**Content:**

I offer **integrative behavioral couples therapy** (**IBCT**) as a core approach in my practice. This post covers the basics of **IBCT therapy** and includes a case example to give you an idea of how it works. I offer this method in [online therapy](https://dralanjacobson.com/virtual-therapy-guide/), and often [pair it with other forms of treatment](https://dralanjacobson.com/integrative-therapy/). Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you want more information about how an integrative behavioral couple therapy approach could benefit you.

## Integrative Behavioral Couples Therapy Overview

IBCT therapy integrates two key elements:

1. **Behavioral Interventions:** Traditional [couples therapy](https://dralanjacobson.com/couples-therapy/) techniques focus on changing specific behaviors within the relationship. These interventions aim to improve communication, increase positive interactions, and reduce negative ones.
2. **Emotional Acceptance**: This aspect of IBCT therapy emphasizes helping partners understand and accept differences between them, fostering emotional connection and empathy. Rather than just changing behaviors, Integrative Behavioral Couple Therapy encourages couples to develop greater tolerance and acceptance for each other’s flaws and emotional sensitivities.

IBCT therapy is distinct because it combines strategies for **changing behaviors** with techniques that promote **acceptance** of inevitable conflicts and differences in relationships. Partners work on practical solutions to problems and deeper emotional understanding, making it a comprehensive approach to improving relationships.

Integrative behavioral couples therapy is evidence-based and known to [help couples achieve more satisfying, resilient relationships](https://dralanjacobson.com/marriage-counseling/). It is particularly helpful for partners struggling with ongoing conflicts, emotional disconnect, or feeling stuck in negative patterns.

### Effectiveness of IBCT Therapy

[**Integrative Behavioral Couple Therapy (IBCT)** has been shown to be an effective treatment](https://www.sciencedirect.com/science/article/abs/pii/S2352250X1630046X) for partners experiencing relationship distress. Its effectiveness stems from its balanced approach that combines behavior change with emotional acceptance. Here’s a breakdown of its effectiveness based on research and clinical studies:

#### 1. Long-Term Improvement

Research indicates that [couples who undergo IBCT often experience significant improvements in relationship satisfaction and communication](https://psycnet.apa.org/record/2004-12113-004). Importantly, these improvements tend to be sustained over time. Studies that have followed couples for several years after treatment show that many continue to benefit from the therapy, reporting better conflict management and deeper emotional connection compared to couples who did not undergo Integrative Behavioral Couples Therapy.

#### 2. Effectiveness Compared to Traditional Behavioral Couple Therapy (TBCT)

IBCT was partly developed to address the limitations of Traditional Behavioral Couple Therapy (TBCT), which focused more narrowly on behavior modification. In comparison to TBCT, research shows that:

- [**IBCT tends to work more effectively in the long term**](https://psycnet.apa.org/fulltext/2014-44018-003.html), integrating emotional acceptance and behavioral changes.
- Partners undergoing IBCT tend to report higher satisfaction levels and feel more emotionally connected to their partners.
- **Relapse rates** (where couples fall back into old patterns) are lower with Integrative Behavioral Couples Therapy than traditional treatment.

#### 3. Suitability for Different Types of Couples

[IBCT has been found effective for a range of couples](https://link.springer.com/article/10.1007/s10591-020-09560-8), including those with high levels of distress. It is especially helpful in cases where traditional behavioral therapy might fail due to deep-seated emotional issues or repeated cycles of conflict. Couples dealing with chronic conflicts, emotional disconnection, and difficulty accepting each other’s flaws often benefit more from IBCT than purely behavioral approaches.

#### 4. Acceptance Component of Integrative Behavioral Couples Therapy

One of the key reasons for IBCT’s success is the emphasis on **acceptance** alongside change. By teaching couples to accept certain unchangeable aspects of each other or their relationship, Integrative Behavioral Couple Therapy reduces the emotional burden of conflict. This helps couples who have struggled with a “change-only” mindset, fostering compassion, patience, and resilience in relationships.

#### 5. Empirical Support for Integregtaive Behavioral Couples Therapy

A large body of research supports IBCT’s efficacy. In controlled clinical trials:

- IBCT has resulted in significant improvements in **relationship satisfaction** for a wide range of couples.
- **Follow-up studies** show that after Integrative Behavioral Couple Therapy, couples generally maintain or continue to improve their emotional closeness and conflict management long after therapy ends.

## Specific Issues of Integrative Behavioral Couple Therapy

Studies also show that IBCT is effective in dealing with specific relationship problems such as:

- **Infidelity recovery**: Helping couples rebuild trust and acceptance.
- **Parenting stress**: Assisting couples in managing stress and conflict around parenting.
- **Chronic health issues**: Supporting couples facing medical challenges where one partner has a chronic illness.

### Summary of Integrative Behavioral Couples Therapy Effectiveness:

- **Improvement in relationship satisfaction** and communication for most couples.
- **Sustained long-term results** after therapy ends.
- Particularly effective for **high-distress couples** and those struggling with deep emotional conflicts.
- Greater impact compared to traditional behavioral approaches due to its focus on **acceptance**.

## IBCT Therapy Example

Sarah and John are struggling in their relationship**.** Sarah often feels emotionally distant from John, while John feels that Sarah is too critical of him. They argue frequently about household responsibilities and their different parenting styles. Over time, their communication has broken down, and they both feel disconnected. They’ve decided to try Integrative Behavioral Couple Therapy (IBCT) to improve their relationship.

### The IBCT Therapy Process in Action:

#### 1. Initial Assessment:

I conduct a detailed assessment of Sarah and John’s relationship in the first few sessions. The couple identifies the specific patterns of behavior that lead to conflict and the deeper emotional issues beneath these patterns. I find that Sarah often feels overwhelmed with responsibilities at home, leading her to become critical. John, in response, feels hurt and withdraws emotionally, which in turn makes Sarah feel more neglected and alone.

I explain the core concepts of IBCT:

- Behavioral strategies to change negative interaction patterns.
- Acceptance strategies to foster empathy and understanding of each other’s differences.

#### 2. Identifying Themes of Conflict:

Through exploration, I help them identify recurring themes in their conflict:

- Theme 1: Different coping styles. Sarah deals with stress by becoming more controlling, while John tends to withdraw.
- Theme 2: Perfectionism vs. relaxation. Sarah feels everything must be done perfectly (e.g., chores, parenting), whereas John believes in letting things slide sometimes to avoid burnout.

#### 3. Behavioral Interventions:

I introduce practical techniques to help Sarah and John address their conflicts. This might include:

- Communication training: Teaching the couple to express their needs and frustrations in a non-blaming, constructive manner. 
    - For example, Sarah learns to say, “I feel overwhelmed when I handle the housework alone,” instead of criticizing John directly.
    - John learns to listen actively and acknowledge Sarah’s feelings instead of getting defensive or withdrawing.
- Behavior exchange: Encouraging positive interactions by identifying specific behaviors each partner can change or improve. 
    - For instance, John agrees to take on specific household tasks regularly, and Sarah agrees to be less critical and recognize John’s efforts.

#### 4. Acceptance Interventions:

Next, I work on the acceptance component, helping Sarah and John to understand and empathize with each other’s emotional vulnerabilities:

- Acceptance of Sarah’s anxiety: John comes to understand that Sarah’s perfectionism and critical tendencies stem from her anxiety about being overwhelmed. Instead of taking her criticism personally, he learns to empathize with her need for security and control.
- Acceptance of John’s withdrawal: Sarah begins to see that John’s withdrawal is not a rejection of her, but his way of coping with feeling inadequate when faced with criticism. She learns to approach him with more compassion rather than frustration.

I might introduce exercises like “empathic joining”, where Sarah and John are encouraged to express vulnerable feelings (e.g., Sarah admitting how scared she feels when things aren’t perfect, or John sharing how unappreciated he feels), which builds mutual understanding.

#### 5. Unified Detachment in IBCT Therapy:

I introduce unified detachment to help the couple step back from emotionally charged situations. This technique allows Sarah and John to view their problems more objectively, almost like they’re working together to solve a puzzle. Instead of feeling personally attacked when conflict arises, they approach issues more as a team, asking, “How can we manage this situation together?”

For example, when an argument about chores starts, they recognize their typical cycle: Sarah gets critical, John shuts down. They catch themselves early in the process and break the cycle by talking calmly, saying, “We’re falling into the old pattern again—let’s take a step back.”

#### 6. Building Emotional Connection:

As Sarah and John progress through therapy, they learn to manage their conflicts more effectively and work on deepening their emotional bond. I guide them through exercises that foster emotional intimacy, such as:

- Shared activities: They commit to spending quality time together, free from distractions or responsibilities.
- Expressing appreciation: They regularly affirm each other’s efforts and positive qualities, rebuilding feelings of warmth and closeness.

#### 7. Long-Term Change and Maintenance:

As Integrative Behavioral Couple Therapy progresses, Sarah and John develop greater resilience in managing their relationship challenges. They understand that some differences (e.g., Sarah’s need for control and John’s relaxed approach) won’t entirely disappear, but they now have tools to handle these issues with acceptance and understanding.

Even after therapy ends, they continue to apply the skills they’ve learned—communicating openly, managing conflicts constructively, and staying connected emotionally.

---

### Integrative Behavioral Couples Therapy Outcome

By the end of IBCT therapy, Sarah and John have:

- Reduced their negative patterns of communication (criticism and withdrawal).
- Gained a deeper understanding of each other’s emotional needs.
- Developed practical strategies to manage conflicts.
- Built a stronger, more resilient emotional connection.

This scenario shows how IBCT integrates behavioral changes and emotional acceptance to help couples resolve conflicts and create a deeper emotional bond.

## Summary and My Work with IBCT

I provide Integrative Behavioral Couple Therapy when it is indicated, and borrow from its theories and methods even more than that. It pairs well with [parental counseling](https://dralanjacobson.com/parent-coaching/), [Emotionally Focused Therapy](https://dralanjacobson.com/eft-therapy-for-couples/) or [Imago Relationship Therapy](https://dralanjacobson.com/imago-relationship-therapy/). I have found it to be quite successful with couples facing a specific, identifyable stress or a persistent issue that they cannot overcome after a long time. Integrative Behavioral Couples Therapy can be delivered as [online couples therapy](https://dralanjacobson.com/virtual-couples-therapy/).

Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you have any questions or want to learn more about IBCT therapy could benefit you.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Couples Therapies

---

### [Treatment for Severe Anxiety](https://dralanjacobson.com/treatment-for-severe-anxiety/)

**Published:** August 24, 2024
**Author:** Dr. Alan Jacobson

**Content:**

I provide **treatment for severe anxiety**, which often involves a combination of approaches, including a mix of therapy, lifestyle changes, and sometimes alternative therapies. In this post, I go over **therapy for severe anxiety**, including the approaches I use, the additional steps you can take, and some general information about **severe social anxiety disorder**. In other posts, I go over treatment for other types of anxiety that can be severe, including [fear of public speaking](https://dralanjacobson.com/cbt-for-fear-of-public-speaking/), [fear of flying](https://dralanjacobson.com/flying-anxiety-treatment/), [panic attacks](https://dralanjacobson.com/panic-attack-treatment/), [test-taking anxiety](https://dralanjacobson.com/test-taking-anxiety/), and specific phobias.

This post provides a general overview of treatments for severe social anxiety disorder to help you become an informed customer whether you choose my services or those of someone else. Please do not hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you have any questions about my approach or practice.

## Severe Social Anxiety Disorder Overview

Severe Social Anxiety Disorder (SAD) is a chronic mental health condition characterized by an intense and persistent fear of social situations where one might be scrutinized, judged, or embarrassed. This fear is often so overwhelming that it interferes significantly with daily life, relationships, and functioning.

### Key Characteristics of Severe Social Anxiety Disorder:

1. **Intense Fear of Social Situations:**
    - People with severe SAD experience extreme fear in situations where they might interact with others, be observed, or perform in front of others.
    - Common feared situations include [speaking in public](https://dralanjacobson.com/fear-of-public-speaking-therapy-process/), meeting new people, eating in front of others, or attending social gatherings.
2. **Avoidance Behavior:**
    - Individuals may go to great lengths to avoid social situations altogether to avoid intense fears. This can lead to isolation and difficulties in personal and professional life.
    - In severe cases, avoidance behavior can severely limit one’s ability to attend school, work, or engage in everyday activities.
3. **Physical Symptoms:**
    - The symptoms can trigger intense physical symptoms, such as rapid heartbeat, sweating, trembling, blushing, nausea, or even panic attacks.
    - These symptoms often reinforce the fear of embarrassment or judgment, creating a vicious cycle.
4. **Cognitive Symptoms:**
    - People with SAD may have an overwhelming fear of being negatively evaluated or humiliated. They may also have distorted thinking, such as believing they are inadequate or that others are always critical.
    - They might engage in “mind-reading,” assuming others judge them harshly even when no evidence supports this belief.
5. **Impact on Daily Life:**
    - Severe social anxiety disorder can lead to significant impairment in social, occupational, and educational functioning.
    - Relationships may suffer as the individual avoids social interactions and career advancement might be hindered due to avoidance of job-related social activities like meetings or presentations.
6. **Co-Occurring Conditions:**
    - Severe social anxiety disorder often co-occurs with other mental health disorders, such as depression, other anxiety disorders, or substance use disorders.
    - The presence of these co-occurring conditions can exacerbate the symptoms and complicate treatment.

### Causes and Risk Factors:

- **Genetic Factors:** There is evidence to suggest that [social anxiety disorder has a genetic component](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5325045/), meaning it can run in families.
- **Environmental Factors:** Traumatic or negative social experiences, such as bullying or rejection, particularly during childhood or adolescence, can contribute to the development of Severe Social Anxiety Disorder.
- **Brain Chemistry:** An [imbalance in neurotransmitters](https://www.healthline.com/health/chemical-imbalance-in-the-brain) like serotonin may play a role in anxiety disorders.
- **Temperament:** Individuals with a naturally shy, inhibited, or introverted temperament may be more prone to developing social fears.

## Treatment for Severe Anxiety

Here’s an overview of the types of treatment for severe anxiety that may help, and in my practice, I can coordinate a plan for you that provides therapy for severe anxiety in combination with other approaches.

### 1. Therapy for Severe Anxiety In Brief

- **[Cognitive Behavioral Therapy](https://dralanjacobson.com/cbt-for-social-anxiety/) (CBT):** This is one of the most effective forms of therapy. It helps you identify and challenge negative thought patterns and behaviors.
- **[Exposure Therapy](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/):** Often used for phobias and panic disorders, this therapy gradually exposes you to the source of your anxiety in a controlled way to reduce fear.
- **[Dialectical Behavior Therapy](https://en.wikipedia.org/wiki/Dialectical_behavior_therapy) (DBT):** Originally developed for borderline personality disorder, DBT is also effective for treating social fears. It combines mindfulness with CBT strategies.
- **[Acceptance and Commitment Therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) (ACT):** Focuses on accepting worries rather than fighting them and committing to actions that align with your values despite fears.

More about [therapy for severe anxiety](https://dralanjacobson.com/therapy-for-social-anxiety-disorder/) is below.

### 2. Medications as Treatment for Severe Anxiety:

I often suggest that you try therapy for severe anxiety before medications so that when you feel an improvement, you know exactly what is working. For some, therapy for severe anxiety works well but not quite well enough, and medication can increase the effects. These are the medications often prescribed.

- **Selective Serotonin Reuptake Inhibitors (SSRIs):** Commonly prescribed antidepressants that can help reduce symptoms (e.g., Sertraline, Escitalopram).
- **Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs):** Similar to SSRIs but also affect norepinephrine (e.g., Venlafaxine, Duloxetine).
- **Benzodiazepines:** These are fast-acting medications (e.g., Lorazepam, Clonazepam), but they are usually prescribed for short-term use due to the risk of dependence.
- **Beta-Blockers:** Sometimes used to manage physical symptoms like rapid heartbeat (e.g., Propranolol).
- **Buspirone:** A medication that’s less likely to cause dependence.

### 3. Lifestyle Changes:

In addition to therapy for severe anxiety, there are other steps you can take

- **Exercise:** Regular physical activity can reduce symptoms.
- **Diet:** Eating a balanced diet, avoiding excessive caffeine and alcohol, and staying hydrated can help.
- **Sleep:** Ensuring good sleep hygiene and enough rest is crucial for mental health.
- **[Mindfulness and Relaxation Techniques](https://dralanjacobson.com/mindfulness-therapy/):** Practices like meditation, deep breathing, and progressive muscle relaxation can be effective.

### 4. Alternative Therapy for Severe Anxiety

While these approaches may not be enough to reduce your fears alone, they can help.

- **Herbal Supplements:** Some people find relief with supplements like valerian root, kava, or chamomile, but these should be used with caution and under the guidance of a healthcare provider.
- **Acupuncture:** This traditional Chinese medicine technique has been shown to help some people.
- **[Yoga and Tai Chi](https://www.health.harvard.edu/staying-healthy/tai-chi-or-yoga-4-important-differences):** These combine physical movement, breath control, and meditation, which can help.

### Group Treatment for Severe Anxiety:

- **Group Participation**: Participating in a support group, either in-person or online, can provide comfort and advice from others who understand what you’re going through.

I can help coordinate a plan made up of all of these areas to provide the best treatment for severe anxiety for your unique needs,

## Best Therapy for Severe Anxiety

The best therapy for severe anxiety can vary depending on you, the nature of your anxiety, and other personal factors. However, some therapies are widely recognized as being particularly effective:

### 1. [Cognitive Behavioral ](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/)Treatment for Severe Anxiety

- **Why It’s Effective:** CBT is considered the gold standard for treating these fears. It focuses on identifying and challenging negative thought patterns and behaviors that contribute.
- **How It Works:** CBT teaches you to reframe negative thoughts, manage stress, and confront fears in a controlled manner. It often includes techniques like exposure therapy, where you gradually face your fears in a safe environment.
- **Evidence:** Numerous studies have shown that CBT is highly effective in reducing symptoms and preventing relapse. You come away from therapy with a toolkit to use to reduce your sensitivity to triggers that cause social fears.

### 2. [Exposure Therapy](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/) for Severe Anxiety

- **Why It’s Effective:** This is particularly useful as [therapy for specific phobias](https://dralanjacobson.com/therapy-for-phobias/), severe social anxiety disorder, and panic disorder. It helps reduce the fear associated with triggers.
- **How It Works:** You’re gradually exposed to the source in a controlled way, allowing you to desensitize yourself to the trigger.
- **Evidence:** Research supports [exposure therapy for anxiety disorders](https://dralanjacobson.com/exposure-therapy-for-anxiety/) as a powerful tool in reducing the frequency and intensity of episodes.

### 3. [Dialectical Behavior Therapy](https://en.wikipedia.org/wiki/Dialectical_behavior_therapy) (DBT):

- **Why It’s Effective:** Originally developed for borderline personality disorder, DBT is also effective for severe social anxiety disorder, particularly when intense emotions accompany it.
- **How It Works:** DBT combines mindfulness practices with CBT techniques. It teaches skills like distress tolerance, emotion regulation, and interpersonal effectiveness.
- **Evidence:** DBT is particularly effective for individuals with severe symptoms and co-occurring conditions like depression.

### 4. [Acceptance and Commitment Treatment for Severe Anxiety](https://dralanjacobson.com/act-psychotherapy/):

- **Why It’s Effective:** ACT is useful for those struggling to accept their symptoms. It helps you focus on living a meaningful life despite fears.
- **How It Works:** ACT encourages you to accept anxious thoughts rather than fight them, and to commit to actions aligned with your values.
- **Evidence:** Studies have shown that ACT effectively reduces symptoms and improves quality of life, particularly in chronic cases.

### 5. [Mindfulness-Based Stress Reduction](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) (MBSR):

- **Why It’s Effective:** [Mindfulness-based stress reduction](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) can be beneficial for those whose anxiety is related to stress. It teaches mindfulness meditation and awareness techniques.
- **How It Works:** Through mindfulness, you learn to focus on the present moment, which can reduce the tendency to [ruminate on anxious thoughts](https://www.psychologytoday.com/us/blog/inviting-a-monkey-to-tea/202410/how-to-unstick-your-mind-from-negative-thoughts?msockid=1686e8c22e816b8a1935fc532fc26a1c).
- **Evidence:** Research has shown MBSR to reduce symptoms of anxiety, stress, and depression.

### Choosing the Best Treatment for Severe Anxiety

- **Personal Fit:** The effectiveness of therapy can depend on your personal preferences, the specific nature of your fears, and your relationship with your therapist.
- **Combination Approaches:** Sometimes, combining therapies (e.g., CBT with mindfulness techniques) can be more effective than a single approach. This is why I offer an [integrative approach](https://dralanjacobson.com/integrative-therapy/).
- **Consultation:** It’s essential to consult with a mental health professional like me to assess your specific needs and determine the best course of action.

Overall, **[Cognitive Behavioral Therapy](https://dralanjacobson.com/cbt-for-depression/) (CBT)** is often the first line of treatment for severe anxiety, but exploring other options like DBT, ACT, or MBSR might be beneficial depending on your specific circumstances.

## Treatment for Severe Anxiety Example

Here is a fictional example of therapy for severe anxiety that involves the structured and evidence-based approaches I commonly use:

### Combining CBT and Mindfulness

#### Therapy for Severe Anxiety: Initial Assessment

- Goal: Understanding your specific triggers, symptoms, and their impact on daily life.
- Process: 
    - I gather background information about your worries, including when they started, specific events that trigger them, and how they manifest (e.g., [panic attacks](https://dralanjacobson.com/panic-attack-treatment/), constant worry, physical symptoms like a racing heart).
    - Then, we discuss goals and expectations for therapy. For example, you might want to reduce panic attacks or manage social situations better.

#### Identifying Negative Thought Patterns

- Goal: Help you recognize how your thoughts contribute.
- Example Exercise: 
    - Many people with [social anxiety](https://dralanjacobson.com/cbt-for-social-anxiety/) might identify automatic negative thoughts, such as “Everyone will judge me” when preparing for a social event. In those cases, I guide you in recognizing that these thoughts are distorted and not necessarily true.

#### Challenging Irrational Beliefs

- Goal: Teach you how to challenge and reframe negative or irrational thoughts.
- Example Technique: 
    - I might introduce techniques like thought records. For instance, if you think, “I’ll embarrass myself during a presentation,” I encourage you to evaluate the evidence for and against this thought and develop a more balanced perspective: “I’ve prepared well, and it’s unlikely I’ll embarrass myself.”

#### Exposure Therapy for Severe Anxiety

- Goal: Gradually expose yourself to feared situations to reduce symptoms over time.
- Example Exercise: 
    - For those with panic disorder, I may introduce interoceptive exposure, where you are guided to deliberately experience physical sensations (e.g., rapid heart rate or dizziness) in a controlled environment. This helps reduce the fear of those sensations.
    - Those with social anxiety might gradually be exposed to social situations, starting with smaller, less intimidating situations and working up to larger or more anxiety-provoking ones (e.g., attending a small gathering and then later giving a presentation).

#### Building Coping Strategies

- Goal: Equip you with coping tools for managing anxiety in everyday life.
- Techniques: 
    - Breathing exercises to manage acute symptoms such as panic attacks (e.g., [deep diaphragmatic breathing](https://my.clevelandclinic.org/health/articles/9445-diaphragmatic-breathing)).
    - [Progressive muscle relaxation](https://www.healthline.com/health/progressive-muscle-relaxation) helps you learn to relax your body, reducing the physical symptoms.
    - Mindfulness meditation, which involves staying present and observing thoughts without judgment, can help manage chronic worry.

#### Relapse Prevention and Long-term Strategies

- Goal: Ensure you are prepared to manage anxiety in the future, even after therapy ends.
- Plan: 
    - I help you develop a long-term plan for dealing with triggers and potential setbacks. We discuss strategies to maintain progress, including continuing with relaxation techniques, staying active, and challenging negative thoughts as they arise.
    - Booster sessions are scheduled to check progress and provide additional support as needed.

#### Treatment for Severe Anxiety Outcome:

The goal is to lead to significantly reduced anxiety levels, fewer panic attacks, and increased confidence in handling social situations. You will have developed coping strategies that help you manage anxiety when it arises and feel more in control of your thoughts and reactions

## My Approach

I provide treatment for severe anxiety that often involves therapy mixed with alternative and adjunctive approaches that combine to give you the best possible results. This post focused on Severe Social Anxiety Disorder, but I also treat specific anxieties such as [fear of flying](https://dralanjacobson.com/fear-of-flying-therapy/), [public speaking phobias](https://dralanjacobson.com/public-speaking-anxiety/), and [panic attacks](https://dralanjacobson.com/panic-attack-treatment/).

Please do not hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you have any questions about my approach or about treatment for severe anxiety in general.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Symptom Relief

---

### [Does Therapy Help? What Form of Therapy Works Best?](https://dralanjacobson.com/does-therapy-help-what-form-of-therapy-works-best/)

**Published:** June 16, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Common questions I am asked are, “Does therapy help?”, “Can therapy help with \_\_\_\_\_\_\_\_\_\_\_?”, and, “What form of therapy works best?” As a psychologist who works with individuals, couples, and families, I can confidently say that **therapy can change lives.** Whether you’re struggling with anxiety, depression, relationship issues, or simply feeling stuck, you can find a form of treatment that offers a structured, compassionate space to find clarity, learn new skills, and move toward meaningful change. So many people assume they have to be in crisis to seek help, but in reality, therapy is for anyone who wants to understand themselves better, break unhelpful patterns, or build stronger relationships.

This post answers the above and other questions, including “**Does therapy help with depression?**” and “**Does therapy help with anxiety?**”

## Does Therapy Help?

**Therapy helps** for a wide range of emotional, psychological, and relational challenges. Whether you’re dealing with overwhelming feelings, recurring conflict, or want [help with major life transitions](https://dralanjacobson.com/life-transitions-therapy/), it provides a safe, structured space to explore issues, develop insight, and build practical coping strategies. Numerous studies show that it can produce lasting improvements in mood, behavior, and functioning, often as effectively as medication—and in some cases, more so. Importantly, this type of treatment is not just for those in crisis. It can enhance well-being, build self-awareness, improve communication, and support personal growth.

The effectiveness depends on several factors, including the nature of the issue, the approach used, and the strength of the relationship between therapist and client. For many people, therapy offers a uniquely supportive environment where they can gain clarity, acquire new skills, and work through entrenched patterns with the guidance of a trained professional.

Here’s how therapy helps in specific situations:

### Does Therapy Help with Depression?

**Yes.** Many [different types of therapy for depression](https://dralanjacobson.com/best-types-of-therapy-for-depression/) are proven to work, especially for mild to moderate cases, and often complements medication in more severe cases. It helps individuals identify the roots of their depression, shift unhelpful thought patterns, and re-engage with life in meaningful ways.

#### Effective therapies for depression include:

- **[Cognitive Behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT):** Teaches how to challenge negative thinking and increase positive behaviors.
- **[Interpersonal Therapy](https://dralanjacobson.com/interpersonal-therapy/) (IPT):** Focuses on improving relationships and resolving social stressors.
- **[Psychodynamic](https://dralanjacobson.com/psychodynamic-therapy/):** Helps explore underlying emotional conflicts, often rooted in early experiences.
- **[Behavioral Activation](https://dralanjacobson.com/behavioral-activation/):** Encourages scheduling of pleasurable or meaningful activities to combat withdrawal and apathy.

So, does therapy help with depression? Absolutely!

### Does Therapy Help with Anxiety?

**Yes.** It is highly effective for all types of anxiety, including generalized anxiety, panic disorder, social anxiety, and [treating specific phobias](https://dralanjacobson.com/therapy-for-phobias/). It helps reduce distress, improve functioning, and increase confidence in managing anxious thoughts and situations.

#### Commonly used therapies include:

- **[CBT for Social Anxiety](https://dralanjacobson.com/cbt-for-social-anxiety/) (Cognitive Behavioral Therapy):** Identifies anxious thought patterns and replaces them with realistic thinking, while reducing avoidance behaviors.
- **[Exposure Therapy](https://dralanjacobson.com/exposure-therapy-for-anxiety/):** Involves facing feared situations in a safe, gradual way to reduce avoidance and reactivity.
- **[Acceptance and Commitment Therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) (ACT):** Encourages mindfulness and commitment to personal values in the presence of anxiety.
- **[Mindfulness-Based Cognitive Therapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) (MBCT):** Combines mindfulness meditation with cognitive techniques.

Does therapy help with anxiety? It can be invaluable!

### Does Couples Therapy Help?

**Yes.** [Couples treatment](https://dralanjacobson.com/couples-therapy/) can be highly effective at improving communication, resolving recurring conflicts, rebuilding trust, and enhancing emotional intimacy. Even couples not in crisis can benefit from therapy to deepen their connection or navigate changes like parenting or relocation.

#### Well-supported approaches include:

- **[Emotionally Focused Couples Therapy](https://dralanjacobson.com/eft-therapy-for-couples/) (EFT):** Focuses on attachment needs and emotional bonding.
- **[Gottman Method](https://www.gottman.com/about/the-gottman-method/):** Based on decades of research, targeting communication patterns and conflict resolution.
- **[Integrative Behavioral Couple Therapy](https://dralanjacobson.com/integrative-behavioral-couples-therapy/) (IBCT):** Combines acceptance and behavior change strategies.
- **Cognitive Behavioral Couples Therapy (CBCT):** Works on identifying and reshaping distorted beliefs and unhelpful interaction patterns.
- **[Relational Life Therapy](https://dralanjacobson.com/relational-life-therapy-rlt/) (RLT)**: Works to address power imbalances, built-up resentment, and dysfunctional relationship patterns

### Does Family Therapy Help?

**Yes.** Family treatment can help improve dynamics, address communication breakdowns, support children or teens with emotional or behavioral challenges, and heal from collective stress like trauma, divorce, or illness. It’s beneficial when one member’s challenges impact the entire household. It can also help with [family estrangement](https://dralanjacobson.com/family-estrangement-therapy/) or to [help blended families](https://dralanjacobson.com/blended-family-therapy-step-parent-counseling/).

#### Common family therapy models include:

- **[Structural Family Therapy](https://dralanjacobson.com/structural-family-therapy/):** Reorganizes unhealthy family roles and boundaries.
- **[Strategic Family Therapy](https://dralanjacobson.com/strategic-family-therapy-powerful-positive-time-limited/):** Targets specific patterns and behaviors through focused interventions.
- **[Narrative Family Therapy](https://dralanjacobson.com/narrative-family-therapy/):** Helps the family “re-author” their story in a more empowering way.
- **Functional Family Therapy (FFT):** Often used with at-risk youth, integrating behavior change and relationship improvement.

### Final Thought:

Whether it’s for emotional health, relationship repair, or navigating complex transitions, therapy empowers individuals to make lasting changes, gain a deeper understanding of themselves, and lead more fulfilling lives.

## What Form of Therapy Should I Choose?

The [right form of therapy](https://dralanjacobson.com/types-of-therapy/) depends on what youre struggling with, how you prefer to communicate, and what kind of change you’re seeking. There’s no one-size-fits-all answer, but here’s a guide to help you decide:

### 1. What Are You Seeking Help For?

- **Anxiety or Depression:**
    - **Cognitive Behavioral (CBT)** is one of the most researched and effective therapies for both.
    - **Acceptance and Commitment (ACT)** or [**Mindfulness-Based Therapy**](https://dralanjacobson.com/mindfulness-therapy/) may help if you want to manage distress rather than change your thoughts directly.
    - **Interpersonal (IPT)** is useful if your symptoms are linked to relationship stress or life transitions.
- **Relationship or Marital Issues:**
    - **Emotionally Focused (EFT)** and the **Gottman Method** are excellent for improving emotional connection and communication.
    - **Integrative Behavioral Couples (IBCT)** helps with both acceptance and behavioral change.
- **Family Conflict or Parenting Struggles:**
    - **Structural** helps reorganize family roles and boundaries.
    - **Strategic** focuses on resolving specific problematic patterns.
    - **Family-Based** is often used with children or teens, especially if one family member is struggling with behavior, eating issues, or school problems.
- **Self-Exploration, Past Trauma, or Complex Emotional Patterns:**
    - **Psychodynamic (including [STDP](https://dralanjacobson.com/short-term-dynamic-psychotherapy/)),** **Jungian, or [insight therapy](https://dralanjacobson.com/insight-therapy/) approaches** explore your past, subconscious conflicts, and inner world.
    - **Eye Movement Desensitization and Reprocessing (EMDR)** is especially effective for trauma and PTSD.

### 2. Do You Want Practical Tools or Deep Insight?

- Choose **CBT**, **ACT**, or [**Solution-Focused Therapy**](https://dralanjacobson.com/solution-focused-therapy/) if you want short-term, structured sessions with clear strategies and homework.
- Choose **Psychodynamic** or [**Humanistic Therapy**](https://dralanjacobson.com/humanistic-therapy/) if you want to explore your emotions, past experiences, or identity more deeply over time.

### 3. How Do You Prefer to Engage?

- **Talk-Based:** Most therapies involve verbal dialogue and reflection.
- **[Creative Counseling](https://dralanjacobson.com/creative-counseling/):** If you express yourself best through movement, drawing, or music, look into [**Art Therapy**](https://arttherapy.org/what-is-art-therapy/), [**Music Therapy**](https://www.musictherapy.org/about/musictherapy/), or [**Drama Therapy**](https://positivepsychology.com/drama-therapy/).
- **Body-Based:** If you carry trauma or anxiety physically, [**Somatic Experiencing**](https://dralanjacobson.com/somatic-therapy/) or **Sensorimotor**  approaches may be right for you.
- **[Virtual Therapy Options](https://dralanjacobson.com/virtual-therapy-guide/):** Many therapies are now offered online, making access easier.

### Final Tips:

- **Start with your goals.** Do you want symptom relief, deeper insight, better relationships, or all of the above?
- **Don’t worry about choosing perfectly at first.** Many therapists integrate techniques from various approaches tailored to your specific needs.
- **A strong connection with your therapist** is just as important—if not more—than the approach they use.

If you’re unsure, consider a [consultation session to discuss the therapist’s approach](https://dralanjacobson.com/therapy-faqs/) and how it aligns with your concerns. You’re allowed to ask questions and switch therapists if it’s not the right match. We do not take it personally at all when people want to switch – in fact, we can often help you find a better match.

### Can Therapy Help Virtually?

**Yes. Virtual approaches can be just as effective as in-person.** Research consistently shows that online approaches (also called [teletherapy](https://dralanjacobson.com/telehealth-therapy-teletherapy/) or telehealth counseling) are effective for [treating major depression](https://dralanjacobson.com/treating-major-depression/), anxiety, PTSD, relationship issues, and more. It offers convenience, privacy, and access to therapists who may not be nearby, especially helpful for people with busy schedules, health limitations, or those living in rural areas.

### Therapies that work well online include:

- **[CBT online](https://dralanjacobson.com/therapy-online-approaches-techniques-and-outcomes/) (Cognitive Behavioral)**
- **ACT (Acceptance and Commitment)**
- **[Couples therapy](https://dralanjacobson.com/therapy-faqs/) (e.g., EFT, Gottman Method)**
- **Mindfulness-based approaches**
- [**Existential**](https://dralanjacobson.com/existential-therapy/) and [**Logotherapy**](https://dralanjacobson.com/logotherapy/)

Video sessions, phone calls, and even text-based therapy can all be helpful depending on your comfort level and needs. What matters most is the connection with your therapist and your commitment to the process.

### Can Therapy Help If It’s Only Once per Week?

**Yes. Most approaches are designed around a once-a-week model, which has proven to be effective.** Weekly sessions provide enough consistency to build a strong relationship with your therapist, reflect on insights between meetings, and practice new coping strategies in daily life. For many people, this rhythm strikes the right balance between support and autonomy.

In some cases, people may benefit from more frequent sessions (e.g., during crises or intensive treatment), while others taper down to biweekly or monthly check-ins once progress has been made. The frequency can be adjusted based on goals, availability, and needs.

### Can Therapy Help Teenagers?

**Yes. [Therapy for teens](https://dralanjacobson.com/therapy-for-teens/) can be life-changing.** Adolescence is a pivotal period for emotional development, identity formation, and learning to manage stress. Meeting with a psychologist helps teens navigate anxiety, depression, self-esteem issues, social pressures, family conflict, and academic stress. It also gives them a safe space to express themselves without judgment.

#### Common therapy types for teens include:

- **CBT:** Teaches coping skills for anxiety, depression, and negative thinking.
- **[DBT for Teens](https://dralanjacobson.com/dbt-for-teens/) (Dialectical Behavior Therapy):** Helps with emotional regulation and impulse control—especially effective for teens struggling with intense emotions or self-harm.
- **[Family Therapy](https://dralanjacobson.com/family-therapy/):** Improves communication and understanding between parents and teens.
- **Art or Play:** Offers non-verbal ways to process emotions, especially for younger or less verbal teens.

A therapist trained in adolescent development will tailor the approach to the teen’s personality and challenges. With the right fit, therapy can improve a teen’s mental health, relationships, and resilience well into adulthood. Does therapy help with depression in teenagers? Yes. Does therapy help with anxiety in teenagers? Yes, that too!

## What is a New and Promising Form of Therapy

The field of mental health is constantly evolving, with innovative therapies emerging that blend neuroscience, mindfulness, technology, and evidence-based practice. While traditional talk therapies remain highly effective, here are some **new and promising forms of therapy** gaining attention for their potential to transform mental health care:

#### 1. EMDR (Eye Movement Desensitization and Reprocessing)

Originally developed for trauma and PTSD, EMDR is now being applied to anxiety, depression, and phobias. It uses bilateral stimulation (like eye movements) to help the brain reprocess distressing memories, reducing emotional intensity and promoting healing.
**Why it’s promising:** Fast-acting for trauma, even when traditional talk therapy hasn’t worked.

#### 2. [Neurofeedback](https://www.verywellmind.com/neurofeedback-therapy-definition-techniques-and-efficacy-5193195)

This cutting-edge approach uses real-time brainwave data to help individuals learn how to regulate their own brain activity. It’s non-invasive and increasingly used for ADHD, anxiety, depression, PTSD, and sleep disorders.
**Why it’s promising:** It helps retrain the brain without medication by increasing awareness of internal states.

#### 3. Virtual Reality (VR Therapy)

Virtual reality is being integrated into exposure approaches for phobias, PTSD, and social anxiety by simulating realistic environments in a controlled, safe space.
**Why it’s promising:** It provides immersive, customizable scenarios that make treatment more engaging and accessible.

#### 4. Somatic Experiencing (SE)

This body-focused approach helps people release trauma stored in the nervous system by paying attention to physical sensations and movement. It’s especially helpful for trauma survivors who feel stuck in “fight, flight, or freeze.”
**Why it’s promising:** It bypasses language, helping those who struggle to articulate emotional pain.

#### 5. [Psychedelic-Assisted](https://athomepsychedelictherapy.com/) *(in clinical trials and some legal contexts)*

Therapies involving substances like psilocybin (magic mushrooms), MDMA, or ketamine—combined with psychotherapy—are showing powerful results in reducing [treatment-resistant depression](https://dralanjacobson.com/treatment-resistant-depression/), PTSD, and end-of-life anxiety.
**Why it’s promising:** Some patients experience rapid and lasting relief after just a few sessions under professional guidance.

#### 6. Internal Family Systems (IFS)

IFS treats the mind as a system of “parts” (like the inner critic, wounded child, or protector). Instead of silencing these parts, IFS helps them collaborate and heal through a compassionate, self-led process.
**Why it’s promising:** It integrates mindfulness and trauma-informed care in a non-pathologizing way.

#### 7. Mentalization-Based (MBT)

Originally designed for borderline personality disorder, MBT helps people better understand their own and others’ mental states. It’s increasingly used for relationship issues, attachment problems, and emotional dysregulation.
**Why it’s promising:** It strengthens emotional insight and improves interpersonal functioning.

These emerging therapies are opening doors for individuals who may not have responded to traditional methods or who are seeking more personalized, brain-body integrated care. While not all are widely available or suitable for everyone, they represent the future of mental health—**more tailored, holistic, and innovative** than ever before. If you’re curious about trying something new, [contact me](https://dralanjacobson.com/contact/) anytime. I try to stay up to date on these exciting developments, even those I do not offer.

## What Kind of Therapists are There?

There are many different **kinds of therapists**, each with specialized training, techniques, and target populations. Here’s a breakdown of the most common types of therapists and what they do:

### What Kind of Therapists are There: Credentials or Licensure

**Title****What They Do****[Clinical Psychologist](https://dralanjacobson.com/what-is-a-clinical-psychologist/) (PhD or PsyD)**Trained in [psychological testing](https://psychologicalassessments.com/), diagnosis, and therapy; often treat complex mental health conditions.**[Licensed Clinical Social Worker](https://www.verywellmind.com/licensed-clinical-social-worker-3145146) (LCSW)**Focus on emotional and behavioral issues and often address social/environmental stressors.**Licensed Professional Counselor (LPC/LMHC)**Provide talk therapy for a range of emotional and mental health issues.**[Marriage and Family Therapist](https://www.aamft.org/AAMFT/Directories/Find_a_Therapist.aspx) (LMFT)**Specialize in relationship dynamics, couples counseling, and family therapy.**Psychiatrist (MD or DO)**A medical doctor who can prescribe medication and provide therapy. Often focuses on medication management.**School Psychologist**Works in school settings to address learning, behavior, and emotional issues in students.[**Therapeutic Tutor** ](https://therapeutictutoring.com/)Combines academic tutoring with psychotherapeutic methods.**Art/Music/Drama Therapist**Uses creative arts to help clients express themselves and process trauma or emotions.### What Kind of Therapists are There: Therapeutic Modality or Approach

**Type****Focus or Technique****Cognitive Behavioral Therapist (CBT)**Helps clients identify and change distorted thought patterns and behaviors.**Dialectical Behavior Therapist (DBT)**Focuses on emotional regulation, distress tolerance, and interpersonal effectiveness—often used for BPD.**Psychodynamic Therapist**Explores unconscious processes and early life experiences to understand present behavior.**Humanistic/Person-Centered Therapist**Emphasizes empathy, self-growth, and client empowerment.**EMDR Therapist**Uses Eye Movement Desensitization and Reprocessing to treat trauma and PTSD.**Trauma-Informed Therapist**Prioritizes safety, trust, and sensitivity to trauma experiences in treatment.**Mindfulness-Based Therapist**Incorporates meditation and present-moment awareness to manage stress, anxiety, and depression.### What Kind of Therapists are There: By Population or Specialty

**Specialty****Clients Served****Child or Adolescent Therapist**Specializes in developmental and emotional issues in youth.**Couples Therapist**Works with romantic partners on communication, conflict, or intimacy issues.**Family Therapist**Focuses on family dynamics and systemic issues.**Grief Counselor**Helps individuals process loss and bereavement.**Addiction Counselor**Works with substance use and behavioral addictions.**LGBTQ+ Affirming Therapist**Provides inclusive support for sexual and gender identity concerns.**Veterans or Trauma Therapist**Specialized training in working with combat trauma, PTSD, and military culture.**Career Counselor**Helps with job stress, transitions, or vocational decisions.### What Kind of Therapists are There: Setting or Delivery

**Setting****Description**[**Private Practice Therapist**](https://dralanjacobson.com/finding-a-private-practice-therapist/)Sees clients independently, often for weekly sessions.**Community Mental Health Therapist**Works in nonprofit or government-funded clinics.**School-Based Therapist**Supports students in academic settings.**Teletherapist**Provides care remotely via video or phone.**Inpatient/Residential Therapist**Works with individuals in hospitals or treatment centers.There are also closely aligned fields such as executive coaching and more general leadership coaching. [Choosing the best therapist](https://dralanjacobson.com/choosing-the-best-therapist-for-you/) for you may mean doing some homework about the potential types.

## Final Thought

Bottom line: “Does therapy help?” Yes, and it can be life-changing. And if you’ve ever wondered, “Can therapy help me?” I encourage you to give it a try. Even one conversation with a supportive professional can open the door to relief, insight, and hope. Almost any form of therapy isn’t about being “broken.” It’s about being human. Whether in person or online, once a week or on your timeline, it is a powerful tool for growth, healing, and connection. You deserve support, and there is no shame in seeking it. Your future self may thank you for the courage to take this step.

If you’d like some help finding a good match, have additional questions about [how to find the best therapist](https://dralanjacobson.com/the-best-way-to-find-a-therapist-using-therapist-finders-word-of-mouth-and-other-therapy-resources/) for you, or would like to inquire about my services, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Mindfulness-Based Cognitive Therapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/)

**Published:** December 17, 2023
**Author:** Dr. Alan Jacobson

**Content:**

**Mindfulness-Based Cognitive Therapy** (**MBCT**) is a therapeutic approach combining techniques from these powerful and effective approaches. It was initially developed to help prevent relapse in individuals who have experienced recurrent episodes of depression. I provide this method as a subset of [CBT](https://dralanjacobson.com/mindfulness-therapy/) to a wide variety of clients, from teenagers to adults. It can also be done with families (with older children) and couples. I also use it in [my clinical specialties](https://dralanjacobson.com/intensive-therapy-and-specialty-services/), including [Sports Psychology](https://dralanjacobson.com/sports-psychology/) and Executive Coaching. Finally, I offer two specific types: mindfulness-based cognitive therapy for anxiety and mindfulness-based cognitive therapy for depression. The following is a guide to help you decide whether mindfulness based cognitive therapy might be for you, but feel free to [get in touch](https://dralanjacobson.com/contact/) any time.

### What is Mindfulness Based Cognitive Therapy (MBCT)? ![Mindfulness-based cognitive therapy](https://dralanjacobson.com/wp-content/uploads/2023/12/cognition-300x300.png "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

The core idea behind MBCT is to cultivate an awareness of your thoughts, feelings, bodily sensations, and the surrounding environment. This involves practicing meditation, [body scanning](https://health.clevelandclinic.org/body-scan-meditation), and other exercises to develop a non-judgmental awareness of the present moment.

In MBCT, cognitive techniques are integrated with these practices. It aims to help you recognize and change automatic negative thought patterns that can lead to depression or anxiety. By becoming more aware of these thoughts and feelings, you can learn to respond to them healthier rather than getting caught in cycles of rumination and distress.

### Mindfulness-Based Cognitive Therapy Development

Mindfulness-based cognitive Therapy (MBCT) originated in the late 1990s as a response to the need for effective treatments to prevent relapse in individuals who had experienced recurrent episodes of depression. The development of MBCT involved the collaboration of several individuals, primarily [Zindel Segal](https://en.wikipedia.org/wiki/Zindel_Segal), [Mark Williams](https://www.goodtherapy.org/famous-psychologists/mark-williams.html), and [John Teasdale](https://en.wikipedia.org/wiki/John_D._Teasdale). These pioneers combined elements from cognitive treatment, developed by [Aaron Beck](https://en.wikipedia.org/wiki/Aaron_Beck), with [Jon Kabat-Zinn](https://en.wikipedia.org/wiki/Jon_Kabat-Zinn). They aimed to create a program that could address the tendency of individuals in remission from depression to relapse into depressive episodes.

The core concept was based on the idea that individuals who have recovered from depression might be at risk of relapse when faced with certain triggers or stressors. They may fall back into negative thinking patterns that contributed to their depression in the first place.

[Research conducted on MBCT](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995449/) showed promising results, demonstrating its efficacy in reducing the risk of relapse in individuals with a history of depression. Over time, MBCT’s applications expanded beyond depression to address various mental health conditions and stress-related issues.

## What is Mindfulness Based Cognitive Therapy Used For?

Mindfulness-Based Cognitive Therapy (MBCT) follows a specific process designed to create change that improves well-being and contentment. The following is an overview of my MBCT process, though I tailor it more specifically to each person.

### MBCT Structure

1. Psychoeducation: Initially, clients learn about the interaction between thoughts, feelings, and behaviors. They begin to more fully understand the role of automatic negative thinking in maintaining emotional distress through [cognitive therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/).
2. Training: Clients are then introduced to paying attention to the present moment without judgment. Techniques such as focused breathing, body scans, and certain types of movement are taught to cultivate awareness.
3. [Cognitive Restructuring](https://dralanjacobson.com/cognitive-restructuring/): MBCT incorporates cognitive techniques to identify and challenge negative thought patterns. Individuals learn to recognize automatic negative thoughts and develop more adaptive ways of responding to them.

### In and Out of Session Work

In-person sessions involve guided exercises, discussions, and cognitive techniques. Clients are also encouraged to practice exercises daily outside of sessions. This regular practice helps reinforce skills learned during the sessions and integrates these practices into daily life.

### What is Mindfulness-based Cognitive Therapy Succesful With?

The hoped-for outcomes of MBCT include:

1. Increased awareness of thoughts and feelings: Clients learn to observe their thoughts and emotions without attaching judgment or reacting impulsively to them. This helps in creating a space between thoughts and reactions, leading to more adaptive responses.
2. Coping: Clients develop skills to manage stress, negative emotions, and difficult situations by applying mindfulness techniques to stay grounded in the present moment. The stresses may not go away, but you’ll feel more capable of managing them and possibly putting them aside when needed.
3. Reducing Relapse: For those prone to depression or other mental health issues, mindfulness based cognitive therapy aims to prevent relapse by teaching skills to recognize and interrupt negative thought patterns before they escalate.
4. Enhancing Well-being: Beyond managing specific symptoms, MBCT aims to improve overall well-being by promoting self-awareness, self-compassion, and resilience. It is, therefore, a great approach for people feeling a general [sense of malaise](https://www.healthline.com/health/malaise).

The effectiveness of MBCT often relies on regular practice and integrating these techniques into daily life. By consistently applying these skills, people can experience lasting benefits in managing their mental health and overall well-being.

## Mindfulness-Based Cognitive Therapy Results

The effectiveness of MBCT has been studied in various contexts beyond depression, including anxiety disorders, [stress reduction,](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) chronic pain management, and more. It’s often offered in group settings but can also be adapted for [individual therapy](https://dralanjacobson.com/individual-therapy/). Here are some key findings from studies exploring the effectiveness of MBCT:

### Mindfulness-Based Cognitive Therapy for Depression

One of the primary areas of focus for MBCT research has been preventing relapse in individuals with a history of recurrent depression. Studies have demonstrated that this method can be as effective as maintenance antidepressant medication in preventing relapse for those with three or more previous depressive episodes. I have found mindfulness-based cognitive therapy for depression to be very helpful for those whose depression is longstanding and other methods have not worked.

Here is how I use mindfulness-based cognitive therapy for depression:

#### Combining Therapy with Mindfulness

Mindfulness-based cognitive therapy for depression integrates principles of cognitive treatment, which focuses on identifying and challenging negative thought patterns, with self-awareness practices. By becoming more aware of automatic negative thoughts and patterns that contribute to depression, you learn to step back from these thoughts and relate to them more skillfully.

#### Mindfulness-Based Cognitive Therapy for Depression Practices

Mindfulness-based cognitive therapy for depression incorporates various mindfulness techniques, including meditation, body scans, and movement. These practices help you develop greater present-moment awareness, allowing them to observe their thoughts and emotions without getting caught up in them.

#### Recognizing Triggers

Through mindfulness-based cognitive therapy for depression, you learn to recognize early signs and triggers of depressive relapse. By becoming more attuned to the onset of negative thoughts and emotions, you can intervene early and prevent a downward spiral into depression.

#### Acceptance and Self-Compassion

Mindfulness-based cognitive therapy for depression emphasizes acceptance of one’s experiences, including difficult emotions associated with depression, without judgment or self-criticism. By cultivating self-compassion and kindness toward yourself, you learn to respond to depressive symptoms with greater understanding and gentleness.

Research has shown that mindfulness-based cognitive therapy for depression can be effective in [reducing the risk of depressive relapse](https://dralanjacobson.com/cbt-for-depression/) for individuals with a history of recurrent depression.

### Mindfulness-Based Cognitive Therapy for Anxiety

While the primary focus has been on depression, MBCT has also shown efficacy in reducing symptoms of anxiety disorders, such as generalized anxiety disorder (GAD), social anxiety, and [panic disorder](https://dralanjacobson.com/panic-attack-treatment/). It helps you become more aware of their anxious thoughts and teaches you skills to respond more effectively. I like MBCT, in particular, with people who have several different anxiety symptoms.

Here’s how I use mindfulness-based cognitive therapy for anxiety:

#### Mindfulness-Based Cognitive Therapy for Anxiety Techniques

Mindfulness-based cognitive therapy for anxiety incorporates various practices, including meditation, body scanning, and mindful breathing. These methods help you become more aware of their thoughts, feelings, bodily sensations, and the present moment without judgment.

#### Cognitive Restructuring

Like traditional cognitive therapy, mindfulness-based cognitive therapy for anxiety also focuses on identifying and challenging negative thought patterns that contribute to anxiety. You learn to observe their thoughts and emotions without becoming entangled in them, allowing for greater perspective and the opportunity to reframe unhelpful thoughts.

#### Acceptance and Compassion

Mindfulness-based cognitive therapy for anxiety emphasizes acceptance of one’s experiences, including anxiety symptoms, without trying to suppress or avoid them. This acceptance, coupled with [self-compassion practices](https://positivepsychology.com/how-to-practice-self-compassion/), can reduce the tendency to react with fear or avoidance to anxiety-provoking situations.

#### Relapse Prevention

A significant aspect of mindfulness based cognitive therapy for anxiety is its focus on preventing relapse. Individuals learn skills to recognize early signs of anxiety and depressive relapse, allowing them to intervene effectively using this combined technique.

Research has shown that mindfulness-based cognitive therapy for anxiety can be quite effective.

### MBCT and Stress Reduction

Mindfulness-based cognitive therapy for anxiety is effective in reducing perceived stress levels. By cultivating non-reactivity to stressors, people often report feeling less overwhelmed and better equipped to manage life’s challenges. I have used mindfulness-based cognitive therapy, which is great for athletes, people with stressful jobs, and the [therapy for college and graduate students](https://dralanjacobson.com/therapy-for-college-students/).

### MBCT and Enhancing Well-being

Beyond clinical conditions, MBCT has been associated with improved overall well-being and quality of life. It can lead to greater self-awareness, increased emotional regulation, and improved interpersonal relationships. It is a great approach with [existential therapy](https://dralanjacobson.com/existential-therapy/) and couples and families facing similar challenges and stressors together.

While these results are promising, it’s essential to note that individual experiences with mindfulness-based cognitive therapy for anxiety and depression may vary. Factors like the severity of the condition, individual differences, and adherence to the program (e.g., doing assigned homework) can influence outcomes. Nonetheless, the overall body of research suggests that MBCT can be a valuable tool in promoting mental health and well-being, and it is certainly a strong piece of my integrative practice.

## Mindfulness Based Cognitive Behavioral Therapy Case Example

Alex is a 20-year-old college sophomore majoring in biology. Over the past year, he’s struggled with anxiety, particularly around exams, presentations, and deadlines. He often procrastinates and then panics as deadlines approach. He reports racing thoughts, physical tension, and trouble sleeping before tests. Alex has a history of mild depression in high school but hasn’t received formal therapy until now.

He was referred to me, and after hearing about the approaches I can provide, he opted for Mindfulness-Based Cognitive Therapy (MBCT).

### Mindfulness Based Cognitive Behavioral Therapy Goals:

- Reduce academic anxiety and rumination
- Improve attention and emotional regulation
- Build self-awareness of automatic negative thoughts
- Prevent a relapse into depression

### Intervention Plan:

Structure:
8-week mindfulness based cognitive behavioral therapy, with weekly sessions + daily home practice.

#### Key Mindfulness Based Cognitive Behavioral Therapy Techniques

- Body Scan Meditation:
    Helped Alex become aware of tension he carried in his shoulders and jaw before exams. He began practicing this daily to manage physical symptoms of stress.
- Three-Minute Breathing Space:
    Alex used this quick technique before studying to anchor himself and redirect attention. It helped him observe his anxious thoughts without reacting automatically.
- Awareness of Thoughts:
    He learned to recognize his recurring thought, *“I’m going to fail no matter what,”* and label it as just a thought—not a fact.
    → This reduced its power over him and interrupted the rumination cycle.
- Activity Monitoring:
    Identified avoidance behaviors, like scrolling social media or over-cleaning when he felt overwhelmed.
    Check-ins helped him notice these impulses and re-engage with his work more consciously.
- Loving-Kindness Meditation:
    Encouraged a more compassionate internal dialogue. Alex reported feeling less self-critical when he didn’t meet his own expectations.

### Mindfulness-Based Cognitive Therapy Outcome:

By the end of 8 weeks of Mindfulness Based Cognitive Behavioral Therapy

- Alex reported lower anxiety scores on the GAD-7 scale.
- He felt more in control of his attention and emotional responses.
- He began to study earlier, with fewer last-minute cramming episodes.
- Sleep improved, and he noticed a more balanced approach to his workload.

He continues using these practices independently and occasionally checks in with me.

## MBCT Conclusions and My Work

Overall, MBCT equips people with skills to manage difficult emotions, reduce stress, and prevent relapses by fostering greater self-awareness and promoting a more balanced way of relating thoughts and emotions. I use it in my work with individuals, couples, families, and various [clinical specialties](https://dralanjacobson.com/intensive-therapy-and-specialty-services/). I deliver MBCT via [online therapy](https://dralanjacobson.com/virtual-therapy-guide/) and in person, so I’m happy to provide this approach to people nationwide. Mindfulness-based cognitive therapy for depression or anxiety can be delivered alone or as part of a more integrated approach. I also provide [mindfulness-based stress reduction therapy](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/).

If you have any questions about mindfulness-based cognitive therapy for depression or anxiety, [mindfulness counseling](https://dralanjacobson.com/reality-therapy-and-mindfulness-counseling/) in general, or want to discuss [my services](https://dralanjacobson.com/), please feel free to [contact me](https://dralanjacobson.com/contact/) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Flying Anxiety Treatment Process](https://dralanjacobson.com/flying-anxiety-treatment/)

**Published:** August 12, 2023
**Author:** Dr. Alan Jacobson

**Content:**

The **flying anxiety** treatment process typically involves a combination of strategies and therapies to reduce fear, manage worries, and gradually build confidence in flying. Treatment for anxiety while flying, such as I offer, is structured and, for most people, highly effective. Here’s a general outline of the treatment process, followed by an example of reducing the strength of the anxiety and flying connection.

## Flying Anxiety Treatment Goals

The first step in flying anxiety treatment is setting goals. I usually set three overall goals for this type of treatment. However, the actual details can vary based on the severity of the anxiety and anxiety connection and your specific needs. Here are some common treatment goals for flying anxiety.

### Understanding and Education

By the end of treatment, I hope to help you better understand the [mechanics of flying](https://www.explainthatstuff.com/howplaneswork.html), the safety measures in place, and the statistics supporting air travel safety. Providing accurate information about the various aspects of flying can help dispel misconceptions and irrational fears. This is an essential initial step in [cognitive-behavioral treatment](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) and will be the backdrop against which we will later identify and challenge negative thought patterns and beliefs related to traveling by airplane.

### Flying Anxiety Treatment Toolkit

I want to work to help you develop a toolkit that helps you with your particular fears. This toolkit will be uniquely tailored to when you experience your fears. It may include visualization, deep breathing, progressive muscle relaxation, biofeedback, positive self-talk, and mindfulness meditation. It may also include building a positive support network and communicating more effectively when fearful. Finally, it may include other aspects of self-care before and after flights, such as ways to fall asleep, nutrition tips, and exercise ideas.

### Exposure and Goal Setting

The other goal of flying anxiety treatment is exposure through technology such as virtual reality that can simulate anxiety and flying experiences in a controlled environment, [guided visualization](https://positivepsychology.com/visualization-meditation/), or actual slights. We will set goals to gradually increase exposure at a pace that you are comfortable with, perhaps starting with just visiting an airport without boarding an airplane and watching planes take off and land. I want you to feel a sense of accomplishment after these steps!

## Flying Anxiety Treatment Initial Steps

The first step we will do is to [educate you about flying and aviation](https://www.stratosjets.com/blog/fear-of-flying-statistics-trends-facts/). Learning about the safety measures, statistics, and the science behind flight can help dispel myths and misconceptions contributing to fear. That will help us start identifying and challenging negative thought patterns related to anxiety while flying. Our goal will be to replace irrational fears with more rational and realistic beliefs.

### What Causes Anxiety While Flying

It’s not always essential to know precisely where anxiety and flying became connected in the first place. In fact, for many people, the reason stays elusive even if we try. The good news is that, unlike many other challenges I treat, knowing the reasons is not essential. We will still talk about it since many people are curious about why this is happening. There are different reasons that people describe for their flight anxiety, including:

1. Fear of the unknown: Many people fear the novel aspects of flight, such as the sensation of being in the air, turbulence, and the complexity of aircraft systems. This fear is often overcome after a few flights, though avoidance of flying due to these fears can lead to increased fear.
2. Fear of crashes: Although statistically rare, concerns about plane crashes can be a significant source of worry. High-profile aviation incidents in the media, as can realistic depictions in movies and TV, can exacerbate this fear and connect anxiety and flying.
3. Claustrophobia: The limited space within an aircraft cabin can trigger a fear of enclosed spaces, especially on long flights, as can a fear of heights.
4. Lack of control: Passengers have no control over the flight, which can be distressing for those who like to control their environment. Turbulence can cause discomfort for many passengers who want to feel like they have control, even though it’s a normal part of flying.
5. Fear of terrorism: Concerns about terrorism and hijacking can connect flying and anxiety, especially in the aftermath of high-profile incidents.
6. Previous traumatic experiences: Individuals who have experienced a traumatic flight or other stressful incidents during travel may develop flight anxiety as a result.

### Less Common Causes of a Anxiety and Flying Connection ![Flying anxiety treatment](https://dralanjacobson.com/wp-content/uploads/2023/08/Flying-2-300x200.avif "Flying 2 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

1. [Social anxiety](https://dralanjacobson.com/therapy-for-social-anxiety/): Some people may fear the social aspects, such as sitting close to strangers or worrying about interactions with attendants and fellow passengers.
2. Health concerns: People with medical conditions or fearing becoming ill on an airplane may experience fear.
3. Fear of flying alone: Flying without a companion can be a source of fear for some individuals.
4. [Generalized anxiety](https://dralanjacobson.com/therapy-for-generalized-anxiety-disorder/): People with a tendency toward worry may experience a flying and anxiety connection due to the stressors and uncertainties associated with air travel.
5. Noise and discomfort: The loud sounds, crowded conditions, and the discomfort of sitting in a confined space for an extended period can contribute to anxiety.

It’s important to note that anxiety while flying can range from mild discomfort to a debilitating condition. Many strategies, including [therapy, relaxation techniques, and medications](https://dralanjacobson.com/fear-of-flying-therapy/), can help individuals manage and overcome their flight anxiety. If you or someone you know struggles with this, consider seeking support from a mental health professional or a flight anxiety program to address the specific triggers and fears.

## Exposure and Relaxation

Our next step is to gradually – at a comfortable pace – expose yourself to the aspects of the flying and anxiety connection. This could start with looking at pictures of airplanes, then watching videos of takeoffs and landings, and eventually progressing to simulated flights and actual flights. At this point, we will also work on relaxation techniques that might include deep breathing exercises to calm your body’s physiological responses to anxiety and flying, learning to relax your muscles systematically to reduce tension and promote a sense of calm, and mindfulness and meditation, which help you stay focused on the present moment and reduce excessive worrying about the future.

### Adjunctive Therapy

We might use virtual reality to allow you to experience anxiety and flying in a controlled and simulated environment. It can be a helpful tool for gradually desensitizing yourself to anxiety while flying. We might also see if there are local support groups if you want to connect with others who share similar fears and can provide a sense of understanding and community. Sharing experiences and coping strategies can be empowering.

While medications may help some people, they do not cure flying anxiety. You can talk to your primary care provider about medications for short-term relief while we work on fixing things longer-term.

Flying anxiety is sometimes the only presenting concern when people come for treatment, but at other times, there are other anxieties that people want to work on. I can tailor [my services](https://dralanjacobson.com/) in either case.

## Flying Anxiety Last Steps

Over time, we’ll work on exposing yourself to increasingly real-life scenarios. This might start with spending time at an airport, then progressing to short flights, and eventually longer ones. It will be essential to recognize and celebrate your achievements along the way. Each step you take toward overcoming flying anxiety is a significant accomplishment.

## A Case of Anxiety While Flying

Sarah is a 32-year-old woman with severe anxiety while flying. Her fear centers around turbulence and the lack of control. She has avoided flying for ten years, but a family wedding abroad has forced her to reconsider.

- In therapy, Sarah learns how to challenge her catastrophic thinking by learning facts about air travel safety. She practices [mindfulness techniques](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) when imagining herself on a flight. For example, she works to disengage the anxiety and flying connection by challenging her thoughts: 
    - **Identifying negative thoughts**: “I’m sure the plane will crash during turbulence.”
    - **Challenging thoughts with logic**: “I’ve flown many times, and nothing bad has happened. Planes are built to withstand turbulence.
- Sarah engages in progressive exercises designed to reduce the anxiety and flying connection. 
    - **Video exposure**: She watches videos of planes taking off and landing while practicing relaxation exercises. Over time, she feels more comfortable with the idea of flight.
    - **Imagination Exposure**: Then I ask her to imagine being in different stages of a flight (e.g., packing for the trip, boarding the plane, experiencing takeoff). I guide her to focus on breathing and managing anxiety during these visualizations.
    - **Real-Life Exposure**: Before she takes a longer flight, she books a short, easy one to expose her to real air travel while using coping mechanisms learned in therapy.
- During the practice flight, she uses deep breathing and muscle relaxation. Though she experiences mild fear during turbulence, she is able to remind herself that it’s normal and not dangerous. She uses these techniques: 
    - **Deep Breathing**: Inhaling slowly through the nose for four counts, holding for four, and exhaling for six.
    - **Progressive Muscle Relaxation (PMR)**: Gradually tensing and relaxing different muscle groups to release tension.
    - **Mindfulness Meditation**: Staying grounded in the present moment to calm racing thoughts.

Through therapy, Sarah significantly reduces the anxiety and flying connection and can attend the wedding with more confidence.

## Summary and My Work

Your [treatment process](https://dralanjacobson.com/types-of-therapy/) for anxiety while flying will be highly individualized – what works for one person might not work for another. You can see one example of [therapy for flying](https://dralanjacobson.com/fear-of-flying-treatment/) in another post. In my [integrative psychological practice](https://dralanjacobson.com/integrative-therapy/), I combine multiple therapies that address these fears, finding the perfect match for each client. We can also pursue other goals in our work together.

I look forward to [talking with you](https://dralanjacobson.com/contact/) further if you want to learn more about my **flying anxiety** treatment.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Fear of Flying Services

---

### [CBT for Depression](https://dralanjacobson.com/cbt-for-depression/)

**Published:** March 25, 2024
**Author:** Dr. Alan Jacobson

**Content:**

I commonly use CBT for depression as a first-line approach, though often with [humanistic methods](https://dralanjacobson.com/basic-tenets-of-humanistic-psychology/) and [positive psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/) mixed in. Cognitive behavioral therapy for depression is an evidence-based psychotherapy approach widely used for treating many mental health conditions. If you already know about CBT and would like to speak to me about therapy services, feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime. The following is an overview of how CBT for major depression and for less severe symptoms is typically applied.

## CBT for Depression Overview

Here are the basic tenets of cognitive behavioral therapy for depression:

### Understanding Thoughts, Feelings, and Behaviors

In CBT for depression, you learn to recognize the connections between your thoughts, feelings, and behaviors. You’ll become aware of negative thought patterns and how these patterns contribute to your symptoms. It’s an enlightening process where many people don’t realize the actual thoughts underlying their daily lives and how common and possibly negative they are.

### Identifying Negative Thought Patterns

I will work to help you identify and challenge negative thought patterns, such as catastrophizing (expecting the worst), black-and-white thinking, and overgeneralization. By recognizing and challenging these patterns, you can develop more balanced and realistic ways of thinking through a course of CBT for depression. This area often becomes a focus of homework.

### [Behavioral Activation](https://dralanjacobson.com/behavioral-activation/) in CBT for Depression

Depressive states often lead to withdrawal from activities and social interactions (often referred to as “[anhedonia](https://en.wikipedia.org/wiki/Anhedonia)“). Behavioral activation techniques help you gradually reintroduce enjoyable and fulfilling activities into your life. By increasing engagement in positive behaviors through this facet of cognitive-behavioral therapy for depression, you can improve your mood and sense of well-being. We’ll always go at a pace you are comfortable with, of course.

### [Cognitive Restructuring](https://dralanjacobson.com/cognitive-restructuring/) in CBT for Depression

This step in cognitive behavioral therapy for depression involves challenging and restructuring negative thoughts and beliefs. You will learn to examine the evidence for and against your negative beliefs and develop more adaptive ways of thinking. For example, you might learn to reframe a situation from “I’m a failure” to “I experienced a setback, but it doesn’t define my worth as a person.”

### CBT Techniques for Depression to Help You Cope

CBT teaches practical coping strategies to manage depressive symptoms. These may include relaxation techniques, problem-solving skills, assertiveness training, and stress management strategies. During this phase, we may use some [mindfulness techniques](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) and [solution-focused work](https://dralanjacobson.com/solution-focused-therapy/).

## Cognitive Behavioral Therapy for Depression Steps

Here are the steps typically involved in Cognitive Behavioral Therapy for depression:

### 1. Assessment and Goal Setting

I conduct an initial assessment to understand your symptoms, history, and challenges. Together, we’ll identify [specific goals for therapy](https://dralanjacobson.com/therapy-for-depression/), such as reducing symptoms, improving functioning, or enhancing coping skills. This is where we might choose the other [therapies to integrate](https://dralanjacobson.com/integrative-therapy/) along with cognitive behavioral therapy for depression.

### 2. Learning About Cognitive Behavioral Therapy for Depression

I’ll explain your diagnosis, its symptoms, and how CBT can help. You’ll learn about the [cognitive and behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) factors contributing to your symptoms and how to change these patterns. This education alone often brings a sense of relief and control.

### 3. Identifying Negative Thoughts

In cognitive behavioral therapy for depression, you’ll learn to recognize and monitor your negative thoughts and automatic cognitive distortions. You’ll build a toolkit that helps you do this, including using thought records to identify patterns of thinking associated with [depressive symptoms](https://my.clevelandclinic.org/health/diseases/9290-depression).

### 4. Challenging Negative Thoughts

In CBT for depression, you’ll learn to challenge your negative thoughts and beliefs by examining evidence for and against them. You’ll learn to develop more balanced and realistic interpretations of situations, which can help alleviate symptoms.

### 5. CBT for Depression and Behavioral Activation

Next, you’ll identify activities you once enjoyed, or that give you a sense of accomplishment, but have stopped doing due to your symptoms. You’ll work to schedule and gradually reintroduce these activities into your routine, even if you don’t initially feel motivated.

### 6. Developing Coping Strategies

My clients learn coping skills to manage distressing emotions and situations. This may include relaxation techniques, problem-solving skills, assertiveness training, and effective communication strategies. These strategies become a toolkit you can draw from after therapy.

### 7. [CBT Strategies](https://dralanjacobson.com/cbt-techniques/) for Depression and Core Beliefs

In later stages of therapy, you may work on identifying and challenging underlying [core beliefs or schemas](https://www.schematherapy.com/id73.htm) that contribute to your current state. This deeper work in CBT for Depression helps address the root causes of symptoms.

### 8. Cognitive Behavioral Therapy for Depression Homework

You will often be given homework assignments to practice the skills you’ve learned in therapy sessions. This helps reinforce learning and allows you to apply these skills in real-life situations. One reason why CBT for depression is often time-limited is that you can do some work outside of sessions, and that speeds the process.

### CBT for Depression and Monitoring Progress

Throughout therapy, we will track your progress toward treatment goals. This helps identify areas of improvement that may need further attention or adjustment. As you reach your original goals, we can set new ones, or you can decide to lessen or stop the frequency of therapy.

### CBT Strategies for Depression Relapse Prevention

CBT equips individuals with skills to prevent relapse once treatment is completed. Clients learn to recognize [early warning signs of depression](https://www.healthline.com/health/depression/recognizing-symptoms) and develop strategies to cope with stressors and triggers effectively. Some people return for booster sessions to ensure they remember all the strategies they can use to help calm periods of sadness.

## CBT for Major Depression

When a client is experiencing symptoms that are particularly acute and severe, I use CBT for major depression, which is a step up from regular CBT. CBT for [major depression](https://en.wikipedia.org/wiki/Major_depressive_disorder) involves a thorough assessment, more significant psychoeducation, and more aggressive work toward identifying and challenging [cognitive distortions](https://positivepsychology.com/cognitive-distortions/). We might use more relaxation techniques and stress management strategies to reduce symptoms and cope with stress more effectively.

### CBT for Major Depression: The Difference

CBT for major depression works to quickly address severe symptoms, which means some aspects of usual cognitive-behavioral therapy for depression may be put on hold at the beginning. Our work together at the start will be intensive and designed to get you to feel stable and relatively in control, and at that point, we will move back into a more traditional approach that is less urgent yet quite effective.

CBT for [major depression](https://dralanjacobson.com/treating-major-depression/) is typically structured, goal-oriented, and time-limited. The duration and frequency of therapy sessions may vary depending on your needs and progress, but it may be more frequent than typical [individual therapy](https://dralanjacobson.com/individual-therapy/). It’s important for individuals undergoing CBT for major depression to actively engage in therapy, complete homework assignments, and practice skills learned in therapy sessions.

## Cognitive-Behavioral Therapy for Depression Example

Here’s an example of how CBT strategies for depression might work in practice:

Jim is a 44-year-old father of three who is a lawyer and was generally happy until a few months ago when he developed a depressed mood and feelings of helplessness because a variety of stressors had, in his words, “caught up to me.” He has had bouts of deep sadness before, and while he’s usually been able to fight through them, he feels more urgency right now so he can continue to be a good father and not fall behind at work.

### Cognitive-Behavioral Therapy for Depression: Initial Assessment

I start by conducting an assessment to understand Jim’s symptoms, triggers, thought patterns, and behaviors associated with his symptoms. Together, we design specific goals for therapy, such as reducing symptoms, improving mood, and enhancing overall well-being. We talked about what it would feel like if CBT for depression “worked” and made that part of our goal-setting.

### Identifying Negative Thought Patterns

I help Jim identify negative thought patterns contributing to their challenges, such as [catastrophizing, black-and-white thinking, and self-blame](https://positivepsychology.com/cognitive-distortions/). Some of Jim’s automatic thoughts include worries about dire consequences for his family if he does not perform well at work, worries that unexpected financial stress could occur at any time, and some fears that despite his success at work, he is actually “an impostor.” Jim is asked to recognize these and other automatic negative thoughts as they occur.

### CBT Techniques for Depression to Challenge Negative Thoughts

Now that we’ve identified these negative thought patterns, I guide Jim in challenging and restructuring them. This involves examining evidence for and against the negative thoughts, considering alternative explanations, and developing more balanced and realistic perspectives. He agrees to start listening to his rational side that knows that he is performing well, that one mistake would not be enough to cause catastrophic problems at work, and that his success at work is real, and he has many subjective ways to measure that.

### CBT for Depression and Behavioral Activation

The next step is developing a plan where Jim will engage in enjoyable and meaningful activities, even when he doesn’t feel like doing them. As this progresses, Jim will schedule and prioritize activities that promote a sense of accomplishment and pleasure to counteract symptoms. We’ll also discuss problem-solving skills to address life stressors and difficulties more effectively so that even small stressors do not add up to something that feels unmanageable. This may involve breaking problems down into manageable steps, generating potential solutions, considering consequences, and implementing an action plan.

I provide empathy, support, and encouragement throughout therapy while challenging unhelpful patterns and fostering empowerment. Jim makes great strides, and his symptoms start to lift. At that point, I work with him to develop strategies for maintaining progress and preventing relapse. Jim will learn to identify early warning signs of relapse, [practice coping skills](https://www.happierhuman.com/coping-skills/), and create a plan for managing setbacks.

## Q&A

### Q: What is CBT for depression?

**A:** CBT techniques for depression focus on how thoughts, feelings, and behaviors are connected. CBT helps identify and challenge negative thought patterns, such as feelings of worthlessness or hopelessness, and replace them with more balanced, realistic ones. The goal is to improve mood, increase daily functioning, and provide tools to manage future emotional challenges. CBT is structured, collaborative, and usually goal-oriented.

### Q: What is CBT therapy for depression?

**A:** CBT therapy for depression involves working with a trained mental health professional like me who guides you through a series of steps to understand the patterns contributing to your symptoms. This includes:

- Identifying unhelpful or distorted thinking (like “I’m a failure”)
- Exploring how these thoughts affect your emotions and behaviors
- Learning new coping strategies, such as reframing thoughts or increasing engagement in meaningful activities
    CBT is active and often includes homework assignments to practice new skills outside of [individual therapy](https://dralanjacobson.com/individual-therapy/) sessions, making it practical and empowering for clients.

### Q: How does CBT work for depression?

**A:** CBT techniques for depression work by breaking the cycle of sadness through targeted interventions in thinking and behavior. People with this diagnosis often experience a loop of negative thoughts (e.g., “I can’t do anything right”) that lead to discouraging emotions and avoidance behaviors (e.g., withdrawing from friends or work). CBT strategies for depression help by:

- Teaching you to spot and question these negative thoughts
- Encouraging behavior changes like setting small, achievable goals
- Reinforcing positive activities that provide a sense of accomplishment or pleasure
    This process gradually improves mood and builds resilience against future episodes.

### Q: How effective is CBT for depression?

**A:** CBT techniques for depression have been highly researched and proven effective. Clinical studies show that it is equally effective as antidepressant medication for many people, especially those with mild to moderate symptoms. One of the key benefits of CBT strategies for depression is that they teach long-term skills that continue to be useful after therapy ends. Many find that CBT reduces symptoms and helps prevent future relapses by promoting healthier thinking habits.

### Q: How many CBT sessions are needed for depression?

**A:** The number needed varies from person to person, depending on the severity and complexity of their symptoms. On average:

- Mild to moderate challenges may respond well to **12 to 16 sessions**
- CBT for major depression that is more severe or chronic might require **20 or more sessions**
    Sessions typically occur weekly and last around 50 minutes. Some clients benefit from periodic follow-up or “booster” sessions after the main treatment to maintain progress and reinforce skills.

## Summary and My Work

Overall, CBT for depression is a structured, goal-oriented approach that empowers individuals to challenge negative thinking patterns, change unhelpful behaviors, and develop more adaptive coping strategies. It is widely thought of as the [best treatment for anxiety and depression](https://dralanjacobson.com/therapy-for-depression-and-anxiety/). It’s typically conducted over a series of sessions. The [collaborative nature of CBT](https://dralanjacobson.com/cbt-for-depression/) empowers my clients to take an active role in their treatment and develop skills they can continue to use after therapy has ended.

I offer cognitive behavioral therapy for depression that is mild and chronic ([often termed “dysthymia”](https://www.hopkinsmedicine.org/health/conditions-and-diseases/dysthymia)) and CBT for major depression when symptoms are more severe. I also provide [CBT-SAD](https://dralanjacobson.com/seasonal-affective-disorder-treatment/) with is cognitive-behavioral therapy for seasonal symptoms. I’d be happy to talk to you about how CBT for depression may be a fit for you, so please feel free to [contact me](https://dralanjacobson.com/contact/) anytime or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Mental Health Diagnoses

---

### [Women with ADHD](https://dralanjacobson.com/women-with-adhd/)

**Published:** December 26, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Women with ADHD** often present differently than men, which can lead to underdiagnosis or misdiagnosis. **ADHD symptoms in women** tend to be more subdued and masked, making them easy to miss. **Signs of ADHD in women** are also harder to perceive since many with the diagnosis can manage them and become quite successful regardless. In this post, I go over therapy for an attention deficit in women, how it can help you manage symptoms, and how you can take advantage of the strengths and potential that come with the diagnosis.

Of course, it is important to note that no two people are alike, and any generalization about “female” or “male” symptoms will not hold for everyone. This post explores certain tendencies and patterns, but many women with ADHD also present with more traditional symptoms. If you would like more information about how therapy can help, don’t hesitate to [get in touch with me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime. Please also note my post about [girls with ADHD](https://dralanjacobson.com/therapy-for-girls-with-adhd/).

## Women with ADHD Overview

The following is an overview of the challenges and strengths of women with ADHD.

### Common ADHD Symptoms in Women

- **Inattentive Symptoms Dominate:** They are more likely to have [inattentive-type](https://psychcentral.com/adhd/adhd-inattentive-type) rather than [hyperactive/impulsive type](https://www.simplypsychology.org/adhd-hyperactive-impulsive-type.html).
- **Masking and Coping Mechanisms:** Many learn to mask their symptoms, making recognizing them harder.
- **Emotional Dysregulation:** Increased sensitivity to rejection (Rejection Sensitive Dysphoria) and heightened emotional responses are common ADHD symptoms in women.
- **Chronic Overwhelm:** Women with ADHD often report feeling constantly overwhelmed by daily tasks and responsibilities, not because of a lack of ability but because of the attention deficit.
- **Procrastination and Perfectionism:** These traits can co-exist in women with ADHD, leading to cycles of productivity bursts followed by burnout.
- **Hormonal Influence:** ADHD symptoms in women can fluctuate with hormonal changes (e.g., menstrual cycles, pregnancy, menopause).

### Common Challenges for Women with ADHD

- **Relationships:** Difficulty managing emotions can strain personal and romantic relationships.
- **Academics/Work:** Time management, organization, and focus challenges may hinder academic or career success.
- **Self-Esteem:** Years of unmet expectations or perceived underachievement may impact self-worth.
- **Mental Health Comorbidities:** Higher rates of anxiety, depression, and eating disorders are seen.

### Why ADHD in Women Is Often Overlooked

- Adult female ADHD symptoms are less likely to involve overt hyperactivity or other obvious signs.
- Social expectations often pressure women to be organized, nurturing, and responsible, leading them to mask their struggles.
- Symptoms can overlap with other conditions like [depression and anxiety](https://dralanjacobson.com/therapy-for-depression-and-anxiety/), leading to misdiagnosis.

### Diagnosis and Treatment of Women with ADHD

- Diagnosis often happens later in life, sometimes when their children are diagnosed.
- Treatment includes a combination of medication (e.g., stimulants, non-stimulants), therapy (e.g., [CBT for ADHD](https://dralanjacobson.com/cbt-for-adhd/), coaching), and lifestyle adjustments (e.g., time management tools and routines).

### Strengths of Women with ADHD

- Creativity and unique problem-solving abilities.
- High levels of empathy and [emotional intelligence](https://psychologicalassessments.com/emotional-intelligence-testing/).
- Ability to hyperfocus on areas of interest.
- Inner strength and resilience that has been used to overcome challenges even before diagnosis.
- Often have higher [IQ scores](https://psychologicalassessments.com/iq-testing/), on average, than nondiagnosed people

## ADHD Symptoms in Women

Many ADHD symptoms in women often present differently than in men, which can lead to misdiagnosis or being overlooked. They are more likely to have **inattentive type**, and their symptoms are often internalized rather than outwardly visible. Here is more detail:

---

### 1. Attention Deficit Symptoms

- **Easily Distracted:** Difficulty staying focused on tasks, conversations, or lectures.
- **Forgetfulness:** Frequently forgetting appointments, deadlines, or daily tasks.
- **Poor Organization:** Struggling to prioritize or manage time effectively.
- **Losing Things:** Misplacing keys, phones, wallets, or other everyday items.
- **Procrastination:** Difficulty starting or completing tasks, especially those that require sustained attention.
- **Daydreaming:** Tendency to zone out, even during important conversations.
- **Difficulty Following Instructions:** Struggling to follow multi-step tasks or instructions.

---

### 2. Hyperactive and Impulsive ADHD Symptoms in Women

- **Restlessness:** Feeling internally restless, even if it’s not outwardly visible.
- **Talking Excessively:** Talking a lot or interrupting others in conversations.
- **Impulsive Decisions:** Making quick decisions without thinking about consequences.
- **Interrupting Others:** Speaking out of turn or finishing other people’s sentences.
- **Difficulty Relaxing:** Finding it hard to sit still or wind down, even during leisure time.

---

### 3. Emotional Dysregulation ADHD Symptoms in Women

- **Mood Swings:** Intense emotional reactions to minor triggers.
- **[Rejection Sensitivity Dysphoria](https://www.psychologytoday.com/us/blog/friendship-20/201907/what-is-rejection-sensitive-dysphoria?msockid=1686e8c22e816b8a1935fc532fc26a1c) (RSD):** Extreme emotional pain in response to perceived criticism or rejection.
- **Low Frustration Tolerance:** Becoming easily irritated or overwhelmed.
- **Overwhelm and Burnout:** Struggling to balance responsibilities, leading to exhaustion.

---

### 4. Social and Relationship Challenges for Women with ADHD

- **Difficulty Maintaining Friendships:** Forgetting to respond to messages or feeling overwhelmed by social interactions.
- **Feeling Misunderstood:** Struggling to explain behaviors or emotions to others.
- **Fear of Criticism:** Constantly worrying about being judged.

---

### 5. Coping Mechanisms and Masking in Women with ADHD

- **Overcompensating:** Working excessively hard to hide struggles.
- **Perfectionism:** An attention deficit can lead to setting unrealistically high standards to avoid failure.
- **Masking Symptoms:** Hiding restlessness or inattentiveness to appear “normal.”

---

### Why ADHD Symptoms in Women Are Often Missed

- ADHD symptoms in women are mistaken for anxiety, depression, or mood disorders.
- Societal expectations lead them to internalize their struggles rather than seek help.
- Women are more likely to be labeled as “emotional” or “disorganized” rather than being evaluated for an attention deficit.
- Most have developed significant resilience, strength, and flexibility, allowing them to overcome their challenges
- Similarly, many have taken advantage of the [benefits of having ADHD](https://psychologicalassessments.com/benefits-of-adhd/)

## Signs of ADHD in Women

An attention deficit often presents differently, leading to frequent underdiagnosis or misdiagnosis. Many remain undiagnosed until adulthood, often when their children are evaluated. Below are the key signs of ADHD in women across different areas of life:

---

### 1. Attention Deficit In Women with ADHD

- An attention deficit can lead to difficulty focusing on tasks, conversations, or instructions.
- Frequently losing or misplacing items (keys, phone, wallet).
- Forgetfulness in daily activities (e.g., paying bills, attending appointments).
- Procrastination is especially common with tasks that require sustained attention.
- An attention deficit in women can lead to zoning out during conversations or meetings.
- Struggling to follow multi-step instructions despite high intelligence.
- Poor time management and missing deadlines.

---

### 2. Hyperactivity and Impulsivity in Women with ADHD

- Adult female ADHD symptoms often include feeling internally restless or having racing thoughts.
- Talking excessively or interrupting others during conversations.
- Acting impulsively, such as making sudden decisions without thinking them through.
- Difficulty relaxing or feeling guilty when trying to rest.
- Engaging in risky or thrill-seeking behaviors.
- Fidgeting or an inability to sit still for long periods.

---

### 3. Emotional Dysregulation in Women with ADHD

- Intense feelings of frustration or irritability.
- Feeling easily overwhelmed by daily responsibilities.
- Difficulty managing stress or pressure.

---

### 4. Executive Dysfunction and ADHD in Women

- Difficulty starting tasks, even ones that seem simple.
- Struggling with prioritizing or organizing tasks.
- Often feeling overwhelmed by to-do lists.
- Poor follow-through on plans or commitments.
- Chronic lateness or underestimating the time needed for tasks.

---

### 5. Social and Relationship Signs of ADHD in Women

- Feeling [socially anxious](https://dralanjacobson.com/therapy-for-social-anxiety-disorder/) or awkward in group settings.
- Overcommitting to social events and then feeling overwhelmed.
- Misunderstandings in communication or appearing distracted during conversations is one of the more common signs of ADHD in women.
- Fear of criticism or rejection from peers.

---

### 6. Self-Perception and Mental Health

- Persistent feelings of inadequacy or underachievement.
- Chronic self-criticism and low self-esteem are signs of ADHD in women who are undiagnosed.
- Frequently comparing oneself to others and feeling like they’re “failing at life.”
- Coexisting mental health conditions, such as anxiety, depression, or [eating disorders](https://www.healthline.com/nutrition/common-eating-disorders).
- Feeling like they must work harder than others to keep up.

---

### 7. Coping Mechanisms and Masking

- Overcompensating by becoming hyper-organized or perfectionistic.
- Relying heavily on reminders, lists, and alarms is a clear sign.
- Masking symptoms to appear “put together” or “normal.”
- Avoiding tasks or situations where they might fail.

---

### Why Signs of ADHD in Women Often Go Unrecognized

- Signs of ADHD in women are often internalized rather than externalized.
- Symptoms are frequently mistaken for anxiety, depression, or personality traits.
- Women with ADHD often have signs of strength, resilience, high intelligence, and adaptability, which mask their challenges.

## Therapy for an Attention Deficit in Women

[Individual therapy](https://dralanjacobson.com/individual-therapy/) is a powerful tool for women with ADHD, especially given the unique ways an attention deficit in women can manifest and impact their lives. Below are the [most effective therapeutic approaches](https://dralanjacobson.com/adhd-therapy-for-adults/) tailored to address attention deficit in women.

---

### 1. Cognitive Behavioral Therapy

- **Focus:** Changing unhelpful thought patterns and developing practical coping strategies.
- **How It Helps:**
    - Builds time management and organizational skills.
    - Reduces procrastination and avoidance behaviors that are signs of ADHD in women.
    - Improves emotional regulation and impulse control.
- **Why It’s Effective:** Helps address perfectionism, chronic overwhelm, and self-criticism, which are common among women with ADHD.

---

### 2. Coaching for an Attention Deficit in Women

- **Focus:** Goal setting, time management, and daily structure.
- **How It Helps:**
    - Provides accountability and regular check-ins.
    - Develops strategies to break down tasks into manageable steps.
    - Helps establish routines and organizational systems.
- **Why It’s Effective:** Coaches provide individualized support, which is particularly helpful for women balancing work, home, and personal life.

---

### 3. [Acceptance and Commitment Therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) for Women with ADHD

- **Focus:** Accepting challenges and committing to value-driven actions.
- **How It Helps:**
    - Encourages mindfulness and being present in the moment.
    - Reduces emotional reactivity and overwhelm.
    - Builds resilience against setbacks.
- **Why It’s Effective:** Helps women let go of guilt and self-blame for past struggles.

---

### 4. Dialectical Behavior Therapy

- **Focus:** Emotional regulation, distress tolerance, and interpersonal skills.
- **How It Helps:**
    - Reduces impulsive behaviors.
    - Improves communication and conflict resolution.
    - Enhances emotional stability.
- **Why It’s Effective:** Helps address intense emotions and rejection-sensitive dysphoria (RSD).

---

### 5. [Mindfulness-Based Therapies](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/)

- **Focus:** Increasing self-awareness and focus through mindfulness techniques.
- **How It Helps:**
    - Improves focus and attention span.
    - Reduces stress and anxiety.
    - Encourages non-judgmental self-awareness.
- **Why It’s Effective:** Helps pause and process before reacting impulsively.

---

### 6. [Group Therapy](https://dralanjacobson.com/group-therapy/) or Support Groups for Women with ADHD

- **Focus:** Sharing experiences and learning coping strategies with peers.
- **How It Helps:**
    - It provides a sense of community and reduces feelings of isolation and misunderstanding of adult female ADHD symptoms.
    - Encourages accountability and support.
    - Helps members realize the advantages of adult female ADHD symptoms.
- **Why It’s Effective:** Builds a connection with others who understand these challenges.

---

### 7. Psychoeducation

- **Focus:** Learning about the diagnosis and its impact on behavior, emotions, and relationships (the common signs of ADHD in women).
- **How It Helps:**
    - Increases self-awareness and understanding of signs of ADHD in women.
    - Provides tools and resources for managing challenges.
- **Why It’s Effective:** Knowledge reduces shame and promotes self-compassion.

I also use [brief solution-focused therapy](https://dralanjacobson.com/solution-focused-therapy/) when a specific challenge needs to be addressed.

## Case Example: Therapy for ADHD in Women

#### **Background Information:**

- **Name:** Sarah
- **Age:** 28
- **Occupation:** Marketing Specialist
- **Adult female ADHD symptoms presenting:**
    - Chronic procrastination and missed deadlines at work
    - Difficulty focusing during meetings and conversations
    - Feeling overwhelmed by daily tasks and responsibilities
    - Anxiety and low self-esteem from repeated perceived failures

---

### Therapy for ADHD in Women: Treatment Plan

1\. [Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT):

- Adult Female ADHD Symptoms of Focus: 
    - Time management and task prioritization skills.
    - Challenging negative self-talk (“I’m lazy” or “I’ll never succeed”).
    - Developing coping strategies for emotional overwhelm.
- Techniques Used: 
    - Breaking tasks into smaller steps with clear deadlines.
    - Using timers for focused work sessions (e.g., Pomodoro Technique).
    - Thought reframing exercises to reduce self-criticism.

#### 2. ADHD Coaching:

- Adult Female ADHD Symptoms of Focus: 
    - Building daily and weekly routines.
    - Setting SMART goals (Specific, Measurable, Achievable, Relevant, Time-bound).
    - Accountability for completing tasks and following schedules.
- Example Strategy: Using a digital planner with reminders for tasks, appointments, and breaks.

#### 3. Mindfulness and Emotional Regulation:

- Adult Female ADHD Symptoms of Focus: 
    - Developing self-awareness of emotional triggers.
    - Practicing mindfulness meditation for 5-10 minutes daily.
    - Using breathing exercises during moments of overwhelm.
- Technique Example: “5-4-3-2-1 Grounding Exercise” for moments of anxiety.

#### 4. [Workplace Accommodations](https://psychologicalassessments.com/psychological-testing-for-workplace-accommodations/):

- Adjustments Made: 
    - Flexible deadlines for non-urgent tasks.
    - Weekly check-ins with her manager for task prioritization.
- Outcome: Improved clarity on expectations and reduced stress at work.

#### 5. Support Network:

- Group Therapy: Attending monthly support group sessions.
- Social Support: Openly communicating with close friends about the diagnosis and asking for support when overwhelmed.

---

### Therapy for ADHD In Women: Results After 4-6 Months:

- **Focus & Productivity:** Improved ability to complete tasks on time with fewer distractions.
- **Emotional Regulation:** Better at managing emotional reactions to criticism.
- **Self-Esteem:** Increased confidence in her abilities and reduced feelings of inadequacy.
- **Work Performance:** Positive feedback from her manager regarding her organization and task management.
- **Overall Well-Being:** Sarah reports feeling less overwhelmed and more in control of her daily life.

---

### Key Takeaways:

- **[Holistic Treatment Works Best](https://dralanjacobson.com/natural-adhd-treatment-for-adults/):** A combination of medication, coaching, lifestyle, and support systems effectively addressed Sarah’s needs.
- **Emotional Support Is Crucial:** Therapy and support groups helped Sarah feel less isolated.
- **Practical Tools Make a Difference:** Time management strategies and workplace accommodations were essential for her success.

## Summary and Our Work

An attention deficit in women may look different than men’s due to societal influences and a woman’s natural inner strengths and resilience. I provide therapy to address ADHD symptoms in women (and [treatment of ADHD in teen girls](https://dralanjacobson.com/teenage-girls-with-adhd/)), with a focus on bringing out natural potential and advantages while addressing the barriers the diagnosis presents. These methods can pair well with [therapy for work-life balance](https://dralanjacobson.com/therapy-for-work-life-balance/) and [therapy for people with a learning disorder](https://dralanjacobson.com/therapy-for-people-with-learning-disorders/).

If you have any questions about ADHD in women or how therapy might help please [get in touch with me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Specialties

---

### [PreMarital Counseling](https://dralanjacobson.com/premarital-counseling/)

**Published:** October 16, 2024
**Author:** Dr. Alan Jacobson

**Content:**

I provide **premarital counseling,** which is designed to proactively help couples improve their communication, problem-solving, and coping strategies. **Pre-marital counseling** can be a valuable way to improve your bond and confidence as a couple while deepening your relationship. **Online premarital counseling** allows me to reach couples nationwide, but if you would prefer to be seen in person, I can help you find someone who meets your needs. If you are looking for more depth to an approach, **premarital therapy** may be the best choice. I go over the difference later in this post.

The following is an overview of the online premarital counseling services I provide. If you’d like more information, you are welcome to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

## Premarital Counseling Overview

Premarital counseling is a type of [therapy for couples](https://dralanjacobson.com/marriage-counseling/) who are planning to get married. It aims to help partners build a strong foundation for their marriage by addressing important topics and developing healthy communication skills. Premarital counseling helps couples better understand each other’s needs, expectations, and concerns. It helps them develop skills that will help maintain a healthy and strong relationship and identify and address potential issues before they become significant problems. Online premarital counseling often works as well as in-person.

## Goals of Premarital Counseling

1. Enhancing Communication: Pre-marital counseling often includes teaching effective communication skills to ensure open and honest dialogue. However, this can be a challenge for couples with different communication styles and expectations.
2. Setting Expectations: It is important to discuss expectations regarding roles, responsibilities, and lifestyle choices before marriage. Premarital counseling provides a safe and structured way to ensure that those conversations happen and are productive.
3. Conflict Resolution: Equipping couples with tools to handle disagreements and conflicts constructively helps them be ready to manage inevitable challenges that may arise. For some couples, the courtship period has been free of much conflict, so proactively preparing for when it may happen can be important.
4. Financial Planning: In pre-marital counseling, addressing financial habits, budgeting, and planning for the future is sometimes needed. This ensures that expectations align and processes are in place to manage everything.
5. Family and Parenting: Premarital counseling also discusses views on family, children, and parenting styles. Many couples have had these conversations. However, there could be blind spots or areas they are avoiding that can be addressed in the comfort of premarital counseling.
6. Strengthening Connection: Building emotional and physical intimacy is important for some pairs. This is especially true if there are subtle differences in expectations and hopes. If these differences are not proactively addressed, they can magnify as time goes on.

### Topics Covered in Premarital Counseling

The topics we might cover in pre-marital counseling flow from the above and include:

1. Communication Skills: Learning to communicate effectively and listen empathetically is one of the core goals of premarital counseling.
2. Conflict Resolution: Developing strategies for resolving conflicts in a healthy manner is essential, especially if there have been few fights during courtship.
3. Financial Management: Some clients find it helpful to discuss finances, including spending habits, saving, and financial goals.
4. Family Dynamics: Understanding each other’s family background and its impact on the relationship is important for all couples. Even if there are no challenges now, a deeper understanding of these issues can help bring the couple together.
5. [Fear of sexual or emotional Intimacy](https://dralanjacobson.com/fear-of-intimacy/): Exploring expectations and concerns about physical intimacy is important for some clients, especially if there are any subtle (or not-so-subtle) differences emerging.
6. Values and Beliefs: Aligning core values, beliefs, and life goals is essential, at least at a deep level. It is crucial to start these conversations at least and ensure they can go well before marriage.
7. Roles and Responsibilities: Clarifying roles and responsibilities within the marriage is also important, again, especially if there are subtle differences that either partner is concerned about.

Premarital counseling can provide invaluable tools and insights to help couples navigate their future together with confidence and mutual understanding.

## Online Premarital Counseling Example

Online premarital counseling helps couples prepare for marriage, focusing on improving communication, setting realistic expectations, and addressing potential areas of conflict. Here’s a fictitious and simple example of what an online premarital counseling session might look like:

---

**Me:** *Welcome, and congratulations on your engagement! It’s great that you’re taking this step to build a strong foundation for your marriage. Today, we’ll focus on a few important areas in a relationship, such as communication, conflict resolution, finances, and expectations. Let’s start with communication. How would you both describe the way you communicate with each other?*

**Partner 1 (Alex):** *I think we usually communicate pretty well. But sometimes, I feel like we don’t really understand each other during disagreements.*

**Partner 2 (Taylor):** *Yeah, I agree. We talk a lot, but it feels like we’re going in circles and not solving anything when we argue.*

**Me:** *That’s very common in relationships. It’s important to learn how to communicate effectively, especially during conflicts. Let’s try an exercise. Each of you, share something that’s been on your mind lately. The other partner should listen without interrupting and then repeat back what they heard, using their own words. Alex, would you like to start?*

**Alex:** *Sure. I’ve been feeling a bit overwhelmed with wedding planning. I love that we’re working on it together, but it feels like there’s a lot of pressure to get everything perfect.*

**Me:** *Taylor, can you summarize what Alex just said?*

**Taylor:** *You’re feeling stressed about the wedding, and it seems like it’s a lot to handle right now. You feel pressured to make it perfect.*

**Me:** *Good. How does that feel, Alex? Does Taylor’s summary capture what you’re trying to say?*

**Alex:** *Yes, that’s pretty much it.*

**Me:** *This kind of active listening helps build empathy and understanding. Now, let’s talk about conflict resolution. How do you both typically handle disagreements?*

**Taylor:** *We try to talk it out, but sometimes I just need space to cool off. Alex wants to solve the problem right away, which makes me feel like I don’t have time to process things.*

**Alex:** *Yeah, I feel like if we don’t resolve it right away, it might get worse.*

**Me:** *It sounds like you have different conflict styles—Taylor needs time to process, and Alex prefers to address things immediately. A good middle ground might be setting a “cooling-off” period where you agree to step away for a bit but commit to coming back to the issue at a specific time. Does that sound like something you could try?*

**Alex & Taylor:** *Yes, that sounds like a good idea.*

**Me:** *Great. Now, let’s move on to finances. Have you discussed how you plan to manage money after you’re married?*

**Alex:** *We’ve talked about it a little. I’m more of a saver, and Taylor likes to spend on experiences and travel.*

**Taylor:** *Yeah, I like to live in the moment, but I know we need to save for the future.*

**Me:** *It’s common for couples to have different approaches to money. The key is to find a balance that works for both of you. Have you considered creating a budget together, where you allocate funds for both saving and spending?*

**Alex:** *We haven’t yet, but it sounds like something we should do.*

**Me:** *It’s a good step toward financial harmony. Finally, let’s talk about expectations for the future. Have you discussed your long-term goals—things like children, career aspirations, or where you want to live?*

**Taylor:** *We’ve talked about having kids eventually, but we’re not sure when.*

**Alex:** *Yeah, we’re both focused on our careers right now, so we’re thinking a few years down the road.*

**Me:** *It’s important to keep those conversations going, especially as life changes. Being on the same page about major life decisions will help you navigate challenges together.*

---

### Online Premarital Counseling Takeaways:

1. [**Active listening**](https://hbr.org/2024/01/what-is-active-listening) to improve communication.
2. **Conflict resolution strategies** that consider both partners’ needs.
3. **Financial planning** to align goals and habits.
4. **Long-term expectations** to ensure shared vision for the future.

## Pre-marital Counseling vs. Premarital Therapy

Pre-marital counseling and premarital therapy both serve to help couples prepare for marriage, but they differ in scope, focus, and depth. Here’s a breakdown of the differences between the two:

### 1. Pre-marital Counseling vs. Premarital Therapy Focus and Goals

- **Premarital Counseling:**
    - **Focus:** Primarily on preparing for a healthy marriage by discussing key topics like communication, finances, roles, values, family expectations, and conflict resolution.
    - **Goal:** To equip couples with the tools and strategies to navigate common challenges in marriage and build a strong foundation for their relationship. It is more **future-focused** and tends to be educational and preventative.
- **Premarital Therapy:**
    - **Focus:** Similar areas (communication, conflict, etc.) but with a greater focus on **resolving deeper emotional or psychological issues** that may be affecting the relationship. It can explore **past traumas, unresolved conflicts, [attachment issues](https://www.verywellmind.com/what-is-an-attachment-disorder-4580038)**, or individual mental health concerns that might impact the marriage.
    - **Goal:** To address underlying problems that might hinder the success of the relationship. It involves **deeper emotional work** and may deal with specific concerns, such as anxiety, trust issues, or unresolved trauma.

### 2. Pre-marital Counseling vs. Premarital Therapy Depth

- **Premarital Counseling:**
    - **Surface-level and practical** exploration of relationship dynamics. It’s often structured around specific topics like communication, financial planning, and family expectations. Counseling is typically more **short-term** and often includes questionnaires or exercises to facilitate discussion and understanding between the partners.
- **Premarital Therapy:**
    - **Deeper psychological exploration** that can uncover and address issues from each individual’s past or present that may be impacting the relationship. Therapy often involves exploring family backgrounds, emotional baggage, unresolved conflicts, or attachment styles. It is more likely to require **longer-term engagement**, depending on the depth of the issues being explored.

### 3. Pre-marital Counseling vs. Premarital Therapy Methods

- **Premarital Counseling:**
    - Typically focuses on marriage preparation and may be conducted by someone who is less experienced or credentialed.
    - Often follows a **structured curriculum** or framework, including practical discussions, exercises, and assessments (e.g., communication exercises or [personality compatibility tests](https://psychologicalassessments.com/compatibility-testing/)).
- **Premarital Therapy:**
    - Led by a **licensed therapist or [clinical psychologist](https://dralanjacobson.com/my-bio/)** with specific training in relationship dynamics and [clinical psychotherapy](https://dralanjacobson.com/types-of-therapy/).
    - Utilizes various [**therapeutic techniques**](https://dralanjacobson.com/types-of-therapy/) (e.g., [cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/), [emotion-focused therapy](https://dralanjacobson.com/eft-therapy-for-couples/)) to address deeper issues and heal relational wounds.

### 4. Pre-marital Counseling vs. Premarital Therapy Length

- **Premarital Counseling:**
    - Usually involves a few sessions (often 3-8), depending on the couple’s needs. It’s shorter and more focused on specific aspects of marriage preparation.
- **Premarital Therapy:**
    - It is more extensive and ongoing. If deep issues need to be worked through, therapy may last for months or longer. If ongoing challenges arise, it may evolve into [couples therapy](https://dralanjacobson.com/couples-therapy/).

### 5. Types of Issues Addressed

- **Online Premarital Counseling:**
    - Communication styles
    - Financial management
    - Roles and responsibilities
    - Conflict resolution
    - Parenting and family planning
    - Expectations around sex and intimacy
- **Online Premarital Therapy:**
    - Deeper emotional or psychological concerns
    - Trust issues or infidelity in the past
    - Anxiety or mental health concerns affecting the relationship
    - Trauma (either individual or relational)
    - Attachment issues or [family-of-origin](https://psychology.tips/family-of-origin-meaning/) conflicts
    - Unresolved arguments that are causing significant strain

### 6. Preventative vs. Healing Approach

- **Online Premarital Counseling:**
    - **Preventative** in nature, aiming to help couples identify and address potential issues before they become major problems in the marriage.
- **Online Premarital Therapy:**
    - More of a **healing** approach, focusing on fixing or addressing existing problems and emotional issues that are already affecting the relationship.

---

### Which One to Choose?

- **Online Premarital Counseling** is ideal for couples who feel generally good about their relationship but want to ensure they’re prepared for marriage. It’s useful for learning skills to navigate common marital issues.
- **Online Premarital Therapy** is better suited for couples who are struggling with deeper issues or emotional challenges that require more intensive work or if they want to explore how past experiences may affect their future together.

Both options can greatly benefit couples by providing them with skills and insights to create a successful, healthy marriage. The choice between counseling and therapy largely depends on the couple’s needs and the complexity of the issues they want to address.

## Summary and My Work

In pre-marital counseling, couples can explore their relationship dynamics and prepare for a successful marriage by addressing key areas. I can provide the structure around this, offering tools to improve communication, intimacy, and understanding to help couples establish a foundation for future challenges. I offer mostly online premarital counseling services and [online couples therapy](https://dralanjacobson.com/virtual-couples-therapy/).

If you’d like more information about pre-marital counseling and how it might benefit you, you are welcome to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Couples Therapies

---

### [CBT for OCD](https://dralanjacobson.com/cbt-for-ocd/)

**Published:** April 8, 2024
**Author:** Dr. Alan Jacobson

**Content:**

I offer **CBT for OCD** for adolescents and adults, both virtually and in person. **Cognitive-behavioral therapy for OCD** is considered a cornerstone treatment, given its effectiveness**.** This post goes over how I use **CBT for obsessive-compulsive disorder**, with an example and some alternatives.

This post is designed to help you become an informed and educated consumer of these services, whether you pursue treatment with me or not. I would be happy to talk with you about any of this. Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) any time.

### What is CBT?

CBT, or [Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/), is a type of psychotherapy that focuses on changing negative thought patterns and behaviors. It is based on the concept that our thoughts, feelings, and behaviors are interconnected and that changing negative thoughts and behaviors can improve mood and functioning. I provide CBT as a core service in my practice.

CBT is typically short-term and goal-oriented, and it involves techniques such as:

1\. Identifying Negative Thoughts: Recognizing and challenging irrational or unhelpful thoughts.
2\. Cognitive Restructuring: Reframing negative thoughts in a more positive or realistic light.
3\. Behavioral Activation: Encouraging activities that bring pleasure or a sense of accomplishment.
4\. [Exposure Therapy](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/): Gradually facing feared situations in a controlled way to reduce anxiety.
5\. Skill Training: Developing coping skills like problem-solving and stress management.

CBT is used to treat a variety of mental health conditions, [including depression](https://dralanjacobson.com/cbt-for-depression/), [anxiety disorders](https://dralanjacobson.com/cbt-for-social-anxiety/), phobias, and [post-traumatic stress disorder](https://en.wikipedia.org/wiki/Post-traumatic_stress_disorder) (PTSD). It is evidence-based and is effective in numerous studies.

### What is OCD?

Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by persistent, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that an individual feels driven to perform. These obsessions and compulsions can interfere significantly with daily functioning and cause distress.

#### Key Features of OCD

1\. Obsessions: Intrusive and unwanted thoughts, images, or urges that cause distress or anxiety. Common themes include:

– Fear of contamination or germs
– Aggressive or horrific thoughts about harming oneself or others
– Doubts about having done something correctly (like locking the door)
– Unwanted, forbidden, or taboo thoughts involving sex, religion, or harm

2\. Compulsions: Repetitive behaviors or mental acts that a person feels compelled to perform in response to an obsession or according to rules that must be applied rigidly. These behaviors aim to reduce distress or prevent a feared event, but they are not realistically connected to what they are intended to prevent or are clearly excessive. Common compulsions include:

– Washing and cleaning
– Checking (e.g., ensuring the stove is off multiple times)
– Counting
– Ordering and arranging
– Repeating actions a certain number of times

[CBT for OCD](https://dralanjacobson.com/therapy-for-ocd/) is a great fit since they are both rooted in automatic, irrational, and exaggerated thinking. OCD involves having these thoughts, while CBT aims to help you reduce or eliminate them. Cognitive-behavioral therapy for Obsessive-compulsive disorder truly works and is, therefore, often the first treatment I use.

It should be noted that a person can have OCD with only mild compulsions that follow the obsessions.

## CBT for OCD Process

While the process of CBT for OCD can vary, here is a general look at the steps:

### CBT for OCD Psychoeducation

We start CBT for [obsessive-compulsive disorder](https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd) with education. The goal is to educate you or your child about OCD, including its symptoms, causes, and the [principles of CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/). Some people start to experience relief after this initial step since it clarifies the causes of the symptoms and what is maintaining them. Once you start to see that your symptoms are not “real,” yet there are real reasons why they are happening, it helps you separate yourself from the disorder.

### Exposure and Response Prevention (ERP)

ERP is a core component of CBT for OCD. It involves deliberately exposing oneself to situations that trigger obsessions (exposure) while refraining from compulsive behaviors (response prevention). Over time, this helps you learn that your anxiety decreases on its own without needing to perform compulsions. Of course, we go at a pace you are comfortable with, often starting with merely trying to delay responding if you can’t choose not to respond at all.

### Cognitive Restructuring

This involves identifying and challenging irrational thoughts (cognitions) related to OCD. Through techniques such as cognitive restructuring, you learn to replace these irrational thoughts with more realistic and balanced ones. I’ll often assign homework exercises to reinforce the cognitive restructuring skills learned in therapy and encourage you to practice these skills. Many people find that CBT for obsessive-compulsive disorder helps them hear the thoughts that they had previously been unaware of. This in itself can be eye-opening and powerful.

### Cognitive-Behavioral Therapy for OCD Behavioral Experiments

These involve testing the validity of one’s beliefs related to OCD through structured experiments. This can help you gather evidence that challenges their OCD-related beliefs and assumptions. I’ll guide you on how to do these, and you’ll do them as homework outside the sessions. These experiments are enjoyable and even sometimes fun. Some people choose to have trusted people in their life join them, both for enjoyment and so the other person understands what it’s like to have the disorder.

### Mindfulness in CBT for Obsessive-Compulsive Disorder

[Mindfulness techniques](https://dralanjacobson.com/mindfulness-therapy/) can help you increase awareness of your thoughts and feelings without judgment. [Acceptance and Commitment Therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) (ACT), which incorporates mindfulness and acceptance strategies, can also be helpful as an adjunct to CBT for OCD. Mindfulness can help in so many other ways as well, and many clients who have had cognitive-behavioral therapy for OCD continue to use mindfulness techniques to help in other areas of their lives even after their symptoms subside.

### CBT for OCD Relapse Prevention

Once significant progress has been made, our focus shifts to maintaining gains and preventing relapse. This involves developing strategies to cope with any future OCD symptoms that may arise, and thus having a CBT for OCD toolkit you can use going forward.

## Cognitive-Behavioral Therapy for OCD Example

Here’s an example of how CBT might be applied in the treatment of OCD:

### CBT for OCD Assessment and Treatment Planning

Julie came in with symptoms of OCD since a recent promotion and the birth of her first child. She has been finding herself having increased compulsions to do unnecessary or repetitive tasks to reduce her anxiety at home and work.

We start this course of CBT for OCD by conducting a thorough assessment to understand Julie’s specific OCD symptoms, triggers, and the impact on her daily life. I provide psychoeducation about OCD, explaining how obsessions and compulsions work and why she is likely experiencing them now during these stressful, even if positive, life transitions. We also discuss the principles of CBT for obsessive-compulsive disorder as an effective treatment approach.

Next, we set treatment goals. Together, we establish clear, measurable treatment goals. These goals include reducing the frequency and intensity of obsessions and compulsions, enhancing her overall contentment and quality of life, and developing more positive stress management methods.

### CBT for Obsessive-Compulsive Disorder Process

It is now time to dive in and begin the process of cognitive-behavioral therapy for OCD. The cornerstone approach will be [Exposure and Response Prevention](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/) (ERP). I work with Julie to help her identify their specific triggers for obsessions and compulsions. We then collaboratively develop a hierarchy of feared situations or triggers, ranging from least to most anxiety-provoking.

**Exposure and Response Prevention**

Outside of sessions, Julie will start with exposures to less distressing triggers and gradually progress to more challenging ones while refraining from engaging in compulsive behaviors. For example, since one of her obsessions and compulsions is about germs and contamination, she will start by touching mildly dirty objects and refraining from washing her hands immediately afterward.

**Cognitive Restructuring**

We will start working on cognitive restructuring once Julie has succeeded with some ERP. I help her identify and challenge her irrational beliefs related to OCD. For instance, she believes touching a doorknob without washing her hands could lead to illness. I help her evaluate the evidence for and against this belief so she can develop a more balanced perspective.

Cognitive restructuring leads to the next phase of Julie’s cognitive-behavioral therapy for OCD: Behavioral Experiments. I guide her in conducting experiments to test the accuracy of her OCD-related beliefs. This involves intentionally exposing herself to situations they fear will trigger obsessions but refraining from performing compulsions. When she touches a doorknob, she will see how long she can hold out from washing her hands, and we will go over the consequences (or lack thereof) of doing this.

**[Mindfulness Therapy](https://dralanjacobson.com/mindfulness-therapy/)**

Throughout this cognitive-behavioral therapy for OCD, I will introduce [mindfulness cognitive therapy techniques](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) to help Julie develop greater awareness of her thoughts and emotions without judgment. She will practice mindfulness exercises during therapy sessions and as part of homework assignments to cultivate acceptance of uncertainty and discomfort.

Throughout the CBT for obsessive-compulsive disorder treatment process, I provide guidance, support, and encouragement while also fostering Julie’s independence and self-efficacy. CBT for OCD treatment sessions are collaborative, with the two of us working together as a team to achieve the established goals. She’ll leave therapy without symptoms and with a toolkit to manage daily stress.

## CBT for OCD Case Example 2: Adolescent

- **Name:** Sarah (fictional example)
- **Age:** 15
- **Sport:** Competitive soccer player
- **Presenting Issue:** Obsessive-Compulsive Disorder (OCD) with contamination fears and compulsive handwashing
- **Impact on Life:** Struggles with excessive handwashing before and after games, avoids high-fives and team huddles, and is anxious about using shared sports equipment.

### Cognitive-behavioral Therapy for OCD Treatment Plan:

1. **CBT for Obsessive-compulsive Disorder Psychoeducation:**

- Teach Sarah about OCD, explaining how intrusive thoughts and compulsions reinforce anxiety.
- Discuss how avoidance behaviors (e.g., refusing to touch teammates) actually increase anxiety over time.

2. **Identifying Triggers & Exposure Hierarchy:**

- Work with Sarah to list her triggers, ranking them from least to most distressing. Examples: 
    - Touching a soccer ball handled by others (moderate distress)
    - High-fiving a teammate (high distress)
    - Using the locker room showers without excessive washing (very high distress)

3. **Exposure and Response Prevention (ERP):**

- Gradual exposure to feared situations while resisting compulsions.
- Example: Start by touching a soccer ball and delaying handwashing for 5 minutes, then increase the delay over time.
- Encourage Sarah to engage in team huddles and high-fives without immediately washing her hands.

4. **[ Cognitive Restructuring](https://dralanjacobson.com/cognitive-restructuring/):**

- Challenge irrational thoughts (e.g., “If I don’t wash my hands, I will get sick and miss the game”).
- Use evidence-based thinking (e.g., “Other players touch the ball and don’t get sick constantly”).

5. **Coping Strategies & [Mindfulness-Based Cognitive Therapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/):**

- Teach relaxation techniques (e.g., deep breathing, grounding exercises) to manage anxiety.
- Use visualization (e.g., imagining playing confidently without engaging in compulsions).

6. **Homework & Reinforcement:**

- Assign practice exercises for exposure outside of therapy (e.g., using shared equipment at practice without excessive washing).
- Reward progress with positive reinforcement (e.g., celebrating when she completes an exposure).

### CBT for Obsessive-compulsive Disorder Outcomes:

- Reduced compulsive handwashing and avoidance behaviors.
- Increased ability to engage in team activities without excessive distress.
- Improved overall confidence and enjoyment in soccer without OCD interfering.

Through cognitive-behavioral therapy for OCD, Sarah was able to participate more in team activities and pursue her sport to her full potential. She also learned coping skills and mindfulness techniques that helped her off the field. In general, she felt more resilient and strong after therapy, and her improved performance and comfort in athletics added to that strength.

## Summary and My Work

I offer cognitive-behavioral therapy for OCD as a [virtual treatment](https://dralanjacobson.com/virtual-therapy-guide/) and in person. CBT for OCD is usually conducted over a series of regular weekly [individual therapy](https://dralanjacobson.com/individual-therapy/) sessions, with a length of time determined by your progress and the severity of symptoms. The specific treatment plan is tailored to your needs and may involve variations of the abovementioned techniques. CBT for obsessive-compulsive disorder can even be done in a[ couples therapy](https://dralanjacobson.com/couples-therapy/) or [family therapy](https://dralanjacobson.com/family-therapy/) framework where the other people are there to help with some of the skill-building, [cognitive psychology](https://www.verywellmind.com/cognitive-psychology-4157181) experiments, and exposure methods.

This form of therapy can be combined with other approaches such as [acceptance and commitment psychotherapy](https://dralanjacobson.com/act-psychotherapy/) and [schema therapy](https://dralanjacobson.com/schema-therapy/). Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime to discuss CBT for OCD and how it could help you or your child.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Mental Health Diagnoses

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### [Metacognitive Therapy (MCT): Stop Overthinking Now](https://dralanjacobson.com/metacognitive-therapy-mct/)

**Published:** September 20, 2024
**Author:** Dr. Alan Jacobson

**Content:**

## What Is Metacognitive Therapy (MCT)? (Quick Overview)

Metacognitive therapy (MCT) is an evidence-based approach that helps you change how you respond to your thoughts—rather than trying to change the thoughts themselves. It focuses on reducing patterns like worry, rumination, and overthinking that keep anxiety and distress going.

**Key elements include:**

- Reducing overthinking, worry, and rumination
- Changing beliefs about thinking (e.g., “I can’t control my thoughts”)
- Learning to disengage from unhelpful thought patterns
- Building flexible attention and mental control

### When Is Metacognitive Therapy Used?

- Anxiety and chronic worry
- Depression and rumination
- OCD and intrusive thoughts
- PTSD and persistent mental distress

MCT is considered a **transdiagnostic treatment**, meaning it targets underlying thinking processes across many disorders rather than focusing on specific symptoms.

### How Is MCT Different from CBT?

- CBT focuses on *changing the content* of thoughts
- MCT focuses on *changing your relationship to thoughts*
- MCT reduces overthinking rather than analyzing it

MCT targets patterns like worry and rumination directly, which are seen as key drivers of distress.

**Metacognitive Therapy** (MCT) is a relatively recent psychological treatment developed by psychologist [Adrian Wells](https://en.wikipedia.org/wiki/Adrian_Wells) that focuses on how people think about and regulate their thoughts rather than the content of their thoughts. It is based on the premise that psychological distress (e.g., anxiety, depression, or [obsessive-compulsive symptoms](https://dralanjacobson.com/cbt-for-ocd/)) is maintained by maladaptive thinking patterns, mainly how we respond to negative or distressing thoughts. I offer metacognitive therapy exercises either as a stand-alone approach or as part of integrative therapy with other techniques. I also offer Metacognitive Interpersonal Therapy, which is more specific to difficulties in social situations and relationships.

## Introduction to MCT

There are three main pillars of MCT:

1. **Metacognition**: This refers to thinking about thinking. MCT emphasizes how you evaluate and control your cognitive processes, including worry, rumination, and attention.
2. **Cognitive Attentional Syndrome (CAS)**: According to Metacognitive Therapy, emotional problems are largely the result of the CAS, which includes: 
    - Worry and Rumination: Persistent, repetitive thinking about potential threats (worry) or past problems (rumination).
    - Threat Monitoring: Hypervigilance for potential threats or dangers.
    - Unhelpful Coping Behaviors: Avoidance behaviors or safety-seeking actions that, while intended to reduce anxiety, reinforce it in the long run.
3. **Beliefs about Thinking**: Metacognitive Therapy focuses on changing dysfunctional metacognitive beliefs. You might believe that worrying is useful (e.g., “If I worry, I can prevent bad things from happening”) or uncontrollable (e.g., “I can’t stop worrying”). In reality it is controllable and not helpful.

### Goals of Metacognitive Therapy:

The primary goal of MCT is to help you alter how you respond to distressing thoughts by addressing your metacognitive beliefs. Rather than trying to change the content of thoughts (as in traditional cognitive-behavioral therapy), Metacognitive Therapy encourages you to adopt a new relationship with your thoughts—learning to see them as transient events in the mind that don’t need to be engaged with.

### Metacognitive Therapy Techniques

- **Attention Training Technique (ATT)**: An MCT method designed to help you break free from threat monitoring and improve your attentional control.
- **Detached Mindfulness**: These metacognitive therapy exercises teach you to let thoughts come and go without engaging with them.
- **Behavioral Experiments**: These MCT experiments encourage you to test the validity of your metacognitive beliefs, such as whether worrying prevents bad things from happening.

### Metacognitive Therapy Effectiveness:

By offering a unique approach compared to traditional therapies by shifting focus from thought content to how thoughts are managed, metacognitive therapy exercises are effective in treating various psychological disorders, including [generalized anxiety disorder](https://dralanjacobson.com/therapy-for-generalized-anxiety-disorder/) (GAD), depression, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). Research suggests it can be beneficial for individuals who struggle with chronic worry or rumination.

## Metacognitive Therapy exercises

Metacognitive Therapy uses a variety of exercises designed to change how you relate to your thoughts and beliefs about thinking. Here are some key Metacognitive Therapy exercises:

### Attention Training Technique (ATT)

ATT is one of the core metacognitive therapy exercises, designed to help you improve your control over attention and reduce excessive focus on negative thoughts or worries:

- Step 1: I ask you to sit in a quiet environment and focus on specific sounds around you, such as the clock ticking, traffic, or birds chirping.
- Step 2: After a few minutes, you are asked to switch focus between different sounds.
- Step 3: Eventually, I encourage you to switch focus more rapidly, moving your attention between multiple sounds simultaneously.
- Goal: This exercise helps you realize you can shift attention at will, which reduces rumination and worry by breaking habitual focus on negative thoughts.

### MCT Detached Mindfulness

Detached mindfulness teaches you to observe your thoughts without reacting to them or becoming emotionally engaged.

- Step 1: I encourage you to imagine your thoughts as objects passing by, like clouds in the sky or leaves floating down a stream.
- Step 2: When a distressing thought arises, you are asked to acknowledge it without analyzing or reacting to it.
- Step 3: You practice noticing the thought and then letting it go, returning to calm observation.
- Goal: Over time, you learn to adopt a more neutral and detached stance toward your thoughts, which decreases the emotional impact of negative thinking.

### Worry Postponement

This is also one of the core metacognitive therapy exercises I use, helping you regain control over chronic worrying by teaching you to set aside specific times for worry.

- Step 1: You are asked to create a designated “worry time,” such as 15 minutes in the evening when you are allowed to worry as much as you like.
- Step 2: Whenever a worry arises, you note it down throughout the day but postpone thinking about it until the scheduled worry time.
- Step 3: During worry time, you can engage with your worries, but outside of this time, you aim to keep the worries at bay.
- Goal: By postponing worry, you begin to see that your worries are not urgent or uncontrollable, and this reduces the frequency and intensity of your worrying.

### MCT Behavioral Experiments

These metacognitive therapy exercises are designed to challenge and test metacognitive beliefs, such as “I need to worry to prevent bad things from happening” or “If I stop monitoring threats, I’ll be unprepared.”

- Step 1: I help you identify a specific belief, such as “If I don’t worry, I will be unprepared for bad events.”
- Step 2: You are encouraged to conduct an experiment to test this belief. For example, you might stop worrying for a set period (e.g., one day) and observe whether anything negative happens as a result.
- Step 3: After the experiment, you review what actually happened versus what you predicted would happen.
- Goal: These experiments help you disconfirm irrational metacognitive beliefs and develop more adaptive ways of responding to your thoughts.

### Exploring Positive and Negative Beliefs About Worry

These are metacognitive therapy exercises designed to identify and challenge both positive and negative beliefs about worry and rumination:

- Step 1: You are asked to list both positive and negative beliefs they hold about your thinking patterns. For example: 
    - Positive belief: “Worry helps me stay prepared.”
    - Negative belief: “Worry is uncontrollable and never stops.”
- Step 2: You and I work together to challenge these beliefs. For example: 
    - “What evidence do you have that worry helps you stay prepared?”
    - “Is it possible that worrying is increasing your distress rather than helping you?”
- Goal: The goal is to help you see that both positive and negative beliefs about worry are dysfunctional and can be modified to improve emotional well-being.

### Attentional Refocusing

This exercise involves teaching you to refocus your attention when you find yourself worrying or ruminating excessively.

- Step 1: You are asked to notice when you are engaging in repetitive thinking (e.g., worrying or ruminating).
- Step 2: You are then instructed to intentionally refocus your attention on a task or activity that requires concentration, such as a hobby or work task, or even focus on your breathing.
- Goal: The exercise helps reduce the tendency to get stuck in repetitive thought loops by building the your ability to redirect their attention.

### Modifying Metacognitive Beliefs

This involves helping clients understand and modify their metacognitive beliefs about the importance or danger of certain thoughts.

- Step 1: You are asked to identify specific beliefs about your thoughts, such as “I can’t stop worrying” or “If I don’t think about this, something bad will happen.”
- Step 2: I help you challenge these beliefs by providing evidence that thoughts are not inherently dangerous or uncontrollable.
- Step 3: You practice modifying these beliefs to be more flexible and realistic, such as “Worrying doesn’t actually prevent bad things, it just makes me feel worse.”
- Goal: By changing metacognitive beliefs, you learn to reduce their engagement with unhelpful thought patterns.

### Threat Monitoring Reduction

This exercise helps reduce excessive monitoring of potential threats, which is common in anxiety disorders.

- Step 1: You are asked to notice when you are engaging in threat monitoring, such as constantly scanning your environment for danger or worrying about potential future problems.
- Step 2: I work with you to shift your attention away from threat monitoring and toward neutral or positive stimuli.
- Goal: Over time, reducing threat monitoring can lower anxiety levels and improve well-being.

These Metacognitive Therapy exercises, practiced consistently, help you gain greater control over your thoughts and reduce the distress caused by maladaptive thinking patterns.

## Metacognitive Interpersonal Therapy Overview

Metacognitive interpersonal therapy (MIT) is an integrative therapeutic approach that combines metacognitive strategies with a focus on interpersonal relationships. Developed by [Giancarlo Dimaggio](https://www.researchgate.net/profile/Giancarlo-Dimaggio) and colleagues, MIT addresses cognitive and relational aspects by helping you improve self-awareness, regulate emotions, and develop healthier interpersonal relationships.

### Core Concepts of Metacognitive Interpersonal Therapy

1. **Metacognition**: In MIT, metacognition refers to the ability to understand one’s own and others’ mental states, emotions, and intentions. This can help you more accurately perceive and interpret your thoughts and feelings and those of others.
2. **Interpersonal Functioning**: Many challenges are characterized by maladaptive relationship patterns, such as fear of abandonment, difficulties with trust, or excessive dependence. Metacognitive Interpersonal Therapy seeks to improve interpersonal functioning by addressing these patterns and enhancing relational skills.
3. **Emotional Dysregulation**: Metacognitive Interpersonal Therapy also focuses on [emotional dysregulation](https://psychologicalassessments.com/emotional-dysregulation-testing/) that can cause impulsive or self-destructive behaviors.
4. **Self and Identity**: MIT emphasizes helping you develop a more coherent and stable sense of self. If you struggle with an unstable sense of identity, it can result in confusion, emotional turmoil, and unhealthy relationship dynamics.

Key Components of Metacognitive Interpersonal Therapy

1. **Metacognitive Monitoring and Control**: MIT focuses on enhancing your ability to observe your own cognitive processes (thoughts, emotions, beliefs). This is done through reflective exercises where you are encouraged to notice how they think and feel in certain situations, especially in interpersonal contexts.
2. **Formulation of Maladaptive Interpersonal Patterns**: One of the key interventions in MIT is helping you identify their maladaptive [interpersonal schemas](https://dralanjacobson.com/schema-therapy/) or patterns. These patterns often emerge from past experiences, particularly early attachment relationships, and affect current relationships. For example, someone might have a “fear of abandonment” schema that causes them to cling to others or become overly dependent, creating relationship strain.
3. **Socratic Dialogue and Guided Discovery**: I use [Socratic questioning](https://en.wikipedia.org/wiki/Socratic_questioning) to help you explore the accuracy and utility of your thoughts and beliefs. This questioning technique encourages you to challenge their rigid, maladaptive thinking patterns and develop more flexible and adaptive ways of understanding your relationships and emotions.
4. **Promoting Autobiographical Self-Coherence**: Many struggle with fragmented and incoherent narratives about themselves. Metacognitive Interpersonal Therapy helps you integrate past experiences into a more cohesive and realistic understanding of your life story. This can help reduce confusion about identity and foster greater self-awareness.
5. **Addressing Dysfunctional Interpersonal Cycles**: Metacognitive Interpersonal Therapy focuses on helping you identify and break dysfunctional interpersonal cycles. For example, a client may engage in behaviors that push others away, which in turn reinforces their belief that they are unlovable or bound to be abandoned. MIT helps clients understand and interrupt these cycles, leading to healthier and more stable relationships.

### Techniques Used in MIT

1. **Metacognitive Reflection**: I help you reflect on your thoughts and feelings, particularly in interpersonal relationships. This enables you to identify patterns of thought that may be causing distress or conflict in relationships.
2. **Emotional Regulation Training**: Techniques from emotion regulation therapies, such as mindfulness or distress tolerance skills, may be used to help you manage intense emotions that interfere with your relationships.
3. **Role Play and Interpersonal Feedback**: Role-playing exercises allow you to practice healthy communication and boundary-setting in a controlled environment. I may also provide direct feedback on how your interpersonal style affects your relationships.
4. **Behavioral Experiments**: You are encouraged to test new ways of interacting with others in real-life situations. For example, you might try assertively expressing their needs or setting boundaries more clearly and then reflect on the results in our next session.

### Effectiveness

Studies have shown that Metacognitive Interpersonal Therapy can be effective in reducing symptoms, particularly those related to emotional instability, impulsivity, and interpersonal difficulties. By enhancing metacognitive skills and improving relational patterns, clients who engage in MCT often experience greater emotional stability and more fulfilling relationships.

## Summary and My Work

In my integrative practice, I offer metacognitive therapy and metacognitive interpersonal therapy (MCT). MCT is part of the [“third wave” therapies](https://dralanjacobson.com/third-wave-psychotherapy/) that are [client-centered](https://dralanjacobson.com/client-centered-therapy/), positive, and focused on potential. I often combine MCT with other approaches, such as [reality therapy](https://dralanjacobson.com/reality-therapy-and-mindfulness-counseling/), [schema-focused therapy](https://dralanjacobson.com/schema-therapy/) and [mindfulness therapy](https://dralanjacobson.com/mindfulness-therapy/).

If you have any questions about MCT, MIT, or the metacognitive therapy exercises discussed here, please don’t hesitate to [schedule a consultation](https://www.picktime.com/scheduleaconsult) or [contact me](https://www.picktime.com/scheduleaconsult).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Values Clarification Therapy: Find Direction & Purpose](https://dralanjacobson.com/values-clarification-therapy/)

**Published:** September 22, 2025
**Author:** Dr. Alan Jacobson

**Content:**

## What Is Values Clarification Therapy? (Quick Overview)

Values clarification therapy is a structured process that helps you identify what truly matters to you and align your decisions and actions with those values. It focuses on increasing self-awareness, resolving inner conflict, and creating a clearer sense of direction in life.

**Key elements include:**

- Identifying core values and priorities
- Recognizing gaps between values and current behavior
- Resolving internal conflicts or competing priorities
- Making decisions that feel more authentic and aligned

Clarifying values helps guide choices, improve well-being, and create a stronger sense of purpose.

### When Is Values Clarification Therapy Helpful?

- Feeling stuck, uncertain, or directionless
- Difficulty making decisions or setting goals
- Internal conflict between competing priorities
- Life transitions (career, relationships, identity)

When people are disconnected from their values, they often feel unfulfilled or conflicted—even if things look “fine” on the surface.

### How Values Clarification Therapy Works

- Explore what matters most across key areas of life
- Identify patterns where actions don’t match values
- Clarify priorities and resolve conflicting values
- Translate values into concrete, daily decisions

Values work helps align behavior with what matters most, improving motivation and long-term change.

## Introduction to VCT

Many people struggle with decisions, relationships, or a sense of direction in life, not because they lack insight or resources, but because they feel uncertain about what really matters to them. Many describe a sense of “drifting” or making choices based on habit, pressure, or circumstance rather than conscious intention. Values Clarification Therapy (VCT) is a structured yet highly personalized therapeutic process that helps individuals discover, define, and actively live in alignment with their core values. Unlike [therapy models](https://dralanjacobson.com/types-of-therapy/) that focus only on symptom reduction, the values clarification process emphasizes meaning, authenticity, and purpose. Specifically, values clarification exercises help clients uncover what gives their lives direction and satisfaction, and then translate those insights into daily choices.

This post provides an overview of VCT, but given the uniqueness of each person’s needs, goals, and barriers, I invite you to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult#services/service) to discuss how this method might benefit you or a loved one.

### Overview of Values Clarification Therapy ![Values Clarification Therapy](https://dralanjacobson.com/wp-content/uploads/2025/09/choices-300x214.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Values Clarification Therapy is not about prescribing morals or imposing ideals. Instead, it provides tools and guided reflection for clients to identify what they believe in most deeply, whether it be relationships, creativity, honesty, achievement, compassion, spirituality, or balance.

### Key Goals of VCT

While values clarification therapy is uniquely tailored to each client, the overall goals are often quite similar:

1. **Awareness:** Helping clients identify and articulate their principles.
2. **Consistency:** Exploring where behavior aligns or conflicts with those principles.
3. **Decision-making:** Using clarified values to guide present and future choices.
4. **Meaning-making:** Supporting a sense of purpose and direction in life.
5. **Resilience:** Strengthening motivation during challenges by grounding in core beliefs.

### Who Benefits Most From Values Clarification Therapy?

The values clarification process is effective for a wide range of people at various stages of life. For example:

- **Adolescents and Teens** – who are developing identity and independence.
- **Young Adults** – navigating education, career, and relationship transitions.
- **Adults in Midlife** – questioning career choices, priorities, or life balance.
- **Older Adults** – seeking meaning in retirement, legacy, and life review.
- **Clients with Anxiety or Depression** – who may feel “stuck” or disconnected from purpose.
- **Clients Facing Major Decisions** – such as marriage, divorce, relocation, or career change.

## Values Clarification Exercises

Below is a set of exercises commonly used in VCT. Each includes a description, the method used, and its therapeutic purpose. These exercises can be used as part of the larger VCT process or as standalone add-ons to various other types of [psychotherapy services](https://dralanjacobson.com/psychotherapy/) (see below).

1. **Card Sort**

- **Description:** Clients sort cards containing words like *integrity, family, success, adventure, faith, security*.
- **Values Clarification Exercises:** Sort into piles: “Very Important,” “Important,” “Not Important.” Then rank top 5–10.
- **Purpose:** Provides a visual and interactive way to prioritize principles. Often reveals surprising gaps between assumed and actual priorities.

2. **Role Model Reflection**

- **Description:** Identify 2–3 people admired deeply (family, historical figures, celebrities).
- **Values Clarification Exercises:** Write or discuss what qualities make them admirable. Translate these qualities into value statements (e.g., “I admire their courage” → “I value bravery and authenticity”).
- **Purpose:** Helps clients externalize and identify beliefs they may not consciously name.

3. **Life Compass / [Wheel of Values](https://positivepsychology.com/wheel-of-life-coaching/)**

- **Description:** A circle divided into domains (family, work, health, community, leisure, spirituality).
- **Values Clarification Exercises:** Rate each domain on a 1–10 scale based on current alignment with core beliefs. Draw a wheel and see where it feels unbalanced.
- **Purpose:** Creates a visual map of where principles are supported and where they are neglected.

4. **Decision Dilemmas**

- **Description:** Explore a real or hypothetical difficult decision (e.g., job vs. family time).
- **Values Clarification Exercises:** Discuss how each choice reflects or violates core values.
- **Purpose:** Builds skill in applying these principles to real-world decisions.

5. [ **The Legacy Question**](https://www.legacyproject.org/guides/lifeintquestions.html)

- **Description:** Imagine writing one’s own obituary or a eulogy from a loved one.
- **Values Clarification Exercises:** What would you want them to say? What contributions or qualities matter most?
- **Purpose:** Helps clients identify enduring principles beyond short-term goals.

6. **Daily Alignment Journal**

- **Description:** End-of-day journaling with two prompts: 
    1. “Which of my actions today reflected my core values?”
    2. “Where did I act against them?”
- **Purpose:** Builds awareness in daily life and highlights patterns for change.

7. **Forced Choice Ranking**

- **Description:** Clients are given two values at a time and asked, “If you could only choose one, which would it be?”
- **Purpose:** Creates clarity by highlighting trade-offs and underlying priorities.

8. **Ideal Day Exercise**

- **Description:** Clients imagine a “perfect day” from morning to night.
- **Values Clarification Process:** Explore what they are doing, who they are with, and what makes the day meaningful. Extract values embedded in the vision (e.g., freedom, creativity, family).
- **Purpose:** Connects core beliefs to lived experience in vivid, personal ways.

## Values Clarification Process

In values clarification therapy, the general process goes something like this:

1. **Assessment & Rapport-Building**
    - Understand the client’s context, presenting concerns, and readiness for self-reflection.
    - Introduce the purpose of values work—clarity, not prescription.
2. **Exploration**
    - The values clarification process uses exercises (card sorts, reflections, journaling) to identify possible core beliefs.
    - Encourage free association, metaphors, and storytelling.
3. **Prioritization**
    - Narrow down to a small number (usually 5–8) of “core values.”
    - Discuss why each one matters, how it developed, and how it shows up in life.
4. **Application to Life Domains**
    - Apply principles to relationships, work, education, health, community, and recreation.
    - Identify conflicts (e.g., valuing both security and freedom).
5. **Goal-Setting & Action Planning**
    - Translate core principles into actionable commitments.
    - Example: “Because I value family, I will schedule weekly dinners with my parents.”
6. **Reflection & Adjustment**
    - The values clarification process often uses check-ins to monitor alignment over time.
    - Reassess as life circumstances or priorities shift.

### Methods Values Clarification Can Be a Part Of

- **[Acceptance and Commitment Psychotherapy](https://dralanjacobson.com/act-psychotherapy/):** Central to ACT’s focus on values-driven action.
- **[Motivational Interviewing](https://dralanjacobson.com/motivational-interviewing/) (MI):** Enhances motivation by connecting behavior change to core principles.
- **[Cognitive-Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT):** Values used to counteract avoidance and shape goals.
- **[Existential Therapy](https://dralanjacobson.com/existential-therapy/):** Helps clients address meaning, mortality, and authenticity.
- **[Career Counseling](https://www.goodtherapy.org/learn-about-therapy/issues/career-counseling) & Coaching:** Guides educational and vocational choices.
- **[Positive Psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/) Approaches:** Connects values to strengths and flourishing.

## Case Examples of VCT

The following fictional examples show how values clarification exercises can help people of different ages. Of course, your own needs may differ, and you’re welcome to contact me to discuss how VCT might benefit you or a loved one.

### Case 1: Values Clarification Therapy for a High School Student

Challenge:
Sarah, a 16-year-old, came to therapy at her parents’ request after increased conflict at home and declining grades. She felt torn between pleasing her parents, who emphasized academics, and fitting in with her peer group, which valued social status and risky behavior. She often made impulsive choices, later regretting them, and reported “not knowing who I really am.”

VCT Assessment:
Using a Card Sort, Sarah identified “authenticity,” “loyalty,” and “creativity” as important. Yet her behavior (skipping homework to socialize, hiding parts of herself to fit in) conflicted with these principles. In a Role Model Reflection, she named her grandmother, whom she admired for “always being honest even when it was hard.” This highlighted her yearning for authenticity, despite current peer pressure.

Vaues Clarification Process:
Through journaling and discussion, Sarah explored what authenticity and loyalty meant to her personally. She practiced identifying small daily choices, like telling the truth about where she was going or spending time with supportive friends, that reflected those principles. She also worked with her parents to negotiate realistic academic goals, framed as part of her value of “loyalty to family.”

Outcome:
Over several months, Sarah reported less anxiety around peers and greater confidence in her decisions. She joined the school art club (honoring her creativity) and built a new peer group aligned with her core principles. Her academic engagement improved because she felt she was acting in loyalty to her family, not just following rules. Her sense of identity strengthened, and conflicts at home decreased.

### Case 2: Values Clarification Therapy for a Recent College Grad.

Challenge:
Michael, age 25, came to therapy with symptoms of mild depression, lack of motivation, and a sense of being “stuck.” After graduating from college, he took a job in finance that provided stability but felt draining. He described waking up each day with dread and “living for weekends,” but felt guilty considering a career change, fearing he would disappoint his parents.

VCT Assessment:
A Daily Alignment Journal showed Michael spent nearly all his time in activities that did not reflect his stated core principles. During a Wheel of Values exercise, he identified “creativity,” “personal growth,” and “adventure” as deeply important, yet none were present in his current lifestyle. In a Decision Dilemma, he contrasted staying in finance (security, pleasing family) versus exploring creative careers (growth, authenticity).

Values Clarification Process:
Therapy focused on weighing trade-offs and reframing choices not as failures but as value-driven commitments. Michael experimented with incorporating creativity outside of work, joining a photography class and traveling locally. As he built evidence that creativity and adventure were achievable, he gained confidence to explore career transitions. Through a unique values clarification process, we set small goals: updating his portfolio, networking in creative fields, and discussing his intentions with his family in a way that emphasized authenticity and growth, rather than rejecting security.

Outcome:
Within a year, Michael transitioned into a junior design role at a startup. His depressive symptoms lessened significantly as he reported feeling energized, motivated, and aligned with his beliefs. Though his parents initially expressed concern, they came to respect his commitment to living authentically. Michael described himself as “finally living my own life, not the one I thought I had to.”

### Case 3: Values Clarification Exercises with an Older Adult

Challenge:
Linda, a 62-year-old marketing executive, presented with anxiety about retirement. She feared losing her sense of identity and relevance, reporting, “If I’m not working, I’m nobody.” She also struggled with insomnia and rumination about the future.

VCT Assessment:
Through the Legacy Questions exercise, Linda realized she wanted to be remembered for “guiding others,” “sharing wisdom,” and “making a difference beyond the office.” A Forced Choice Ranking highlighted that while she valued “success” throughout her career, “contribution” and “wisdom” were now more central. This shift created an existential tension: she was still living by past ideals (achievement, status) while her present values had changed.

Values Clarification Process:
Therapy helped Linda envision retirement not as an end but as a transition into a new phase of contribution. She brainstormed ways to embody her ideals outside of the corporate world. She began mentoring younger colleagues before her retirement, which gave her a sense of continuity and fulfillment. Through the values clarification process, we also identified concrete steps: joining a nonprofit board, scheduling community volunteer work, and writing her memoirs. Sleep-focused interventions were designed to reduce nighttime rumination by reinforcing value-aligned activities during the day.

Outcome:
Linda retired with far less anxiety than anticipated, reporting that her days felt “full but meaningful.” She became a mentor to several young professionals, joined a nonprofit supporting women in business, and began work on a book project. Her insomnia decreased as her sense of purpose increased. She described retirement not as a loss of identity, but as “finally having the freedom to live by the ideals that matter most now.”

### Conclusion

These cases illustrate the adaptability of Values Clarification Therapy across life stages. For a teen, VCT supports identity development and resilience against peer pressure. For a young adult, it provides direction during career and life transitions. For an older adult, it offers continuity, meaning, and peace during major life changes. In each instance, clarifying and living by core principles served as a compass, helping clients navigate uncertainty and align their lives with what truly matters.

## Summary and My Work

Values Clarification Therapy offers a powerful way for individuals to live with greater authenticity, purpose, and joy. By exploring, naming, and applying core principles, clients create a compass that guides them through life’s complexities. Teens gain identity and confidence, young adults find direction, and older adults discover meaning and legacy. Ultimately, the values clarification process helps clients not only survive challenges but thrive, living each day in alignment with what matters most.

If you have any questions about values clarification exercises or the overall VCT process, please don’t hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult#services/service) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Tree of Life Therapy: Build Meaning & Resilience](https://dralanjacobson.com/tree-of-life-therapy/)

**Published:** December 3, 2025
**Author:** Dr. Alan Jacobson

**Content:**

## H2: What Is Tree of Life Therapy? (Quick Overview)

Tree of Life therapy is a narrative-based approach that uses the metaphor of a tree to help individuals explore their life story, strengths, and future goals. Representing different parts of life, such as roots (past), trunk (strengths), and branches (hopes), helps people build resilience and a stronger sense of identity.

**Key elements include:**

- Exploring your past, identity, and personal story
- Identifying strengths, values, and support systems
- Reframing difficult experiences in a more empowering way
- Building hope, direction, and resilience

### When Is Tree of Life Therapy Used?

- Trauma, stress, or difficult life experiences
- Low self-esteem or identity struggles
- Children, teens, or individuals who benefit from creative expression
- Life transitions or feeling stuck

This approach is especially effective because it focuses on strengths and allows people to share their stories in a safe, non-threatening way.

### How Tree of Life Therapy Works

- **Roots:** your history, culture, and influences
- **Trunk:** your strengths, values, and skills
- **Branches:** your hopes, goals, and future direction
- **Leaves/Fruits:** important people and supports in your life

This structured, visual process helps organize life experiences into a coherent and empowering narrative.

## Introduction to TOLT

As a psychologist who uses [narrative therapy](https://dralanjacobson.com/narrative-therapy/) and [strengths-based approaches](https://dralanjacobson.com/strength-based-therapy/) in my work, I often reach for the **Tree of Life Therapy activity** when people need a safe, non-threatening way to tell their story without being retraumatized. It’s simple, visual, and empowering: instead of digging for pathology, we map resources, relationships, hopes, and history. The goal of **Tree of Life Narrative Therapy** is to help people notice the skills and connections that have sustained them and to expand possibilities for a preferred future.

## Tree of Life Therapy History & Background ![Tree of Life Therapy](https://dralanjacobson.com/wp-content/uploads/2025/12/Tree-of-Life-200x300.png "Tree of Life | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

The Tree of Life Therapy approach emerged in the early 2000s during community-based psychosocial work in Southern Africa. At that time, practitioners were seeking ways to support children and families affected by HIV/AIDS, war, displacement, trauma, poverty, and systemic oppression. Traditional [Western diagnostic approaches](https://www.autoimmuneinstitute.org/articles/explained-holistic-vs-modern-western-medicine/) were not culturally aligned, often re-traumatizing, and did not acknowledge the rich cultural knowledge, communal identity, and spiritual traditions that sustained these communities.

### Tree of Life Therapy Origins and development

- Ncazelo Ncube, a Zimbabwean psychologist and community worker, co-created Tree of Life Therapy while working at [REPSSI](https://student.repssi.org/) (Regional Psychosocial Support Initiative).
- [David Denborough](https://findanexpert.unimelb.edu.au/profile/647606-david-denborough) and colleagues at the [Dulwich Centre](https://dulwichcentre.com.au/the-tree-of-life/) helped refine, document, and disseminate the Tree of Life Therapy approach internationally.
- The method draws heavily from narrative therapy, especially [Michael White and David Epston](https://exploringyourmind.com/michael-white-and-david-epston-the-pioneers-of-narrative-therapy/)’s ideas of externalizing problems, honoring cultural knowledge, and re-authoring identity through story. It is sometimes referred to as Tree of Life Narrative Therapy.

#### Why a tree?

This metaphor was intentionally chosen because:

- Trees hold deep cultural, spiritual, and ecological meaning across many societies.
- They illustrate growth, rootedness, nourishment, storms, resilience, and interconnectedness.
- The visual nature of drawing a tree gives participants distance and emotional safety while exploring identity.

#### Global expansion

Over time, the Tree of Life Therapy activity spread to:

- Schools, community centers, refugee camps, and crisis-response programs
- [Trauma-informed](https://dralanjacobson.com/trauma-informed-care/) youth services
- [Indigenous communities](https://en.wikipedia.org/wiki/Indigenous_peoples) using adapted versions
- Clinical settings as a therapeutic exercise
- Adult [psychotherapy](https://dralanjacobson.com/psychotherapy/) and [life-transition work](https://dralanjacobson.com/life-transitions-therapy/)
- [Family therapy](https://dralanjacobson.com/family-therapy/) and [intergenerational healing](https://fherehab.com/learning/intergenerational-trauma-cultural-stigma-guide-healing/) groups

Because it is non-pathologizing, adaptable, and culturally inclusive, it has become one of the most widely disseminated narrative-based group interventions globally.

### What the Tree of Life Therapy Activity is Used For

The Tree of Life Therapy activity is a flexible psychosocial and therapeutic tool. It is used across individual, group, educational, and community settings to achieve a range of emotional, clinical, and developmental goals.

#### Primary uses of the Tree of Life Therapy Activity include:

1. Trauma-informed emotional support

- The Tree of Life exercise helps people tell their story without reliving traumatic memories.
- It allows clients to contextualize difficulties (“storms”) rather than internalizing shame.

2. Strengths-based identity reconstruction

- The Tree of Life Therapy activity is beneficial for people whose identities have been diminished by hardship, stigma, or labels (e.g., “refugee,” “disabled,” “at-risk youth”).
- It encourages participants to reclaim narratives of capability, survival, and purpose.

3. Enhancing resilience and coping skills

- Identifies protective factors (values, skills, relationships) that can be strengthened.
- Helps map internal and external resources.

4. Supporting children and adolescents

- The Tree of Life Therapy activity can be used in schools facing community violence.
- It can help youth experiencing grief, academic stress, bullying, or family conflict.
- It helps foster care and adoption transitions
- The Tree of Life exercise can help with self-esteem building

5. Grief, loss, and life transitions

- The Tree of Life exercise allows safe acknowledgment of loss without forcing emotional exposure.
- It is helpful for medical diagnoses, chronic illness, retirement, immigration, or role changes.

6. Community healing and collective meaning-making

- Grouping trees and communal storytelling fosters solidarity, empowerment, and shared purpose.
- It is commonly used in humanitarian contexts.

7. Clinical therapy integration

- The Tree of Life Therapy activity is rapport-building
- It can also be an early-phase narrative assessment
- The Tree of Life exercise is a values and strengths clarification tool
- It is also a grounding technique before deeper trauma work
- It can be a creative intervention during stalled therapy processes

In essence, the Tree of Life Therapy activity is used wherever a gentle, empowering, culturally adaptable method of exploring identity and resilience is needed.

## The Tree of Life Exercise

The Tree of Life Therapy activity uses tree parts as metaphors. Facilitators guide participants in drawing or creating a tree, then in naming and exploring each part. Below is a typical structure and therapeutic purpose for each element.

1. **Preparation & safety**
    - Explain the purpose of the Tree of Life Exercise, gain consent, and set limits (this is strengths-mapping, not trauma processing). Emphasize that participants decide what to share.
    - Materials: paper, markers, stickers; for groups, create a calm, private space.
2. **Roots — “Where you come from.”**
    - Prompt: “Who or what has fed you and shaped you?” (family, cultural roots, important places, traditions)
    - Purpose: grounds identity, acknowledges history and cultural resources.
3. **Ground/Soil — “Current life & context.”**
    - Prompt: “What is happening in your life right now?” (school, community, challenges, daily routines)
    - Purpose: locates the person in the present context without pathologizing.
4. **Trunk — “Skills, values, strengths.”**
    - Prompt: “What skills and values keep you standing? What helps you cope?”
    - Purpose: externalizes and names capacities (problem-solving, humour, persistence).
5. **Branches — “Hopes and dreams.”**
    - Prompt: “What do you want to grow toward?” (goals, wishes, aspirations)
    - Purpose: future-oriented, creates agency and possibility.
6. **Leaves — “People who support you.”**
    - Prompt: “Who are the people (or animals, places) you can rely on?”
    - Purpose: maps social support and attachment figures.
7. **Fruits/Gifts — “Gifts you’ve received or can share.”**
    - Prompt: “What gifts or talents have you been given?” (skills, cultural knowledge, kindness)
    - Purpose: reinforces strengths and what can be shared with others.
8. **Storms/Challenges (sometimes drawn as clouds, stones, or pests)**
    - Prompt: “What has made growing hard?” (loss, discrimination, illness)
    - Purpose: acknowledges hardship in a contained way so it doesn’t dominate the whole story.
9. **Reflection and re-authoring**
    - I then elicit stories that explain each element, externalize problems (e.g., “the storm” rather than “you are broken”), explore unique outcomes (times when problems were resisted), and collaborate on meaning and next steps.
10. **Closing & Linking**
    - Together, we link strengths on the picture to practical steps (e.g., trunk skills that can be used to reach branch goals). Optionally create a shared group picture or take home a copy. For groups, include communal rituals that honour stories.

**Therapeutic mechanisms**: externalization, strengths amplification, meaning-making, social reconnection, cultural validation, and future orientation. The exercise is deliberately adaptable — it can be a single session, a brief series, or part of a more extended therapy plan.

### Combining the Tree of Life Exercise with Other Methods

The Tree of Life exercise pairs well with several therapeutic approaches:

- **Narrative therapy** is rooted in narrative ideas—sometimes referred to as Tree of Life Narrative Therapy —and uses narrative questions to deepen re-authoring.
- **Trauma-informed care:** use it as a safe, low-arousal option before any trauma processing; it helps build resources first.
- **[Art therapy](https://arttherapy.org/what-is-art-therapy/) & [creative therapies](https://dralanjacobson.com/creative-counseling/):** the drawing and metaphorical work align naturally with art and music interventions.
- **[CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/)/Skills training:** after identifying trunk skills, you can teach specific behavioral or cognitive skills to strengthen those capacities.
- **Family therapy/systemic work:** create family trees or shared community trees to map relational strengths and obligations.
- **[Group psychosocial interventions](https://dralanjacobson.com/group-therapy/):** The Tree of Life Therapy activity is used in schools, camps, or humanitarian responses to build collective resilience.

### Practical tips for clinicians/facilitators

- Respect cultural meanings — ask about tree symbolism in the person’s culture.
- Keep it strengths-first: only invite naming of storms if participant chooses; avoid intrusive probing.
- Use creative variations: collages, clay, artificial intelligence, and group mural.
- Use it as an entry point: follow up with targeted interventions (skills teaching, family work, trauma-informed processing) as needed.

### Limitations & cautions

- The Tree of Life therapy activity is **not** a standalone trauma treatment for severe [PTSD](https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd) — it’s a resource-building, narrative exercise best used within a trauma-informed care plan.
- Therapists must avoid minimizing real harm; storm themes should be acknowledged and, if needed, referred for appropriate clinical care.
- Adapt language and delivery to developmental level, literacy, and cultural context.

## Tree of Life Therapy Case Examples

The following case examples help illustrate how the Tree of Life activity is used in therapy.

### 1. Tree of Life Narrative Therapy with a Teen

Maya, grieving her mother’s death, avoided discussing emotions and experienced [panic attacks](https://dralanjacobson.com/panic-attack-treatment/). She felt fragile, ashamed of “breaking down,” and disconnected from her peers.

#### Tree of Life Narrative Therapy Work

1. Establishing safety & consent
    I emphasized that the Tree of Life exercise was not about “talking about the trauma” but about understanding who she is as a person. This reduced panic and defensiveness.
2. Roots exploration
    I helped Maya identify small but meaningful memories—cooking with her mother, the smell of jasmine in their yard. These were framed as *resources* rather than triggers. I gently mirrored: “Your mother taught you care, and creativity, and those qualities are still alive in you.” This reframing allowed Maya to feel connected to her mother without overwhelming sadness.
3. Trunk strengthening
    When Maya minimized her strengths (“I just doodle”), I used narrative practices: 
    - Externalizing the self-critic (“That’s the Doubting Voice speaking”)
    - Highlighting unique outcomes (“Tell me a time your art helped you calm down”)
    - Thickening the story of values (“What does art allow you to express?”), Maya recognized her creativity as an active coping tool.
4. Linking branches to real goals
    I translated hopes (art classes, completing a memorial art project) into actionable steps: 
    - A weekly art practice routine
    - Enrolling in an after-school art program
    - Creating a timeline for the memorial project
5. Storms reframed
    Panic was externalized as “the wave,” something that visits rather than defines her. She learned grounding skills using imagery from her picture (e.g., “feel your roots,” “focus on the solid trunk”).

#### Tree of Life Narrative Therapy Outcome

Within six weeks, panic attacks reduced, school attendance improved, and she displayed more emotional openness. Maya reported feeling “more like myself again” rather than “the girl whose mom died.”

### 2. Tree of Life Narrative Therapy with a Young Adult

Omar felt rootless, isolated, and ashamed that nightmares and memories intruded at night. He felt pressure to “be strong” and hide distress.

#### Tree of Life Narrative Therapy Activity

1. Strengths-based cultural validation
    To start Tree of Life Narrative Therapy, I highlighted the significance of his roots—language, cooking, and community traditions. This countered the dominant narrative: “I am a displaced person.”
    He instead began to narrate: “I come from a culture of hospitality and resilience.”
2. Social scaffolding through group sharing
    Sharing leaves (supportive people) helped him realize he was not alone. He heard others’ stories and felt a sense of belonging. Through Tree of Life Narrative Therapy, I offered metaphors of support (“your trunk is strong even in storms”), which strengthened communal identity.
3. Externalizing trauma symptoms
    Nightmares were described metaphorically as “night storms,” visiting rather than defining him.
    Questions included: 
    - “When the storms visit, what helps your tree stay standing?”
    - “Which strengths from your trunk help you face them?”
    - This reduced shame and normalized his experience.
4. Linking strengths to future plans
    His identified talents—fixing radios, storytelling—were connected to local training opportunities.
    He created a clear path: 
    - - Enroll in a technical workshop
        - Volunteer once weekly, fixing donated electronics
        - Attend a peer support group for connection
5. Tree of Life Narrative Therapy re-authoring
    Rather than “I survived by accident,” the group explored narratives of intention, courage, and persistence during their migration. This thickened a preferred identity: “I am resourceful and committed.”

#### Outcome

Omar developed friendships, joined training programs, and reported fewer episodes of isolation. His sense of identity broadened beyond survivorhood into contribution and purpose.

### 3. Tree of Life Exercise with an Adult

Sheila’s chronic illness forced her early retirement from a career she loved. She felt useless, depressed, and disconnected from her sense of competence.

#### Tree of Life Exercise

1. Honoring roots without idealizing the past
    I helped Sheila revisit her history of leadership, community service, and creativity. The goal was to reclaim identity, not deny present limitations.
2. Slow, mindful trunk-building
    Sheila initially dismissed her skills (“They don’t matter anymore”). I used micro-narratives: 
    - Times when her organizational skills helped her manage medical appointments
    - Moments when her listening skills supported friends
    - She showed acts of quiet resilience daily
3. Reclaiming agency through branches
    We divided her goals (writing memoir pieces, starting a baking circle) into gentle, manageable steps: 
    - Choosing one small baking project per week
    - Writing for 5 minutes daily
    - Asking neighbors if they’d join a monthly circle
    - I emphasized that growth can be slow—trees grow incrementally.
4. Mapping support and reducing isolation
    Sheila realized she had more leaves (supportive people) than she recognized. She strengthened these connections, increasing resilience.
5. Naming storms and coping tools
    We externalized shame, fatigue, and fear of judgment.
    I helped her build a plan using metaphors: 
    - “Roots” → grounding techniques
    - “Trunk” → pacing strategies
    - “Leaves” → asking for help
    - “Branches” → future-oriented motivations

#### Tree of Life Exercise Outcome

Sheila regained a sense of purpose, experienced fewer depressive episodes, and successfully launched a monthly community baking group. She reported feeling “alive again,” with her identity now broader than her illness.

## Conclusion and My Work

The Tree of Life is a gentle, empowering, narrative-based method that helps people reclaim identity, recognize strengths, and build resilience. It works across cultures, age groups, and therapeutic contexts by avoiding pathologizing individuals and instead amplifying the skills and supports that sustain them. When used skillfully, it provides both emotional safety and creative space for healing, identity reconstruction, and future-oriented hope.

If you have questions about Tree of Life Narrative Therapy or would like to learn more about how the Tree of Life Therapy activity might benefit you, don’t hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult#book/services) at any time.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Types of Therapy

---

### [Life Review Therapy: Meaning, Reflection & Acceptance](https://dralanjacobson.com/life-review-therapy-deeper-meaning-and-acceptance/)

**Published:** November 9, 2025
**Author:** Dr. Alan Jacobson

**Content:**

## What Is Life Review Therapy? (Quick Overview)

Life review therapy is a structured process of reflecting on your life experiences—both positive and difficult—to better understand your story, resolve past conflicts, and develop a greater sense of meaning and acceptance. It is often guided by a therapist and helps integrate past experiences into a more coherent and fulfilling life narrative.

**Key elements include:**

- Reflecting on important life events, relationships, and turning points
- Making sense of both positive and painful experiences
- Resolving regret, conflict, or unfinished emotional issues
- Developing a more integrated and meaningful life narrative

### When Is Life Review Therapy Helpful?

- Feeling stuck in regret or unresolved past experiences
- Life transitions (midlife, aging, identity shifts)
- Loss, grief, or existential concerns
- Desire for greater meaning, clarity, or emotional closure

Life review therapy is commonly used to help people process their past and improve well-being, including reducing depression and increasing life satisfaction.

### What Changes Through Life Review Therapy?

- Greater acceptance of your life story
- Reduced regret, guilt, or unresolved emotional pain
- Increased sense of purpose and coherence
- More peace with past decisions and experiences

Research shows that reflecting on life experiences can improve well-being, strengthen relationships, and reduce psychological distress.

## Introduction to LRT

Life Review Therapy is a structured therapeutic process that involves guided reflection on one’s experiences to promote understanding, acceptance, and psychological integration. The roots of the life review process lie in the work of [**Dr. Robert Butler**](https://en.wikipedia.org/wiki/Robert_N._Butler), a geriatric psychiatrist who first proposed the concept in the 1960s. Butler argued that as individuals age, they naturally reflect on their past, and that this reflection, when facilitated in a supportive environment, can lead to emotional healing, deep satisfaction, and a sense of integrity. It is related but distinct from Reminiscence Therapy, as we will share in this post.

Life Review Therapy has since evolved into a widely used intervention in [**geriatric mental health**](https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults), [**palliative care**](https://www.webmd.com/palliative-care/when-is-palliative-care-appropriate), [**narrative therapy**](https://dralanjacobson.com/narrative-therapy/), and [**trauma-informed work**](https://dralanjacobson.com/trauma-informed-care/). While the life review process is particularly popular in elder care settings, it has also found relevance among younger adults facing identity crises, major transitions, or trauma recovery.

## What Is Life Review Therapy? ![Life Review Therapy and Reminiscence Therapy](https://dralanjacobson.com/wp-content/uploads/2025/11/Life-Review-Therapy-200x300.png "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

This structured, reflective therapeutic approach helps individuals examine, organize, and make sense of their experiences over time. Rather than focusing solely on current symptoms or recent stressors, it invites people to step back and ask broader life review questions: *What has my life been about? What patterns do I see? What still matters to me now?*

The life review process often involves guided reflection on specific life review questions concerning key phases, relationships, achievements, losses, values, and turning points, integrating both pride and regret into a coherent personal narrative.

At its core, the benefits of life review extend well beyond nostalgia. It’s about **integration**: helping a person understand how their past informs who they are today and how they want to move forward.

Life review therapy has deeper and more interdisciplinary roots than it’s often given credit for.

### Early Foundations

The formal concept was articulated in the 1960s by psychiatrist [**Robert N. Butler**](https://en.wikipedia.org/wiki/Robert_N._Butler), who challenged the prevailing belief that older adults’ focus on the past reflected cognitive decline or depressive rumination. Butler observed that many older adults engaged in reflection as a **developmental task rather than** a pathology.

He framed the life review process as a natural way to:

- Achieving coherence
- Resolving unfinished emotional business
- Preparing psychologically for later stages

This idea closely aligns with [Erik Erikson](https://www.simplypsychology.org/erik-erikson.html)’s final psychosocial stage: ego integrity versus *despair*. The life review process was seen as the mechanism through which integrity could be achieved.

#### A Clinically Useful Distinction

A simple way to explain it to clients:

*“Reminiscence therapy helps you remember.
Life review therapy helps you understand.”*

That distinction alone often clarifies why someone might feel temporarily comforted by reminiscing but profoundly changed by the life review process.

### Empirical Development of the Life Review Process

By the 1980s and 1990s, research demonstrated that a structured life review process could:

- Reduce [depressive symptoms in older adults](https://www.nia.nih.gov/health/mental-and-emotional-health/depression-and-older-adults)
- Improve satisfaction and meaning
- Decrease death anxiety
- Support emotional integration near the end

These benefits of life review led to its adoption in:

- [Geriatric psychology](https://www.betterhelp.com/advice/psychologists/how-a-geriatric-psychologist-can-help-with-the-challenges-of-aging/)
- [Hospice and palliative care](https://www.nia.nih.gov/health/hospice-and-palliative-care/what-are-palliative-care-and-hospice-care)
- Long-term care settings

### Modern Evolution of Life Review Therapy

In contemporary practice, life review therapy has evolved beyond its original age-bound framing.

Key shifts include:

- **From endings to transitions**
- **From symptom reduction to meaning construction**
- **From memory recall to identity integration**

Today, the life review process is used with:

- Retiring professionals
- Adults facing health changes
- Individuals navigating grief, divorce, or relocation
- High-functioning older adults seeking purpose beyond productivity

Modern clinicians often integrate the life review process with:

- [Narrative identity theory](https://en.wikipedia.org/wiki/Narrative_Identity)
- Meaning-centered psychotherapy (e.g., [Logotherapy](https://dralanjacobson.com/logotherapy/))
- [Positive psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/) and wisdom research
- [Trauma-informed care](https://dralanjacobson.com/trauma-informed-care/)

This evolution reflects a broader recognition: **the need to find meaning does not belong to a single age—it emerges whenever identity shifts faster than meaning can keep up**.

## Life Review Therapy vs. Reminiscence Therapy

**Reminiscence therapy** is about *recalling* the past.
**Life review therapy** is about *integrating* the past.

Both involve memory, but their goals, structure, and psychological depth are distinct.

### Reminiscence Therapy

Reminiscence therapy involves recalling past experiences—often pleasant or neutral memories—to enhance mood, stimulate cognition, and foster social connection. It is typically non-evaluative and present-focused.

The emphasis of reminiscence therapy is on **remembering rather than interpreting**.

#### Primary Goals of Reminiscence Therapy

- Improve mood and emotional well-being
- Reduce loneliness and isolation
- Stimulate memory and conversation
- Increase social engagement

#### How Reminiscence Therapy is Used

- Group settings (assisted living, memory care)
- Informal storytelling
- Memory prompts (photos, music, objects)
- Focus on positive or neutral experiences

#### Who It Serves

- Older adults
- Individuals with dementia or [mild cognitive impairment](https://www.aarp.org/health/conditions-treatments/what-is-mild-cognitive-impairment/?msockid=11bfc8531a0a68d92fe7de471bde693f)
- Long-term care and community programs
- Social and recreational contexts

#### Clinical Depth

Reminiscence therapy is **supportive rather than exploratory**. It typically does not address regret, guilt, unresolved conflict, or meaning-making in a structured manner.

### Life Review Therapy

Life review therapy is a structured, therapeutic process that examines things **chronologically and thematically**, including both positive and painful experiences. The goal is to help individuals create a coherent, compassionate, and meaningful narrative.

The emphasis is on **evaluation, integration, and meaning**.

#### Primary Goals of Life Review Therapy

- Resolve regret and unfinished emotional business
- Reduce despair, guilt, or self-criticism
- Strengthen identity coherence
- Clarify values and legacy
- Support ego integrity and psychological peace

#### How it is Used

- [Individual psychotherapy](https://dralanjacobson.com/individual-therapy/)
- Guided chronological reflection
- Exploration of turning points, losses, choices, and values
- Integration of emotions, insight, and perspective

#### Who It Serves

- Older adults facing retirement, loss, or end-of-life concerns
- Middle-aged adults questioning meaning or identity
- Individuals [navigating major transitions](https://dralanjacobson.com/life-transitions-therapy/)
- [Existential](https://dralanjacobson.com/existential-therapy/) or meaning-centered therapy contexts

#### Clinical Depth

Life review questions are **deeply therapeutic**. It invites emotional processing, reframing, self-forgiveness, and integration—often addressing material that has never been fully acknowledged or resolved.

### Key Differences Between Life Review and Reminiscence Therapy at a Glance

**Feature****Reminiscence Therapy****Life Review Therapy**Primary FocusMemory recallMeaning and integrationStructureInformal, flexibleStructured, guidedEmotional DepthLight to moderateModerate to deepIncludes Regret & Pain?Usually avoidedIntentionally exploredGoalComfort, connectionCoherence, peace, directionClinical OrientationSupportivePsychotherapeutic### Can Life Review and Reminiscence Therapy Be Used Together?

Yes—and often they are.

Reminiscence can serve as a **gentle entry point**, especially for individuals who are hesitant or emotionally fragile. The life review process builds on this foundation, moving from remembering *what happened* to understanding *its meaning*.

In practice:

- Reminiscence warms the soil
- Life review questions do the deeper work

## The Life Review Process In Practice

The following is an overview of how I and others use these techniques in clinical practice.

### Who Life Review Therapy Serves

This method is especially beneficial for:

- **Older adults** processing aging, grief, and legacy
- Individuals in **palliative or hospice care** seeking peace or meaning
- People [coping with life **transitions**](https://dralanjacobson.com/life-transitions-therapy/), such as retirement, relocation, or empty nesting
- Those struggling with **regret, guilt, or unresolved trauma**
- Individuals experiencing [**existential distress**](https://dralanjacobson.com/existential-therapy/) or a loss of purpose
- Clients with **cognitive impairment** (e.g., [early-stage dementia](https://www.alz.org/alzheimers-dementia/stages)), where it can stimulate memory and improve mood

The benefits of life review often extend to adults of any age who wish to make sense of their personal history and develop a more cohesive understanding of identity.

### Life Review Therapy Questions

Life Review therapy questions typically unfold and are organized around the following techniques:

1. **Chronological Exploration**: Clients are guided to reflect sequentially on different stages (e.g., childhood, adolescence, adulthood).
2. **Thematic Reflection**: The focus is placed on recurring themes, such as love, work, family, achievements, failures, or turning points.
3. **Memory-Prompting Tools:** Photographs, music, letters, or personal artifacts are used to elicit memories and evoke emotions.
4. **Narrative Reconstruction**: Clients are assisted in reinterpreting painful events in a more integrated and compassionate manner.
5. **Meaning-Making Exercises**: I facilitate insight into the meaning of events, the client’s growth, and the legacy they wish to leave.
6. **Written or Creative Expression**: Some clients write memoirs, create timelines, or engage in art, poetry, or storytelling.
7. **Forgiveness Work**: Encouraging reconciliation with oneself and others, particularly in addressing unresolved issues and conflicts.

To magnify the benefits if life review, I use a tone of respect, empathy, and validation, encouraging clients to share openly while offering reframing and emotional support as needed.

### Approaches Commonly Combined with Life Review Therapy

Life review therapy is especially powerful when integrated with other modalities:

**Logotherapy:** Life review questions clarify *where meaning has been present or absent*; logotherapy helps translate those insights into purpose-driven action.

**Narrative Therapy:** Clients learn to re-author their story—separating identity from outdated roles, failures, or inherited expectations.

**Acceptance and Commitment Therapy (ACT):** ACT complements life review questions by helping clients commit to values-based choices in the present, even when uncertainty or discomfort remains.

**Cognitive-Behavioral Therapy (CBT):** CBT can help address distorted beliefs that emerge during reflection (e.g., “It’s too late,” “I wasted time”) and replace them with more adaptive perspectives.

**Trauma-Informed Approaches:** When painful memories arise, trauma-sensitive pacing and regulation strategies ensure the review process remains stabilizing rather than overwhelming.

**Reminiscence Therapy**: As described above

### Benefits of Life Review

Evidence and clinical reports suggest several benefits of life review, including:

- Increased overall satisfaction and a **sense of meaning**
- Decreased **depression and anxiety**, especially in older adults
- Greater **self-acceptance** and reduced regret
- Improved **emotional resilience** and peace with past choices
- Enhanced **interpersonal relationships** through reconciliation and sharing
- Slower **cognitive decline** and improved memory recall in early-stage dementia
- A renewed sense of **legacy and personal worth**

The benefits of Life Review Therapy extend beyond being psychologically therapeutic. It is also **spiritually affirming**. It can be used for those who seek deeper meaning, and also as one of the best [kinds of therapy for depression](https://dralanjacobson.com/best-types-of-therapy-for-depression/) in older people.

## LRT Case Examples

The following case examples illustrate the various ways in which the benefits of life review therapy can be seen.

### Case Example: Widow in Assisted Living

Mildred is an older adult who begins life review therapy after family members and staff at her assisted living facility notice increasing sadness, social withdrawal, and frequent preoccupation with past mistakes. Her transition to assisted living followed the death of her husband, a loss that left her feeling unanchored and alone. In sessions, she expresses persistent guilt about not having been a more patient mother and regret over career opportunities she believes she missed.

Rather than presenting with acute clinical depression, Mildred appears burdened by unresolved self-judgment and a growing sense that perceived failures overshadow her life’s meaning.

#### Life review questions

Structured life review questions are introduced to help Mildred reflect on her past in a way that honors both joy and hardship. Sessions proceed chronologically and experientially.

Mildred recounts:

- Joyful childhood summers and formative family memories
- A wartime romance that shaped her sense of devotion and resilience
- The challenges and satisfactions of raising children during constrained social and economic circumstances

She brings photo albums, letters, and music from earlier periods, which serve as anchors for memory, emotional access, and narrative coherence. With therapeutic support, Mildred begins to contextualize her decisions—recognizing how cultural expectations, limited options, and competing responsibilities influenced the choices she made.

Therapeutic work focuses on validating her contributions as a mother, partner, and stabilizing presence in her family; reframing regret with compassion; and identifying the values that consistently guided her actions, even during difficult periods.

#### Benefits of Life Review for Mildred

Over time, Mildred’s affect softens, and her mood improves. She becomes more socially engaged within the assisted living community and demonstrates greater emotional openness. As a culminating exercise, she writes a letter to each of her grandchildren, sharing lessons, expressions of love, and reflections on resilience—an act she describes as deeply grounding and peaceful.

Mildred characterizes the benefits of life review as “finally tying a bow on my story,” reflecting a shift from self-criticism toward integration, acceptance, and a renewed sense of dignity and meaning in the later stage.

---

### Case Example: A Mid-Life Adult Seeking Meaning

David, a 47-year-old professional, seeks therapy not because of a crisis, but because of a persistent sense of emptiness. By external measures, he is successful: he has a stable career, is financially secure, and is respected in his field. Yet he describes feeling “flat,” disengaged, and increasingly disconnected from his work and relationships.

He doesn’t feel depressed in a clinical sense. Instead, he feels unmoored.

#### Life review process

In life review therapy, sessions move chronologically and thematically:

- Early adulthood reveals a strong drive for achievement shaped by family expectations
- Mid-career reflections highlight accomplishments—but also repeated sacrifices of creativity and personal values
- Key turning points emerge: moments where he *almost* chose a different path but didn’t
- Losses that were never fully processed—particularly the quiet loss of imagined futures—are acknowledged

Through guided reflection and life review questions, David begins to see a pattern: his decisions were well executed but insufficiently shaped by his own values.

#### Benefits of Life Review for David

Rather than making impulsive changes, David draws on insights to realign himself with neglected values—mentorship, creative contribution, and meaningful service. The benefits of life review include helping him shift from reflection to intentional redesign of the next chapter.

---

### Case Example: An Older Adult Struggling With Retirement

Margaret is a 69-year-old retired healthcare administrator who entered therapy one year after retiring. She reports no major depression, no cognitive concerns, and good physical health. Yet she describes a growing sense of restlessness, irritability, and loss of identity.

“I did everything right,” she says. “And now I don’t know who I’m supposed to be.”

Her days feel long and unstructured. Volunteer work hasn’t “clicked.” Travel feels pleasant but strangely hollow. She notices increasing rumination about earlier career decisions, relationships that faded, and talents she never fully explored.

#### Life review questions

Rather than treating retirement as a problem, the benefits of life review include seeing it as a *developmental transition*.

The work unfolds across several dimensions:

- **Role identity**: Margaret’s sense of self had been tightly bound to competence, responsibility, and being needed
- **Unintegrated pride**: Significant accomplishments had never been emotionally claimed—they were “what was expected.”
- **Unresolved regret**: Not dramatic failures, but quieter “roads not taken.”
- **Legacy questions**: A growing concern about what, if anything, she is passing forward

Through structured reflection, Margaret begins to see things as coherent rather than fragmented, including a long arc of service, leadership, and resilience—alongside suppressed creativity and relational longing.

#### Benefits of Life Review Therapy for Margaret.

The benefits of life review include helping Margaret shift from asking *“What do I do now?”* to *“What kind of elder do I want to be?”*

She begins mentoring younger professionals, reconnects with creative writing abandoned decades earlier, and reframes retirement not as an ending, but as a **change in authorship**—from executor of responsibilities to steward of wisdom.

---

## Is the Life Review Process Only for Older Adults?

No—this is a common misconception.

While older adults often engage naturally, **the technique is highly effective for adults at any age who are asking big-picture questions**, such as:

- *Is this how I want to live?*
- *What am I optimizing for?*
- *What do I want the next phase to stand for?*

Midlife, in particular, is a powerful window because people often have sufficient lived experience to recognize patterns, but still ample opportunity to make meaningful changes.

### Modern Applications of Life Review Questions

Today, life review questions are used far beyond their original context, including:

- **Transitions and burnout**
- **Career and identity realignment**
- **Grief and cumulative loss**
- **Existential anxiety**
- **High-functioning individuals who feel “successful but unfulfilled.”**
- **Leadership and executive coaching contexts**
- **Trauma-informed meaning reconstruction**

In modern practice, the process is often shorter, more flexible, and integrated with forward-looking interventions rather than conducted as a purely retrospective exercise.

### Other FAQs

**Is life review therapy about dwelling on the past?**
No. The goal is integration, not rumination. Reflection serves clarity and forward movement. Reminiscence Therapy may be a better choice when someone wants to explore the past to find meaning and understanding of past events.

**How structured is the process?**
It can range from highly structured (phases, timelines, prompts) to more fluid, depending on the client’s needs and tolerance. Life review questions can be incorporated into various types of therapy.

**Does it require long-term therapy?**
Not necessarily. The life review process can be conducted as a focused intervention over a limited number of sessions or woven into ongoing work.

**What if someone feels they’ve made “wrong” choices?**
Life review questions help clients hold regret with compassion, extract learning, and recognize remaining agency—rather than getting stuck in self-blame.

**Can it help high-functioning people who don’t feel “clinically ill”?**
Absolutely. It’s particularly valuable for individuals whose distress is existential rather than symptomatic.

## Conclusion and My Work

Across many stages of living, the same truth holds: people do not struggle because their lives lacked value. They struggle because that value has not yet been fully named, owned, or integrated. Life review questions offer a structured way to do exactly that—whether someone is 45 and questioning direction, or 75 and redefining purpose.

Life Review Therapy is a deeply reflective and compassionate approach that helps individuals of all ages—especially older adults—make peace with their past, find meaning in their journey, and feel whole as they move into later stages. By promoting emotional resolution and narrative integration, it supports not just psychological well-being but also the spiritual and existential dimensions of human experience. I also offer [Quality of Life Therapy](https://dralanjacobson.com/quality-of-life-therapy/) and [Tree of Life Therapy](https://dralanjacobson.com/tree-of-life-therapy/).

If you want to learn more about the benefits of life review therapy and how it could help you or a loved one,

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Types of Therapy

---

### [Supportive-Expressive Therapy: Insight & Change](https://dralanjacobson.com/supportive-expressive-therapy/)

**Published:** November 18, 2024
**Author:** Dr. Alan Jacobson

**Content:**

## What Is Supportive-Expressive Therapy? (Quick Overview)

Supportive-expressive therapy is a form of psychodynamic therapy that combines emotional support with deeper exploration of thoughts, feelings, and relationship patterns. It helps you better understand recurring interpersonal dynamics and make meaningful, lasting changes.

**Key elements include:**

- A strong, supportive therapeutic relationship
- Exploring emotions and personal experiences
- Identifying recurring relationship patterns
- Gaining insight that leads to meaningful change

### When Is Supportive-Expressive Therapy Used?

- Anxiety, depression, or emotional distress
- Relationship difficulties or recurring interpersonal patterns
- Feeling stuck in the same emotional cycles
- Desire for deeper self-understanding and long-term change

This approach is often used across a range of mental health concerns and focuses on understanding underlying relational patterns driving distress

### How It Works

- Supportive: builds safety, stability, and trust
- Expressive: explores deeper emotions and patterns
- Together: create both immediate relief and long-term insight

The combination helps reduce isolation while strengthening coping and self-understanding

## Introduction to this Therapy Technique

**Supportive-Expressive Therapy** (SET) is a type of psychodynamic therapy specifically designed to help you express and explore emotions tied to your experiences, especially those that are difficult or painful. It combines elements of supportive and expressive approaches, making it particularly effective for a variety of concerns and helpful for people of all ages. It can also be delivered virtually with no loss of effect. I offer **supportive-expressive psychodynamic therapy** to adolescents and adults both virtually and in person. This post provides an overview, but if you still have questions or would like to know more about how **supportive-expressive psychotherapy** might benefit you or a loved one, feel free to [reach out](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Supportive-Expressive Therapy Overview

The following is an overview of supportive-expressive therapy. I then provide more detailed information about techniques, followed by a fictitious case example.

### Key Features of Supportive-Expressive Therapy

1. **Supportive Element**: 
    - I offer emotional support and validation and help strengthen my client’s coping mechanisms.
    - The therapeutic relationship is collaborative and non-judgmental, focusing on building trust and safety.
2. **Expressive Element**: 
    - I encourage the client to explore and verbalize underlying emotions, [unconscious conflicts](https://www.sciencedaily.com/releases/2012/06/120616145531.htm), and thoughts.
    - I help them identify recurring patterns, particularly those involving relationships and interactions with others.
3. **Focus on Conflict and Themes**: 
    - The therapy often centers on identifying “[core conflictual relationship themes](https://en.wikipedia.org/wiki/Core_conflictual_relationship_theme)” (CCRT), which are patterns of problematic relationships or conflicts that influence the client’s behavior and emotional state.
4. **Supportive-Expressive Therapy is Goal-Oriented**: 
    - I aim to help my clients gain insight into their issues, express repressed emotions, and find healthier ways of coping and relating to others.
    - Supportive-expressive therapy may also focus on changing problematic behaviors by addressing the underlying emotional conflicts.

### Conditions Treated with Supportive-Expressive Therapy

- [**Depression and Anxiety**](https://dralanjacobson.com/therapy-for-depression-and-anxiety/): Supportive-expressive psychodynamic therapy helps clients explore the deeper roots of their symptoms, particularly those tied to unresolved conflicts or trauma.
- [**Life Transitions**](https://dralanjacobson.com/life-transitions-therapy/): Supportive-expressive therapy helps people facing a variety of life transitions and decisions.
- **[Substance Abuse Disorders](https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health):** Supportive Expressive Therapy was originally developed for treating substance use disorders and helping clients explore emotional conflicts driving their addiction.
- **ADHD and [Learning Disorders](https://psychologicalassessments.com/psychological-testing-for-learning-disabilities/)**: This is especially if these issues are causing difficulties in emotional expression, communication, and relational conflicts.

### Techniques Used in Supportive-Expressive Psychotherapy

- **Clarification**: I help clarify my client’s thoughts and feelings, making it easier to explore them in depth.
- **Confrontation**: I gently point out discrepancies between what my client says and their feelings or actions.
- **Interpretation**: I help my client connect their current feelings and past experiences, especially early relationships.

### Differences Between Supportive-Expressive Therapy and Other Methods

- Unlike purely [supportive therapy](https://dralanjacobson.com/supportive-psychotherapy/), supportive-expressive psychotherapy encourages deeper exploration and expression of underlying conflicts.
- Unlike [cognitive-behavioral therapies](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT), supportive-expressive psychotherapy focuses more on the emotional and relational aspects rather than directly changing thoughts.

### Suitability and Effectiveness

- Supportive-expressive psychotherapy can benefit individuals open to exploring their emotions and relationships in depth.
- Depending on the individual’s needs, it is often most effective when combined with other therapies, such as I do in my integrative psychological practice.

## Supportive-Expressive Therapy Techniques

The following Supportive-Expressive Therapy techniques are delivered within a [psychodynamic framework](https://dralanjacobson.com/psychodynamic-therapy/). These techniques help clients explore unconscious conflicts and patterns in relationships and provide support in addressing these issues. Below are some common techniques used in supportive-expressive psychotherapy, categorized by their function:

### 1. Supportive Techniques

The goal is to stabilize the client, enhance their coping skills, and provide a safe environment for exploration.

- **Validation**: 
    - I acknowledge and affirm the client’s experiences and emotions.
    - Example: *“It makes sense that you feel upset given everything you’ve been through. Your feelings are completely understandable.”*
- **Empathy and [Active Listening](https://hbr.org/2024/01/what-is-active-listening)**: 
    - I show empathy and attentively listen to the client, creating a sense of safety and trust.
    - This involves paraphrasing and reflecting back the client’s words, demonstrating understanding.
- **Encouragement of Adaptive Coping**: 
    - I reinforce positive behaviors and coping mechanisms the client is already using.
    - Example: *“It’s great that you’ve been using deep breathing to calm yourself during stressful moments.”*
- **Ego Strengthening**: 
    - Techniques to boost the client’s self-esteem and confidence are used, especially if they have low self-worth or anxiety.
    - Example: Highlighting the client’s strengths and resilience: *“You’ve shown a lot of strength in getting through this challenging period.”*
- **Limit Setting**: 
    - Providing gentle boundaries or structure, especially if the client displays maladaptive behaviors during sessions.
    - Example: *“I notice you often shift the topic when we start discussing your relationship. Let’s try to stay with that feeling a little longer today.”*

### 2. Expressive Techniques

These supportive-expressive psychotherapy techniques help clients explore underlying conflicts, unconscious patterns, and emotional issues.

- **Clarification**: 
    - I help clients clarify their thoughts, emotions, and behaviors by asking open-ended questions and reflecting on their statements.
    - Example: *“You mentioned feeling angry when your partner cancels plans, but you also said you’re used to this happening. Can we explore what comes up for you in these moments?”*
- **Confrontation**: 
    - I gently challenge the client’s avoidance, defense mechanisms, or inconsistencies in their narrative.
    - Example: *“You say that you don’t care about what others think, but it sounds like their opinions have a big impact on how you feel about yourself.”*
- **Interpretation**: 
    - I interpret current thoughts, feelings, and behaviors to past experiences, especially early childhood or relationship dynamics.
    - Example: *“It seems like when you get close to someone, you start to fear they’ll leave you, similar to how you felt with your father’s frequent absences during childhood.”*
- **Exploring Core Conflictual Relationship Themes (CCRT)**: 
    - Identifying and discussing recurring patterns in the client’s relationships: wishes, expected responses from others, and their own emotional responses.
    - Example: *“You often find yourself in relationships where you feel undervalued and anxious, almost as if you’re trying to resolve an old conflict from your past.”*
- **Free Association**: 
    - The client is encouraged to say whatever comes to mind, which can help reveal unconscious thoughts and feelings.
    - I help my client explore these thoughts without judgment.

### 3. Combining Elements

The interplay between supportive and expressive techniques is crucial in supportive-expressive psychotherapy:

- **Balancing Insight and Support**: 
    - I adjust the level of expressive work based on my client’s emotional state. If the client becomes overwhelmed, I may pivot back to supportive techniques.
    - Example: After a challenging interpretation, I might follow up with supportive statements to help my client process and integrate the insight.
- **Providing a Corrective Emotional Experience**: 
    - My consistent and supportive presence allows my clients to experience a healthier relational dynamic than they may have encountered.
    - This helps the client internalize new ways of relating and understanding themselves.

### 4. Application of Supportive-Expressive Psychotherapy Techniques

- **Initial Phase**: Focus on building rapport, using more supportive techniques, and assessing the client’s core conflicts.
- **Middle Phase**: Gradually introduce expressive techniques, exploring deeper emotional conflicts and relationship patterns.
- **Termination Phase**: Emphasize supportive techniques to help the client integrate insights, prepare for the end of therapy, and reinforce new coping skills.

### 5. Role of the Therapeutic Relationship

The therapeutic relationship itself is a key tool in supportive-expressive psychotherapy. It serves as a microcosm of my client’s relational patterns, providing a space to explore and modify them within the safe context of therapy. For example, I observe and discuss the client’s feelings and behaviors towards them (transference), which may mirror my client’s dynamics with significant others.

- Example: *“I notice you seem hesitant to share certain things with me, almost like you expect me to be critical. Do you think this might be similar to your experience with your mother?”*

By integrating these techniques, supportive-expressive therapy helps clients develop insight into their emotional lives, make connections between past and present, and find healthier ways of managing their relationships and emotions.

## Supportive-Expressive Psychodynamic Therapy Case Example

Here is a case example of how Supportive Expressive Psychodynamic Therapy might work in practice, with a focus on its psychodynamic components.

**Background**:
Anna is a 30-year-old woman seeking therapy for difficulties in her romantic relationships and ongoing anxiety. She feels a pattern of choosing partners who are emotionally unavailable, leading to feelings of rejection and intense sadness. Anna also struggles with self-esteem and often finds herself fearful of being abandoned.

### Supportive-Expressive Psychodynamic Therapy Sessions

**Initial Session**: During the first few supportive-expressive psychodynamic therapy sessions, I use supportive techniques to establish rapport and provide a safe environment. Anna shares her history of turbulent relationships, including a childhood marked by her father’s absence due to work and a distant, critical mother. I listen empathetically, validate her feelings, and offer a non-judgmental space.

**Exploration of Core Conflictual Relationship Theme (CCRT)**: As supportive-expressive psychodynamic therapy progresses, the expressive component of SET becomes more prominent. The therapist gently probes deeper into Anna’s relationship patterns. Through exploration, they identify a *core conflictual relationship theme*:

- **Wish**: Anna wishes for closeness, validation, and emotional support.
- **Response from Others**: Partners are often emotionally unavailable, distant, or critical, mirroring her early experiences with her parents.
- **Response from Self**: Anna feels anxious, unworthy, and fears abandonment.

**Clarification and Confrontation**: I use *clarification* by reflecting on Anna’s statements and patterns, helping her see the recurring theme in her relationships. For example:

Me: *“You mentioned feeling unworthy and anxious when your partner doesn’t respond as you hope. These feelings seem quite familiar, almost like they come up often in your relationships. Does that feel true for you?”*

Anna begins to realize that her intense reactions aren’t solely about her current partner but are linked to her early experiences with her mother’s criticism and emotional unavailability.

I also use *gentle confrontation* when Anna appears to blame herself entirely for her relationship failures:

*Me:”I notice that you tend to quickly assume there’s something wrong with you when your partner pulls away. Do you think there might be another explanation related to the kind of partners you’re choosing?”*

**Interpretation and Insight**: I offer an *interpretation*, connecting Anna’s current difficulties to her early relationship experiences:

Me: *“It seems like a part of you seeks partners similar to your mother in some ways—critical or distant. It’s almost as if you’re trying to resolve an old wound, hoping that it will be different this time and you’ll finally get the love and approval you wanted as a child.”*

This insight helps Anna understand why she gravitates toward certain partners and why these relationships leave her empty and anxious.

### Supportive-Expressive Psychodynamic Therapy Techniques

Throughout the process, I use supportive techniques to help Anna feel validated and to bolster her self-esteem. When Anna fears being alone, I normalize her feelings, reassuring her and helping her develop healthier coping mechanisms.

**Change and New Behavior**: Anna begins to notice her patterns more clearly over time. She starts to challenge her automatic thoughts of unworthiness and explores dating partners who are more emotionally available. Anna also works on setting boundaries and recognizing red flags early in relationships.

In the later sessions, the supportive-expressive psychodynamic therapy focus shifts to reinforcing these positive changes and helping Anna integrate her new understanding into her everyday life. She reports feeling less anxious and more empowered in her romantic relationships.

### Summary of Supportive-Expressive Therapy Techniques Used

1. **Supportive Techniques**: 
    - Validation of Anna’s feelings.
    - Strengthening coping mechanisms (e.g., self-soothing when feeling anxious).
    - Establishing a trusting therapeutic relationship.
2. **Expressive Techniques**: 
    - Identifying and exploring the core conflictual relationship theme (CCRT).
    - Clarifying patterns and inconsistencies in Anna’s experiences.
    - Offering interpretations to connect past and present experiences.
3. **Supportive-expressive Psychodynamic Therapy Outcome**: 
    - Increased insight into her relationship patterns.
    - Improved self-esteem and self-worth.
    - Better choice of partners and healthier relationships.

This case illustrates how supportive-expressive psychodynamic therapy can integrate supportive and expressive elements to help clients gain insight into their unconscious conflicts while providing the emotional support needed to facilitate change.

## Summary and My Work

I provide supportive-expressive therapy in the treatment of depression and anxiety, as well as life transitions and other issues. I also use it in [couples therapy](https://dralanjacobson.com/couples-therapy/) and [group treatment](https://dralanjacobson.com/group-therapy/), and in specialties including treatment of [college students](https://dralanjacobson.com/therapy-for-college-students/) and [fears of public speaking](https://dralanjacobson.com/public-speaking-anxiety/), as well as [therapy for single moms and dads](https://dralanjacobson.com/therapy-for-single-moms-and-dads/). This method is [effective as virtual psychotherapy](https://dralanjacobson.com/virtual-therapy-guide/) as well as in person. The techniques can be used in conjunction with [narrative therapy](https://dralanjacobson.com/narrative-therapy/) and other [humanistic approaches](https://dralanjacobson.com/humanistic-therapy/). It can be used as a specific adjunct to other approaches, such as [treatment for people with a learning disorder](https://dralanjacobson.com/therapy-for-people-with-learning-disorders/).

If you would like to discuss how supportive-expressive psychotherapy might benefit you or a loved one or have general questions about the approach, feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Narrative Family Therapy: Examples & Techniques](https://dralanjacobson.com/narrative-family-therapy/)

**Published:** December 2, 2024
**Author:** Dr. Alan Jacobson

**Content:**

## **What Is Narrative Family Therapy? (Quick Overview)**

Narrative family therapy helps families reshape the stories they tell about themselves and one another, often improving communication and reducing conflict. It focuses on separating people from problems and building more empowering, collaborative narratives.

### **Key elements include:**

- Externalizing problems (seeing the issue as separate from the person)
- Identifying and reshaping unhelpful family narratives
- Strengthening preferred stories that support growth and connection

## **When is Narrative family therapy used?**

- Family conflict
- Communication breakdowns
- Parent-child struggles
- Identity or life transition issues

## Introduction to the Method

**Narrative family therapy** is a groundbreaking approach to transforming how therapists can help families deepen their relationships and reach greater contentment and understanding. **Narrative therapy for families** emphasizes the stories each member has internalized about their family history and current relationships. This can promote healing, empowerment, and change. **Narrative family therapy techniques** help clients reframe their perspectives, fostering a deeper understanding of themselves and their challenges. This lens allows families to separate themselves from their problems, leading to more meaningful and lasting solutions. I also offer narrative couples therapy.

If you have any specific questions about how narrative couples therapy or family treatment would benefit you or have any questions about the approach in general, please [get in touch](https://dralanjacobson.com/contact/) with me or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

*The stories we tell ourselves shape our reality and have the power to redefine our lives.*

### Key Takeaways

- **Narrative family therapy techniques** empower families by treating them as experts in their own lives.
- **Narrative therapy with families** emphasizes the significance of personal and family stories in shaping identity and mental health.
- I work collaboratively with families to **re-author life stories**, promoting healing. **Narrative couples therapy** has similar goals, but often only in the context of the relationship’s history.
- **Storytelling** plays a crucial role in separating families from their challenges.
- Integrating **narrative family therapy techniques** with other therapeutic approaches enhances its effectiveness.

## Understanding Narrative Family Therapy

[Narrative therapy](https://dralanjacobson.com/narrative-therapy/), a relatively modern approach, views individuals as the experts of their own lives and focuses on the stories they tell. These personal and often deeply held stories shape identities, influence behaviors, and impact mental health. By examining and, if necessary, re-authoring, individuals can reshape their identities and overcome challenges. Developed by [Michael White and David Epston](https://exploringyourmind.com/michael-white-and-david-epston-the-pioneers-of-narrative-therapy/), this therapy relies on the belief that problems are separate from people, and changing the narrative can change a person’s life.

### Narrative Theory

In narrative family therapy, the therapist and client collaborate to explore the stories that define the client’s life. This approach shifts the focus from the problem itself to the story surrounding it. Through this process, family members learn how their stories affect their identities and relationships. **Narrative family therapists** use **maps** to guide clients in identifying and challenging negative or limiting stories, paving the way for new, empowering stories.

Language is central to narrative therapy for families. The words and phrases family members use can influence their thoughts and feelings. Analyzing clients’ language, I help them recognize patterns and assumptions that may hold them back. This is one way that narrative family therapy techniques empower clients to reconstruct stories, creating possibilities for change and growth.

Another key principle is separating the person from their problem. By externalizing issues, families can view them more objectively and less personally. This allows for more creative problem-solving and reduces feelings of guilt or shame. Through this process, families can reclaim their power and agency, transforming their relationship with their difficulties.

Ultimately, narrative therapy for families is about telling and retelling stories in ways that highlight strengths, resilience, and potential. By focusing on the stories that shape lives, we work together to create change and foster a sense of empowerment and agency. Of course this is also true for [narrative therapy for couples](https://dralanjacobson.com/narrative-couples-therapy/).

## Benefits of Narrative Family Therapy

The benefits of narrative therapy for families are profound and far-reaching. It offers family members a unique path to empowerment and healing. By focusing on personal stories, members gain a stronger sense of agency and control over their lives within the family. This shift in perspective fosters empowerment, encouraging individual members and the whole family to take ownership and make positive changes in their relationships.

Narrative family therapy techniques encourage positive change through storytelling. By re-authoring, clients can view their challenges from a new perspective, uncovering hidden strengths and resources. This **outcomes technique** allows them to develop alternative life stories emphasizing resilience and hope, leading to more positive psychological outcomes.

### New Perspectives

Family members who engage in narrative family therapy techniques often learn to view their challenges from a new perspective. This shift allows them to see themselves separate from their issues, reducing feelings of helplessness or self-blame. By externalizing problems and focusing on unique outcomes, family members can identify solutions and take proactive steps toward change.

Finally, narrative therapy for families supports the development of alternative family life stories. By exploring different versions, family members can choose stories that align with their values and aspirations. This process encourages personal growth and transformation, helping clients build a more fulfilling and meaningful life together.

## Narrative Family Therapy Techniques

Most narrative family [therapy techniques](https://dralanjacobson.com/therapy-techniques-for-depression-anxiety-and-phobias/) help clients reshape their stories and foster change. One core technique is **externalization**, which encourages clients to view their problems as separate from themselves. By giving a problem a name and characterizing it, clients can gain distance and perspective, reducing its power over them.

**Re-authoring** is another crucial technique in narrative therapy for families. This process involves helping clients construct new, empowering stories reflecting their and the family’s strengths and potential. Clients can reframe things by focusing on moments of resilience and success, creating a more hopeful outlook. The [Tree of Life Therapy exercise](https://dralanjacobson.com/tree-of-life-therapy/) can be quite useful at this step.

**Deconstruction** is a technique that challenges dominant and limiting stories. Family members work together to dissect and analyze the stories that have shaped the family identity. Then, they can break free from restrictive stories and create new possibilities by questioning assumptions and exploring alternative interpretations.

**Mapping a problem’s influence** is a technique that helps clients understand its impact on their family lives. By exploring how the problem affects different areas of the family, members can gain a more comprehensive understanding of their influence. This insight allows them to develop strategies for managing and reducing negative impact.

Therapeutic documents, such as letters or certificates, are another tool used. These documents reinforce new insights, providing members with tangible reminders of their progress. By documenting their journey, the family can reflect on their growth and feel empowered to continue their therapeutic work.

### Importance of Storytelling in Narrative Family Therapy

Storytelling lies at the heart of narrative therapy for families, offering a transformative tool for exploration and healing. It creates a safe space for members to delve into their experiences, providing a framework for understanding complex emotions and events. Through storytelling, members can express themselves freely and authentically, fostering a sense of connection and understanding.

Stories help clients make sense of their emotions and experiences in the family. Individual members can gain clarity and insight into their feelings by organizing thoughts into stories. This process allows them to explore the underlying causes of their challenges and develop strategies for coping and change.

#### Therapeutic Storytelling

Therapeutic storytelling can dismantle negative self-perceptions. Clients often hold onto family stories that portray them negatively, reinforcing feelings of guilt, shame, or inadequacy. Members can challenge these perceptions and build a more positive self-image by re-authoring and fostering self-acceptance, closeness, and nurturing. By sharing stories, clients feel heard and validated, strengthening the [therapeutic relationship](https://positivepsychology.com/components-of-therapeutic-relationship/). This connection is essential for effective family therapy, as it encourages clients to explore things openly and honestly.

Storytelling encourages reflection and the discovery of new meanings. Revisiting and reinterpreting stories can help families uncover hidden strengths and resources, leading to personal growth and transformation. This process empowers each member to create new stories that align with their values and aspirations, promoting healing and change.

## Narrative Couples Therapy Overview

Narrative couples therapy offers a powerful framework for [treating couples](https://dralanjacobson.com/couples-therapy/), fostering open communication and collaboration. By focusing on shared narratives, partners can gain insight into their dynamics and relationships, promoting healing and growth.

In narrative couples therapy, partners learn to externalize shared problems. By naming their issues and exploring their impact, they can view these challenges as separate from themselves, reducing blame and conflict. This process encourages collaboration and problem-solving, helping couples find solutions.

### Narrative Couples Therapy Techniques

Couples gain insight into their relationship dynamics through storytelling. Couples can identify patterns and assumptions contributing to conflict or dissatisfaction by exploring the stories that define their partnership. This process encourages open communication and fosters a deeper understanding of each other’s perspectives.

Narrative couples therapy techniques foster open communication. By creating a safe space for storytelling, partners can share their experiences and feelings, promoting connection and understanding. This approach encourages empathy and validation, strengthening family bonds and resilience.

Narrative couples therapy techniques help them co-create solutions to their issues. By exploring different versions of their stories, partners can identify strategies for addressing their challenges and building a more harmonious and supportive environment. This collaborative process in narrative couples therapy empowers them to take ownership of their narratives and create positive change.

Narrative couples therapy offers a powerful approach that fosters open communication, collaboration, and healing. By exploring shared narratives, partners can gain insight into their dynamics and relationships, promoting growth and resilience.

## Cultural Sensitivity in Narrative Family Therapy

Cultural sensitivity is a crucial aspect of narrative therapy for families. It respects families’ unique backgrounds. By honoring diverse cultural perspectives, I enhance the effectiveness of my practice and foster a more inclusive and supportive environment. By understanding and respecting clients’ cultural and family backgrounds, I can tailor interventions to align with their values and beliefs. This approach fosters trust and rapport, promoting a more effective therapeutic alliance.

Exploring the stories that define cultural identity allows me to gain insight into the family’s experiences and challenges. This understanding allows me to provide more targeted and relevant interventions, promoting healing and growth. This helps families feel seen and heard, fostering a sense of empowerment and validation. In this way, I encourage members to engage more fully in the therapeutic process, leading to more positive outcomes.

[Cultural sensitivity](https://en.wikipedia.org/wiki/Cultural_sensitivity) also promotes inclusivity and trust in narrative therapy for families. By creating a safe and supportive environment for exploration, I can encourage family members to share their stories and experiences openly. This approach fosters a sense of connection and understanding, promoting healing and growth.

## Challenges of Narrative Therapy for Families

While narrative therapy for families offers a powerful approach to healing, it also presents challenges and limitations. Some family members may struggle to articulate their stories, making engaging in the therapeutic process difficult. Thus, narrative therapy for families requires considerable time and patience. Exploring and re-authoring within a family system can be time-consuming and require significant attention.

Some family members may prefer more structured or directive approaches, making narrative exploration difficult. I remain flexible and adaptable, tailoring interventions to meet each member’s needs and preferences. I also need to navigate the complexity of clients’ stories carefully. Stories can be intricate, multifaceted, and challenging, but they also provide rich opportunities for insight and growth.

## Narrative Therapy for Families FAQs

### Can you summarize this approach?

Yes. Family narrative therapy techniques focus on the stories families tell about their lives and experiences. It helps families identify unhelpful stories and create new, more positive ones to promote healing and growth.

### What are the five steps of narrative therapy for families?

The five steps of narrative therapy for families are:

1. Externalizing the problem – separating the issue from the individual
2. Re-authoring the story – challenging negative themes and creating new, empowering ones
3. Mapping the influence – exploring how stories shape beliefs and behaviors
4. Unique outcomes – identifying times when the issue was not present
5. Thickening the new plot – strengthening the preferred story to promote change

### What is the narrative approach in family therapy?

This approach involves viewing families as the authors of their own stories. I help members identify and reframe unhelpful narratives, challenge limiting beliefs, and create new, more empowering stories that promote healing, nurturance, and growth. Narrative family therapy techniques emphasize the power of storytelling in shaping our family identities and experiences.

## Summary and My Work

I offer narrative therapy for families where the children are older adolescents or adults (including [therapy for adult siblings](https://dralanjacobson.com/adult-sibling-therapy/) or [mothers and daughters](https://dralanjacobson.com/mother-daughter-therapy/)). The virtual methods I use for families with younger children are not ideal. Narrative family therapy techniques are also interwoven into many other [psychotherapy approaches](https://dralanjacobson.com/types-of-therapy/) I use in [family therapy](https://dralanjacobson.com/family-therapy/), such as [solution-focused therapy for families](https://dralanjacobson.com/solution-focused-family-therapy-focusing-on-positive-change/), [family systems therapy](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/), [emotionally focused family therapy](https://dralanjacobson.com/emotionally-focused-family-therapy/), and [strategic family therapy](https://dralanjacobson.com/strategic-family-therapy-powerful-positive-time-limited/). I offer these methods as [online therapy](https://dralanjacobson.com/virtual-therapy-guide/), which can be helpful if all members are not going to be at the same place at the time of the appointment. It is well suited to [adult family therapy](https://dralanjacobson.com/adult-family-therapy/) and finding [better work-life balance](https://dralanjacobson.com/therapy-for-work-life-balance/).

If you have any specific questions about how narrative family therapy techniques would benefit you, please [get in touch](https://dralanjacobson.com/contact/) with me or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.linkedin.com/company/psychologicalscience/)

**Categories:** Family therapies

---

### [Does Therapy Work?](https://dralanjacobson.com/does-therapy-work/)

**Published:** October 7, 2023
**Author:** Dr. Alan Jacobson

**Content:**

A common question that people have, which I fully respect, is “**Does therapy work?**“. You will be dedicating your valuable time, energy, and thoughtfulness to a process that can sometimes lead to discomfort and psychological challenges. Thus, asking this question is intelligent and natural. The short answer is that treatment can be very effective, meaningful, and essential. However, the effectiveness depends on various factors. These factors include the [type of therapeutic approach](https://dralanjacobson.com/), the specific issues being addressed, the skills and expertise of the therapist, and your willingness and commitment. This post answers the more general question and concludes with additional answers to “Does couples therapy work?” and “Does family therapy work?”

## Keys to Answering “Does Therapy Work?”

The following are three keys to answering the question, “Does therapy work?” or, more precisely, “Will it work for me?” Later in this post we go over related answers to, “Does family therapy work?” and the same for couples treatment.

### Type of Therapy and the Question, “Does Therapy Work?”

I can provide different types of therapy and sometimes braid them together to give the best combination. I choose among [cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) (CBT), [positive psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/), [Solution-Focused Therapy](https://dralanjacobson.com/solution-focused-therapy/), [gestalt therapy](https://dralanjacobson.com/gestalt-therapy/), and more. It is essential that we choose the best approach to suit your needs and the questions you came into therapy asking.

### Therapist’s Qualifications and Fit

The competence and experience of the [therapist play a crucial role in the success of therapy](https://dralanjacobson.com/therapy-models-and-therapist-styles-a-complete-guide-to-finding-the-right-fit/). The therapeutic relationship is essential. A trusting and [supportive relationship](https://psychnews.psychiatryonline.org/doi/10.1176/appi.pn.2020.6a31) between me and you is vital to success. I suggest you read about [my approach](https://dralanjacobson.com/types-of-therapy/) and [my bio](https://dralanjacobson.com/my-bio/) and maybe browse [my blog](https://dralanjacobson.com/blog/) to see if it seems I would be a good fit for you. I can even help you find a different therapist if you are looking for an approach I do not provide. There is a wide network of colleagues I can refer you to. You can find more about the [differences between behavioral health professionals](https://dralanjacobson.com/therapist-vs-psychologist-therapist-vs-psychotherapist/) in a separate post.

### Does Therapy Work? It may Depend on Motivation

Your willingness to engage and actively participate in the process will significantly impact its effectiveness. Openness to change and a commitment to working on one’s issues are important. I will provide a safe, confidential, and kind environment to maximize your chances of engaging. We will go over the probable duration and course of treatment. Time and consistency are essential, and you must know what to expect. Both of us must have clear goals and realistic expectations. Progress may not always be linear, and setbacks can occur.

## Does Therapy Work for All Issues?

The answer to “Does Therapy Work?” depends on the problem’s nature and severity. Some issues may be more challenging to treat than others. When we first meet, I will let you know whether I feel treatment can be effective for the issues you bring and what you should expect as far as relief from any symptoms.

The longer answer to the question, “Does therapy work for all issues?” involves looking at the issue’s type, severity, and cause. It also depends on what you mean by “work.” For example, while it may not be able to eliminate a depression that was caused by a chemical imbalance, it can help you manage the symptoms and find more relief than you’d have without treatment. If you are anxious or depressed because of an ongoing issue, treatment may be unable to change the issue, but it can help you better manage its effects.

### Ways to Enhance Effectiveness

So, does therapy work? Yes, it does, and there are ways to enhance the chances it will work for you. For example:

#### Evidence-Based Approaches

Many therapeutic approaches have been extensively studied and shown to be effective. These therapies help answer the question, “Does therapy work?” by bringing data and statistics about how people have been helped, and the methods are based on science. I offer [Cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) (CBT), which is an evidence-based approach. I also provide [exposure methods for some anxieties](https://dralanjacobson.com/exposure-therapy-for-anxiety/). These two approaches I use in my practice are examples of science-based approaches.

#### Match to the Issue

The type of treatment should match the specific issue being addressed. For example, a person struggling with depression may benefit from [cognitive-behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/), a person experiencing life transition may do well with [positive psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/), and someone with short-term stress may look to [Solution-Focused Therapy](https://dralanjacobson.com/solution-focused-therapy/). I offer a variety of clinical approaches, and that is why I describe my practice as “integrative.”

If I feel that another approach would better serve you, I have a network of trusted providers I can refer you to.

#### Does Therapy Work? Only if the Therapist is Well-Trained

The therapist’s qualifications, experience, and training play a significant role in the effectiveness. It’s essential to work with a licensed and reputable therapist. You can read [my bio](https://dralanjacobson.com/my-bio/) on this site and decide whether I meet this criteria, and I’d also be happy to talk to you more generally about what to look for in a therapist if you feel we are not a match.

#### Consistency and Persistence

Consistency in attending sessions and actively participating is critical to achieving positive outcomes. Some issues may require ongoing or intermittent treatment over an extended period. It’s essential to be patient and persistent. In some cases, involving family members, friends, or support groups can enhance the effectiveness.

#### Cultural Sensitivity

The cultural competence of the therapist can be crucial in ensuring that therapy is appropriate and effective for individuals from diverse backgrounds. This does not mean that the therapist has to be an exact match for your cultural heritage, but you do need to feel understood and accepted.

Ultimately, the effectiveness of treatment is a highly individualized experience. Some people may experience significant improvements and relief from their symptoms, while others may find it less helpful. This is why I offer a consultation before we start so we can discuss the likely outcomes for your specific concerns and an expected timeline.

## Does Couples Therapy Work?

If you are considering going as a couple, “Does couples therapy work?” may be top of mind. This may be a more complex situation. A lot depends on why you are seeking couples treatment and each person’s motivation to engage. If the reason for treatment is something both people feel they can work through and both commit to, then it can work very well.

With couples treatment, I try to be clear if the goals are realistic. In some cases, due to uneven motivation or the depth of the problem, I will tell the couple that treatment may not help. This is rare, and I mention this more so you know that if we work together, I hope it will work well.

[Couples therapy](https://dralanjacobson.com/couples-therapy/) includes various evidence-based methods to improve communication, resolve conflicts, and strengthen relationships. The effectiveness depends on the method used, the therapist match, and the couple’s willingness to engage. So, does couples therapy work? Here’s a breakdown of some widely used approaches:

1. **[ Emotionally Focused Therapy](https://dralanjacobson.com/emotionally-focused-family-therapy/) (EFT)**

- **Focus**: Strengthening emotional bonds and attachment security.
- **How it works**: Helps partners recognize negative interaction patterns and replace them with more secure, supportive behaviors.
- **Effectiveness**: Research shows about 70–75% of couples move from distress to recovery, with long-term improvements.

2. [ **The Gottman Method**](https://www.gottman.com/about/the-gottman-method/)

- **Focus**: Building friendship, managing conflict, and creating shared meaning.
- **How it works**: Uses assessments to identify problem areas and provides structured exercises to improve communication and intimacy.
- **Key principles**: 
    - Building a strong friendship foundation.
    - Avoiding the “Four Horsemen” (criticism, contempt, defensiveness, stonewalling).
    - Managing conflict constructively rather than eliminating it.
- **Effectiveness**: Studies indicate couples who practice these skills show long-term improvements.

3. **Cognitive-Behavioral For Couples (CBCT)**

- **Focus**: Changing unhelpful thoughts and behaviors in the relationship.
- **How it works**: Helps partners identify and modify negative thought patterns that lead to conflict and dissatisfaction.
- **Effectiveness**: Effective for reducing conflict and improving problem-solving skills, especially when stressors like mental health challenges are involved.

4. **[ Integrative Behavioral Couples Therapy](https://dralanjacobson.com/integrative-behavioral-couples-therapy/) (IBCT)**

- **Focus**: Accepting differences and improving communication.
- **How it works**: Uses acceptance-based strategies to help partners understand and cope with each other’s differences rather than trying to change them.
- **Effectiveness**: Found to be particularly effective for couples dealing with chronic conflict.

5. [ **Imago Relationship Therapy**](https://dralanjacobson.com/imago-relationship-therapy/)

- **Focus**: Understanding how childhood experiences shape adult relationships.
- **How it works**: Encourages deep listening, empathy, and mirroring exercises to help partners connect on a deeper level.
- **Effectiveness**: Works well for couples with unresolved emotional wounds.

6. **Narrative Therapy**

- **Focus**: Changing the “story” partners tell about their relationship.
- **How it works**: Helps couples reframe their relationship struggles in a more positive or constructive way.
- **Effectiveness**: Useful for breaking toxic cycles and seeing the relationship from a new perspective.

### When Does Couples Therapy Work Best?

- Both partners are motivated to improve the relationship.
- The couple seeks help before problems become severe.
- The method is chosen carefully to suit the couple’s needs.
- There is no ongoing abuse or active substance addiction (which often require additional interventions first).
- Sometimes when one or both members are also in [individual therapy](https://dralanjacobson.com/individual-therapy/) to address issues outside the relationship

In conclusion, the answer to the question, “Does couples therapy work?” is generally yes, with greater chances when the fit between you and your challenges and the approach chosen is maximized.

## Does Family Therapy Work?

[Family therapy](https://dralanjacobson.com/family-therapy/) can be highly effective, especially when conflicts, communication breakdowns, or major life transitions affect family dynamics. Like couples therapy, its success depends on the right approach, the family’s willingness to engage, and the specific challenges being addressed. Does family therapy work? It can be vitally important and successful if the timing is right and everyone is motivated.

### Common Methods of Family Treatment

1. **[ Structural Family Therapy](https://dralanjacobson.com/structural-family-therapy/) (SFT)**

- **Focus**: Examines and restructures family interactions and hierarchies.
- **How it works**: 
    - I observe how family members interact and identify unhealthy dynamics.
    - I set clear boundaries (e.g., balancing authority between parents and children).
    - The process strengthens parental leadership and support systems.
- **Effectiveness**: Useful for families with rigid roles, power struggles, or unclear boundaries.

2. [ **Bowenian Family Therapy**](https://dralanjacobson.com/bowenian-family-therapy/)

- **Focus**: Understanding generational patterns and emotional interdependence.
- **How it works**: 
    - Identifies emotional cutoffs (where family members withdraw instead of resolving conflicts).
    - Encourages differentiation (helping individuals maintain their identity while staying emotionally connected).
    - Uses a genogram (a type of family tree) to explore patterns across generations.
- **Effectiveness**: Best for families struggling with unresolved generational conflicts or emotional enmeshment.

3. [ **Systemic Family Therapy**](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/)

- **Focus**: Views the family as a system where each member’s behavior affects the whole.
- **How it works**: 
    - Helps family members understand how their behaviors trigger reactions in others.
    - Encourages positive changes in interactions.
    - Uses reframing techniques to shift perspectives on problems.
- **Effectiveness**: Beneficial for families dealing with long-term conflicts, mental health struggles, or addiction.

4. **Cognitive-Behavioral Family Therapy (CBFT)**

- **Focus**: Changing harmful thought patterns and behaviors within the family.
- **How it works**: 
    - Identifies and challenges negative thinking patterns.
    - Teaches healthy communication and coping strategies.
    - Assigns homework tasks (e.g., practicing active listening).
- **Effectiveness**: Strong evidence supports its use for families facing stress, trauma, or behavioral issues.

5. [ **Narrative Family Therapy**](https://dralanjacobson.com/narrative-family-therapy/)

- **Focus**: Helping families rewrite the “stories” they tell about their problems.
- **How it works**: 
    - Encourages family members to separate themselves from negative narratives (e.g., “We always fight”).
    - Highlights strengths and resilience.
    - Uses storytelling to reframe challenges in a constructive way.
- **Effectiveness**: Useful for families dealing with trauma, self-esteem issues, or blame cycles.

6. **[ Solution-Focused Brief Therapy](https://dralanjacobson.com/solution-focused-family-therapy-focusing-on-positive-change/) (SFBT)**

- **Focus**: Finding quick, practical solutions rather than analyzing deep-rooted problems.
- **How it works**: 
    - Encourages families to focus on what is working instead of dwelling on problems.
    - Uses “miracle questions” (e.g., “If things were suddenly better tomorrow, what would be different?”).
    - Sets small, achievable goals.
- **Effectiveness**: Works well for families needing short-term, goal-oriented solutions.

### When Does Family Therapy Work Best?

- Family members are open to participating and making changes.
- There is a therapist who understands the family’s unique dynamics and cultural background.
- The family is dealing with conflicts, transitions, or specific stressors.
- The approach aligns with the family’s needs—some benefit from long-term therapy, while others need short-term, solution-focused methods.

So, “Does family therapy work?” if everyone participates and is motivated, and the fit is good with the approach chosen, it can be very beneficial.

## Summary and Conclusions

It’s important to note that treatment is not a one-size-fits-all solution, and what works for one person may not work as effectively for another. I may not be the best fit for you because another approach may work more effectively, and we can discuss that.

So, **does therapy work**? Does couples therapy work? How about family treatment? If the above issues fall into place, it can be a valuable tool for personal growth, self-discovery, and mental health concerns. Mental health treatment has worked well for many people I have seen; as psychologists, we always learn and improve our craft. As I’ve said elsewhere, results should be meaningful, measurable, and clear. Then, when you ask yourself, “Does therapy work?” after a few sessions, you should come to a clear answer. If you’re considering treatment with me or anyone else, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a free consultation](https://www.picktime.com/scheduleaconsult) with any questions.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Therapy Approaches

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### [The Science of Positive Psychology: Strengths-Based Growth Transforms Well-Being](https://dralanjacobson.com/positive-psychology-powerful-benefits/)

**Published:** May 10, 2023
**Author:** Dr. Alan Jacobson

**Content:**

**Positive Psychology** is an [approach to therapy](https://dralanjacobson.com/types-of-therapy/) that focuses on the positive aspects of human experiences, such as what makes us happy and content, how we can improve our well-being, and the best path to flourishing in life. It emphasizes the study of emotions, personal strengths, and virtues and aims to help individuals and communities thrive. While roadblocks and situational stress will be explored, the goal is to find new pathways and strategies to overcome these challenges. Positive psychology therapists follow [strengths based therapy](https://dralanjacobson.com/strength-based-therapy/) and [humanistic psychology](https://dralanjacobson.com/humanistic-psychology/), core aspects of my practice. This post provides an overview of this method, with a positive psychology example at the end.

---

**Ready to Experience the Benefits of Positive Psychology?**
Start harnessing your strengths, resilience, and meaning today with evidence-based guidance. Use the [contact page](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) with Dr. **Alan Jacobson, Clinical Psychologist.** *Expert support can help you apply positive psychology in your life.*

---

##  **What Positive Psychology Is — A Strengths-Based Scientific Approach**

Positive psychology is a branch of psychology that studies the factors that make life meaningful, fulfilling, and worth living. Instead of focusing solely on dysfunction or pathology, it explores **what helps people thrive** — including happiness, resilience, optimism, engagement, character strengths, and purpose. This field was popularized by pioneers like Martin Seligman and Mihaly Csikszentmihalyi and has grown into a global research area with applications in therapy, coaching, education, and organizational well-being.

Experts describe positive psychology as focusing on:

- Positive experiences (joy, gratitude)
- Positive traits (resilience, compassion)
- Positive institutions and communities

This broader view helps individuals *go beyond surviving to truly flourishing*.

### **How Positive Psychology Enhances Mental Resilience & Well-Being**

A growing body of research demonstrates that positive psychology practices aren’t just feel-good strategies — they *produce measurable improvements* in well-being and mental health. Meta-analyses show that interventions such as gratitude letters, strengths exercises, and optimism training lead to sustained gains in well-being and reductions in symptoms such as depression and stress.

Key psychological benefits include:

- **Greater emotional resilience** — better capacity to cope with adversity
- **Increased life satisfaction and optimism**
- **Stronger social connections and support**
- **Enhanced creativity and problem-solving abilities**

Positive emotions also broaden thinking and build lasting psychological resources — a phenomenon described in the *broaden-and-build* theory of positive emotions.

### **Positive Psychology & Physical Health: The Mind-Body Advantage**

Research indicates that the benefits of positive psychology extend into the physical domain as well. Individuals who regularly experience positive emotions and engage in strengths-based activities tend to demonstrate:

- Improved immune function
- Lower stress and inflammation
- Better overall health outcomes

This is because a positive perspective not only enhances mental well-being but also *supports physiological health and resilience*, going beyond the absence of disease to a truly holistic definition of health.

### **How Positive Psychology Works in Everyday Life**

Applied positive psychology can be integrated into daily routines and therapeutic practices through evidence-based exercises, such as:

- **Gratitude journaling** — reflecting on positive experiences
- **Strengths identification (e.g., VIA Character Strengths)** — building on personal assets
- **Mindfulness and engagement practices** — boosting awareness and flow
- **Optimism and goal-setting frameworks** — encouraging purposeful growth

These practices not only improve mood in the moment but also contribute to long-term growth and satisfaction.

## Positive Psychology in Practice ![Positive Psychology Therapists](https://dralanjacobson.com/wp-content/uploads/2023/05/Emotional-IQ-300x200.jpg "Emotional IQ | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Positive psychology emerged as a distinct field in the late 20th century, with psychologists like [Martin Seligman](https://ppc.sas.upenn.edu/people/martin-ep-seligman) and [Mihaly Csikszentmihalyi](https://en.wikipedia.org/wiki/Mihaly_Csikszentmihalyi) playing prominent roles in its development. It emerged as a response to psychology’s traditional focus on mental illnesses and dysfunction. Instead of solely addressing people’s problems and disorders, this new method was designed to promote the factors contributing to a fulfilling and meaningful life.

Positive psychology therapists shift the focus of [individual therapy](https://dralanjacobson.com/) from talking about problems to instilling hope and energy. Instead of just addressing negative symptoms, this approach aims to explore and enhance experiences and qualities that contribute to a fulfilling life. We will find ways to improve well-being and deepen meaningfulness and connection.

### What is Positive Psychology Therapy Used For

In my practice, positive psychology therapy is used for many purposes, all focused on enhancing well-being, happiness, and optimal functioning in individuals, groups, and communities. Here are some common applications:

#### Enhancing Happiness and Well-being

Positive psychology therapists aim to increase positive emotions, satisfaction with life, and overall well-being. We might use [gratitude exercises](https://positivepsychology.com/gratitude-exercises/), mindfulness practices, and fostering relationships to accomplish this. In general, this type of therapy is helpful for anyone experiencing either a long-term or situational dip in their mood.

#### Improving Mental Health

Positive psychology therapy techniques can be used as complementary approaches to traditional therapy to alleviate symptoms of depression, anxiety, and other mental health issues. You can develop resilience and coping strategies by focusing on your strengths. We might combine your treatment with any number of other [humanistic approaches](https://dralanjacobson.com/basic-tenets-of-humanistic-psychology/), such as [narrative therapy](https://dralanjacobson.com/narrative-therapy/) and [gestalt therapy](https://dralanjacobson.com/gestalt-therapy/).

#### Building Resilience

Positive psychology treatment helps individuals develop resilience in the face of adversity. If you feel pleasant emotions, such as optimism and hope, you can better navigate challenges and bounce back from setbacks. Thus, this approach is very effective for anyone who has experienced a setback or a roadblock and wants to get back on track.

Positive psychology can serve as a preventive measure against mental health issues by promoting good emotions and well-being. Enhancing resilience and well-being can reduce the risk of developing mental health problems.

#### Enhancing Performance Using Positive Psychology Techniques

Positive psychology techniques enhance performance and productivity in various fields, including education, sports, and business. Cultivating happy emotions and strengths can help you achieve greater success and fulfillment in your endeavors. Thus, I often use this approach in my [intensive therapy](https://dralanjacobson.com/intensive-therapy-and-specialty-services/) specialties, such as [sports psychology](https://dralanjacobson.com/sports-psychology/), executive coaching, and [college admissions consulting](https://dralanjacobson.com/college-admissions-counseling/).

Positive [psychology focuses on identifying and cultivating individual strengths](https://dralanjacobson.com/humanistic-psychology/) and virtues. By leveraging these strengths, individuals can experience greater fulfillment and achieve their goals more effectively.

#### Promoting Good Relationships

[Positive psychology (Wikipedia)]() emphasizes the importance of relationships and social connections in promoting well-being. Techniques such as active listening, empathy, and forgiveness can strengthen relationships and foster a sense of belonging. For this reason, I use positive psychology methods in both [couples therapy](https://dralanjacobson.com/couples-therapy/) and [family therapy](https://dralanjacobson.com/family-therapy/).

Positive psychology therapy promotes flourishing and optimal functioning in individuals and communities by focusing on strengths and meaningful experiences.

### The Role of Barriers

All of this is not to say that we won’t look at roadblocks and challenges; at times, we will look into the past to see where they originated and how they’ve progressed. However, the goal is always to find hope in your ability to overcome any challenges your history has brought your way. Our journey together will lead to a greater understanding of your reservoirs of strength and resilience and, in many cases, rediscovering pockets of self-esteem and competence that have been lost or clouded over time.

Positive psychology works well as an approach on its own and can be used as an adjunct to a more specific form of treatment. I weave these techniques and methods into most of my [therapeutic approaches](https://dralanjacobson.com/types-of-therapy/). You can also learn more about [how positive psychology supports well-being and happiness]()

## Positive Psychology Therapists’ Techniques

These methods have been studied, refined, and empirically proven. We will use evidence-based strategies and interventions to help you lead a happier, more meaningful, and more connected life. This approach can make you feel more profound gratitude, hope, and power. Techniques outside of our sessions may include journaling, mindfulness practices, and strength assessments. Our sessions will explore aspects of your life regarding where things are bottled up, stuck, or blocked and how we can unlock your strength and happiness. You can see a positive psychology example below that shows these methods.

### The Positive Psychology Therapists’ Toolkit

Here are some specific tools we may use as part of a Positive Psychology treatment course:

1. Character Strengths Assessment: Identifying and utilizing your signature strengths is critical. Tools like the [VIA Character Strengths Survey](https://www.viacharacter.org/) can help you see your character strengths and find ways to apply them in daily life.
2. Affirmations: Regular affirmations can rewire your thought patterns and boost self-esteem and self-confidence. These are statements about yourself and your abilities, and we will work on having you not just repeat them but believe them!
3. [Mindfulness Practice](https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/mindfulness-exercises/art-20046356): Practicing mindfulness involves focusing on the present moment without judgment or overthinking. Regular meditation can reduce stress, improve focus and attention, and increase overall well-being.
4. Acts of Kindness: Engaging in acts of kindness towards others can create a nice feedback loop of happiness and well-being. You will begin seeing the world through a different, more optimistic lens.
5. Savoring: The practice of savoring involves thoroughly enjoying and appreciating experiences, making them more meaningful and memorable is a good positive psychology example. Sometimes, these experiences are quick and otherwise may have gone unnoticed.
6. Visualization: Visualization techniques involve mentally imagining good outcomes, success, or achievements, which can increase motivation and self-belief. We will work on visualization that captures both the acts and the feelings behind them.
7. Flow State Activities: Engaging in activities that challenge your skills can lead to a state of [feeling of flow](https://www.verywellmind.com/what-is-flow-2794768) where you feel fully immersed and highly satisfied.
8. Three Good Things Exercise: At the end of each day, you may be asked to reflect on three things that happened to you that day and why they made you feel good.
9. Strength-Based Goal Setting: Many people stop creating new goals when feeling down or lacking confidence. We will work to align your goals with your character strengths and values to increase motivation and resilience.
10. Reframing: Many people suffer from automatic thoughts that turn negative, so we will work on reframing negative situations by finding good aspects or opportunities for growth. This is a positive psychology example that is closely related to [cognitive restructuring](https://dralanjacobson.com/cognitive-restructuring/) and [cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/).

### How This Method is Different

Positive psychology is designed to assess potential, hope, and transformation. This does not mean that we would ignore barriers and challenges, but rather approach them with the idea of possibilities—that you may be able to overcome them using your strengths or by finding coping strategies that diminish their effect. It also does not mean that we will ignore challenges that have happened in the past, but we will not view them as anchors that make our goals in the here and now unreachable.

Many choose positive psychology therapists because they want to find or increase hope in progress. They want to work on what might hold them back while staying attuned to what got them there. Positive psychology can easily be paired with other forward-looking approaches, such as cognitive-behavioral and [solution-focused therapy](https://dralanjacobson.com/solution-focused-therapy/).

## Positive Psychology Example

This fictitious positive psychology example focuses on an individual’s strengths and well-being rather than solely addressing problems. It shows how positive psychology therapists like me apply these concepts.

### Positive Psychology Example: Building Resilience in a College Student

#### Background:

Maria, a 20-year-old college sophomore, has been overwhelmed by her academic workload, social commitments, and part-time job. She often criticizes herself for not meeting her expectations and worries about failing. Despite this, Maria has strong interpersonal skills, enjoys volunteering, and is passionate about creative writing.

#### Intervention Focus:

Using a positive psychology approach, I work with Maria to enhance her well-being by focusing on her strengths and fostering positive emotions.

#### Positive Psychology Steps Taken:

1. **Identifying Strengths:**
    Through a strengths-based assessment, Maria identifies her top strengths as creativity, kindness, and social intelligence. She realizes these traits help her excel in creative writing and connect with others.
2. **Setting Goals:**
    Maria sets meaningful goals that align with her strengths. For example, she decides to start a blog about student mental health, combining her passion for writing with her desire to help others.
3. **Gratitude Practice:**
    Maria begins a gratitude journal, writing down three things she’s grateful for daily. This practice helps her shift her focus from stress to nice aspects of her life.
4. **Flow Activities:**
    She learns about “flow”—being fully immersed in activities she enjoys. Maria schedules weekly creative writing sessions, which she finds both fulfilling and energizing.
5. **Resilience-Building Techniques:**
    Maria practices reframing negative thoughts and focusing on solutions rather than dwelling on problems. She learns mindfulness techniques to stay present and reduce anxiety.

#### Positive Psychology Example Outcome:

After three months, Maria reports feeling more confident and optimistic. She can manage her time better, feels less overwhelmed, and is proud of her blog’s helpful impact on peers. Her improved well-being has translated into better academic performance and stronger relationships. While this is a fictitious positive psychology example, I see these outcomes.

This positive psychology example demonstrates how this method emphasizes flourishing by leveraging strengths and cultivating positive emotions rather than only addressing deficits. Positive psychology therapists focus on potential and possibilities.

## Common Questions About Positive Psychology

### What is Positive Psychology?

**A:** It is a branch of psychology that explores the science of human flourishing. Rather than focusing solely on mental illness, it emphasizes strengths, virtues, and factors that help people live meaningful, fulfilling lives. It asks questions like: *What makes people truly happy? How can we cultivate more resilience, hope, and compassion in ourselves and others?*

### What Does Positive Psychology Focus On?

**A:** As evidenced in the positive psychology example above, this approach focuses on the **favorable aspects of the human experience**. Key areas of interest include:

- **Positive emotions** (joy, gratitude, hope)
- **Character strengths** (such as courage, kindness, and perseverance)
- **Meaning and purpose**
- **Healthy relationships**
- **Resilience and coping strategies**
- [**Flow states**](https://dralanjacobson.com/flow-state/) (being fully engaged in meaningful activity)
    It studies what allows individuals, communities, and organizations to thrive.

### What is Applied Positive Psychology?

**A:** Positive psychology therapists take the principles and findings of the science and implement them in practical settings to improve well-being and performance**.** Examples include:

- Coaching individuals to identify and use their strengths
- Creating school programs that teach optimism and resilience
- Designing workplace cultures that foster engagement and purpose
- Helping clients set and pursue intrinsically rewarding goals

### What is Positive Psychology Therapy?

**A:** As you can see in the positive psychology example above, this therapeutic approach complements traditional therapy by emphasizing **what’s going right** in a person’s life. Rather than focusing exclusively on problems, it:

- Helps clients build on their strengths
- Encourages gratitude practices, such as writing down three good things each day
- Promotes acts of kindness and forgiveness
- Guides clients to identify and pursue meaningful life goals
- Builds hope and optimism through evidence-based exercises

This type of therapy can be particularly effective for depression, anxiety, and overall life satisfaction.

### What is the Positive Psychology Movement?

**A:** The positive psychology movement began in the late 1990s, when Dr. Martin Seligman, then president of the [American Psychological Association](https://www.apaservices.org/), called for a new focus in psychology: not just fixing what’s wrong, but also **enhancing what’s right**. The movement:

- Advocates for a more balanced view of mental health
- Supports research on well-being, strengths, and positive development
- Has influenced fields like education, business, healthcare, and coaching

This shift has helped broaden the scope of the profession to include prevention, thriving, and human potential.

### How Can Positive Psychology Help You Become Happier?

**A:** It provides tools and practices proven to increase well-being, such as:

- **Gratitude journaling:** Writing down things you’re thankful for can increase happiness and reduce depression.
- **Strengths-based work:** Identifying your top strengths and using them daily improves motivation and life satisfaction.
- **Mindfulness and savoring:** Being present and appreciating the moment helps combat stress and boosts joy.
- **Building better relationships:** Investing in quality social connections is a strong predictor of happiness.

By focusing on what uplifts and energizes you, this approach helps you live more intentionally and joyfully.

### What is Positive Psychology in the Workplace?

**A:** In the workplace, positive psychology therapists work to:

- Improve employee engagement and motivation
- Enhance teamwork and communication
- Reduce burnout through strengths-based tasks
- Cultivate a sense of purpose and alignment with organizational values
- Foster positive leadership and a supportive company culture

Companies that apply these principles often see increased productivity, lower turnover, and higher job satisfaction.

## Summary and Conclusions

As you can see from the positive psychology example above, this approach is part of an exciting and promising field that has the potential to transform your life in lasting ways. Even if we do a more focused kind of treatment, such as [cognitive-behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) (CBT), we will still do it within the framework of this approach. You can decide how much our [treatment together](https://dralanjacobson.com/) will be wrapped in this framework – for some, this approach becomes the primary aspect of our work together, but for others, it becomes an adjunct to a more specific approach to therapy. More information can be found at **[The Journal of Positive Psychology (Peer‑Reviewed Journal)](https://en.wikipedia.org/wiki/The_Journal_of_Positive_Psychology?utm_source=chatgpt.com).**

### My Practice

Like most positive psychology therapists, I incorporate all the basic pillars of this method into my work, even when we choose different approaches. We won’t ignore the past, but we will not see it as something that has to hold you back. We’ll explore what got you here, but only in the context of how you can move forward and reach new goals. As much as positive psychology is a fairly general approach, your specific treatment plan will have specific and measurable goals. I use it with individuals and [couples in therapy](https://dralanjacobson.com/couples-therapy/) and also in [executive functioning coaching](https://dralanjacobson.com/executive-functioning-coaching/) and [psychological testing](https://www.psychologicalassessments.com).

I also use this method in several of my specialty services and [intensive therapy services](https://dralanjacobson.com/intensive-therapy-and-specialty-services/). For example, given that this approach is popular in organizational psychology, I use it in Executive Coaching. I also use it in my [college admissions](https://dralanjacobson.com/college-admissions-counseling/) specialty to reduce stress and open up a feeling of possibility, and in [Therapeutic Tutoring](https://therapeutictutoring.com/). This approach works virtually or I can refer you to positive psychology therapists in your area.

I welcome any questions about **Positive Psychology** and its use in therapy through the[ contact page](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## More FAQ

### **What benefits does positive psychology provide?**

Positive psychology enhances emotional well-being by increasing positive emotions, resilience, life satisfaction, and meaning. It also strengthens relationships, fosters optimism, and supports physical health through stress reduction and improved immune function.

### **How is positive psychology different from traditional therapy?**

Traditional therapy often focuses on reducing symptoms and alleviating distress. Positive psychology complements this by *building strengths*, enhancing *what’s working well*, and helping individuals flourish rather than just cope.

### **Is there scientific evidence supporting positive psychology?**

Yes — multiple meta-analyses and systematic reviews show that positive psychology interventions significantly improve well-being and reduce symptoms of depression, stress, and anxiety.

### **Can I practice positive psychology on my own?**

Absolutely. Practices like gratitude journaling, strengths reflection, and intentional engagement in meaningful activities are accessible ways to apply positive psychology principles daily.

### **How long does it take to see benefits?**

Some benefits (like improved mood) can occur quickly with consistent practice, while deeper shifts in resilience and life satisfaction tend to develop over weeks or months of consistent application.

### **Are positive psychology practices suitable for everyone?**

While broadly beneficial, the best outcomes often come when practices are tailored to the individual’s strengths, values, and life context — often with guidance from a trained clinician.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.linkedin.com/company/psychologicalscience/)

**Categories:** Therapy Approaches

---

### [Schema Therapy](https://dralanjacobson.com/schema-therapy/)

**Published:** July 30, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Schema therapy** is an [integrative approach](https://dralanjacobson.com/integrative-therapy/) to psychotherapy that combines elements of cognitive-behavioral therapy, psychoanalytic theory, attachment theory, and other therapeutic schools of thought. Dr. Jeffrey Young developed **schema psychotherapy** in the 1980s and is primarily aimed at treating chronic mental health issues and personality disorders, especially those that have not responded well to other forms of therapy. This post aims to provide general information about **schema-focused therapy** and **schema couples therapy** (**SCT**), but if you would like more specific information about what it can do for you, feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Schema Therapy Overview

The following is an overview of schema-focused therapy, including its underlying concepts, goals, and applications.

### Key Concepts of Schema Therapy

The key aspects of this approach fall into four categories:

1. **Schemas are deeply** ingrained patterns of thought and behavior, often developed in childhood, that shape how individuals view themselves and the world. These can be positive or negative, and when they are maladaptive and stuck, therapy can help.
2. **Maladaptive Coping Styles** are ways individuals cope with their blueprints that often perpetuate their problems. These can include avoidance, surrender, or overcompensation.
3. **Modes are** Moment-to-moment emotional states and coping responses that individuals experience. These modes include the Vulnerable Child, Angry Child, Punitive Parent, and Healthy Adult.
4. **Core Emotional Needs** are Basic emotional needs that, when unmet, contribute to developing maladaptive patterns. These needs include safety, love and connection, autonomy, realistic limits, and spontaneity.

### Goals of Schema therapy

The goals of schema-focused therapy follow the scaffolding listed above:

- **Identify and understand maladaptive schemas**: We will collaborate to identify your schemas and understand their origins.
- **Develop healthier coping strategies**: Clients learn to recognize their maladaptive coping styles and develop healthier ways to deal with them.
- **Schema Healing**: Work is done to heal the underlying issues by addressing unmet emotional needs, challenging and changing negative beliefs, and fostering healthier thinking and behavior patterns.

### Applications of Schema-Focused Therapy

The applications for schema psychotherapy include:

Schema-focused therapy is particularly effective for individuals with personality disorders, such as borderline personality disorder. It is also useful for [treating chronic depression,](https://dralanjacobson.com/treating-major-depression/) anxiety disorders, eating disorders, and relationship difficulties.

This approach focuses on the deep-rooted patterns contributing to psychological distress, helping individuals achieve lasting change and improve their overall quality of life.

## Schema-Focused Therapy Techniques

Schema-focused therapy combines several other methods, borrowing from attachment theory, [gestalt therapy](https://dralanjacobson.com/gestalt-therapy/), [cognitive therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/), and [attachment theory](https://www.simplypsychology.org/attachment.html). The result is the following techniques, among others:

- **Cognitive Techniques**: Challenging and restructuring maladaptive thoughts and beliefs is a core aspect of this approach, though, unlike [regular CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/), there is more focus on your past and how you got here as far as underlying irrational and exaggerated thoughts.
- **Experiential Techniques**: [Guided imagery](https://health.clevelandclinic.org/guided-imagery), role-playing, and other techniques can be used to access and work through emotions and memories tied to schemas.
- **Behavioral Techniques**: Implementing new, healthier behaviors to replace maladaptive coping strategies. This area often involves homework, which is central to this approach.
- **Diaries:** Clients keep diaries to record schema-triggering events and their emotional responses, which helps them identify and challenge dysfunctional thoughts.
- **Imagery Rescripting:** Patients are guided to revisit distressing memories and alter the outcome in their imagination to change the emotional response associated with those memories.
- **[Chair Work](https://positivepsychology.com/empty-chair-technique/):** Patients use two chairs to role-play different parts of themselves (e.g., the part influenced by a schema and the healthy adult part) to facilitate internal dialogues and resolve conflicts.

## Schema Psychotherapy Example

The following is a sample of how I might use schema psychotherapy in my practice. This example is fictitious and straightforward, but it should give you an idea of what schema-focused therapy is like and how it might be used.

#### Background Information

- **Client**: John, a 30-year-old male
- **Presenting Problems**: Chronic feelings of inadequacy, difficulties in relationships, and persistent depressive symptoms.
- **History**: John reports a history of emotional neglect and critical parenting during his childhood. He struggles with feelings of worthlessness and has a pattern of self-sabotage in both personal and professional settings.

#### Initial Assessment

During the initial assessment, I identified several maladaptive patterns that John appears to have developed:

1. **Defectiveness/Shame**: John believes he is inherently flawed and unlovable. He may not always think this consciously, but this underlying thought creates doubt and fear in social situations.
2. **Failure**: Despite evidence to the contrary in many areas of his life, John expects to fail in achieving his goals and to be inadequate compared to others.
3. **Emotional Deprivation**: John has people who care about him in his life, but no matter how much evidence there is to the contrary, he feels that others will never meet his emotional needs.

#### Schema Therapy Treatment Plan

1. **Psychoeducation**: 
    - I start schema-focused therapy by educating John about blueprints, their development, and their impact on thoughts, emotions, and behaviors.
    - I explain the goals of schema therapy, which include identifying and modifying maladaptive patterns.
2. **Schema Identification and Awareness**: 
    - Through discussions and schema psychotherapy exercises, John becomes aware of his patterns. He learns to recognize the situations that trigger them and the following emotions and behaviors.
3. **Cognitive Techniques**: 
    - I then help John challenge and reframe his maladaptive blueprints. For example, when John feels defective, he is encouraged to examine the evidence for and against this belief and to develop more balanced and realistic thoughts.
4. **Experiential Techniques**: 
    - Imagery rescripting: John is guided to visualize past situations where he felt emotionally deprived or criticized. In these visualizations, the therapist helps John to imagine alternative, more nurturing responses.
    - Chair work: John engages in dialogues with different parts of himself (e.g., the “critical parent” vs. the “vulnerable child”) to foster self-compassion and challenge internalized negative messages.
5. **Behavioral Pattern Breaking**: 
    - John and I identify specific behaviors that reinforce his frameworks. Together, we develop and practice new, healthier behaviors.
    - For instance, John practices assertiveness in his relationships to counteract his emotional deprivation blueprints, learning to express his needs and set boundaries.
6. [**Therapeutic Relationship**](https://dralanjacobson.com/types-of-therapy/): 
    - I provide a corrective emotional experience, offering consistent empathy, validation, and support. This helps John internalize a more positive and nurturing relationship model.

#### Schema Psychotherapy Outcome

Over time, John notices changes in his thoughts, feelings, and behaviors. He reports:

- Reduced intensity and frequency of feelings of worthlessness.
- Improved self-esteem and confidence in his abilities.
- Healthier relationships where he feels more comfortable expressing his needs.
- A more optimistic outlook on his future, with a willingness to take on new challenges.

John continues to work on maintaining these changes and preventing relapse by using the skills and techniques learned in schema psychotherapy.

## Schema Couples Therapy (SCT)

Schema Couples Therapy (SCT) is a therapeutic approach that integrates principles of schema psychotherapy with couples therapy including [premarital therapy](https://dralanjacobson.com/premarital-counseling/). In Schema Couples Therapy, these schemas are understood as playing a role in how individuals relate to one another within a romantic partnership, often leading to conflict and distress.

Here’s a breakdown of the main concepts and processes in Schema Couples Therapy:

### Key Concepts of Schema Couples Therapy

1. **Schemas**: These are enduring, negative beliefs or patterns that develop early in life based on unmet emotional needs. These might include abandonment, mistrust, defectiveness, or emotional deprivation. In couples, partners may trigger and exacerbate each other, leading to recurring conflicts.
2. **Modes**: A mode is a state or part of the self that a person shifts into when a schema is activated. Common modes include the “Vulnerable Child” mode, where one feels emotionally needy or abandoned, or the “Punitive Parent” mode, where one is overly self-critical. In couples, certain modes may interact in toxic patterns, like when one partner’s “Vulnerable Child” mode triggers the other’s “Detached Protector” mode, leading to feelings of abandonment and distance.
3. **Unmet Needs**: SCT therapy emphasizes understanding each partner’s unmet emotional needs, which could be needs for love, stability, validation, autonomy, or understanding. Recognizing and addressing these unmet needs in each other is essential to breaking the cycle of conflict.
4. **Maladaptive Coping Styles**: When patterns are triggered, individuals often respond in maladaptive ways, such as avoidance, surrender, or overcompensation. These coping styles may create repetitive, unhelpful interactions in relationships. For example, one partner might withdraw (avoidance) when feeling criticized, while the other responds by escalating (overcompensation) their demands for attention.

### Process of Schema Couples Therapy

SCT aims to help partners understand their own and each other’s schemas, recognize patterns, and find healthier ways to meet each other’s needs. Here’s a typical schema couples therapy process:

1. **Assessment**: In the initial sessions, I help each partner identify their core schemas, modes, and unmet needs. I do this through questionnaires, guided discussions, and exploring family history to understand where these patterns originated.
2. **Understanding Triggers and Patterns**: In SCT, I guide partners to work on identifying moments when their schemas and modes are triggered in the relationship, and how this contributes to conflict. For example, if one partner has an abandonment schema, they might interpret their partner’s need for space as rejection, leading to an emotional reaction that intensifies the conflict.
3. **Building Empathy and Compassion**: Schema Couples Therapy emphasizes building empathy for each other’s childhood experiences and unmet needs. Partners learn to see each other’s behaviors as expressions of underlying pain rather than intentional attacks, which fosters compassion and patience.
4. **Changing Maladaptive Patterns**: I guide the couple in practicing healthier ways to respond to needs, moving away from avoidance or escalation and towards open communication, validation, and nurturing. This process involves learning to express emotions and needs more constructively and to support each other in feeling secure and valued.
5. **Strengthening Positive Interactions**: In schema couples therapy, partners work on strengthening positive and nurturing aspects of the relationship. This may include engaging in meaningful activities together, fostering affection, and actively practicing mutual validation and care. The goal is to help each partner meet core emotional needs within the relationship.

### SCT Case Example: Sarah and Mike

**Background**: Sarah has an abandonment pattern due to her parents’ divorce and a tendency to feel rejected when her partner, Mike, is emotionally distant. Mike, on the other hand, has a mistrust pattern from a past betrayal in a relationship, making him withdrawn when he feels vulnerable.

**SCT Therapeutic Process**

This is a brief version of what happens in SCT.

- **Assessment**: Sarah recognizes her abandonment pattern, while Mike identifies his mistrust pattern that has [caused a fear of intimacy](https://dralanjacobson.com/fear-of-intimacy/). Together, they see how Sarah’s needs for reassurance and Mike’s withdrawal create a cycle of conflict.
- **Understanding Patterns**: When Sarah feels Mike pulling away, she becomes anxious and tries to pull him closer, which triggers his mistrust and leads him to shut down further.
- **Empathy Building**: With guidance, they explore each other’s backgrounds, learning that Sarah’s fears come from a deep-seated need for security and that Mike’s distance is not a rejection but a way to protect himself.
- **Changing Patterns**: Instead of pulling away, Mike practices staying engaged with Sarah when she’s anxious while Sarah works on expressing her fears without overwhelming Mike.
- **Strengthening Positive Interactions**: Their SCT homework is to start dedicating time for weekly “check-ins,” fostering an open dialogue that reinforces trust and security.

### Benefits of Schema Couples Therapy

- **Deeper Insight**: SCT helps partners understand each other’s emotional wounds and childhood origins of current behaviors.
- **Lasting Change**: By targeting core beliefs rather than surface behaviors, SCT aims for lasting change in relationship patterns.
- **Emotional Intimacy**: Partners learn to meet each other’s needs in a way that builds intimacy and reduces relational tension.
- **Conflict Resolution**: Couples can identify and address triggers constructively, reducing repetitive conflicts.

Schema Couples Therapy can be transformative for couples struggling with deep-seated relational patterns, fostering personal growth and relational resilience.

## Schema Therapy Research

Schema-focused therapy has been extensively researched and has shown effectiveness in treating a variety of psychological disorders, especially personality disorders. I prefer to use clinical techniques that have some experimental basis to show that they are effective. Below is an overview of some key research findings and studies in schema psychotherapy:

### Effectiveness for Borderline Personality Disorder

1. **Giesen-Bloo et al. (2006)**: 
    - Study: Compared schema therapy with transference-focused psychotherapy (TFP) in treating BPD.
    - Results: This method was more effective than TFP in reducing BPD symptoms and improving quality of life. Patients in the ST group showed higher rates of recovery (45% vs. 24% for TFP).
2. **Farrell, Shaw, & Webber (2009)**: 
    - Study: Investigated the effectiveness of schema therapy in a group format for BPD.
    - Results: Significant improvements in BPD symptoms, overall functioning, and reductions in self-harm behaviors were observed. The group format was found to be a feasible and effective delivery method.

Mechanisms of Change

1. [**Roediger, Stevens, & Brockman (2018)**](https://psycnet.apa.org/record/2018-30793-000): 
    - Study: Examined the mechanisms through which this method brings about change.
    - Results: Key mechanisms identified include cognitive restructuring, experiential techniques, and the therapeutic relationship. These components help patients understand and modify deep-seated maladaptive frameworks.

### Schema Therapy for [Chronic Depression](https://dralanjacobson.com/treating-major-depression/)

1. [**Renner et al. (2016)**](https://pubmed.ncbi.nlm.nih.gov/26780673/): 
    - Study: Investigated the effectiveness of schema psychotherapy for chronic depression.
    - Results: Schema-focused therapy led to significant reductions in depressive symptoms and improvements in quality of life. It was particularly effective for patients with comorbid personality disorders.

### Schema Therapy in Different Formats

1. **Reiss et al. (2014)**: 
    - Study: Evaluated the effectiveness of schema psychotherapy in individual and group formats.
    - Results: Both formats were effective, with group treatment providing additional benefits such as peer support and reduced feelings of isolation.

### Research on Specific Techniques

1. **Imagery Rescripting**: 
    - [Arntz et al. (2007)](https://pubmed.ncbi.nlm.nih.gov/18005935/): Found that imagery rescripting was effective in reducing symptoms of PTSD and other anxiety disorders by altering the emotional and cognitive impact of traumatic memories.
2. **Chair Work**: 
    - [Kellogg (2004)](https://psycnet.apa.org/record/2004-19522-012): Highlighted the efficacy of chair work in addressing maladaptive aptterns by allowing patients to confront and dialogue with different parts of themselves.

### Meta-Analyses and Reviews

1. [**Jacob & Arntz (2013)**](https://psycnet.apa.org/record/2012-34408-000): 
    - Review: Comprehensive review of schema-focused therapy research.
    - Findings: This approach consistently demonstrated effectiveness in treating personality disorders, chronic depression, and other complex psychological conditions.
2. [**Masley, Gillanders, Simpson, & Taylor (2012)**](https://pubmed.ncbi.nlm.nih.gov/22074317/): 
    - Meta-analysis: Examined the overall efficacy of schema psychotherapy.
    - Results: This approach was highly effective, particularly for personality disorders, with large effect sizes in symptom reduction and improvement in quality of life.

## Summary and My Work

[Schema therapy online](https://dralanjacobson.com/therapy-online-approaches-techniques-and-outcomes/) and in person has a robust evidence base supporting its efficacy for a variety of psychological disorders. It is effective in individual and group formats and employs [cognitive restructuring](https://positivepsychology.com/cbt-cognitive-restructuring-cognitive-distortions/), experiential methods, and a strong therapeutic relationship to facilitate change. Long-term studies suggest that the benefits are durable, and specific techniques like imagery rescripting and chair work are particularly effective. These are why I use this approach in my [integrated therapy](https://dralanjacobson.com/integrative-therapy/) practice, along with other “[third-wave treatments](https://dralanjacobson.com/third-wave-psychotherapy/)” like [compassion-focused therapy](https://dralanjacobson.com/compassion-focused-therapy/) and others such as [relational therapy](https://dralanjacobson.com/relational-therapy/).

Schema therapy is a powerful blend of different clinical approaches that can help people for whom specific [individual therapy](https://dralanjacobson.com/individual-therapy/) approaches have failed or difficulties have deep roots that are hard to access. Schema psychotherapy benefits clients motivated to change but stuck in their current situation. While I typically use schema-focused therapy with [individual clients](https://dralanjacobson.com/individual-therapy/), I occasionally use it in [couples therapy](https://dralanjacobson.com/couples-therapy/) when one person’s challenges are affecting the pair, and this is called schema couples therapy or SCT. If you feel this approach could be helpful for you, feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Schema Therapy FAQs:

### What is schema therapy, and how does it work?

Schema therapy is an integrative approach that combines elements of cognitive-behavioral therapy, psychoanalytic theory, attachment theory, and more, aiming to treat chronic mental health issues and personality disorders by addressing deeply ingrained patterns of thought and behavior called schemas.

### What are the main concepts of schema therapy?

The main concepts include schemas, which are ingrained thought patterns; maladaptive coping styles; modes, which are emotional states and responses experienced moment-to-moment; and core emotional needs like safety, love, autonomy, and spontaneity.

### What are the goals of schema therapy online?

The goals are to identify and understand maladaptive schemas, develop healthier coping strategies, and heal underlying issues by addressing unmet emotional needs, changing negative beliefs, and fostering healthier thinking and behavior.

### In what conditions is this therapy particularly effective?

Schema therapy is especially effective for personality disorders such as borderline personality disorder, as well as for treating chronic depression, anxiety disorders, eating disorders, and relationship difficulties.

### What techniques are used in schema therapy?

Schema therapy integrates techniques such as cognitive restructuring, experiential methods (e.g., guided imagery and chair work), behavioral techniques, diary recording, imagery rescripting, and role-playing to identify, challenge, and modify deep-seated patterns.

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 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Therapy Approaches

---

### [Creative Counseling: Deeper Insight and Added Healing Power](https://dralanjacobson.com/creative-counseling/)

**Published:** March 17, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Creative counseling, or creative therapy, is a therapeutic approach that integrates artistic and expressive techniques—such as music, art, drama, dance, and writing—into traditional counseling practices. Creative therapies allow clients to explore emotions, thoughts, and experiences in nonverbal or symbolic ways, making it especially helpful for individuals who struggle with traditional [types of therapy](https://dralanjacobson.com/types-of-therapy/). While I do not offer Creative Arts Therapy as a primary approach, I do mix its methods with many of the techniques I use, including [Acceptance and Commitment Psychotherapy](https://dralanjacobson.com/act-psychotherapy/) (ACT), Gestalt, [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/), [Positive Psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/), and other holistic approaches.

I believe healing and growth emerge from structured reflection and expressive therapy. Traditional talk therapy offers invaluable cognitive insights, but emotions and experiences reside beyond words for many people. By incorporating creative counseling into my [integrative practice](https://dralanjacobson.com/integrative-therapy/)—through art, movement, storytelling, and metaphor—you can access deeper layers of self-awareness, process emotions in nonverbal ways, and cultivate resilience. My approach is grounded in the belief that each person’s journey is unique, and therapy should honor their strengths, values, and ways of making meaning.

## Creative Counseling Overview ![Creative counseling and creative therapy](https://dralanjacobson.com/wp-content/uploads/2025/03/music-294x300.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Creative counseling is an approach that integrates expressive arts and related techniques into therapy to help individuals process emotions, navigate challenges, and foster personal growth. Unlike traditional talk therapy, creative counseling allows individuals to communicate and explore feelings in nonverbal or symbolic ways, which can be especially useful for those who struggle with verbal expression. It is often a core part of [personal counseling](https://dralanjacobson.com/personal-growth-counseling/), especially for those who enjoy creative expression.

### How Is Creative Counseling Used?

Creative counseling can be tailored to each individual’s needs and preferences, interwoven . Below are some commonly used methods:

1. **Expressive Therapy Using Art**

- **How It Works**: Clients use drawing, painting, sculpting, or collage-making to express emotions, thoughts, and subconscious feelings.
- **Uses**: Helps process trauma, reduce anxiety, improve self-awareness, and promote emotional healing.
- **Example Exercise**: Creating a “[Feelings Mandala](https://www.therapistaid.com/therapy-worksheet/mandalas)” to represent different emotions through colors and shapes.

2. **Music Therapy**

- **How It Works**: Clients listen to, create, or move to music as a way to express themselves and regulate emotions.
- **Uses**: Helps with emotional regulation, relaxation, self-expression, and memory recall.
- **Example Exercise**: Identifying songs that reflect emotions and discussing their personal meaning.

3. **Drama Therapy**

- **How It Works**: Uses role-playing, storytelling, and improvisation to help individuals process experiences and explore different perspectives.
- **Uses**: Helps build confidence, process trauma, and practice social interactions.
- **Example Exercise**: Reenacting a difficult life experience in a safe environment to gain new insights.

4. **Dance/Movement Therapy**

- **How It Works**: Clients use movement and body awareness to express emotions and release tension.
- **Uses**: Helps individuals process emotions stored in the body, increase self-confidence, and develop coping strategies.
- **Example Exercise**: “Emotion in Motion,” where clients use movement to express different emotions without words.

5. **Writing Therapy**

- **How It Works**: Journaling, poetry, storytelling, or letter writing is used as a form of self-expression and emotional exploration.
- **Uses**: Helps with processing grief, reducing stress, and improving emotional clarity.
- **Example Exercise**: Writing a letter to one’s past or future self to reflect on growth and change.

### Who Benefits Most from Creative Counseling?

Creative counseling can be particularly beneficial for individuals who:

- **Struggle with verbal communication** – Such as neurodivergent individuals (ADHD, autism), young children, or those processing trauma.
- **Experience anxiety, depression, or PTSD** – For example, [therapeutic forgiveness](https://dralanjacobson.com/forgiveness-therapy-steps-and-integrations/) through creative expression can serve as an emotional outlet and a form of self-regulation.
- **Have difficulty identifying or expressing emotions** – Using art, music, or movement can help bring subconscious emotions to the surface.
- **Prefer hands-on or experiential learning** – Those who find traditional talk therapy limiting may engage more fully with creative methods.
- **Are in high-stress or emotionally demanding careers** – Such as healthcare workers, artists, or educators who need outlets to process emotions.

## Case Example: Using Expressive Therapy with a College Student

- **Name**: Sarah
- **Age**: 20
- **College Major**: Psychology
- **Presenting Issues**: Anxiety, academic stress, social isolation
- **Background**: Sarah is an introverted college sophomore struggling with anxiety related to academic pressure and social interactions. She often feels overwhelmed but has difficulty expressing her emotions in words. I had been providing ACT and Narrative Therapy with Sarah, but we took a therapeutic detour so I could use some creative therapy techniques with her.

### Therapeutic Approach Using Expressive Therapy

**Session 1: Introduction to Creative Arts Therapy**

- I introduced Sarah to creative arts therapy, explaining that she doesn’t need to be “good” at art—it’s about self-expression, not skill.
- **Creative Therapy Activity**: “Emotion Colors” 
    - Sarah is asked to select colors that represent different emotions she feels throughout the week.
    - She then creates an abstract painting, blending the colors in ways that feel natural to her.
- **Reflection**: After finishing, Sarah discusses how certain colors represent stress, calmness, or excitement. She notices that dark colors dominate, revealing the weight of her anxiety.

**Session 2: Exploring Stress Through Visual Metaphor**

- **Activity**: “The Mountain and the Storm” 
    - Sarah is asked to draw a mountain (herself) and a storm (stressors in her life).
    - She illustrates exams as dark clouds, deadlines as lightning, and social pressure as wind trying to push her over.
- **Reflection**: I help Sarah identify which stressors feel strongest and discusses strategies for staying “grounded” like the mountain.
- **Outcome**: Through creative arts therapy, Sarah gains a visual representation of how stress affects her and begins brainstorming coping strategies.

**Session 3: Strengths and Self-Compassion**

- **Activity**: “Self-Portrait with a Twist” 
    - Instead of a literal self-portrait, Sarah creates a collage representing her strengths and resilience.
    - She cuts out images, words, and symbols that reflect her determination, creativity, and personal growth.
- **Reflection**: I encourage Sarah to see her progress and self-worth beyond academic achievements.

### Expressive Therapy Impact

- **Increased Emotional Awareness**: Sarah now identifies stressors more clearly.
- **Alternative Coping Tools**: Art becomes a nonverbal way for Sarah to process emotions.
- **Improved Self-Esteem**: The collage exercise helps her recognize strengths she had overlooked.

### Conclusion

By incorporating creative arts therapy, Sarah found a less intimidating way to process emotions, making her college experience feel more manageable. Over time, she became more comfortable expressing herself, both visually and verbally, leading to reduced anxiety and better emotional regulation.

## Case Example: Using Creative Therapy for a Career Transition

- **Name**: David
- **Age**: 38
- **Occupation**: Former marketing manager, exploring a career change
- **Presenting Issues**: Uncertainty, fear of failure, identity loss, stress
- **Background**: David worked in marketing for 15 years but recently left his job due to burnout. He is considering a career in a different field but feels lost and unsure about his future direction. While [logotherapy](https://dralanjacobson.com/logotherapy/) and [gestalt therapy](https://dralanjacobson.com/gestalt-therapy/) were my primary approaches, we decided to use some creative therapies to get him unstuck.

### Therapeutic Creative Therapy Approach

**Session 1: Identifying Emotions Through Art**

- **Creative Therapy Activity**: “Inner Landscape” 
    - David is asked to create an abstract drawing of his current emotional state using colors, shapes, and symbols.
    - His artwork includes a lot of chaotic lines and contrasting colors, representing confusion and inner conflict.
- **Reflection**: I help David explore how the different elements reflect his emotions about leaving his job and stepping into the unknown.

**Session 2: Visualizing the Future**

- **Creative Therapy Activity**: “The Two Paths” 
    - David draws two different paths: one representing staying in his current career and another representing a potential new career.
    - He fills each path with symbols, words, and colors that represent how he envisions those choices.
- **Reflection**: This exercise helps David externalize his fears and hopes, allowing him to compare the emotional weight of each choice.
- **Outcome**: David realizes that while staying in marketing feels “safe,” it also looks gray and uninspiring, while the creative career, though uncertain, feels vibrant and exciting.

**Session 3: Strengths and Career Identity**

- **Creative Therapy Activity**: “Personal Strength Collage” 
    - David collects images, words, and textures from magazines to create a collage that represents his skills, passions, and personal values.
- **Reflection**: By assembling this visual representation, David begins to see how his past experiences and strengths can support his transition into a new career.
- **Outcome**: He identifies common themes—creativity, communication, and leadership—that reassure him he’s not starting from scratch.

### Therapeutic Impact

- **Increased Clarity**: David gains insight into what he truly wants from his next career.
- **Reduced Fear**: By visualizing his strengths and future possibilities, he feels more empowered to take steps forward.
- **Emotional Processing**: The artistic exercises help David process the loss of his old career identity while embracing a new path.

### Conclusion and Outcomes

Art therapy helped David externalize and explore his emotions, allowing him to approach his career transition with greater confidence and self-awareness. By using creative expression, he was able to process fear, identify strengths, and visualize a future aligned with his passions.

## The Power of Creative Therapies

Creative arts therapy harnesses the power of artistic expression to facilitate emotional healing, personal growth, and self-discovery. By engaging in activities like art, music, movement, drama, and writing, you can access deep emotions, process trauma, and develop new ways of understanding yourself. Unlike traditional talk therapy, creative therapies provide a nonverbal and experiential path to healing.

### Why is Creative Counseling So Effective?

1. **Accessing the Subconscious Mind**

Creative therapies allow individuals to express emotions and thoughts that may be difficult to articulate. Through artistic expression, the [subconscious mind](https://en.wikipedia.org/wiki/Subconscious) is engaged, revealing hidden fears, desires, and patterns that might not emerge in verbal discussions.

🔹 *Example*: A client struggling with unresolved grief may unknowingly depict their feelings in an abstract painting before recognizing their emotional blockages.

2. **Reducing Stress and Anxiety**

Engaging in creative activities triggers the relaxation response, reducing stress hormones like [cortisol](https://en.wikipedia.org/wiki/Cortisol). Creating art, listening to music, or engaging in movement-based therapy can induce a meditative state, lowering anxiety and promoting calmness.

🔹 *Example*: A college student overwhelmed by academic pressure may use journaling or expressive painting as a way to release tension and gain emotional clarity.

3. **Enhancing Emotional Regulation**

Creative therapies provide a safe space to explore and express emotions without judgment. This helps individuals learn to regulate their emotions in a healthier way, improving overall mental well-being.

🔹 *Example*: A person with PTSD may find relief in creative arts therapy using dance and movement to process trauma stored in the body and regain a sense of control.

4. **Encouraging Personal Growth and Identity Exploration**

Artistic expression fosters self-reflection, helping individuals understand who they are, what they value, and where they want to go in life. This is particularly useful during life transitions, such as career changes, personal loss, or identity struggles.

🔹 *Example*: A midlife professional considering a career change might use vision boards and creative writing to explore new possibilities and reconnect with passions.

5. **Promoting Neurodiversity-Inclusive Healing**

Creative therapies are particularly beneficial for neurodivergent individuals, such as those with ADHD or autism, who may experience challenges with verbal communication or traditional therapeutic approaches. Engaging in hands-on, sensory-based therapies allows for self-expression in a way that feels natural and comfortable.

🔹 *Example*: An autistic adult who struggles with verbalizing emotions may use creative arts therapy using music to convey feelings through sound rather than words.

### Different Forms of Creative Therapies and Their Benefits

1. **Expressive Therapy Using Art**

- Helps process trauma and grief
- Enhances self-awareness and emotional expression
- Encourages problem-solving through visual metaphors

2. **Expressive Therapy Using Music**

- Reduces stress and anxiety through sound healing
- Enhances emotional release and memory recall
- Encourages social connection in group settings

3. **Creative Therapy Using Drama**

- Provides a safe space for exploring emotions through storytelling
- Helps with role-playing difficult conversations or traumatic events
- Strengthens communication and self-confidence

4. **Creative Therapy Using Dance/Movement**

- Encourages emotional expression through body movement
- Helps process trauma and release stored emotions
- Improves body awareness and self-confidence

5. **Expressive Therapy Using Writing**

- Provides a structured way to process thoughts and emotions
- Helps with self-reflection and cognitive processing
- Supports individuals in reframing traumatic experiences

### The Transformational Impact of Creative Counseling

**Creative Arts Therapy Heals Trauma** – Allows for nonverbal processing of deep-seated pain.
**Creative Arts Therapy Fosters Resilience** – Encourages problem-solving and self-discovery.
**Many Creative Therapies Encourage Playfulness** – Promotes joy and exploration as a healing tool.
**Creative Therapies Empowers Individuals** – Helps clients find their own voice and strengths.

Creative therapies are not just about making art—they are about making meaning. They provide a pathway to healing that embraces expression, transformation, and the unique journey of each individual.

## Conclusion

Expressive therapy is not just about resolving distress—it is about fostering a life that feels rich, authentic, and aligned with one’s deepest values. By weaving together evidence-based approaches like ACT, Gestalt, [Logotherapy](https://dralanjacobson.com/logotherapy/), and Positive Psychology with the power of creative expression through creative arts therapy, I give people tools for emotional regulation and opportunities for personal transformation. Creative therapies allow individuals to rewrite narratives, reconnect with their strengths, and embrace uncertainty with curiosity rather than fear, whether through storytelling, art, or embodied movement. Healing is not just about finding answers—it is about discovering new ways to experience and engage with life.

If you have any questions about this approach or the creative therapy techniques in this post, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Life Therapists: A Powerful Hybrid of Life Coach and Therapist](https://dralanjacobson.com/life-therapists/)

**Published:** June 25, 2025
**Author:** Dr. Alan Jacobson

**Content:**

People often seek out support to help them navigate challenges, transitions, and aspirations. But with so many helping professionals available, one common question arises: What’s the difference between a life coach and a therapist? While both aim to help individuals lead more fulfilling lives, their methods, qualifications, and areas of focus are quite distinct. This article provides a clear breakdown of the difference between a life coach vs. a therapist in terms of training, goals, scope of practice, and ethical responsibilities. It also explores a growing hybrid model, Life Therapists, who blend therapy and coaching, which offers an integrated path toward both healing and self-actualization. Whether you’re seeking support for mental health, personal growth, or transition, understanding these distinctions can help you choose the right kind of guidance for your journey.

### Difference Between a Life Coach and a Therapist ![Life therapy and life therapists](https://dralanjacobson.com/wp-content/uploads/2025/06/The-road-less-travelled-300x157.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

The primary difference between a life coach and a therapist lies in their training, goals, and scope of practice. Here’s a clear breakdown:

#### Therapist (Mental Health Professional)

**Primary Focus:**
Healing emotional pain, treating mental health conditions, and helping people function better.

**Training & Credentials:**

- Master’s or doctoral degree in psychology, counseling, social work, or psychiatry.
- Licensed by the state (e.g., LMFT, LCSW, LPC, PhD, PsyD, MD).
- Required to follow ethical and legal standards (HIPAA, [mandated reporting](https://www.verywellmind.com/what-is-mandated-reporting-5206106), etc.).

**Typical Goals:**

- [Treat anxiety and depression](https://dralanjacobson.com/therapy-for-depression-and-anxiety/), trauma, grief, or personality disorders.
- Explore past experiences, particularly those from early life or family issues.
- Improve psychological functioning and relationships.
- [Therapy for burnout](https://dralanjacobson.com/burnout-therapy/) and other occupational stressors

**[Therapy Methods](https://dralanjacobson.com/types-of-therapy/) May Include:**

- [Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT)
- [Psychodynamic Therapy](https://dralanjacobson.com/psychodynamic-therapy/)
- [EMDR](https://www.emdr.com/what-is-emdr/), [DBT](https://dralanjacobson.com/dbt-for-teens/), [Mindfulness-based therapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/)
- [Family treatment](https://dralanjacobson.com/family-therapy/) or [couples therapy](https://dralanjacobson.com/couples-therapy/)
- For couples, [relational life therapy](https://dralanjacobson.com/relational-life-therapy-rlt/)
- [Tree of Life Therapy](https://dralanjacobson.com/tree-of-life-therapy/)

#### Life Coach

**Primary Focus:**
Helping individuals set and achieve personal or professional goals, increase motivation, and improve satisfaction.

**Training & Credentials:**

- No standardized or required credentials (but many are certified through programs like [ICF](https://coachingfederation.org/)).
- Not a licensed mental health professional.
- Cannot diagnose or treat mental health conditions.

**Typical Goals:**

- Career changes, time management, and balance
- Confidence-building, communication skills
- Goal-setting, accountability, and motivation
- [Navigating life transitions](https://dralanjacobson.com/life-transitions-therapy/) (e.g., new job, divorce, moving)

**Methods May Include:**

- [Motivational interviewing](https://dralanjacobson.com/motivational-interviewing/)
- Future-focused planning and visualization
- Productivity tools and strategies
- Weekly check-ins and progress tracking

#### Difference Between a Life Coach and a Therapist: Summary

**Aspect****Therapist****Coach****Credentials**Licensed mental health professionalCertification (optional)**Focus**Mental health & emotional healingPersonal development & goal setting**Can Diagnose?**YesNo**Can Treat Disorders?**Yes (e.g., depression, anxiety)No**Insurance Eligible?**Often, yesRarely**Time Orientation**Past & presentPresent & future**Regulations**Highly regulatedLoosely regulated#### Difference Between a Life Coach and a Therapist: Example

- A **therapist** helps a client heal from childhood trauma and manage anxiety.
- A **life coach** helps a client clarify their values and create a plan to transition into a new career.

If you’re trying to decide between a life coach vs. a therapist, here’s a quick guide:

- Choose a **therapist** if you’re dealing with mental health issues, trauma, or distress.
- Choose a **coach** if you’re generally functioning well but want help achieving your goals or improving your performance.

## Life Therapists: Life Coach and Therapist

**Some professionals are both therapists and certified coaches**, offering a unique blend of services. These individuals typically hold a **license to practice therapy** (e.g., LPC, LCSW, LMFT, PsyD, PhD) **and have completed additional training in coaching**, often through programs like the **[International Coach Federation](https://coachingfederation.org/) (ICF)** or similar organizations.

### Advantages of Seeing Someone Who Is Both a Therapist and a Life Coach

1. **Greater Flexibility in Services**

- Can address **both mental health needs** (e.g., anxiety, trauma, emotional regulation) **and performance goals** (e.g., career changes, confidence-building).
- Able to **adapt the approach** based on what you need in the moment, whether deep emotional work or practical, action-oriented coaching.

2. **Seamless Transition from Healing to Growth**

- If you’re recovering from stress, burnout, or trauma, this dual-trained professional can **guide you into the next phase of growth** without needing to change providers.
- You don’t have to “start over” with someone new when you’re ready to shift from therapy to coaching.

3. **Expertise in Boundaries and Ethics**

- Licensed therapists are trained to **maintain clear boundaries**, protect confidentiality, and **know when therapy is needed over coaching,** and vice versa.
- They are **legally accountable** to professional boards and [ethical guidelines](https://www.apa.org/ethics/code).

4. **Deeper Insight and Tools**

- Can integrate [**evidence-based clinical tools**](https://www.hopkinsmedicine.org/evidence-based-practice/model-tools) (like CBT, EMDR, or [trauma-informed approaches](https://dralanjacobson.com/trauma-informed-care/)) **with motivational coaching techniques** (like goal-setting, visualization, and accountability).
- More likely to recognize and **appropriately respond to underlying mental health concerns** that a traditional coach might miss.

5. **Efficiency and Continuity**

- Rather than working with two separate providers, you can **receive integrated support through a single relationship**.
- Saves time and offers a more holistic experience.

### Things to Clarify Before Starting with Life Therapists

- Ask whether the provider functions as a therapist, a coach, or both. Some will separate their services (e.g., they might only offer coaching to out-of-state clients if they’re licensed in one state).
- **Therapy is regulated by state licensure** and health laws; coaching is not. When receiving coaching, you are **not under a medical or clinical care agreement** unless it’s made explicit.
- **Insurance generally doesn’t cover coaching**, even from a therapist.

### Example Scenario

A provider who is a licensed psychologist and a certified life coach:

- When working with someone with high-functioning anxiety, the therapist might use CBT and emotional regulation techniques to reduce anxiety symptoms (therapy).
- Later, when the client is ready, the therapist shifts to helping them set boundaries at work, build confidence, and pursue a leadership role (coaching).

## Who Are Life Therapists and How Are They Trained?

The term **“Life Therapist”** is not a formally licensed or standardized professional title, such as “[clinical psychologis](https://dralanjacobson.com/what-is-a-clinical-psychologist/)t” or “licensed professional counselor.” Instead, it is an umbrella term often used by professionals who blend [**psychotherapy**](https://dralanjacobson.com/psychotherapy/), **life coaching**, and **personal development** strategies to help clients live more fulfilled, purposeful lives. Life Therapists (or [personal growth counselors](https://dralanjacobson.com/personal-growth-counseling/)) focus not only on healing emotional distress but also on helping clients identify values, clarify goals, and create meaningful change in various life domains, such as career, relationships, health, and self-growth.

### How do Life Therapists Start?

Most practitioners who describe themselves as Life Therapists come from one of the following backgrounds:

- **Licensed mental health professionals**, such as: 
    - [Psychologists](https://locator.apa.org/) (PhD or PsyD)
    - [Licensed Clinical Social Workers](https://www.verywellmind.com/licensed-clinical-social-worker-3145146) (LCSW)
    - Licensed Professional Counselors (LPC)
    - [Marriage and Family Therapists](https://www.aamft.org/AAMFT/LEARN_About_MFTs/default.aspx) (LMFT)
    - [Psychiatric Nurse Practitioners](https://my.clevelandclinic.org/health/articles/psychiatric-nurse-practitioner-pmhnp) (PMHNPs)
- **Life coaches with advanced training** who also have a background or certification in counseling or psychology
- [**Integrative therapists**](https://dralanjacobson.com/integrative-therapy/) who combine psychotherapy with holistic approaches such as mindfulness, spirituality, health coaching, or somatic practices
- **Retired or non-traditional therapists** who no longer maintain licensure but still offer guidance in a therapeutic or coaching capacity (often clearly labeled as non-clinical)

### Training Pathways for Life Therapists

There is no single training path for Life Therapists, but most professionals follow one of two routes:

1. **Clinical Route (Licensed Professionals)**

These clinicians complete:

- A graduate degree in psychology, counseling, or social work (e.g., MSW, MA in Counseling, PsyD)
- State licensure requirements, including supervised clinical hours and board exams
- Continuing education in specific life therapy modalities, such as: 
    - [Positive Psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/) (e.g., certification from the Flourishing Center or UPenn’s Positive Psychology Center)
    - Cognitive-Behavioral Therapy (CBT) and [Acceptance and Commitment Therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) (ACT)
    - Meaning-Centered Therapy or [Logotherapy](https://dralanjacobson.com/logotherapy/)
    - Integrative or holistic therapy approaches
    - Personal planning and coaching skills

They may then choose to brand their services under the “Life Therapy” model, often offering both traditional and future-focused, strengths-based work.

2. **Coaching-Integrated Route (Non-Licensed Professionals)**

Some Life Therapists identify more as life coaches with therapeutic training and may pursue:

- A coaching certification (e.g., through the International Coach Federation \[ICF\])
- Training in positive psychology, behavior change, motivational interviewing, or mindfulness
- Coursework or certification in [Life Review Therapy](https://dralanjacobson.com/life-therapy/), Logotherapy, Relational Life Therapy, or integrative wellness
- Supervised mentorship or practical experience with a focus on goal-setting, values work, and personal growth

While these practitioners do not diagnose or treat mental disorders, they can be valuable resources for clients who are not in acute psychological distress but seek structured support and growth.

#### Key Skills and Competencies

Regardless of background, most Life Therapists are trained in:

- Active listening and empathic communication
- Strengths-based and solution-focused strategies
- Motivational interviewing and goal planning
- Values clarification and narrative reframing
- Integration of CBT and mindfulness principles
- Ethical practice and clear boundaries between coaching and therapy

### Life Therapists’ Credentialing and Ethics

If a Life Therapist is a licensed mental health professional, they are held to the ethical standards of their licensing board. If they are working as a coach or unlicensed counselor, they are typically guided by the ethics of their certification body (like ICF) and must avoid offering mental health treatment outside their scope.

Life Therapy is a holistic and integrative therapeutic approach that emphasizes helping individuals align their lives with meaning, purpose, and personal values. Developed in the late 20th and early 21st centuries, Life Therapy draws from a fusion of humanistic psychology, existential therapy, cognitive-behavioral strategies, and mindfulness-based practices. While it is not a rigidly defined or trademarked modality like CBT or DBT, the term “[Life Therapy](https://dralanjacobson.com/life-therapy/)” is often used by practitioners who seek to provide guidance that is both therapeutic and coaching-oriented. It emerged in response to a growing demand for therapy that not only addresses pathology but also promotes flourishing, life satisfaction, and practical growth.

Life Therapy often shares conceptual roots with the work of [**Carl Rogers**](https://en.wikipedia.org/wiki/Carl_Rogers) (person-centered therapy), [**Viktor Frankl** ](https://en.wikipedia.org/wiki/Viktor_Frankl)(logotherapy), and modern **positive psychology**, particularly the contributions of [**Martin Seligman** and **Mihaly Csikszentmihalyi**](https://positivepsychology.com/founding-fathers/). It also includes Life Review Therapy started by [Dr. Robert Butler](https://en.wikipedia.org/wiki/Robert_N._Butler).

### Who Is It Best For

[Life Therapy](https://dralanjacobson.com/quality-of-life-therapy/) is particularly beneficial for individuals who:

- Are seeking greater purpose or meaning in their lives
- Feel “stuck” or are navigating transitions (career changes, divorce, midlife crises)
- Do not meet criteria for a mental health diagnosis but still experience emotional discomfort, dissatisfaction, or decision paralysis.
- Prefer a collaborative, strengths-based, future-oriented approach.
- Are interested in therapy that blends traditional counseling with coaching

It is also effective for individuals who are high-functioning but want to optimize their emotional well-being, goal-setting, and self-awareness.

### Techniques Used

Life Therapy is flexible and eclectic, but common techniques include:

1. [**Values Clarification**](https://positive4mind.com/resources/pdf/values-clarification.pdf): Clients identify and prioritize their core values to guide future decisions using a [values clarification process](https://dralanjacobson.com/values-clarification-therapy/).
2. [**Narrative Reframing**](https://psychology.tips/narrative-therapy-techniques/): Clients explore the story they tell about themselves and reshape it in empowering ways.
3. **Existential Dialogue**: Discussions that explore meaning, freedom, responsibility, and authenticity.
4. **Goal Setting and Action Plans**: Drawing on coaching principles, therapists help clients set specific, measurable, and attainable goals.
5. **Mindfulness and Present-Centered Practices**: Techniques to promote self-awareness, reduce stress, and focus attention on what matters most.
6. [**Cognitive Restructuring**](https://dralanjacobson.com/cognitive-restructuring/): Identifying and challenging limiting beliefs or maladaptive thought patterns.
7. **Life Review or Timeline Work**: Reflecting on past experiences to better understand one’s identity and growth trajectory.

### Outcomes

Clients engaged in [life psychotherapy](https://dralanjacobson.com/quality-of-life-therapy/) often report:

- Increased clarity about direction and decisions
- Improved self-esteem and emotional resilience
- A stronger sense of meaning and purpose
- Reduced anxiety or depression related to existential concerns
- More satisfying relationships and work-life alignment
- Greater confidence in navigating transitions

Since it is not a disorder-driven approach, success is typically measured not just by symptom reduction but by increases in life satisfaction, goal attainment, and personal fulfillment.

### Case Example

**Case: Anna, a 47-Year-Old Marketing Executive in Transition**

Anna sought treatment after experiencing burnout in her career. Although financially successful, she reported feeling “empty” and questioned whether her work had any real meaning. She did not meet criteria for depression or anxiety, but she expressed a persistent low-grade dissatisfaction and a fear that she had “wasted her life climbing the wrong ladder.”

Through treatment, Anna worked with a therapist to clarify her values using structured exercises. She discovered that creativity, authenticity, and service were core to her identity, yet her current role prioritized status and financial metrics over these values. With this insight, she engaged in narrative therapy techniques to reframe her life story, not as a failure to find purpose, but as a journey of discovering what truly matters. She also set structured goals to transition into consulting and eventually launched a project that helped mentor younger professionals.

After eight months, Anna reported feeling more energized, peaceful, and confident. She said the therapy had not only reduced her stress but fundamentally changed how she views her time, relationships, and future.

### Life Therapists and Therapy Conclusion

Life Therapy provides a unique space for individuals to engage in profound personal exploration, goal-setting, and aligning their values. By blending elements of psychotherapy and coaching, it serves individuals who seek not just to manage mental health concerns, but to live more intentional, meaningful lives. It is especially well-suited for those facing pivotal transitions or seeking to recalibrate their path toward greater authenticity and fulfillment.

## Q & A

### Q: Do I need a life coach or a therapist?

**A:** It depends on your goals. If you’re struggling with anxiety, depression, trauma, or other mental health concerns, a licensed therapist is the right choice. They are trained to diagnose and treat psychological disorders. On the other hand, if you’re feeling stuck, unmotivated, or want to improve specific areas of your life (like career or relationships), a coach can help you set goals and create actionable steps. Some people benefit from working with both, depending on their needs. The question of life coach vs. therapist may not always be straightforward, so it may be best to find a life therapist who combines both.

### Q: What is a life coach vs. a therapist?

**A:** A **therapist** (LPC, LCSW, LMFT, PsyD, etc.) focuses on healing emotional distress, working through past experiences, and improving psychological well-being. They are licensed professionals with advanced clinical training. A **coach** helps individuals set and achieve their personal or professional goals. Coaches do not treat mental illness and are not required to have specific credentials, although many complete certification programs.

### Q: Is a life coach a therapist?

**A:** No. While both roles involve helping people improve their lives, a coach is not a therapist. Therapists are licensed to diagnose and treat mental health conditions; coaches are not. Coaches may be excellent motivational guides, but they cannot legally or ethically provide therapy unless they are also licensed professionals.

### Q: What is a love life therapist?

**A:** A “love life therapist” typically refers to a licensed therapist or coach who specializes in romantic relationships, dating, and intimacy. If you’re struggling with patterns in romance, difficulty connecting with others, or recovering from past relationship trauma, a licensed therapist trained in relationship issues can help. A relationship coach may also assist with dating strategies or confidence, but again, not with mental health treatment.

## Summary and Conclusion

“Life Therapists” are usually highly trained professionals, often licensed therapists or coaches, who integrate evidence-based therapy, positive psychology, and coaching to help clients build more meaningful, values-driven lives. While there is no single training program or credential for this title, most Life Therapists bring a combination of clinical expertise, coaching techniques, and personal development tools to their practice. Clients seeking a Life Therapist should look for transparency about the practitioner’s credentials, scope of practice, and approach to ensure a good fit for their needs. A subset of life therapy is [personal growth counseling](https://dralanjacobson.com/personal-growth-counseling/), which focuses on setting and reaching goals related to bringing new levels of contentment and growth.

If you would like more information about life therapists or a life coach vs. a therapist, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult#services/service).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Types of Therapy

---

### [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/)

**Published:** November 4, 2023
**Author:** Dr. Alan Jacobson

**Content:**

**Narrative therapy** is an approach to psychotherapy that focuses on the stories or narratives people construct about their lives. I use this approach [in my work](https://dralanjacobson.com/types-of-therapy/) with individuals, [couples](https://dralanjacobson.com/couples-therapy/), and families. Narrative therapy interventions were developed in the 1980s by [Michael White and David Epston](https://exploringyourmind.com/michael-white-and-david-epston-the-pioneers-of-narrative-therapy/). They are based on the idea that people’s problems and identities are shaped by the stories they tell themselves and others. Narrative therapy techniques aim to help individuals reframe and reauthor these stories in a way that empowers them and allows them to move toward their preferred outcomes.

I use narrative therapy as a primary approach and also as an adjunct to [other therapeutic approaches](https://dralanjacobson.com/types-of-therapy/). It can be used with [families with older children](https://dralanjacobson.com/family-therapy/), as[ narrative therapy for couples](https://dralanjacobson.com/couples-therapy/), and even with coworkers in some circumstances. I also use it with some specialties, such as executive coaching and [sports psychology](https://dralanjacobson.com/sports-psychology/).

## Critical Principles of Narrative Therapy

This approach has specific principles that make it effective. The following are the keys to using narrative therapy techniques:

### Narrative Therapy Externalizes Problems

Instead of seeing problems as inherent within the individual, narrative therapy interventions help individuals externalize their issues by separating them from their identity. This can help people see their problems as separate entities that they can address and change.

### Deconstructing Dominant Narratives

In my work, I encourage clients to examine and challenge the dominant cultural and societal stories that may influence their self-perceptions and values. I then work with them to create alternatives highlighting their strengths, values, and preferred identities. This process can help clients find new ways of understanding themselves and their problems.

### Narrative Therapy and Unique Outcomes

Narrative therapy recognizes that each person’s experience is unique. The therapist helps clients explore their unique perspectives and experiences. My job is to act as an “external witness” who listens without judgment and provides a safe space for clients to share their stories. This helps my clients feel heard and validated.

### The Importance of Collaboration

In narrative therapy, you and I collaborate in the therapeutic process, with you taking an active role in shaping your life story. I am careful not to interject my opinions so my clients can explore their stories without judgment and interference.

As you can see, narrative therapy is a [humanistic approach](https://dralanjacobson.com/humanistic-psychology/) and can be easily combined with some of my other treatment approaches.

## Narrative Therapy Process

Narrative therapy techniques are often interwoven with other [humanistic methods](https://dralanjacobson.com/humanistic-psychology/), usually involving the following processes:

### Scaffolding in Narrative Therapy Interventions

Narrative therapy interventions often involve therapeutic documents, such as letters, journals, or certificates. These help clients articulate and reinforce their preferred story. Much of this work is done as homework outside of sessions. This way, the self-exploration often continues well after therapy ends.

We’ll pay attention to the stories that are not being told, as these may hold vital information. I Encourage individuals to explore aspects of their experience that they might be overlooking or neglecting.

### Mapping Influence in Narrative Therapy

We may create a visual representation of the relationships between different aspects of your life and their influence on each other. This can help you gain insights into the complexity of their experiences. We might use the popular [Tree of Life exercise](https://dralanjacobson.com/tree-of-life-therapy/) in this step.

### Reflective Questioning

I use open-ended and reflective questions to encourage individuals to explore their stories deeply, which can help them gain new perspectives and insights.

It’s important to note that narrative therapy interventions are a collaborative and non-pathologizing approach, meaning they don’t label individuals as “broken” or “disordered.” Instead, they focus on exploring personal narratives and the co-construction of alternative, more empowering stories. My job is to create a safe and respectful space for clients to explore and reshape their stories.

## Narrative Therapy Uses

I use narrative therapy to address a variety of personal and emotional challenges. The focus is on helping individuals reframe their life stories and narratives in a more empowering way and align them with their values. Here are some common issues for which I choose this approach:

### Narrative Therapy Interventions and Depression

Narrative therapy interventions can help individuals challenge and change the negative and self-defeating narratives that often accompany depression. People can improve their mental and emotional well-being by creating new, more positive stories about their lives. These techniques often pair well with [cognitive behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/), reducing irrational and exaggerated thoughts based on the stories.

### Narrative Therapy and Anxiety

I use this approach to help individuals reframe and reduce anxiety. This therapy helps them explore stories that contribute to their anxious thoughts and behaviors. Again, [cognitive behavioral therapy](https://dralanjacobson.com/cbt-for-depression/) is often mixed in to address the thinking leading to uneasy thoughts.

### Narrative Therapy and Trauma

Individuals can process and make sense of [traumatic experiences using nattative therapy](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/). By giving people the opportunity to construct new stories, they can find ways to heal and move forward from their trauma. This approach is often paired with a trauma-specific process such as [Eye movement desensitization](https://www.emdr.com/what-is-emdr/). Although I do not do EMDR myself, I can work closely with someone who does in your treatment.

### Relationship Issues and Narrative Therapy

I use this approach in [couples](https://dralanjacobson.com/couples-therapy/) or [families with older children](https://dralanjacobson.com/family-therapy/) to explore and reframe relationship dynamics, address communication problems, and help individuals understand their roles in conflicts and challenges. In this case, we look for narratives in the diad or family that are “stuck” and causing stress between members.

### Self-esteem and Self-identity

Narrative therapy can assist individuals in improving their self-esteem. It can challenge negative self-narratives and construct more positive and authentic self-identities. This approach pairs well with [client-centered therapy](https://dralanjacobson.com/client-centered-therapy/) and [positive psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/), setting the stage for these issues to be safely uncovered.

### Narrative Therapy Techniques and Grief and Loss

Narrative therapy techniques can help individuals process their grief by exploring the stories and memories they have of the person who passed away and the impact of the loss on their lives. This method can be used with families or friend groups.

### Identity and Cultural Issues

I help people use narrative therapy to navigate issues related to cultural identity, discrimination, and [social justice](https://www.britannica.com/topic/social-justice). It allows individuals to explore how larger societal stories have affected their sense of self and place in the world.

### Personal Growth and Life Transitions

Narrative therapy interventions can help individuals navigate major life transitions, such as career changes, retirement, or other significant shifts, by reauthoring their life stories and goals.

Narrative therapy techniques are highly adaptable and can be applied in individual, family, couples, and [group therapy](https://dralanjacobson.com/group-therapy/) settings. I use them to empower individuals to become the authors of their own life stories, challenge limiting ideas, and create new, more positive, and preferred stories that align with their values and aspirations.

## Future Directions and Innovations in Narrative Therapy

The future of narrative therapy interventions holds exciting possibilities, with innovations and advancements expanding its potential and scope. [**Digital storytelling tools**](https://www.bookwidgets.com/blog/2018/04/learning-by-telling-stories-7-amazing-storytelling-tools-for-teachers-and-students) are one such innovation, offering new ways for clients to engage with their stories. These tools provide a creative expression and exploration platform, enhancing the therapeutic experience.

Research continues to explore this method’s effectiveness, providing valuable insights into its impact and potential applications. By examining the outcomes of interventions, researchers can identify best practices and refine therapeutic techniques, enhancing the efficacy of in-person and [online therapy](https://dralanjacobson.com/virtual-therapy-guide/) practice.

Innovations are integrating technology with traditional narrative therapy techniques, offering new opportunities for engagement and exploration. I have found that I can provide more dynamic and interactive therapeutic experiences by incorporating digital tools and platforms, fostering client engagement and empowerment.

Cross-cultural studies enhance the understanding of narrative therapy interventions, providing insights into how they can be adapted to diverse cultural contexts. These studies promote a more inclusive and culturally sensitive practice, enhancing the effectiveness of these interventions.

Future developments aim to refine and expand narrative therapy techniques, offering new possibilities for healing and growth. By embracing innovation and exploration, I hope to continue to evolve my [integrative psychological practice](https://dralanjacobson.com/integrative-therapy/), providing more effective and empowering interventions for my clients.

## Conclusions and My Work

[In my work](https://dralanjacobson.com/), narrative therapy interventions are used to address a wide range of psychological and emotional issues, including depression, anxiety, trauma, and relationship problems. It can benefit individuals who feel stuck in negative self-perceptions or societal expectations. By changing their stories, clients can gain new perspectives, build resilience, and work toward positive change. I use it generally in [individual, couples, and family work](https://dralanjacobson.com/) and with [my clinical specialties](https://dralanjacobson.com/intensive-therapy-and-specialty-services/) such as executive coaching and [sports psychology](https://dralanjacobson.com/sports-psychology/). I often combine narrative therapy with other approaches, such as [schema therapy](https://dralanjacobson.com/schema-therapy/).

### Narrative Therapy Techniques: Example

Here’s an example of how a narrative therapy session might unfold. This example is fictitious, purposely simple, and brief, but it gives a sense of how I would use narrative therapy techniques in practice.

Sarah is a 35-year-old woman experiencing low self-esteem at work and dissatisfaction with her career. She got a recent promotion, but a feeling of “[imposter syndrome](https://www.verywellmind.com/imposter-syndrome-and-social-anxiety-disorder-4156469)” has made it hard for her to enjoy it and be as proud and confident as she feels she should be.

#### Step One: Externalizing the Problem

- I ask, “Sarah, can you tell me more about what brings you here today?”
- “I feel like I’m not good enough at my job. When I compare myself to my colleagues, which I do often, I always fall short.”
- “It sounds like the feeling of ‘not being good enough’ is really affecting you. Let’s try to give that feeling a name. How about we call it the ‘Imposter in the mirror’? When did you first notice the Impotser in the mirror showing up in your life?”
- “I guess it’s been around for a long time, probably since I was a kid. I always felt like I had to be perfect to get approval from my parents and I never felt good enough or accomplished enough.”

#### Step Two: Mapping the Influence of the Problem

- I say, “So, the Imposter in the mirror has been around for quite some time. How has it affected different areas of your life?”
- “It makes me doubt myself at work, and I avoid taking on new challenges because I’m afraid I’ll fail. This also affects my relationships because I constantly seek validation from others.”
- “It sounds like it strongly influences many parts of your life. Let’s explore some instances where you could keep it at bay or didn’t have as much power over you.”
- “There was a time when I led a successful project at work. I felt confident and proud of my accomplishments.”
- “How did you keep the Imposter in the mirror from taking over?”
- “I think I was really passionate about the project, and I had a supportive team. I also received positive feedback from my manager, which boosted my confidence.”
- “Passion, support, and positive feedback helped you overcome the Imposter in the mirror. How can we use these elements to create a new story about your abilities and potential?”

#### Step Three: Reauthoring the Narrative

- I start, “Let’s start crafting a new story. Instead of focusing on the Imposter, we can highlight your strengths and achievements. For instance, ‘Sarah is a dedicated professional who excels when she is passionate about her work and supported by her team.’ How does that sound?
- “That sounds much more empowering. I like it.”
- Wonderful. How can you remind yourself of this new story in your daily life? What steps can you take to reinforce it?”
- “I can start by setting small, achievable goals at work and seeking feedback from my colleagues. I’ll also remind myself of past successes and focus on my strengths.”
- “That sounds like a great plan. You have the power to create and live out your own story.”

In this example, I use narrative therapy techniques to help Sarah externalize her problem, understand its impact, identify moments when she has successfully managed it, and reauthor her narrative to focus on her strengths and achievements. This process empowers Sarah to see herself in a new light and take proactive steps to reinforce her positive self-image.

If you have any questions about **narrative therapy** or closely related [schema therapy](https://dralanjacobson.com/schema-therapy/), and how we might use it in our work together, feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult). I can also answer questions about [narrative family therapy](https://dralanjacobson.com/narrative-family-therapy/).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Narrative Couples Therapy](https://dralanjacobson.com/narrative-couples-therapy/)

**Published:** February 28, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Couples can become entangled in negative stories about their relationships—stories that define them by their conflicts rather than their strengths. Narrative couples therapy, rooted in the work of [Michael White](https://en.wikipedia.org/wiki/Michael_White_(psychotherapist)) and [David Epston](https://en.wikipedia.org/wiki/David_Epston), offers a transformative approach by using specially designed strategies that help partners separate from their problems and rewrite their relationship story to foster connection, understanding, and growth. Narrative therapy for couples views problems not as intrinsic to the individuals but as external influences that shape interactions and perceptions. In sum, narrative therapy interventions for couples can be powerful and effective, especially for people who have been together for a while.

### Narrative Couples Therapy Process

Partners often say, “We are always fighting,” or “We just don’t communicate well,” reinforcing a rigid and problem-saturated story. Through narrative therapy for couples, we’ll challenge these limiting stories, explore alternative stories, and highlight moments of resilience and love that have been overshadowed by conflict. By externalizing issues and identifying preferred ways of relating, you can regain agency in shaping your relationship to align with your values and aspirations. This treatment is also used for individual and [family therapy](https://dralanjacobson.com/family-therapy/), particularly around [life transitions](https://dralanjacobson.com/life-transitions-therapy/) and longstanding conflict or [sibling or parent estrangement](https://dralanjacobson.com/family-estrangement-therapy/).

## Narrative Couples Therapy Overview ![Narrative couples Therapy](https://dralanjacobson.com/wp-content/uploads/2025/02/couple-sunset-200x300.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Narrative therapy for couples is a powerful approach that helps partners reframe their relationship challenges by examining the core stories they tell about themselves and each other. Instead of seeing people as “stuck” in conflict, it encourages partners to explore alternative stories emphasizing strengths, shared values, and possibilities for change. This method is closely aligned with [positive psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/).

### Core Narrative Therapy Interventions for Couples

- **Externalization exercises**: Naming and describing the problem as separate from the core relationship
- **Re-authoring conversations**: Highlighting positive relationship moments and resilience
- **Letter writing**: Writing to the problem or to each other from a new perspective
- **Mapping the influence**: Examining how a problem affects the couple and how they respond to it.

See the next section for more information about narrative therapy interventions for couples, including examples of what each intervention does.

## Narrative Therapy Interventions for Couples

This therapy method helps partners reshape their relationship stories by separating problems from their identities and fostering new, constructive narratives. Here are some key techniques used in narrative therapy for couples:

1. **Externalization**

- Narrative therapy interventions for couples help partners see the problem as separate from themselves.
- Example: Instead of saying, “You’re always so critical,” reframe it as “Criticism has been getting in the way of our connection.”
- Partners work together against the issue rather than against each other.

2. **Re-Authoring Conversations**

- Narrative therapy interventions for couples encourage partners to identify moments when the problem was not present or when they successfully navigated challenges.
- Example: “Tell me about a time when you handled conflict in a way that made you feel close.”
- It helps shift the narrative from a problem-saturated story to one that highlights strengths and resilience.

3. **Mapping the Influence**

- In narrative therapy for couples, partners explore how the problem affects their relationship and individual lives.
- Questions like: 
    - “How does this issue impact your daily interactions?”
    - “What does it take away from your relationship?”
- It also examines how each partner responds to the problem, reinforcing their agency in addressing it.
- The [Tree of Life exercise](https://dralanjacobson.com/tree-of-life-therapy/) may be used

4. **Exploring Unique Outcomes**

- Narrative therapy for couples helps partners identify times when the couple successfully resisted the problem.
- Example: “Can you recall a moment when stress didn’t lead to an argument? What was different that time?”
- This method reinforces positive behaviors and alternative ways of interacting.

5. **Deconstructing Cultural Narratives**

- Narrative therapy for couples examines how societal norms and expectations shape the couple’s beliefs and conflicts.
- Example: “How have traditional gender roles influenced how you communicate or resolve conflict?”
- It helps partners create a relationship story that aligns with their values rather than imposed expectations.

6. **Letter Writing in Narrative Couples Therapy**

- Narrative therapy for couples encourages couples to write letters to each other or to the problem itself.
- Example: Writing a letter to “Blame” or “Resentment,” describing its impact and setting boundaries with it.
- Strengthens emotional expression and perspective-taking.

7. **Creating a Shared Narrative**

- Partners work together to craft a new, preferred relationship story using narrative therapy interventions for couples.
- This involves identifying their core values, strengths, and vision for the future.
- Example: “What kind of story do you want to tell about your relationship five years from now?”

These techniques help couples shift from viewing their relationship through a problem-focused lens to one of collaboration, growth, and shared meaning.

### Narrative Therapy Questions for Couples

Narrative therapy for couples uses thought-provoking questions to help couples explore their relationship stories, externalize problems, and create new, empowering stories. Here are some key types of questions used in narrative therapy for couples:

1. **Externalizing the Problem**

- “If we were to give this problem a name, what would it be?”
- “How does \[the problem\] show up in your relationship?”
- “What tricks does \[the problem\] use to create distance between you?”
- “How do each of you respond when \[the problem\] appears?”

2. **Mapping the Influence of the Problem**

- “What effects does this problem have on your daily interactions?”
- “When does \[the problem\] seem strongest?”
- “What emotions or thoughts does this problem bring up for each of you?”
- “How does this issue affect the way you see yourself as a partner?”

3. **Finding Unique Outcomes**

- “Can you think of a time when this problem didn’t take over your relationship?”
- “What were you doing differently in those moments?”
- “What does that say about your ability to handle challenges together?”
- “How did it feel when the problem wasn’t in control?”

4. **Exploring Dominant and Alternative Stories**

- “What story do you currently tell yourselves about your relationship?”
- “How has this story been shaped by past experiences, family expectations, or society?”
- “What story about your relationship would you rather tell?”
- “What qualities do you each bring to the relationship that are often overlooked?”

5. **Reauthoring the Relationship Story**

- “If your relationship were a book or movie, what title would it have now?”
- “What title would you like it to have in the future?”
- “What values or themes would you like your relationship story to focus on?”
- “Are there small steps you can take to move toward the story you want to create?”

6. **Strengthening Connection and Positive Identity**

- “What do you appreciate most about your partner that you don’t express often?”
- “What first drew you to each other, and do you still see those qualities today?”
- “When do you feel most connected, and how can you create more of those moments?”
- “What shared goals or dreams do you have that you’d like to revisit?”

These questions help partners move away from blame and conflict, uncover hidden strengths, and, hopefully, rewrite their relationship stories more positively.

## Case Example

James and Lisa, a married couple in their early 40s, seek therapy due to ongoing conflicts over communication and trust. Lisa feels that James shuts down emotionally, while James believes Lisa is too critical. Over time, they have developed a negative core story: “We are just not compatible.”

**Step 1: Externalizing the Problem in Narrative Couples Therapy**

Instead of seeing each other as the problem, I help them externalize it.

- Me: *“What if we gave this struggle a name? If this communication pattern were a character in your story, what would it be called?”*
- James: *“Maybe ‘The Wall’—because I shut down and block her out.”*
- Lisa: *“I see it as ‘The Critic’—because I always feel like I have to correct things.”*

By naming and externalizing the problem, they start to see it as something they can work against together rather than blaming each other.

**Step 2: Mapping the Influence of the Problem**

I explore how “The Wall” and “The Critic” impact their relationship.

- Me: *“When does ‘The Wall’ show up most?”*
- James: *“Whenever Lisa brings up something she’s upset about, I feel attacked and shut down.”*
- Me: *“And Lisa, when do you notice ‘The Critic’ taking over?”*
- Lisa: *“When James pulls away, I feel unheard, so I push harder.”*

This cycle becomes clear: Lisa’s criticism triggers James’s withdrawal, and his withdrawal triggers more criticism.

**Step 3: Exploring Unique Outcomes**

I help them identify moments when the pattern didn’t dominate.

- Me: *“Can you remember a time when you talked about a tough issue without ‘The Wall’ or ‘The Critic’ interfering?”*
- Lisa: *“Actually, last week, we had a great talk about parenting without arguing.”*
- James: *“Yeah, because we were relaxed and not stressed.”*
- Me: *“What did you both do differently in that moment?”*

By highlighting exceptions, the couple starts seeing their ability to communicate well.

**Step 4: Reauthoring the Relationship Story**

I help them co-create a new story.

- Me: *“What if we rewrite your relationship story? Instead of ‘We’re not compatible,’ what new story could fit better?”*
- James: *“Maybe ‘We’re learning to communicate better.’”*
- Lisa: *“Or ‘We’re a team, even when we struggle.’”*

They now focus on their ability to grow rather than feeling doomed by past patterns.

**Step 5: Strengthening the New Narrative**

I assign a homework exercise:

- Each partner writes a letter to “The Wall” and “The Critic,” setting boundaries with them.
- They practice a daily appreciation exercise, expressing one positive thing about each other.

### Outcome and Next Steps

Over time, James and Lisa use narrative therapy interventions for couples to begin recognizing their communication strengths, reducing blame, and seeing their struggles as external challenges rather than inherent flaws in their relationship.

## My Work with Narrative Couples Therapy

Narrative couples therapy is not about erasing past struggles but reclaiming the power to define one’s relationship beyond the problems. When you learn to rewrite your shared story, you shift from feeling stuck in conflict to recognizing your ability to create change. By externalizing issues, identifying strengths, and constructing new core stories based on mutual respect and understanding, partners can foster a renewed sense of connection.

### Key Aspects of Narrative Therapy for Couples:

1. **Externalizing the Problem**—Instead of blaming each other, narrative therapy for couples teaches them to see the issue as something outside of themselves. For example, instead of saying, “You’re so controlling,” a partner might say, “Control has been interfering in our relationship.”
2. **Rewriting Negative Stories** – Many partners develop rigid, negative narratives about each other over time (e.g., “We always fight” or “You never listen to me”). Narrative couples therapy helps them identify exceptions and create new, more empowering narratives.
3. **Exploring Dominant and Alternative Stories**—Partners often get stuck in dominant, problem-saturated stories about their relationship. **Narrative** therapy interventions for couples help them uncover alternative stories that highlight resilience, love, and moments of connection.
4. **Deconstructing Cultural and Social Influences** – Many relationship struggles stem from societal expectations (e.g., gender roles, cultural norms). Narrative therapy helps couples critically examine these influences and redefine their relationships on their own terms.
5. **Strengthening a Shared Narrative** – Through guided conversations, narrative couples therapy helps them co-author a new story that emphasizes their hopes, values, and vision for the future.

### Goals, Process, and Contact

Ultimately, narrative therapy empowers partners to move forward not as adversaries but as co-authors of a meaningful and evolving relationship story—one that honors their struggles while emphasizing their capacity for love, growth, and resilience. As a psychologist, my role is to guide this process, helping people recognize that they are more than their challenges and that they can write a future that aligns with their deepest hopes for their relationship.

In my [integrative psychological practice](https://dralanjacobson.com/integrative-therapy/), I often mix narrative therapy for couples with other techniques, including [creative arts therapy](https://dralanjacobson.com/creative-counseling/), [Imago relationship therapy](https://dralanjacobson.com/imago-relationship-therapy/) and [emotionally focused couples treatment](https://dralanjacobson.com/eft-therapy-for-couples/). It can be used for specific challenges, such as [treating codependency](https://dralanjacobson.com/codependency-therapy/). This form of treatment can easily and effectively be delivered online, which can be particularly helpful when the partners may not always be in the same place at the same time for our sessions. This method usually involves homework, such as discussion or thought homework between sessions.

If you have any questions about narrative couples therapy, how it might work for you, or how narrative therapy interventions for couples might be part of our work together, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime. I can also tell you more about [narrative therapy for individuals](https://dralanjacobson.com/narrative-therapy/) and for [family treatment](https://dralanjacobson.com/family-therapy/).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Quality of Life Therapy: Flourish and Become Fulfilled](https://dralanjacobson.com/quality-of-life-therapy/)

**Published:** June 23, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Life Therapy, also known as Quality of Life Therapy (QOLT), is deeply rooted in the belief that healing and growth are not limited to treating symptoms; instead, it involves helping people discover purpose, build meaningful connections, and create an identity that reflects who they truly are. Over the years, I’ve trained in and integrated several evidence-based approaches that support this broader, more human-centered vision. This type of treatment offers a flexible, personalized path toward emotional well-being, resilience, and lasting change. When you decide to use life psychotherapy, you are seeking a robust and enduring form of treatment with wide-ranging results.

## Life Therapy: An Overview ![Quality of Life Therapy (QOLT)](https://dralanjacobson.com/wp-content/uploads/2025/06/choices-3.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Quality of Life Therapy (QOLT) is a structured, evidence-based positive psychology intervention developed by [**Dr. Michael B. Frisch**](https://www.mentorcoach.com/positive-psychology-coaching/interviews/interview-michael-frisch-ph-d/), a clinical psychologist and professor at Baylor University. It emerged in the early 2000s as part of a growing movement to shift behavioral health treatment from a focus solely on symptom reduction to an emphasis on flourishing, fulfillment, and overall well-being. Quality of Life Therapy is based on Frisch’s empirically derived model of happiness and satisfaction, which he outlines in his book [*Quality of Life Therapy: Applying a Life Satisfaction Approach to Positive Psychology and Cognitive Therapy* (2006)](https://www.amazon.com/Quality-Life-Therapy-Satisfaction-Psychology/dp/0471213519).

Quality of Life Therapy integrates traditional **[cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT)** techniques with a structured assessment and intervention model that targets 16 key areas of quality of life, including relationships, work, health, play, goals, and spirituality. The underlying assumption in QOLT is that psychological distress often results from dissatisfaction in one or more of these domains, and that enhancing fulfillment in these areas can promote well-being and prevent relapse.

### Who Life Therapy Is Best For

A life therapist can be beneficial for individuals who:

- Are experiencing mild to moderate depression or anxiety
- Are dealing with chronic stress or looking for [burnout therapy](https://dralanjacobson.com/burnout-therapy/)
- Want to enhance life satisfaction or personal growth
- Are in recovery from mental illness and want to improve resilience
- Are [undergoing life transitions](https://dralanjacobson.com/life-transitions-therapy/) (e.g., divorce, retirement, illness)
- Prefer a structured, collaborative, and goal-oriented therapeutic approach

Quality of Life Therapy can also be adapted for high-functioning individuals, couples, and groups seeking personal development or coaching.

### Techniques Used in Quality of Life Psychotherapy

Life psychotherapy uses a semi-manualized format centered around the **[Quality of Life Inventory](https://ppc.sas.upenn.edu/resources/questionnaires-researchers/quality-life-inventory) (QOLI),** a self-report tool that measures satisfaction and importance across 16 areas. Based on QOLI results, [individual therapy](https://dralanjacobson.com/individual-therapy/) focuses on increasing fulfillment in areas rated as currently important and unsatisfying. Quality of Life Therapy techniques include:

1. [**Cognitive Restructuring**](https://dralanjacobson.com/cognitive-restructuring/): Identifying and changing unhelpful beliefs that hinder satisfaction (e.g., perfectionism, pessimism).
2. **Gratitude Practices**: Encouraging reflection on what’s going well in life, even amidst challenges.
3. **Goal Setting and Planning**: Creating specific, meaningful goals in targeted domains.
4. [**Behavioral Activation**](https://dralanjacobson.com/behavioral-activation/): Encouraging pleasurable and mastery-oriented activities to build momentum and joy.
5. [**Forgiveness and Acceptance Work**](https://positivepsychology.com/forgiveness-exercises-tips-activities-worksheets/): Letting Go of Resentments That Block Well-being.
6. **Savoring and Mindfulness**: Increasing awareness and appreciation of positive moments.
7. **Happiness Exercises**: Including strengths-based reflection, optimism training, and envisioning best possible selves.
8. [**Values Clarification Process**](https://dralanjacobson.com/values-clarification-therapy/): Discover, define, and actively live out core principles.

I use a flexible workbook-style format, guiding you through structured exercises while also addressing emotional and interpersonal barriers that arise.

### Outcomes of Quality of Life Therapy

Life psychotherapy has been shown to produce meaningful improvements in both clinical and non-clinical populations. Reported outcomes include:

- Increases in overall satisfaction and happiness
- Reductions in depressive and anxious symptoms
- Greater resilience to stress and adversity
- Enhanced goal clarity and sense of purpose
- More balanced and fulfilling lifestyles
- Lower relapse rates in clients with chronic disorders

Several studies support the use of Quality of Life Therapy as an effective adjunct or alternative to traditional CBT, especially for clients who are motivated by growth rather than pathology-focused treatment. It is closely related to [personal counseling](https://dralanjacobson.com/personal-growth-counseling/), though it usually focuses more on symptoms than counseling does.

## Life Psychotherapy Case Examples

The following examples highlight how life psychotherapy is used.

### 1. Life Psychotherapy with a Software Engineer with Low Mood and Burnout

Marcus sought a life therapist after experiencing a prolonged period of burnout, low energy, and disengagement from his work and relationships. He did not meet the criteria for major depression but scored below average on measures of satisfaction. He described his daily experience as “on autopilot” and said he often felt unfulfilled despite material success.

Using the QOLI, Marcus identified that while work and financial security were satisfactory, he was deeply unfulfilled in areas such as friendships, fun, personal growth, and romance, all of which he rated as very important. In sessions, Marcus worked on shifting negative thought patterns (e.g., “I don’t have time for friends anymore”) and began scheduling small, meaningful activities, like weekly dinners with old friends and joining a hiking group. He also clarified personal values and set new goals related to creativity and spirituality.

After three months of life psychotherapy, Marcus reported improved mood, greater enthusiasm, and a more vibrant sense of daily purpose. By focusing on the domains that mattered most to him, he was able to build a routine more in line with his values.

### 2. QOLT with a Retired Teacher Adjusting to Life Transitions

Evelyn, a 67-year-old retired teacher, began therapy after struggling with feelings of emptiness and loss of direction following retirement. Though she had strong family ties, she described her days as “blurry and repetitive,” and her QOLI results showed low satisfaction in the domains of purpose, community involvement, and health.

In life psychotherapy, Evelyn explored how much of her identity had been tied to her teaching role and how its absence left a void. Together, she and I used [cognitive restructuring](https://dralanjacobson.com/cognitive-restructuring/) to challenge beliefs such as “I’m no longer useful” and implemented behavioral activation strategies focused on re-engagement. Evelyn began volunteering at a local literacy center, attending gentle yoga classes, and reconnecting with former colleagues.

After four months, Evelyn’s QOLI scores improved across several domains, especially in purpose and community. She described feeling “alive again” and reported a more balanced daily structure filled with meaningful social and physical activity.

### 3. Life Therapy with a College Student Struggling with Direction and Self-Worth

Lina, a 21-year-old college junior, entered therapy reporting anxiety, lack of motivation, and uncertainty about her future. She felt “stuck” and compared herself unfavorably to peers. The QOLI revealed low satisfaction in self-esteem, goals and values, and creativity, though she rated all of these domains as highly important.

Life psychotherapy focused on clarifying Lina’s values, developing self-compassion, and identifying sources of authentic motivation. Through journaling exercises, Lina explored her interest in [environmental design](https://iere.org/what-is-environmental-design/)—a passion she had dismissed as “impractical.” I also integrated [mindfulness therapy](https://dralanjacobson.com/mindfulness-therapy/) techniques and strengths-based reframing to help Lina notice accomplishments and internalize positive feedback.

Over the next semester, Lina switched to a more fulfilling major and joined a sustainability club. Her QOLI scores showed substantial gains in the domains of creativity, self-esteem, and goals and values. Lina described feeling “more like myself” and expressed optimism about her future direction.

## Integrating Quality of Life Therapy with Other Approaches

Quality of Life Therapy (QOLT) is a flexible, evidence-based approach that can be effectively integrated with several other therapeutic models. Because it focuses on enhancing satisfaction across meaningful domains rather than solely reducing symptoms, QOLT complements both traditional and modern forms of psychotherapy. Below are some of the most common therapies that can be used alongside:

1. **[ Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT) and [Metacognitive Therapy](https://dralanjacobson.com/metacognitive-therapy-mct/) (MCT)**
    QOLT, MCT, and CBT share a focus on identifying and modifying unhelpful thought patterns. While CBT and MCT target the reduction of distressing symptoms such as anxiety or depression, QOLT expands this focus to include increasing fulfillment and life satisfaction. Integrating the approaches allows clients to [reframe negative beliefs](https://goodexistence.com/15-ways-to-reframe-negative-thoughts/) (“I’m not doing enough”) while simultaneously identifying value-based goals and pleasurable activities that improve overall well-being.
2. **[ Acceptance and Commitment Psychotherapy](https://dralanjacobson.com/act-psychotherapy/) (ACT)**
    QOLT pairs naturally with ACT’s emphasis on living in accordance with personal values. The QOLI can help clarify what truly matters to the client, while ACT techniques—such as mindfulness, acceptance of difficult emotions, and committed action—support movement toward those values even in the presence of discomfort. This combination can help clients transform avoidance into purposeful engagement.
3. **[ Positive Psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/) and [Strength-Based Approaches](https://dralanjacobson.com/strength-based-therapy/)**
    Both QOLT and positive psychology emphasize cultivating positive emotion, engagement, and meaning. Integrating the two deepens focus on identifying strengths, gratitude practices, and savoring exercises, while the QOLI provides a structured way to assess where satisfaction and values align—or diverge.
4. [ **Mindfulness-Based Therapies**](https://dralanjacobson.com/mindfulness-therapy/)
    QOLT complements [mindfulness-based stress reduction](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) (MBSR) and [mindfulness-based cognitive therapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) (MBCT) by linking present-moment awareness to specific quality domains. Mindfulness helps clients notice automatic patterns that diminish satisfaction, while QOLT encourages conscious choices that enhance well-being across relationships, self-care, and creativity.
5. **[ Interpersonal Therapy](https://dralanjacobson.com/interpersonal-therapy/) (IPT)**
    Because social connectedness and relationships are key domains of the QOLI, combining QOLT with IPT can be particularly powerful. Clients can use the QOLI to identify relational areas contributing to low satisfaction, then apply IPT strategies to improve communication, resolve conflict, and deepen meaningful connections.
6. **[ Psychodynamic](https://dralanjacobson.com/psychodynamic-therapy/) or [Insight-Oriented Therapy](https://dralanjacobson.com/insight-therapy/)**
    In longer-term or insight-oriented work, QOLT offers a structured complement to the exploration of underlying emotional themes. By quantifying satisfaction across different areas, the QOLI can reveal patterns—such as recurring dissatisfaction in intimacy or achievement—that may reflect deeper conflicts, providing a bridge between insight and actionable change.
7. **Coaching and [Solution-Focused Approaches](https://dralanjacobson.com/solution-focused-therapy/)**
    QOLT integrates smoothly with coaching and solution-focused models, which emphasize practical steps toward positive change. The QOLI helps clients pinpoint high-priority domains, and therapy then centers on building specific, measurable actions to increase satisfaction in those areas.

**In Summary:**
Quality of Life Therapy enhances, rather than replaces, other therapeutic modalities. Whether used in a structured clinical setting or as part of integrative, holistic care, it provides a positive, values-based framework for helping clients not only alleviate distress but also build a life that feels meaningful, balanced, and fulfilling.

## The Work in QOLT

A [**life therapist**](https://dralanjacobson.com/life-therapists/) bridges the gap between traditional psychotherapy—focused on emotional healing—and life coaching, which emphasizes action, purpose, and personal growth. The goal is to help clients not only process their past but also build a clear, fulfilling path forward.

### Core Focus Areas

1. **Emotional Healing and Growth**
    Life therapy helps clients understand the emotional roots of current struggles—such as self-doubt, anxiety, or relationship difficulties—and develop healthier coping patterns. 
    - Exploring formative experiences and internalized beliefs
    - Working through unresolved emotional pain
    - Building resilience and self-compassion
2. **Direction and Purpose**
    A major part of life therapy involves clarifying goals, values, and a sense of meaning. 
    - Clarifying what truly matters to the client
    - Identifying strengths, interests, and intrinsic motivations
    - Creating a personal vision and long-term goals
3. **Behavioral and Cognitive Change**
    Life therapy uses evidence-based techniques from [CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/), ACT, and motivational interviewing to help clients make tangible changes. 
    - Reframing unhelpful thinking patterns
    - Developing problem-solving and decision-making skills
    - Building consistency and follow-through
4. **Relationship and Communication Skills**
    Many clients seek help for interpersonal challenges—romantic, familial, or professional. 
    - Enhancing empathy and assertiveness
    - Learning to set boundaries
    - Improving conflict resolution and emotional attunement
5. **Stress, Balance, and Wellbeing**
    Life therapy often takes a **holistic approach**, addressing mind–body health. 
    - Mindfulness and relaxation training
    - Coaching of daily routines (sleep, exercise, nutrition, time management)
    - Preventing burnout and cultivating self-care routines

### Approaches and Methods

- **[Integrative therapy](https://dralanjacobson.com/integrative-therapy/):** Blends modalities like CBT, mindfulness, psychodynamic work, and coaching methods.
- **Narrative therapy:** Helps clients reframe their stories with greater agency and meaning.
- **Positive psychology:** Emphasizes strengths, gratitude, and growth mindsets.
- **Solution-focused therapy:** Encourages small, achievable steps toward desired outcomes.

Life psychotherapy sessions are typically more **goal-oriented** than traditional psychotherapy while maintaining emotional depth and clinical grounding.

## Summary and My Work

Ultimately, life psychotherapy is not just about reducing distress. It’s about helping you thrive. My work draws from a rich blend of relational, cognitive-behavioral, meaning-centered, and [insight-oriented therapy](https://dralanjacobson.com/insight-therapy/) approaches because I believe that each person’s journey is multidimensional. Whether you’re facing a transition, relationship challenge, emotional block, or simply a desire to live more intentionally, life therapy allows us to work holistically, honoring your story, fostering your strengths, and supporting you in feeling not just functional, but deeply fulfilling. It’s never too late to heal, reflect, connect, and grow. For couples, see my post about the similar approach called [Relational Life Therapy](https://dralanjacobson.com/relational-life-therapy-rlt/).

Rather than focusing exclusively on symptom reduction, QOLT invites clients to build fulfilling, values-driven lives across multiple domains. It is particularly well-suited for individuals seeking not just to heal but to thrive. Thus, it is an ideal model for those navigating stress, dissatisfaction, or personal transitions who desire purposeful change.

If you have any questions about the work of a [life therapist](https://dralanjacobson.com/life-therapists/) or Quality of Life Therapy, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Types of Therapy

---

### [Therapy for Work-Life Balance: Finding Harmony](https://dralanjacobson.com/therapy-for-work-life-balance/)

**Published:** February 15, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Finding a **better work-life balance** can be challenging, especially with increasing job demands, family responsibilities, and personal goals. **Therapy for work-life balance** can be a valuable tool in helping individuals set boundaries, manage stress, and create a more fulfilling routine. I provide services that combine psychotherapy with work-life balance coaching to help adults of all ages improve their mood, motivation, and contentment. These methods can benefit those in individual, couple, or family therapy. This post covers my techniques and has two case examples of healthy work-life balance therapy courses.

I welcome any questions about how this treatment might benefit you or a loved one. [Contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Therapy for Work-Life Balance Overview**![Therapy for work-life balance](https://dralanjacobson.com/wp-content/uploads/2025/02/advantages-and-disadvantages-300x165.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")**

The basic tenets of healthy work-life balance therapy include:

1. **Identifying Imbalances**

- Therapy can help you recognize patterns of overworking, burnout, or neglecting personal well-being.
- I can assist in assessing priorities and identifying areas where balance is needed.

2. **Stress & Anxiety Management**

- I teach techniques like **[mindfulness therapy](https://dralanjacobson.com/mindfulness-therapy/), deep breathing**, and [**cognitive restructuring**](https://dralanjacobson.com/cognitive-restructuring/) to reduce stress.
- Therapy can help reframe negative thoughts about productivity and success.

3. **Better Work-Life Balance Through Setting Healthy Boundaries**

- Learning to say “no” to excessive demands without guilt.
- Establishing clear job hours and personal time for self-care and relationships.
- Practicing **assertive communication** to manage job load and expectations.

4. **Work-Life Balance Therapy for Job-Related Burnout**

- Therapy can help recognize [early signs of burnout](https://www.verywellhealth.com/signs-of-burnout-8683361) and develop recovery strategies.
- Techniques such as **self-compassion, rest, and pattern adjustments** can be explored.
- Exploring alternative career paths or modifications if necessary.

5. **Healthy Work-Life Balance by Enhancing Time Management**

- I can help clients develop realistic schedules that accommodate both parts of life.
- Prioritizing tasks effectively to reduce overwhelm.
- Learning time-blocking and productivity techniques that prevent job stress from spilling into personal life.

6. **Improving Relationships & Personal Well-Being**

- Strengthening relationships by dedicating quality time to family and friends.
- Addressing guilt or pressure that comes with dual responsibilities.
- Reconnecting with hobbies and personal interests outside of your job.

7. **Work-Life Balance Therapy Methods**

- **[Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT):** Helps challenge stress and perfectionism.
- **[Mindfulness-Based Stress Reduction](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) Therapy:** Encourages presence and stress reduction.
- **[Solution-Focused Therapy](https://dralanjacobson.com/solution-focused-therapy/):** Helps set practical goals and well-being.
- **[Career Testing](https://psychologicalassessments.com/career-testing/):** Part of work-life balance coaching, this method assists with job satisfaction and decision-making.

## Therapy for Work-Life Balance Goals

Achieving better work-life balance is an ongoing process that requires intentional changes and self-awareness. Therapy can provide a safe space to explore stressors, develop coping mechanisms, and build a lifestyle that fosters both professional success and personal fulfillment.

### Work-Life Balance Therapy Approaches

Different approaches can help individuals manage stress, set boundaries, and create a healthy work-life balance. Here’s a breakdown of some of the most effective methods:

1. **Cognitive Behavioral Therapy (CBT)**

**Focus:** Changing unhelpful thought patterns and behaviors.

🔹 **How It Helps:**

- Identifies negative beliefs about your job, success, and self-worth.
- Helps reframe perfectionism and imposter syndrome.
- Teaches stress-management techniques like cognitive restructuring.

🔹 **Example Strategy:**
I may help a client challenge thoughts like *“I must always be available at my job, or I’ll fail”* and replace them with healthier beliefs like *“Rest and breaks help me perform better.”*

2. **Mindfulness-Based Therapy for Work-Life Balance**

**Focus:** Staying present and reducing stress through awareness and relaxation techniques.

🔹 **How It Helps:**

- It encourages being present in the moment instead of constantly worrying.
- Reduces anxiety through meditation, breathing exercises, and body awareness.
- It helps individuals detach from stress after office hours.

🔹 **Example Strategy:**
Using [**mindful transitions**](https://focuskeeper.co/glossary/what-is-mindful-transitions/)—such as deep breathing or a short walk—to mentally separate from your job at the end of the day.

3. **[Acceptance and Commitment Therapy](https://dralanjacobson.com/act-psychotherapy/) for Work-Life Balance**

**Focus:** Accepting challenges while committing to meaningful personal and professional goals.

🔹 **How It Helps:**

- Encourages accepting stress and setbacks instead of fighting against them.
- Uses **values-based decision-making** to prioritize what truly matters.
- It helps you avoid burnout by aligning your career with personal fulfillment.

🔹 **Example Strategy:**
A client struggling might explore whether their habits align with their core values, like **family time, creativity, or well-being**, and adjust accordingly to achieve better work-life balance.

4. **Solution-Focused Brief Therapy for Work-Life Balance**

**Focus:** Finding practical solutions to improve things quickly.

🔹 **How It Helps:**

- Identifies small, immediate changes that lead to a better balance.
- Encourages goal-setting and tracking progress.
- Uses a strengths-based approach to build on what’s already positive.

🔹 **Example Strategy:**
I might ask: *“What’s one small thing you could do this week to improve balance?”* and help develop actionable steps.

5. **Career & Work-Life Balance Coaching**

**Focus:** Addressing job satisfaction, career growth, and various challenges.

🔹 **How It Helps:**

- Work-life balance coaching helps identify whether stress is due to **job dissatisfaction** or **poor habits**.
- It assists with career and [life transitions](https://dralanjacobson.com/life-transitions-therapy/) and job changes for better fulfillment.
- It also provides strategies for improving relationships and productivity.

🔹 **Example Strategy:**
A professional struggling with **burnout** might explore whether they need **role adjustments, career shifts, or better delegation** in work-life balance coaching.

6. **[Psychodynamic Therapy](https://dralanjacobson.com/psychodynamic-therapy/) for Work-Life Balance**

**Focus:** Exploring deeper emotional patterns and past experiences influencing habits.

🔹 **How It Helps:**

- Examines how childhood experiences shape current attitudes.
- It helps uncover **unconscious pressures** to prove self-worth through achievements.
- It encourages emotional processing and self-awareness.

🔹 **Example Strategy:**
I might help clients realize that their **tendency to overdo it** comes from childhood expectations of always needing to be “productive” to earn approval.

There’s no one-size-fits-all approach to achieving better work-life balance. I often combine techniques based on individual needs, such as **CBT for stress, mindfulness for relaxation, and career counseling.**

## Case Example: Therapy for Healthy Work-Life Balance

**Client Profile**

- **Name:** Sarah
- **Age:** 35
- **Occupation:** Marketing Manager
- **Challenges:** Chronic stress, burnout, difficulty setting boundaries, guilt about taking personal time
- **Therapy Approach:** Cognitive Behavioral Therapy (CBT) + Mindfulness-Based Therapy

### Work-Life Balance Therapy Session 1: Identifying the Problem

Sarah seeks therapy because she feels overwhelmed by her job, stays late, and checks emails on weekends. She reports **exhaustion, anxiety, and irritability** and struggles to spend quality time with her family.

**Better Work-Life Balance Strategy:**

- **Assess balance:** Sarah tracks how much time she spends on her job vs. her personal life.
- **Identify unhelpful thoughts:** Sarah believes, *“If I’m not constantly available, I’ll lose my job.”*

### Work-Life Balance Therapy Session 2: Challenging Negative Beliefs (CBT)

Sarah and I discuss **reframing her mindset** about responsibilities.

**Intervention:**

- **Cognitive restructuring:** Challenges the thought *“I must always be available.”*
    - **New belief:** *“I can set limits and still be a valuable employee.”*
- **Behavioral experiment:** Sarah stopped checking emails after 7 PM for one week to see if her performance had changed.

Outcome: Sarah realizes that her team manages well without her constant availability.

### Work-Life Balance Therapy Session 3: Setting Healthy Boundaries

Sarah learns [**assertive communication**](https://www.healthline.com/health/assertive-communication) techniques to set boundaries with her boss and colleagues.

**Strategies for Better Work-Life Balance:**

- **Schedule adjustments:** Sarah blocks her hours and schedules breaks.
- **Email & phone boundaries:** She communicates her new hours to her team.
- **Self-care integration:** Sarah adds exercise and relaxation into her daily routine.

Outcome: Sarah starts feeling more in control of her time.

### Work-Life Balance Therapy Session 4: Mindfulness & Stress Management

Sarah still experiences job anxiety, so I introduce mindfulness techniques.

**Strategies for Better Work-Life Balance:**

- **Mindful transitions:** A 5-minute deep breathing exercise before switching modes.
- **Grounding techniques:** Focusing on sensory experiences (sight, sound, touch) to stay present with family.
- **Letting go of perfectionism:** Practicing self-compassion when she doesn’t complete everything.

Outcome: Sarah reports feeling more relaxed and present in her personal life.

### Work-Life Balance Therapy Session 5: Maintaining Work-Life Balance

Sarah and I review progress and create a **long-term healthy work-life balance therapy plan.**

**Key Takeaways:**

- **More personal time:** Sarah enjoys weekends without guilt.
- **Reduced stress:** Fewer worries during off-hours.
- **Better communication:** She confidently says “no” to unnecessary late-night tasks.
- **Improved well-being:** She feels more energized and connected with loved ones.

This case demonstrates how **CBT, mindfulness, and boundary-setting** can help individuals reclaim control and achieve a healthy work-life balance.

## Case Example 2: Better Work-Life Balance for a Woman with Young Children

**Client Profile**

- **Name:** Jessica
- **Age:** 32
- **Occupation:** Project Manager
- **Family Situation:** Married with two young children (ages 3 and 5)
- **Challenges:** Overwhelmed with her job and parenting, guilt about not spending enough time with kids, exhaustion, difficulty setting boundaries with her boss.

### Therapy for Work-Life Balance Session 1: Identifying the Core Issues

Jessica comes to therapy for work-life balance feeling **burnt out, guilty, and frustrated.** She feels she is failing both at her job and as a mother. She often works late at night after putting her kids to bed and has no personal time.

### Strategy:

- **Assess daily schedule:** Jessica logs her time to identify where stress peaks occur.
- **Identify cognitive distortions:** Jessica believes *“I have to be everything to everyone, or I’m failing.”*

### Therapy for Work-Life Balance Session 2: Challenging Perfectionism (CBT)

Jessica and I explore the **unrealistic expectations** she places on herself.

**Work-Life Balance Coaching Intervention:**

- **Cognitive restructuring:**
    - Old belief: *“A good mother should always be fully present, and a good employee should be available 24/7.”*
    - New belief: *“I can be a great mom and professional by setting realistic limits.”*
- **Time prioritization:** Differentiating **urgent vs. important** tasks.

**Outcome:** Jessica acknowledges she cannot do everything perfectly and starts delegating small tasks at home.

### Work-Life Balance Coaching Session 3: Setting Boundaries & Creating a Realistic Routine

Jessica struggles to **say no** to extra responsibilities and finds it hard to **balance her job and parenting to create a** healthy work-life balance.

**Work-Life Balance Coaching Strategies:**

- **Separation:**
    - Creates **a structured schedule** (sets start & stop times).
    - Implements a **shutdown routine** to transition mentally.
- **Boundary Setting:**
    - Communicates **clear availability** to colleagues.
    - Uses an **auto-responder email** after hours.
- **Quality Time with Kids:**
    - Blocks **distraction-free time** with children (30-minute focused playtime).
    - Uses **guilt-free independent playtime**.

**Outcome:** Jessica starts feeling more in control of her time and enjoys small, intentional moments with her kids.

### Therapy for Work-Life Balance Session 4: Managing Mom Guilt & Prioritizing Self-Care

Jessica feels guilty when she’s working and guilty when she’s not. She also neglects her well-being.

**Healthy Work-Life Balance Strategies:**

- **Reframing guilt:**
    - Old thought: *“If I take time for myself, I’m being selfish.”*
    - New thought: *“Caring for myself makes me a better mom and professional.”*
- **Self-care integration:**
    - Small **daily moments of self-care** (a short walk, journaling, or deep breathing).
    - Plans **weekly personal time** (even just 30 minutes for a favorite activity).

**Outcome:** Jessica recognizes self-care as essential, not a luxury. She schedules a **weekly “mom break”** and lets go of the guilt.

### Session 5: Long-Term Strategies & Maintaining Balance

Jessica and I reflected on her progress and created a sustainable, healthy work-life balance plan. She decided to continue meeting once each month to check in and monitor her progress.

**Key Takeaways:**

- **More present parenting:** Focused, guilt-free time with kids.
- **Boundaries upheld:** She stops checking emails during family dinner.
- **Less burnout:** Jessica feels more in control of her schedule.
- **Self-care as a priority:** She now enjoys solo walks without feeling guilty.

This case illustrates how a work-life balance coaching plan using **CBT, boundary-setting, and self-care strategies** can help parents manage stress and effectively and comfortably meet their responsibilities.

## Summary and My Work

If you have had difficulty finding a healthy work-life balance and would like to see if well-established and proven psychotherapy methods might help, please feel free to contact me or schedule a consultation. Better work-life balance is always possible and particularly important during transition periods. My approach combines work-life balance coaching with therapy approaches such as CBT, ACT, mindfulness therapy, [life therapy](https://dralanjacobson.com/life-therapy/), and others for an integrated approach to care. I usually provide this service as part of [individual therapy](https://dralanjacobson.com/individual-therapy/) but it can also be used in [couples therapy](https://dralanjacobson.com/couples-therapy/) and [family treatment](https://dralanjacobson.com/family-therapy/).

This approach can be delivered [effectively as virtual](https://dralanjacobson.com/virtual-therapy-guide/) work-life balance therapy in most cases, which allows me to serve people in most US states. It can be interwoven with some of my specialties, such as executive coaching, leadership coaching, and even [sports psychology](https://dralanjacobson.com/sports-psychology/) (where the issue is between the sport and work or school). I work with people looking for help in many ways. It works well with many therapy combinations, including mindfulness and [reality therapy](https://dralanjacobson.com/reality-therapy-and-mindfulness-counseling/), and CBT and [Life Therapy](https://dralanjacobson.com/quality-of-life-therapy/).

If you have any questions about my services as a [life coach](https://dralanjacobson.com/life-therapists/) and psychologist or want suggestions for better work-life balance, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime. A consultation is always free and includes practical suggestions even if you will not start therapy right away, or if you just want to know more about [how to find therapy](https://dralanjacobson.com/how-to-find-therapy-in-new-york-or-anywhere-a-guide-to-getting-started/).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.linkedin.com/company/psychologicalscience/)

**Categories:** Types of Therapy

---

### [Psychoeducation: Value and Vital Importance in Therapy](https://dralanjacobson.com/psychoeducation/)

**Published:** August 23, 2025
**Author:** Dr. Alan Jacobson

**Content:**

I believe that healing begins with understanding. In my practice, I integrate psychoeducation into every stage of therapy because knowledge empowers clients. When people grasp the ‘why’ behind their struggles and the methods that might lessen them, they gain a clearer path to change. Depression, ADHD, PTSD, and anxiety psychoeducation transforms therapy into a collaborative process. Clients are not passive recipients but active partners in their own growth. My goal is to ensure that every client and family feels informed, supported, and capable of applying what they learn both in and outside of sessions. What is psychoeducation, and how can it benefit you and your family? I will answer that next.

## What is Psychoeducation? ![Psychoeducation](https://dralanjacobson.com/wp-content/uploads/2025/08/research-2.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

ADHD, anxiety, PTSD, or depression psychoeducation is the process of providing clients (and sometimes their families) with structured, [evidence-based information](https://www.cdc.gov/genomics/media/pdfs/2024/04/Evidence-Based_Practice_508.pdf) about mental health conditions, [therapy approaches](https://dralanjacobson.com/types-of-therapy/), coping strategies, and wellness practices. It is not simply “giving information,” but rather a therapeutic intervention that helps clients understand their challenges, normalize their experiences, and build practical skills to manage symptoms.

### What It Involves:

- Explaining the nature, causes, and course of a condition in clear, non-technical terms.
- Clarifying how thoughts, feelings, and behaviors interact.
- Teaching clients about available treatment options and lifestyle supports.
- Encouraging active participation, questions, and shared decision-making.
- Providing resources (handouts, videos, worksheets, apps).
- Involving family members or support systems when appropriate.

### Psychoeducation Techniques:

- **Didactic Teaching:** Using structured explanations, analogies, or visuals.
- **Interactive Dialogue:** Encouraging questions and discussion.
- **Skills Training:** Teaching coping strategies, stress management, relaxation, or organizational tools.
- **Normalization:** Framing symptoms as common and understandable rather than signs of personal weakness.
- **Collaborative Goal-Setting:** Linking information to client goals and choices.
- **Relapse Prevention Planning:** Educating about warning signs and proactive steps.

### Benefits of Psychoeducation

Psychoeducation has wide-ranging benefits that extend beyond simply “understanding” a condition. Its power lies in reducing fear and confusion, fostering motivation, and providing practical strategies that can be applied immediately. Some of the most important benefits include:

1. **Reduces Stigma and Self-Blame**

- Clients often believe their symptoms are due to weakness, laziness, or being “broken.”
- Psychoeducation reframes mental health difficulties as understandable, common, and rooted in biology, psychology, and environment.
- This shift reduces shame, allowing clients to approach treatment with self-compassion instead of guilt.

2. **Increases Insight and Self-Awareness**

- Clients begin to recognize triggers, warning signs, and patterns in their thoughts, emotions, and behaviors.
- This knowledge fosters early intervention (e.g., noticing when anxiety is escalating or when depressive thoughts return).
- Increased awareness empowers clients to make conscious, intentional changes rather than acting on autopilot.

3. **Enhances Treatment Adherence**

- When clients understand how and why treatments work—whether therapy techniques, medication, or lifestyle changes—they are far more likely to follow through.
- Knowledge reduces skepticism about therapy or fears about medication.
- It also helps clients weigh risks/benefits, leading to informed choices rather than resistance.

4. **Promotes Skill Development and Coping**

- Psychoeducation provides concrete tools for managing symptoms (e.g., breathing exercises, organization strategies, [sleep hygiene](https://www.sleepfoundation.org/sleep-hygiene), mindfulness practices).
- Clients not only learn “what” to do but “why” these [strength-based therapy techniques](https://dralanjacobson.com/strength-based-therapy/) work, which increases motivation to use them consistently.
- Over time, clients become more self-reliant and capable of regulating their own distress.

5. **Improves Communication and Relationships**

- When family members or partners are included, psychoeducation fosters empathy and reduces blame.
- Loved ones learn that symptoms (like irritability, forgetfulness, withdrawal) are not intentional but part of the condition.
- Families gain strategies to support rather than criticize, which strengthens relationships and decreases conflict.

6. **Reduces Anxiety and Uncertainty**

- Many clients feel lost when symptoms seem unpredictable or uncontrollable.
- Psychoeducation provides a roadmap, explaining what to expect, possible triggers, and the typical course of treatment.
- This predictability reduces fear and builds confidence in handling future challenges.

7. **Encourages Collaboration and Empowerment**

- Therapy becomes a partnership rather than a top-down process.
- Clients are invited into decision-making, goal-setting, and treatment planning.
- This increases ownership of the therapeutic process, leading to stronger engagement and longer-term outcomes.

8. **Prevents Relapse and Builds Resilience**

- Psychoeducation highlights early warning signs of symptom recurrence and encourages proactive action plans.
- Clients develop “toolkits” they can return to after therapy ends.
- It helps shift focus from crisis management to ongoing wellness and prevention.

9. **Generalizes Beyond Therapy**

- The knowledge and skills clients gain apply not only to their presenting issue but to other areas of life.
- For example, stress management [strategies learned for panic attacks](https://dralanjacobson.com/panic-attack-treatment/) may also improve sleep, work performance, or relationships.
- This broad impact enhances overall quality of life and long-term functioning.

10. **Restores Hope and Motivation**

- Understanding that symptoms have causes, and that recovery is possible, gives clients hope.
- Seeing practical steps forward reduces feelings of helplessness.
- Hope itself becomes a motivator, fueling persistence in the face of difficulty.

What is psychoeducation? It helps clients feel less alone, less confused, and more capable. It bridges the gap between insight and action. What is psychoeducation like in each type of treatment? That is covered next.

## Case Examples of Psychoeducation in Practice

Here are examples of how your therapist might use psychoeducation in your treatment.

1. ### Panic and Anxiety Psychoeducation

A client experiences panic attacks and fears they are “going crazy” or having a heart attack. **Anxiety psychoeducation** helps by:

- Explaining the [fight-or-flight system](https://www.verywellmind.com/what-is-the-fight-or-flight-response-2795194) and how panic attacks are a false alarm of the body’s survival mechanism.
- Teaching the “panic cycle” (how fear of fear fuels more panic).
- Normalizing symptoms like a racing heart, dizziness, and shortness of breath.
- Anxiety psychoeducation provides techniques such as controlled breathing, grounding, and gradual exposure.
- Offering reassurance that panic attacks are not physically dangerous and often peak within minutes.

Anxiety psychoeducation reduces fear of the symptoms and builds confidence in managing panic episodes.

2. ### Depression Psychoeducation

A client feels hopeless, guilty, and unmotivated. They assume they are “lazy” and beyond help. **Depression psychoeducation** can:

- Explain the biological, cognitive, and situational factors that contribute to depression.
- Normalize experiences of fatigue, loss of interest, and negative thinking patterns.
- Clarify how depression alters perception (the “depression filter”).
- Depression psychoeducation teaches [behavioral activation techniques](https://dralanjacobson.com/behavioral-activation/), how small actions (e.g., walking, socializing) improve mood over time.
- Review holistic treatment options beyond [individual therapy](https://dralanjacobson.com/individual-therapy/), including exercise and sleep hygiene.

With this depression psychoeducation framework, the client begins to separate their identity from the illness, reduce shame, and commit to consistent action.

3. ### ADHD Psychoeducation

An adolescent or [adult with ADHD](https://dralanjacobson.com/adhd-therapy-for-adults/) feels disorganized and criticized. **ADHD psychoeducation** includes:

- Explaining how [ADHD is related to brain functioning](https://www.buoyhealth.com/learn/inside-adhd-brain-science) in areas like working memory, inhibition, and time perception.
- Normalizing challenges with procrastination, distractibility, and [hyperfocus](https://en.wikipedia.org/wiki/Hyperfocus).
- Introducing practical tools (planners, reminders, visual timers, apps).
- Teaching about medication options, coaching strategies, and behavioral systems.
- ADHD psychoeducation educates families or teachers about supportive practices (clear instructions, structured routines).

This approach empowers the client to reframe ADHD not as laziness but as a brain-based difference requiring specific supports.

4. ### Family Psychoeducation

A family in frequent conflict believes one member is the “problem.” **Family psychoeducation** helps by:

- Teaching [family systems](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/) concepts (each member influences the whole system).
- Reviewing the stress response and communication breakdowns.
- Family psychoeducation explains common patterns in conflict escalation.
- Providing frameworks for [active listening](https://positivepsychology.com/active-listening-techniques/), “I” statements, and problem-solving.
- Educating on how stress, trauma, or conditions like ADHD or anxiety can influence family dynamics.

The knowledge gained in family psychoeducation reduces blame, fosters empathy, and gives the family practical tools for more respectful communication.

5. ### A Couple Facing a Life Transition

A couple preparing to move to a new city for one partner’s job feels stressed by uncertainty, role changes, and communication breakdowns. Psychoeducation can:

- Normalize [transition stress](https://dralanjacobson.com/life-transitions-therapy/): Explaining how even positive life changes (marriage, relocation, parenthood, career shifts) naturally increase stress levels.
- Teach about adjustment phases: Educating the couple on the “honeymoon, disillusionment, and adjustment” phases of transition so they anticipate ups and downs.
- Highlight coping differences: Helping each partner recognize how they may have different stress responses (one withdrawing, one becoming more controlling) and how this is common.
- Provide communication frameworks: Teaching conflict de-escalation strategies, problem-solving models, and how to check assumptions rather than personalize stress reactions.
- Empower shared planning: Giving them structured ways to set goals and divide responsibilities so both feel included.

By providing this roadmap, psychoeducation reduces blame, increases empathy, and strengthens the couple’s ability to adapt as a team.

6. ### An Adult Facing Public Speaking Anxiety

A professional with strong technical skills avoids promotions and presentations because of intense [fear of speaking in front of others](https://dralanjacobson.com/fear-of-public-speaking-therapy-process/). Psychoeducation can:

- Explain performance anxiety: Clarifying how adrenaline impacts heart rate, sweating, and tremors, and why these reactions are not dangerous.
- Normalize the fear: Teaching that most people feel anxious before public speaking, and that the body’s alarm system exaggerates the threat.
- Show the anxiety-performance link: Using the “[Yerkes–Dodson law](https://en.wikipedia.org/wiki/Yerkes%E2%80%93Dodson_law)” curve to demonstrate how moderate arousal can enhance performance while extreme anxiety interferes.
- Teach coping strategies: Providing evidence-based tools such as diaphragmatic breathing, grounding techniques, and gradual [exposure and response prevention](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/) (e.g., speaking to small groups first).
- Reframe mistakes: Educating the client that small errors are normal and rarely noticed by the audience.

With this knowledge, the client shifts from avoiding opportunities due to [public speaking anxiety](https://dralanjacobson.com/public-speaking-anxiety/) to approaching them with practical coping tools and realistic expectations.

7. ### An Adult with Flight Anxiety

A client avoids travel and misses family events because of intense [fear of flying](https://dralanjacobson.com/fear-of-flying-therapy/). They report panic symptoms at the airport and catastrophic thoughts during turbulence. Psychoeducation can:

- Explain the mechanics of flight: Reviewing how airplanes are designed for turbulence, what safety checks occur, and how common turbulence is without being dangerous.
- Clarify [flying anxiety](https://dralanjacobson.com/flying-anxiety-treatment/) responses: Teaching how elevated heart rate, sweating, and dizziness are normal fear responses, not signs that the plane is unsafe.
- Normalize the experience: Sharing statistics (flying is far safer than driving) and examples of how many people experience flight anxiety.
- Address control and uncertainty: Educating the client about why lack of control intensifies fear and how focusing on controllable factors (packing routines, relaxation strategies) reduces distress.
- Provide coping tools: Introducing strategies such as breathing techniques, distraction methods, guided imagery, or using apps/podcasts that explain turbulence in real time.
- Highlight graded exposure: Reviewing how clients can start small (watching flight videos, sitting in a stationary plane, short flights) to gradually build tolerance.

Through psychoeducation, the client learns that their fear does not equal danger, reframes turbulence as safe, and gains confidence to resume flying with preparation and coping strategies.

## Psychoeducation with Teens

Adolescents are at a unique stage of development where identity, independence, and peer relationships are central. Anxiety, depression, or ADHD Psychoeducation during [therapy for teens](https://dralanjacobson.com/therapy-for-teens/) can be particularly transformative for teens because it not only provides knowledge but also validates their experiences and equips them with tools during a formative life stage.

### Key Features of Teen Psychoeducation

- Developmentally tailored explanations: Using age-appropriate language, visuals, and analogies that connect to school, sports, or social life.
- Normalization of emotions: Reassuring teens that anxiety, mood swings, and self-doubt are common during adolescence and not signs of being “abnormal.”
- Engagement through interaction: Teens learn best through interactive methods—role plays, videos, apps, or group discussions rather than lectures.
- Focus on peer influence: Helping teens understand how peers, social media, and group norms shape stress and self-esteem.
- Emphasis on strengths: Highlighting resilience, creativity, and problem-solving abilities to boost confidence.
- Family involvement: Educating parents alongside teens to encourage empathy, reduce conflict, and foster supportive communication.

### Benefits for Teens:

- Reduces shame about mental health struggles (e.g., “I’m the only one who feels this way”).
- Improves willingness to try coping tools when they understand how and why they work.
- Builds emotional vocabulary, allowing teens to articulate their feelings more clearly.
- Strengthens relationships with parents, teachers, and peers by improving mutual understanding.
- Increases self-efficacy, which can prevent escalation of symptoms into adulthood.

### Anxiety Psychoeducation for Teens Example:

A 15-year-old girl struggling with social anxiety avoids speaking in class. Psychoeducation helps her see how avoidance strengthens fear, teaches her that anxiety symptoms are not dangerous, and introduces gradual exposure strategies. Simultaneously, family psychoeducation helps her parents learn how not to pressure or overprotect her but instead support her small steps toward confidence.

## Conclusion

Incorporating depression, anxiety, PTSD, and ADHD psychoeducation, as well as learning about more specific issues, is one of the most effective ways I help clients take ownership of their mental health. Whether addressing anxiety, depression, ADHD, or family challenges, education provides both reassurance and direction. It allows clients to recognize patterns, anticipate setbacks, and apply strategies with confidence. Most importantly, it instills hope by showing that difficulties are not character flaws but manageable conditions. My commitment is to walk alongside clients, offering both insight and tools, so that therapy becomes not just a place of relief, but a foundation for lasting self-empowerment.

What is psychoeducation, and what can it do for you? Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult#services/service) anytime to discuss your specific needs and hopes.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Integrated Reality Therapy and Mindfulness Counseling](https://dralanjacobson.com/reality-therapy-and-mindfulness-counseling/)

**Published:** March 24, 2025
**Author:** Dr. Alan Jacobson

**Content:**

I provide **integrated mindfulness counseling and reality therapy**. These two approaches work together to create lasting, meaningful change. Many people struggle with stress, anxiety, procrastination, and feelings of being stuck—whether in their careers, relationships, or personal growth. Reality therapy techniques, which are based on choice theory, empower clients to take responsibility for their choices and align their actions with their goals while mindfulness counseling helps them develop self-awareness, emotional regulation, and present-moment focus. By integrating these approaches, clients learn to **pause, reflect, and choose actions that lead to greater fulfillment and well-being**.

In my practice, I help individuals recognize self-defeating behaviors, cultivate mindfulness skills to manage their emotions and create **practical, goal-oriented strategies** for personal and professional success. Combining these techniques fosters **self-compassion and accountability**, allowing clients to navigate life’s challenges confidently and clearly.

## Reality Therapy Overview

Reality therapy is a form of counseling developed by psychiatrist [**William Glasser**](https://en.wikipedia.org/wiki/William_Glasser) in the 1960s. It is based on **Choice Theory**, which emphasizes personal responsibility, present-focused problem-solving, and making better choices to fulfill basic needs. Unlike traditional [types of therapy](https://dralanjacobson.com/types-of-therapy/), reality therapy does not dwell on the past but instead helps individuals take control of their behaviors and make more effective choices.

### What is Choice Theory?

**Choice Theory** emphasizes personal responsibility, internal motivation, and the power of choices in shaping our lives. Choice theory serves as the foundation for **Reality Therapy** and is based on the idea that all human behavior is driven by the need to satisfy five basic psychological needs.

### Key Principles of Choice Theory

#### All Behavior is a Choice

- Choice theory suggests that we choose our actions, thoughts, and emotions to fulfill our needs.
- Instead of blaming external factors, we control how we respond to situations.

#### Five Basic Psychological Needs Drive Behavior

Glasser used Choice Theory to identify five core needs that motivate all human behavior:

- **Survival** – Basic physical needs (food, shelter, safety).
- **Love & Belonging** – Connection, relationships, and acceptance.
- **Power** – Achievement, competence, recognition.
- **Freedom** – Autonomy, independence, and personal control.
- **Fun** – Enjoyment, learning, and play.

#### The Quality World Concept

- In choice theory, each person develops a unique “Quality World” of **people, places, beliefs, and experiences** that they perceive as important for happiness.
- We make choices that align with this personal vision of a fulfilling life.

#### The Only Person You Can Control is Yourself

- Choice theory postulates that we cannot control others, only our own behaviors and reactions.
- Instead of trying to change people, we can **improve relationships through positive choices**.

#### Total Behavior: How We Act and Feel

- According to Choice Theory, behavior consists of four components: 
    1. **Acting** – What we do (our actions).
    2. **Thinking** – Our thoughts and self-talk.
    3. **Feeling** – Emotions that result from our thoughts and actions.
    4. **Physiology** – How our body responds (stress, energy levels, etc.).
- We can influence our feelings and physical state by changing our actions or thoughts.

### Core Reality Therapy Techniques

1. **Emphasizing Choice & Responsibility** – This method encourages individuals to recognize that their actions are choices rather than reactions to external circumstances.
2. **Focusing on the Present** – Instead of revisiting past experiences, the therapy concentrates on current behaviors and ways to improve them.
3. **Identifying Basic Needs** – Reality therapy also helps clients understand that their behaviors stem from efforts to satisfy five basic needs: 
    - Survival
    - Love & belonging
    - Power (achievement)
    - Freedom
    - Fun
4. **Evaluating Current Behaviors** – It encourages individuals to assess whether their actions are helping them effectively meet their needs.
5. **Developing a Practical Action Plan:** Therapists guide clients in creating a realistic, achievable plan to change ineffective behaviors.
6. **Rejecting Excuses** – Clients are encouraged to take responsibility for their choices instead of blaming external factors.
7. **Building Positive Relationships** – Reality therapy emphasizes healthy relationships to meet psychological needs effectively.

### Benefits of Reality Therapy Techniques

- **Improves personal accountability** by helping individuals recognize and change ineffective behaviors.
- **Enhances problem-solving skills** by focusing on present actions and practical solutions.
- **Strengthens relationships** through a focus on meaningful connections.
- **Boosts self-esteem and confidence** by encouraging effective decision-making.
- **Helps with addiction recovery, behavioral issues, and emotional struggles** by reinforcing personal control over actions.

### Who Do Reality Therapy Techniques Work Best For?

Reality therapy techniques can be highly effective for individuals who:

- Struggle with personal responsibility or impulsive decision-making.
- Experience [**relationship conflicts**](https://dralanjacobson.com/relationship-therapy/) and need strategies for better communication.
- Have **behavioral issues**, such as in schools or correctional settings.
- Deal with **addictions** or compulsive behaviors and need a structured approach.
- Want a **practical, [solution-focused therapy](https://dralanjacobson.com/solution-focused-therapy/)** rather than revisiting past traumas.

Reality therapy techniques may be **less effective** for individuals with severe trauma, deep-seated mental health disorders, or those needing intensive emotional processing.

## Mindfulness Counseling Overview

Mindfulness counseling is a therapeutic approach that integrates mindfulness techniques to help individuals develop awareness, emotional regulation, and stress management. Rooted in Buddhist meditation practices, mindfulness was adapted into psychological therapy, especially through approaches like **[Mindfulness-Based Stress Reduction](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) (MBSR)** and **[Mindfulness-Based Cognitive Therapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) (MBCT)**.

This type of counseling encourages individuals to focus on the present moment, accept their thoughts and emotions without judgment, and develop healthier coping strategies for stress, anxiety, and emotional distress.

### Core Mindfulness Counseling Techniques

1. **Mindful Breathing** – Deep breathing exercises that help individuals stay grounded in the present moment.
2. [**Body Scan Meditation**](https://health.clevelandclinic.org/body-scan-meditation) – A technique that increases awareness of bodily sensations, tension, and stress.
3. **Observing Thoughts Non-Judgmentally** – Encourages clients to acknowledge their thoughts without reacting or identifying with them.
4. **Mindful Movement (e.g., Yoga or Tai Chi)** – Combines physical movement with awareness to enhance relaxation and focus.
5. **Grounding Techniques** – Helps clients focus on sensory experiences (e.g., touch, sound, or sight) to manage anxiety or dissociation.
6. **Acceptance & Self-Compassion Practices** – Encourages clients to be kind to themselves rather than engaging in self-criticism.
7. **Guided Imagery** – Uses visualization techniques to foster relaxation and emotional balance.

### Benefits of Mindfulness Counseling Techniques

- **Reduces stress and anxiety** by promoting relaxation and emotional regulation.
- **Enhances focus and attention**, which can be beneficial for individuals with ADHD.
- **Improves emotional regulation**, helping clients respond to emotions more effectively.
- **Boosts self-awareness and self-compassion**, reducing negative self-talk.
- **Aids in the management of depression** by preventing rumination and negative thought spirals.
- **Supports trauma recovery** by increasing body awareness and emotional safety.
- **Can be integrated with other therapies**, such as [cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT), [dialectical behavior therapy](https://dralanjacobson.com/dbt-for-teens/) (DBT), and [acceptance and commitment therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) (ACT).

### Who Do Mindfulness Counseling Techniques Work Best For?

Mindfulness counseling is particularly beneficial for individuals who:

- Experience **anxiety, stress, or panic attacks** and want tools to manage emotional distress. These can be specific (such as with [presentation anxiety](https://dralanjacobson.com/presentation-anxiety/)) or general
- Struggle with **depression** and need strategies to break negative thought patterns.
- Have **ADHD or difficulty focusing**, as mindfulness improves attention control.
- Are dealing with **trauma or PTSD**, as mindfulness can help build safety and grounding.
- Want to develop **greater emotional regulation and resilience**.
- Are seeking **holistic or non-medication approaches** to mental health management.

It may be **less effective** for individuals with severe mental health conditions that require structured interventions or those who struggle with severe dissociation, as mindfulness can sometimes intensify distress in such cases.

## Integrated Reality Therapy and Mindfulness Counseling

Combining **Reality Therapy** and **Mindfulness Counseling** creates a powerful therapeutic approach that emphasizes both **personal responsibility and present-moment awareness**. This integration helps individuals take control of their choices while developing mindfulness techniques to enhance emotional regulation, reduce stress, and improve relationships.

### How Mindfulness Counseling and Reality Therapy Complement Each Other

- **Reality Therapy** techniques focus on **choices, personal responsibility, and goal-setting**, helping individuals make effective decisions to fulfill their needs.
- **Mindfulness Counseling** enhances **awareness, emotional regulation, and acceptance**, allowing individuals to be present and respond rather than react impulsively.
- Together, these approaches help individuals **acknowledge their current behaviors (mindfulness), evaluate their effectiveness (reality therapy), and make conscious changes (goal-setting).**

### Integrated Techniques & Applications

#### Mindful Self-Awareness + Personal Responsibility

- Clients use mindfulness techniques (e.g., deep breathing and thought observation) to recognize their emotions and reactions.
- They then apply **reality therapy techniques** to evaluate whether their actions align with their needs and goals.

**Example:** A client struggling with anger learns to pause using mindfulness breathing before reacting. Then, they assess whether their typical response (yelling, withdrawing) is helping or harming their relationships.

#### Present-Moment Focus + Practical Problem-Solving

- Mindfulness encourages clients to **stay present** rather than get caught up in regrets (past) or anxieties (future).
- Reality therapy techniques provide a **clear action plan** to make constructive changes in behavior.

**Example:** Someone with social anxiety learns [mindfulness therapy techniques](https://dralanjacobson.com/mindfulness-therapy/) to manage their anxious thoughts before evaluating how their avoidance behavior impacts their need for connection. They then set small, achievable goals for social engagement.

#### Emotional Regulation + Goal-Directed Behavior

- Clients use mindfulness to **sit with difficult emotions** without judgment.
- They then apply reality therapy techniques by choosing behaviors that **effectively meet their needs** instead of relying on impulsive or avoidance-based actions.

**Example:** A person struggling with procrastination uses mindfulness to acknowledge their resistance to work without self-criticism. Then, they use reality therapy strategies to take responsibility and implement small, manageable steps to complete tasks.

#### Building Healthy Relationships

- Mindfulness helps clients **be present and listen actively** in relationships.
- Reality therapy techniques emphasize **accountability and effective communication**, reducing blame and improving interactions.

**Example:** A couple uses mindfulness exercises in [marriage counseling](https://dralanjacobson.com/marriage-counseling/) to remain calm in conflicts. Then, they apply reality therapy to assess their communication patterns and create a plan for healthier interactions.

### Who Benefits from This Integrated Approach?

- **People with anxiety & stress** – Mindfulness reduces worry, and reality therapy provides structured action steps.
- **Individuals with ADHD** – Mindfulness improves focus, while reality therapy helps with goal-setting and accountability.
- **Those struggling with relationships** – Mindfulness fosters presence and empathy, and reality therapy strengthens responsibility and communication.
- **Clients working on addiction recovery** – Mindfulness helps manage cravings, while reality therapy reinforces responsible choices.
- **Anyone seeking personal growth** – The integration of self-awareness (mindfulness) and self-discipline (reality therapy) leads to long-term, meaningful change.

### Case Example: Integrated Reality Therapy & Mindfulness Counseling for an Adult

- **Name:** Sarah, 28 years old
- **Occupation:** Marketing Specialist
- **Presenting Concerns:** Stress, procrastination, social anxiety at work, difficulty managing emotions in professional relationships
- **Goals:** Improve productivity, manage stress, build confidence in workplace interactions

#### Session 1-2: Awareness & Responsibility

**Mindfulness Counseling:**

- Sarah learns **mindful breathing** and **body scan techniques** to recognize stress signals in her body.
- She practices observing thoughts without judgment and noticing self-critical thoughts about work performance.

**Reality Therapy Techniques:**

- Sarah evaluates whether her current behaviors (procrastination, avoiding meetings) are helping or hurting her career goals.
- She takes **responsibility for her choices** and acknowledges areas where she can take control.

**Example:** Sarah realizes that avoiding speaking up in meetings is not meeting her need for career growth and recognition.

#### Session 3-5: Emotional Regulation & Goal Setting

**Mindfulness Counseling:**

- She practices **grounding exercises** (focusing on breath, sounds, and sensations) to manage anxiety before presentations.
- She learns **self-compassion techniques** to reduce harsh self-criticism.

**Reality Therapy Techniques:**

- Sarah sets a **small, achievable goal** to contribute at least one idea in team meetings.
- She reflects on whether her actions move her toward success or reinforce avoidance.

**Example:** Sarah does a 3-minute mindful breathing exercise to calm herself before meetings. She then reminds herself that **she has a choice**: stay silent and feel overlooked or take a small step toward assertiveness.

#### Session 6-8: Action & Behavioral Change

**Mindfulness Counseling:**

- She learns to **pause and breathe before reacting emotionally** when receiving constructive criticism.
- She uses **mindful observation** to assess workplace stress without impulsive reactions.

**Reality Therapy Techniques:**

- She evaluates her progress and makes adjustments. If she hesitates to speak in meetings, she asks, **“Is this choice helping me meet my need for success?”**
- She sets a new goal: **networking with colleagues after work once a month** to reduce social anxiety.

**Example:** When her boss gives feedback, Sarah starts to feel defensive. Instead of reacting immediately, she takes a mindful pause, acknowledges her emotions, and responds professionally rather than shutting down.

#### Results & Benefits

- **Increased Self-Awareness** – Sarah recognizes her anxiety triggers and addresses them mindfully.
- **Improved Confidence** – She actively contributes in meetings and builds professional relationships.
- **Better Emotional Regulation** – She responds thoughtfully to feedback instead of reacting defensively.
- **Enhanced Productivity** – Less procrastination, as she evaluates her choices and takes responsibility for work habits.

#### Conclusion

Sarah develops calmness and control over her professional challenges by integrating mindfulness counseling (self-awareness, emotional regulation) with reality therapy (personal responsibility, goal-setting).

### Case Example: Integrated Reality Therapy & Mindfulness Counseling for a College Student

- **Name:** Jake, 21 years old
- **Situation:** Junior in college, recently moved out on his own
- **Presenting Concerns:** Stress about career planning, social anxiety, procrastination, struggling with independence
- **Goals:** Develop career direction, improve social confidence, manage responsibilities

#### Session 1-2: Building Awareness & Responsibility

**Mindfulness Counseling:**

- Jake practices **mindful breathing and thought observation** to manage stress when thinking about his future.
- He learns **body scan meditation** to recognize physical stress signals (tight shoulders, stomach tension).

**Reality Therapy Techniques:**

- He evaluates his current actions: avoiding career prep, isolating himself socially, and procrastinating on schoolwork.
- The therapist asks, **“Are these choices helping you meet your goals or holding you back?”**
- Jake identifies **his basic needs** (freedom, achievement, belonging) and how his current behaviors prevent him from fulfilling them.

**Example:** Jake realizes that binge-watching YouTube instead of networking or studying is **his choice**—and he can change it.

#### Session 3-5: Emotional Regulation & Goal Setting

**Mindfulness Counseling:**

- Jake practices **grounding exercises** (5-4-3-2-1 technique) before networking events to reduce anxiety.
- He learns **self-compassion** to stop harsh self-criticism about career uncertainty.

**Reality Therapy Techniques:**

- He sets **small, manageable goals**: 
    - Research 3 career fields and talk to at least one professor about them.
    - Attend one campus event per month to expand his social circle.
- He assesses whether his **actions align with his long-term goals**.

**Example:** Before a career fair, Jake uses mindful breathing to calm himself, then reminds himself that attending aligns with his goal of career growth.

#### Session 6-8: Action & Long-Term Change

**Mindfulness Counseling:**

- He practices **acceptance** when things don’t go perfectly (e.g., awkward social interactions).
- He learns to **pause before making impulsive choices** (e.g., skipping class due to stress).

**Reality Therapy Techniques:**

- He reflects on his progress: 
    - If he avoids career planning, he asks: **“Is this choice helping me feel more prepared?”**
    - If he isolates, he considers: **“How does this impact my need for connection?”**
- He **adjusts his goals**: now committing to applying for at least two internships before the semester ends.

**Example:** Jake gets nervous before messaging a professor about career advice. Instead of avoiding it, he **pauses, breathes, and reminds himself that taking action is his choice**—then he sends the email.

#### Results & Benefits

- **Less stress about the future** – Mindfulness reduces overthinking, and reality therapy gives him clear action steps.
- **Increased confidence** – He practices social skills in low-pressure settings and builds a support network.
- **Better productivity** – Instead of procrastinating, he takes small, intentional steps toward career growth.
- **Greater independence** – He manages responsibilities effectively, knowing his choices impact his success.

By combining **mindfulness (self-awareness, emotional regulation)** with **reality therapy (goal-setting, accountability)**, Jake builds confidence, reduces stress, and actively works toward his career and social goals.

## Summary and Conclusion

By integrating **mindfulness counseling and reality therapy**, individuals gain the tools to take control of their lives with both **awareness and purpose**. Mindfulness helps clients stay present and accept their emotions without judgment, while reality therapy and choice theory provide a structured approach to making choices that align with their needs and values. Together, these methods empower individuals to break free from unhelpful patterns, cultivate resilience, and move forward with **confidence, clarity, and intentionality**. This approach is often a core part of the [personal growth counseling](https://dralanjacobson.com/personal-growth-counseling/) services I offer.

Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you are seeking a practical and transformative approach based on mindfulness and choice theory that can provide you with the skills and mindset needed to build a future that reflects your true potential.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Therapy for Teens](https://dralanjacobson.com/therapy-for-teens/)

**Published:** October 1, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Therapy for teens** is a specialized form of treatment I offer to address the emotional, social, and developmental challenges faced during adolescence. This period is often marked by significant changes in identity, relationships, and emotional well-being, making **therapy for adolescents** a valuable tool for helping them navigate this complex time. Often called **counseling for teens**, a side benefit of this approach is that it can give adolescents the lasting idea that therapy can be a great place to turn when they are feeling down. I offer both individual and **group therapy for teens**.

The following post is designed to provide an overview of therapy for teens, but if you have more specific questions about how these services might help you or your child, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Types of Therapy for Teens

Here are some common types of effective therapy for adolescents, all generally related to the [third-wave therapies](https://dralanjacobson.com/third-wave-psychotherapy/) that my practice is built on:

### 1. Cognitive Behavioral Therapy for Teens

- **Purpose**: CBT helps teens understand the relationship between their thoughts, feelings, and behaviors.
- **Approach**: [Cognitive behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) for adolescents Focuses on identifying negative thought patterns and replacing them with healthier ones.
- **Effective for**: Anxiety, depression, stress, self-esteem issues, and more. It is a cornerstone therapeutic approach with this age group and one that can provide important and lasting results. I have a separate post about [CBT for social anxiety](https://dralanjacobson.com/cbt-for-social-anxiety/) in teens.

### 2. Dialectical Behavior Therapy for Adolescents

- **Purpose**: A modified form of CBT that helps teens manage intense emotions and build healthy coping mechanisms.
- **Approach**: DBT counseling for teens teaches mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness.
- **Effective for**: Given its usefulness in treating intense emotions and general lability, [DBT therapy for teens](https://dralanjacobson.com/dbt-for-teens/) is often used to treat borderline personality traits, self-harm, suicidal thoughts, and emotional dysregulation.

### 3. Family Therapy

- **Purpose**: [Family therapy](https://dralanjacobson.com/family-therapy/) for adolescents Improves communication and resolves conflicts within the family unit.
- **Approach**: In this area, we involve family members in sessions to work on understanding and supporting each other.
- **Effective for**: This approach can be used in addition to all of the [individual therapy](https://dralanjacobson.com/individual-therapy/) methods listed here when there are also family conflicts, communication issues, and parenting challenges.

### 4. Art or Music Therapy for Teens

- **Purpose**: Art or music therapy for adolescents allows teens to express themselves creatively through art or music. One common approach is [Adlerian Art Therapy](https://dralanjacobson.com/adlerian-therapy/).
- **Approach**: This approach utilizes drawing, painting, or music as a form of self-expression, which can help adolescents explore emotions nonverbally.
- **Effective for**: I do not provide this form of counseling for teens, but I can refer you to someone who dies. This method can lead to greater emotional expression, reduction of anxiety, and improved self-esteem.

### 5. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

- **Purpose**: Helps teens process and heal from trauma.
- **Approach**: Combines cognitive-behavioral techniques with trauma-sensitive interventions.
- **Effective for**: As its name implies, [TF-CBT](https://dralanjacobson.com/cbt-for-trauma/) helps treat abuse, neglect, or other traumatic experiences.

### 6. [Supportive-Expressive Therapy](https://dralanjacobson.com/supportive-expressive-therapy/) for Adolescents

- **Purpose**: This form of counseling for teens helps younger teens express their feelings and resolve conflicts through games and play.
- **Approach**: This approach provides a safe space for teens to communicate emotions through games and play. It is particularly helpful for adolescents new to treatment and those who are uncomfortable relating their feelings.
- **Effective for**: Younger teens dealing with behavioral issues, trauma, or developmental concerns.

### 7. Mindfulness-Based Therapy for Teens

- **Purpose**: [Mindfulness-based therapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) encourages teens to focus on the present moment, which can help reduce stress and anxiety.
- **Approach**: Incorporates meditation, breathing exercises, and mindful awareness.
- **Effective for**: This is an effective add-on method for adolescents that reduces anxiety, depression, stress, and emotional dysregulation.

### 8. Group Therapy for Adolescents

- **Purpose**: Provides teens with peer support in a structured therapeutic setting.
- **Approach**: Teens participate in group sessions to share experiences and learn from others.
- **Effective for**: [Group therapy](https://dralanjacobson.com/group-therapy/) for adolescents provides a place to feel less isolated, more understood, and more supported. The group teaches skills through the professional leading it and also the modeling of peers. I provide more about group therapy for teens below.

I also provide [supportive psychotherapy](https://dralanjacobson.com/supportive-psychotherapy/) for teens who are not quite ready for a more intensive approach.

## Benefits of Counseling for Teens

There are many benefits of counseling for teens, including:

- **Emotional Support**: A safe space to express and explore feelings that may be new, changing, evolving, or confusing.
- **Coping Skills**: Learn techniques to handle stress, anxiety, and other emotional challenges. Many adolescents come away from treatment with a toolkit they find quite helpful.
- **Improved Communication**: Helps develop better communication skills with peers, family, and authority figures.
- **Self-Awareness**: Encourages teens to understand themselves better, including their emotions, behaviors, and thought patterns.
- **Healthy Relationships**: Learn to build and maintain healthy relationships with family and peers.

### Additional Benefits of Virtual Therapy for Adolescents

Much of the therapy for adolescents I offer is done virtually, which provides some teens added benefits

- [Therapy through virtual platforms](https://dralanjacobson.com/virtual-therapy-guide/) may feel more accessible and comfortable.
- [Virtual counseling](https://dralanjacobson.com/is-virtual-therapy-as-effective-as-in-person/) for teens allows for flexibility and privacy, especially when kids have a busy schedule or do not want to be seen going to a psychologist’s office.
- This approach allows for a much wider choice among potential therapists. Families can look for a therapist who is a perfect match whether or not that person practices close to them.

### How Therapy for Adolescents Can Help

- Counseling for teens can reduce persistent sadness, anxiety, or irritability.
- It can increase excitement about the future and the teen’s potential.
- This service can improve attention, focus behavior, sleeping, or eating habits.
- Therapy for teens can increase comfort in school or social situations.
- Counseling for teens can lower withdrawal from friends and family and help build a positive support network.
- The approaches I use can reduce the chances of self-harm, thoughts of suicide, or extreme mood swings.

Counseling for teens is always tailored to the individual’s needs. The goal is to provide tools and strategies to help them manage challenges, increase contentment, develop positive and exciting goals for the future, and develop resilience during this critical stage of life.

## Therapy for Adolescents Example

Here’s a fictitious example of what counseling for teens is like.

**Scenario**: A 15-year-old adolescent, Emily, has been struggling with anxiety and stress related to school performance, social pressure, and conflicts with her parents. Her grades have dropped, and she’s withdrawing from friends. Her parents decide to take her to a therapist for support.

### [Anxiety Therapy for Teens](https://dralanjacobson.com/therapy-for-teen-anxiety/): First Steps

**Introduction and Building Rapport**

- I welcome Emily and her parents, making them feel comfortable. I explain that the sessions are a safe space to discuss anything without judgment. Her parents leave the session for now, after agreeing that they want Emily to talk freely and will not ask about what is said in our [individual therapy](https://dralanjacobson.com/individual-therapy/) sessions.
- Emily feels nervous and unsure about therapy but agrees to talk.

**Gathering Information**

- I asked Emily about her day-to-day life, school, friends, and how she’s been feeling lately.
- The warm and nonjudgmental atmosphere makes Emily feel overwhelmed by school and social media pressure. She worries she’s not good enough and feels like she’s failing, leading to constant stress and a lack of motivation.

**Identifying Issues**

- I gently help Emily articulate her anxiety and explore what triggers her feelings of stress (e.g., academic expectations, fear of judgment from peers, tension at home).
- Emily shares that her parents often argue about her grades, and she feels misunderstood.

**Counseling for Teens Goal Setting**

- I ask Emily what she hopes to achieve through therapy, such as managing her anxiety, improving her grades, or resolving conflicts with her parents.
- Emily expresses that she wants to feel less anxious and get along better with her parents.

**Introducing Coping Strategies**

- I introduce basic techniques to manage anxiety, such as deep breathing exercises, journaling thoughts, and taking small breaks during stressful situations. I also introduced [Cognitive Behavioral Therapy](https://dralanjacobson.com/cbt-for-depression/) (CBT) to challenge negative thoughts like “I’m a failure.”
- Emily agreed to try these techniques over the next week and report on how they worked.

**Involving the Parents (Family Therapy)**

- I bring the parents into part of the session to help improve communication. Emily shares her feelings about the pressure she’s been under, and I mediate the conversation, helping both sides listen without interrupting.
- Her parents learn how their actions may be contributing to Emily’s stress. I provide suggestions on how to communicate more supportively without escalating conflicts**.**

### Therapy For Teens Later Sessions

**Evaluating Progress**

- In future sessions, I check in on how the coping strategies are working for Emily.
- She reports feeling a little better after using deep breathing techniques and finds journaling helpful for understanding her emotions.

**Exploring Deeper Issues**

- I explore deeper issues that may be contributing to Emily’s anxiety, like her fear of failure or her need for validation from others.
- Emily begins to open up more about feeling insecure about her appearance and the pressure she feels from social media.

**Problem-Solving and Empowerment**

- I help Emily develop practical solutions, like setting realistic academic goals and limiting time on social media to reduce comparison with others. We also discuss how to build better boundaries with her parents and friends.
- She starts feeling more in control of her emotions and her life as she learns to challenge negative thoughts and develops healthier coping mechanisms.

**Continued Parental Involvement**

- We continue to involve the parents in certain sessions, teaching them how to support Emily without adding pressure. This could include learning how to express concern without criticism and practicing active listening techniques.

### Outcome

After several months of therapy, Emily feels more confident in managing her anxiety. She uses the coping strategies she learned in therapy, like deep breathing and challenging negative thoughts, and has built stronger communication with her parents. Her parents understand Emily’s challenges better and have adapted their communication style to be more supportive.

This brief and fictional example shows how therapy for teens can address a teen’s emotional challenges, teach coping strategies, and improve family dynamics. Each session with a client is personalized based on their needs and progresses at a pace comfortable for them.

## Group Therapy for Teens

Many find that [group therapy](https://dralanjacobson.com/group-therapy/) for teens is incredibly supportive and impactful. It offers a space where teens can openly discuss and work through challenges with others who are likely facing similar issues. It’s designed to foster connection, understanding, and mutual support, and it provides a structured setting to guide healthy conversations and coping strategies. I offer online group therapy for teens, allowing adolescents to meet in a confidential space, be unlikely to run into others they know, and be able to see that their concerns and stressors are shared among peers all over the country.

### Common Topics in Teen Group Therapy

Some of the most common themes we cover include:

- [**Anxiety and Depression**](https://dralanjacobson.com/therapy-for-depression-and-anxiety/): In group therapy for teens, members share experiences, strategies, and support around managing mood and anxiety.
- **Peer Pressure and Social Challenges**: Group sessions allow discussions around fitting in, bullying, and relationship-building.
- **Self-Esteem and Identity:** Helps teens explore self-image and self-worth and develop a sense of identity.
- **Family Dynamics**: Issues related to family conflict, communication, and expectations are frequently addressed.
- **Coping Skills**: Teens learn and practice tools for handling stress, emotional regulation, and conflict.

### Benefits of Group Therapy for Teens

1. **Sense of Belonging**: Feeling understood can reduce isolation and foster a sense of connection. This can be as true with virtual group therapy for teens, though some feel this more strongly in person. I can help you find an in-person group if this is true for you or your child.
2. **Improved Communication Skills**: Teens practice expressing themselves openly and respectfully. The group is a safe and comfortable space, allowing for this expression.
3. **Peer Learning and Support**: In group therapy for teens, hearing from peers can provide different perspectives, insights, and encouragement.
4. **Positive Peer Influence**: Group therapy for adolescents helps teens build a supportive network that encourages positive decision-making.

### Common Approaches in Teen Group Therapy

I combine several therapeutic techniques within group therapy for teens, such as:

- **[Cognitive Behavioral Therapy for Social Anxiety](https://dralanjacobson.com/cbt-for-social-anxiety/) and depression (CBT)**: Helps them identify and challenge unhelpful thought patterns. Getting advice and understanding from the group can be quite helpful and reassuring.
- **Dialectical Behavioral Therapy (DBT)**: Teaches coping skills for managing intense emotions. DBT is a cornerstone therapy approach to groups for adolescents.
- [**Expressive Therapies**](https://en.wikipedia.org/wiki/Expressive_therapies): Art, music, or drama therapy can help teens express emotions nonverbally. While I do not offer group therapy for teens that is solely expressive, we will use expressive techniques and exercises, sometimes as homework.

My group therapy for teens follows an “open” format, meaning that new people can join at any time, and each client can stop coming when they feel they have met their goals. That said, the open format does require clients to attend all sessions during their involvement with the group.

Group therapy for teens is significantly less expensive than individual counseling and can have the same powerful benefits. However, it’s not a fit for everyone, so parents and teenagers should [schedule a free consultation](https://www.picktime.com/scheduleaconsult) to discuss the best fit.

## Therapy for Teens: My Work

I provide online therapy for teens as a core part of my practice and in specialty areas such as [Sports Psychology](https://dralanjacobson.com/sports-psychology/), [Fear of Public Speaking](https://dralanjacobson.com/public-speaking-anxiety/), and [Fear of Flying](https://dralanjacobson.com/fear-of-flying-therapy/). Of course it is also a part of [college admissions counseling](https://dralanjacobson.com/college-admissions-counseling/) and [therapy for college students](https://dralanjacobson.com/therapy-for-college-students/).

I use techniques centering around [third-wave therapies](https://dralanjacobson.com/third-wave-psychotherapy/), designed to provide a positive, forward-looking approach that focuses on potential and possibilities. Often this treatment is wrapped in a [brief therapy](https://dralanjacobson.com/brief-therapy/) or a brief [supportive psychotherapy](https://dralanjacobson.com/supportive-psychotherapy/) approach so clients see meaningful results quickly.

If you have questions about how individual or group therapy for teens might help you or your child, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime. Also, if your teen has questions, they may want to read my post about [what talking to a therapist is like](https://dralanjacobson.com/talking-to-a-therapist/).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Specialties

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### [DBT for Teens](https://dralanjacobson.com/dbt-for-teens/)

**Published:** October 10, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**DBT for teens** adapts the standard approach to address adolescents’ unique emotional and behavioral challenges. **DBT therapy for teens** combines cognitive-behavioral techniques with mindfulness practices to help teens manage intense emotions, improve relationships, and reduce impulsive or self-destructive behaviors. **DBT for adolescents** is especially useful for teens dealing with issues like mood disorders, self-harm, suicidal ideation, and other difficulties related to emotional regulation. I provide dialectical behavior therapy for adolescents individually, sometimes referring them to a group for adjunctive treatment if they are interested.

## DBT for Teens Overview

Here is an overview of DBT for adolescents, but you are welcome to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you’d like to know how this approach might help you or a loved one. Dialectical behavior therapy for adolescents can have profound effects.

### Key Components of DBT for Teens:

1. [**Individual Therapy**](https://dralanjacobson.com/individual-therapy/): In dialectical behavior therapy for adolescents, teens work one-on-one to address personal challenges, set goals, and apply skills daily.
2. **Skills Training**: In individual or [group therapy](https://dralanjacobson.com/group-therapy/) settings, teens are taught core DBT skills in four modules: 
    - [**Mindfulness Treatment**](https://dralanjacobson.com/mindfulness-therapy/): Learning to be present and aware in the moment.
    - **Distress Tolerance**: Building skills to cope with difficult situations without resorting to self-destructive behaviors.
    - [**Emotional Regulation**](https://psychologicalassessments.com/emotional-dysregulation-testing/): Understanding and managing intense emotions effectively.
    - **Interpersonal Effectiveness**: Improving communication and relationship skills to handle conflicts and assert needs without damaging relationships.
3. [**Family Therapy**](https://dralanjacobson.com/family-therapy/): Since family dynamics can play a crucial role in a teen’s emotional life, DBT for teens often includes a family component where parents or caregivers learn skills and strategies to support the teen’s progress.
4. **Phone Coaching**: In dialectical behavior therapy for adolescents, clients can seek real-time help when they struggle to use their skills in challenging situations.
5. **Therapist Consultation Team**: When working with other therapists, such as a group DBT for teens provider, we meet regularly to ensure we provide the best care and maintain a collaborative and supportive therapeutic environment.

### Benefits of DBT for Teens:

- **Improved emotional regulation**: In DBT for adolescents, clients learn to manage their feelings and respond to stress healthily.
- **Better coping strategies**: In dialectical behavior therapy for adolescents, they gain skills to deal with challenges and avoid harmful behaviors like self-harm or substance use.
- **Enhanced communication skills**: DBT therapy for teens helps clients navigate relationships more effectively, reducing conflicts with peers, family, and authority figures.
- **Reduced impulsive behaviors**: After DBT for adolescents, clients can think more clearly and make better decisions through skills like distress tolerance and mindfulness.

DBT Therapy for teens is highly structured and is effective in helping teens improve their mental health, especially those who struggle with severe emotional or behavioral issues

## Techniques in DBT Therapy for Teens

Dialectical Behavior Therapy for adolescents uses various techniques to help teens develop skills to manage intense emotions, reduce impulsive behaviors, and improve interpersonal relationships. These techniques are organized into four core modules, each targeting specific emotional and behavioral regulation areas.

### 1. DBT for Teens Mindfulness Techniques

DBT for adolescents mindfulness helps teens recognize their thoughts, emotions, and surroundings without judgment. It teaches them to live in the present moment rather than getting overwhelmed by past or future worries.

- **Observe**: Notice thoughts, emotions, and sensations without reacting to them.
- **Describe**: Label thoughts and feelings without adding interpretations (e.g., “I feel sad” rather than “I am a failure”).
- **Participate**: Engage fully in the present moment without distractions.
- **Non-Judgmental Stance**: Accept thoughts and feelings without labeling them as good or bad.

**Example**: DBT for teens might include practicing observing their breath when anxious and simply noticing the feeling rather than trying to push it away.

### 2. DBT for Teens Distress Tolerance Techniques

These DBT therapy for teens techniques help teens cope with difficult situations in the moment without resorting to harmful behaviors, like self-harm or substance use.

- **TIPP**: A set of strategies to regulate extreme emotions quickly: 
    - **T**emperature: Using cold water or ice to calm down (e.g., splashing cold water on the face).
    - **I**ntense Exercise: Engaging in short bursts of physical activity (e.g., jumping jacks).
    - **P**aced Breathing: Slowing down the breath to reduce emotional intensity.
    - **P**aired Muscle Relaxation: Tensing and relaxing muscles to release tension.
- **Distraction**: Redirecting attention away from distressing thoughts by engaging in activities like listening to music, going for a walk, or doing a puzzle.
- **Self-Soothing**: Using the five senses to calm down (e.g., lighting a scented candle, hugging a pillow, or listening to soothing sounds).

**Example**: DBT for adolescents might suggest taking a cold shower and practicing paced breathing when they feel overwhelmed with anger.

### 3. Emotional Regulation Techniques

These dialectical behavior therapy for adolescents techniques help teens understand their emotions and develop strategies to manage them more effectively.

- **Identifying and Labeling Emotions**: Learning to recognize and accurately name emotions (e.g., recognizing frustration versus anger).
- **Opposite Action**: Doing the opposite of what your emotion urges you to do. If the urge is to withdraw due to sadness, the opposite action would be to engage in an activity that brings enjoyment or connection.
- **Accumulating Positive Experiences**: Engaging in activities that create positive emotions over time (e.g., hobbies, spending time with friends, setting achievable goals).
- **Checking the Facts**: Examining whether the emotional reaction fits the situation or if it’s based on misinterpretations or assumptions.

**Example**: DBT for adolescents might help a teen feeling rejected might check the facts by asking themselves whether they are jumping to conclusions about a friend’s behavior, then choose an opposite action by reaching out to someone they trust.

### 4. Interpersonal Effectiveness Techniques

These DBT therapy for teens techniques teach teens to communicate effectively, maintain relationships, and assert their needs without damaging relationships or self-respect.

- **DEAR MAN**: A skill for asking for what you want while maintaining respect: 
    - **D**escribe the situation.
    - **E**xpress how you feel.
    - **A**ssert what you need.
    - **R**einforce the benefits of meeting your request.
    - **M**indful: Stay focused on the goal.
    - **A**ppear confident.
    - **N**egotiate if needed.
- **GIVE**: A skill for keeping relationships healthy: 
    - **G**entle: Be kind and avoid attacking.
    - **I**nterested: Show you are paying attention.
    - **V**alidate: Acknowledge the other person’s feelings.
    - **E**asy manner: Use humor or smile when appropriate.
- **FAST**: A skill for maintaining self-respect in interactions: 
    - **F**air: Be fair to both yourself and others.
    - **A**pologies: Avoid over-apologizing.
    - **S**tick to values: Stay true to what’s important to you.
    - **T**ruthful: Be honest and avoid exaggeration.

**Example**: A teen might use DEAR MAN to ask a parent for more freedom, describing their responsibility and reinforcing the benefits of mutual trust.

---

### Dialectical Behavior Therapy for Adolescents In Practice:

These modules and techniques can be practiced in therapy sessions and applied in real-life situations. DBT for adolescents focuses on building these skills through individual therapy, group skills training, and family involvement. Teens are encouraged to practice these techniques regularly, often using homework assignments and real-life examples from their week to learn how to handle emotions and relationships more effectively.

## Case Example 1: DBT for Adolescents

An example of Dialectical Behavior Therapy for adolescents can provide a snapshot of how this approach is applied to help a teen struggling with emotional regulation, impulsivity, and interpersonal conflicts.

### DBT for Teens Case Example:

Client: Sarah, a 16-year-old girl, has been experiencing intense mood swings, frequent arguments with her parents and friends, and impulsive behaviors like skipping school and self-harming. She often feels overwhelmed by her emotions and doesn’t know how to cope effectively. We decided that DBT therapy for teens would be a perfect approach.

### 1. Individual Session:

In her one-on-one DBT therapy for teens session, Sarah met with me to discuss a recent incident where she had a heated argument with her mother and, feeling overwhelmed, cut herself.

- Me: “Let’s walk through what happened before the argument. What were you feeling and thoughts going through your mind?”
- Sarah: “I was angry because my mom wouldn’t let me go out with my friends. It felt like she didn’t trust me.”
- Me: “It sounds like the situation triggered some strong emotions. We’ve discussed using mindfulness to notice these feelings before they build up. Could we practice that now?”
- Sarah: “Yeah, I guess I could’ve done that, but I was just too angry in the moment.”
- Me: “That’s okay. What could you have done differently using the Distress Tolerance skills we’ve practiced?”

Together, we review Distress Tolerance skills like using ice on her wrists (a technique to ground herself) or taking a step back to engage in radical acceptance—accepting that while she didn’t like her mom’s decision, it wasn’t something she could change in that moment.

### 2. DBT Therapy for Teens Skills Training:

After that, Sarah and I focused on interpersonal effectiveness to help her navigate conflicts and communicate better.

- Specifically, we review the DEAR MAN skill (see above), so she can ask for what she wants while maintaining self-respect and healthy relationships:

We practice using DEAR MAN in role-plays. Sarah practices respectfully and effectively, asking her mom for more trust.

- Sarah: “Mom, I feel frustrated when I’m not allowed to go out with my friends because it feels like you don’t trust me. I’ve been responsible lately, and I’d like you to reconsider. If you could give me a chance, I can show you I can handle it.”

### 3. Family Therapy Involvement:

Sarah’s parents are involved in [family therapy](https://dralanjacobson.com/family-therapy/), where they learn how to support Sarah’s use of DBT skills at home. I teach them to reinforce Sarah’s progress, listen without judgment, and use validation techniques to acknowledge Sarah’s emotions without escalating conflicts.

- Me: “Let’s talk about validating Sarah’s emotions when upset. You don’t have to agree with her behavior, but saying something like, ‘I can see you’re really upset and frustrated’ can go a long way in helping her feel heard.”

### 4. Phone Coaching:

One evening, Sarah feels like she’s on the verge of an emotional breakdown after a tough day at school. She texts me for help in using her skills. I remind her to practice [Mindfulness and Opposite Action](https://www.mindfulnessmuse.com/dialectical-behavior-therapy/10-practical-examples-of-opposite-action-part-one), encouraging her to do something that helps calm her down, like going for a walk or listening to music instead of reacting impulsively.

### DBT for Adolescents Outcome:

Over time, Sarah learns to apply skills in real-life situations. She becomes more mindful of her emotions, uses Distress Tolerance techniques to cope with overwhelming feelings, and improves her communication with her parents. As a result, her relationships improve, her impulsive behaviors decrease, and she feels more in control of her emotions. DBT therapy for teens was a perfect approach.

## Case Example 2: DBT for Teens and Sports Psychology

Alex, a 16-year-old competitive soccer player, struggles with performance anxiety, emotional outbursts on the field, and self-criticism after mistakes. His coach and parents report that he often gets frustrated, lashes out at teammates, and has difficulty bouncing back after setbacks. Alex’s intense emotions interfere with his performance and team relationships.

### DBT for Teen Athletes Treatment Approach

1. **Mindfulness (Staying Present in the Game)**
    - In our first sessions of DBT for adolescents, specifically designed to integrate [sports psychology](https://dralanjacobson.com/sports-psychology/), Alex learned mindfulness exercises to stay focused on the present moment rather than dwelling on past mistakes or worrying about future plays.
    - He uses techniques like “observe and describe” to notice his thoughts without judgment when under pressure.
2. **Distress Tolerance (Handling Losses and Frustration)**
    - Then, he practices “STOP” (Stop, Take a step back, Observe, Proceed mindfully) to prevent emotional outbursts during games.
    - He uses self-soothing techniques like deep breathing or visualization to stay calm after making mistakes.
3. **Emotion Regulation (Managing Intense Feelings on the Field)**
    - In later sessions of DBT therapy for teens, he learns to identify triggers (e.g., missing a goal, criticism from a coach) and applies skills like opposite action (e.g., responding with encouragement instead of anger).
    - He works on self-validation and [cognitive restructuring](https://dralanjacobson.com/cognitive-restructuring/) of negative self-talk (“I failed” → “I can learn from this and improve”).
4. **Interpersonal Effectiveness (Building Team Relationships)**
    - He also practices DEAR MAN (Describe, Express, Assert, Reinforce, Mindful, Appear confident, Negotiate) to communicate more effectively with teammates and coaches.
    - He learns to ask for support and give constructive feedback rather than reacting with frustration.

### Treatment Outcome

Over time, Alex gains better emotional control, improving his performance and relationships with teammates. He becomes more resilient to setbacks, stays composed under pressure, and enjoys the game more.

## Dialectical Behavior Therapy for Adolescents in My Work

I provide many services for adolescents and young adults, and DBT techniques can be mixed into any of them, including [supportive-expressive therapy](https://dralanjacobson.com/supportive-expressive-therapy/), [brief supportive therapy](https://dralanjacobson.com/supportive-psychotherapy/), treatment that helps teens [overcome a learning disability](https://dralanjacobson.com/therapy-for-people-with-learning-disorders/), and others. I also provide [group therapy for teens](https://dralanjacobson.com/therapy-for-teens/) that use these techniques. They can also be part of my specialty services, such as [Sports Psychology](https://dralanjacobson.com/sports-psychology/) and [College Admissions](https://dralanjacobson.com/college-admissions-counseling/). Dialectical behavior therapy for adolescents is powerful, effective, and enlightening, and can have lasting results. It can be used alone, or as part of an integrative approach of[ therapy for teen anxiety](https://dralanjacobson.com/therapy-for-teen-anxiety/) or depression.

Please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you’d like to know how DBT for teens might help you or a loved one.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Therapy Specialties

---

### [Exposure Therapy for Anxiety](https://dralanjacobson.com/exposure-therapy-for-anxiety/)

**Published:** September 15, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Exposure therapy for anxiety** is a form of cognitive-behavioral therapy (CBT) that is commonly used to treat disorders such as phobias, panic disorder, social anxiety, obsessive-compulsive disorder (OCD), and post-traumatic stress (PTSD). The core principle behind this approach is that individuals can gradually and systematically reduce their anxiety over time by progressively and systematically facing feared situations, thoughts, or sensations. This post covers two common approaches: **exposure therapy for OCD** and **exposure therapy for social anxiety disorder**.

Of course, if you have specific questions about how exposure therapy for anxiety might help you or a loved one, or if you are looking for [therapy for more severe anxiety](https://dralanjacobson.com/treatment-for-severe-anxiety/) or a different [therapy for social anxiety](https://dralanjacobson.com/therapy-for-social-anxiety-disorder/), please [get in touch with me](https://dralanjacobson.com/contact/) anytime or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

## Exposure Therapy for Anxiety Overview

The following is an overview of exposure therapy for anxiety in general.

### Key Components of Exposure Therapy for Anxiety

1. **Gradual Process**: Exposure Therapy for Anxiety typically involves starting with less threatening situations. Then, you gradually work up to more feared situations. This is known as a fear hierarchy, where individuals rank situations from least to most stress-provoking. It is done step by step and at a comfortable pace. *The pace and type of exposure are always tailored to your needs and tolerance level.*
2. **Habituation**: With repeated practice, you become accustomed to the stimulus, and over time, the response decreases. This process is called habituation.
3. **Response Prevention**: In some cases, such as OCD, this method involves preventing you from engaging in compulsive behaviors that are used to reduce symptoms. This is called [exposure with response prevention](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/) (ERP). More about this later
4. **Types of Exposure**: 
    - In-vivo in Exposure Therapy for Anxiety involves direct confrontation with real-life situations that cause fears (e.g., facing crowds, driving, or touching a feared object).
    - Imaginal: In cases where it is difficult to confront the fear directly (e.g., trauma or death), the person imagines the feared situation or memory.
    - Interoceptive: This involves exposing you to the physical sensations (e.g., increased heart rate, shortness of breath) to reduce the fear of those sensations.
5. **Virtual Reality (VR) Exposure**: [Virtual environments](https://en.wikipedia.org/wiki/Virtual_reality) sometimes simulate real-life scenarios for individuals not yet ready for in vivo exposure.

### Conditions Treated

- [**Simple Phobias**](https://www.healthline.com/health/phobia-simple-specific): Systematic desensitization of specific phobias (e.g., fear of heights, animals, flying).
- [**Social Anxiety Disorder**](https://en.wikipedia.org/wiki/Social_anxiety_disorder): Gradual exposure to social situations or public speaking.
- **[Obsessive-Compulsive Disorder](https://en.wikipedia.org/wiki/Obsessive%E2%80%93compulsive_disorder) (OCD)**: Experiencing feared thoughts or situations while preventing the compulsive behavior (ERP).
- [**Panic Disorder**](https://dralanjacobson.com/panic-attack-treatment/): Experiencing bodily sensations associated with panic attacks, like dizziness or rapid heartbeat (interoceptive type).
- **[Post-Traumatic Stress Disorder](https://en.wikipedia.org/wiki/Post-traumatic_stress_disorder) (PTSD)**: Imaginal experiences involving traumatic memories or in vivo exposure to trauma-related situations (with caution).
- [Test-taking anxiety](https://dralanjacobson.com/test-taking-anxiety/): Confronting extreme fear about exam situations

### Effectiveness of Exposure Therapy for Anxiety

Research shows that exposure therapy for anxiety is highly effective, often producing long-lasting results. It requires a strong commitment from the individual and is sometimes emotionally challenging since it involves confronting deeply ingrained fears. Again, we will move at a pace you are comfortable with.

## Exposure Therapy for Social Anxiety Disorder

Exposure therapy for social anxiety disorder is a highly effective treatment. It is designed to reduce intense fears of social situations or being judged, embarrassed, or scrutinized by others. The goal of exposure therapy for social anxiety disorder is to help individuals confront and reduce their fear of social situations by gradually exposing them to anxiety-provoking situations. This allows them to learn that their fears are often exaggerated or unfounded.

### Key Steps in Exposure Therapy for Social Anxiety Disorder:

1. **Assessment and Fear Hierarchy**: 
    - Identify Triggers: The first step in exposure therapy for social anxiety disorder involves identifying specific social situations that trigger symptoms. Common triggers might include a [fear of public speaking](https://dralanjacobson.com/public-speaking-anxiety/), attending parties, meeting new people, or eating in public.
    - Fear Hierarchy: We then work together to create a list of social situations ranked from least anxiety-provoking to most anxiety-provoking. For example: 
        - Mild: Making small talk with a coworker.
        - Moderate: Joining a group conversation at a social gathering.
        - Severe: Giving a presentation in front of a large audience.
2. **Gradual Process**: 
    - In exposure therapy for social anxiety disorder, you start by facing situations that cause mild to moderate levels of stress from the fear hierarchy and gradually work toward more challenging conditions. This includes: 
        - In Vivo: Directly facing real-life social situations is important to exposure therapy for social anxiety disorder. For example, if speaking to strangers triggers things, I may have you practice talking to store clerks or striking up casual conversations with new people.
        - Imaginal: If certain social situations (e.g., giving a speech) are too distressing to face immediately, you may first imagine the situation in detail, rehearsing the feelings and learning to tolerate them.
3. **Exposure Therapy for Social Anxiety Disorder Sessions**: 
    - Repeated Practice: Each task is repeated until the fear lessens. For example, if making small talk causes anxiety, you will continue practicing it multiple times until the anxiety associated with it decreases.
    - Duration: Sessions typically last long enough for your symptoms to decrease naturally, rather than avoiding the situation or leaving early, which reinforces the fear.
    - Homework: You may be asked to practice tasks outside of therapy sessions in real-world settings.
4. **Cognitive Restructuring**: 
    - During exposure therapy for social anxiety disorder, you’ll often engage in cognitive restructuring to challenge negative thoughts and beliefs about social situations.
    - For example, a person might think, “If I speak in front of others, I will embarrass myself.” They learn that the feared outcome is unlikely, or it is manageable even if some discomfort occurs.
5. **Mindfulness and Relaxation Techniques**: 
    - Techniques such as deep breathing, progressive muscle relaxation, or [mindfulness exercises](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) may be incorporated. These help you cope with the physical symptoms (e.g., rapid heartbeat, shaking).
    - These skills can be practiced before or during exposure tasks to make the experience less overwhelming.

### Example of Exposure Therapy for Social Anxiety:

A client with social anxiety [fears public speaking](https://dralanjacobson.com/cbt-for-fear-of-public-speaking/). In session, they create a fear hierarchy. At the lower end, the client practices reading a short text aloud in front of a mirror or to a friend. They progress to speaking in front of small groups of friends or coworkers, and finally, they work up to delivering a short presentation at work. Over time, the fear lessens as they become more accustomed to speaking in front of others. Sessions allow for check-in, ideas for new activities, reflections on past attempts, a toolkit of strategies to manage and reduce anxiety, and motivation maintenance.

### Effectiveness of Exposure Therapy for Anxiety in Social Situations:

- **Highly Effective**: Research has shown that this method is one of the most effective treatments for social anxiety disorder. It helps individuals confront and reduce their fears by breaking the cycle of avoidance.
- **Long-lasting Results**: Many individuals experience long-term improvement after completing exposure therapy for social anxiety.

### Challenges and Barriers:

- **Initial Anxiety**: Confronting feared social situations can initially cause increased stress, but this is a natural part of exposure therapy for social anxiety disorder. The goal is to decrease symptoms over time as you gain more confidence.
- **Commitment**: Regular practice and persistence are key. Some people may struggle to stick with things, but therapist support can help.

## Exposure Therapy for OCD

Exposure therapy for OCD is a common and effective approach. It provides a structured, evidence-based approach that helps individuals confront their obsessions and resist the compulsions they usually engage in to reduce anxiety.

### Key Principles of Exposure Therapy for OCD

1. **Exposure**: This involves deliberately exposing you to situations, thoughts, images, or impulses that trigger your OCD-related distress.
2. **Response Prevention**: This involves resisting the urge to perform compulsions or rituals that you typically use to reduce your symptoms (e.g., hand-washing, checking, counting, etc.).

The combination of these two elements in exposure therapy for OCD helps the person gradually reduce the anxiety associated with obsessive thoughts and teaches them that compulsions are not necessary to relieve distress.

### How Exposure Therapy for OCD Works:

1. **Identifying Obsessions and Compulsions**: 
    - The first step is to identify your specific obsessions (e.g., fear of contamination, fear of harming others, intrusive thoughts) and their associated compulsions (e.g., excessive hand-washing, checking, and mental rituals).
    - We then work together to create a fear hierarchy, ranking different obsessions from least to most anxiety-provoking.
2. **Gradual Exposure**: 
    - You are then gradually exposed to their obsessional fears, starting with less stressful situations. For example: 
        - Mild: Touching a doorknob that feels “contaminated.”
        - Moderate: Using a public restroom without washing hands excessively.
        - Severe: Imagining a feared outcome (e.g., harming a loved one).
    - Over time, as you repeatedly face these fears without performing the compulsions, your anxiety diminishes.
3. **Preventing Compulsions**: 
    - During exposure (which is always done at a pace you are comfortable with), I help you resist the urge to perform your compulsions. For example: 
        - If the obsession is a fear of contamination, you might touch a “contaminated” object and then avoid washing your hands.
        - If the obsession is a fear of harming someone, you might expose yourself to situations where you have intrusive thoughts without performing any neutralizing rituals.
    - By resisting the compulsions, you learn that your anxiety will naturally decrease over time (a process known as habituation) and that the feared outcome is unlikely or not as catastrophic as you believe.
4. **Cognitive Restructuring**: 
    - Exposure therapy for OCD often includes [cognitive-behavioral techniques](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) to challenge the irrational or exaggerated nature of OCD-related thoughts. I help you recognize that the compulsions do not prevent the feared outcome, and the obsessions are often unrealistic.

### Example Treatment Plan:

- **Obsession**: A person with OCD is afraid of germs and contamination, fearing they will get sick or cause harm to others.
- **Compulsion**: The person washes their hands excessively, up to 50 times daily, and avoids touching surfaces in public.

**Exposure Therapy for OCD Plan**:

1. **Step 1**: Touching a clean surface like a table and waiting 5 minutes before washing hands.
2. **Step 2**: Touching a doorknob in their home and waiting 10 minutes before washing.
3. **Step 3**: Touching a public doorknob and waiting 15 minutes, gradually increasing the wait time after each exposure.
4. **Step 4**: Touching multiple public surfaces (e.g., bus handles, restroom doors) without washing hands at all.

Each step is repeated until the anxiety decreases, and over time, the person becomes more comfortable with situations that previously caused intense distress. Exposure Therapy for OCD sessions are used to structure and motivate these steps at a pace you are comfortable with, support your efforts, give you a general toolkit to manage anxiety, and encourage continued practice.

### Effectiveness of Exposure Therapy for Anxiety and OCD:

- **Proven Results**: Exposure Therapy for OCD has been extensively studied and is considered the gold standard treatment for OCD. It leads to significant improvement in the majority of people with OCD, often producing long-lasting results.
- **Breaking the OCD Cycle**: This method helps individuals break the vicious cycle of obsessions and compulsions by teaching them that they can tolerate uncertainty and discomfort without resorting to compulsions.

### Challenges and Considerations:

1. **Initial Reactions**: Confronting obsessions without performing compulsions can be very difficult at first. It’s normal for fears to increase temporarily during exposures, but over time, the fear decreases.
2. **Motivation**: It requires commitment and persistence. Some individuals may find it challenging to resist their compulsions, especially if they have been relying on them for years to manage anxiety.
3. **Customization**: The method should be tailored to the individual’s specific obsessions, compulsions, and tolerance level. The pace of the therapy is important, as going too fast or too slow can impact the effectiveness of treatment.
4. **Therapist Support:** This method is the most effective [kind of therapy for anxiety](https://dralanjacobson.com/best-types-of-therapy-for-anxiety/) when used with the guidance of a trained therapist, who can provide support, encouragement, and strategies for managing the discomfort that comes with facing fears.

### Exposure Therapy for Anxiety and OCD in Daily Life:

After the formal sessions, you will be encouraged to continue to practice in real-life situations. This helps generalize the progress made in therapy to everyday settings. Exposure Therapy for OCD empowers you to manage symptoms on your own, giving you the tools to handle future obsessions and prevent relapse. It is often part of [cognitive-behavioral therapy for OCD](https://dralanjacobson.com/cbt-for-ocd/).

## Summary and My Work

If you have specific questions about how exposure therapy for anxiety might help you or a loved one, or if you’d like to know how this method can be combined with other services I offer (including closely related exposure and response prevention or [ERP Therapy](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/)), please [get in touch with me](https://dralanjacobson.com/contact/) anytime or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Myths About Depression](https://dralanjacobson.com/myths-about-depression/)

**Published:** December 24, 2024
**Author:** Dr. Alan Jacobson

**Content:**

In this post, I go over some of the common **myths about depression**, as well as **facts about depression** that are important to know. Then, I go into more detail about two of the more prominent **depression myths**, that antidepressants are a quick fix and the “**chemical imbalance depression myth**.” My goal is to educate those diagnosed so they feel more understood, less stigmatized, and more aware of the possibilities to feel better. I also hope to educate those around people with this illness to more fully understand what that person’s experience is and how they can help.

If you would like to know more about depression myths, how to help a loved one who has the diagnosis, or how to get help for yourself, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Depression Myths ![myths about depression](https://dralanjacobson.com/wp-content/uploads/2024/12/Facts_Myths-300x136.png "Facts_Myths | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

In this section, I review some myths about depression and then explore two of the more common misunderstandings.

### Common Myths About Depression

Here are some of the more common **myths about depression**, followed by the **facts about depression** to debunk them:

#### 1. Myth: Depression is just sadness.

- Fact: This diagnosis is a complex mental health condition that involves persistent feelings of sadness, hopelessness, and a lack of interest in daily activities. It can also include physical symptoms like fatigue, changes in appetite, and sleep disturbances. Sadness may come and go and is a natural reaction to certain events and occurrences, but the diagnosis goes beyond a mood, runs deeper, and is harder to shake. This is one of the myths about depression that many people hold until they have an episode themselves.

#### 2. Myth: You can just “snap out of it.”

- Fact: These symptoms are not a choice; people can’t simply will themselves to feel better. It often requires therapy, medication, and support from others. People with the diagnosis often hope for a quick fix themselves, but it takes time and effort. The good news is that many forms of therapy, such as [cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) and [acceptance and commitment](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/), tend to start to bring relief relatively quickly.

#### 3. Myth: Only weak people get depressed.

- Fact: This diagnosis affects people of all strengths, backgrounds, and personalities. It is a medical condition, not a character flaw or sign of weakness. In my practice, I have seen a wide variety of people with this diagnosis, and often, the only thing they have in common is depressive symptoms and deeply sad mood. This is one of the myths about depression that reduces the support that people feel and can make symptoms worse.

#### 4. Myth: This diagnosis is always caused by a traumatic event.

- Fact: While traumatic events can trigger things, it can also occur without any clear reason due to genetic, biological, or environmental factors. In fact, sometimes the cause of symptoms remains elusive, even after improvement is seen. This is why many therapy approaches I choose focus on the present and future, not spending too much time analyzing the past if it doesn’t seem fruitful.

#### 5. Myth: Antidepressants are a quick fix.

- Fact: Do antidepressants work? The short answer: Medication can be helpful, but it often works best in combination with therapy and lifestyle changes. Recovery takes time and varies from person to person. Some people do not get relief from medication. More about a closely related chemical imbalance depression myth later.

#### 6. Myth: Talking about it makes it worse.

- Fact: Open conversations can reduce stigma, help individuals seek support, and provide relief. Many [different kinds of therapy for depression](https://dralanjacobson.com/best-types-of-therapy-for-depression/) can provide hope, and even when topics in therapy do create a little sadness, the fact that treatment often works to bring improvement brings contentment afterward. Many people avoid treatment due to depression myths like this one, but often, they are glad they changed their minds.

#### 7. Myth: People who seem happy can’t be depressed.

- Fact: Many people hide their struggles behind smiles and appear functional, often called “high-functioning.” Sometimes, there are real periods of relief from symptoms, but these periods may be short. This is a very common presentation in my practice—another of the depression myths that cuts down on the actual support a person receives.

#### 8. Myth: This diagnosis only affects adults.

- Fact: Children and teenagers can also experience symptoms, though they may look different, such as increased irritability, social withdrawal, or academic decline. Younger people may not realize what is going on with them and may look for quick fixes, changing their social lives or interests.

#### 9. Myth: It will go away on its own.

- Fact: While some mild cases may improve over time, an untreated illness can worsen and lead to serious consequences, including self-harm or suicide. Of all the myths about depression, this one is important to recognize—people around the person who is depressed need to take action.

#### 10. Myth: People with depression are just lazy.

- Fact: This diagnosis often saps energy, motivation, and focus, making even simple tasks feel overwhelming. This is not laziness—it’s a symptom of the illness.

Next, we go over another commonly held untruth: the chemical imbalance depression myth. After that, we’ll go into more detail about whether antidepressants work.

### The Chemical Imbalance Depression Myth

The chemical imbalance depression myth refers to the idea that the illness is caused solely by a **“chemical imbalance”** in the brain—specifically, a deficiency of neurotransmitters like **serotonin.** This has been widely promoted in the past. However, this theory is **oversimplified and outdated**.

---

### Chemical Imbalance Depression Myth vs. Fact

1. **No Single Cause:**
    - Biological, psychological, and social factors influence this multifactorial disorder.
    - Brain chemistry is one piece of the puzzle but not the full picture.
2. **Serotonin and Neurotransmitters:**
    - While **low serotonin levels** might play a role in some people’s depression, studies have shown **not everyone with depression has a serotonin deficiency**. This alone refutes the chemical imbalance depression myth.
    - Antidepressants like **SSRIs (Selective Serotonin Reuptake Inhibitors)** can help alleviate symptoms for some, but they don’t work for everyone.
3. **Brain Structure and Function:**
    - Brain imaging studies suggest differences in **certain brain regions** (e.g., the amygdala, hippocampus, and prefrontal cortex) among people with this illness.
    - Chronic stress can also affect these brain areas.
4. **Genetic and Environmental Factors:**
    - Genetics can increase susceptibility, but life experiences (e.g., trauma, chronic stress, social isolation) also play a major role, knocking down the chemical imbalance depression myth.
5. **Inflammation and Hormones:**
    - Emerging research suggests that **chronic inflammation** and **hormonal imbalances** might contribute in some individuals. This shoots down the chemical imbalance depression myth for some, but not everyone with the illness has one.

---

### Why the Chemical Imbalance Depression Myth Persists

- The chemical imbalance depression myth theory was easy to explain and understand.
- Pharmaceutical companies heavily promoted the idea of marketing [**antidepressant medications**](https://www.drugs.com/drug-class/antidepressants.html).
- The chemical imbalance depression myth provided a biological explanation, helping reduce the stigma around depression being seen as a personal weakness.

---

### Do Antidepressants Work? The Truth

Closely related to the chemical balance depression myth is the question of whether antidepressants work. The answer is complicated, but here is a start:

- Fact: This illness is a **complex condition** with no single cause.
- Fact: Effective treatment often requires a **holistic approach**, including: 
    - **Medication (if needed)**
    - **[Psychotherapy](https://dralanjacobson.com/psychotherapy/) (e.g., CBT, DBT)**
    - **Holistic approaches and lifestyle changes (exercise, sleep, diet)**
    - **Social support**
- Fact: While **brain chemistry is involved**, it is not merely a chemical imbalance—it’s a condition shaped by **genetics, life experiences, brain function, and more**. See more about the chemical imbalance depression myth detailed above.

Thus, while antidepressants aren’t a “quick fix,” they can be effective for managing symptoms when combined with therapy, lifestyle changes, and other support systems. Also, they typically take **4–6 weeks** to reach their full effect.

#### Here’s a breakdown of the path to antidepressants working:

1. **Initial Effects:** Some people might notice improvements in sleep, appetite, or energy levels within the first **1–2 weeks**, but mood improvements usually take longer.
2. **Trial and Error:** Finding the right medication and dosage can take time, as everyone responds differently.
3. **Not a Cure-All:** Antidepressants help manage symptoms, but they don’t address underlying causes on their own. Therapy and self-care are usually essential parts of treatment.

## Facts About Depression

While the above covers myths about depression, some facts about depression are important to know:

### Key Facts About Depression

#### 1. It is a Medical Condition:

- This illness is a real, diagnosable mental health disorder, not just a passing mood or temporary sadness. This is one of the facts about depression that seems to be lessening but persists.

#### 2. It’s More Than Just Feeling Sad:

- The illness involves persistent feelings of sadness, hopelessness, loss of interest, and physical symptoms like fatigue, changes in appetite, and sleep disturbances. You can see how closely this one mirrors the depression myths above.

3\. It’s Common:

- Over 280 million people worldwide suffer from this diagnosis, according to the World Health Organization (WHO).

#### 4. It Can Affect Anyone:

- It doesn’t discriminate—it can affect people of all ages, genders, and backgrounds. I go over the depression myths and facts regarding how it affects children later

#### 5. Women Are More Likely to be Diagnosed:

- Women are nearly twice as likely as men to be diagnosed, though men are less likely to seek help. Whether men actually have the diagnosis less often than women may belong in the depression myths category – it may just be that they don’t seek help.

#### 6. There Are Different Types:

- These include Major Depressive Disorder (MDD), Persistent Depressive Disorder (Dysthymia), Seasonal Affective Disorder (SAD), and Postpartum.

#### 7. Symptoms Vary from Person to Person:

- While sadness is common, some may experience irritability, physical pain, or even a lack of emotion entirely. This is one of the facts about depression that drives my practice. I create a unique treatment plan for each client.

#### 8. It Can Lead to Physical Health Problems:

- It is linked to chronic conditions like heart disease, diabetes, and weakened immune function. This is why treatment

#### 9. It’s Treatable:

- With proper treatment, including [individual therapy](https://dralanjacobson.com/individual-therapy/), medication, and lifestyle changes, most people can improve their quality of life. There are even ways to address what is at first called “[treatment-resistant depression](https://dralanjacobson.com/treatment-resistant-depression/).”

#### 10. Suicide Risk is Higher:

- Untreated symptoms are one of the leading causes of suicide worldwide. Another reason it is vital to understand myths and facts about depression so you can best help the people in your life.

#### 11. Exercise and Sleep Play a Role:

- Regular physical activity, a balanced diet, and good [sleep hygiene](https://en.wikipedia.org/wiki/Sleep_hygiene) can significantly improve symptoms of depression.

#### 12. Social Support is Crucial:

- Strong relationships and support systems can help prevent and manage symptoms. This is why it is important to understand depression myths and facts fully!

#### 13. Stigma Prevents People from Seeking Help:

- Many people avoid treatment due to societal stigma, misunderstanding, or fear of judgment. This is another reason why I wanted to create this post so people could fully understand myths and facts about depression.

#### 14. Early Intervention is Important:

- The earlier it is identified and treated, the better the outcomes. [Treating major depression](https://dralanjacobson.com/treating-major-depression/) is easier when it is caught early.

## Myths About Depression vs. Facts in Children

With children and younger adolescents, the myths about depression are a little different than what we see in adults. This section goes over how this diagnosis presents in kids and the depression myths regarding younger people.

### Myths About Depression in Children

#### Myth 1: Children can’t get depressed; they’re too young to understand real sadness.

- Fact: It can affect children of all ages, even toddlers. It’s not just about feeling sad—it’s a mental health condition that impacts mood, behavior, and physical health.

#### Myth 2: Children with depression are just being lazy or seeking attention.

- Fact: This isn’t a choice or a sign of laziness. It’s a medical condition caused by a mix of genetic, biological, environmental, and psychological factors.

#### Myth 3: Children will “grow out of” depression as they get older.

- Fact: Without proper support and treatment, childhood symptoms can persist or worsen over time, increasing the risk of long-term mental health issues. This is one of the depression myths that teachers, parents, and pediatricians need to be keenly aware of.

#### Myth 4: Only children from “bad” homes or traumatic experiences get depressed.

- Fact: While trauma can contribute, children from stable, loving homes can also experience symptoms due to genetic or biological factors.

#### Myth 5: If a child is depressed, they’ll always appear sad.

- Fact: Depression in children doesn’t always look like sadness. It can show up as irritability, anger, trouble focusing, physical complaints (like stomachaches), or changes in sleep and appetite.

#### Myth 6: Talking about depression with a child will make it worse.

- Fact: Open, age-appropriate conversations about mental health can help children feel understood and supported. Ignoring the issue often makes things worse. This is one of the facts about depression that makes teens hesitate to get help.

#### Myth 7: Therapy is only for adults.

- Fact: Therapy can be incredibly effective for children. Child therapists use age-appropriate tools, like play therapy, to help kids express and process their feelings.

### Overcoming Myths About Depression in Kids

Parents, teachers, pediatricians, and anyone working with children must understand the myths and facts about depression and be willing to help a child in distress.

## Summary and My Work

I provide therapy in an [integrative psychological](https://dralanjacobson.com/integrative-therapy/) way, braiding together powerful and effective treatment approaches based on the unique needs of each client. You can see more in my posts about [cognitive behavioral therapy for depression](https://dralanjacobson.com/integrative-therapy/), acceptance and commitment [therapy for depression](https://dralanjacobson.com/therapy-for-depression/), [behavioral activation](https://dralanjacobson.com/behavioral-activation/), [supportive therapy](https://dralanjacobson.com/supportive-psychotherapy/), and more. [Couples therapy](https://dralanjacobson.com/couples-therapy/) and [family treatment](https://dralanjacobson.com/family-therapy/) is also enhanced by understanding the myths about depression first.

If you still have questions about depression myths and how they may affect you or a loved one or how to get help for yourself, or one or more of the facts about depression resonated with you regarding yourself or a loved one, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Symptom Relief

---

### [Treatment-Resistant Depression](https://dralanjacobson.com/treatment-resistant-depression/)

**Published:** June 10, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Treatment-resistant depression** (TRD), also known as **refractory depression**, is a form of major depressive disorder (MDD) that does not respond adequately to at least two different kinds of treatment, usually including antidepressants. I offer **therapy for treatment-resistant depression**, usually in conjunction with other providers such as psychiatrists. In some cases, I do consider TRD to be defined as symptoms that have not cleared after multiple attempts at different types of therapy, where no medication is involved.

If you feel that you have treatment-resistant depression or would like to talk about any of my services, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult). The following provides an overview of therapy for treatment-resistant depression.

## Treatment-Resistant Depression Overview

Here are some key points about TRD:

### Definition and Criteria of Refractory Depression

TRD is typically defined by the lack of response to therapy and two or more antidepressant medications, each given at an adequate dose for an adequate duration (usually 4-6 weeks per medication). Some people expand the criteria to include people who try two or more different types of psychotherapy. People with TRD often have more severe and longer-lasting symptoms compared to those whose depression responds to initial treatments.

### Potential Causes of Treatment-Resistant Depression

Genetic predispositions, such as those that cause [neurotransmitter imbalances](https://www.healthline.com/health/chemical-imbalance-in-the-brain), are often involved with treatment-resistant depression. Sometimes, psychosocial factors such as chronic stress, traumatic experiences, and inadequate social support are involved as well. In some cases, co-existing medical conditions such as [thyroid disorders](https://my.clevelandclinic.org/health/diseases/8541-thyroid-disease), [chronic pain](https://my.clevelandclinic.org/health/diseases/4798-chronic-pain), or [substance abuse](https://en.wikipedia.org/wiki/Substance_abuse) can complicate the treatment of depression.

Other potential causes of refractory depression include other mental health disorders such as anxiety, bipolar disorder, personality disorders, or substance abuse. Even if they don’t cause it they can generally make depression harder to treat. Isolation or lack of supportive relationships can worsen depression. Finally, for some, poor diet, lack of exercise, and other unhealthy lifestyle choices can contribute to the persistence of depression.

Understanding the multifaceted causes of refractory depression can help us develop the most effective treatment strategies tailored to your needs. That said, sometimes the reasons for the symptoms remain elusive, yet we can still find solutions that reduce or eliminate them. One of the common [myths about depression](https://dralanjacobson.com/myths-about-depression/) is that there is always an obvious cause.

## Therapy for Treatment-Resistant Depression

Psychotherapy can help treat TRD, with the following techniques being the most commonly used [kinds of therapy for depression](https://dralanjacobson.com/best-types-of-therapy-for-depression/):

1. [Cognitive-behavioral therapy](https://dralanjacobson.com/cbt-for-depression/) ([CBT for major depression](https://dralanjacobson.com/cbt-for-depression/)), which focuses on changing negative thought patterns and behaviors, is often the first choice for treatment-resistant therapy.
2. [Dialectical Behavior Therapy](https://en.wikipedia.org/wiki/Dialectical_behavior_therapy) (DBT), which was originally developed for borderline personality disorder, combines CBT with mindfulness and is effective for the emotional regulation difficulties that people often experience with TRD. Note that I only provide [DBT for teens](https://dralanjacobson.com/dbt-for-teens/), but I can help adults find a suitable provider.
3. [Interpersonal Therapy](https://dralanjacobson.com/interpersonal-therapy/) (IPT) is a great choice as a therapy for treatment-resistant depression when improving relationships and social functioning is a major goal.
4. [Psychodynamic Therapy](https://dralanjacobson.com/psychodynamic-therapy/) explores unconscious processes and past experiences affecting current behavior and emotions, so it is a good choice when events from the past are potentially causal.

### Adjunctive Treatment Strategies

1. Medication Adjustments: Switching to different antidepressants, combining medications, or using augmentation strategies (adding a non-antidepressant medication that can enhance the effects of antidepressants) can help with TRD.
2. Repetitive Transcranial Magnetic Stimulation (rTMS): This non-invasive procedure uses magnetic fields to stimulate nerve cells in the brain. I am not an expert in this method, so you should start with your primary care physician to inquire about this.
3. Ketamine and Esketamine: Ketamine, traditionally an anesthetic, and its derivative esketamine have shown rapid antidepressant effects in some TRD patients. You should also speak to your primary care physician if you are thinking or pursuing this route.

### Medication Adjustments

The following are some ways to target TRD, but I would suggest each should be done in conjunction with therapy for treatment-resistant depression. This is why I work closely with several psychiatrists.

1. Switching Antidepressants: Trying different [classes of antidepressants](https://www.verywellmind.com/what-are-the-major-classes-of-antidepressants-1065086).
2. Combination Therapy: Using multiple antidepressants together.
3. Augmentation Therapy: Adding non-antidepressant medications (e.g., antipsychotics, mood stabilizers, or thyroid hormones) to enhance the effects of antidepressants.

## Management and Support

Integrated approaches involving psychiatrists, psychologists, primary care providers, and other specialists can be effective, and I often follow a team approach to treatment. I also encourage support from family, friends, and support groups. Here are some supportive approaches:

### Lifestyle and Complementary Therapies

Often, lifestyle changes are not adequately considered when traditional therapies are tried. Thus, treatment-resistant depression therapy is frequently augmented by complementary techniques and approaches, such as:

1. Exercise: Regular physical activity can help alleviate symptoms of depression.
2. Mindfulness and Meditation: Techniques such as [mindfulness-based cognitive therapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) (MBCT) can help reduce depressive symptoms and prevent relapse.
3. Nutrition: Dietary changes and supplements (e.g., omega-3 fatty acids) may support overall mental health.
4. [Sleep Hygiene](https://www.sleepfoundation.org/sleep-hygiene): Addressing sleep disorders and maintaining good sleep habits can improve mood and overall well-being.

### Integrative and Holistic Approaches

Holistic therapy for treatment-resistant depression can be quite helpful in magnifying the effects of psychotherapy for some people. The following have been shown to help in many cases:

1. Acupuncture: Some evidence suggests it may help [alleviate depression symptoms](https://psychcentral.com/depression/acupuncture-for-depression).
2. [Yoga and Tai Chi](https://www.health.harvard.edu/staying-healthy/tai-chi-or-yoga-4-important-differences) combine physical movement, meditation, and breathing exercises to reduce stress and improve mood.

### Supportive Therapies for Refractory Depression

While many people consider couples and family therapy as exclusively for people who need to work something out as a pair of family group, these approaches can also be helpful when only one member is suffering. The others want to know how to best support them.

1. [Support Groups](https://dralanjacobson.com/group-therapy/): Sharing experiences and coping strategies with others facing similar challenges can provide emotional support.
2. [Couples Therapy](https://dralanjacobson.com/couples-therapy/): Involving your partner in your treatment can be quite helpful so that they can learn how to support you best.
3. [Family Therapy](https://dralanjacobson.com/family-therapy/): Involving family members in treatment can improve communication, support, and understanding.

## Therapy for Treatment-Resistant Depression in My Practice

I continually follow the ongoing research that attempts to understand the biological mechanisms underlying TRD, identify biomarkers for predicting treatment response, and develop new therapeutic options. This leads me to adjust my[ integrated treatment approach](https://dralanjacobson.com/types-of-therapy/). Therapy for treatment-resistant depression requires a personalized and often multi-faceted treatment approach, and I collaborate with all other providers you may have. Continuous monitoring and adjustment of therapies are crucial to finding the most effective treatment for each client with TRD, and we’ll work together to find the best approach for you.

### Example of Refractory Depression Treatment

Sara is a 35-year-old teacher who was diagnosed with [major depressive](https://dralanjacobson.com/treating-major-depression/) disorder at age 28. She has no significant physical health issues, was reasonably happy before the diagnosis, and has some family history of dysthymia.

#### Refractory Depression History

When she was first diagnosed, she was started on a selective serotonin reuptake inhibitor (SSRI) called Escitalopram 20 mg/day. She also had Cognitive-behavioral therapy (CBT) once a week. Unfortunately, she showed minimal improvement after 12 weeks, and her depressive symptoms persisted. Then she changed to a different type of medication called a serotonin-norepinephrine reuptake inhibitor (SNRI), Venlafaxine 150 mg/day. A new treatment approach, weekly sessions of interpersonal therapy, was started. This time, she experienced some improvement in her mood, but significant depressive symptoms remained.

More recently, Sara’s psychiatrist started her on an atypical antipsychotic – Aripiprazole 5 mg/day. A new CBT course involved different strategies and a mixed approach with some humanistic techniques. Again, she saw a slight improvement but was still experiencing severe depressive episodes. She is the same as me, with persistent feelings of sadness, hopelessness, fatigue, difficulty concentrating, and recurrent thoughts of death. She is struggling with daily activities and maintaining work responsibilities. Sara clearly has refractory depression, as she has not achieved sustained remission despite multiple treatment strategies over several years. Her ongoing struggle highlights the need for further evaluation and consideration of alternative treatments.

#### Refractory Depression Treatment

I agreed to see Sara in my integrated practice to try new approaches. I referred her to a psychiatrist I work closely with, and she prescribed Phenelzine, a monoamine oxidase inhibitor, that is in a different class than the ones she’s tried. I initiated schema therapy, which is quite different from what she’s tried. It focuses on identifying and changing deeply ingrained patterns. It is considered a good choice for those with Refractory Depression. I paired that approach with closely related Narrative Therapy. Sara began to have some improvement in coping mechanisms and a reduction in negative thought patterns.

We also focused on lifestyle changes, which had not previously been part of her treatment. She undertook a personalized fitness program, including aerobic and strength training exercises, aiming for 30 minutes five days a week. She also consulted with a nutritionist to ensure a balanced diet rich in omega-3 fatty acids, vitamins, and minerals. Finally, I taught her mindfulness techniques to reduce stress and improve emotional regulation.

Another new approach was to involve her family who would provide support and improve communication. They would join our sessions once a month, and Sara and I would tell them how they could help support her. She also joined a reputable online peer support network for individuals with refractory depression.

#### Monitoring and Follow-Up

I give Sara a monthly normed questionnaire to monitor her symptoms, side effects, and overall progress. We will adjust psychotherapy approaches and other treatments based on these results. Sara’s comprehensive treatment plan incorporates a variety of advanced and holistic approaches to address his refractory depression. This multi-faceted strategy aims to provide sustained relief and improve her quality of life through careful monitoring and adjustment of treatments.

### Treatment-Resistant Therapy Referrals

My [psychological practice is integrative](https://dralanjacobson.com/integrative-therapy/), meaning I mix different clinical approaches to give you the best outcome. This can be helpful as therapy for treatment-resistant depression often needs to evolve as symptoms change. I would be happy to help you gather information about refractory depression and the options you have. Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) to discuss this further.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Specialties

---

### [Family Systems Therapy: Powerful, Effective, and Meaningful](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/)

**Published:** December 8, 2024
**Author:** Dr. Alan Jacobson

**Content:**

Family dynamics can be an intricate web where each thread affects the whole structure. When one thread vibrates, it sends ripples through the entire web. **Family Systems Therapy** dives into these complexities, helping you untangle the knots that often lead to conflict, a lack of compassion, emotional distance, and misunderstanding. **Systemic family therapy** treats you as a cohesive unit, focusing on relationships and interaction patterns rather than isolated issues or individuals. **Family systems therapy techniques** foster healthier dynamics and improve relationships by examining the group as a whole. If you want to discuss how the family systems approach might work for you, please do not hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

If you are interested in this type of treatment as a couple, please see my post on [marriage counseling](https://dralanjacobson.com/marriage-counseling/) or for a specific relationship as [mother-daughter therapy](https://dralanjacobson.com/mother-daughter-therapy/).

## Family Systems Therapy Overview

The following is an overview of systemic family therapy, including a basic introduction and the core concepts. Family systems therapy techniques are covered later in this post.

### Systemic Family Therapy: Key Takeaways

- **Family Systems Theory**: Views families as interconnected units, emphasizing relationships and interaction patterns
- **Core Concepts**: Differentiation, triangulation, boundaries, and genograms are pivotal in therapy
- **Family Therapist’s Role**: Facilitates communication, identifies patterns, and empowers families
- **Benefits**: Enhances communication, resolves conflicts, and strengthens bonds
- **Implementation**: Involves assessment, goal setting, and comprehensive engagement

### Understanding Family Systems Theory

Family Systems Theory revolutionizes our understanding of group dynamics. Unlike traditional approaches that view members as separate entities, this theory sees them as interconnected. One member’s actions, emotions, and behaviors can significantly affect everyone. By viewing them as a unit, we can identify patterns and behaviors that contribute to dysfunction.

In a family systems approach, relationships and interaction patterns take center stage. These patterns often form over generations and can define how members interact. Understanding these patterns is crucial for addressing issues and fostering healthier dynamics. For instance, if they tend to avoid conflict, this avoidance can lead to unresolved issues that increase under the surface over time. By recognizing and addressing these patterns through a family systems approach, they can break the cycle and develop healthier ways of interacting.

Family Systems Theory also emphasizes the influence members have on one another. This interconnectedness means that changes in one member can ripple throughout. Understanding this influence can help identify dysfunctional patterns and address them effectively. For example, a parent’s unresolved issues with their parents can affect their relationship with their children, perpetuating a cycle of dysfunction.

Moreover, this theory provides a framework for analyzing dynamics and improving relationships. By examining the structure and each member’s roles, we can help them understand the root causes of their issues and work toward resolution. This family systems approach addresses current problems and equips families with the tools to handle future challenges.

### Core Concepts of Family Systems Therapy

Family systems therapy is based on several core concepts that guide its practice. One is self-differentiation, which refers to a person’s ability to maintain their identity while being part of the group. Balancing independence with connections is crucial. A well-differentiated individual can engage with their other members without being overwhelmed by emotional ties.

Another key concept in systemic family therapy is **triangulation**. This occurs when a third party, often another member, is drawn into a conflict between two people. This can complicate the original issue and create additional tensions. Recognizing triangulation helps families address conflicts directly, reducing the need to involve others unnecessarily.

Family Systems Therapy also focuses on identifying and altering **repetitive interaction patterns**. These patterns often form unconsciously and can perpetuate dysfunction. Family systems therapy techniques bring these patterns to light, helping families develop healthier ways of interacting. For instance, members who habitually blame one member for all problems can learn to take shared responsibility, reducing stress and improving relationships.

**Boundaries** within the system are another essential concept. These define how members relate to each other and the outside world. Healthy boundaries promote respect and understanding, while rigid or loose boundaries can lead to conflicts and misunderstandings. Therapists help families establish appropriate boundaries to foster better relationships.

Lastly, [**genograms**](https://www.verywellmind.com/what-is-a-genogram-5217739) are systemic family therapy tools that map out family history and identify generational patterns. By visually representing relationships and interactions, genograms help therapists and families understand the influences that shape their dynamics. This insight can be invaluable in addressing long-standing issues and promoting change.

You can see these concepts play out in other closely related methods, such as [Bowen Family Therapy](https://dralanjacobson.com/bowenian-family-therapy/).

### Summary of Family Systems Therapy Goals:

- **Improve communication** and relational patterns.
- Promote **healthy boundaries** and roles.
- Facilitate **understanding and empathy** among members.
- **Reduce conflict** and triangulation.

## The Family Systems Therapist

A family systems therapist like me acts as a guide, helping them navigate their relationships and interactions. We facilitate communication and understanding, creating a safe space where all members can express their thoughts and feelings. This open dialogue is crucial for addressing issues and fostering a supportive environment.

A family systems therapist is key in identifying and addressing dysfunctional family patterns. Observing interactions and listening to stories, we can pinpoint areas of concern and develop healthier patterns. For instance, I might introduce exercises to improve emotional communication if members struggle with expressing emotions.

Another critical aspect is creating a safe space. Members must feel comfortable sharing their thoughts and feelings without fear of judgment or retribution. We foster this environment in the family systems approach, encouraging honest and open communication. This foundation is essential for effective therapy and lasting change.

Family systems therapy focuses on helping families develop healthier ways of interacting. We provide tools and strategies to help families communicate more effectively, resolve conflicts, and build stronger connections. These skills address current issues and equip families to handle future challenges.

I hope to empower families to solve their issues and ultimately build resilience. By fostering communication, understanding, and problem-solving skills, we help families become more self-sufficient. This empowerment is a cornerstone of successful systemic family therapy, enabling them to thrive long after the sessions.

## Benefits of Systemic Family Therapy

Family systems therapy techniques offer many benefits for families looking to improve their relationships. One of the most significant advantages is improved communication and understanding. By focusing on relationships and interactions, this systemic family therapy helps family members express their thoughts and feelings more effectively, reducing misunderstandings and conflicts.

This approach also helps resolve conflicts and reduce family stress. Members can develop healthier ways of interacting by identifying and addressing dysfunctional patterns. This not only resolves current issues but also prevents future conflicts, creating a more harmonious home environment. For example, members who learn to communicate openly about their feelings may experience less tension and stress.

### The Power of The Family Systems Approach

Members learn to identify and change destructive behavior patterns through systemic family therapy. Understanding how these patterns develop and influence interactions can break the cycle of dysfunction, leading to healthier relationships and a more supportive environment.

Furthermore, family systems therapy techniques strengthen bonds and promote emotional support. By fostering open communication and understanding, members can build stronger connections and provide better support for one another. This emotional support is crucial for individual well-being and overall health.

Lastly, family systems therapy techniques enhance problem-solving skills and foster a healthier dynamic. By equipping families with the tools to address issues effectively, we help them navigate challenges more easily. This is how the family systems approach improves relationships and promotes resilience and adaptability.

## Family Systems Therapy Techniques

Here are key family systems therapy techniques I use:

---

### 1. Genogram Creation

- What it is: A visual map spanning generations, showing relationships, conflicts, and behavioral patterns.
- Purpose: Helps identify recurring issues (e.g., trauma, addictions, mental health problems) and relational dynamics.
- How it works: 
    - Clients and I map out members, connections, roles, and significant life events.
    - This promotes insights into generational influences and patterns.

---

### 2. Reframing in Systemic Family Therapy

- What it is: Changing the way members perceive a problem or behavior.
- Purpose: Encourages a shift in perspective to see issues as systemic rather than blaming individuals.
- How it works: 
    - Example: Instead of labeling a child as “lazy,” I reframe it as the child feeling overwhelmed or disconnected from expectations.

---

### 3. [Circular Questioning](https://positivepsychology.com/circular-questioning/) in Family Systems Therapy

- What it is: Ask questions to uncover relationships, beliefs, and patterns.
- Purpose: Reveals hidden dynamics and encourages reflection on how behaviors impact others.
- How it works: 
    - Example: “How does your sister’s anxiety impact your parents?” or “What happens when your father gets angry?”
    - These questions involve everyone and highlight interactions.

---

### 4. Boundary Setting Family Systems Therapy Techniques

- What it is: These family systems therapy techniques help identify and adjust enmeshed (overly close) or disengaged (too distant) relationships.
- Purpose: Promotes healthy autonomy and closeness within the group. [Treats codependency](https://dralanjacobson.com/codependency-therapy/) and other relationship issues.
- How it works: 
    - I help members establish clear boundaries (e.g., respecting privacy and [reducing codependency](https://www.verywellmind.com/what-s-the-best-codependency-treatment-5070487)).

---

### 5. [Differentiation of Self](https://www.thebowencenter.org/differentiation-of-self)

- What it is: Encouraging individuals to balance emotional connection with independence.
- Purpose: Helps individuals avoid being emotionally “fused” with others while maintaining close relationships.
- How it works: 
    - I teach strategies to manage emotional reactivity while maintaining connection with other members.
    - Example: A person learns to remain calm and clear-headed in the midst of conflicts.

---

### 6. Triangulation Interventions

- What it is: Identifying and addressing triangulation, where two members align against a third to reduce tension.
- Purpose: Prevents unhealthy alliances and promotes direct communication.
- How it works: 
    - I encourage direct dialogue between two conflicted members instead of involving a third as a mediator.

---

### 7. Role Analysis and Restructuring

- What it is: Identifying and addressing fixed roles within the group (e.g., the “caretaker,” the “scapegoat,” or the “hero”).
- Purpose: Encourages flexibility and equitable participation.
- How it works: 
    - Members explore unspoken expectations and redistribute roles.
    - Example: The over-functioning mother steps back, allowing other members to share responsibilities.

---

### 8. Communication Training

- What it is: Teaching them to express themselves clearly and listen actively.
- Purpose: Reduces misunderstandings and conflict.
- How it works: 
    - Techniques include “I-statements” (“I feel hurt when you ignore me”) and reflective listening (“What I hear you saying is…”).

---

### 9. Family Systems Therapy Sculpting

- What it is: A physical exercise where members position each other to represent their roles and relationships.
- Purpose: Provides a symbolic, non-verbal way to explore dynamics.
- How it works: 
    - I direct one member to place others in the room to “sculpt” the system.
    - Discussions follow about how each person perceives their role.

---

### 10. Psychoeducation and the Family Systems Approach

- What it is: Educating families about mental health issues, systems theory, or other relevant topics.
- Purpose: Reduces stigma, enhances understanding, and promotes change.
- How it works: 
    - Example: Teaching how ADHD impacts family dynamics and communication styles.

---

### 11. Life-Cycle Exploration

- What it is: Addressing challenges tied to [life transitions](https://dralanjacobson.com/life-transitions-therapy/) (e.g., marriage, parenting, empty nest).
- Purpose: Normalizes difficulties and helps them adapt to change.
- How it works: 
    - I guide them to develop new strategies for coping with life transitions.

---

### 12. [Narrative-Based](https://dralanjacobson.com/narrative-family-therapy/) Family Systems Therapy Techniques

- What it is: Encouraging them to externalize problems and reshape their shared “stories.”
- Purpose: Helps them separate the problem from individual identities.
- How it works: 
    - Example: Instead of saying, “John is always angry,” the problem becomes, “Anger keeps interfering in our relationships.”

---

### Implementing Family Systems Therapy Techniques

Family systems therapy techniques require a structured approach to address group dynamics effectively. I begin by assessing the history. This involves gathering information about interactions, patterns, and roles. Understanding these dynamics is crucial for developing a tailored therapy plan.

I then set clear goals and expectations. This collaborative process ensures everyone is on the same page and working towards common objectives. By establishing these goals, I provide direction and focus for the therapy sessions.

Sessions involve all or most members to ensure comprehensive engagement. This inclusive approach allows me to observe interactions firsthand and address issues more effectively. It also encourages members to participate actively, fostering a sense of shared responsibility.

I use family systems therapy techniques like role-playing to address specific issues. These exercises help members understand different perspectives and develop new ways of interacting. By practicing these skills in a safe environment, families can apply them in real-life situations, improving their relationships and communication.

I provide families with tools and strategies to maintain progress outside of therapy. These resources empower them to continue their growth and development after the sessions. By equipping them with these family systems therapy techniques, I work to help them sustain positive changes and foster a healthier dynamic.

### Addressing Dynamics and Communication

Effective communication is the backbone of healthy group dynamics. Family systems therapy techniques emphasize open and honest dialogue, encouraging members to express their thoughts and feelings constructively. This openness helps resolve conflicts and fosters understanding among members.

I teach active listening skills to improve understanding among members. By focusing on truly hearing what others are saying, they can avoid misunderstandings and build stronger connections. Active listening involves paying attention, asking questions, and reflecting on what is being said.

Members also learn to express emotions constructively rather than reactively. This involves recognizing and addressing emotions before they escalate into conflicts. By managing emotions effectively, members can communicate more clearly and avoid unnecessary tension.

Addressing power imbalances promotes equality and respect. Systemic family therapy helps identify and address these imbalances, ensuring all members feel valued and heard. This balance is crucial for fostering healthy relationships and a supportive environment.

## Case Studies in Family Systems Therapy

Real-life examples from my practice demonstrate the transformative power of a family systems approach. These case studies highlight how therapy can change dynamics and improve relationships. By examining these examples, readers can better understand the therapy process and its potential benefits.

In one case, a family struggling with communication issues succeeded through a family systems approach focused on open dialogue and active listening. They resolved conflicts and built stronger connections, which illustrates the positive impact of therapy on long-term dynamics. Another case showcases applying a family systems approach in diverse situations. Triangulation issues were addressed when they learned to address conflicts directly, reducing tension and improving relationships.

## Systemic Family Therapy Aftercare

Maintaining a healthy system after systemic family therapy requires ongoing effort and dedication. Regular family meetings encourage ongoing communication and connection. These meetings provide a platform for addressing issues, sharing thoughts, and making decisions. By fostering open dialogue, they can prevent misunderstandings and build stronger connections.

Establishing clear boundaries helps maintain respect and understanding within the family. These boundaries define how members relate to each other and the outside world. Families can create a supportive and respectful environment by setting and respecting boundaries.

Families should prioritize spending quality time together. This time allows members to bond, share experiences, and strengthen their relationships. Whether it’s a weekly dinner or an outing, these moments foster connection and support.

Open discussions about emotions and issues prevent misunderstandings. Addressing concerns and emotions openly can help them resolve conflicts and build stronger relationships. This openness is crucial for maintaining a healthy dynamic.

Continuous learning and adaptation keep systems healthy and resilient. Families can navigate challenges more effectively by staying open to new ideas and approaches. This adaptability is key to fostering a supportive and harmonious environment.

Aftercare can also include prescribing [behavioral activation](https://dralanjacobson.com/behavioral-activation/) strategies, which means activities they can do together to bring joy to their relationships.

## Frequently Asked Questions

### What is the family systems approach in therapy?

The family systems approach focuses on understanding the dynamics and interactions within a unit. It views them as a system where each member plays a role and is interconnected with others. This approach considers how changes in one member can impact the entire system.

### What is systemic family therapy?

This therapeutic approach focuses on understanding a system’s communication patterns, behavior, and relationships. It explores how each member influences and is influenced by the others, aiming to create healthier dynamics and relationships.

### What is the difference between IFS and family systems therapy?

[Internal Family Systems](https://dralanjacobson.com/internal-family-systems-therapy-ifs/) (IFS) t focuses on the individual’s internal parts and how they interact. It explores the internal conflicts and dynamics within the individual. In contrast, systems therapy focuses on the dynamics and interactions within the unit, considering the relationships and roles of each member.

### How Can We Get Started?

I welcome you to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) to discuss the family systems approach and the family systems therapy techniques I use in my practice. We can also discuss other modes of [family therapy ](https://dralanjacobson.com/family-therapy/)such as [brief strategic family therapy](https://dralanjacobson.com/strategic-family-therapy-powerful-positive-time-limited/), [emotionally focused family therapy](https://dralanjacobson.com/emotionally-focused-family-therapy/), and [solution-focused family therapy](https://dralanjacobson.com/solution-focused-family-therapy-focusing-on-positive-change/) that pair well and how we might design an [integrative approach](https://dralanjacobson.com/integrative-therapy/). This approach also works well with [failure to launch therapy](https://dralanjacobson.com/adult-family-therapy/) and -other approaches when children are older, as well as [co-parenting counseling](https://dralanjacobson.com/co-parenting-therapy/).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Family therapies

---

### [Bowenian Family Therapy](https://dralanjacobson.com/bowenian-family-therapy/)

**Published:** July 12, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Our emotional lives are not formed in isolation. Generations of family patterns, roles, and relationships shape them. In my work, I utilize Bowen Family Systems Therapy, also known as Bowenian Family Therapy, to help individuals and families gain insight into how these patterns influence their current challenges. This model does not look for someone to blame, nor does it [pathologize symptoms](https://positivepsychology.com/pathologizing/). Instead, it seeks to illuminate the system in which those symptoms developed. Through this work, clients begin to see how emotional reactivity, distance, [over-functioning](https://mywellbeing.com/therapy-101/what-is-overfunctioning), or anxiety are not just personal problems, but part of a larger, inherited story that can be changed with reflection, clarity, and choice. This post also includes Multigenerational Family Therapy, which is closely related.

## Bowenian Family Therapy Overview ![Bowenian family therapy](https://dralanjacobson.com/wp-content/uploads/2025/07/Bowenian-300x212.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Bowenian Family Therapy (also known as Bowen Family Systems Therapy) is a form of psychotherapy that focuses on understanding and improving patterns of behavior and emotional functioning within the family system. Developed by [**Murray Bowen**](https://en.wikipedia.org/wiki/Murray_Bowen), this approach views the family as an emotional unit and uses systems thinking to describe the complex interactions within it. Unlike other [family therapies](https://dralanjacobson.com/family-therapy/) that may emphasize symptom reduction, Bowen Family Systems Therapy focuses on promoting insight, self-differentiation, and long-term emotional maturity.

### Key Concepts and Techniques

Bowenian Family Systems Theory leads to the following core techniques and methods

1. **[Genogram Mapping](https://sfhelp.org/fam/geno.htm) in Bowen Family Systems Therapy**
    A visual tool used commonly in Bowen Family Systems Therapy to trace relationships, emotional patterns, roles, and significant events across three or more generations. This helps identify repeating dynamics like addiction, emotional cutoff, or overfunctioning/underfunctioning roles.
2. **Differentiation of Self**
    Encouraging individuals to become more emotionally autonomous while maintaining connections with parents and siblings. Differentiation reduces reactivity and promotes thoughtful decision-making.
3. **Triangles in Bowenian Therapy**
    Identifying how anxiety often leads to [triangulation](https://www.verywellmind.com/what-is-triangulation-in-psychology-5120617), where two family members draw in a third to stabilize tension. Bowen Family Systems Therapy works to expose and detriangulate these patterns.
4. **Family-of-Origin Exploration**
    In Bowen Family Therapy, clients are guided to revisit their upbringing and relationship with caregivers to uncover unresolved attachment wounds or inherited coping strategies.
5. **Coaching Instead of Direct Intervention**
    In Bowenian Therapy, therapists act as coaches who help clients observe patterns and apply changes outside of sessions. The goal is insight and long-term restructuring, rather than symptom-focused interventions.
6. **Tracking Emotional Cutoffs**
    Exploring where and why emotional distancing occurred across generations, and how those cutoffs may be affecting current relationships, is key in Bowen Family Therapy.
7. **Working with Present and Absent Members**
    Bowenian Family Therapy focuses not only on those in the room but also on how deceased or estranged relatives still influence emotional dynamics.

### Who Is Bowenian Family Therapy Best For?

Bowenian therapy is especially beneficial for:

- **Families experiencing intergenerational conflict** or repeated emotional patterns
- **Individuals seeking personal growth** within the context of their system
- **Adults dealing with anxiety, depression, or relationship struggles** rooted in group dynamics
- **Couples** wanting to understand how family-of-origin issues affect their relationship
- **Parents and children** with high emotional reactivity or enmeshment
- **People from families with trauma, chronic illness, or emotional cutoff**

The Bowen Family Systems Therapy model is often best suited for **high-functioning clients** who are motivated to examine and work on long-standing dynamics. However, it can be adapted for use with diverse populations and in various clinical settings.

### Therapist’s Role

The therapist functions as a **non-anxious presence** in Bowen Family Systems Therapy**,** calm, emotionally neutral, and curious. Rather than taking sides or intervening directly, the therapist coaches clients to observe and change their patterns of interaction, especially outside of sessions. Bowen Family Therapy work is typically medium-term and insight-driven.

Expected Outcomes

- Increased emotional self-regulation and reduced reactivity
- Improved communication within families and relationships
- Greater capacity for intimacy while maintaining individuality
- Long-term growth in self-awareness and interpersonal functioning
- Reduction in intergenerational transmission of dysfunction
- Better coping with anxiety, conflict, and stressors

Outcomes often emerge gradually, as the therapy encourages sustained personal work and changes in relational patterns over time.

## Bowenian Family Systems Theory Integrations

Bowenian Family Therapy can be integrated with:

- **[Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT):** To address specific symptom patterns like anxiety or depression while working on systems issues.
- **[Narrative Family Therapy](https://dralanjacobson.com/narrative-family-therapy/):** Particularly when working with intergenerational trauma or identity issues.
- **[Emotionally Focused Family Therapy](https://dralanjacobson.com/emotionally-focused-family-therapy/) (EFFT):** To deepen emotional connection in couples while using Bowenian insights to reduce fusion and reactivity.
- **[Mindfulness-Based Therapies](https://dralanjacobson.com/mindfulness-therapy/):** To support self-observation and emotional regulation, especially in emotionally intense systems.
- **[Structural Family Therapy](https://dralanjacobson.com/structural-family-therapy/):** To shift family roles and boundaries while maintaining a systems focus.

Bowenian Family Therapy is a systems-based, insight-oriented approach that helps individuals and families understand multigenerational emotional patterns. It emphasizes differentiation of self, healthy emotional boundaries, and the importance of understanding one’s history. This method is most effective for those willing to engage in thoughtful self-exploration and systemic change over time. Bowenian Family Therapy is often used in combination with more directive or emotion-focused approaches for comprehensive care.

## Case Example: Bowenian Family Therapy with Grown Children

Maria, a 62-year-old divorced mother, seeks therapy due to growing tension with her two adult children, Alex (35) and Julia (32). Alex has grown distant, rarely visits, and seems cold during interactions. Julia is more present but often complains of being “emotionally drained” after talking with her mother. Both children report feeling “guilty” and “obligated” rather than genuinely connected.

### Family Background:

Maria grew up in a chaotic home with an emotionally volatile mother and an emotionally absent father. As the eldest of five siblings, she frequently assumed a caretaker role. After divorcing when her children were in their early teens, Maria leaned heavily on them for emotional support. She was never physically abusive but had few emotional boundaries, often oversharing, expressing anxiety openly, and relying on them for reassurance.

### Bowenian Family Systems Therapy Focus:

1. **Genogram Construction**
    I worked with Maria to build a three-generation genogram. This revealed patterns of emotional cutoff (Maria from her father), overfunctioning-underfunctioning dynamics (Maria with her children), and triangulation (Maria often complained about one child to the other).
2. **Differentiation of Self**
    I helped Maria begin to separate her emotional needs from her relationship with her children. She began to explore her own identity beyond the “mother” role. She began practicing sitting with her anxiety rather than discharging it through emotional phone calls or guilt-inducing messages.
3. **Detriangulation**
    Maria learned that venting to Julia about Alex’s distance had placed Julia in an uncomfortable triangle. She committed to stopping this behavior and began working on directly reflecting on her sadness about Alex without pulling Julia into the middle.
4. **Process-Oriented Questions**
    Instead of focusing on how to “fix” her kids or make them visit more, the therapist asked questions like: “What part of this dynamic feels familiar from your upbringing?” and “What would it look like to express sadness without making others responsible for fixing it?”
5. [**Family-of-Origin Work**](https://dralanjacobson.com/family-of-origin-therapy/)
    Maria wrote a letter (never sent) to her deceased mother, acknowledging unresolved grief and the burden of being the “emotional manager” in the system. This Bowen Family Systems Therapy exercise helped her recognize how she repeated this pattern with her children.

### Outcome After 8 Months of Bowen Family Therapy:

- Maria reported increased emotional awareness and reduced anxiety.
- Her children noticed she became less emotionally reactive and less dependent on them for reassurance.
- Alex initiated occasional contact again, and Julia described their relationship as “less heavy and more honest.”
- Maria began developing friendships and hobbies outside of her children, enhancing her sense of self.
- Most importantly, she no longer saw her children’s closeness or distance as a reflection of her worth but as part of their own differentiation journeys.

This case illustrates how Bowenian Family Therapy can help a parent of adult children explore long-standing dynamics, reduce emotional fusion, and promote healthier, more authentic intergenerational relationships.

## Case Example: Bowen Family Therapy with Adolescent Children

Thomas and Elena, both in their early 40s, seek family therapy due to escalating conflicts with their 15-year-old son, Ryan, and 13-year-old daughter, Lily. Ryan is defiant, avoids interaction, and has slipping grades. Lily is anxious, overly compliant, and often takes on the role of peacemaker. Both parents report feeling frustrated, helpless, and emotionally exhausted.

### Family Background:

Elena grew up in a high-pressure household where emotions were minimized, and achievement was paramount. Thomas’s parents divorced when he was 10, and he recalls frequent yelling and being “caught in the middle.” The couple has different parenting styles: Elena tends to over-involve herself in the kids’ lives, while Thomas withdraws during conflict. Their dynamic often leads to indirect communication, with the children becoming emotional conduits between them.

### Therapeutic Methods (Bowenian Family Therapy Approach):

1. **Genogram Construction**
    A three-generation genogram helped uncover patterns of emotional fusion, parental role reversal, and generational triangulation. Elena’s anxious attachment to her parents was mirrored in her over-involvement with Lily, while Thomas’s childhood emotional cutoff mirrored his tendency to disengage from Ryan.
2. **Differentiation of Self**
    Bowen Family Therapy focused on helping both parents become more emotionally separate from their children’s behavior, learning not to interpret defiance or anxiety as personal failure or something to control. They practiced observing their emotional reactions without acting on them immediately.
3. **Bowen Family Therapy Detriangulation**
    I helped the parents recognize how their conflicts were often triangulated through the children, e.g., Thomas criticizing Elena’s parenting through sarcastic comments to Ryan, or Lily reporting one parent’s frustrations to the other. Sessions focused on reducing these patterns by encouraging direct communication between adults.
4. **Bowenian Therapy Process-Oriented Questions**
    I used [reflective questions](https://www.growthtactics.net/self-reflection-questions/) to promote insight: 
    - “When did you start feeling responsible for Lily’s anxiety?”
    - “What makes it difficult for you to set limits without anger?”
        These prompted deeper exploration rather than surface-level behavioral management.
5. **Bowen Family Therapy Historical Work**
    Each parent explored how unresolved emotional attachments to their own parents were influencing their reactions to their children. Elena realized her fear of Ryan failing school echoed her own father’s judgment, while Thomas connected his emotional distance to the unprocessed hurt from his parents’ divorce.
6. **Parent Coaching Outside of Sessions**
    I acted as a coach, helping Thomas and Elena plan small shifts at home, such as stepping back when anxious, giving teens more space to manage their responsibilities, and practicing a neutral tone and timing during conflicts.

### Outcome After 5 Months of Bowen Family Therapy:

- Ryan became less oppositional and more open to conversations with his parents, particularly after Thomas re-engaged with him without criticism.
- Lily reported feeling less responsible for “keeping the peace” and started setting boundaries with her mother.
- Elena learned to tolerate uncertainty and stopped micromanaging homework, leading to more autonomous behavior from both teens.
- Thomas began expressing emotions more directly with Elena rather than through passive withdrawal or sarcasm.
- The family reported a general decrease in reactivity and an increase in emotional calm, even when conflicts arose.

This case illustrates how Bowenian Family Therapy can help parents of adolescents disentangle themselves from unhelpful emotional patterns, support the healthy individuation of their teens, and foster a more emotionally balanced environment. The Bowenian Therapy’s emphasis on intergenerational patterns and emotional boundaries equips families to manage adolescence with greater clarity, respect, and resilience.

## Multigenerational Family Therapy: Overview and Clinical Application

**Multigenerational Family Therapy** is a therapeutic approach grounded in the belief that current psychological struggles and relational patterns are deeply influenced by dynamics that have been passed down through generations. This model, closely associated with Bowenian Family Systems Theory, explores how unresolved emotional issues in previous generations shape the behavior, roles, and relationships of individuals and families in the present.

### Overview of Multigenerational Family Therapy

Multigenerational Family Therapy emphasizes:

- The **group as an emotional system**, where anxiety, roles, and coping mechanisms are transmitted across generations.
- The concept of **differentiation of self** is a person’s ability to maintain emotional independence while staying meaningfully connected to the larger unit.
- The importance of **multigenerational work** in resolving current relational or emotional challenges.
- [**Systemic thinking**](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/), which views problems not as isolated to one individual (the “identified patient”) but as embedded in processes.

#### Who Is It Best For?

The Multigenerational Family Therapy model is particularly effective for:

- Families with **intergenerational patterns of conflict, trauma, or dysfunction**
- Individuals facing **recurring emotional or relationship struggles**
- Parents seeking to **break unhealthy cycles** for the sake of their children
- When there is**[ enmeshment](https://www.simplypsychology.org/what-is-enmeshment.html), emotional cutoff, or chronic anxiety**
- Adult children navigating **aging parent issues** or unresolved history
- Those affected by **cultural or historical trauma**, such as immigration or systemic oppression

### Multigenerational Bowen Family Therapy Goals

- Increased emotional maturity and personal responsibility
- Improved ability to manage conflict and reduce emotional reactivity
- Healing of generational wounds and resolution of inherited trauma
- Reduced projection of unresolved issues onto children or partners
- Strengthened intergenerational relationships, with clearer boundaries
- Greater clarity in roles, expectations, and group identity

### Integration with Other Models

Multigenerational Family Therapy is often integrated with:

- **Structural Therapy:** To address rigid roles or dysfunctional hierarchies
- **Narrative Therapy:** Especially when families have inherited “problem-saturated” stories across generations
- **[Trauma-Informed Therapy](https://dralanjacobson.com/trauma-informed-care/):** To address historical or cultural trauma within a multigenerational framework
- **Mindfulness and CBT:** For present-focused symptom management while addressing systemic roots

### Multigenerational Family Therapy Example Case

A family presents for therapy because the youngest daughter is experiencing panic attacks. Over time, I uncovered that the mother was raised by a highly anxious parent who relied on her for emotional support. The same dynamic is now playing out with the daughter. Through genogram work and differentiation coaching, the mother learns to manage her anxiety without leaning on her daughter, and the daughter becomes less symptomatic as she gains emotional space.

Multigenerational Family Therapy is a powerful approach for breaking cycles of dysfunction, fostering long-term emotional growth, and promoting healthier dynamics. By examining how the past influences the present, this model empowers individuals and families to intentionally and clearly rewrite their emotional legacy.

## Bowenian Family Systems Theory Summary

Working within the Bowenian Family Systems Theory framework allows clients to step back from immediate emotional reactivity and view themselves and their relationships with more objectivity and calm. As clients become more differentiated, they experience greater stability, improved relationships, and a more profound sense of emotional freedom. The changes may not happen overnight, but they are lasting, rooted in awareness rather than quick fixes. My goal is to support each person in becoming more grounded, thoughtful, and emotionally connected, without being consumed by the anxiety of others. When one person in a family changes their behavior, the entire system begins to shift. That is the quiet power of Bowen Family Therapy.

### Bowen Family Systems Therapy

If you have any questions about Bowen Family Systems Therapy or the Bowen Family Therapy approach in general, please don’t hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.linkedin.com/company/psychologicalscience/)

**Categories:** Family therapies

---

### [The Power of Parent Coaching to Create Positive Change](https://dralanjacobson.com/parent-coaching/)

**Published:** January 10, 2025
**Author:** Dr. Alan Jacobson

**Content:**

As you navigate the highs and lows of raising children, it’s natural to seek guidance and support. Enter parental coaching, a powerful tool that can help you unlock your full potential. I provide three levels of professional support: **Parenting coaching** uses scientifically proven methods to help you build skills, confidence, and strategies for addressing challenges and fostering a positive family environment. Still, it does not explore your unique psychological makeup too deeply; **parental counseling** goes a little deeper, looking at how your unique patterns of moods, interpersonal communication, and temperament affect your care of your child; and **parent therapy** goes even further, exploring how your psychological makeup, often including the parenting you received, affects you.

This service offers personalized strategies and insights tailored to your family’s needs, providing the support necessary to tackle challenges head-on and foster a nurturing environment for your children.

### Parenting Coaching, Counseling, and Therapy Services

Please don’t hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you’d like more information about parent coaching, counseling, or therapy or to inquire about my services. The following breaks the service into the three levels described above.

## Parent Coaching Overview

Parent coaching is more than just advice; it’s a partnership that empowers you to make informed decisions for your child’s well-being. At its core, parenting coaching provides *personalized guidance* tailored to your family’s unique needs. I work with you to identify your strengths and address challenges, offering support that aligns with your values and goals.

Parenting coaching sessions often focus on enhancing your strengths while addressing specific challenges. Through active collaboration, I provide research-based strategies and techniques to improve your skills. Imagine having a toolkit with effective strategies to tackle tantrums, bedtime battles, or sibling rivalry. With parent coaching, this becomes a reality.

One key benefit of parenting coaching is the practical application of new skills in real-life scenarios. I often incorporate exercises that help you practice and implement the strategies discussed during sessions. This hands-on approach reinforces learning and empowers you to apply newfound skills confidently.

Parenting coaching equips you with the tools to make informed decisions that promote your child’s well-being. Whether dealing with a toddler’s tantrums or a teenager’s rebellion, coaching provides a supportive environment to explore solutions and foster positive change.

### Benefits of Parenting Coaching

Parenting coaching offers numerous benefits that can transform your parenting journey. One of the most significant advantages is the boost in confidence you experience when handling challenges. With the right tools and strategies, you gain the assurance to navigate even the toughest situations.

Understanding your child’s behavior and [developmental stages](https://www.simplypsychology.org/erik-erikson.html) is another crucial benefit of parenting coaching. I help you understand why your child behaves a certain way, enabling you to tailor your approach to their needs. This knowledge enhances your ability to respond effectively and empathetically to your child’s actions.

Coaching often improves family dynamics and communication. You create a harmonious environment that fosters healthy relationships by learning effective communication techniques and conflict-resolution strategies. As a result, many experience a reduction in stress and anxiety thanks to supportive guidance.

Parent coaching also encourages a proactive approach. Rather than waiting for issues to escalate, you learn to address potential challenges before they become major problems. This [foresight approach](https://foresightpsychology.org/) promotes positive change and allows you to nurture a strong, healthy family dynamic.

### Implementing Parent Coaching Strategies

Consistent practice is key to strengthening your skills and seeing long-term benefits. Set realistic goals and track your progress to measure your success and stay motivated.

Including all caregivers in the process ensures consistency. When everyone is on the same page, children receive clear, unified messages promoting stability and understanding. Adapting strategies to fit your child’s unique personality and needs is essential for success. Remember, what works for one child may not work for another, so flexibility is key.

Celebrating small victories along the way helps maintain motivation and commitment. Whether it’s a successful bedtime routine or a peaceful dinner, acknowledging these wins reinforces your efforts and encourages continued growth.

#### Enhancing Communication with Your Child

Effective communication is the foundation of a strong relationship. Active listening is crucial, showing your child that their thoughts and feelings matter. You reinforce their confidence in expressing themselves by giving them your full attention and responding empathetically.

Open-ended questions encourage your child to share their thoughts and feelings more freely. Instead of asking yes-or-no questions, try exploring topics that allow for more in-depth discussions. This approach fosters a deeper connection and understanding between you and your child.

Clear and respectful communication is vital for building trust and understanding. Using [non-verbal cues](https://www.verywellmind.com/types-of-nonverbal-communication-2795397), like maintaining eye contact and offering reassuring gestures, reinforces your verbal messages. Practice empathy to connect with your child’s emotions, helping them feel understood and supported.

#### Parent Coaching for a Strong Relationship

A strong relationship is built on quality time spent together. Shared activities create lasting memories and foster mutual respect. Whether playing a game, reading a book, or engaging in a hobby, these moments strengthen your bond and promote emotional growth.

Consistent boundaries and expectations provide security and structure for your child. Setting clear guidelines creates an environment where your child feels safe and supported. [Positive reinforcement](https://www.simplypsychology.org/positive-reinforcement.html) encourages desired behaviors and boosts your child’s self-esteem, reinforcing their sense of accomplishment.

A supportive environment fosters open communication and emotional growth. When your child knows they can turn to you for guidance and support, they feel secure in expressing themselves and seeking advice.

#### Addressing Behavioral Challenges

Addressing behavioral challenges requires a proactive approach. Start by identifying triggers and patterns in your child’s behavior to uncover underlying issues. By understanding the root causes, you can develop effective strategies to address them.

Develop a [positive discipline approach](https://www.positivediscipline.com/about-positive-discipline) that focuses on teaching rather than punishment. Collaborate with your child to set achievable goals and consequences, empowering them to take responsibility for their actions. This approach fosters mutual respect and encourages positive behavior changes.

It is crucial to stay calm and patient when addressing challenging behaviors. Your response sets the tone for resolving conflicts, so approach each situation with empathy and understanding. Don’t hesitate to seek support for specific behavioral issues.

### Supporting Your Child’s Development through Parent Coaching

Parent coaching plays a vital role in supporting your child’s development. I can help you understand your child’s developmental milestones, providing insights into their growth and potential challenges. With this knowledge, you can tailor your approach to support their unique learning style and needs.

The strategies provided enhance your child’s cognitive, social, and emotional growth. You create a nurturing and stimulating environment that promotes holistic development by implementing research-based techniques. Informed decisions empower you to make choices that benefit your child’s well-being.

Ongoing coaching keeps you updated on new research and best practices. This continuous learning ensures you’re equipped with the latest tools and insights to support your child’s growth and development.

## Parental Counseling Overview

Parental counseling is a process aimed at supporting you in raising your children effectively, fostering healthy family dynamics, and addressing challenges that arise. It can help you understand your child’s needs, develop effective communication and discipline strategies, and manage stress. Here are some key aspects of parental counseling:

### 1. Goals of Parental Counseling

- **Enhance Skills**: Parental counseling seeks to improve strategies for guiding children through various stages of development.
- **Improve Communication**: Parental counseling fosters open and effective communication.
- **Resolve Conflicts**: Address and resolve family conflicts or behavioral issues.
- **Emotional Support**: Help you manage your emotions, such as stress, guilt, or frustration.
- **Understand Child Development**: Educate you about developmental milestones and age-appropriate behavior.

### 2. Common Topics in Parental Counseling

- **Behavior Management**: Addressing tantrums, defiance, or other behavioral challenges.
- **Academic Support**: Helping children with learning difficulties or school-related stress.
- **Mental Health Awareness**: Understanding mental health issues like ADHD, autism, anxiety, or depression in children.
- **Bonding**: Strengthening relationships and trust.
- **[Co-Parenting Treatment](https://dralanjacobson.com/co-parenting-therapy/) Strategies**: Supporting those who are divorced, separated, or in blended families.

### 3. Types of Parental Counseling

- [**Individual Counseling**](https://dralanjacobson.com/individual-therapy/): Focused on one person’s challenges and goals.
- [**Couples Counseling**](https://dralanjacobson.com/marriage-counseling/): For those addressing issues as a team.
- [**Family Therapy**](https://dralanjacobson.com/family-therapy/): Involves the whole family to work on dynamics and relationships.
- **Group Counseling**: Support and [therapy groups](https://dralanjacobson.com/group-therapy/) for people facing similar challenges.
- **As part of [Divorce Therapy](https://dralanjacobson.com/divorce-counseling/)**: When parents have split

### 4. Benefits of Parental Counseling

- Parental counseling helps you feel more confident and less overwhelmed.
- Provides a safe space to discuss concerns and frustrations.
- Offers tailored strategies for specific challenges.
- Promotes a healthier home environment.

## Parent Therapy Overview

Parent therapy is a form of deeper support designed to help you better understand and address your own emotional, behavioral, or cognitive needs in caring for your children. It can be particularly helpful for those navigating challenges such as ADHD, anxiety, depression, [childhood trauma](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/), or family dysfunction. Here’s an overview:

### Goals of Parent Therapy:

1. **Empowerment**: Parent therapy teaches skills to manage challenging behaviors and emotions effectively despite your own challenges.
2. **Building Understanding**: Help you better understand their child’s unique needs, diagnosis, or developmental milestones.
3. **Improving Communication**: Foster healthy and supportive communication within the family even if you don’t have a model from your own.
4. **Reducing Stress**: Address burnout or emotional challenges that come with caregiving.
5. **Strengthening Relationships**: Build secure and nurturing bonds.

---

### Types of Parent Therapy:

1. **Parent-Child Interaction Therapy (PCIT)**: 
    - Focuses on improving the quality of interactions.
    - Includes live coaching sessions to teach strategies for managing challenging behaviors.
2. **[Cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT)**
    - Helps you manage your stress, anxiety, or depression.
    - Teaches strategies to approach child care with a clear and calm mindset.
3. **Behavioral Parent Training (BPT)**: 
    - Designed to teach you how to reinforce positive behaviors and reduce negative ones.
    - Often used for children with ADHD or oppositional defiant disorder (ODD).
4. **Support Groups**: 
    - Offers a shared space for those experiencing similar challenges.
    - Provides emotional support and practical advice.
5. **Family Therapy**: 
    - Involves the entire family to address dynamics, improve communication, and resolve conflicts.

---

### Reasons for Parent Therapy

Below are some common reasons people might seek parent therapy over the other two options:

#### 1. Managing Parenting Stress

- Cope with feelings of overwhelm, frustration, or burnout from caregiving responsibilities if you have background anxiety or depression.
- Process emotions such as guilt, grief, or disappointment if the child’s development differs from expectations.
- Reduce the impact of stress on your mental health and overall family dynamics.

#### 2. Improving Family Dynamics that Have Deep Roots

- Resolve conflicts or disagreements between caregivers about how to handle challenges.
- Address sibling dynamics, particularly if one child requires more attention due to special needs.
- Create a cohesive and supportive family environment, dispute not having one as a child.

#### 3. Parent Therapy for Processing Personal Emotions

- Explore how past experiences or personal triggers might influence reactions.
- Address fears or anxieties about the child’s future.
- Work through relationship challenges (e.g., co-parenting after a divorce).

#### 4. Preventing Burnout

- Parent therapy helps balance caregiving responsibilities and self-care for your mental health.
- To set boundaries and prioritize mental health while supporting the child.
- Parent therapy helps you connect with support networks to prevent feelings of isolation.

#### 5. Navigating Transitions

- To prepare for significant changes such as a new school, puberty, or the [transition to adulthood](https://dralanjacobson.com/life-transitions-therapy/).
- To manage the impact of life events, such as a move, divorce, or loss, on family stability (see my post about [blended family therapy](https://dralanjacobson.com/blended-family-therapy-step-parent-counseling/)).

Coaching can also be educational, such as when paired with a child’s [therapy for a learning disability](https://dralanjacobson.com/therapy-for-people-with-learning-disorders/).

---

## Conclusion

Parenting coaching, counseling, and therapy offer a transformative experience that empowers you to unlock your full potential. By providing personalized guidance, practical strategies, and ongoing support, my coaching services enhance your ability to navigate the complexities of your role. Implementing these techniques fosters a nurturing environment that promotes your child’s growth and strengthens your relationship.

### Key Takeaways

- Get **personalized guidance** to enhance your family’s unique strengths.
- Gain **insights into your child’s behavior** and improve your confidence.
- Discover strategies to **reduce stress** and improve family dynamics
- Learn to **communicate effectively** with your child, building trust and understanding.

## Parent Coaching FAQs

### What is parent coaching psychoeducation?

This form of education helps you understand your children’s development, behavior, and emotional needs. It provides tools and strategies to improve skills and build stronger relationships with their children.

### What is the parent coaching approach?

Parenting coaching is a collaborative and strengths-based approach that helps you identify their goals, values, and strengths. Coaches like me work to develop personalized strategies and techniques to address challenges and create positive changes in their family dynamics.

### What is the difference between parent coaching and therapy?

Parenting coaching focuses on the present and future, helping you set goals and develop skills to improve your practices. Therapy, on the other hand, often delves into past issues and emotional wounds to promote healing and understanding. While therapy may be necessary sometimes, parenting coaching is more action-oriented and goal-focused.

## Summary and My Work

I provide three levels of care for those who want to work on their strategies and abilities:

1. Parent coaching is a supportive and goal-oriented process designed to help parents build skills, confidence, and strategies for addressing parenting challenges and fostering a positive family environment. Methods are standardized, proven, and powerful.
2. Parental counseling goes a little deeper, looking at the psychological aspects of the parental relationship and how your unique psychological makeup affects the care of your child. It adapts coaching strategies to you.
3. Parent therapy goes even further, delving into deeper emotional or psychological issues that are affecting you. This is often a good choice if there were issues in the parenting you received or you have a mental health diagnosis.

I often provide parenting coaching, counseling, and therapy as part of couples therapy that works toward other goals or to the parents involved in family therapy with me. This work is often relatively short-term and solution-focused. It can be effectively provided virtually. I provide this service for those contemplating having children, who have children at home or have adult children who do not live with them. If group therapy is preferred, I can try to find you a virtual group or an in-person group in your area. Finally, these strategies can be an integral part of [therapy for single moms and dads](https://dralanjacobson.com/therapy-for-single-moms-and-dads/).

Please don’t hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you’d like more information about parental coaching, counseling, or therapy or to inquire about my services.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Family therapies

---

### [EFT Therapy for Couples](https://dralanjacobson.com/eft-therapy-for-couples/)

**Published:** July 26, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Emotionally Focused Therapy** (EFT) is a form of therapy that focuses on adult relationships and attachment/bonding. **EFT Therapy** aims to help partners and individuals understand and transform their emotional responses, particularly those contributing to relationship distress. [Dr. Sue Johnson](https://drsuejohnson.com/) is one of the primary developers of this approach, a relatively new [Humanistic method](https://dralanjacobson.com/basic-tenets-of-humanistic-psychology/). This post goes over some key points about **EFT Couples Therapy**.

## EFT Therapy Overview ![EFT Therapy](https://dralanjacobson.com/wp-content/uploads/2024/07/footprints-sand-sea-beach-preview-300x143.jpg "footprints-sand-sea-beach-preview | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

The following is an overview of the basic tenets of EFT Therapy. Of course, you can always [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you want more information about emotionally focused therapy and how it might work for [you and your partner](https://dralanjacobson.com/couples-therapy/).

### Theoretical Basis for EFT Therapy

Emotionally Focused Therapy (EFT) is grounded in several theoretical foundations that inform its approach and techniques. These theories are primarily rooted in attachment theory, humanistic psychology, and systems theory.

#### Attachment Theory

Key Proponent: [John Bowlby](https://en.wikipedia.org/wiki/John_Bowlby)

Core Concepts:

- Attachment Bonds: Attachment theory posits that humans are wired to seek out and maintain close relationships to ensure survival and emotional security.
- Attachment Styles: Based on their early experiences with caregivers, individuals develop different attachment styles (secure, anxious, avoidant, disorganized), influencing adult relationships.
- Emotional Regulation: Secure attachment helps individuals regulate their emotions effectively. Insecure attachment can lead to difficulties in managing emotions and relationships.

EFT Application:

- EFT aims to create secure attachment bonds between partners by helping them recognize and express their attachment needs and fears.
- The treatment focuses on identifying and modifying negative interaction patterns from insecure attachment styles.
- It also works to provide [therapy for codependency](https://dralanjacobson.com/codependency-therapy/) and other relationship issues.

#### Humanistic Psychology

Key Proponents: [Carl Rogers](https://en.wikipedia.org/wiki/Carl_Rogers), [Abraham Maslow](https://en.wikipedia.org/wiki/Abraham_Maslow)

Core Concepts:

- [Person-Centered Approach](https://dralanjacobson.com/basic-tenets-of-humanistic-psychology/): Emphasizes the importance of empathy, unconditional positive regard, and genuine therapist-client relationships.
- Self-Actualization: When provided with a supportive environment, people have an innate tendency to grow and achieve their full potential.
- Emotional Experience: Emotions are central to human experience and personal growth.

EFT Application:

- I create a safe, empathetic, and non-judgmental environment that encourages clients to explore and express their emotions.
- The therapy emphasizes experiencing and understanding emotions to facilitate change and healing.

#### Family Systems Theory

Key Proponents: [Ludwig von Bertalanffy](https://en.wikipedia.org/wiki/Ludwig_von_Bertalanffy), [Gregory Bateson](https://en.wikipedia.org/wiki/Gregory_Bateson)

Core Concepts:

- Interconnectedness: Systems theory views relationships as interconnected systems where each part affects the whole.
- Circular Causality: Relationship problems result from circular patterns of interaction rather than linear cause-and-effect relationships.
- Homeostasis: Systems seek stability, and changes in one part can lead to changes in the entire system.

EFT Application:

- EFT focuses on partner interaction patterns, viewing their behaviors and emotions as interrelated and mutually influencing.
- The therapy aims to disrupt negative cycles of interaction and establish new, healthier patterns that promote emotional connection and stability.

#### [Integrative Therapy](https://dralanjacobson.com/integrative-therapy/) Approach

EFT integrates these theoretical foundations into a cohesive approach emphasizing the importance of emotional experiences and attachment needs within relational systems. Combining these theories, EFT couples therapy provides a structured yet flexible framework for helping individuals and couples develop secure, emotionally fulfilling relationships.

### Mechanisms of Change

There are three main mechanisms by which emotionally focused therapy produces change.

1. [Attachment Theory](https://dralanjacobson.com/attachment-therapy/): EFT is based on attachment theory, which posits that humans are wired for connection and that secure emotional bonds are essential for mental health and well-being.
2. [Emotional Accessibility](https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2018.00632/full): EFT helps couples create secure attachment bonds by increasing emotional accessibility and responsiveness between partners.
3. De-escalation of Negative Cycles: EFT helps couples identify and de-escalate negative interaction cycles, allowing them to engage in more positive and supportive behaviors.

### Goals of Emotionally Focused Therapy

The main goals of EFT Couples Therapy are to:

1. Strengthen the emotional bond between partners.
2. Create a secure attachment.
3. Foster better communication and emotional responsiveness.

### EFT Couples Therapy Process

EFT Couples Therapy typically involves 8-20 sessions, depending on the complexity of the issues being addressed. There are three primary stages:

1. Assessment: During this phase, I collect background information, including your history, and talk to you about current relationship dynamics. The goal is to identify negative patterns and see your strengths as a couple.
2. Identifying Emotions: The next step is helping partners identify their underlying emotions and needs.
3. Restructuring Interactions: The primary phase involves facilitating new, more positive patterns of interaction, promoting secure attachment.

### EFT Therapy Restructuring Phases

The restructuring phase of emotionally focused therapy listed above has three phases for most couples.

1. De-escalation: Identifying and understanding negative interaction patterns is the first part of restructuring.
2. Restructuring Interactions: Next, partners express deeper emotions and needs, leading to more supportive and understanding interactions.
3. Consolidation and Integration: The final part is strengthening and maintaining new patterns outside therapy sessions.

## EFT Therapy Techniques

**EFT** focuses on strengthening emotional bonds by addressing attachment needs and emotional responsiveness. Here are the key techniques I use in Emotionally Focused Therapy:

---

### 1. Reflecting and Validating Emotions in EFT Therapy

- **Purpose:** Helps clients feel understood and validated.
- **Technique:**
    - Identify the underlying emotions expressed by the client (e.g., fear, sadness, or anger).
    - Reflect these emotions back to the client using empathetic statements, such as:
        > “It sounds like you’re feeling really scared that your partner might not be there for you.”
    - Validate their experience by normalizing their feelings:
        > “It makes sense you’d feel this way given what’s happened.”

---

### 2. Identifying Negative Interaction Patterns

- **Purpose:** Pinpoints unhelpful cycles of interaction that harm the relationship.
- **Technique:**
    - Map out recurring conflicts (e.g., [“pursue-withdraw” cycles](https://www.gottman.com/blog/breaking-pursue-withdraw-pattern-interview-scott-r-woolley-ph-d/) where one partner seeks connection and the other pulls away).
    - Name the cycle as the problem (not the individuals):
        > “This cycle of withdrawing and pursuing seems to be taking over your relationship.”

---

### 3. Reframing the Problem as Attachment Needs

- **Purpose:** Shift the focus from blame to unmet emotional needs.
- **Technique:**
    - Explore the attachment needs underlying negative behaviors.
        Example: 
        - Partner A’s anger stems from a fear of abandonment.
        - Partner B’s withdrawal stems from fear of conflict.
    - Help clients express these needs in vulnerable terms, such as:
        > “When I get angry, it’s because I’m scared you don’t want to be close to me.”

---

### 4. Emotionally Focused Therapy Heightening Emotions

- **Purpose:** Deepens emotional engagement and brings core feelings to the surface.
- **Technique:**
    - Use evocative questions to help clients access deeper emotions:
        > “When your partner pulls away, what’s the worst thing you fear?”
    - Encourage clients to stay with the emotion instead of intellectualizing:
        > “Stay with that sadness—what’s it telling you about what you need?”

---

### 5. Restructuring Emotional Bonds in EFT Therapy

- **Purpose:** Helps partners or family members develop new, secure attachment patterns.
- **Technique:**
    - Guide clients in expressing vulnerable emotions and attachment needs to each other.
        Example: > “I need to feel like you’re here for me when I’m struggling.”
    - Encourage the other partner to respond empathetically:
        > “I didn’t realize how scared you were. I want you to know I’m here.”

---

### 6. EFT Couples Therapy Enactments

- **Purpose:** Create real-time emotional experiences to strengthen connections.
- **Technique:**
    - Ask one partner to express a specific feeling or need directly to the other:
        > “Can you tell your partner how hurt you felt when they didn’t check in with you last week?”
    - Coach the receiving partner to respond in a validating and empathetic way.

---

### 7. EFT Couples Therapy Softening

- **Purpose:** Helps defensive partners or family members access and express vulnerable emotions.
- **Technique:**
    - Encourage individuals to drop defensive stances and reveal softer emotions (e.g., fear or sadness instead of anger).
        Example: > “I’m not just angry; I’m scared I’ll never feel close to you again.”

---

### 8. Tracking Progress and Consolidating Changes

- **Purpose:** Reinforces new patterns and ensures lasting change.
- **Technique:**
    - Highlight successful moments of connection and new behaviors:
        > “Notice how you stayed open to each other during that tough conversation.”
    - Encourage clients to reflect on their growth:
        > “How does it feel to share your needs more openly now?”

---

### EFT Therapy Stages

1. **De-escalation of Conflict:** Identifying negative cycles and reframing issues as attachment needs.
2. **Changing Interaction Patterns:** Facilitating vulnerable emotional expression and creating new bonds.
3. **Consolidation:** Reinforcing new relational patterns and planning for the future.

EFT therapy is highly effective for improving emotional connection, fostering secure attachment, and resolving relational distress.

## EFT Couples Therapy Research

I try to choose clinical techniques that have scientific research backing them. Here are some key findings and insights from research on EFT Couples Therapy:

- Research has consistently shown that EFT is effective for couples, with success rates of around 70-75% for distressed couples.
- Sustained Improvement: Studies have shown that EFT’s benefits are significant and long-lasting, with couples maintaining improvements for years after therapy.
- Meta-Analyses: [Several meta-analyses](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9692186/) have confirmed the effectiveness of EFT in treating relational distress, with significant effect sizes compared to control groups.
- Comparative Studies: EFT Couples Therapy is more effective than other forms of couples therapy, such as [behavioral couples therapy](https://en.wikipedia.org/wiki/Integrative_behavioral_couples_therapy), in improving relationship satisfaction and emotional connection.
- Neuroscientific Findings: Recent [neuroimaging studies have shown that EFT](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6316206/) can change the brain’s response to threats and increase feelings of safety and security between partners.
- Cultural Adaptability: EFT Therapy has successfully adapted for diverse cultural groups, demonstrating its versatility and broad applicability.

## My Work with Emotionally Focused Therapy

Effective delivery of EFT requires specialized training and supervision, ensuring that therapists are well-equipped to handle the complexities of couples’ dynamics. EFT can be integrated with other therapeutic approaches, such as individual therapy, to address underlying issues like trauma or depression. – It is also used effectively for individuals and families, addressing issues like depression, anxiety, and trauma.

### EFT Couples Therapy Example

Here’s a brief and fictitious example of how an Emotionally focused therapy session might unfold for a couple experiencing conflict:

John and Lisa have been married for ten years and have been arguing frequently about John’s long working hours and Lisa’s feelings of emotional neglect. This has intensified since the birth of their second child six months ago.

#### Establishing a Safe Environment

I work to create a non-judgmental and safe space for both partners to express their feelings. I might start by saying, “I want this to be a safe place for both of you to share your thoughts and feelings openly. My goal is to help you understand each other better and work towards strengthening your bond.” I’ll also ask if they have any questions about therapy or the approach we will use.

#### Exploring the Cycle

Next, I help the couple identify their negative interaction patterns and the emotions driving these patterns.

- Lisa: “John is always at work. When he comes home, he’s too tired to talk to me. I feel like I’m not important to him.”
- John: “I work hard to provide for our family. When I get home, I’m exhausted. I feel like nothing I do is ever enough for Lisa.”
- Me: “It sounds like a cycle in which John feels unappreciated and Lisa feels neglected. Let’s explore these feelings further. John, when Lisa expresses her frustration, how do you feel?”
- John: “I feel like a failure like I’m letting her down despite my efforts.”
- Me: “And Lisa, when John withdraws, what’s that like for you?”
- Lisa: “I feel lonely and unloved.”

#### Accessing Primary Emotions:

In the next step in EFT Couples Therapy, I guide the couple to access and express their deeper, more vulnerable emotions.

- Me: “Lisa, can you share with John how his long hours make you feel on a deeper level?”
- Lisa: “John, I feel abandoned when you’re not around. I’m scared that you don’t love me anymore.”
- John: “I didn’t realize you felt that way. I just thought you were angry with me.”

#### Restructuring Interactions:

The next step involves helping the couple express their needs and fears in a way that fosters connection and understanding.

- Me: “John, can you tell Lisa how you feel when she says she feels abandoned?”
- John: “I feel sad because I love you and don’t want you to feel that way. I need you to know that my work is important to me, but so are you.”
- Lisa: “I need to feel more connected to you, John. Can we find a way to spend more quality time together?”

#### Consolidating Gains:

Finally, I support the couple in solidifying their new patterns of interaction, “You both did a great job expressing your feelings and needs. Let’s work on a plan to ensure you have regular time together to strengthen your connection.”

I assign them homework to schedule regular date nights or daily check-ins to maintain their emotional bond. Future sessions will continue to address new issues and reinforce positive changes.

Over time, John and Lisa become more attuned to each other’s emotional needs, leading to a stronger, more secure relationship. This example illustrates how EFT Therapy helps couples move from a cycle of disconnection to one of emotional engagement and security.

### Future Directions

I intend to continue studying the results of EFT Couples therapy as I do with all the techniques I use. As time passes, I hope to assess the sustained impact of emotionally focused therapy on couples’ relationships. I also plan to integrate technology, such as certain apps, to make EFT therapy more accessible and to enhance [therapy outcomes](https://dralanjacobson.com/does-therapy-work/). Emotionally focused therapy has been proven effective and is still evolving, which is a great combination and a core part of my combined [humanistic treatment](https://dralanjacobson.com/humanistic-therapy/) and [relationship therapy](https://dralanjacobson.com/relationship-therapy/) approach. I also use this method in [family treatment](https://dralanjacobson.com/family-therapy/) and [pre-engagement counseling](https://dralanjacobson.com/discernment-counseling-pre-engagement-counseling/).

If you and your partner think EFT Therapy might be a good choice, or if you’d like more information to make a decision, please [contact me](https://dralanjacobson.com/contact/) anytime or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Couples Therapies

---

### [CBT-I for Sleep Difficulties](https://dralanjacobson.com/cbt-i-for-sleep-difficulties/)

**Published:** June 22, 2024
**Author:** Dr. Alan Jacobson

**Content:**

Cognitive Behavioral Therapy for Insomnia (online CBT-I) is an evidence-based treatment that focuses on changing thoughts and behaviors that cause difficulties. CBT-I for sleep addresses the underlying issues contributing to insomnia. Here’s an overview of CBT for insomnia and the components typically involved. Other forms of psychotherapy for insomnia can also be woven in.

Please feel free to [contact me](https://dralanjacobson.com/contact/) or set up a [free consultation](https://www.picktime.com/scheduleaconsult) to discuss whether CBT-I for sleep difficulties might be helpful for you or a loved one. We can also discuss how [other therapeutic techniques](https://dralanjacobson.com/integrative-therapy/) could be mixed in if you have other goals.

## The Emergence of Cognitive Behavioral Therapy for Insomnia

Understanding the history of this method helps you see how its effectiveness and strength have emerged over time. Here’s an overview of that history:

### Early Foundations of CBT for Insomnia

- **1960s-1970s**: Behavioral approaches to insomnia emerged, rooted in classical conditioning principles. Psychologists recognized that poor sleep often became associated with certain bedtime behaviors or settings (e.g., anxiety linked to the bedroom).
- **Stimulus Control Therapy**: Developed by [Dr. Richard Bootzin](https://en.wikipedia.org/wiki/Richard_Bootzin) in 1972, this approach emphasized breaking negative associations with the bedtime environment and reinforcing positive behaviors. It remains a cornerstone of the approach.

### Development of Cognitive Approaches

- **1980s**: Cognitive techniques addressing unhelpful thoughts about sleep (e.g., “If I don’t sleep eight hours, I’ll fail tomorrow”) began to supplement behavioral strategies.
- Researchers linked insomnia to hyperarousal, both physiological and cognitive, further justifying the use of therapies aimed at calming the mind.

### Emergence of CBT-I as a Unified Model

- **1990s-2000s:** CBT-I for sleep was formally established as a combination of behavioral techniques (stimulus control, sleep restriction) and cognitive interventions (addressing worry and unrealistic sleep expectations).
- Studies showed CBT-I for sleep to be as effective as, or superior to, medication for long-term insomnia management, with fewer side effects.

### Modern Advancements in CBT for Insomnia

- **Digital Delivery**: The 2010s saw the rise of online CBT for insomnia courses, making the therapy more accessible. These include apps and online courses guided by AI or professionals.
- **Inclusion in Guidelines**: Organizations like the [American Academy of Sleep Medicine](https://aasm.org/) and the [National Institute for Health and Care Excellence](https://www.nice.org.uk/) (NICE) recommend CBT-I as the first-line treatment for insomnia.
- **Integration with Comorbidities**: CBT for insomnia has been adapted for individuals with insomnia alongside other conditions, such as [treatments for depression and anxiety](https://dralanjacobson.com/therapy-for-depression-and-anxiety/), PTSD, and chronic pain.

CBT-I continues to evolve today, incorporating mindfulness-based techniques and focusing on personalizing interventions for greater effectiveness. It remains a gold standard treatment for insomnia.

## Key Components of Online CBT-I for Sleep ![CBT-in for sleep](https://dralanjacobson.com/wp-content/uploads/2024/06/woman-sleeping-242x300.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

The following are the basic tenets of cognitive behavioral therapy for insomnia:

### Step 1: CBTI for Sleep Education

We will start by discussing slumber cycles and what constitutes good [sleep hygiene](https://www.sleepfoundation.org/sleep-hygiene). This includes learning about biological processes such as [circadian rhythms](https://en.wikipedia.org/wiki/Circadian_rhythm) and pressure. This education prepares you for setting goals. What outcome do you want from cognitive behavioral therapy for insomnia? We’ll break this up into measurable steps so you can track your progress and stay motivated to improve.

We’ll also discuss things more generally, including creating an environment conducive to slumber (e.g., dark, quiet, and cool bedroom), avoiding caffeine, alcohol, and heavy meals before bedtime, and establishing a routine.

### Step 2a: Cognitive Psychotherapy for Insomnia

Next, we will dive into the [CBT portion of treatment](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/). This revolves around identifying and challenging negative thoughts and beliefs. You’ll develop a more positive mindset about sleep capabilities and address anxiety related to insomnia. Along with the cognitive portion, you’ll also learn progressive muscle relaxation, deep breathing exercises, and meditation to reduce physical and mental tension.

### Step 2b: Behavioral Psychotherapy for Insomnia

The next step is working to associate the bed and bedroom with slumber rather than wakefulness and to reduce the daytime-related anxiety that stays with you when you go to bed. Homework may include going to bed only when sleepy, getting out of bed if unable to doze, and maintaining a consistent wake-up time. You’ll limit the time spent in bed to the actual time spent sleeping to build a drive, gradually increasing time in bed as efficiency improves.

### Effectiveness of Online CBT for Insomnia

#### 1. Clinical Evidence \*

- **Short-term improvements**: Studies show that online CBT-I significantly reduces the time it takes to fall asleep (sleep onset latency), decreases nighttime awakenings, and increases total sleep time.
- **Sustained benefits**: Unlike medication, online CBT-I provides long-term benefits. Many individuals maintain improvements in sleep quality for months or years after completing therapy.
- **Efficacy across populations**: Online CBT-I is effective for primary insomnia and for insomnia comorbid with conditions like anxiety, depression, or chronic pain.

#### 2. Comparisons with Sleep Medications \*

- **Similar or superior outcomes**: Research indicates that online CBT-I is as effective as, or more effective than, sleep medications in the short term.
- **Fewer side effects**: Unlike medications, online CBT-I has no pharmacological side effects or risks of dependency.
- **Durability of results**: While medications often provide temporary relief, online CBT-I addresses underlying issues, resulting in sustained improvements.

\* [Citation](https://pmc.ncbi.nlm.nih.gov/articles/PMC6796223/)

## Cognitive Behavioral Therapy for Insomnia Example

Cognitive Behavioral Therapy for Insomnia (online CBT-I) is a structured, evidence-based program, and Casey, a 28-year-old medical student, pursued it because of this. This fictional example shows how a online CBT-I for sleep program might be structured.

### Online CBT for Sleep Assessment Phase

I start with a comprehensive interview to assess Casey’s history, current nighttime habits, and potential contributing factors to her insomnia. I ask questions about whether other family members have experienced the same issues and whether any other psychological challenges exist in her family. We cover all aspects of her life, including work, social, and hobbies, looking for possible sources of stress and contentment.

As part of the assessment, I asked Casey to track her sleep patterns for the next week with a specific journal covering quality, daytime sleepiness, and other related factors. She also uses an app that tracks the quality of her slumber and aspects that she may not be aware of.

### Online CBT-I for Sleep: Psychoeducation

In our next session, I will educate Casey about practices that promote good rest, such as maintaining a regular schedule, creating a comfortable environment, and [avoiding caffeine](https://www.sleepfoundation.org/nutrition/how-long-does-it-take-caffeine-to-wear-off) and electronics before bed. We go over the basics of [circadian rhythm](https://en.wikipedia.org/wiki/Circadian_rhythm) and the importance of rest. Then, we review the approach and what it will entail, including the types of homework she will be asked to do. Cognitive behavioral therapy for insomnia is a perfect choice for Casey, given how smart, insightful, and organized she is.

### CBT for Insomnia: Behavioral Interventions

We learn from her journaling that Casey is having the most difficulty falling asleep, and then she wakes up once or twice and has trouble relaxing when this happens. We talk about some behavioral interventions that are typically used in CBT for insomnia, including:

- **Stimulus Control:** Strengthen the bed-rest connection by only using the bed for sleep, going to bed only when tired, and getting out of bed if unable to fall back after 20 minutes, even if it is late at night.
- **Restriction:** Limit the time spent in bed to match the amount of sleep one gets, gradually increasing it as efficiency improves. Specifically, she will change her bedtime to a little later and watch TV in another room until she feels tired.
- **Relaxation Techniques:** I teach Casey relaxation exercises like progressive muscle relaxation, deep breathing, or guided imagery to induce greater restfulness.

### CBT for Insomnia: Cognitive Interventions

In addition to the behavioral interventions, there are cognitive techniques that are used with CBT for insomnia, including

- **Cognitive Restructuring:** We work to identify and challenge Casey’s unhelpful thoughts and beliefs (e.g., “I must get 8 hours of sleep to function”) and replace them with more realistic and positive ones (e.g., “I can do fine with less sleep as long as it is restful.”)
- **Paradoxical Intention:** We reduce the pressure of bedtime by encouraging her to stay awake and avoid trying too hard to sleep. The homework after session two is to stay up a full hour later than usual and continue to journal to see what effects that produces.

### CBT for Sleep Difficulties and Hygiene

Along with the specific CBT-I techniques above, Casey will more generally work to improve her nighttime routine, including:

- Maintaining a consistent sleep schedule (any changes we make, she’ll do for at least a week or two).
- Create a restful bedtime environment using apps to promote rest and [mindfulness](https://dralanjacobson.com/mindfulness-therapy/).
- Limiting exposure to screens and bright lights before bed.
- Avoiding caffeine and heavy meals close to bedtime. She realizes, for example, that she should not have desserts containing chocolate after dinner.
- She incorporates regular physical activity into her day, but not too close to bedtime.

### Online CBT-I for Sleep Sessions

Here is how the example above is broken down into sessions.

#### **Session 1: Initial Assessment and Sleep Education**

- **Objective:** Gather information and educate.
- **Activities:**
    - Review her sleep diary and questionnaires.
    - Discuss her sleep history and current issues as far back as childhood.
    - Explore her family history of insomnia, anxiety, and stress management concerns.
    - Discuss other stressors now and in her recent history
    - Educate her about sleep hygiene and the basics of rest

#### **Session 2: Introduction to Cognitive Behavioral Therapy for Insomnia**

- **Objective:** Implement stimulus control and rest restriction.
- **Activities:**
    - Introduce stimulus control and other [CBT methods](https://dralanjacobson.com/cbt-techniques/).
    - Develop a sleep restriction schedule based on the diary.
    - Teach relaxation, [mindfulness techniques](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/), and simple meditations.

#### **Session 3: Cognitive Techniques (CBT for Insomnia)**

- **Objective:** Address unhelpful thoughts and beliefs about sleep.
- **Activities:**
    - Introduce [cognitive restructuring](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) – how it works and what will be involved.
    - Practice identifying and challenging unhelpful thoughts.
    - Continue to monitor her [sleep diary](https://www.sleepfoundation.org/wp-content/uploads/2021/02/SF-23-127_Sleep_Diary_Interactive.pdf) and adjust behavioral techniques as needed.

#### **Session 4: Review and Adjust**

- **Objective:** Evaluate progress and make necessary adjustments.
- **Activities:**
    - Review her progress with her diary and questionnaires.
    - Adjust the restriction schedule if necessary, but not more often than weekly.
    - Reinforce cognitive and behavioral techniques, what is working, and what could work better.
    - Introduce paradoxical intention if needed.

#### **Session 5: Maintenance Strategies**

- **Objective:** Plan for long-term maintenance of good sleep habits.
- **Activities:**
    - Discuss strategies for preventing relapse based on the triggers she’s learned.
    - Create a plan for maintaining sleep improvements.
    - Schedule follow-up sessions if needed – she decides to continue to come in every two weeks until she feels that she has made all the gains she set out to make.

This structure provides a comprehensive approach to CBT-I for sleep, focusing on the [behavioral and cognitive](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) aspects of her difficulties.

## CBT-i for Sleep Q&A

### Q: What is CBT for Insomnia (Online CBT-I)?

**A:** Cognitive Behavioral Therapy for Insomnia (CBT-I) is a scientifically proven, non-medication treatment for chronic insomnia. It is designed to help individuals identify and change the thoughts, behaviors, and habits that interfere with healthy sleep.

CBT-I works by addressing the root causes of insomnia rather than just the symptoms. Many people with insomnia develop anxiety around sleep, irregular sleep schedules, or habits, like using screens in bed or spending too much time awake in bed, that unintentionally make sleep worse. CBT-I helps reverse these patterns through a combination of strategies, including:

- [Cognitive techniques](https://dralanjacobson.com/cbt-techniques/) to challenge negative thoughts like “I’ll never be able to fall asleep” or “If I don’t sleep 8 hours, I can’t function.”
- Behavioral strategies such as: 
    - Sleep restriction to improve sleep efficiency by limiting time in bed
    - Stimulus control to strengthen the mental link between bed and sleep
    - Relaxation training to calm the mind and body before bedtime
- Sleep hygiene education to adjust habits around caffeine, alcohol, screen use, and bedtime routines

CBT-I is typically delivered over 4 to 8 weekly sessions and can be done in-person, via telehealth, or through guided online programs. Unlike sleeping pills, which can lose effectiveness over time, CBT-I offers long-term improvements and often eliminates the need for medication altogether.

Leading medical organizations, including the American Academy of Sleep Medicine and the American College of Physicians, recommend it as the first-line treatment for chronic insomnia.

### Q: What is CBT-i used for?

**A:** CBT-I is primarily used to treat chronic insomnia—difficulty falling asleep, staying asleep, or waking up too early. It’s also helpful for people who experience sleep anxiety, rely on sleep medications, or struggle with irregular sleep patterns due to stress, anxiety, or other mental health concerns.

### Q: What is CBT therapy for insomnia?

**A:** CBT therapy typically includes:

- **Sleep education** – Understanding how sleep works
- **Cognitive strategies** – Challenging negative thoughts about sleep
- **Sleep restriction** – Matching time in bed with actual sleep time
- **Stimulus control** – Strengthening the bed-sleep connection
- **Relaxation techniques** – Reducing mental and physical tension before bed
- **Sleep hygiene** – Adjusting lifestyle habits that affect sleep

### Q: What is the best therapy for insomnia?

**A:** Yes. Research shows CBT-I is more effective and longer-lasting than sleeping pills for most people. It’s considered the gold standard treatment for insomnia by organizations like the [American College of Physicians](https://www.acponline.org/).

Most people begin to see improvement within **4 to 8 weeks**. Some notice better sleep within the first two weeks, especially when following the plan consistently.

### Q: Is there online CBT for sleep?

**A:** Absolutely. I offer online CBT for sleep, including:

1. **Using a Secure Telehealth Platform**

- I conduct online CBT for sleep via a [HIPAA-compliant](https://www.atlantic.net/hipaa-compliant-hosting/hipaa-compliance-guide-what-is-hipaa/) video platform
- Online CBT for sleep sessions are typically 45–60 minutes and occur weekly over 4–8 weeks.

2. **Following a Structured online CBT for sleep Protocol**

This includes:

- **Assessment & Sleep Diary**: Start with a sleep history and daily sleep logs.
- **Psychoeducation**: Teach clients how sleep works and what affects it.
- **Stimulus Control**: Help clients associate bed with sleep only.
- **Sleep Restriction Therapy**: Align time in bed with actual sleep time.
- [**Cognitive Restructuring**](https://dralanjacobson.com/cognitive-restructuring/): Address and reframe unhelpful sleep-related thoughts.
- **Sleep Hygiene & Relaxation Techniques**: Optimize lifestyle and mental habits that impact sleep.

3. **We May Use Digital Tools to Enhance Treatment**

I incorporate online tools such as:

- **Sleep diaries** (via email or online apps)
- **CBT therapy for sleep apps** (as homework supplements)
- **Automated reminders** or sleep log review between sessions

4. **We’ll Track Progress**

- Review sleep diary data weekly (use spreadsheets or apps)
- Adjust time-in-bed recommendations based on sleep efficiency
- Monitor cognitive and behavioral changes over time

5. **Provide Follow-Up and Maintenance**

- Offer booster sessions or check-ins after the main treatment phase
- Encourage continued use of learned strategies

Q: How do I do CBT therapy for sleep?

**A:** You can work with a trained therapist like me who does online CBT therapy for sleep. The process typically involves:

1. Tracking your sleep habits with a diary
2. Creating a consistent sleep-wake schedule
3. Limiting time in bed to build strong sleep pressure
4. Avoiding stimulating activities in bed (like phone use)
5. Practicing relaxation or mindfulness before bed
6. Replacing negative thoughts with realistic sleep expectations

Online CBT therapy for sleep is usually as effective as in-person therapy.

## CBT-I for Sleep in My Practice

The following are the steps involved in CBT-I for sleep difficulties and what to expect with each:

1. Assessment: This is the initial evaluation of your patterns, habits, and potential causes of insomnia. We’ll trace this back as far as you’ve had these challenges.
2. Goal Setting: We will establish specific, measurable goals for improvement. This will help you see your progress and stay motivated throughout treatment.
3. Intervention: Next, we will implement CBT-I techniques for insomnia. Usually, this means meeting weekly for 4-6 weeks before potentially moving to an every-other-week model. You will keep a diary between sessions to track progress and identify patterns.
4. Adjustment: We will modify CBT for insomnia techniques based on your response to treatment.
5. Maintenance: When you have seen satisfactory improvement, we’ll develop a long-term plan to sustain your improvements. This may include coming in for booster sessions as necessary.

### Cognitive Behavioral Psychotherapy for Insomnia: Possibilities

I offer several possibilities for clients to receive CBT therapyfor sleep:

- [**Individual Therapy**](https://dralanjacobson.com/individual-therapy/): One-on-one sessions are the most frequent type of cognitive behavioral therapy for insomnia. These sessions are easy to deliver virtually, so I serve [most states in the US](https://dralanjacobson.com/).
- [**Couples Therapy**](https://dralanjacobson.com/couples-therapy/): CBTI for sleep challenges can be delivered to couples if both people are experiencing insomnia or one person is experiencing issues and the other person wants to help.
- **[Family Therapy](https://dralanjacobson.com/family-therapy/):** Similar to couples therapy, CBT-I for sleep can work in family treatment to help one or more members while others provide support.
- [**Integrated Therapy**](https://dralanjacobson.com/types-of-therapy/): CBT for insomnia can be one part of a more comprehensive treatment plan. Many people who receive cognitive behavioral therapy for insomnia also want to address other challenges and barriers.

### Referrals for CBT Therapy for Sleep

I would happily set up a [free consultation](https://www.picktime.com/scheduleaconsult) if you’re considering online CBT-I for sleep problems. We can discuss whether cognitive behavioral therapy for insomnia suits your situation. If not, we can discuss whether another psychotherapy for insomnia technique may work, or I can refer you to outside providers with other specialties.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Symptom Relief

---

### [Humanistic Therapy: Focusing on Inner Strength](https://dralanjacobson.com/humanistic-therapy/)

**Published:** May 14, 2023
**Author:** Dr. Alan Jacobson

**Content:**

**Humanistic Therapy** is an approach that emerged in the mid-20th century as a reaction to the prevailing perspectives focused on problems and challenges. **Humanistic Treatment** emphasizes the importance of understanding human behavior regarding meaning, values, and personal growth. Psychologists like me who use **humanistic therapy techniques** believe that every individual has an inherent worth and potential for [self-actualization](https://www.healthline.com/health/self-actualization), which is realizing and fulfilling one’s unique potential.

Humanistic therapy is often associated with Carl Rogers, who developed the [person-centered therapy](https://dralanjacobson.com/client-centered-therapy/) approach. In person-centered therapy, the therapist creates a supportive and non-judgmental environment where clients can explore their thoughts, feelings, and experiences. I act as a facilitator, helping clients gain insight into themselves.

## Humanistic Treatment Overview

Central to humanistic treatment is [self-actualization](https://positivepsychology.com/self-actualization/), which refers to the innate drive for individuals to develop and become the best version of themselves. By acknowledging and nurturing this drive, individuals can lead more fulfilling lives and reach a state of psychological well-being. In [my work](https://dralanjacobson.com/), I emphasize the importance of self-acceptance and self-expression and the need for positive and empathic relationships with others.

### Holistic Perspective and Self-Actualization

Humanistic therapists view individuals as complex beings with physical, emotional, social, and spiritual dimensions. They consider all these aspects when working with clients to promote overall well-being. This approach strongly emphasizes the concept of self-actualization, which is the innate drive to realize one’s full potential. Therapists work with clients to help them understand their unique paths toward self-actualization.

Humanistic therapy techniques can be particularly effective for individuals seeking personal growth, self-exploration, and increased self-awareness. It can also be valuable in helping people overcome obstacles and make positive changes in their lives. Specifically, humanistic therapy is used to address a wide range of issues, including personal growth, self-esteem, relationship problems, anxiety, depression, and [existential concerns](https://dralanjacobson.com/existential-therapy/). This approach is widely practiced and has influenced various other [forms of therapy](https://dralanjacobson.com/types-of-therapy/) and [individual counseling](https://dralanjacobson.com/individual-therapy/).

### Humanistic Therapy: Past vs. Present

While some therapeutic approaches, such as psychoanalysis, may focus on the past, humanistic therapy primarily centers on the present and future. It encourages you to explore their current experiences, emotions, and goals. Humanistic psychology emphasizes the importance of the present moment and your subjective experience. It encourages individuals to focus on their immediate experience and embrace their authentic emotions, thoughts, and desires. Humanistic psychologists believe that this focus on the present moment, known as mindfulness, can lead to greater self-awareness and personal growth. It’s not that we won’t look into the past a little, but only as it influences your thoughts, feelings, and overall mood today.

### Humanistic Treatment Goals

Humanistic treatment offers a powerful alternative to traditional approaches by emphasizing uniqueness and potential. It promotes a holistic and positive understanding of human nature, focusing on subjective experiences, personal growth, and self-actualization. The goal is to help you find inner strength and resiliency and empower you to feel more meaning and fulfillment. We work collaboratively to identify and address your concerns and goals. I fully respect your autonomy and make it my job to facilitate self-exploration.

### Summary of the Basic Tenets:

1. Humans are innately good
2. This emphasizes the individual’s worth, the centrality of human values, and human beings’ creative, active nature.
3. Behavior is not constrained by either the experience of the individual or current circumstances (determinism).
4. Personal agency refers to the choices we make in life, the paths we take, and their consequences—this is what we explore in therapy.
5. The optimistic approach focuses on the noble human capacity to overcome hardship, pain, and despair.

## Humanistic Therapy in Practice

Your experience of [humanistic psychology](https://dralanjacobson.com/basic-tenets-of-humanistic-psychology/) will differ depending on the other strategies we mix in. Think of humanistic therapy as an overarching philosophy that can guide and frame everything else we do, but it is not a specific approach. We’ll mix in approaches such as [cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) (CBT), dynamic therapy, [positive psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/), and client-centered. Regardless of our approaches, the overarching view will help you feel respected, understood, and encouraged for who you are in the moment. The goal is to help you understand the past as it affects today, but most of all, to understand today as it affects tomorrow.

Psychologists like me who practice humanistic therapy offer [unconditional positive regard](https://en.wikipedia.org/wiki/Unconditional_positive_regard), meaning we accept and support our clients without judgment. This helps clients feel safe and valued in the therapeutic relationship. You will be encouraged to make your own decisions and take responsibility for your actions.

This approach can be combined with other, such as is the case with [existential humanistic therapy](https://dralanjacobson.com/humanistic-existential-therapy/).

### Humanistic Therapy Techniques

In my work, I use humanism in a wide variety of ways, including the following examples:

1. **Self-Exploration and Personal Growth**: Humanistic therapy techniques often help individuals explore their inner thoughts, feelings, and experiences in a nonjudgmental and supportive environment. You will develop a deeper understanding of yourself and your emotions, leading to personal growth and self-improvement. This process can lead to a more positive self-concept and improved self-esteem. You can fully appreciate your worth and value through genuine acceptance and validation.
2. **Developing Authenticity**: Humanistic therapy helps you [live more authentically](https://www.psychologytoday.com/us/blog/click-here-happiness/201904/develop-authenticity-20-ways-be-more-authentic-person?msockid=1686e8c22e816b8a1935fc532fc26a1c) and make choices that align with your values and desires. By improving self-awareness and communication skills, you might build healthier and more fulfilling relationships with others. You might come better to understand your emotions and the emotions of others. This increased emotional intelligence can improve interpersonal skills and more fulfilling relationships.
3. **Anxiety, Depression, and Stress Management**: Humanistic therapy often includes [mindfulness and relaxation techniques](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) to help you manage anxiety and stress and develop coping strategies to deal with life’s challenges. The focus on self-acceptance and self-compassion can contribute to improved mood and outlook.
4. **Creativity and Self-Expression**: This approach can be particularly effective for individuals seeking to tap into their creativity and self-expression. By fostering a nonjudgmental environment, clients can explore their creative talents and find joy in artistic endeavors. More generally, humanistic therapy techniques can assist you in discovering your true potential so you can become the best version of yourself.
5. **Coping with Transitions**: [Life transitions](https://psychologicalassessments.com/life-transitions-testing/), such as career changes, retirement, or major life events, can be challenging. Humanistic therapy provides a space to reflect on these transitions, understand emotions, and adapt to change more effectively.

## Humanistic Therapy for Adults: Example

A typical humanistic treatment involves client-centered therapy sessions, in which I provide a supportive environment and my client leads us in the direction they want to take.

### Humanistic Therapy for Adults Case Example

**Background:** Sarah is a 30-year-old woman struggling with low self-worth and dissatisfaction with her career. She often compares herself to her peers and feels she has not achieved what she “should” have by this stage in life. These feelings have led to anxiety, moments of depression, and a loss of motivation.

### Humanistic Approach:

- **Humanistic Therapy Approach:** I use [active listening](https://hbr.org/2024/01/what-is-active-listening), [unconditional positive regard](https://positivepsychology.com/unconditional-positive-regard/), empathy, and congruence (authenticity). Instead of directing the conversation or diagnosing Sarah, I encourage her to share her thoughts and feelings in a non-judgmental space.
- **Interaction:** Sarah shares her feelings of being “stuck” and her fear of failing. I acknowledge these feelings without attempting to fix or analyze them, responding with phrases like, “It sounds like you’re feeling overwhelmed and unsure of what the next step should be.”

### Humanistic Therapy Techniques:

- **Humanistic Therapy Techniques and Self-Discovery:** With my consistent support and open-ended questions like, “What do you feel is holding you back?” Sarah realizes her self-worth has long been tied to external validation and comparisons. She identifies that the expectations of others have overshadowed her dreams.
- **Humanistic Therapy Techniques and Empowerment:** I continue to offer unconditional positive regard and reflect on her strengths that Sarah may not have noticed. This helps Sarah begin to recognize her inherent value and appreciate her choices.
- **Humanistic Therapy Techniques and New Insights:** Sarah expresses a newfound interest in pursuing a creative project she had abandoned due to fear of judgment. I support her decision to explore this without pushing for immediate action, allowing her the freedom to choose her pace.

**Outcome:** Over several sessions, Sarah feels more confident about defining her life on her terms. She takes small steps toward her passion, which boosts her sense of accomplishment and self-worth. The humanistic treatment approach helps her reconnect with her values, fostering self-acceptance and reducing her anxiety.

### Key Elements Highlighted:

- **Empathy and Listening:** I continuously demonstrate understanding and make Sarah feel seen and heard.
- **Client-Centered:** The sessions revolve around what Sarah wants to explore, allowing her to lead the discovery process.
- **Non-Directive Support:** I do not offer solutions but instead facilitate Sarah’s ability to find her own answers.

This case example shows how humanistic therapy can be empowering by helping clients gain clarity, self-compassion, and personal growth through self-exploration and authentic interaction with me.

## Humanistic Treatment for Teens: Example

**Background:** a 16-year-old high school junior, Alex, has been feeling increasingly withdrawn and anxious. She struggles with low self-esteem, especially when comparing herself to her peers on social media. Recently, her grades have slipped, and she avoids participating in activities she used to enjoy, such as playing the guitar and being part of her school’s music club. Her parents are concerned about her lack of motivation and overall mood.

### Humanistic Treatment Approach

- **My Approach:** I meet Alex with unconditional positive regard, ensuring she feels accepted without pressure. The goal is to create an open and safe humanistic treatment environment where Alex feels comfortable sharing her thoughts and emotions.
- **Building Trust:** I listen to Alex talk about her daily life, frustrations, and feelings of inadequacy. When Alex mentions feeling “invisible” among her peers, I reflect this by saying, “It sounds like you’re feeling overlooked and unsure if people truly see or appreciate you.”

### Humanistic Therapy Techniques:

- **Self-Exploration:** I use open-ended questions such as, “What activities make you feel most like yourself?” and “Can you share a time when you felt proud of what you accomplished?” Alex talks about the joy she used to feel while playing guitar and how she now worries he isn’t good enough to keep up with other musicians he follows online.
- **Artistic Expression:** I incorporate music into sessions, encouraging Alex to play the guitar during a few sessions or write down her feelings as song lyrics. This non-verbal expression helps Alex reconnect with her passion and gain a sense of achievement.
- **Empathy and Validation:** When Alex shares her fear of being judged, I respond empathetically, saying, “It’s understandable to feel that way when we put so much pressure on ourselves. Your feelings make sense given what you’re going through.”

### Facilitating Growth:

- **Shift in Self-Perception:** Over time, Alex starts recognizing that she doesn’t need to be perfect or match up with the online personas of others. I highlight her strengths, such as his creativity and dedication, helping her see herself more positively.
- **Empowering Choices:** I encourage Alex to set small, personal goals. For example, she decides to join a relaxed music jam session with friends instead of pressuring herself to perform in a competitive setting. I reassured her that pursuing what makes her happy was more important than external validation.

### Outcome:

After several weeks of humanistic treatment, Alex starts showing signs of improvement. She participates in his music club again and begins sharing original songs with close friends. Her self-esteem gradually rises as he realizes she is valued for who he is, not just for what she accomplishes or how she compares to others.

#### Humanistic Treatment Benefits Observed:

- **Improved Self-Esteem:** Alex starts viewing herself with more compassion and less self-criticism.
- **Reconnection with Interests:** Returning to activities that bring her joy helps boost his overall mood.
- **Healthy Coping Skills:** Learning to express emotions through music becomes a tool for managing stress.
- **Strengthened Identity:** Alex becomes more confident in her own worth and less reliant on external comparisons.

### Key Elements Highlighted:

- **Empathic Listening:** Validating Alex’s feelings without judgment, creating a supportive space.
- **Creative Integration:** Using music as a therapeutic tool for expression and self-connection.
- **Open-Ended Questions:** Helping Alex explore her identity and feelings without pressure or specific outcomes.
- **Unconditional Positive Regard:** Reinforcing that she is accepted regardless of his struggles or perceived failures.

This case example illustrates how humanistic therapy can support teens by creating an environment where they feel safe to explore, express, and ultimately, find self-acceptance.

## Conclusion and Resources

Humanistic therapy is a [strength based therapy ](https://dralanjacobson.com/strength-based-therapy/)approach to [psychotherapy and counseling](https://dralanjacobson.com/psychotherapy/) that emphasizes a holistic view of individuals, focusing on their personal growth, self-awareness, and self-actualization. This approach strongly emphasizes the individual’s capacity for [self-determination](https://en.wikipedia.org/wiki/Self-determination) and personal responsibility. It is rooted in the belief that people inherently possess the potential for positive change and self-improvement.

Overall, humanistic therapy techniques are versatile and can be adapted to address a wide range of psychological and emotional issues. They focus on empathy, authenticity, and individual growth, making them valuable approaches for those seeking a deeper understanding of themselves and their experiences. Humanistic therapy approaches are congruent with [third-wave psychotherapies](https://dralanjacobson.com/third-wave-psychotherapy/) that underlie my practice, as well as other approaches such as [existential treatment](https://dralanjacobson.com/existential-therapy/).

There are many excellent sources of information about humanistic treatment, including [this article about this therapeutic approach](https://positivepsychology.com/humanistic-psychology/) from the excellent site “Positive Psychology” and this detailed piece about the emergence of this approach that may appeal to history buffs.

### Humanistic Therapy in My Practice

I’d be happy to talk with you about **humanistic therapy** and whether it is [one of the clinical approaches](https://dralanjacobson.com/types-of-therapy/) that would work well for you. Just use my [contact page](https://dralanjacobson.com/contact/) or [schedule a free consultation](https://www.picktime.com/scheduleaconsult).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [CBT for ADHD](https://dralanjacobson.com/cbt-for-adhd/)

**Published:** August 19, 2024
**Author:** Dr. Alan Jacobson

**Content:**

I offer **CBT for ADHD** for adults and adolescents. **Cognitive-behavioral therapy for ADHD** is widely recognized and effective and can be combined with other approaches, such as **mindfulness therapy,** if desired. **CBT exercises for ADHD** can provide a powerful strategy to help you develop coping mechanisms, improve executive functioning, and manage symptoms such as inattention, hyperactivity, and impulsivity. In this post, I go over this method in detail, and at the end, I provide an example of **CBT for Attention Deficit Disorder** in an adult. You can also see an example of [ADHD and anxiety in girls](https://dralanjacobson.com/therapy-for-girls-with-adhd/) in another post.

Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime to go over how CBT for attention deficit disorder might work for you or a loved one. I also provide [natural ADHD treatment for adults](https://dralanjacobson.com/natural-adhd-treatment-for-adults/) that incorporates these techniques.

## CBT for ADHD Overview

The following are the basic tenets of cognitive-behavioral therapy for ADHD:

### Cognitive Restructuring:

[CBT helps](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) people with ADHD recognize and challenge negative thought patterns that contribute to feelings of frustration, inadequacy, or anxiety. By reframing these thoughts, individuals can develop a more positive and realistic outlook on their abilities and challenges.

### CBT for ADHD Behavioral Strategies

CBT for attention deficit disorder focuses on teaching practical skills to manage [ADHD symptoms](https://www.healthline.com/health/adhd/signs). This can include time management techniques, organizational strategies, and problem-solving skills. For example, breaking tasks into smaller, manageable steps can help with overwhelming projects.

### CBT for ADHD Emotional Regulation

Many people with ADHD struggle with emotional regulation. CBT for attention deficit disorder provides tools to manage emotions, reduce impulsivity, and cope with stress healthily.

### Cognitive-behavioral Therapy for ADHD and Mindfulness

[Incorporating mindfulness](https://dralanjacobson.com/mindfulness-therapy/) into CBT can help individuals with ADHD improve focus and reduce distractibility. Mindfulness practices encourage staying present in the moment, which can be particularly beneficial for managing ADHD symptoms.

### Developing Healthy Routines

CBT for attention deficit disorder helps establish and maintain daily routines, which is crucial for people with ADHD. Regular routines can reduce chaos and increase predictability, making it easier to manage time and responsibilities.

### Tailoring CBT for ADHD

CBT for ADHD often needs to be tailored to meet your specific needs. This might involve focusing more on behavioral interventions or integrating other therapeutic approaches, such as coaching or skills training, to address specific challenges. It can be specifically tailored for [women with ADHD](https://dralanjacobson.com/women-with-adhd/) who show nontraditional or less obvious symptoms.

### Effectiveness of CBT for ADHD

Research has shown that cognitive-behavioral therapy for ADHD can be particularly effective in reducing symptoms in adults and adolescents. It can improve overall functioning, enhance self-esteem, and reduce co-occurring issues such as [anxiety or depression](https://dralanjacobson.com/therapy-for-depression-and-anxiety/). While CBT exercises for ADHD may not be a cure, they provide tools to manage their symptoms more effectively and lead a more organized and fulfilling life.

## CBT Exercises for ADHD

Here are some effective CBT exercises for ADHD. These exercises are often initially practiced both in therapy sessions and then continued as homework.

### CBT Exercises for ADHD: Thought Records

- Purpose: Use [CBT methods](https://dralanjacobson.com/cbt-techniques/) for ADHD to identify and challenge negative or irrational thoughts.
- How to Use: When feeling frustrated or overwhelmed, write down the situation, your [automatic thoughts](https://positivepsychology.com/challenging-automatic-thoughts-positive-thoughts-worksheets/), the emotions associated with those thoughts, then challenge them by examining evidence for and against them. Finally, write down a more balanced or realistic thought.
- Example: If you think, “I’ll never finish this project,” you can challenge it by writing down evidence of past successes and reframe it as “I’ve finished projects before; I can break this down into smaller steps to manage it better.”

### CBT for ADHD Behavioral Activation

- Purpose: To increase engagement in positive activities, which can help combat procrastination and low motivation.
- How to Use: Create a list of activities that bring you joy or a sense of accomplishment. Schedule these activities into your week, especially when you typically feel unmotivated or distracted.
- Example: If you enjoy drawing or going for a walk, schedule these activities into your daily routine to boost mood and energy levels.

### Time Management Practice

- Purpose: To improve planning and organizational skills.
- How to Use: Use a planner or digital calendar to break down your day into blocks of time. Prioritize tasks by urgency and importance, and set specific, realistic deadlines for each task.
- Example: Break down a big project into smaller tasks, such as “research,” “outline,” and “write the first draft,” each with its deadline.

### CBT for Attention Deficit Disorder and Mindfulness Meditation

- Purpose: To increase focus and reduce distractibility.
- How to Use: Practice mindfulness by setting aside 5-10 minutes daily to sit quietly and focus on your breath. When your mind wanders, gently bring your attention back to your breathing.
- Example: Use a mindfulness app or guided meditation to help you stay focused during the practice.

### Impulse Control Training

- Purpose: To reduce impulsive behaviors.
- How to Use: Practice “STOPP” techniques: 
    - Stop
    - Take a breath
    - Observe what’s happening
    - Pull back and get some perspective
    - Proceed with something that will help you.
- Example: Before making a quick decision, practice STOPP to evaluate whether the action is in your best interest.

### Problem-Solving CBT Exercises for ADHD

- Purpose: To develop better decision-making and problem-solving skills.
- How to Use: When faced with a problem, write down the problem, brainstorm possible solutions, evaluate the pros and cons of each solution, choose one, and then implement it.
- Example: If you’re struggling with managing your workload, brainstorm options like delegating tasks, asking for help, or rescheduling non-essential tasks.

### Cognitive-Behavioral Therapy for ADHD and Reward Systems

- Purpose: To reinforce positive behavior and task completion.
- How to Use: Set up a reward system where you reward yourself for completing tasks or making progress on goals. The reward should be something meaningful to you.
- Example: If you complete a difficult task, reward yourself with something enjoyable, like watching a favorite show or having a treat.

### CBT for ADHD and Organizational Challenges

- Purpose: To improve organizational skills in a fun and engaging way.
- How to Use: Set small, specific challenges to organize a particular area of your life, such as your workspace, digital files, or schedule.
- Example: Challenge yourself to clean up your desk in 10 minutes or organize your email inbox by the end of the week.

### Progressive Muscle Relaxation

- Purpose: To reduce physical tension and stress.
- How to Use: Practice [progressive muscle relaxation](https://positivepsychology.com/progressive-muscle-relaxation-pmr/) by tensing and slowly releasing each muscle group, starting from your toes and working up to your head.
- Example: Use this exercise during stress or before bed to help calm your mind and body.

### Setting SMART Goals in Cognitive-Behavioral Therapy for ADHD

- Purpose: To create achievable and realistic goals.
- How to Use: Set Specific, Measurable, Achievable, Relevant, and Time-bound goals (SMART). Break larger goals into smaller steps and track your progress.
- Example: Instead of setting a vague goal like “be more organized,” set a SMART goal like “spend 15 minutes each day organizing my workspace for the next month.”

These CBT exercises for ADHD can help you build structure, improve self-control, and enhance your ability to manage daily challenges. Consistent practice of these techniques can lead to significant improvements in managing symptoms.

## Cognitive-Behavioral Therapy for ADHD Example ![CBT for ADHD](https://dralanjacobson.com/wp-content/uploads/2024/08/remember-300x300.jpg "remember | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Julie is a 28-year-old woman diagnosed with ADHD. She struggles with procrastination and time management and often feels overwhelmed by her tasks at work, leading to missed deadlines and stress.

### Cognitive-behavioral Therapy for ADHD Session Focus

We focus on improving her time management skills and addressing negative thought patterns related to her work performance. This example is purposely simple to explain how CBT exercises for ADHD work in a typical session. The conversation is fictitious, of course,

### Example CBT for Attention Deficit Disorder Session

1. Identifying the Problem: 
    - Me: “Julie, you’ve mentioned feeling overwhelmed by your workload and that it often leads to procrastination. Can you tell me more about what goes through your mind when you start a task?”
    - Julie: “I look at everything I must do, and it feels impossible. I think, ‘There’s no way I can get all this done,’ so I avoid it and do something else.”
2. Challenging Negative Thoughts: 
    - Me: “It sounds like you’re having a thought that you won’t be able to get everything done. Let’s challenge that thought. What evidence do you have that supports or contradicts it?”
    - Julie: “Well, I’ve finished big projects before, but it always feels like a huge mountain at the start.”
    - Me: “Exactly. You’ve succeeded in the past. How can we reframe this thought to be more realistic?”
    - Julie: “Maybe I can remind myself that I’ve done it before, and I just need to break it down into smaller steps.”
3. CBT for ADHD Behavioral Strategies: 
    - Me: “Let’s work on breaking your tasks into smaller, more manageable parts. We can use a time management technique called ‘chunking.’ Instead of looking at the entire project, you’ll focus on one small task at a time.”
    - Julie: “Okay, I can try that. I’ll start by outlining the project and then tackle one section at a time.”
4. Setting SMART Goals: 
    - Me: “Let’s set a SMART goal for the week. How about spending 30 minutes each morning outlining your project before moving on to the next task? Does that sound doable?”
    - Julie: “Yes, that feels manageable.”
5. Practicing Mindfulness: 
    - Me: “When you start feeling overwhelmed, practice mindfulness for a few minutes. Focus on breathing and bring your attention back to the present moment. This can help reduce the anxiety that comes with feeling overwhelmed.”
    - Julie: “I’ll try that. I’ve noticed that when I focus on my breathing, it does help me calm down.”
6. Reviewing CBT for Attention Deficit Disorder Progress: 
    - Me: “We’ll review how these strategies worked for you next week. We’ll see what went well and what we might need to adjust. Remember, it’s about progress, not perfection.”

### CBT for Attention Deficit Disorder Homework:

- Task Breakdown: Julie will practice breaking down her work tasks into smaller steps and focus on completing one step at a time.
- Mindfulness Practice: She will spend 5 minutes daily practicing mindfulness, especially when overwhelmed.
- Thought Records: Julie will keep a [thought record](https://positivepsychology.com/thought-records/), noting when she feels overwhelmed, the thoughts that come up, and how she can reframe those thoughts.

### CBT for ADHD Follow-Up:

In the next session, Julie and I will discuss her progress and any challenges she encountered and adjust the strategies as needed. I will reinforce positive changes and continue to build on the CBT exercises for ADHD.

This example illustrates how cognitive-behavioral therapy for ADHD helps someone manage their symptoms by addressing negative thought patterns, implementing practical strategies, and setting achievable goals. CBT exercises for ADHD become a toolkit you can use after treatment has ended.

## CBT for ADHD in an Adolescent

Here’s a fictitious case example illustrating how cognitive-behavioral therapy for ADHD can be used for an adolescent:

---

### Case Example: CBT for attention deficit disorder

Jake, a 15-year-old high school sophomore, has been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), predominantly inattentive type. His symptoms include difficulty focusing during classes, procrastinating on homework, poor time management, and frequently misplacing items (e.g., textbooks and notebooks). This has led to slipping grades, tension with his parents, and frustration at feeling “lazy” and “out of control.”

Jake’s parents sought cognitive-behavioral therapy for ADHD as a non-medication intervention to help him develop better organizational habits, [emotional regulation](https://psychologicalassessments.com/emotional-dysregulation-testing/), and self-confidence.

---

### CBT Exercises for ADHD

1. **Psychoeducation about ADHD**
    - **Goal:** Help Jake understand ADHD as a brain-based challenge, not a personal flaw.
    - **Example:** Jake learned that ADHD affects his executive functioning (planning, working memory, and impulse control). By externalizing the problem (ADHD is not *him*), Jake felt less ashamed. 
        - *Me:* “Your brain works differently regarding focus and planning. Our job is to build strategies that work for you.”

---

2. **Identifying Negative Thought Patterns**
    - **Goal:** Address Jake’s unhelpful self-talk (“I’m lazy,” “I can’t do this”).
    - **Example:** I introduced Jake to the concept of [automatic negative thoughts](https://www.healthline.com/health/mental-health/stop-automatic-negative-thoughts) (ANTs). They identified his habit of catastrophizing when overwhelmed. 
        - *Me:* “You said, ‘I’ll fail this whole class if I don’t finish this paper.’ How can we reframe that?”
        - *Jake:* “Maybe I can think, ‘It’s just one assignment. If I start now, I can do enough to get through it.’”

---

3. **Behavioral Interventions and Skills Training**
    - **Breaking Tasks into Manageable Steps**
        - *Example:* Jake learned to break large assignments into smaller, time-limited tasks (e.g., “Write the outline tonight, finish the intro tomorrow”). The therapist used timers and planners to reinforce this method.
    - **Time Management and Use of External Tools**
        - *Example:* Jake started using a **visual planner** and alarms to structure his day. Homework became manageable because he scheduled **short, focused work periods** (25 minutes) with 5-minute breaks (similar to the [Pomodoro technique](https://en.wikipedia.org/wiki/Pomodoro_Technique)).
    - **Organizational Systems**
        - *Example:* I worked with Jake to create consistent routines for keeping his backpack, locker, and workspace organized.
        - *Jake:* “I now keep everything for math in a folder, so I don’t lose my assignments anymore.”

---

4. **Improving Emotional Regulation**
    - **Goal:** Address Jake’s frustration and impulsivity.
    - **Example:** I introduced **[mindfulness-based cognitive therapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) techniques** (e.g., deep breathing and grounding exercises) to help Jake pause before reacting to stress. 
        - *Jake:* “When I get mad that homework is hard, I stop and take three deep breaths. It makes it easier to start.”

---

5. **Parental Involvement**
    - **Goal:** Support Jake’s progress at home and improve family dynamics.
    - **Example:** Jake’s parents learned to use **positive reinforcement**. They praised Jake’s effort (“Great job starting that essay!”) instead of focusing on missed deadlines.

---

### Outcome

Over 12 weeks, Jake’s academic performance improved. His grades rose, and even more importantly, Jake felt more capable and less overwhelmed. He developed tools to manage procrastination, organize his materials, and reframe negative thoughts. By learning to view ADHD as a challenge he could work with, Jake’s confidence increased.

---

### Summary of CBT Exercises for ADHD Used:

1. Psychoeducation
2. Identifying and reframing negative thoughts
3. Task breakdown, time management, and organization skills
4. Emotional regulation strategies
5. Parental coaching

This approach highlights how CBT for attention deficit disorder can empower adolescents to develop concrete skills, build self-awareness, and improve their emotional well-being. I offer [ADHD treatment for teens](https://dralanjacobson.com/adhd-treatment-for-teens/) as a specialty.

## CBT for Attention Deficit Disorder in My Practice

I offer cognitive-behavioral therapy for ADHD as an [individual therapy](https://dralanjacobson.com/individual-therapy/), virtually and in person. I can also weave these techniques into [couples therapy](https://dralanjacobson.com/couples-therapy/), whether the couple needs this help or one person wants to help the other. It can also be delivered in specialty areas such as my work with [college students](https://dralanjacobson.com/therapy-for-college-students/), executive coaching, or [sports psychology](https://dralanjacobson.com/sports-psychology/). CBT as a [treatment for adult ADHD](https://dralanjacobson.com/adhd-therapy-for-adults/) is particularly effective, particularly when combined with [executive functioning coaching](https://dralanjacobson.com/executive-functioning-coaching/).

Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime to go over how CBT for ADHD might be a good therapeutic approach for you or a loved one.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Mental Health Diagnoses

---

### [Natural ADHD Treatment for Adults](https://dralanjacobson.com/natural-adhd-treatment-for-adults/)

**Published:** November 13, 2024
**Author:** Dr. Alan Jacobson

**Content:**

Holistic and **natural ADHD treatment for adults** focuses on addressing the mind, body, and lifestyle factors contributing to symptoms. Beyond therapy and medication, it incorporates lifestyle changes, nutritional strategies, alternative therapies, and mindfulness practices. In my practice, I offer **treatment for ADHD in adults** that incorporates these holistic approaches while also providing more traditional treatment. The following is a comprehensive guide to **treatment for adult ADHD**, but please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime if you have specific questions.

## Natural ADHD Treatment for Adults

The following goes over treatment for adult ADHD that weaves together holistic approaches with more traditional methods.

### 1. Mind-Body Treatment for Adult ADHD

- **Mindfulness Meditation:** [Mindfulness-based practices](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) can help reduce impulsivity and improve focus by training attention and reducing stress. Apps like Headspace or Calm offer guided ADHD-specific meditations.
- **Yoga:** Yoga combines physical movement, breathwork, and meditation, helping with relaxation and emotional regulation. It can be particularly effective in reducing hyperactivity and increasing self-awareness. This makes it a great adjunct to [therapy for adult ADHD](https://dralanjacobson.com/adhd-therapy-for-adults/).
- **Cognitive Behavioral Treatment for Adult ADHD:** [CBT for ADHD](https://dralanjacobson.com/cbt-for-adhd/) helps address negative thought patterns and teaches strategies for managing impulsivity, time management, and organization. It’s often used alongside mindfulness techniques.

### 2. Nutritional ADHD Treatment for Adults

- **Balanced Diet:** Emphasize whole foods like fruits, vegetables, lean proteins, and healthy fats. Avoid processed foods, sugar, and artificial additives, as these can worsen symptoms.
- **[Omega-3 Fatty Acids](https://www.healthline.com/nutrition/12-omega-3-rich-foods):** Found in fish oil supplements, walnuts, and flaxseeds, omega-3s have been shown to support brain health and may help reduce ADHD symptoms.
- **Magnesium and Zinc:** These minerals can help with relaxation, focus, and mood regulation. Foods like spinach, pumpkin seeds, and nuts are good sources.
- **Limit Stimulants:** Reducing caffeine and sugar intake can prevent mood swings and energy crashes.

I provide more information about nutritional natural ADHD treatment for adults and a disclaimer later in this post.

### 3. Exercise and Movement

- **Regular Physical Activity:** Aerobic exercises like running, swimming, or cycling increase dopamine and norepinephrine levels in the brain, which can help improve focus and mood.
- **Strength Training:** Resistance training can boost mental health and improve executive functioning.
- **Outdoor Activities:** Spending time in nature (e.g., hiking, gardening) can be calming and improve attention.

### 4. Herbal and Nutritional Supplements

- You should consult your doctor or a registered dietician before taking supplements. It is beyond the scope of my practice to give advice about supplements, but I do believe some can work well for many people.

### 5. Sleep Hygiene Treatment for ADHD in Adults

- **Consistent Sleep Schedule:** Maintain a regular sleep routine to help regulate your internal clock and support cognitive function. [CBT-I therapy](https://dralanjacobson.com/cbt-i-for-sleep-difficulties/) can help if needed.
- **Reduce Screen Time:** Limiting screen exposure an hour before bed can help improve sleep quality.
- **Relaxation Techniques:** Consider incorporating deep breathing exercises or progressive muscle relaxation to wind down before sleep.

### 6. Behavioral ADHD Treatment for Adults

- **Time Management Tools:** Using timers, calendars, and reminders can help with task management and reduce overwhelm.
- **Create Structure:** Establish a consistent daily routine to help manage time effectively and reduce decision fatigue.
- **Break Tasks into Smaller Steps:** Use techniques like the Pomodoro method to work in short, focused intervals.

### 7. Social and Emotional Support

- **[Therapy Groups](https://dralanjacobson.com/group-therapy/):** Joining an ADHD support group as part of treatment for ADHD in adults can help address emotional challenges and provide a sense of community.
- **Family and Friends:** Educate close friends and family about her symproms to foster understanding and reduce potential conflicts.

### 8. Alternative Treatment for Adult ADHD

- **Acupuncture:** Some individuals find [acupuncture helps with relaxation](https://mpacupuncture.com/5-reasons-to-try-acupuncture-for-stress-and-anxiety-relief/) and focus when used as a natural treatment for adult ADHD, although research is still limited.
- **[Neurofeedback](https://www.psychologytoday.com/us/therapy-types/neurofeedback?msockid=1686e8c22e816b8a1935fc532fc26a1c):** This non-invasive treatment for adult ADHD uses real-time monitoring of brain activity to help train the brain to function more efficiently.
- **Massage Therapy:** Regular [massages can help reduce stress](https://www.stress.org/news/face-massages-that-may-help-relieve-stress/) and promote relaxation.

### Personalized ADHD Treatment for Adults

Holistic treatment is highly individualized. Experimenting with different approaches and finding what works best for you might take some time. Keeping a journal of symptoms, lifestyle habits, and interventions can help track progress and identify effective natural ADHD treatments for adults.

## Treatment for Adult ADHD Case Example

**Client:** Anna, a 35-year-old marketing professional
**Symptoms:** Since childhood, Anna has struggled with focus, time management, and impulsivity. She often feels overwhelmed, procrastinates on projects, and finds it difficult to maintain a consistent routine. She also experiences chronic stress, poor sleep, and fluctuating energy levels. We decided to explore natural ADHD treatment for adults.

### Natural ADHD Treatment for Adults Goals:

- Improve focus and productivity at work.
- Manage stress and reduce overwhelm.
- Establish a consistent routine for better time management.
- Explore non-medication options as she prefers a holistic approach.

---

### Natural ADHD Treatment for Adults Plan

#### 1. Initial Assessment

Anna underwent a comprehensive evaluation that included:

- A detailed health and lifestyle history.
- A mental health assessment to rule out co-occurring conditions (e.g., anxiety, depression).
- A dietary analysis and review of sleep habits.

#### 2. Lifestyle Changes

- **Exercise:** Anna was encouraged to engage in **aerobic exercise** (e.g., brisk walking or jogging) for 30 minutes 5 times a week. This was chosen to help increase dopamine and norepinephrine, improving her focus and mood.
- **Sleep Hygiene:** She implemented a consistent sleep schedule, aiming for 7-8 hours of rest each night. To support better sleep, Anna limited screen time 1 hour before bed and used a relaxation technique (progressive muscle relaxation) to wind down.

#### 3. Mindfulness and Cognitive Treatment for ADHD in Adults

- **[Mindfulness-Based Stress Reduction](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) (MBSR):** Anna started a daily mindfulness practice using a guided meditation app for 10 minutes each morning. This helped her become more aware of her thoughts and reduce impulsive behaviors.
- **[Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT):** She began weekly cognitive treatment for ADHD in adults focusing on time management and restructuring negative thought patterns related to procrastination and self-criticism.

#### 4. Nutritional Adjustments

- **Balanced Diet:** Anna increased her intake of whole foods, focusing on lean proteins, vegetables, and complex carbohydrates. She reduced processed sugar and limited caffeine intake to prevent energy spikes and crashes.
- **Supplements:** After consulting with a healthcare provider, Anna added **Omega-3 fish oil** (1,000 mg daily) and **Magnesium glycinate** (250 mg in the evening) to her regimen to support cognitive function and relaxation.

#### 5. Behavioral Strategies and Time Management ([Executive Function Coaching](https://dralanjacobson.com/executive-functioning-coaching/))

- **Task Prioritization:** Using a simplified version of the [**Eisenhower Matrix**](https://asana.com/resources/eisenhower-matrix), Anna categorized her tasks by urgency and importance. This helped her prioritize better and tackle high-priority items first.
- **Pomodoro Technique:** She adopted the Pomodoro method, working in 25-minute intervals followed by 5-minute breaks. This treatment for ADHD in adults helped her stay focused and reduced the urge to multitask.
- **Visual Reminders and Digital Tools:** Anna used a combination of a physical calendar and a digital app to keep track of deadlines, set reminders, and plan her daily schedule.

#### 6. Social and Emotional Support

- **Support Group:** Anna joined a local group treatment for ADHD in adults program, which meets once a month. This gave her a safe space to share experiences, learn coping strategies, and connect with others facing similar challenges.
- **Family Involvement:** Anna’s partner attended a few sessions with her therapist to understand her ADHD better and learn ways to provide support without adding pressure.

#### 7. Alternative Natural ADHD Treatment for Adults

- **Acupuncture:** Anna tried acupuncture twice a month to help with stress relief. After sessions, she reported feeling calmer and noticed a slight improvement in her ability to focus.
- **Yoga:** She added a weekly yoga class to strengthen her mind-body connection, which helped her practice mindfulness as a natural adhd treatment for adults and reduce anxiety.

---

### Treatment for Adult ADHD, Progress After 3 Months

**Improvements:**

- Anna reported feeling more in control of her daily schedule, with less procrastination.
- Her focus during work tasks improved, and she could complete projects more efficiently.
- Her sleep quality increased, and she felt more rested in the mornings.
- She was less overwhelmed and had better tools to manage stress.

**Ongoing Challenges:**

- On particularly busy days, Anna still slipped back into old multitasking habits and became easily distracted.
- There were occasional bouts of impulsivity, especially when feeling emotionally stressed.

**Adjustments:**

- I recommended additional treatment for ADHD in adults for emotional regulation, including **journaling** and [**mindful therapy techniques**](https://dralanjacobson.com/mindfulness-therapy/) during moments of overwhelm.
- A follow-up consultation with a dietitian led to the inclusion of more protein-rich snacks to help stabilize blood sugar levels throughout the day.

---

### Conclusion

Anna’s case highlights the effectiveness of a holistic treatment for ADHD in adults, blending lifestyle changes, therapy, nutrition, and support systems. While not every symptom was resolved, her overall quality of life improved significantly without medication. The key was creating a personalized, adaptable plan that addressed her unique needs and preferences.

## Nutritional Treatment for ADHD in Adults

Natural treatments for ADHD in adults focus on lifestyle changes, diet, and alternative therapies that aim to support brain health and alleviate symptoms without pharmaceutical medications. These approaches can be particularly helpful for those who prefer non-medication strategies or want to supplement their existing treatment plan. Here’s a comprehensive guide:

### Dietary Treatments for Adult ADHD

It’s very important to note that you must consult with your doctor or a registered dietician before taking any supplements. My advice below is relative to dietary choices and not supplements, and even then you should consult with your doctor before making any significant changes in what you eat.

- **Balanced Diet:** Prioritize a diet rich in whole foods, including lean proteins, vegetables, whole grains, and healthy fats. These nutrients help stabilize blood sugar and support cognitive function.
- **[Omega-3 Fatty Acids](https://my.clevelandclinic.org/health/articles/17290-omega-3-fatty-acids):** Omega-3s are essential for brain health and can improve focus and attention. Sources include: 
    - Fatty fish (salmon, sardines, mackerel)
    - Flaxseeds and chia seeds
    - Fish oil supplements (2,000-3,000 mg of combined EPA and DHA daily)
- **Protein Intake:** Protein-rich foods like eggs, nuts, lean meats, and legumes can help increase dopamine levels, which play a role in focus and concentration.
- **Reduce Sugar and [Processed Foods](https://www.webmd.com/diet/what-are-processed-foods):** High-sugar diets can cause blood sugar spikes and crashes, leading to worsened symptoms like impulsivity and irritability.
- **Magnesium and Zinc:** These minerals can support cognitive function and mood regulation. Good sources include: 
    - Magnesium: Leafy greens, nuts, seeds, dark chocolate
    - Zinc: Pumpkin seeds, chickpeas, meat, and shellfish

## Summary and My Work

As a clinical psychologist, I am trained in many effective clinical methods for treating ADHD in adults. However, that does not mean no other effective adjunctive approaches exist. Thus, when I treat adult symptoms, I welcome holistic approaches. Natural ADHD treatment for adults combines tried-and-true clinical techniques with lifestyle, social, nutritional, and behavioral strategies. Please also see my specialty in [therapy for women with ADHD](https://dralanjacobson.com/women-with-adhd/) and [therapy for girls with ADHD](https://dralanjacobson.com/therapy-for-girls-with-adhd/).

### Get Treatment for ADHD in Adults

If you would like more information about natural ADHD treatment for adults (or related [ADHD treatment for teens](https://dralanjacobson.com/adhd-treatment-for-teens/)) and how it might benefit you or a loved one, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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](https://www.linkedin.com/company/psychologicalscience/)

**Categories:** Symptom Relief

---

### [Attachment-Based Therapy](https://dralanjacobson.com/attachment-therapy/)

**Published:** January 17, 2025
**Author:** Dr. Alan Jacobson

**Content:**

**Attachment therapy** refers to a variety of therapeutic approaches aimed at addressing issues related to early life experiences or trauma. These therapies aim to improve emotional connections and relationships, typically between caregivers and children or adults and their partners. I use **attachment-based therapy** for families, individuals, and couples, and I mix **attachment-based interventions** with other methods to have an integrative [trauma-informed approach](https://dralanjacobson.com/trauma-informed-care/) that can be uniquely tailored to each client or family. Attachment-based family therapy is a cornerstone treatment.

If you have any questions about how these methods might benefit you, a loved one, or your family, please feel free to [schedule a consultation](https://www.picktime.com/scheduleaconsult) or [contact me](https://dralanjacobson.com/contact/) anytime.

## Categories of Attachment Therapy Approaches

Attachment therapy can be used in various ways. Here are the most common and how they relate to my services.

### 1. Child-Centered Attachment Therapy

- **Attachment-Based Family Therapy (ABFT):** Focuses on repairing trust and communication between parents and children, often used for adolescents struggling with depression or conflict.
- **[Dyadic Developmental Psychotherapy](https://ddpnetwork.org/about-ddp/dyadic-developmental-psychotherapy/) (DDP):** Helps children with trauma or disruptions form secure relationships through improved emotional connection and communication.
- **[Theraplay](https://theraplay.org/):** Engages children and their caregivers in structured, playful activities to promote trust.

### 2. Trauma-Focused Attachment Therapy

- **[Trust-Based Relational Intervention](https://www.attachmenttraumanetwork.org/trust-based-relational-interventions-tbri/) (TBRI):** An evidence-based approach for children who have experienced trauma, focusing on connection, empowerment, and correcting behavior through trust.
- **[Eye Movement Desensitization and Reprocessing](https://www.emdr.com/what-is-emdr/) (EMDR):** Often used with individuals who have experienced trauma, helping them process painful memories and develop healthier emotional patterns.

### 3. Adult-Focused Attachment-Based Therapy

I do provide these types of treatment for older adolescents and adults.

- **[Emotionally Focused Therapy](https://dralanjacobson.com/eft-therapy-for-couples/) (EFT):** Commonly used with couples to address insecurities and improve emotional bonds, but [emotionally focused individual therapy](https://dralanjacobson.com/emotionally-focused-individual-therapy/) is also an option.
- **[Internal Family Systems](https://dralanjacobson.com/internal-family-systems-therapy-ifs/) (IFS):** A therapy that addresses inner emotional conflicts often rooted in early attachment wounds by working with different “parts” of the self.

## Attachment-Based Interventions

The attachment-based interventions I use are designed to address issues stemming from relationships, typically rooted in early interactions between children and their caregivers. These interventions aim to improve relational dynamics, enhance emotional security, and resolve difficulties. Below is an overview of the attachment-based interventions I use.

---

### 1. Attachment-Based Family Therapy (ABFT)

- **Purpose:** These attachment-based interventions are primarily for adolescents struggling with depression, trauma, or suicide risk.
- **Approach:**
    - Focuses on repairing and strengthening the parent-child relationship.
    - Encourages open communication and rebuilding trust.
    - Addresses family conflict and emotional disconnection.

I provide more information about ABFT below.

---

### 2. Dyadic Developmental Psychotherapy (DDP)

- **Purpose:** Helps children with trauma or disrupted attachment develop healthy relationships.
- **Approach:**
    - Relies on a supportive and emotionally attuned environment.
    - Encourages co-regulation of emotions between the child and caregiver.
    - Uses playful, accepting, curious, and empathic interactions (PACE).

---

### 3. Theraplay

- **Purpose:** A structured play-based therapy to improve parent-child attachment.
- **Approach:**
    - Uses guided activities to promote connection, engagement, and joy.
    - Focuses on four dimensions: structure, engagement, nurture, and challenge.
    - Strengthens the caregiver’s ability to meet the child’s emotional needs.

---

### 4. Trust-Based Relational Intervention (TBRI)

- **Purpose:** Designed for children from hard places, such as those with trauma or adoption experiences.
- **Approach:**
    - Based on three principles: empowering, connecting, and correcting.
    - Helps children feel safe and understood while addressing behavioral challenges.

---

### 5. Circle of Security (COS)

- **Purpose:** A set of attachment-based interventions for parents to enhance security in young children.
- **Approach:**
    - Helps parents recognize their child’s needs.
    - Encourages responsive caregiving and emotional availability.
    - Strengthens the child’s sense of safety and ability to explore.

---

### 6. Emotionally Focused Therapy (EFT)

- **Purpose:** These attachment-based interventions are often used in couples therapy to address insecurities and relationship distress.
- **Approach:**
    - Focuses on identifying and reshaping negative interaction patterns.
    - Strengthens emotional bonds by fostering secure relationships.
    - Encourages vulnerability and open communication.

---

### 7. Mentalization-Based Therapy (MBT)

- **Purpose:** Enhances the ability to understand and reflect on one’s own and others’ emotions and intentions.
- **Approach:**
    - Particularly helpful for individuals with deep-seated difficulties, including borderline personality disorder (BPD).
    - Encourages the development of a secure sense of self and healthier interpersonal relationships.

---

### 8. Parent-Child Interaction Therapy (PCIT)

- **Purpose:** Improves behavior in children with emotional challenges.
- **Approach:**
    - Combines coaching for parents with live observation and feedback.
    - Strengthens the parent-child bond while managing difficult behaviors.

---

### Key Goals of Attachment-Based Interventions

1. **Repairing Relationships:** Attachment-based interventions foster trust, safety, and secure relationships.
2. **Regulating Emotions:** Attachment-based interventions teach co-regulation and self-regulation strategies.
3. **Enhancing Sensitivity:** Attachment-based interventions improve caregivers’ ability to respond to emotional needs.
4. **Promoting Resilience:** Attachment-based interventions help individuals form healthier relationships and cope with stress.

---

## Attachment-Based Family Therapy (ABFT)

Attachment-Based Family Therapy (ABFT) is a structured, evidence-based therapeutic approach to address family relational ruptures. It is particularly effective for adolescents and young adults experiencing depression, trauma, suicidal ideation, or family conflict. ABFT aims to repair trust and improve emotional bonds between family members.

---

### Core Principles of Attachment-Based Family Therapy

1. **Theoretical Framework:**
    - Attachment-based family therapy focuses on the emotional connection between adolescents and caregivers.
    - It aims to create a secure base where the adolescent feels safe, supported, and understood.
2. **Relational Repair:**
    - Attachment-based family therapy prioritizes resolving relational ruptures that may contribute to emotional or behavioral difficulties.
    - It encourages caregivers to be emotionally available and responsive to their child’s needs.
3. **Emotion-Focused Approach:**
    - Attachment-based family therapy helps family members express and understand underlying emotions driving conflict or disconnection.
    - It facilitates open communication to strengthen relational bonds.

---

### Five Treatment Phases of Attachment-Based Family Therapy

1. **Relational Reframe (Phase 1):**
    - Establishes trust between the therapist and family members.
    - Shifts focus from the adolescent’s symptoms (e.g., depression, suicidal ideation) to repairing relationships as the root cause.
2. **Adolescent Alliance Building (Phase 2):**
    - Creates a safe space for the adolescent to express their thoughts and feelings without fear of judgment.
    - Encourages exploration of pain, such as feeling unsupported or misunderstood.
3. **Parent Alliance Building (Phase 3):**
    - Helps caregivers reflect on their own emotions and behaviors that may contribute to the relational strain.
    - Prepares caregivers to listen empathetically and respond constructively to the adolescent’s concerns.
4. **Attachment Task (Phase 4):**
    - Brings the adolescent and caregiver(s) together for emotionally focused discussions.
    - Facilitates conversations about past hurts, unmet needs, and desires for change.
    - Strengthens emotional bonds and builds a foundation of trust and security.
5. **Autonomy and Competence (Phase 5):**
    - Supports the adolescent in developing independence and problem-solving skills.
    - Reinforces the caregiver’s role as a supportive and secure base while allowing appropriate autonomy.

---

### Attachment-Based Family Therapy Target Population

Attachment-based family therapy is typically used for:

- Adolescents and young adults (12–24 years old).
- Families experiencing high levels of conflict or disconnection.
- Youth struggling with depression, anxiety, trauma, or suicidal ideation.

---

### Therapeutic Goals

- Repair ruptures and restore trust between family members.
- [Treats depression](https://dralanjacobson.com/treating-major-depression/), anxiety, or suicidal thoughts.
- Improve communication and emotional expression within the family.
- Foster a secure relationship, allowing adolescents to feel supported while developing autonomy.

---

### Benefits of Attachment Therapy for Families

- Empirically supported for reducing suicidal ideation and depression when providing [therapy for teens](https://dralanjacobson.com/therapy-for-teens/).
- Strengthens family relationships, promoting long-term emotional resilience.
- Tailored to the unique dynamics of each family.

---

### Evidence and Effectiveness of Attachment Therapy for Families

Research consistently supports attachment-based family therapy as an effective treatment for:

- Adolescent depression.
- Family conflict.
- Suicide prevention in at-risk youth.

## Attachment-Based Therapy for Couples

My use of attachment-based therapy for couples focuses on strengthening emotional bonds by addressing certain dynamics in the relationship. The [therapy helps couples](https://dralanjacobson.com/couples-therapy/) identify and heal disconnection, conflict, or insecurity patterns, fostering a secure and supportive partnership.

---

### Key Principles of Attachment-Based Therapy for Couples

1. **Addressing the Foundation of Relationships:**
    - Partners seek safety, connection, and emotional support from each other.
    - Insecure styles (e.g., anxious, avoidant) can lead to conflict, miscommunication, or emotional distance.
2. **Emotionally Focused Therapy (EFT) as a Model:**
    - EFT is the most widely used attachment-based therapy for couples.
    - It identifies and transforms negative interaction patterns to rebuild trust and closeness.
3. **Focusing on Emotional Needs:**
    - It helps partners recognize and express their relational needs (e.g., love, acceptance, and reassurance).
    - Encourages vulnerability to foster deeper intimacy and understanding.

---

### Therapeutic Goals

- Strengthen emotional connection and intimacy.
- Heal past relational wounds or betrayals.
- Improve communication and reduce conflict.
- Foster a secure relationship.
- Empower couples to co-regulate emotions and provide mutual support.

---

### Common Techniques in Attachment Therapy for Couples

1. **Identifying Negative Interaction Patterns:**
    - Explore how each partner’s style influences conflicts or emotional distance.
    - Break cycles of blame, criticism, or withdrawal.
2. **Creating a Safe Emotional Environment:**
    - Develop trust so partners feel safe expressing their fears, needs, and emotions.
    - Use nonjudgmental listening and empathy to promote connection.
3. **Promoting Vulnerability:**
    - Help partners share deeper emotions (e.g., fear of rejection, loneliness) rather than surface-level frustrations.
    - Encourage meaningful conversations that address the root of issues.
4. **Reprocessing Emotional Injuries:**
    - Address unresolved hurts or betrayals that undermine trust.
    - Work through painful memories to foster forgiveness and repair.
5. **Building Secure Bonds:**
    - Teach partners how to respond to each other’s needs in ways that create safety and reassurance.
    - Reinforce positive interactions that nurture the relationship.

---

### Key Concepts for Couples

- **Relational Styles:**
    - **Secure:** Partners feel comfortable with intimacy and autonomy.
    - **Anxious:** A partner may seek constant reassurance, fearing abandonment.
    - **Avoidant:** A partner may distance themselves emotionally to maintain independence.
    - **Disorganized:** A mix of anxious and avoidant behaviors, often rooted in unresolved trauma.
- **Protest Behaviors:**
    - Behaviors like nagging, withdrawing, or criticizing often stem from unmet needs.
- **Secure Base:**
    - The goal is to create a relationship where both partners feel emotionally safe and supported.

---

### Who Can Benefit from Attachment Therapy for Couples?

1. Couples experiencing emotional distance or disconnection or [fear of intimacy](https://dralanjacobson.com/fear-of-intimacy/).
2. Those struggling with frequent arguments or communication issues.
3. Partners dealing with infidelity or betrayal.
4. Couples [navigating life transitions](https://dralanjacobson.com/life-transitions-therapy/) (e.g., becoming parents, job changes, aging).
5. Individuals with attachment insecurities affect their relationships.

---

### Benefits of Attachment-Based Couples Therapy

- Improved emotional intimacy and trust.
- Greater understanding of each other’s needs and fears.
- Reduced conflict and healthier communication patterns.
- Healing of relational wounds and increased resilience as a couple.
- A stronger, more secure partnership.

---

This form of [Couples Therapy](https://dralanjacobson.com/couples-therapy/) can transform relationships by addressing the core emotional needs of both partners.

## Attachment Therapy for Individuals

Attachment-based therapy for individuals focuses on understanding how early experiences influence current thoughts, emotions, behaviors, and relationships. It aims to help individuals develop secure relationship patterns, heal from wounds, and build healthier bonds with themselves and others.

---

### Key Principles of Attachment Therapy for Individuals

1. **Attachment as a Lifelong Process:**
    - Early patterns formed in childhood with caregivers shape adult relationships, self-esteem, and emotional regulation.
    - Insecure styles (e.g., anxious, avoidant, disorganized) can lead to difficulties in relationships or coping with stress.
2. **Healing Relational Wounds:**
    - Attachment-based therapy addresses unresolved trauma, neglect, or abandonment from early life.
    - Attachment-based therapy focuses on developing a secure sense of self and the ability to form healthy connections.
3. **The Therapist as a Secure Base:**
    - The therapeutic relationship models a secure attachment, providing a safe space for exploration and healing.
    - Through consistent and empathetic interactions, clients can reprocess past injuries through attachment-based therapy.

---

### Goals of Attachment Therapy for Individuals

- **Develop Emotional Awareness:** Understand how relational patterns influence emotional reactions.
- **Heal from Trauma:** [Process childhood traumas](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/) and [treat unresolved grief](https://dralanjacobson.com/grief-therapy/) or loss.
- **Improve Relationships:** Build healthier, more secure relationships by addressing maladaptive patterns.
- **Enhance Self-Worth:** Cultivate a stronger sense of identity and self-esteem.
- **Learn [Emotional Regulation](https://psychologicalassessments.com/emotional-dysregulation-testing/):** Develop tools to manage anxiety, anger, or fear effectively.

---

### Attachment-Based Interventions for Individuals

1. **Exploration of Early Experiences:**
    - Reflect on childhood relationships with caregivers to identify patterns (secure, anxious, avoidant, disorganized relationships).
    - Understand how these patterns affect current relationships and behaviors (and thus, I often mix in [family of origin therapy techniques](https://dralanjacobson.com/family-of-origin-therapy/)).
2. **Creating a Secure Therapeutic Relationship:**
    - I offer empathy, consistency, and validation to model secure attachment.
    - This relationship helps clients feel safe to explore difficult emotions and experiences.
3. **Processing Emotional Pain:**
    - Focus on unprocessed feelings of rejection, neglect, or abandonment.
    - Use techniques like [mindfulness-based stress reduction](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/), [narrative therapy](https://dralanjacobson.com/narrative-therapy/), or EMDR (Eye Movement Desensitization and Reprocessing) to process trauma. [Creative therapy](https://dralanjacobson.com/creative-counseling/) using artistic expression can also be helpful.
4. **Rewriting Narratives:**
    - Challenge and reframe negative beliefs formed through insecure relationships (e.g., “I’m unlovable,” “People will always leave me”).
    - Build a healthier internal narrative centered on self-compassion and resilience.
5. **Building Emotional Regulation Skills:**
    - Teach strategies like grounding, mindfulness, and co-regulation to manage intense emotions.
    - Help clients learn to self-soothe and develop a secure sense of self.
6. **Developing Healthy Relationship Skills:**
    - Address unhealthy patterns like people-pleasing, avoidance, or fear of intimacy.
    - Practice assertiveness, setting boundaries, and vulnerability in relationships.

---

### Who Can Benefit?

1. **Individuals with Insecure Styles:**
    - Anxious: Fear of rejection, constant need for reassurance.
    - Avoidant: Emotional distancing, fear of dependence.
    - Disorganized: Conflicting needs for closeness and avoidance, often linked to trauma.
2. **People Struggling with Relationships:**
    - Difficulty maintaining close, healthy relationships.
    - Patterns of conflict, dependency, or emotional withdrawal.
3. **Those with Trauma or Loss Histories:**
    - Early childhood trauma, neglect, or abuse.
    - Experiences of significant loss or separation.
4. **Individuals Facing Anxiety, Depression, or Emotional Challenges:**
    - Chronic feelings of unworthiness, loneliness, or emotional instability.

---

### Common Therapeutic Approaches

1. **Emotionally Focused Individual Therapy (EFIT):**
    - Focuses on identifying and transforming negative emotional patterns rooted in emotional needs.
2. **Internal Family Systems (IFS):**
    - Works with “parts” of the self, such as the wounded inner child, to address pain.
3. **Mentalization-Based Therapy (MBT):**
    - Helps individuals understand and reflect on their own and others’ emotions and intentions.
4. **Trauma-Focused Interventions:**
    - **EMDR (Eye Movement Desensitization and Reprocessing):** Processes traumas.
    - **[Somatic Experiencing](https://dralanjacobson.com/somatic-therapy/):** Addresses how trauma is stored in the body.
5. **[Relational Psychotherapy](https://dralanjacobson.com/relational-therapy/):**
    - It focuses on the dynamics of relationships and how past experiences influence them.

---

### Benefits of Attachment Therapy for Individuals

- Greater self-awareness of emotional needs and patterns.
- Healing from relational wounds and past trauma.
- Enhanced ability to form and maintain healthy, secure relationships.
- Improved self-esteem and emotional resilience.
- [Reduction in anxiety and depression symptoms](https://dralanjacobson.com/therapy-for-depression-and-anxiety/) and feelings of isolation.

---

Attachment-based therapy is deeply transformative for individuals. It helps clients uncover the root causes of their struggles and develop the skills needed for a healthier, more connected life.

## Summary and My Work

I provide attachment-based therapy as a stand-alone treatment and also as an adjunct to other forms of couples, family, and [individual therapy](https://dralanjacobson.com/individual-therapy/). I provide most of this work virtually, which works well for older children and adults and particularly for families with adult children who do not live in the same place. This treatment tends to be one of the longer-term methods, but you should feel meaningful improvement along the way. If you have any questions about attachment therapy or how it could benefit you or your family, [schedule a consultation](https://www.picktime.com/scheduleaconsult) or [contact me](https://dralanjacobson.com/contact/) anytime

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [CBT For Trauma](https://dralanjacobson.com/cbt-for-trauma/)

**Published:** October 5, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Trauma-Focused Cognitive Behavioral Therapy** (TF-CBT or CBT-TF) is an evidence-based treatment specifically designed for children and adolescents who have experienced traumatic events. CBT for trauma is also used for adults, though it’s more commonly focused on youth. CBT-TF is a perfect fit for my [trauma-informed practice](https://dralanjacobson.com/trauma-informed-care/), helping individuals process the events, develop coping strategies, and manage emotional and psychological distress related to these experiences.

If you would like more information about Trauma-Focused Cognitive Behavioral Therapy or how it might benefit you or a loved one, please feel free to [contact me](https://dralanjacobson.com/contact/) anytime or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

## Trauma-Focused Cognitive Behavioral Therapy for Children and Teens

The following is a general overview of Trauma-Focused Cognitive Behavioral Therapy for children and teenagers.

### Key Components of CBT for Trauma:

1. **Psychoeducation**: Trauma-Focused Cognitive Behavioral Therapy starts by educating the client about the events and their effects on the mind and body. This helps normalize your reactions.
2. **Parent/Caregiver Involvement**: Parents or caregivers often participate in CBT-TF sessions, learning strategies to support the child and manage their emotions.
3. **Cognitive Processing**: CBT for trauma helps individuals identify and change unhelpful thoughts about the events. Children and adolescents learn to reframe thoughts that may make them feel guilt, fear, or shame.
4. **Expressive and [Narrative Techniques](https://dralanjacobson.com/narrative-therapy/)**: In a safe and supportive environment, clients gradually talk about the trauma to reduce its emotional power. This is sometimes done through writing or other forms of creative expression.
5. **Relaxation Techniques**: Learning relaxation methods such as deep breathing, [progressive muscle relaxation](https://positivepsychology.com/progressive-muscle-relaxation-pmr/), or [mindfulness strategies](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) to manage stress and anxiety.
6. **Affect Regulation**: An important part of trauma-focused cognitive behavioral therapy is helping clients understand and manage their emotions, especially triggered feelings of fear, anger, or sadness.
7. **Coping Skills:** CBT-TF also includes developing healthy coping strategies for dealing with future stress and challenges and replacing maladaptive responses.

### CBT for Trauma Structure:

- Typically, TF-CBT is short-term, lasting 12 to 20 sessions, though this can vary based on individual needs.
- The therapy can be delivered individually or in a group but is highly structured and goal-oriented.

### CBT-TF Effectiveness:

TF-CBT has been shown to reduce PTSD symptoms, depression, anxiety, and behavioral issues in children and adolescents. It’s considered one of the most effective therapies for young populations. It’s commonly used for children who have been affected by abuse, domestic violence, accidents, or natural disasters.

## TF-CBT Techniques

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) involves a structured set of techniques aimed at helping individuals, especially children and adolescents, process experiences and develop coping skills. The techniques are based on the principles of [cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT) and are adapted to address specific issues. Below are key Trauma focused [CBT techniques](https://dralanjacobson.com/cbt-techniques/):

### 1. CBT for Trauma Psychoeducation

- Objective: Teach clients and their caregivers about trauma, its effects, and how symptoms develop.
- Technique: Provide information about how the brain and body react, normalize responses (e.g., hypervigilance, nightmares), and explain the purpose of therapy. This helps reduce guilt or self-blame and empowers individuals to understand their reactions.

### 2. Relaxation Techniques

- Objective: Help clients manage stress, anxiety, and arousal symptoms.
- Techniques: 
    - Deep Breathing: Individuals learn to take slow, deep breaths to calm their nervous system.
    - Progressive Muscle Relaxation: Involves tensing and relaxing different muscle groups to reduce physical tension.
    - Mindfulness: Focus on present-moment awareness to manage emotional distress.
    - Guided Imagery: Visualizing calming and peaceful scenes to reduce anxiety.

### 3. Affective Regulation

- Objective: Teach clients to recognize and regulate their emotions.
- Techniques: 
    - Emotion Identification: Help individuals name their emotions and understand triggers.
    - Emotional Expression: Practice expressing emotions in healthy, adaptive ways.
    - Coping with Anger or Sadness: Techniques for managing strong emotions, such as using time-outs or cognitive reframing.

### 4. Cognitive Processing ([Cognitive Restructuring](https://positivepsychology.com/cbt-cognitive-restructuring-cognitive-distortions/))

- Objective: Challenge and change unhelpful thoughts (e.g., guilt, shame, fear).
- Techniques: 
    - Thought Records: Clients write down distressing thoughts and challenge their accuracy or helpfulness.
    - [Cognitive Restructuring Worksheet](https://dralanjacobson.com/cognitive-restructuring/): Keep track of the thoughts you want to target and what works to reduce their impact
    - Cognitive Triangle: Focus on the relationship between thoughts, emotions, and behaviors to promote healthier thinking.
    - Reframing: Shift negative beliefs (e.g., “It was my fault”) into more balanced perspectives (e.g., “I did the best I could in that situation”).

### 5. CBT for Trauma Narrative

- Objective: Gradually expose individuals to their memories in a safe and supportive way to reduce avoidance and fear.
- Techniques: 
    - Writing or Verbal Expression: The child or adolescent creates a detailed narrative of the event, discussing emotions and thoughts that come up. This is done over multiple sessions to reduce emotional distress associated with the memories.
    - Creative Expression: For those unable or unwilling to verbalize, using art, drawing, or play to express their experience.
    - Graded Exposure: I encourage clients to share their story in increasing levels of detail, starting with less distressing aspects.

### 6. In Vivo Exposure in CBT for Trauma

- Objective: Help clients confront real-life situations or places they’ve been avoiding due to fears.
- Technique: Gradual, supported exposure to triggers (e.g., a place where the event happened or a particular activity) to reduce fear and avoidance behaviors.

### 7. Cognitive-Behavioral Parenting Interventions (for Children/Adolescents)

- Objective: Equip parents with skills to support their child’s healing and manage behaviors.
- Techniques: 
    - Behavioral Strategies: Training parents in [positive reinforcement](https://positivepsychology.com/positive-reinforcement-psychology/), [active listening](https://en.wikipedia.org/wiki/Active_listening), and setting appropriate boundaries.
    - Coaching: Parents practice helping their child express feelings, talk about trauma, and regulate emotions.
    - Parent Psychoeducation: Teach parents about symptoms and how to support recovery best.

### 8. Conjoint Parent-Child Sessions (if applicable)

- Objective: Encourage open communication about trauma between the child and the caregiver.
- Techniques: 
    - Sharing the Trauma Narrative: The child or adolescent shares their story with the caregiver in a supportive, therapist-guided setting.
    - Joint Problem Solving: Child and parent work together on coping strategies and processing feelings.
    - Parent Emotional Support: Parents are guided on how to respond empathically and supportively to their child’s disclosure.

### 9. Enhancing Safety and Future Development

- Objective: Focus on ensuring physical and emotional safety and plan for the future.
- Techniques: 
    - Safety Planning: Create plans for managing future risk or triggers (e.g., avoiding risky situations, setting boundaries).
    - Problem-Solving Skills: Teach individuals how to manage future challenges and navigate situations that may arise due to trauma (e.g., bullying, conflict).
    - Empowerment: Encourage the client to set future goals and work toward a positive identity.

### 10. CBT-TF Grief and Loss Processing

- Objective: Address the feelings of grief, loss, or unresolved emotions.
- Techniques: 
    - Grief-focused interventions: Support children and adolescents in understanding and expressing their grief, often related to loss of innocence, safety, or loved ones.
    - Symbolic Gestures: Creating rituals or symbolic actions to help process grief, such as writing letters to lost loved ones or engaging in meaningful memorial activities.

These TF-CBT techniques help individuals work through their traumatic experiences, build emotional resilience, and develop healthier coping mechanisms for the future. The combination of cognitive and behavioral strategies makes TF-CBT a comprehensive and highly effective treatment model.

## CBT for Trauma in Adults

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is primarily designed for children and adolescents, but some principles and approaches from CBT-TF can be adapted for adults. While TF-CBT focuses on the developmental needs of younger individuals, the core elements of addressing trauma can still be relevant for adult populations. Adults may also benefit from Trauma-Focused CBT to process their traumatic experiences, especially those stemming from childhood or long-standing issues.

### Adaptations of TF-CBT for Adults

1. **Psychoeducation**: For adults, psychoeducation focuses on understanding how trauma impacts the brain, body, and emotions. Adults are provided with information on how trauma influences their current thinking patterns and behaviors, with a focus on increasing self-awareness and breaking the cycle of trauma-related thoughts.
2. **Cognitive Restructuring**: Adults learn how to identify distorted or unhelpful thoughts. These thoughts often include self-blame, guilt, or feeling unsafe. Through therapy, individuals are guided to challenge these thoughts and replace them with healthier, more balanced ones.
3. **Trauma Narrative**: Similar to children, adults are encouraged to confront their trauma by creating a trauma narrative, but the process may be more tailored to adult life experiences. The narrative can involve reflecting on events through talking, writing, or other creative means, helping the individual gradually desensitize to painful memories.
4. **Exposure Techniques:** These involve confronting painful emotions and memories in a safe and controlled therapeutic setting. For adults, this may include revisiting difficult memories and processing emotions in a supportive environment, leading to decreased avoidance behaviors.
5. **Emotion Regulation and Coping Skills**: Adults learn relaxation techniques like mindfulness, meditation, or deep breathing, as well as more advanced coping strategies that help them manage emotions and stressors they encounter in everyday life. These techniques also help in reducing anxiety, hyperarousal, and irritability that often follow trauma.
6. **Behavioral Interventions**: TF-CBT for adults often involves working on behavioral changes, including identifying triggers that remind them of the events and learning new, healthier ways to respond to these triggers. This can reduce symptoms of avoidance or hypervigilance.
7. **Processing Trauma-Related Losses and Guilt**: Many adults experience complex feelings of guilt, shame, or grief. The therapeutic process may focus on working through these emotions, understanding their roots, and developing a more compassionate perspective toward oneself.

### Key Differences in Trauma-Focused Cognitive Behavioral Therapy for Adults:

- **Past and Present Focus**: While TF-CBT for children often focuses on present-day issues, the adult version might emphasize connections between past experiences and current life challenges, with a deeper exploration of long-standing patterns.
- **Complex Trauma**: Adults often come into therapy with more complex or layered experiences, sometimes compounded by multiple events. Trauma-Focused Cognitive Behavioral Therapy for adults can involve deeper, multi-session work on processing these experiences.

### CBT for Trauma and [Active listening](https://en.wikipedia.org/wiki/Active_listening):

TF-CBT for adults can be useful for those who:

- Experienced events in childhood and are dealing with the long-term effects.
- Have experienced more recent challenges, such as military combat, sexual assault, or domestic violence.
- Need support for complex PTSD (C-PTSD), where multiple events have occurred over time.

### Alternatives for Adults:

While CBT for TRauma can be adapted for adults, some other therapies are often used as primary treatments for adult survivors:

- **[Prolonged Exposure Therapy](https://www.apa.org/ptsd-guideline/treatments/prolonged-exposure) (PE)**: Focuses on revisiting traumatic memories and confronting avoided situations or feelings. I do not provide this form of specialized therapy.
- **[Eye Movement Desensitization and Reprocessing](https://en.wikipedia.org/wiki/Eye_movement_desensitization_and_reprocessing) (EMDR)**: A structured therapy that helps process events through guided eye movements or other bilateral stimulation. I also do not do EMDR, but I can refer you to someone who does.
- **Cognitive Processing Therapy (CPT)**: Another form of CBT for trauma which helps adults challenge and reframe distorted thoughts.

TF-CBT for adults can be effective, especially when there’s a structured approach, but other therapies might complement or be preferred depending on the individual’s needs

## My Work With CBT-TF

I provide CBT for Trauma as [individual therapy](https://dralanjacobson.com/individual-therapy/) and [family therapy](https://dralanjacobson.com/family-therapy/) to adolescents and adults both virtually and in person. I do not provide CBT-TF to children because this method is best done in person with them. My work is primarily with those who are older now but [experienced trauma in childhood](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/). If you have any questions about Trauma-focused CBT or how it might help you or a loved one, please don’t hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Specialties

---

### [Gestalt Therapy](https://dralanjacobson.com/gestalt-therapy/)

**Published:** September 30, 2023
**Author:** Dr. Alan Jacobson

**Content:**

My practice is [Humanistic](https://dralanjacobson.com/humanistic-psychology/). However, there are many different approaches in that area. One of them that I lean on when putting together an integrative approach to help each individual therapy client uniquely is **Gestalt therapy**. This form of psychotherapy emphasizes the importance of the present moment and your subjective inner experience. **Gestalt therapy methods** are experiential and active, and **Gestalt treatment** overall is quite interactive.

Gestalt Therapy techniques were developed by [Fritz Perls](https://en.wikipedia.org/wiki/Fritz_Perls), [Laura Perls](https://en.wikipedia.org/wiki/Laura_Perls), and [Paul Goodman](https://en.wikipedia.org/wiki/Paul_Goodman) in the 1940s and 1950s as a reaction to more traditional approaches of the day that focused on problems and neuroses that had their roots in an individual’s childhood. The [term “gestalt”](https://www.merriam-webster.com/dictionary/gestalt) comes from the German word for “whole” or “pattern.” In this context, it refers to the idea that you should strive to understand yourself and your experiences as an integrated entity rather than a collection of separate parts.

## Key Principles of Gestalt Therapy

The following are the tenets that gestalt therapy methods are based on.

### Gestalt Therapy and the Here and Now

Gestalt treatment strongly emphasizes the present moment. I often encourage clients to focus on their current thoughts, feelings, and sensations rather than dwelling on past experiences beyond what is helpful or worrying too much about what they have no control over in the future.

### Awareness and Responsibility

Central to Gestalt therapy is the concept of self-awareness. You will be encouraged to become more aware of your thoughts, emotions, and behaviors as they occur, which can lead to greater self-understanding and personal growth. Gestalt therapy methods promote individual responsibility for thoughts, feelings, and actions. You will be encouraged to take ownership of your choices and the consequences of those choices.

### Holism and Contact in Gestalt Therapy

As mentioned earlier, Gestalt therapy views [individuals as holistic beings](https://brainmanager.io/blog/mental/what-is-holistic-well-being-and-health). It seeks to help you integrate and reconcile the various aspects of yourself, including your thoughts, emotions, and physical sensations. Then it looks at how you interact with their environment and others. We will explore how you contact the world around you and how these interactions impact your well-being.

### The Figure-Ground Phenomenon

The [figure-ground perception](https://www.verywellmind.com/what-is-figure-ground-perception-2795195) concept highlights the importance of distinguishing between the “figure” (the primary focus of attention) and the “ground” (the background or context). Understanding this distinction can help you gain insight into your perceptions and reactions. This becomes a key to the approach.

## Uses for Gestalt Therapy Techniques

Gestalt therapy techniques emphasize the importance of understanding the whole person and their experiences in the present moment rather than focusing solely on past events. Here are some common ways I use Gestalt treatment:

### Self-Exploration and Personal Growth

Gestalt therapy techniques can help you deeply explore your thoughts, feelings, and behaviors, promoting self-awareness and personal growth. It can help you identify and solve problems in your life, both personal and professional. It can even help you tap into your creative potential and express yourself more authentically through art, writing, or other creative outlets.

### Gestalt Therapy and Emotional Regulation

This approach can assist you in identifying and managing your emotions more effectively, improving your emotional regulation and resilience. Addressing the sources of tension and anxiety in the present moment may be particularly helpful for coping with stress and anxiety.

### Gestalt Therapy and Relationship Issues

Gestalt therapy can facilitate communication and help people better understand their relational dynamics. In the workplace, it can assist small groups in dealing with workplace challenges such as stress, conflict, and group dynamics.

### Gestalt Treatment of Specific Diagnoses

Gestalt therapy can help individuals with mood disorders by exploring the root causes of their [depressive symptoms](https://dralanjacobson.com/treating-major-depression/) and finding ways to improve their emotional well-being. It can also be used to process past traumatic experiences and assist individuals in coming to terms with their trauma. It can be used to help individuals confront and overcome phobias and irrational fears.

### Self-Esteem and Self-Confidence

I use Gestalt therapy for those looking to boost their self-esteem and self-confidence by exploring their self-concept and self-perception.

Gestalt therapy is a versatile approach that can be adapted to various therapeutic needs and situations. We can use it together to help you become deeply self-aware, make meaningful changes in your life, and feel more content.

## Gestalt Therapy Methods

Gestalt therapy is a highly experiential approach, and its techniques are tailored to my clients’ needs. It can be effective for those seeking personal growth, self-awareness, and improved relationships. However, it’s not for every client and every presenting concern, and thus, it is part of my integrative approach that may or may not be part of the services you and I choose.

Here are some common Gestalt therapy methods:

### Empty Chair Technique

This technique is used to help clients work through unresolved conflicts or unexpressed emotions. The client may imagine the person they have an issue with sitting in an empty chair and conversing with them. Like the empty chair technique, there is a two-chair technique, where you alternate between sitting in each chair to express different aspects of yourself or conflicting feelings.

### Gestalt Therapy Techniques: Exaggeration and Amplification

This technique asks you to exaggerate or amplify certain behaviors or feelings to make them more noticeable and better understand them. I often use exaggeration and amplification in Gestalt therapy [for couples](https://dralanjacobson.com/couples-therapy/).

### Gestalt Therapy Topdog/Underdog Dialogue

In this technique, clients explore the internal conflict between their “Topdog” (critical, controlling self) and their “Underdog” (vulnerable, submissive self) to better understand and integrate these aspects of themselves. This technique is particularly helpful when people are going through a transition or face a decision or challenge they have mixed feelings about.

### The Cycle of Experience

This model helps clients understand their internal processes by identifying the cycle of sensation, awareness, mobilization, action, and contact. You can learn to interrupt unproductive patterns and create more fulfilling responses. Learning to see this cycle in your life can be quite helpful, and I often give homework related to this technique.

### Paradoxical Gestalt Therapy Methods

Gestalt therapy suggests that change can occur when individuals fully accept and embrace their current experience rather than trying to change it. Paradoxically, you may find the motivation and clarity you need to make positive changes after you accept things as they are

Some of these techniques may be given as tasks or exercises for clients to practice outside therapy sessions to enhance self-awareness and personal growth. Also, in general, I’ll encourage you to stay present in the moment outside of therapy, exploring current thoughts, feelings, and experiences rather than dwelling on the past or worrying about the future.

## Conclusions and My Services

Gestalt therapy techniques aim to help individuals develop greater self-awareness, improve their capacity for self-acceptance, and make meaningful changes in their lives. Gestalt therapy may not be a fit for everyone, or in some cases, I may choose one or two Gestalt therapy methods while mostly choosing another approach. We will go over all of this when we first meet. My [integrative approach](https://dralanjacobson.com/types-of-therapy/) is designed to give input into what you feel will help.

### Gestalt Treatment Example

The following is a Gestalt treatment example from my practice. Of course, this specific example is fictitious, but it covers the usual gestalt therapy methods I might use. It is quite simple and general, but should give you an idea about how this approach works.

Maria, a 32-year-old woman, seeks therapy due to feelings of anxiety and dissatisfaction with her life. She feels stuck in her job and has difficulties enjoying her social relationships.

#### Gestalt Treatment Session Initial Steps

I start by setting the tone that we will be working here and now and looking for clues as to underlying challenges and barriers. I might ask Maria to take a moment at the beginning to notice how she feels in the room, both physically and mentally. She responds that she feels tense in her shoulders and has a lot on her mind. With prodding, she realizes that the tightness in her shoulders almost makes her feel like she is carrying a heavy load.

#### Gestalt Treatment Dialogs

I ask Maria, “If that tension could speak, what would it say?” She says, “It would probably say, ‘I’m tired and overwhelmed.'” I decided to use the empty chair technique. I say, “Imagine your tension is sitting in this empty chair. Talk to it as if it were a person. What would you say?” She says, “Why are you always here? Why can’t you go away?” I ask her to switch roles, “Be the tension and respond to Maria.” She says, “I’m here because you always push yourself too hard. You never take a break.”

Through this technique, Maria realizes she’s not giving herself enough time to rest. She’s always on the go, taking a toll on her.

#### Homework, Experiments, and Ending the Session

Maria is asked to explore what it would be like to take a break. She starts by setting aside 15 minutes daily to relax and do something she enjoys. I asked her how she felt now compared to when we started the session. She responded, “I feel a bit lighter and more hopeful. I see that I need to be kinder to myself.”

#### Key Gestalt Therapy Methods Used

– Present-Moment Awareness: Focusing on the client’s feelings and bodily sensations.
– Dialogic Process: Encouraging the client to dialogue with parts of themselves.
– Empty Chair Technique: Facilitating a conversation between clients and their internal conflicts.
– Experiments: Trying out new behaviors or ways of thinking during the session.

As you can see, gestalt therapy methods are highly experiential and dynamic, focusing on the “here and now” and encouraging clients to discover their own solutions through increased self-awareness. This approach is a cousin of [Internal Family Systems](https://dralanjacobson.com/internal-family-systems-therapy-ifs/) methods, which can be used together.

I primarily use Gestalt treatment in [individual sessions](https://dralanjacobson.com/individual-therapy/), though it also has some use with [couples therapy](https://dralanjacobson.com/couples-therapy/) and even [small groups](https://dralanjacobson.com/group-therapy/). It can also be used with a variety of my specialty services, including executive coaching and [sports psychology](https://dralanjacobson.com/sports-psychology/). I apply it to a wide range of presenting issues, including personal growth, relationship problems, anxiety, depression, and more.

I’d be happy to answer any questions you have about [my services](https://dralanjacobson.com/) or **Gestalt Therapy**. [Contact me](https://dralanjacobson.com/contact/) any time.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Relationship Therapy](https://dralanjacobson.com/relationship-therapy/)

**Published:** July 17, 2024
**Author:** Dr. Alan Jacobson

**Content:**

I provide **online** **relationship therapy**, or **relationship counseling**, to help couples improve their relationships and work out specific challenges and goals. As with all of my practice, I use an integrated clinical approach, mixing in relationship therapy activities with many approaches. This allows me to combine established [cognitive-behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/), [couples-based narrative](https://dralanjacobson.com/narrative-therapy/), [emotionally-focused](https://dralanjacobson.com/eft-therapy-for-couples/), and [solution-focused therapies](https://dralanjacobson.com/solution-focused-therapy/). I also offer [premarital counseling](https://dralanjacobson.com/premarital-counseling/) for those who are entering a formal commitment.

This post is designed to give you an overview of relationship therapy. I also welcome you to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you’d like to learn more about how my services might work for you and your partner.

## Relationship Therapy Overview

The following are the general tenets of the relationship therapy services I provide. Relationship therapy can be quite helpful in many circumstances as couples work to strengthen and deepen their bond. It can help when communication has become negative, leading to misunderstandings and conflict, and when there has been a breach of trust. It can help when the couple faces significant life transitions such as the birth of a child, relocation, or job changes. Finally, it can help when partners feel emotionally disconnected or the same issues arise without resolution.

### Goals of Relationship Therapy

1. Improving Communication: I work to counsel couples about how to communicate more effectively and listen to each other. The object is to promote truly understanding what the other person has to say and responding in a way that shows that understanding (or with a question if clarity is needed).
2. Resolving Conflicts: Relationship counseling helps couples identify and resolve conflicts in a healthy manner. Arguments may be okay if they are productive and each member truly hears what the other person said before responding. They may not be okay if they repeat and do not resolve.
3. Rebuilding Trust: In some cases, relationship counseling is designed to help the couple work through issues of trust that may have been damaged by infidelity or other breaches.
4. Enhancing Intimacy: Strengthening emotional and physical intimacy can often be a goal of relationship therapy. This can be true for newer couples when desires do not match or in longer-standing partnerships when something has changed regarding patterns and intensity of intimacy.
5. Developing Problem-Solving Skills: This form of treatment is often more proactive, equipping couples with tools to handle future challenges.

### Relationship Counseling Clinical Approaches

1. Emotionally Focused Therapy (EFT): This approach focuses on emotions and attachment styles to improve connection. It is often a good choice when one or both members have experienced something in their family of origin that affects the current bond somehow.
2. [Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) (CBT): This cornerstone approach identifies and changes negative thought patterns and behaviors.
3. [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/): In longer-term relationships, couples have formed a narrative of their bond that may be unhelpful, dated, or otherwise negative. This therapy helps the couple reframe that narrative.
4. [Integrative Behavioral Couples Therapy](https://dralanjacobson.com/integrative-behavioral-couples-therapy/) (IBCT): In this approach, couples learn to manage differences that may not change but can work to their advantage or at least not cause strife.

### Benefits of Relationship Therapy

1. Better Understanding: Almost every couple in relationship therapy wants to gain a deeper understanding of each other’s needs and perspectives. I use specific relationship therapy activities to help you meet this goal.
2. Strengthened Bond: Building a stronger, more resilient relationship is also a cornerstone goal. Many of the relationship therapy activities listed below work toward this goal.
3. Enhanced Coping Skills: Relationships are bound to go through periods of stress and upset, both crises they must face together and their individual challenges. Learning how to handle stress and conflict more effectively is an important goal.
4. Prevention: Relationship counseling can help address issues before they become major problems.

## Relationship Therapy Activities

The following relationship therapy activities aim to strengthen communication, trust, and understanding between partners. We might do these activities in therapy sessions, or I might assign them as homework. Here are some relationship therapy activities I’ve found to be effective:

### 1. Active Listening Exercise

- Goal: Improve communication by focusing on listening rather than responding.
- Activity: One partner speaks for 3-5 minutes about something important to them while the other listens without interrupting. Afterward, the listener summarizes what they heard to ensure they understood correctly. Then, switch roles.

### 2. The “I Feel” Statement

- Goal: Foster emotional expression and reduce blaming language.
- Activity: Practice expressing feelings without judgment by using the formula: “I feel \[emotion\] when \[situation\] because \[reason\].” This encourages partners to express emotions without being accusatory.

### 3. Appreciation Ritual

- Goal: Increase positive interactions and gratitude.
- Activity: Every day, each partner expresses three things they appreciate about the other. This helps shift focus from problems to the positive aspects of the relationship.

### 4. Love Map Questions

- Goal: Build emotional intimacy by knowing each other more deeply.
- Activity: Partners ask each other open-ended questions about their preferences, goals, and life experiences. Examples include: “What are your dreams for the future?” or “What’s your favorite childhood memory?”

5\. Conflict Resolution Role Play

- Goal: Practice healthy ways to handle disagreements.
- Activity: Re-enact a recent disagreement, but this time with better communication tools (like active listening or “I feel” statements). Discuss how each partner could improve their approach to resolving conflicts.

6\. Time Capsule

- Goal: Create shared goals and memories.
- Activity: Write down dreams, goals, and wishes for your relationship over the next few years. Seal them in an envelope and revisit it on a future date (e.g., one year later) to see how you’ve grown together.

### 7. Weekly Check-In

- Goal: Maintain regular, open communication about relationship needs.
- Activity: Set aside time once a week to discuss how each partner is feeling in the relationship. Use this time to address any concerns, appreciate each other, and plan for the week ahead.

### 8. Sharing Dreams and Aspirations

- Goal: Deepen emotional connection by discussing life goals.
- Activity: Take turns sharing your individual dreams and aspirations. Support each other in brainstorming ways to make those dreams a reality, creating a shared vision of the future.

### 9. Couple’s Gratitude Journal

- Goal: Cultivate gratitude and positive focus in the relationship.
- Activity: Each day, both partners write one thing they are grateful for about each other. At the end of the week, review and share the entries.

### 10. Date Night Planning

- Goal: Prioritize quality time together.
- Activity: Plan a weekly or monthly date night where both partners take turns organizing the activity. Make sure it’s something fun or meaningful for both of you.

These relationship therapy activities can be tailored to suit the needs of each relationship, whether the focus is on communication, intimacy, trust, or conflict resolution.

## Relationship Counseling Example

In this fictional example, Jill and John came in for relationship counseling to address their frequent arguments and general lack of understanding since their first child was born. They have been married for four years, and until now, things have gone well, but it has also been a relatively stress-free period in both of their lives. They have chosen online relationship therapy since Jill travels a lot and they don’t want the flow of sessions to be interrupted.

### Relationship Counseling Step One: Setting Goals

In the first session, I asked them to share what had been happening and what they hoped to achieve through counseling. I also asked what would happen between them to feel that counseling was a success. We talked about their history together and when communication and understanding were at their best. Generally, they agree that they seem to be arguing all the time about minor things, and it feels like they’re not hearing or understanding each other anymore. They think that there is a background tension that is not lifting.

### Relationship Therapy Step Two: Identifying Issues

We explore some of the common themes in their arguments. Jill said that she often feels overwhelmed, and when she asks John for help, he seems uninterested. John says he does not mean to ignore her needs but feels overwhelmed at work. They both realize that they often argue when exhausted and struggle to attend to what the other person is saying or needs.

### Step Three: Relationship Therapy Activities

I chose two of the relationship therapy exercises listed above to work on that the couple will continue to practice outside of our session:

#### Active Listening Exercise

We started with an active listening exercise. Jill shared her feelings about an issue, and John listened and then repeated what he heard. Jill said, “I felt overwhelmed with the chores and needed your help. However, I felt you didn’t care.” John replied, “So, you felt overwhelmed and needed my help, but you felt like I didn’t care?” This led to a discussion that helped them see each others’ points of view. Active listening is one of the relationship therapy activities I almost always do.

#### Exploring Underlying Emotions

When we finished the first exercise, I asked John how it felt to hear Jane say that. He said it made him realize he needs to be more attentive to her needs. He said he was stressed with work but didn’t communicate that. I then asked Jill how it felt to hear John acknowledge her feelings. Jill said it felt good to be heard. She understands he’s stressed too, and they need to support each other better.”

#### Developing Communication Strategies

At the end of the session, we discussed some strategies for improving communication. They decided to set aside time each day to check in with each other and express any concerns. For this week, they decided they would practice active listening during your check-ins. The topics would include a fair distribution of household chores to alleviate some of Jane’s stress.

This structured approach to online relationship counseling [helps couples](https://dralanjacobson.com/couples-therapy/) better understand each other, improve communication, and develop healthier habits.

## Online Relationship Therapy Effectiveness

Online relationship therapy has grown in popularity, especially with the rise of telehealth services, and has proven effective for many couples. The flexibility and accessibility of virtual platforms make it a convenient option, while the core principles of therapy remain the same. Here’s a breakdown of the effectiveness of online relationship therapy:

### Benefits of Online Relationship Therapy

1. **Convenience and Accessibility**
    - **Accessibility**: Couples can attend sessions from the comfort of home, reducing logistical barriers like travel time, geographical limitations, or conflicting schedules.
    - **Scheduling Flexibility**: Online relationship therapy sessions can be scheduled more easily, including during evenings or weekends, accommodating busy couples who may struggle to find time for traditional therapy. It can also allow partners not in the same place due to work or travel to attend together.
2. **Comfort and Openness**
    - **Comfort of Home**: Being in a familiar space for online relationship therapy can help couples feel more at ease, which may lead to more open and honest communication. More space and a familiar environment may also make relationship therapy activities easier.
    - **Less Pressure**: Some people may feel less intimidated by online sessions than in-person meetings, potentially enhancing their ability to express emotions and concerns.
3. **Increased Access to Specialists**
    - Couples can work with me or another specialized therapist who might not be available in their local area. Online relationship therapy platforms offer access to a wider range of professionals with specific expertise you are looking for.
4. **Evidence-Based Approaches**
    - Studies suggest that cognitive behavioral therapy (CBT), emotional-focused therapy(EFT), and [Gottman Method](https://www.psychologytoday.com/us/therapy-types/the-gottman-method?msockid=1686e8c22e816b8a1935fc532fc26a1c) interventions, commonly used in relationship counseling, are as effective when delivered online as in person. Research indicates that the therapeutic alliance (the bond between therapist and clients) can be successfully developed in virtual relationship therapy.
5. **Anonymity and Privacy**
    - For couples who may feel stigmatized about seeking therapy, the relative anonymity of virtual relationship therapy sessions can provide a more private, judgment-free way to engage in counseling. This can be especially helpful for couples from small communities or those with privacy concerns.
6. **Continuous Support**
    - Online platforms often offer access to chat, email, or text support between sessions, allowing for ongoing communication with me. This can provide continuous guidance rather than be limited to weekly or biweekly in-person sessions.

### Challenges of Online Relationship Therapy

1. **Technological Issues**
    - Connection problems or poor audio/video quality can disrupt virtual relationship therapy sessions. While the platform I use is equipped to handle this, it’s still a potential challenge that can impact the flow of communication and therapy progress.
2. **Nonverbal Communication Limitations**
    - I may miss out on [nonverbal cues](https://www.verywellmind.com/types-of-nonverbal-communication-2795397) (body language, facial expressions) that are more easily noticed in person. This could affect my ability to gauge emotions or tension between partners fully.
3. **Distractions at Home**
    - While being in a familiar setting can help couples feel comfortable, it can also lead to distractions (kids, pets, household responsibilities), making it harder to focus during virtual relationship therapy sessions.
4. **Lack of Physical Presence**
    - For some couples, the lack of a physical presence in the same room as the therapist can feel less personal. The tactile and embodied nature of in-person therapy may be important to those who prefer face-to-face interaction, especially with certain relationship therapy activities.

### Research on Effectiveness

- **2014 Study**: A study published in the Journal of Sex & Marital Therapy found that online relationship therapy, specifically when using cognitive-behavioral and emotionally focused methods, was as effective as face-to-face therapy for improving relationship satisfaction, communication, and emotional health.
- **2020 Study**: A more recent study during the pandemic era, published in [*Family Process*](https://onlinelibrary.wiley.com/journal/15455300?msockid=1686e8c22e816b8a1935fc532fc26a1c), showed that online couple therapy was not only effective but also experienced higher participation rates and better follow-up attendance compared to traditional therapy. This highlights how online platforms can sustain commitment to the process.
- **Therapeutic Alliance**: Several studies have shown that the [therapeutic bond](https://positivepsychology.com/components-of-therapeutic-relationship/), one of the strongest predictors of therapy success, can be effectively built and maintained through online therapy, with couples reporting satisfaction with their therapists.

### When Online Relationship Therapy is Not Recommended

- **Severe Relationship Issues**: In cases of severe issues like domestic violence or emotional abuse, online relationship counseling might not provide the immediate intervention required for safety and crisis management.
- **Poor Technology Access**: For couples with unreliable internet or technological skills, online relationship counseling may not be viable. These logistical hurdles can create added frustration rather than a therapeutic benefit.

## Summary and My Work

Relationship therapy is highly effective for many couples. I use many methods and approaches in my [integrative psychological practice](https://dralanjacobson.com/integrative-therapy/), so we’ll design an approach that works best for you. I focus on relationship therapy activities that we can try in session, and you can continue as homework. This approach can be used for specific struggles, such as when one person (or both) has a [fear of intimacy](https://dralanjacobson.com/fear-of-intimacy/).

If you want to hear more about relationship counseling in general, my [therapeutic approach](https://dralanjacobson.com/types-of-therapy/), or specific types of relationship therapy, please [get in touch](https://dralanjacobson.com/contact/) with me or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Couples Therapies

---

### [Interpersonal Therapy](https://dralanjacobson.com/interpersonal-therapy/)

**Published:** May 13, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Interpersonal Therapy** (IPT Therapy) is a [short-term, focused treatment](https://dralanjacobson.com/brief-therapy/) for depression and other mental health disorders. **IPT Therapy** is based on the idea that social issues play a significant role in the development and maintenance of psychological symptoms. In my practice, I use Interpersonal Therapy for depression, anxiety, life transitions, and other challenges in combination with other [humanistic methods and techniques](https://dralanjacobson.com/humanistic-psychology/). I also do Dynamic Interpersonal Therapy, which is closely related.

## What is Interpersonal Therapy?

If you want to discuss how interpersonal therapy might work for you or a loved one, I’d be happy to talk to you at any time. Feel free to[ schedule a consultation](https://www.picktime.com/scheduleaconsult) or [contact me](https://dralanjacobson.com/contact/) anytime. First, here is an overview of IPT therapy, and then some specific information and a case example about interpersonal therapy for depression.

### Origins, Theory, and Research

IPT was developed in the 1970s by [Gerald Klerman](https://en.wikipedia.org/wiki/Gerald_Klerman) and [Myrna Weissman](https://en.wikipedia.org/wiki/Myrna_Weissman) as a treatment for major depressive disorder. It has since been adapted for other mental health conditions, including [bipolar disorder](https://en.wikipedia.org/wiki/Bipolar_disorder), [anxiety disorders](https://dralanjacobson.com/therapy-for-social-anxiety/), [eating disorders](https://www.healthline.com/nutrition/common-eating-disorders), and [post-traumatic stress disorder](https://en.wikipedia.org/wiki/Post-traumatic_stress_disorder) (PTSD). It is grounded in the belief that psychological symptoms often respond to difficulties in relationships and social roles. The underlying philosophy is that improving interpersonal functioning and addressing problematic relationships can help reduce psychological symptoms.

Numerous studies have demonstrated the effectiveness of interpersonal therapy for depression and other mental health conditions. This approach is as effective as [cognitive-behavioral](https://dralanjacobson.com/cbt-for-depression/) (CBT) and medication for depression, with some evidence suggesting it may be particularly beneficial for people experiencing relationship-related issues.

## What is Interpersonal Therapy in Practice

This approach aims to improve relationships and social functioning that affect mental health by identifying and addressing problems in these areas. It typically involves exploring four key areas:

### 1. Social disputes

This area involves addressing conflicts or misunderstandings in relationships that may contribute to the individual’s distress. Most often, these struggles have a current component, but IPT therapy can also be used to resolve challenges and barriers related to former relationships. We may also explore the past as it relates to how you overcame challenges, and if there are ways you can learn to manage today’s stressors.

### 2. Interpersonal Therapy and Role Transitions

[Life transitions](https://dralanjacobson.com/life-transitions-therapy/) such as marriage, divorce, job loss, or retirement can disrupt social roles and lead to emotional difficulties. IPT therapy helps individuals adjust to these changes. It is not uncommon for a couple who is planning to get married to come in for this type of treatment or even to pursue it separately so they can work out their own issues and not bring them into the marriage.

### 3. IPT Therapy and Grief

Interpersonal therapy helps individuals cope with the loss of a loved one or other significant losses, which can often trigger or exacerbate depressive symptoms. Using these methods, you can work on unresolved conflicts and issues in your relationship with the person you lost or work on related difficulties that arise with people in your life.

### 4. Interpersonal deficits

Some people may struggle with social skills or have difficulty forming and maintaining relationships. Interpersonal therapy helps them develop more effective social skills. This can be a perfect adjunct to other types of treatment.

## Interpersonal Therapy Techniques

This type of treatment is typically structured, time-limited, and collaborative. As with many[ humanistic therapies](https://dralanjacobson.com/humanistic-psychology/) I provide, the focus is on the here and now rather than delving deeply into past experiences too deeply. It starts with identifying specific social problems or patterns that may contribute to challenges. This involves exploring past and present relationships, communication styles, and social interactions to understand how these factors impact the client’s mood.

Once interpersonal issues are identified, we collaboratively set treatment goals to improve interpersonal functioning, such as resolving conflicts, [adjusting to life transitions](https://dralanjacobson.com/life-transitions-therapy/), or enhancing social support. This method can have powerful and lasting results, as it addresses longstanding challenges and barriers.

Here are some examples of the specific interpersonal therapy techniques I use:

### Social Inventory

This method involves examining the client’s current and past relationships to identify key themes and patterns. By gaining insight into your history, I can better understand the factors contributing to your [depression and tailor treatment](https://dralanjacobson.com/best-treatment-for-depression/) accordingly. Sometimes, I suggest IPT after getting to know a client’s social history, even when we are also using another [therapeutic method](https://dralanjacobson.com/types-of-therapy/).

### Role-playing and Communication Skills Training

This method often incorporates role-playing exercises and communication skills training to help clients improve their ability to express themselves assertively, set boundaries, and navigate interactions more effectively. This sometimes leads to homework outside of sessions.

### Interpersonal Therapy and Problem Solving

IPT helps clients develop problem-solving skills to address conflicts and challenges. This may involve breaking down problems into manageable steps, generating potential solutions, and evaluating the pros and cons of each option.

### IPT Therapy and Role Transitions

Interpersonal therapy helps clients adjust to significant [life transitions](https://dralanjacobson.com/life-transitions-therapy/), such as starting a new job, ending a relationship, or becoming a parent. This may involve exploring your feelings about the transition, identifying sources of support, and developing coping strategies. This method often involves homework as you try out new communication and coping strategies to determine their effectiveness.

### Improving Social Support

IPT focuses on enhancing the client’s social support network by identifying supportive individuals in their lives, strengthening existing relationships, and building new connections. This may involve exploring barriers to social support and finding ways to overcome them. This is why interpersonal therapy is such a popular [group treatment](https://dralanjacobson.com/group-therapy/) approach: It can be used in real time to address social challenges.

### Ending Interpersonal Therapy and Relapse Prevention

Toward the end of treatment, these methods help clients develop strategies to maintain their progress and prevent relapse. This may involve identifying warning signs of depression recurrence, practicing coping skills, and accessing ongoing support as needed.

These interpersonal therapy techniques are typically implemented within a structured and time-limited framework. We work together to achieve treatment goals and improve social contentment and functioning.

## Interpersonal Therapy for Depression

Interpersonal therapy is widely used as a [treatment for depression](https://dralanjacobson.com/best-treatment-for-depression/). It’s grounded in the understanding that relationships and social context greatly influence one’s emotional state. Here’s how I borrow from the strategies of interpersonal therapy for depression:

### Assessment

I begin by conducting a thorough assessment of my client’s current social functioning and relationships, as well as their symptoms of depression. This assessment helps identify patterns of interaction and areas of difficulty in relationships that may be contributing to the depression. We often use other [third-wave treatment](https://dralanjacobson.com/third-wave-psychotherapy/) methods, such as CBT or ACT, at first. Then, when it becomes clear that interpersonal issues are also playing a role, we layer on IPT therapy to address those issues.

### Setting Goals in Interpersonal Therapy for Depression

Based on the assessment, we collaboratively set treatment goals. These goals often revolve around improving social functioning, such as resolving conflicts, adjusting to life transitions, or improving communication skills. In an integrative practice, your treatment plan may have different methods for different goals, and interpersonal therapy for depression may be chosen for the contributing social factors.

### Identifying Issues

I help clients identify specific social issues contributing to their depression. These issues could include unresolved conflicts, [grief and loss](https://dralanjacobson.com/grief-therapy/), role transitions, or social isolation. It is not uncommon for social issues to underlie challenges such as depression and anxiety, and thus, this approach can be helpful in many circumstances.

### Working Through Problems

Once the issues are identified, we work together to address them. This may involve learning new communication skills, practicing assertiveness, or exploring ways to navigate difficult relationships. Interpersonal therapy also focuses on enhancing each client’s social support network. This may involve identifying supportive individuals in their lives, strengthening existing relationships, and building new connections.

### Grieving and Processing Losses

For clients who are dealing with grief or loss, I often use interpersonal therapy techniques within a supportive environment to help them express their feelings and work through the [grieving process](https://dralanjacobson.com/grief-therapy/). This may involve revisiting memories, exploring the significance of the loss, and finding ways to cope with the pain.

## Dynamic Interpersonal Therapy

While **Dynamic Interpersonal Therapy (DIT)** and **Interpersonal Therapy (IPT)** sound similar and focus on social relationships, they come from **different theoretical backgrounds** and have **distinct approaches**. Here’s a clear comparison to help you differentiate them:

### Dynamic Interpersonal Therapy vs. Interpersonal Therapy

**Dynamic Interpersonal Therapy (DIT)****Interpersonal Therapy (IPT)****Theoretical Base**Psychodynamic ([object relations](https://dralanjacobson.com/relational-therapy/), attachment)Biopsychosocial model, with roots in psychodynamic and [cognitive-behavioral theory](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/)**Focus**Unconscious patterns rooted in early relationshipsCurrent social problems contributing to mood disorders**Treatment Goal**Insight into repeating patterns and emotional conflictsSymptom reduction by improving social functioning in the present**Length**Brief (typically 16 sessions)Brief (12–16 sessions)**Developed For**Depression, but adapted for other issuesOriginally for depression, now also used for grief, eating disorders, etc.### Core Differences in Practice

**Dynamic interpersonal therapy techniques****Interpersonal therapy techniques****Exploration of the past**Strong emphasis on how early attachment relationships shape current patternsPast is only explored as it relates to current issues**Use of transference**Yes – the therapeutic relationship is used to explore patternsNo – therapist remains more neutral and focused on external relationships**Intervention style**Interpretive and insight-orientedMore structured and problem-solving**Focus area**One central interpersonal affective focus (IPAF) that drives the formulationOne of four focus areas: grief, role transitions, disputes, deficits#### Example Focus Areas

- **DIT:** “I withdraw when I feel rejected because I expect others will abandon me like my father did.”
- **IPT:** “I’m struggling to adjust after moving schools and losing my social network.”

#### Ideal Client Fit

**DIT****IPT****Best for clients who…**Have recurring relational issues rooted in early attachment; benefit from insight.Need support navigating current life changes and interpersonal stressors**May not suit clients who…**Prefer structured, solution-focused approachesNeed deeper exploration of long-term emotional patterns### Dynamic Interpersonal Therapy Summary

**If you want to…****Go with…**Understand deep-rooted emotional patterns in relationships.**DIT**Improve current interpersonal functioning and reduce depressive symptoms**IPT**### Dynamic Interpersonal Therapy for Depression: A Case Example

Here’s a case example of **Dynamic Interpersonal Therapy (DIT)** for an **adolescent girl**.

#### “Sara” – A 16-Year-Old Girl with Depression

**Presenting Problem:** Sara, a 16-year-old girl, is referred by her school counselor due to persistent low mood, irritability, social withdrawal, and declining academic performance. She reports feeling “numb” and often worthless. She has also started skipping classes and avoiding her friends.

**Assessment and Formulation:** During the dynamic interpersonal therapy assessment phase, Sara shares that her parents recently divorced, and she now lives with her mother. She describes her father as emotionally distant and critical. Her relationship with her mother is strained; Sara feels smothered and misunderstood. Her core interpersonal affective focus (IPAF) is identified as: **“Fear of being rejected or unloved if she expresses her true feelings.”**

DIT formulation identifies a **repeating interpersonal pattern**:

- **Experience:** Sara feels hurt and dismissed when others don’t understand her.
- **Expectation:** She believes others will reject or criticize her if she expresses vulnerability.
- **Response:** She withdraws emotionally, leading to further isolation and reinforcing her belief that she is unlovable.

#### Dynamic Interpersonal Therapy for Depression Goals:

- Help Sara recognize and understand this pattern.
- Explore how this dynamic originated in early relationships (especially with her father).
- Develop new ways of relating and expressing her needs.

#### Key Sessions in the 16-Session DIT Framework

**Session 1–4 (Engagement & Focus):** I build rapport and help Sara feel safe in the space. Together, we identify her IPAF. Through guided discussion, Sara begins to see the link between her current relationships and past patterns with her father.

**Session 5–10 (Working Through):** Sara is encouraged to notice her emotional reactions in the office. When she starts withdrawing from me after discussing a painful memory, so we explore this as a reenactment of her fear of rejection. With my support, she practices staying present and expressing her feelings.

In parallel, she discusses a recent falling out with a friend. We identify how her pattern—expecting rejection and pulling away—played out. She tries a new approach by talking to her friend honestly about her feelings, which leads to a positive response.

**Session 11–15 (Consolidation):** Sara becomes more aware of her emotions and can better express them. She reports feeling closer to her mother after having a conversation about feeling overwhelmed. I help reinforce her new, more adaptive relational strategies.

**Session 16 (Ending):** Sara reflects on her growth, particularly her increased emotional insight and improved communication. The ending is used to process the loss of the therapeutic relationship and to solidify her ability to use what she’s learned.

#### Dynamic Interpersonal Therapy for Depression Outcome

Sara reports feeling less depressed and more connected to her peers and family. She continues seeing the school counselor monthly for check-ins. Her academic performance improves, and she re-engages in extracurricular activities.

DIT, IPT, and My Work

Interpersonal Psychotherapy and Dynamic Interpersonal Therapy are well-established, structured forms of treatment that focus on the relational aspects of mental health. By improving social functioning and addressing specific challenges, IPT therapy helps alleviate psychological symptoms and enhance overall quality of life. In my [integrative psychological practice](https://dralanjacobson.com/examples-of-integrative-therapy/), I use interpersonal therapy for depression, social anxiety, and other diagnoses, often as an adjunct to other methods.

### What is Interpersonal Therapy in Practice

I use interpersonal therapy in the following ways:

- Adult individual: The most common form is IPT [therapy for individual adults](https://dralanjacobson.com/individual-therapy/) who want to work on emotional challenges, social anxieties, or just general contentment
- Adolescent IPT Therapy (IPT-A): This method addresses teenagers’ developmental needs and social challenges. It is specifically designed to be developmentally appropriate for adolescents. I use a similar approach in my [young adult groups](https://dralanjacobson.com/group-therapy-for-young-adults/).
- [Group Treatment](https://dralanjacobson.com/group-therapy/): In my [fear of public speaking groups](https://dralanjacobson.com/fear-of-public-speaking-groups/), for example, I use these methods to leverage peer support and shared experiences.
- [Couples Therapy](https://dralanjacobson.com/couples-therapy/): Often couples can work on the issues that affect their relationship, even if they have their roots in prior relationships
- Maintenance Interpersonal therapy for depression: I use this approach to prevent relapse in individuals with recurrent depression.
- Brief IPT: This approach is a shorter version for use when long-term is not feasible, or there are specific long-term goals.

Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime to discuss how IPT therapy might be helpful for you or if you generally want more information.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

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### [Mindfulness Therapy](https://dralanjacobson.com/mindfulness-therapy/)

**Published:** December 3, 2023
**Author:** Dr. Alan Jacobson

**Content:**

**Mindfulness therapy** is a therapeutic approach that incorporates **mindfulness therapy techniques** to help individuals manage their thoughts, emotions, and mental health. I use this approach both in [online therapy](https://dralanjacobson.com/virtual-therapy-guide/) and in person to reduce stress, anxiety, depression, and other psychological issues. I use it with individuals and [couples](https://dralanjacobson.com/couples-therapy/) in [traditional therapy](https://dralanjacobson.com/) and [my clinical specialties](https://dralanjacobson.com/intensive-therapy-and-specialty-services/). Below, you will see how mindful therapy works, particularly mindfulness techniques for depression. Feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) with any questions, but first, here is an overview.

## Mindfulness Therapy Overview

The following overview can help you understand mindfulness therapy techniques so you know what to expect and what using it in your everyday life might entail. These can be woven into other approaches in my [integrative practice](https://dralanjacobson.com/integrative-therapy/), or stand-alone in our work together.

### What is Mindfulness?

This term refers to a mental state characterized by being fully present and engaged in the current moment without judgment or distraction. It involves paying deliberate attention to one’s thoughts, feelings, bodily sensations, and the surrounding environment. Here are the key components:

1. 1. Present-moment Awareness: This involves focusing on the present moment and acknowledging thoughts and sensations as they arise without getting carried away.
    2. Nonjudgmental observation involves observing thoughts, emotions, and sensations without labeling them as good or bad. Instead of reacting impulsively, individuals practice acceptance and understanding.
    3. Acceptance and Openness: It encourages acceptance toward experiences, allowing them to be as they are without trying to change or resist them.
    4. Focused Attention: Practicing often involves directing attention to a specific point of focus, such as the breath, bodily sensations, or a particular activity, to anchor oneself in the present moment.
    5. Cultivation of Awareness: This approach aims to cultivate a heightened awareness of one’s thoughts, emotions, and bodily sensations, promoting a deeper understanding of oneself and one’s surroundings.

### What is Mindfulness Therapy

The primary focus of mindfulness therapy is to cultivate present-moment awareness, helping individuals observe their thoughts and feelings without judgment. Techniques often involve [meditation practice](https://www.mayoclinic.org/tests-procedures/meditation/in-depth/meditation/art-20045858), [breathing exercises](https://www.healthline.com/health/breathing-exercise), and [guided imagery](https://en.wikipedia.org/wiki/Guided_imagery) to increase self-awareness and promote relaxation.

Therapists like me trained in these approaches teach clients to be more present in their experiences, acknowledging and accepting their thoughts and feelings rather than trying to suppress or avoid them. This practice can lead to increased emotional regulation, improved concentration, and greater well-being.

I maintain a supportive and non-judgmental environment throughout this process, encouraging clients to develop [self-compassion feelings](https://self-compassion.org/) and acceptance. The pace of progress varies for each individual, and the therapy is often tailored to suit your unique needs and preferences.

## Mindfulness Therapy Techniques

Mindfulness therapy techniques are approaches aimed at cultivating these states. I often use these mindfulness therapy techniques with therapies like Mindfulness-Based Stress Reduction ([MBSR](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/)) and Mindfulness-Based Cognitive Therapy ([MBCT](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/)) to help clients manage stress, anxiety, and depression and improve overall well-being. Here are some common mindfulness therapy techniques I use:

### Mindfulness therapy techniques involving breathing

These mindfulness therapy techniques involve focusing on the breath as it moves in and out of the body. You pay attention to the sensation of breathing, such as the rise and fall of the chest or the feeling of air passing through the nostrils. This is often done in conjunction with a [body scan](https://health.clevelandclinic.org/body-scan-meditation), where you systematically bring attention to different parts of your body, starting from the toes and moving upward to the head. I’ll ask you to notice any sensations, tension, or discomfort without trying to change anything.

### Self Observation

This involves observing thoughts, feelings, and sensations as they arise in the present moment without getting caught up in them or reacting to them. It’s about being a neutral observer of your inner experiences and can bring excellent insight.

### Mindful Activities like walking or eating

This technique involves bringing awareness to the sensations involved in everyday activities. You might try walking while being aware of the movement of the feet, the contact with the ground, and the surrounding environment. It can be practiced indoors or outdoors. You could also pay full attention to the eating experience, including food’s appearance, smell, taste, and texture. It’s about savoring each bite and being fully present during the meal.

### Loving-Kindness Mindfulness Therapy Techniques

This practice involves cultivating feelings of love, compassion, and goodwill toward oneself and others. It typically involves repeating phrases such as “May I be happy, may I be healthy, may I be safe, may I live with ease” while bringing oneself and others to mind. This is often combined with mindful Listening, which involves fully focusing on what someone else is saying without interrupting or formulating a response in your mind. It’s about giving the speaker your full attention and being present in the conversation.

These are just a few examples of mindfulness therapy techniques; many more variations and practices are available. In our work together, I will help you find techniques that resonate most with you and guide you toward incorporating them into your daily life for maximum benefit.

### Mindfulness Techniques for Depression

As an example of this approach, here are two mindfulness techniques for depression I use:

1. The [R.A.I.N. Technique](https://www.mindful.org/tara-brach-rain-mindfulness-practice/) is one of the central mindfulness techniques for depression. This acronym stands for Recognize, Accept, Investigate, and Non-identification. It’s a systematic way of working with difficult emotions or thoughts, allowing you to approach the causes of your depression with self-compassion.
2. Journaling involves writing down thoughts, feelings, and experiences with an attitude of curiosity and non-judgmental awareness. If you are sad at times, you can gain insights into the thought patterns and emotional responses that create that sadness. This is one of the mindfulness techniques for depression you can do as self-help.

There are many other mindfulness techniques for depression in many [third-wave therapies](https://dralanjacobson.com/third-wave-psychotherapy/).

## Mindfulness Techniques for Depression: The Process

Mindfulness techniques for depression are provided in a structured yet flexible process that typically unfolds over several sessions. Here’s an overview of the general process I use:

### Assessment and Introduction

We’ll start by having you help me fully understand your concerns, history, and current challenges. This helps me tailor the mindfulness approach to your unique needs. I’ll review the basic concepts and techniques, explaining the practice of being present in the moment, nonjudgmentally observing your thoughts and feelings, and using breath and body awareness as anchors. Together, we’ll design a treatment plan that addresses the challenges and barriers you face and enhances your strengths and abilities.

### Practicing Mindfulness

Once we have a solid treatment plan, I will guide you through exercises such as focused breathing, body scans, or meditation. These practices help you become more aware of your thoughts, emotions, and bodily sensations. I may use apps or virtual reality. Once you are comfortable with the techniques, I will help you apply them in your daily routines. This might involve incorporating them into activities like eating, walking, or conversing.

### Exploration and Reflection

Once you use mindfulness therapy techniques in your daily life, we will use our sessions to explore your experiences with practice in sessions. We’ll talk about challenges, breakthroughs, and any changes they’ve noticed in their thoughts, emotions, or behaviors. Of course, we will continually adapt and change our planning to match what you need to reach your goals.

Together, we will periodically assess progress, considering changes in symptoms, coping mechanisms, and overall well-being. This evaluation also guides adjustments in the therapy process if needed.

### Cognitive Restructuring Mindfulness Therapy

In some cases, I will merge [cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) and the cognitive restructuring techniques that are a part of CBT. This combination helps address negative thought patterns and behaviors. This can also be interwoven with [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/), [Psychodynamic Therapy](https://dralanjacobson.com/psychodynamic-therapy/), and others. As you can see above, mindfulness techniques for depression are one example of how all of this can work.

### Mindfulness Therapy Follow-Up

Once clients have acquired skills and are working, I will provide strategies for maintaining progress and preventing relapse. This might include ongoing practice, group sessions, or other resources. Clients often reach out after we have reminded them of some of our techniques or to learn how to adapt their techniques to new stressors.

Consistency in practice and openness to the process is crucial for deriving mindfulness techniques for depression’s maximum benefit.

## Mindful Therapy Case Example

Here’s a **mindful therapy case example** illustrating how mindfulness therapy techniques can be applied in therapy:

---

Anna is 32 and experiencing anxiety, mild depression, and work-related stress. She just moved to a new city to take a new job after the break up of a long-term relationship.

### Presenting Issue

Anna works in a fast-paced corporate job and feels overwhelmed by persistent worries about work deadlines and making mistakes. She experiences symptoms like racing thoughts, difficulty sleeping, and irritability. Anna reports feeling disconnected and unable to enjoy daily life in her new city despite usually being a very social person.

### Mindful Therapy Goal

To reduce anxiety symptoms and improve Anna’s ability to manage stress through mindful therapy.

---

### Mindful Therapy Intervention Plan

#### 1. Psychoeducation

I explain that our work will involve “the practice of paying attention to the present moment without judgment.” Anna learns how mindful therapy can help reduce reactivity to stressful thoughts and improve self-awareness.

#### 2. Body Scan Exercise

- I guide Anna through a **10-minute body scan**, helping her bring attention to different body parts.
- **Purpose:** This exercise helps Anna notice areas of tension and reconnect with bodily sensations instead of being consumed by her thoughts.

**Example Dialogue:**
“As you bring your attention to your shoulders, simply notice if there’s any tension or tightness. There’s no need to change anything—just observe it.”

Outcome: Over time, Anna becomes aware that she unconsciously tenses her shoulders when stressed.

---

#### 3. Mindful Therapy Breathing Technique

- Anna learns [**diaphragmatic breathing**](https://www.healthline.com/health/diaphragmatic-breathing) as an anchor when she feels anxious.
- She practices a simple technique: inhale for 4 counts, hold for 2, exhale for 6 counts.

**Example Reflection:**
“When I focus on my breath, I feel calmer. I still have anxious thoughts, but they seem quieter.”

---

#### 4. Mindful Observation of Thoughts (Cognitive Defusion)

The therapist introduces the idea of observing, rather than identifying, thoughts:

- Anna practices labeling thoughts like “worrying” or “planning” when they arise.
- **Example Metaphor:** I use the analogy of **watching leaves float down a stream**—Anna learns to let thoughts come and go without reacting to them.

Outcome: Anna gains the ability to step back from intrusive thoughts rather than feeling trapped in them.

---

### Mindfulness Therapy Progress

After six weeks of mindful therapy, Anna reports:

- A reduction in anxiety symptoms.
- Better awareness of when stress is building up.
- Improved ability to pause and respond rather than react to stressful situations.
- More hopefulness and energy to go out socially

She says: “I still get anxious and sad at times, but I now have tools to ground myself and return to the present moment.”

---

Mindful therapy helped Anna develop a healthier relationship with her thoughts and emotions, reducing her stress and increasing overall well-being.

## Conclusions and My Work

In this section, you’ll learn about what you can expect from mindfulness therapy and how I use it in my practice.

### Mindfulness Therapy Outcomes

Mindful therapy has been extensively studied and has shown promising results across various mental health conditions. Here is what you can expect:

1. Stress Reduction: These interventions have effectively reduced stress levels by teaching individuals to manage their responses to stressors and cultivate a more present-centered awareness.
2. Anxiety and Depression: Mindful therapy techniques for depression and anxiety have shown positive effects in reducing symptoms of anxiety and depression. Practices like Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) have been particularly effective in preventing relapse for those with recurrent depression.
3. Improved Emotional Regulation: [Mindfulness counseling](https://dralanjacobson.com/reality-therapy-and-mindfulness-counseling/) helps individuals develop better emotional regulation by fostering a non-reactive and non-judgmental attitude toward emotions. This can lead to decreased emotional reactivity and increased emotional resilience.
4. Enhanced Cognitive Functioning: Studies suggest that mindfulness can improve cognitive functioning, including attention, memory, and executive function, by training individuals to sustain focus and reduce mind wandering.
5. Better Sleep Quality: These practices have been linked to improved sleep quality. They help individuals reduce rumination and worry, promote relaxation, and improve sleep patterns.
6. Improved Overall Well-being: Regular practice increases well-being, including greater life satisfaction, self-awareness, and inner peace.

Research continues to support the effectiveness of these approaches as a valuable tool in mental health treatment and overall well-being. This is why I use many of these techniques in my practice.

### My practice

I use mindfulness therapy with individuals, couples, and families. It is part of my core services and also in specialty areas such as [Sports Psychology](https://dralanjacobson.com/sports-psychology/), Executive Coaching, and [College Admissions](https://dralanjacobson.com/college-admissions-counseling/). Mindfulness Therapy is sometimes a stand-alone approach, but more commonly, it is interwoven with another set of techniques, the most common being Mindfulness-Based Stress Reduction ([MBSR](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/)) and [Mindfulness-Based Cognitive Therapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) ([MBCT](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/)). Less commonly, I use it with other methods that may cause stress, such as [exposure and response prevention](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/). As you can see above, there are also mindfulness techniques for depression that can help, and it can be used alongside [executive function coaching](https://dralanjacobson.com/executive-functioning-coaching/).

Mindfulness therapy can be used with [couples](https://dralanjacobson.com/couples-therapy/), [families with older children](https://dralanjacobson.com/family-therapy/), small work groups, or groups of people facing the same challenge or stress. I can provide treatment in all these circumstances through [online therapy](https://dralanjacobson.com/virtual-therapy-guide/) and in person.

These techniques can also be beneficial for people dealing with chronic pain, anxiety disorders, depression, and even those seeking personal growth and self-awareness. I look forward to [speaking with you](https://dralanjacobson.com/contact/) about how **mindfulness therapy** may benefit you.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Therapy Approaches

---

### [ERP: Exposure and Response Prevention Therapy](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/)

**Published:** December 10, 2023
**Author:** Dr. Alan Jacobson

**Content:**

**ERP**, or **Exposure and Response Prevention therapy**, is a type of cognitive-behavioral therapy (CBT) commonly used to treat anxiety disorders, particularly [obsessive-compulsive disorder](https://dralanjacobson.com/therapy-for-ocd/) (OCD). In **ERP therapy**, you are gradually exposed to feared situations or thoughts (exposure) and then are encouraged to resist the accompanying compulsion or ritual (response prevention). This process helps you learn to manage your anxiety without relying on your usual compulsive behaviors. **ERP techniques** have lasting and deep effects. At the end of this post are exposure and response prevention examples that may help you see what the treatment would be like, but feel free to [contact me](https://dralanjacobson.com/contact/) to go over your specific concerns.

## Exposure and Relapse Prevention Therapy Overview ![Exposure and response prevention ERP](https://dralanjacobson.com/wp-content/uploads/2023/12/path6-300x200.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

The development of ERP therapy can be traced back to the 1960s and 1970s when psychologists and researchers were exploring effective ways to treat OCD. One of the pioneers in this field was [Dr. Victor Meyer](https://en.wikipedia.org/wiki/Vic_Meyer), who, in the 1960s, suggested that exposure to feared stimuli without engaging in the associated compulsive behaviors might help reduce anxiety.

In the 1980s, the work of psychologists [Edna B. Foa](https://en.wikipedia.org/wiki/Edna_B._Foa) and [Reid Wilson](https://anxieties.com/about/) played a crucial role in shaping ERP therapy as it is known today. Foa and Wilson combined the principles of exposure therapy with a focus on preventing the compulsive responses that typically follow anxiety-provoking thoughts or situations. They emphasized the importance of confronting feared situations directly and resisting the urge to perform rituals or compulsions.

Today, ERP therapy remains one of the most widely used and effective psychological treatments for OCD. It has also been adapted and utilized for other anxiety-related conditions, demonstrating its versatility and success in helping individuals manage and overcome their fears and compulsions.

Exposure and response prevention techniques involve facing feared situations, objects, thoughts, or images that trigger anxiety. The response prevention component involves refraining from engaging in the usual compulsive behaviors or rituals that alleviate anxiety temporarily. Over time, repeated exposure without engaging in compulsive behavior helps reduce the anxiety associated with the triggers.

ERP therapy is evidence-based and is highly effective in treating OCD and other anxiety disorders. It requires a structured and gradual approach. The goal of ERP for OCD is to help individuals gradually confront their fears, reduce anxiety, and learn healthier ways to cope without relying on obsessions or compulsive behaviors.

## Exposure and Response Prevention Techniques

Below is more information about the process used with exposure and relapse prevention techniques, but here is a summary of what the therapy involves.

### Basic Tenets of ERP Techniques

ERP techniques are [primarily used to treat anxiety disorders, especially OCD](https://dralanjacobson.com/exposure-therapy-for-anxiety/) (Obsessive-Compulsive Disorder). Exposure and relapse prevention techniques revolve around deliberately confronting situations, thoughts, images, or objects that trigger anxiety or distress. Exposure is gradual and systematic, starting with less distressing triggers and progressively moving towards more challenging ones. The goal of ERP techniques is “response prevention,” involving refraining from engaging in compulsive behaviors or rituals that typically reduce anxiety.

ERP techniques include imaginal exposure, where individuals vividly imagine the feared situations or thoughts, facing them without performing compulsions. Still, they also involve real-life exposure to feared situations or objects. For instance, someone with contamination fears might touch a doorknob without immediately washing their hands.

### Adjunctive Processes

Exposure and relapse prevention therapy can also involve scripting, where we help you create narratives or scripts of feared situations or scenarios. Reading or listening to these scripts repeatedly helps desensitize individuals to their anxiety triggers. We also use “Interoceptive Exposure,” where we deliberately induce physical sensations or symptoms that are typically feared.

ERP is typically conducted under the guidance of a trained therapist and requires collaboration between the therapist and the individual receiving treatment. It’s important to know that we always proceed at a pace that you find challenging yet manageable, ensuring the process is effective and not overwhelming.

## Using ERP Techniques in Practice

While the above provides an overview of ERP techniques, this section describes the process in more detail. In therapy, **Exposure and Response Prevention Therapy techniques** are designed to help you confront your fears and reduce anxiety associated with your obsessive-compulsive disorder (OCD) or other anxiety disorders. Here are some common **ERP techniques** that I use:

### Hierarchical Exposure in ERP

In this case, I work with the individual to create a hierarchy of feared situations or triggers, ranking them from least distressing to most distressing. This helps in gradually exposing you to increasingly anxiety-inducing situations, always at a pace you are comfortable with. For example, in [airplane flying](https://dralanjacobson.com/fear-of-flying-treatment/), an initial step might involve going to the airport to watch airplanes take off and land. For [fear of public speaking,](https://dralanjacobson.com/fear-of-public-speaking-therapy-process/) you might be asked to practice a speech just in front of me.

### Exposure and Response Prevention Techniques In Vivo

ERP techniques usually involve real-life exposure to feared situations or triggers. For instance, someone with contamination fears might touch a doorknob without washing their hands immediately afterward. We can use [AR and VR](https://www.popsci.com/technology/ar-vs-vr/) techniques in the office to accomplish some of that. As we progress, we will work on prolonged exposure, where you stay in the feared situation or are exposed to the trigger for an extended period without engaging in the compulsive behavior. This helps in habituating to the anxiety and reducing its intensity over time.

### Imaginal ERP Techniques

This ERP technique involves vividly imagining the feared situations or triggers in the mind. For example, someone with OCD related to harming others might imagine accidentally harming a loved one and resisting the urge to perform a ritual to neutralize the thought. We might work on this in the office, and you may be asked to do some of it at home as homework. Like imaginal exposure, the individual writes a detailed script describing their feared situation or obsessive thoughts. Then, they repeatedly read or listen to this script without engaging in compulsive behavior.

### Response Prevention Techniques

These Exposure and Response Prevention techniques involve deliberately not engaging in the compulsive behaviors or rituals that usually follow the exposure to a trigger. It’s crucial in breaking the cycle of anxiety and compulsive actions. In this case, I might ask you to expose yourself to a feared situation, but one that is milder or controlled, and as you start to be compelled to take an irrational action, you will learn how to resist using my support.

### Flooding in Exposure and Response Prevention Therapy

This involves exposure to the most feared situation or triggers immediately rather than gradually. It can be intense but effective for some individuals. I use this technique only when the client requests it because they have found that it helps in the past or when there is reason to believe it will work. I would never use this type of technique without the client’s permission.

### Mindfulness and Acceptance

Integrating [mindfulness techniques](https://dralanjacobson.com/mindfulness-therapy/) can help individuals observe their anxious thoughts or sensations without trying to control or suppress them. Acceptance-based strategies can also help reduce the struggle against unwanted thoughts.

ERP Therapy is tailored to each individual’s fears and triggers. I will gradually expose you to feared situations or thoughts while supporting you in resisting the urge to perform compulsions. Over time, this helps reduce anxiety and the need for compulsive behaviors, leading to improved coping mechanisms.

## ERP Therapy Outcomes

Research shows that ERP therapy can be highly effective for many people with OCD. Formal studies have consistently demonstrated positive outcomes, with significant reductions in OCD symptoms and improvements in daily functioning. The success rates vary from person to person, but many people experience a notable decrease in symptoms and an improved quality of life. ERP therapy is more effective than other forms of therapy or medication alone for OCD. Exposure and Response Prevention for OCD have also been shown to have longer-lasting effects and a lower risk of relapse compared to medication alone.

### Exposure and Response Prevention Examples

I have found ERP techniques to be helpful for people of all ages, and even with couples, when one person has OCD or a phobia and the other is going to work to help them overcome it. It can even be helpful in family therapy, where one (or more) people have OCD or a phobia, and the rest of the family wants to be part of the solution.

It’s important to note that therapy outcomes often depend on various factors, including the severity of the OCD or phobic symptoms, your commitment to the therapy, and your willingness to take some risks related to exposure. It also may depend on the level of other stresses in your life.

Overall, ERP therapy has a strong track record of success in helping people manage and alleviate symptoms of OCD and phobias, enabling them to lead more fulfilling lives. The effects of response and exposure prevention therapy can last a long time.

The following two more specific **exposure and response prevention examples** may help you see what treatment would be like.

## Case Example 1: Exposure and Response Prevention for OCD

Here is a fictional case example of **Exposure and Response Prevention** for **OCD**—this one focuses on **contamination OCD**, which is one of the most common subtypes.

**Client:** Sarah, 27-year-old graphic designer
**OCD Subtype:** Contamination OCD
**Main Fear:** Germs from public surfaces causing illness
**Compulsion:** Excessive hand washing, avoiding touching doorknobs, using hand sanitizer repeatedly

### Initial Assessment

Sarah reports spending up to **3 hours a day** washing her hands and sanitizing. She avoids public bathrooms, refuses to shake hands, and experiences intense anxiety if she feels “dirty.”

### Exposure and Response Prevention for OCD Plan

**Goal:** Reduce compulsive hand-washing and avoidance behaviors and tolerate uncertainty around contamination.

#### Exposure Hierarchy:

**Level****Exposure and Response Prevention for OCD****SUDs\* Rating**1Touching her own phone without washing hands20/1002Touching doorknob at home, then waiting 10 mins40/1003Touching office doorknob, no hand washing60/1004Using a public restroom and leaving without hand sanitizer80/1005Shaking hands with someone and then eating lunch95/100\*SUDs = Subjective Units of Distress

#### Response Prevention

In each exposure, Sarah is **not allowed to perform the compulsion** (e.g., no hand-washing immediately after touching a doorknob). Instead, she is coached to sit with the discomfort and **ride the wave of anxiety**.

### ERP for OCD Progress Over Time

Over 12 sessions of ERP for OCD, Sarah moves up the hierarchy:

- Her distress after touching public surfaces drops from 90 to 30.
- She begins using public bathrooms without rituals.
- She now only washes her hands when genuinely necessary (e.g., after using the restroom or before eating).

### ERP for OCD Key Takeaways

- **ERP for OCD is effective** by breaking the cycle: Obsession → Anxiety → Compulsion.
- Over time, Sarah’s brain **learned a new association**: touching surfaces ≠ danger.
- The emphasis is on **tolerating uncertainty**, not achieving total comfort.

## Case Example 2: Exposure and Response Prevention Therapy for Phobias

Here’s a **case example of Exposure and Response Prevention Therapy** for **phobias**—in this case, a **dog phobia (cynophobia)**.

**Client:** Marcus, 35-year-old teacher
**Phobia:** Dogs
**Main Fear:** Being bitten or attacked by a dog
**Avoidance Behaviors:** Crosses the street to avoid dogs, avoids parks, won’t visit friends who own dogs, scans surroundings constantly for dogs

### Initial Assessment

Marcus reports high anxiety (up to 100/100 on a SUDs scale) when near dogs—even small, calm ones. His fear developed after witnessing a dog bite a child when he was 10. He knows most dogs are safe but says, *“I just can’t help the panic.”*

### Exposure and Response Prevention Therapy for Phobias Plan

**Goal:** Help Marcus confront and tolerate his fear without fleeing or seeking safety behaviors.

#### Exposure Hierarchy:

**Level****Exposure Task****SUDs Rating**1Looking at photos of calm dogs20/1002Watching videos of dogs on YouTube35/1003Standing 20 feet away from a leashed dog at a park50/1004Standing 5 feet from a calm leashed dog70/1005Sitting next to the dog while the owner holds the leash85/1006Petting the dog gently for a few seconds95/100#### Response Prevention

Marcus is coached **not to leave**, cross the street, or use distractions during exposures. He practices **slowing his breathing**, staying in the moment, and letting the anxiety rise and fall on its own.

### ERP for Phobias Progress Over Time

Over several sessions:

- Marcus’s SUD response to dogs drops significantly using exposure and response prevention techniques.
- He begins walking in parks again without fear.
- He can visit friends with calm dogs and interact with them briefly.

### ERP for Phobias Key Takeaways

- Exposure and Response Prevention techniques work for phobias by [**desensitizing the fear response**](https://positivepsychology.com/systematic-desensitization/) and helping the brain **relearn safety**.
- The **“response prevention”** is often not fleeing, avoiding, or mentally reassuring oneself.
- Repeated, gradual exposure **reduces fear over time**—even if it doesn’t eliminate the [simple phobia](https://dralanjacobson.com/therapy-for-phobias/), it makes it manageable.

## Conclusion and My Work

I provide ERP Therapy as both a standalone therapy and in combination [with other techniques](https://dralanjacobson.com/types-of-therapy/). As mentioned above, exposure and response prevention techniques will always go at a pace you are comfortable with. ERP for OCD and phobias often requires some homework to be most successful. The treatment course can often be time-limited, and gains are often clear and measurable.

I also use ERP techniques for specialty services such as Fear of Flying, [Public Speech Anxiety](https://dralanjacobson.com/speech-anxiety-treatment/), and Sports Psychology. It can be interwoven through [couples](https://dralanjacobson.com/couples-therapy/) and [families with older children](https://dralanjacobson.com/family-therapy/) when people surrounding a person with [OCD](https://dralanjacobson.com/therapy-for-ocd/) want to help. I would be happy to provide you with more exposure and response prevention examples closer to what you seek.

Please feel free to [be in touch](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) at any time to discuss **Exposure and Response Prevention Therapy** or how **ERP** Therapy might benefit you.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Mindfulness-Based Stress Reduction (MBSR)](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/)

**Published:** January 7, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Mindfulness-Based Stress Reduction** (**MBSR**) was developed by [Dr. Jon Kabat-Zinn](https://en.wikipedia.org/wiki/Jon_Kabat-Zinn) in the late 1970s. It centers around using mindfulness to help people manage stress and pain and promote overall well-being. **Mindfulness based stress reduction therapy** teaches you to cultivate awareness of the present moment without judgment, helping you better understand your thoughts, emotions, and bodily sensations. I have seen clients report increased self-awareness, better stress coping mechanisms, and a greater sense of overall calm and well-being after regularly practicing MBSR techniques. At the end of this post, I provide an example of **MBSR therapy.**

You are welcome to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime to discuss how Mindfulness based stress reduction therapy might be helpful to you or someone you know, but I wanted to provide an overview first.

## Uses of Mindfulness-Based Stress Reduction

MBSR benefits a wide range of people and presents challenges and hopes. Here are some areas where I’ve found MBSR has shown to be particularly helpful as an adjunct to other forms of therapy:

### Mindfulness-based Stress Reduction and Anxiety

As the name implies, Mindfulness-based stress reduction was specifically designed to help people manage stress, teaching techniques to cope with daily stressors more effectively. The goal is an additive effect, where MBSR techniques help initially, and their effect gets larger as time goes on. Practicing mindfulness can aid in relaxing the mind and body, promoting better sleep patterns. The nice thing about mindfulness based stress reduction therapy is that it can help with situational stresses and also with underlying anxiety that is mild but pervasive.

### Depression and the MBSR Approach

Mindfulness-based Stress Reduction can alleviate symptoms of anxiety and depression by promoting a greater sense of awareness and reducing rumination. This makes it a great adjunct to [Cognitive-behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) and other more structured approaches. It helps people develop the ability to respond to emotions more skillfully and with greater awareness. MBSR may not directly address the causes of depression, but it can help reduce the intensity of symptoms and increase your feelings of being able to manage them.

### Chronic Pain and Mindfulness-Based Stress Reduction

People dealing with chronic pain conditions often find relief and better coping mechanisms through MBSR practices. They can effectively distract themselves from the pain symptoms and feel more hopeful and capable. As with depression, mindfulness based stress reduction therapy does not target the cause of the pain or even the pain itself, but it can make it feel much more manageable and less limiting. Interestingly, however, some clients report that their level of pain does subside a bit, even with this therapy that does not address the cause of pain.

### Improved Focus and Concentration

Regular practice of mindfulness techniques can enhance attention span and concentration. This can be a great approach for those who come in looking for help with [Attention Deficit Hyperactivity Disorder](https://www.mayoclinic.org/diseases-conditions/adult-adhd/symptoms-causes/syc-20350878), but it is also quite effective for anyone whose stress and anxiety get in the way of work, school, or home tasks. Mindfulness does exactly what it should do, allowing you to be more focused and in the moment rather than distracted.

### Increased Self-Awareness Through MBSR

Mindfulness-Based Stress Reduction cultivates deeper self-awareness, leading to a better understanding of oneself, thoughts, and behaviors. This can be quite helpful for those feeling a longer long-term malaise or looking for greater meaningfulness in their lives. MBSR promotes a greater sense of overall well-being by encouraging a more mindful and present-centered way of living. Mindfulness based stress reduction therapy complements [existential therapy](https://dralanjacobson.com/existential-therapy/), for example, as it makes you feel more present and aware.

Mindfulness-based stress reduction isn’t limited to individuals facing specific issues—it’s beneficial for anyone interested in cultivating mindfulness and improving their quality of life. It is a perfect adjunctive approach to other types of therapy.

## Mindfulness-Based Stress Reduction Techniques

I use various techniques that help clients cultivate mindfulness and reduce stress. Here are just a few examples:

1. Mindful Breathing: Focus on the body’s breath moving in and out. This technique helps anchor attention to the present moment. Like [cognitive therapy](https://dralanjacobson.com/cbt-for-depression/), it is designed to help you weed out unhelpful, exaggerated, and irrational thinking.
2. [Body Scan Meditation](https://www.healthline.com/health/body-scan-meditation): A guided practice where attention is systematically moved through different body parts, bringing awareness to physical sensations without judgment. This skill can be in your toolkit for times when you need to take a step back and become more aware of your thoughts when you are feeling stressed or upset.
3. [Sitting Meditation](https://plumvillage.org/articles/enjoy-sitting-meditation): Sitting quietly and observing thoughts, emotions, and bodily sensations as they arise without getting attached to or reacting to them. This is a type of meditation that many people like because it can be used in a wide variety of situations, even at a desk at work or in a meeting.
4. [Mindfulness in Daily Activities](https://www.healthline.com/health/mind-body/mindfulness-activities): Bringing these feelings into everyday tasks like eating, washing dishes, or any routine activity by paying full attention to the experience without distraction.
5. Guided Imagery and Visualization: Using mental imagery to evoke a sense of relaxation and calmness. I often pair this with positive self-talk and affirmations that help you dismiss negative thinking.

Mindfulness based stress reduction therapy aims to give clients a toolkit for managing stress and enhancing overall well-being through regular practice. It’s not uncommon for clients to return for a refresher to ensure their toolkit is up-to-date and full!

## Results of Therapy

I have seen the results of Mindfulness-Based Stress Reduction (MBSR) vary from person to person, depending on the difficulties the person is managing, how consistently the practice is incorporated into their life, and the goals they set. However, I have usually seen several powerful benefits of MBSR, including:

### MBSR and Stress Reduction

Mindfulness based stress reduction therapy helps people better cope with stress by fostering awareness of the present moment and promoting a non-judgmental attitude. The stresses themselves may not go away, but people feel more capable of managing them and putting them aside more frequently.

### Improved Emotional Well-being

Practicing mindfulness has led many clients to see reduced symptoms of anxiety and depression and an overall improvement in emotional well-being. The effects can be lasting and help, particularly with negative thoughts and feelings that have been difficult to shake.

### Enhanced Focus and Concentration

Regular mindfulness practice may contribute to improved attention and concentration, as it encourages the development of sustained attention in the present moment. This can be helpful when faced with a specific complex or challenging task, but it can also be helpful in day-to-day situations where stress builds up.

### Better Physical Health

Some studies suggest that MBSR can positively affect physical health, such as lower blood pressure and improved immune system function. It has also been used as a complementary approach for managing chronic pain, helping individuals develop a different relationship with their pain through mindful awareness.

## Mindfulness Based Stress Reduction Therapy in My Practice

I practice using an integrative therapy model, and MBSR therapy is an adjunctive approach that I commonly use. It is a part of my traditional [therapy services](https://dralanjacobson.com/psychotherapy/) and in several specialties, including [sports psychology](https://dralanjacobson.com/sports-psychology/) and executive coaching. Mindfulness-based stress reduction is easy to do as part of [online therapy](https://dralanjacobson.com/virtual-therapy-guide/).

### MBSR Therapy Example

MBSR therapy is an evidence-based program I use to help my clients manage stress, anxiety, pain, and depression through mindfulness practices.

Julie is a 22-year-old college student experiencing anxiety and worry due to the pressures of what she will do after she graduates and, generally, how she will transition to true adulthood. She has never experienced this type of stress before. She found some relief after trying a meditation app, so she decided to pursue MBSR therapy.

#### Example of an MBSR Therapy Session

We start by reviewing Julie’s week. When did she feel at her best, and when did she feel the most low? We look for patterns in her thinking, using [CBT techniques](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) to look for exaggerated or irrational thoughts to see how much she could stay in the present during these times. She also reviews the ways she used the two apps she uses – one is a brief meditation app, and the other a mindfulness app.

I remind her that we will stay focused on the present moment for our purposes. We discuss her experiences with the practices she is learning, discuss challenges, and reflect on how mindfulness affects her daily life. I provide insights and guidance about how she can expand these practices and make them more timely.

Finally, we do some exercises in class, applying mindfulness to their thoughts, emotions, and sensations, observing them without attachment or judgment. We focus on the thoughts causing her stress and practice mindfulness techniques to address them. I give Jane mindfulness exercises to practice, such as daily meditation (even some she can do in class), mindful eating, and keeping a journal of their experiences. This helps her integrate mindfulness into her daily life, targeting those automatic thoughts.

#### Example Homework Assignments

Here is more detail about the homework assignments I give Julie as part of MBSR therapy:

1. Daily Meditation: She will practice 2-3 5-10 minute guided meditations daily, focusing on her breath or a body scan. She can do these whenever the thoughts are strongest, and no one around her needs to know she is doing it.
2. [Mindful Eating](https://www.health.harvard.edu/staying-healthy/8-steps-to-mindful-eating): Because Julie wants to enjoy mealtime with her friends or even when eating alone, she blocks out her thoughts, paying full attention to the taste, texture, and smell of the food and noticing the sensations of eating without distractions.
3. Reflection Journal: To enhance our work together and build her own insights, Julie will keep a journal to reflect on your mindfulness practice, noting any changes in her stress levels, awareness, and reactions to daily events.

#### Results of MBSR Therapy

As a result of MBSR therapy, Julie feels a reduction in stress and anxiety, improved emotional regulation, enhanced focus and concentration, and an increased sense of hope and excitement about her future. By integrating mindfulness practices into daily life, mindfulness-based stress reduction therapy helped her cultivate a more mindful approach to her experiences, leading to greater resilience, a better quality of life, and reduced interference of doubt and worry.

I offer these methods to many clients, such as those seeking [therapy for adult ADHD](https://dralanjacobson.com/adhd-therapy-for-adults/), including those looking for [natural treatment for adult ADHD](https://dralanjacobson.com/natural-adhd-treatment-for-adults/), or [women with ADHD](https://dralanjacobson.com/women-with-adhd/) looking for specialized treatment. I also have a subspecialty in [treating ADHD in girls](https://dralanjacobson.com/therapy-for-girls-with-adhd/), and I use these methods for many types of anxiety, mild depression, and general malaise. It can be helpful in as an adjunct when processing deep-seated feelings like we do in [emotionally focused individual therapy](https://dralanjacobson.com/emotionally-focused-individual-therapy/) or cognitive techniques used in [MBCT](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/). I would be happy to talk to you about how MBSR might benefit you, [mindfulness counseling](https://dralanjacobson.com/reality-therapy-and-mindfulness-counseling/) in general, or answer any questions you have about **mindfulness-based stress reduction**, so please feel free to [schedule a consultation](https://www.picktime.com/scheduleaconsult) or [contact me](https://dralanjacobson.com/contact/).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.instagram.com/appliedpsychological) [ ![social network 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](https://www.linkedin.com/company/psychologicalscience/)

**Categories:** Therapy Approaches

---

### [Therapy for Single Moms and Dads](https://dralanjacobson.com/therapy-for-single-moms-and-dads/)

**Published:** January 13, 2025
**Author:** Dr. Alan Jacobson

**Content:**

I provide **therapy for single moms and dads** aimed at helping parents feel stronger, more supported, and more confident. My [integrative approach](https://dralanjacobson.com/integrative-therapy/) is positive and solution-focused. Our work together will help you see the benefits of single parenting and how to overcome its barriers and challenges. Therapy provides a deep dive into maximizing your strengths, taking care of yourself, and feeling fully content with your parenting style and abilities. A slightly lower level of care is *counseling* for single moms and dads, which focuses more on support and advice but does not provide as much psychological intervention. At the end of the post, I describe a fictitious single parent therapy case involving a single mom with depression.

If you have any questions about therapy or counseling for single moms and dads or how it could benefit your family, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Benefits of Single Parenting

While it can come with unique challenges, there are also important benefits of single parenting that are often overlooked for both the parent and the child. Here are some of the benefits of single parenting.

### Benefits of Single Parenting for You Both

#### Strong Bond Between Parent and Child

- You often spend more one-on-one time with their children, fostering a deep, close relationship.
- This bond can lead to better communication and a stronger emotional connection, two of the key benefits of single parenting.

#### Freedom in Parenting Style

- You have full control over decisions, including discipline, education, and household routines, without needing to compromise with another adult.

#### Flexible Household Dynamics

- You can adapt more easily to change, such as relocations or shifts in routines, without needing to accommodate another adult’s preferences.

#### Customized Family Environment

- You can create a home environment that aligns with your own values and priorities, such as promoting a particular culture or lifestyle.

#### Enhanced Emotional Intelligence

- Both parents and children often develop strong [emotional intelligence](https://psychologicalassessments.com/emotional-intelligence-testing/) due to open communication and shared challenges.

---

### Benefits of Single Parenting For Children

#### Greater Sense of Independence for the Child

- Children in single-parent households often learn responsibility and self-reliance early on.
- They often develop strong problem-solving skills and adaptability.

#### Positive Role Modeling

- Children witness their parent’s hard work and dedication, which can instill values like determination, independence, and perseverance. Many parents of grown children report that this turned out to be one of the key benefits of single parenting.

---

### Benefits of Single Parenting for You

#### Opportunity for Personal Growth

- The benefits of single parenting include helping you develop resilience, resourcefulness, and confidence as you tackle challenges and responsibilities independently.

#### Financial and Career Autonomy

- You have control over your financial decisions and career choices, enabling you to focus on personal goals and your family’s priorities.

#### Stronger Sense of Community

- You may build a particularly strong support network, connecting with friends, family, and community resources for assistance and companionship.

While it can require significant effort, the benefits of single parenting include opportunities for growth, connection, and resilience for both parent and child.

---

## Single Parent Therapy

Being a single parent can often feel like juggling multiple roles at once, with hardly any time left for yourself. The challenges and the need for support and self-care are real. Single parent therapy can be a lifeline, offering single moms and dads the tools and guidance necessary to navigate the demanding waters of parenthood. The benefits of single parent therapy are manifold, empowering you to survive and thrive.

### Single Parent Therapy Key Takeaways

- Therapy for single moms and dads can provide a supportive environment for single moms to express feelings without judgment.
- Understanding and addressing mental health is crucial for effective parenting.
- Various therapy options, including online and [group therapy](https://dralanjacobson.com/group-therapy/), cater to your diverse needs.
- Self-care is essential for maintaining physical and emotional health, and therapy can offer strategies to incorporate it into daily life.
- Attending therapy for single moms and dads can reduce feelings of isolation and foster personal growth and resilience.

### Importance of Mental Health

Your mental health plays a pivotal role in your ability to parent effectively. It impacts how you handle stress, make decisions, and connect with your children. Mental health care isn’t just a luxury; it’s a necessity that allows you to function at your best.

Having good mental health gives you the resilience to face daily challenges head-on. Resilience isn’t just about bouncing back from adversity; it’s about adapting to stress and overcoming obstacles. When you take care of your emotional needs, you’re better equipped to handle the ups and downs of parenting. Your mental health stability creates a nurturing environment where your children feel safe and loved.

Awareness of your mental health needs empowers you to seek appropriate support. When you acknowledge that you might need help, you take the first step toward improvement. [Mental health issues are common](https://www.verywellhealth.com/mental-illness-5113353), but addressing them can significantly enhance your quality of life. Access to single parent therapy services can provide the tools and strategies you need to manage stress and improve your overall well-being.

### Benefits of Therapy for Single Moms and Dads

Individual therapy for single moms and dads offers a sanctuary where you can express your feelings without fear of judgment. It’s a space to be honest and share your struggles and triumphs. This openness fosters a sense of relief and can be incredibly healing.

With professional guidance, you’ll develop coping strategies for stress and anxiety. Things can get overwhelming, but single parent therapy equips you with practical tools to manage stress more effectively. You’ll learn to prioritize your needs and make decisions that align with your goals.

Therapy for single moms and dads also enhances parental decision-making skills. It provides a clearer perspective on your challenges, helping you make informed choices that benefit both you and your children. Regular sessions promote personal growth and self-awareness, enabling you to understand your triggers and behavior patterns.

Moreover, single parent therapy reduces feelings of isolation and loneliness. By connecting with me or a support group, you realize that you’re not alone in your struggles. This sense of community and support can be incredibly empowering, giving you the strength to face challenges head-on.

### Types of Therapy for Single Moms and Dads

There’s a wide variety of single parent therapy options designed to meet your unique needs. Support groups offer a wonderful opportunity to connect with other single moms who understand your challenges. These groups provide a sense of belonging and shared experience, which can be incredibly reassuring.

[Online therapy](https://dralanjacobson.com/virtual-therapy-guide/), which I and many others provide, is another flexible option that fits seamlessly into your busy life. The convenience of online single parent therapy means you can schedule sessions at times that work best for you, ensuring that your mental health remains a priority.

Individual single parent therapy sessions focus on your unique personal needs. I tailor the approach to suit your concerns, helping you work through personal challenges and set achievable goals. On the other hand, [family therapy](https://dralanjacobson.com/family-therapy/) can improve communication with your children, fostering healthier relationships.

[Cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) for single moms and dads is a powerful tool for managing negative thoughts and behaviors. It provides practical strategies for changing unhelpful patterns and developing a more positive outlook.

### Individual Therapy for Single Moms and Dads

[Individual therapy](https://dralanjacobson.com/individual-therapy/) is a personalized experience focusing on your concerns and goals. You’ll build a trusting and supportive relationship, creating a safe space to explore your thoughts and emotions.

These one-on-one sessions offer [privacy and confidentiality](https://keydifferences.com/difference-between-privacy-and-confidentiality.html), allowing you to speak freely without fear of judgment. This level of intimacy and trust is the cornerstone of effective therapy. We’ll work together to identify challenges and set personal goals, whether they’re related to parenting, career, or personal growth.

Regular appointments create a consistent support system. Knowing you have a scheduled time to focus on yourself can be incredibly reassuring. These sessions become a sanctuary where you can reflect, recharge, and plan for the future.

Therapy for single moms is not just about addressing mental health issues; it’s about empowering you to take control of your life. It’s about giving you the tools and confidence to make decisions that align with your values and aspirations.

### Therapy for Single Moms and Dads FAQs

**How to help a struggling single mom?**

If you know a mom who is struggling, you can offer support in several ways. You can help by offering to babysit her kids, providing a listening ear, helping with household chores, or simply being there for her when she needs someone to talk to. Small gestures of kindness can make a big difference. You can also notice the benefits of single parenting when you see them and let your friend or family member know.

**How to best cope with being a single mom?**

Coping involves prioritizing self-care, setting boundaries, seeking support from friends and family, and practicing stress-relief techniques such as meditation or exercise. It’s important to remember that it’s okay to ask for help when needed and to take time for yourself to recharge and rejuvenate. Counseling for single moms and dads can play an important role, and single parent therapy can help if the problems run deeper.

**What are some practical ideas for coping?**

Acknowledging their feelings, seeking therapy or counseling, joining support groups, [practicing mindfulness](https://dralanjacobson.com/mindfulness-therapy/), and engaging in activities that bring you joy are essential.

## Case Example: Single Mom with Depression

Maria, a 35-year-old mother of two children (ages 8 and 5), works full-time as a nurse. Since her divorce two years ago, she has struggled with feelings of sadness, fatigue, and hopelessness. Maria often feels overwhelmed by her responsibilities and feels guilty for not spending enough quality time with her children. She reports difficulty sleeping, low energy, and a lack of interest in activities she once enjoyed. As a single mom with depression, Maria hopes therapy will improve her ability to parent effectively and enjoy life.

---

### Therapy for Single Moms with Depression: Process

#### 1. Initial Assessment

- Tools Used: 
    - Depression scales, such as the PHQ-9 (Patient Health Questionnaire).
    - Intake interview to understand Maria’s history, triggers, and symptoms.
- Findings: 
    - Moderate-to-severe depression.
    - Key stressors include financial strain, lack of co-parenting support, and feelings of isolation.

#### 2. Therapeutic Goals for a Single Mom with Depression

- Reduce symptoms of depression.
- Enhance Maria’s coping skills and emotional resilience.
- Improve her ability to manage parenting and work demands.
- Strengthen her support network.

#### 3. Therapeutic Interventions for a Single Mom with Depression

**A. [Cognitive-Behavioral Therapy for Depression](https://dralanjacobson.com/cbt-for-depression/) (CBT):**

- Focus: Challenge and reframe negative thought patterns.
- Example Activity: 
    - Identify Maria’s automatic negative thoughts, such as “I’m failing as a mother” or “I’ll never feel better.”
    - Replace them with realistic, balanced thoughts, like “I’m doing the best I can, and that’s enough for now.”
- Homework: Journaling positive moments each day, even small achievements.

**B. [Mindfulness-Based Stress Reduction](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) (MBSR):**

- Focus: Help Maria manage stress through mindfulness practices.
- Example Activity: 
    - Guided breathing exercises or body scans to reduce feelings of overwhelm.
    - A 10-minute daily mindfulness practice, such as focusing on the present moment with her children.

**C. Emotion-Focused Therapy (EFT):**

- Focus: Process and validate Maria’s emotions related to her divorce and single parenting.
- Example Activity: Exploring her feelings of guilt and sadness in a safe space, helping her accept and manage these emotions.

**D. [Solution-Focused Brief Therapy](https://dralanjacobson.com/solution-focused-therapy/) (SFBT):**

- Focus: Build on Maria’s strengths and set achievable goals.
- Example Activity: 
    - Identify small, manageable steps to improve her routine, such as creating a consistent bedtime for her children to reduce evening stress.

**E. Building Social Support:**

- Encourage Maria to reconnect with friends, join a parenting support group, or seek community resources.
- Role-play conversations to help Maria ask for help from trusted individuals.

#### 4. Progress Monitoring

- Regular check-ins using tools like the PHQ-9 to track changes in depressive symptoms.
- Maria reflects on her emotional well-being and her ability to cope with stressors.

#### 5. Parenting Support

- Address feelings of inadequacy as a parent by discussing realistic expectations and celebrating small wins.
- Share time-management strategies to balance work, parenting, and self-care.

---

### Outcome:

Over 12 weeks of single parent therapy, Maria reports:

- A decrease in depressive symptoms.
- Improved ability to handle stressful situations using mindfulness and CBT techniques.
- Greater confidence in her parenting abilities.
- A stronger sense of connection with her children and support network.

---

This case highlights how therapy for a single mom with depression can empower single parents like Maria to manage depression, strengthen relationships, and build resilience.

## Counseling for Single Moms and Dads

If you want to focus on support and get parenting advice but feel you are generally doing well with parenting, counseling for single moms and dads may be a good choice. It can always be moved up to the level of therapy if needed. The services available through counseling for single moms and dads might include the items in the next section and more.

### Counseling for Single Moms and Dads Services

1. **Balancing all of your responsibilities** is an art that requires practice and patience. Time management and organizational skills are crucial, and counseling for single moms and dads gives you a toolbox of [healthy work-life balance](https://dralanjacobson.com/therapy-for-work-life-balance/) strategies.
2. **Enhancing the benefits of single parenting**, as listed above, is an important goal of counseling for single moms and dads.
3. **Setting boundaries is essential**. It’s okay to say no and carve out time for your rejuvenation. Self-care isn’t selfish; it’s necessary to maintain physical and emotional health. Whether it’s a daily walk, a quiet cup of coffee, or a few minutes of meditation, these practices can significantly improve your well-being. In counseling for single moms and dads, we’ll review a new routine and how to implement it.
4. **Mindfulness techniques** can enhance your ability to stay present with your children. By being mindful, you can engage more fully in the moment, creating meaningful connections with your kids. This presence is beneficial for your relationship with them and a form of self-care for you. I teach mindfulness strategies in counseling for single moms and dads.
5. **Incorporating self-care** into your routine also models healthy habits for your kids. When they see you taking care of yourself, they learn the importance of self-love and personal well-being. This is perhaps one of the most valuable lessons you can impart as a parent, and counseling for single moms and dads will help with that communication.
6. A vital part of counseling for single moms and dads is **providing a supportive environment** for you to express feelings, develop coping strategies, and enhance personal growth.

## Summary and My Work

I provide therapy and counseling for single moms and dads, designing a treatment plan that uniquely fits your family. This plan is designed to bring out your strengths and help you overcome challenges and barriers. Single parent therapy can uniquely meet your needs and give you a toolbox of strategies that help you day to day. I also offer [co-parenting therapy](https://dralanjacobson.com/co-parenting-therapy/) and [divorce counseling](https://dralanjacobson.com/divorce-counseling/) for those in the process of splitting up when children are involved.

### Reach Out for Therapy for Single Moms and Dads

I hope this post provided the overview you need, and perhaps gave you some ideas for self-care. If you have any questions about how therapy for single moms and dads could benefit you and your family, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Specialties

---

### [Existential Therapy](https://dralanjacobson.com/existential-therapy/)

**Published:** December 18, 2023
**Author:** Dr. Alan Jacobson

**Content:**

**Existential therapy** uses a philosophical approach that explores the fundamental issues of human existence, such as freedom, responsibility, choice, meaning, and the inevitability of death. In my integrative practice, I often weave existential treatment techniques (and closely related [logotherapy techniques](https://dralanjacobson.com/logotherapy/)) into other methods, though they can also be used as standalone. Existential crisis treatment is particularly suited as [online therapy](https://dralanjacobson.com/virtual-therapy-guide/) and can be used with [couples treatment](https://dralanjacobson.com/couples-therapy/) and [family therapy with older children](https://dralanjacobson.com/family-therapy/) (usually when the children are grown). The following provides an overview of existential psychotherapy, but you can also [contact me](https://dralanjacobson.com/contact/) anytime or [schedule a consultation](https://www.picktime.com/scheduleaconsult) to discuss your unique situation.

### How Existential Therapy Came to Be

Existential treatment techniques emerged from the works of philosophers like [Søren Kierkegaard](https://en.wikipedia.org/wiki/S%C3%B8ren_Kierkegaard), [Friedrich Nietzsche](https://en.wikipedia.org/wiki/Friedrich_Nietzsche), [Martin Heidegger](https://en.wikipedia.org/wiki/Martin_Heidegger), and [Jean-Paul Sartre](https://en.wikipedia.org/wiki/Jean-Paul_Sartre). However, the formalization of existential psychotherapy owes much to the work of several influential psychologists and psychiatrists who integrated philosophy with therapeutic practice:

1. Viktor Frankl: While Frankl is more associated with logotherapy, his work heavily influenced existential therapy. His experiences in the concentration camps during World War II led him to [develop logotherapy](https://dralanjacobson.com/logotherapy/), which emphasizes the search for meaning as a primary motivational force in human beings.
2. [Rollo May](https://exploringyourmind.com/rollo-may-the-father-of-existential-psychology/): An American psychologist who played a significant role in introducing existential therapy to the United States. May integrated the philosophy of meaning with psychology, emphasizing the importance of choice, responsibility, and the search for meaning in therapy.
3. [Irvin Yalom](https://www.yalom.com/biography): Yalom’s contributions popularized existential therapy in contemporary psychology. His [Existential Psychotherapy Book](https://en.wikipedia.org/wiki/Existential_Psychotherapy_(book)) outlined the key concepts of existential psychotherapy and demonstrated their practical application in therapeutic settings.

These pioneers integrated philosophy and psychology, focusing on the subjective human experience, freedom, responsibility, and the search for meaning. They highlighted the importance of addressing deep concerns and the impact of issues of meaningfulness on an individual’s mental health and well-being. Existential therapy techniques continue to evolve, drawing from various modern philosophical and psychological perspectives while emphasizing exploring the deeper dimensions of human existence and the quest for meaning in life.

## Existential Therapy Overview

The primary goal of existential psychotherapy is to help individuals understand themselves more deeply by confronting and exploring their existence and the challenges inherent in being human. Therapists employing this approach often assist clients in examining their beliefs, values, and choices, emphasizing personal responsibility and the consequences of one’s actions.

### Key Concepts in Existential Therapy

1. Freedom and Responsibility: Individuals are seen as having the freedom to make choices and are responsible for the consequences of those choices.
2. Anxiety: The anxiety that arises when confronted with the uncertainties and complexities of life, including the search for meaning and purpose.
3. Search for Meaning: Exploring and finding meaning in one’s life, despite the inherent lack of inherent meaning in the universe.
4. Death and Mortality: Acknowledging the reality of death and how it influences our choices and perspectives on life.
5. Authenticity: Encouraging individuals to live authentically, being true to oneself and one’s values.

This approach doesn’t follow a strict set of techniques but rather focuses on the therapeutic relationship and engages in open-ended conversations, reflections, and explorations to help individuals come to terms with their existence and find ways to live more authentically and meaningfully.

### Results of Existential Psychotherapy

The results of existential psychotherapy can vary for each person, but I’ve seen the following outcomes:

1. Increased Self-Awareness: In existential psychotherapy, clients often gain a deeper understanding of themselves, their values, and their beliefs. They become more aware of their choices, responsibilities, and the impact of their actions on their lives.
2. Finding Meaning and Purpose: Through the exploration and reflection of existential psychotherapy, people often discover or redefine what gives their life meaning. They might find new purposes or reframe existing ones, leading to a more fulfilling.
3. Acceptance of Responsibility: Existential psychotherapy encourages people to take responsibility for their choices and actions. Clients often develop a greater sense of accountability for their lives and direction.
4. Exploration of Freedom: Clients explore their freedom to make choices and the consequences of those choices. They may learn to embrace their freedom rather than feel overwhelmed by it.
5. Coping with Existential Concerns: Existential therapy helps clients grapple with larger concerns such as mortality, isolation, meaninglessness, and freedom. It doesn’t necessarily provide solutions but helps individuals develop ways of coping with these concerns.
6. Increased Resilience: Clients often become more resilient in facing life’s challenges. They may develop a greater capacity to tolerate ambiguity and uncertainty inherent in the human condition.

## Existential Psychotherapy In My Work

I have used existential psychotherapy both as a standalone and as part of therapy that includes [other therapeutic approaches](https://dralanjacobson.com/integrative-therapy/). I’ve seen it benefit individuals experiencing a life transition, feeling anxious or depressed but unsure why, seeking to understand themselves better, or grappling with questions of purpose and meaning in life. The unique perspective on human experiences and the psychological challenges we experience can be eye-opening and powerful. Some of the ways I’ve used it include:

### Exploration of Meaning and Purpose

Existential treatment techniques help people explore meaninglessness, purposelessness, or feelings of emptiness in life. It assists in finding or creating personal meaning and purpose. This can be particularly helpful when people face a crisis of meaning—a period of intense questioning or uncertainty about life—because it helps them navigate the crisis and move forward. In these situations, it aids in understanding one’s identity, values, and beliefs.

### Existential Therapy Techniques in Crisis Situations

Existential therapy techniques can be beneficial during moments of crisis, such as the loss of a loved one, major life changes, or when confronted with mortality. It assists individuals in making sense of these experiences and finding ways to cope.

### Existential Crisis Therapy and Anxiety and Depression

Existential therapy techniques can be used to address anxiety, particularly [generalized anxiety](https://dralanjacobson.com/therapy-for-generalized-anxiety-disorder/) that does not seem to have a cause, [grief reactions](https://dralanjacobson.com/grief-therapy/), and depression by exploring their roots, such as the fear of death, freedom, or isolation, and helping people find ways to navigate these emotions. I’ve used this approach frequently when people feel a general sense of unease, of never being emotionally fulfilled or truly happy.

When these feelings have their roots in longstanding relationship issues, existential therapy can help understand relationship dynamics, personal responsibility within relationships, and the impact of these concerns on interactions with others.

### Enhancing Personal Growth

Aside from addressing specific problems or challenges, this approach can foster personal growth by encouraging individuals to live more authentically, take responsibility for their choices, and embrace life’s uncertainties. It can assist individuals in making important life decisions by exploring the values, beliefs, and motivations that underlie those decisions. For those seeking to explore their lives’ spiritual or existential dimensions, this therapy can provide a framework for deeper self-exploration.

Existential treatment techniques are flexible and can be integrated with other therapeutic approaches, allowing me to tailor their methods to each individual’s unique needs and situations. It’s particularly beneficial for those drawn to philosophical inquiries, introspection, and exploring the deeper aspects of human existence.

## Existential Crisis Treatment Example

A crisis of meaning is a period of deep questioning about one’s purpose, values, and existence. Existential crisis treatment often involves a multifaceted approach, combining psychological, philosophical, and sometimes spiritual strategies. Here’s a fictitious example of existential crisis treatment in my practice:

John, a 35-year-old man, is experiencing a crisis of meaning after a major career change. He reports feelings of purposelessness, anxiety about the future, and questioning the meaning of his work and life. He has trouble sleeping and often feels overwhelmed by thoughts about mortality and the direction of his life. In the intake, John and I decided that existential crisis treatment would be our core approach.

### Existential Crisis Treatment Plan

1\. John begins weekly sessions focusing on his fears and uncertainties. We discuss themes from the philosophy of meaning to frame his concerns in a broader context. I use logotherapy techniques to help John explore and identify sources of meaning in his life. We’ll also use [cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT) to help identify and change negative thought patterns, focusing on creating a more positive outlook on life. Finally, we’ll directly address the issues of meaning, freedom, isolation, and mortality. This therapy helps individuals find personal meaning and accept the inherent challenges of existence.

2\. John starts a daily [mindfulness meditation](https://www.mindful.org/mindfulness-how-to-do-it/) routine to help manage anxiety and stay present. He is encouraged to journal his thoughts and feelings daily. He also takes a painting class to express himself creatively. He’ll incorporate regular exercise, such as jogging and yoga, into his routine to improve his physical and mental well-being.

5\. John explores different spiritual practices, attending a few meditation retreats and exploring philosophical literature. He also joins a local book club focused on existential literature to connect with others experiencing similar questions.

### Existential Crisis Treatment Outcome

Over several months of holistic existential crisis treatment, John reports a significant reduction in anxiety and a greater sense of peace and purpose. He finds new meaning in his career by mentoring younger colleagues and engaging in community service. John feels more connected to himself and others, having developed a deeper understanding of his values and purpose.

This holistic existential crisis treatment approach addresses various aspects of John’s life, helping him navigate his crisis and find a renewed sense of meaning and direction.

## Existential Treatment Example: Empty Nest

Here is an example of how **existential treatment** might be applied to a **woman experiencing “empty nest syndrome”**—a stage in life when children leave home and a parent (often a mother) may feel a loss of purpose or identity.

### Client Profile (fictional):

**Name:** Karen, 52 years old
**Background:** She recently became an empty nester after her youngest child left for college. She is married but feels disconnected from her spouse. Formerly a full-time stay-at-home mom, she is now struggling with feelings of meaninglessness and loneliness.

### Existential Treatment

#### Initial Concerns:

Karen expresses sadness, boredom, and a vague sense of purposelessness. She says things like:

- “I don’t know who I am anymore.”
- “I gave my whole life to my children. Now what?”
- “There’s nothing to look forward to.”

#### Existential Treatment Goals:

- Help Karen explore her sense of **identity beyond the mother role**.
- Confront existential themes like **freedom, isolation, meaning, and mortality**.
- Empower Karen to make **authentic choices** and take responsibility for shaping her life.

#### Key Moments in Existential Treatment:

1. **Exploring Meaning and Identity**

I ask:

“What gave your life meaning when your children were home? What aspects of that still matter to you now?”

Karen realizes she loved nurturing, teaching, and creating a warm home. These values still matter—just need a new expression.

2. **Addressing Freedom and Responsibility**

Me:

“It can feel overwhelming to have so much freedom suddenly. But it also means you can choose what comes next. What small step could you take toward something that feels fulfilling?”

Karen begins volunteering at a local library where she reads to children, which reconnects her with a sense of purpose.

3. **Normalizing Isolation and Embracing Connection**

Me:

“It’s normal to feel alone during major life transitions. But this space can also be a chance to re-learn how to connect—with yourself, your partner, or your community.”

Karen opens up about her distant marriage. She and her husband eventually started attending couples therapy.

4. **Confronting Mortality and Finite Time**

Me:

“You’ve entered a new phase of life. It’s a reminder that time is limited. How do you want to spend the time you have?”

Karen reflects on dreams she’d put aside—like traveling and painting. She signs up for a local art class.

### Existential Treatment Outcome:

Over time, Existential Treatment helps Karen reclaim her autonomy and embrace midlife’s uncertainty. She doesn’t have all the answers—but she’s more comfortable with the **freedom to choose** and **create meaning** in this new chapter.

## Existential Counseling vs. Therapy

**Existential counseling** and **therapy** are closely related, but they have subtle differences in emphasis and context. Here’s a breakdown:

### Existential Counseling vs. Therapy

**Existential Counseling****Existential Therapy****Focus**Practical guidance for navigating life’s meaning, choices, and transitions.Deeper exploration of existential concerns (e.g., death, freedom, isolation, meaninglessness).**Depth**Often less intensive; suitable for people facing life decisions or crises, but not necessarily mental illness.Can be more intensive; may be used with clinical issues like depression, anxiety, or trauma.**Setting**Often found in coaching, life transitions, pastoral or educational settings.Usually practiced in clinical or psychotherapeutic settings.**Style**Conversational, reflective, and often time-limited.May be long-term, with a deeper dive into a person’s psyche and existential anxiety.**Client Goals**Clarify values, find direction, accept uncertainty.Explore suffering, confront mortality, find authentic existence.**Practitioner**May be a counselor, coach, or trained facilitator.Usually a licensed therapist or [clinical psychologist](https://dralanjacobson.com/what-is-a-clinical-psychologist/) with training in existential approaches.### Overlap Between Existential Therapy and Counseling

Both approaches aim to help clients:

- Take responsibility for their choices
- Embrace freedom and uncertainty
- Find or create meaning in life
- Live more authentically

### From Our Example:

If someone like **Karen (from the empty nest example)** is feeling lost and unsure of her next step but isn’t clinically depressed, **existential counseling** might guide her through that transition.

But if she’s experiencing deep despair, hopelessness, or a loss of will to live, **existential therapy** would offer a space to work through those deeper emotional and philosophical struggles.

## Summary and Next Steps

I would [be happy to discuss](https://dralanjacobson.zohobookings.com/#/customer/services) how existential therapy could help you, whether as a primary approach or mixed with [other clinical methods](https://dralanjacobson.com/types-of-therapy/). I work with individuals, couples, and families with grown kids using existential therapy. This approach can be used as a [online therapy](https://dralanjacobson.com/virtual-therapy-guide/) or in person. I often braid existential therapy techniques with other approaches, particularly [psychodynamic therapy](https://dralanjacobson.com/psychodynamic-therapy/) and [narrative therapy](https://dralanjacobson.com/narrative-therapy/). This approach fits well with some [intensive therapy services](https://dralanjacobson.com/intensive-therapy-and-specialty-services/), too.

Please feel free to [contact me](https://dralanjacobson.com/contact/) to discuss **existential therapy** or inquire about [my services](https://dralanjacobson.com/types-of-therapy/).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Therapy Approaches

---

### [ACT: Acceptance and Commitment Therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/)

**Published:** December 9, 2023
**Author:** Dr. Alan Jacobson

**Content:**

I use **Acceptance and Commitment Therapy**, also known as **Acceptance Therapy**, to help clients develop psychological flexibility—the ability to be present, open up to unpleasant feelings, and take actions aligned with their values. **ACT therapy** is often an approach that is combined with other [Humanistic approaches](https://dralanjacobson.com/humanistic-psychology/) and is considered a core “[third wave therapy.](https://dralanjacobson.com/third-wave-psychotherapy/)” This approach is quite flexible and easy to deliver virtually and in person, and most people find that it leaves them with a helpful toolkit of acceptance and commitment exercises to use when stresses recur or barriers pop up. Thus, this approach can be relatively short-term and solution-focused.

Acceptance and Commitment Therapy can work well with couples and families, and I also use it in some specialty work, including [Fear of Flying](https://dralanjacobson.com/fear-of-flying-therapy/) and [Public Speaking Anxiety](https://dralanjacobson.com/public-speaking-anxiety/). This approach can be delivered [virtually](https://dralanjacobson.com/virtual-therapy-guide/) and in person.

**What is Acceptance and Commitment Therapy?**

Here’s a breakdown of this method’s key components:

1. Acceptance: Acknowledging and accepting one’s thoughts and feelings rather than trying to suppress or eliminate them. This doesn’t mean liking or agreeing with those thoughts and feelings but rather allowing them to exist without struggling against them.
2. Cognitive Defusion: Learning to see thoughts as what they are—just thoughts—rather than as facts or instructions. It involves distancing oneself from unhelpful thoughts by recognizing that they are mental events, not necessarily accurate representations of reality.
3. Being Present: [mindfulness practice](https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/mindfulness-exercises/art-20046356) and being fully aware and engaged in the present moment without judgment. This helps individuals observe their thoughts and feelings without getting entangled.
4. Values Clarification: Identifying what matters most in life, clarifying personal values, and setting goals aligned with those values. This step helps individuals understand what they truly want and stand for.
5. Committed Action: Taking purposeful actions that align with one’s values, even in the presence of discomfort or difficult thoughts and emotions. This involves setting specific, achievable goals and committing to behavioral changes.

Acceptance and Commitment Therapy encourages individuals to embrace their thoughts and feelings while moving toward a meaningful life. It can be a powerful and effective approach for many people, one with lasting benefits.

**Acceptance Therapy Exercises**

Here are some Acceptance and Commitment Therapy exercises I use:

**Mindfulness in Acceptance Therapy**

[Mindfulness techniques](https://dralanjacobson.com/mindfulness-therapy/) are central to ACT therapy. I’ll help you observe your thoughts, feelings, and sensations non-judgmentally, allowing you to create psychological distance from your challenges and barriers. We might do some cognitive defusion work described above during these exercises. One technique I often use is repeating a distressing thought until it loses its impact or mentally singing it in a funny voice. We’ll also practice mindful breathing, body scans, and mindful eating to increase [present-moment awareness](https://positivepsychology.com/present-moment/) and reduce reactivity to thoughts and emotions.

**Self-as-Context in ACT Therapy**

This involves helping you develop a sense of self separate from your thoughts and feelings. You learn to see yourself as the context in which your experiences occur rather than being defined by those experiences.

**Metaphors and Parables**

I often use metaphors and stories to illustrate key concepts, making them more accessible and memorable. You’ll also start to think of your own [personal metaphors](https://www.examples.com/metaphor/personal-metaphor.html) to use in your daily life. This can be a fun exercise for couples and families.

**Experiential Acceptance and Commitment Exercises**

Through Acceptance Therapy, you’ll develop a toolkit of activities designed to help you experience mindfulness, acceptance, and other principles directly outside of sessions. Examples might include visualization exercises, role-playing, or behavioral experiments. These are particularly useful in [couples approaches](https://dralanjacobson.com/couples-therapy/) and [family treatment](https://dralanjacobson.com/family-therapy/) using acceptance and commitment therapy.

**ACT Therapy and Values-Based Exposure**

You’ll engage in exposure exercises aimed at helping you confront feared situations or emotions in the service of your values. This can help reduce avoidance behaviors and increase psychological flexibility.

These techniques are typically flexible and tailored depending on each client’s needs and preferences. One goal of acceptance and commitment therapy is to emphasize developing a lasting toolkit that can be used outside sessions to enhance their effectiveness.

**ACT Therapy Uses**

This method is used to treat various mental health issues, including anxiety, depression, substance abuse, chronic pain, and more. While it’s not specifically tailored to address specific disorders, it can be effective as a complementary or standalone therapy for several conditions. I also wrote a post with more detail about how I use [ACT Psychotherapy](https://dralanjacobson.com/act-psychotherapy/) for specific diagnoses.

**Acceptance and Commitment Therapy and Anxiety**

ACT Therapy can help individuals with anxiety disorders by teaching mindfulness and acceptance techniques to cope with anxious thoughts and sensations, allowing them to engage in meaningful activities despite their anxiety. Incorporating these strategies helps individuals develop skills to manage anxiety more effectively, reducing the impact anxiety has on their lives and allowing them to pursue what is meaningful to them. It doesn’t seek to eliminate anxiety altogether but rather changes the relationship with anxiety, reducing its interference with living a fulfilling life.

**Acceptance Therapy and Depression**

This approach assists individuals in managing depressive symptoms by promoting acceptance of difficult emotions, clarifying values, and encouraging committed actions that align with personal values, even when feeling low. By [focusing on psychological](https://dralanjacobson.com/humanistic-psychology/) flexibility and helping individuals reconnect with what’s important in their lives, this method can effectively reduce the impact of depressive symptoms. It aims to change the relationship with depression, allowing individuals to live more fully and take steps toward a richer, more fulfilling life despite the presence of depressive thoughts and feelings.

ACT Therapy can be particularly useful for [Seasonal Affective Disorder](https://dralanjacobson.com/seasonal-affective-disorder-treatment/).

**Acceptance and Commitment Therapy and Chronic Pain**

For those experiencing chronic pain, acceptance and commitment therapy focuses on accepting pain sensations without allowing them to dominate one’s life, fostering [mindfulness](https://dralanjacobson.com/mindfulness-therapy/), and encouraging engagement in activities that bring fulfillment. Acceptance and Commitment Therapy helps individuals lead fuller lives despite chronic pain by fostering psychological flexibility and promoting engagement in valued activities. It teaches skills to manage the emotional impact of pain and encourages individuals to focus on what they can control, thereby improving their overall well-being and functioning.

**ACT Therapy and Eating Disorders**

In the case of eating disorders, this approach can help individuals manage distressing thoughts related to body image and food, emphasizing values-based actions and defusing harmful thoughts. Acceptance and Commitment Therapy doesn’t directly target symptom reduction but aims to change the individual’s relationship with their thoughts and feelings, fostering a more flexible and values-based approach to life. Eating disorder treatment can complement other therapeutic approaches, promoting long-term behavioral changes and improved psychological well-being.

Often, a [multidisciplinary approach](https://www.td.org/insights/multidisciplinary-teamwork-ensures-better-healthcare-outcomes), often involving medical, nutritional, and psychological interventions is typically necessary for comprehensive eating disorder treatment.

**Other Uses**

- **Obsessive-Compulsive Disorder (OCD)** – Acceptance therapy teaches cognitive defusion techniques to lessen the impact of intrusive thoughts.
- **Post-Traumatic Stress Disorder (PTSD)** – Supports processing trauma while fostering psychological flexibility.
- **Addiction & Substance Use Disorders** – Encourages value-driven behavior instead of reliance on substances for relief.
- **Stress Management** – Teaches mindfulness and acceptance to navigate life stressors effectively.
- **Relationship Issues** – Helps individuals engage in healthy communication and act according to their values.
- **Low Self-Esteem & Self-Doubt** – Encourages defusion from negative self-judgments and promotes self-compassion.
- **Workplace Burnout** – Supports resilience and balance through mindfulness and value-driven decision-making.
- [**Sleep Disorders and Insomnia**](https://dralanjacobson.com/cbt-i-for-sleep-difficulties/) – Reduces rumination and anxiety around sleep difficulties.
- **[High Functioning Autism](https://psychologicalassessments.com/testing-for-high-functioning-autism/) & ADHD** – Helps individuals accept neurodivergence while fostering flexibility in managing daily challenges.
- **Grief & Loss** – Encourages accepting emotions while continuing to engage in a meaningful life.
- **Health Anxiety & Medical Conditions** – Helps individuals cope with uncertainty and focus on quality of life.

**Acceptance and Commitment Therapy Results**

The results of Acceptance Therapy can vary from person to person, but many clients find it helpful in managing difficult thoughts and emotions, improving mental health, and enhancing overall well-being. This has included the following changes:

**Increased Psychological Flexibility**

This approach aims to enhance psychological flexibility, allowing people to be more open, mindful, and able to adapt to different situations. This leads to reduced avoidance and greater [emotional resilience](https://positivepsychology.com/emotional-resilience/). People feel more adept at managing stressors, letting go of psychological pain, and facing each day. “Homework” feels good and productive.

**ACT Therapy Exercises and Improved Coping Strategies**

Through acceptance and commitment therapy, people often learn effective coping [strategies to manage depression](https://dralanjacobson.com/therapy-for-depression/), stress, anxiety, and other mental health challenges. They develop skills to respond to difficult thoughts and feelings in a healthier way. By identifying personal values and committing actions toward stressors, people often experience a greater sense of purpose, satisfaction, and fulfillment in various areas of life.

**Reduced Symptoms Through Acceptance and Commitment Therapy**

Many people treated with Acceptance Therapy report [reductions in symptoms related to social anxiety](https://dralanjacobson.com/therapy-for-social-anxiety-disorder/), depression, PTSD, chronic pain, and other psychological difficulties. Behavioral changes align with personal values, and people start engaging in activities that are meaningful to them, even in the presence of discomfort or difficult emotions.

**Acceptance and Commitment Therapy and Improved Relationships**

As people become more aware of their thoughts and feelings and learn to respond to them differently, their relationships can benefit from increased empathy, understanding, and effective communication. This is why I often use a form of ACT Therapy with couples and families.

The effectiveness of Acceptance Therapy can depend on various factors, including your willingness to engage in the therapeutic process, the nature and severity of the issues being addressed, and the consistency of practice outside sessions. Overall, I have seen this approach help many individuals lead more fulfilling lives by fostering psychological flexibility and empowering them to follow their values.

**Case Example: ACT for Anxiety & Self-Doubt**

Sarah, a 22-year-old college student, struggles with social anxiety and low self-esteem. She avoids social situations, fearing judgment, and has difficulty asserting herself in class. She often experiences racing thoughts, self-criticism, and a desire to avoid discomfort by procrastinating on important tasks.

Sarah seeks ACT therapy after realizing her avoidance negatively impacts her academic performance and relationships. She wants to feel more confident and engaged but feels stuck in a cycle of fear and avoidance.

**Acceptance and Commitment Therapy Process**

1. **Creative Hopelessness & Acceptance**

- Sarah initially expresses frustration, saying she just wants to “get rid of” her anxiety.
- I gently explore how her avoidance strategies (e.g., skipping social events, overpreparing for class discussions, avoiding eye contact) have only reinforced her fears.
- Instead of fighting anxiety, she learns to acknowledge and accept its presence while still pursuing meaningful actions.

2. **Cognitive Defusion**

- Sarah identifies self-critical thoughts: *“I’m not interesting,”* *“Everyone will think I’m awkward.”*
- Instead of challenging them like in CBT, she practices **defusion techniques**, such as: 
    - Saying the thought in a silly voice.
    - Repeating it aloud until it loses its meaning.
    - Labeling it as: “I am having the thought that I’m not interesting.”
- She notices that thoughts are just mental events, not absolute truths.

3. **Mindfulness & Present-Moment Awareness**

- Sarah practices mindfulness exercises to observe her thoughts and emotions without judgment.
- She learns to focus on the present rather than ruminating about past social failures or future fears.
- Breathing exercises help her ground herself during anxious moments.

4. **Values Clarification**

- I guide Sarah in identifying her core values: 
    - **Connection** (She wants meaningful friendships.)
    - **Growth** (She values learning and taking on challenges.)
- By aligning her actions with these values, she begins to shift her focus from avoiding discomfort to pursuing a meaningful life.

5. **Committed Action**

- Sarah sets small, achievable goals, such as making eye contact with classmates and speaking up in class once a week.
- Instead of aiming for perfection, she learns to tolerate discomfort while staying committed to her values.
- She practices self-compassion, acknowledging that growth is a process.

**ACT Outcome**

Over time, Sarah becomes more comfortable with uncertainty and imperfection. She still experiences anxiety but no longer lets it dictate her actions. By engaging in meaningful experiences despite discomfort, she builds confidence and a more fulfilling life.

**Conclusions and My Work**

Acceptance Therapy is versatile and [focuses on enhancing psychological](https://dralanjacobson.com/humanistic-psychology/) flexibility, making it applicable to various mental health challenges. It aims to improve one’s relationship with thoughts and emotions rather than directly treating specific symptoms. Its principles can be adapted and integrated into treatment plans for different diagnoses, often proving beneficial in promoting overall well-being and resilience.

**Acceptance and Commitment Therapy in My Practice**

I use various exercises and metaphors to help individuals understand and apply these principles, making Acceptance and Commitment Therapy an experiential and practical method. It can be used as a stand-alone, but more commonly, I weave these principles into other aspects of my work in my [integrative practice](https://dralanjacobson.com/integrative-therapy/) where it pairs well with other approaches such as [reality therapy](https://dralanjacobson.com/reality-therapy-and-mindfulness-counseling/) and [forgiveness therapy](https://dralanjacobson.com/forgiveness-therapy-steps-and-integrations/).

**How I Use Acceptance Therapy**

This approach can be used with individuals, [couples therapy](https://dralanjacobson.com/couples-therapy/), and [families treatment](https://dralanjacobson.com/family-therapy/). It can be used in person or as a[ virtual approach](https://dralanjacobson.com/virtual-therapy-guide/). I use it in several [clinical specialties](https://dralanjacobson.com/intensive-therapy-and-specialty-services/), including [Fear of Flying](https://dralanjacobson.com/fear-of-flying-therapy/), Executive Coaching, and [Sports Psychology](https://dralanjacobson.com/sports-psychology/).

Please [contact me](https://dralanjacobson.com/contact/) anytime if you have questions about Acceptance and Commitment Therapy or want to discuss how I could use ACT Therapy to help you with your unique goals.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Therapy Approaches

---

### [Motivational Interviewing](https://dralanjacobson.com/motivational-interviewing/)

**Published:** February 7, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Motivational interviewing** is a therapy technique I use that aims to help clients find the motivation within themselves to make positive changes in their lives. The approach was developed by psychologists [William R. Miller](https://williamrmiller.net/) and [Stephen Rollnick](https://www.stephenrollnick.com/) in the 1980s and has since gained widespread recognition for its effectiveness. Motivational interviewing techniques fit my integrative therapy practice well, particularly because they share much in common with my [humanistic therapy](https://dralanjacobson.com/basic-tenets-of-humanistic-psychology/) methods. Motivational interviewing stages of change provide a powerful and effective framework for lifelong improvements. I commonly use this method in my specialties, including sports psychology and executive coaching, and I also often integrate a motivational interview into [individual therapy](https://dralanjacobson.com/individual-therapy/) and [couples therapy](https://dralanjacobson.com/couples-therapy/) approaches.

You can contact me anytime to discuss how motivational interviewing techniques might help you, but first, I wanted to provide this overview.

## What is Motivational Interviewing? ![Motivational Interviewing](https://dralanjacobson.com/wp-content/uploads/2024/02/achieve.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Most practitioners follow five main tenets of motivational interviewing. If you have read my blog or other parts of this website, you will see how closely motivational interviewing stages of change track the humanistic approach underlying my [integrated practice](https://dralanjacobson.com/integrative-therapy/).

### 1. Express Empathy

I work hard to understand the client’s perspective, showing empathy and acceptance. This creates a supportive environment where you feel understood, not judged, and respected. I want to understand your world from your perspective, and I respect how you see it nonjudgmentally. When I work with couples, this includes understanding the uniqueness of your relationship.

### 2. Develop Discrepancy In Motivational Interviewing

I help clients explore the discrepancies between their current behavior and goals or values. By highlighting this disconnect, each client is motivated to make changes to align their behavior with their aspirations. Again, it is not societal expectations we align with but your expectations of yourself. This process is not done in a negative or judgemental manner – it is not about the “problems” that are causing you not to live the life you envision, but rather the hurdles you can overcome to get there.

### 3. Motivational Interviewing Avoids Conflict

While some therapy methods confront defensiveness, in motivational interviewing, I avoid arguments and resistance by adopting a collaborative and non-confrontational approach. This involves listening actively, respecting the client’s autonomy, and avoiding the urge to persuade or coerce. You may find that you are in conflict with yourself, and this is okay with an MI approach, but you will not feel that you are in conflict with me. We’ll always be working together.

### 4. Rolling with Resistance

Rather than opposing resistance directly, a motivational interview acknowledges it and gently encourages you to explore it further. By avoiding power struggles and fostering a sense of autonomy, I hope to move the client towards change at their own pace. This also differs from other approaches that confront resistance or see it as a negative. I find that resistance is merely data, telling us that there is something you are pushing against, and that thing may be worth uncovering to see what it is causing.

### 5. Motivational Interviewing Supports Self-Efficacy

I help clients builds confidence in their ability to change by highlighting their past successes, strengths, and resources. This empowers the client to take responsibility for their actions and believes in their capacity to overcome obstacles. We may peer into the past not just to find what has gone wrong but also times when you felt you were living your life to its fullest and feeling most content.

## Motivational Interviewing Techniques

Motivational interviewing techniques I use include the following:

1. Open-ended questions: Instead of asking yes/no questions, I often ask open-ended questions, encouraging you to elaborate on your thoughts, feelings, and experiences. This allows for a deeper exploration of your motivations and goals.
2. Reflective listening: I [listen actively](https://www.verywellmind.com/what-is-active-listening-3024343) and reflect on what you say, using empathy and understanding. Reflective listening helps you feel heard and validated and encourages you to explore your motivations and concerns.
3. Affirmations: Affirmations recognize your strengths, efforts, and past successes. By affirming these positive qualities and achievements, I hope to boost your self-esteem and confidence in your ability to change.
4. Summarizing: Periodically summarizing what you’ve said in that session and previously can help you clarify your thoughts and feelings and reinforce key points. Summarizing also demonstrates that I am actively listening and understand your perspective.
5. Eliciting change talk: Change talk refers to your statements that indicate a willingness, ability, reasons, and need for change.

These motivational interviewing techniques are used flexibly and, in combination, tailored to your unique needs and circumstances. The overarching goal is to facilitate collaborative and non-confrontational conversations so you can explore your motivations for change and develop your solutions. These techniques are designed to elicit your reasons for change rather than imposing anyone else’s agenda.

## Motivational Interviewing Stages of Change

Motivational Interviewing stages of change, also known as the [Transtheoretical Model](https://en.wikipedia.org/wiki/Transtheoretical_model), outline the process people go through when they think about, start, and maintain new behaviors.

Here are the motivational interviewing stages of change and how they relate to the techniques I use in my practice

### Motivational Interviewing Stages of Change: Precontemplation

In this first of the motivational interviewing stages of change, clients start when they have not considered the change. They may be unaware of the problem or underestimating the need for change. The Motivational interviewing strategies I use are designed to raise awareness of the issue, provide information, and explore the client’s values and goals. I use reflective listening to highlight discrepancies between their current behavior and broader goals.

### Motivational Interviewing Stages of Change: Contemplation

Now, clients recognize the problem and start to think about the possibility of changing. They are ambivalent and may weigh the pros and cons of change. I work to explore ambivalence, discuss the pros and cons of change, and support the client in envisioning a positive future with change. I use [decisional balance exercises](https://myusf.usfca.edu/sites/default/files/users/hrietman/Decisional%20Balance%20HANDOUT.pdf) to help clarify their thoughts.

### Motivational Interviewing Stages of Change: Preparation

At this stage, clients intend to take action soon and may start making small changes. They are planning to change and gather resources. My job is to assist them in developing a clear and achievable action plan. I work with them to enhance their commitment to change by setting realistic goals and identifying supportive resources. All the while, I provide encouragement and support.

### Motivational Interviewing Stages of Change: Action

At this point in therapy, clients modify their behavior and make significant efforts to change actively. I continue to offer support and encouragement, reinforcing the importance of behavior change and helping them solve any challenges. I work to acknowledge successes and provide feedback.

### Motivational Interviewing Stages of Change: Maintenence

After a little more time, clients have sustained their positive changes and are working to prevent relapse. I support continued commitment and discuss ways to handle potential triggers. I also help clients integrate the new behavior into their identity and lifestyle.

During the Motivational Interviewing stages of change, my role is to support and guide the client through these stages by fostering an environment of empathy, collaboration, and empowerment. The ultimate goal is to help clients move through the motivational interviewing stages of change at their own pace, increasing their commitment to change.

## Motivational Interview (MI) Example: Adult Struggling with Exercise

**Scenario:** Lisa, a 42-year-old woman, has been advised by her doctor to incorporate regular exercise into her routine to help manage her high blood pressure and stress. However, she struggles with motivation and consistency. Here is a sample motivational interview I might use:

**Me:** “Lisa, thanks for coming in today. I understand your doctor has suggested adding more physical activity to your routine. How do you feel about that?”

**Lisa (L):** “Yeah, she mentioned it. I know exercise is good for me, but I just don’t have the energy or time for it.”

**Me:** “It sounds like you recognize the benefits, but fitting it into your schedule feels overwhelming.”

**L:** “Exactly. Between work and taking care of my kids, I barely have a moment for myself.”

**Me:** “That makes a lot of sense—you have a lot on your plate. What do you think would change for you if you found a way to be more active?”

**L:** “Well, I guess I’d have more energy, and maybe my stress levels wouldn’t be so high. My doctor also said it could help with my blood pressure, so I wouldn’t have to go on medication.”

**Me:** “So, you’re thinking that exercise could help you feel better and possibly prevent needing medication. Those sound like strong reasons. What do you think is the biggest barrier to getting started?”

**L:** “Time is a big one. By the time I get home from work and take care of the kids, I just want to sit on the couch and relax.”

**Me:** “That makes sense. You work hard all day, and relaxing is important too. If you could find a way to fit in even a small amount of movement without disrupting your routine too much, what might that look like?”

**L:** “I guess I could start with something simple, like a 10-minute walk after dinner. Maybe even doing some stretching while I watch TV.”

**Me:** “That sounds like a great, realistic start. What do you think would make it easier to stick with?”

**L:** “If I had someone to do it with, like a friend or even my kids. They have so much energy—I could take them to the park instead of just watching them play.”

**Me:** “That’s a great idea! Involving your kids could make it more enjoyable and help you stay motivated. On a scale of 1 to 10, how confident do you feel about starting with a 10-minute walk?”

**L:** “Maybe a 7? I think I could do it, but I worry about being too tired.”

**Me:** “A 7 is a strong start! What could help bring that up to an 8 or 9?”

**L:** “Maybe setting a reminder on my phone or putting my walking shoes by the door, so I don’t forget.”

**Me:** “That’s a great strategy. Would you like to check in next time to see how it’s going and adjust if needed?”

**L:** “Yeah, that sounds good. I’ll give it a try!”

### Key Motivational Interviewing Techniques Used:

- **Open-ended questions** (“How do you feel about that?”)
- **Reflective listening** (“You recognize the benefits, but fitting it in feels overwhelming.”)
- **Exploring ambivalence** (“What do you think would change for you if you found a way to be more active?”)
- **Eliciting change talk** (“What do you think is the biggest barrier?” “What might that look like?”)
- **Scaling confidence** (“On a scale of 1 to 10, how confident do you feel?”)
- **Problem-solving collaboratively** (“What would make it easier to stick with?”)

By guiding Lisa toward small, achievable steps, motivational interviewing techniques help her build motivation without feeling pressured.

## Motivational Interview (MI) Example: Teen Struggling in School

**Scenario:** Jordan, a 16-year-old high school junior, has high academic potential but struggles with motivation and poor grades. His teachers and parents are concerned, but he doesn’t see the point in trying harder. Here is a motivational interview I might use in this type of situation:

**Me:** “Jordan, thanks for meeting with me today. Your teachers and parents have noticed that your grades aren’t reflecting your potential. What are your thoughts on that?”

**Jordan (J):** *\[Shrugs\]* “I don’t know. School just feels pointless sometimes. It’s like, no matter what I do, there’s always more work.”

**Me:** “It sounds like school feels overwhelming, and you’re not sure if putting in more effort would even be worth it.”

**J:** “Yeah, exactly. I know I could do better, but what’s the point? College is expensive, and I don’t even know what I want to do after high school.”

**Me:** “So, part of you knows you have the ability, but it’s hard to feel motivated when you’re not sure where it’s leading.”

**J:** “Yeah. Plus, I get distracted easily. I’ll start homework, but then I check my phone, and suddenly an hour’s gone.”

**Me:** “That makes sense. It sounds like distractions make it harder to focus, and without a clear goal, finding the motivation to push through is tough. What do you think would be different if you did feel more motivated?”

**J:** “I guess I’d actually get my work done instead of procrastinating. Maybe my parents wouldn’t be so stressed about my grades.”

**Me:** “So, getting your work done could help reduce stress at home. What else do you think you’d gain?”

**J:** “I mean… I do want to have options after high school. I just don’t know what yet.”

**Me:** “That’s totally fair—figuring out the future is a big deal. What if we focused on keeping your options open for now? What’s one small change you think could help you stay on track?”

**J:** “Maybe setting a timer when I do homework, so I don’t get sucked into my phone. I could also try doing my work at the library instead of at home.”

**Me:** “That’s a great idea! Changing your environment and using a timer could make a big difference. On a scale of 1 to 10, how confident are you that you could try that this week?”

**J:** “Hmm… maybe a 6? I think I could do it, but I might still get distracted.”

**Me:** “A 6 is a solid start! What would help make that a 7 or 8?”

**J:** “Maybe asking a friend to study with me, so I stay on task.”

**Me:** “That’s a great strategy. Would you like to check in next time and see how it’s working?”

**J:** “Yeah, sure. I’ll give it a shot.”

### Key Motivational Interview Techniques Used:

- **Open-ended questions** (“What are your thoughts on that?”)
- **Reflective listening** (“It sounds like school feels overwhelming, and you’re not sure if it’s worth the effort.”)
- **Exploring ambivalence** (“If you *did* feel more motivated, what do you think would be different?”)
- **Eliciting change talk** (“What’s one small change you think could help?”)
- **Scaling confidence** (“How confident are you, on a scale of 1 to 10?”)
- **Collaborative problem-solving** (“What would help make that a 7 or 8?”)

By helping Jordan explore his reasons for improvement and focusing on *small, achievable* changes, we comfortably went through the motivational interviewing stages of change.

## Summary and My Work

I use motivational interviewing techniques in conjunction with other therapeutic approaches and found it quite effective in helping clients address a wide range of issues, from depression to weight management to anxieties. I use these techniques in my specialty areas, particularly [sports psychology](https://dralanjacobson.com/sports-psychology/) and executive coaching.

### What is Motivational Interviewing Used For?

Motivational interviewing is used for various purposes in my practice, including:

1. Behavior Change: Motivational interviewing techniques are often utilized to facilitate behavior change in areas such as substance abuse, unhealthy eating habits, physical inactivity, smoking cessation, and more. It helps clients explore their motivations for change and resolve any conflicting feelings they may have about it. Motivational interviewing brings out the healthy side of you, the part of you that truly wants to change.
2. Substance Abuse Treatment: Motivational interviewing techniques are particularly effective in the treatment of addiction. It helps individuals examine their reasons for substance use, consider the impact of their behavior on their lives, and increase their motivation to engage in treatment and recovery. I have used motivational interviewing with a wide variety of people who want to change their relationships with substances.
3. Health and Wellness: Motivational interviewing can encourage clients to adopt healthier lifestyle behaviors, such as exercising regularly, improving diet, managing chronic conditions, and adhering to medical treatment plans. It is a perfect adjunct to other therapies and programs designed to work on the physical aspects of these issues.
4. Mental Health: I commonly use motivational interviewing techniques in traditional [individual therapy](https://dralanjacobson.com/individual-therapy/) to enhance motivation for treatment and engagement in therapeutic activities.

### The Motivational Interview for Those Who Are Hesitant

Many individuals struggling with mental health issues may feel ambivalent or resistant to seeking treatment. Motivational interviewing techniques help us collaborate about your concerns, goals, and values, increasing motivation. Suppose you are reading this post or this website with a skeptical eye, have had a lack of success in therapy before, or are looking to refer someone hesitant. In that case, motivational interviewing techniques may increase openness and, eventually, excitement about the potential [effectiveness of treatment](https://dralanjacobson.com/how-long-does-therapy-take/).

Overall, motivational interviewing is a [client-centered, collaborative approach](https://dralanjacobson.com/client-centered-therapy/) that respects an individual’s autonomy and helps them find their own intrinsic motivation for change rather than imposing external pressure or directives. It’s a versatile method that can be adapted to various contexts and promote positive behavior change, which is why it has become a central part of my practice.

I would be happy to speak to you about an [integrated therapy approach](https://dralanjacobson.com/integrative-therapy/) that includes motivational interviewing techniques. [Contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Emotionally Focused Family Therapy (EFFT)](https://dralanjacobson.com/emotionally-focused-family-therapy/)

**Published:** January 1, 2025
**Author:** Dr. Alan Jacobson

**Content:**

**Emotionally Focused Family Therapy (EFFT)** is a powerful, proven, and [evidence-based therapeutic approach](https://positivepsychology.com/evidence-based-therapy/) designed to improve relationships by addressing members’ emotional bonds and attachment patterns. I often use emotionally focused therapy for families as a stand-alone approach. However, I sometimes mix in an emotion-focused family therapy technique or two in an [integrative psychological approach](https://dralanjacobson.com/integrative-therapy/) with other [family therapy](https://dralanjacobson.com/family-therapy/) methods, including [systems therapy](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/) or [solution-focused treatments](https://dralanjacobson.com/solution-focused-family-therapy-focusing-on-positive-change/). It can be used in [marriage counseling](https://dralanjacobson.com/marriage-counseling/) and [co-parenting counseling](https://dralanjacobson.com/co-parenting-therapy/) as well.

---

## Principles of EFFT

1. **Attachment Theory as a Foundation:**
    - EFFT focuses on how family members seek and respond to emotional support from one another.
    - Emotional security is viewed as essential for healthy functioning.
2. **Emotional Awareness and Regulation:**
    - Family members are guided to constructively identify, express, and manage their emotions.
    - I help uncover deeper emotions driving surface-level conflict.
3. **Restructuring Family Interactions:**
    - Patterns of negative interaction are identified (e.g., blaming, withdrawing).
    - New patterns are established, fostering emotional closeness and understanding.
4. **Creating Secure Bonds:**
    - The ultimate goal of emotionally focused therapy for families is to create a sense of safety, trust, and emotional connection among family members.

---

### The Emotionally Focused Family Therapy Process:

1. **Assessment and De-escalation:**
    - I first identify conflict and emotional disconnection patterns in emotionally focused therapy for families.
    - Immediate conflict is de-escalated to create a safe space for open dialogue.
2. **Restructuring Emotional Engagement:**
    - Members share their emotions and needs more vulnerably.
    - Patterns of communication shift to promote empathy and responsiveness.
3. **Consolidation and Integration:**
    - New interaction patterns are reinforced in emotionally focused therapy for families.
    - Families learn to resolve future conflicts independently using the skills developed in sessions.

---

### Key Goals of Emotionally Focused Family Therapy

- Strengthen emotional bonds.
- Improve communication and empathy.
- Create a secure and supportive environment.
- Foster resilience in handling future challenges.

---

### Emotionally Focused Family Therapy Benefits

Emotionally Focused Family Therapy (EFFT) is a versatile approach that can address a wide range of challenges, emotional struggles, and relational dynamics. Below are groups and situations where emotionally focused therapy for families can be particularly beneficial:

---

#### 1. Families Experiencing High Conflict

- Constant arguing, yelling, or unresolved disagreements.
- Frequent power struggles between parents and children or among siblings.
- Cycles of blame, defensiveness, or emotional withdrawal.
- Difficulty addressing recurring issues without escalation.

Examples:

- A teenager feels misunderstood and withdraws emotionally, while parents react with frustration, creating a cycle of disconnection.
- A family experiences [political stress and anxiety](https://dralanjacobson.com/therapy-for-political-anxiety/) that causes conflict

---

#### 2. Families Facing Major [Life Transitions](https://dralanjacobson.com/life-transitions-therapy/)

- Divorce or separation.
- Remarriage and blending families.
- Moving to a new home, city, or country.
- Birth of a new child.
- Adjustments related to aging parents or caregiving responsibilities.

Example: After a divorce, a child feels torn between parents, and communication breaks down, causing emotional distress. This is also a common reason people come for [adult sibling therapy](https://dralanjacobson.com/adult-sibling-therapy/).

---

#### 3. Families Coping with Grief, Loss, or Trauma

- Loss of a loved one (e.g., death, miscarriage).
- Experiencing collective trauma (e.g., accidents, violence, or natural disasters).
- Coping with a long-term illness of a family member.

Example: A family struggles to talk about their loss after a fire, leaving emotions unprocessed and creating distance.

---

#### 4. Families with Emotional or Behavioral Challenges in Children or Teens

- Anxiety, depression, or mood disorders.
- ADHD, autism, or other neurodivergent conditions.
- School refusal, academic struggles, or social isolation.
- Acting out behaviors, defiance, or substance use.

Example: A child with ADHD feels unsupported at home, while parents feel overwhelmed by behavioral challenges, leading to frustration on both sides.

---

#### 5. Families Experiencing Emotional Disconnection

- Family members feel emotionally distant or isolated.
- A lack of trust or safety when expressing feelings.
- A sense of loneliness within the family unit despite physical presence.
- [Adult-child estrangement](https://dralanjacobson.com/family-estrangement-therapy/)

Example: Parents and children rarely have meaningful conversations, and when conflict arises, everyone retreats to their own space.

---

#### 6. Families Navigating Cultural, Social, or Identity Challenges

- Cultural or generational gaps between family members.
- Challenges related to immigration or acculturation stress.
- Gender identity, sexual orientation, or LGBTQ+ issues within the family dynamic.

Example: A teenager comes out as LGBTQ+, but family members struggle to understand or provide emotional support.

---

#### 7. Parents Seeking Stronger Bonds with Their Children

- Difficulty building emotional closeness.
- Parental guilt over past decisions or absence.
- Feeling unappreciated or disconnected from children.

Example: A parent who works long hours feels distant from their child, leading to emotional barriers.

---

#### 8. Preventative Family Support

- Strengthening relationships before problems arise.
- Preparing for anticipated stressors (e.g., a child leaving for college).
- Building resilience and healthy communication patterns.

Example: A family starts therapy before their eldest child leaves for college to maintain strong emotional bonds despite the distance.

---

### Why EFFT is Effective Across These Situations:

- Focuses on emotional safety and vulnerability.
- Helps uncover and address underlying attachment needs.
- Teaches families how to repair emotional ruptures.
- Equips family members with tools for healthy communication and connection.

EFFT is adaptable and can support families from diverse cultural, social, and emotional backgrounds.

- Families experiencing high levels of conflict.
- Families dealing with grief, trauma, or major life transitions.
- Parents and children struggling with behavioral or emotional issues.
- Families where members feel emotionally distant or disconnected.

---

## Emotion-Focused Family Therapy Techniques

Emotionally Focused Family Therapy (EFFT) utilizes a structured approach to help families recognize and transform negative interaction patterns, build emotional security, and strengthen [attachment bonds](https://www.verywellmind.com/what-is-attachment-theory-2795337). Below are key techniques commonly used in emotionally focused therapy for families:

---

### 1. Tracking Negative Interaction Patterns

- Emotion-Focused Family Therapy Technique: I help members identify recurring negative cycles (e.g., blaming, withdrawing, defending) that create emotional disconnection.
- Example: A child shuts down emotionally when a parent raises their voice, causing the parent to become more frustrated, reinforcing the child’s withdrawal.
- Emotionally Focused Therapy for Families Goal: Increase awareness of these patterns to reduce their impact.

---

### 2. EFFT Emotional Validation

- Emotion-Focused Family Therapy Technique: I validate each family member’s emotional experiences, helping them feel heard and understood without judgment.
- Example: “It sounds like you feel hurt when your sibling dismisses your feelings. That must be really difficult.”
- Goal: Create a safe space for sharing vulnerable emotions.

---

### 3. Reframing in Emotionally Focused Family Therapy

- Emotion-Focused Family Therapy Technique: I help family members view each other’s behaviors through an attachment lens rather than seeing them as deliberate hurtful acts.
- Example: Instead of seeing a teen’s withdrawal as disrespect, a parent might reframe it as the teen feeling overwhelmed or scared.
- Goal: Shift perspectives to foster empathy and reduce defensiveness.

---

### 4. EFFT Evocative Responding

- Emotion-Focused Family Therapy Technique: I use open-ended questions and [reflective listening](https://psychology-spot.com/reflective-listening/) to help family members explore their deeper emotions.
- Example: “When your parent dismissed your concern, what was that like for you deep down?”
- Goal: Bring forward underlying emotions that drive surface-level reactions.

---

### 5. Heightening Emotional Experiences

- Emotion-Focused Family Therapy Technique: I amplify key emotions or moments in the conversation to emphasize their importance.
- Example: “Pause for a moment—can you feel how scared you are when your child pulls away?”
- Goal: Make core emotional experiences more visible and impactful.

---

### 6. Restructuring Emotional Bonds

- Emotion-Focused Family Therapy Technique: Family members are guided to express their deeper emotional needs to each other in a safe and vulnerable way.
- Example: A parent might say, “When you shut me out, I feel like I’ve failed you, and it hurts deeply.”
- Goal: Foster emotional openness and responsiveness among family members.

---

### 7. Enactments in Emotionally Focused Family Therapy

- Emotion-Focused Family Therapy Technique: I encourage family members to communicate their emotions and attachment needs directly to each other rather than through me.
- Example: “Can you turn to your child and tell them how much it hurts when they avoid talking to you?”
- Goal: Build real-time emotional connection and practice new interaction patterns.

---

### 8. Softening Responses in Emotionally Focused Family Therapy

- Emotion-Focused Family Therapy Technique: I help family members express softer, more vulnerable emotions instead of defensive or reactive ones.
- Example: A father might shift from anger to expressing sadness about feeling disconnected from his child.
- Goal: Reduce emotional defenses and increase authentic connection.

---

### 9. Restructuring [Attachment Dynamics](https://dralanjacobson.com/attachment-therapy/)

- Emotion-Focused Family Therapy Technique: I help family members identify their attachment needs and communicate them effectively.
- Example: “When you raise your voice, I feel unsafe, and I need to know you still care about me.”
- Goal: Build secure and supportive emotional bonds.

---

### 10. Consolidation and Integration

- Emotion-Focused Family Therapy Technique: Toward the end of therapy, I help the family reflect on their progress and solidify new patterns of emotional connection.
- Example: The family discusses how they can use their new communication tools in future conflicts.
- Goal: Ensure long-term change and resilience in emotional interactions.

---

### How Emotion-Focused Family Therapy Techniques Work Together:

- I **guide emotional exploration** and facilitate vulnerable communication.
- Family members **learn to identify and disrupt negative cycles.**
- Emotional safety is **established and reinforced.**
- Families leave therapy with **practical tools for ongoing connection and resilience.**

---

## Emotionally Focused Therapy for Families Case Example

### Family Background:

- **Adolescent:** 14-year-old girl, *Emily*
- **Parents:** Mother (*Sarah*, 42) and Father (*James*, 45)
- **Presenting Problem:** Emily has become withdrawn, spends most of her time in her room, and refuses to share her thoughts or feelings with her parents. Her grades are slipping, and she recently had a panic attack at school.
- **Family Dynamics:**
    - Sarah tends to respond with worry and over-involvement, which Emily perceives as nagging.
    - James often withdraws emotionally, believing Emily needs “space.”
    - Both parents feel helpless and blame themselves for Emily’s struggles.

---

### Emotionally Focused Therapy for Families Phase 1: Assessment and De-escalation

**Emotionally Focused Therapy for Families Goal:** Identify negative interaction cycles and create emotional safety.

- **Observation:**
    - Sarah hovers over Emily, asking questions about her day, while Emily responds with one-word answers or ignores her.
    - James avoids engaging, often retreating to work or TV.
- **Identified Pattern:**
    - *Pursue-Withdraw Cycle:* Sarah pursues Emily for emotional connection, Emily withdraws, and James further withdraws from both.
- **Therapist Intervention:**
    - Validate everyone’s feelings (e.g., “Emily, it makes sense that you might shut down when you feel overwhelmed. Sarah, your worry comes from a deep place of love. James, it’s hard to know how to respond when emotions feel intense.”).
    - De-escalate blame and create emotional safety.

---

### Phase 2: Accessing and Restructuring Emotional Experiences

**Goal:** Help each family member identify and express deeper emotions driving their behavior.

- **Emily’s Emotional Experience:**
    - Initially quiet and defensive, Emily eventually reveals she feels like a disappointment to her parents.
    - She expresses fear of failing and being judged.
- **Sarah’s Emotional Experience:**
    - Sarah admits her over-involvement comes from fear—she’s scared Emily will struggle like she did in her teenage years.
- **James’s Emotional Experience:**
    - James shares that he feels inadequate as a father and avoids conversations because he’s afraid of making things worse.
- **Emotion-Focused Family Therapy Techniques:**
    - *Evocative Responding:* “Emily, when you feel like a disappointment, what happens inside?”
    - *Reframing:* “Sarah, your ‘nagging’ comes from a place of love and fear for Emily’s well-being.”
    - *Enactments:* Emily shares her fear of failure directly with her parents, while Sarah and James respond vulnerably rather than reactively.

---

### Phase 3: Restructuring Emotional Bonds with EFFT

**Goal:** Create new patterns of emotional connection.

- **I Encourage Vulnerable Communication:**
    - Emily shares, “When you keep asking me if I’m okay, it feels like you don’t trust me to handle things on my own.”
    - Sarah responds, “I’m so sorry, Emily. I ask so much because I love you and I’m scared, but I see now that it feels suffocating.”
    - James says, “Emily, I’ve been avoiding talking to you because I don’t want to say the wrong thing. But I’m here, and I want to be better.”
- **New Patterns Established:**
    - Sarah learns to give Emily space while still expressing support.
    - James makes an effort to engage emotionally, checking in without avoiding difficult conversations.
    - Emily feels more comfortable sharing her struggles, knowing she won’t be judged or overwhelmed.

---

### Phase 4: Consolidation and Integration

**Goal:** Reinforce new emotional connection patterns and prepare for future challenges.

- **I Reflect Progress:**
    - Highlighting moments of genuine connection and vulnerability.
    - Reinforcing tools for emotional communication (e.g., using “I feel” statements).
- **Family Plan Moving Forward:**
    - Weekly family check-ins to share feelings and address concerns.
    - Sarah practices pausing before reacting out of fear.
    - James commits to regular emotional check-ins with Emily.

---

### Emotionally Focused Family Therapy Outcomes:

- Emily’s relationship with her parents improves significantly.
- Her grades stabilize, and she feels less pressure to be perfect.
- Sarah and James feel more confident in their parenting roles.
- They create a foundation of trust, vulnerability, and emotional safety.

---

### Key Emotionally Focused Family Therapy Techniques Used:

- **Tracking Negative Patterns:** Identified the pursue-withdraw cycle.
- **Reframing:** Shifted perceptions of each family member’s behavior.
- **Evocative Responding:** Explored deep emotional fears and needs.
- **Enactments:** Facilitated direct and vulnerable communication.
- **Restructuring Attachment Dynamics:** Fostered emotional security.

## Summary and My Work

I provide emotionally focused therapy for families with older children, including adults. My [online therapy approach](https://dralanjacobson.com/virtual-therapy-guide/) allows members to attend even if they are not in the same place. EFFT can also be used in [couples therapy](https://dralanjacobson.com/couples-therapy/) and with specific dyads, such as in [mother-daughter therapy](https://dralanjacobson.com/mother-daughter-therapy/). It can also have some use in specialty areas such as when [politics causes family conflict](https://dralanjacobson.com/politics-and-family-therapy/) and when providing [college admissions help](https://dralanjacobson.com/college-admissions-counseling/). I also use these techniques in emotionally focused individual therapy ([EFIT](https://dralanjacobson.com/emotionally-focused-individual-therapy/)).

If you have any questions about emotionally focused family therapy or want to know how EFFT might benefit you, please don’t hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Family therapies

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### [Behavioral Activation for Improved Mood and Meaningfulness](https://dralanjacobson.com/behavioral-activation/)

**Published:** December 16, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Behavioral Activation Therapy** (BA) is a structured, evidence-based approach primarily used to treat depression, but it can also help with other mood-related issues. It focuses on identifying and increasing engagement in positive, meaningful activities that align with your values and interests. **Behavioral activation treatment** helps you reconnect with sources of joy and achievement while reducing avoidance. In this post, I review this method, some of the techniques we’ll use (most notably the **behavioral activation worksheet**), and a case example. I’ll also show how this approach often pairs with cognitive restructuring. It also works well with [ACT psychotherapy](https://dralanjacobson.com/act-psychotherapy/) and [narrative therapy](https://dralanjacobson.com/narrative-therapy/).

If you have any questions about how behavioral activation therapy might work for you or a loved one or general questions about this approach, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Behavioral Activation Overview

![Behavioral Activation Therapy](https://dralanjacobson.com/wp-content/uploads/2024/12/butt-4-200x300.jpg "Woman Jogging Outside | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

The following is an overview of behavioral activation treatment. Of course, as with any [cognitive-behavioral approach](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/), your treatment plan will be uniquely tailored to your needs and goals.

### Core Principles of Behavioral Activation Therapy

1. **Behavior-Emotion Connection**
    - Behavioral activation therapy recognizes that **behaviors influence mood**. A lack of activity or engagement can worsen feelings of depression and vice versa.
2. **Breaking the Avoidance Cycle**
    - Depression often leads to **withdrawal** from activities, relationships, and responsibilities, which further reinforces low mood. Behavioral activation helps break this cycle by encouraging small, manageable steps to re-engage with life.
3. **Focus on Observable Change**
    - Behavioral activation treatment emphasizes **observable and measurable behaviors** (e.g., “Go for a 10-minute walk,” rather than “Feel happy”).

---

### How Behavioral Activation Works

1. **Activity Monitoring**
    - You track their daily activities and rate your moods on a behavioral activation worksheet to identify patterns (e.g., “When do I feel better or worse?”).
2. **Activity Scheduling**
    - Plan specific, **achievable activities** that bring **pleasure** (e.g., hobbies) or **mastery** (e.g., completing a small chore).
3. **Identifying Values and Goals**
    - Activities align with your broader **values** to promote purpose and satisfaction.
        Example: If health is a core value, scheduling time for exercise or cooking healthy meals becomes a priority.
4. **Problem-Solving Barriers**
    - In [individual therapy sessions](https://dralanjacobson.com/individual-therapy/), you address challenges like procrastination, fatigue, or negative thoughts that hinder activity engagement.
5. **Graded Exposure**
    - For people who struggle with overwhelming tasks, a well-designed behavioral activation worksheet uses a **step-by-step approach** to gradually reintroduce activities.

---

### Who Can Benefit from Behavioral Activation Therapy?

I use behavioral activation therapy with a wide variety of people, including:

- Individuals with **depression**, including major depressive disorder, [seasonal affective disorder](https://dralanjacobson.com/seasonal-affective-disorder-treatment/), or challenging [life transitions](https://dralanjacobson.com/life-transitions-therapy/)
- People experiencing low energy, loss of motivation, or anhedonia (loss of interest)
- Those with **anxiety** that stops them from doing things they would otherwise enjoy
- [Young adults in therapy](https://dralanjacobson.com/therapy-for-college-students/) who are struggling with school or social challenges and anyone who has low self-esteem

---

### Benefits of Behavioral Activation Treatment

- **Improves mood and energy levels**
- Promotes a sense of **achievement and purpose**
- Breaks negative cycles of avoidance and inactivity
- Encourages healthier coping strategies

---

Behavioral Activation therapy is often used as part of **Cognitive Behavioral Therapy (CBT)** but can also be delivered as a standalone treatment. Its simplicity and practicality make it accessible and effective.

## CBT BA Techniques

Here are key **techniques used in Behavioral Activation Therapy** to help you engage in meaningful activities and improve your mood:

---

### 1. Activity Monitoring

- **Purpose**: To identify current patterns of behavior and their impact on mood.
- **How**: Use a behavioral activation worksheet to track daily activities, thoughts, and feelings. 
    - Example: “I noticed I feel worse when I stay in bed all morning, but slightly better after walking my dog.”

---

### 2. Activity Scheduling

- **Purpose**: Plan specific activities ahead of time to break cycles of avoidance and inactivity.
- **How**: 
    - Start with small, **specific** tasks (e.g., “Go for a 10-minute walk at 4 PM”).
    - **Schedule activities** in a calendar or planner.
- **Tip**: Treat the activities like appointments that cannot be skipped.

---

### 3. Graded Task Assignment

- **Purpose**: Overcome overwhelm by breaking tasks into smaller, achievable steps.
- **How**: Gradually increase the difficulty of activities. 
    - Example: 
        - Step 1: Spend 5 minutes cleaning the desk.
        - Step 2: Add another 5 minutes tomorrow.
        - Step 3: Tidy the entire desk area over the week.

---

### 4. Pleasant and Mastery Activities

- **Purpose**: Balance activities that bring **pleasure** with those that bring a sense of **accomplishment** (mastery).
- **How**: Make two lists on your behavioral activation worksheet: 
    - **Pleasant Activities** (e.g., watching a movie, drawing, listening to music).
    - **Mastery Activities** (e.g., completing an assignment, doing laundry, cooking).
- Schedule a mix of both to boost mood and motivation. This is why I often use [creative arts therapy](https://dralanjacobson.com/creative-counseling/) as an adjunct to this approach.

---

### 5. Values-Based Activities

- **Purpose**: Ensure activities align with personal values to create meaning and purpose (which we’ll discuss in our behavioral activation therapy sessions).
- **How**: Identify key values (e.g., health, relationships, education) and set goals accordingly. 
    - Example: If “family” is a value → Schedule a phone call with a loved one.

---

### 6. Overcoming Barriers

- **Purpose**: Identify and address obstacles that interfere with activity completion.
- **How**: Use problem-solving techniques: 
    - **Barrier**: “I feel too tired to go outside.”
    - **Solution**: “I’ll start with just sitting outside for 2 minutes.”
    - **Barrier**: “I don’t feel motivated.”
    - **Solution**: “I’ll focus on how I might feel better after completing the activity.”

---

### 7. Behavioral Activation Experiments

- **Purpose**: In behavioral activation therapy, we’ll test assumptions about how an activity will make you feel.
- **How**: 
    - Prediction: “If I go for a walk, I’ll still feel tired, and nothing will change.”
    - Action: Go for the walk.
    - Outcome: “After walking, I actually felt a little more awake and refreshed.”
- **Tip**: Track and challenge negative predictions.

---

### 8. Use of Rewards

- **Purpose**: Reinforce positive behavior by rewarding yourself after completing activities.
- **How**: Pair activities with small, enjoyable rewards. 
    - Example: “After I finish studying for 30 minutes, I’ll watch an episode of my favorite show.”

---

### 9. Behavioral Substitution

- **Purpose**: Replace unhelpful activities with more constructive ones.
- **How**: Identify avoidance and swap it for positive activities. 
    - Example: Instead of scrolling on social media, go outside for 5 minutes.

---

### 10. Behavioral Activation Worksheets

- **Purpose**: Measure progress and identify what works.
- **How**: After completing an activity, rate your mood on a scale of 1-10. 
    - Example: “Before the walk: 3/10. After the walk: 5/10.”
- Use this feedback to prioritize effective activities.

---

These behavioral activation treatment techniques can be tailored to specific needs, such as **students struggling with procrastination**, **individuals with ADHD**, or anyone experiencing depressive moods.

## Behavioral Activation Worksheet Example

---

### Step 1: Activity Monitoring

Track your current activities and mood to identify patterns.

Time of DayActivityMood (Rate 1-10)Thoughts or Feelings8:00 AMWoke up, stayed in bed3/10Tired, “I can’t do this.”10:00 AMScrolled on phone2/10Felt stuck and unmotivated**Instructions**:

- For 1-2 days, write down what you’re doing and rate your mood during or after each activity (1 = very low, 10 = very high).
- Look for activities that make you feel better, worse, or neutral.

---

### Step 2: Identifying Values and Goals

**What’s important to you?** Write down your values and a small goal for each.

Value (What matters?)Activity Goal (Specific and Small)HealthGo for a 10-minute walk today.Social ConnectionText one friend to say hello.EducationSpend 15 minutes working on one assignment.---

### Step 3: Activity Scheduling

Plan activities for the next few days based on your values and goals.

Time of DayActivity (Specific)How Likely Will I Do This? (1-10)Completed? (Y/N)Mood After9:00 AMGet out of bed and stretch7/102:00 PMSpend 10 minutes reading or studying6/104:00 PMGo outside for a short walk5/10**Tips**:

1. Start small. Even 5 minutes counts.
2. Make the activities specific and realistic.
3. Schedule activities at a specific time of day.

---

### Step 4: Identify and Overcome Barriers

What might stop you from doing these activities? Write down solutions:

ActivityPotential BarrierSolutionGo for a 10-minute walk“I feel too tired.”Remind myself it’s just 10 minutes; put on sneakers now.Text a friend“I don’t know what to say.”Keep it simple: “Hey, how are you doing?”---

### Step 5: Reflect and Adjust the Behavioral Activation Worksheet

After completing activities, look at the behavioral activation worksheet and reflect on how you felt:

1. Which activities improved your mood? 
    - Example: “Going for a walk made me feel clearer and more energized.”
2. What was challenging? How can you adjust next time? 
    - Example: “It was hard to start studying, so I’ll set a 5-minute timer tomorrow.”

---

### Bonus Tip: Use a reward system!

- After completing a scheduled activity, reward yourself with something small you enjoy (e.g., watch a short video, have a favorite snack).

---

### Weekly Reflection

Each week look at your behavioral activation worksheet and think about:

- What progress have I made this week?
- What will I focus on next week?

---

## Behavioral Activation Treatment Case Example

Here’s a fictitious **case example** illustrating how Behavioral Activation Therapy (BA) can be applied:

---

### Behavioral Activation Therapy Example: Sarah, a College Student with Depression

**Background:**

- **Sarah** is a 20-year-old college sophomore who has felt **overwhelmed, sad, and unmotivated** for the past two months.
- She used to enjoy attending classes, spending time with friends, and going to the gym. Recently, she has been **isolating herself**, skipping classes, and spending hours in bed scrolling on her phone.
- Her grades have dropped, and she reports feeling **“lazy” and “hopeless”** about improving her situation.

---

### Step 1: Activity Monitoring

- Sarah starts her behavioral activation worksheet by tracking her daily activities and mood for a week.
- Findings: 
    - She spends **most of her time in bed** (up to 12 hours), avoiding assignments and not responding to texts from friends.
    - Her mood is lowest when she isolates herself and skips responsibilities.
    - On a rare day she forced herself to attend a class, her mood improved slightly.

---

### Step 2: Identifying Values and Goals

- In one of her first behavioral activation therapy sessions, Sarah identified the **values** that are important to her: 
    - Education
    - Health and Fitness
    - Friendships and connection
- Sarah sets small, **achievable goals** that align with these values.

---

### Step 3: Creating the Behavioral Activation Worksheet

Sarah and I talk about her scheduling specific activities to break the cycle of inactivity and avoidance gradually.

- **Goals for Week 1** (small, manageable steps): 
    - **Education**: Attend 1 class this week (even if just for 30 minutes).
    - **Health**: Go for a 10-minute walk twice this week.
    - **Social Connection**: Reply to 1 friend’s text message.

These behavioral activation treatment goals are **realistic**, specific, and time-limited to avoid overwhelm.

---

### Step 4: Graded Exposure and Problem-Solving

- **Barriers**: Sarah initially struggles with low energy and negative thoughts like, *“What’s the point?”*
    - To problem-solve, I encourage her to focus on **how she might feel after completing the activity**, rather than before.
    - Sarah agrees to **set alarms** and remind herself, *“I’ll feel better if I just try for 5 minutes.”*
- **Graded Exposure**: 
    - Once she successfully completes smaller goals, they increase the intensity: 
        - **Week 2 Goals**: Attend two classes, increase her walk to 20 minutes, and invite a friend to coffee.

---

### Step 5: Monitoring Progress

Over time, Sarah notices that:

- After walking, her mood improves slightly, and she feels less “stuck.”
- Attending class and completing even small assignments give her a **sense of accomplishment**.
- Texting a friend reduces feelings of isolation, and she plans to see people.

Her behavioral activation worksheet reflects increased **engagement** in positive, meaningful tasks and reduced time spent in bed.

---

### Behavioral Activation Therapy Outcome After 8 Weeks

- Sarah is attending most of her classes and feeling more engaged in schoolwork.
- She’s back to going to the gym twice a week and spending time with friends.
- Her mood has improved, and she reports feeling **“more like myself again.”**

---

### Key Takeaways

- In behavioral activation treatment, reintroducing small activities aligned with Sarah’s values helped her break the cycle of **avoidance** and **low mood**.
- Behavioral activation treatment showed her to take action first (behavior change), improving her mood.

## Pairing Behavioral Activation with Cognitive Restructuring

**Behavioral Activation (BA)** and **Cognitive Restructuring** complement each other well, particularly in **Cognitive Behavioral Therapy (CBT)**. While behavioral activation treatment focuses on changing behaviors to improve mood, cognitive restructuring addresses the negative thoughts and beliefs that often lead to low mood and avoidance.

Together, they create a powerful combination:

- **Behavioral Activation Treatment** helps clients **act their way into feeling better** by engaging in meaningful activities.
- **Cognitive Restructuring** helps them **think their way into feeling better** by challenging and reframing unhelpful thoughts.

---

### How They Pair Together

1. #### **Identifying the Behavior-Thought Cycle**

    - Low mood often leads to avoidance, which reinforce negative thoughts, creating a cycle.
    - Example: 
        - Thought: *“I’ll fail, so there’s no point in starting.”*
        - Behavior: Avoiding studying → Feeling worse.
    - Combining techniques: 
        - BA: Schedule 10 minutes of studying to break the avoidance.
        - Cognitive Restructuring: Challenge the thought with *“I don’t need to be perfect, I just need to start small.”*

---

2. #### **Behavior as a Tool to Test Thoughts**

    - Behavioral Activation can serve as a “**behavioral experiment**” to test the accuracy of negative beliefs.
    - Example: 
        - Thought: *“If I go to the gym, I’ll embarrass myself because I’m out of shape.”*
        - BA: Commit to going to the gym for 5 minutes.
        - Reflection: *“No one paid attention to me, and I felt better after exercising.”*
    - Outcome: The action disproves the negative thought, and cognitive restructuring can reinforce a new belief: *“It’s okay to start slow; people aren’t judging me.”*

---

3. #### **Addressing Barriers to Behavioral Activation**

    - Negative thoughts often serve as **barriers** to engaging in activities. Cognitive restructuring can challenge these thoughts and clear the path for action.
    - Example: 
        - Barrier Thought: *“I won’t enjoy it, so why bother?”*
        - Restructuring: *“Even if I don’t love it, doing something is better than doing nothing.”*
        - BA Action: Schedule a small, manageable activity like taking a 5-minute walk.

---

4. #### **Reinforcing Positive Outcomes**

    - After completing activities planned through BA, Cognitive Restructuring can help the client reflect on the experience and reinforce positive changes.
    - Example: 
        - Activity: Went to a class after weeks of skipping.
        - Thought: *“I can’t do this; it’s too overwhelming.”*
        - Reflection: *“It wasn’t perfect, but I showed up, and that’s a win.”*
    - Cognitive Restructuring helps shift the focus from perceived “failure” to recognizing progress.

---

5. #### **Creating Momentum**

    - Behavioral Activation provides **immediate behavioral momentum**, which makes cognitive work easier.
    - As mood improves with action, negative thoughts can lose their grip.
    - Example: 
        - Small win from BA: Completing one task → Improved mood.
        - [Cognitive Restructuring](https://dralanjacobson.com/cognitive-restructuring/): “If I managed that, maybe I can handle something else, too.”

---

### Example: Anna’s Case

**Scenario**: Anna, a college student, avoids writing a paper because of the thought, *“I’m a terrible writer; I’ll fail anyway.”*

- **Cognitive Restructuring**: 
    - Challenge the thought: *“I don’t need to be perfect; I just need to get started.”*
- **Behavioral Activation**: 
    - Schedule 10 minutes of writing.
- **Outcome**: Sarah realizes writing for 10 minutes isn’t as overwhelming as she thought, and she feels a sense of accomplishment.
- **New Thought**: *“I’m not perfect, but I can make progress when I try.”*

---

### Why the Pairing Works

- Behavioral Activation focuses on **what you do** to create immediate mood improvement.
- Cognitive Restructuring helps address **why you think** you can’t act, breaking mental barriers.

Together, they build a reinforcing cycle of **better behavior → better thoughts → improved mood**.

## Summary and My Work

I provide behavioral activation treatment, often but not always paired with [cognitive restructuring](https://dralanjacobson.com/cognitive-restructuring/). This [therapy is effective virtually](https://dralanjacobson.com/virtual-therapy-guide/), which works well since much of the approach involves homework you do outside of sessions. Behavioral activation treatment is often time-limited, and while it is most commonly associated with individual therapy, it is something that [couples in therapy](https://dralanjacobson.com/couples-therapy/) and whole [families in treatment](https://dralanjacobson.com/family-therapy/) can benefit from as well. It pairs well, for example, with [solution-focused therapy for families](https://dralanjacobson.com/solution-focused-family-therapy-focusing-on-positive-change/), [Acceptance Therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) for individuals, and other methods such as [work-life balance therapy](https://dralanjacobson.com/therapy-for-work-life-balance/) and [therapy for political anxiety](https://dralanjacobson.com/therapy-for-political-anxiety/).

If you have any questions about behavioral activation therapy, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Therapy Approaches

---

### [Strategic Family Therapy: Powerful, Positive, Time-Limited](https://dralanjacobson.com/strategic-family-therapy-powerful-positive-time-limited/)

**Published:** December 18, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Strategic Family Therapy** is a brief, goal-oriented therapeutic approach that focuses on solving specific problems within a family system. It was developed primarily by [**Jay Haley**](https://en.wikipedia.org/wiki/Jay_Haley) and influenced by the work of [Salvador Minuchin](https://en.wikipedia.org/wiki/Salvador_Minuchin) (Structural Family Therapy). This model views problems as embedded in family interactions rather than just within individuals. I offer **strategic family therapy interventions** that are powerful and positive and designed to work fast. As you will see in the **brief strategic family therapy** example below, this approach works well for families facing a specific challenge or barrier. However, it is also used when a family is going through a transition.

I offer strategic family therapy for families with older children, including adults, and for specific dyands such as with [therapy for mother-daughter relationships](https://dralanjacobson.com/mother-daughter-therapy/). The [online therapy approach](https://dralanjacobson.com/virtual-therapy-guide/) is often not the most effective for families with younger children. If you have specific questions, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

---

### Core Principles of Strategic Family Therapy Interventions ![Brief strategic family therapy interventions](https://dralanjacobson.com/wp-content/uploads/2024/12/Charity.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

1. **Problem-Focused**: I target specific family issues rather than long-term personality changes.
2. **Systems Perspective**: Problems are seen as part of ongoing family dynamics or communication patterns.
3. **Directive**: I provide tasks or interventions in session and as homework to interrupt unhelpful cycles and patterns.
4. **Brief**: Strategic Family Therapy is often short-term, focusing on solving immediate issues.

---

### Strategic Family Therapy Interventions Commonly Used

1. **Reframing**: I offer alternative ways of viewing family behaviors, changing how the problem is understood.
2. Paradoxical Interventions: Prescribing the problematic behavior to help the family recognize its dysfunction.
3. **Directives**: Assigning tasks or specific behaviors for family members to complete between sessions.
4. **Family Structure Focus**: Identifying and shifting power dynamics or alliances that perpetuate conflict.
5. **Interrupting Patterns**: Intervening in habitual family cycles, often by changing communication patterns or behaviors.

---

### Goals of Strategic Family Therapy

Strategic Family Therapy’s goals are focused on solving problems by identifying and disrupting dysfunctional family patterns of interaction. I work to bring about rapid and practical change rather than a long-term exploration of the family’s history.

Here are the primary goals of brief strategic family therapy and examples of strategic family therapy interventions I use:

---

#### 1. Solve the Presenting Problem

- The primary and immediate goal of brief strategic family therapy is to address the specific problem that brought the family to therapy.
- Example: If a child is acting out, the goal is to stop the disruptive behavior by changing family dynamics.

---

#### 2. Interrupt Dysfunctional Patterns

- Brief strategic family therapy identifies recurring cycles or behaviors that maintain the problem and intervenes to break those patterns.
- Example: If parents react to a child’s tantrum by giving in, the therapist might direct the parents to respond differently to stop reinforcing the behavior.

---

#### 3. Realign Family Hierarchies and Roles

- Brief strategic family therapy [helps families establish healthy boundaries](https://blog.calm.com/blog/family-boundaries) and roles, particularly when there is confusion in authority.
- Example: Empowering parents to reclaim authority in cases where children have taken control or alliances have been formed against one parent.

---

#### 4. Promote Change Through Action

- Strategic Family Therapy is action-oriented, focusing on behavioral change rather than deep emotional insight.
- I give the family specific tasks or directives to experiment with new behaviors and interactions.
- Example: Assigning a task for a parent to stay calm during a child’s tantrum to change the escalation pattern.

---

#### 5. Increase Family Flexibility

- Encouraging the family to adapt and be more flexible in their interactions makes it easier to address future problems.
- Example: Teaching family members new ways of communicating and problem-solving to prevent rigid patterns from returning.

---

#### 6. Shift Perspectives (Reframing)

- Helping family members view problems and behaviors from a new perspective reduces blame and promotes understanding.
- Example: Reframing a child’s defiance as an attempt to gain attention or structure rather than simply bad behavior.

---

#### 7. Empower the Family System

- Strengthening the family’s ability to solve problems independently by highlighting their existing strengths and resources.
- Example: Identifying times when the family successfully handled challenges and encouraging them to replicate those strategies.

---

#### 8. Achieve Quick, Measurable Change

- Strategic Family Therapy aims for brief, targeted interventions that create observable and meaningful family functioning improvements.
- Example: Within a few sessions, a family may report reduced conflict, improved communication, or better behavior from a child.

---

### Brief Strategic Family Therapy Summary

Strategic Family Therapy interventions are **practical, action-oriented, and systemic**. By addressing specific problems, interrupting patterns, and empowering families to change their behaviors, this approach fosters quick and sustainable improvements in family functioning

---

### When Brief Strategic Family Therapy is Used

Strategic Family Therapy is often applied in:

- Adolescent problematic behaviors or sibling conflict
- Substance abuse interventions
- Parent-child conflicts, including when reward systems are not working
- Communication breakdowns in families
- [Family transitions](https://dralanjacobson.com/life-transitions-therapy/) include children going to college, parents separating, or a new child being born.
- [Adult child estrangement](https://dralanjacobson.com/family-estrangement-therapy/), especially when reconciliation is the goal.

---

This approach emphasizes my ability to **observe**, **assess**, and **strategically intervene** in ways tailored to the family’s specific needs. It is highly practical, emphasizing action and measurable progress rather than deeply exploring family history. For longstanding, engrained challenges, other approaches, such as [Family Systems Therapy](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/) and [Narrative Family Therapy](https://dralanjacobson.com/narrative-family-therapy/), may be indicated.

## Strategic Family Therapy Interventions

The **Strategic Family Therapy Interventions** I use are designed to directly address and resolve family problems by identifying and altering dysfunctional patterns of interaction. These interventions are **directive, problem-focused, and goal-oriented**, often involving specific tasks or strategies that help families interrupt problematic cycles. Below are some common **strategic family therapy interventions**:

### Systemic Family Therapy Interventions List

---

#### 1. Reframing

- Definition: Changing the way a problem or behavior is perceived by offering a new, more positive or neutral interpretation.
- Example: Instead of labeling a child’s misbehavior as “rebellious,” I might reframe it as an attempt to gain attention and connection.
- Goal: To reduce blame and shift the family’s understanding of the issue.

---

#### 2. Prescribing the Symptom (Paradoxical Intervention)

- Definition: I “prescribe” the problematic behavior, encouraging the family or individual to engage intentionally.
- Example: A family is told to argue at specific times during the day. This may highlight the absurdity of the behavior or reduce its occurrence.
- Goal: To disrupt the family’s pattern and help them gain control over the behavior.

---

#### 3. Directives

- Definition: Specific tasks or instructions are assigned to family members to change behavior or interaction patterns.
- Example: A parent might be asked to respond differently (e.g., staying calm) when a child acts out, or family members might be tasked with spending quality time together.
- Goal: To promote healthier behaviors and interactions outside of therapy sessions.

---

#### 4. Ordeals

- Definition: Assigning a task that makes the problematic behavior or symptom more effortful or undesirable to continue.
- Example: If a teenager refuses to get out of bed, the therapist might suggest that the parent wakes them every hour through the night to “help them sleep better.”
- Goal: To make maintaining the symptom harder than resolving it.

---

#### 5. Interrupting Patterns (Pattern Disruption)

- Definition: Intervening in repetitive family patterns to force change.
- Example: If a parent consistently nags a child to do homework and the child resists, the parent might be directed to stop nagging completely, breaking the cycle.
- Goal: To interrupt dysfunctional cycles and allow new, healthier patterns to emerge.

---

#### 6. Circular Questioning

- Definition: Asking questions that help family members see the problem from different perspectives.
- Example: *“What do you think your brother feels when you ignore him? How do you think that affects the rest of the family?”*
- Goal: To increase awareness of relational dynamics and foster empathy.

---

#### 7. Hierarchical Realignment

- Definition: Reorganizing family roles to restore proper boundaries and power structures.
- Example: Helping parents reclaim authority in families where children have taken control or formed alliances against one parent.
- Goal: To create healthier family hierarchies and boundaries.

---

#### 8. Pretend Techniques

- Definition: Family members are asked to “pretend” to engage in a problematic behavior.
- Example: A child pretending to have a tantrum while parents “respond” calmly.
- Goal: To reduce the emotional charge of the behavior and allow the family to practice new, healthier responses.

---

#### 9. Positive Connotation

- Definition: Assigning a positive or purposeful meaning to problematic behaviors.
- Example: A child’s refusal to do chores could be reframed as a way to test family limits and seek structure.
- Goal: To help families see behaviors as part of a system rather than blaming individuals.

---

#### 10. Strategic Rituals

- Definition: Creating specific routines or rituals to address family problems.
- Example: Scheduling a “family problem-solving night” where everyone discusses issues constructively.
- Goal: To provide structure and promote healthier family interactions.

---

#### 11. Metaphors and Symbolic Tasks

- Definition: Using stories, symbols, or metaphors to address family issues indirectly.
- Example: Comparing a family’s dynamic to a team that needs cooperation, highlighting the need for teamwork.
- Goal: To address resistance and promote insight in an indirect, non-threatening way.

---

### Goals of Strategic Family Therapy Interventions

The overall aim of these interventions is to:

1. Disrupt **dysfunctional family patterns**.
2. Create **new, healthier ways** of interacting.
3. Solve the **presenting problem** quickly and effectively.

---

Strategic Family Therapy relies on my ability to observe, analyze, and **strategically intervene** in ways that produce rapid change, empowering families to function in healthier and more productive ways.

## Brief Strategic Family Therapy Case Example

Here is a **case example** illustrating the use of **Brief Strategic Family Therapy** interventions:

---

### Case Overview

- **Presenting Problem**: A 15-year-old teenage boy, Jason, is skipping school and frequently arguing with his parents. The family reports constant tension, with Jason ignoring his father’s authority and siding with his mother, who often “rescues” him from punishment.
- **Family System Dynamics**: 
    - Jason has become the focus of the family’s problems.
    - The father feels disrespected and powerless.
    - The mother feels stuck between supporting Jason and managing the father’s frustrations.
    - A **triangulation** dynamic has emerged, where Jason and his mother are aligned, leaving the father excluded.

---

### Interventions Used

1. **Reframing the Problem**
    - I reframe Jason’s behavior to test family boundaries and seek attention rather than label him as “defiant” or “lazy.”
    - *“Jason isn’t ignoring his father to be bad; perhaps he’s asking for clearer guidance in a roundabout way.”*
    - **Purpose**: This reduces blame and creates a new perspective that positions Jason’s behavior as fixable.

---

2. **Directive: Changing Parental Responses**
    - I give the parents a clear task: 
        - **Father**: Instead of yelling when Jason skips school, calmly tell him: *“I’m disappointed you skipped, and I expect you to make it up tomorrow.”*
        - **Mother**: Stop “rescuing” Jason from consequences and let the father take the lead in handling discipline.
    - **Purpose**: This intervention shifts the family’s [**interactional patterns**](https://youaremom.com/parents/life-in-a-relationship/relationships/10-family-interaction-patterns-that-can-be-harmful/) and reestablishes the father’s role as the authority figure.

---

3. **Prescribing the Symptom (Paradoxical Intervention)**
    - I instruct Jason’s parents to **schedule arguments**: 
        - *“Every day at 6 p.m., I want you to argue about Jason skipping school, but only for 10 minutes.”*
    - **Purpose**: By making the arguments intentional, the family becomes aware of their unproductive behavior, often leading to fewer arguments.

---

4. **Hierarchical Realignment**
    - I address the power dynamic by [restructuring the family hierarchy](https://dralanjacobson.com/structural-family-therapy/): 
        - The mother is directed to support the father in decisions, reinforcing a unified parental front.
    - Jason is instructed to ask permission from both parents for privileges (e.g., going out).
    - **Purpose**: This intervention restores parental authority and breaks the [**triangulation** dynamic](https://www.verywellmind.com/what-is-triangulation-in-psychology-5120617).

---

5. **Pattern Interruption**
    - I notice that Jason’s skipping school triggers his father’s outbursts, which are followed by the mother intervening.
    - I ask the father to stay calm and assign Jason a small, manageable task as a consequence (e.g., washing dishes for the day).
    - **Purpose**: Interrupt the predictable escalation pattern and replace it with calmer, solution-oriented responses.

---

### Outcome

- After a few sessions, the family reports: 
    - Jason is skipping school less often and responding better to his father’s authority.
    - The mother feels relieved to step back and support the father.
    - Arguments have significantly decreased, and the parents present a unified front.
- The family system shifts toward healthier dynamics by disrupting dysfunctional patterns and using targeted interventions.

---

This case highlights how **Brief Strategic Family Therapy** interventions such as **reframing, directives, hierarchical realignment, and paradoxical interventions** can quickly and effectively address family issues by focusing on interactions and solutions.

## Summary and My Work

I provide brief strategic family therapy to families where the children are adolescents or adults (including [adult sibling therapy](https://dralanjacobson.com/adult-sibling-therapy/)), often mixing in other approaches such as [family systems therapy](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/), [emotionally focused family therapy](https://dralanjacobson.com/emotionally-focused-family-therapy/), and [narrative family therapy](https://dralanjacobson.com/narrative-family-therapy/) in my [integrative psychological practice](https://dralanjacobson.com/integrative-therapy/). It is often paired with [solution-focused family therapy](https://dralanjacobson.com/solution-focused-family-therapy-focusing-on-positive-change/), which shares many of the same techniques. I have found this approach to be powerful and effective, particularly when challenges and barriers are not deeply engrained in the family dynamics and instead a point-in-time issue that has arisen.

If you have any questions about strategic family therapy and how it might work for your family, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Family therapies

---

### [Therapy for People with Learning Disorders](https://dralanjacobson.com/therapy-for-people-with-learning-disorders/)

**Published:** February 24, 2025
**Author:** Dr. Alan Jacobson

**Content:**

I provide **therapy for people with learning disorders** (LDs), helping people navigate the unique challenges at school, work, and in everyday life. Learning disabilities and mental health are linked and can impact self-esteem, contentment, and academic or professional success. However, you can overcome a learning disability and find new strengths and opportunities. My approach is centered on providing a supportive space where clients can develop deeper awareness, coping strategies, and confidence in their abilities. Through evidence-based therapies like [Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT), [Acceptance and Commitment Therapy](https://dralanjacobson.com/act-psychotherapy/) (ACT), [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/), and executive function coaching, I help individuals manage their learning challenges and build resilience and self-advocacy skills. Later in this post, you can get an idea of my approach through a case example of therapy for learning disabilities and depression.

If you have any questions about my services in general, how to overcome a learning disability, or therapy for people with learning disorders, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Learning Disabilities and Mental Health

People with LDs often experience mental health challenges due to the struggles they face in school, work, and social settings. These challenges can include anxiety, depression, low self-esteem, and emotional regulation difficulties. Understanding this connection between learning disabilities and mental health is key to finding the right support.

### How Learning Disabilities and Mental Health are Linked

Here are some common symptoms that people with unaddressed LDs often face:

1. **Chronic Stress & Anxiety** – Difficulty keeping up with academic or work demands can lead to frustration and anxiety.
2. **Low Self-Esteem** – Repeated struggles can cause feelings of failure, leading to self-doubt and low confidence.
3. **Social Challenges** – Some LDs, like dyslexia, can make communication or social interactions harder, leading to isolation.
4. **Emotional Regulation Issues** – Struggles with executive functioning (common in ADHD) can make it harder to manage emotions.
5. **Depression & Burnout** – Feeling misunderstood, unsupported, or constantly overwhelmed can contribute to depression.

### Holistic Approaches and Therapy for People with Learning Disorders

There are a variety of approaches that can help you overcome the effects of an LD, such as:

- **Therapy & Counseling** – Cognitive Behavioral Therapy (CBT), [Dialectical Behavioral Therapy](https://dralanjacobson.com/dbt-for-teens/) (DBT), and talk therapy can help manage anxiety, stress, and self-esteem issues, thereby disconnecting learning disabilities and mental health.
- **Executive Function Coaching** – Helps with organization, time management, and reducing overwhelm.
- **Mindfulness & Stress Management** – Techniques like deep breathing, meditation, and movement-based therapies (yoga, exercise) can improve emotional regulation and disengage learning disabilities and mental health challenges.
- **Support Groups & Community** – Finding others with similar experiences can reduce feelings of isolation and provide coping strategies.
- **Self-Advocacy & Accommodations** – Requesting [accommodations at school](https://psychologicalassessments.com/testing-for-educational-accommodations/) or work can ease stress and improve confidence.

### How to Overcome a Learning Disability

While there is no cure, you can overcome a learning disability by finding positive strategies, accommodations, and support systems that help you succeed, find new opportunities, and reach your full potential. Here’s a step-by-step approach to managing and thriving:

#### Overcome a Learning Disability Through Understanding

- Get a formal diagnosis if you haven’t already.
- Learn about your specific challenges (e.g., dyslexia, dyscalculia, ADHD, etc.).
- Recognize your strengths—many people with learning disabilities excel in creative or problem-solving areas.

#### Use Accommodations and Assistive Technology

- Request [accommodations at work](https://psychologicalassessments.com/psychological-testing-for-workplace-accommodations/) or school (extra time on tests, note-taking assistance, audiobooks, etc.).
- Use technology like speech-to-text software, text-to-speech programs, and organizational apps.
- Break tasks into smaller, manageable steps.

#### Develop Effective Learning Strategies

- Try multi-sensory learning (visual, auditory, kinesthetic).
- Use graphic organizers, color-coding, and mind maps for better comprehension.
- Practice active reading strategies like summarizing or discussing key points.

#### Strengthen Executive Functioning Skills

- Use planners, digital calendars, or reminder apps to stay organized.
- Develop routines and structure to help with time management.
- Work on self-advocacy skills—learn how to ask for help when needed.

#### Seek Support from Professionals

- Work with a specialized [academic therapist](https://therapeutictutoring.com/academic-therapist/) or tutoring specialist.
- Consider therapy (more in the next section)
- Join support groups for people with LDs.

#### Build Self-Confidence and Resilience

- Focus on your progress, not perfection.
- Develop a growth mindset—view challenges as opportunities to grow.
- Surround yourself with people who encourage and support you.

#### [Occupational Therapy](https://www.medicalnewstoday.com/articles/what-is-occupational-therapy) (OT)

- Supports motor skills, sensory processing, and daily living tasks
- Can help with handwriting, organization, and executive function challenges
- Often used for people with ADHD, dyslexia, and dyspraxia

#### [Speech and Language Therapy](https://www.verywellhealth.com/speech-therapy-5217266) (SLT/Speech Therapy)

- Helps with communication difficulties, including expressive/receptive language issues
- Supports social communication and pragmatics
- Useful for individuals with dyslexia, autism, or other language-processing difficulties

#### Executive Function Coaching

- Focuses on skills like organization, planning, and time management
- Helps individuals with ADHD or LDs develop routines
- Can be combined with therapy for better results

#### Social Skills Training to Overcome a Learning Disability

- Helps with reading social cues, making friends, and navigating conversations
- Useful for autistic individuals or those with nonverbal learning disabilities

## Types of Therapy for People with Learning Disorders

Therapy for people with learning disorders can be highly beneficial, offering support in areas like emotional regulation, social skills, executive functioning, and self-esteem. The right type of therapy depends on individual needs, but here are some common approaches:

Different therapeutic approaches can help individuals with learning disabilities manage challenges like self-doubt, anxiety, and frustration. Here’s how **Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT), and Narrative Therapy** can be beneficial:

### Acceptance and Commitment Therapy for People with Learning Disorders

**Focus:** Accepting challenges and committing to personal values instead of avoiding difficulties.

**How ACT Helps Overcome a Learning Disability:**

- Encourages **self-acceptance** rather than struggling against LD-related difficulties.
- Uses **mindfulness** to help with frustration and focus issues.
- Helps build **psychological flexibility** – adjust instead of feeling stuck.
- Encourages individuals to commit to **meaningful goals**, despite obstacles.

**Example Strategy:**
A student with dyslexia might struggle with reading but, through ACT, can accept this challenge and focus on alternative strategies (e.g., audiobooks) while pursuing their passion for storytelling.

### Cognitive Behavioral Therapy for People with Learning Disorders

**Focus:** Identifying and changing negative thought patterns that contribute to emotional distress.

**How CBT helps People Overcome a Learning Disability:**

- Addresses **self-doubt and negative self-talk** (e.g., “I’m not smart enough”).
- Helps reframe **perfectionism and failure** as opportunities.
- Provides strategies to manage **test anxiety, procrastination, and frustration**.
- It improves **emotional regulation** by helping individuals recognize and change thought patterns.

**Example Strategy:**
Someone with ADHD who struggles with organization might replace the thought **“I’ll never be good at this”** with **“I can improve with the right strategies and support.”**

### Narrative Therapy for People with Learning Disorders

**Focus:** Rewriting personal stories to emphasize strengths and resilience.

**How Narrative Therapy Helps People Overcome a Learning Disability:**

- It helps individuals see themselves beyond their **LD diagnosis**—focusing on strengths rather than struggles.
- Encourages **reframing experiences** (e.g., “I’m resilient” instead of “I always fail”).
- It uses storytelling to explore **identity beyond academic performance**.
- It empowers individuals to shape their own **positive narratives** rather than internalizing societal stigma.

**Example Strategy:**
A student who believes “I’m a failure because I struggle in school” might rewrite their story: “**I face challenges, but I am creative, determined, and capable of success in my own way.”**

### Which Therapy is Best?

- **ACT** therapy for people with learning disorders is great for building **self-acceptance** and focusing on **values-based action**.
- **CBT** therapy for people with learning disorders helps with **negative thoughts, anxiety, and emotional regulation**.
- **Narrative Therapy** helps shift **self-identity** and develop a **positive personal story**.

### Psychoeducation & Counseling for People with Learning Disorders

In addition to the more formal therapy approaches listed above, I also provide education and general counseling to clients with LDs and guidance to their parents if they are children. This approach:

- Helps individuals understand their challenges and develop self-advocacy skills
- Can include [family therapy](https://dralanjacobson.com/family-therapy/) to support parents/caregivers in understanding needs

## Case Example: Learning Disabilities and Depression

**Name:** Alex (fictional example)
**Age:** 19
**Diagnosis:** Dyslexia and ADHD
**Presenting Concern:** Struggling with learning disabilities and depression, as well as low self-esteem after transitioning to college

**Case History**

Alex was diagnosed with **dyslexia** in elementary school and **ADHD** in middle school. Despite receiving accommodations, she always felt “behind” her peers. Throughout high school, she developed coping strategies that helped but often avoided reading-heavy tasks.

Now in college, Alex faces overwhelming coursework, struggles with time management, and feels embarrassed asking for help. Her grades are declining, and she withdraws from social activities, feeling like she “isn’t smart enough.” Negative self-talk (“I’ll never succeed”) leads to **persistent sadness, fatigue, and loss of motivation**—signs of **depression**.

### Learning Disabilities and Depression Therapeutic Approach

#### CBT for Learning Disabilities and Depression

- - **Challenge Negative Thoughts:** Identifying and replacing self-defeating beliefs with realistic, encouraging statements.
    - **Behavioral Activation:** Setting small, achievable goals to rebuild motivation and self-confidence.

**Example:** Negative Thought: *“I’m stupid because I struggle with reading.”;* Reframed Thought: *“I have challenges, but I can use audiobooks and other strategies to succeed.”*

#### ACT for Learning Disabilities and Depression

- - **Mindfulness for Emotional Regulation:** Observing thoughts without judgment.
    - **Values-Based Goals:** Focusing on what matters (e.g., passion for creative projects) rather than academic perfection.

**Example:** Alex accepts her challenges instead of fighting them and focuses on personal growth.

#### Narrative Therapy for Learning Disabilities and Depression

- - **Rewriting Self-Perception:** Moving from a “failure” mindset to recognizing strengths.
    - **Empowerment through Storytelling:** Seeing challenges as part of a bigger journey toward resilience.

**Example:** Alex reworks her personal narrative from *“I’m broken”* to *“I’m resourceful and persistent.”*

### Outcome & Progress

- After a few months of therapy for learning disabilities and depression, Alex develops **self-compassion** and utilizes accommodations without shame.
- With **executive function coaching**, she creates structured study routines.
- Her mood improves as she engages in **social activities** and focuses on strengths beyond academics.

This example highlights how certain [types of therapy](https://dralanjacobson.com/types-of-therapy/) can help individuals with **learning disabilities and depression** reframe their struggles and build resilience.

## Conclusion and My Work

Living with an LD can be challenging, but with the right support, individuals can thrive in both academic and personal settings. As a [clinical psychologist](https://dralanjacobson.com/what-is-a-clinical-psychologist/), I aim to empower clients by equipping them with practical strategies and emotional resilience to navigate their unique profiles and unlink learning disabilities and mental health challenges. Therapy for people with learning disorders provides a space to reframe negative beliefs, develop strengths, and create a fulfilling path forward. With patience, self-acceptance, and the right accommodations, people can succeed on their own terms.

### Therapy for people with learning disorders: Subspecialties

I also offer two subspecialties in addition to traditional therapy for people with learning disorders:

#### Testing for Accommodations

You typically need formal testing to document your LD to receive accommodations in school or work. The process involves:

- **[Cognitive ability assessments](https://psychologicalassessments.com/iq-testing/) (IQ, memory, processing speed)** – E.g., WAIS, WISC
- **[Academic achievement testing](https://psychologicalassessments.com/achievement-testing/) (reading, writing, math skills)** – E.g., WIAT, Woodcock-Johnson
- **[Executive function](https://psychologicalassessments.com/executive-functioning-assessments/) & attention (for ADHD assessments)** – E.g., TOVA, D-KEFS
- **Language processing (for dyslexia, speech issues)**

**Possible Accommodations That Help People Overcome a Learning Disability:**

- **Extra time** on exams
- **Note-taking assistance or audio recordings**
- **Reduced-distraction testing environments**
- **Assistive technology (text-to-speech, dictation software, etc.)**
- **Flexibility with deadlines or workload**

#### Therapeutic Tutoring for Learning Disabilities

Unlike regular tutoring, [**therapeutic tutoring**](https://therapeutictutoring.com/) (or [educational therapy](https://therapeutictutoring.com/educational-therapy/)) combines academic support with cognitive and emotional strategies to address both learning disabilities and mental health. :

- Teaches **executive function skills** (organization, time management) that help people overcome a learning disability.
- It uses multi-sensory learning (great for dyslexia, ADHD, and processing disorders).
- Teaches **study strategies, self-esteem enhancement, and coping skills** (which helps, for example, with learning disabilities and depression and anxiety)
- It often involves **special education teachers or specialists** trained in LDs.

Therapeutic tutoring addresses learning disabilities and mental health concerns that are affecting progress and potential.

---

In addition to general therapy that seeks to unlink learning disabilities and mental health challenges and the subspecialties above, I can provide services that work on [sports performance](https://dralanjacobson.com/sports-psychology/) with athletes who have an LD, and [fear of public speaking](https://dralanjacobson.com/public-speaking-anxiety/) that is related to some LDs, among other specific therapies. I can weave in addressing LDs to any therapy course in my [integrative psychological practice](https://dralanjacobson.com/integrative-therapy/).

If you have any questions about my services, how to overcome a learning disability, or therapy for people with learning disorders, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Specialties

---

### [Sports Performance Psychology Process](https://dralanjacobson.com/sports-performance-psychology/)

**Published:** May 20, 2023
**Author:** Dr. Alan Jacobson

**Content:**

**Sports Performance Psychology** can be a powerful and effective way to improve athletic performance and increase motivation and enjoyment. It can also provide significant improvements in cognition that carry over outside the field of play. [Sports psychology has been proven to work](https://positivepsychology.com/sports-psychology/), and while it is always uniquely tailored to the individual, this post goes over the formal protocol that I usually follow, ending with an example of how a **sports performance psychologist** like me might use techniques to build **mental toughness in athletes** that carries over into other aspects of their lives.

**What is a Sports Performance Psychologist?**

A **sports performance psychologist** is a highly trained professional who specializes in applying psychological principles and techniques to help athletes improve their mental and emotional well-being and performance in sports. I work with athletes of all levels—from amateurs to elite professionals—focusing on enhancing the psychological factors contributing to athletic performance, such as enhancing mental toughness in athletes.

**Key Areas of Focus:**

1. **Skills Training**: A sports performance psychologist helps athletes develop mental skills like focus, confidence, relaxation, and visualization, which can improve athletic performance.
2. **Athletic Performance Anxiety**: We assist athletes in managing nerves and stress before, during, and after competition. [Techniques like mindfulness](https://dralanjacobson.com/mindfulness-therapy/) and relaxation exercises are often used.
3. **Motivation**: We work with athletes to increase motivation, whether intrinsic (self-driven) or extrinsic (external rewards), and help set realistic goals for improvement.
4. **Mental Toughness in Athletes**: A sports performance psychologist helps athletes develop strategies for staying calm and focused in high-pressure situations, such as crucial moments of a game or other athletic performance.
5. **Injury Recovery**: We support athletes emotionally and mentally during injury recovery, helping with the mental challenges of rehabilitation, such as fear of re-injury, loss of confidence, and frustration.
6. **Team Dynamics**: We may work with teams to enhance communication, resolve conflicts, and foster a positive team culture.
7. **Confidence Building**: A sports performance psychologist helps athletes overcome self-doubt, build mental resilience, and strengthen their belief in their abilities.
8. **Mind-Body Connection**: We emphasize the link between mental well-being and athletic performance, showing athletes how to use their minds to control physical reactions and improve athletic outcomes.

**Sports Performance Psychology Methods and Techniques:**

A sports performance psychologist often braids together some of the following techniques:

- **[Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT)**: Used to address negative thoughts and beliefs that may affect athletic performance.
- **Visualization/Imagery**: Athletes imagine performing successfully to boost confidence and mental readiness.
- **Relaxation Techniques**: Deep breathing, progressive muscle relaxation, or meditation help reduce stress and anxiety.
- **Goal Setting**: Setting specific, measurable, and achievable goals helps athletes stay focused and motivated.
- **Self-Talk Training**: Building mental toughness in athletes involves helping them control and guide their inner dialogue to stay positive and focused.

**When Athletes Work with a Sports Performance Psychologist:**

There are many reasons why an athlete may look to the services of a sports performance psychologist, including:

- To improve focus and concentration during competition.
- When they feel anxiety or stress, it interferes with their performance.
- To work through slumps or athletic performance plateaus.
- To overcome performance fears (e.g., fear of failure or fear of injury).
- When facing challenges like team conflict or transition phases (e.g., moving from amateur to professional levels).

In summary, a sports performance psychologist helps athletes optimize their mental game, enhancing their overall performance and well-being. We play a key role in the athlete’s journey by supporting mental health, managing stress, and building resilience and mental toughness in athletes. These factors contribute to success on and off the field.

**Sports Performance Psychology Process**

The following is the general process for sports performance psychology work.

1. **Collecting History**

I start by taking a history in the sport of choice:

- How long have they been playing, and when do they play best? What have been the athletic performance highlights and the opposite?
- When was their best game or performance? Their worst? When did they experience “[Athletic Flow](https://dralanjacobson.com/flow-state/)“?
- What logistics led to that event regarding sleep, diet, practices, etc.?
- How confident did the athlete feel right before the performance and leading up to it? What anxieties were there?
- What were they thinking about during the athletic performance? How would an observer have described their behavior?
- What did coaches say or do?
- Outside of sports, how was s/he feeling emotionally during that time?

Overall, I’m looking for the trajectory of the athlete’s career so far – when (and if possible, why) have there been jumps or drops in performance? It’s important to know where things are and how they got there.

Then, I look beyond sports and get a more general developmental history of the athlete in areas such as school, social life, and home. As mentioned, effective sports performance psychology therapy can positively impact other areas, and the converse is also true – happiness and contentment outside of athletics can help performance.

2. **Sports Performance Psychology Plan**

After collecting the history, we will build the sports performance psychology plan. What might peak performance look like? How are things going now? What goals has the athlete set for performance, and what timelines are in place? As with history, I also look at other areas where performance is important. For high school and college athletes, how is school going? How is s/he feeling socially? What other activities are there, and how are they going?

Next, we begin to piece together the story of the student athlete’s journey so far in a way that emphasizes the positive and hopeful aspects of what the future could bring. We have explored the past and present, and the next step moves to the future. I carefully combine objective and subjective data to craft the plan. We must come to some highly tangible and measurable data points to tell what is working. It is also important for the [athlete to see clear improvement](https://dralanjacobson.com/athletic-performance-improvement/) that enhances mental toughness in athletes. I also pay close attention to improvements in less measurable areas, such as confidence, enjoyment, and motivation. These factors carry over outside of sports.

If you think it would be helpful, I can also connect with coaches and teachers during this phase. They may have insights or ideas that would be helpful. This might also help us understand the coach or teacher’s style and approach, which could guide the plan.

3. **Sports Performance Psychology Treatment**

After collecting information and building a treatment plan, it is time for the actual sports performance psychology therapy to begin. I teach many different techniques designed to help the athlete perform their best. These techniques include:

- **Goal setting:** Helping athletes set realistic and achievable performance goals.
- **Visualization:** Teaching athletes to rehearse their actions and performance mentally.
- **Self-talk:** Encouraging positive self-talk and managing negative thoughts in key to building mental toughness in athletes.
- **Concentration and focus:** Enhancing an athlete’s ability to concentrate during competition.
- **Stress management:** Teaching strategies to cope with performance anxiety and pressure.
- **Emotional control:** Helping athletes manage their emotions, such as anger or frustration, during competition.
- **Motivation:** Maintaining and boosting an athlete’s motivation and commitment to training and competition.

The type and combination of techniques used will depend on what the athlete prefers and thinks will work and what I believe is the best fit, given my experience. This planning is always done in collaboration with you!

4. **Sports Performance Psychology Homework**

Often, during this phase, we might give a homework assignment related to an upcoming competition – what we want the athlete to remember about what they were thinking or feeling during certain phases of competition, for example. After a while, this homework shifts into how the athlete will use techniques learned in sessions during competition. As time passes, therapy changes and evolves as the athlete sees improvement or gets stuck.

We will often add new goals to replace those that were reached. Eventually, therapy may move to less often or as needed. Still, usually, top athletes maintain contact and connection with a psychologist throughout their career, especially after they see the power and effectiveness of sports performance psychology!

Out treatment together may involve reviewing film or a live broadcast, 24/7 phone support when needed for a boost before an athletic competition, and 24/7 phone support after a competition should there be aspects of the competition that would best be discussed as soon as possible.

5. **Enhanced Services**

Like all my[ clinical specialties](https://dralanjacobson.com/intensive-therapy-and-specialty-services/), sports performance psychology can include help outside the scheduled weekly sessions. If you feel it would help, we can plan to connect right before a competition to go over the techniques you’ve learned and how to institute them most effectively at the moment. We can also connect right afterward if it would be helpful to go over things before you forget some of the details of your thoughts and feelings during the competition.

Our extra work might include looking at film or connecting with coaches, and can also be combined with my [college admissions services](https://dralanjacobson.com/college-admissions-counseling/) if you are in high school and hope to be a student-athlete. We might also use one of the many [sports performance improvement](https://dralanjacobson.com/sports-performance-improvement-innovations/) technological innovations available.

**Case Example: Building Mental Toughness in Athletes**

A sports performance psychologist often works on building mental toughness in athletes, focusing on both the physical and psychological demands they face in their sport and their personal lives. Building mental toughness in athletes is crucial for overcoming obstacles, maintaining focus under pressure, and bouncing back from setbacks. Here’s a case example of how a sports performance psychologist like me might build mental toughness in a college student-athlete:

**Athlete Background:**

Sarah is a sophomore who is a sprinter and has recently struggled with consistency in her performances. While she’s talented and has the physical capability, she struggles with self-doubt and anxiety, especially when the stakes are high. She tends to get frustrated after setbacks, affecting her motivation and focus for future events.

**Sports Performance Psychology Techniques**

1. **Building Confidence Through Self-Talk:**
    - **Athletic Performance Issue**: Sarah’s self-doubt tends to undermine her confidence during high-pressure situations.
    - **Intervention**: 
        - Teach Sarah the power of positive self-talk to combat negative thoughts. Help her create a set of affirmations like “I am strong,” “I am prepared,” or “I am capable of handling challenges.”
        - Incorporate visualization exercises where Sarah imagines herself succeeding and handling adversity with confidence.
        - Encourage her to reframe failure as a learning opportunity rather than a reflection of her ability.
2. **Emotional Regulation & Focus:**
    - **Issue**: Sarah struggles with controlling emotions when things aren’t going her way, causing her to lose focus in races.
    - **Intervention**: 
        - Introduce mindfulness exercises like meditation and breathing techniques to help her manage anxiety and stay present during competition.
        - Practice mindfulness under controlled conditions in training so she can apply it in high-pressure situations.
        - Develop strategies for Sarah to refocus quickly after a mistake (e.g., focus on one breath, reset, and keep going).
3. **Goal Setting and Resilience:**
    - **Issue**: Sarah feels discouraged when her results don’t match her expectations, causing a dip in her motivation.
    - **Intervention**: 
        - Help Sarah break down her long-term goals into smaller, more manageable milestones. For example, setting personal bests, improving specific skills, or mental markers like staying calm during competition.
        - Teach Sarah how to bounce back from setbacks by framing challenges as part of her growth journey.
        - Use journaling to track progress, reflect on lessons from difficult situations, and celebrate incremental achievements.
4. **Building a Support System:**
    - **Issue**: Sarah’s isolation during tough times can increase her feelings of pressure.
    - **Intervention**: 
        - Encourage Sarah to develop strong relationships with teammates and coaches where she feels comfortable expressing concerns and seeking support.
        - Provide tools for constructive feedback so that Sarah feels supported rather than criticized when addressing her performance.
        - Help her understand the importance of balance, advocating for self-care and finding time to rest mentally and physically.
5. **Preparation and Focus During Training:**
    - **Issue**: Sarah’s focus during training can sometimes be inconsistent, affecting her progress.
    - **Intervention**: 
        - Help Sarah implement pre-performance routines (like listening to motivating music or reviewing her goals) to get into the right mindset.
        - Create a structured training plan that includes both physical and mental components, like mental rehearsals or reflective practice sessions after each workout.
        - Emphasize the value of consistency in mental preparation—Sarah should treat every training session as an opportunity to build mental toughness, not just physical strength.
6. **Sports Performance Psychology Visualization Techniques:**
    - **Issue**: Sarah struggles with anxiety and nerves before big races, often imagining negative outcomes.
    - **Intervention**: 
        - Introduce Sarah to visualization techniques where she mentally rehearses her race, focusing on executing every part of her technique smoothly and confidently.
        - Encourage her to visualize success regularly, including the feeling of crossing the finish line strong, maintaining her form, and overcoming difficult moments.

**Mental Toughness in Athletes Implementation Plan:**

1. **Weekly Mental Skills Training**: Sarah will meet with me weekly to work on these areas, such as reframing negative thoughts and practicing mindfulness.
2. **Athletic Performance Journaling & Reflection**: Sarah will start journaling after every race and practice to reflect on how she handled emotions, setbacks, and successes. She will note specific areas to work on.
3. **Group Training Sessions**: Occasionally, she will participate in group activities with teammates where they practice mental skills together, fostering a sense of camaraderie and shared learning.
4. **Continuous Check-ins with Coaches**: Regular feedback from her coach will ensure alignment with her goals and mental approach, giving her tangible steps to work on during practices and competitions.

**Athletic Performance Results:**

The following are the [sports psychotherapy](https://dralanjacobson.com/sports-psychotherapy-outcomes/) outcomes for Sarah

- **Confidence Growth**: Over time, Sarah will likely notice a boost in her self-confidence, especially when faced with challenges, as she learns to use positive self-talk and visualization techniques.
- **Improved Focus**: By developing mindfulness and emotional regulation skills, Sarah should be able to stay focused and maintain composure during competition, no matter the pressure.
- **Increased Resilience**: With clear goals and a better understanding of setbacks as learning opportunities, Sarah will be more resilient when things don’t go as planned and stay motivated to keep improving.

Mental toughness in athletes is a vital skill that can be developed through focused practice and learning. For a college student-athlete like Sarah, building mental toughness is not just about pushing through physical limits but developing the mental resilience to handle challenges, stay focused, and maintain a positive mindset no matter the circumstance.

**Summary and My Work**

The methods I use with athletes and coaches are well-established and proven scientifically through well-run research. There should be meaningful and measurable changes in performance and related changes in motivation and enjoyment. We will set specific goals and realistic timelines that enable us to assess the effectiveness of each intervention as we go. Sports performance psychology treatment can be valuable for athletes and teams seeking a competitive edge. You can read an example of [Sports Psychotherapy](https://dralanjacobson.com/sports-psychotherapy-example/) and some[ athletic performance improvement self-help strategies](https://dralanjacobson.com/athletic-performance-improvement/) on my blog.

**Sports Performance Psychology for Teams**

I can also provide services such as building mental toughness in athletes for teams, using many of the same techniques, and working on team chemistry, communication, and roles. In these cases, coaches play an integral role in the design and implementation of the work. These services can be delivered to teams who play a team sport and individuals who compete as part of a team but in individual events. Often, the homework given to team sports participants involves doing something together.

**Athletic Performance Improvement Plans**

My work as a sports performance psychologist is individually tailored to the athlete, the sport, and the current level of athletic performance. We can also decide on the frequency we will meet, the likely duration of services, and whether any [general therapy services](https://dralanjacobson.com/) will be mixed in. I would be happy to [talk to you](https://dralanjacobson.com/contact/) about your goals and what therapy might consist of. For more information about **sports performance psychology** and to sign up for a free consultation, visit my [Sports Psychology Specialty](https://dralanjacobson.com/sports-psychology/) page.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Sports Psychology

---

### [Internal Family Systems Therapy (IFS)](https://dralanjacobson.com/internal-family-systems-therapy-ifs/)

**Published:** August 5, 2024
**Author:** Dr. Alan Jacobson

**Content:**

I provide Internal Family Systems Therapy (IFS Therapy), a psychotherapy approach developed by [Dr. Richard C. Schwartz](https://en.wikipedia.org/wiki/Richard_C._Schwartz) in the 1980s. It is based on the idea that the mind comprises multiple sub-personalities or “parts,” each with unique perspectives, memories, and roles. The internal family systems model aims to help individuals achieve healing by fostering harmony and balance among these internal parts. This approach can be used alone or, more commonly, combined with other approaches in an interactive practice like mine. It fits well with many [humanistic approaches](https://dralanjacobson.com/basic-tenets-of-humanistic-psychology/) and [psychodynamic therapy](https://dralanjacobson.com/psychodynamic-therapy/).

If you already know about Internal Family Systems Therapy and want to talk about how it might work for you, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Internal Family Systems Model

This section provides an overview of the internal family systems model, including its components and uses.

### Internal Family Systems Components

Here are some key concepts and components of IFS Therapy:

1. **Parts of the Internal System**: 
    - Managers: These parts try to maintain control over the internal and external environments to protect the person from feeling hurt or vulnerable.
    - Exiles: These are often the parts that carry the pain, trauma, and memories of past experiences. Managers typically suppress or exile them.
    - Firefighters: These parts emerge when exiles break out and their painful feelings surface. Firefighters attempt to numb or distract from this pain, often through impulsive or harmful behaviors.
2. **Self**: 
    - In the internal family systems model, the self is considered the core of the person, characterized by qualities such as compassion, curiosity, calmness, confidence, creativity, courage, clarity, and connectedness. In IFS therapy, it is believed that everyone has a Self capable of leading the internal system toward healing.
3. **Unburdening**: 
    - This IFS Therapy process involves helping the exiled parts release the burdens of pain and trauma, often leading to relief and integration within the individual.
4. **Integration**: 
    - IFS therapy aims to help all parts of the self work together harmoniously, led by the Self. This integration leads to a more balanced and healthy internal system.
5. **Therapeutic Relationship**: 
    - In the internal family systems model, the therapist serves as a guide to help the client connect with and navigate their internal parts. The therapist models qualities of the Self and helps the client cultivate these within themselves.

### Internal Family Systems Uses

IFS therapy is effective in treating a variety of [psychological issues individuals face](https://dralanjacobson.com/individual-therapy/), including clinical depression, anxiety, PTSD, and more. As detailed above, the internal family systems model emphasizes the importance of understanding and healing the inner family of parts rather than focusing solely on external symptoms. It is a solid approach when an individual wants to process [adult child estrangement](https://dralanjacobson.com/family-estrangement-therapy/).

## Internal Family Systems Therapy Process

Internal Family Systems Therapy employs various techniques to help individuals understand, relate to, and heal their internal parts. Here are some fundamental techniques used in IFS Therapy:

1. **Mapping the System**: 
    - You and I create a visual or conceptual map of your internal parts. This helps identify the different parts, their roles, relationships, and the dynamics between them.
2. **Getting to Know the Parts**: 
    - I then guide you in identifying and connecting with your parts. This involves noticing thoughts, emotions, and physical sensations representing different parts. You might do some of this as early homework in IFS therapy.
    - I will ask you to listen to their parts without judgment, fostering an open and curious attitude.
3. **Unblending**: 
    - This internal family systems therapy technique involves helping you differentiate or “unblend” from your parts. When a part is very active, it can blend with your identity, making it difficult to see it as separate.
    - Unblending helps you recognize that you are not the part but rather have a part experiencing certain thoughts and feelings.
4. **Accessing the Self**: 
    - In the next step in internal family systems therapy, I encourage you to access your Self, the core aspect of your calm, compassionate, and curious identity.
    - Techniques such as mindfulness, visualization, and relaxation exercises can help you connect with your Self.
5. **Dialoguing with Parts**: 
    - Next, I facilitate conversations with your parts. This dialogue helps parts express their concerns, desires, and roles.
    - I help you listen to the parts with empathy and curiosity, fostering understanding and connection.
6. **Witnessing and Validating**: 
    - Next, you are guided to witness the experiences and burdens of your parts without trying to fix or change them immediately.
    - This process validates the parts’ feelings and experiences, which can be healing.
7. **Unburdening**: 
    - This IFS therapy technique involves helping parts release the burdens they carry, often related to past trauma or negative beliefs.
    - I’ll help you assist the part to let go of these burdens, which can lead to a sense of relief and freedom.
8. **Integration and Harmonization**: 
    - The goal is to create harmony and balance among the parts, led by the Self. This involves fostering cooperation and collaboration among parts.
    - This core aspect of the internal family systems model involves doing homework where you integrate the changes and healing that occur during therapy into your daily life.

### Other IFS Therapy Methods

In addition to the process above, some clients benefit from having inner family meetings. Similar to family therapy, but within the internal system, these meetings involve bringing multiple parts together for a dialogue. This can help resolve conflicts, improve communication, and create a sense of unity among the parts.

Other people enjoy using creative expression techniques where you draw, journal, or role-play to explore and express their parts. These techniques can help us access and understand parts that might be difficult to reach through verbal communication alone.

Each internal family therapy technique is designed to help clients build a compassionate relationship with their internal parts, leading to healing and greater internal harmony. My role in the internal family systems model is to facilitate this process, ensuring you feel safe and supported throughout your journey.

## IFS Therapy Example

Sarah is a 35-year-old woman experiencing anxiety and low self-esteem, especially in social situations. She has tried some other [types of therapy ](https://dralanjacobson.com/types-of-therapy/)but with only minimal success.

### Session Outline:

#### 1. **Introduction and Establishing Safety**

I’ve already talked to Sarah on the phone after she called with questions about how internal family systems therapy might work for her. She is quite creative and insightful, and I thought it might be a good fit. I start by saying, “Welcome, Sarah. Today, we’ll explore some parts of yourself that might be contributing to your anxiety and low self-esteem. Remember, you control this process, and we’ll go at your pace.”

#### 2. **Mapping the System**

- **Me:** “Let’s start by identifying the different parts of you that come up when you feel anxious or have low self-esteem. Can you think of a time when you recently felt this way?”
- **Sarah:** “Yes, last week at a work meeting, I felt really anxious and unsure of myself.”
- **Me:** “Great. Can you describe the different feelings, thoughts, or sensations you noticed during that time?”

Sarah identifies:

- A critical voice telling her she’s not good enough (a **Manager** part).
- A sense of overwhelming fear and inadequacy (an **Exile** part).
- A strong urge to leave the room or distract herself (a **Firefighter** part).

#### 3. **Getting to Know the Parts**

- Me: “Let’s start with the critical voice. Can you focus on it for a moment and see if it has anything it wants to tell you?”
- Sarah: “It says I need to be perfect, or people will think I’m a failure.”

#### 4. **Unblending**

- Me: “That’s an important part of you. Let’s see if you can step back a little and observe this critical voice without being overwhelmed. Can you imagine it sitting beside you rather than inside you?”
- Sarah: “I think so. It feels a bit separate now.”

#### 5. **Accessing the Self**

- Me: “Now that you have some space, can you find a sense of calmness or curiosity inside yourself? This is your Self, which can help lead the way.”
- Sarah: “I feel a bit more relaxed and curious about why this part is so critical.”

#### 6. **Dialoguing with Parts**

- Me: “From this place of curiosity, let’s ask the critical part: Why does it feel the need to be so hard on you? What is it trying to protect you from?”
- Sarah: “It says it’s trying to protect me from being judged or failing. It thinks if I’m perfect, no one can hurt me.”

#### 7. **Witnessing and Validating**

- Me: “Thank you for sharing that. Let’s acknowledge that this part has been working hard to protect you. Can you thank it for its efforts?”
- Sarah: “Thank you for trying to keep me safe.”

#### 8. **Unburdening**

- Me: “Would this part be willing to let go of some of its burdens, knowing that you’re now aware of its concerns and can take over from here?”
- Sarah: “It’s willing to try. It feels lighter already.”

#### 9. **Integration and Harmonization**

- Me: “Let’s invite the other parts—the fearful part and the part that wants to escape—to join this conversation. Can you listen to them and see their feelings about what’s happening?”
- Sarah: “The fearful part feels relieved that it doesn’t have to carry the weight alone. The part that wants to escape feels like it can relax a bit.”

#### 10. **Closing the Session**

- Me: “You did great work today, Sarah. How do you feel about what we discovered?”
- Sarah: “I feel more in control and compassionate toward myself. I understand these parts better now.”

#### Follow-Up:

- Me: “For our next session, let’s continue exploring these parts and see if other parts need attention. Meanwhile, practice being curious and compassionate towards your parts.”

This example illustrates how an internal family systems therapy session might unfold. My client is helped to understand and heal their internal system through a compassionate and structured approach.

## Summary and My IFS Work

Internal family systems therapy is an excellent approach for those who want to explore their inner psychology creatively and powerfully. The internal family systems model provides an excellent adjunctive treatment to cognitive-behavioral and [humanistic therapy techniques](https://dralanjacobson.com/humanistic-therapy/) such as [gestalt therapy](https://dralanjacobson.com/gestalt-therapy/) and [narrative treatment](https://dralanjacobson.com/narrative-therapy/). Note that as much as they sound alike, IFS is different from [family systems therapy](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/), which involves treating the whole family. It is also different from the [family of origin therapy](https://dralanjacobson.com/family-of-origin-therapy/), which explores the actual childhood relationships that affect you now.

If this treatment approach resonates, or you just want more information about how it might work for you, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Sports Psychotherapy Outcomes](https://dralanjacobson.com/sports-psychotherapy-outcomes/)

**Published:** September 5, 2023
**Author:** Dr. Alan Jacobson

**Content:**

**Sports psychotherapy** focuses on the psychological aspects of sports performance and well-being. The outcomes of my [services in sports psychology](https://dralanjacobson.com/sports-psychology/) are centered around enhancing an athlete’s mental and emotional state to improve their performance and to have those improvements carry over into other aspects of their life, as you can see in the [sports psychotherapy example](https://dralanjacobson.com/sports-psychotherapy-example/) I posted. This post covers an overview and expected outcomes of [the process](https://dralanjacobson.com/sports-performance-psychology/) of sports psychotherapy.

I always [welcome inquiries](https://dralanjacobson.com/contact/) about how any of my services can meet your or your child’s unique needs, and I hope this overview helps you become an informed consumer, whether you choose my services or others.

## Sports Psychotherapy Toolkit

Throughout our Sports Psychotherapy work, we will develop a toolkit to help the athlete as challenges, opportunities, and stressors arise. These may include:

### Sports Psychotherapy and Stress Management

Sports psychotherapy helps athletes develop coping strategies for dealing with the pressures and stressors, such as competition or high expectations. Techniques like relaxation training and mindfulness can be taught to manage stress effectively. [Cognitive therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) techniques can also help with developing coping and self-improvement skills.

These interventions also offer relaxation techniques, stress management strategies, and mental rehearsal to help athletes stay composed during high-pressure situations.

### Sports Psychotherapy and Confidence Building

Building self-confidence is a crucial outcome of our work together. Athletes learn to believe in their abilities and develop a positive self-image. This newfound confidence can significantly impact their performance, overall well-being, and pursuits off the field. [Cognitive-behavioral techniques](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) and [narrative principles](https://dralanjacobson.com/narrative-therapy/) can help and be part of the toolkit.

### Improved Concentration and Focus

Athletes who use this service learn to maintain focus during practice and competition, block out distractions, and stay in the present moment. Enhanced concentration can lead to better decision-making and skill execution. It can also lengthen the period where the athlete feels “flow.” Techniques like mindfulness and mental imagery can sharpen an athlete’s ability to concentrate, focus on the task, and block out distractions during competitions.

### Mental Resilience Through Sports Psychotherapy

Athletes develop mental toughness and resilience to bounce back from setbacks, failures, or losses. They learn to view challenges as opportunities for growth and development. This is where we might build the toolkit with [Solution-Focused Therapy](https://dralanjacobson.com/solution-focused-therapy/) and more [narrative principles](https://dralanjacobson.com/narrative-therapy/).

### Sports Psychotherapy for Improved Performance

Enhancing athletes’ mental resilience, focus, and confidence can improve their [athletic performance](https://dralanjacobson.com/sports-performance-psychology/). In sports psychotherapy, athletes learn to manage performance anxiety, maintain concentration, and harness the power of positive thinking. Our goal is to have the athlete improve in the field of play and experience the [Athletic Flow](https://dralanjacobson.com/flow-state/) or “being in the zone” more frequently. We use goal-setting, focus, concentration, visualization, and confidence-building techniques to help athletes perform at their best under pressure.

We set specific, measurable, achievable, relevant, and time-bound ([SMART](https://www.atlassian.com/blog/productivity/how-to-write-smart-goals)) goals at the beginning of the sports psychotherapy program. The athlete will learn how to create action plans and strategies to achieve these goals, whether related to performance, skill development, or competition results. Everything that works becomes part of the athlete’s toolkit going forward.

## Other Sports Psychotherapy Goals

Sports therapy is also designed to help athletes reach other goals off the field. It doesn’t just focus on the field of play itself and helps athletes manage their lifestyle, stressors, and relationships outside of their athletic endeavors. Athletes often experience personal growth by developing skills like goal-setting, time management, and self-awareness that extend beyond their athletic career.

### Better Communication and Conflict Resolution

Teams often require effective communication. My services are designed to help [athletes improve](https://dralanjacobson.com/athletic-performance-improvement/) their communication skills, resolve conflicts, and build more robust team dynamics. These skills also carry over into other aspects of their academic experience and careers. Many employers like hiring current or former athletes because they know they have these types of skills.

### Sports Therapy and General Wellness

Beyond performance enhancement, sports therapy focuses on athletes’ mental health and well-being. It provides a safe space to discuss and manage issues such as anxiety, depression, and stress that may affect an athlete’s life both on and off the field. In addition, athletes often learn life skills such as time management, goal setting, and decision-making.

These are just two short examples of the other [improvements that athletes can make through sports](https://dralanjacobson.com/sports-performance-improvement-innovations/) therapy. There are many more, and we review all the possibilities as we design your unique treatment plan.

## Sports Therapy Results

After a course of sports therapy treatment, each athlete should feel that they’ve made improvements in three specific areas:

### Sports Psychotherapy and Confidence

Athletes often face adversity, stress, and setbacks. Sports psychology equips them with strategies to cope effectively, develop resilience, and bounce back from setbacks more quickly. The athlete should feel more confident performing at or close to their peak more often after sports psychotherapy. This also includes feeling they can overcome barriers in this area, such as anxiety, worry, and doubt. They should find themselves experiencing “flow” more often.

### Sports Psychotherapy and Focus

Athletes should feel better able to focus and attend before and during practices and games. It should feel like things have slowed down for them somehow. This should also help them develop their communication and leadership skills. Many athletes feel that these gains carry over into other aspects of their lives, where challenging school and work situations also “slow down” in ways that allow them to process information better and respond.

### Sports Therapy and General Improvement

The gains should carry over into other areas of their life. Those abilities to manage stress, overcome barriers, and develop solutions and coping strategies should be evident in school, work, and even socially.

The efficacy of sports psychology techniques can vary based on an athlete’s receptiveness, consistency in practice, and the skill of the psychologist or mental coach. Athletes who actively engage in mental and physical training often experience more significant benefits in their overall performance and well-being.

## Conclusions and My Services

Overall, the outcomes of sports therapy are aimed at helping athletes develop the mental skills and resilience needed to excel and lead a more balanced and fulfilling life. My [Sports Psychology Services](https://dralanjacobson.com/sports-psychology/) cover all of this and are available to athletes of all ages and all levels. I have provided treatment to high school, college, and professional athletes, and to this point, I have helped athletes in many different team and individual sports.

I sometimes provide sports psychotherapy to entire teams or groups of leaders within the team (such as captains). This work with teams is designed to build better communication, trust, and cohesion among athletes, fostering a supportive environment that enhances overall team performance. I also consult with coaches who want to weave the principles of [sports psychology](https://dralanjacobson.com/sports-psychology/) into their work.

My sports psychotherapy services can be delivered in the traditional once-weekly manner or can be an intensive service where I provide more and offer more flexibility about the times we can meet. It can be a [virtual](https://dralanjacobson.com/virtual-therapy-guide/) service or one that can be done in person.

If you’d like to learn more about **sports psychotherapy**, how [My clinical specialties](https://dralanjacobson.com/intensive-therapy-and-specialty-services/) might work for you, or even get a few quick tips, please [get in touch](https://dralanjacobson.com/contact/) with me any time. You can also try my [sports performance psychology self-help tips](https://dralanjacobson.com/athletic-performance-improvement/) if you want to get an idea of what these methods might be like.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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**Categories:** Sports Psychology

---

### [Third-Wave Psychotherapy](https://dralanjacobson.com/third-wave-psychotherapy/)

**Published:** September 23, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Third-wave psychotherapy (**aka **third-wave CBT** or **third-wave cognitive-behavioral therapy**) refers to a movement that focuses on a more holistic and context-driven approach to mental health**.** I offer most of the third-wave therapies in my practice, often braiding them together for the best results for each client. I also combine them with other approaches, such as [existential](https://dralanjacobson.com/existential-therapy/), [logotherapy](https://dralanjacobson.com/logotherapy/), and [Narrative therapy](https://dralanjacobson.com/narrative-therapy/), which share some common ideals. This post provides an overview of third-wave therapy and an example of how they might work in practice at the end.

If you have specific questions about third-wave psychotherapy and how it might work for you or a loved one, please feel free to [call me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime. I generally use third-wave therapy in [individual counseling](https://dralanjacobson.com/individual-therapy/), but there are also ways to use it in [couples counseling](https://dralanjacobson.com/couples-therapy/) and [family therapy](https://dralanjacobson.com/family-therapy/). Of course, I also mix these methods into my [clinical specialty areas](https://dralanjacobson.com/intensive-therapy-and-specialty-services/).

## Third-Wave Psychotherapy Overview

While original CBT approaches focused on behaviorism (changing specific behaviors), and the second round of CBT added [cognitive restructuring](https://dralanjacobson.com/cognitive-restructuring/) (changing thought patterns), third-wave therapies incorporate mindfulness, acceptance, and an emphasis on values and context rather than just symptom reduction. Third-wave CBT is an exciting advancement.

### Third-Wave Psychotherapy History

Third-wave psychotherapy was primarily developed by a group of psychologists and researchers who sought to build upon traditional cognitive-behavioral therapy (CBT) approaches by integrating mindfulness, acceptance, and contextual factors into treatment. While there is no single founder of “third-wave therapy” several key figures were instrumental in its development:

1. [**Steven C. Hayes**](https://en.wikipedia.org/wiki/Steven_C._Hayes): A major figure in the third-wave CBT, Hayes developed **[Acceptance and Commitment Therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) (ACT)** in the late 1980s. ACT focuses on accepting difficult thoughts and emotions while committing to actions aligned with personal values. Hayes’ work played a crucial role in shifting the focus of therapy from symptom reduction to psychological flexibility.
2. [**Zindel Segal, Mark Williams, and John Teasdale**](https://psycnet.apa.org/record/2001-05895-000): These psychologists developed **[Mindfulness-Based Cognitive Therapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) (MBCT)**, which blends traditional CBT with mindfulness practices. It was designed to prevent depression relapse and is one of the key approaches in the third-wave CBT.
3. **[Paul Gilbert ](https://en.wikipedia.org/wiki/Paul_Gilbert_(psychologist))**developed**[ Compassion-Focused Therapy](https://dralanjacobson.com/compassion-focused-therapy/) (CFT),** a third-wave CBT approach that emphasizes self-compassion and addresses the role of self-criticism in mental health. Though less well-known than ACT and DBT, CFT is part of the broader third-wave CBT movement.

These thinkers helped expand traditional CBT into more experiential and holistic approaches, integrating mindfulness, acceptance, and values to promote lasting change. The third wave has become an influential part of modern psychotherapy, especially for conditions like anxiety, depression, and personality disorders.

### Key Third-Wave Therapies

As also mentioned above, some key third-wave therapies include:

1. **[Acceptance and Commitment Therapy](https://dralanjacobson.com/act-psychotherapy/) (ACT)**: This third-wave psychotherapy emphasizes accepting emotions rather than avoiding them while committing to value-driven actions. Its goal is psychological flexibility—being able to adjust to situations while maintaining personal values.
2. **[Dialectical Behavior Therapy](https://en.wikipedia.org/wiki/Dialectical_behavior_therapy) (DBT)**: Originally developed for borderline personality disorder, DBT is a third-wave cognitive-behavioral approach that integrates mindfulness with skills like emotion regulation, interpersonal effectiveness, and distress tolerance. (I provide [DBT therapy for teens](https://dralanjacobson.com/dbt-for-teens/) but not adults.)
3. **[Mindfulness-Based Cognitive Therapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) (MBCT)**: This third-wave cognitive-behavioral approach combines traditional CBT with [mindfulness therapy](https://dralanjacobson.com/mindfulness-therapy/) techniques. This third-wave therapy is used primarily to prevent the relapse of depression by helping individuals observe their thoughts and feelings without judgment.
4. **[Compassion-Focused Therapy](https://dralanjacobson.com/compassion-focused-therapy/) (CFT)**: This more recent third-wave psychotherapy focuses on cultivating self-compassion and reducing self-criticism, which can be a major barrier to psychological well-being.
5. **[Mindfulness-Based Stress Reduction](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) (MBSR)**: Finally, MBSR is a third-wave cognitive-behavioral approach that uses mindfulness and meditation techniques to reduce stress, anxiety, and chronic pain.

These methods emphasize mindfulness, acceptance, and a nonjudgmental approach to thoughts and feelings. They aim for long-term psychological flexibility rather than quick fixes for specific symptoms.

## Third-Wave Therapy Example: ACT

An example of third-wave therapy in action is Acceptance and Commitment Therapy (ACT), which focuses on helping individuals accept their thoughts and feelings without trying to change or avoid them. Instead of trying to eliminate negative emotions, ACT teaches people to live with these experiences while focusing on their core values and taking meaningful actions. The result is a greater sense of meaning and positivity, reducing the power of negative thoughts and feelings. ACT is one of the core third-wave cognitive-behavioral therapies I use.

The following is a brief, fictitious example designed to give you an idea of how this third-wave psychotherapy works.

### Example Scenario: Social Anxiety

Jill is a 25-year-old graduate student with social anxiety. Despite being a friendly and engaging person, she avoids situations where she has to interact with others, such as attending social events or speaking in public. Traditionally, cognitive-behavioral therapies might have focused on challenging and reframing her thoughts to be less fearful or anxious about these situations. However, I choose ACT (a third-wave therapy) for Jill, and in session we work on:

1. **Acceptance**: I help Jill recognize and accept that feelings of anxiety may come up in social situations. Instead of trying to suppress or eliminate these feelings, I show her how to acknowledge them without judgment. She practices this for homework in social situations at school, starting with smaller and less challenging ones.
2. **Mindfulness**: I teach Jill mindfulness techniques to observe her anxious thoughts (e.g., “People will judge me”) as just thoughts, not necessarily truths. She learns to experience these thoughts without being consumed by them. In each subsequent session, Jill reports back on how this went, and we refine the mindfulness third-wave therapy techniques as needed to make them more effective.
3. **Values-Based Action**: I help Jill clarify what really matters to her (e.g., building meaningful relationships and achieving professional success) and encourage her to take steps in line with these values, despite the presence of anxiety. For Jill, this includes attending a social networking event in her field even if she feels anxious, as building these relationships is important to her. Again, we only go as fast as Jill is comfortable with in third-wave cognitive behavioral therapy.

### ACT Third-Wave Psychotherapy Outcome

The goal of this third-wave cognitive-behavioral approach isn’t to eliminate JIll’s anxiety but to help her live a meaningful life while accepting that discomfort may sometimes be part of that process. Paradoxically, she finds that her social anxiety significantly decreases even though it is not directly targeted.

## Third-Wave CBT Example

A good example of **third-wave Cognitive-Behavioral Therapy (CBT)** is **Mindfulness-Based Cognitive Therapy** (MBCT), a therapeutic approach combining traditional CBT and mindfulness practices. This third-wave psychotherapy is often used to prevent the recurrence of depression and to help individuals deal with anxiety. As with the above, this fictitious case is designed to show you how third-wave CBT might work in practice.

### Example Scenario: Recurrent Depression

John has experienced recurrent bouts of mild depression, which have happened despite most things going well in his life. [Traditional CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) might involve identifying and challenging negative thought patterns (e.g., “I’m worthless” or “Nothing ever goes right for me”). In contrast, third-wave cognitive-behavioral MBCT focuses on helping John observe these thoughts more detachedly, without engaging or trying to change them directly.

### How MBCT might work

1. **Mindfulness Practice:** I teach John mindfulness meditation techniques, which involve bringing attention to the present moment and observing thoughts, feelings, and bodily sensations without judgment. For example, John practices a “body scan,” paying attention to different bodily sensations, such as observing his breathing. This is a core third-wave cognitive-behavioral technique.
2. **Decentering from Thoughts**: John learns to view his negative thoughts (e.g., “I’m a failure”) as just mental events rather than factual truths. Instead of getting caught up in their content, he is encouraged to observe them as passing phenomena, like clouds in the sky. This third-wave therapy technique reduces the emotional impact of those thoughts.
3. **Recognizing Early Warning Signs**: A key part of MBCT is teaching John to recognize early signs of relapse into depression (such as ruminating or feeling low energy). With mindfulness, he becomes more aware of these signals and can better respond to them mindfully rather than reactively.
4. **Acceptance and Non-Judgment**: Instead of fighting against negative moods or thoughts, John learns to accept their presence without labeling them as good or bad. For example, when he starts feeling sad or unmotivated, he will practice accepting these feelings without immediately assuming they’ll spiral into a full depressive episode.
5. **Values and Action**: Alongside general mindfulness, MBCT helps people reconnect with activities and values that give their life meaning. For John this involves gradually re-engaging in working out, joining adult sports leagues, and volunteering at his church, even while experiencing low mood.

### CBT Third-Wave Psychotherapy Outcome:

By blending mindfulness with cognitive approaches, third-wave cognitive-behavioral MBCT helps John break the cycle of rumination and negative thought patterns that often trigger depressive episodes. The focus is not on eliminating negative thoughts but on changing the relationship to those thoughts through awareness and acceptance. For John, this third-wave therapy approach reduces the intensity, duration, and effect of his low mood.

## Third-wave Therapies for Children and Adolescents

Third-wave therapies can be adapted effectively for children and adolescents.

For kids, these therapies focus on helping them become more aware of their thoughts and emotions without becoming overwhelmed. Here’s a breakdown of how I might apply them with younger clients:

1. **Acceptance and Commitment Therapy (ACT):** ACT encourages kids to accept challenging feelings instead of avoiding or fighting them. Through activities, metaphors, and games, children learn to recognize their thoughts and emotions without judgment. ACT can be helpful for children experiencing anxiety, depression, and ADHD, helping them practice staying present and clarifying values for decision-making.
2. **Dialectical Behavior Therapy (DBT):** Originally designed for adults with intense emotional experiences, DBT for kids focuses on emotional regulation and distress tolerance. Adaptations for children often involve skill-building games, group activities, and family-based sessions to support their emotional resilience. DBT can be particularly beneficial for children dealing with mood disorders, impulsivity, or self-esteem challenges.
3. **Mindfulness-Based Cognitive Therapy (MBCT):** MBCT combines cognitive therapy with mindfulness practices. For kids, this can look like fun breathing exercises, mindful movement, and sensory activities to build attention and awareness skills. MBCT helps children manage stress and build positive coping strategies, supporting emotional and social growth.
4. **Compassion-Focused Therapy (CFT):** Though less common with younger populations, CFT can help children develop self-compassion and reduce self-criticism, often tailored for those who struggle with perfectionism or harsh self-judgment.

### Specific Adaptations for Kids

With kids, third-wave therapies use age-appropriate language and engaging, hands-on activities, such as:

1. Using visual aids such as pictures and books and having them create their own artwork. For adolescents, this involves drawing or playing creative games. These visual aids can be a cornerstone of a third-wave cognitive-behavioral approach.
2. We use metaphors (like the “thought train” or “worry monster”) and stories to make the abstract concepts of mindfulness, acceptance, and compassion more accessible.
3. Playing games that illustrate the concepts of third-wave CBT can help me reach younger children.
4. Meeting for [group therapy](https://dralanjacobson.com/group-therapy/), especially for adolescents, is an effective way of helping them engage and understand the concepts.

Given the above, you can see why I do not usually deliver third-wave CBT or other third-wave therapies to younger children virtually. For those under 13, the best approach is usually in person. The exception is when we do family therapy, or therapy with a parent and child together, where I can help you engage with your child. This can be delivered as [virtual psychotherapy](https://dralanjacobson.com/virtual-therapy-guide/).

## Summary and My Practice

My clinical psychology practice centers around third-wave therapy. I chose this core approach because it is both powerful and positive. I have seen people find success with third-wave psychotherapy while they are able to focus on their potential and possibilities. I also appreciate third-wave therapies for the ease of combining them with other approaches for even more effective treatment, and they can be used as part of [brief therapy](https://dralanjacobson.com/brief-therapy/) courses, and combined with other approaches such as [behavioral activation](https://dralanjacobson.com/behavioral-activation/). I use these methods in many of my specialty areas, including [sports psychology](https://dralanjacobson.com/sports-psychology/), [therapy for college students](https://dralanjacobson.com/therapy-for-college-students/), and [fear of flying](https://dralanjacobson.com/fear-of-flying-therapy/) and [public speaking phobias](https://dralanjacobson.com/public-speaking-anxiety/).

My practice is integrative, meaning that we can combine different third-wave therapies to maximize your benefit. Third-wave CBT is often my first choice as a [therapy for depression](https://dralanjacobson.com/therapy-for-depression/) and anxiety, but other techniques are also commonly mixed in.

If you have any questions about my practice and how I use third-wave psychotherapy, or specifically how we might work together using third-wave therapies, please feel free to [call me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Solution-Focused Family Therapy: Focusing on Positive Change](https://dralanjacobson.com/solution-focused-family-therapy-focusing-on-positive-change/)

**Published:** December 18, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Brief Solution-Focused Family Therapy (SFFT)** is a **brief, goal-oriented therapeutic approach** that emphasizes finding solutions to problems rather than focusing on the problems themselves. Developed by [**Steve de Shazer**](https://en.wikipedia.org/wiki/Steve_de_Shazer) and [**Insoo Kim Berg**](https://en.wikipedia.org/wiki/Insoo_Kim_Berg) in the 1980s, it is rooted in the idea that families have the strengths and resources to overcome challenges. I provide solution-focused therapy for families where the children are older adolescents and adults, given that the virtual treatment approach does not work as well for younger children. If you have specific questions about solution-focused family therapy interventions and how they might work for you, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

---

## Solution-Focused Family Therapy Overview

The following is an overview of solution-focused therapy with families, followed by two examples of these practice methods.

### Core Principles of Solution-Focused Therapy with Families

1. **Focus on Solutions, Not Problems**: Solution-focused family therapy interventions help identify and build upon what is working.
2. **Strength-Based Approach**: Members are viewed as capable of creating solutions.
3. **Future-Oriented**: Solution-focused family therapy focuses on envisioning the future where the problem is resolved.
4. **Small Changes Lead to Bigger Changes**: Even small, incremental changes can disrupt unhelpful patterns and create positive momentum.
5. **Families Know Best**: I collaborate with the family, believing they are the experts on their own lives.

---

### Solution-Focused Family Therapy Interventions

These are some of the more common brief solution-focused family therapy interventions I provide:

1. **Miracle Question**
    - A question that invites members to envision a future without the current problem:
        *“If a miracle happened tonight and the problem was gone, what would be different in your life tomorrow?”*
2. **Scaling Questions**
    - Asking clients to rate their problems’ severity or progress on a scale of 0–10.
    - Example: *“On a scale of 1 to 10, how confident can you solve this problem? What would help you move up one point?”*
3. **Exception Questions**
    - Identifying times when the problem did not occur to highlight strengths and effective behaviors.
    - Example: *“Can you think of a time when this problem wasn’t happening? What was different then?”*
4. **Coping Questions**
    - Recognizing resilience and ability to cope, even when things are difficult.
    - Example: *“How have you managed to keep things from getting worse?”*
5. **Compliments and Reinforcement**
    - Acknowledging members’ efforts and strengths to empower and motivate change.

---

### Goals of Solution-Focused Family Therapy

1. Solution-focused therapy for families helps members set clear, realistic, and achievable goals.
2. Solution-focused therapy for families identifies and amplifies solutions that already work.
3. This approach shifts the focus from problems to possibilities.
4. This approach also fosters hope and confidence in the family’s ability to resolve challenges.

---

### When It’s Used

Solution-focused family therapy interventions are particularly effective for:

- [Family therapy](https://dralanjacobson.com/family-therapy/) is needed for **communication or nurturance issues**
- Parent-child conflicts or sibling rivalries
- Times of [life transitions](https://dralanjacobson.com/life-transitions-therapy/) and other adjustment-based stress
- Couples or family members dealing with stress or crises
- Situations where one member has expressed a concern about the group’s functioning

### Key Advantage of Brief Solution-Focused Family Therapy

Solution-focused family therapy interventions are **time-efficient** and **empowering.** They focus on the family’s strengths, making them a positive and motivating approach for those seeking fast, practical solutions.

## Brief Solution-Focused Family Therapy Case Example 1: Adolescent

Here is a **case example** illustrating the use of **Brief Solution-Focused Family Therapy:**

---

### Case Overview

- **Presenting Problem**: A family seeks solution-focused family therapy because their 15-year-old daughter, Emily, refuses to do her homework and frequently argues with her parents. The parents feel frustrated and exhausted, while Emily feels misunderstood and criticized.
- **Family System Dynamics**: 
    - The parents focus heavily on what Emily is *not* doing, which escalates tension.
    - Emily avoids discussing school and withdraws when criticized.
    - Both parents feel stuck in a cycle of nagging and arguing.

---

### Solution-Focused Family Therapy Interventions

1. **Establishing Goals for brief solution-focused family therapy**
    - I begin by asking them what they would like to achieve: 
        - *“If this problem were solved, what would be different?”*
    - The family responds: 
        - Emily: “My parents would stop nagging me, and I’d feel less stressed about homework.”
        - Parents: “Emily would do her homework without us arguing about it.”
    - **Purpose**: This focuses on a **clear, positive future goal** rather than the problem itself.

---

2. **The Miracle Question**
    - I ask: 
        - *“Suppose a miracle happens tonight while you’re sleeping, and when you wake up, the problem is gone. How would you know the miracle happened?”*
    - Responses: 
        - Emily: “I would get my homework done right after school, and my parents wouldn’t keep asking me about it.”
        - Parents: “We’d feel calmer and wouldn’t need to remind Emily constantly.”
    - **Purpose**: This helps them envision a solution and identify small, achievable changes.

---

3. **Scaling Questions**
    - I ask them to rate the situation on a scale of 0 to 10: 
        - *“On a scale of 0 to 10, where 0 is ‘Emily never does homework,’ and 10 is ‘she does it without reminders,’ where are you now?”*
    - Emily says “4,” and the parents agree.
    - I then ask: 
        - *“What would it take to move from a 4 to a 5? What small step could each of you take?”*
    - Responses: 
        - Emily: “Maybe I could try starting my homework before dinner.”
        - Parents: “We could agree to check in just once after school instead of asking repeatedly.”
    - **Purpose**: Scaling breaks progress into small, manageable steps and reduces overwhelm.

---

4. **Exception Questions**
    - I explore times when the problem did not occur: 
        - *“Tell me about a time when Emily did her homework without arguments. What was different?”*
    - The parents recall that Emily did her homework on the weekend without prompting because she wanted extra time to play a game afterward.
    - I highlight this exception and asks: 
        - *“How can you do more of what worked then?”*
    - They establish a similar system where Emily does her homework before playing games.
    - **Purpose**: This helps them recognize their strengths and identify practical solutions based on what already works.

---

5. **Compliments and Reinforcement**
    - Throughout the session, I reinforce their efforts: 
        - *“It sounds like you’re already taking steps in the right direction. Emily, it’s great that you suggested starting homework before dinner—that shows you’re motivated.”*
        - *“You’ve worked together before to create positive changes, and I’m confident you can do it again.”*
    - **Purpose**: Compliments build confidence, motivation, and hope for their ability to resolve the issue.

---

### Brief Solution-Focused Family Therapy Outcome

- After a few sessions of brief solution-focused family therapy interventions: 
    - Emily starts her homework right after school 4 out of 5 weekdays.
    - The parents reduce their reminders to a single check-in, which reduces arguments.
    - They all report feeling calmer, more connected, and proud of their progress.

---

This case example demonstrates how **Solution-Focused Therapy with Families** helps identify goals, recognize strengths, and take small, actionable steps to create positive changes while staying focused on solutions rather than problems.

## Brief Solution-Focused Family Therapy Case Example 2: Grown Children

Here is an example of **solution-focused therapy** with families that have **grown children**:

---

### Case Overview

- **Structure**: 
    - Parents (Mary and John, in their 60s)
    - Two adult children (Anna, 30, and Mike, 28)
- **Presenting Problem**: 
    - The family is experiencing tension because Anna recently moved back home due to financial difficulties. Mary (the mother) feels overwhelmed by Anna’s presence, while Mike feels neglected because his parents are focused on Anna. They argue frequently, and everyone feels disconnected.
- **Family Dynamics**: 
    - Mary feels responsible for “fixing” Anna’s problems.
    - John avoids the conflict by withdrawing and staying out of discussions.
    - Anna feels criticized and unsupported, and Mike resents the attention Anna receives.

---

### Brief Solution-Focused Family Therapy Interventions

1. **Establishing Goals**
    - I start by asking each member:
        *“What do you hope to achieve from therapy? What would things look like if the problems were solved?”*
    - Responses: 
        - Mary: *“I want to feel less stressed and stop feeling like I have to fix everything for Anna.”*
        - Anna: *“I’d like my parents to trust that I’m trying to figure things out and not criticize me so much.”*
        - John: *“I’d like the family to argue less and feel more peaceful at home.”*
        - Mike: *“I want to feel like I matter too, and I’d like more time with my parents.”*
    - **Purpose**: This helps them identify shared goals and shift focus from problems to solutions.

---

2. **The Miracle Question**
    - I ask:
        *“Suppose a miracle happens tonight while you sleep, and when you wake up, everything is better. What would be different?”*
    - Responses: 
        - Mary: *“I’d feel calmer, and we’d all talk without arguing.”*
        - Anna: *“My parents would ask how they can support me instead of assuming I’m failing.”*
        - John: *“I’d feel included and able to help without avoiding the issues.”*
        - Mike: *“I’d feel like part of the family again, and we’d spend more time together.”*
    - **Purpose**: This exercise helps them imagine a future where solutions are possible and highlights small, actionable changes.

---

3. **Scaling Questions**
    - I ask each member to rate their current satisfaction with interactions on a scale of 0 to 10. 
        - Mary: *“I’d say a 3.”*
        - Anna: *“A 4.”*
        - John: *“A 5.”*
        - Mike: *“I’d say 2.”*
    - I then ask:
        *“What would need to happen to move up one point on the scale?”*
    - Responses: 
        - Mary: *“If Anna helped more around the house, I’d feel less overwhelmed.”*
        - Anna: *“If my mom acknowledged that I’m trying to get back on my feet, that would help.”*
        - John: *“If we sat down and discussed things calmly, I’d feel better.”*
        - Mike: *“If my parents invited me for a dinner or showed more interest in my life, I’d feel included.”*
    - **Purpose**: This helps them break progress into small, achievable steps.

---

4. **Exception Questions**
    - I explore times when they gets along well and tension is minimal:
        *“Tell me about a time when you all felt connected and things were going smoothly.”*
    - Responses: 
        - Anna: *“Last weekend, when we had dinner together and played a board game, everyone seemed happy.”*
        - John: *“Yes, that night felt good because we weren’t talking about problems.”*
    - I ask:
        *“What was different about that evening? How can you do more of that?”*
    - They agree to schedule a **weekly family dinner** where they avoid discussing stressful topics.
    - **Purpose**: Exception questions highlight what works and encourage them to replicate positive behaviors.

---

5. **Compliments and Reinforcement**
    - I highlight their strengths and efforts throughout the session: 
        - *“It’s impressive that you’re all here working toward better communication—that shows how much you care about each other.”*
        - *“Mary, it sounds like you’re doing your best to support Anna. That’s a strength, even though it’s overwhelming at times.”*
        - *“Anna, it’s great that you want to take responsibility for your future and repair relationships at the same time.”*
    - **Purpose**: Reinforcing strengths builds hope and motivation for change.

---

### Solution-Focused Family Therapy Outcome

- After several sessions of solution-focused family therapy interventions: 
    - Mary reduces her involvement in Anna’s day-to-day struggles, allowing Anna to feel more independent.
    - Anna takes on small household responsibilities, which reduces Mary’s stress.
    - John becomes more engaged, initiating family dinners and encouraging calm discussions.
    - Mike feels included as the family dedicates time to activities that involve everyone.
- They all report improved communication, fewer arguments, and a stronger sense of connection.

---

This case example demonstrates how **Solution-Focused Family Therapy** helps families identify goals, build on strengths, and take small, actionable steps toward positive change, even when dealing with complex dynamics involving grown children.

## Summary and My Work

### Core Principles of Solution-Focused Therapy for Families:

In summary, solution-focused therapy for families is a short-term, goal-oriented [therapeutic approach](https://dralanjacobson.com/types-of-therapy/) focusing on finding solutions rather than analyzing problems. It’s especially effective because it emphasizes strengths, collaboration, and practical steps toward positive change. Solution-focused therapy for families has the following advantages:

1. **Solution-focused Therapy for Families Focuses on Solutions, Not Problems:**
    - Instead of digging into the root causes of issues, solution-focused therapy for families emphasizes what the family wants to achieve and how they can get there.
2. **Solution-focused therapy for families Uses a Strength-Based Approach:**
    - Highlights and builds on their strengths, past successes, and resilience.
3. **Solution-focused Therapy for Families Uses Future-Oriented Goals:**
    - I help them envision their desired future and set clear, achievable goals.
4. **Solution-focused Therapy for Families Uses Small, Achievable Steps:**
    - They are encouraged to make small, practical changes that lead to meaningful improvements over time.
5. **Solution-focused Therapy for Families Uses Exception-Finding Questions:**
    - I ask about times when the problem was not present or was less intense, exploring what was different and why it worked.

### My Work

I provide virtual brief solution-focused family therapy interventions when the children are adolescents or adults (including [sibling therapy for adults](https://dralanjacobson.com/adult-sibling-therapy/)), often mixing in other approaches such as [emotion-focused family therapy](https://dralanjacobson.com/emotionally-focused-family-therapy/), [brief strategic family therapy](https://dralanjacobson.com/strategic-family-therapy-powerful-positive-time-limited/), [family systems therapy](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/), and [narrative family therapy](https://dralanjacobson.com/narrative-family-therapy/). This approach is most helpful when challenges and barriers are due to specific transitions or changes in dynamics, as opposed to deeply engrained and longstanding issues. It works well with adult family therapy and therapy for specific relationships, such as the [mother-daughter bond](https://dralanjacobson.com/mother-daughter-therapy/), as the members face transitions together. It can also be used alongside [parental counseling](https://dralanjacobson.com/parent-coaching/) for couples working on their parenting strategies, in [adult child estrangement therapy](https://dralanjacobson.com/family-estrangement-therapy/), and in [therapy for co-parents](https://dralanjacobson.com/co-parenting-therapy/).

If you have any questions about solution-focused family therapy or want to discuss how it might help your family, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Family therapies

---

### [Sports Performance Improvement Innovations](https://dralanjacobson.com/sports-performance-improvement-innovations/)

**Published:** August 13, 2023
**Author:** Dr. Alan Jacobson

**Content:**

There have been many recent innovations and trends in **sports performance improvement.** I do not have access to all of these sports performance improvement technologies in my practice. However, I can certainly refer you as an adjunct to my [sports psychology services](https://dralanjacobson.com/sports-psychology/). I’d be happy to [talk with you](https://dralanjacobson.com/contact/) about how we might design a plan incorporating sports performance improvement innovations, but first, I wanted to present this overview.

## Benefits of Sports Performance Improvement Tech.

Sports performance improvement technology has revolutionized how athletes train, compete, and recover. Here are some key benefits of using such technology and the ways they can generate a competitive edge:

1. **Data-Driven Insights**: Sports Performance Improvement technologies gather extensive data on various aspects of an athlete’s skill, including speed, power, endurance, and technique. This data can be analyzed to provide valuable insights into strengths and weaknesses, enabling athletes and coaches to make informed decisions about training and strategy.
2. **Precision Training**: With sports performance technology, athletes can engage in highly targeted training regimens. By identifying specific areas that need improvement, athletes can focus on exercises and drills that address those needs, leading to more efficient and effective training.
3. **Real-Time Feedback**: Many sports performance improvement technologies offer real-time feedback during training sessions. This instant feedback lets athletes and coaches adjust form, technique, and strategy immediately. This iterative process can accelerate skill development and enhance outcomes.
4. **Injury Prevention**: Some technologies can monitor an athlete’s movement patterns and biomechanics to identify potential injury risks. By addressing these risks proactively, athletes can modify their training routines or techniques to reduce the likelihood of injuries.
5. **Customization**: Technology allows personalized training plans based on an individual’s strengths, weaknesses, and goals. This customization ensures that athletes are not wasting time on exercises that do not contribute to their specific needs.
6. **Motivation and Engagement**: [Fun Gamification](https://builtin.com/design-ux/gamification) elements in performance technology, such as virtual challenges and leaderboards. This can boost motivation and engagement. Athletes may be more likely to push themselves during training when they can track progress and compete against themselves or others.
7. **Recovery Optimization**: Recovery is a crucial aspect of athletic performance. Performance technology can monitor sleep quality, heart rate variability, and muscle recovery. This data can guide athletes in optimizing their recovery routines for better overall performance.
8. **Remote Coaching**: Performance technology enables coaches to provide guidance and feedback to athletes remotely. This is particularly useful for athletes training in different locations or under unique circumstances.

Overall, sports performance improvement technology empowers athletes and coaches with data, insights, and tools that can lead to more efficient training, better outcomes, reduced injury risks, and a deeper understanding of the nuances of an athlete’s capabilities.

## Drawbacks to Athletic Improvement Technology

Despite the excitement surrounding the sports performance improvement technologies listed above, there are some drawbacks to using these approaches. First, an overreliance on the technologies listed above can reduce the essential and valuable “gut” feelings that coaches and trainers can have about performance and needs. Often, simple observation and assessment can be quite valuable and, at the very least, should be paired with any additional technology. Second, technology can paint an incomplete picture or reduce awareness of peripheral performance-related factors. For example, something as simple as the weather or as complicated as anxiety may not be factored in. Finally, many of the technologies above focus on the mental aspect of sports rather than the physical or vice versa.

New technology must be combined with tried and true sports performance improvement techniques. This paints a comprehensive and complete picture and ensures no gaps in the conclusions and plans.

## Sports Performance Improvement Technology

### Data Analytics and Wearable Technology: 

Wearable data-producing technology, such as fitness trackers, GPS devices, and heart rate monitors, have become integral in tracking athletes’ metrics. This data helps coaches and [athletes identify areas for improvement](https://dralanjacobson.com/athletic-performance-improvement/) and make informed training decisions. Advanced [motion analysis systems](https://en.wikipedia.org/wiki/Motion_analysis) help athletes optimize their techniques and form. High-speed cameras, motion capture systems, and force platforms provide valuable insights into movement patterns, enabling athletes to refine their skills.

Many apps and platforms are designed to help athletes track their progress, receive personalized training plans, and connect with coaches and peers for guidance and motivation.

### Virtual Reality (VR) and Augmented Reality (AR)

[VR and AR](https://www.pcmag.com/news/augmented-reality-ar-vs-virtual-reality-vr-whats-the-difference) technologies have been increasingly used in sports training to simulate game scenarios, enhance mental preparation, and visualize tactics. They can also be used for injury rehabilitation and to analyze game footage from different perspectives. Athletes also use environmental simulation chambers to replicate different altitudes, temperatures, and humidity levels. This helps them acclimate to different conditions and gain a competitive edge in specific environments.

### Genetic Testing and Personalized Training

Some athletes have started using genetic testing to understand their genetic predispositions for muscle composition, injury risk, and metabolism. This information can guide personalized training and recovery strategies.

There are just three of the categories of sports performance improvement innovations that are emerging. I will continue to monitor what is out there and what works, and I look forward to integrating new technology into my practice.

## Athletic Performance Improvement in My Practice

There are some areas of sports performance improvement that I have integrated into my practice, including:

### Sports Performance Improvement Nutrition and Recovery Strategies

Research in sports nutrition and recovery techniques has led to [improved performance](https://dralanjacobson.com/athletic-performance-improvement/). Athletes now use personalized diet plans, supplements, and [recovery methods](https://humankinetics.me/2021/07/15/what-are-the-best-recovery-strategies-for-athletes/) to optimize their energy levels, reduce fatigue, and enhance overall performance. I can provide guidelines and advice, even if you pursue more specific treatment with a nutritional counselor.

### Sports Performance Improvement Mental Training

Mental skills training, including mindfulness, visualization, and cognitive exercises, is now widely recognized as a critical aspect of [sports performance psychology](https://dralanjacobson.com/sports-performance-psychology/). Athletes I work with learn to enhance focus, concentration, and resilience under pressure. We will also work on sleep optimization using sleep-tracking technology and adopting strategies to ensure the athlete gets sufficient, high-quality sleep for better recovery and performance.

### Technology I Use for Athletic Performance Improvement

I incorporated some VR-based training and some technology that gives real-time feedback. When possible, I try to coordinate with the coaches and trainers my clients are already working with to see what they will use and what they think would be helpful. I want them to feel our work together will complement their work and fit in well.

## Summary and Conclusions

Remember that the sports performance improvement industry continuously evolves, and new technologies and methods are constantly emerging. I work to stay updated with the latest trends and innovations in sports performance to optimize training and achieve competitive success effectively. When I can integrate them into my [sports psychology](https://dralanjacobson.com/sports-psychology/) practice, that’s what I do, and when a specialist better delivers these services, I make sure I know some highly qualified people I can refer to.

The field of sports performance improvement is changing and evolving rapidly and can be key to gaining a competitive advantage and reaching your peak ability. That said, nothing is more important than hard work, determination, and mental preparation, so [I do not overly rely on technology](https://dralanjacobson.com/sports-psychotherapy-outcomes/). We’ll work together to find the best fit between your goals and the innovations above while also using the latest innovations in [sports psychology](https://dralanjacobson.com/sports-psychology/).

Please [contact me](https://dralanjacobson.com/contact/) with any questions or if you want an initial consultation regarding **sports performance improvement**.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Sports Psychology

---

### [Humanistic Existential Therapy](https://dralanjacobson.com/humanistic-existential-therapy/)

**Published:** September 7, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Humanistic Existential Therapy** is an approach to psychotherapy that combines principles from both [humanistic psychology](https://dralanjacobson.com/basic-tenets-of-humanistic-psychology/) and [existential philosophy](https://dralanjacobson.com/existential-therapy/). The core of this therapy focuses on helping individuals explore their personal experiences, choices, and sense of meaning in life. As detailed below, I offer **humanistic and existential therapies** individually and as a combined approach.

This post breaks down the key components of humanistic and existential therapies and the core aspects of an integrative approach called humanistic existential therapy. If you’d like information about how an existential humanistic therapy approach might work for you or a loved one or have any general questions about either approach, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Humanistic and Existential Therapies

**Humanistic and Existential Therapies** are two distinct but closely related [approaches to psychotherapy](https://dralanjacobson.com/types-of-therapy/). Both emphasize individual experience, personal growth, and the search for meaning, but they have unique philosophical roots and therapeutic techniques. Here’s a breakdown of the similarities and differences between humanistic and existential therapies:

- **Self-Actualization**: Inspired by [Abraham Maslow’s hierarchy of needs](https://en.wikipedia.org/wiki/Maslow's_hierarchy_of_needs), humanistic therapy aims to help individuals reach their highest potential.
- **Person-Centered Approach**: [Carl Rogers’](https://en.wikipedia.org/wiki/Carl_Rogers) [client-centered therapy](https://dralanjacobson.com/client-centered-therapy/) emphasizes unconditional positive regard, empathy, and authenticity from the therapist. The therapist is a non-directive guide, allowing clients to explore and discover their own solutions.
- **Focus on the Present**: Humanistic therapy emphasizes living in the present moment rather than being fixated on past experiences or future anxieties.
- **Personal Responsibility**: Clients are viewed as having the ability to take control of their lives and make choices that align with their values and goals.

#### Main Techniques:

- **Unconditional Positive Regard**: I offer complete acceptance of the client, fostering a safe space for exploration.
- **Empathy**: I work to understand and reflect the client’s emotions deeply.
- **Congruence**: I am genuine and transparent in my interactions with clients.

### Existential Therapy

Existential therapy focuses on deeper questions about life, meaning, and existence. It encourages clients to face their anxieties about freedom, isolation, death, and meaninglessness while recognizing their ability to create purpose and make choices in an uncertain world.

#### Key Principles:

1. **Freedom and Responsibility**: Existential therapists believe that individuals are free to make choices, but this freedom comes with the burden of responsibility.
2. **Search for Meaning**: Clients are encouraged to confront life’s existential questions (e.g., “Why am I here?” or “What is the meaning of life?”) and find personal meaning and purpose.
3. **Existential Anxiety**: Awareness of life’s uncertainties, such as death and isolation, creates anxiety. Rather than avoiding this anxiety, existential therapy helps individuals confront and work through it.
4. **Authenticity**: Clients are encouraged to live authentically, in line with their true values and desires, rather than conforming to societal pressures.

#### Main Techniques:

- **Confronting Existential Issues:** I guide clients through discussions of life, death, freedom, and isolation.
- **Phenomenological Approach**: I focus on understanding the client’s subjective world experience.
- **Meaning-Making**: Helping clients discover or create meaning in life, even in difficult or painful experiences.

### Similarities Between Humanistic and Existential Therapies:

- **Focus on the Individual**: Existential humanistic therapy is client-centered, valuing personal experience and individual perspectives.
- **Personal Growth**: Existential humanistic therapy fosters self-awareness, self-acceptance, and personal responsibility.
- **Present Focus**: Existential humanistic therapy prioritizes the present moment and helps clients make active choices to shape their future.
- **Therapeutic Relationship**: Existential humanistic therapy stresses the importance of a strong, trusting, and non-judgmental therapeutic relationship.

### Differences:

1. **Philosophical Roots**: 
    - Humanistic therapy is rooted in a more optimistic view of human nature, where people are seen as inherently good and striving for growth.
    - Existential therapy is based on existential philosophy, which acknowledges the inherent struggles of human existence, such as anxiety, isolation, and death.
2. **Focus on Meaning**: 
    - Humanistic therapy focuses more on self-actualization and personal fulfillment.
    - Existential therapy focuses on finding meaning in the face of existential dilemmas.
3. **View of Anxiety**: 
    - - Humanistic therapy tends to see anxiety as a result of blocked personal growth or unfulfilled potential.
        - Existential therapy views anxiety as an inherent part of being human, especially in relation to freedom, death, and isolation.
    
    ## Humanistic Existential Therapy Overview
    
    The following is what humanistic existential therapy involves in practice.
    
    ### Humanistic Psychology Elements:

    - - - **Self-Actualization**: Based on the work of Carl Rogers and Abraham Maslow, [humanistic therapy](https://dralanjacobson.com/humanistic-therapy/) emphasizes personal growth, self-actualization, and fulfilling one’s potential.
            - **Unconditional Positive Regard**: This is a central tenet, especially in Carl Rogers’ client-centered therapy, where therapists offer empathy, acceptance, and nonjudgmental support.
            - **Focus on the Present**: Humanistic therapy encourages clients to focus on their current experiences rather than being overly preoccupied with the past or future.
    
    ### Existential Psychology Elements:

    - - - **Freedom and Responsibility**: Existential therapy, inspired by thinkers like [Viktor Frankl](https://en.wikipedia.org/wiki/Viktor_Frankl), [Rollo May](https://en.wikipedia.org/wiki/Rollo_May), and [Irvin Yalom](https://en.wikipedia.org/wiki/Irvin_D._Yalom), emphasizes individuals’ freedom to make choices and the accompanying responsibility.
            - **Search for Meaning**: This approach delves into questions about life, death, meaning, and purpose. It asks clients to confront these questions and find their own answers.
            - **Dealing with Anxiety**: Deep anxiety, stemming from awareness of life’s uncertainties and limitations, is seen as a natural part of life. The therapy helps individuals understand and navigate this anxiety rather than avoid it.
    
    ### Main Goals of Humanistic Existential Therapy

    - - - **Authenticity**: Existential humanistic therapy helps individuals live authentically and embrace their true selves.
            - **Empowerment through Choice**: It encourages individuals to recognize their freedom and responsibility in shaping their lives.
            - **Meaning-Making**: This involves assisting individuals in finding or creating meaning, especially when confronted with life’s existential challenges such as death, isolation, freedom, and meaninglessness.
    
    ### Existential Humanistic Therapy Techniques

    - - - **Phenomenological Exploration**: This technique involves exploring the client’s subjective experience without judgment or preconceived notions.
            - **Existential Dialogue**: Therapist and client engage in a dialogue that emphasizes understanding the client’s worldview and their place in the world.
            - **Reflection and Self-Inquiry**: Clients are encouraged to reflect on their thoughts, values, and emotions to gain deeper self-understanding.
    
    Humanistic Existential Therapy is beneficial for clients facing issues of identity, life transitions, meaning, or deep personal crises. It’s a flexible, holistic approach that is tailored to the individual rather than relying on a one-size-fits-all method.
    
    ## Existential Humanistic Therapy Example
    
    Here’s an example of how **Humanistic Existential Therapy** might work in practice, combining elements from both humanistic and existential therapies.
    
    ### Scenario:
    
    A client, Sarah, is a 35-year-old professional who feels unfulfilled despite having a successful career. She expresses feelings of emptiness, lack of meaning in life, and growing anxiety about the passage of time. She frequently questions her purpose and struggles with deep concerns about death, freedom, and whether her life has any real significance.
    
    ### Humanistic Existential Therapy Session Example
    
    #### Initial Conversation (Existential Exploration):

    - - - **Me**: “It sounds like you’ve been thinking a lot about what your life means and whether you’re living it in a way that feels right for you. Can you tell me more about what has been coming up for you recently?”
            - **Sarah**: “Yes, I’ve achieved a lot, but I don’t feel happy. I keep wondering if I’m wasting time or missing out on something more meaningful. And then I get anxious, thinking about how fast life is passing me by.”
    
    #### Deep Themes:

    - - - **Freedom and Responsibility**: I explore Sarah’s freedom to make choices about her life. We discuss the weight of this freedom and the responsibility she feels to live authentically.
            - **Existential Anxiety**: Sarah’s anxiety about time and meaning is a central theme. I work to normalize this anxiety as a part of the human condition, exploring how acknowledging the inevitability of death can motivate her to live a more meaningful life.
    
    #### Therapist’s Existential Intervention:

    - - - **Me**: “It sounds like you’re feeling a sense of urgency to find more meaning. This anxiety you’re feeling about time passing, while uncomfortable, can also be an invitation to look at what really matters to you and what you want to create with the time you have. What would it look like for you to live in a more authentic way?”
    
    #### Humanistic Elements:

    - - - **Empathy and Unconditional Positive Regard**: I listen without judgment and validate Sarah’s feelings. I show deep empathy for her struggle, creating a safe, supportive space where Sarah feels accepted.
            - **Focus on Self-Actualization**: I encourage Sarah to explore her strengths, desires, and values. I help her identify aspects of her life where she feels fulfilled and areas where she may be compromising her true self.
    
    #### Humanistic Exploration:

    - - - **Me**: “You’ve mentioned that your career has been successful, but it seems like something is missing for you. What are the things that truly light you up, the things that make you feel like you’re living in alignment with your values?”
            - **Sarah**: “I love working with people and being creative. But lately, I’ve been spending so much time on administrative tasks that I’ve lost touch with that part of my work.”
    
    #### Self-Actualization and Empowerment:

    - - - **Me**: “It sounds like reconnecting with that creative side of yourself could bring you more joy and fulfillment. What steps could you take to start incorporating more of that into your life?”
            - **Sarah**: “Maybe I could take on a project that lets me be more hands-on with the creative process. And outside of work, I’ve always wanted to take art classes, but I keep putting it off.”
    
    #### Conclusion of the Session:

    - - - **Me**: “It seems like there’s an opportunity here to bring more of what you love into your life—both in and out of work. As we continue exploring together, let’s look at how you can make choices that align with what truly matters to you, and how to navigate the fear that comes up around that.”
            - **Sarah**: “I think that could help. I want to feel like I’m not just going through the motions but actually living in a way that means something to me.”
    
    ### Humanistic Existential Therapy Analysis and Outcome

    - - - **Existential Themes**: I helped Sarah face her anxiety about time and meaning, guiding her to reflect on the importance of living authentically. By confronting these existential concerns, Sarah begins to see her anxiety not as a burden but as a signal to make meaningful changes.
            - **Humanistic Elements**: My empathy and positive regard create a safe environment for Sarah to explore her feelings. We emphasize Sarah’s strengths and desires, encouraging her to make choices that align with her true self, which is a core aspect of self-actualization.
    
    Over time, through existential humanistic therapy, Sarah may come to feel more empowered to make choices that align with her values, healthily confront her deepest concerns, and create a life that feels more meaningful and fulfilling.
    
    ## Summary and My Work
    
    I offer humanistic and existential therapies as separate approaches or as a mixed approach called existential humanistic therapy. This approach can help if, despite many aspects of life going quite well, it is not all adding up to a deep sense of fulfillment and contentment. It can also be helpful if you have significant and deep life concerns that are hard to shake, or are facing major [life transitions](https://dralanjacobson.com/life-transitions-therapy/), such as in [single parent therapy](https://dralanjacobson.com/therapy-for-single-moms-and-dads/).
    
    ### Learn More About Humanistic Existential Therapy
    
    For more information about how an existential humanistic therapy approach, or closely related [logotherapy](https://dralanjacobson.com/logotherapy/), might work for you or a loved one, or general information about humanistic and existential therapies, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Examples of Integrative Therapy](https://dralanjacobson.com/examples-of-integrative-therapy/)

**Published:** February 6, 2024
**Author:** Dr. Alan Jacobson

**Content:**

There are many **examples of integrative therapy** that clinicians like me use to produce the best results for our clients. The goal of an integrative practice is to uniquely tailor the interventions to what will work best and be most comfortable for our clients. Choosing a path will be something we do together. There are many possibilities, and I will ensure you feel comfortable and secure with our chosen methods.

The following are some examples of integrative therapy I use in my practice. As you will see, combining different methods can produce a powerful and effective combination for treatment. This is not an exhaustive list, and as you browse [my blog](https://dralanjacobson.com/blog/) and see the different therapeutic approaches I use, you may get an idea of what combination will work best for you.

I would be happy to [speak with you](https://dralanjacobson.com/contact/) about the combinations of approaches that might work well for you, but first, here is an overview that may give you some ideas.

## Examples of Integrative Therapy in My Practice

Integrative therapy seeks to harness the strengths of different therapeutic modalities and integrate them synergistically. This integration can enhance the effectiveness of treatment by combining complementary approaches and addressing multiple layers of your experience. Here are some of the more common examples of integrative therapy that I use:

### Cognitive-behavioral (CBT) and Mindfulness-Based Stress Reduction (MBSR)

Integrating [CBT techniques](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) with mindfulness practices from [MBSR](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) can help you develop awareness of your thoughts and emotions while learning effective coping strategies. This is one of the more powerful examples of integrative therapy and, therefore, a common one I use. This powerful approach brings fast and meaningful results for some since both techniques are designed to show some benefits fairly quickly.

This combination is particularly well-suited for many forms of anxiety, stress management in general, and work- or school-related stress. It is great for people who want to come away with a toolkit to use should stress return.

### Psychodynamic and Gestalt Therapy

Combining [psychodynamic exploration of unconscious processes](https://dralanjacobson.com/psychodynamic-therapy/) with the experiential techniques of [Gestalt therapy](https://dralanjacobson.com/gestalt-therapy/) can help you gain insight into your underlying motivations and unresolved issues while also addressing present-moment experiences. In short, this approach brings your unconscious thoughts and feelings to life. This is a powerful combination of two otherwise quite different approaches and one that you will likely not see in a non-integrative practice.

This combination is particularly helpful with life transitions, [general malaise](https://www.medicalnewstoday.com/articles/327062) (longstanding mild depression), and a feeling of having a lack of meaning in life. It may take a little longer than other approaches, but the results can be profound.

### Family Systems and Narrative Therapy

Integrating the systemic perspective of family systems therapy with the [narrative approach](https://dralanjacobson.com/narrative-therapy/) can help families understand how their stories and interactions shape their dynamics, facilitating positive change and fostering new narratives. This approach is most commonly used with [family therapy](https://dralanjacobson.com/family-therapy/) where the children are older adolescents or adults. It also works well with [couples therapy](https://dralanjacobson.com/couples-therapy/). I enjoy using this approach because the whole family can get involved, and the insights that people reach can be quite powerful and interesting.

This approach suits many families well, particularly when the issues and concerns are not urgent or severe, but they want to regain closeness and improve relationships.

### Existential Therapy and Acceptance and Commitment Therapy (ACT)

Combining [existential exploration](https://dralanjacobson.com/existential-therapy/) of life’s meaning and freedom with the acceptance-based strategies of ACT can help you develop psychological flexibility and live by your values despite existential concerns. This is an example of integrative therapy that works well with clients who come in without a specific intense stressor but more of a [general malaise](https://en.wikipedia.org/wiki/Malaise). I have found that this treatment method, combining ACT and [existential logotherapy](https://dralanjacobson.com/logotherapy/), works well for those who cannot quite figure out why they don’t feel like life has enough meaning or enjoyment but don’t know why.

This example of integrative therapy works well for life transitions, grief and loss, and general malaise. It also is a sound approach for people who want to develop a deeper sense of meaning in their lives.

### [Existential Humanistic](https://dralanjacobson.com/humanistic-existential-therapy/)

This form of therapy is a combination of two closely-related approaches that work well together.

### Solution-focused Therapy and Motivational Interviewing

Integrating the [solution-focused approach](https://dralanjacobson.com/solution-focused-therapy/) of setting specific goals and exploring solutions with collaborative and client-centered [motivational interviewing](https://dralanjacobson.com/motivational-interviewing/) techniques can empower you to make positive changes and achieve their desired outcomes. These two techniques both produce relatively fast results and in combination, they can produce motivating and empowering change.

These two techniques, in combination, work well for depression, anxiety, and specific stresses. They are good whenever the concern is clear and specific, and the goals are measurable.

## Over-arching Examples of Integrative Therapy

The power of integrative therapy lies in its ability to tailor treatment to the unique needs of each [individual therapy](https://dralanjacobson.com/individual-therapy/) client while drawing from a diverse range of therapeutic approaches. Above, I went over specific examples of integrative therapy, but here are some more general aspects of the power of integrative therapy.

### Holistic Examples of Integrative Therapy

This general approach considers the whole person—mind, body, and spirit—recognizing that mental health issues often stem from a combination of psychological, biological, social, and spiritual factors. Integrative therapy can provide more comprehensive and effective treatment by addressing these various aspects. Often, to feel better and more content, a holistic approach works well, and we can piece together methods to make this happen.

### Customized Examples of Integrative Therapy

As an integrative therapist, I can adapt their approach to meet clients’ needs and preferences. This customization allows me to incorporate techniques and interventions from multiple modalities, ensuring that treatment fully aligns with your goals and experiences. In addition, we can change things as you reach goals or we realize that a new approach may help.

### Switching Between Methods

Sometimes, as in the examples above, an integrative approach means that techniques are used simultaneously, but it can also refer to alternatives between therapeutic approaches. There are many examples of integrative therapy in my practice where we change therapeutic approaches as we go, using different techniques to tackle different issues or approaching the same issue in different ways.

Integrative therapy can address a wide range of issues, from specific symptoms of mental illness to broader concerns related to personal growth, relationships, and existential questions. By integrating multiple therapeutic perspectives, clients can receive more comprehensive and multifaceted treatment.

## Conclusions and Next Steps

[Integrative therapy](https://dralanjacobson.com/integrative-therapy/) emphasizes collaboration between you and me, empowering you to participate actively in their healing process. Integrative therapy is well-suited to addressing my client’s diverse needs, including cultural, religious, and philosophical differences. I can draw from a broad toolkit of interventions to tailor treatment to my client’s background, values, and preferences.

Overall, the power of integrative therapy lies in its ability to provide holistic, personalized, and effective treatment that addresses the complexity of human experience and promotes healing, growth, and well-being. It allows us to combine and alternate techniques to address your concerns in a powerful and multifaceted way. All of this is not to say that choosing a provider who focuses on just one or two approaches is a mistake – many very talented therapists focus on one or two. If there is a very specific approach you are looking for it can make it easy to do a search.

These are just a few examples, and I use many other examples of integrative therapy approaches. Please feel free to [schedule a consultation](https://www.picktime.com/scheduleaconsult) or [contact me](https://dralanjacobson.com/contact/) if you want to discuss any of this further.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Types of Therapy

---

### [ACT Psychotherapy](https://dralanjacobson.com/act-psychotherapy/)

**Published:** March 9, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**ACT Psychotherapy** is a [cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) (CBT) that is designed to help individuals develop psychological flexibility by teaching them to accept their thoughts and feelings rather than trying to change or control them. [Acceptance and Commitment Therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) encourages individuals to commit to actions consistent with their values, even in complex thoughts and emotions. I offer a specific approach to ACT for depression and another similar approach to ACT for OCD and other anxieties.

If you know that acceptance and commitment psychotherapy is for you, please [get in touch with me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime. I’d be happy to talk to you about how we can use this method as a stand-alone or part of an integrated approach. Here is an overview of this method, including how I use it for three specific diagnoses:

## Core Principles of ACT Psychotherapy

The core principles of Acceptance and Commitment Therapy include:

1. Acceptance: Instead of trying to eliminate or suppress unpleasant thoughts and emotions, ACT psychotherapy encourages individuals to acknowledge and accept them as normal reactions to life circumstances.
2. Cognitive Defusion: This involves learning to observe thoughts without necessarily identifying with or being controlled by them. Techniques such as mindfulness are often used to achieve cognitive defusion.
3. Being Present: ACT Psychotherapy emphasizes the importance of being fully present in the moment rather than getting caught up in past regrets or future worries. [Mindfulness practices](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) are commonly integrated to cultivate present-moment awareness.
4. Values Clarification: In ACT Psychotherapy, you are encouraged to identify your core values – the qualities and principles they want to guide your life. This approach helps you take committed action that is aligned with those values.
5. Committed Action: ACT Psychotherapy focuses on helping you take action towards living a meaningful and fulfilling life, even when faced with obstacles or uncomfortable thoughts and emotions.
6. Self-as-Context: This concept involves recognizing that you are more than your thoughts and feelings. Instead of identifying with transient experiences, you learn to see yourself as the context within which their experiences occur.

I use ACT Psychotherapy to treat a wide range of mental health issues, including depression, anxiety, [substance abuse](https://en.wikipedia.org/wiki/Substance_abuse), [chronic pain](https://my.clevelandclinic.org/health/diseases/4798-chronic-pain), and stress-related disorders.

## ACT for Anxiety

Acceptance and Commitment Therapy can be particularly effective for anxiety because it offers practical strategies for dealing with anxious thoughts and feelings while also helping individuals live more fully in alignment with their values. Overall, ACT for Anxiety provides a holistic approach to managing anxiety by helping individuals build psychological flexibility and resilience in the face of anxious thoughts and feelings. It empowers individuals to live fully, even in the presence of anxiety, by taking purposeful action guided by their values and goals. Here’s how ACT for anxiety works:

### ACT for Anxiety Step One: Acceptance

Instead of controlling or suppressing anxious thoughts and feelings, ACT for anxiety encourages you to acknowledge and accept them as normal reactions to stress or uncertainty. This acceptance can reduce anxiety and create space for more constructive responses. You learn to have self-compassion and greater understanding by being non-judgmental.

### ACT for Anxiety Step Two: Cognitive Defusion

ACT for anxiety teaches techniques to help you distance yourself from your anxious thoughts. By learning to observe thoughts without getting entangled in them, you can reduce the impact of anxious thinking on your emotions and behavior. You learn to watch and more deeply understand your thoughts before they automatically create emotions.

### ACT Psychotherapy for Anxiety Step Three: Committed Action

You will now be encouraged to take small, manageable steps toward your goals and values despite feeling anxious. This may involve gradually facing feared situations or engaging in activities that bring a sense of fulfillment and meaning.

### Other Steps Along the Way

Mindfulness practices, such as mindful breathing or body scans, are central to Acceptance and Commitment Therapy. These techniques help you stay grounded in the present moment, reducing the tendency to ruminate on past events or worry about the future, which are common triggers for anxiety. By focusing on the present moment, you can cultivate greater awareness of their anxiety triggers and learn to respond more effectively to them in real-time.

Anxiety often leads to avoidance of situations or activities that are important to us. Acceptance and Commitment Therapy helps individuals clarify their values and identify the actions they can take to move toward those values, even in anxiety. ACT for anxiety helps you recognize that they are more than their anxious thoughts and feelings. By developing a broader perspective on themselves and their experiences, you can reduce the impact of anxiety on their self-concept.

## ACT for Depression

Acceptance and Commitment Therapy can be an effective approach to [treating depression](https://dralanjacobson.com/treating-major-depression/) by helping individuals develop psychological flexibility and engage in behaviors that are aligned with their values. Here’s how ACT for depression works in my practice:

### ACT for Depression Step One: Acceptance

Rather than trying to suppress or eliminate negative thoughts and feelings associated with depression, ACT for depression encourages individuals to acknowledge and accept them as natural parts of the human experience. Acceptance can help reduce the struggle with depressive symptoms and foster a greater sense of self-compassion.

### ACT Psychotherapy for Depression Step Two: Cognitive Defusion

ACT for depression teaches techniques to help you distance yourself from your depressive thoughts and beliefs. You can reduce their impact on mood and behavior by learning to observe these thoughts without getting entangled in them.

### ACT Psychotherapy for Depression Step Three: Committed Action

Despite depression, you are encouraged to take small, manageable steps toward your goals and values. This may involve engaging in activities that bring a sense of fulfillment, even if they initially feel daunting or challenging.

### Other Steps Along the Way

Mindfulness practices are central to ACT for depression and can help individuals cultivate present-moment awareness. By observing thoughts, feelings, and sensations without judgment, you can develop greater clarity and emotional balance. This can be particularly beneficial for managing depressive symptoms. By focusing on the present moment, you can develop greater awareness of your depressive triggers and learn to respond more effectively to them in real time.

Depression often leads to a loss of interest in activities that were once meaningful or enjoyable. ACT for depression helps you clarify your values and identify the actions you can take to move toward those values, even in the presence of depression. Acceptance and Commitment Therapy for depression helps you recognize that you are more than your depressive thoughts and feelings. By developing a broader perspective on yourself and your experiences, you can reduce the impact of depression on your self-concept.

Overall, ACT for depression provides a holistic approach to managing symptoms by helping you build resilience and engage in behaviors that promote well-being and vitality. It empowers you to live fully, even in the presence of depressive symptoms, by taking purposeful action guided by your values and goals.

## ACT for OCD

Acceptance and Commitment Therapy can be a helpful approach to treating [Obsessive-Compulsive Disorder](https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd) (OCD) by focusing on acceptance, mindfulness, and committed action. Here’s how ACT for OCD works:

### ACT for OCD Step One: Acceptance

Instead of trying to suppress or control intrusive thoughts and urges, ACT for OCD encourages you to accept them as natural occurrences of the mind. Acceptance involves allowing these thoughts to come and go without engaging in compulsive behaviors or becoming distressed by them. By accepting your symptoms as part of your identity, you develop self-understanding and more confidence.

### ACT Psychotherapy or OCD Step Two: Cognitive Defusion

ACT for OCD teaches techniques to help you distance yourself from your obsessive thoughts and reduce their impact. By practicing cognitive defusion, you can observe their thoughts without immediately reacting to them or believing them to be true.

### ACT Psychotherapy for OCD Step Three: Committed Action

Despite experiencing OCD symptoms, you are encouraged to take steps toward your values and goals. This may involve gradually facing feared situations or engaging in activities that bring a sense of fulfillment, even if OCD-related thoughts or urges are present. Facing your anxiety is a crucial step in overcoming obsessive-compulsive disorder.

### Other Important Steps

Mindfulness practices can help you become more aware of your thoughts, feelings, and bodily sensations without judgment. Mindfulness can provide a sense of grounding and perspective, allowing you to respond more skillfully to OCD-related thoughts and urges. By focusing on the present moment, you can develop greater awareness of your OCD triggers and learn to respond more effectively to them in real time.

OCD often leads individuals to prioritize avoidance and safety behaviors over activities that are personally meaningful or important. ACT for OCD helps you clarify your values and identify actions you can take to live a meaningful life despite the presence of OCD symptoms. ACT for OCD helps you recognize that you are more than your OCD symptoms. By developing a broader perspective on yourself and your experiences, you can reduce the impact of OCD on your identity and self-concept.

## Summary and My Work

It’s important to note that while ACT psychotherapy can benefit individuals with many challenges, I often used it as part of an integrated approach combined with interventions such as [exposure and response prevention](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/) (ERP), [cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) (CBT), and humanistic approaches. I use this approach in some specialty services, including fear of flying therapy and fear of public speaking treatment. I also often weave this therapeutic approach into my group treatment offerings.

Acceptance and commitment psychotherapy can be delivered [virtually or in-person](https://dralanjacobson.com/is-virtual-therapy-as-effective-as-in-person/). It can be part of [couples treatment](https://dralanjacobson.com/couples-therapy/) and [family therapy](https://dralanjacobson.com/family-therapy/), though it is often used with [individual treatment](https://dralanjacobson.com/individual-therapy/).

If you have any questions about ACT psychotherapy or how it might benefit you, please [schedule and consultation](https://www.picktime.com/scheduleaconsult) or [contact me](https://dralanjacobson.com/contact/) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Approaches

---

### [Integrative Therapy](https://dralanjacobson.com/integrative-therapy/)

**Published:** November 12, 2023
**Author:** Dr. Alan Jacobson

**Content:**

I provide **Integrative Therapy,** which combines elements from different therapeutic modalities and theories. The goal is to tailor the approach to your unique needs, drawing on various techniques and perspectives to create a more comprehensive and personalized treatment. **Integrative psychotherapy** is versatile and can be adapted for use in different populations, including children, adolescents, adults, and older adults. **Integrative psychology** can be applied in various settings, including [in-person and virtual](https://dralanjacobson.com/is-virtual-therapy-as-effective-as-in-person/) treatment.

You can [contact me](https://dralanjacobson.com/contact/) to discuss [my approach](https://dralanjacobson.com/types-of-therapy/) in more detail, but first, here are some benefits, drawbacks, and uses for integrative psychotherapy.

I also cover some [examples of integrative therapy](https://dralanjacobson.com/examples-of-integrative-therapy/) in a separate post.

## Benefits of Integrative Therapy

There are many benefits of integrative therapy, including:

### Integrative Therapy is Eclectic

Integrative therapy allows me to incorporate techniques and interventions from various therapeutic approaches, including [cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) (CBT), [psychodynamic therapy](https://dralanjacobson.com/psychodynamic-therapy/), and [humanistic](https://dralanjacobson.com/humanistic-psychology/) therapy. This eclectic nature allows me to adapt my approach based on your unique and potentially changing needs and preferences. This adaptability allows for a more dynamic and responsive therapeutic process.

### Integrative Therapy is Holistic

Integrative therapy often takes a holistic view of the client. It considers not only the psychological aspects but also the emotional, social, and sometimes spiritual dimensions of a person’s experience. This approach recognizes that individuals are complex and multifaceted. It helps me integrate culturally sensitive approaches to address the diversity of my clients and their backgrounds.

### Emphasis on Collaboration

The therapeutic relationship is considered a partnership between the therapist and the client. Clients are often involved in decision-making regarding therapeutic goals and methods, fostering collaboration and empowerment. I want to help you be a fully informed customer, understanding the different approaches well enough so that our work fits your needs.

### IntegratFocus on Strengths

Integrative therapy often emphasizes identifying and utilizing the client’s strengths and resources to promote personal growth and resilience. Thus it works well with the [humanistic techniques](https://dralanjacobson.com/humanistic-psychology/) that I use, including [positive psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/), [client-centered therapy](https://dralanjacobson.com/client-centered-therapy/), and [gestalt therapy](https://dralanjacobson.com/gestalt-therapy/).

## Drawbacks of Integrative Therapy

Integrative therapy is a broad approach that allows therapists to draw on the richness of different therapeutic traditions to meet each client’s unique needs. However, in some cases, integrative therapy is not the best approach.

This method offers flexibility and the potential to tailor treatment to individual needs. However, it has its drawbacks and challenges, like any therapeutic approach. Here are some potential drawbacks to integrative therapy:

### Lack of Focused Expertise

Integrative therapists draw from various therapeutic approaches. This can be beneficial for a broad range of issues. However, this breadth may come at the expense of in-depth expertise in a specific therapeutic model. Clients with highly specific or specialized needs might benefit more from a therapist with specialized training. When a client requests a particular method that I do not provide, such as Eye-Movement Desensitization ([Eye movement desensitization](https://www.emdr.com/what-is-emdr/)) and Dialectical Behavior Therapy ([DBT approach](https://en.wikipedia.org/wiki/Dialectical_behavior_therapy)), I prefer to refer them to someone who does, as opposed to trying to piece together an integrative approach. In addition, sometimes, a client presents with a specific challenge that needs a particular approach.

When looking for an integrative therapist, you must be sure they have received significant training in each type of treatment they combine. I am sure I have advanced and up-to-date knowledge and expertise in every integrative psychology approach I use.

### Perceived Inconsistency

Because integrative therapy is not confined to a single theoretical orientation, the consistency of the therapeutic approach can vary between sessions. This lack of consistency may not be for clients who prefer a more structured and predictable therapeutic experience.

### Longer Timeline for Integrative Therapy

Integrative psychotherapy may involve more sessions than some other approaches. Given that our work together may borrow from several different philosophies of care, it may take a little longer for everything to come together. If you are looking for a more focused and time-limited approach, you may want to try [cognitive-behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) or [Solution-Focused Therapy](https://dralanjacobson.com/solution-focused-therapy/) alone.

## Integrative Psychology Uses

I use Integrative psychotherapy across a variety of situations and mental health concerns. Its adaptability and flexibility make it a valuable approach for addressing various issues. Here are some common uses for integrative therapy in my practice:

### Treatment of Certain Mental Health Challenges

I use Integrative psychotherapy to address certain mental health issues that respond well to this flexible and multifaceted treatment approach. Some examples include [general anxiety disorders](https://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/symptoms-causes/syc-20360803), mild depression, and existential fears. By drawing on different therapeutic techniques, I can tailor this treatment of longer-term issues to your specific needs and change things as necessary to get at the roots of the challenge.

For individuals who have experienced trauma, integrative psychology can provide a comprehensive approach to healing. I often integrate psychology techniques from trauma-focused modalities to address the emotional and psychological impact of traumatic experiences.

### Integrative Therapy for Stress Reduction

Integrative therapy can combine specific techniques with relaxation and stress reduction skills, making it effective for individuals dealing with high levels of stress in their lives that compound other challenges. [Mindfulness ](https://www.healthline.com/health/mind-body/what-is-mindfulness)and other practices may be integrated to promote emotional well-being in a more general sense, which helps us understand the other challenges affecting you.

### Relationship Issues and Integrative Psychology

Integrative therapy can be beneficial for [couples therapy](https://dralanjacobson.com/couples-therapy/) or [families with older children](https://dralanjacobson.com/family-therapy/) experiencing relationship difficulties. It allows me to combine strategies from different therapeutic modalities to address communication problems, conflicts, and relationship dynamics. Since relationship issues can be complex and have a variety of causes, this combined approach can be quite helpful. It also allows us to change gears as necessary when sessions become too heated or as the relationships evolve.

### Self-Exploration and Personal Growth

Individuals seeking self-exploration, personal development, or a better understanding of themselves may find integrative psychology helpful. This approach to [individual therapy](https://dralanjacobson.com/individual-therapy/) allows a holistic exploration of thoughts, emotions, and behaviors. Many people come to therapy without a highly specific complaint, feeling like they are just not getting enough out of life or have a general sense of malaise. The integrated psychology approach may be a perfect fit as we dig deeper into these general feelings.

### Workplace Stress and Burnout

Integrative therapy can be applied in the context of workplace stress and burnout. Clients I have seen who were experiencing challenges in their professional lives benefited from a combination of stress management techniques and strategies to enhance resilience.

In summary, integrative therapy has diverse and adaptable applications to a wide range of situations, both in person and [virtually](https://dralanjacobson.com/virtual-therapy-guide/), making it a valuable option for individuals seeking support and personal growth across various contexts and mental health concerns.

## Integrative Psychotherapy Example

Integrative psychotherapy combines various therapeutic approaches to suit individual client needs, integrating techniques from different schools of thought. Here’s an example of how I might use integrative psychology in my practice:

### Joe’s Background

Joe is a 35-year-old man experiencing anxiety and depression. He has a history of [childhood trauma](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/) and struggles with low self-esteem and relationship issues, including being fearful of committing. He is doing very well at his job as a lawyer, though he sometimes feels like he is not as good at it as he truly is – he’s labeled this “imposter syndrome.”

### Initial Integrative Psychology Assessment

I start by conducting a comprehensive assessment, considering John’s psychological, emotional, and behavioral history. Joe is a perfect fit for an integrative psychotherapy approach. I feel comfortable having the experience and expertise to help him by combining cognitive-behavioral (CBT), psychodynamic, and mindfulness-based techniques.

### Integrative Psychotherapy Treatment Plan

We decide on a three-part plan, where we will weave together certain powerful and proven methods:

1. [**Cognitive-behavioral therapy (CBT)**](https://dralanjacobson.com/cbt-for-depression/)
    - Goal: Address Joe’s negative thought patterns and behaviors.
    - Techniques: 
        - Cognitive Restructuring: Helping Joe identify and challenge his negative thoughts.
        - Behavioral Activation: Encouraging Joe to engage in activities that bring him joy and fulfillment.
2. [**Psychodynamic Therapy**](https://dralanjacobson.com/psychodynamic-therapy/)
    - Goal: Explore John’s unconscious patterns and unresolved conflicts from his past.
    - Techniques: 
        - Free Association: Allowing Joe to speak freely about his thoughts and feelings.
        - Dream Analysis: Interpreting Joe’s daydreams and nighttime dreams to uncover hidden emotions and conflicts.
        - Exploring Childhood Experiences: Understanding how Joe’s past influences his current behavior and emotions.
3. [**Mindfulness-Based Techniques**](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/)
    - Goal: Help Joe manage his anxiety and improve his emotional regulation.
    - Techniques: 
        - Mindfulness Meditation: Teaching Joe to stay present and non-judgmental of his thoughts and feelings.
        - Breathing Exercises: Helping Joe use his breath to calm his mind and body.

### Integrative Therapy Sessions

1. **Session 1-3: Building Trust and Understanding**
    - The first task is establishing a solid therapeutic relationship, building trust, and understanding Joe’s concerns and goals.
    - Psychodynamic techniques are used to explore John’s past and identify patterns of emotional and behavioral reactions at work and socially.
2. **Session 4-8: Addressing Negative Thoughts**
    - Next, I would introduce CBT techniques, helping Joe recognize and challenge his negative thoughts.
    - Joe’s homework is to begin practicing [cognitive restructuring and behavioral activation](https://pubmed.ncbi.nlm.nih.gov/34264703/).
3. **Session 9-12: Integrating Mindfulness**
    - I teach John mindfulness techniques to manage his anxiety.
    - Joe’s homework is to practice mindfulness meditation and breathing exercises during sessions and at home.
4. **Session 9+: Deepening Insights and Behavioral Changes**
    - As time passes, and until Joe feels he has reached his goals and does not want to set new ones, I continue to integrate CBT and psychodynamic techniques, deepening John’s insights into his behavior and emotions.
    - Joe works on changing maladaptive behaviors and developing healthier coping mechanisms.

### Progress and Outcomes

Joe starts to recognize and challenge his negative thoughts, experiences less anxiety, and becomes more aware of his emotional patterns. He also gains deeper insights into his past, improves his self-esteem, and builds healthier relationships. Finally, due to mindfulness practices, he starts to feel more generally content and confident. An integrative psychology approach allows me to tailor treatment to Joe’s unique needs, combining various techniques to address his anxiety, depression, and unresolved trauma effectively.

## Conclusions and My Work

Integrative therapy is an approach that combines elements from different therapeutic modalities and theoretical frameworks. Integrative psychology aims to use the most effective and relevant methods from various schools of psychotherapy to meet each client’s unique needs. Rather than strictly adhering to one therapeutic approach, I draw on various techniques and theories to create a customized and flexible treatment plan.

I provide integrative therapy using techniques I am well trained in, including [psychodynamic](https://dralanjacobson.com/psychodynamic-therapy/), [positive psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/), [narrative](https://dralanjacobson.com/narrative-therapy/), [cognitive behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/), [Gestalt](https://dralanjacobson.com/gestalt-therapy/), and [client-centered therapy](https://dralanjacobson.com/client-centered-therapy/) techniques. This approach can be used with [couples](https://dralanjacobson.com/couples-therapy/) and [families with older children](https://dralanjacobson.com/family-therapy/).

I would be happy to [talk with you](https://dralanjacobson.com/contact/) to discuss the ways **integrative therapy** might help and, specifically, what types of therapy I might use to help with your unique goals and challenges.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Types of Therapy

---

### [Grief Therapy](https://dralanjacobson.com/grief-therapy/)

**Published:** December 20, 2023
**Author:** Dr. Alan Jacobson

**Content:**

**Grief therapy,** also known as **bereavement therapy,** is a [form of psychotherapy](https://dralanjacobson.com/) specifically designed to help individuals cope with and navigate through the intense emotions and challenges associated with loss. Grief and loss therapy provides support, guidance, and strategies to manage the various stages, which can include denial, anger, bargaining, depression, and acceptance.

I provide grief therapy to individuals, [couples](https://dralanjacobson.com/couples-therapy/), [families with older children](https://dralanjacobson.com/family-therapy/), and small groups. Grief and loss therapy can be done in person and as [online therapy](https://dralanjacobson.com/virtual-therapy-guide/). I’d be happy to [talk to you](https://dralanjacobson.com/contact/) about how this approach could benefit you or someone you know, but first, here is an overview of the service.

## Grief Therapy Overview

When I provide grief therapy, I create a safe and supportive environment for you to express your feelings, thoughts, and experiences related to the loss you’ve encountered. I may use [different therapeutic approaches](https://dralanjacobson.com/integrative-therapy/) such as cognitive-behavioral (CBT), narrative, or mindfulness-based treatment to assist you in processing your emotions, adjusting to life changes, and finding healthy ways to cope.

The goal of grief and loss therapy is not to erase the pain of loss but to help individuals understand and accept their emotions, develop resilience, and gradually adapt to their new reality. It can also provide tools to manage the practical aspects, such as handling daily life, making decisions, and adjusting to the absence of a loved one.

### Goals of Bereavement Therapy

Overall, bereavement therapy aims to provide compassionate support, facilitate healing, and help individuals adjust to life without their loved one while honoring their memory. It’s important to note that the specific goals and techniques of bereavement therapy may vary depending on your needs and preferences. Through bereavement therapy, you explore the meaning of the loss and how it fits into their broader sense of identity and purpose. This can involve reflecting on the relationship with the deceased, finding ways to carry on their legacy, and seeking meaning amid pain.

### Other Forms of Treatment

In addition to grief therapy that is done individually and with couples and families, it can involve participating in groups with others who have experienced similar losses. These groups can provide a sense of community, validation, and support. I can refer you to a [bereavement group treatment](https://therapybypro.com/15-group-therapy-activities-for-grief-loss-and-bereavement/) provider, which can be in addition to or sometimes instead of our work together.

## Grief Therapy Techniques

Grief therapy encompasses various techniques and approaches aimed at helping you navigate the complex emotions and challenges associated with loss. The most important part is providing a safe space to express your feelings, thoughts, and experiences related to the loss. This involves [active listening](https://positivepsychology.com/active-listening-techniques/), empathy, and validation of emotions. However, some specific approaches and techniques can work well. Here are some common techniques I use in grief and loss therapy:

### Cognitive-Behavioral Techniques (CBT) for Grief Therapy

[Cognitive behavioral treatment](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) as bereavement therapy involves identifying and challenging unhelpful thought patterns or beliefs related to the loss. This might involve reframing thoughts, managing triggers, or addressing feelings of guilt or anger. Addressing irrational fears and anxieties allows you to process the loss more effectively.

### Mindfulness and Relaxation Techniques

Teaching [mindfulness exercises](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/), deep breathing, or progressive muscle relaxation to help manage stress, anxiety, and overwhelming emotions can be helpful. These techniques are usually an add-on to other methods. They help you process your emotions in a more open and relaxed way, but with professional guidance.

### Narrative Grief and Loss Therapy

Encouraging individuals to tell their stories and make sense of their experiences can be an effective approach to grief therapy. This can involve [creating a therapeutic narrative](https://dralanjacobson.com/narrative-therapy/) around the loss, finding meaning, and integrating the loss into their life story. This, of course, involves reviewing how the lost loved one fits into your life narrative.

### Grief and Loss Education

Grief therapy often involves helping individuals understand the grieving process, including the different stages of grief, common reactions, and the normalization of their experiences. Knowing what to expect can reduce added fear and anxiety, and it can also help you help others who may share your feelings.

### Grief Therapy Homework

In addition to the specific techniques listed above, I often give homework, including:

1. Grief Journaling: Encouraging individuals to keep a journal to express their emotions, thoughts, and memories of the loss. Writing can be therapeutic and help in processing feelings.
2. Rituals and Symbolism: Incorporating rituals, ceremonies, or creating symbolic gestures to honor and remember the person who has passed away. This can be a helpful way to find closure and continue bonds in a different form.
3. Art and Expressive Therapies: Using creative activities like art, music, or drama as a means of expression and processing emotions that might be difficult to articulate verbally.

The overall goal is to encourage individuals to actively engage with their grief, acknowledge their emotions, and gradually integrate the loss into their lives so that they can move forward.

## Outcomes of Grief Therapy

The outcomes of grief therapy can vary from person to person, and there isn’t a one-size-fits-all approach. However, some common goals we might set and the potential outcomes of bereavement therapy may include:

### Emotional Expression in Bereavement Therapy

Grief therapy provides a safe space for individuals to express and explore their emotions related to the loss. This may involve talking about the deceased, sharing memories, and expressing sadness, anger, guilt, or even relief. This is an important step, and we will proceed with it at a pace you are comfortable with.

### Understanding Grief

I help individuals understand the grieving process and normalize their emotional responses. This understanding can be crucial in reducing anxiety and confusion about the intensity and duration of these feelings. This process is particularly important for those who enter grief and loss therapy, having never experienced a significant loss.

### Bereavement Therapy and Coping Strategies

Grief therapy aims to equip individuals with coping strategies to deal with the challenges of grief. These strategies may include developing healthy ways to manage stress, finding support from others, and learning to navigate the ups and downs. It also helps individuals adjust to life without their loved one. This adjustment is not about forgetting the person but finding a way to integrate the loss into one’s life and move forward.

### Identifying and Resolving Complicated Grief

Some individuals may experience [complicated grief](https://www.mayoclinic.org/diseases-conditions/complicated-grief/symptoms-causes/syc-20360374), where the grieving process is prolonged and more intense. This approach can help identify and address factors contributing to complicated grief and facilitate resolution. Complicated reactions are common and can be addressed in bereavement therapy, but they require more time and effort. Sometimes, there are even delayed reactions, where you feel you overcame the emotions initially, but they come back unexpectedly later.

### Enhanced Well-being Through Bereavement Therapy

Ultimately, the goal of this approach is to improve your overall well-being. This may involve rebuilding a sense of purpose, finding new meaning, and gradually adapting to a changed reality without the deceased. It often involves connecting individuals with support networks through group treatment, support groups, or [community resources](https://healgrief.org/grief-support-resources/). Building a supportive network can be instrumental in the healing process.

It’s important to note that this process is a unique and individual experience and outcomes can vary. As I get to know you at the beginning of treatment, we’ll make a plan, and I’ll be able to give a general idea of your course.

## Conclusions and My Work

My approach is always tailored to the individual, couple, or family’s needs and preferences. I assess and determine the most effective techniques for each person’s grieving process. It is often a combination of the above, all wrapped in a [humanistic approach](https://dralanjacobson.com/humanistic-psychology/), that I use. There can often be a sprinkling of [existential](https://dralanjacobson.com/existential-therapy/) and even [dynamic methods](https://dralanjacobson.com/psychodynamic-therapy/) as well.

### Process of Entering Grief and Loss Therapy

Entering grief and loss therapy with me involves several steps to begin the healing process. Here is what to expect:

1. The first step in grief and loss therapy typically involves an assessment, including discussing the circumstances of the loss, your emotional and physical reactions, your support network, and any previous experiences with grief or trauma.
2. Based on the assessment, we will work together to establish goals. These goals may include processing emotions, developing coping strategies, addressing unresolved issues, or finding meaning and purpose.
3. Loss can encompass a wide range of emotions, including sadness, anger, guilt, confusion, and numbness. In grief therapy, you can explore and process these emotions in a healthy and constructive way.
4. We’ll then work on learning and practicing coping strategies to manage the intense emotions associated with loss. These strategies may include relaxation, mindfulness, journaling, creative expression, or connecting with supportive resources.

Overall, entering grief and loss therapy is a courageous step toward healing and rebuilding a sense of hope and resilience after experiencing a significant loss. It’s important to find a therapist who specializes in grief counseling and who you feel comfortable working with as you navigate this journey of healing and transformation.

### Grief Therapy Referrals

If you or someone you know is experiencing grief and finding it challenging to cope, please feel free to be in touch at any time about grief and loss therapy. I’d be happy to [talk to you](https://dralanjacobson.com/contact/) about what bereavement therapy can offer, help you find a provider, or talk to you about my **grief therapy** services.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Symptom Relief

---

### [Emotional Support Pet Examples](https://dralanjacobson.com/emotional-support-pet-example/)

**Published:** May 10, 2024
**Author:** Dr. Alan Jacobson

**Content:**

An **emotional support pet** is an animal that provides comfort and support to people dealing with various mental health challenges. While they aren’t technically considered service animals like guide dogs, emotional support pets can still improve their human companion’s emotional well-being. In this post, I will go over getting an **ESA letter** for a fictional person who wants to have their pet be an **emotional support dog** because they have taken a new job in a new city and need to find an apartment to allow the dog to live there. I also provide a fictitious example of a person hoping to get an **[emotional support](https://dralanjacobson.com/emotional-support-animals-esa/) cat**. Any animal that can provide help with a diagnosed mental health challenge can be an ESA.

My page about Emotional Support Animals has even more information about the process of [ESA Assessments](https://dralanjacobson.com/emotional-support-animals-esa/). I always provide a brief screening to ensure you have an excellent chance of qualifying before you pay for this evaluation. However, I cannot make any guarantees until I get to know you.

## Emotional Support Dog Example

Here is a fictitious example of an emotional support dog and how her human companion got an ESA Letter.

### Emotional Support Dog Step One: The Emotional Support

Meet Bella, a golden retriever who [emotionally supports](https://dralanjacobson.com/emotional-support-animals-esa/) her owner, Sarah. Sarah struggles with anxiety and depression, and despite being a successful and well-regarded lawyer, she finds it challenging to cope with daily stressors and some longer-term challenges in her family life. Sarah has an opportunity to work in a new city and is quite excited about the opportunity.

After an initial search for apartments, she realized it might be hard to find a place close to the new work that would allow her to have Bella with her. She contacted me to get an emotional support dog to help her [manage her mental health](https://dralanjacobson.com/psychotherapy/). After an initial consultation, I told Sarah she would likely qualify for an ESA letter.

In her interview, Sarah tells me that Bella can sense when Sarah is feeling overwhelmed or anxious. She provides comfort by snuggling up to Sarah, gently nudging her, or sitting quietly by her side. Bella’s presence helps Sarah feel [calmer and more grounded](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/), especially during moments of heightened anxiety or sadness.

#### Beyond Emotional Support

Beyond [anxiety support](https://dralanjacobson.com/emotional-support-animals-esa/), Bella also encourages Sarah to engage in regular exercise and outdoor activities. They go for long walks in the park together, play fetch, and enjoy the fresh air. These activities benefit Bella’s physical health and contribute to Sarah’s overall well-being by [boosting her mood and reducing stress](https://www.medicalnewstoday.com/articles/how-does-exercise-reduce-stress). Having Bella by her side gives Sarah a sense of companionship and unconditional love. Knowing that Luna is always there to provide comfort helps Sarah navigate life’s challenges with greater resilience and confidence.

Sarah and Luna form a strong bond built on trust, understanding, and mutual companionship—a bond that enhances Sarah’s mental well-being each day.

### Emotional Support Pet Step Two: The Diagnosis

Not everyone who benefits from the companionship of an animal qualifies for an emotional support pet. You also need to have a [psychological diagnosis](https://psychcentral.com/conditions/conditions-index) that creates a significant challenge in your life. Thus, before Sarah can get an ESA letter, I need to assess her for a diagnosis that would qualify her to have an emotional support dog like Bella.

I evaluated Sarah’s symptoms, history, and overall functioning to determine if having an emotional support pet would be beneficial for her mental health. Given her level of anxiety, her constant worries, and the fact that these symptoms have been constant for much of her adult life, I find that she has an anxiety disorder called [generalized anxiety disorder](https://my.clevelandclinic.org/health/diseases/23940-generalized-anxiety-disorder-gad) (GAD).

### Emotional Support Pet Step Three: The Combination

It’s important to note that Sarah’s diagnosis alone may not be sufficient to qualify for an ESA letter. I need to determine that having an emotional support pet would contribute to her well-being. As described in step one, it is easy to connect Sarah’s diagnosis with her relationship with Bella. I can see how much her emotional support dog would help her overcome or reduce some of her symptoms.

I am happy to provide Sarah with an ESA letter, which verifies the need for the animal and allows for certain accommodations in housing and travel situations. She can use it to fly to the new city with Bella right next to her and to get an apartment near her work that may otherwise not allow pets.

## Emotional Support Cat Example

Emotional support pets can, of course, include cats. Cats provide comfort and companionship to individuals with mental health challenges. Here’s an example of when I might write an ESA letter for someone with a cat.

### Emma and Her Cat, Luna

Emma has been diagnosed with anxiety and depression. These conditions often make it challenging for her to navigate daily tasks, maintain social relationships, and find joy in activities she once loved. Emma’s therapist recommended getting an emotional support pet to help manage her symptoms. Emma decided to adopt a cat, Luna, from a local shelter. Luna quickly became a source of comfort and joy in Emma’s life.

### Emotional Support Cat Step One: The Emotional Support

Whenever Emma feels anxious, petting Luna and hearing her purr has a calming effect. The rhythmic motion and the sound of purring help lower Emma’s heart rate and reduce anxiety levels. Luna’s playful antics and affectionate behavior bring smiles and laughter to Emma’s day, helping to lift her mood and reduce feelings of depression. Caring for Luna provides Emma with a sense of purpose and routine. Feeding, grooming, and playing with Luna allow Emma to get out of bed and stay active.

Luna offers unconditional love and companionship, which helps Emma feel less lonely. Having Luna around makes Emma feel supported and understood, even when human interaction feels overwhelming. Taking Luna for walks (on a leash) or having friends who enjoy cats has opened up opportunities for Emma to engage in conversations with other pet owners, helping improve her social skills and reduce social anxiety.

### Emotional Support Pet Step Two: The Diagnosis

Not everyone who benefits from a cat’s companionship qualifies for an emotional support pet. You also need to have a psychological diagnosis that creates a significant challenge in your life. Thus, before Emma can get an ESA letter, I need to assess her for an appropriate diagnosis that qualifies her for an emotional support cat like Luna.

I received a letter from her therapist, which helped to jump-start our process. I also evaluated Emma’s symptoms and history and found that she has a depressive disorder called [dysthymic disorder](https://en.wikipedia.org/wiki/Dysthymia). This diagnosis will qualify her to have an emotional support cat.

### Emotional Support Pet Step Three: The Combination

Emma’s diagnosis alone was insufficient to qualify her for an ESA letter. I must also assess whether having an emotional support cat would contribute to her mental health functioning. This step was easy; it is evident that Luna was already helping her overcome some of her depressive symptoms.

I provided Emma with an ESA letter, which her landlord accepted. This example highlights how an emotional support cat can positively impact someone’s life by providing emotional stability, comfort, and a sense of purpose.

## The ESA Letter

Having an emotional support dog or other pet can offer companionship, reduce feelings of loneliness, provide a sense of purpose, and even help alleviate [symptoms of anxiety](https://dralanjacobson.com/therapy-for-generalized-anxiety-disorder/), depression, or other mental health conditions. However, it’s important to note that emotional support animals are not granted the same legal protections as [service animals](https://www.ada.gov/topics/service-animals/), and their presence in certain places (such as restaurants or on airplanes) may not be guaranteed unless accommodations are made in advance.

### Key Points to Remember About The ESA Letter

- An emotional support pet does not require special training to provide immense psychological benefits through companionship. There just needs to be a connection between the pet’s behavior and personality and the relief the human feels that helps an emotional challenge.
- To qualify for an ESA letter, a licensed mental health professional must determine that the animal is important to the individual’s mental health. This cannot be done without a face-to-face (even if virtual) assessment. It usually just takes one meeting.
- An emotional support pet is protected under certain laws, such as the [Fair Housing Act](https://www.hud.gov/program_offices/fair_housing_equal_opp/fair_housing_act_overview), which allows them to live with their owners even in housing that does not typically allow pets. However, they do not have the same rights to public access as service animals.

### My Work

Knowing how much joy, emotional support, and companionship animals can bring to humans, I am glad to provide emotional support pet evaluations. Getting an ESA letter is not terribly expensive, but I do not bill insurance directly for the service. However, your insurance company may reimburse you, and I will provide you with all the information you need to pursue that reimbursement. I go beyond the actual ESA letter, giving you ideas and suggestions for having your companion animal help you address your challenges.

The ESA letter you receive will not be specific to your current pet, though it may be specific to the type of animal. For example, in the first example above, I would have said that Sarah qualified for an emotional support dog. In the second case, Emma qualified for an emotional support cat, but without being specific about the current animal.

If you are considering getting an emotional support dog or other pet, don’t hesitate to [get in touch](https://dralanjacobson.com/contact/) with me anytime or [schedule a consultation](https://www.picktime.com/scheduleaconsult). We can discuss whether an ESA letter would benefit your situation and help you understand the necessary steps for obtaining the appropriate documentation.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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**Categories:** Therapy Specialties

---

### [Seasonal Affective Disorder Treatment](https://dralanjacobson.com/seasonal-affective-disorder-treatment/)

**Published:** October 28, 2023
**Author:** Dr. Alan Jacobson

**Content:**

**Seasonal depression therapy** is designed for is a type of depression that occurs at a specific time of year, typically in the fall and winter months when there is less natural sunlight. I provide specific **seasonal affective disorder treatment** and also help clients who come for other concerns but realize that there is also a seasonal component. **SAD Treatment** is comprehensive and multifaceted. This disorder’s primary cause is a lack of sunlight, which can disrupt the body’s internal clock and lead to changes in mood-regulating neurotransmitters, such as serotonin and melatonin. Seasonal affective disorder treatments often involve therapy with a [cognitive-behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) (called **CBT-SAD**), [positive psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/), or [client-centered therapy](https://dralanjacobson.com/client-centered-therapy/) approach in combination with lifestyle changes, [light therapy](https://www.sleepfoundation.org/light-therapy), and, in some cases, medication.

## What Causes SAD

While the exact cause of SAD is not fully understood, several factors are believed to contribute to its development. This information can be helpful as you decide on your best course for seasonal affective disorder treatment.

1. Reduced sunlight: The most widely accepted theory is that reduced exposure to natural sunlight during the fall and winter months can disrupt the body’s internal clock and affect the production of certain neurotransmitters like serotonin and melatonin. This disruption in the body’s circadian rhythm can lead to mood disturbances. Of course, this problem is exacerbated in areas where winter weather keeps people inside where they don’t even get exposure to the sunlight that is available. Seasonal affective disorder treatment with light can help.
2. Sleep Cycles: Changes in the body’s biological clock and melatonin production, influenced by the amount of natural light, can play a role in SAD. Melatonin supplements is a hormone that regulates sleep-wake cycles and may be overproduced in individuals with SAD. Reduced sleep can affect mood. Seasonal affective disorder treatment that focuses on improving the amount and quality of sleep can be helpful. Check with your doctor before taking any supplements, such as melatonin.
3. Genetics: Some individuals may have a genetic predisposition to SAD. If there is a family history of mood disorders or SAD, an individual may be at a higher risk of developing the condition. One example of this is [vitamin D deficiency](https://my.clevelandclinic.org/health/diseases/15050-vitamin-d-vitamin-d-deficiency), which has been linked to depression. Some research suggests that vitamin D supplementation may help alleviate SAD symptoms in individuals with a deficiency.
4. Lifestyle factors: Diet, exercise, and other factors can contribute to seasonal affective disorder. Poor dietary choices and a lack of physical activity during the winter months may exacerbate symptoms. Using a nutritionist as part of seasonal affective disorder treatment can be very helpful.

It’s important to note that not everyone is equally susceptible to SAD, and its exact cause can vary from person to person. Even with all of the possibilities above, it is good to look to a therapist who can direct you toward a combination approach to SAD Treatment that will help. The seasonal affective disorder treatments I and others offered are proven and powerful.

## Seasonal Affective Disorder Treatment Overview

Here are some common seasonal depression therapy methods:

### Light Therapy as a Seasonal Affective Disorder Treatment

[Light therapy](https://www.sleepfoundation.org/light-therapy) is a common and effective SAD Treatment. It involves exposure to a bright light that simulates natural sunlight. You can buy a light used for seasonal affective disorder treatment at any popular online shopping site. Then, you sit in front of a lightbox, which emits full-spectrum or white light for a specified duration each day, usually in the morning. You can do this while doing other daily tasks, such as answering e-mails or doing work that involves staying in one place. The light helps to regulate the body’s circadian rhythms and improve mood. Light therapy is most effective when used consistently.

A subset of light therapy as a seasonal affective disorder treatment are [dawn simulators](https://en.wikipedia.org/wiki/Dawn_simulation). Dawn simulators are devices that gradually increase light intensity in the morning, simulating a natural sunrise. This can help individuals wake up more gently and improve their mood in the morning. Getting this better start can carry through throughout the day.

### Seasonal Depression Therapy with CBT (CBT-SAD)

Cognitive-behavioral therapy (CBT) and other forms of psychotherapy can help individuals with SAD address negative thought patterns, manage stress, and develop coping strategies. Therapy can also help individuals identify and change behaviors contributing to SAD, such as overeating or social withdrawal. Therapy as a seasonal affective disorder treatment can be short-term, done at the time of year just before and when SAD occurs, or it can be done as a part of ongoing treatment. More about CBT-SAD later.

### Medication as a Seasonal Affective Disorder Treatment

Antidepressant medications, particularly selective serotonin reuptake inhibitors ([SSRI medications](https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825)), are sometimes prescribed for SAD, especially when symptoms are severe or do not respond to other treatments. Medications can be combined with light therapy or psychotherapy for better results. The positive aspect of using medication as a seasonal affective disorder treatment is that you may only need to take them for part of the year. Still, it is essential to discuss this with your provider.

I feel strongly that anyone on psychiatric medications should also pursue therapy since therapy can help reduce the chances that the medications will continue to be needed in the future. Seasonal affective disorder treatments that involve medications often have a goal of having you not need the medication in future years.

### Lifestyle Changes as Seasonal Depression Therapy

Making certain lifestyle adjustments can help alleviate SAD symptoms and are thus part of many seasonal affective disorder treatments. These changes are an effective seasonal depression therapy and include:

- Get regular exercise, especially outdoors, when possible.
- Maintaining a healthy diet and managing carbohydrate cravings.
- Manage stress through relaxation techniques, such as yoga, meditation, or [deep breathing exercises](https://positivepsychology.com/deep-breathing-techniques-exercises/). I can teach you these in our work together.
- Socialize and stay connected with friends and family.
- Ensure your home and workspace receive ample natural light.

## Seasonal Affective Disorder Types

There are a few different types or subtypes of SAD based on the season in which the symptoms occur:

### Winter-onset Seasonal Affective Disorder

This is the most common type of SAD, and it typically begins in the late fall or early winter and lasts until spring. Symptoms often include increased sleep, daytime fatigue, weight gain, and a general feeling of sadness or hopelessness. Of course, this type of challenge and requests for seasonal affective disorder treatment are more common the further north you live and, thus, the less sunshine you get.

### Summer-onset SAD

This is a less common subtype of seasonal affective disorder, and it usually starts in the late spring or early summer and ends in the fall. People with [summer-onset SAD](https://www.healthline.com/health/summer-SAD-is-all-too-real) may experience symptoms such as poor appetite, insomnia, anxiety, and irritability. The science behind summer-onset seasonal affective disorder is less clear. Still, like winter-onset SAD, it likely involves a combination of factors, including changes in light exposure, circadian rhythms, and genetic predisposition.

## Seasonal Affective Disorder Treatments Using CBT (CBT-SAD)

Cognitive Behavioral Therapy (CBT) can be tailored for Seasonal Affective Disorder (SAD). Sometimes called CBT-SAD, this structured approach is designed to help individuals manage seasonal depression. Unlike general CBT, CBT-SAD addresses specific challenges tied to seasonal changes and the impact of reduced sunlight on mood. In my [integrative psychological practice](https://dralanjacobson.com/integrative-therapy/), CBT is the cornerstone approach for treating SAD (along with [acceptance and commitment therapy](https://dralanjacobson.com/act-psychotherapy/) and [mindfulness approaches](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/)).

### Key Components of Seasonal Affective Disorder Treatment Using CBT

1. **Cognitive Restructuring**
    - This involves identifying and challenging negative thoughts associated with winter and the shorter days. People coming in for SAD treatment often experience feelings of hopelessness, isolation, or dread during the fall and winter.
    - I help my client reframe these thoughts with more balanced, positive perspectives.
2. **Behavioral Activation**
    - Individuals are encouraged to engage in activities that bring joy and fulfillment, even when motivation is low. This might include hobbies, social activities, or daily walks outside.
    - These active seasonal affective disorder treatments aim to counter the tendency to withdraw and increase exposure to natural light, which can naturally improve mood.
3. **Building Coping Skills for Seasonal Triggers**
    - SAD can be triggered by specific environmental cues, such as shorter days, colder temperatures, or holiday-related stress.
    - CBT-SAD helps people develop coping mechanisms for these seasonal triggers, like establishing a structured daily routine, engaging in stress-reduction techniques, or practicing self-compassion during challenging times.
4. **Developing Positive Associations with Winter**
    - Reframing winter as a season that can hold enjoyable experiences encourages you to plan activities that make the colder months more fulfilling.
    - This may include adopting winter-specific hobbies or engaging in community activities, which can help shift perspective.

### Duration and Effectiveness

- CBT for SAD typically involves weekly sessions over six to eight weeks, either individually or in group settings.
- Studies show that CBT-SAD can be as effective as light therapy for managing SAD, and the benefits tend to last beyond the winter season, reducing symptoms in future winters as well.

Since SAD symptoms and their impact vary from person to person, it’s important for any of the seasonal affective disorder treatments to be tailored to each individual’s needs. THis is where having an integrative psychological practice helps.

## CBT-SAD Treatment Example

Jodi is a thirty-two-year-old graphic designer living in Seattle. For the past three winters, she has noticed a recurring pattern of mood changes starting in late October and lasting until early March. Her symptoms include:

- Persistent low mood
- Decreased energy and fatigue
- Increased sleep duration
- Craving for carbohydrates leading to weight gain
- Difficulty concentrating
- Withdrawal from social activities

Recognizing these patterns, Jane consults with her primary care physician who recommends SAD Treatment. I see Jodi virtually and will coordinate her multifaceted seasonal depression therapy. Her physician prescribes a vitamin D supplement as well.

### SAD Treatment Plan

Jodi and I agree on the following SAD treatment plan that integrates several seasonal affective disorder treatments:

1. **Light Therapy:**
    - Implementation: Jodi will use a light therapy box emitting 10,000 lux of cool-white, fluorescent light. She positions the box about 16-24 inches from her face, ensuring the light enters her eyes indirectly.
    - Duration: 30 minutes each morning, shortly after waking up.
    - Expected Outcome: [Mimicking natural sunlight to trigger biochemical changes](https://www.sciencedirect.com/science/article/abs/pii/S1568163720302245) in the brain that elevate mood. This is a key SAD treatment.
2. **Cognitive Behavioral Therapy (CBT-SAD):**
    - Implementation: Jodi begins weekly sessions with me for CBT-SAD as a cornerstone treatment.
    - Focus Areas: 
        - Identifying and challenging negative thought patterns related to the winter months.
        - Developing coping strategies to manage stress and depressive symptoms.
        - Planning engaging activities to counteract withdrawal tendencies.
    - Expected Outcome: This area of seasonal depression therapy will equip Jodi with tools to modify unhelpful behaviors and thoughts, fostering resilience against symptoms.
3. **Lifestyle Modifications:**
    - Physical Activity: Incorporating at least 30 minutes of moderate exercise, like brisk walking, five times a week.
    - Diet: Focusing on a balanced diet rich in omega-3 fatty acids, fruits, and vegetables to support overall well-being.
    - [Sleep Hygiene](https://dralanjacobson.com/cbt-i-for-sleep-difficulties/): Establishing a consistent sleep schedule to regulate circadian rhythms.
    - Social Engagement: Scheduling regular meet-ups with friends and joining a local book club to combat social withdrawal is an informal seasonal depression therapy.

### Seasonal Affective Disorder Treatment Outcome:

Over the course of six weeks, Jodi reports a noticeable improvement in her mood and energy levels. The combined approach of light therapy, CBT-SAD, vitamin D supplements, and lifestyle changes helps her navigate the winter months with reduced SAD symptoms. She feels more in control and prepared to handle future seasonal challenges.

SAD Treatment often requires a multifaceted approach tailored to the individual’s needs. Combining therapies—like light therapy, [cognitive psychotherapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/), supplements, and lifestyle adjustments—can offer significant relief.

## Seasonal Affective Disorder Treatments and My Work

Seasonal affective disorder treatments are unique for each person, even if the symptoms happen at the same time of year for many. We will design a seasonal depression therapy program based on your unique symptoms and other aspects of your life. [My approach](https://dralanjacobson.com/types-of-therapy/) will vary depending on your preferences as well, and you can read more about my various approaches throughout [my blog](https://dralanjacobson.com/blog/).

When I do seasonal depression therapy, we often do not focus solely on the symptoms but also talk about other challenges you are facing as well. This way, the positive effects of seasonal depression therapy can carry over into the months when you do not experience symptoms. SAD treatment may also include [holiday anxiety therapy](https://dralanjacobson.com/holiday-anxiety/).

It’s essential to start SAD treatment before the onset of symptoms, as preventative measures can be more effective. Sometimes, people do not recognize the signs of SAD until they are already moderate. Please [contact me](https://dralanjacobson.com/contact/) anytime to discuss **seasonal affective disorder treatments** and how they might help you.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

 [ ![social network 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](https://www.instagram.com/appliedpsychological) [ ![social network 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](https://www.linkedin.com/company/psychologicalscience/)

**Categories:** Types of Therapy

---

### [College Admission Help](https://dralanjacobson.com/college-admission-help/)

**Published:** May 8, 2023
**Author:** Dr. Alan Jacobson

**Content:**

My [clinical specialties](https://dralanjacobson.com/intensive-therapy-and-specialty-services/) include **college admission help**. I provide services designed to help students present themselves to the college in the most compelling way possible. This involves ensuring a fit between the student and the colleges they are applying to and amplifying that fit to make an admissions department agree that the student would be a great addition to their community. We will design an overall strategy, and my [college admissions](https://dralanjacobson.com/college-admissions-counseling/) help services will ensure that your application resonates with them and that you present as an ideal candidate for that community. This will include **college admissions essay help**, interview training, and a complete action plan regarding other steps.

Given that this is a [clinical specialty service](https://dralanjacobson.com/intensive-therapy-and-specialty-services/), I can provide on-demand services such as check-ins virtually before interviews, last-minute essay help, help with timely thank yous, and fast responses to admissions and other inquiries.

The information below is designed to give you an idea of the college admissions help process, but of course, every client’s needs are unique. We will work to emphasize strengths, show how the student can overcome challenges evident in the application, and deliver a compelling product to the school about the student’s fit.

## College Admission Help First Steps

The admission process is akin to a comprehensive and multifaceted performance, so performance psychology methods are a great fit. The goal is for the student to prepare, practice, and present herself or himself to the admissions department and others to be seen as a good fit. Others may include alums, coaches, interviewers, and professors who may be involved in the decision.

First, we will discuss what kind of student admissions is looking for and how the student can present her or himself to gain the best chances to get in. Then, we break down the process into its parts. What specific aspects of the process tap into areas where the student is already strong and where work is needed? These areas include standardized test-taking, interviewing, writing essays, talking more informally with coaches and others, answering college-specific questions, and following up. The result is an initial college admissions help Action Plan.

### Assessments and Evaluations

To help accomplish this task, we may do some guided assessments as part of my college admissions help services:

- How did the student do on the required or optional [standardized testing](https://en.wikipedia.org/wiki/List_of_standardized_tests_in_the_United_States)?
- How do they come across in interviews or video submissions?
- What about less formal conversation, as might happen with a professor or coach?
- Are there addressable academic challenges – a particular course that needs a higher grade or a challenging course that should be taken?
- Are other interests being pursued so the student shows how well-rounded they are?

## College Admission Help Action Plan

The results of the above will guide our college admissions help Action Plan. Remember that just because a metric is deemed a strength does not mean it will not appear on the Action Plan. In many cases, fully developing a strength to stand out may be just as crucial as addressing weaknesses.

The specific college admission help plan we’ll use will be unique to the student and specifically suited to the colleges on their list. I’ve written up an [College admission services](https://dralanjacobson.com/college-admissions-consulting/) and some [self-help](https://dralanjacobson.com/college-admissions-self-help/) ideas (which you can find elsewhere – such as through supports like [Well-respected PrepScholar](https://blog.prepscholar.com/what-looks-good-on-a-college-application)). The Action plan will list the challenges that need to be overcome and the strengths that need to become clear to the college. It will have specific steps and dates by which you hope to reach these goals.

### Modifying the College Admission Help Action Plan

Your college admissions help Action Plan will become a “living” document, meaning that we will update it as time passes and you reach new goals or develop new insights. The college application process is hard to predict at first – the schools the student is interested in may change as visits happen, new accomplishments may change the equation somehow, and for athletes, the coaches who show interest may guide things to a degree. We will make changes as necessary, while at the same time, there may be overarching factors that we want to keep in mind so we do not deviate from the original ideals and goals.

## College Admissions Help Ongoing Work

Our work together will center around your plan in the above step. We will tailor each session to what goals or goals you want to work on, keeping in mind the timeframes so we plan accordingly. There will certainly be homework to be done in between sessions, and we will review that when we meet. As mentioned above, we will sometimes change your goals or add new ones as we see how the whole process is going for you.

One way to look at [college admissions](https://dralanjacobson.com/college-admissions-counseling/) help is to work backward from the acceptance stage and understand what will happen to get accepted to the schools you are looking at. We’ll work on any of those factors individually, ensuring we are pointed toward getting you to the best place possible and sending a compelling application to each college. Sometimes, our work will be very diverse, working on goals that almost seem unrelated, but that’s because the [College admission services](https://dralanjacobson.com/college-admissions-consulting/) process demands that you have addressed many aspects of your accomplishments and potential.

### How Therapy Can Be Integrated

The [college admissions](https://dralanjacobson.com/college-admissions-counseling/) process is complex and stress-inducing. My college admissions help services are designed to help students present themselves with confidence, clarity, and powerful simplicity. For some students, some extra work is needed for that to happen. There may be difficulties in clarity of expression or organization due to a learning difference or [Attention-Deficit Hyperactivity Disorder](https://dralanjacobson.com/cbt-for-adhd/), or [intense anxiety](https://dralanjacobson.com/treatment-for-severe-anxiety/) may affect confidence. In these cases, we can weave [more traditional therapy](https://dralanjacobson.com/) into your college admission help services. This may mean longer sessions or a more intensive service, but it should subtract from what you receive regarding college admission help.

## College Admissions Essay Help

I offer college admissions essay help relative to strategy and content. Crafting a compelling essay is a critical step in the application process. I can help you create an essay that stands out, presents you in a deeply meaningful way, and fits the rest of your strategy for each application. Before we discuss the actual steps, I will help you research each college so you can tailor your essay to explain why you’re a good fit for that specific school. This will be especially important as you write essays that are unique to a school.

### College Admissions Essay Help Step One: Understand the Prompt

- **Read Carefully:** Thoroughly understand what the prompt is asking. Identify key themes or questions. Link it to what you want the admissions committee to understand about you that may not be reflected elsewhere or needs further highlights.
- **Reflect on Your Experience:** Think about experiences, achievements, or challenges that align with the prompt.
- **Personal Stories:** Choose a story or experience that highlights your unique qualities and perspectives.
- **Show Growth:** Reflect on how the experience shaped you, what you learned, and how it impacted your goals.
- **Be Authentic:** Focus on what makes you unique. Admissions officers want to hear your authentic voice. I can help with that and help you develop a plan to have others who know you well read it.

### College Admissions Essay Help Step Two: Create an Outline

- **Introduction:** Start with a hook that grabs attention. Introduce the main theme or story.
- **Body:** Develop the story or idea, highlighting your qualities, skills, and how you overcame challenges. Be specific and use vivid details.
- **Conclusion:** Reflect on the significance of the story or experience. Connect it to your future aspirations and how they align with the college’s values.
- **Be Honest and Genuine:** Don’t try to impress with big words or complex ideas. Clarity and sincerity are more important.
- **Focus on Your Voice:** Write in a tone that feels natural to you. This is your chance to let your personality shine, and my college admissions essay help will center on this.

### College Admissions Essay Help Step Three: Revise

- **Seek Feedback:** Share your essay with teachers, friends, or family for constructive feedback.
- **Edit for Clarity:** Ensure each sentence contributes to the overall message. Cut out unnecessary details.
- **Proofread:** Check for grammar, spelling, and punctuation errors. I suggest hiring an outside consultant who specializes in English grammar and punctuation.
- **Consistency:** Ensure that your essay aligns with the rest of your application. This will be a central part of the college essay help I can provide.

## College Admission Help Service Limitations

College admissions is a complicated process, and parts are outside my scope as a psychologist. I would always suggest a team approach to the [college admissions](https://dralanjacobson.com/college-admissions-counseling/) process. Some people are quite good at different parts of the process, but few, if any, are good at it!

I suggest you augment my services with other professionals I can refer you to. For example, suppose you need help writing an essay. In that case, I can help make sure the content matches the overall strategy and approach you are taking regarding being a student-athlete and that it provides the depth needed. Still, I work closely with professional editors who can ensure the grammar is perfect and important principles of writing are followed..

There also may be people in the field who have specific connections at a school or specific connections relative to a major the student is pursuing. Again, I will refer you to those people when I can and tailor my work to fit with what they provide.

## Conclusions and My Services

I would be happy to talk to you and design an outline of what I could provide you or your child regarding college admission help. We can go over their goals, the challenges they’ve faced, the strengths that we want to emphasize, and where they are in the process. I’d be happy to provide some advice and tips and describe a plan if you choose to use my services. I can also provide referrals for more specific help. College admissions essay help is usually part of the service and can even be a stand-alone if you have everything else well-covered.

### College Admission Service Limitations

College admissions is a complicated process, and parts are outside my scope as a psychologist. I would always suggest a team approach to the [college admissions](https://dralanjacobson.com/college-admissions-counseling/) process, Some people are quite good at different parts of the process, but few, if any, are good at it!

College admissions essay help is a good example. Suppose you need help with grammar and punctuation. In that case, I can help ensure the content matches the overall strategy and approach you are taking and provides the depth needed. Still, I work closely with professional editors who can ensure the grammar is perfect and important principles of writing are followed. Then my college admissions essay help can focus on the content, strategy

There also may be people in the field who have specific connections at a school or specific connections relative to a major the student is pursuing. Again, I will refer you to those people when I can and tailor my college admissions help to fit with what they provide.

More information is in my [college admission self-help](https://dralanjacobson.com/college-admissions-self-help/) post; [College admission services](https://dralanjacobson.com/college-admissions-consulting/) is in another post. I also provide adjunctive treatment that may be helpful to some clients (e.g. [ADHD Treatment for adults](https://dralanjacobson.com/natural-adhd-treatment-for-adults/) and adolescents). Please [get in touch with me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) to learn more about the **college admission help** I can provide.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.linkedin.com/company/psychologicalscience/)

**Categories:** College Admissions Services

---

### [College Admissions Consulting Example](https://dralanjacobson.com/college-admissions-consulting/)

**Published:** May 8, 2023
**Author:** Dr. Alan Jacobson

**Content:**

The following is a **college admissions consulting** example. Of course, my [college admissions services](https://dralanjacobson.com/college-admissions-counseling/) are uniquely tailored to each client, but this example may help you see how I can help. If you have any questions about how hiring a psychologist **college admissions consultant** might work for you, please don’t hesitate to [reach out](https://dralanjacobson.com/contact/).

## College Admissions Consulting: Initial Steps

Hannah hopes to attend one of the colleges she visited and loved. These colleges are all realistic but will still be difficult to get into. Everything will have to go well during the interview and application process for her to get in; in other words, she needs to reach her peak performance throughout the process. She comes in looking for college admissions consulting services to help her maximize her strengths and overcome challenges. This way, she can present the most compelling application possible.

Hannah is a lacrosse player who thinks she wants to [major in Psychology](https://www.forbes.com/advisor/education/psychology-and-counseling/psychology-degree-guide/).

### The College Admissions Consulting Plan

We start by defining the goal and designing a treatment plan. The overall goal, of course, is to get into college. More specifically, it can be stated as “connecting strongly with the coach, producing the best application, and having the most favorable interview possible.” While Hannah has a general idea of where she wants to apply, this process will likely lead us to add to her list. As she explores what will make her application as compelling as possible, it may lead to new insights into the schools that will best fit.

### Making the Connections

We concentrate on the connections – the conversations with the coach and the potential admissions interview. Hannah has done well in interview situations before, but none has risen to the level of [college admission](https://dralanjacobson.com/college-admission-help/). She can point out some challenges that might crop up. This includes using “um” too much, stumbling when a question is difficult and unexpected, and not knowing exactly how to manage eye contact.

### The College Admissions Consulting Action Plan

Before we dive into the actual college admissions consulting work, we need to put together an action plan that has three components:

1. A timeline of when everything is due: This may include formal deadlines such as when applications are due when she needs to sign up for interviews, and when she needs to take and potentially retake the SATs. It also may include less formal dates, such as when she should communicate with coaches or professors at the school in her likely major.
2. A delineation of responsibilities: With her parents helping, we need to be very clear about exactly who is doing what at each step. This eliminates any confusion about my role and everyone’s responsibilities.
3. Back-up plans: We need to be sure we are not focusing so much on her top schools that we do not put enough time into the excellent [safety schools](https://blog.prepscholar.com/what-is-a-safety-school) and even the “realistic” ones on her list. They may have slightly different application components. Schools are susceptible to feeling that they are a backup.

## College Admissions Consulting: The Work

During our treatment, we will teach aspects of peak performance in interview situations. Of course, we will do trial interviews that include questions commonly asked by coaches and during admissions interviews. The role-play is filmed. This way, we can watch it later and work on anything that subtracted from Hannah being as compelling, persuasive, and likable as she truly is.

### Working in the Application

Next, we work on the application. How can her description of her sports, extracurriculars, and essays work cohesively to paint a powerful picture? How should this be tweaked for different schools, if possible? And what does this mean for how she should approach and prepare the people doing references for her? We want to tailor each application to the school it is going to as much as possible. We will emphasize her academic strengths, interests, and goals. She’ll also describe how she has overcome barriers and challenges.

### The College Essay 

Writing a compelling essay is a crucial part of the college application process. My work with Hannah will be to help her refine her ideas, choose a topic that fits with who she is and what the colleges are looking for, and be unique and interesting to the reader. We will then work on effectively structuring the essay to showcase her personality and experiences. When Hannah completes a good draft, I will refer Hannah and her family to a professional proofreader.

### The “Optional” Materials

Most of the time, “optional” materials are not really optional. Aside from art portfolios from students applying to be an art major, optional materials often show the school the applicants’ level of interest and effort. Some schools allow students to submit a short video, a supplemental essay, a web page, or a resume. We will keep a list of these items and ensure we are working to prepare for each of them.

## Ancillary College Admissions Consultant Work

During our work, I will assist Hannah in creating and refining her resume, highlighting her achievements, extracurricular activities, leadership roles, and community service. I will also help her choose how to select and approach teachers or mentors for strong letters of recommendation. This will include how to help the recommender include the information that best fits how Hannah describes herself to the colleges.

While Hannah is an excellent test-taker and has done well on her SATs, she plans to retake them, and I will provide [test preparation resources](https://www.bestcolleges.com/blog/free-sat-prep-resources/) and strategies to improve her test scores. I will also provide strategies to reduce anxiety and effectively pace herself during the test.

## College Admissions Consulting: Later Steps

Some of Hannah’s colleges offer interviews as part of the application process. We will build on our initial work that helped Hannah effectively present herself with more specific tips on what she might be asked, what she wants to cover, and, again, how to present herself confidently and articulately. We will review how to research each school and ensure the interviewer knows she has done so.

Our work will include going over how Hannah will talk to each coach. We want to show that she has done her homework. She’ll cover the facts and topics that the coach can hear and connect well. Hannah will also contact a Psychology professor at each school to ask questions about their department, the requirements, and the opportunities the major presents. There is no guarantee that the professor will inform admissions that she reached out. However, gathering information as she ranks her schools is still important.

As the deadlines approach, we will work on specific deadlines to keep everything organized. This will include applications, financial aid options, and scholarship opportunities.

## A Psychologist College Admissions Consultant: Example 2

When you hire a psychologist who is a college admissions consultant like me, you get a combination approach that covers both the usual college admission consultant work and also provides help navigating the stress and anxiety involved in the process. You also get a deeper psychological approach to presenting yourself in a way that resonates with the admissions committee.

In short, a psychologist college admissions consultant guides you on selecting schools that are a good fit, crafting meaningful essays, preparing for interviews, and organizing application materials into a coherent and compelling presentation. Here’s a fictitious example scenario involving how a psychologist works as a college admissions consultant:

### College Admissions Consultant Example

Sarah is a high school senior with strong academics and excellent extracurriculars who is unsure how to present herself effectively in her college applications. She also worries a bit about having [presentation anxiety](https://dralanjacobson.com/presentation-anxiety/) during any interviews.

#### Initial Consultation:

We start by discussing Sarah’s goals and what she wants in a college. We discuss any schools in mind, how visits have gone, and general aspects such as size and location. She has a few schools in mind but has not developed a plan, and she’s worried about her essays and how to stand out in the application process.

We aim to review her list of schools and others and discuss how they align with her academic and personal goals. Then, we’ll add more schools that may be a good fit and collaborate on her essays to highlight her unique strengths and experiences and why they’d make her a perfect fit at those schools.

We realize she would prefer a school that is strong in environmental science and has a strong campus community. She also wants to try to walk on and try to join a rowing team. Finally, she wants to be in a nice college town but not a city, and wants to be close enough to home where it is a drive or a short flight. Together, we will discuss the possibilities and see which ones resonate.

She decides which people will write her references and I help her craft a letter to them that helps frame what she hopes they will say.

#### Essay Development:

Considering the schools Sarah is interested in, we brainstormed some suitable essay topics. She thinks about moments that have shaped her, what passions drive her, and how she can showcase her personality and achievements. She wants to show the college her deep compassion and connection to others. She hopes to show them how she overcame childhood anxiety and wants to help others do the same.

All of her schools have strong environmental programs in the classroom and the community. They also value students who want to contribute to society after they graduate and who want to support the surrounding community while they are there. Since Sarah is passionate about climate change and has been involved in several related projects, she writes about how one of those experiences influenced her decision to study environmental science.

She adds a section about how she presented the project at a local elementary school and motivated the kids there to volunteer to help, as well as her interactions with them when they did. She describes a poignant moment when a young girl who reminded Sarah of herself came out of her shell and was so happy to be helping.

#### Application Review and Interview Prep:

Before she submits her application, we review her entire application package. We want to ensure that your application is cohesive, with each component supporting the overall narrative that she hopes to portray, which we’ve determined will resonate with the admissions committees. I give feedback on any areas that need tweaking.

Many of her schools conduct interviews as part of the admission process, so we conduct mock interviews to help her feel confident and prepared. We go over some [cognitive behavioral techniques](https://dralanjacobson.com/cbt-for-fear-of-public-speaking/) to reduce [speech anxiety](https://dralanjacobson.com/speech-anxiety-treatment/). I provide tips on how to articulate her thoughts clearly, make a positive impression, and ensure that everything fits with her overall strategy.

#### Final Steps:

My role as a college admissions consultant does not stop with the application. I support her through the waiting period, including how she will contact the rowing coach, a professor or two, and her admissions counselor. I may also help with decision-making once she starts hearing back from schools.

While Sarah feels confident about her essays and interviews, the work of a college admissions consultant was most valuable in helping her find schools that provide a deep fit and make her feel well-prepared to start her college journey

## Conclusions and General Notes

It’s important to note that my college admissions consulting specialty service can vary and is uniquely tailored to each client. The above services may be more emphasized in my overall [college admissions service](https://dralanjacobson.com/college-admissions-counseling/) or less depending on the student’s needs. Sometimes, as a college admissions consultant I only do one part of the process, like test and interview preparation or essay design. Other times, I do even more, including mixing in other [clinical services](https://dralanjacobson.com/).

My blog offers more information about my college admissions consulting services, including information about the [admissions counseling process](https://dralanjacobson.com/college-admission-help/) and [self-help tips](https://dralanjacobson.com/college-admissions-self-help/). If you have any questions or want to inquire about my services, please don’t hesitate to [schedule a consultation](https://www.picktime.com/scheduleaconsult) or [reach out](https://dralanjacobson.com/contact/).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

 [ ![social network 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](https://www.linkedin.com/company/psychologicalscience/)

**Categories:** College Admissions Services

---


## Pages

### [Therapy Services](https://dralanjacobson.com/)

**Published:** December 26, 2023
**Author:** Dr. Alan Jacobson

**Content:**

# Dr. Alan Jacobson, Psy.D. Licensed Psychologist

## Integrative Therapy to Help You Feel Better, Get Unstuck, Find New Meaning, and Live More Fully

If you are feeling anxious, overwhelmed, stuck, unable to find a deeper purpose, or simply ready for meaningful change, welcome! I am a Clinical Psychologist with 25 years of practice. I founded The Foresight Psychological Institute to provide leading-edge therapy, testing, and coaching services. This website provides information about the psychotherapy services I provide, and information about the larger company can be found at [Foresight Psychological Institute](https://appliedpsychologicalscience.com/).

 [Schedule a Consult](https://www.picktime.com/scheduleaconsult)

## About Me and My Approach:

[R](https://dralanjacobson.com/my-bio/)

### [My Bio](https://dralanjacobson.com/my-bio/)

Learn more about everything you might want to know about **my background, education, clinical training, recent continuing education, and where I have worked**. It also includes my credentials and professional memberships. Finally, learn a little about my life outside the office.

[More about my background](https://dralanjacobson.com/my-bio/)

[R](https://dralanjacobson.com/psychotherapy/)

### [Traditional Therapy](https://dralanjacobson.com/psychotherapy/)

Learn more about individual, family, and couples therapy in general and what each will be like. My practice integrates many [powerful and effective](https://dralanjacobson.com/telehealth-therapy-teletherapy/) techniques. This page will help you learn more about the process, time frame, and potential outcomes.

[More about therapy](https://dralanjacobson.com/types-of-therapy/)

[R](https://dralanjacobson.com/types-of-therapy/)

### [My Therapy Approach](https://dralanjacobson.com/types-of-therapy/)

Learn about the **clinical approaches I choose from to help you reach your treatment goals**. This includes what you should expect along the way – the measurable and meaningful results. The process should not be a mystery, and the gains should be obvious to you and others.

[More about my approach](https://dralanjacobson.com/types-of-therapy/)

## Virtual Psychotherapy Service Area

I can provide [individual, couples and group therapy](https://dralanjacobson.com/psychotherapy/) and [psychological testing](https://www.psychologicalassessments.com) virtually in the states shaded green. In most cases, these services can be equally [effective and powerful virtually](https://dralanjacobson.com/virtual-therapy-guide/) compared to in-person. However, particularly with testing, there are times when seeing someone in person may be a better option. I can refer you to someone in your local area in those cases.

 [Virtual Therapy Guide](https://dralanjacobson.com/virtual-therapy-guide/)

 ![Virtual Therapy Service Area](https://dralanjacobson.com/wp-content/uploads/2024/11/PsyPACT-Map-1.png "PsyPACT Map | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Services available in all blue areas in the map above.

## Current Wait Times:

Wait times for vary based on the specific days and times of day you need, but below is a general idea of my current wait times. I update this as much as needed.

Many people wonder whether it’s worth waiting for psychotherapy to find the right match. It’s a balancing act since so many very talented therapists are available.

My suggestion is that the amount of time you should be willing to wait should be related to the specific nature of your concern; if a therapist has a hard-to-find specialty or uses an approach that you think is a perfect fit, you may want to wait longer to start. Of course, the urgency of your needs should also play a role.

 **Therapy appointments during the late afternoon**:

10-14 days

**Therapy appointments during the morning or early afternoon**:

8-10 days

**Therapy appointments during the evening (after 5:00pm)**:

14-21 days

 ## My Therapy Philosophy

I am a [Licensed Clinical Psychologist](https://dralanjacobson.com/what-is-a-clinical-psychologist/) who has been providing psychotherapy to adolescents, adults, couples, and families for over 20 years. My practice is integrative, meaning that I am trained in a wide variety of techniques that can be combined and alternated to produce measurable, important, and meaningful results. My psychotherapy approach is positive, empathic, and solution-focused. I strongly believe that the results should not be a mystery – it should be clear that it works as you feel more content, develop new insights, reach your goals, and set new ones.

You should take your time to find a therapist who is a good fit for you, and that is why I (and most of my colleagues) [offer a consultation](https://www.picktime.com/scheduleaconsult) to make sure you feel I am a good fit for what you are looking for and what you hope to accomplish. We can also discuss whether psychotherapy is a good fit for you, what [talking to a psychologist](https://dralanjacobson.com/talking-to-a-therapist/) is like, and [how to find the right therapist](https://dralanjacobson.com/how-to-choose-the-right-therapist/) for you if I’m not a fit.

 [More about my therapy methods](https://dralanjacobson.com/types-of-therapy/)

 [More about who I am](https://dralanjacobson.com/my-bio/)

## Frequently Asked Questions

#### **[How long does therapy take](https://dralanjacobson.com/how-long-does-therapy-take/)?**

Therapy is a transformative process that can be life-changing. How long therapy takes depends on the methods we choose, how deep-seated your challenges are, and how high the barriers are to positive change. However, after 4-6 sessions, you should experience significant improvement, and then along the way, you should experience measurable and meaningful change as you go. We’ll work together to find a timeline that works for you.

#### **[What is a Clinical Psychologist](https://dralanjacobson.com/what-is-a-clinical-psychologist/)?**

A clinical psychologist has gone through four years of school after college, including two years of part-time closely supervised direct care experience, one year of full-time supervised experience after that, and then another year post-graduation. Then, they have to pass a very intensive and difficult exam to prove they have the knowledge necessary to practice. You can find more in my post where I [compare therapists, psychologists, psychotherapists and counselors](https://dralanjacobson.com/therapist-vs-psychologist-therapist-vs-psychotherapist/).

#### **[What’s the best way to find a therapist](https://dralanjacobson.com/how-to-find-a-therapist/)?**

There are many effective ways to find a therapist, and it’s not only okay but actually highly suggested that you be picky! Therapy can really create huge positive changes and the [fit with your therapist](https://dralanjacobson.com/how-to-find-a-good-therapist/) is vital. Start with word-of-mouth and browse websites like mine. You can also look to platforms like PsychologyToday and [ZenCare](https://zencare.co/provider/therapist/alan-jacobson). Keep in mind that in our field we are not competitive – if you contact me and I’m not the best fit, I’ll work hard to find you someone who is.

#### **[How can I tell how qualified a psychologist is](https://dralanjacobson.com/my-bio/)?**

Given the amount of education and supervised training a psychologist gets, even when they have just graduated, they already have four years of actual practice, and many were in the field before they went to graduate school. That said, experience is valuable, and asking how long they’ve been practicing can help. Also, look for a psychologist online or in person who has furthered their credentials postgraduation, such as becoming a National Register Certified.

#### [**How would you summarize your approach**](https://dralanjacobson.com/types-of-therapy/)**?**

I use what are called third-wave therapies, the latest innovations in some of the more powerful and effective approaches in the field. This includes [Cognitive-Behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/), [Acceptance and Commitment](https://dralanjacobson.com/act-psychotherapy/) (ACT), [Compassion Focused](https://dralanjacobson.com/compassion-focused-therapy/) (CFT), [Mindfulness-Based Cognitive](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) (MBCT), and [Schema-focused therapy](https://dralanjacobson.com/schema-therapy/). All of it is surrounded in a [positive psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/), [humanistic approach](https://dralanjacobson.com/basic-tenets-of-humanistic-psychology/). The goal is meaningful, measurable results that occur after a short period.

#### **[Will virtual therapy work for me](https://dralanjacobson.com/virtual-therapy-guide/)**

You can find information about virtual therapy throughout my site, particularly in [my blog](https://dralanjacobson.com/blog/). It boils down to fit. The techniques I use can be equally effective and powerful, and for some even more so, when delivered online. However, some people prefer the in-person experience of therapy and find virtual delivery does not work as well for them. If you’re not sure, try whichever approach you feel more comfortable with at first and see how it goes.

 [Ask A Question](https://dralanjacobson.com/contact/)

### What’s New?

As the field of Psychological continues to evolve, with advances in methods, new technology, specific ways to enhance the virtual experience, and new ways to combine techniques, I stay committed to continually learning how to provide the more effective, meaningful, and enduring services. I work hard to stay at the forefront of innovation while finding ways to reduce fees and expand offerings without ever compromising on quality or impact.

Below are some of the latest updates in my practice that reflect this ongoing commitment to excellence and innovation.

[](https://performancepsychology.net/corporate-testing/)

### [Emotional Support Animal Assessments](https://performancepsychology.net/corporate-testing/)

Healing from mental health and wellness challenges to being your happiest and most content self is not just about therapy. I promote a broad approach beyond our work together, and for many an [emotional support animal](https://dralanjacobson.com/emotional-support-animals-esa/) can play a large role. Whether you see me for treatment, or just need to see if you qualify, I [welcome your call](https://dralanjacobson.com/contact/) and I can give you an idea of your chances before you pay. You can also read some [ESA examples](https://dralanjacobson.com/emotional-support-pet-example/) in my blog.

 [Learn More](https://dralanjacobson.com/emotional-support-animals-esa/)

[](https://psychologicalassessments.com/accommodations/)

### [Therapeutic Tutoring for Children and Adults](https://psychologicalassessments.com/accommodations/)

Many children, adolescents, and adults struggle to learn not because of cognitive ability but rather because of the effect of mental health challenges on their ability to study in a way that helps them understand, retain, and then effectively use the information. Therapeutic tutoring combines high level traditional tutoring techniques and the types of therapy psychologist like me use. The result is improved confidence and understanding.

 [Learn More](https://therapeutictutoring.com/)

[](https://dralanjacobson.com/sports-psychology/)

### [Military Fitness for Duty Assessments](https://dralanjacobson.com/sports-psychology/)

The US Military wants to ensure that those who want to serve are physically and mentally fit for the service they will undertake. For this reason, they carefully review the mental health history of those who want to enlist or commission. My independent assessments use objective measures to help evaluate this and determine your fitness for military duty. This letter can be given to MEPS.

 [Learn More](https://psychologicalassessments.com/military-waiver-evaluations/)

## Practice Overview:

Homepage Additions — Dr. Alan Jacobson20+

Years in practice

44

States served virtually

Psy.D.

Licensed clinical psychologist

Current availability

 Mornings & afternoons 8–10 days

 Late afternoons 10–14 days

 Evenings (after 5pm) 10–14 days

 [Schedule a consult](https://www.picktime.com/scheduleaconsult) Free • No commitment

## Is this a fit for me?

 〰

 Anxiety, worry & panic

 Generalized anxiety, social anxiety, health anxiety, OCD-adjacent patterns, and panic disorder. Using CBT, ACT, and mindfulness-based approaches for lasting change. CBTACTMindfulnessVirtual

 😔

 Depression & low motivation

 For people feeling stuck, low, or disconnected. A strengths-based, positive psychology approach that emphasizes what's possible — not just what's wrong. Behavioral activationSchema therapyPositive psychology

 ∞

 Meaning & existential concerns

 Questions of purpose, identity, mortality, freedom, and values. For people at a crossroads or searching for deeper meaning — not just symptom relief. Existential therapyACTHumanisticValues-based

 🛤

 Life transitions & choices

 Career changes, relationship shifts, relocation, divorce, loss, and major decisions. Therapy that helps you navigate uncertainty and move forward with clarity. Solution-focusedACTHumanistic

 ✈

 Fear of flying & public speaking

 Intensive and group formats available. Structured, time-limited programs with a strong track record. Often resolved in fewer sessions than traditional therapy. Intensive formatGroup availableExposure therapy

 🚀

 Sports & occupational performance

 For athletes, executives, and professionals seeking a mental edge. Focus, resilience, performance under pressure, and recovery from setbacks. Sports psychologyHRV biofeedbackExecutive functioningPerformance Science Lab

 🎓

 College & early adulthood

 Support for students and young adults navigating academics, identity, independence, and the transition into adult life — including college admissions stress and early career challenges. College studentsCollege admissionsYoung adultsExecutive functioning

 ❤

 Couples & family therapy

 Communication, conflict, intimacy, and major life decisions. Family therapy for adolescents and parents navigating difficult transitions. CouplesFamilyAdolescents

 🛡

 ESA & military evaluations

 Emotional support animal assessments and independent military fitness-for-duty evaluations. Objective, thorough, and delivered with professionalism and discretion. ESA lettersMilitary waiver evaluationsObjective assessment

For any of these — or if you're not sure

A free consultation is always the right first step.

No commitment • I'll help you find the right fit, even if it's not me.

 [Schedule a free consult →](https://www.picktime.com/scheduleaconsult)

##  Fees & Insurance

### Session Fees

 The standard fee for a 45–50 minute therapy session is **$210**. For longer sessions, each additional 15 minutes is billed at **$70**. A limited number of sliding scale spots are available for clients who demonstrate financial need — please feel free to raise this during your consultation. Please note that these fees are for traditional therapy. Services like psychological testing and other evaluations or intensive services may be significantly more.

### Insurance

 I am an out-of-network provider and do not bill insurance directly. However, I am happy to provide you with a **Superbill** — a detailed receipt that includes the diagnostic and procedure codes your insurance company requires — which you can submit to your insurer for potential reimbursement.

 Many clients with PPO plans receive partial reimbursement this way, though I cannot guarantee any particular outcome, as reimbursement decisions are made solely by your insurance company. I encourage you to contact your insurer in advance to ask about your out-of-network mental health benefits.

### FSA & HSA Cards Accepted

 Flexible Spending Account (FSA) and Health Savings Account (HSA) cards are accepted as payment. Psychotherapy typically qualifies as an eligible expense under these plans, but please verify with your plan administrator if you have any questions.

###  Good Faith Estimate — No Surprises Act

 Under the federal [ No Surprises Act ](https://www.cms.gov/nosurprises), you have the right to receive a **Good Faith Estimate** of the expected cost of your care before your first appointment. This estimate will outline the anticipated cost of services based on your treatment needs. You will not be charged more than the estimated amount without advance notice.

 If you have questions about this estimate or your rights under this law, please don’t hesitate to ask — I’m happy to walk you through it.

##  Credentials & Professional Memberships

### Credentials

 🎓Psy.D.

Doctor of Psychology

 🎓MBA

Master of Business Administration

 🏥CHSP

Certified Health Service Psychologist

 📋Licensed Psychologist

Multi-state licensure

### Professional Memberships

- APA American Psychological Association
- CPA California Psychological Association
- NYSPA New York State Psychological Association

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### [Individual Therapy](https://dralanjacobson.com/individual-therapy/)

**Published:** January 2, 2024
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: September 6, 2026

 # Individual Therapy

Individual therapy, also known as individual counseling, is the cornerstone of my practice. I offer individual psychotherapy for a wide range of people, and I use an integrated approach to ensure measurable and meaningful results.

Powerful | Effective| Meaningful | Measurable

Ages 16+

 [Book A Consultation](https://www.picktime.com/scheduleaconsult)

## Individual Therapy Overview

**[Individual therapy](https://dralanjacobson.com/therapy-faqs/)**, also known as **individual psychotherapy**, involves a one-on-one session between me and you. This treatment focuses on addressing emotional challenges, mental health concerns, and barriers to feeling happy and content.

### Approaches

I use various techniques and approaches tailored to the client’s needs, including [cognitive-behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) (CBT), [psychodynamic](https://dralanjacobson.com/psychodynamic-therapy/), [humanistic](https://dralanjacobson.com/humanistic-psychology/), [narrative](https://dralanjacobson.com/narrative-therapy/), [client-centered therapy](https://dralanjacobson.com/client-centered-therapy/), and others. The goals often include improving [coping skills](https://positivepsychology.com/coping/), resolving conflicts, managing emotions, developing new insights, and promoting overall mental well-being. There are often some specific symptom reduction goals as well.

### Issues I Treat

Individual therapy provides a confidential space to discuss your concerns without fear of judgment. I work with people on a wide range of issues, including anxiety, depression, trauma, relationship difficulties, self-esteem issues, general dissatisfaction and malaise, existential concerns, and more. [My practice is trauma-informed](https://dralanjacobson.com/trauma-informed-care/).

 ![Individual Therapy Office](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "IMG_0474 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## About Individual Therapy

The following covers the basics of the services that I provide. Of course, you are welcome to [contact me](https://dralanjacobson.com/contact/) anytime to talk about your specific hopes and goals for our work together. I am also happy to talk to you about what [talking to a therapist](https://dralanjacobson.com/talking-to-a-therapist/) is like so you feel fully prepared.

### Individual Therapy Uses

Individual therapy can help with various concerns, challenges, and barriers. It can also help with more general senses of a lack of contentment or malaise. Here are some of the more common reasons people come in for individual psychotherapy:

1\. **Emotional concerns**: Together, we can address emotional conditions like anxiety and depression. These challenges can present in myriad ways, from more intense feelings that come and go to milder but pervasive states of being.

2\. **Emotional-behavioral concerns**: Some emotional concerns include a behavioral component, such as insomnia, compulsions, or [panic attacks](https://dralanjacobson.com/panic-attack-treatment/). Individual therapy can address both the emotional and behavioral components.

2\. **Relationship or Social Challenges**: Treatment can help people manage specific occurrences, such as navigating through a breakup or work conflict, and more general barriers, such as social anxiety or fears of intimacy. It can also help with a more general lack of confidence and connection.

3\. **Grief and Loss**: Individual therapy can be very helpful if you are coping with the death of a loved one, dealing with loss, or navigating the stages of grief. Treatment gives you a chance to grieve safely and comfortably, with guidance that navigates the process.

4\. **Stress Management**: Treatment can help you learn new techniques for managing stress, anxiety, or overwhelming life situations. You’ll feel more able to cope with and handle work, home, and social challenges.

5\. **Self-Exploration and Growth**: Individual psychotherapy is not always about challenges and barriers. Many clients come seeking personal development, enhancing self-awareness, and fostering self-improvement. Some are looking to explore existential concerns.

6\. **Life Transitions**: Adjusting to major life changes such as career shifts, relocation, retirement, or identity exploration is a common pathway in individual therapy. These times often produce stress and uncertainty, which individual therapy can unpack.

7\. **Improving Self-Esteem**: Individual therapy is often used for longstanding and stuck general goals, such as building self-confidence and self-worth. Educational, social, and occupational goals related to these issues can be set.

8\. **Parenting Challenges**: This approach is used for those seeking guidance and support in navigating parenting issues and challenges.

Individual therapy offers a safe and confidential space to explore their thoughts, feelings, and behaviors. It provides tools, strategies, and support to cope with challenges, improve mental health, and enhance overall well-being. The list above provides a general overview, but [we can discuss](https://dralanjacobson.com/contact/) how individual therapy could benefit you and help you reach your goals.

### Individual Psychotherapy Techniques

Individual therapy encompasses various techniques tailored to a person’s needs. [My practice is integrative](https://dralanjacobson.com/integrative-therapy/), meaning that instead of focusing on one individual approach, I borrow from many approaches and braid them together for the most effective course of treatment to help you meet your goals. Here are some of my more commonly used individual therapy techniques:

1\. [Cognitive Behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) (CBT): This type of individual psychotherapy focuses on identifying and changing negative thought patterns and behaviors contributing to distress and lack of contentment. CBT is a relatively fast and scientifically proven method of [reducing anxiety and improving mood](https://dralanjacobson.com/cbt-for-depression/). It requires some homework on your part.

2\. [Mindfulness-Based Techniques](https://dralanjacobson.com/mindfulness-therapy/): Mindfulness encourages present-moment awareness, using exercises to manage stress and improve thought patterns. Mindfulness is not usually a primary focus of treatment but rather a way to boost you and make other treatments, including CBT, more effective and powerful.

3\. [Psychodynamic Approaches](https://dralanjacobson.com/psychodynamic-therapy/): This form of individual therapy explores unconscious thoughts and past experiences to understand present behavior and feelings. Psychodynamic individual psychotherapy often takes a little longer than other approaches, but the results can be deep and meaningful, with significant present-day positive effects.

4\. [Humanistic Approaches](https://dralanjacobson.com/humanistic-psychology/): This form of individual therapy surrounds almost every technique I use. It emphasizes personal growth, self-actualization, and understanding your unique experience. Humanistic individual counseling is optimistic, focusing on strength and potential. It is more solution-focused than focusing extensively on problems. A related subset includes [personal growth counseling](https://dralanjacobson.com/personal-growth-counseling/), which involves fully focusing on personal fulfillment rather than symptoms.

5\. [Existential Treatment](https://dralanjacobson.com/existential-therapy/): This is for clients experiencing a general malaise and lack of contentment, even when things go reasonably well. Existential approaches help clients explore the meaning and purpose of life and confront existential challenges.

6\. [Narrative Treatment](https://dralanjacobson.com/narrative-therapy/): I also frequently borrow from this type of treatment. It focuses on the stories we construct about our lives and how they shape our identities. Through therapy, clients learn how to challenge and change narratives that are not hopeful and optimistic and then how to pursue more positive paths.

7\. [Exposure and Response Prevention](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/): For clients looking for help with phobias, [fears of flying, and fears of public speaking,](https://dralanjacobson.com/public-speaking-fear/) I provide this approach, which involves gradual and controlled exposure to anxiety-inducing situations to reduce fear and anxiety.

8\. [Gestalt framework](https://dralanjacobson.com/gestalt-therapy/): This type of individual therapy focuses on your present-moment experience and emphasizes personal responsibility. Gestalt therapy is optimistic, assuming that you have the tools to find happiness already on board.

9\. [Internal Family Systems](https://dralanjacobson.com/internal-family-systems-therapy-ifs/): This method relates to the idea that your mind in made up of distinct sub-personalities or “parts,” each with unique thoughts, feelings, and roles. Bringing harmony to these parts brings contentment and healing.

10\. [Family of Origin Therapy](https://dralanjacobson.com/family-of-origin-therapy/): Explores how early experiences in important relationships affect you now, and how you can break generational cycles, heal from past trauma, and learn new ways to cope and thrive.

11\. [Adlerian Therapy](https://dralanjacobson.com/adlerian-therapy/): A robust positive framework to help people break engrained but unhelpful patterns and develop new goals and strategies that bring greater contentment and deeper connections.

I provide individual [therapy for teens](https://dralanjacobson.com/therapy-for-teens/) 16 years and older and adults or all ages.

### Individual “Counseling”

Many people refer to this form of treatment as “individual counseling” since it is designed to provide counsel while you work through your thoughts and ideas and progress toward positive change. This terminology fits well and is often used instead of “psychotherapy.”

Therapy or Counseling is designed to help you better understand yourself, your thoughts, feelings, and behaviors and develop skills to manage challenges and improve your overall well-being. In addition, and perhaps more importantly, individual counseling is designed to help you reach new levels of meaningfulness and contentment. You should feel like specific symptoms that might involve anxiety, depression, or stress have diminished, but also that you generally feel better, happier, and stronger.

Individual counseling is a unique experience in which you can discuss your concerns, experiences, and emotions in a confidential, nonjudgmental, and supportive environment. I will integrate a variety of proven and powerful therapeutic techniques, but you will truly be doing the work.

### Bottom Line

This treatment can be short-term or long-term, depending on what challenges you want to tackle and whether you want to add new goals once you do.

It’s vitally important for clients to feel comfortable with their therapist and to establish a trusting relationship to facilitate progress and growth through inividual counseling, so please know that it is fully respected if you decide that I am not a good fit. If I am, I am humbled that you might choose me, and I pledge to ensure that your experience is as comfortable and successful as possible.

 ## Individual Psychotherapy FAQ

##### What individual psychotherapy techniques will you use?

My practice is integrative, meaning that I am trained in a [variety of techniques and approaches](https://dralanjacobson.com/types-of-therapy/) that can help. When we meet and I learn more about what you are looking for, I can go over the possible combinations of approaches, and we can choose what will work best together.

##### How long will individual psychotherapy take?

After you make your goals and we discuss an approach, we’ll discuss [your treatment plan](https://positivepsychology.com/mental-health-treatment-plans/), which will describe how long it may take to see measurable and meaningful improvements through individual therapy.

##### How often will we meet?

I like to start with weekly sessions for at least 3-4 weeks to get things moving, and I can make sure I fully understand your background and what you want to achieve. After that, we can discuss the frequency of sessions moving forward and even whether one of my specialty services that provides more frequent contact might be a good choice.

##### Will we meet virtually or in-person?

I meet with most clients virtually, and I’ve found no difference in the speed or effectiveness of meeting this way. If you live near my Norwood, MA, office, we can discuss meeting in person. I provide more information about virtual treatment in my blog post: [Virtual Therapy Effectiveness](https://dralanjacobson.com/virtual-therapy-guide/)

##### How will I know that treatment is working?

I feel strongly that it should not be a mystery whether individual counseling is working. We will outline measurable, important, and meaningful goals, and along the way, we will make sure that treatment is working to help you reach them.

 ### From Dr. Jacobson’s Desk

Of everything I do, individual sessions are where I most often get to watch someone rediscover a part of themselves they’d quietly stopped trusting. People rarely show up because they’ve enjoyed getting stuck; they show up because something that used to work stopped working, and no one had yet asked the question that actually matters: what fits *you*, specifically, not the general idea of “someone with anxiety” or “someone going through a transition.”

That’s the entire reason I trained across more than twenty approaches instead of settling into one or two (I go into how I actually use that training on my [MATCH framework page](https://dralanjacobson.com/the-match-framework-of-integrative-therapy/)). One-on-one work is where that flexibility matters most, because it’s just the two of us in the room, and I can move as quickly or as carefully as your history and your goals actually call for, rather than as a fixed protocol calls for.

If you’re not sure whether individual therapy is the right starting point, or whether couples or family work might serve you better given what’s going on, that’s a completely reasonable thing to bring to a free consultation. I’d rather help you find the right door than have you guess.

— Dr. J

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### [Public Speaking Anxiety](https://dralanjacobson.com/public-speaking-anxiety/)

**Published:** December 26, 2023
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: July 6, 2026

 # Public Speaking Anxiety Therapy

Public speaking fear treatment will help you overcome your fears, reduce anticipatory anxiety, and become an effective public speaker. Overcoming public speaking anxiety is possible with the right approach and some hard work. Public speaking fear therapy is therefore a cornerstone service in my practice.

 [Schedule a Free Consultation](https://www.picktime.com/scheduleaconsult)

Fear of public speaking — sometimes called speech anxiety or glossophobia — is among the most common fears there is, and one of the most treatable. Whether it shows up as dread before a work presentation, avoidance of opportunities you actually want, or full panic at a podium, therapy can change your relationship with speaking in a matter of months. I offer public speaking anxiety therapy in person and virtually in 40+ states through PSYPACT.

## Why Public Speaking Feels So Threatening

Public speaking anxiety isn't a character flaw or a lack of preparation — it's a threat response. Your nervous system treats an audience the way it would treat genuine danger, which is why willpower alone rarely fixes it. The fear usually traces to some combination of:

- **Fear of judgment** — the sense that every listener is evaluating you, and that a visible mistake would be catastrophic
- **Past experiences** — a presentation that went badly, ridicule in school, or criticism that taught your brain to associate speaking with harm
- **Perfectionism** — a standard so high that anything short of flawless registers as failure
- **Fear of the fear itself** — worrying that others will see you blush, shake, or lose your words, which produces exactly those symptoms
- **Temperament and biology** — some nervous systems are simply more reactive to social evaluation, which shapes the starting point but not the outcome

Understanding which of these drives your anxiety matters, because it shapes which treatment elements we emphasize.

## How I Treat Public Speaking Anxiety

My approach draws on the methods with the strongest evidence for speech anxiety, combined and sequenced for your specific presentation of the fear:

### Cognitive Behavioral Therapy

We identify the specific thoughts that fuel the fear — "I'll freeze," "they'll think I'm incompetent" — test them against evidence, and build more accurate replacements. CBT is the backbone of effective treatment for speaking anxiety.

### Gradual Exposure

We build a ladder from low-stakes speaking situations to the ones you fear most, climbing at a pace that stretches you without overwhelming you. Avoidance feeds this fear; structured practice starves it.

### Mindfulness & Physiological Tools

Breathing, grounding, and attention-training techniques that calm the body's alarm response — so the racing heart and shaky hands stop hijacking your performance while the deeper work takes hold.

### Visualization & Rehearsal

Mental rehearsal of successful speaking experiences, which research shows shares much of the benefit of live practice — and pairs powerfully with real exposure work.

For some clients, we also discuss adjuncts: coordination with a prescriber about short-term options like beta-blockers for high-stakes events, or group formats where practicing in front of supportive others is itself the treatment. These supplement therapy; they don't replace it.

## What the Therapy Process Looks Like

1. **Free consultation**A brief call to hear what speaking situations trouble you, answer your questions, and make sure we're a good fit before you commit to anything.
2. **Assessment**We map your specific version of the fear — the situations, thoughts, body sensations, and avoidance patterns — because a fear of freezing mid-sentence needs different emphasis than a fear of being visibly nervous.
3. **Skills first**Early sessions build your toolkit: cognitive strategies and physiological regulation you can use immediately, so you have something that works before we approach harder challenges.
4. **Graduated practice**We work up your exposure ladder — in session, between sessions, and in real speaking situations as they arise — consolidating what works after each step.
5. **Real-world consolidation**The goal isn't comfort in my office; it's the meeting, the wedding toast, the conference talk. We finish by cementing gains where they matter and building your plan for maintaining them.

**Have a major presentation coming up?** For clients facing a high-stakes event on a short timeline, I offer an intensive format: condensed preparation sessions, day-of coaching support, and follow-up afterward. It's not a substitute for full treatment, but it can carry you through the event that can't wait — and often becomes the start of the longer work.

## What This Looks Like in Practice

### Case Example: The Promotion That Required a Voice

Jenn, a senior analyst, turned down a management role twice because it involved monthly presentations to leadership. In our assessment, her fear centered on visible anxiety — being seen shaking or flushing — more than on the content itself. We began with physiological tools and cognitive work on her prediction that visible nervousness would discredit her, then built an exposure ladder from recording herself, to presenting to me, to speaking up in low-stakes meetings, to volunteering for a small internal briefing. Five months in, she accepted the promotion; her first leadership presentation was uncomfortable but entirely doable, and by the third one, the dread had shrunk to ordinary pre-meeting nerves. *(Details are illustrative and do not describe an actual client.)*

## Virtual Therapy for Public Speaking Anxiety

Speech anxiety treatment translates unusually well to telehealth: exposure practice over video mirrors the remote presentations most professionals actually fear, recordings and rehearsals integrate naturally, and research supports online CBT for social and performance anxiety. Through PSYPACT, I work with clients in more than 40 states — so if you've been putting this off because of location or schedule, that barrier is gone.

## Frequently Asked Questions

### Can fear of public speaking really be overcome?

Yes — it's one of the most treatment-responsive anxiety presentations. Most clients don't become people who feel nothing at a podium; they become people whose nerves are ordinary and manageable, who stop avoiding opportunities, and who trust themselves to perform even when anxious. That shift is very achievable.

### How long does public speaking anxiety therapy take?

Many clients see meaningful change within a few months of weekly sessions, with the timeline depending on how long-standing and severe the fear is and how much real-world practice is available between sessions. High-stakes events on short timelines can be addressed with an intensive format while longer-term work continues.

### Is public speaking anxiety the same as social anxiety?

It can be a feature of social anxiety disorder, but many people fear public speaking specifically while being comfortable in other social situations. Part of assessment is determining which pattern fits you, because treatment emphasis differs — though both respond well to the same core methods.

### What is glossophobia?

Glossophobia is the clinical-sounding term for fear of public speaking. Whether your experience is best described as glossophobia, speech anxiety, presentation anxiety, or performance anxiety, the underlying mechanics — and the treatment — are essentially the same.

### Does online therapy work for speech anxiety?

Yes. Online CBT for social and performance anxiety is well supported by research, and video sessions offer a unique advantage here: practicing presentations over video directly rehearses the remote-meeting format many people fear most. Through PSYPACT I can work virtually with clients in 40+ states.

### Will I need medication?

Most clients don't. Therapy is the primary treatment for public speaking anxiety. For some high-stakes situations, short-term options like beta-blockers can be discussed in coordination with a prescriber — as a supplement to the skills work, never a replacement for it.

### What if my presentation is only weeks away?

Reach out anyway. An intensive format — condensed preparation, practical day-of strategies, and follow-up — can get you through the event that can't wait. Many clients then continue with standard therapy so the next presentation requires no rescue at all.

## Your Voice Is Worth the Work

Start with a free consultation — tell me about the speaking situations you're facing, and I'll tell you exactly how we'd approach them. In person or virtual in 40+ states.

 [Schedule a Free Consultation](https://www.picktime.com/scheduleaconsult)

## Public Speaking Fear Therapy Example 1

The following is a fictional example of **public speaking anxiety therapy**. Of course, all clients are different, and this example is designed to give a general idea of what public speaking fear therapy would be like, even though your own therapy might be different.

Jim came looking for public speaking fear treatment because he had to give a weekly seminar at his work in front of anywhere from 5-20 people. He knows he is well-regarded at work, and is confident in his job performance, but he still has been experiencing these fears for some time. His anxiety manifests in both physical symptoms, such as shortness of breath and rapid heartbeat, plus psychological symptoms, such as anticipatory anxiety and extreme self-consciousness.

### Public Speaking Anxiety Therapy Initial Steps

We start by working to identify the specific aspects that make Jim anxious. For him, it is a fear of being judged or making mistakes. We start to challenge those fears with reality – does he have any evidence that people are actually judging him harshly or unfairly, or that he’s prone to making mistakes? These types of challenges to his irrational and exaggerated thoughts will become a cornerstone of our work together.

We also instituted a plan by which he will practice a little more when in front of others. Practice is key to building confidence. He had realized that, as opposed to when he was in college and could basically talk off the cuff, the high-level professional atmosphere puts more pressure in place, and he might do well to become more familiar with his material.

Finally, we worked on having him imagine himself giving a successful and well-received speech. Visualization helped reframe his mindset and created positive associations.

### Public Speaking Fear Treatment in the Moment

While we worked on all of the above to try to reduce the intensity of Jim’s anticipatory anxiety and make sure he was well-prepared and more confident, we also worked on ways he could make the actual experience better. Jim worked to learn effective deep breathing exercises that can help calm his nerves, focusing on slow, deep breaths to regulate his anxiety.

He also followed on the CBT techniques noted above by challenging negative thoughts he had right before and even during his engagement. Looking for irrational and exaggerated thoughts that are the cornerstone of public speaking anxiety therapy and labeling them as such was key. He reminded himself of his strengths and past successes. He replaced thoughts like “I’ll mess up” with “I am well-prepared, and I can do this.”

Finally, he learned that instead of worrying about how he is perceived, he would shift his focus to the message he wanted to convey. Concentrating on providing value to his audience took his mind off of his own performance. These initial steps in public speaking anxiety treatment proved powerful and effective.

### Advanced Steps

As Jim started to experience success with these techniques, he wanted to speed the process and get even closer to overcoming public speaking anxiety. He found ways to work his way up to larger audiences and found that each successful experience built his confidence for more challenging situations. Joining a Toastamsters group helped him gain confidence by knowing that he was presenting well. He started to mix in humor and visual aids that helped him bring even more value to his audience, which, in turn, gave him more confidence.

Public speaking anxiety treatment produces small steps, and this worked well for Jim, continually giving him confidence along the way. With persistence and practice, he built the confidence he needed to become a more effective and comfortable public speaker, successfully overcoming public speaking anxiety.

## Public Speaking Anxiety Therapy, Example 2

Here is another example of a client overcoming public speaking anxiety with details [about the process](https://dralanjacobson.com/fear-of-public-speaking-therapy-process/). Your journey will be unique, so this example is given here to give you an idea of how public speaking fear treatment generally works. We will devise a specific plan to address your unique fears and their etiologies. Public [speaking fear](https://dralanjacobson.com/fear-of-public-speaking-groups/) therapy is usually time-limited and effective, and you will see meaningful and powerful results.

Please feel free to [contact me](https://www.picktime.com/scheduleaconsult) anytime or [schedule a consultation](https://www.picktime.com/scheduleaconsult) to discuss therapy for overcoming public speaking anxiety.

### Public Speaking Fear Therapy Techniques

I run an [integrated psychological practice](https://dralanjacobson.com/types-of-therapy/), which means that I am trained in a variety of techniques designed to help you get the results you are looking for. We will review the possibilities during our first few sessions and devise a plan that fits your needs. I often use [cognitive-behavioral treatment](https://dralanjacobson.com/cbt-for-fear-of-public-speaking/) (CBT) as a cornerstone public speaking feat therapy, but we can also borrow from [Exposure-response prevention](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/) (ERP) where you challenge yourself gradually at a pace you are comfortable with to confront your fears. We can also use some [narrative techniques](https://dralanjacobson.com/narrative-therapy/) and [psychodynamic approaches](https://dralanjacobson.com/psychodynamic-therapy/) to understand where your fears originated.

An example is a good way to explain how public speaking fear therapy works. Thus, the following is an overview of fictitious public speaking fear treatment. Your treatment will be individually and uniquely designed, of course, but this example shows the steps and possibilities.

### Public Speaking Anxiety Therapy

Jenn came to therapy to overcome her fears because her job requires her to talk in front of her team at weekly meetings, with larger public speaking engagements for clients every month. She is knowledgeable and good at her job but has developed speech anxiety, including severe anticipatory stress and anxiety during her talks. Her heart races, and she feels that her voice quivers in a way people can perceive.

She also feels like she cannot get the right words out, especially at the beginning of each talk when she is most anxious. She is frustrated because otherwise, she enjoys her job and feels great in many aspects of her life, but the worries dominate her thoughts. Jenn was very motivated for public speaking anxiety treatment.

### Initial Assessment

I explained to Jenn that overcoming public speaking anxiety was very possible. Together, we noticed the irrational and exaggerated thoughts were causing much of her anxiety before and during her public speaking experiences. We also discussed how her physical symptoms added to the anxiety, making her self-aware and concerned. Jenn said she experienced some relief just from hearing all of that. She said the analysis and understanding helped her develop optimism about her public speaking fear treatment.

### Overcoming Public Speaking Anxiety, First Steps

After I explained the different possible approaches to Jenn, we decided to go with one of the most proven and powerful techniques, cognitive-behavioral therapy (CBT). CBT will help identify and challenge her negative thoughts and beliefs contributing to her fear and anxiety and replace them with more positive and realistic ones. CBT is a cornerstone public speaking fear therapy approach.

The initial aassessment included discussing, in detail, her specific fears, triggers, and types of situations she finds most difficult. We explored her history and found that the anxiety started soon after she decided that her career would be in marketing and when she got this exciting new job. Before then, she had had very little trouble with [public speaking,](https://dralanjacobson.com/public-speaking-anxiety/) but most of her opportunities had been back in college five years ago. She said it was confusing because she hadn’t ever had a bad experience, so she couldn’t figure out what initially triggered her anxiety.

### Overcoming Public Speaking Anxiety Treatment Plan

After we talked about her background and the etiology of her fears, we decided on three goals to help her in overcoming public speaking anxiety:

1. Public speaking fear therapy will reduce her anticipatory anxiety, both the frequency and intensity of her worries before these engagements
2. Public speaking fear therapy will help her overcome public speaking anxiety during the presentations themselves, with specific strategies to be learned
3. Public speaking fear therapy will improve her effectiveness at preparation so that she feels more confident beforehand

These goals will form the basis for our work together.

### Psychoeducation

Before diving into the public speaking anxiety treatment itself, I provided some psychoeducation, explaining the nature of anxiety, the fight-or-flight response, and how it is usually based on some threat – we would need to find out what that threat was! We also discussed the role of negative thinking patterns and how they create exaggeration and irrationality that are not based on actual danger.

I also taught her basic relaxation techniques, such as deep breathing, progressive muscle relaxation, and mindfulness exercises. These techniques can help reduce anxiety and promote a sense of calm during these situations.

I also gave her homework to read resources that show how people can be successful at overcoming public speaking anxiety, such as excellent articles in [Forbes Magazine](https://www.forbes.com/sites/forbescoachescouncil/2022/11/07/how-to-conquer-your-fear-of-public-speaking-five-unique-steps/?sh=7140f8e4426e) and from the [Mayo Clinic](https://www.mayoclinic.org/diseases-conditions/specific-phobias/expert-answers/fear-of-public-speaking/faq-20058416).

### CBT for Overcoming Public Speaking Anxiety

Jenn was already relieved that her fears were not due to any actual threats and knew she had to let her natural confidence about her abilities shine through. She wasn’t sure how to do it, but she felt more optimistic. We started CBT with ccognitive restructuring, which involved some homework where Jenn noticed and wrote down her specific negative thoughts before, during, and after each talk.

In the public speaking fear treatment session, we examined the evidence for and against those thoughts and developed more balanced and rational alternatives. For example, she worries that she will look foolish or say something wrong when she gives a talk. We challenged that by looking for times[,](https://dralanjacobson.com/public-speaking-anxiety/) such as when she talks to colleagues or makes phone calls for work, when she makes these types of mistakes and doesn’t really care, and she realized how exaggerated her fear is.

We could find several exaggerated or irrational beliefs and challenge all of them in session, but now she needed to challenge them in real time. In public speaking anxiety therapy sessions, we did some role-playing and rehearsal where we replayed actual scenarios, using her new cognitive and relaxation skills. I made sure to point out her successes with these techniques so she would see her progress and recognize her achievements.

### Carrying it Forward

It was time for Jenn to practice her techniques in real situations. To provide additional support, I arranged phone calls with her before she followed small and large speech engagements. During the calls, we reviewed her techniques; I provided a positive and hopefully motivated review of her progress and reminded her of the relaxation techniques she could use.

As time passed, she became much less stressed and realized more clearly how irrational and exaggerated fears had affected her. She increasingly challenged herself to do even more talks—volunteering, for example, to give some new employee orientation talks to get more exposure.

Our final step in her path to overcoming our public speaking anxiety therapy was having her learn strategies for maintaining their progress and preventing relapse, including continued practice, ongoing use of relaxation techniques, and how she could quickly address any future challenges that arise.

### Public Speaking Anxiety Add-on Methods

Jenn decided to use two additional aspects of my clinical specialties. First, she would tape her experiences so I could remind her exactly when to use her techniques, have her notice that she came across much better than she thought, and help her learn to overcome any challenges in relaying information. Second, we would connect during times when she was experiencing particularly intense anticipatory fear so we could notice any irrational or exaggerated thinking patterns on the spot.

### Overcoming Public Speaking Anxiety in My Practice

I offer public speaking fear therapy to a wide variety of people, including those who have to speak in front of large audiences for work, those who get nervous in social situations when they talk in a group setting, and those who have to give smaller but frequent talks for their jobs. We start by exploring when the fears started, how they progressed, and what symptoms they created. I make sure that public speaking fear treatment will help, and we can discuss whether an alternative or adjunctive public speaking fear treatment may be helpful, such as a [therapeutic group](https://dralanjacobson.com/fear-of-public-speaking-groups/) or medication.

### Your Public Speaking Fear Therapy

The public speaking anxiety treatment techniques we might use together may vary depending on your unique presentation and fears. We might use CBT, more specific exposure therapy, and possibly more general [humanistic psychology](https://dralanjacobson.com/humanistic-psychology/) if your fear relates to an actual event. Remember that overcoming public speaking anxiety treatment can be delivered in a traditionally scheduled once-weekly manner or as a specialty service with additional services that can be delivered at specific times.

I hope this example of public speaking fear therapy was helpful. My blog also contains [self-help tips](https://dralanjacobson.com/public-speaking-fear/) and information about the [therapy process](https://dralanjacobson.com/fear-of-public-speaking-therapy-process/). Feel free to [contact me](https://dralanjacobson.com/contact/) if you think I can help you with **overcoming public speaking anxiety**.

## Benefits of Public Speaking Anxiety Therapy

### The benefits of public speaking fear therapy include:

 ![Public speaking anxiety therapy](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "success 3 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

R

##### Public Speaking Fear Therapy Reduces Anticipatory Anxiety

R

##### Public speaking anxiety therapy improves all-around confidence

R

##### Public speaking anxiety treatment improves performance

R

##### Public speaking anxiety therapy can be used for other anxieties

R

##### Public speaking anxiety therapy can be done virtually

There are other benefits of public speaking anxiety therapy for each individual. Use the contact form below if you’d like to talk about what this approach could do for you.

 ## Contact Me

To learn more about my **public speaking anxiety therapy** services and to chat about your needs and hopes to see if I may be a fit, please use my contact page. Public speaking fear treatment truly works, and I look forward to helping you!

A consultation is always free and completely confidential!

 ![public speaking anxiety treatment](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "abstract background internet")

### Call

(617)-680-5488

### Email

hello@dralanjacobson.com

### Address

In person: Westwood, MA & Lee, NH

[Virtual: Serving 40 states](https://dralanjacobson.com/virtual-therapy-guide/)

### Hours

Inquire

 [ ![social network 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](https://www.facebook.com/appliedpsychologicalscience) [ ![social network 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](https://www.instagram.com/appliedpsychological) [ ![social network 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---

### [Virtual Therapy Guide](https://dralanjacobson.com/virtual-therapy-guide/)

**Published:** November 24, 2024
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: July 4, 2026

# Virtual Therapy Guide

Most of my practice is now virtual, and this guide covers everything prospective clients ask about it: how sessions work, who it fits (and who it doesn't), what it costs, how privacy is protected, and how to get the most out of it. Virtual therapy gives you a far wider choice of therapists than your driving radius allows, makes scheduling dramatically easier — and because my overhead is lower, my self-pay fee for virtual sessions is lower than for in-person work.

## Who Virtual Therapy Works Best For

Virtual therapy means meeting with a licensed clinician by secure video rather than in an office. It's an especially strong fit if you:

- Want the best-matched therapist, not the nearest one — including access to [specialty services](https://dralanjacobson.com/intensive-therapy-and-specialty-services/) that may not exist near you, like my nationwide [fear of flying](https://dralanjacobson.com/fear-of-flying-group/) and [public speaking anxiety](https://dralanjacobson.com/fear-of-public-speaking-groups/) groups.
- Have a schedule that makes commuting to appointments unrealistic — I see [college students](https://dralanjacobson.com/therapy-for-college-students/) between classes and professionals on lunch breaks, including evening slots I couldn't offer if I had to be in an office.
- Are a couple or family whose members aren't in the same place — partners who travel, adult siblings in different cities, parents and college kids. Everyone joins from wherever they are, something an office can never offer.
- Move between states — students home for the summer, professionals who split time between coasts. I'm licensed to see clients in 44 states, so treatment continues wherever you are.
- Face mobility, transportation, health, or privacy barriers to office visits — there's no waiting room, and no chance of running into someone you know.
- Want costs down: no commute, no parking, no babysitter for couples with a sleeping infant — plus my lower telehealth self-pay rate.

**A distinctive use case:** virtual sessions can be scheduled as urgent "boosters" around the moments that matter — a session the day before a flight for someone working on fear of flying, or right before a major presentation for someone with public speaking anxiety. Meeting where you are, when it counts, is something in-person scheduling rarely allows.

## When Virtual Therapy Is Not the Right Fit

I'd rather tell you this directly than have you discover it three sessions in. Virtual therapy is not ideal when:

- **You can't get a private space.** If a confidential hour is impossible where you live or work, the format works against the therapy.
- **The method requires presence.** A few techniques — [EMDR](https://www.emdr.com/what-is-emdr/) in its standard form, play therapy for younger children, some hands-on interventions — don't translate fully to video. Whether virtual work suits a child depends on age and needs; I cover that in detail in [my article on virtual vs. in-person effectiveness](https://dralanjacobson.com/is-virtual-therapy-as-effective-as-in-person/).
- **Screens just don't work for you.** Some people never feel as connected on video, and that feeling matters — the therapeutic relationship is the strongest predictor of outcome. If we start virtually and it isn't clicking, I'll say so, and I'm happy to refer you to a well-matched in-person colleague. In my experience very few clients end up needing that, but the door is always open.

Technical realities are worth naming too: connections drop (I keep a backup connection, but it happens), and video trims some nonverbal information — I've learned to ask a few more questions to compensate. These are manageable friction, not dealbreakers, but you should know they exist.

## Is It Effective?

The research consistently finds virtual therapy as effective as in-person care across depression, anxiety, PTSD, and relationship concerns, and my own caseload bears that out: most of my practice is virtual, and I see no difference in outcomes between clients I treat online and in person. Some work is actually *better* virtually — exposure exercises happen in your real environment rather than a simulated one, and executive functioning supports get built directly into your actual routines. For the full picture — including the research, when in-person has the edge, and special considerations for children and families — see [Is Virtual Therapy as Effective as In-Person?](https://dralanjacobson.com/is-virtual-therapy-as-effective-as-in-person/)

## The Approaches I Use Virtually

Nearly everything I do in the office translates online: [CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (with shared screens for thought records and exposure hierarchies), [mindfulness-based work](https://dralanjacobson.com/mindfulness-therapy/), [ACT](https://dralanjacobson.com/act-psychotherapy/), [motivational interviewing](https://dralanjacobson.com/motivational-interviewing/), [psychodynamic therapy](https://dralanjacobson.com/psychodynamic-therapy/), and psychoeducation for conditions from ADHD to mood disorders. Rather than repeat it all here, I've written a dedicated piece on [how each approach is adapted online, with case examples](https://dralanjacobson.com/therapy-online-approaches-techniques-and-outcomes/) — from Schema Therapy to exposure work to ADHD coaching.

## Privacy and Security

Sessions run on a secure, encrypted, HIPAA-compliant videoconferencing platform built for healthcare — not consumer video apps. Your side matters too: choose a private spot, use headphones, and if privacy at home is complicated, we'll problem-solve it together (cars parked somewhere quiet are a time-honored therapy venue). One firm rule: I won't conduct sessions while you're driving.

## Getting the Most From Your Virtual Sessions

- **Protect the hour.** Same room, same time when possible — ritual helps the work. Tell housemates you're unavailable; a locked door and headphones handle most privacy concerns.
- **Set up like it matters.** Stable internet, charged device, camera roughly at eye level so we're actually looking at each other.
- **Have a plan B.** If video fails mid-session, we switch to phone and keep going — decide that with me in advance so a dropped connection costs us two minutes, not the session.
- **Don't multitask.** The biggest virtual-therapy failure mode isn't technology — it's treating the session like a call you can half-attend. Close the other tabs.
- **Use the setting.** Being home is an asset: we can look at the actual homework pile fueling the ADHD overwhelm, or do exposure practice in the real environment where the anxiety lives.

### Deciding how to choose? Start here

If you're weighing private-practice virtual therapy against subscription platforms — or trying to understand the difference between a psychologist, a therapist, and a psychiatric provider — I've written a plain-English guide to choosing the right online therapy option for your situation.

## Virtual Therapy: Frequently Asked Questions

 Does virtual therapy cost less than in-person?In my practice, yes — my self-pay fee for virtual sessions is lower than for in-person work because my overhead is lower. Clients also save the indirect costs: commuting time, parking, and childcare. If you're using insurance, telehealth sessions are generally covered on the same basis as in-person sessions, though you should confirm the details of your specific plan.

 What technology do I need for virtual sessions?A computer, tablet, or smartphone with a camera; a reliable internet connection; and a private space. Headphones are strongly recommended for both privacy and audio quality. Before our first session I'll send a secure link — there's nothing to install or configure, and we'll test everything at the start of that first meeting.

 Is virtual therapy private and secure?Yes. I use an encrypted, HIPAA-compliant platform designed specifically for healthcare, and I conduct sessions from a private space. You control the other half: a private room and headphones on your end keep the session as confidential as any office visit — with the added benefit that there's no waiting room where you might run into someone you know.

 Which states can you see clients in?I'm licensed to practice in 44 states through my state licenses and PSYPACT, the interstate compact for psychologists. This also means treatment can continue when you travel or relocate — college students home for the summer and professionals who split time between states can keep the same therapist year-round. When we first speak, I'll confirm coverage for the state you'll be in.

 Can couples or family members join from different locations?Yes — this is one of virtual therapy's genuine advantages over office-based work. Partners who travel, adult siblings in different cities, and parents with children away at college can all join the same session from wherever they are. I regularly see couples and families whose members are rarely in the same place at a mutually convenient time.

 What if virtual therapy turns out not to be a good fit for me?Then we'll say so and act on it. Some people never feel as connected through a screen, and forcing the format serves nobody. If in-person treatment would suit you better, I'll refer you to a well-matched colleague in your area — in my experience few clients end up making that switch, but knowing the option exists tends to make the first virtual sessions easier, not harder.

## Find Out if Virtual Therapy Fits

Schedule a free initial consultation. We'll talk through your goals, how virtual sessions would work for your situation, and whether we're a good match — with no obligation to continue afterward.

 [Schedule a Free Consultation](https://www.picktime.com/scheduleaconsult)

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### [How I Create and Review the Content on This Site](https://dralanjacobson.com/editorial-standards/)

**Published:** September 12, 2026
**Author:** Dr. Alan Jacobson

**Content:**

Last updated: \[September, 2026\]

  Everything on this site about therapy, treatment approaches, and what to expect in working with me comes from my own clinical training and 25+ years of practice — not generic content created for a therapy website. Here’s how it actually gets made.

## I Create and Review Every Clinical Page Myself

 I’m Dr. Alan Jacobson, Psy.D., MBA — a licensed clinical psychologist practicing across Massachusetts, California, New Hampshire, and New York, with PSYPACT telehealth authority in 44 states. You can read my full background on [my bio page](/my-bio/) and see how I structure treatment on [my approach page](/my-therapy-approach/). Pages with a “Clinically Reviewed By” note show when I last reviewed that specific page.

## What the Content Is Based On

 What I create reflects how I actually practice — the modalities I use (including EMDR and Polyvagal Theory–informed approaches), APA guidelines, and the clinical literature I draw on for a given presenting concern. When I describe what therapy for a specific issue looks like, it’s describing my actual approach, not a generic summary.

## Where AI Tools Fit In

 I sometimes use AI tools to help draft or organize pages, but the clinical content — what a treatment approach involves, what to expect, how I think about a presenting concern — is mine. I review everything before it’s published.

## Keeping This Current

 I revisit clinical pages periodically, and any time something changes in my licensure, practice offerings, or the guidelines I follow. You’ll see a “last reviewed” date on pages that have gone through this process.

## Something Look Off?

 If you notice anything inaccurate or outdated, I’d like to know — reach out via [my contact page](/contact/). For the network-wide version of this policy, see [Foresight Psychological Institute’s editorial standards](https://appliedpsychologicalscience.com/editorial-standards/).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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### [Dr. Alan Jacobson, Psy.D. | Advanced Online Therapy Nationwide](https://dralanjacobson.com/my-bio/)

**Published:** December 26, 2023
**Author:** Dr. Alan Jacobson

**Content:**

# Dr. Alan Jacobson, Psy.D. – Licensed Clinical Psychologist

Dr. Alan Jacobson, Psy.D., is a Licensed Clinical Psychologist with over 20 years of experience providing psychotherapy to adolescents and adults. He offers both in-person and secure online therapy services nationwide, specializing in depression, anxiety, self-esteem concerns, and attention-related challenges.

## About Dr. Jacobson

Dr. Jacobson specializes in the treatment of depression, anxiety, excessive worry, low self-esteem, existential worries, life dissatisfaction, attention and focus challenges, and stress related to work, school, and relationships. He works with individuals, couples, and families, using an integrative and evidence-based approach tailored to each client’s goals and needs.

His therapeutic style combines the latest science on cognitive and behavioral strategies, insight-oriented work, and practical skill-building to promote emotional resilience, strength, greater meaning, and long-term change. Dr. Jacobson’s approach emphasizes clarity, depth, and measurable progress rather than surface-level symptom management.

### Therapy for Adolescents (Teenagers)

Dr. Jacobson works with older adolescents experiencing:

- Anxiety and excessive worry
- Depression and mood changes
- Academic stress and performance pressure
- Attention and focus challenges
- Low self-esteem and social concerns[](https://dralanjacobson.com/sports-performance-improvement-innovations/)
- [Sports performance improvement](https://dralanjacobson.com/sports-performance-improvement-innovations/)

Therapy with teenagers emphasizes emotional resilience, practical coping strategies, and improved communication within families when appropriate.

### Therapy for Adults

Dr. Jacobson provides individual therapy for adults navigating:

- Depression and persistent low mood
- Anxiety disorders and chronic stress
- Work-related burnout and performance challenges
- Relationship difficulties
- Desire for more meaning and existential concerns
- Life transitions and identity concerns
- Attention and executive functioning issues

His approach integrates cognitive-behavioral strategies, insight-oriented exploration, and skill development to promote lasting change rather than short-term symptom relief.

### Online Therapy Nationwide

Online therapy allows clients across the country to access high-quality psychological care through [secure telehealth platforms](https://dralanjacobson.com/virtual-therapy-guide/). Dr. Jacobson has completed advanced training to ensure that online therapy meets the same standards of effectiveness, confidentiality, and professionalism as in-person treatment.

Telehealth is particularly well-suited for:

- Busy professionals
- College students
- Individuals in underserved areas
- Clients seeking flexible scheduling
- Anyone seeking the best possible match without regard for geography

Services are available to clients in states where Dr. Jacobson is licensed.

###  Integrative and Evidence-Based Approach

. Jacobson’s therapeutic style is integrative, meaning he selects from established, research-supported approaches based on each client’s presentation. Treatment may include cognitive and behavioral interventions, [insight-oriented](https://dralanjacobson.com/insight-therapy/) exploration, executive functioning strategies, and structured skill-building.

The goal of therapy is not only symptom reduction, but increased clarity, emotional stability, resilience, and long-term personal growth.

### Professional Background and Credentials

Dr. Jacobson earned his doctorate in clinical psychology from The [University of Hartford](https://www.hartford.edu/) and completed over 5,000 hours of supervised clinical training. He maintains advanced continuing education beyond licensing requirements and is credentialed by the National Register of Health Service Psychologists. He has also completed specialized training to ensure that [therapy online](https://dralanjacobson.com/therapy-online-approaches-techniques-and-outcomes/) meets the same standards of quality and effectiveness as in-person care.

### Finding the Right Therapist

[Choosing the right therapist](https://dralanjacobson.com/choosing-the-best-therapist-for-you/) is an important decision. If you are considering working together, you are welcome to schedule a consultation or explore additional information about Dr. Jacobson’s therapeutic approach to determine whether it feels like a good fit.

## In Dr. Jacobson’s Own Words

I am a [Clinical Psychologist](https://dralanjacobson.com/what-is-a-clinical-psychologist/) with 20 years of experience providing therapy to children, adolescents, and adults. I use a variety of types of therapy using an optimistic, empowering, forward-looking view centered around potential and possibilities. I work within The Foresight Psychological Institute, a company I founded that also provides [psychological testing](https://psychologicalassessments.com/), executive coaching, and [Therapeutic Tutoring](https://therapeutictutoring.com/).

### History of my practice

My [private therapy practice](https://dralanjacobson.com/finding-a-private-practice-therapist/) has been broadly based, so I’ve worked with people with a wide variety of challenges, goals, and symptoms. Most commonly, I’ve worked with people who are experiencing **depression, anxiety, worry, existential concerns, work or school performance issues, life transitions, or attention/focus challenges**. In some cases, these concerns are longstanding; in others, they are transitional. Some people come to me with specific symptoms, while others are feeling a **more general sense of being down, stuck, or lacking meaningfulness**. I work with individuals, couples, and families and do [psychological testing](https://www.psychologicalassessments.com). I do not see children as individual clients, but I do provide family therapy. Recently, seeing the opportunity to serve more people in more ways with positive, optimistic, empirically-based health and wellness services I founded [The Foresight Psychological Institute](https://foresightpsychology.org/) and moved my practice under that umbrella.

I have always offered a sliding scale, discounting my fee up to 30% for those who need it. I also help people get reimbursed by their insurance company when possible. Finally, I offer deeply discounted rates in order to give back to my field for certain specialties including [Emotional Support Pet](https://dralanjacobson.com/emotional-support-animals-esa/) evaluations, assessments for [accommodations for college](https://psychologicalassessments.com/college-accommodations/) and work to help people thrive, and [military evaluations](https://psychologicalassessments.com/military-psych-evaluations/) for those who want to enlist but have been turned down.

### Who I am

I have lived in the Boston area my whole life and am raising four children. I am deeply involved in my community, providing everything from [youth sports coaching ](https://dralanjacobson.com/youth-sports-parents/)to parent and teacher workshops. I have done a great deal of volunteer work in psychology and human services, including being on several Boards of Directors of non-profits. I stay quite active, being involved in various sports leagues.

My higher education started at Tufts University, where I was a Child Study major, and then I went to The University of Hartford for my master’s and doctorate. More recently, I got my MBA at UMass. Before returning to practice full-time, I was in executive leadership roles, and I still do a lot of consulting in the healthcare field. Throughout all of this, I have maintained my private practice, though it was sometimes smaller than it is now.

I am qualified and trained to provide telehealth to most US states, and I offer some state-specific services such as [therapy in California](https://dralanjacobson.com/therapy-in-california/).

### My qualifications

During my education at the University of Hartford, I completed around 3,000 hours of supervised training before I graduated and around 2,000 the year afterward. Since becoming licensed, I have done 240 hours of continuing education, including most recently taking an 18-hour course designed to ensure that I could provide [telehealth with the same quality and effectiveness](https://dralanjacobson.com/telehealth-therapy-teletherapy/) as in-person treatment. I also recently became credentialed by the National Register of Health Service Psychologists, which is only available to psychologists with the highest education and training requirements. (I explain the differences between [therapists vs. counselors](https://dralanjacobson.com/therapist-vs-psychologist-therapist-vs-psychotherapist/) and therapists vs. psychologists and more in a different post.)

### What does it all mean?

There are many excellent psychologists out there. I am quite proud of my field for the level of commitment, training, empathy, and effectiveness so many of my fellow psychologists show. So, how do you read a page like this and know whether I am a good match or whether another [clinical psychologist](https://dralanjacobson.com/what-is-a-clinical-psychologist/) with a similar but slightly different bio is for you? The short answer is to be in touch, and we can talk and see.

The longer answer: several factors may affect your decision about which [clinical psychologist](https://dralanjacobson.com/what-is-a-clinical-psychologist/) to choose for you:

1\. Approach: What specialties does the psychologist have regarding specific training and experience? In my case, I have experience with Cognitive, Positive, and Humanistic psychology. What this means is that **I am a good fit if you want a solution-focused, positive, strength-based approach** that will look back at the past as far as how it influences things today, but we won’t get “stuck” there.

2\. Individual, Couples, Family: You may come in for individual therapy, but you think there is a chance this will turn into family therapy. This can be particularly true if you bring in a teenager or older child. You may want to ensure the psychologist is trained in both approaches.

3\. A match for you: Some people look for a psychologist who is a match in some way, such as having kids, growing up in the area, being young, being older, having a similar cultural background, etc. Other times, they may want someone quite different – such as when a person contemplating marriage or having children wants a psychologist who is married or has children or when a younger person would prefer an older psychologist who has gone through what they are going through.

4\. Personality: This may be the most important variable but is also the hardest to pick up from a bio. You may want a psychologist who you “click” with. Maybe it is something easy to see, like a similar sense of humor, but often, it is a general feeling that is hard to describe. This is why you should always go into your first session looking to make sure you feel it is a match. It may also be why you should not obsess too much about #s 1-3 since this last factor may be more important. Sometimes, it’s best to go with your gut feeling on this!

### Next steps

Now that you’ve read this page, considering the factors in the prior section, what should happen next? If it sounds like I may be a fit, please feel free to [give me a call or send me an e-mail](https://dralanjacobson.com/contact/). **Therapy involves a mutual assessment of fit**: You need to decide if what I have to offer fits what you are looking for and whether my style matches what you think will work best for you. I will make sure that I think I can help you with your unique concerns – whether I am potentially the right therapist who can bring meaningful, measurable, and lasting change. We can also talk about the other services that Foresight provides, such as many [types of psychological testing](https://psychologicalassessments.com/types-of-psychological-testing/), management coaching, and [educational therapy](https://therapeutictutoring.com/educational-therapy/).

We will schedule an intake appointment if a phone conversation suggests it is worth meeting. This will allow us to talk in person, where you can ask questions and get a feel for my approach and style. Once again, at the end of the initial session, we need to decide whether this is the best course for you. There is never any obligation or commitment. As we move forward, we can discuss how long treatment might last and how you are doing. Thanks for reading this through. Whether you call me or any other provider, I hope the information on this page proves helpful!

 Dr. Jacobson is licensed in four states, holds PSYPACT authority across 44 states, and has been featured on NPR, Politico, NECN, and WPRI.

 [Verify credentials & licensure →](https://appliedpsychologicalscience.com/founder-bio/#credentials-licensure) | [Media & advisory roles →](https://appliedpsychologicalscience.com/founder-bio/#media-recognition)

 ![Dr. Alan Jacobson](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "Me | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

##  As Seen In

NPR

Radio

NECN

Television

WPRI TV

Television

Politico

May 2026 — Politics Is Breaking Us

The Patriot Ledger

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---

### [Executive Functioning Coaching](https://dralanjacobson.com/executive-functioning-coaching/)

**Published:** March 2, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Executive functioning coaching helps individuals develop planning, organization, time management, task initiation, emotional regulation, and self-monitoring skills. It’s especially beneficial for people with ADHD, learning differences, [high-functioning autism](https://psychologicalassessments.com/psychological-testing-for-autism/), or other traits who may struggle with these areas. Struggles with organization, time management, and self-regulation can significantly impact daily life for students, professionals, or adults navigating life’s demands despite solid intelligence and capabilities. In this post, I review the basics of my executive function coaching services, with case examples of the work of an executive function coach for adults and an executive functioning coach for teens.

### Integrated Executive Functioning Coaching

Traditional executive functioning coaching offers valuable tools for improving structure and productivity. However, when deeper emotional barriers such as anxiety, low self-esteem, or perfectionism interfere, these strategies alone may not be enough. By integrating [psychotherapy techniques](https://dralanjacobson.com/psychotherapy/) with executive function coaching, I can address both **the practical and psychological aspects** of executive dysfunction, creating a more holistic and sustainable path toward success.

## Executive Functioning Coaching Benefits ![Executive Functioning Coaching](https://dralanjacobson.com/wp-content/uploads/2025/03/feedback-300x201.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

1. **Improved Time Management & Task Prioritization**

- An executive functioning coach for teens and adults helps individuals **stop procrastinating** and develop realistic time management habits.
- They teach **time blocking, backward planning, and prioritization techniques** (e.g., [Eisenhower Matrix](https://sps.columbia.edu/sites/default/files/2023-08/Eisenhower%20Matrix.pdf)).
- They reduce last-minute stress by creating structured routines for assignments, projects, and appointments.
- An executive function coach for adults and teens supports **consistent scheduling**, helping clients establish a daily rhythm that works for them.

2. **Increased Organization & Structure**

- Executive Functioning Coaching helps create systems for tracking tasks, deadlines, and responsibilities (e.g., planners and digital tools).
- It assists in **decluttering physical and digital spaces**, making it easier to find important documents or materials.
- It encourages [**habit stacking**](https://www.betterup.com/blog/habit-stacking), where new organizational habits are tied to existing routines (e.g., checking a planner daily while drinking coffee).

3. **Enhanced Task Initiation & Follow-Through**

- Executive Functioning Coaching provides **step-by-step guidance on breaking down large tasks** to reduce overwhelm.
- It uses strategies like **the [“Just Start” method](https://lifehacker.com/mastering-the-art-of-just-start-1764837543)** or the **5-Minute Rule** to overcome procrastination.
- It helps individuals **develop a sense of urgency and momentum**, making it easier to complete work consistently.
- Executive Functioning Coaching uses **accountability check-ins** to reinforce progress and ensure follow-through.

4. **Better Emotional Regulation & Stress Management**

- Executive Function Coaching teaches clients to **recognize emotional barriers** (e.g., anxiety, perfectionism, fear of failure) that interfere.
- It integrates **[cognitive behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT) techniques** to reframe negative self-talk.
- It uses **mindfulness and distress tolerance techniques** from [Dialectical Behavior Therapy](https://dralanjacobson.com/dbt-for-teens/) (DBT) to help manage frustration and overwhelm.
- Executive Function Coaching encourages **self-compassion**, helping clients overcome self-judgment and build confidence in their abilities.

5. **Strengthened Self-Advocacy & Independence**

- Executive Function Coaching helps clients identify their **learning and working styles** so they can create environments that support their success.
- It teaches **self-advocacy skills**, especially for students and professionals who need accommodations or flexibility.
- It builds **resilience and problem-solving skills**, encouraging individuals to troubleshoot challenges on their own.
- Executive Function Coaching encourages **growth mindset thinking**, helping clients see setbacks as learning opportunities rather than failures.

6. **Increased Motivation & Accountability**

- Executive Function Coaching provides **external structure and support** to help clients stay on track.
- **It uses reward systems and positive reinforcement** to build intrinsic motivation.
- It encourages clients to set **realistic, achievable goals** and track their progress.
- Executive Function Coaching helps develop **personalized motivation techniques**, such as body doubling or gamification, to make work feel less overwhelming.
- I often mix [motivational interviewing](https://dralanjacobson.com/motivational-interviewing/) with this step when people feel stuck

### Who Can Benefit from Executive Functioning Coaching?

- **Students** struggling with homework, test preparation, or time management.
- **Professionals** who have difficulty staying organized, meeting deadlines, or managing responsibilities.
- **Adults with ADHD or executive dysfunction** who need strategies to stay on top of daily tasks.
- **Anyone experiencing overwhelm, procrastination, or lack of follow-through** in personal or professional life.

## Executive Function Coaching Techniques

An executive functioning coach for teens and adults uses a variety of techniques to help individuals improve skills related to organization, time management, task initiation, and emotional regulation. Here are some key techniques I often use:

1. **Time Management & Task Prioritization**

- [**The Pomodoro Technique**](https://www.todoist.com/productivity-methods/pomodoro-technique) – Working in short, timed intervals (e.g., 25 minutes of focused work, 5-minute break).
- **Time Blocking** – Scheduling specific times for tasks in a calendar.
- **Backward Planning** – Starting with the deadline and working backward to set milestones.
- **The Eisenhower Matrix** – Categorizing tasks by urgency and importance to prioritize effectively.

2. **Organization & Planning**

- **Externalizing Information** – Using planners, apps, whiteboards, or sticky notes to track tasks instead of relying on memory.
- **Chunking Tasks** – Breaking large tasks into smaller, manageable steps.
- **Color Coding** – Using colors to differentiate tasks, subjects, or priorities.
- **Visual Schedules** – Using visuals to outline daily routines.

3. **Task Initiation & Overcoming Procrastination**

- **“Just Start” Method** – Committing to working on a task for just 5 minutes to reduce resistance.
- **Implementation Intentions** – Planning ahead by stating “If X happens, then I will do Y” (e.g., “If I get distracted, I will set a timer for 10 minutes to refocus”).
- [**Body Doubling**](https://psychcentral.com/adhd/adhd-body-doubling) – Working alongside someone else (virtually or in person) for accountability.

4. **Emotional Regulation & Motivation**

- **Name It to Tame It** – Identifying emotions and stressors to reduce their impact.
- **Reframing Negative Thoughts** – Changing “I can’t do this” to “I can break this into smaller steps.”
- **Self-Compassion Techniques** – Practicing positive self-talk and recognizing effort over perfection.
- **Reward Systems** – Using small rewards as motivation after completing tasks.

5. **Self-Monitoring & Accountability**

- **Daily Check-Ins** – Reviewing progress at the beginning and end of each day.
- **Habit Stacking** – Attaching new habits to existing ones (e.g., “After I brush my teeth, I will check my planner”).
- **Accountability Partners** – Checking in with a coach, friend, or group for support.

### Integrated Approach

Combining executive function coaching with certain [types of therapy](https://dralanjacobson.com/types-of-therapy/) creates a holistic approach that addresses both practical skill-building and emotional barriers that interfere with executive functioning. While EF work provides tools for organization, time management, and self-regulation, psychotherapy helps individuals understand and overcome psychological challenges like anxiety, perfectionism, [emotional dysregulation](https://psychologicalassessments.com/emotional-dysregulation-testing/), and low self-esteem.

## Case Example: Executive Function Coach for Adults

- **Name:** Alex (fictional)
- **Age:** 28
- **Occupation:** Graduate student & part-time freelancer
- **Main Challenges:**
    - Frequently misses deadlines due to procrastination
    - Feels overwhelmed by large projects and avoids starting them
    - Has difficulty balancing school, work, and personal life
    - Often forgets appointments and important tasks

### Executive Functioning Coaching Goals:

1. Improve time management and reduce procrastination by working with an executive function coach for adults who also provides therapy.
2. Develop strategies for task initiation and follow-through.
3. Create a structured system for balancing work, school, and life.
4. Build self-confidence and reduce overwhelm.

### Strategies & Techniques Used:

1. **Time Management & Task Prioritization**

- **Use of an Executive Function Coach for Adults:** Introduced **time blocking** and **backward planning**
- **Implementation:** Alex learned to break down assignments into smaller steps and schedule them in her calendar.
- **Outcome:** Deadlines became more manageable, and Alex felt less overwhelmed.

2. **Task Initiation & Overcoming Procrastination**

- **Use of an Executive Function Coach for Adults:** Used the **“Just Start” method** and **Pomodoro technique**
- **Implementation:** Alex committed to working on tasks for just 5 minutes at a time. Also used 25-minute work sessions followed by 5-minute breaks.
- **Outcome:** Reduced avoidance, making it easier to start and complete tasks.

3. **Organization & Accountability**

- **Use of an Executive Function Coach for Adults:** Set up a **weekly accountability check-in** with the coach.
- **Implementation:** Alex reviewed goals and progress every Monday via email. She used a digital planner for tracking assignments and deadlines.
- **Outcome:** Increased self-awareness and consistency.

4. **Emotional Regulation & Motivation**

- **Use of an Executive Function Coach for Adults:** Practiced **reframing negative thoughts** and **self-reward systems**
- **Implementation:** Instead of saying, “I’ll never finish this,” Alex learned to say, “I can do one small part at a time.” Also introduced a reward system (e.g., watching an episode of a favorite show after completing work).
- **Outcome:** Improved self-confidence and reduced frustration with tasks.

### Three Months’ Improvement with an Executive Function Coach for Adults

- Increased ability to start and complete tasks on time
- Fewer missed deadlines and forgotten appointments
- Better balance between school, work, and self-care
- More confidence in handling academic and professional responsibilities

## Case example: Executive Functioning Coach for Teens

- **Name:** Jake (fictional)
- **Age:** 16
- **School Situation:** High school junior with good potential but inconsistent grades
- **Main Challenges:**
    - Frequently forgets homework and misplaces school materials
    - Struggles to start and complete assignments on time
    - Feels overwhelmed by long-term projects and studying for tests
    - Gets easily distracted when doing schoolwork

### Coaching Goals:

1. Working with an executive functioning coach for teens will Improve the organization and tracking of schoolwork.
2. He will develop time management strategies for assignments and tests.
3. There will be an increase in focus and task initiation.
4. The executive functioning coach for teens will help him build self-confidence and reduce school-related stress.

### Executive Functioning Coaching Strategies & Techniques Used:

1. **Organization & Tracking Assignments**

- **Strategy:** Introduced **externalizing information** using a digital planner and color-coded folders.
- **Implementation:** Jake started using a calendar for due dates and a notebook for daily to-do lists.
- **Outcome:** Reduced lost assignments and improved consistency in turning in work.

2. **Time Management & Prioritization**

- **Strategy:** Used the **Eisenhower Matrix** to prioritize tasks by urgency and importance.
- **Implementation:** Jake learned to plan homework time using a mix of time blocking and reminders.
- **Outcome:** He stopped waiting until the last minute and became more proactive with assignments.

3. **Task Initiation & Overcoming Procrastination**

- **Strategy:** Introduced the **5-Minute Rule** (just start a task for 5 minutes).
- **Implementation:** Jake started homework by committing to just five minutes, reducing the mental barrier to starting.
- **Outcome:** He found it easier to get started and was more likely to complete tasks.

4. **Focus & Distraction Management**

- **Strategy:** Used **body doubling** and the **Pomodoro technique** for studying.
- **Implementation:** Jake worked alongside a friend during study sessions and used 25-minute focused work periods with short breaks.
- **Outcome:** Improved concentration and got more done in shorter time blocks.

5. **Accountability & Emotional Regulation**

- **Strategy:** Weekly check-ins with the coach to review progress and challenges.
- **Implementation:** Jake reflected on what went well each week and where he needed more support. Practiced self-compassion techniques when feeling overwhelmed.
- **Outcome:** Increased self-awareness and confidence in managing school responsibilities.

### Results After 3 Months with an Executive Functioning Coach for Teens

- Fewer missed assignments and better organization
- Improved ability to start and complete tasks
- Less overwhelmed with long-term projects
- Better focus and study habits

## How Executive Function Coaching and Psychotherapy Work Together

Combining **executive function (EF) coaching** with **psychotherapy techniques** can be highly effective, especially for individuals struggling with ADHD, autism, anxiety, or depression. While EF coaching focuses on **skill-building and practical strategies**, psychotherapy addresses **underlying emotional and psychological barriers** that may interfere with executive functioning.

**Executive Function Coaching****Psychotherapy Techniques**Focuses on **behavioral strategies** for time management, organization, and goal-setting.Addresses **emotional and psychological barriers** like anxiety, low self-esteem, and trauma.Helps with **task initiation, follow-through, and accountability**.Uses CBT, DBT, and mindfulness therapy to manage procrastination, emotional dysregulation, and negative thought patterns.Encourages external supports (planners, timers, reminders).Works on internal supports (self-awareness, emotional processing, and coping skills).Involves structured goal-setting with measurable progress.Explores deeper personal challenges that might be blocking progress.### Integrated Techniques for a Holistic Approach

1. **Cognitive Behavioral Therapy (CBT) + Executive Functioning Coaching (EFC)**

- **CBT helps reframe negative thoughts** about productivity and self-worth.
- A therapist who is also an executive functioning coach for teens and adults builds **practical habits** to replace avoidance behaviors.
- **Example:** Someone who believes “I’m terrible at time management” can use CBT to challenge that thought and EF coaching to implement a **time-blocking system**.

2. **Dialectical Behavior Therapy (DBT) + EFC**

- DBT teaches **emotional regulation, distress tolerance, and mindfulness**—all crucial for executive function struggles.
- A therapist who is also an executive functioning coach for teens and adults provides **structure** to apply these skills in daily life.
- **Example:** A person who avoids tasks due to emotional overwhelm can use DBT’s **“name it to tame it”** approach and EF coaching to **break tasks into smaller, manageable steps**.
- Note that I only provide DBT for teens)

3. **[ Motivational Interviewing](https://dralanjacobson.com/motivational-interviewing/) (MI) + EFC**

- MI helps **identify intrinsic motivation** and reduce resistance to change.
- A therapist who is also an executive functioning coach for teens and adults provides **concrete steps** to take action.
- **Example:** A teen resistant to using planners can explore **why** they dislike structure and work with a coach to find a **customized system** that works for them.

4. **Mindfulness-Based Therapy + EFC**

- Mindfulness helps with **impulse control, attention, and stress management**.
- A therapist who is also an executive functioning coach for teens and adults applies mindfulness techniques to **stay present while working on tasks**.
- **Example:** Someone who constantly switches between tasks can use **deep breathing and mindful refocusing** to improve attention during study sessions.

5. **[Acceptance and Commitment Psychotherapy](https://dralanjacobson.com/act-psychotherapy/) (ACT) + EFC**

- ACT helps **accept struggles without getting stuck in avoidance**.
- A therapist who is also an executive functioning coach for teens and adults provides **actionable ways** to work through executive dysfunction.
- **Example:** Instead of waiting to feel motivated, a person learns to take **small, committed actions** even when they feel unmotivated.

### Case Example: Mixing Executive Functioning Coaching & Therapy

**Client: Maya, 25, ADHD & Anxiety**

#### Challenges:

- Procrastinates on work projects due to fear of failure.
- Gets overwhelmed by long to-do lists.
- Struggles with emotional regulation when feeling pressured.

#### Executive Function Coach for Adults Integrated Approach

- **CBT & Executive Function Coaching** (EFC) → Challenged perfectionist thinking and used **“done is better than perfect”** mindset.
- **DBT & EFC** → Used **“opposite action”** to push through avoidance and set **small, achievable goals**.
- **Mindfulness & EFC** → Practiced grounding techniques before starting tasks to reduce anxiety.
- **EF Tools:** Time blocking, body doubling, and setting external deadlines.

Results After 3 Months with an Executive Function Coach for Adults who is also a therapist:

- Reduced procrastination and started tasks earlier.
- Lower stress when facing deadlines.
- Improved ability to manage emotions when overwhelmed.

### Who Benefits Most from This Approach?

- Adults & teens with **ADHD, autism, anxiety, or depression**.
- Individuals struggling with **task initiation, emotional regulation, and procrastination**.
- People who need **both practical strategies and deeper emotional processing**.

## Summary and My Work

The combination of **executive functioning coaching and psychotherapy** is a powerful approach for individuals struggling with focus, organization, and follow-through. By pairing structured strategies with emotional and cognitive interventions, an executive function coach for adults and teens helps clients develop better habits and **understand and overcome the mental roadblocks** that have held them back.

Having a therapist and executive functioning coach for teens and adults fosters long-term change by teaching **external tools (planners, time management, accountability systems)** and **internal skills (emotional regulation, cognitive restructuring, and mindfulness)**. Clients who engage in this process often experience **less frustration, greater confidence, and a renewed sense of control** over their lives. With the right blend of psychological insight and practical coaching, you can develop the skills and mindset needed to thrive.

Please note that for children and teens, The Foresight Psychological Institute also offers [Therapeutic Tutoring](https://therapeutictutoring.com/). For adults, we offer Leadership Coaching that can include executive functioning work. Finally, we also provide [ADHD coaching for college students](https://dralanjacobson.com/adhd-coaching-for-college-students-effective-enduring/).

Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Frequently Asked Questions: Executive Functioning Coaching

Common questions about executive functioning coaching — what it involves, who it helps, and how it works alongside therapy.

   What are executive functions, and why do they matter so much for daily life? + Executive functions are the cognitive skills that allow people to plan, organize, initiate, sustain, and complete goal-directed behavior — essentially, the brain’s management system for everything that requires deliberate effort. They include working memory (holding information in mind while using it), cognitive flexibility (shifting attention and adapting to change), inhibitory control (stopping automatic responses in favor of intentional ones), planning and organization, task initiation, time management, and emotional regulation. The [research on executive functioning](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4084861/) consistently shows it is one of the strongest predictors of academic performance, occupational success, and life outcomes — more predictive, in many studies, than IQ. This is why someone can be highly intelligent and yet chronically struggle with deadlines, organization, and follow-through: intelligence and executive functioning are distinct capacities. Executive functioning challenges affect students, professionals, parents, and anyone whose daily demands exceed their current capacity for self-management — and they are highly responsive to structured coaching. See also the [emotional dysregulation testing page](https://psychologicalassessments.com/emotional-dysregulation-testing/) for assessment of related challenges.

   Who benefits most from executive functioning coaching? + Executive functioning coaching benefits a wider population than most people expect — it is not exclusively for people with clinical diagnoses. The most common populations include: teens and college students struggling with homework, test preparation, long-term projects, and time management; adults with [ADHD](https://dralanjacobson.com/adhd-therapy-for-adults/), [high-functioning autism](https://psychologicalassessments.com/psychological-testing-for-autism/), anxiety, or depression whose conditions affect planning and self-regulation; professionals who perform well in their areas of expertise but struggle with organizational demands, delegation, or meeting deadlines; high achievers whose output does not reflect their actual capability because executive dysfunction creates chronic inefficiency and frustration; and anyone experiencing overwhelm, procrastination, or consistent difficulty following through on intentions despite genuine effort and intelligence. As illustrated by Alex’s, Jake’s, and Maya’s case examples on this page, the presenting situations look different across ages and contexts — but the underlying skills being built are consistent. The coaching adapts; the framework doesn’t. See also the [ADHD coaching for college students](https://dralanjacobson.com/adhd-coaching-for-college-students-effective-enduring/) and [adult ADHD coaching](https://dralanjacobson.com/adhd-coaching-for-adults-help-for-focus-and-concentration/) pages for formats tailored to those specific populations.

   What is the difference between executive functioning coaching and standard ADHD coaching? + The distinction is primarily about scope. [ADHD coaching](https://dralanjacobson.com/adhd-coaching-for-adults-help-for-focus-and-concentration/) is specifically tailored to the profile of challenges and strengths associated with ADHD — including the emotional dysregulation, rejection sensitivity, and identity dimensions that ADHD produces alongside the executive functioning gaps. Executive functioning coaching is broader: it addresses the same practical skill domains — planning, organization, task initiation, time management, self-monitoring — but serves clients whose executive functioning challenges arise from a wider range of sources, including anxiety, depression, autism, learning differences, high-stress life stages, or simply the demands of an increasingly complex professional or academic environment exceeding current capacity. Many clients with ADHD receive executive functioning coaching as a core component of their treatment; many clients without an ADHD diagnosis benefit equally from the same coaching framework. In Dr. Jacobson’s practice, the techniques and accountability structures are substantially the same — what differs is the clinical understanding of what is driving the deficit, which shapes how the coaching is framed and which emotional dimensions are integrated alongside the practical work.

   Why does working with a licensed psychologist make a difference for executive functioning coaching? + Executive functioning coaching is an unregulated field — practitioners range from highly trained specialists to individuals with no formal background in psychology, neuroscience, or clinical practice. What distinguishes working with a licensed clinical psychologist is the ability to identify and address the psychological layer beneath the practical challenge. When procrastination is driven by clinical anxiety — not poor habits — a standard coach may teach time management while the anxiety continues to undermine every system built. When perfectionism reflects a trauma history, or task avoidance involves rejection sensitive dysphoria associated with ADHD, or overwhelm is clinical depression rather than disorganization — a psychologist recognizes this and applies evidence-based clinical treatment alongside the coaching. The integrated approach described in this page’s comparison table — combining [CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/), [DBT](https://dralanjacobson.com/dbt-for-teens/), [Motivational Interviewing](https://dralanjacobson.com/motivational-interviewing/), [ACT](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/), and mindfulness with practical EF coaching — is only possible when the provider has full clinical training and licensure. This is what produces durable change rather than temporary productivity improvements that collapse under stress. For more on what distinguishes different types of providers, see the [therapist vs. psychologist guide](https://dralanjacobson.com/therapist-vs-psychologist-therapist-vs-psychotherapist/).

   What does a typical executive functioning coaching session look like? + Sessions are typically 45–55 minutes and follow a consistent structure that combines review, skill-building, and forward planning. A standard session opens with a brief check-in on mood, energy, and context; moves to a structured review of wins, barriers, and incomplete goals since the last session; identifies which skills or systems need adjustment based on what worked and what didn’t; introduces or refines a specific technique — time blocking, backward planning, the Pomodoro method, body doubling, implementation intentions — tailored to the current challenge; and closes with an explicit accountability commitment for the coming week, often including a shared digital tracking tool or brief check-in protocol. Screen sharing enables live work on planners, calendars, task lists, and digital organization systems. Between sessions, clients may use asynchronous tools — a shared Google Doc, a brief email check-in, a progress log — to maintain accountability and momentum without waiting a full week. For teens specifically, brief parent check-ins are often incorporated to ensure the home environment is supporting rather than inadvertently undermining the skills being built in sessions. See also the [Therapeutic Tutoring](https://therapeutictutoring.com/) program for students who need both executive functioning support and content-area academic help.

   I’ve tried planners and productivity apps before and nothing sticks. Why would coaching be different? + This is one of the most important and most frequently asked questions in executive functioning work — and the answer goes to the heart of what distinguishes coaching from self-help. Planners and apps fail not because the tools are wrong but because the barriers to using them are psychological rather than informational. Someone already knows they should use a planner; the reason they don’t is that anxiety about what’s on the list makes opening it feel aversive, or perfectionism makes any system feel inadequate before it starts, or ADHD makes habit formation genuinely harder neurobiologically than it is for neurotypical people, or depression removes the motivational fuel that makes any system feel worth maintaining. Coaching addresses these barriers directly — identifying which specific psychological mechanism is causing the system to fail and applying the appropriate intervention. The accountability relationship is also a clinically meaningful variable: [research on behavior change](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3996567/) consistently shows that external accountability significantly improves the rate at which new habits form and persist. A planner sitting on a desk provides no accountability; a weekly coaching session with a review of commitments made last week does. Most clients who have “tried everything” find that what was missing was not a better tool but a structured relationship that addressed the actual barrier rather than working around it.

   How long does executive functioning coaching take, and what does progress look like? + Most clients begin with weekly sessions during the active skill-building phase — typically the first 2–4 months — then taper to biweekly or monthly sessions as systems stabilize and habits internalize. As illustrated by Alex’s, Jake’s, and Maya’s case examples on this page, meaningful functional improvement is typically visible within 3 months: fewer missed deadlines, reduced procrastination, better task initiation, and more consistent follow-through. Deeper gains — improved self-confidence, reduced shame and self-criticism, more durable habit formation — typically emerge over a longer arc. The realistic expectation for a focused course of executive functioning coaching is 3–6 months of active work followed by a maintenance phase of periodic check-ins. Many clients return for brief booster sessions when new life demands — a new job, a move, a change in academic program — create fresh executive functioning challenges rather than starting over from scratch. For teens, coaching often runs on an academic calendar, intensifying at the start of each semester and tapering during summer. For college students, the [ADHD coaching for college students](https://dralanjacobson.com/adhd-coaching-for-college-students-effective-enduring/) page describes a structured semester-paced format that mirrors academic demands.

   How do I get started with executive functioning coaching — and can it be done online? + Yes — executive functioning coaching is fully compatible with online delivery, and virtual sessions offer specific clinical advantages: sessions can be conducted from the home or work environment where executive functioning challenges actually occur, screen sharing enables live work on planning tools and organizational systems, and eliminating commute time removes a common barrier to consistent attendance — which is itself a meaningful predictor of outcomes. Dr. Jacobson is a [PSYPACT](https://psypact.org/)-participating psychologist licensed in 44 states, making virtual executive functioning coaching accessible nationwide. The first step is a free 20-minute consultation — a practical conversation about what you’re experiencing, what you’ve already tried, and what your goals are. Dr. Jacobson will recommend whether executive functioning coaching, [ADHD therapy](https://dralanjacobson.com/adhd-therapy-for-adults/), or a combination makes the most sense, and outline what a realistic course of work looks like. No commitment required. Related pages worth reviewing: [adult ADHD coaching](https://dralanjacobson.com/adhd-coaching-for-adults-help-for-focus-and-concentration/), [ADHD coaching for college students](https://dralanjacobson.com/adhd-coaching-for-college-students-effective-enduring/), [ADHD treatment for teens](https://dralanjacobson.com/adhd-treatment-for-teens/), [early career coaching](https://dralanjacobson.com/early-career-coaching/), [Therapeutic Tutoring](https://therapeutictutoring.com/), and [ADHD testing](https://psychologicalassessments.com/adhd-testing/) through Precision Psychological Assessments.

 Intelligence isn’t the problem. The right systems and support can close the gap.

Schedule a free 20-minute consultation with Dr. Jacobson — a practical conversation about what’s getting in your way and what executive functioning coaching might offer.

 [ Schedule a Free Consultation ](https://www.picktime.com/scheduleaconsult) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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](https://www.instagram.com/appliedpsychological) [ ![social network 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](https://www.linkedin.com/company/psychologicalscience/)

---

### [Early Career Coaching for Young Adults and New Professionals](https://dralanjacobson.com/early-career-coaching/)

**Published:** September 9, 2026
**Author:** Dr. Alan Jacobson

**Content:**

The first years of a career are among the most consequential — and the most psychologically demanding — of a professional life. Identity is in flux, decisions carry unfamiliar weight, self-doubt is common even among high achievers, and the gap between where you are and where you want to be can feel larger than it actually is. Early career coaching with a licensed clinical psychologist addresses both the practical and the psychological dimensions of this transition — not just what to do, but what’s getting in the way of doing it. Dr. Jacobson brings an unusual combination of credentials to this work: 25 years of clinical experience as a licensed psychologist, an MBA, and a background in organizational behavior and [life transitions](https://dralanjacobson.com/life-transitions-therapy/). This means the coaching is grounded in both psychological depth and practical professional knowledge — a combination that is rare in either clinical practice or business coaching alone.

**Looking for funding, startup consulting, or crowdfunding support for an early-stage entrepreneurial or creative project?** That work lives at [Performance Psychology Group’s Early Career Accelerator](https://performancepsychologygroup.com/early-career-accelerator/) — a program that sets aside a significant portion of annual revenue to provide no-upfront-cost services to entrepreneurs, independent film and TV producers, musicians, and artists aged 18–30. This page focuses on the psychological and professional coaching work Dr. Jacobson does with early-career adults in his clinical and coaching practice.

---

## Who Early Career Coaching Is For

Early career coaching at dralanjacobson.com is designed for:

- **College students and recent graduates** navigating the transition from academic life to professional identity — uncertain about direction, overwhelmed by options, or struggling to translate their abilities into opportunities.
- **Young professionals in their first or second role** who feel stuck, underchallenged, or misaligned with their work — and who sense a gap between where they are and where they want to be.
- **Early-career adults with ADHD** whose executive functioning challenges are creating friction in professional settings. This work connects directly with the [ADHD coaching for college students](https://dralanjacobson.com/adhd-coaching-for-college-students-effective-enduring/) and [adult ADHD coaching](https://dralanjacobson.com/adhd-coaching-for-adults-help-for-focus-and-concentration/) services.
- **Young adults experiencing imposter syndrome, performance anxiety, or fear of failure** that is interfering with their ability to take professional risks, advocate for themselves, or show up at their full capacity.
- **New professionals managing [social anxiety](https://dralanjacobson.com/therapy-for-social-anxiety-disorder/) or [fear of public speaking](https://dralanjacobson.com/public-speaking-anxiety/)** in work settings — presentations, networking events, leadership situations — where these concerns are directly limiting advancement.
- **Career changers and pivoters** in their 20s and early 30s who are considering leaving one field for another and need a structured, psychologically informed process for evaluating that decision — rather than making it from anxiety or frustration alone.
- **Young adults navigating the emotional weight of [career transitions](https://dralanjacobson.com/life-transitions-therapy/)** — including the identity disruption, self-doubt, and grief that can accompany leaving a path that no longer fits.
 
---

## What Makes a Psychologist-Coach Different

Career coaching is an unregulated field — anyone can offer it regardless of training or credentials. What distinguishes working with a licensed clinical psychologist is the ability to address the psychological layer underneath the career question:

- **When procrastination is driven by clinical anxiety** — not poor time management — a psychologist recognizes and treats the anxiety directly rather than offering productivity frameworks that cannot reach it.
- **When imposter syndrome is severe enough to constitute a self-esteem or identity disorder**, a psychologist can deliver evidence-based treatment — [CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/), [ACT](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/), [Schema Therapy](https://dralanjacobson.com/schema-therapy/) — not just reassurance.
- **When career confusion reflects a deeper identity question** — who am I, what do I actually value, what kind of life do I want — a psychologist can hold that existential dimension with the same rigor brought to practical planning. See [existential therapy](https://dralanjacobson.com/existential-therapy/) and [personal growth counseling](https://dralanjacobson.com/personal-growth-counseling/) for related work.
- **When early career stress is affecting mental health** — producing depression, anxiety, or burnout — a psychologist can address the clinical presentation directly, coordinate with other providers if needed, and ensure the coaching work is built on a stable psychological foundation.
 
The result is coaching that goes beneath the surface — not just “what should I do next?” but “what’s actually stopping me, and how do I move past it in a lasting way?”

---

## Core Areas of Early Career Coaching

### 1. Career Clarity and Direction

Identifying your strengths, values, and interests with precision — and translating that picture into a concrete professional direction — rather than defaulting to external expectations or choosing by process of elimination. This work uses evidence-based tools including the [VIA Character Strengths inventory](https://www.viacharacter.org/), values clarification frameworks, and [Motivational Interviewing](https://dralanjacobson.com/motivational-interviewing/) to resolve ambivalence about direction.

### 2. Confidence, Self-Efficacy, and Imposter Syndrome

Building genuine professional confidence — not the kind that depends on external validation, but the kind grounded in accurate self-knowledge and progressive accomplishment. [Research consistently shows](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7174436/) that imposter syndrome is particularly prevalent among high-achieving young professionals and that targeted cognitive and values-based interventions produce durable improvement. [Cognitive restructuring](https://dralanjacobson.com/cognitive-restructuring/), ACT, and strengths-based work are the primary tools here.

### 3. Performance Anxiety and Communication

Addressing the anxiety that surfaces in high-stakes professional situations — presentations, interviews, networking, leadership moments — using the same exposure-based and cognitive approaches that produce reliable results in clinical treatment. See the dedicated pages on [public speaking anxiety](https://dralanjacobson.com/public-speaking-anxiety/) and [test-taking and performance anxiety](https://dralanjacobson.com/test-taking-anxiety/) for more detail.

### 4. Executive Functioning and Productivity

Building the organizational systems, time management habits, and task initiation strategies that professional demands require — particularly for early-career adults with ADHD or significant executive functioning challenges. This work connects directly with the [executive functioning coaching](https://dralanjacobson.com/executive-functioning-coaching/) page, which describes the specific skills and techniques used.

### 5. Identity, Meaning, and Values Alignment

Helping young adults develop a clear sense of professional identity that is genuinely their own — not assembled from parental expectations, peer comparison, or social media benchmarks. This includes working through the identity disruption that often accompanies career pivots, the grief of leaving a path that no longer fits, and the process of constructing a personal narrative that makes sense of both past choices and future direction. [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/) and [personal growth counseling](https://dralanjacobson.com/personal-growth-counseling/) are central to this dimension.

### 6. Preventing Burnout and Building Sustainable Habits

Establishing the work-life balance, boundary-setting, and self-regulation habits that sustain long-term performance — rather than building a career on a foundation of chronic overwork and compensating strategies that eventually collapse. [Mindfulness-based approaches](https://dralanjacobson.com/mindfulness-therapy/) and [work-life balance therapy](https://dralanjacobson.com/therapy-for-work-life-balance/) are integrated here when needed.

---

## The Early Career Accelerator: A Note

If you are an entrepreneur, independent creator, musician, or film/TV producer aged 18–30 looking for no-upfront-cost startup consulting, crowdfunding support, or project coaching, that program lives at [Performance Psychology Group’s Early Career Accelerator](https://performancepsychologygroup.com/early-career-accelerator/). The Accelerator sets aside a significant portion of annual revenue specifically to fund access to high-quality professional guidance for early-stage projects — with no fees unless your project succeeds.

The psychological and professional coaching described on this page operates independently of the Accelerator and is available to any early-career adult seeking support for the professional and identity challenges of the first years of working life.

---

## How Early Career Coaching Works

Sessions are conducted entirely virtually via secure video — accessible from anywhere in the United States. Dr. Jacobson is a [PSYPACT](https://psypact.org/)-participating psychologist licensed in 44 states, which means location is never a barrier. Sessions are typically 45–55 minutes, initially weekly during active skill-building and goal-setting phases, tapering to biweekly or monthly as goals consolidate. Most clients engage in a focused course of 8–20 sessions, though this varies depending on the breadth of goals and whether clinical dimensions require additional attention alongside the coaching work.

Early career coaching can run alongside individual therapy — with Dr. Jacobson or another provider — when clinical support is also needed. For more on how coaching and therapy differ and interact, see the [therapist vs. psychologist guide](https://dralanjacobson.com/therapist-vs-psychologist-therapist-vs-psychotherapist/).

## Frequently Asked Questions: Early Career Coaching

Common questions about what early career coaching involves, who it helps, and how it differs from standard career or business coaching.

   What is early career coaching, and how is it different from standard career counseling? + Early career coaching is a structured, forward-focused intervention designed to help young adults develop professional direction, build the skills and confidence their careers require, and navigate the psychological challenges that accompany the first years of working life. It differs from standard career counseling — which typically focuses on assessments, job search strategy, and resume development — in that it addresses the deeper psychological and identity dimensions that determine whether practical career advice actually translates into action. The [American Psychological Association’s research on early career development](https://www.apa.org/monitor/2020/04/early-career) consistently shows that structured professional support during the first five years of a career significantly improves both performance outcomes and long-term career satisfaction. When delivered by a licensed clinical psychologist, early career coaching can simultaneously address the practical planning layer and the psychological barriers — anxiety, imposter syndrome, identity uncertainty — that prevent those plans from being executed. See also the [personal growth counseling](https://dralanjacobson.com/personal-growth-counseling/) and [life transitions therapy](https://dralanjacobson.com/life-transitions-therapy/) pages for closely related work.

   What is imposter syndrome, and how does coaching address it? + Imposter syndrome — the persistent feeling of being fraudulent or undeserving of one’s accomplishments despite evidence to the contrary — is [documented at particularly high rates among high-achieving early-career professionals](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7174436/) and is one of the most common presenting concerns in early career coaching. It produces risk avoidance, reluctance to advocate for oneself, difficulty accepting positive feedback, and a chronic sense of waiting to be “found out.” Left unaddressed it limits career progression, erodes wellbeing, and makes every professional success feel provisional rather than real. Coaching addresses imposter syndrome at multiple levels: [CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) targets the automatic negative thoughts and attributional patterns that sustain it; [ACT](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) helps clients act in alignment with their values and goals even when the imposter feelings are present rather than waiting until they disappear; and strengths-based work using tools like the [VIA Character Strengths inventory](https://www.viacharacter.org/) builds an accurate and grounded picture of genuine capability. Many clients find that imposter syndrome diminishes significantly within a focused course of coaching — not because they stop questioning themselves, but because they develop a more accurate and compassionate relationship with their own competence.

   I know what I want to do but can’t seem to make myself do it. Can coaching help with that? + Yes — and this is one of the most common and most clinically interesting presentations in early career coaching. The gap between knowing and doing is rarely a knowledge or information problem; it is almost always a psychological one — anxiety about failure, perfectionism that prevents starting, identity uncertainty about whether the goal is genuinely yours, or executive functioning challenges that interfere with task initiation and follow-through. Each of these has a specific and effective treatment. Anxiety-driven avoidance responds well to [CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) and graduated exposure. Perfectionism responds to cognitive restructuring and ACT-based work around values vs. self-judgment. Identity uncertainty is addressed through [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/) and values clarification. Executive functioning gaps are addressed through the practical scaffolding described on the [executive functioning coaching](https://dralanjacobson.com/executive-functioning-coaching/) page. What distinguishes a psychologist-coach from a standard productivity coach is the ability to identify which of these is actually operating — and apply the right intervention rather than a generic one. Most clients find that once the underlying barrier is named and addressed, the knowing-doing gap closes much more quickly than they expected.

   I’m not sure what career I want at all. Is coaching still useful if I don’t have a direction yet? + Yes — this is exactly the situation early career coaching is designed for. Direction uncertainty at the start of a career is normal and developmentally appropriate, but it becomes a problem when it produces paralysis, chronic anxiety, or a series of reactive choices made from pressure rather than genuine self-knowledge. Coaching addresses this by working backward from values and strengths rather than forward from job titles — helping you develop an accurate picture of what matters most to you, what you are genuinely good at, and where those two things overlap with real opportunities. [Motivational Interviewing](https://dralanjacobson.com/motivational-interviewing/) is particularly effective for resolving the ambivalence that often accompanies direction uncertainty. Assessment tools such as the VIA Character Strengths survey and structured values clarification exercises provide concrete data points to anchor the conversation. Many clients find that once they have a clear picture of their own values and strengths — as distinct from what they think they should want — the direction becomes considerably clearer. For the identity dimensions of this work, see also [personal growth counseling](https://dralanjacobson.com/personal-growth-counseling/) and the [life transitions therapy](https://dralanjacobson.com/life-transitions-therapy/) page.

   How is early career coaching different from therapy — and can I do both? + Coaching is primarily forward-focused and performance-oriented — building skills, direction, and confidence. Therapy is more focused on understanding and healing — processing emotional history, treating clinical conditions, and addressing psychological patterns that cause suffering. In practice, for early-career adults, the two overlap significantly: the self-doubt that coaching addresses often has roots that therapy is better positioned to process; the career clarity that coaching builds often requires the emotional stability that therapy provides. When both are indicated, they are most effective running alongside each other — one focused on the clinical and emotional layer, the other on the practical and performance layer. Dr. Jacobson can provide both in an integrated way, or can coordinate with another therapist if a client prefers. An important note: Dr. Jacobson does not simultaneously provide individual therapy and coaching to the same client in separate dual-role relationships — the integration happens within a single coherent engagement rather than in two separate tracks with the same provider. For more on how coaching and therapy differ in general, see the [therapist vs. psychologist guide](https://dralanjacobson.com/therapist-vs-psychologist-therapist-vs-psychotherapist/) and the [therapy for college students](https://dralanjacobson.com/therapy-for-college-students/) page for clinical support specifically designed for this life stage.

   I have ADHD and it’s affecting my work. Is early career coaching or ADHD coaching the right fit? + Often both — and they fit together naturally. Early career coaching addresses the broader questions of direction, confidence, and professional identity; ADHD coaching addresses the specific executive functioning challenges — task initiation, time management, organization, sustained attention — that ADHD creates in professional settings. For early-career adults with ADHD, these two tracks are deeply interrelated: ADHD symptoms make it harder to execute on career goals, and career uncertainty makes ADHD symptoms harder to manage. In Dr. Jacobson’s practice, these dimensions are addressed in an integrated way rather than sequentially. For college students specifically, the [ADHD coaching for college students](https://dralanjacobson.com/adhd-coaching-for-college-students-effective-enduring/) page describes a structured, semester-focused format. For adults beyond college, the [adult ADHD coaching](https://dralanjacobson.com/adhd-coaching-for-adults-help-for-focus-and-concentration/) page covers the full range of executive functioning coaching available. If a formal ADHD evaluation has not yet been completed, referrals for [comprehensive ADHD testing](https://psychologicalassessments.com/adhd-testing/) through Precision Psychological Assessments are available.

   I’m an entrepreneur or creative professional early in my career. Is this coaching or the Accelerator the right fit? + It depends on what you primarily need. If your primary needs are startup consulting, crowdfunding strategy, platform connections, project funding, or operational support for an entrepreneurial or creative project — and you are 18–30 or within five years of starting your entrepreneurial journey — the [Early Career Accelerator at Performance Psychology Group](https://performancepsychologygroup.com/early-career-accelerator/) is specifically designed for that, with no upfront costs and a pay-it-forward model if your project succeeds. If your primary needs are the psychological and professional dimensions described on this page — direction uncertainty, imposter syndrome, performance anxiety, confidence, identity, ADHD management, or burnout prevention — then early career coaching here is the right fit. In many cases, both are relevant: the practical project support at PPG and the psychological coaching here complement each other and can run simultaneously. The initial consultation will help clarify which combination of services best fits your specific situation. See also the [founder coaching](https://dralanjacobson.com/founder-coaching/) page for psychologist-led coaching specifically designed for founders navigating the demands of building a company.

   How do I get started with early career coaching? + The first step is a free 20-minute consultation — a practical conversation about where you are in your career, what’s feeling stuck or uncertain, and what you’re hoping coaching might offer. Sessions are conducted entirely virtually via secure video; Dr. Jacobson is a [PSYPACT](https://psypact.org/)-participating psychologist licensed in 44 states, making early career coaching accessible regardless of your location. There’s no commitment required, and the consultation itself is often clarifying — most people leave with a clearer picture of whether coaching, therapy, or a combination is the right next step, and what a realistic course of work might look like. Related pages worth reviewing before reaching out: [personal growth counseling](https://dralanjacobson.com/personal-growth-counseling/), [life transitions therapy](https://dralanjacobson.com/life-transitions-therapy/), [therapy for college students](https://dralanjacobson.com/therapy-for-college-students/), [adult ADHD coaching](https://dralanjacobson.com/adhd-coaching-for-adults-help-for-focus-and-concentration/), [executive functioning coaching](https://dralanjacobson.com/executive-functioning-coaching/), [founder coaching](https://dralanjacobson.com/founder-coaching/), and [the Early Career Accelerator at Performance Psychology Group](https://performancepsychologygroup.com/early-career-accelerator/) for project-specific support.

 The first years of your career matter. So does the support you have during them.

Schedule a free 20-minute consultation with Dr. Jacobson — a practical conversation about where you are and what early career coaching might offer.

 [ Schedule a Free Consultation ](https://www.picktime.com/scheduleaconsult) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.linkedin.com/company/psychologicalscience/)

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### [The MATCH Framework: How I'll Build Your Individualized Plan](https://dralanjacobson.com/the-match-framework-of-integrative-therapy/)

**Published:** August 29, 2026
**Author:** Dr. Alan Jacobson

**Content:**

After 25 years and training across more than twenty evidence-based approaches, here’s exactly how I figure out what will actually work for you — and why no two treatment plans I write look the same.

Therapy isn’t one-size-fits-all, and I don’t think it should be practiced like it is. Over 25 years, I’ve trained across more than twenty clinical approaches — CBT, ACT, EMDR, Schema Therapy, Polyvagal-informed work, and more, all covered on my [Types of Therapy page](https://dralanjacobson.com/types-of-therapy/) — not to have a favorite, but to have options. My job in our first few sessions isn’t to fit you into whichever modality I happen to reach for first. It’s to understand you well enough to braid together the specific combination of techniques that fits your goals, your history, and how you actually respond to treatment.

I call that process MATCH. It’s the same framework whether you’re coming in for individual therapy, couples work, family therapy, or coaching — the modalities change, the process for choosing them doesn’t.

**What that looks like in practice:** most clients notice real, measurable movement within 4–6 sessions — not because I picked the “right” technique on the first try, but because the plan keeps adjusting until something clearly works. 

## The MATCH framework

Five steps, applied to every client relationship regardless of what brings you in:

M### Multidimensional Assessment

I start by understanding the whole picture — your history, relationships, physiology, goals, and what’s already been tried — not just the symptom that brought you in.

A### Applied Psychological Science

Every technique I draw on is grounded in the clinical research base, not instinct alone — the same evidence-first standard behind everything at the [Center for Applied Psychological Science](https://appliedpsychologicalscience.com/).

T### Tailored Integrative Plan

From there, I build a plan drawn from the [more than twenty approaches I’ve trained in](https://dralanjacobson.com/types-of-therapy/) — chosen specifically for you, not a fixed protocol everyone gets.

C### Continued Collaboration and Measurement

Therapy isn’t “set it and forget it.” We track what’s actually working using measurable, meaningful markers of progress, and I adjust the plan as we go rather than sticking with something that isn’t landing.

H### Holistic Integration

The techniques above aren’t used in isolation — I braid them together into one coherent approach that addresses mind and body, thought and emotion, individual and relational context, so treatment fits the whole person, not just a diagnosis.

## Why I don’t practice one-size-fits-all therapy

Most therapists are trained deeply in one or two modalities and use them for nearly everyone who walks through the door — which works well for some people and poorly for others, largely by chance. Twenty-five years of practice gave me the alternative: enough breadth across evidence-based approaches that I’m not choosing your treatment based on what I know best, but on what actually fits your goals, your history, and your physiology. MATCH is the discipline that keeps that choice deliberate instead of habitual.

## Who I work with using this approach

The MATCH framework underlies every kind of work I do. Explore how it applies to your situation:

- [Individual Therapy](https://dralanjacobson.com/individual-therapy/)
- [Couples Therapy](https://dralanjacobson.com/couples-therapy/)
- [Family Therapy](https://dralanjacobson.com/family-therapy/)
- [Group Therapy](https://dralanjacobson.com/group-therapy/)
- [Executive Coaching](https://dralanjacobson.com/executive-coaching/)
- [ADHD Coaching](https://dralanjacobson.com/adhd-coaching-for-adults-help-for-focus-and-concentration/)
- [Anxiety Therapy](https://dralanjacobson.com/best-types-of-therapy-for-anxiety/)
- [Life Transitions](https://dralanjacobson.com/life-transitions-therapy/)
- [Full List of Therapy Types](https://dralanjacobson.com/types-of-therapy/)

## About Dr. Jacobson

I’m a licensed clinical psychologist with 25+ years of experience, licensed in Massachusetts, California, New Hampshire, and New York, with PSYPACT authority covering telepsychology across 44 states. My approach is grounded in positive psychology and humanistic values — strength-based, future-oriented, and collaborative — applied through whichever combination of evidence-based techniques actually fits you. You can read more on [my full bio](https://dralanjacobson.com/my-bio/).

## Frequently asked questions

### What does MATCH stand for?

MATCH is the five-step process I use to build every treatment plan: Multidimensional Assessment (understanding the whole person), Applied Psychological Science (grounding every technique in clinical research), Tailored Integrative Plan (selected from more than twenty approaches I’ve trained in), Continued Collaboration and Measurement (tracking progress and adjusting as we go), and Holistic Integration (braiding techniques together into one coherent approach). It’s the same process whether you’re starting individual therapy, couples work, family therapy, or coaching.

### Do I need to know which type of therapy I want before we start?

No — that’s the point of the MATCH process. Most clients come in describing what they’re struggling with, not which modality they’d like. I use our first several sessions to understand your history, goals, and how you respond to different approaches, then build the plan from there. You’re welcome to ask about specific techniques you’ve read about, like EMDR or ACT, and we can talk through whether they fit.

### How is this different from typical single-approach therapy?

Many therapists practice one or two modalities and apply them broadly, which works well for some clients and less well for others, often by chance rather than fit. Because I’ve trained across more than twenty evidence-based approaches, I can select and combine techniques based on what actually matches your situation, rather than being limited to whichever framework I know best.

### How soon will I notice results?

Most clients notice real, measurable change within 4–6 sessions. That timeline reflects the Continued Collaboration and Measurement step of MATCH — I’m tracking meaningful markers of progress from early on, so if something isn’t working, we adjust rather than waiting months to find out.

### What if the plan needs to change partway through?

That’s expected, not a failure of the original plan. People change, circumstances change, and what worked in month one isn’t always what’s needed in month six. The Continued Collaboration and Measurement step exists specifically so the plan can evolve with you rather than staying fixed once it’s set.

## Curious how MATCH would apply to you?

A free, 20-minute consultation is the easiest way to start — no commitment, just a conversation about what you’re working through.

[Schedule a Free Consult](https://www.picktime.com/scheduleaconsult)

![Graphic of The MATCH Framework with five connected circles labeled M A T C H: Multidimensional, Applied, Tailored, Continued, Holistic.](https://dralanjacobson.com/wp-content/uploads/2026/08/match-framework-featured-image-1024x538.png "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")From the Desk of Dr. Jacobson

One closing thought, from me directly: MATCH isn’t a framework I built to sound impressive on a page. It’s genuinely how I organize twenty-five years of training so that it’s useful to the specific person in front of me, not just tidy on a shelf. If any of this resonates with what you’re working through, I’d like to hear about it.— Dr. J.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

 [ ![social network 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---

### [Dr. Jacobson's Approach to Coaching Teens and Adults](https://dralanjacobson.com/dr-jacobsons-approach-to-coaching-teens-and-adults/)

**Published:** September 7, 2026
**Author:** Dr. Alan Jacobson

**Content:**

Coaching · Dr. Jacobson’s Approach

Coaching and therapy ask different questions. Coaching asks “what do you want to build from here?” My clinical background just means I never lose sight of the whole person while we build it.

Executive, Career & Focus Coaching

**The short version:** My coaching work is future-focused, goal-driven, and grounded in the assumption that you’re resourceful, not that something needs fixing. It’s distinct from therapy in scope and purpose, though my clinical training shapes how I coach: I notice patterns, blind spots, and emotional undercurrents that a purely business-trained coach might miss, without turning a coaching engagement into therapy by another name. 

In this section

- [How I approach coaching](#our-approach)
- [What I offer](#what-we-offer)
- [From the Desk of Dr. Jacobson](#desk)
- [Frequently asked questions](#faq)

## How I Approach Coaching

Coaching and therapy share a room, a conversation style, and often a person, but they’re not the same discipline, and I hold that distinction carefully. The International Coaching Federation defines coaching as partnering with clients in a thought-provoking, creative process that inspires them to maximize their personal and professional potential, and draws the line clearly: coaching focuses on the present and future, assumes resourcefulness rather than something needing to be healed, and does not diagnose or treat mental illness.1 That’s the model I follow. A coaching engagement with me is oriented toward a goal you’ve named, not a diagnosis, and it moves at the pace of building something forward rather than working through something backward.

What my clinical background adds isn’t a hidden therapy agenda, it’s pattern recognition. Twenty-five years of clinical work means I notice when procrastination is really an executive functioning issue, when a leadership struggle is really a conflict-avoidance pattern learned decades ago, or when “I just need better time management” is masking something that would genuinely benefit from therapy instead. When that’s the case, I say so directly and can refer accordingly, consistent with the same ethical boundary the ICF asks all coaches to maintain.1

## What I Offer

Coaching for Leaders & Managers

### [Executive Coaching](https://dralanjacobson.com/executive-coaching/)

For senior leaders navigating high-stakes decisions, team dynamics, and the isolation that often comes with the role.

### [Management Coaching](https://dralanjacobson.com/management-coaching/)

Practical support for new and experienced managers building the interpersonal and organizational skills the role demands.

### [Leadership Coaching](https://dralanjacobson.com/leadership-coaching/)

Developing the judgment, communication, and self-awareness that separate good leaders from good individual performers.

Coaching by Career Stage

### [Founder Coaching](https://dralanjacobson.com/founder-coaching/)

For founders carrying the particular weight of building something from nothing, often with few peers who understand it firsthand.

### [Early Career Coaching](https://dralanjacobson.com/early-career-coaching/)

Building confidence, direction, and workplace skills in the first years of a career, before patterns calcify.

Coaching for Focus & Follow-Through

### [ADHD Coaching](https://dralanjacobson.com/adhd-coaching-for-adults-help-for-focus-and-concentration/)

Skills-based, practical coaching for adults managing focus, time management, and task follow-through day to day.

### [Executive Functioning Coaching](https://dralanjacobson.com/executive-functioning-coaching/)

Building the planning, organization, and follow-through skills that underlie performance at work and at home, whether or not ADHD is part of the picture.

From the Desk of Dr. Jacobson

People sometimes ask why a clinical psychologist offers coaching at all, since the two fields get lumped together so often. Here’s my honest answer: I like the work precisely because it’s different. Therapy asks me to sit with what’s difficult and help someone heal at whatever pace that takes. Coaching asks me to help someone who is often already doing fine build something specific and forward-looking, faster, and with a clearer finish line in mind. I find that energizing in a different way than therapy is, and I think you can feel the difference in how a session goes.

That said, I don’t leave my clinical training at the door. If I notice a pattern in a coaching client that looks more like an anxiety disorder than a leadership challenge, I’ll tell you plainly, and we’ll talk about whether therapy would serve you better, either instead of or alongside coaching. I’d rather be useful to you honestly than keep a coaching engagement going past the point where it’s the right tool for the job.

— Alan

**Worth knowing before you start:** coaching isn’t a substitute for therapy when what you’re facing is a diagnosable mental health condition causing significant distress. If that sounds like your situation, I’ll say so during a consultation, and we can talk about individual therapy instead, or in addition. 

Related resources

- [The MATCH Framework](https://dralanjacobson.com/the-match-framework-of-integrative-therapy/) — how I build individualized plans across therapy and coaching alike
- [Individual Therapy](https://dralanjacobson.com/individual-therapy/)
- [Adult ADHD Therapy](https://dralanjacobson.com/adhd-therapy-for-adults/)
- [ADHD Coaching for College Students](https://dralanjacobson.com/adhd-coaching-for-college-students-effective-enduring/)
- [Executive Functioning Coaching](https://dralanjacobson.com/executive-functioning-coaching/)

### Not sure if coaching or therapy is the right fit?

A free consultation is the easiest way to find out, and I’ll tell you honestly if I think the other is a better starting point.

[Schedule a Free Consultation](https://www.picktime.com/scheduleaconsult)[See the MATCH Framework](https://dralanjacobson.com/the-match-framework-of-integrative-therapy/)

What’s the difference between coaching and therapy with you?Coaching is future-focused and goal-driven, aimed at building toward something you’ve named, and it doesn’t involve diagnosing or treating mental health conditions. Therapy addresses emotional difficulties, mental health conditions, and past experiences shaping the present. My clinical background informs how I coach, but a coaching engagement follows the coaching model, not the therapy model.

Can I do coaching and therapy with you at the same time?In some cases, yes, though it depends on the specifics of what each is addressing. I’ll talk this through with you directly during a consultation, since the right structure depends on your particular goals and circumstances.

What if I start coaching and it becomes clear I need therapy instead?I’ll tell you directly if that’s what I’m noticing. Because I’m a licensed clinical psychologist as well as a coach, I’m positioned to recognize when a concern goes beyond what coaching is designed to address, and we can talk about shifting to therapy instead of, or alongside, the coaching work.

Do you coach individuals, or teams and organizations too?My coaching work is primarily one-on-one, whether the client is an executive, founder, manager, or early-career professional. Reach out during a consultation to discuss your specific situation and goals.

How long does a coaching engagement typically last?It depends entirely on your goals. Some clients come in with a specific, bounded objective and wrap up in a matter of months; others use coaching on an ongoing basis through a role transition or period of growth. We’ll set clear goals at the start so it’s never a mystery whether the engagement is working.

Is coaching conducted virtually?Yes. Coaching is available virtually, which many clients find easier to fit around demanding schedules, in addition to limited in-person availability near my Massachusetts and New Hampshire offices.

**Sources**1. International Coaching Federation. “Referring a Client to Therapy: A Set of Guidelines.” [coachingfederation.org](https://coachingfederation.org/wp-content/uploads/2024/12/icf-research-guide-referring-client-to-therapy.pdf)

![Approach to Coaching](https://dralanjacobson.com/wp-content/uploads/2026/09/road-1024x640.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist") ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

 [ ![social network 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](https://www.facebook.com/appliedpsychologicalscience) [ ![social network 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](https://www.instagram.com/appliedpsychological) [ ![social network icon](data:image/svg+xml;base64,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) ](https://www.linkedin.com/company/psychologicalscience/)

---

### [Family Therapy](https://dralanjacobson.com/family-therapy/)

**Published:** January 4, 2024
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: September 7, 2026

 # Family Therapy

I offer **family therapy**, also known as **family counseling**, nationwide. My specialty is working with families where the children are older adolescents or adults. **Family treatment** can be delivered virtually to ensure everyone can attend despite busy schedules and sometimes different time zones.

Powerful | Meaningful | Effective

 [Book A Family Therapy Consultation](https://www.picktime.com/scheduleaconsult)

## Family Therapy Overview

Family Treatment focuses on improving relationships and communication within a system. It is based on the idea that issues or conflicts are often best understood and resolved by addressing the group as a whole rather than just focusing on individual members in isolation.

### My Family Counseling Services

I offer family therapy primarily in three situations:

1. When the children are teenagers, and the family is going through a transition or specific stress.
2. **Family therapy when the children are grown**, and they want to improve their relationships. A subset of this is [family estrangement therapy](https://dralanjacobson.com/family-estrangement-therapy/).
3. **When a client I see individually wants to work on something related to certain relationships**, they invite that member to a limited number of their sessions.

Note that I do family treatment with younger children because so much of my work is virtual, and this is not the preferred method when children are younger.

I do a good amount of [adult family therapy](https://dralanjacobson.com/adult-family-therapy/) and [therapy for adult siblings](https://dralanjacobson.com/adult-sibling-therapy/) when the children are grown, given that I have a virtual practice that allows people to attend even if they don’t live in the same place.

 ![Family Therapy](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "IMG_0474 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## Keys to Family Therapy

The primary goal of family therapy is to identify and address issues that may be causing distress. This can include conflicts, communication problems, behavioral issues, and emotional distress. The following are the basic tenets of family treatment:

### The Systems Perspective

Therapists like me view families as complex systems with unique dynamics, roles, and patterns of interaction. Problems are seen as arising from these dynamics rather than solely resulting from individual issues. We consider how changes in one member’s behavior or attitudes can impact the entire system. We aim to help individuals make positive changes that benefit everyone involved.

### Inclusivity in Family Counseling

Family therapy can involve various members, depending on the situation. It may include parents and children, couples, or even extended members, depending on the nature of the problems being addressed. I see families with adolescents and those where all the children are grown. Sometimes, I see only the part where there is tension, but usually, I try to involve everyone.

### My Role in Family Treatment

I typically act as a facilitator, helping members express their thoughts and feelings and guiding the process of problem-solving and conflict resolution. The goal of family counseling is that the positive changes, realizations, and insights gained in sessions transition to their life outside of sessions. My role is often to point out aspects of their relationships they are unaware of or, better yet, help them see this themselves.

## Family Therapy Techniques

Family treatment can be helpful for a wide range of issues, such as marital conflicts, parent-child conflicts, substance abuse, mental health issues, and other challenges that affect group functioning.

I use various techniques to help clients understand and resolve their issues. These include communication skills training, role-playing,[ genograms](https://en.wikipedia.org/wiki/Genogram) (diagrams of roles), and other interactive exercises:

### Genograms

A[ genogram](https://www.therapistaid.com/therapy-guide/genograms) visually represents structure and relationships. I use genograms to help members understand their history and identify behavior patterns and intergenerational issues. Genograms become “living” documents we use as relationships evolve and change. Often, we add significant people outside the immediate family to the genogram.

### Communication skills training

We might work together to improve communication. Techniques may include active listening, assertiveness training, and teaching members how to express their feelings and needs more effectively. The goal is for the gains made in the session to carry over into other aspects of life.

### Role-playing in Family Counseling

Role-playing exercises helps members practice effective communication and problem-solving skills. In a scenario, members may take on different roles to explore different perspectives and responses. For example, two members in conflict may take the other person’s role to understand the other person’s perspective.

### Sculpting and Systemic Mapping

[In this technique](https://www.betterhelp.com/advice/therapy/family-sculpting-psychodrama-for-family-therapy/), members physically arrange themselves to represent their relationships, roles, and feelings. It can help visualize group dynamics and uncover underlying issues. [Systemic mapping](https://www.mypeoplepatterns.com/blog/structural_mapping) involves creating a visual map or diagram of the system, highlighting patterns of interaction, alliances, and conflicts. It helps members and the therapist understand the dynamics at play.

### Rituals and routines

I may encourage the development of new rituals and routines to enhance connections and create a sense of stability. Meetings are one ritual that can provide a safe space for [open and constructive communication](https://www.thoughtfulleader.com/encouraging-open-communication/), where members can discuss issues, set goals, and make decisions together.

### Encouraging empathy

I often work on building empathy within the group. They may use storytelling, role reversal, or perspective-taking exercises to help members better understand each other’s experiences and emotions.

## Family Therapy Approaches

There are several approaches to family treatment that I follow:

### [Structural family therapy](https://dralanjacobson.com/structural-family-therapy/)

This therapy approach, developed by [Salvador Minuchin](https://en.wikipedia.org/wiki/Salvador_Minuchin), focuses on the organization and structure of the group. The treatment often uses techniques like joining (aligning with the group) and boundary setting to help reorganize the system more healthily. Usually, clients have come to therapy because specific roles are not working, or members are not taking on the roles they should.

### [Strategic family therapy](https://dralanjacobson.com/strategic-family-therapy-powerful-positive-time-limited/)

Developed by [Jay Haley](https://en.wikipedia.org/wiki/Jay_Haley) and others, this approach emphasizes problem-solving and goal-oriented strategies. I may assign “homework” or give directives to members to address specific issues. This type of family counseling examines history and how roles have evolved.

### Narrative family therapy

This approach views problems as separate from individuals and encourages members to reframe their [stories and narratives](https://dralanjacobson.com/narrative-therapy/) about their lives. Members can find new solutions and perspectives by changing how they perceive their issues. [Narrative family therapy](https://dralanjacobson.com/narrative-family-therapy/) is a great fit when the kids are older adolescents or adults.

### [Solution-focused family therapy](https://dralanjacobson.com/solution-focused-family-therapy-focusing-on-positive-change/)

The [Solution-Focused Therapy](https://dralanjacobson.com/solution-focused-therapy/) technique identifies and amplifies solutions rather than dwelling on problems. I work with you to determine what is working and build on those strengths. We often work within a specific timeline with specific goals you want to resolve. Sometimes, this approach is used when there is a particular deadline when they want to be finished with therapy by, perhaps an event or transition that can be predicted.

### Family Systems Therapy

This approach looks at the group as a whole, and understand systems of communicating, relating, and behaving that are influenced by the group. [Family systems therapy](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/) appreciates how the members have developed both strong ways of relating and where they are stuck due to problematic patterns and barriers. This approach is particularly effective when the children are older. There are many specific methods within this approach, including [Bowenian Family Therapy](https://dralanjacobson.com/bowenian-family-therapy/).

### Emotionally Focused Family Therapy

This powerful, proven, and [evidence-based therapeutic approach](https://positivepsychology.com/evidence-based-therapy/) is designed to improve relationships by addressing longstanding emotional bonds and attachment patterns. [Emotionally focused family therapy](https://dralanjacobson.com/emotionally-focused-family-therapy/) looks for strengths and areas where things are stuck and is particularly useful with families where the children are older, including adults.

The [specific techniques and approaches](https://dralanjacobson.com/types-of-therapy/) used in family treatment can vary depending on needs and the nature of the issues being addressed. Family counseling is a collaborative process so that we will discuss possible approaches. You will usually decide which fits your unique dynamics and challenges.

I also offer treatment for specific relationships, such as [mother-daughter therapy](https://dralanjacobson.com/mother-daughter-therapy/).

## Specific Topics and Challenges

[](https://dralanjacobson.com/politics-and-family-therapy/)

#### [Politics or Current Events Cause Conflict](https://dralanjacobson.com/politics-and-family-therapy/)



#### Adult Sibling Conflict and Estrangement 



#### Difficulties During Transitions

[](https://dralanjacobson.com/blended-family-therapy-step-parent-counseling/)

#### [Blended Family Transitions](https://dralanjacobson.com/blended-family-therapy-step-parent-counseling/)

[](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/)

#### [Improving the System to Bring Closeness ](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/)

[](https://dralanjacobson.com/structural-family-therapy/)

#### [Strengthening Roles and Relationships](https://dralanjacobson.com/structural-family-therapy/)

## Family Treatment FAQ

##### What family therapy techniques will you use?

My therapy practice is integrative, and each group is unique, so I always draw from various techniques and approaches that I feel would be most effective. When we meet, and I learn more about you and what you are looking for, I will go over the possible approaches and combinations of methods I am leaning toward.

##### How long will family counseling take?

The course depends on the goals you want to reach and how long and challenges or barriers that affect those goals have been in place. I can say that you should see meaningful and important improvements in your relationships along the way, and there should be a clearer answer to how long it will take as we move along.

##### How often will we meet?

I like to start family therapy with weekly sessions for at least 3-4 weeks to fully understand what you are looking for and the history of your relationships. After that, we can discuss the frequency of sessions and what works best for your goals and schedules.

##### Will we meet virtually or in-person?

I meet with many clients virtually, and I’ve found no difference in the effectiveness of doing family treatment that way. For many, it’s easier and sometimes necessary to meet virtually because they will not be in the same place simultaneously. I provide more information about my experience with online therapy in [my blog](https://dralanjacobson.com/blog/): [Virtual Therapy Effectiveness](https://dralanjacobson.com/virtual-therapy-guide/).

##### How will we know that family counseling is working?

Family counseling can be powerful and quite effective, and it should not be a mystery whether it is working – we will set measurable and clear goals at the start, and as we progress, we will check in to make sure therapy is working to help you reach them.

 ## From Dr. Jacobson’s Desk

Most of the families I see aren’t in crisis. They’ve simply gotten stuck in patterns nobody chose on purpose and nobody quite knows how to name out loud. Because so much of my family work happens with adult or older adolescent children, often scattered across time zones by now, I spend a good part of the first session just getting everyone comfortable being in the same room again, even a virtual one.

What’s kept me interested in this work over the years is how often a single shift changes the whole system’s temperature: one person asking a different question than usual, or one old role finally getting said out loud instead of just lived out. I try not to walk in assuming who “the problem” is, because families rarely have just one, and the member who looks most stuck is often the one carrying the most weight for everyone else.

If it’s been hard to even agree on whether therapy is worth trying, that disagreement itself is a completely normal place to start from.

— Dr. J

 ![Dr. Alan Jacobson, Clinical Psychologist](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "Me | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

 ## Other Questions? 

 Family therapy is effective in many cases, helping improve relationships and find more constructive ways to address problems. It can also prevent further issues from arising. Technically, [couples therapy](https://dralanjacobson.com/couples-therapy/) is a family therapy, but I explore that area separately here. Everyone participating must be motivated, though the level of motivation can differ among members. We also have to come up with a treatment plan collaboratively, and the entire group must be involved in approving it.

### Reasons to Call

If you and other loved ones are experiencing issues that you believe could benefit from family therapy, feel free to reach out for a [free consultation](https://www.picktime.com/scheduleaconsult) where we can go over how the treatment might help you. Together, we can assess your specific needs and begin to develop a treatment plan tailored to your situation.

### Call

(617)-680-5488

### Email

hello@dralanjacobson.com

### Address

In person: Westwood, MA & Lee, NH

Virtual: Serving 40 states

 [ ![social network 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](https://www.facebook.com/appliedpsychologicalscience) [ ![social network icon](data:image/svg+xml;base64,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) ](https://www.instagram.com/appliedpsychological) [ ![social network icon](data:image/svg+xml;base64,PHN2ZyB3aWR0aD0iMTYiIGhlaWdodD0iMTYiIHZpZXdCb3g9IjAgMCAxNiAxNiIgZmlsbD0ibm9uZSIgeG1sbnM9Imh0dHA6Ly93d3cudzMub3JnLzIwMDAvc3ZnIj4KPGcgY2xpcC1wYXRoPSJ1cmwoI2NsaXAwXzM0M185OTUpIj4KPHBhdGggZD0iTTE0LjgxNTYgMEgxLjE4MTI1QzAuNTI4MTI1IDAgMCAwLjUxNTYyNSAwIDEuMTUzMTNWMTQuODQzOEMwIDE1LjQ4MTMgMC41MjgxMjUgMTYgMS4xODEyNSAxNkgxNC44MTU2QzE1LjQ2ODggMTYgMTYgMTUuNDgxMyAxNiAxNC44NDY5VjEuMTUzMTNDMTYgMC41MTU2MjUgMTUuNDY4OCAwIDE0LjgxNTYgMFpNNC43NDY4NyAxMy42MzQ0SDIuMzcxODhWNS45OTY4N0g0Ljc0Njg3VjEzLjYzNDRaTTMuNTU5MzggNC45NTYyNUMyLjc5Njg4IDQuOTU2MjUgMi4xODEyNSA0LjM0MDYyIDIuMTgxMjUgMy41ODEyNUMyLjE4MTI1IDIuODIxODggMi43OTY4OCAyLjIwNjI1IDMuNTU5MzggMi4yMDYyNUM0LjMxODc1IDIuMjA2MjUgNC45MzQzNyAyLjgyMTg4IDQuOTM0MzcgMy41ODEyNUM0LjkzNDM3IDQuMzM3NSA0LjMxODc1IDQuOTU2MjUgMy41NTkzOCA0Ljk1NjI1Wk0xMy42MzQ0IDEzLjYzNDRIMTEuMjYyNVY5LjkyMTg4QzExLjI2MjUgOS4wMzc1IDExLjI0NjkgNy44OTY4NyAxMC4wMjgxIDcuODk2ODdDOC43OTM3NSA3Ljg5Njg3IDguNjA2MjUgOC44NjI1IDguNjA2MjUgOS44NTkzOFYxMy42MzQ0SDYuMjM3NVY1Ljk5Njg3SDguNTEyNVY3LjA0MDYzSDguNTQzNzVDOC44NTkzNyA2LjQ0MDYzIDkuNjM0MzggNS44MDYyNSAxMC43ODc1IDUuODA2MjVDMTMuMTkwNiA1LjgwNjI1IDEzLjYzNDQgNy4zODc1IDEzLjYzNDQgOS40NDM3NVYxMy42MzQ0VjEzLjYzNDRaIiBmaWxsPSIjNDM0OTYwIi8+CjwvZz4KPGRlZnM+CjxjbGlwUGF0aCBpZD0iY2xpcDBfMzQzXzk5NSI+CjxyZWN0IHdpZHRoPSIxNiIgaGVpZ2h0PSIxNiIgZmlsbD0id2hpdGUiLz4KPC9jbGlwUGF0aD4KPC9kZWZzPgo8L3N2Zz4K)](https://www.linkedin.com/company/psychologicalscience/)

---

### [Couples Therapy](https://dralanjacobson.com/couples-therapy/)

**Published:** January 3, 2024
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: September 6, 2026

 # Couples Therapy

I provide couples therapy to any people in a committed relationship. This treatment can bring people closer, increase understanding, and provide insights no matter how long people have been together. A couples therapist allows clients to do needed work its hard to do on their own. Closely related “[Marriage Counseling](https://dralanjacobson.com/marriage-counseling/)” is dedicated to partners who have had a formal commitment.

Powerful | Effective | Relationship Changing

 [Book A Couples Therapy Consultation](https://www.picktime.com/scheduleaconsult)

## Couples Therapy Overview

During couples therapy sessions, I provide a safe and supportive environment for couples to explore their feelings, thoughts, and concerns. I work to help clients identify negative patterns of behavior and communication and provide tools and techniques to improve their relationship.

### **Couples Therapy Formats**

This therapy can be conducted in various formats, including individual sessions with a therapist, joint sessions with both partners or a combination of the two. The duration of treatment varies depending on the pair’s specific needs and the nature of their issues. I also offer [premarital counseling](https://dralanjacobson.com/premarital-counseling/) as a sub-specialty.

### **Couples Therapy Results**

Overall, couples therapy can be a valuable resource for those seeking to improve their relationship, whether facing specific challenges or simply looking to enhance their connection and communication. It can provide a framework for people to work through difficulties and create a healthier, more satisfying partnership.

 ![Couples Therapist](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "IMG_0474 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## Reasons for Couples Therapy

This form of treatment is a valuable resource for those facing a wide range of challenges. It can be delivered after marriage or as pre-marital counseling to address potential issues and build a strong foundation for their marriage. This treatment can also be helpful for those in a long-term relationship, whether or not it will likely lead to marriage. The issues addressed in couples therapy include but are not limited to:

### Couples Therapy for Communication Problems

Many people struggle with effective communication, leading to misunderstandings, conflicts, and emotional distance. Treatment can teach better [communication skills and techniques](https://www.helpguide.org/articles/relationships-communication/effective-communication.htm). This is a common starting point since communication provides the basis for many other changes.

### Couples Therapy for Conflict Resolution

Conflicts are a natural part of any relationship, but unresolved conflicts can lead to resentment and long-term damage. I can help people learn how to address and resolve conflicts healthily and productively. One example is money-related disputes, which are common in relationships and can lead to significant stress. Treatment can help you develop strategies for managing finances and resolving money-related conflicts.

### Couples Therapy After Infidelity

Trust is often broken when one or both partners have been unfaithful, and the relationship can be severely damaged. Therapy can help couples work through the aftermath of infidelity, rebuild trust, and decide whether to continue the relationship.

### Intimacy Issues

Many pairs experience intimacy-related challenges, including differences in sexual desire, dysfunction, or issues related to past trauma. Treatment can assist in addressing these issues and finding ways to improve their physical and emotional connection.

### Couples Therapy and Parenting Issues

Raising children can stress a relationship as parent navigate differences in parenting styles, values, and priorities. [Parent therapy](https://dralanjacobson.com/parent-coaching/) can guide couples on how to co-parent effectively and maintain a healthy relationship while raising a family. One offshoot of this is [stepparenting therapy](https://dralanjacobson.com/blended-family-therapy-step-parent-counseling/).

## Steps in Couples Therapy

The first session often involves me getting to know the pair, their history, and the issues they are facing. I help them identify their goals for treatment. These goals could include improving communication, resolving conflicts, or rebuilding trust. Establishing a trusting and open relationship among us is essential during this phase. This helps them feel comfortable discussing their concerns and emotions.

### The Start of Couples Therapy

Many pairs struggle with effective communication. For treatment to have the maximum chance for success, I teach them how to communicate better by listening actively, expressing themselves clearly, and avoiding destructive communication patterns like criticism, contempt, defensiveness, and stonewalling. This also involves strategies for resolving conflicts more healthily, including identifying underlying issues, compromising, and finding win-win solutions.

### Exploration of Underlying Issues

As the therapy progresses, we often uncover and explore the deeper issues contributing to their conflicts, such as past traumas, family dynamics, or individual emotional struggles. This is where we might try [individual sessions alongside joint sessions](https://dralanjacobson.com/individual-therapy/), which can help address personal issues affecting the relationship.

### Homework From the Couples Therapist

Clients are often given homework assignments to practice the skills and strategies they learn in therapy daily. This can be essential for making lasting changes. The success of couples therapy may depend on how motivated both people are to work on things outside of sessions.

### Progress Evaluation and Couples Therapy Termination

I periodically evaluate progress and whether the pair are achieving their goals. When they feel they have completed their goals and made substantial progress, we may terminate therapy. Alternatively, some continue with periodic “maintenance” sessions to ensure continued growth and stability.

## Outcomes

The outcomes of treatment can vary depending on several factors, including the specific issues you are facing and the level of commitment from both partners. Here are some potential outcomes:

### Improved Communication through Couples Therapy

Treatmemt often focuses on enhancing communication skills, which can help partners better understand each other’s needs and concerns. Improved communication can lead to healthier and more productive interactions, which in turn can lead to better tools and strategies for resolving conflicts more effectively. Clients can learn how to address disagreements constructively and find mutually satisfying solutions. They can also learn new problem-solving skills, which are essential for addressing challenges that may arise in the future.

### Increased Intimacy and Meaning through Couples Therapy

Many people seek therapy to reconnect with each other emotionally and physically. Couples therapy can help reignite intimacy and strengthen the emotional bond between partners. For some, treatment can reaffirm their commitment to each other. They may realize the value of their relationship and work to nurture it.

### Better Understanding of Relationship Dynamics

People often gain insight into the patterns and dynamics in their relationship. This awareness can help them break negative cycles and make positive changes. Those facing emotional distress, such as depression or anxiety, related to their relationship may experience relief and improvement in their mental health through treatment.

### Couples Therapy and Coping with Life Transitions

People may seek treatment during significant life transitions, such as becoming parents, retiring, or dealing with illness. It can help them adapt to these changes and maintain a strong partnership. Sometimes, treatment can be helpful after the transition. It allows them to process what went well, what could have gone better, and how they can best support each other going forward.

It’s important to note that treatment effectiveness can vary, and success is not guaranteed. It largely depends on both partners’ willingness to engage in the process and make necessary changes. Sometimes, therapy is seen as a last resort, but other times, the pair is generally doing well and wants to iron out some ongoing issues.

## What Do Couples Therapists Do?

### A couples therapist helps couples resolve conflicts and improve their relationships. Their primary goals include:

1\. Improving Communication: A couples therapist helps couples develop effective communication skills, ensuring both partners can constructively express their feelings and needs.

2\. Conflict Resolution: A couples therapist assists couples in resolving disputes by identifying underlying issues and teaching problem-solving techniques.

3\. Enhancing Intimacy: A couples therapist works to strengthen emotional and physical intimacy, addressing any barriers to closeness.

4\. Building Trust: A couples therapist helps the pair rebuild trust, especially after incidents like infidelity or betrayal.

5\. Identifying Patterns: A couples therapist identifies negative relationship patterns and works to replace them with healthier behaviors. They help people set realistic goals for their relationship and develop a plan to achieve them.

6\. Providing Support: Therapists offer a supportive environment where both partners feel heard and understood.

7\. Offering Tools and Techniques: A couples therapist provides practical tools and techniques that can improve relationships outside of therapy sessions.

8\. Facilitating Difficult Conversations: A couples therapist creates a safe space for couples to discuss sensitive topics that they may find challenging to address.

### Couples Therapist Approaches

A couples therapist uses various therapeutic approaches, such as [Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) (CBT), [Emotionally Focused Therapy](https://dralanjacobson.com/eft-therapy-for-couples/) (EFT), [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/), and others. In an integrative practice like mine, I can tailor the [relationship therapy](https://dralanjacobson.com/relationship-therapy/) interventions to the specific needs of each client.

## Couples Therapy FAQ

#### What individual couples techniques will you use?

My psychology practice is integrative and thus I can draw from a variety of techniques and approaches. When we meet and I learn more about what the two of you are looking for, I will go over the possible approaches and combinations of methods we can choose from. One possibility is [interpersonal therapy](https://dralanjacobson.com/interpersonal-therapy/) while another is [narrative couples therapy](https://dralanjacobson.com/narrative-family-therapy/).

#### How long will couples therapy take?

After you make your goals, we’ll discuss your treatment plan, which will describe how long it may take to see meaningful and important improvements in your relationship. The depth of your challenges and how long they have affected your relationship will play a part.

#### How often will we meet?

I like to start with weekly sessions for at least 3-4 weeks so I can fully understand the history of your relationship and the challenges you are facing. After that, we can discuss the frequency of sessions, and we can always change it as you reach goals or set new ones.

#### Will we meet virtually or in-person?

I meet with many clients virtually, and I’ve found no difference in the effectiveness of meeting online. For many, it’s easier to meet virtually because they will not be in the same place simultaneously. When we are scheduled. I provide more information about online treatment in my blog post: [Virtual Therapy Effectiveness](https://dralanjacobson.com/virtual-therapy-guide/).

#### How will we know that couples therapy is working?

It should not be a mystery whether therapy is working. We will set measurable, important, and clear goals, and as we progress, we will ensure that relationship therapy is working to help the two of you reach them.

 ![Couples Therapy](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "couple")

 ### From the Desk of Dr. Jacobson

Over years of sitting with couples, I’ve noticed that the pairs who do best aren’t the ones who agree the most, they’re the ones who manage to stay curious about each other even in the middle of an argument. My job isn’t to decide who’s right about the dishes or the budget; it’s to help both of you hear what’s actually being said underneath the disagreement you’re having on the surface, which is very often not really about the dishes or the budget at all.

Couples work asks something specific of me as a therapist: to hold two people’s histories, needs, and blind spots at the same time, evenhandedly, without either partner quietly feeling like I’ve picked a side. I take that balance personally, not just professionally, and I say so directly in session when I notice myself leaning one way, because that transparency tends to build more trust than pretending perfect neutrality ever could.

If you’re coming in after a specific rupture, or simply because it’s been a while since the two of you felt curious about each other, both are good reasons to reach out.

— Alan

 ## Other Questions? Contact Me

I am a couples therapist, and this form of treatment is a large part of [my practice](https://dralanjacobson.com/types-of-therapy/), but it is vitally important that both members are motivated and engaged and can agree on the goals and, to some degree, the problems. I do not specifically list couples therapy under [My clinical specialties](https://dralanjacobson.com/intensive-therapy-and-specialty-services/), but it can be delivered similarly as an intensive service. If you have any questions about couples therapy and how it might help you, please[ contact me](https://dralanjacobson.com/contact/) any time.

### Call

(617)-680-5488

### Email

hello@dralanjacobson.com

### Address

In person: Westwood, MA & Lee, NH

Virtual: Serving 40 states

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](https://www.facebook.com/appliedpsychologicalscience) [ ![social network 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](https://www.instagram.com/appliedpsychological) [ ![social network 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---

### [Finding Therapy in Massachusetts](https://dralanjacobson.com/therapy-in-massachusetts/)

**Published:** January 16, 2026
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: September 4, 2026

 # Therapy in Massachusetts

 Searching for therapy in Massachusetts often means navigating a dense and highly specialized mental-health landscape. From world-class medical systems and universities to distinct licensure standards and insurance structures, Massachusetts therapy operates within a framework that is very different from most other states. Whether you’re trying to find a therapist in Massachusetts for anxiety, depression, trauma, ADHD, family stress, or life transitions, working with a Massachusetts therapist who understands the local clinical culture can make a meaningful difference in outcomes.
  Get In TouchAbout Divi

### **Why It’s Vital to Use a Therapist in Massachusetts: Connections**

Massachusetts has one of the most sophisticated—and regulated—mental health environments in the country.

- The state is home to major hospitals, teaching institutions, and specialty clinics that influence standards of care.
- Insurance requirements, referral pathways, and documentation expectations are often more complex than in other states.
- Schools, universities, and medical providers expect clinicians to understand Massachusetts-specific processes and terminology.

A therapist in Massachusetts who is locally grounded knows how to collaborate with physicians, school systems, universities, and employers across the state. They understand the expectations of Massachusetts families, the academic pressures common in the region, and the cultural norms that shape how people approach therapy.

 distinctive cultural diversity—from Silicon Valley tech stress to Central Valley agricultural communities to the entertainment industry in Los Angeles.

### **Why State-Specific Guidelines and Ethics Matter**

Massachusetts has its own ethical, legal, and professional expectations that directly affect therapy:

- Licensure and scope of practice: Massachusetts has clearly defined training and supervision requirements that shape how therapists practice.
- Privacy and records access: State laws govern who can access therapy records, how long records are kept, and how information is shared.
- Care involving minors and families: Consent, confidentiality, and parental involvement follow Massachusetts-specific rules.
- Telehealth standards: Virtual therapy must comply with Massachusetts licensure laws based on the client’s physical location.

A Massachusetts therapist who understands these details helps ensure your care is ethical, legally sound, and uninterrupted.

01

## Q: The **Process to Find the Best Therapist in Massachusetts for You**

The Best Process for Finding the Right Therapist in Massachusetts

To find therapy in Massachusetts that truly fits, consider this approach:

1. Use location-specific searches. Phrases like *therapist in Massachusetts* or *Massachusetts therapy* help filter providers appropriately.
2. Verify licensure. Confirm your therapist is licensed to practice in Massachusetts.
3. Ask about experience with local systems. Schools, healthcare providers, and workplaces all matter.
4. Evaluate the relationship. A strong therapeutic connection is as important as credentials.
5. Think long-term. The best Massachusetts therapy supports not just symptom reduction, but personal growth and resilience.

01

## Q: **Are all types of therapists in Massachusett the same?**

No. Massachusetts licenses several mental health professions, each with different educational paths and clinical strengths:

- Psychologists (PhD or PsyD): Doctoral-level clinicians with advanced training in assessment, diagnosis, evidence-based treatment, and complex clinical presentations. Psychologists often provide psychological testing, ADHD and learning evaluations, and high-level clinical consultation.
- Licensed Independent Clinical Social Workers (LICSWs): Master’s-level clinicians with extensive training in mental health treatment and systems-based care. LICSWs often integrate therapy with medical, educational, and community resources.
- Licensed Mental Health Counselors (LMHCs): Master’s-level clinicians trained in psychotherapy, counseling theory, and practical interventions. They frequently focus on individual therapy, stress management, trauma recovery, and life transitions.

Each type of Massachusetts therapist brings valuable expertise. The best choice depends on whether your needs are diagnostic, therapeutic, systems-focused, or skills-based.

01

## Q: Can I Work with my Massachsetts Therapt Virtually?

Research shows that online therapy is highly effective for most mental health concerns, including anxiety, depression, trauma, ADHD, and family stress. In Massachusetts, teletherapy is especially helpful for clients balancing demanding academic, professional, or family schedules. When provided by a Massachusetts therapist who understands state regulations, online therapy can be both clinically powerful and logistically practical.

02

## Q: How to Find Therapy That is Specialized?

In a state with advanced healthcare such as Massachusetts, you can find just about every major therapy modality. I and many other therapists employ an integrative model so we can tailor treatment to your needs.

Here are the more common approaches to therapy in Massachusetts:

- [Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT): Focuses on helping you discover and challenge irrational and exaggerated thoughts that are automatic and hard to control. CBT Is often the first choice for depression, anxiety, OCD, and panic disorder.
- [Dialectical Behavior Therapy](https://dralanjacobson.com/dbt-for-teens/) (DBT): This form of therapy combines CBT with mindfulness and behavioral strategies. DBT is excellent for hard-to-treat depression, social anxiety, and emotional dysregulation.
- [Psychodynamic Therapy](https://dralanjacobson.com/psychodynamic-therapy/): This form of therapy often takes longer than the others because it digs deeper, exploring unconscious patterns of thinking that may have roots in your childhood. It helps with longstanding mild depression, a general sense of meaninglessness, and a desire for personal improvement when symptoms are mild.
- [Internal Family Systems](https://dralanjacobson.com/internal-family-systems-therapy-ifs/) (IFS): A relatively new type of psychotherapy which helps identify, organize, and integrate different aspects of your self.
- [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/), [Creative Therapy](https://dralanjacobson.com/creative-counseling/): These powerful and creative therapies, also including logotherapy and existential therapy, can deepen your experience whether used on their own or combined with other techniques.

In my integrative practice I combine these and other methods based on your unique symptoms, needs, and hopes. I cover family therapy in Massachusetts below. You don’t have to know exactly what [form of therapy](https://dralanjacobson.com/does-therapy-help-what-form-of-therapy-works-best/) you’re looking for ahead of time because most therapists like me will cover all of the possibilities and empower you to make decisions at the start and along the way.

03

## Q: How do I Find the Right Therapist in Massachsetts for Me?

Finding a therapist in Massachusetts involves looking beyond fancy websites and the letters after their name and finding a professional that you feel understands you and can help you improve and grow.

Here’s a brief guide to finding the [best psychotherapist](https://dralanjacobson.com/choosing-the-best-therapist-for-you/) in Massachusetts for you or your family:

- Specialties: Look for a professional with training and experience with people with similar symptoms, concerns, strengths, and hopes as you.
- Therapeutic approach: Some therapists in Massachusetts focus on warmth and empathy, others on education and structure, and still others on presenting challenges and exposure.
- Identity and culture: You may find it important to work with a clinician who shares an important aspect of your identity, such as your race, gender, age, background, or experience.
- Licensing: Ensure they’re independently licensed in Massachusetts, even if they’re providing telehealth from another state.

*Tip: Most therapists in Massachusetts offer a [free 10–15 minute consultation](https://www.picktime.com/scheduleaconsult).* You may want to ask:

- Using \_\_\_\_\_\_\_\_\_\_ approach, what will a typical session entail?
- How much experience and training do you have in \_\_\_\_\_\_\_\_\_\_?
- Do you take my insurance plan, or help me find out if I can get reimbursed?

05

## Q: How Do I Find Family Therapy in Massachusetts?

Family therapy in Massachusetts can be essential to address problems, barriers, and conflict in family systems. There may be something as specific as divorce or separation, or something more general such as communication issues and a relational drift. There are many experienced family therapists in Massachusetts, so you may want to start your search for family therapy in California by:

- Using a referral site such as Psychology Today or Zencare
- Looking for providers with certain credentials (see above)
- Using word-of-mouth or asking other healthcare providers
- Looking through websites like this one

06

## **Can minors consent to therapy in California?**

Often, yes. Many Massachusetts therapists regularly collaborate with public schools, private schools, and colleges. This may include consultation, documentation, or coordination of supports, all within ethical boundaries.

07

## Q: Can I see a California Therapist while Traveling

Only if you are physically located in California at the time of your session. Teletherapy is governed by where the client is sitting, not where the therapist lives. Thus an important decision point when looking for a therapy in California is whether they are also licensed in other states. This is an important distinction, for example, with college students who live or go to school outside of CA.

## Case Example: Adult Therapy in Massachusetts

Daniel, a 41-year-old professional living outside Boston, began searching for therapy after experiencing burnout, sleep disruption, and persistent self-criticism. He initially tried a national teletherapy service but found the sessions felt generic and disconnected from his reality. His therapist had little familiarity with the academic and professional pressures common in Massachusetts.

When Daniel decided to find a therapist in Massachusetts, he looked for someone who understood the region’s work culture and high performance expectations. His new Massachusetts therapist quickly recognized how Daniel’s perfectionism was reinforced by his environment. Therapy focused not only on symptom relief, but on reshaping internal standards, managing cognitive overload, and building sustainable success. The local understanding made therapy feel relevant and grounded rather than abstract.

## Case Example: Family Therapy in Massachusetts

**Background:**

The Chen family in suburban Massachusetts sought therapy for their teenage daughter, who was struggling with anxiety and academic pressure. Previous therapy had focused narrowly on coping skills, without addressing the broader school context.

Their Massachusetts therapist understood the structure of local school systems, the intensity of academic expectations, and how anxiety often manifests in high-achieving students. Therapy included family sessions, coordination with school supports, and guidance around realistic expectations. Over time, the family developed healthier communication patterns and their daughter regained confidence and balance.

## Case Example: Young Adult Therapy in Massachusetts

Sophia, a 20-year-old sophomore at a competitive Massachusetts university, began looking for therapy after her anxiety escalated during her second semester. Although she had always been a strong student, she found herself freezing during exams, avoiding office hours, and spiraling into self-doubt when comparing herself to peers. Late nights, dense reading loads, and constant performance pressure left her exhausted and emotionally stuck.

Sophia initially tried her university’s counseling center. While helpful in the short term, the limited number of sessions and rotating clinicians made it difficult to build continuity. She then searched online to *find a therapist in Massachusetts* who could provide ongoing support and understood the realities of college life in the state.

Her Massachusetts therapist immediately recognized familiar patterns: high achievement masking anxiety, fear of disappointing others, and difficulty tolerating imperfection—issues commonly intensified in academically rigorous Massachusetts colleges. The therapist also understood how campus systems worked, including disability services, academic advising, and the process for requesting accommodations.

Therapy focused on both emotional regulation and practical navigation of college demands. Sophia learned strategies to manage test anxiety, restructure perfectionistic thinking, and build sustainable study routines. With her consent, her therapist helped her understand how to approach the university’s accessibility office and what documentation would—and would not—be appropriate under Massachusetts norms.

Over time, Sophia became more confident advocating for herself, participating in class, and setting realistic expectations. Therapy didn’t lower her standards—it helped her redefine success in a way that was healthier and more sustainable within the Massachusetts academic environment.

This experience highlighted how working with a Massachusetts therapist who understands local universities, academic culture, and student support systems can make therapy feel relevant, effective, and empowering rather than generic.

 The Bottom Line:Choosing the right therapist in Massachusetts is an investment in clarity, stability, and forward momentum. With a Massachusetts therapist who understands both the clinical science and the local context, therapy becomes a practical, empowering tool for meaningful change.

 [ ![social network icon](data:image/svg+xml;base64,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) ](https://www.facebook.com/appliedpsychologicalscience) [ ![social network 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](https://www.instagram.com/appliedpsychological) [ ![social network icon](data:image/svg+xml;base64,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)](https://www.linkedin.com/company/psychologicalscience/)

---

### [College Student Therapy](https://dralanjacobson.com/therapy-for-college-students/)

**Published:** May 6, 2024
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: September 4, 2026

# In Person and Online Therapy for College Students

Specially designed therapy for young adults to help you reach your potential, enjoy your choices, and discover more about yourself. Young adult counseling can be powerful, effective, and timely. Online therapy for college students, in particular, works well because it allows for a very flexible approach when you’re at school and home.

 [Schedule a Free Consultation](https://www.picktime.com/scheduleaconsult)

## Beyond Therapy: Complete Support for College Students

Therapy is often the right place to start, but it isn't the only support students need. Depending on what's going on — executive functioning struggles, academic difficulty, or a need for formal accommodations — these related services are frequently used alongside therapy, not instead of it.

 Skills & Coaching### ADHD Coaching for College Students

A practical, skills-based complement to therapy for procrastination, time management, and task follow-through — while therapy handles the emotional and clinical side.

 [Explore ADHD Coaching →](https://dralanjacobson.com/adhd-coaching-for-college-students-effective-enduring/)

 Academic Support### Therapeutic Tutoring for College Students

When academic struggles are tangled up with ADHD, a learning difference, or anxiety, therapeutic tutoring pairs subject instruction with clinical insight into how a student actually learns.

 [See Therapeutic Tutoring →](https://therapeutictutoring.com/therapeutic-tutoring-for-college-students/)

 Testing & Documentation### College Accommodations Testing

If ADHD, a learning disability, autism, or anxiety is affecting coursework or exams, most colleges require a formal evaluation before approving accommodations.

 [Learn About Accommodations Testing →](https://psychologicalassessments.com/college-accommodations/)

**Online therapy for college students** can be incredibly beneficial, as it provides support during significant transition and growth. I have enjoyed providing therapy for young adults, including those in college and beyond, for over 20 years. I use an [integrated approach](https://dralanjacobson.com/examples-of-integrative-therapy/), combining different methods to meet each client’s unique needs. Due to recent demand, I have expanded my practice by becoming licensed in more states. I can now provide online therapy for college students in many states. This expansion also can usually allow me to see my clients whether they are home or at school if that involves more than one state.

Whether you are a college student or a college looking to know more about practices that can serve your students, please feel free to [contact me](https://dralanjacobson.com/contact/) anytime or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

In addition to general therapy, some specific services I offer college students include [Fear of Public Speaking](https://dralanjacobson.com/cbt-for-fear-of-public-speaking/) and [Test-Taking Anxiety](https://dralanjacobson.com/test-taking-anxiety/).

 ![Therapy for College Students](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "cropped-Students-outside-building.jpg | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## Learn More About Therapy for College Students

Contact me with questions.

[Contact Me](https://dralanjacobson.com/contact/)

## More about Therapy for Young Adults

College students need to know that seeking therapy is a sign of strength and self-care, and it’s okay to ask for help when needed. Young adult counseling can provide valuable support and resources to help students thrive academically, emotionally, and socially during college. I follow the following basic tenets in in person and online therapy for college students:

1\. Being flexible in my approach and willing to adjust based on their evolving needs and progress.

2\. Empower clients to take an active role in their healing journey.

3\. Continuously monitoring their progress and soliciting feedback about their experience in treatment.

4\. Adjusting my approach accordingly to ensure it remains effective and meaningful for them.

##### How is Therapy for College Students Designed

The college years are unique and important in young adults’ social and emotional development. During this time, they face new opportunities, barriers, and challenges. Due to academic pressures, social dynamics, and personal challenges, college can be stressful for many students. Therapy can be a valuable resource for managing these stressors. I specifically design therapy for this stage of life while borrowing from tried-and-true methods such as [cognitive-behavioral therapy](https://dralanjacobson.com/cbt-for-depression/) (CBT), [Acceptance and Commitment therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) (ACT), [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/), and [existential approaches](https://dralanjacobson.com/existential-therapy/).

##### How can I make the most out of treatment

There are several ways to ensure that you get the most out of in person or online young adult counseling:

- **Be Open and Honest**: Transparency with your therapist helps address issues effectively. Remember, therapy for college students is fully confidential. Nothing you say will be shared with anyone else.
- **Set Goals**: Define what you want to achieve through therapy. We will work together to design a treatment plan that will bring you powerful, measurable, and meaningful results.
- **Regular Attendance**: Consistency is key to making progress, as busy as your college life is.
- **Utilize Campus Resources**: As an adjunct to therapy, campus wellness activities, extracurricular involvement, and support groups may help.

##### What kind of therapy for young adults is available

I offer the following types of young adult counseling services, including college students:

- [**Individual Therapy**](https://dralanjacobson.com/individual-therapy/): One-on-one sessions are the most common form of treatment I provide
- [**Group Therapy**](https://dralanjacobson.com/group-therapy-for-young-adults/): Sessions with peers facing similar issues where you can get support, empathy, and understanding are sometimes available
- **Workshops and Seminars**: I offer these meetings that focus on stress management, mindfulness, time management, and other relevant topics.

 ![Online therapy for college students](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "Hands of Woman Using Laptop Computer")

## Therapy for College Students Overview

Before considering outside therapy for college students such as I provide, here are some key aspects to consider:

### The Role of Counseling Services on Campus

Most colleges and universities offer counseling services for their students. These services are provided by talented clinicians with particular training and expertise in young adult counseling. These services are often free or available at a low cost and are very helpful in helping students navigate academic, personal, and emotional challenges. I have many close colleagues who do this work, and I am continually impressed by their compassion, talent, and insightfulness.

Some college counseling centers refer to outside providers like me because of their mission and approach. When a student has a concern that is best addressed throughout the year, not just while the student is on campus, I often get a referral. When a student’s concerns go beyond affecting their educational pursuits, some college counselors refer to me. Finally, I may have a clinical specialty, such as [sports psychology](https://dralanjacobson.com/sports-psychology/), [fear of public speaking](https://dralanjacobson.com/public-speaking-anxiety/), or a clinical approach unavailable at the college counseling center.

### Types of Therapy for College Students

I offer the following young adult counseling approaches:

#### Individual Therapy for College Students

The most common type of therapy for young adults I provide is [one-on-one therapy sessions](https://dralanjacobson.com/individual-therapy/). Individual online therapy for college students provides a safe and confidential space for students to explore their thoughts, feelings, and concerns. I use a variety of techniques, which I go over later in this post, to offer support, guidance, and coping strategies for managing stress, anxiety, depression, relationship issues, and more.

#### Group Therapy for Young Adults

[Group therapy for young adults](https://dralanjacobson.com/group-therapy-for-young-adults/) allows students to connect with peers experiencing similar challenges. It can provide a sense of community, validation, and support as students share their experiences and learn from one another. I can open the group to students from colleges nationwide, giving them feelings of community and privacy.

#### Workshops and Support Groups

Often at the request of college counseling centers, I offer workshops and support groups on stress management, [mindfulness techniques](https://dralanjacobson.com/mindfulness-therapy/), self-esteem, and interpersonal skills. These can be valuable opportunities for students to learn new skills and connect with others in a supportive environment.

I also provide related services such as [college ADHD coaching](https://dralanjacobson.com/adhd-coaching-for-college-students-effective-enduring/).

## My Approach to Therapy for Young Adults

My approach to therapy for young adults is multifaceted, considering the uniqueness of each student’s background, challenges, and strengths. Here’s a general framework:

### Comprehensive Assessment

I start by thoroughly assessing the student’s mental, emotional, social, and physical well-being. This may include exploring family dynamics, cultural background, academic or vocational goals, and past traumas or challenges. This occurs in a safe and non-judgmental space where the student feels comfortable. I work hard to acknowledge the student’s need for autonomy, exploration, and independence while providing support and guidance.

### Strengths-Based Approach

We will [focus on identifying and leveraging their strengths](https://dralanjacobson.com/positive-psychology-powerful-benefits/) and resilience. I help clients recognize their abilities and resources to overcome obstacles and achieve their goals. Together, we will set meaningful and achievable goals for treatment. I want to ensure I fully understand what they hope to gain from the process and how they envision improving their lives.

### Evidence-Based Therapy for Young Adults

As with all approaches, therapy for young adults should lead to powerful, obvious, and, if possible, measurable results. I utilize various therapeutic techniques and modalities tailored to my client’s needs and preferences. I can combine aspects of [cognitive-behavioral therapy](https://dralanjacobson.com/cbt-for-social-anxiety/) (CBT), [mindfulness-based approaches](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/), narrative therapy, [Adlerian](https://dralanjacobson.com/adlerian-therapy/), and solution-focused therapy. I often work to facilitate the exploration of identity, values, beliefs, and life purpose. This helps clarify their priorities and make decisions aligned with their authentic selves.

I try to equip young adults with a “toolkit” of practical coping skills and strategies for managing stress, regulating emotions, improving communication, and navigating relationships effectively. I greatly respect young adults’ intelligence and wisdom, so I work to allow for greater autonomy and self-reliance while providing guidance and support as needed. The goal is not to rely on a therapist but to navigate life’s challenges independently.

### Cultural Sensitivity in Therapy for College Students

I respect and integrate their cultural background and identity in young adult counseling. I’m mindful of [cultural factors](https://psycnet.apa.org/fulltext/2018-11631-001.html) influencing their experiences, beliefs, and help-seeking behaviors.

By integrating these principles into my approach, I hope to effectively support young adults in navigating the complexities of this transitional phase and facilitate their growth, resilience, and well-being.

## Frequently Asked Questions: Therapy for College Students

Answers to the most common questions about in-person and online therapy for college students.

### What issues can therapy for college students help with?

College students face a distinct mix of stressors — academic pressure, identity exploration, relationship challenges, and major life transitions all at once. Therapy can help with anxiety, depression, test-taking anxiety, fear of public speaking, social difficulties, perfectionism, and adjustment issues. Many students also benefit from support around executive functioning and ADHD coaching. Treatment is tailored to what each individual student brings to therapy.

### Can I see you for online therapy if I'm away at school in a different state?

Yes — this is one of the most practical advantages of working with a PSYPACT-participating psychologist. Dr. Jacobson is licensed in 44 states, which means he can typically continue seeing students whether they're at their home address or at a college in another state. You don't need to find a new therapist every September and May. PSYPACT exists specifically to address this problem for students and traveling clients.

### How is working with an outside therapist different from using my college's counseling center?

College counseling centers are staffed by skilled clinicians and are often the right first step. However, they typically operate only during the academic year, carry high caseloads, and may have session limits. An outside therapist like Dr. Jacobson provides year-round continuity, no session caps, and specialty expertise — such as sports psychology, fear of flying, or deeper evidence-based work — that may not be available on campus. Many students use both resources simultaneously.

### What therapy approaches do you use with college students?

Dr. Jacobson uses an integrative approach, drawing from whichever methods best fit each student's needs and goals. Common approaches include Cognitive-Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Narrative Therapy, Mindfulness-Based approaches, and Existential Therapy. The approach evolves as the student's needs change throughout the semester and across the year.

### Is online therapy as effective as in-person therapy for college students?

Research consistently supports the effectiveness of online therapy for a wide range of mental health concerns. A large body of evidence — including studies published by the American Psychological Association — indicates that telepsychology produces outcomes comparable to in-person treatment. For college students specifically, online therapy offers the added benefits of scheduling flexibility, privacy, and the ability to meet from a dorm room, apartment, or home between semesters.

### Is everything I say in therapy confidential?

Yes. Everything you share in therapy is legally and ethically protected by confidentiality. Dr. Jacobson will not share information with your parents, your college, or anyone else without your written consent. The only exceptions are narrow legal requirements related to imminent safety — the same standards that apply to all licensed psychologists. Many students feel significantly more comfortable once they understand that college, family, and health records are completely separate.

### What does therapy for college students cost, and do you take insurance?

Online therapy sessions for college students are offered at a lower rate than in-office sessions. Dr. Jacobson is an out-of-network provider, meaning he does not bill insurance directly, but many clients are reimbursed by their insurance plans for a portion of fees. It is worth calling the member services number on your insurance card to ask about your out-of-network mental health benefits. A detailed breakdown of fees and insurance information is available on the Therapy FAQs page.

### How do I get started with therapy?

The first step is a free 20-minute consultation. This is a no-pressure conversation where you can share what you're looking for, ask questions, and get a sense of whether working together feels right. There's no commitment required. Most students find it much easier than they expected. You can contact Dr. Jacobson directly or schedule below at a time that works for your schedule.

### Do you offer anything beyond therapy, such as ADHD coaching, for college students?

Yes. Therapy addresses the emotional and clinical side of college life, but many students also want hands-on, practical support for procrastination, time management, and task follow-through. ADHD coaching is a skills-based complement to therapy — the two are often used together, with coaching handling day-to-day executive functioning and therapy handling anxiety, mood, and adjustment. Learn more on the ADHD Coaching for College Students page.

### What if academics are the main struggle — not something therapy typically addresses?

When academic difficulty is tangled up with ADHD, a learning difference, or anxiety, subject tutoring alone often isn't enough. Therapeutic Tutoring for College Students, offered through Dr. Jacobson's sister practice, pairs academic instruction with clinical insight into how a student actually learns, so support addresses both the material and the underlying obstacle. It's frequently used alongside therapy rather than instead of it.

### Can you help me get accommodations for exams or coursework?

If ADHD, a learning disability, autism, or anxiety is affecting a student's coursework or testing, most colleges require a formal psychological evaluation before approving accommodations like extended time or a distraction-reduced setting. This evaluation is different from therapy and is provided through Dr. Jacobson's testing practice. Visit the College Accommodations Testing page for details on what documentation colleges typically require.

 ![Young adult counseling](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "P-02 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

### Benefits and advantages

## Online Therapy for College Students

Online therapy for college students has become increasingly popular due to its accessibility, convenience, and often lower cost than traditional in-person therapy. Many platforms offer specialized services tailored to students’ needs, including flexible scheduling and various communication methods (e.g., text, video, phone).

### Benefits of Young Adult Counseling Online:

1. **Accessibility**: Students can access therapy from anywhere, eliminating the need to travel to my office.
2. **Flexibility**: Online therapy for college students offers more flexible scheduling options, which can accommodate the unpredictable schedules of college students.
3. **Affordability**: My fees for young adult counseling are lower than my in-office fees.
4. **Anonymity and Comfort**: Students may feel more comfortable opening up about personal issues from the privacy of their own space.
5. **Variety of Communication Methods**: Options like texting or [asynchronous messaging](https://slack.com/blog/collaboration/asynchronous-communication-best-practices) can be less intimidating for some students than face-to-face conversations.

### Am I the Right Match?

You should do your homework after deciding to look into young adult counseling online. For example:

- **Services Offered and Schedule**: I offer video and phone options and can accommodate most schedules. That said, some therapists may also offer chat options, weekend appointments, and a combination of in-person and virtual sessions, which I do not.
- **Cost**: Consider your budget and whether my fees are reasonable and will not cause nardship
- **Specialization**: Please review my specialties on other parts of this website and on this page to ensure that my approach resonates with you.
- **Privacy and Security**: The platform I use has strong privacy and security measures to protect your information.

Please feel free to contact me below for more information about any of the above or about online therapy for college students in general. An initial consultation is always free.

 [ ![social network 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---

### [Executive Coaching](https://dralanjacobson.com/executive-coaching/)

**Published:** June 22, 2026
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: September 4, 2026

 # Executive Coaching (or CEO Coaching)

Executive coaching services, also known as CEO coaching, is available for all C-level leaders. An executive coach can provide services to bring out the best in high-level leaders, reducing blind spots and helping them develop their natural strengths.

 [Schedule a Free Consultation](https://www.picktime.com/scheduleaconsult)

## How Executive Coaching Services Help: 

1. Communicate Your Vision: Executive coaching can ensure your leadership vision is communicated in the most compelling and hopeful way to each group of stakeholders.
2. Delegate Effectively: Learn to motivate your team so they take on additional responsibilities and tasks, all in service of being part of the larger business goals.
3. Overcome weaknesses: Learn what your strengths and weaknesses are, and how you can overcome your challenges and enhance your abilities.
4. Build your presence: Understand how to build and grow [your leadership presence](https://performancepsychologygroup.com/executive-leadership-coaching/) through direct communication, social media, and communication platforms.

 ![Executive Coach](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "Confident young businesswoman in futuristic interior | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## What an Executive Coach Can Provide

We offer several types of executive coaching services, including:

### Leadership Development

This type of service[ focuses on helping leaders](https://performancepsychologygroup.com/executive-coaching/) enhance their skills, including communication, decision-making, emotional intelligence, and strategic thinking. It also helps them improve their job performance, set and achieve goals, and overcome challenges hindering their success. This type of service often helps leaders enhance their [public speaking,](https://www.dralanjacobson.com/public-speaking-anxiety/) storytelling, and compelling messaging to various stakeholders. It also assists them in developing a strong and influential presence, which can enhance their impact and influence in the workplace.

### Career Transition Executive Coaching Services

Those transitioning to a new role or career can benefit from expert guidance that assists in setting goals, developing a career strategy, and making a successful transition. Those looking to advance their careers, secure promotions, or make strategic career moves can benefit from services that help them achieve their goals.

### Onboarding

New leaders in an organization may receive guidance to help them adapt to their new roles and integrate into the [company culture](https://www.forbes.com/advisor/business/company-culture/) more effectively. Similarly, succession planning and talent development [coaching helps people prepare for higher leadership](https://www.dralanjacobson.com/leadership-coaching-process/) roles.

### Specific Goal Executive Coaching

This type of [coaching is designed to help executives](https://performancepsychologygroup.com/executive-coaching/) with particular goals identified as challenges for them or the company. This may include helping them navigate and resolve conflicts in the workplace, whether they involve colleagues, teams, or even external stakeholders. Another example is when leaders face organizational changes or transformations, they may receive coaching to help them lead and manage these transitions effectively. Other specific goals may include negotiation, conflict resolution, or project management.

### Stress and Well-being CEO Coaching

In today’s high-pressure business world, [executives may require coaching](https://performancepsychologygroup.com/executive-leadership-coaching/) to manage stress, improve work-life balance, and promote overall well-being. Services in this area often helps them manage their time more efficiently, set priorities, and increase productivity.

### Diversity and Inclusion CEO Coaching Services

CEOs may seek guidance to promote diversity and inclusion in their organizations, addressing biases and fostering a more inclusive work environment.

These are just a few examples of the various CEO coaching services we offer. The specific focus of the plan we develop together will depend on the needs and objectives of the executive and the organization. These [management consulting](https://performancepsychologygroup.com/management-coaching/) services can be delivered to individuals and leadership teams to improve their collaboration, communication, and overall effectiveness.

### Our Unique CEO Coaching Services

We offer [performance psychology](https://mantracare.org/therapy/therapy-types/performance-psychology/)-based CEO **coaching services** based on psychological training and our [experience as a C-level executives](https://www.dralanjacobson.com/my-bio/) for over ten years. CEO Coaching services provide numerous benefits to individual executives and their organizations. Despite the name, these services are often used in succession planning for those in line for higher leadership position. We also have a specialty in executive coaching for startups.

Our sister agency provides [leadership testing](https://psychologicalassessments.com/leadership-testing/) services to help deeply assess your strengths and challenges before you start these services.

 ![CEO Coaching](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "venture_05 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## Executive Coaching Service FAQ

##### What is Executive Coaching?

Executive coaching, also known as CEO coaching, is a specialized service for current and emerging leaders.We offer performance psychology-based executive coaching services based on psychological training and each executive coach having [experience as a C-level executive](https://www.dralanjacobson.com/my-bio/) for at least ten years. These services provide numerous benefits to individualsand their organizations.

##### What are the potential benefits to organizations?

Of course, in most cases, it’s hard to break out which benefits affect the organization and which affect the individual, so most of the benefits of having an executive coach listed here, even though it is quite favorable for the individual to develop their leadership skills. There are six main benefits of executive coaching services for organizations:

– Enhanced Leadership Skills: An executive coach can help leaders identify and develop their strengths while addressing areas that need improvement. It enables [our clients to strengthen their leadership](https://performancepsychologygroup.com/executive-leadership-coaching/) skills, such as decision-making, communication, conflict resolution, and strategic thinking. This, of course, provides significant benefits to the organization, and often, the leader can pass along her or his new skills to the next level of leaders in the organization who may be on a C-level track.

– Better Goal Setting and Time Management: An executive coach can assist leaders in setting clear and achievable goals for themselves and their teams. They also help leaders prioritize tasks and manage their time effectively to maximize productivity.

– Talent Development and Team Building: Clients learn strategies to identify and nurture organizational talent. They also acquire techniques for building strong, cohesive teams that work well together.

– Succession Planning and Career Development: CEO coaching can assist leaders in planning their career trajectories and preparing for future roles. This ensures a smooth leadership transition and helps in succession planning within the organization.

– Enhanced Decision-Making: Through our services, executives can refine their decision-making processes, weighing the pros and cons, considering alternatives, and making more effective choices. This leads to better outcomes for the organization.

##### What are the benefits to the individuals?

Again, all of the above benefits the individual in addition to the organization, but these benefits are more specific to helping the executive refine her or his skills. Of course, the same goes here – while I list these as benefits to individuals, they certainly positively affect organizations.

– Increased Self-Awareness: CEO coaching works closely with leaders to foster self-awareness, helping them understand their behaviors, motivations, and impact on others. With increased self-awareness, leaders can make better-informed choices and lead with authenticity.

– Improved Emotional Intelligence: Executive coaching services often focus on developing emotional intelligence, which includes empathy, self-regulation, and social skills. Leaders with high emotional intelligence can build stronger relationships, manage stress, and foster a positive work environment.

– Improved Communication and Interpersonal Skills: CEO coaching services focus on improving communication skills, including active listening, assertiveness, and constructive feedback. Executives who can communicate effectively can inspire and motivate their teams more successfully.

– Stress Management and Work-Life Balance: High-level positions often come with significant stress. We support executives in managing stress and achieving a healthier work-life balance, contributing to overall well-being and sustained performance.

– Confidential and Unbiased Support: Executive coaches provide a safe and confidential space for leaders to discuss challenges and work through sensitive issues without fear of judgment. This allows for open and honest conversations that can lead to meaningful growth.

Forbes recently described some [unexpected benefits](https://www.forbes.com/sites/forbescoachescouncil/2023/03/24/five-benefits-of-executive-coaching-that-might-surprise-you/) of executive coaching services.

##### What is the goal?

Overall, executive coaching services are a valuable investment that supports the growth and development of leaders, leading to a more successful and sustainable organization. When [executives improve their leadership](https://performancepsychologygroup.com/executive-leadership-coaching/) skills and overall effectiveness, it positively impacts the organization’s performance. More decisive leadership fosters a more productive and engaged workforce, leading to improved outcomes and success for the company.

##### How do I find out more?

Please get in touch with us if you want to hear more about executive coaching services. We can serve individuals or groups and can work with current C-suite members and rising leaders in an organization. We are happy to go over your specific needs and goals so we can describe exactly what we will provide and help you accomplish.

## Executive Coaching Self Help

**Executive coaching self-help** is designed to provide some advice and guidance to leaders who want to try to handle things independently or try techniques before deciding whether to use our services.

Whether these techniques are enough or you want more formal assistance, you should be commended for seeking a path toward improving your performance, skills, and overall effectiveness. One way or another, you should see positive changes in your leadership abilities, communication skills, decision-making, and other essential qualities required in your position.

R

### Executive Coaching Self-Help: Time Management

Almost any executive benefits from prioritizing tasks effectively and managing time efficiently. Executive roles often come with demanding schedules, so mastering time management skills is essential for maintaining productivity and reducing stress. Also, focus on improving your communication skills, including active listening, assertiveness, and the ability to convey complex ideas clearly and concisely. These areas may or may not be on your specific list for improvement, but they are still worth working on

R

##### Executive Coaching Self-Help: Get Feedback

It’s best if you began any journey to improve as an executive with an assessment to understand your strengths and areas for improvement. This can involve 360-degree feedback, personality assessments, and self-assessments. Listen attentively to people’s concerns and challenges related to your leadership, and provide a safe and non-judgmental space for them to express themselves. Use open-ended questions to get feedback and encourage deeper thinking.

This process will be helpful for you and also shows how much you respect your colleagues and want to grow.

R

##### Executive Coaching Self-Help: Set Goals

You need to set clear and measurable goals. These goals should be specific, achievable, relevant, and time-bound ([SMART objectives](https://www.forbes.com/advisor/business/smart-goals/)). Focus on your strengths and also seek to leverage those strengths to overcome challenges and achieve your goals. Identify specific behaviors that need improvement and develop strategies for changing those behaviors. Developing [emotional intelligence](https://www.psychologicalassessments.com/emotional-intelligence%20-testing/) to enhance self-awareness, self-regulation, social skills, empathy, and motivation is a strong step, though hard to do on your own.

R

##### Stay Accountable Through Feedback

Make sure to get regular feedback on your progress from the people who initially helped, and stay accountable for your goals by setting action plans and reviewing progress regularly. Include getting feedback about whether you are understanding and navigating cultural differences and promoting inclusivity and diversity within your organizations. Explore ethical dilemmas and get advice about whether everyone agrees that you are making morally sound decisions.

R

##### Network and Build Relationships

Develop and maintain valuable professional relationships, including mentors who you look up to and who have experience that will help you become a better leader. Look for people who give you honest feedback, and with whom there are no potential conflicts of interest (e.g., a person who works for a competitor).

### Final thoughts

## When to Choose Executive Coaching

If you try some of these specific techniques above on your own but are not seeing the results you are looking for, you may want to hire an experienced executive coach, even temporarily. We will carefully choose from the techniques listed here as well as others, and we will tailor these techniques to the most effective and successful services for youexperience. You establish a trusting and confidential relationship with the [executive coach to ensure a safe and productive](https://performancepsychologygroup.com/executive-coaching/) environment.

### Personal Areas for Improvement

CEO coaching self-help should also include a dose of more personal improvement. You certainly want to improve in your role for the good of your company and your performance. You should also set out to improve in ways that will bring you more enjoyment in your professional life and perhaps even your life outside of work.

### Examples of Personal Improvement

One example of using executive coaching for personal improvement involves cultivating[ emotional intelligence](https://www.psychologicalassessments.com/emotional-intelligence%20-testing/), as it plays a crucial role in effective leadership. Practice self-awareness, empathy, and emotional regulation to build stronger relationships with your team and stakeholders. Another example is working on stress management. As an executive, stress is often part of the job. Learn and practice stress management techniques such as meditation, [mindfulness practice](https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/mindfulness-exercises/art-20046356), exercise, or hobbies to maintain your well-being and resilience.

### Other Suggestions for Executives

Beyond the formal coaching, even if delivered as self-help, there are some suggestions that we often make to all leaders. First, stay committed to your personal and professional growth. Read books, attend seminars, and engage in ongoing learning to stay up-to-date with the latest trends and practices. Be motivated to improve continually. Second, ensure you are always willing to receive feedback, consider new perspectives, and embrace change. And finally, pay attention to the advice and insights provided by those around you. Active listening helps you absorb information and apply it effectively.

## Conclusions

It is vitally important that [during this process](https://performancepsychologygroup.com/executive-coaching/), you hold yourself accountable for your development. Regularly review your progress, celebrate successes, and identify areas needing attention. These services can be highly beneficial and powerful.

 ### Executive Coaching Since 2001

Overall, executive coaching services are a valuable investment that supports the growth and development of leaders, leading to a more successful and sustainable organization. When our clients improve their leadership skills and overall effectiveness, it positively impacts the organization’s performance. More decisive leadership fosters a more productive and engaged workforce, leading to improved outcomes and success for the company.

Some agencies go as far as to build executive coaching services into their strategic planning, realizing the value these services can bring and ensuring they remain part of the plan moving forward. Some leaders make executive coaching services part of their employment contract, and some boards of directors require the services for new leaders, especially those who show promise but are less experienced.

 ![Executive Coaching Services](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "attorney-2 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

### My Executive Coaching Services

 We offer executive coaching services as a specialty area. This means that we are available to go above and beyond the [traditional meeting schedule each week and provide targeted services](https://www.dralanjacobson.com/therapy/) when needed. This might mean checking in before an important meeting, when there is a crisis, or when a crucial decision must be made.

 ![Executive Coaching Services](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "attorney-2 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## Get In Touch

**Executive coaching** services are available to individuals who are currently executives, rising leaders in an organization, and groups of leaders. Executive coaching services can be part of a formal succession plan and can be negotiated as part of a promotion. Whether an individual or a company hires us for these or related services, the experience is the same, and the results of CEO Coaching are powerful and effective. We look forward to discussing how these services fit your or your agency’s goals.

[(617)-680-5488](tel:+6176805488)

[Schedule a Free Consultation](https://www.picktime.com/scheduleaconsult)

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### [Management Coaching](https://dralanjacobson.com/management-coaching/)

**Published:** June 22, 2026
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: September 4, 2026

 # Management Coaching

 20+ of general management coaching and time and stress management coaching

01

## Management Coaching

A transformative experience for leaders seeking to enhance their impact and presence. By focusing on key areas such as confidence, clarity, and influence, these services can help individuals in leadership positions achieve their professional goals, contribute more significantly to their organizations, and feel good about all of it.

02

## Time Management Coaching

Helping leaders effectively budget and use their time. Time management coaching can be helpful for any leader who has many tasks on their list and needs to prioritize without losing effectiveness or quality. This decision-making can improve sigfnificantly to give leaders a better work-life balance, more contentment, and a feeling of control on even the busiest days.

03

## Stress Management Coaching

Helping leaders at all levels develop the ability to manage uncertainty and anxiety even during the busiest times. Stress management coaching can be delivered to groups or individuals and can be accomplished in a time-limited number of sessions. Any business where leaders can be under pressure at times can benefit from this service.

### Performance Psychology Framework

Management coaching, including specialty areas of time and stress management coaching, relies primarily on performance psychology principles. 

 [Get Started](https://www.picktime.com/scheduleaconsult)

### Established Business Principles

We incorporate business principles into all of our services to ensure that what you are learning about leadership directly translates to the bottom line.

 [Get Started](https://www.picktime.com/scheduleaconsult)

### Innovative Managment Coaching

The resut is a [powerful and innovative approach](https://performancepsychologygroup.com/founder-services/) to all services, including time management coaching and stress management coaching.

 [Get Started](https://www.picktime.com/scheduleaconsult)

## How to Choose

Here are some of the important factors when choosing management coaching.

 ![Management Coaching](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "creative-marketing-icon-6 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")



#### Experience and Credentials

Look for a management coach with extensive experience, proven success, and relevant credentials. All of our clinicians have at least 15 years of experience.



#### Client Testimonials:

Seek feedback from past clients to gauge the coach’s effectiveness. Our unique services have received many positive reviews that we are quite happy to share.



#### Style

Ensure the clinician’s style and approach align with your learning preferences and needs. We learn about you and your needs before assigning a coach.



#### Specialization

Choose a clinician specializing in the areas you want to develop. We offer general services as well as time management coaching and stress management coaching.

## What is Management Coaching?

Our services offer a personalized development process designed to enhance the skills, knowledge, and effectiveness of managers. It focuses on helping managers enhance performance, develop leadership capabilities, and achieve both professional and organizational objectives. This type of service typically involves one-on-one sessions, but it can also include group services for teams.

### Key Aspects of Management Coaching

1\. Self-Awareness and Emotional Intelligence

– Increasing self-awareness about personal strengths and areas for improvement.
– Developing emotional intelligence to manage oneself and relationships effectively.
– Understanding and managing the impact of emotions on decision-making and behavior.

2\. Leadership and Decision-Making Skills

– Enhancing leadership abilities to motivate and inspire teams.
– Improving decision-making processes and strategic thinking.
– Learning to balance short-term tasks with long-term strategic goals.

3\. Communication and Interpersonal Skills

– Strengthening verbal and non-verbal communication skills.
– Learning to listen actively and provide constructive feedback.
– Building strong relationships with team members, peers, and superiors.

4\. Conflict Resolution and Problem-Solving

– Developing skills to manage and resolve conflicts effectively.
– Enhancing problem-solving abilities to address challenges and find innovative solutions.

5\. Planning and Productivity

– Learning to prioritize tasks and manage time efficiently.
– Implementing strategies to enhance personal and team productivity.

6\. Change Management

– Developing the ability to lead change within the organization effectively.
– Learning to navigate and support teams through transitions and transformations.

Management coaching is a valuable tool for developing the skills and capabilities of individuals at all levels of the organization. By focusing on areas such as leadership, communication, and problem-solving, these services enable individuals to become more effective in their roles, resulting in improved performance, enhanced team dynamics, and greater organizational success.

 ![Advisory Services for Startups](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "meetup-01 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## General Management Coaching

## Service Process

**1. Assessment and Feedback:**
– Initial assessments to understand current strengths and areas for improvement. Our sister company can provide formal [management testing](https://psychologicalassessments.com/best-management-testing-and-personality-testing-for-teams/) or specific assessments, such as for [psychological resilience](https://psychologicalassessments.com/a-psychological-stress-test-vs-a-mental-trauma-test/) to start this process.
– Gathering feedback from peers, subordinates, and superiors.

**2. Goal Setting:**
– Setting clear, achievable goals for the engagement process.

**3. Personalized Coaching Sessions:**
– Regular one-on-one sessions to work on specific areas.
– Role-playing and practice exercises to develop skills.

**4. Action Plan and Implementation:**
– Creating an action plan to implement new skills and behaviors.
– Regular follow-ups to ensure progress and adjust strategies as needed.

**5. Evaluation and Adjustment:**
– Continuous evaluation of progress towards goals. This might involve [corporate personality testing](https://psychologicalassessments.com/business-personality-tests/).
– Making necessary adjustments to the plan based on feedback and results.

 ![Management Coaching Services](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "checklist | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## Specialty Management Coaching

### Time Management Coaching

 ![Time Management Coaching](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "beats")

Focusing on helping leaders improve their ability to budget time effectively, prioritize tasks, and enhance productivity. Here are the key components of this specialty service:

### Key Strategies and Tools

- **Prioritization Techniques**: Learning methods such as the Eisenhower Matrix to categorize tasks by urgency and importance.
- **Time Blocking**: Allocating specific blocks of time for different tasks to ensure focused work and reduce multitasking.
- **Task Management Systems**: Utilizing tools like to-do lists, project management software, and calendars to organize tasks and deadlines.
- **Delegation Skills**: Identifying tasks that can be delegated to others to free up time for high-priority activities.
- **Goal Setting and Planning**: Breaking down larger goals into smaller, manageable tasks and setting realistic deadlines.

### Time Management Coaching Benefits

- **Improved Efficiency**: Better use of time leads to more tasks being completed in less time.
- **Increased Focus**: Clear prioritization and planning reduce distractions and help maintain focus on high-impact activities.
- **Enhanced Job Satisfaction**: Effective planning reduces the feeling of being overwhelmed, leading to greater job satisfaction.
- **Better Work-Life Balance**: Efficient planning allows for more time to be spent on personal activities and family.

A specialized service designed to help leaders identify, understand, and manage stress effectively. The goal is to reduce stress levels, improve coping mechanisms, and enhance overall well-being. Here’s an in-depth look at this specialty service:

### Key Strategies and Techniques

- Relaxation Techniques: Methods such as deep breathing exercises, progressive muscle relaxation, and guided imagery.
- Mindfulness and Meditation: Practices that help individuals stay present and reduce anxiety.
- Cognitive Behavioral Techniques: Strategies to reframe negative thinking patterns and develop a more positive outlook.
- Planning: Learning to manage time effectively to reduce stress from deadlines and overwhelming tasks.
- Setting Boundaries: Learning to say no and set limits to avoid overcommitting and burnout.

### Benefits of Stress Management Coaching

- Reduced Stress Levels: Effective strategies lead to lower stress levels and a calmer demeanor.
- Enhanced Emotional Well-being: Better stress control contributes to improved mood, reduced anxiety, and higher overall happiness.
- Better Leadership: Lower stress levels often result in better focus, decision-making, and productivity.
- Better Work-Life Balance: Effective reduction of stress allows for a healthier balance between work and personal life.

### Stress Management Coaching

 ![Stress Management Coaching](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "decisions | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

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](https://www.facebook.com/appliedpsychologicalscience) [ ![social network icon](data:image/svg+xml;base64,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) ](https://www.instagram.com/appliedpsychological) [ ![social network 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---

### [Founder Coaching](https://dralanjacobson.com/founder-coaching/)

**Published:** June 22, 2026
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: September 4, 2026

#  Founder Coaching for Startups

Get Advanced and Innovative Services from an Experienced Startup Founder Coach

 #### Develop, Power, and Spread Your Vision

#### Create and Maintain the Perfect Culture

#### Set and Achieve Personal and Professional Stretch Goals 

## **Founder Coaching for Startups Overview**

**Founder coaching** is a specialized form of coaching tailored to entrepreneurs and startup founders’ unique challenges and needs. It focuses on supporting founders in their personal and professional growth while navigating the complexities of building and scaling a business. Here’s how our founder coaching typically works:

### Startup Founder Coaching Personal Development:

We help leaders understand their strengths, weaknesses, values, and leadership styles. We encourage a growth mindset, resilience, and adaptability to handle the uncertainties of entrepreneurship. We support these leaders in managing stress, maintaining balance, and preventing burnout. We provide a safe space for founders to express concerns, fears, and challenges associated with entrepreneurship. Then, we offer motivation and encouragement during difficult times or when facing setbacks.

### Leadership and Decision-Making:

We help founders develop effective leadership qualities, communication, and team-building skills. We provide support and guidance in making critical decisions, setting priorities, and aligning actions with long-term goals. We provide strategies for resolving conflicts and managing challenging situations within the business.

### Business Strategy and Development:

We assist leaders in defining and refining their business vision, mission, and goals. We assist them in creating or adjusting business strategies to adapt to market changes or growth opportunities. We offer guidance on building networks, partnerships, and seeking mentorship. We help them set clear, achievable goals and action plans to track progress. Then, we serve as an accountability partner to ensure commitment to goals and actions.

### Transition and Growth with a Startup Founder Coach:

Our startup founder coaching services assist in scaling the business while maintaining its core values and culture. We help founders plan for company transitions, exits, or leadership changes. Our funder coaching services aim to empower entrepreneurs by providing them with guidance, support, and tools to enhance their leadership abilities, improve decision-making skills, and navigate the entrepreneurial journey more effectively. We customize our [approach to meet each founder](https://performancepsychologygroup.com/founder-services/) or startup’s specific needs and goals.

## Our Founder Coaching Process

Startup Founder Coaching involves supporting founders in developing their skills, leadership capabilities, and overall effectiveness in growing and managing their businesses. Our coaching process typically follows these steps:

1\. **Assessment and Goal Setting**: We want to understand your background, strengths, challenges, and objectives. Together, we will define clear and achievable goals, a parallel process between your personal goals and goals for the business.

2\. **Development of Action Plans**: You will work collaboratively with your startup founder coach to develop strategies and action plans to achieve the identified goals in measurable and meaningful ways. This means using specific milestones and key performance indicators (KPIs) to track progress.

3\. **Skill Enhancement and Training**: Coaching for founders is not just about weaknesses; making sure you are fully tapping into your strengths may be just as important. Thus, we will provide guidance, resources, and coaching sessions to enhance your strengths and help you improve on challenges.

5\. **Problem-Solving and Decision-Making**: As we move along, we will assist you in addressing business challenges, making informed decisions, and problem-solving. to enhance business outcomes.

6\. **Feedback and Reflection**: We will provide constructive feedback based on observations and assessments to foster continuous improvement while also encouraging self-reflection and evaluation to facilitate personal growth and learning.

As our engagement progresses, we will adjust strategies and action plans based on changing circumstances or new insights. Our Coaching for Founders, even when time-limited, is an ongoing, iterative process rather than a one-time event. We look forward to acknowledging and celebrating milestones achieved and successes attained throughout the coaching journey!

## Startup Founder Coaching FAQ

##### Do I Need Founder Coaching?

It is unlikely that you *need* a Startup Founder Coach. You’ve likely accomplished a lot and will probably accomplish much more. However, competition for funding, visibility, and consumer support in the start-up space is fierce, and coaching for founders is designed to give you an edge.

##### How Will I Know that Founder Coaching is Working?

Our planning will always include measurable, meaningful, and specific goals. You should know it is working because data will back it; if not, remember that our services are guaranteed.

##### What is So Unique About Your Approach?

There are many very talented people providing founder coaching. Some are psychologists, and others are MBAs and former C-level executives. Our staff are both, meaning that they can deliver a [unique and important range of startup founder coaching services](https://performancepsychologygroup.com/founder-services/) that can be combined and interwoven in many ways

##### Is Founder Coaching Time Limited?

The Founder Coaching engagement is always time-limited, but the results of coaching for founders should persist. Also, many founders come back to us for additional help along their journey as new opportunities for growth arise.

 ![Founder Coaching FAQ](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "light-1 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## What Does a Startup Founder Coach Do?

A **startup founder coach** typically provides guidance, support, and mentorship to individuals who are launching or growing their own startup ventures. We provide start-up founder coaching to a wide variety of leaders within our [coaching specialty areas](https://performancepsychologygroup.com/). Here are some key aspects of what a startup founder coach from PPG might do for you:

### A Startup Founder Coach and Strategy 

Startup founder coaching assists founders in developing and refining their business strategies, including market positioning, product development, customer acquisition, and revenue models. [Our startup founder coaches](https://performancepsychologygroup.com/startup-consulting/) all have experience in C-level business strategy and are also trained and experienced mental health providers. They will help you Stay updated on industry trends, best practices, and emerging technologies to provide founders with the most relevant and up-to-date advice and support.

### Startup Founder Coaching and Goal Setting and Accountability

A start-up founder coach from PPG will help you set specific, measurable, achievable, relevant, and time-bound (SMART) goals, and hold you accountable for making progress toward those goals. They will offer constructive feedback and encourage reflection on successes and failures, helping founders learn and grow from their experiences.

### Problem-Solving with a Startup Founder Coach

A Startup founder coach will offer advice and support in navigating challenges and overcoming obstacles commonly faced by startup founders, such as fundraising, team building, product-market fit, and scaling. They will serve as a trusted sounding board and confidant for founders to discuss ideas, concerns, and challenges openly and without judgment.

### Networking and Connections

A startup founder coach will provide access to valuable networks, connections, and resources within the startup ecosystem, including investors, mentors, potential customers, and industry experts. In other words, a startup founder coach will open up their own network to you.

### Personal Development and Coaching for Founders 

A startup founder coach supports founders in developing the personal and leadership skills necessary for success, such as communication, decision-making, resilience, and emotional intelligence. They help foster a positive and growth-oriented mindset, providing motivation and encouragement during the ups and downs of the startup journey.

Overall, a startup founder coach plays a crucial role in helping entrepreneurs navigate the complexities of building and scaling a startup, providing guidance, support, and encouragement along the way. Please feel free to [contact us](https://performancepsychologygroup.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

![Startup Founder Coach](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## Founder Coaching Client Feedback

## "PPG's Startup Founder Coaching goes well beyond what you might expect. I felt like I gained so much useable, practical, and new strategies to lead effectively and grow my company."

CEO, successful start-up

## "Our Startup Founder Coach had amazing experience. He was skilled as a psychologist but also had amazing success as a CEO. We felt extremely lucky to find him."

[Click Here](#)

### Final thoughts

## Coaching for Founders

Coaching for Founders is designed to help you better understand your leadership style and how it can be enhanced. We look for possibilities and potential, focusing on your strengths and how to bring them out. Coaching for founders is also designed to help you reach new levels of meaningfulness and contentment in your job and mission. Startup Founder Coaching provides a confidential, nonjudgemental, and supportive environment to those who often otherwise feel that they are under a microscope.

We always provide a free consultation so you can be sure that our founder coaching for startups services are the right fit for you. There is absolutely no obligation. We are confident in our

### Get In touch

## Contact Us or Schedule a Consultation

 [Schedule a consultation regarding founder coaching. We will have a founder coach get back to you.](https://www.picktime.com/scheduleaconsult)

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### [ADHD Coaching for Adults: Help for Focus and Concentration](https://dralanjacobson.com/adhd-coaching-for-adults-help-for-focus-and-concentration/)

**Published:** September 30, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Many people arrive at therapy with years of self-blame, believing that their difficulties with organization, follow-through, or focus stem from laziness or character flaws. In reality, these struggles reflect [neurobiological differences](https://www.psychreg.org/neurobiology-neuroscience-understanding-differences-intersections-study-brain/) in attention regulation, working memory, and executive functioning. An adult ADHD coach combines the practical focus of skills training with the relational support of a collaborative partnership. While therapy often addresses underlying emotional distress or comorbid conditions, coaching directly targets the “how” of daily functioning – how to plan, how to execute, how to sustain. When the ADHD coach for adults is a [clinical psychologist](https://dralanjacobson.com/what-is-a-clinical-psychologist/), coaching can be seamlessly integrated with evidence-based [therapy approaches](https://dralanjacobson.com/types-of-therapy/), offering clients both action-oriented tools and emotional depth. ADHD coaching for adults is uniquely tailored to each client.

This post also includes self-help for focus and concentration that can be used alongside ADHD coaching for adults, including:

- **How to improve concentration**
- **How to remain focused at work**
- **How to improve attention span**

### Who is ADHD Coaching for Adults Best For

ADHD coaching for adults is particularly beneficial for those who:

- Have **persistent [executive functioning](https://dralanjacobson.com/executive-functioning-coaching/) challenges,** including disorganization, procrastination, forgetfulness, or difficulty finishing tasks.
- Experience **patterns of frustration and burnout**, often working harder than others but with less visible payoff.
- Are **highly intelligent or creative** but unable to channel their strengths consistently.
- Desire **accountability and feedback**, knowing what to do but struggling to actually do it.
- Those seeking practical, solution-focused strategies and help for focus and concentration, as well as emotional exploration
- Having been newly diagnosed in adulthood, individuals often seek to make sense of past struggles and build new systems moving forward.

An adult ADHD coach is best suited to individuals with stable mood and mental health. However, it can be combined with [psychotherapy](https://dralanjacobson.com/psychotherapy/) for those managing anxiety, depression, or trauma alongside ADHD.

## Techniques Used in ADHD Coaching for Adults

An ADHD coach for adults draws from multiple approaches, but its hallmark is **practical, hands-on skill-building**. Techniques used in ADHD coaching for adults include:

- [**Psychoeducation**](https://dralanjacobson.com/psychoeducation/): An ADHD coach for adults normalizes an attention deficit as a neurodevelopmental condition, reframing “failures” as skill gaps rather than flaws.
- **Structured Goal Setting**: An ADHD coach for adults uses SMART (specific, measurable, attainable, relevant, time-bound) frameworks, then breaks goals into “micro-steps.”
- [**Time Management Systems**](https://www.additudemag.com/punctuality-time-blindness-adhd-apps-tips/): Visual timers, alarms, time-blocking, daily rituals, and “future-self planning” techniques.
- [**Accountability Mechanisms**](https://workbrighter.co/gentle-accountability-guide/): A key aspect of an adult ADHD coach’s work is regular check-ins, tracking systems, and shared dashboards for progress monitoring.
- **Task Initiation Supports**: The ADHD coach for adults uses strategies like “[body doubling](https://www.simplypsychology.org/adhd-body-doubling.html),” the two-minute rule, or starting with a single “activation step.”
- **Emotional Regulation Skills**: An Adult ADHD coach will identify ADHD-related rejection sensitivity, perfectionism, or shame and apply [grounding techniques](https://health.clevelandclinic.org/grounding-techniques).
- **Strengths-Based** Planning: Building environments where [positive traits of ADHD](https://psychologicalassessments.com/benefits-of-adhd/), like creativity, hyperfocus, and risk tolerance, become assets.

### Integrating Other Psychological Techniques

When a psychologist provides ADHD coaching for adults, the benefit lies in [integrating deeper therapeutic modalities](https://dralanjacobson.com/adhd-therapy-for-adults/) with practical strategies. Some ways these approaches blend include:

- **[Cognitive-Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT)**: Many adults with an attention deficit internalize self-defeating beliefs (“I always fail,” “I can’t be trusted with deadlines”). [Coaching integrates CBT](https://dralanjacobson.com/cbt-for-adhd/) by helping clients test these thoughts against evidence and replace them with realistic, adaptive beliefs.
- **[Acceptance and Commitment Psychotherapy](https://dralanjacobson.com/act-psychotherapy/) (ACT)**: ADHD can’t always be “fixed,” but clients can learn to live by values despite challenges. For example, [a student who procrastinates](https://dralanjacobson.com/adhd-coaching-for-college-students-effective-enduring/) might anchor their work not in fear of failure but in the value of contributing to their future.
- **[Motivational Interviewing](https://dralanjacobson.com/motivational-interviewing/) (MI)**: Especially useful for ambivalence about change. An Adult ADHD coach uses MI to help clients clarify their reasons for change in their own words, enhancing intrinsic motivation.
- **Mindfulness and [Somatic Awareness](https://dralanjacobson.com/somatic-therapy/)**: Techniques such as [breath regulation](https://www.healthline.com/health/breathing-exercise), grounding exercises, and mindful task initiation help reduce emotional impulsivity and increase task focus.
- **[Trauma-Informed](https://dralanjacobson.com/trauma-informed-care/) Approaches**: Many adults with undiagnosed ADHD grew up with chronic criticism or misunderstanding, leaving wounds of shame. A psychologist-coach can create a reparative experience by fostering compassion, validation, and adaptive coping.
- **[Dialectical Behavior Therapy ](https://dralanjacobson.com/dbt-for-teens/)(DBT) Skills**: Tools from DBT, such as distress tolerance and emotion regulation strategies, can help adults with ADHD who feel hijacked by frustration or rejection sensitivity.

This integration enables coaching to go beyond “tips and tricks,” allowing the adult ADHD coach to provide a holistic process that addresses both the practical and emotional aspects of the condition.

## Case Studies

### ADHD Coaching for Adults Case Study: The Overwhelmed Professional

**Background**: Maria, a 34-year-old marketing executive, had always been praised for her creativity but quietly struggled with focus and organization. Recently promoted, she found herself missing deadlines, ignoring emails, and working late into the night to catch up. Her self-esteem was crumbling.

**ADHD Coaching for Adults Process**: The ADHD coach for adults began with psychoeducation, helping Maria reframe her struggles as symptoms of ADHD rather than personal failings. She and her coach implemented structured routines: color-coded digital calendars, daily 15-minute “plan and prioritize” sessions, and setting deadlines one day earlier than actual due dates to reduce last-minute panic. Cognitive-behavioral strategies targeted her perfectionism, which often led to avoidance.

**Outcomes**: Within three months, Maria had reduced missed deadlines by 70%, delegated more effectively, and reported improved sleep. More importantly, she began to see herself as competent again. With ACT strategies, she anchored her work in her value of “leadership through creativity,” restoring her confidence in the workplace.

### Adult ADHD Coach Case Study: The Entrepreneur with Ideas but No Follow-Through

**Background**: David, 41, ran a small design business. He brimmed with ideas but described himself as a “serial starter.” He often launched projects impulsively, only to abandon them when a new idea emerged. His employees were frustrated, and his business was stagnating.

**Coaching Process**: The initial focus of the adult ADHD coach was on externalizing his executive functions: creating a structured project management system and assigning clear timelines. David began storing new ideas in a “parking lot journal” reviewed monthly, instead of chasing each one immediately. Mindfulness practices helped him pause before acting on new impulses, and they also helped her learn how to improve concentration. Motivational interviewing helped him recognize that focusing on fewer projects aligned better with his long-term goal of financial security for his family.

**Outcomes**: Over the course of six months, David successfully completed a major rebranding project that significantly increased his company’s visibility. He reported greater respect from his team, reduced anxiety, and a sense of control. He learned that ADHD did not mean suppressing his creativity, but rather managing it strategically.

## Subspecialty: ADHD Coaching for Women Who Were Previously Undiagnosed

A growing area, and one requiring exceptional sensitivity, is [ADHD coaching for women](https://dralanjacobson.com/women-with-adhd/), especially those diagnosed later in life. Many women were overlooked in childhood because their symptoms presented less as hyperactivity and more as inattentiveness, internalization, or perfectionism. They often excelled academically by overcompensating, only to experience collapse in adulthood when demands became unmanageable.

### Unique challenges in women with ADHD include:

- **Masking and Overcompensation**: Years of hiding symptoms often lead to burnout.
- **High Rates of Anxiety and Depression**: Often secondary to unrecognized ADHD struggles.
- **Role Overload**: Balancing work, parenting, and caregiving without adequate support.
- **Late-Life Identity Shifts**: The diagnosis can trigger grief for “lost years” but also relief and self-compassion.

### ADHD coaching for women and men who were diagnosed late often involves:

- **Validation and Psychoeducation**, reframing decades of struggles through an ADHD lens.
- **Addressing Shame and Perfectionism**, using CBT and trauma-informed approaches.
- **Practical Role Management**, with systems to reduce overwhelm from multitasking and caretaking.
- **Values-Based Rebuilding**, helping women envision futures aligned with their authentic strengths rather than societal expectations.

ADHD coaching for women and men who discover their attention deficit later is often life-changing. It provides both the emotional healing of reinterpreting their past and the practical scaffolding to thrive moving forward.

### ADHD Coaching for Women Case Study: The Parent and Returning Student

**Background**: Leah, 28, was a single mother of a 6-year-old, who had recently returned to college. She described constant exhaustion, late assignments, and feelings of inadequacy both as a student and a parent. Diagnosed only recently, she had no framework for understanding her difficulties.

**Coaching Process**: The ADHD coach for adults began with time-blocking her week, designating protected study hours when childcare was available. Visual reminders around her home supported both household routines and school tasks. “Body doubling” was arranged through virtual study groups. Acceptance and Commitment Therapy emphasized her values of education and parenting, helping her persist through overwhelm. Simultaneously, CBT addressed negative self-talk: “I’m failing at everything.”

**Outcomes**: By the end of the semester, with her hard work, determination, and specialized ADHD coaching for women, Leah had passed all her courses and reported improved consistency in parenting routines. She developed a sense of pride, no longer equating her attention deficit with incompetence. With ongoing coaching, she became proactive in setting boundaries with her time and developed long-term confidence in balancing her dual roles.

## Self-Help for Focus and Concentration

### How to Remain Focused at Work

Remaining focused in a busy workplace can be particularly challenging for individuals with an attention deficit, especially when interruptions, emails, and multitasking demand constant attention. Here are some strategies to try before or in conjunction with ADHD coaching for adults:

1. **Structure Your Environment**
    - Use noise-canceling headphones or white noise to minimize auditory distractions.
    - Keep your immediate workspace clear of visual clutter to reduce overstimulation.
    - Position yourself away from high-traffic areas if possible.
2. **Plan Your Day in Blocks**
    - Group similar tasks together (emails in one block, meetings in another).
    - Begin with your most important or difficult task during your peak energy time.
    - Use the “15-minute rule”: commit to just 15 minutes of a challenging task—you’ll often keep going.
3. **Use Visual Cues and External Reminders**
    - Place sticky notes, checklists, or a digital dashboard in your line of sight.
    - Set calendar reminders with alerts to prompt you to transition between tasks.
4. **Build in Micro-Breaks**
    - Take 2–5 minutes every hour to stretch, walk, or engage in deep breathing. These short resets help maintain focus throughout the day.
5. **Communicate Boundaries**
    - If possible, let colleagues know when you’re in a “deep work” period and prefer not to be interrupted.
    - Use a visual signal, such as a sign or status light, to show you’re unavailable.

**Takeaway:**
Small, structured changes in your environment and schedule can significantly enhance your ability to maintain focus. By setting clear boundaries and using reminders, you reduce distractions and create a consistent rhythm that supports productivity.

### How to Improve Attention Span

Adults with this diagnosis often feel their attention drifts quickly, even on tasks they want to complete. Knowing how to improve attention span involves practice and structure:

1. **Practice “Attention Training”**
    - Try short mindfulness exercises (e.g., focusing on your breath for 1–2 minutes).
    - Slowly extend the length of focus sessions over time.
2. **Use the Pomodoro Technique**
    - Work for 25 minutes, then take a 5-minute break.
    - After four cycles, take a longer break (15–20 minutes).
    - This rhythm trains the brain to sustain focus in manageable chunks.
3. **Engage Multiple Senses**
    - Reading aloud, using colored pens, or listening to instrumental music while working can help anchor attention.
    - Movement-based strategies, such as standing while reading or walking during phone calls, can also be helpful.
4. **Train Your “Focus Muscle” Gradually**
    - Start with 5–10 minutes of concentrated work and slowly increase the duration.
    - Track your improvement—seeing progress motivates continued effort.
5. **Fuel and Rest Your Brain**
    - Stay hydrated and avoid excessive caffeine intake, as it can worsen distractibility later.
    - Prioritize sleep—fatigue dramatically reduces attention capacity.

**Takeaway:**
Knowing how to improve attention span centers around consistent, intentional practice. By combining sensory engagement, mindful focus, and healthy routines, adults with ADHD can build stronger attention endurance over time.

### How to Improve Concentration

Concentration goes beyond attention span; it’s about immersing yourself in tasks without constant mental wandering. Here are some self-help strategies regarding how to improve concentration:

1. **Clarify Your Task Before Starting**
    - Write down precisely what you’re about to do. Instead of “work on the report,” try “write the introduction paragraph.”
    - Defining tasks sharply reduces ambiguity, which can derail concentration.
2. **Eliminate Competing Inputs**
    - Silence unnecessary notifications on your phone and computer.
    - Keep only the materials you need for your current task within easy reach.
3. **Anchor Yourself Physically**
    - Some people find that fidget tools, doodling, or even chewing gum provide just enough stimulation to support mental concentration.
    - Others benefit from posture cues, such as sitting upright or leaning slightly forward while working.
4. **Build in Accountability**
    - Use “body doubling”—working alongside a colleague, friend, or virtual partner—to stay on task.
    - Report progress to someone else at the end of a focused session.
5. **Link Concentration to Rewards**
    - Break large tasks into smaller parts, then reward yourself for completing each one.
    - Rewards don’t need to be large—taking a walk, watching a funny video, or savoring a cup of coffee can help reinforce focus.

**Takeaway**: Knowing how to improve concentration involves remaining focused, extending attention span, and improving concentration are skills that can be strengthened with the right strategies. The key is **externalizing support systems** (using reminders, timers, accountability) and **being kind to yourself.** Progress comes not from perfection but from consistent, small steps.

## ADHD Coaching for Adults: Conclusion

ADHD coaching for adults is a transformative approach that bridges the gap between skill-building and emotional growth. For professionals overwhelmed by disorganization, entrepreneurs struggling with too many ideas, students balancing multiple roles, or women newly discovering their identity, an adult ADHD coach offers not just tools but also hope. When integrated with therapeutic techniques and delivered by a psychologist, it empowers clients to replace cycles of shame with cycles of success. The goal of the ADHD coach for adults is not to eliminate all symptoms but to live fully and authentically with it—harnessing strengths, managing challenges, and building a life defined not by limitation but by possibility.

## Frequently Asked Questions: ADHD Coaching for Adults

Common questions about adult ADHD coaching — what it involves, how it differs from therapy, and how to get started.

   What is ADHD coaching for adults, and how is it different from ADHD therapy? + ADHD coaching for adults is a practical, skills-focused intervention targeting the “how” of daily functioning: how to plan, how to execute, how to sustain attention, and how to manage time, organization, and follow-through. It differs from [ADHD therapy](https://dralanjacobson.com/adhd-therapy-for-adults/) in its primary orientation — coaching is forward-looking and performance-focused, while therapy addresses the emotional, psychological, and clinical dimensions of ADHD, including co-occurring anxiety, depression, and the self-esteem damage that accumulates over years of unmanaged symptoms. When ADHD coaching is delivered by a licensed clinical psychologist, as it is in Dr. Jacobson’s practice, the two dimensions are integrated rather than separated: practical skill-building and emotional depth work together in the same relationship rather than requiring two different providers. The [national ADHD organization CHADD](https://chadd.org/about-adhd/treatment-of-adhd/) supports a multimodal approach — combining coaching, therapy, and where indicated medication — as the current best-practice standard for adult ADHD. For college students, a more structured semester-paced format is described on the [ADHD coaching for college students](https://dralanjacobson.com/adhd-coaching-for-college-students-effective-enduring/) page.

   Why should I work with a psychologist for ADHD coaching rather than a general ADHD coach? + ADHD coaching is an unregulated field — anyone can call themselves an ADHD coach regardless of training or credentials. A licensed clinical psychologist brings a fundamentally different level of training and clinical capability to coaching work. The most important distinction is the ability to hold both dimensions simultaneously: when a coaching client’s procrastination turns out to be driven by clinical anxiety, when perfectionism reflects a trauma history, or when apparent “laziness” is actually rejection sensitive dysphoria — a psychologist-coach recognizes and addresses these clinical layers rather than applying generic productivity frameworks to a clinical problem. Dr. Jacobson’s 25 years of clinical experience means that the coaching work is informed by deep understanding of the neurobiological, psychological, and relational dimensions of ADHD — not just familiarity with productivity techniques. This is particularly valuable for adults whose ADHD co-occurs with anxiety, depression, or significant self-esteem damage, as described in the [ADHD therapy for adults](https://dralanjacobson.com/adhd-therapy-for-adults/) page. For a broader discussion of what distinguishes different types of mental health providers, see the [therapist vs. psychologist guide](https://dralanjacobson.com/therapist-vs-psychologist-therapist-vs-psychotherapist/).

   Who is adult ADHD coaching best suited for? + ADHD coaching is most beneficial for adults who experience persistent [executive functioning challenges](https://dralanjacobson.com/executive-functioning-coaching/) — disorganization, procrastination, forgetfulness, difficulty finishing tasks, or time blindness — in their professional or personal lives. It is particularly effective for highly intelligent or creative adults whose strengths are evident but who cannot channel them consistently; for professionals who are performing adequately but at significant personal cost through overwork and compensating strategies that no longer scale; for newly diagnosed adults making sense of past struggles and building new systems; and for entrepreneurs and business owners whose ADHD affects follow-through, team management, and strategic execution. As illustrated by Maria’s, David’s, and Leah’s case examples on this page, coaching adapts to very different life contexts. It is best suited to individuals with reasonably stable mood — when anxiety, depression, or significant emotional dysregulation are significant, [ADHD therapy](https://dralanjacobson.com/adhd-therapy-for-adults/) is typically the right starting point, with coaching integrated once clinical stability is established. See also the page on [ADHD in women](https://dralanjacobson.com/women-with-adhd/) for the distinct presentation and coaching needs of women diagnosed later in life.

   What specific skills does ADHD coaching for adults build? + The core skill domains in adult ADHD coaching include: time management systems — visual timers, time-blocking, alarms, and future-self planning techniques; task initiation — strategies like body doubling, the two-minute rule, and activation steps that break the avoidance cycle; structured goal-setting using SMART frameworks broken into micro-steps that prevent overwhelm; accountability mechanisms — shared dashboards, progress tracking, and regular check-ins that externalize the executive functions ADHD impairs; organization systems tailored to the individual’s environment and work style rather than generic productivity frameworks; and emotional regulation — identifying ADHD-related rejection sensitivity, perfectionism, or shame and applying grounding and [cognitive restructuring](https://dralanjacobson.com/cognitive-restructuring/) techniques. A critical principle throughout is strengths-based planning: building environments where [genuine ADHD strengths](https://psychologicalassessments.com/benefits-of-adhd/) — creativity, hyperfocus, risk tolerance, generativity — become strategic assets rather than sources of self-doubt. The self-help section of this page provides an introduction to many of these techniques for clients who want to begin experimenting before starting coaching.

   I was recently diagnosed with ADHD as an adult. Is coaching or therapy the right first step? + For most adults receiving a late ADHD diagnosis, the first priority is making sense of the diagnosis itself — and this is where a psychologist’s involvement is uniquely valuable. A new diagnosis typically triggers a range of emotions: relief that there is an explanation for decades of struggles, grief for opportunities missed or time lost, and sometimes anger or disorientation. Psychoeducation — deeply understanding what ADHD actually is neurologically and what it explains about your personal history — is the foundation of all effective intervention. Whether this happens in a coaching or therapy frame depends on the intensity of the emotional response and whether co-occurring conditions are present. For adults whose primary challenges are practical and whose mood is reasonably stable, coaching can begin immediately and be profoundly clarifying. For adults who are experiencing significant anxiety, depression, or shame responses to the diagnosis, therapy is the right starting point. Many adults benefit from both simultaneously or in sequence. If a formal evaluation has not yet been completed, Dr. Jacobson can refer for [comprehensive ADHD testing](https://psychologicalassessments.com/adhd-testing/) through Precision Psychological Assessments to establish a clear diagnostic picture before starting either service.

   How does ADHD coaching address the shame and self-blame that many adults carry? + This is often the most clinically significant dimension of adult ADHD coaching — and the one most frequently underestimated. Many adults with ADHD arrive having spent years interpreting their struggles as laziness, irresponsibility, or lack of willpower. They have been told — by teachers, parents, employers, and themselves — that they could do it “if they just tried harder.” This accumulated self-blame is not a minor obstacle; it is often the primary barrier to engaging with coaching strategies, because every new attempt to change feels loaded with the history of previous “failures.” The first and most foundational task of ADHD coaching is psychoeducation: reframing the struggles as symptoms of a neurodevelopmental condition rather than character flaws. As illustrated by Maria’s case example on this page, this reframe is not merely feel-good validation — it is clinically necessary for clients to engage with strategies without the undermining weight of shame. [CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) targets the specific automatic negative thoughts (“I always fail,” “I can’t be trusted with deadlines”), trauma-informed approaches address the wounds left by years of chronic misunderstanding and criticism, and [ACT](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) helps clients act in alignment with their values even when shame is present rather than waiting until shame disappears — which it rarely does spontaneously without direct treatment.

   How long does adult ADHD coaching take, and what does progress look like? + Adult ADHD coaching is typically more flexible in duration than structured therapy protocols. Many clients begin with weekly sessions during the active skill-building phase — usually the first 2–4 months — and taper to biweekly or monthly sessions as systems stabilize and skills internalize. The three case examples on this page illustrate realistic timelines: Maria saw meaningful functional improvement within three months; David completed a major project milestone within six months; Leah passed her semester while managing single parenting with ongoing coaching support. Early progress tends to show up as practical gains first — fewer missed deadlines, reduced morning chaos, more consistent follow-through on commitments. Deeper gains in self-confidence and identity follow over a longer arc. Many clients return for brief booster periods when new life transitions or role changes create fresh demands — a job change, a move, the start of a business — rather than treating coaching as a one-time intervention. The flexibility to engage intensively during high-demand periods and scale back during stable ones is one of the practical strengths of a coaching format. See the [how long does therapy take guide](https://dralanjacobson.com/how-long-does-therapy-take/) for broader context on treatment duration.

   How do I get started with adult ADHD coaching — and can it be done online? + Yes — adult ADHD coaching is fully compatible with online delivery, and virtual sessions offer specific practical advantages: they can be conducted from the work or home environment where ADHD challenges actually occur, screen sharing enables live work on planning tools, calendars, and organizational systems, and the elimination of commute time removes a common barrier to consistent attendance. Dr. Jacobson is a [PSYPACT](https://psypact.org/)-participating psychologist licensed in 44 states, making virtual adult ADHD coaching accessible nationwide. The first step is a free 20-minute consultation — a practical conversation about what you’re experiencing, what you’ve already tried, and what your goals are. From there, Dr. Jacobson will recommend whether coaching, therapy, or a combination makes the most sense, and outline what a realistic course of work looks like for your specific situation. No commitment required. Related pages worth reviewing before reaching out: [ADHD therapy for adults](https://dralanjacobson.com/adhd-therapy-for-adults/), [executive functioning coaching](https://dralanjacobson.com/executive-functioning-coaching/), [ADHD in women](https://dralanjacobson.com/women-with-adhd/), [natural ADHD treatment for adults](https://dralanjacobson.com/natural-adhd-treatment-for-adults/), and [ADHD testing](https://psychologicalassessments.com/adhd-testing/) through Precision Psychological Assessments.

 ADHD is not a character flaw — and the right coaching makes that felt, not just understood.

Schedule a free 20-minute consultation with Dr. Jacobson — a practical conversation about what you’re experiencing and what a course of adult ADHD coaching might look like for you.

 [ Schedule a Free Consultation ](https://www.picktime.com/scheduleaconsult) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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---

### [How to Navigate Political Differences Using Family Therapy](https://dralanjacobson.com/politics-and-family-therapy/)

**Published:** March 28, 2025
**Author:** Dr. Alan Jacobson

**Content:**

I provide **family therapy for political differences** across multiple states, helping them navigate challenges when ideological beliefs create tension at home, even when members live in different states. In today’s polarized climate, political disagreements can strain even the closest bonds, sometimes leading to conflict, emotional distance, or even creating a situation where **politics and family estrangement** connect. My approach to mixing **politics and family therapy** focuses on fostering respectful communication, setting healthy boundaries, and helping members find common ground while maintaining their beliefs. Whether working with parents and grown children, siblings, or multi-generational families, my goal is to guide families toward understanding, healing, and preserving meaningful connections despite their differences.

---

### Political differences don’t have to mean permanent division.

[Contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) to explore whether structured family therapy can help restore stability, comfort, closeness, and respect.

---

## Politics and Family Therapy Overview ![Politics and family therapy](https://dralanjacobson.com/wp-content/uploads/2025/03/red-and-blue-235x300.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Politics can be tricky in family therapy, especially when members have deeply held but opposing views. It often brings up issues of values, identity, and power dynamics, which can lead to conflict or [family estrangement](https://dralanjacobson.com/family-estrangement-therapy/) if not handled well.

### When Political Conflict Masks Deeper Relational Wounds

Political disagreements in families are rarely just about policy. More often, they are about identity, safety, belonging, and respect.

When a family member feels dismissed or morally judged, the nervous system reacts as though the relationship itself is under threat. Conversations escalate not because of the topic, but because of what the topic represents — autonomy, values, loyalty, generational shifts, or perceived betrayal.

In family therapy, we often discover that political conflict is layered over deeper dynamics such as:

- Longstanding power struggles
- Attachment insecurity
- Unresolved resentment
- Fear of losing connection
- Shame or moral injury

When these underlying patterns are addressed, political differences become more manageable. The goal is not agreement. The goal is restoring emotional safety so disagreement does not feel like abandonment.

### The Psychological Cost of Political Estrangement

When families fracture over politics, the emotional consequences can be significant.

[Research from the Pew Research Center]() has documented increasing political polarization in the United States. What is less discussed is the psychological toll this polarization takes inside homes.

Chronic political conflict can contribute to:

- Heightened anxiety
- Persistent anger and rumination
- Grief related to emotional cutoff
- Increased stress during holidays and gatherings
- Emotional insecurity in children exposed to high conflict

According to the [American Psychological Association](https://www.apaservices.org/advocacy/issues/children-youth-families), ongoing relational stress can have meaningful effects on mental and physical well-being.

Estrangement may provide temporary relief from conflict, but it often leaves unresolved grief, guilt, and loss. Therapy offers a structured environment to reduce intensity, improve communication, and determine whether repair — or clearer boundaries — are possible.

### What If We Don’t Agree on “Reality”?

One of the most destabilizing aspects of modern political conflict is the sense that family members no longer share a common understanding of facts.

When disagreements move from “We see this differently” to “You are living in a different reality,” conversations can quickly become emotionally charged and unproductive.

In therapy, we approach this carefully and respectfully.

Rather than debating facts, the focus shifts to:

- Emotional reactions to perceived threat
- Fear of moral invalidation
- The need to feel heard and understood
- How conversations escalate and why

Family therapy does not function as a fact-checking forum. It is a structured process aimed at improving relational functioning. Even when agreement feels impossible, it is often possible to:

- Develop boundaries around political discussions
- Reduce hostility and contempt
- Improve emotional regulation
- Restore a sense of basic respect

Disagreement does not have to mean disconnection. With the right structure, families can coexist with difference while preserving dignity and relationship.

## How Family Therapy Helps When Politics Divides You

In a therapeutic setting, the goal isn’t necessarily to get everyone to agree but to foster understanding, respect, and effective communication. I use specific techniques in family therapy for political differences, such as:

#### 1. Active Listening and Validation

Politics and Family Therapy Goal: Improve understanding and reduce emotional reactivity.

How It Works:

- Each person takes turns speaking while others listen without interrupting.
- The listener paraphrases what was said to ensure understanding.
- I may encourage responses like, *“I hear that you feel strongly about this because it affects your values of fairness and justice.”*

Why It Helps:

- Reduces defensiveness by making people feel heard.
- Encourages curiosity over criticism.

#### 2. Emotion-Focused Politics and [Family Therapy Techniques](https://dralanjacobson.com/family-therapy/)

Politics and Family Therapy Goal: Shift discussions from facts and arguments to emotions and experiences.

How It Works:

- Instead of debating political points, members are asked to describe their emotional reactions to political issues.
- Example: Instead of saying, *“You’re wrong about immigration!”*, someone might say, *“Hearing your views on immigration makes me feel anxious because I worry about how it affects our community.”*
- I guide them toward recognizing shared emotions, like fear, hope, or frustration, even if the reasons behind them differ.

Why It Helps:

- Humanizes the discussion, making it less about “winning” and more about connecting.
- Encourages empathy by focusing on personal experiences rather than abstract policies.

#### 3. Boundaries and Conflict Management

Politics and Family Therapy Goal: Create rules for how and when political discussions happen to prevent constant conflict.

How It Works:

- They set agreements like: 
    - “No political talk at family dinners.”
    - “If a conversation gets heated, we take a break and revisit it later.”
    - “We agree to avoid name-calling or personal attacks.”
- I teach de-escalation strategies, such as using humor, taking deep breaths, or shifting to a neutral topic when tensions rise.

Why It Helps:

- Prevents political arguments from overshadowing relationships.
- Creates a safer, more respectful environment for discussions.

#### 4. Exploring Core Values & Finding Common Ground

Politics and Family Therapy Goal: Shift focus from political disagreements to shared values.

How It Works:

- I help members identify the values underlying their beliefs.
- Example: A conservative parent and a liberal child might argue over taxes, but both might agree that they value economic security and fairness.
- Once common values are identified, discussions become more about achieving shared goals than fighting over political labels.

Why It Helps:

- Builds a foundation for mutual respect.
- Shows that people with different political views often care about similar things but prioritize solutions differently.

#### 5. Perspective-Taking & [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/)

Politics and Family Therapy Goal: Help members see the world from each other’s viewpoints.

How It Works:

- I might ask each person to articulate their political beliefs from the other person’s perspective.
- Example: A parent might be asked, *“How do you think your child sees this issue?”* and vice versa.
- Storytelling is encouraged—members share how their political beliefs formed through personal experiences.

Why It Helps:

- Fosters empathy and reduces demonization of opposing views.
- It helps people understand that individual experiences, not just ideology shape political beliefs.

#### 6. Differentiation & Individual Autonomy

Politics and Family Therapy Goal: Allow family members to maintain their own beliefs without feeling pressured to conform.

How It Works:

- I reinforce that holding different political views while maintaining bonds is okay.
- I encourage statements like, *“I love and respect you, even if we don’t agree on this.”*
- We separate identity from expectations and avoid “all-or-nothing” thinking (e.g., “If we don’t agree, we can’t be close”).

Why It Helps:

- It reduces the pressure to “convert” other members.
- It helps people navigate political differences without cutting off relationships.

## How Family Therapy for Political Differences Can Help

Family therapy for political differences can help by improving communication, reducing conflict, and strengthening relationships despite ideological disagreements. Here’s how it can make a meaningful impact:

1. Creating a Safe Space for Dialogue

In family therapy for political differences, I provide a neutral environment where members can express their views without fear of judgment or retaliation. This structured setting prevents conversations from escalating into heated arguments.

2. Teaching Healthy Communication Skills

Family therapy for political differences introduces skills such as:

- [Active listening](https://positivepsychology.com/active-listening-techniques/): Learning to hear and understand, not just react.
- Using “I” statements: Expressing feelings without attacking (e.g., *“I feel frustrated when…”* instead of *“You’re wrong because…”*).
- De-escalation techniques: Recognizing when to pause conversations before they turn into conflicts.

3. Reducing Emotional Reactivity

Politics often trigger strong emotions tied to identity and values. Family therapy for political differences helps individuals recognize their emotional triggers and respond more calmly instead of reacting impulsively.

4. Helping Families Set Boundaries

For families where political discussions frequently lead to conflict, therapy can guide them in setting boundaries, such as:

- Agreeing on times when political topics are off-limits.
- Establishing rules to ensure respectful conversations.
- Allowing individuals to disengage when discussions become too stressful.

5. Fostering Empathy and Understanding

I help members see beyond political labels and recognize the personal experiences that shape each other’s beliefs. This can make disagreements less about “winning” and more about understanding one another.

6. Finding Common Ground

Many political disagreements stem from different ways of solving the same problems. Family therapy for political differences helps families identify shared values—such as security, fairness, or freedom—to appreciate their commonalities rather than just focusing on differences.

7. Strengthening Bonds

Ultimately, family therapy for political differences helps families prioritize their relationships over political disagreements. It reinforces the idea that it’s possible to disagree with someone while still loving and respecting them deeply.

### **A Neutral and Structured Approach**

When politics enters family therapy, neutrality matters.

My role is not to endorse beliefs, challenge ideologies, or arbitrate political “rightness.” My role is to protect the therapeutic space — ensuring that each family member feels heard, respected, and emotionally safe. Clinical neutrality means I do not take sides in political disagreements. Instead, I focus on how those disagreements are affecting communication patterns, emotional regulation, attachment security, and overall relational functioning.

This work is grounded in established psychological science. Drawing from evidence-based approaches in family systems therapy, cognitive-behavioral principles, and emotion regulation research, we examine how conflict escalates, why certain topics trigger disproportionate reactions, and what skills can interrupt those cycles. When needed, we incorporate structured communication frameworks that reduce defensiveness and increase clarity.

A systems-focused lens is essential. Political conflict rarely exists in isolation. It is influenced by generational roles, longstanding family dynamics, power structures, identity development, and historical patterns of conflict. By looking at the system rather than a single “problem person,” we reduce blame and increase shared responsibility for change.

Finally, the work is outcome-driven. Therapy is not open-ended debate. We define clear goals at the outset — whether that means reducing escalation, restoring contact, setting healthy boundaries, or improving emotional regulation during high-stakes conversations. Progress is evaluated by measurable changes in behavior, tone, and relational stability.

The aim is not agreement. The aim is stability, respect, and a family structure capable of holding difference without collapsing under it.

## Politics and Family Estrangement

Relatives cut off or severely limit contact when differences occur because of ideological conflicts. This is the connection between politics and family estrangement. It can involve:

- Emotional distancing (e.g., avoiding certain members, limiting conversations).
- Physical separation (e.g., skipping gatherings, moving away).
- Complete cutoffs (e.g., blocking phone calls, ending relationships altogether).

### Politics and Family Estrangement Connect When:

- One or both parties feel disrespected or threatened by the other’s beliefs.
- Conversations become toxic, filled with personal attacks or demeaning language.
- A person’s political identity is tied to their moral or personal worth, making differences irreconcilable.
- Misinformation or extreme media influences deepen divides.

### What Can Prevent Estrangement?

While some instances of politics and family estrangement are unavoidable, many can be prevented with proactive strategies:

1. Establishing Healthy Communication

- Use “I” statements to express feelings rather than accuse (e.g., *“I feel hurt when…”* instead of *“You’re ignorant and wrong.”*).
- Practice active listening—showing a willingness to hear the other person’s perspective without interrupting.
- Avoid loaded or inflammatory language that escalates conflicts.

2. Setting Boundaries

- Decide when and where political discussions are appropriate (e.g., “Let’s not talk about politics at family dinners”).
- Agree to disagree on certain topics instead of feeling pressured to change each other’s minds.
- Take breaks from heated discussions rather than letting them spiral into fights that connect politics and family estrangement.

3. Focusing on Shared Values & Relationships

- Identify common values (e.g., both sides may care about justice, safety, or economic security, even if they have different ideas on achieving them).
- Prioritize bonds over political views—reminding each other that love and respect are more important than winning an argument.
- Engage in non-political activities together to strengthen relationships outside of ideological debates.

4. Practicing Empathy & Perspective-Taking

- Try to understand *why* members hold their beliefs—considering their background, experiences, and fears.
- Instead of assuming bad intentions, ask questions like, “What life experiences led you to see things this way?”
- Recognize that political beliefs are often deeply tied to personal identity, and changing them takes time (if ever).

5. Limiting Exposure to Polarizing Media

- Misinformation and partisan media can amplify family divisions. Consider discussing how each person consumes news and encourage fact-checking and diverse sources.
- Recognize that social media often worsens conflicts—some families agree to avoid online political debates.

6. Therapy & Mediation

- I can help navigate these conflicts in a neutral setting, preventing politics and family estrangement from taking hold.
- If full reconciliation isn’t possible, therapy can help members maintain limited but respectful contact instead of completely leading to a politics and family estrangement connection.

### When is Estrangement Necessary?

While prevention is ideal, in some cases, politics and family estrangement may not be an unhealthy option—especially when a member:

- Engages in verbal abuse, harassment, or threats over political beliefs.
- Refuses to respect boundaries and continuously forces political discussions.
- Uses politics as an excuse for harmful behavior, such as racism, sexism, or homophobia, making the relationship unsafe.

Limited or no contact may be necessary for emotional well-being in such cases. However, politics and family estrangement do not need to be connected except as a last resort after other efforts to repair the relationship have been made.

## Case Example: Politics and Family Therapy

### The Family

- Parents: John (62) and Linda (60) – politically conservative, watch traditional news sources, and value national security and economic stability.
- Daughter: Emily (30) – politically progressive, engaged in activism, values social justice and environmental policies.
- Son: Mark (35) – moderate, tries to stay out of family debates but gets pulled into conflicts.

### The Conflict

Political differences were manageable for years but escalated during a recent family gathering.

- John made a political comment about immigration policy that Emily found offensive.
- Emily reacted emotionally, accusing her father of being ignorant and insensitive.
- Linda tried to de-escalate, but Mark got involved, saying both sides were too extreme.
- The conversation turned into a shouting match, ending with Emily storming out and refusing to return home for future events.
- Since then, Emily has distanced herself, avoiding her parents’ calls and limiting communication. Suddenly, they faced the possibility of politics and family estrangement becoming linked.

### How Family Therapy for Political Differences Could Help

1. Family therapy for political differences creates a safe space for Discussion.

I guide conversations so they don’t spiral into personal attacks.

- Each family member gets a turn to express their feelings, not just what they believe politically.
- Example: Instead of John saying, *“Young people don’t understand how the world works,”* he could be encouraged to say, *“I feel frustrated when my views are dismissed because of my age.”*
- Instead of Emily saying, *“Dad, you’re a bigot,”* she could say, *“Hearing that comment makes me feel like you don’t care about issues that are important to me.”*

2. Establishing Boundaries

They could set rules about when and how political discussions happen.

- Avoiding politics at family gatherings to maintain positive relationships.
- Agreeing to walk away when conversations become heated rather than arguing.

3. Finding Common Ground

I might guide them to recognize shared values:

- John values security → Emily values fairness → Both agree that policies should keep people safe and protect rights.
- Linda values family unity → Mark values avoiding conflict → Both agree they want the family to stay connected.

They can have more productive conversations by shifting focus from political labels to shared values.

4. Repairing the Relationship

If estrangement continues, therapy might explore rebuilding trust without forcing agreement.

- John and Linda might reach out in a non-political way (e.g., “We love and miss you” instead of sending political articles).
- Emily might express what she needs to feel comfortable reconnecting.
- Mark might help mediate discussions rather than avoid them.

### Family Therapy for Political Differences Outcome Possibilities

1. Improved Understanding – The family learns to disagree respectfully and focus on maintaining their bond.
2. Reduced Conflict – Political arguments become less frequent, and gatherings become more enjoyable.
3. Partial Reconciliation – Emily may still distance herself politically but resumes a relationship with her parents.
4. Continued Estrangement – Emily may keep her distance permanently if John and Linda refuse to respect boundaries.

Key Takeaways

- Political estrangement often stems from feeling unheard, disrespected, or emotionally hurt rather than just policy disagreements.
- Therapy doesn’t aim to change beliefs but helps families communicate effectively and preserve relationships.
- Boundaries, empathy, and finding common ground are essential for preventing lasting damage.

## Conclusion

Political differences don’t have to lead to family breakdowns. Through structured conversations, emotional awareness, and intentional boundary-setting, families can learn to navigate ideological conflicts while maintaining love and respect for one another. Families prioritizing their relationships over winning debates creates space for meaningful dialogue and long-term harmony. While reconciliation isn’t always possible, many families find that therapy helps them move from conflict to coexistence, proving that strong family ties can endure even the most profound political divides. Politics and family estrangement do not need to be connected.

The methods above can be combined with other [types of therapy](https://dralanjacobson.com/types-of-therapy/), including [emotionally-focused family therapy](https://dralanjacobson.com/emotionally-focused-family-therapy/) and [family systems therapy](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/). It can be used as part of [adult sibling therapy](https://dralanjacobson.com/adult-sibling-therapy/) as well. If you have any questions about how this approach could benefit you or your family, please [get in touch](https://dralanjacobson.com/contact/) with me or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Frequently Asked Questions

### Can family therapy help if political beliefs are very different?

Yes. Therapy does not aim to change political beliefs but to improve communication, emotional regulation, and relational safety despite differences.

### Is it appropriate to discuss politics in therapy?

When political differences are affecting relationships, they are clinically relevant. Ethical guidelines support addressing issues that impact emotional and relational functioning.

### What if one family member refuses to compromise?

Therapy can still be helpful by clarifying boundaries, improving communication patterns, and addressing underlying emotional triggers.

### Can political conflict damage children?

High-conflict environments increase stress and insecurity in children. Therapy can reduce emotional intensity and model respectful disagreement.

### Do you take sides in political disagreements?

No. Therapy focuses on relational functioning, not ideology.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

 [ ![social network 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](https://www.facebook.com/appliedpsychologicalscience) [ ![social network 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](https://www.instagram.com/appliedpsychological) [ ![social network 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](https://www.linkedin.com/company/psychologicalscience/)

---

### [Mother–Daughter Therapy: Heal & Strengthen Your Bond](https://dralanjacobson.com/mother-daughter-therapy/)

**Published:** January 15, 2025
**Author:** Dr. Alan Jacobson

**Content:**

## **What Is Mother–Daughter Therapy? (Quick Overview)**

Mother–daughter therapy is a form of family therapy that focuses on improving communication, resolving conflict, and strengthening emotional connection between mothers and daughters. It provides a structured, supportive space to better understand each other and rebuild trust.

It can help with:

- Frequent arguments or ongoing tension
- Emotional distance or feeling misunderstood
- Difficult life transitions (teen years, adulthood, aging)
- Rebuilding trust after past hurt

### When Is Mother–Daughter Therapy Helpful?

- Communication breakdowns or recurring conflict
- Feeling disconnected or emotionally distant
- Struggles during adolescence or life transitions
- Longstanding hurt, resentment, or unresolved issues

Therapy is often sought when patterns of conflict repeat or emotional distance grows over time

## **What Changes in Mother–Daughter Therapy?**

- More open, calm communication
- Greater empathy and understanding
- Healthier boundaries
- A stronger, more supportive relationship

Therapy helps families develop healthier interaction patterns and rebuild connections

## Introduction to this Form of Treatment

The mother-daughter relationship is a unique and powerful connection that can shape a woman’s emotional and psychological development. Yet, like any important relationship, it requires effort, understanding, and sometimes, a little help to maintain and strengthen. Whether you’re experiencing tension or misunderstandings or simply wish to deepen the bond you share, mother-daughter therapy (also known as mother-daughter counseling) offers valuable tools and insights. You can transform your relationship into a source of happiness and support through effective communication and mutual understanding. I offer therapy for mother-daughter relationships (and, of course, mother-son therapy as well!). Feel free to [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

### Mother-Daughter Therapy Key Takeaways

- Strong bonds provide deep emotional security and lifelong support.
- Healthy relationships enhance mental health and resilience against stress
- Understanding and addressing common sources of conflict can improve communication
- Mother-daughter therapy offers a neutral space to strengthen relationships
- Setting clear goals and tracking progress can lead to successful mother-daughter therapy outcomes

## Importance of Mother-Daughter Relationships

The bond between a mom and daughter is often the first and most formative relationship in a person’s life. It acts as a blueprint for future interactions and relationships. This strong bond provides a secure foundation of love, understanding, and support that can last a lifetime.

### Benefits of Strong Mother-Daughter Bonds

A strong connection fosters emotional security and trust. This relationship becomes a safe haven where you can express your emotional needs without fear of judgment. It provides a foundation for lifelong support and understanding, ensuring you both have someone to lean on through life’s challenges.

Moreover, a close bond encourages open communication and emotional sharing. Mutual respect and appreciation naturally follow when you feel heard and valued. This empathy and love create a nurturing environment where you both can thrive. In essence, a strong bond is a blend of trust, emotional needs, empathy, and love, which leads to a fulfilling relationship.

### Impact of Healthy Relationships on Mental Health

Healthy relationships have a profound impact on mental health. They reduce stress and improve emotional well-being by providing a reliable support system. Positive interactions boost self-esteem and confidence in both parties, allowing them to face life’s challenges with resilience.

A nurturing relationship fosters resilience against mental health challenges, offering a buffer against [depression and anxiety](https://dralanjacobson.com/therapy-for-depression-and-anxiety/). Emotional support from family members is crucial in promoting overall mental wellness. Engaging in mother-daughter counseling or therapy can further enhance these benefits, ensuring you continue to grow and support each other.

## Benefits of Family Therapy for Mother-Daughter Relationships

Every relationship faces challenges, and this dynamic is no exception. Understanding the root causes of conflict and communication issues can help you navigate these challenges more effectively. [Generational differences](https://culturepartners.com/insights/understanding-different-generations-key-traits/) often lead to misunderstandings and conflicts. Different upbringings and societal norms can create a chasm that feels difficult to bridge. These differences can manifest as jealousy or stress, triggering disagreements and emotional strain.

Moreover, different communication styles can cause friction and misinterpretations. What might seem like a harmless comment to one can be perceived as hurtful by the other. Unresolved past issues may also resurface, adding layers to existing conflicts. Conflicting expectations and roles often create tension, leading to a cycle of stress and conflict that can be challenging to break.

### Improving Communication Dynamics

Improving communication is key to resolving misunderstandings and strengthening the bond. In mother-daughter counseling, open discussions about feelings help clarify misunderstandings and build a foundation of trust. Active listening—giving full attention and showing empathy—can significantly reduce miscommunication.

Setting boundaries is another crucial step. It ensures respect and understanding of personal space while maintaining a healthy balance in the relationship. Consistent communication builds trust and transparency, creating a safe environment for both parties to express their thoughts and emotions. Developing these communication skills takes time and effort, but the rewards are well worth it; thus, it is a core goal of therapy for mother-daughter relationships.

Mother-daughter therapy can be an invaluable tool in strengthening the bond. It offers a structured environment where both parties can address issues openly and honestly.

### Role of Mother-Daughter Therapy in Strengthening Bonds

Therapy for mother-daughter relationships provides a neutral space for open dialogue, allowing you to express your feelings without fear of judgment. I can help identify and address underlying relational patterns contributing to conflict.

Counseling fosters understanding and empathy, helping you see each other’s perspectives. Structured sessions encourage collaborative problem-solving, allowing you to work together to find solutions. Engaging in mother-daughter therapy can cultivate a healthier, more supportive relationship.

### Addressing Underlying Issues in Mother-Daughter Therapy

Mother-daughter therapy also uncovers the root causes of conflict and emotional distress, offering a path to healing and reconciliation. I guide families in developing healthier communication strategies, [addressing past trauma](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/), [healing from codependency](https://dralanjacobson.com/codependency-therapy/), and strengthening the present relationship. This support aids in healing and reconciliation, allowing you to move forward with a renewed sense of trust and understanding. Whether through traditional methods, coaching, or exploring the specific relationship dynamic, therapy for mother-daughter relationships is valuable in building a stronger, more resilient bond.

## How Mother-Daughter Counseling Works

### Setting Goals for Mother-Daughter Counseling Sessions

Setting clear goals is essential for a successful mother-daughter therapy experience. Goals guide the therapeutic process and help you measure progress over time. You’ll collaboratively set objectives to ensure you are both invested in the process and motivated to achieve positive outcomes.

Defined goals focus on specific issues and desired outcomes, allowing you to address the most pressing concerns in your relationship. Realistic objectives in therapy for mother-daughter relationships foster a sense of achievement and progress, keeping you both engaged and committed to the process.

### Tracking Progress and Adjusting Goals as Needed

Regular assessments help monitor improvements and challenges, providing opportunities to adjust goals as needed. Flexibility in goals accommodates changing needs and insights, ensuring that therapy remains relevant and effective.

Continuous feedback ensures alignment with progress in therapy for mother-daughter relationships, allowing you to make necessary adjustments and maintain motivation. You can achieve meaningful and lasting change in your relationship by tracking progress and adjusting objectives. We’ll set measurable, meaningful, and realistic goals from the start.

### Building Trust in Mother-Daughter Therapy

Trust and openness are the cornerstones of a strong relationship. A safe environment encourages honest and open communication, allowing you to express yourself without fear of judgment. Mutual respect and understanding form the basis of trust, creating a foundation for a strong emotional bond.

Regular positive interactions inside and outside mother-daughter therapy sessions strengthen this bond, reinforcing feelings of safety and acceptance. Consistent support nurtures a sense of security, ensuring you both feel valued and understood.

### Encouraging Vulnerability in Mother-Daughter Therapy

Vulnerability invites deeper connections and emotional intimacy, allowing you to share your true selves. Honest dialogue fosters authentic relationships, promoting understanding and empathy. Shared experiences build empathy and mutual respect, reinforcing the bond’s foundation. Trustworthy communication is essential in maintaining this foundation, ensuring you feel supported and connected. We work on all of that in therapy for mother-daughter relationships.

### Developing Healthy Communication Skills

Effective communication is key to strengthening the mother-daughter relationship. By developing healthy communication skills, you can enhance understanding and reduce conflict. Thus, we will work on:

#### Active Listening Techniques

[Active listening](https://www.verywellmind.com/what-is-active-listening-3024343) involves giving full attention to the speaker and seeking to understand their message. Reflective responses validate and clarify the speaker’s message, ensuring you’re both on the same page.

Non-verbal cues, such as eye contact and body language, enhance empathy and connection, creating a more supportive environment. Open-ended questions encourage further sharing and exploration, fostering more profound understanding and communication.

#### Effective Expression of Thoughts and Emotions

Clear articulation reduces misunderstandings and conflicts, allowing you to express yourself effectively. “I” statements express feelings without assigning blame, promoting a more constructive dialogue.

Constructive feedback from each other and me fosters growth and understanding, helping you improve your communication skills in mother-daughter counseling. Emotional awareness enhances self-expression and empathy, creating a more supportive and understanding relationship.

#### Creating Quality Time Together

Spending quality time together is essential for strengthening the bond. Shared activities and meaningful interactions create lasting memories and deepen connections. Shared activities strengthen emotional connections and memories, providing opportunities to bond and connect. Quality time fosters a sense of belonging and unity, creating a more cohesive relationship.

Positive experiences create lasting bonds and joy, reducing stress and enhancing relationship satisfaction. Fun activities provide a break from everyday stressors, allowing both parties to enjoy each other’s company and strengthen their bond. Scheduled time ensures consistent connection and interaction, allowing both parties to prioritize their relationship. Meaningful conversations deepen understanding and empathy, promoting a more supportive and connected relationship.

Rituals and traditions create a sense of family identity, reinforcing the importance of the mother-daughter relationship. Intentional presence enhances the quality of shared moments, ensuring that both parties feel valued and understood.

Again, we’ll design a plan for this and continually review it in mother-daughter counseling sessions.

## Mother-Son Therapy

Mother-son therapy can be invaluable for strengthening this unique bond, addressing communication challenges, and resolving conflicts. This type of therapy often involves better understanding of each other’s perspectives, building trust, and creating healthier dynamics.

### Common Reasons for Mother-Son Therapy

- **Communication Breakdown**: Difficulty expressing feelings or understanding each other’s perspectives.
- **Behavioral Issues**: Addressing challenges like ADHD, autism, or other conditions affecting family interactions.
- **Conflict Resolution**: Navigating disagreements or lingering resentment.
- **Life Transitions**: Adjusting to changes such as divorce, remarriage, or adolescence.
- **Strengthening Emotional Bonds**: Enhancing closeness and mutual understanding.

### Types of Mother-Son Therapy

- **Traditional Family Therapy**: Focuses on the family unit, addressing how everyone interacts and improving overall dynamics.
- **Attachment-Based Therapy**: This form of mother-son therapy explores how early attachment styles influence current relationships and behaviors.
- **[Cognitive-behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) mother-son therapy** helps identify and change behavior and thought patterns that cause conflict or misunderstanding.
- **Play Therapy** (for younger children): Engages children in play to express emotions and resolve issues.
- **Trauma-Focused Mother-Son Therapy**: Addresses the impact of past trauma on the relationship.

### Benefits and Outcomes

- Improved communication and conflict resolution skills.
- Greater empathy and understanding of each other’s feelings and needs.
- Reduced stress and tension within the relationship.
- A stronger emotional connection.

## Mother-Daughter Therapy FAQs

**What about other family diads?**

Mother-daughter therapy and mother-son therapy are specialized to focus on improving these relationships. Of course, I also offer services to address communication issues, resolve conflicts, and strengthen the bond between fathers and their children.

**How do you fix a damaged relationship?**

Mother-daughter counseling is designed to help fix a damaged relationship. When we meet, both of you need to open up communication channels and practice active listening. Building trust, setting boundaries, and practicing empathy is also crucial in repairing a strained relationship, and therapy for mother-daughter relationships can be an effective tool in addressing underlying issues and rebuilding a healthy relationship.

**What is the mother-daughter symbiotic syndrome?**

This psychological syndrome describes a relationship dynamic in which the mother relies heavily on her daughter for emotional support, validation, and identity. This can lead to enmeshment, boundary issues, and codependency, affecting both individuals’ emotional well-being and autonomy. Therapy for mother-daughter relationships can address this.

**What is the root cause of the mother-daughter conflict?**

The root cause of conflict can vary from family to family, but common factors include communication breakdowns, unresolved issues from the past, differing expectations, and personality clashes. Unrealistic expectations, lack of boundaries, and unmet needs can also contribute to tensions in the relationship. Identifying and addressing these underlying issues in mother-daughter counseling can be crucial in resolving conflicts and strengthening the bond between mothers and daughters.

## Summary and My Work

I provide mother-daughter therapy (aka mother-daughter counseling) with younger children through adults. I also provide mother-son therapy and other combinations of family treatment. Traditional family therapy can sometimes be modified to include occasional sessions with just some members to work on specific bonds. The approaches I use to work with dyads are based on traditional [family counseling](https://dralanjacobson.com/family-therapy/), such as [emotionally focused family therapy](https://dralanjacobson.com/emotionally-focused-family-therapy/), [strategic family therapy](https://dralanjacobson.com/strategic-family-therapy-powerful-positive-time-limited/), and [narrative family treatment](https://dralanjacobson.com/narrative-family-therapy/). There are also more specific methods, such as [attachment therapy](https://dralanjacobson.com/attachment-therapy/), when there has been trauma or loss.

### Contact Me for Mother-Daughter Therapy

Therapy for mother-daughter relationships can be powerful and life-changing, and I would be happy to discuss how it might benefit your relationship. Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Frequently Asked Questions: Mother–Daughter Therapy

Common questions about how mother–daughter therapy works, what to expect, and whether it’s right for your relationship.

   What is mother–daughter therapy, and how is it different from individual therapy?Mother–daughter therapy is a specialized form of [family therapy](https://dralanjacobson.com/family-therapy/) focused specifically on the relationship between a mother and daughter — rather than on either person individually. While individual therapy explores one person’s inner world, mother–daughter therapy addresses the dynamic between two people: the communication patterns, relational histories, unspoken expectations, and emotional cycles that play out between them. Sessions create a structured, neutral space where both parties can speak honestly, be heard without defensiveness, and begin building new ways of relating. It is useful at any life stage — from adolescence through adulthood and into the later years of a parent’s life.

  What kinds of issues bring mothers and daughters to therapy?The most common presenting issues include chronic conflict and recurring arguments that never fully resolve; emotional distance or a sense of feeling misunderstood; struggles during major life transitions such as adolescence, leaving for college, marriage, divorce, or a parent’s aging; longstanding hurt, resentment, or unresolved grievances from the past; and patterns of [codependency or enmeshment](https://dralanjacobson.com/codependency-therapy/) that make it difficult for either person to maintain healthy boundaries. Some families come in after a specific rupture — a betrayal, a difficult conversation, or an estrangement — while others come because a slow drift has left the relationship feeling hollow or tense. Both are valid reasons to seek support, and both respond well to treatment.

  What therapeutic approaches are used in mother–daughter therapy?Dr. Jacobson draws from several evidence-based models depending on the nature of the relationship and each family’s needs. Core approaches include [Emotionally Focused Family Therapy (EFFT)](https://dralanjacobson.com/emotionally-focused-family-therapy/), which targets the attachment patterns and emotional cycles that drive conflict; [Narrative Family Therapy](https://dralanjacobson.com/narrative-family-therapy/), which helps each person examine the stories she has constructed about the relationship and herself; and [Strategic Family Therapy](https://dralanjacobson.com/strategic-family-therapy-powerful-positive-time-limited/), a structured, goal-directed approach that produces change efficiently. When past trauma or loss is part of the picture, [attachment-based therapy](https://dralanjacobson.com/attachment-therapy/) and [trauma-informed work](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/) are integrated. The approach is always tailored to the specific relationship rather than applied as a formula.

  What is the mother–daughter symbiotic syndrome, and can therapy help?The mother–daughter symbiotic syndrome describes a relational pattern in which a mother relies heavily on her daughter for emotional support, identity, or validation — and the daughter’s own sense of self becomes entangled with her mother’s needs and moods. This dynamic, which overlaps significantly with [codependency](https://dralanjacobson.com/codependency-therapy/), creates boundary confusion, limits the daughter’s autonomy, and can affect both parties’ mental health and relationships outside the family. The [American Psychological Association](https://www.apa.org/topics/parenting) recognizes enmeshment as a meaningful risk factor for emotional development. Therapy directly addresses these patterns by helping both mother and daughter understand how the dynamic formed, what it costs each of them, and how to move toward a relationship grounded in genuine connection rather than emotional dependency.

  How does therapy actually improve communication between mothers and daughters?Communication work in therapy goes well beyond learning to “listen better.” Sessions focus on identifying the specific patterns that cause communication to break down — often, one person pursues and the other withdraws; or both escalate; or one minimizes and the other catastrophizes. Once these cycles are visible, each person can begin to understand her own role in the pattern and experiment with new responses. Practical skills built in session include [active listening techniques](https://www.verywellmind.com/what-is-active-listening-3024343), using “I” statements to express feelings without triggering defensiveness, setting and respecting boundaries, and regulating emotional reactivity in the moment. Many families find that the communication improvements generalize quickly — showing up not just in sessions but in everyday interactions at home.

  Can mother–daughter therapy help if there has been serious conflict, estrangement, or past trauma?Yes — in fact, these are often the situations where therapy is most needed and most valuable. Serious or longstanding conflict, periods of estrangement, and the effects of past [childhood trauma](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/) or loss all leave marks on the relationship that do not resolve on their own. Therapy creates a structured environment for approaching these histories with both honesty and care — pacing the work to what each person can tolerate, building enough safety for genuine vulnerability, and working toward repair without requiring either party to minimize what happened. Research on [family estrangement](https://dralanjacobson.com/family-estrangement-therapy/) consistently shows that reconciliation is possible in many cases when both parties are willing to engage in supported, structured dialogue. Even when full reconciliation isn’t the goal, therapy can help each person find clarity, reduce the weight of unresolved grief, and move forward.

  Does mother–daughter therapy work online, or does it need to be in person?Mother–daughter therapy is fully compatible with online delivery and works well via secure video sessions. This is particularly useful for mothers and daughters who live in different cities or states — a common reality during college years, early adulthood, or when an aging parent relocates. Dr. Jacobson is a [PSYPACT](https://psypact.org/)-participating psychologist licensed in 44 states, which means he can typically see both participants regardless of where each is located. Many families find that the logistics of meeting online actually lower the barrier to starting — there’s no need to coordinate driving to the same office, which can itself be a source of friction. For more on how virtual sessions are structured, see the [virtual therapy guide](https://dralanjacobson.com/virtual-therapy-guide/).

  How do we get started, and what happens in the first session?The first step is a free 20-minute consultation — typically with one or both family members — to discuss what’s been happening, what each person hopes to get from therapy, and whether this approach and fit make sense. The first full session focuses on gathering background from both perspectives, identifying the patterns that are causing the most difficulty, and beginning to set collaborative goals. Most families find this initial session both clarifying and relieving — it normalizes what has felt uniquely broken and opens a clear path forward. You can also review the [guide to choosing a family therapy approach](https://dralanjacobson.com/which-type-of-family-therapy-is-right-for-you/) and the general [Therapy FAQs](https://dralanjacobson.com/therapy-faqs/) before reaching out.

 Ready to strengthen your relationship?

Schedule a free 20-minute consultation with Dr. Jacobson — a low-pressure conversation about where things stand and what therapy might offer.

 [ Schedule a Free Consultation ](https://www.picktime.com/scheduleaconsult) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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### [Family Estrangement Therapy: Parents, Siblings, or Families](https://dralanjacobson.com/family-estrangement-therapy/)

**Published:** January 24, 2025
**Author:** Dr. Alan Jacobson

**Content:**

**Family estrangement** is a complex and painful experience where individuals or groups become emotionally or physically distant from each other, often due to unresolved conflicts, differing values, or harmful behavior. It can happen between parents and children, siblings (“**Adult sibling estrangement**“), or extended family members. I provide individual therapy for individuals working through these issues, **couples therapy for estranged parents**, and **family therapy for adult child estrangement** when the goal is reconciliation or increased understanding.

## Family Estrangement Overview

Family estrangement can be triggered by various factors, such as:

1. **Abuse**: Emotional, physical, or psychological abuse can lead to a break in the relationship.
2. **Unresolved conflict**: Long-standing arguments or disagreements that have never been fully addressed.
3. **Toxic behavior**: Patterns of manipulation, control, or disrespect that make maintaining a relationship unhealthy.
4. **Different values or lifestyles**: Disagreements on personal choices, beliefs, or life decisions can cause rifts.
5. **Poor communication**: Lack of communication or ineffective communication can deepen misunderstandings.

### Emotional Impact

The emotional impact of family estrangement can be profound, often leading to feelings of grief, guilt, anger, and loneliness. For some, the split is necessary for personal well-being; for others, it’s a painful loss they hope to heal from. I offer several types of therapy for adult-child estrangement, including for clients who seek [individual therapy](https://dralanjacobson.com/individual-therapy/) to address their feelings and whether reconciliation is possible, as well as couples and families who want to process things together.

### Family Therapy for Adult Child Estrangement

A course of family therapy for adult child estrangement can be a powerful tool for healing, especially when the relationship has become strained over time but has not broken. As the family navigates changing dynamics and unresolved issues, therapy for family estrangement can provide a neutral space to work through emotions, misunderstandings, and any past hurts that have led to the current situation. The emotional wounds may run deep, and parents and children may feel hurt, frustrated, or resentful.

Here’s how [family therapy](https://dralanjacobson.com/family-therapy/) can help in the case of adult child estrangement:

#### 1. Creating a Safe, Neutral Space

Family treatment can provide a safe, neutral environment where both parties — the parent(s) and the adult child — can express their feelings without fear of judgment or escalation. I help guide the conversation to stay constructive and focused on understanding each other rather than getting lost in blame or anger.

#### 2. Addressing Past Wounds

These situations often result from unresolved conflicts, misunderstandings, or harmful behavior. Treatment can help identify the root causes, whether it’s poor communication, [childhood trauma](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/), unmet needs, or value differences. The adult child and the parents need to acknowledge and address any past wounds that might still affect their relationship today.

#### 3. Improving Communication Skills

Miscommunication is common in these relationships, and therapy for adult child estrangement can teach both sides how to communicate more effectively. Parents and adult children may struggle with speaking openly, listening actively, or expressing themselves without judgment. I can teach them how to have difficult conversations, set healthy boundaries, and respect each other’s feelings. [Psychotherapy](https://dralanjacobson.com/psychotherapy/) can help each person communicate in a way that promotes understanding rather than conflict.

#### 4. Exploring the Impact of Family Estrangement

The pain of these splits can often go unspoken. Parents may feel rejected or hurt, and adult children may feel unheard or unsupported. Treatment gives both sides the chance to talk about how things have impacted their mental health, their feelings of loss, and any emotions they’ve been holding back. This can help everyone recognize the deep emotional toll the estrangement has caused and find ways to process those feelings.

#### 5. Understanding Each Other’s Perspectives

One of the key goals of family therapy is for everyone involved to understand the other person’s perspective better. Parents might see their behavior as protective or well-intentioned, while adult children may feel stifled or misunderstood. Our meetngs can help both sides realize that their intentions, while different, come from a place of caring or fear. This deeper understanding can create the foundation for healing.

#### 6. Exploring Boundaries and Expectations for Family Estrangement Therapy

One challenge in these relationships, especially with adult children, is setting healthy boundaries. Sometimes, parents struggle to relinquish control or have difficulty respecting their adult child’s autonomy. Similarly, adult children may need help learning to set clear boundaries with their parents without feeling guilty. Therapy can help both parties navigate these tricky waters, ensuring that boundaries are respected and that expectations are realistic.

#### 7. Deciding on Reconciliation or Acceptance

In some cases, treatment may reveal that reconciliation is not possible or healthy, especially if there are patterns of toxic behavior or abuse. In such situations, therapy can help parents and adult children understand the relationship and learn how to find closure or acceptance. The goal may shift from reconciliation to learning how to live in a way that allows everyone to heal.

#### 8. Rebuilding Trust After Family Estrangement

If the split is rooted in broken trust, [emotionally-focused family therapy](https://dralanjacobson.com/emotionally-focused-family-therapy/) can slowly rebuild that trust. This might involve acknowledging past wrongs, apologizing, and committing to change. Trust is often not rebuilt overnight, but therapy for adult child estrangement can provide the framework for starting that process healthily and constructively.

#### 9. After Therapy for Adult Child Estrangement: Improving the Future

Even if full reconciliation isn’t possible immediately, therapy can help create a blueprint for healthier future interactions. This could involve understanding when to step back, respecting each other’s needs, and knowing when to engage or disengage.

### Is Family Estrangement Therapy Right for You?

For family estrangement therapy to be effective, both the parents and the adult child need to be willing to participate. It can be tough if one party is hesitant or resistant to the process, especially if the situation is due to deep hurt or unresolved issues. However, even if only one party is open, it can still be beneficial for gaining perspective and healing individual wounds.

Family therapy for adult child estrangement might be a good idea if:

- All parties are willing to explore the reasons behind the difficulties.
- There’s a desire to heal or improve the relationship, even by setting healthy boundaries.
- There’s an openness to difficult conversations, apologies, and forgiveness.

### Approaches to Family Estrangement Therapy

Family estrangement therapy can be beneficial when navigating complex emotions. It provides a safe space to explore the feelings of hurt, anger, grief, or even relief that often accompany such situations. I can help you process those emotions, understand the dynamics that led to the current situation, and guide you in deciding whether reconciliation is possible or healthy for you.

There are a few different approaches that therapy for adult child estrangement might take in these situations:

1. **Individual Treatment for Adult Child Estrangement** can help you work through your personal feelings, manage stress or anxiety related to estrangement, and improve your coping strategies. I can help you explore your emotions, your family history, and how the estrangement has impacted your mental health.
2. **Family Treatment for Adult Child Estrangement**: If you’re open to reconciliation or simply want to understand the dynamics at play, family treatment can provide a neutral space where you and your family members can express your feelings and work toward understanding each other. However, this can only work if all parties are willing to engage.
3. **[Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT)** for therapy for adult child estrangement can help reframe negative thought patterns that may have developed. It could also help process guilt, anger, or resentment and learn how to approach these emotions in a healthier way.
4. **[Trauma-Informed Therapy](https://positivepsychology.com/trauma-informed-therapy/) for Adult Child Estrangement**: If your relationships were hurt by any form of abuse or deep emotional harm, trauma-informed therapy can be essential in healing from those experiences. It can help you understand the impact of trauma and develop strategies for self-care and rebuilding your sense of safety and well-being.

Therapy for adult child estrangement can also help with practical aspects, like setting boundaries, managing expectations, or deciding whether to reach out to estranged family members and, if so, how.

## Therapy for Estranged Parents

A course of therapy for estranged parents is a unique and often difficult journey. Parents going through estrangement often feel a deep sense of loss, confusion, and guilt, especially if the reasons for the estrangement are unclear or seem beyond their control. Therapy for estranged parents can help these parents process their emotions, gain clarity, and possibly work toward healing — whether that’s within the family or just for their own peace of mind.

Here’s how therapy for estranged parents can be beneficial:

1. **Understanding and Processing Emotions**: Parents may feel grief, anger, sadness, or helplessness. Therapy for estranged parents can provide a space to talk through those emotions and understand why they’re feeling the way they are. Parents need to have an outlet for these feelings so they don’t build up in unhealthy ways.
2. **Gaining Perspective**: Sometimes, parents struggle to understand the reasons behind the estrangement or do not fully grasp their role. In therapy for estranged parents, I can help them gain perspective, look at things from their child’s point of view, and process any unhealthy patterns or dynamics that might have contributed.
3. **Improving Communication**: One of the biggest challenges is often communication. In therapy for estranged parents, parents can learn healthy communication skills—expressing themselves without triggering defensive reactions, listening actively, and respecting boundaries.
4. **Healing and Self-Care**: Therapy for estranged parents can help them focus on their healing process, which is crucial. Whether things are temporary or permanent, [couples therapy](https://dralanjacobson.com/couples-therapy/) can help them find ways to cope with the emotional fallout and rebuild their emotional well-being. Sometimes, focusing on self-compassion and rebuilding a sense of identity outside the family dynamic can be essential for recovery.
5. **Exploring Reconciliation**: If a parent wants to rebuild the relationship, therapy for estranged parents can help them explore how (or if) reconciliation might be possible. Sometimes, parents may need help understanding if they’re ready to reconnect, if their child is open to it, or if the relationship is better left in its current state for everyone’s well-being.
6. **Setting Boundaries and Managing Expectations**: Therapy for estranged parents can help them understand how to set healthy boundaries with their children, especially if there’s been toxic behavior or unresolved conflict. It can also help them manage expectations — sometimes, the goal of therapy for estranged parents is not necessarily to reconcile but to come to terms with the relationship as it stands.

### Is Therapy for Estranged Parents Right for You?

It’s important to have clear goals going into therapy for estranged parents, whether it’s healing emotionally, improving communication, or finding closure. Therapy isn’t a guarantee of reconciliation, but it can offer tools and insights that make it easier to process the complex emotions involved. If you’re feeling stuck or overwhelmed, this can be a constructive way to work through those feelings, whether the ultimate goal is reconnection or acceptance.

## Therapy for Adult Sibling Estrangement

Treatment for adult sibling estrangement can be incredibly beneficial, as sibling relationships can be deeply impactful and sometimes quite complex. Siblings becoming estranged can stem from years of unresolved conflict, miscommunication, or differing values. However, siblings can also experience intense love and loyalty toward each other, which makes adult sibling estrangement especially painful.

Adult sibling estrangement therapy can help estranged siblings navigate their relationship in several key ways:

1. **Addressing Underlying Issues**: Sometimes, adult sibling estrangement results from deeper issues—whether those are longstanding family dynamics, past trauma, jealousy, or resentment. Therapy can help both siblings understand the root causes of their conflict. By unpacking the emotions tied to these issues, they can gain insight into their behavior and how it may have contributed. This can help both sides approach the situation with more empathy and understanding.
2. **Improving Communication**: Miscommunication and misunderstandings are often at the heart of adult sibling estrangement. In therapy, siblings can improve their communication skills — learning to express their feelings without blaming or escalating conflict, listening actively, and communicating their needs healthily.
3. **Rebuilding Trust**: If siblings have broken trust, therapy can provide a framework for rebuilding it. Rebuilding trust often involves acknowledging past wrongs, taking accountability, and demonstrating a willingness to change. Therapy can also help both siblings identify their emotional needs and learn how to meet them in a way that fosters trust, even if it takes time.
4. **Setting Boundaries**: In some cases, siblings may need to set clear boundaries with one another, especially if the adult sibling estrangement is tied to toxic behavior or manipulation. Treatment can help siblings navigate setting these boundaries while respecting one another’s individuality. It can also help siblings understand that boundaries don’t necessarily mean the end of the relationship; they can be part of a healthy and respectful dynamic.
5. **Exploring Reconciliation or Closure**: Adult sibling estrangement therapy can provide a space to explore whether reconciliation is possible — or if it’s healthier for the siblings to move on from the relationship. Sometimes, therapy reveals that reconciliation may not be realistic, and the goal may shift toward finding closure or acceptance. Whether they reconcile or not, treatment can help siblings process their feelings and achieve peace.
6. **Emotional Healing**: The emotional impact of adult sibling estrangement can leave deep scars. Treatment can support each sibling’s healing process, whether that involves dealing with feelings of rejection, guilt, anger, or sadness. Sometimes, healing may also mean coming to terms with the loss of what the sibling relationship could have been.
7. **Family Therapy**: Family therapy might be helpful if the adult sibling estrangement is part of a broader family dynamic. Family therapy can help identify and address patterns in family communication that contribute. If the whole family is involved, it might create a more holistic understanding of the issues at play.
8. **Neutral Mediator**: In cases where siblings struggle to speak to each other, I can act as a neutral mediator, providing a safe space for both sides to share their perspectives without feeling attacked. This can be especially helpful if the siblings are stuck in a cycle of blame or if they are struggling to open up to each other on their own.

### Is Adult Sibling Estrangement Therapy Right for You?

If you’re considering therapy for adult sibling estrangement, it’s important to check if both siblings are open to the idea. Therapy works best when both parties are willing to engage in the process, so having an honest conversation about why therapy could be helpful is a good first step. Sometimes, one sibling may need to go through individual therapy first, especially if the estrangement is tied to personal trauma or deep emotional pain.

Whether or not reconciliation is the ultimate goal, adult sibling estrangement therapy can provide healing and a path forward, whether they end up reconnecting or learning to live with the residual feelings healthily.

## Summary and My Work

I offer multiple types of therapy for adult child estrangement. I mix in techniques, including [solution-focused family therapy](https://dralanjacobson.com/solution-focused-family-therapy-focusing-on-positive-change/) and [narrative family therapy](https://dralanjacobson.com/narrative-family-therapy/). This treatment can be helpful for individuals, parents, siblings, and the entire family. It is used in many circumstances, including as [therapy for political anxiety](https://dralanjacobson.com/therapy-for-political-anxiety/), [therapy for blended families](https://dralanjacobson.com/blended-family-therapy-step-parent-counseling/), and when [politics causes estrangement](https://dralanjacobson.com/politics-and-family-therapy/) in families. [Acceptance and forgiveness therapy](https://dralanjacobson.com/forgiveness-therapy-steps-and-integrations/) is often helpful when estrangement cannot be solved.

If you have questions about therapy for adult child estrangement or family estrangement in general or would like more information about my services, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Frequently Asked Questions: Family Estrangement Therapy

Common questions about therapy for family estrangement — what it involves, who it helps, and whether reconciliation has to be the goal.

   How common is family estrangement — and why does it happen? + Family estrangement is far more common than most people realize — and far more stigmatized than it should be. Research by [Cornell sociologist Karl Pillemer](https://www.cornellpress.cornell.edu/book/9781501765070/fault-lines/), author of *Fault Lines*, estimates that approximately 27% of Americans are estranged from a family member, with tens of millions experiencing estrangement from a parent, child, or sibling at some point in their lives. The most common causes include longstanding unresolved conflict, patterns of toxic or abusive behavior, fundamental value differences, poor communication habits that calcified over decades, and life transitions — a marriage, a divorce, a death — that exposed existing fault lines. Estrangement is rarely a single event; it is almost always the accumulated product of a pattern, often years or decades in the making. Understanding why estrangement happens is the first step toward deciding what, if anything, to do about it. Therapy creates the structured space to examine that pattern honestly — without pressure toward any particular outcome. See also the [adult family therapy](https://dralanjacobson.com/adult-family-therapy/) and [adult sibling therapy](https://dralanjacobson.com/adult-sibling-therapy/) pages for related contexts.

   Does family estrangement therapy require reconciliation as the goal? + No — and this is one of the most important things to understand before starting. Therapy for family estrangement does not presuppose reconciliation as the correct or desired outcome. For some people and some situations, reconciliation is the goal and is achievable. For others, the right outcome is clarity about why limited contact or no contact is the healthiest choice — and the emotional processing to make peace with that decision rather than carrying it as unresolved grief or guilt. For still others, the goal is somewhere in between: a redefined relationship that is less close than what existed before but more sustainable than complete cutoff. Therapy helps each person clarify what they actually want, evaluate what is realistically possible, and move toward an outcome they can live with — rather than one that is externally prescribed. This is a significant clinical distinction: a therapist who pushes reconciliation regardless of safety or fit does their client a disservice. Dr. Jacobson’s approach holds the outcome open and follows the client’s lead, informed by honest clinical assessment of what each situation makes possible. See also [forgiveness therapy](https://dralanjacobson.com/forgiveness-therapy-steps-and-integrations/), which addresses closure that does not require contact.

   I am an estranged parent. Can therapy help me even if my adult child won’t participate? + Yes — and individual therapy for estranged parents is often where the most meaningful work begins. Parents experiencing estrangement from an adult child carry a distinctive emotional burden: grief that is often disenfranchised (not socially recognized the way other losses are), guilt that may or may not reflect actual responsibility, confusion about what happened and why, and the particular pain of a loss that involves someone still living. Individual therapy provides a space to process those emotions honestly, gain perspective on the dynamics that contributed to the estrangement — including one’s own role without self-punishment — develop healthier communication strategies if and when contact is possible, and build self-compassion and coping skills regardless of whether reconciliation ever occurs. Many estranged parents also find that changes in their own communication patterns and emotional regulation — things they can control entirely — create conditions that make their adult child more open to contact over time. The [APA’s coverage of estrangement research](https://www.apa.org/monitor/2019/04/estrangement) highlights the significant mental health impact on estranged parents and the value of targeted therapeutic support. For couples navigating estrangement together, couples therapy provides an additional layer of support when the estrangement is affecting the parental relationship.

   I am an adult child who has cut off contact with a parent. Can therapy help me process this? + Yes — and this is one of the most important and least-served populations in family estrangement therapy. Adults who have reduced or ended contact with a parent often carry a complex mixture of relief, grief, guilt, doubt, and continued anger — sometimes simultaneously. Estrangement from a parent does not eliminate the attachment or the emotional impact of that relationship; it simply changes the nature of the contact. Therapy provides a space to process the grief of the family you needed but didn’t have, examine whether your decision reflects your genuine values and wellbeing or has become its own source of suffering, navigate the social stigma and family pressure that often accompanies estrangement, and, if and when it feels right, consider what — if anything — a different kind of contact might look like. Critically, therapy in this context does not pressure reconciliation. The work is about your wellbeing, your clarity, and your ability to make decisions that reflect who you are rather than reacting from pain or obligation. [Trauma-informed therapy](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/) is often part of this work when the estrangement is rooted in a history of abuse or neglect — and it ensures that any consideration of contact is made from a foundation of genuine safety rather than hope or external pressure.

   How does family estrangement therapy work when both parties are willing to participate? + When both parties are willing to engage, family estrangement therapy typically proceeds in phases. The first phase establishes safety — creating ground rules for communication within sessions so that each person can speak and be heard without the conversation deteriorating into the same patterns that drove the estrangement. The second phase focuses on understanding — exploring each person’s experience of the relationship, the events or patterns they identify as pivotal, and the emotions underneath the surface positions. This is often the most clinically rich and surprising phase: it is common for both parties to discover that their experience of the same relationship was genuinely different, in ways neither had been able to hear before. The third phase addresses the practical: what, if any, relationship is possible or desired going forward, what conditions make that relationship safe and sustainable, and how to communicate about difficult topics without triggering the patterns that caused the rupture. [Emotionally Focused Family Therapy](https://dralanjacobson.com/emotionally-focused-family-therapy/), [Narrative Family Therapy](https://dralanjacobson.com/narrative-family-therapy/), and [Solution-Focused approaches](https://dralanjacobson.com/solution-focused-family-therapy-focusing-on-positive-change/) are all used depending on what each family’s situation calls for.

   How is therapy for adult sibling estrangement different from parent-child estrangement therapy? + The core therapeutic principles are similar — creating safety, building understanding, exploring the path forward — but the relational dynamics and typical presenting issues differ in important ways. Parent-child estrangement almost always involves a significant power differential in origin: parents who had authority over a child’s early life, and the lasting effects of how that authority was exercised. Sibling estrangement more frequently centers on childhood role assignments, favoritism, competition for parental attention, or a specific rupture in adulthood — an inheritance dispute, a caregiving disagreement, a perceived betrayal. Sibling relationships also lack the formal social and legal structures that parent-child relationships carry, which means the decision about contact is more open and less freighted with obligation. Therapy for adult sibling estrangement tends to focus more on peer dynamics — the relational patterns between equals rather than between authority figures and dependents — and frequently involves more direct work on communication and negotiation skills alongside the emotional processing. For more depth on sibling-specific dynamics, the [adult sibling therapy page](https://dralanjacobson.com/adult-sibling-therapy/) covers the full range of presenting situations, including caregiving conflicts, inheritance disputes, and longstanding role rigidity.

   Can family estrangement therapy be done online when family members are in different locations? + Yes — and virtual delivery is particularly well-suited to this population. Estranged family members almost always live in different cities or states — geographic distance is frequently both a cause and a consequence of estrangement. Online sessions via secure video allow all parties to attend from wherever they are, which eliminates the logistical barriers that have historically made this type of work difficult to sustain. Individual sessions, joint sessions with two family members, and larger family sessions can all be delivered virtually in whatever configuration the treatment calls for. Dr. Jacobson is a [PSYPACT](https://psypact.org/)-participating psychologist licensed in 44 states, allowing him to work with family members across most of the country in the same session. For more on how virtual sessions are structured, see the [virtual therapy guide](https://dralanjacobson.com/virtual-therapy-guide/) and the overview of [online therapy approaches and outcomes](https://dralanjacobson.com/therapy-online-approaches-techniques-and-outcomes/).

   How do I get started with family estrangement therapy? + The first step is a free 20-minute consultation — typically with one person, which is the most common starting point since estrangement by definition often means the other party is not yet engaged. That conversation covers what the estrangement involves, how long it has been going on, what you’re hoping to get from therapy, and whether individual or joint sessions make more sense to start. There’s no commitment required and no pressure toward any particular outcome. Many people find the consultation itself meaningful — simply being able to describe a situation that often carries shame and social isolation to someone who responds without judgment is its own form of relief. Related pages worth reviewing depending on your specific situation: [adult sibling therapy](https://dralanjacobson.com/adult-sibling-therapy/), [adult family therapy](https://dralanjacobson.com/adult-family-therapy/), [mother–daughter therapy](https://dralanjacobson.com/mother-daughter-therapy/), [therapy for political family conflict](https://dralanjacobson.com/politics-and-family-therapy/), [forgiveness therapy](https://dralanjacobson.com/forgiveness-therapy-steps-and-integrations/), and the [guide to choosing a family therapy approach](https://dralanjacobson.com/which-type-of-family-therapy-is-right-for-you/).

 Whether you want to reconnect, find closure, or simply understand — therapy can help you get there.

Schedule a free 20-minute consultation with Dr. Jacobson — a confidential conversation about your situation and what therapy might offer.

 [ Schedule a Free Consultation ](https://www.picktime.com/scheduleaconsult) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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### [Separation and Divorce Counseling](https://dralanjacobson.com/divorce-counseling/)

**Published:** April 11, 2025
**Author:** Dr. Alan Jacobson

**Content:**

**Divorce counseling** and **divorce therapy** are designed to help individuals or couples navigate the emotional, psychological, and practical challenges of ending a marriage. I work with individuals and couples navigating the complexities of this [life transition](https://dralanjacobson.com/life-transitions-therapy/). Whether you’re in the early stages of separation, facing high conflict, or trying to co-parent effectively, counseling for divorce can provide structure, clarity, and emotional support during a deeply challenging time. Counseling or therapy for divorce helps you reduce conflict, communicate more constructively, and make decisions that protect your emotional well-being—and, when applicable, the well-being of your children.

Through [evidence-based strategies](https://www.apa.org/practice/resources/evidence/), we’ll focus on practical solutions, emotional resilience, and helping you move forward with greater confidence and peace of mind.

## Divorce Counseling Overview

### Why is Divorce Counseling Used?

This approach is used to:

- **Help process emotions** like grief, anger, guilt, or fear.
- **Support healthy communication**, especially if children or co-parenting are involved.
- **Assist in making informed decisions** about the process, finances, custody, etc.
- **Provide guidance** on how to transition to the next stages of life.
- **Prevent high-conflict situations** from escalating, especially when the split is contentious.
- **Prevent expensive legal processes** by opening the door to mediation

### Why is Divorce Counseling Helpful?

It can be helpful because it:

- **Reduces emotional distress** and helps people manage stress more effectively.
- **Improves clarity** and decision-making during a chaotic and emotional time.
- **Supports children** by helping parents work together and reduce the emotional toll on the family.
- **Teaches coping skills** for change, rejection, loneliness, or a sense of failure.
- **Promotes closure** and healing, making it easier to move on in a healthy way.

### Is Divorce Counseling Required?

- **Legally?** Usually, counseling for divorce is **not required**—though some courts may mandate counseling or mediation for custody cases or if children are involved.
- **Voluntarily?** Many people choose it on their own or at the suggestion of an attorney, mediator, or family member.
- In some religious or community settings, **pre-divorce counseling** may be encouraged or expected.

### What Techniques Are Used?

Clinicians may use a range of therapeutic approaches:

- **[Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT):** Helps reframe negative thoughts and manage emotional responses.
- **[Emotionally Focused Therapy for couples](https://dralanjacobson.com/eft-therapy-for-couples/) (EFT):** Explores attachment needs and emotional patterns, especially if couples attend together.
- **[Narrative Couples Therapy](https://dralanjacobson.com/narrative-couples-therapy/):** Encourages clients to re-author their personal stories in a way that empowers them.
- **Conflict Resolution Techniques:** Teaches skills to reduce arguing and improve communication, often helpful in co-parenting.
- **[Mindfulness-Based Stress Reduction](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/):** Helps with anxiety, emotional regulation, and acceptance.
- **[Solution-Focused Therapy](https://dralanjacobson.com/solution-focused-therapy/):** Focuses on creating practical steps for future stability.

### Individual Divorce Counseling

Divorce counseling doesn’t have to involve both partners—it can be highly effective as an **[individual therapy](https://dralanjacobson.com/individual-therapy/) process**. In individual divorce counseling, a person works one-on-one with me to process the emotional impact of separation, gain clarity about their needs, and develop healthy coping strategies.

This type of counseling can help with:

- Managing grief, anger, or anxiety
- Making informed decisions about the process
- Developing communication strategies for dealing with an ex
- Adjusting to new routines, roles, and identity
- Building resilience and preparing for future relationships

Even if the other partner isn’t open to counseling, individual support can make a huge difference in navigating the transition more calmly and confidently.

## Divorce Counseling vs. Divorce Therapy

While divorce counseling and divorce therapy are often used interchangeably, they can have different foci depending on the context and your goals. Here’s a breakdown of the key differences between counseling and therapy for divorce:

### Divorce Counseling

#### The focus of Counseling for Divorce:

- Divorce counseling is short-term and solution-oriented.
- It provides practical support and guidance through the **logistics**.
- Divorce counseling may involve **coping strategies, conflict resolution**, and help with **communication**, especially around co-parenting.
- It is often used when managing the **process** rather than deeper emotional issues.

#### Who Provides Counseling for Divorce:

- Often done by psychologists, licensed counselors, social workers, mediators, or coaches.
- Your [choice of provider](https://dralanjacobson.com/how-to-choose-the-right-therapist/) should be guided by your goals and the extent of the experience and training of the professional you need
- Counseling for divorce may not always involve deep [types of psychotherapy](https://dralanjacobson.com/types-of-therapy/).

#### Examples of Topics Covered:

- How to talk to children about the changes
- How to set up co-parenting arrangements
- Preparing emotionally for court or mediation
- Managing household transitions
- Managing common friendships
- Addressing extended family issues

### Divorce Therapy

#### Focus:

- Therapy for divorce is more **in-depth and long-term**, focused on **emotional healing and psychological impact**.
- It often includes [therapy for grief](https://dralanjacobson.com/grief-therapy/), identity, self-esteem, attachment wounds, or trauma resulting from the transition.
- Therapy for divorce is common for people who are struggling with anxiety, depression, or trauma related to the relationship.

#### Who Provides It:

- Only [licensed psychologists](https://dralanjacobson.com/what-is-a-clinical-psychologist/) or therapists trained in mental health treatment provide therapy for divorce.
- It may be individual therapy for divorce, [couples therapy](https://dralanjacobson.com/couples-therapy/) (during or after separation), or [family therapy](https://dralanjacobson.com/family-therapy/).

#### Examples of Topics Covered:

- Healing from betrayal, abuse, or long-term emotional strain
- Redefining your identity
- Managing depression, anxiety, or trauma symptoms
- Working through attachment or relationship patterns

### Where Counseling for Divorce and Therapy for Divorce Overlap

- Both may help you **understand what went wrong**, learn from the experience, and rebuild your life.
- Both can improve **coping skills**, reduce stress, and offer emotional support.

#### In Short:

- Think of **divorce counseling** as helping you **get through** the process and **divorce therapy** as helping you **heal from** it.
- You can do both! Many people start with counseling and later move into therapy once the practical pieces are settled.

## Separation Counseling

### Purpose:

- Separation counseling helps couples (or individuals) navigate the emotional and practical aspects of separating, either temporarily or as a trial step before making a final decision.

### When Is Separation Counseling Used:

- When one or both partners are unsure if they want a full split
- During a trial separation, where the goal is clarity or personal space
- When couples want to evaluate whether reconciliation is possible

### Separation Counseling Focus Areas:

- Clarifying intentions: Is this a step toward a split or a pause to gain perspective?
- Setting ground rules for separation (living arrangements, finances, parenting)
- Exploring emotional and relational issues that led to the separation
- Facilitating respectful communication during a highly uncertain time
- Deciding whether to reconcile, split, or continue separating

#### Couples or Individuals?

Separation counseling often involves both partners, but one can also attend alone for support.

## Case example: Counseling for Divorce and Co-parenting

Here’s a fictional but realistic case example to illustrate how **divorce counseling** helped a couple co-parent effectively after separation:

### Background:

Sarah and Jason had been married for 10 years and had two young children, ages 5 and 8. After years of growing apart and constant arguing, they decided to split. Although the decision to separate was mutual, they were both angry and resentful. Every conversation turned into a fight, especially about the kids.

### Why They Went to Divorce Counseling:

Their lawyer recommended counseling for divorce after multiple failed attempts to agree on a parenting schedule. The court also urged them to cooperate better for the kids’ sake.

### What Happened in Counseling:

#### Establishing Ground Rules

I helped them create communication rules—like no interrupting, no blame language, and using “I” statements (e.g., “I feel overwhelmed” vs. “You never help”).

#### Focusing on the Kids

Sessions kept returning to one theme: **“What’s best for your children?”** This shifted their perspective from “me vs. you” to “we as co-parents.”

#### Parenting Plan Development

With my guidance, they:

- Developed a detailed parenting schedule that accounted for both their work hours and the kids’ routines.
- Agreed on consistent rules across both homes (bedtimes, screen time, homework expectations).
- Created a shared calendar for school events, medical appointments, and holidays.

#### Emotional Processing (but not therapy)

They were allowed space to express their hurt and frustration, but I always redirected them back to constructive action.

#### Conflict Management Tools

They learned to handle disagreements without dragging the kids into it or rehashing old marital issues. Counseling for divorce techniques included:

- Email or co-parenting apps for neutral communication
- “Cool-off” time if emotions run too high
- Problem-solving steps to use when issues come up

### Divorce Counseling Results:

- Communication improved significantly—short, to the point, and focused on the kids.
- The children became more relaxed and secure, no longer caught in the middle of parental conflict.
- Sarah and Jason reported fewer arguments and more trust in each other’s parenting.
- They continued periodic check-ins with the counselor to tweak the plan and handle bumps in the road.

#### Takeaway:

Counseling for divorce didn’t make them friends again, but it helped them become **functional, respectful co-parents**. And that made a world of difference for their children.

## Case example: Conflict Reduction to Avoid an Expensive Divorce

Here is a case example showing how divorce therapy helped a couple **reduce conflict**, use **mediation**, and **avoid a costly legal battle**.

### Background:

David and Monica had been married for 14 years. They had no children but shared a home, two businesses, and several joint financial accounts. When they decided to split, things quickly got hostile, especially around money and who would keep which assets.

Each had already spoken to attorneys, and both were gearing up for a long court battle. Monica was angry and felt betrayed. David felt shut out and defensive. Communication was toxic or completely shut down.

A mutual friend suggested they try **divorce therapy and mediation** before spending tens of thousands on litigation. Reluctantly, they agreed to meet with me for divorce therapy.

### What Happened in Divorce Therapy:

#### De-escalating Emotion

In therapy for divorce, I helped them unpack their emotional responses—Monica’s betrayal and David’s fear of losing control—and guided them toward more objective, goal-focused conversations. This helped reduce blame and reactive communication.

#### Clarifying Goals in Therapy for Divorce

Each person identified their **top priorities**:

- Monica wanted a clean financial split and to keep her share of one business.
- David wanted to avoid selling their home and ensure the divorce didn’t bankrupt them both.

This clarity helped shift the focus from fighting over everything to working toward mutual outcomes.

#### Working Through Emotions

In their therapy for divorce, I helped the couple work through their complicated emotions:

- [Acceptance and Commitment Therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) to promote healing from long-term emotional strain
- Narrative therapy to redefine their identities
- CBT for managing depression and anxiety

#### Introducing Mediation

I explained the difference between court litigation and mediation. With trust slowly rebuilding, they agreed to move into mediation and work with a neutral mediator while continuing with counseling support.

#### Improving Communication

In therapy for divorce, they learned conflict-management tools like:

- Speaking in “problem-solution” terms instead of accusations
- Taking breaks during heated conversations
- Using a mediator or therapist as a third party to keep discussions productive

#### Planning the Financial Separation

In mediation, they:

- Divided assets with minimal legal wrangling
- Created a written agreement that protected both parties
- Worked with a financial advisor to understand tax implications and future planning

### Results of Therapy for Divorce and Mediation:

- Things were finalized **without litigation**, saving them both around $25,000–$30,000 in legal fees.
- Their businesses were split fairly and continued operating.
- Though not friends, they were civil, respectful, and capable of negotiating future matters without needing lawyers.
- Each moved forward with a clear sense of emotional closure and financial stability.

#### Takeaway:

Divorce therapy gave them the space to **lower their emotional temperature**, avoid court, and keep control of the process—saving time, money, and unnecessary trauma.

## Conclusion and My Work

A marital split doesn’t have to mean destruction—it can be a doorway to personal growth, healthier boundaries, and a more grounded future. Whether you’re seeking guidance on co-parenting, reducing conflict, or simply finding stability amid significant change, I’m here to support you every step of the way. Together, we can turn a difficult transition into a meaningful opportunity for healing, clarity, and renewed purpose.

Counseling for divorce can be delivered virtually or in person, and the partners do not have to be in the same place, which makes virtual treatment often preferred. I see individuals and couples for this type of treatment, but I do not usually mix the two types after we’ve started. I can help you find a good mediator if our work together brings you to that point (possibly helping you avoid a much more expensive process!)

If you have any questions about divorce therapy or counseling, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Frequently Asked Questions: Separation and Divorce Counseling

Common questions about divorce counseling and therapy — what each involves, who it helps, and how to get started.

   What is the difference between divorce counseling and divorce therapy? + The terms are often used interchangeably, but they describe meaningfully different emphases. Divorce counseling is typically shorter-term and solution-oriented — focused on getting through the process: co-parenting arrangements, communication structure, conflict reduction, and practical logistics. Divorce therapy is more in-depth and longer-term, focused on emotional healing — processing grief, identity reconstruction, attachment wounds, depression, anxiety, or trauma that the relationship and its ending have produced. Think of counseling as helping you get through the divorce, and therapy as helping you heal from it. Many people benefit from both, often starting with counseling during the acute process and moving into therapy once the practical pieces are settled. Dr. Jacobson provides both, and the [APA’s evidence-based practice guidelines](https://www.apa.org/practice/resources/evidence/) support a range of approaches across both counseling and therapy frameworks for divorce. See also the [grief therapy](https://dralanjacobson.com/grief-therapy/) and [life transitions therapy](https://dralanjacobson.com/life-transitions-therapy/) pages for related dimensions of this work.

   Do both spouses need to attend, or can divorce counseling help one person alone? + Both formats are available and clinically valuable. Individual divorce counseling — one person working with Dr. Jacobson alone — is often the right starting point, particularly when the other spouse is unwilling to participate, when the split is highly adversarial, or when one person needs a private space to process emotions, gain clarity, and develop strategies without the presence of their spouse. Individual work addresses grief, anger, decision-making under stress, identity adjustment, communication strategies for dealing with an ex, and preparation for the next chapter. Joint counseling — both spouses attending together — is most useful for co-parenting coordination, conflict reduction, and logistical planning, as illustrated by Sarah and Jason’s case example on this page. An important note: once a format is established, Dr. Jacobson does not typically switch between seeing someone individually and seeing them jointly with their spouse, as this creates ethical complexity around dual roles. The starting format is discussed in the initial consultation.

   Can divorce counseling actually save money on legal fees? + Yes — and this is one of the most practically significant but least-discussed benefits of divorce therapy. High-conflict divorces that proceed to litigation are extraordinarily expensive: attorney fees alone commonly run $25,000–$100,000 or more per party, and contested proceedings can take years. As illustrated by David and Monica’s case example on this page, divorce therapy that reduces emotional temperature and helps each party clarify their actual priorities — rather than fighting on principle — frequently opens the door to mediation, which is far less costly and preserves much more control over outcomes than court. A therapist is not a mediator or attorney, but the emotional and communication work done in divorce therapy directly prepares couples for productive mediation by reducing reactivity, increasing clarity about goals, and creating a baseline of civil communication. [Research on divorce mediation](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4770927/) consistently shows that mediated agreements are reached faster, cost significantly less, and produce higher satisfaction and compliance rates than litigated outcomes. Dr. Jacobson can provide referrals to trusted mediators when the work together reaches that point.

   What is separation counseling, and how is it different from divorce counseling? + Separation counseling addresses the period when a couple has separated — physically, legally, or emotionally — but has not yet made a final decision about the future of the marriage. It is the right modality when one or both partners are unsure whether separation is a step toward divorce or a temporary space to gain clarity, and when a trial separation needs clear ground rules and structured communication to be productive rather than damaging. The focus is on clarifying intentions, establishing workable living and financial arrangements, facilitating respectful communication during a highly uncertain time, and exploring whether reconciliation is possible or desirable. It differs from divorce counseling in that the outcome remains open — separation counseling does not presuppose that divorce is the destination. For couples where one partner is clearly leaning toward leaving and the other wants to stay, [discernment counseling](https://dralanjacobson.com/discernment-counseling-pre-engagement-counseling/) is specifically designed for that mixed-agenda situation and may be a better starting point. For couples committed to reconciliation, [marriage counseling](https://dralanjacobson.com/marriage-counseling/) is the right frame.

   How does divorce counseling help when children are involved? + Children’s adjustment to divorce is directly and powerfully predicted by the quality of the co-parenting relationship — not by the divorce itself. [Research from the American Psychological Association](https://www.apa.org/topics/parenting/divorce) consistently shows that children of divorce who are exposed to ongoing parental conflict — at transitions, through overheard arguments, by being used as messengers — show significantly higher rates of anxiety, depression, and behavioral difficulties. Children who are buffered from adult conflict and whose parents co-parent cooperatively show outcomes comparable to children from intact families. Divorce counseling when children are involved focuses on exactly this: helping parents develop a working co-parenting relationship, creating consistent structures across two households, establishing communication protocols that keep children out of the middle, and developing parenting plans that are specific and realistic. As illustrated by Sarah and Jason’s case example on this page, even parents who cannot be in the same room without conflict can develop the skills to co-parent functionally. For deeper co-parenting work, the dedicated [co-parenting therapy page](https://dralanjacobson.com/co-parenting-therapy/) covers this in more detail.

   What does divorce therapy address emotionally — beyond the logistics? + Divorce is one of the most significant losses a person can experience — even when it is the right decision and even when both parties agree. The emotional terrain of divorce typically includes grief for the relationship, the family structure, and the future that was planned; anger, which may be appropriate but also needs to be channeled constructively; guilt, particularly around children or around one’s own contribution to the relationship’s failure; fear about financial stability, loneliness, and the prospect of starting over; identity disruption, particularly for people whose sense of self was heavily tied to being a partner or parent in a particular family structure; and, for many people, shame — the sense that divorce represents failure in a domain that feels deeply personal. Divorce therapy addresses each of these dimensions using [CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) for the cognitive distortions that intensify shame and catastrophizing, [ACT](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) for building psychological flexibility in the face of uncertainty, [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/) for reconstructing a meaningful personal story from the experience, and [grief therapy](https://dralanjacobson.com/grief-therapy/) for the layers of loss involved. The goal is not to accelerate healing artificially but to ensure the emotional work gets done — rather than suppressed or bypassed — so that the next chapter can be built on a solid foundation.

   Can divorce counseling be done online when the two partners live separately? + Yes — and virtual delivery is especially well-suited to divorce counseling for several practical reasons. Separated or divorcing partners often live at different addresses — sometimes in different cities or states — making coordination to a shared physical office difficult or tension-producing. Online sessions via secure video eliminate this barrier entirely: each person can attend from wherever they are, which also removes the friction of traveling to and from the same location together. Individual divorce counseling is equally simple online — no scheduling coordination with a spouse required. Dr. Jacobson provides divorce counseling and therapy entirely virtually and is a [PSYPACT](https://psypact.org/)-participating psychologist licensed in 44 states, making these services accessible regardless of where each party is located. For more on how virtual sessions are structured, see the [virtual therapy guide](https://dralanjacobson.com/virtual-therapy-guide/).

   How do I get started with divorce counseling or therapy? + The first step is a free 20-minute consultation — typically with one person, though both parties are welcome to schedule separately or together. That conversation covers where you are in the process, what’s been most difficult, whether children are involved, and what you’re hoping to get from counseling or therapy. From there, Dr. Jacobson will recommend a starting structure — individual counseling, joint sessions, or a combination — and discuss a realistic timeline. Many people find the consultation itself clarifying: having a clinician name what’s happening, identify which type of support best fits, and outline a clear path forward reduces the overwhelm that often keeps people from starting. There’s no commitment required. Related pages worth reviewing depending on your situation: [co-parenting therapy](https://dralanjacobson.com/co-parenting-therapy/), [blended family therapy](https://dralanjacobson.com/blended-family-therapy-step-parent-counseling/), [discernment counseling](https://dralanjacobson.com/discernment-counseling-pre-engagement-counseling/), [grief therapy](https://dralanjacobson.com/grief-therapy/), [life transitions therapy](https://dralanjacobson.com/life-transitions-therapy/), and [adult family therapy](https://dralanjacobson.com/adult-family-therapy/).

 The end of a marriage doesn’t have to mean the end of your stability.

Schedule a free 20-minute consultation with Dr. Jacobson — a practical conversation about where you are and what counseling or therapy might offer at this stage.

 [ Schedule a Free Consultation ](https://www.picktime.com/scheduleaconsult) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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---

### [Powerful Therapy for Fear Of Intimacy](https://dralanjacobson.com/fear-of-intimacy/)

**Published:** January 31, 2025
**Author:** Dr. Alan Jacobson

**Content:**

I offer **therapy for fear of intimacy** that focuses on uncovering the root causes of the anxiety, developing trust, and building healthier emotional connections. This therapy can have a deep and lasting effect on your relationships and your overall sense of connection and wellness. The causes of a fear of intimacy can vary, and our plan will revolve around your unique causes. This post goes over how to overcome a fear of intimacy with or without therapy. It includes two case examples involving treating a sudden fear of intimacy. If you have any questions or want to discuss how these methods might benefit you or a loved one, don’t hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Fear of Intimacy, Overview ![Fear of Intimacy](https://dralanjacobson.com/wp-content/uploads/2025/01/footprints-sand-sea-beach-preview-300x143.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

The following covers how the cause of a fear of intimacy can guide treatment and common treatment methods.

### Causes of a Fear of Intimacy

The causes of a fear of intimacy vary from person to person, as it can stem from various psychological, emotional, and past experiences. Here are some of the more common causes:

#### 1. Childhood Attachment Causes of a Fear of Intimacy

- **Avoidant Attachment:** If a child grows up with emotionally distant or neglectful caregivers, they may learn to suppress emotions and avoid closeness, one of the more common causes of a fear of intimacy.
- **Anxious Attachment:** Inconsistent caregiving can lead to a worry about abandonment or being “enough” for others.
- **Trauma Bonding:** Growing up in an unstable or abusive environment can make closeness feel dangerous or unpredictable.

#### 2. Past Relationship Trauma

- **Betrayal or Infidelity:** If someone has been cheated on or deeply hurt in past relationships, they may associate closeness with pain and rejection.
- **Emotional or Physical Abuse:** Previous toxic relationships can make a person hesitant to trust again.
- **Loss of a Loved One:** A breakup, divorce, or death of a close person can create subconscious anxiety that getting close means inevitable loss.

#### 3. Vulnerability & Rejection

- Some people associate emotional closeness with exposing their flaws or weaknesses.
- They worry about being judged, criticized, or abandoned once their “true self” is seen.

#### 4. Low Self-Esteem & Self-Worth Issues

- Feeling unworthy of love or believing they don’t deserve deep connections.
- Inner beliefs like *“If they really knew me, they wouldn’t love me.”*

#### 5. Anxiety about Losing Independence

- Some people equate closeness with losing control or sacrificing their autonomy.
- A history of controlling relationships or overly dependent partners can make closeness feel suffocating.

#### 6. Unresolved Emotional Pain & Suppression

- Bottled-up emotions from past wounds can create discomfort around emotional expression.
- If someone grew up in an environment where emotions were dismissed (e.g., “Stop crying, it’s not a big deal”), they may struggle to open up.

#### 7. Societal or Cultural Influences

- Societal norms that discourage emotional vulnerability, especially in men, can make intimacy feel unnatural or unsafe.
- Cultural beliefs about relationships, marriage, or gender roles can shape how a person views closeness.

#### 8. Mental Health Factors

- **Anxiety Disorders:** The causes of a fear of intimacy can relate to [social anxiety](https://dralanjacobson.com/therapy-for-social-anxiety-disorder/) or [generalized anxiety disorder](https://dralanjacobson.com/therapy-for-generalized-anxiety-disorder/).
- **Depression:** Low energy, self-worth issues, and emotional detachment can make forming connections difficult.
- **PTSD (Post-Traumatic Stress Disorder):** Trauma survivors, especially those who experienced [abuse in childhood](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/), may develop an instinct to avoid closeness.

### Therapy for Fear of Intimacy: Methods

The more common approaches to therapy for fear of intimacy include:

#### 1. [Cognitive-behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT)

CBT helps identify and change the negative thought patterns that are often the causes of a fear of intimacy, such as vulnerability in relationships. It teaches coping strategies to reduce avoidance behaviors and build confidence in emotional closeness.

#### 2. [Psychodynamic Therapy](https://dralanjacobson.com/psychodynamic-therapy/)

This approach explores past experiences, especially childhood attachment patterns, to uncover unresolved issues that often cause a fear of intimacy. Understanding these patterns can help create healthier relational dynamics and overcome a fear of intimacy.

#### 3. [Exposure Therapy](https://dralanjacobson.com/exposure-therapy-for-anxiety/)

Gradual exposure (both emotional and physical) in a safe and controlled way can help you overcome a fear of intimacy by desensitizing the fear and reducing avoidance behaviors.

#### 4. [Emotionally Focused Therapy (EFT)](https://dralanjacobson.com/emotionally-focused-individual-therapy/)

Often used in couples therapy for fear of intimacy, EFT helps individuals express emotions more openly and fosters secure attachments in relationships. This method can work no matter the causes of a fear of intimacy, even if each couple member has a different reason.

#### 5. [Somatic Therapy](https://www.health.harvard.edu/blog/what-is-somatic-therapy-202307072951)

For those who experience physical reactions (like anxiety or shutting down), [somatic awareness](https://dralanjacobson.com/somatic-therapy/) for fear of intimacy helps process stored trauma in the body and build comfort with closeness. It is thus an effective way to overcome a fear of intimacy in many people.

#### 6. [Group Therapy](https://dralanjacobson.com/group-therapy/) or Support Groups

Hearing others’ experiences and sharing your struggles in a supportive setting can reduce shame and foster growth, helping you overcome a fear of intimacy in a safe environment.

#### 7. [Mindfulness and Self-Compassion Practices](https://dralanjacobson.com/mindfulness-therapy/)

Meditation, journaling, and self-compassion exercises can help you develop a healthier relationship with your emotions and reduce self-judgment around your struggles.

## How to Overcome a Fear of Intimacy

Whether you choose therapy for fear of intimacy or want to resolve it on your own, here are some exercises to help:

### 1. Overcome a Fear of Intimacy Through Self-Reflection

- Write about past relationships (romantic, familial, or friendships).
- Identify moments where you felt emotionally distant or afraid of closeness.
- Explore what triggered those anxieties and what emotions came up.
- Ask yourself: *What do I believe about intimacy? What scares me about being close to someone?*

### 2. Gradual Exposure to Vulnerability

- Start by sharing small personal details with a trusted friend or partner.
- Practice making eye contact for longer periods in conversations.
- Increase physical touch (hugs, holding hands, gentle touches) with trusted individuals.

### 3. Identify and Challenge Negative Beliefs

- Write down thoughts like *“If I let someone in, they will hurt me”* or *“I don’t deserve love.”*
- Question their accuracy and reframe them into positive affirmations like *“I am capable of love and connection.”*

### 4. Overcome a Fear of Intimacy in the Mirror

- Look at yourself in the mirror daily and say affirmations related to your causes of a fear of intimacy like: 
    - *“I am worthy of love and deep connection.”*
    - *“This relationship is safe.”*
    - *“I can open up at my own pace.”*

### 5. Somatic Awareness & Relaxation

- Notice how your body reacts when thinking about closeness. Do you tense up, feel restless, or numb?
- Practice deep breathing, progressive muscle relaxation, or grounding techniques (like holding a comforting object).

### 6. Visualization Exercise to Overcome a Fear of Intimacy

- Imagine yourself in a loving, safe relationship. Visualize moments of closeness—holding hands, deep conversations, comforting embraces.
- Notice how it feels. If resistance arises, acknowledge it with kindness rather than push it away.

### 7. Practicing Safe Vulnerability

- Start with non-romantic connections. Open up a little more to a friend, share a small worry, or ask for emotional support.
- Pay attention to how people respond—you might find that not everyone rejects closeness.

### 8. Set Small Intimacy Goals

- If physical touch is related to your causes of a fear of intimacy, start with casual gestures like high-fives.
- If emotional vulnerability is hard, try sharing a little about your day or emotions with someone you trust.

## Sudden Fear of Intimacy, Case Example

Emma, a 29-year-old graphic designer, had been in a loving relationship with her boyfriend, Daniel, for nearly a year. Their relationship was emotionally and physically fulfilling, and Emma felt safe with Daniel. However, after discussing the possibility of moving in together, she developed a sudden fear of intimacy, including intense fear and discomfort.

### Sudden Fear of Intimacy Symptoms & Reactions

- She began avoiding deep conversations about the future.
- She felt anxious and uneasy whenever Daniel expressed affection.
- Lost interest in physical closeness and started making excuses to avoid it.
- She had intrusive thoughts like *“What if I lose myself in this relationship?”* or *“What if he stops loving me?”*
- Experienced occasional panic attacks when thinking about commitment.

### Sudden Fear of Intimacy Possible Triggers

- **Past Relationship Trauma:** Emma had been in a previous toxic relationship where she felt emotionally trapped. The idea of living with someone again subconsciously triggered memories of feeling controlled and caused her sudden fear of intimacy.
- **Worry about Abandonment or Rejection:** She grew up in a household where love was conditional, making her worry that if she got too close, Daniel might leave.
- **Loss of Independence:** Emma had worked hard to build a life independently. Moving in together felt like she was sacrificing her autonomy, also contributing to her sudden fear of intimacy.

### Therapeutic Approach & Healing Process

1. **Identifying the Root Cause:** In therapy, Emma explored how her past relationships and childhood experiences contributed to her sudden fear of intimacy.
2. **Gradual Exposure:** Instead of rushing, she and Daniel decided to spend weekends together before fully committing.
3. **Cognitive Restructuring:** In therapy for fear of intimacy, she practiced shifting thoughts from *“I will lose myself”* to *“I can maintain my independence while being close to someone.”*
4. **Somatic Therapy for Fear of Intimacy:** To manage physical anxiety, Emma practiced deep breathing and progressive muscle relaxation when painful feelings arose.
5. **Open Communication:** She shared her worries with Daniel, who reassured her that they could move at a safe pace.

### Therapy for Sudden Fear of Intimacy Outcome

Over time, Emma’s sudden fear of intimacy lessened. Acknowledging and addressing her emotions rather than avoiding them, she learned that closeness didn’t mean losing herself—it meant growing together with trust and understanding.

## Fear of Intimacy in Men, Case Example

Jake, a 34-year-old software engineer, had been dating his girlfriend, Lisa, for eight months. Their relationship was going well, and Lisa was emotionally open and affectionate. However, as their relationship deepened, Jake began withdrawing. He started avoiding conversations about the future, felt uncomfortable with too much emotional closeness, and found excuses to spend more time alone.

### Fear of Intimacy in Men Symptoms & Reactions

- **Avoidance of Deep Conversations:** Whenever Lisa asked about their future together, Jake would change the subject or make jokes to deflect.
- **Emotional Withdrawal:** He became distant, less affectionate, and hesitant to express emotions.
- **Fear of Commitment:** He worried about losing his independence and felt uneasy when Lisa expressed her love more openly.
- **Increased Irritability:** He became easily frustrated with small things in the relationship, using them as reasons to push Lisa away.
- **Self-Sabotage:** He started focusing more on work, spending extra hours at the office, and making excuses to avoid quality time together.

### Possible Causes

1. **Childhood Attachment Issues:**
    - Jake’s parents were emotionally distant, teaching him that vulnerability was a sign of weakness.
    - He was raised in an environment where expressing emotions wasn’t encouraged, making intimacy feel foreign and uncomfortable.
2. **Past Relationship Trauma:**
    - He was deeply hurt in a previous relationship where his ex suddenly left, making him associate closeness with potential heartbreak.
    - He developed the belief that emotional attachment leads to pain, causing him to avoid deep connections.
3. **Fear of Losing Independence:**
    - As someone who valued his freedom and personal space, the idea of sharing his life with someone else felt suffocating.
    - He equated commitment with control or restriction, worried he would lose himself in the relationship.
4. **Self-Worth & Vulnerability Struggles:**
    - Deep down, Jake feared that if Lisa saw his weaknesses, she wouldn’t love him anymore.
    - He struggled with expressing emotions because he had been conditioned to believe that men should always be “strong” and self-reliant.

### Therapeutic Approach & Healing Process

1. **Recognizing Patterns:**
    - Through self-reflection and therapy, Jake acknowledged that his anxiety wasn’t about Lisa but about his past wounds and belief systems. This is often a necessary first step when someone needs to overcome a fear of intimacy.
2. **Gradual Emotional Exposure:**
    - He started sharing small personal thoughts and feelings with Lisa instead of shutting down.
    - He practiced expressing appreciation and love in ways that felt comfortable to him.
3. **Challenging Negative Beliefs:**
    - In therapy for fear of intimacy, he worked on reframing thoughts like *“Intimacy is a trap”* to *“Closeness can be fulfilling and safe.”*
4. **Balancing Independence & Closeness:**
    - He learned that being in a relationship didn’t mean losing his autonomy.
    - He and Lisa established boundaries that allowed him to maintain personal space while deepening their bond.
5. **Building Trust & Emotional Safety:**
    - He communicated his worries with Lisa, and they worked together at a pace that didn’t feel overwhelming.
    - Over time, he realized that closeness didn’t mean weakness but connection and mutual support.

### Therapy for Fear of Intimacy in Men: Outcome

With patience and effort, Jake understood his unique causes of a fear of intimacy, which made him more comfortable. He no longer saw closeness as a threat but as a way to deepen his relationship healthily and securely.

## Summary and My Work

I offer therapy for fear of intimacy for individuals and couples. In some cases, adults feel an unexpected and sudden fear of intimacy, and in others, it has been a longstanding pattern. Either way, I braid together [third-wave psychotherapy](https://dralanjacobson.com/third-wave-psychotherapy/) approaches with some other tried-and-true methods, such as [schema therapy](https://dralanjacobson.com/schema-therapy/) and [relational therapy](https://dralanjacobson.com/relational-therapy/) to help clients overcome a fear of intimacy. Of course, this is often a part of [pre-engagement therapy](https://dralanjacobson.com/discernment-counseling-pre-engagement-counseling/), [premarital counseling](https://dralanjacobson.com/premarital-counseling/), and [marriage therapy](https://dralanjacobson.com/marriage-counseling/).

If you want to hear more about individual or [couples therapy](https://dralanjacobson.com/couples-therapy/) methods that might help you or a loved one, [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Frequently Asked Questions: Therapy for Fear of Intimacy

Common questions about fear of intimacy — what causes it, how therapy helps, and how to know if this is what’s affecting your relationships.

   What is fear of intimacy, and how is it different from simply being private or independent? + Fear of intimacy is a persistent pattern of anxiety, avoidance, or shutdown in response to emotional or physical closeness — even when that closeness is wanted. It differs from simply being private or valuing independence in that it is driven by anxiety rather than preference: people with a fear of intimacy often deeply want connection but find themselves pulling back, becoming emotionally unavailable, or sabotaging relationships as they deepen. The experience is frequently confusing and distressing — “I want this but I can’t let myself have it.” This is distinct from introversion (a preference for less social stimulation), healthy boundaries (knowing one’s limits), or a considered choice to be alone. The [American Psychological Association’s](https://www.apa.org/topics/relationships/attachment) research on adult attachment consistently shows that intimacy avoidance is rooted in early relational experiences — particularly attachment patterns formed with caregivers — not in character or preference. It is also distinct from [social anxiety](https://dralanjacobson.com/therapy-for-social-anxiety-disorder/), which involves fear of social judgment; fear of intimacy specifically involves the discomfort of being deeply known by someone close.

   What are the signs that someone has a fear of intimacy? + The signs are often more behavioral than subjective — many people with a fear of intimacy don’t identify it as a fear at all. Common patterns include: consistently ending relationships when they begin to deepen; finding reasons to withdraw or pick fights when a partner gets emotionally close; avoiding conversations about the future or commitment; feeling suffocated or anxious when a partner expresses strong affection; a history of keeping relationships at a surface level or choosing emotionally unavailable partners; difficulty expressing needs, vulnerabilities, or emotions to someone close; and a sense of relief when a relationship ends, even one that was otherwise good. Physical intimacy avoidance — reducing or eliminating sexual contact as emotional intimacy grows — is also common. The two case examples on this page — Emma’s sudden fear of intimacy triggered by moving-in discussions, and Jake’s pattern of emotional withdrawal and self-sabotage — illustrate how these signs appear in practice. Both are recognizable presentations, and both responded well to structured therapy. See also the [attachment therapy](https://dralanjacobson.com/attachment-therapy/) page for the foundational framework that underlies most fear of intimacy work.

   Why does fear of intimacy develop — and is it always rooted in childhood? + Childhood attachment experiences are the most common root — but not the only one. Early relationships with caregivers who were emotionally unavailable, inconsistent, or abusive teach the developing nervous system that closeness is unsafe, unreliable, or costly. This produces avoidant or anxious attachment patterns that persist into adult relationships. However, fear of intimacy can also develop or intensify in adulthood following significant relational trauma: a betrayal or infidelity that shattered trust; a painful loss — through death, abandonment, or a sudden breakup — that created an association between closeness and loss; a controlling relationship that made closeness feel dangerous; or even a sudden life transition — like moving in together, as in Emma’s case — that reactivates dormant fears. [Research on adult attachment](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085906/) shows that attachment patterns are not fixed — they are updated by significant relational experiences throughout life, for better and worse. This is important clinically: it means that fear of intimacy acquired in adulthood can be addressed without necessarily excavating all of childhood, and that positive relational experiences — including the therapeutic relationship itself — can update the attachment system toward greater security.

   Is fear of intimacy more common in men — and does it present differently? + Fear of intimacy affects people across all genders, but it does present differently — and in men it is more frequently misread as emotional unavailability, immaturity, or lack of interest, rather than recognized as an anxiety-driven pattern. As described in Jake’s case example on this page, men with a fear of intimacy often present with emotional withdrawal, increased irritability, self-sabotage through overwork or avoidance, and discomfort with any language of commitment — not because they don’t care but because closeness triggers the same anxiety that produces avoidance. Socialization plays a significant role: many men are conditioned from early childhood that emotional vulnerability is weakness, making the natural anxiety around intimacy harder to name or seek help for. [Research on men’s mental health](https://www.apa.org/monitor/2019/01/ce-corner) consistently shows that men are significantly less likely to seek therapy even when experiencing symptoms — which means fear of intimacy in men often goes untreated for longer and causes more relationship damage before it is addressed. Therapy for fear of intimacy in men uses the same core approaches but is framed around autonomy, competence, and practical skill-building in ways that resonate with how many men approach problem-solving. Dr. Jacobson works with both individuals and couples across all gender presentations.

   What does therapy for fear of intimacy actually involve? + Therapy for fear of intimacy is integrative by nature — no single approach addresses all of the cognitive, emotional, somatic, and relational dimensions involved. Dr. Jacobson’s work in this area combines several frameworks depending on each client’s specific presentation. [Attachment-based therapy](https://dralanjacobson.com/attachment-therapy/) explores the relational history that formed the avoidance pattern and creates a corrective relational experience within the therapeutic relationship itself. [CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) targets the automatic negative beliefs — “if they really knew me, they’d leave,” “closeness means losing myself” — that drive avoidance behaviors. [Schema Therapy](https://dralanjacobson.com/schema-therapy/) addresses the deeper belief systems — emotional deprivation, defectiveness, abandonment schemas — that often underlie chronic intimacy fears. [Somatic therapy](https://dralanjacobson.com/somatic-therapy/) works with the body’s stored anxiety responses around closeness — the physical tightening, shutdown, or dissociation that can occur when intimacy increases. [Emotionally Focused Therapy](https://dralanjacobson.com/emotionally-focused-individual-therapy/) helps clients identify, name, and express the underlying emotions — usually fear and grief — that avoidance has been protecting against. The therapeutic relationship itself is a central healing mechanism: experiencing a consistent, non-judgmental, reliably present relationship often begins updating the attachment system before any explicit technique is applied.

   Should I do individual therapy or couples therapy for fear of intimacy? + The answer depends on whether the fear of intimacy is primarily an individual pattern or a relational dynamic that the couple is navigating together. Individual therapy is typically the better starting point when one partner has a longstanding fear of intimacy rooted in personal history — the work of understanding where the pattern came from and beginning to shift it is most effectively done individually, at least initially. Couples therapy — particularly [Emotionally Focused Couples Therapy (EFT)](https://dralanjacobson.com/eft-therapy-for-couples/) — is most effective when the fear of intimacy is showing up as a relational pattern between two specific people: the pursuer-withdrawer dynamic that EFT directly targets is the most common relational expression of intimacy avoidance. Many clients benefit from both simultaneously or sequentially — individual work to understand and begin shifting the personal roots, combined with couples work to change the relational dynamic in real time. [Relational Life Therapy](https://dralanjacobson.com/relational-life-therapy-rlt/) is also effective for fear of intimacy in couples where emotional withdrawal and power imbalance are central features. Dr. Jacobson sees both individuals and couples for this issue and can discuss which starting point makes the most sense in the initial consultation. See also the [marriage counseling](https://dralanjacobson.com/marriage-counseling/) and [couples therapy](https://dralanjacobson.com/couples-therapy/) pages for related services.

   Can fear of intimacy be overcome — or is it a permanent part of someone’s personality? + It can absolutely be overcome — and the research on attachment supports this clearly. Attachment patterns are not fixed neurological structures; they are relational templates that were learned and can be updated through new relational experiences. The two case examples on this page illustrate this well: Emma and Jake both made meaningful, lasting progress within a focused course of therapy. They did not become different people — they developed a more accurate understanding of what was driving their avoidance and built the skills and tolerance to engage with closeness differently. The goal of therapy is not to eliminate the anxiety around intimacy — some degree of vulnerability will always be present in genuine closeness — but to build enough capacity to stay present with that anxiety rather than fleeing it. Most clients report that the work produces not only better relationships but a significantly improved sense of self: less self-criticism, more self-compassion, and a clearer understanding of their own emotional world. For clients whose fear of intimacy is linked to [childhood trauma](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/), treatment typically takes longer but remains achievable with the right therapeutic approach and a genuine commitment to the process.

   How do I get started with therapy for fear of intimacy? + The first step is a free 20-minute consultation with Dr. Jacobson — a practical, low-pressure conversation about what you’ve been experiencing in your relationships, how long the pattern has been present, and what you’re hoping to change. Sessions are conducted virtually via secure video, making it easy to attend from home — which for many people with anxiety around vulnerability is itself a more comfortable starting point than an unfamiliar office. Dr. Jacobson is a [PSYPACT](https://psypact.org/)-participating psychologist licensed in 44 states, making virtual therapy for fear of intimacy accessible nationwide. There’s no commitment required. Many clients find the initial consultation itself a meaningful first experience of talking openly about something they’ve carried privately for a long time. Related pages worth reviewing depending on your situation: [attachment therapy](https://dralanjacobson.com/attachment-therapy/), [EFT for couples](https://dralanjacobson.com/eft-therapy-for-couples/), [schema therapy](https://dralanjacobson.com/schema-therapy/), [childhood trauma therapy](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/), [Relational Life Therapy](https://dralanjacobson.com/relational-life-therapy-rlt/), and [couples therapy](https://dralanjacobson.com/couples-therapy/).

 Wanting connection while fearing it is exhausting — and it doesn’t have to stay that way.

Schedule a free 20-minute consultation with Dr. Jacobson — a confidential conversation about what you’ve been experiencing and what therapy might offer.

 [ Schedule a Free Consultation ](https://www.picktime.com/scheduleaconsult) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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icon](data:image/svg+xml;base64,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) ](https://www.linkedin.com/company/psychologicalscience/)

---

### [Marriage Counseling](https://dralanjacobson.com/marriage-counseling/)

**Published:** October 12, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Marriage counseling**, or **marriage therapy**, helps couples navigate challenges in their relationships and improve their connection and contentment. The goal is to improve communication, resolve conflicts, and strengthen emotional bonds. I offer **online marriage counseling** to couples in a committed relationship, pre-marriage counseling before they fully commit, and [compatibility testing](https://psychologicalassessments.com/compatibility-testing/). This post goes over these services in detail, and I have a page dedicated to the more general [couples therapy](https://dralanjacobson.com/couples-therapy/), but if you have specific questions or want to talk about how these services could benefit you and your spouse, don’t hesitate to [get in touch with me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

### When to Consider Marriage Counseling ![Online Marriage Counseling](https://dralanjacobson.com/wp-content/uploads/2024/10/couple-on-bikes-300x198.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Marriage therapy can be a valuable tool for couples at various stages of their relationship, whether facing challenges, navigating transitions, or simply seeking to strengthen their bond. Here are key indicators that it might be time to consider in-person or online marriage counseling:

---

#### 1. Communication Problems

- Frequent misunderstandings or misinterpretations.
- Conversations often turn into arguments or become overly defensive.
- One or both partners avoid discussing important issues.
- Silent treatment or passive-aggressive behavior becomes common.

**Example:** Simple discussions about daily tasks escalate into heated arguments.

---

#### 2. Trust Issues

- Infidelity (emotional or physical).
- Dishonesty about finances, activities, or feelings.
- Difficulty rebuilding trust after a betrayal.

**Example:** A partner lied about a significant purchase, and now there’s lingering doubt about their transparency.

---

#### 3. Lack of Intimacy or Affection

- Decreased physical affection or sexual intimacy.
- Emotional disconnection or feelings of loneliness within the relationship.
- Partners feel more like roommates than romantic partners.
- Sometimes one partner has a [fear of intimacy](https://dralanjacobson.com/fear-of-intimacy/)

**Example:** Physical affection has dwindled, and conversations feel superficial.

---

#### 4. Frequent or Unresolved Conflict

- Arguments recur without resolution.
- One or both partners feel unheard or dismissed.
- Resentment builds over unresolved issues.

**Example:** Fights about chores or finances keep happening with no change in behavior.

---

#### 5. [Life Transitions](https://dralanjacobson.com/life-transitions-therapy/) or Major Changes

- Adjusting to major life events (e.g., parenthood, job loss, retirement, relocation).
- Difficulty navigating changes in roles and responsibilities.
- Increased stress putting pressure on the relationship.

**Example:** The birth of a child has created tension due to unequal sharing of responsibilities. (In this case, I can also mix in [parent coaching](https://dralanjacobson.com/parent-coaching/) and therapy.)

---

#### 6. Emotional Distance or Feeling Alone

- Feeling unsupported by your partner.
- Emotional needs are not being met.
- Feeling lonely even when spending time together.

**Example:** You confide more in friends or family than in your partner.

---

#### 7. Financial Disagreements

- Ongoing conflicts about budgeting, spending, or saving.
- Financial dishonesty or hidden debts.
- Different financial priorities cause tension.

**Example:** One partner prioritizes saving, while the other frequently overspends.

---

#### 8. Parenting Conflicts

- Disagreements over parenting styles or discipline.
- One partner feels unsupported in parenting decisions.
- Parenting stress spills over into the marital relationship.

**Example:** One parent is lenient while the other enforces strict rules, leading to frequent arguments.

---

#### 9. Considering Separation or Divorce

- Thoughts or discussions about separation are becoming more frequent.
- Staying together feels more like an obligation than a choice.
- Partners feel emotionally checked out from the relationship.

**Example:** One or both partners have started imagining life apart.

---

#### 10. You Want to Improve Your Relationship

- Even without major issues, you want to enhance your connection.
- Strengthening communication skills.
- Learning to prevent future conflicts.

**Example:** You’re preparing for marriage or a major transition and want a strong foundation.

---

### When Immediate Help is Necessary:

- **Abuse:** Emotional, physical, or verbal abuse. (Safety should always come first.)
- **Addiction Issues:** Substance abuse or other compulsive behaviors impacting the relationship.
- **Mental Health Crises:** Severe depression, anxiety, or suicidal thoughts affecting either partner.

---

Marriage counseling isn’t just for relationships on the brink of collapse—it’s a valuable resource for couples facing challenges, navigating change, or wanting to grow together. Seeking marriage guidance early can prevent small problems from turning into deep fractures.

## Results of Marriage Counseling

There are many potential positive outcomes of marriage therapy, such as:

### 1. Marriage Therapy for Communication Improvement

- Many issues in marriages stem from poor communication. Couples counseling teaches couples how to listen to each other, express their feelings clearly, and avoid destructive communication patterns.

### 2. Marriage Guidance During Conflict

- Often, a couple experiences some conflict or a series of conflicts before coming in for marriage counseling. In session, they are taught strategies for handling disagreements constructively, aiming to reach compromises that satisfy both partners instead of escalating conflicts.

### 3. Emotional Healing Through Marriage Counseling

- For couples dealing with emotional wounds like betrayal, mistrust, or past trauma, marriage counseling provides a safe space to work through these feelings with the guidance of a neutral third party.

### 4. Rebuilding Intimacy in Marriage Counseling

- Emotional and physical intimacy may fade over time. I help couples rekindle their connection by addressing unmet needs, improving closeness, and fostering a sense of partnership.

### 5. Marriage Guidance During Major Life Changes

- Major transitions such as having children, financial issues, or health challenges can strain a relationship. Marriage counseling can help couples adjust to these changes together.

### 6. Tools for Long-Term Success

- Marriage counseling addresses immediate issues and equips couples with tools for future challenges, such as empathy-building exercises and problem-solving techniques.

There are also specific times when marriage guidance can help, such as managing [holiday anxiety](https://dralanjacobson.com/holiday-anxiety/).

## Online Marriage Counseling Approaches

The majority of what I do is online marriage counseling since that gives me a chance to serve more people who feel I am a good fit and is particularly helpful when couples need to do therapy from different places due to work or other scheduling issues. Here are the approaches I use that are [equally effective with online therapy](https://dralanjacobson.com/is-virtual-therapy-as-effective-as-in-person/). There are several approaches to online marriage counseling, each with theories, techniques, and focus areas. Here are some of the most commonly used online marriage therapy approaches I use:

### 1. [Emotionally Focused Therapy](https://dralanjacobson.com/eft-therapy-for-couples/) (EFT)

- Focus: Emotionally Focused Therapy emphasizes the emotional connection between partners and is a cornerstone online marriage counseling approach.
- Goal: To identify and change negative patterns in emotional responses that disrupt relationships.
- Techniques: I help couples recognize their emotional needs and teach them how to express vulnerability in a way that strengthens their bond. EFT is based on attachment theory and helps build secure, loving attachments between partners.
- Best for: Couples who feel disconnected or are experiencing emotional distance.

### 2. [Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT) for Couples

- Focus: Cognitive Behavioral Therapy examines how thoughts, behaviors, and feelings influence relationships.
- Goal: To change unhelpful patterns of thinking and behavior that contribute to conflict or dissatisfaction in the relationship.
- Techniques: Couples are taught how to identify negative thought patterns and reframe them in healthier ways. They also practice effective problem-solving and communication techniques.
- Best for: Couples dealing with specific issues like frequent arguments, anger, or miscommunication.

### 3. [Imago Relationship Therapy](https://dralanjacobson.com/imago-relationship-therapy/)

- Focus: Imago Therapy integrates spiritual and behavioral perspectives and focuses on how early childhood experiences shape relationships.
- Goal: To transform conflict into an opportunity for healing and growth by understanding underlying emotional needs.
- Techniques: Couples participate in structured dialogues, where they mirror, validate, and empathize with each other’s feelings. The focus is on understanding each partner’s childhood wounds and how they affect the relationship.
- Best for: Couples seeking a deep exploration of emotional triggers and relational patterns rooted in the past.

### 4. [Solution-Focused Marriage Therapy](https://dralanjacobson.com/solution-focused-therapy/)

- Focus: This approach is future-oriented and focuses on solutions rather than dwelling on past issues.
- Goal: To identify what works well in the relationship and build on those strengths.
- Techniques: I provide marriage guidance so couples can set specific, achievable goals and work on amplifying positive behaviors rather than analyzing problems. Sessions are often shorter and more goal-directed.
- Best for: Couples who want quick, practical strategies to improve their relationship.

### 5. [Narrative Marriage Counseling](https://dralanjacobson.com/narrative-therapy/)

- Focus: [Narrative therapy](https://dralanjacobson.com/narrative-therapy/) encourages couples to reframe their stories about their relationship and each other.
- Goal: To separate the couple from the problems they are facing by viewing problems as external entities rather than intrinsic to the relationship.
- Techniques: Couples are encouraged to “rewrite” their story more positively and empoweringly. The therapist helps them see their problems in a broader context and change negative narratives.
- Best for: Couples who feel stuck in negative patterns and want a fresh perspective on their relationship.

### 6. Psychodynamic Marriage Counseling

- Focus: [Psychodynamic therapy](https://dralanjacobson.com/psychodynamic-therapy/) is based on the idea that unconscious forces and unresolved conflicts from the past influence current relationships.
- Goal: To bring these unconscious issues to the surface and help couples understand how they affect their relationship.
- Techniques: I work with couples to explore their past experiences and unresolved emotions, identifying patterns that may drive negative interactions. This self-awareness helps partners make conscious changes.
- Best for: Couples interested in exploring deep emotional issues and the impact of past relationships on their current dynamics.

### 7. Integrative Behavioral Couple Therapy (IBCT)

- Focus: This approach integrates traditional behavioral therapy with acceptance-based strategies.
- Goal: To help couples change negative behavior patterns and learn to accept each other’s differences rather than trying to change them.
- Techniques: Couples are taught communication skills, problem-solving techniques, and ways to increase positive interactions. The focus is also on helping partners understand and accept challenging aspects of each other’s personalities.
- Best for: Couples dealing with chronic conflicts or differences in personality.

### 8. [Relational Life Therapy](https://dralanjacobson.com/relational-life-therapy-rlt/) (RLT)

- Focus: This approach emphasizes balance, helping individuals understand their personal needs while maintaining the integrity of the relationship.
- Goal: To guide couples toward more conscious, intimate relationships by focusing on authenticity, respect, and equality.
- Techniques: I use direct feedback and coaching to address power imbalances, unhealthy dynamics, or distorted views of intimacy.
- Best for: Couples who are struggling with power imbalances or emotional withdrawal.

Each online marriage counseling approach offers different tools and strategies to address unique relationship challenges. The choice of method often depends on your specific needs and what resonates most with both partners. There are also more specific approaches, such as [attachment therapy for couples](https://dralanjacobson.com/attachment-therapy/) who experienced trauma in childhood.

## Marriage Therapy Example

Here’s an example of how a marriage therapy session might unfold using [Emotionally Focused Therapy](https://dralanjacobson.com/eft-therapy-for-couples/) (EFT) as the approach. This fictional online marriage counseling example shows how I might help a couple reconnect emotionally.

### Online Marriage Counseling Case Scenario:

Sarah and David have been married for seven years, but they’ve become emotionally distant lately. Sarah feels David is too withdrawn, while David feels that Sarah is constantly critical. They chose online marriage counseling because it is easiest for Sarah to join from work.

### Marriage Counseling Session 1: Understanding the Problem

Me: “Welcome, Sarah and David. I understand you’re feeling disconnected. Could each of you share your perspective on what’s happening in your relationship?”

- Sarah: “I feel like David is never really present. He’s either on his phone or lost in his thoughts when we’re together. It makes me feel like I’m not important to him.”
- David: “It’s not that I don’t care, I just feel like no matter what I do, it’s never enough for Sarah. I no longer know how to make her happy, so I withdraw to avoid more arguments.”

Me: “Thank you for sharing. It sounds like you’re both caught in a cycle where Sarah feels neglected and David feels criticized, leading to more distance. This is common, and we can work on breaking this pattern. Let’s explore your emotions deeper.”

### Marriage Counseling Session 2: Sharing Vulnerable Emotions

Me: “David, when Sarah says you seem distant, how does that make you feel?”

- David: “I feel overwhelmed. Like I can’t meet her expectations. So, I retreat.”

Me: “And Sarah, when David retreats, what does that bring up for you emotionally?”

- Sarah: “I feel abandoned and unloved. I start thinking maybe he doesn’t care about me anymore.”

Me: “So, Sarah, your fear of abandonment causes you to seek more connection from David. But David, feeling overwhelmed, pulls away even more, which deepens Sarah’s fears. Do you see how this cycle keeps you both stuck?”

### Marriage Counseling Session 3: Creating New Patterns

Me: “Let’s try a new way of interacting. David, instead of withdrawing when Sarah expresses her needs, I want you to share your overwhelming feelings in the moment. Sarah, instead of expressing frustration, try sharing the fear or sadness behind it. Can you both practice that now?”

- Sarah: “David, when you pull away, it hurts. I’m scared you no longer want to be close to me.”
- David: “I didn’t realize how much my distance affects you. When you seem upset, I feel like I’m failing as a husband, so I avoid the situation.”

Me: “Great, you’re starting to share your deeper emotions instead of reacting with frustration or retreating. This will help you connect in a healthier way.”

### Marriage Counseling Session 4: Building Intimacy

Me: “In this session, we will focus on rebuilding emotional closeness. I want you to think of one time recently when you felt loved by your partner and share that moment.”

- Sarah: “Last week, David made me coffee without me asking. It was a small gesture, but it made me feel cared for.”
- David: “I felt loved when Sarah touched my arm while watching TV. It made me feel connected to her.”

Me: “These moments may seem small, but they’re important for nurturing your bond. Focus on building more of these positive interactions daily.”

### Marriage Therapy Outcome:

Sarah and David learn to communicate their vulnerabilities throughout therapy instead of reacting defensively. They start to recognize each other’s emotional needs, rebuilding emotional intimacy. They move from a cycle of blame and withdrawal to understanding and connection.

This is just one example of how online marriage counseling might progress using an EFT approach. Other [relationship therapy](https://dralanjacobson.com/relationship-therapy/) approaches, like [Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT), would focus more on changing thoughts and behaviors. Marriage therapy can even be specific, such as when [holiday anxiety](https://dralanjacobson.com/holiday-anxiety/) needs to be addressed.

## Summary and My Work

I provide online marriage counseling using the abovementioned techniques, often in combination, in ways that uniquely fit each couple. [Virtual therapy is effective](https://dralanjacobson.com/virtual-therapy-guide/) and provides certain conveniences that make the process easier in many cases. Marriage therapy can be done alongside [family therapy](https://dralanjacobson.com/family-therapy/) or [individual counseling](https://dralanjacobson.com/individual-therapy/), but I would not see you for both (I could refer you to a trusted colleague if you’d like). Feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) to discuss how marriage therapy, including [virtual couples counseling](https://dralanjacobson.com/virtual-couples-therapy/), might benefit you.

## Frequently Asked Questions: Online Marriage Counseling

Common questions about marriage counseling — what it involves, how it works online, and how to know if it’s the right step for your relationship.

   Does marriage counseling actually work — what does the research say? + Yes — marriage counseling has a strong and growing evidence base. The [American Psychological Association](https://www.apa.org/topics/marriage-relationships/couples-therapy) recognizes couples therapy — particularly Emotionally Focused Therapy (EFT) and Cognitive Behavioral approaches — as evidence-based treatments that produce significant improvements in relationship satisfaction, communication, and conflict resolution. Research on EFT specifically shows that approximately 70–75% of couples move from distress to recovery, and that gains are maintained at follow-up. The caveat is that outcomes depend heavily on both partners’ genuine engagement, the timing of when couples seek help, and the fit between the approach and the couple’s specific issues. Couples who seek help earlier — before resentment has calcified into contempt or emotional withdrawal — tend to see stronger and faster results. Marriage counseling is not a last resort; it is most effective as a proactive investment, and many couples use it not because things are bad but because they want to build on what’s already working. See the [couples therapy overview](https://dralanjacobson.com/couples-therapy/) for more on the range of approaches available.

   Is online marriage counseling as effective as in-person sessions? + Yes — research consistently supports the clinical equivalence of online and in-person couples therapy. A substantial body of evidence, including studies published in peer-reviewed journals on [telehealth-delivered relationship interventions](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8136177/), shows comparable outcomes across communication improvement, conflict reduction, and relationship satisfaction. Beyond equivalence, online marriage counseling offers specific practical advantages: it eliminates the logistical friction of coordinating two people’s schedules to reach the same physical office, allows each partner to attend from their own environment, and makes consistent attendance significantly easier — which is itself a strong predictor of positive outcomes. Online delivery is also particularly valuable for couples where one or both partners travel frequently for work, or where scheduling constraints make in-person appointments unreliable. Dr. Jacobson provides online marriage counseling exclusively and is a [PSYPACT](https://psypact.org/)-participating psychologist licensed in 44 states. See the [virtual therapy guide](https://dralanjacobson.com/virtual-therapy-guide/) for more on how online sessions work.

   How do I know which marriage counseling approach is right for us? + The right approach depends on the nature of your relationship challenges, how you each process emotions, and what you’re hoping to get from counseling. As a general guide: [Emotionally Focused Therapy (EFT)](https://dralanjacobson.com/eft-therapy-for-couples/) is the gold standard for couples experiencing emotional distance or disconnection and for rebuilding secure attachment; [CBT for couples](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) works best for specific recurring conflict patterns and communication breakdowns; [Relational Life Therapy (RLT)](https://dralanjacobson.com/relational-life-therapy-rlt/) is highly effective for power imbalances, emotional withdrawal, or when previous therapy has felt too passive; [Imago Relationship Therapy](https://dralanjacobson.com/imago-relationship-therapy/) is particularly useful for couples whose conflict patterns are rooted in childhood wounds and attachment history; and [Solution-Focused Brief Therapy](https://dralanjacobson.com/solution-focused-therapy/) suits couples who want efficient, goal-directed work with a future orientation. In practice, Dr. Jacobson uses an integrative approach — drawing from whichever frameworks best fit each couple’s dynamics — rather than applying a single method rigidly. The initial consultation is the clearest way to identify which approach is the best fit for your specific situation.

   My spouse is reluctant to come to counseling. What can I do? + Spouse reluctance is extremely common and is one of the most frequently asked questions in marriage counseling. A few things help. First, framing matters: “we need therapy” can feel like an accusation; “I want us to have a space to actually be heard” tends to land differently. Second, one partner beginning individual therapy — to work on their own contribution to the relationship’s difficulties and develop new communication skills — often shifts the dynamic enough that the other partner becomes more open over time. Third, a single consultation session — framed as exploratory rather than a commitment to ongoing therapy — has a much lower barrier to entry than “starting counseling.” Many reluctant spouses who agree to one session to evaluate fit end up engaged in the process once they experience that the therapist is genuinely neutral and not there to adjudicate blame. For situations where one partner is leaning toward leaving entirely, [discernment counseling](https://dralanjacobson.com/discernment-counseling-pre-engagement-counseling/) is specifically designed for mixed-agenda couples and may be a better starting point than traditional marriage counseling. See also [individual therapy](https://dralanjacobson.com/individual-therapy/) for support while navigating this.

   Can marriage counseling help after infidelity — or is it too late? + Yes — and infidelity recovery is one of the situations where marriage counseling is most needed and most effective, provided both partners are willing to engage genuinely. Research on couples who remain together after infidelity and seek therapy shows that many go on to build stronger, more honest relationships than they had before the betrayal — because the betrayal forced a level of honesty and vulnerability that the relationship had previously avoided. The work is neither quick nor linear. It involves the betrayed partner processing grief, anger, and shattered trust at their own pace; the partner who betrayed taking genuine accountability without defensiveness; and both partners examining the relational dynamics — not excusing the betrayal, but understanding the context — that contributed to the vulnerability. [Emotionally Focused Therapy](https://dralanjacobson.com/eft-therapy-for-couples/) is particularly well-suited to infidelity recovery because it targets the attachment rupture at the heart of the betrayal. [Relational Life Therapy](https://dralanjacobson.com/relational-life-therapy-rlt/) is also effective for its directness about accountability and its active coaching toward genuine repair. The timeline is longer than typical couples counseling — typically 6–18 months — but meaningful recovery is achievable for couples who commit to the process.

   How long does marriage counseling typically take? + Treatment length varies considerably depending on the presenting issues, the severity of distress, and the goals. For couples with a relatively stable relationship seeking to improve communication or address a specific area of friction, a focused course of 8–16 sessions over 3–4 months is often sufficient to produce meaningful change. For couples in significant distress — chronic conflict, emotional disconnection, infidelity recovery, or longstanding resentment — treatment typically runs 6–12 months of weekly sessions before tapering. Solution-focused approaches can produce useful shifts more quickly; deeper approaches like EFT and psychodynamic work take longer but tend to produce more lasting structural change. Many couples also find it useful to return for brief booster courses — 3–6 sessions — when new stressors arise (a major life transition, a relapse of old patterns) rather than waiting until things deteriorate significantly. The [how long does therapy take guide](https://dralanjacobson.com/how-long-does-therapy-take/) provides additional context, and realistic timelines are discussed in the initial consultation based on your specific situation.

   Can marriage counseling be combined with individual therapy? + Yes — and the combination is often clinically valuable. Many couples in marriage counseling benefit from one or both partners also doing individual therapy, particularly when personal history, individual mental health, or deeply rooted patterns are significantly affecting the relationship. The two services complement each other: individual therapy provides space to process personal material — childhood wounds, anxiety, depression, identity — without taking up the couples session’s focus on the relational dynamic. An important note about Dr. Jacobson’s practice: he does not see the same person for both individual therapy and marriage counseling simultaneously, as this creates ethical complexity around dual roles. When both services are indicated, he can refer one partner to a trusted colleague for individual work while continuing the couples counseling, or vice versa. This arrangement ensures each modality operates with appropriate clinical independence. Marriage counseling can also run alongside [family therapy](https://dralanjacobson.com/family-therapy/) when children’s wellbeing is part of the presenting picture — see the [adult family therapy](https://dralanjacobson.com/adult-family-therapy/) and [co-parenting therapy](https://dralanjacobson.com/co-parenting-therapy/) pages for related services.

   How do we get started with online marriage counseling? + The first step is a free 20-minute consultation with Dr. Jacobson — a practical conversation about what’s been happening in your relationship, what each of you is hoping to get from counseling, and whether this approach and fit make sense. Both partners are welcome on the call, though one partner scheduling it alone is equally fine. The consultation is low-pressure and non-committal — many couples find it clarifying simply to speak with someone who names the dynamic they’ve been living in and outlines a clear path forward. From there, Dr. Jacobson will recommend a starting approach and discuss a realistic timeline based on your specific situation. Related pages worth reviewing depending on your situation: [EFT for couples](https://dralanjacobson.com/eft-therapy-for-couples/), [Relational Life Therapy](https://dralanjacobson.com/relational-life-therapy-rlt/), [discernment counseling](https://dralanjacobson.com/discernment-counseling-pre-engagement-counseling/), [divorce counseling](https://dralanjacobson.com/divorce-counseling/), [premarital counseling](https://dralanjacobson.com/premarital-counseling/), and [compatibility testing](https://psychologicalassessments.com/compatibility-testing-for-couples/).

 Every strong marriage is built — not just found.

Schedule a free 20-minute consultation with Dr. Jacobson — a low-pressure conversation about where you are and what marriage counseling might offer your relationship.

 [ Schedule a Free Consultation ](https://www.picktime.com/scheduleaconsult) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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### [Discernment Counseling and Pre-Engagement Counseling](https://dralanjacobson.com/discernment-counseling-pre-engagement-counseling/)

**Published:** March 20, 2025
**Author:** Dr. Alan Jacobson

**Content:**

I help couples navigate one of the most significant decisions of their lives: whether to move forward toward marriage with confidence or to recognize and possibly work to overcome potential incompatibilities before making a lifelong commitment. Unlike traditional [couples therapy](https://dralanjacobson.com/couples-therapy/), discernment counseling focuses on clarity rather than problem-solving, offering a structured space for partners to explore their feelings, values, and long-term compatibility. Pre-engagement counseling is similar, taking discernment therapy further by equipping couples with the tools to build a strong foundation for marriage—before engagement pressures set in. This overall guidance and counseling process is often more subjective and less structured than other techniques.

Through guided reflection, values exploration, and communication strategies, I help partners understand their relationship’s strengths and potential challenges. My goal is to ensure that every couple I work with makes a thoughtful, informed decision about their future together rather than proceeding based on societal expectations or emotional momentum. If you have any questions about this method and how it might benefit you, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## What is Discernment Counseling: Process, Purpose, and Why It’s Used ![Discernment counseling and pre-engagement counseling](https://dralanjacobson.com/wp-content/uploads/2025/03/The-road-less-travelled-300x157.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

### What is Discernment Counseling Used For?

Discernment counseling is a structured, short-term approach designed for couples uncertain whether to continue their relationship or separate. It is beneficial when one partner is leaning toward ending the relationship (the “leaning-out” spouse), while the other wants to work on improving it (the “leaning-in” spouse). Unlike [traditional couples therapy](https://dralanjacobson.com/marriage-counseling/), which assumes both partners are committed to repairing the relationship, discernment therapy focuses on helping them decide their next steps with greater clarity and confidence.

### Why is Discernment Counseling Used?

Discernment counseling is beneficial because many couples facing serious relationship doubts struggle with indecision, conflict, or emotional distress. It provides a structured and supportive environment to:

- **Clarify Feelings and Perspectives**: Each partner gets guidance and counseling space to express their concerns and desires.
- **Understand Contributions to Relationship Issues**: Couples explore how they each contributed to the current problems, preventing blame and fostering personal insight.
- **Avoid Premature or Regretted Divorce**: It helps couples make informed decisions rather than rushing into separation out of frustration.
- **Provide a Path Forward**: Whether they choose to work on the marriage or separate, discernment counseling ensures they move forward with greater awareness and mutual understanding.

### What is Discernment Counseling Like?

1. **Initial Assessment (First Session)**
    - I meet with both partners together to understand their situation and relationship history.
    - Each partner shares their perspective on why they consider separating or staying together.
    - I explain that the goal of discernment therapy is **not to fix the marriage but to gain clarity** on what to do next.
2. **Individual Discernment Therapy Sessions**
    - I often meet with each partner separately to explore their feelings, concerns, and motivations.
    - The “leaning-out” spouse may discuss why they feel the relationship is unworkable, while the “leaning-in” spouse may explore their hopes for reconciliation.
    - I help each partner reflect on their role in the relationship’s difficulties.
3. **Joint Guidance and Counseling**
    - The couple comes together again to share insights from their individual sessions.
    - I help facilitate a constructive conversation about the next steps.
4. **Decision-Making**
    - After 1-5 discernment therapy sessions (depending on the couple), they choose one of three paths: 
        1. **Stay in the relationship as is (not recommended as a long-term solution).**
        2. **Commit to couples therapy and working on the relationship.**
        3. **Move toward separation or divorce thoughtfully and respectfully.**

### Key Differences from Traditional Couples Therapy

**Discernment Therapy****Traditional Couples Therapy**Focuses on decision-makingFocuses on improving the relationshipShort-term (1-5 sessions)Long-term commitment (weeks to months)Assumes uncertaintyAssumes both partners want to work on the marriageHelps clarify individual roles in the problemFocuses on problem-solving and communicationMay lead to separation or therapyAims to strengthen the relationship### Who is Discernment Therapy For?

- Couples facing **serious relationship doubts** but unsure about divorce (often used as part of [separation counseling](https://dralanjacobson.com/divorce-counseling/)).
- “Mixed-agenda” couples (one wants to stay, the other is leaning toward leaving).
- Couples who have **tried [relationship therapy](https://dralanjacobson.com/relationship-therapy/) before but remain uncertain** about their future.
- Those who want to make a **thoughtful and informed** decision rather than reacting emotionally.

### Who is Discernment Therapy Not For?

- Couples where **both** partners are fully committed to working on the relationship (they should go directly to couples or pre-engagement therapy – see below).
- Situations involving domestic abuse, such as power imbalances, make discernment counseling ineffective.
- Couples where one partner has **already made a firm decision** to leave and is unwilling to reconsider.

### Conclusion

Discernment counseling provides couples a safe space to explore their relationship, understand their individual contributions to problems, and make an informed decision about their future. Whether they separate or commit to working on the relationship, the guidance and counseling process helps them move forward with **greater clarity, respect, and confidence**.

## Common Discernment Counseling Questions

Discernment therapy involves deep reflection on the relationship, often guided by key questions. These discernment counseling questions help partners explore their feelings, contributions to the relationship dynamic, and possible paths forward.

### Discernment Counseling Questions for Both Partners (During Joint Sessions)

1. **What brings you here today?**
2. **Where do you see challenges in your relationship right now?**
3. **What do you hope to get out of these guidance and counseling sessions?**
4. **Do you feel like you’ve given your best effort to this relationship? Why or why not?**
5. **What would need to change for you to feel confident in staying together?**
6. **How has your relationship evolved over time? Are there patterns in your conflicts?**
7. **What strengths does your relationship still have despite the challenges?**
8. **What do you fear most about separating? How about staying together?**

### Questions for the “Leaning-Out” Partner (Considering Divorce/Separation)

1. **What led you to start thinking about leaving the relationship?**
2. **Have you already emotionally disengaged from the relationship? If so, when did that happen?**
3. **What efforts have you made to improve the relationship?**
4. **Do you believe your partner understands your perspective? Why or why not?**
5. **What are your biggest hesitations about leaving?**
6. **What would it take for you to consider staying and working on the relationship?**
7. **If you decide to leave, how do you want to handle the separation respectfully and mindfully?**
8. **Are there unresolved personal issues that might be influencing your decision?**

### Questions for the “Leaning-In” Partner (Wanting to Work on the Relationship)

1. **What makes you want to stay in the relationship?**
2. **How do you feel about your partner’s concerns about the relationship?**
3. **What steps have you taken to address the problems in your relationship?**
4. **Do you believe your partner sees a real change in you? Why or why not?**
5. **Are you willing to make changes, even if they don’t guarantee your partner will stay?**
6. **How have you contributed to the relationship’s difficulties?**
7. **If your partner decides to leave, how will you handle that outcome?**
8. **What personal growth would you like to focus on in guidance and counseling, regardless of the relationship’s future?**

### Questions for Individual Reflection (Both Partners)

- **What attracted you to your partner in the first place? Do you still see those qualities?**
- **Have you been the partner you want to be? Why or why not?**
- **If you had to describe your relationship’s story in three key moments, what would they be?**
- **How are relationship patterns from your past repeating?**
- **What would be different if you woke up tomorrow and your relationship was exactly how you wanted it?**
- **What is your deepest hope for yourself, regardless of the relationship’s outcome?**

### Final Decision Discernment Counseling Questions

- **Have you gathered enough insight to make a clear decision?**
- **If you choose to stay, are you fully committing to working on the relationship?**
- **How can you make this transition as respectful and thoughtful as possible if you choose to leave?**
- **What lessons do you want to take from this experience moving forward?**

These questions help facilitate honest discussions, leading to a more thoughtful and confident decision.

## Discernment Therapy Techniques

Discernment counseling uses a structured, short-term approach to help couples gain clarity about their relationship’s future. Unlike traditional couples therapy, it employs unique guidance and counseling techniques to guide each partner through self-reflection, open communication, and decision-making.

### Key Techniques in Discernment Counseling

1. **Individual & Guidance and Counseling Joint Sessions**

- Each session includes both **individual** and **joint** conversations.
- I meet with both partners together, then separately, before coming back to discuss insights.
- This approach allows for **personal reflection** while still fostering communication.

2. **“Leaning-In” vs. “Leaning-Out” Perspectives**

- I help the **“leaning-out” partner** (who is considering ending the relationship) explore their doubts, frustrations, and potential regrets.
- The **“leaning-in” partner** (who wants to work on the relationship) is encouraged to listen, self-reflect, and avoid pressuring their partner.

3. **Personal Contribution Awareness**

- Couples explore how **each partner has contributed** to the relationship’s difficulties.
- This technique avoids blaming and instead promotes **self-awareness and accountability**.
- Partners are asked to reflect on: 
    - How their actions or behaviors may have affected the relationship.
    - Whether they have been their “best selves” in the relationship.
    - What would they need to change if they stayed together?

4. **“Three Paths” Discernment Therapy Framework**

I present three possible paths:

1. **Stay in the relationship without making changes** (not usually recommended).
2. **Commit to actively working on the relationship** through couples therapy and personal growth.
3. **Separate or divorce** thoughtfully and respectfully.

Each partner is encouraged to reflect on the path most aligned with their needs.

5. **Future Visualization**

- I may ask: 
    - “If you wake up tomorrow and your relationship is exactly how you want it to be, what has changed?”
    - “If you choose to separate, what would you want that process to look like?”
- This technique helps partners mentally explore different futures before making a decision.

6. **“Softening the Narrative” Approach**

- Instead of framing the relationship in terms of failure, I help partners see it as a journey of growth.
- Couples discuss their **relationship story**, identifying both the positives and struggles without focusing solely on blame.

7. **Emotional Regulation Techniques**

- Since discernment therapy involves **difficult emotions**, counselors guide partners in: 
    - Managing defensiveness.
    - Practicing **active listening** instead of reacting impulsively.
    - Using **“I” statements** instead of accusatory language.

8. **Setting Time Limits**

- The process is **short-term** (1-5 sessions), so each session is structured to maximize effectiveness.
- Couples are encouraged to **avoid rushed decisions** but also not remain stuck in indecision indefinitely.

**Why These Discernment Therapy Techniques Matter**

- Discernment Therapy techniques help **prevent impulsive separations or decisions made out of frustration**.
- They create a **safe, non-judgmental space** where both partners feel heard.
- They encourage **self-reflection**, helping each person learn valuable lessons regardless of the outcome.

## Pre-Engagement Counseling: What It Is & Why It Matters

Pre-engagement counseling is a form of relationship counseling designed for couples **who are seriously dating and considering engagement** but want to ensure they are making a well-informed decision. It helps partners explore compatibility, expectations, and potential challenges before committing to marriage. Pre-engagement counseling differs from discernment therapy in that there may not be a member leaning out, or any threat to the relationship; instead, they often have identified some issues they need to work on and there is often a sense of optimism that this can be done successfully.

### Why Pre-Engagement Counseling?

While [premarital counseling](https://dralanjacobson.com/premarital-counseling/) is common after engagement, **pre-engagement counseling can be even more beneficial** because:

- There is **less pressure**—neither partner has officially committed yet.
- Pre-engagement counseling helps couples **identify potential conflicts** early and work on solutions.
- It also encourages **deep discussions about values, expectations, and long-term goals** before engagement.
- Pre-engagement counseling can prevent **future heartbreak** by ensuring both partners are compatible before committing formally.

### Key Topics Covered in Pre-Engagement Counseling

1. **Relationship Expectations & Compatibility**

- Why do you want to get married? What does marriage mean to each of you?
- What qualities do you value most in each other?
- Are there any deal-breakers in your relationship?

2. **Communication & Conflict Resolution**

- How do you handle disagreements?
- Do you feel heard and respected when discussing difficult topics?
- What are your conflict resolution styles, and do they work together?

3. **Family Background & Upbringing**

- How did your families handle relationships, and how has that influenced your views?
- What family traditions or values are important to you?
- Are there any family issues (e.g., boundaries, expectations, past trauma) that could affect your marriage?

4. **Finances & Money Management**

- How do you view money? Are you a spender or a saver?
- Do you believe in shared or separate finances in marriage?
- How will you handle debt, budgeting, and financial goals as a couple?

5. **Career & Life Goals**

- What are your individual career goals, and how do they align with each other?
- Where do you see yourselves living long-term?
- How will you balance work, family, and personal growth?

6. **Religious & Cultural Differences**

- How do your faiths or cultural backgrounds influence your views on marriage?
- How will you handle religious practices, traditions, or holidays?
- If you plan to have children, how will you raise them regarding religion/culture?

7. **Sex, Intimacy, and Affection**

- What does intimacy mean to each of you?
- How do you express and receive love? ([Love languages](https://www.simplypsychology.org/five-love-languages.html))
- Are there any concerns or expectations regarding physical intimacy?

8. **Children & Parenting**

- Do you both want children? If so, how many?
- What are your parenting styles and discipline beliefs?
- How do you feel about childcare responsibilities and roles?

9. **Boundaries & Independence**

- How much personal space or alone time do you each need?
- How will you balance friendships and external relationships?
- What are your expectations for handling in-law relationships?

10. **Handling Stress & Major Life Events**

- How do you each cope with stress, loss, or difficult times?
- How do you support each other during hardships?
- What happens if unexpected challenges arise (e.g., job loss, illness, infertility)?

### Common Techniques Used in Pre-Engagement Counseling

1. **Personality & Compatibility Assessments** – Tools like the [**Prepare/Enrich**](https://www.prepare-enrich.com/) assessments help couples explore strengths and challenges.
2. **Communication Exercises** – Role-playing and active listening exercises improve understanding.
3. **Conflict Resolution Strategies** – Learning techniques to handle disagreements constructively.
4. **Financial Planning Discussions** – Budgeting exercises and discussions about money habits.
5. **Values Exploration** – Identify core values and ensure alignment with major life goals.

### Who Should Consider This Type of Guidance and Counseling?

- Couples who are **seriously dating** and considering marriage.
- Couples who want to ensure they are fully aligned **before getting engaged**.
- Partners who have **concerns about compatibility or past relationship challenges**.
- Couples with **different backgrounds, beliefs, or expectations** who want to address potential conflicts early.

### Final Thoughts

Pre-engagement counseling helps couples enter engagement and marriage with **greater confidence, clarity, and emotional preparedness**. It can **strengthen relationships, prevent future conflicts, and confirm whether marriage is truly the right step**.

## Case Example: Pre-Engagement Discernment Counseling

Alex (30) and Jordan (28) have been dating for three years and are considering engagement. However, Alex has **serious doubts about long-term compatibility**, while Jordan is eager to get engaged. They seek **pre-engagement counseling** with some aspects of discernment therapy to explore their concerns and make a well-informed decision about their future.

### Session 1: Identifying the Core Issues

Guidance and Counseling Techniques Used: Initial Assessment & “Leaning-In vs. Leaning-Out” Framework

- I start with discernment counseling questions to assess where each partner stands: 
    - **Alex (Leaning-Out Partner):** Worried about financial differences and communication struggles.
    - **Jordan (Leaning-In Partner):** Committed to making the relationship work and ready for engagement.
- The couple shares their goals: 
    - Alex wants **clarity** before committing.
    - Jordan wants to **address concerns and move forward** with engagement.
- **Outcome:** The couple agrees to explore their concerns over multiple sessions before deciding.

### Session 2: Values & Compatibility Assessment

Guidance and Counseling Techniques Used: Values Exploration & Future Visualization

- I guide the couple through a **values alignment exercise** that involves more discernment counseling questions that ask them to rank: 
    - Career priorities
    - Family expectations
    - Financial goals
    - Religious/cultural beliefs
- Jordan and Alex **identify key differences**: 
    - Alex values **financial independence** and prefers separate finances.
    - Jordan wants a **joint financial approach** and sees money as a shared responsibility.
- **Future Visualization Technique:**
    - I ask: “If you wake up 10 years from now, what does your ideal marriage look like?”
    - Alex and Jordan **realize they have different visions for financial planning and family structure**.

### Session 3: Communication & Conflict Resolution

Guidance and Counseling Techniques Used: Conflict Style Assessment & Role-Playing

- The couple completes a pre-engagement counseling **conflict resolution quiz**, identifying their styles: 
    - Alex tends to **withdraw** when arguments escalate.
    - Jordan prefers to **resolve conflicts immediately**, which sometimes pressures Alex.
- **Role-Playing Exercise:**
    - I have them **reenact a past disagreement** using active listening techniques.
    - They practice **“I” statements** instead of blame: 
        - Jordan: “I feel anxious when financial conversations are avoided.”
        - Alex: “I feel overwhelmed when pressured to combine finances.”
- **Outcome:** The couple **better understands their conflict patterns** and how to improve communication.

### Session 4: Decision-Making Framework

Guidance and Counseling Techniques Used: The “Three Paths” Approach & Pros/Cons Analysis

- I present three options: 
    1. **Proceed with engagement** while working on their concerns.
    2. **Pause the relationship** to reflect and work on individual growth.
    3. **Decide to separate** if their differences feel too significant.
- They create a **pros and cons list** for each path.
- **Outcome:**
- - Alex realizes they need more time to address personal concerns before committing.
    - Jordan, though disappointed, agrees they should **delay engagement** and continue counseling to strengthen their foundation.

### Final Guidance and Counseling Session: Clarity & Moving Forward

Guidance and Counseling Techniques Used: Personalized Growth Plan & Follow-Up Strategy

- The couple sets **individual and relationship goals**, including: 
    - Alex working on expressing feelings instead of withdrawing.
    - Jordan learning to give Alex space without feeling rejected.
- They agree to **revisit engagement discussions in six months** after making progress.
- I provide a **relationship roadmap** with exercises for continued growth.

### Final Takeaways

**Outcome:** The couple postpones engagement, recognizing they need more growth before committing.
**Key Insights:** They gain tools to navigate finances, communication, and decision-making.
**Success Measure:** They make a **mutual, informed decision** rather than rushing into engagement.

#### Why Pre-Engagement Counseling Worked

- **Discernment counseling questions and other techniques** helped Alex and Jordan clarify their feelings without pressure.
- **Guided pre-engagement counseling exercises** provided structure, preventing emotional reactions from dominating discussions.
- The **short-term framework (5 sessions)** gave them clarity without feeling rushed or stuck.

## Summary and My Work

Commitment is one of the most important choices a person can make, and discernment or pre-engagement counseling provides the necessary space for couples to explore this decision with honesty and intentionality. Whether a couple ultimately moves forward together or chooses a different path, the process fosters self-awareness, healthy communication, and a deeper understanding of their relationship dynamics.

By addressing potential concerns before engagement, couples can enter marriage with greater confidence, emotional security, and a shared vision for the future. The most successful relationships are built not just on love but on a foundation of mutual understanding, respect, and the willingness to grow together. My role as a psychologist is to guide couples through this journey with guidance and counseling that helps them find clarity, connection, and the best path forward for their unique relationship.

If you have any specific questions about this method, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime. You may also be interested in [compatibility testing](https://psychologicalassessments.com/compatibility-testing-for-couples/), which I also offer.

## Frequently Asked Questions: Discernment Counseling and Pre-Engagement Counseling

Common questions about discernment therapy and pre-engagement counseling — what each involves, who they help, and how to get started.

   What is discernment counseling, and how is it different from couples therapy? + Discernment counseling is a short-term, structured process designed for couples where one or both partners are uncertain whether to stay in the relationship or separate — not to repair the relationship, but to reach a clear, informed decision about its future. This is the key distinction from [traditional couples therapy](https://dralanjacobson.com/couples-therapy/), which assumes both partners are committed to working on the relationship together. Discernment counseling assumes uncertainty, and the goal is clarity rather than change. Developed by psychologist [William Doherty at the University of Minnesota](https://www.discernmentcounseling.com/), it is specifically designed for “mixed-agenda” couples — where one partner is leaning toward leaving and the other wants to stay — and typically involves just 1–5 sessions. At the end, the couple chooses one of three paths: staying as is, committing to couples therapy, or separating thoughtfully. See also [marriage counseling](https://dralanjacobson.com/marriage-counseling/) and [divorce counseling](https://dralanjacobson.com/divorce-counseling/) for related services depending on where your situation lands.

   My partner wants to leave but I want to stay. Can discernment counseling help? + Yes — this is precisely the situation discernment counseling is designed for. The “leaning-in” partner (who wants to stay) and the “leaning-out” partner (who is considering leaving) are the classic mixed-agenda couple that discernment therapy addresses directly. The process creates a structured, non-pressuring space where the leaning-out partner can explore their doubts honestly without feeling interrogated or guilt-tripped, and where the leaning-in partner can be heard without the conversation devolving into an argument about who is right. Critically, discernment counseling does not pressure either partner toward any particular outcome — it is not couples therapy in disguise, and it does not assume reconciliation is the goal. What it does do is help both partners understand their own contributions to the relationship’s difficulties, gain genuine clarity about what they want, and make a decision they can live with regardless of which direction it goes. Many couples who enter discernment counseling leaning in opposite directions find that the process itself — simply being heard and understood in a structured way — shifts the dynamic meaningfully.

   What is pre-engagement counseling, and how is it different from premarital counseling? + Pre-engagement counseling happens before the proposal — while a couple is seriously dating and considering whether to get engaged, rather than after the decision has already been made. This is its primary distinction from [premarital counseling](https://dralanjacobson.com/premarital-counseling/), which typically occurs after engagement and focuses on preparing for the wedding and marriage ahead. Pre-engagement counseling operates with less external pressure — neither partner has officially committed yet — which creates more psychological freedom to have honest conversations about potential incompatibilities, differing values, or unresolved concerns. Research by the [Prepare/Enrich program](https://www.prepare-enrich.com/) and others consistently shows that couples who address compatibility concerns before commitment have better long-term outcomes than those who surface these issues after engagement. Pre-engagement counseling covers the full range of significant topics: financial styles, family expectations, children and parenting, conflict resolution patterns, intimacy, career goals, and religious or cultural differences — all the domains that predict long-term compatibility.

   We’re happy together but have some concerns. Is pre-engagement counseling still useful? + Absolutely — and this is actually the ideal situation for pre-engagement counseling. Unlike discernment counseling, which addresses uncertainty or mixed agendas, pre-engagement counseling works best with couples who are generally optimistic about their relationship but want to be intentional about addressing specific concerns before committing. Common situations include: one partner wanting children and the other being uncertain; financial philosophies that haven’t been explicitly discussed; different religious or cultural backgrounds that have felt manageable so far but could become more significant in a marriage; or simply a desire to enter engagement with both partners fully informed rather than on the basis of emotional momentum alone. The [American Psychological Association](https://www.apa.org/topics/marriage-relationships/premarital) recognizes that structured premarital preparation — of which pre-engagement counseling is the earlier, lower-pressure version — reduces divorce risk and increases relationship satisfaction. Raising concerns in a structured therapeutic context before engagement is far less fraught than raising them after the proposal, when social and family expectations have already been set.

   Does discernment counseling mean we’re heading toward divorce? + No — and this is one of the most important misconceptions to correct. Discernment counseling does not presuppose or push toward any particular outcome. Many couples who complete the process choose to commit to couples therapy and actively work on their relationship — discernment counseling clarified that there was enough there to fight for, even if the current situation was untenable. Others do choose separation, but do so thoughtfully and with mutual understanding rather than in a crisis state. A third group decides to stay as is while gathering more clarity. The goal is an informed, deliberate decision made by both partners — not a predetermined outcome. What discernment counseling prevents is the two most costly alternatives: staying in a relationship indefinitely without clarity, which produces chronic unhappiness; or separating impulsively out of frustration, which produces regret. If both partners are already committed to working on the relationship and neither is leaning out, traditional [couples therapy](https://dralanjacobson.com/couples-therapy/) or [Relational Life Therapy](https://dralanjacobson.com/relational-life-therapy-rlt/) is likely a better fit than discernment counseling.

   What does compatibility testing involve, and how does it fit with pre-engagement counseling? + Compatibility testing uses validated psychological assessment tools to give couples a data-driven picture of their relationship strengths, growth areas, and potential points of friction — structured information that deepens and accelerates the pre-engagement counseling process. The most widely used is the [Prepare/Enrich assessment](https://www.prepare-enrich.com/), which covers communication, conflict resolution, financial management, leisure activities, sexual expectations, parenting, family of origin patterns, and more. Rather than relying solely on conversation — which is influenced by what each partner is willing to say out loud — assessment tools surface dynamics that might otherwise take months or years to become apparent. [Compatibility testing through Precision Psychological Assessments](https://psychologicalassessments.com/compatibility-testing-for-couples/) can be used as a standalone service or integrated directly into a course of pre-engagement counseling, providing a structured foundation for the sessions that follow. It is particularly useful for couples who want an objective picture of their relationship alongside the more exploratory, conversation-based counseling process.

   Can discernment or pre-engagement counseling be done online? + Yes — both services are fully compatible with online delivery and work well via secure video sessions. The reflective, conversation-based nature of discernment counseling and pre-engagement counseling translates naturally to the virtual format — unlike some treatment approaches that benefit from physical presence, these services are primarily about structured dialogue, values exploration, and guided reflection, all of which are fully achievable online. Virtual delivery also offers a specific practical advantage: couples who live apart, travel frequently, or have demanding schedules can attend consistently without the logistical friction of coordinating

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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### [Co-Parenting Therapy](https://dralanjacobson.com/co-parenting-therapy/)

**Published:** February 7, 2025
**Author:** Dr. Alan Jacobson

**Content:**

**Co-parenting therapy**, or **co-parenting counseling**, is designed to help separated, divorced, or never-married couples work together to raise their child(ren) in a healthy and cooperative way. It focuses on reducing conflict, improving communication, and ensuring the child’s well-being remains the priority. I offer therapy for co-parents in a variety of circumstances, including when the two parents may not get along perfectly, when the court is involved, when things are fully amicable, when blended families are involved, and when they were never a serious couple. Healthy co-parenting is possible in almost all circumstances!

### Basics of Healthy Co-Parenting

Healthy co-parenting is built on mutual respect, communication, consistency, and a shared focus on the child’s well-being. Below are the key components of a successful relationship.

---

#### 1. Effective Communication in Healthy Co-parenting

- **Respectful Tone**: Speak calmly and respectfully, even when disagreements arise.
- **Clear and Concise Messages**: Avoid long-winded explanations and unnecessary emotions in discussions.
- **Active Listening**: Show understanding by acknowledging the other’s perspective.
- **Use Neutral Communication Tools**: If direct communication is challenging, use email, text, or [family scheduling apps](https://parentswonder.net/co-parenting-apps/).
- **“I” Statements**: Express feelings without blame (e.g., “I feel concerned when…” instead of “You never…”).

---

#### 2. Child-Centered Decision Making

- **Prioritizing the Child’s Needs**: Every decision should be based on what’s best for the child, not personal grievances.
- **Keeping Conflict Away from the Child**: Avoid arguing or badmouthing the other parent in front of the child.
- **Encouraging a Strong Relationship with Both**: Support the child’s bond with the other, even if you have personal disagreements.
- **Avoiding Alienation**: Never manipulate or discourage the child from loving the other.

---

#### 3. Consistency and Stability

- **Coordinated Styles**: While some differences are natural, basic rules (bedtimes, discipline, schoolwork) should be consistent across both homes.
- **Predictable Schedules**: A stable routine reduces stress and anxiety for the child.
- **Flexibility When Needed**: Be willing to adjust schedules for the child’s benefit (e.g., special events, vacations).
- **Follow Through on Agreements**: Keeping commitments builds trust and reliability.

---

#### 4. Healthy Boundaries = Healthy Co-parenting

- **Respecting Each Other’s Personal Lives**: Avoid unnecessary interference in the other’s personal relationships.
- **Keeping Romantic and Parenting Roles Separate**: New partners should be introduced gradually and respectfully.
- **Avoiding Overstepping**: Each person should respect the other’s role without micromanaging.
- **No Using the Child as a Messenger**: Communicate directly with each other, not through the child.

---

#### 5. Conflict Resolution and Problem-Solving

- **Address Issues Privately and Calmly**: Discuss conflicts when the child is absent.
- **Focus on Solutions, Not Blame**: Work toward resolving issues rather than dwelling on past mistakes.
- **Compromise When Necessary**: A balanced approach ensures both feel heard.
- **Use Mediation if Needed**: A neutral third party can help resolve major disputes.

---

#### 6. Respecting Each Parent’s Role

- **Valuing Each Person’s Contributions**: Both have unique strengths and roles.
- **Recognizing Different Styles**: Minor differences should be respected unless they harm the child.
- **Encouraging the Child’s Bond with Extended Family**: Grandparents, aunts, and uncles can provide additional support and stability.

---

#### 7. Emotional Regulation and Self-Care

- **Managing Personal Emotions**: Deal with frustration privately to avoid reacting negatively.
- **Seeking Support When Needed**: [Individual therapy](https://dralanjacobson.com/individual-therapy/), support groups, or talking with friends can help manage stress.
- **Taking Care of Yourself**: A well-balanced parent is a better co-parent.

---

#### 8. Adapting to Changes Over Time

- **Adjusting as the Child Grows**: Needs to evolve; be open to modifying schedules, responsibilities, and expectations.
- **Revisiting Agreements Periodically**: Check in occasionally to ensure plans remain effective.
- **Handling Major Life Changes Respectfully**: Job changes, relocations, or remarriage should be discussed openly and with the child’s best interest in mind.

---

### Healthy Co-Parenting Conclusion

Healthy co-parenting is about collaboration, mutual respect, and maintaining a focus on the child’s well-being. While challenges are inevitable, using these principles can create a positive and stable environment for the child to thrive. Co-parenting therapy can help when it’s hard to establish these principles on your own.

### Your Unique Circumstance

If you would like more information about co-parenting therapy and how it might help in your unique circumstances or have questions about healthy co-parenting to your family, please [get in touch with me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

## Co-Parenting Therapy

The following overview of therapy for co-parents may help you decide if it would be helpful for you.

### Goals of Co-Parenting Therapy

- Improve communication
- Establish clear and respectful boundaries
- Reduce conflict and emotional reactivity
- Develop a consistent plan
- Focus on the child’s emotional and developmental needs
- Teach problem-solving and conflict-resolution skills
- Encourage cooperation and shared decision-making

### Who Can Benefit?

- Co-parenting counseling is useful for various family situations, particularly when parents struggle with cooperation and effective communication. Here’s a more detailed look at who can benefit:
    #### 1. Divorced or Separated Families

    - Therapy for co-parents can help parents who need guidance in transitioning from a romantic relationship.
    
    - It can help those struggling with unresolved emotional pain that affects this transition.
    
    - It is a good fit for creating a structured, child-focused plan, and is often used in [divorce counseling](https://dralanjacobson.com/divorce-counseling/).

    #### 2. High-Conflict Situations

    - Therapy for co-parents can help those who frequently argue or struggle with unresolved disputes.
    
    - It is a good fit for those dealing with communication breakdowns that make scheduling, discipline, or decision-making difficult.
    
    - It works well when one or both struggle with trust issues, anger, or resentment toward the other.

    #### 3. Differing Styles

    - One may be more authoritarian, while the other is more permissive, leading to inconsistency for the child, in which case therapy for co-parents can help reduce the effects on children.
    
    - It can help couples who struggle to agree on rules, discipline, school choices, or medical decisions.
    
    - Finally, it helps families where one parent is more involved than the other, causing an imbalance in responsibilities.

    #### 4. Blended Families and Healthy Co-Parenting

    - Therapy for co-parents can help those navigating relationships with new partners.
    
    - It can help manage children’s emotions and expectations when introduced to a blended family structure.
    
    - It can establish healthy roles and boundaries.

    #### 5. Court-Ordered Co-Parenting Therapy

    - Some may be required to attend therapy due to legal custody disputes or conflicts affecting the child.
    - Co-parenting therapy helps establish a cooperative dynamic as part of mandated divorce or custody agreements.
    - It can assist with developing an agreement that satisfies court requirements.

Aside from these situations, sometimes co-parenting therapy can be helpful when people generally get along but want to reduce the effects of their separation on the children.

### Common Topics in Co-Parenting Therapy

- Setting up a structured plan
- Managing emotions and reducing resentment
- Parallel vs. cooperative care
- Dealing with new partners or blended families
- Handling disagreements over discipline, schooling, or medical decisions

### Approaches Used in Co-Parenting Therapy

- Different therapeutic approaches may be used depending on the specific challenges. Here are the most common:
    #### 1. [Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT)

    - A cornerstone of co-parenting counseling, this method helps people identify and change negative thought patterns that lead to conflict.
    
    - Teaches emotional regulation skills to respond calmly in stressful situations.
    
    - Encourages self-reflection on how one’s behavior impacts the relationship dynamic.

    #### 2. Conflict Resolution and Mediation Techniques

    - Teaches effective negotiation and compromise strategies necessary for healthy relationships.
    
    - It helps people resolve disagreements constructively without escalating into arguments.
    
    - Encourages both to focus on solutions rather than blame.

    #### 3. Child-Focused Interventions

    - Keeps the child’s emotional and developmental needs as the priority.
    
    - It helps people recognize how their conflict affects their child.
    
    - It guides them in making decisions based on the child’s best interests rather than personal grievances.

    #### 4. Parallel Strategies (for High-Conflict Cases)

    - Helps people disengage from direct communication when necessary while still meeting the child’s needs.
    
    - It establishes firm boundaries and structured plans to reduce conflicts.
    
    - Uses written communication or third-party mediation to minimize emotional interactions.

    #### 5. Communication Skills Training

    - CST teaches parents how to speak respectfully and effectively, even when disagreeing, which is a key ingredient for healthy co-parenting.
    - It encourages using “I” statements instead of accusations (e.g., “I feel concerned when…” instead of “You always…”).
    - It helps people recognize non-verbal communication cues and emotional triggers.

## Case Example 1: Therapy for Co-Parents Who Generally Get Along

Emily and Jake divorced two years ago and share custody of their 8-year-old daughter, Sophie. While both love Sophie deeply, their inability to communicate without conflict has led to frequent disputes over decisions. Emily feels Jake is too lenient, while Jake believes Emily is too controlling. Their arguments often happen in front of Sophie, causing her distress.

After a particularly heated argument about school choices, Emily and Jake seek therapy for co-parents to improve their relationship for Sophie’s sake.

---

### Co-Parenting Therapy Process

#### 1. Initial Therapy for Co-parents Assessment (Session 1-2)

- I meet with Emily and Jake separately to understand their perspectives, grievances, and goals.
- They both express a desire to co-parent effectively but admit that anger and resentment from the divorce interfere.
- Sophie is showing signs of stress, including difficulty sleeping and reluctance to transition between homes.

#### 2. Establishing Healthy Communication (Sessions 3-5)

- I introduce structured communication techniques, such as: 
    - Speaking in a neutral, fact-based manner.
    - Using “I” statements instead of blaming each other.
    - Setting ground rules for discussions (e.g., no raising voices).
- Emily and Jake practice these techniques during role-play exercises.
- They agree to use an app to reduce misunderstandings over schedules.

#### 3. Conflict Resolution & Decision-Making Strategies (Sessions 6-8)

- I help them develop problem-solving techniques, such as: 
    - Taking turns presenting their viewpoints before discussing compromises.
    - Focusing on Sophie’s needs instead of past resentments.
    - Using a mediation strategy when they cannot agree on major decisions.
- They establish a shared parenting plan, including: 
    - Consistent rules across both households.
    - A clear holiday and vacation schedule.
    - A plan for handling emergencies.

#### 4. Addressing Emotional Triggers (Sessions 9-12)

- I help them recognize emotional triggers from their past that spill into their current relationship dynamic – even though they generally get along, this is usually still necessary.
- Jake acknowledges feeling criticized, which makes him defensive, while Emily admits her need for control comes from anxiety.
- They work on emotional regulation techniques, such as pausing before responding to conflict and managing stress privately.

#### 5. Child-Focused Strategies (Sessions 13-15)

- I shift focus to how Sophie is affected by their interactions.
- They recognize that arguing in front of Sophie is harming her emotional well-being.
- Each one commits to keeping disagreements private and presenting a united front on decisions.
- They learn how to reassure Sophie and encourage her relationship with both of them.

---

### Therapy for Co-Parents Outcome

After therapy for co-parents, Emily and Jake developed a healthier relationship:

- They communicate respectfully and effectively.
- They have clear conflict-resolution strategies in place.
- Sophie feels more secure and happy transitioning between homes.
- They maintain boundaries and no longer allow past relationship wounds to affect things now.

While challenges still arise, they now have tools to manage them constructively. They continue to occasionally schedule brief therapy for co-parents to reinforce progress.

## Case Example 2: Co-parenting Counseling with Blended Families

Mark and Lisa divorced five years ago and share custody of their 12-year-old son, Ethan. Mark recently remarried to Sarah, who has two children from a previous marriage. Ethan now spends time in a household with new step-siblings and a stepmother, which has caused tension. Lisa struggles with Mark’s new family dynamic and feels replaced, while Ethan resents forming a bond with Sarah and his step-siblings.

Arguments between Mark and Lisa have increased, with Lisa accusing Mark of prioritizing his new family over Ethan. Meanwhile, Sarah feels like an outsider and is unsure of her role in Ethan’s life. After multiple conflicts, Mark and Lisa agree to seek co-parenting counseling to navigate their blended family situation.

---

### Co-parenting Counseling Process

#### 1. Initial Co-Parenting Counseling Assessment (Sessions 1-2)

- I meet with Mark and Lisa separately to understand their perspectives.
- Mark feels Lisa is making things difficult due to jealousy over his new marriage.
- Lisa feels excluded from major decisions and worries Ethan is uncomfortable in Mark’s new home.
- Ethan reports feeling “stuck in the middle” and reluctant to bond with Sarah and her kids.

---

#### 2. Defining Roles and Boundaries (Sessions 3-5)

- I help Mark and Lisa establish clear boundaries regarding roles: 
    - Lisa remains Ethan’s primary mother figure.
    - Sarah will take on a supportive role.
    - Mark must balance his attention between Ethan and his new family.
- Sarah is included in a session to clarify her role: 
    - She will respect Lisa’s authority as Ethan’s mother.
    - She will gradually build a relationship with Ethan based on trust rather than discipline.

---

#### 3. Managing Emotions and Conflict Resolution (Sessions 6-8)

- Lisa works through feelings of being “replaced” and learns to focus on effective care rather than personal emotions.
- Mark acknowledged Lisa’s concerns and agreed to keep her informed about major decisions.
- Co-parenting counseling conflict-resolution strategies are introduced, including: 
    - Meetings to discuss issues privately and constructively.
    - Keeping conversations child-focused instead of emotionally charged.
    - Using neutral language when discussing each other’s families.

---

#### 4. Helping Ethan Adjust (Sessions 9-11)

- I held a family co-parenting counseling session with Ethan to help him express his feelings (using [solution-focused family therapy](https://dralanjacobson.com/solution-focused-family-therapy-focusing-on-positive-change/)).
- Ethan feels like an “outsider” in Mark’s new family and worries Lisa will be upset if he gets close to Sarah.
- Lisa reassured Ethan that having a positive relationship with Sarah was okay.
- Mark and Sarah work on including Ethan in family activities without forcing a bond.

---

#### 5. Establishing Family Unity Without Forcing It (Sessions 12-15)

- I helped everyone accept that relationships take time.
- Sarah and Ethan find shared interests that naturally build rapport.
- Mark and Lisa develop a more structured plan that includes: 
    - Consistency between households.
    - Scheduled one-on-one time for Ethan with each adult.
    - A respectful approach to step-parent involvement.
- The focus shifts toward long-term cooperation and adjusting as Ethan’s needs evolve.

---

### Co-Parenting Counseling Outcome

- Lisa and Mark co-parent with less conflict and more communication.
- Ethan feels more secure and comfortable in both households.
- Sarah understands her role and no longer feels pressure to “replace” Lisa.
- The blended family dynamic is improving with patience and mutual respect.

While ongoing adjustments are necessary, co-parenting counseling has laid the foundation for healthy co-parenting in a blended family experience

## Summary and My Work

I provide co-parenting counseling for families in all the situations listed above and when two people who get along just want to be sure they are practicing healthy co-parenting techniques. Sometimes, this combines with regular [family therapy](https://dralanjacobson.com/family-therapy/) or [blended family therapy](https://dralanjacobson.com/blended-family-therapy-step-parent-counseling/), where the children also attend sessions.

For more information about co-parenting therapy and how it might help or want to know more about healthy co-parenting, please [get in touch with me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

## Frequently Asked Questions: Co-Parenting Therapy

Common questions about co-parenting counseling — what it involves, who it helps, and how to get started.

   What is co-parenting therapy, and how is it different from couples therapy or divorce counseling? + Co-parenting therapy is focused specifically on the parenting relationship between two adults who share children — not on their past romantic relationship or personal emotional healing. The goal is not reconciliation, processing the end of the marriage, or addressing the individuals’ mental health in isolation. It is squarely focused on the child: improving communication between the parents, reducing the conflict children are exposed to, establishing consistent structures across two households, and developing a cooperative decision-making framework. This distinguishes it from [couples therapy](https://dralanjacobson.com/couples-therapy/), which works on the romantic relationship, and from [divorce counseling](https://dralanjacobson.com/divorce-counseling/), which helps individuals process the emotional experience of separation. Co-parenting therapy can be delivered alongside either of those services, or independently. The [American Psychological Association](https://www.apa.org/topics/parenting/divorce) recognizes that the quality of the co-parenting relationship — independent of the quality of the prior marriage — is one of the strongest predictors of children’s adjustment after divorce.

   Do both parents need to agree to attend, or can co-parenting therapy begin with just one? + Ideally both parents participate, since the co-parenting relationship by definition involves two people. However, therapy can begin with one parent and still produce meaningful benefit. When only one parent attends, the focus shifts to what that person can control: their own communication style, their emotional reactivity in interactions with the other parent, how they respond to conflict, and how they protect their children from adult tensions. Changes in one parent’s behavior often shift the dynamic of the co-parenting relationship measurably over time, even without the other parent’s direct participation. This individual work also frequently serves as a foundation — many co-parents who are initially unwilling to attend joint sessions become more open once they see that their co-parent is engaging in good faith rather than building a case against them. For parents in high-conflict situations where direct joint sessions are not yet feasible, a parallel support model — each parent working with a therapist who coordinates on approach — can also be effective. See also the [individual therapy](https://dralanjacobson.com/individual-therapy/) page for support for the parent working alone.

   How does high-conflict co-parenting affect children, and what does therapy do about it? + The research on this is unambiguous and sobering. [Peer-reviewed studies](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4724258/) consistently show that children exposed to ongoing parental conflict — arguing at exchanges, being used as messengers, hearing one parent criticized by the other, witnessing hostility — experience elevated rates of anxiety, depression, behavioral problems, and academic difficulties. The damage is not from the divorce itself but from the sustained conflict that follows it. In high-conflict co-parenting situations, therapy focuses on three things: reducing the frequency and intensity of direct conflict between parents; creating structured communication systems (apps, email protocols, third-party exchanges) that minimize unproductive contact; and helping each parent understand how their behavior — even when it feels justified — is landing for the child. As illustrated in the case examples on this page, children like Sophie and Ethan often show rapid improvement in emotional wellbeing and home transitions once the parental conflict around them decreases. The child-focused frame — “what does this cost Sophie?” — is often the most powerful lever for motivating change in resistant co-parents.

   We generally get along — do we still need co-parenting therapy? + Yes — and this is one of the most underserved situations in co-parenting support. Parents who generally get along often avoid therapy because they assume it’s only for high-conflict situations, and in doing so miss an opportunity to build the structures and skills that will serve them — and their children — when harder moments inevitably arrive. Even cooperative co-parents frequently discover in therapy that they have unexamined assumptions about parenting styles, decision-making authority, or how transitions are handled that create friction without either parent fully understanding why. Proactive co-parenting therapy can establish explicit shared agreements, develop a clear decision-making framework for major choices (schooling, medical care, extracurriculars), and give both parents a shared language for addressing disagreements before they escalate. It is also valuable during anticipated transitions: a parent’s remarriage, a relocation, a child moving to a new school, or a significant change in custody arrangements. Think of it as maintenance rather than repair — far less disruptive and far more effective when done proactively.

   How does co-parenting therapy work when a blended family is involved? + Blended family situations add significant complexity to the co-parenting relationship — particularly when a new partner’s role, a stepparent’s authority, or the introduction of step-siblings creates conflict between the original co-parents. As illustrated in the Mark, Lisa, and Sarah case example on this page, co-parenting therapy in blended family situations typically requires addressing three levels simultaneously: the relationship between the biological co-parents, the role of the new partner or stepparent, and the child’s experience of navigating multiple household dynamics. Therapy helps define clear and respectful roles — what Sarah can and cannot do in Ethan’s life, what Lisa’s authority is and how it is honored, what Mark’s responsibility is to bridge both worlds. It also helps co-parents disentangle their personal feelings about the new family structure from the child-focused decisions that actually matter. For situations where blended family dynamics are the primary presenting concern, [blended family therapy](https://dralanjacobson.com/blended-family-therapy-step-parent-counseling/) provides a more comprehensive framework that can be coordinated with co-parenting work.

   What happens in court-ordered co-parenting therapy — and is it different from voluntary therapy? + Court-ordered co-parenting therapy follows the same clinical framework as voluntary therapy — the same goals, the same approaches, the same child-focused orientation — but with additional structure around documentation and, in some cases, reporting to the court. When attendance is court-mandated, Dr. Jacobson works within those requirements while maintaining the therapeutic integrity of the process. The most important thing to understand about court-ordered co-parenting therapy is that it is still therapy: the most productive outcomes come when both parents engage genuinely rather than going through the motions. Many parents who initially arrive resentfully or defensively — because they feel forced into it rather than choosing it — shift their orientation once they see that the focus is genuinely on the child rather than on adjudicating blame. Outcomes in court-ordered cases are comparable to voluntary cases when both parties engage authentically. Dr. Jacobson can provide documentation of attendance and general progress as required by the court, within the bounds of confidentiality.

   Can co-parenting therapy be done online when the two parents live in different places? + Yes — and virtual delivery is particularly well-suited to co-parenting therapy for several reasons. Co-parents who have separated often live in different parts of the same city or in entirely different states; online sessions eliminate the logistical complexity and tension of having to travel to and from the same physical location together. Joint sessions via secure video work smoothly — both parents can attend from wherever they are, which also reduces the interpersonal friction that can arise from shared physical space before or after a session. Dr. Jacobson is a [PSYPACT](https://psypact.org/)-participating psychologist licensed in 44 states, making virtual co-parenting therapy accessible to both parents regardless of where each is located. Individual sessions, joint sessions, and any combination can all be delivered virtually. See the [virtual therapy guide](https://dralanjacobson.com/virtual-therapy-guide/) for more on how online sessions are structured.

   How do we get started with co-parenting therapy? + The first step is a free 20-minute consultation — typically with one parent, though both are welcome to join. That conversation covers what’s been happening, how the children are being affected, what has been tried, and what your goals are. From there, Dr. Jacobson will recommend a starting structure — whether to begin with separate individual sessions, joint sessions, or a combination — and discuss a realistic timeline. There’s no commitment required. Many parents arrive at that first conversation uncertain whether their situation is “bad enough” for therapy; the answer is almost always that proactive support is far more effective than waiting until the situation deteriorates further. Related pages worth reviewing: [blended family therapy](https://dralanjacobson.com/blended-family-therapy-step-parent-counseling/), [divorce counseling](https://dralanjacobson.com/divorce-counseling/), [family therapy](https://dralanjacobson.com/family-therapy/), [adult family therapy](https://dralanjacobson.com/adult-family-therapy/), and the [guide to choosing a family therapy approach](https://dralanjacobson.com/which-type-of-family-therapy-is-right-for-you/).

 Your children deserve two parents who can work together — even if you can’t be together.

Schedule a free 20-minute consultation with Dr. Jacobson — a practical conversation about your co-parenting situation and what therapy might offer.

 [ Schedule a Free Consultation ](https://www.picktime.com/scheduleaconsult) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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---

### [Blended Family Therapy and Step-Parent Counseling](https://dralanjacobson.com/blended-family-therapy-step-parent-counseling/)

**Published:** June 13, 2025
**Author:** Dr. Alan Jacobson

**Content:**

I provide blended family therapy that often includes step parent counseling and support. I’ve worked with people across the country who are navigating the often misunderstood challenges of remarriage, co-parenting, and integration. While the love that brings two adults together can be strong, the process of blending households when children are involved is rarely seamless. Stepparenting therapy, in particular, can reduce confusion, emotional isolation, and the feeling of juggling invisible expectations and unclear boundaries. Overall, therapy for blended families can be powerful, enduring, and vital.

Blended family therapy offers a dedicated space to process these complex dynamics, explore your role at your own pace, and develop tools to build meaningful relationships, trust, and insight. Therapy for blended families can help improve closeness, understanding, and a sense of shared vision and goals. Step parent counseling provides individualized support that can transform how you show up for your partner, your stepchildren, and yourself. I offer blended and step family therapy nationally through secure telehealth platforms to ensure accessibility, regardless of location (which can be particularly helpful when the children are grown and therefore not in the same place).

## Blended Family Therapy Overview ![Blended family therapy and step parent counseling](https://dralanjacobson.com/wp-content/uploads/2025/06/Footprints-300x225.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Blended families are becoming increasingly common, and they come with unique relational and emotional challenges. Formed when one or both partners bring children from previous relationships into a new unit, these families must navigate shifting roles, complex loyalties, parenting conflicts, and the task of building new emotional bonds. Blended family therapy provides structured support to help these families develop cohesion, manage conflict, and create a shared identity. Tailored [therapeutic methods](https://dralanjacobson.com/types-of-therapy/) aim to validate each member’s experience while building bridges between individuals and subsystems.

### Benefits of Blended Family Therapy Approaches

Blended family therapy is not a one-size-fits-all approach; it applies to a wide range of family structures that combine histories, values, and parenting approaches. Each group brings its own set of complexities, from custody arrangements and co-parenting with ex-partners to reconciling cultural or generational differences. Understanding the family’s composition and history is key to tailoring the therapy process.

#### Types of therapy for blended families include:

- **Traditional Stepfamilies:** Step-family therapy is used when one or both adults have children from previous marriages or relationships.
- **Repartnered Families without Legal Marriage:** Cohabiting partners blending their children’s lives without formal marriage.
- **Same-Sex Blended Families:** LGBTQ+ couples who blend children from prior relationships or through adoption/surrogacy.
- **Multigenerational Blended Families:** Grandparents, uncles/aunts, or older siblings take active roles in child-rearing.
- **Cross-Cultural or Interfaith Blended Families:** Families navigating different cultural, religious, or racial backgrounds.
- **Adoptive or Foster-Inclusive:** Includes those where one or more children are adopted or in foster care, integrated into a blended household.

### Methods and Approaches Used in Blended Family Therapy

Blended family therapy draws from various therapeutic models to address the emotional and relational challenges that can arise in complex family systems. The choice of method often depends on the developmental stage, presenting issues, and willingness to engage in structured interventions.

#### Core approaches in therapy for blended families include:

- **[Structural Family Therapy](https://dralanjacobson.com/structural-family-therapy/) (Minuchin):** Focuses on reorganizing family roles and boundaries to promote healthy functioning. Especially effective for clarifying the parental hierarchy and reducing parent-child enmeshment.
- **[Bowenian Blended and Step Family Therapy](https://dralanjacobson.com/bowenian-family-therapy/):** Examines intergenerational patterns, emotional fusion, and loyalty conflicts. Helps members differentiate and self-regulate without triangulation.
- **[Narrative Therapy](https://dralanjacobson.com/narrative-therapy/) for Blended Families:** Encourages each member to share their personal story and re-author the collective narrative, thereby reducing “us vs. them” dynamics.
- **[Cognitive-Behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) Family Therapy (CBFT):** Builds problem-solving, anger management, and communication skills through structured tasks and role-play.
- **[Attachment-Based Therapy](https://dralanjacobson.com/attachment-therapy/):** Targets broken bonds, especially between children and stepparents. Builds safety through attunement, validation, and repair.
- **[Emotionally Focused Couples Therapy](https://dralanjacobson.com/emotionally-focused-family-therapy/) (EFT):** Strengthens the emotional foundation, enabling couples to lead their family with a united front.
- **Psychoeducation and [Co-Parenting Skills Training](https://www.sharedparenting.org/therapeuticcoparenting):** Helps align styles, discipline approaches, and household expectations across different caregivers.

### Benefits of Blended Family Therapy

Blended families often experience emotional stress due to competing attachments, divided loyalties, or clashing parenting ideologies. Therapy for blended families can help reduce this stress by giving all members a voice, developing empathy, and providing concrete strategies for conflict resolution and family building.

#### Key benefits of therapy for blended families:

- **Improved communication** across subsystems (e.g., stepparent-child, parent-coparent).
- **Clarification of roles** and family structure.
- **Reduction in conflict** and behavioral acting out.
- **Increased trust and emotional safety**, especially for children.
- **Healthier parental alignment** in co-parenting and discipline.
- **Better transitions** during remarriage, relocation, or custody changes.
- **Resilience and adaptability** during future stressors.

### The Process of Blended Family Therapy

The process unfolds over several stages. It begins with establishing safety and understanding dynamics, then moves into skill-building, restructuring relationships, and fostering long-term resilience. Sessions may involve the whole family, parent dyads, or children alone, depending on the treatment goal.

#### Stages of the process:

1. **Assessment and Rapport-Building:** Conduct interviews with each member; assess family history, structure, roles, conflict patterns, and emotional bonds.
2. **Goal Setting:** Develop shared therapeutic goals (e.g., reducing tension between stepparent and adolescent, clarifying parenting roles).
3. **Subgroup Work:** Separate sessions for couples, siblings, or parent-child dyads to address sensitive issues or unresolved tensions.
4. **Whole-Family Sessions:** Practice communication skills, express needs safely, and negotiate new roles or routines together.
5. **Skill Building:** Teach tools such as active listening, collaborative decision-making, and emotional regulation.
6. **Consolidation and Planning for the Future:** Review gains, anticipate future challenges, and establish maintenance strategies to ensure ongoing unity.

### Outcomes of Blended Family Therapy

The desired outcomes of therapy vary based on each family’s structure and struggles, but generally focus on creating a more functional and emotionally connected household. Long-term success is rooted in mutual respect, realistic expectations, and the development of a “new normal” that honors all histories.

#### Positive outcomes include:

- **Stronger stepparent-child relationships** based on trust rather than forced authority.
- **Greater unity** and identity as a family unit.
- **Reduced triangulation** and loyalty conflicts.
- **Stable and consistent co-parenting practices** across homes.
- **Improved emotional regulation** in children who felt displaced or anxious.
- **Increased marital satisfaction** and couple stability.
- **Tools for handling transitions** (e.g., adding new children, changing custody).

## Therapy for Blended Families: Case Example with Younger Children

Here’s a **case example** of therapy for blended families with **younger children**, incorporating several therapeutic methods. This scenario is fictional, but it reflects real-life patterns observed in blended family therapy.

### Case Example: The Martinez-Stevens Family

**Background:**
Jessica (34) and Marcus (36) recently got married and moved in together with their children from previous relationships. Jessica has two sons, Elijah (7) and Noah (5), while Marcus has a daughter, Ava (6). The family has been living together for six months. While Jessica and Marcus are happy in their relationship, their children struggle to adapt. Elijah resents Marcus’s authority, Ava becomes withdrawn around Jessica, and the children often fight. The adults are also clashing over discipline, as Marcus believes in strict rules while Jessica prefers a gentler approach.

### Assessment and Initial Impressions

I conduct an **initial assessment** using **structural step family therapy** to map family roles and hierarchies. It becomes clear that Elijah feels protective of his younger brother and is rejecting Marcus’s authority. Ava, a quiet and sensitive child, seems caught in loyalty conflicts between her biological mother (who is minimally involved) and Jessica, who is trying to step into a caregiving role.

Jessica and Marcus also completed a brief **parenting attitudes inventory** to identify their core values and differences in discipline. I observe that they inadvertently undermine each other’s authority in front of the children.

### Therapy for Blended Families: Interventions Used

#### 1. Structural Family Therapy (Minuchin)

I begin by clarifying **boundaries and roles** in the family. Sessions help the adults build a **united parental subsystem**, establishing a clear hierarchy that positions them as a team.

- Intervention: A family “team chart” is created on a whiteboard, showing parent roles, shared rules, and what is expected from each child.
- Outcome: The children begin to understand consistent rules and boundaries, and Elijah starts testing limits less often when consequences become predictable.

#### 2. Attachment-Based Interventions

Because Ava is shy and disengaged, I use [**attachment-focused play**](https://playstronginstitute.com/play-therapy/complete-guide/theory/parent-child-attachment/how-does-play-therapy-incorporate-attachment-theory) between her and Jessica to promote emotional bonding. Jessica is guided to use soft, attuned responses to Ava’s signals during joint drawing and storytelling activities.

- Intervention: Jessica and Ava engage in a game where they create “a day in the life of a dragon family,” choosing roles for each dragon to explore feelings about change and loyalty.
- Outcome: Ava begins sitting closer to Jessica during sessions and starts voluntarily showing her schoolwork at home.

#### 3. Narrative Therapy for Blended Families

I invite each child to **draw or describe “their family before and after the change”** to give voice to unspoken feelings. Elijah creates a picture of his “old house” with just him, Noah, and Mom, saying, “It was calm then.” Ava says, “I have two houses and two moms now, but I don’t know which one needs me more.”

Intervention: I help the children externalize their worries (e.g., “Loyalty Lion” or “Angry Tornado”) and frame change as something their family is learning to handle together.

- Outcome: Children begin to feel heard, and the adults gain insight into how deeply the transitions are impacting their identities.

#### 4. Cognitive-Behavioral Step Family Therapy (CBFT)

To reduce sibling fights, I teach the kids simple **emotion identification** and **conflict-resolution** tools.

- Intervention: The use of a “Feelings Thermometer” and role-playing problem-solving scenarios (“What to do when someone takes your toy?”).
- Outcome: Noah, previously silent during conflict, starts saying “I’m in the red zone” when upset, giving adults a cue to intervene early.

#### 5. Parenting Psychoeducation

Jessica and Marcus attend sessions focused on:

- The “blender effect” (gradual vs. instant bonding).
- Stepparent discipline roles (initially more of a coach than enforcer).
- Communication strategies that preserve each other’s authority.
- Intervention: They create a shared discipline plan and agree to “pause and talk privately” when disagreements arise.
- Outcome: Less arguing in front of the kids, more trust between partners.

### Progress and Outcomes After 12 Sessions

- **Elijah** now tolerates Marcus’s authority and seeks his help on homework.
- **Ava** has grown closer to Jessica and initiates affection at home.
- **Sibling rivalry** has decreased, and shared playtime has increased.
- **Jessica and Marcus** report improved communication and feel more aligned.
- The family agrees to reduce treatment frequency and use monthly “check-in” sessions for continued support.

## Blended Family Therapy Case Example with Teenagers

Here’s a **case example of therapy for blended families involving a family with teenagers**, showing how multiple therapeutic approaches can be integrated to address developmental needs, loyalty conflicts, communication breakdowns, and relationship dynamics.

### Blended Family Therapy Case Example

**Background:**
Angela (45) and Darren (47) have been married for two years. Angela has a daughter, Tessa (16), and Darren has two sons: Malik (17) and Jordan (14). All three teens live full-time with the couple and attend the same high school. While Angela and Darren have a strong marital bond, they face growing tension with the teens. Tessa feels like an outsider and resents the “boys club” dynamic. Malik and Jordan complain that Angela is overly critical and plays favorites. Both sets of children have had limited contact with their other biological parent. The household is marked by sarcasm, isolation, and frequent arguments.

### Initial Assessment and Dynamics

I start therapy for blended families using a **Bowenian and Structural family therapy lens**. I assess generational influences, family triangles, and boundary issues. Malik, the oldest, is caught between defending his brother and mediating arguments with Angela. Tessa reports feeling emotionally “shut out” by her stepfather and the boys. Darren and Angela report feeling exhausted and often disagree on how to handle the kids.

#### During intake, I note:

- There is an emotional cutoff between Tessa and Darren.
- Loyalty binds the brothers.
- Poor conflict resolution often results in escalation rather than compromise.

### Blended Family Therapy Approaches Used

#### 1. Bowenian Family Therapy for Blended Families: Differentiation and Triangulation

I identify emotional triangles between Malik, Darren, and Angela. Malik is acting as an emotional buffer, which adds stress to his role and distances Darren from Jordan. Therapy for blended families will focus on helping Malik **differentiate** from this role.

- **Intervention:** Malik engages in individual sessions to explore his own identity and disengage from emotional over-functioning.
- **Outcome:** Malik starts setting boundaries and lets his father and Angela take more responsibility for conflict resolution.

#### 2. Structural Family Therapy for Blended Families: Redefining Subsystems

I map out the family hierarchy and restructure relationships to restore clear boundaries.

- **Intervention:** A family genogram and subsystem diagram help illustrate how blurred alliances have formed.
- **Activity:** They create a new “household agreement” where rules, roles, and responsibilities are co-developed.
- **Outcome:** Angela and Darren start functioning as a stronger unit, and the teens feel less caught in alliance-building.

#### 3. Narrative Therapy for Blended Families: Rewriting Family Identity

Tessa describes herself as the “outsider who doesn’t belong.” Narrative work helps her explore and externalize this story.

- **Intervention:** Tessa writes a “Letter from the Outsider,” then a “Letter from the Inside” imagining what belonging could feel like.
- **Outcome:** She shares this in a family session, prompting more empathy from Jordan and Darren, who express surprise at how excluded she feels.

#### 4. [Emotionally Focused Couples Therapy](https://dralanjacobson.com/eft-therapy-for-couples/) (EFT)

Angela and Darren attend private couples sessions to strengthen their emotional bond and create a more secure parental alliance.

- **Intervention:** They utilize EFT techniques to address attachment needs and foster resilience against teen-related stressors.
- **Outcome:** With less defensiveness and stronger collaboration, they begin presenting a united front, reducing mixed messages for the teens.

#### 5. CBFT and Communication Skills

In therapy for blended families sessions, I teach structured communication tools, including:

- “I” statements
- Time-outs and cool-downs
- Repair attempts after conflict
- **Activity:** Teens practice conflict-resolution role-plays using real scenarios from home.
- **Outcome:** Jordan begins using “I feel” language instead of storming out, and Tessa requests one-on-one time with Darren to rebuild trust.

### Progress and Outcomes After 12 Sessions

- **Tessa** reports feeling more included and has developed a respectful, if cautious, relationship with Darren.
- **Malik** is less overburdened emotionally and is focusing on his college applications and social life.
- **Jordan** shows improved emotional regulation and openly jokes with Angela for the first time.
- **Angela and Darren** report less parenting conflict and more clarity about their shared values and strategies.
- Mealtimes, which were once tense or avoided, now occur three times per week with some shared conversation and laughter.

## Stepparenting Therapy: How It Can Fit

**Stepparenting therapy** is a highly valuable component of **blended family therapy** and can be used either as a **standalone intervention** or integrated into broader **step family therapy systems work**. Below is an overview of what stepparenting therapy entails, its role within the blended family context, and how it can be integrated into a comprehensive treatment plan utilizing multiple modalities.

### Stepparenting Therapy Overview

**Stepparenting therapy** is focused psychological support for individuals stepping into a parenting role with children who are not biologically theirs. It addresses the emotional, relational, and role-based challenges, such as a lack of immediate bonding, discipline dilemmas, role confusion, or feelings of resentment, guilt, or exclusion.

Stepparenting therapy can be delivered through:

- [**Individual therapy**](https://dralanjacobson.com/individual-therapy/)
- **[Couples therapy](https://dralanjacobson.com/couples-therapy/) focused on stepfamily dynamics**
- **Stepparent-inclusive sessions within step family therapy**

### Why Stepparenting Therapy Matters in Blended Family Work

Stepparents often feel caught between:

- Wanting to form close relationships with stepchildren
- Facing rejection or indifference
- Navigating unclear authority roles
- Being blamed for conflict they didn’t create

Stepparenting therapy provides a safe and judgment-free space for processing these dynamics and developing realistic expectations. It also helps them explore their **internal reactions** (e.g., shame, jealousy, helplessness) that may be difficult to share within the family.

### Common Themes Addressed in Stepparenting Therapy

- **Grief and Loss**: Letting go of imagined “instant family” expectations.
- **Attachment and Rejection**: Navigating one-sided efforts to connect.
- **Loyalty Conflicts**: Understanding children’s bonds with the other biological parent.
- **Power and Role Ambiguity**: Clarifying expectations for authority, discipline, and affection.
- **Couple Alignment**: Addressing feelings of being unsupported by the biological parent.
- **Boundary-Setting**: Knowing when to step back, when to lean in.

### How Stepparenting Therapy Fits into Blended Family Treatment

#### 1. Stepparenting Therapy as a Parallel Process: Individual Support

- While the family or couple works together in sessions, the stepparent can meet separately with a therapist to: 
    - Process frustration or guilt
    - Learn attachment-based strategies
    - Rehearse new approaches for bonding and limit-setting

**Example Fit:** In the Holloway-Brooks family (teen case), Darren might meet alone to explore why he feels rejected by Tessa and how to engage without pushing too hard.

#### 2. Stepparenting Therapy Integrated in Couples Therapy

- Couples therapy often requires a dedicated focus on stepparent dynamics, especially when disagreements over rules and approaches lead to conflict.

**Approach:** Use **Emotionally Focused Therapy (EFT)** to help the stepparent express unmet needs (“I want to feel like I matter too”) and for the partner to validate and respond effectively.

**Example Fit:** Angela might share with Darren that she feels undermined in front of his sons, and they explore how to affirm her while maintaining trust with the boys.

#### 3. Dyadic Step Family Therapy

- Stepparenting therapy can include guided sessions between a stepparent and stepchild, allowing them to build a connection through structured activities, storytelling, or shared problem-solving.

**Approach:** Use **attachment-based and narrative techniques** to:

- Externalize barriers (“The Wall Between Us”)
- Explore small shared rituals (e.g., a weekly walk, a cooking activity)
- Promote bonding without forcing affection

**Example Fit:** In the Martinez-Stevens family (young children), Marcus and Elijah could have a dyadic session where they build a “trust tree,” each adding leaves with things they’re willing to try.

#### 4. Psychoeducation Sessions for the Stepparent

- Many stepparents benefit from being taught: 
    - The **slow-cooker vs. microwave metaphor** (relationships with stepkids take time)
    - The **stages of stepfamily development** (initial fantasy, resistance, adjustment, bonding)
    - Discipline dos and don’ts for non-biological parents

This can be part of early-stage stepparenting therapy or introduced when tensions rise.

### Outcomes of Including Stepparenting Therapy

- Individuals gain **confidence and clarity** in their role through stepparenting therapy.
- Fewer **power struggles** between stepparents and children.
- Stepparenting therapy can increase **couple satisfaction** and alignment.
- Children feel less “parented by a stranger” and more respected.
- Greater **resilience** in the face of setbacks or slow bonding progress.

## Individual Step Parent Counseling as an Adjunct

Step parent counseling as an **adjunct** to blended family therapy serves as a specialized support system for stepparents navigating the emotional, relational, and role-related complexities of their position. While blended family therapy addresses the needs of the whole household system, adjunctive step parent counseling provides a **dedicated space** to explore the unique stressors, expectations, and internal conflicts that often go unspoken in group settings. This counseling can occur in tandem with family or couples therapy and is often most effective when coordinated with the overall treatment goals for the family.

### Purpose of Adjunctive Step Parent Counseling

- **Focus on the Individual Experience**: Step Parent Counseling offers space for the stepparent to process feelings of rejection, resentment, invisibility, or self-doubt without the pressure of defending themselves in front of children or partners.
- **Promotes Emotional Regulation**: Helps them manage triggers and disengage from power struggles or over-involvement.
- **Builds Strategic Patience**: Teaches the importance of pacing relationships with stepchildren and embracing long-term bonding over instant attachment.
- **Supports Identity Formation**: Encourages the development of a self-defined identity that is neither parent nor outsider, but something in between.

### When to Use Step Parent Counseling

- The stepparent feels **isolated or alienated** within the household.
- The couple disagrees over **discipline, rules, or roles**.
- Children are **actively rejecting** or avoiding the stepparent.
- The stepparent expresses **burnout, guilt, or resentment**.
- There is progress in [family therapy](https://dralanjacobson.com/family-therapy/), but the stepparent feels stuck or disengaged.
- There is a risk of **relationship dissolution** due to stress.

### Core Themes Explored in Adjunct Sessions

1. **Role Ambiguity and Realistic Expectations**
    - Clarify the stepparent’s role across developmental stages (e.g., coach vs. disciplinarian).
    - Normalize common challenges (slow bonding, feeling like a “guest” in your own home).
2. **Internal Conflict and Emotional Reactions**
    - Explore shame, anger, grief, or jealousy that may be hard to share with partners or children.
    - Identify personal triggers rooted in past experiences (e.g., family of origin dynamics).
3. **Relationship Pacing and Bonding Techniques**
    - Introduce attachment-based micro-interventions (e.g., shared rituals, low-pressure engagement).
    - Emphasize attunement and presence over authority.
4. **Communication and Boundaries**
    - Role-play ways to assert needs to a partner without blame or criticism.
    - Practice setting boundaries with children that respect existing attachments.
5. **Alliance Building with the Biological Parent**
    - Reinforce couple alignment through unified rules and conflict repair strategies.
    - Avoid “good cop/bad cop” dynamics or split alliances.

### Examples of Step Family Therapy Integration

- While the whole group on improving communication in session, the stepparent uses adjunct therapy to process **why they feel easily dismissed** by their stepchildren.
- As the **couple negotiates discipline strategies**, the stepparent uses individual counseling to identify **past wounds** (e.g., fear of rejection, need for control) that fuel overcorrection or disengagement

### Benefits of Adjunct Step Parent Counseling

- Greater **empathy and patience** in the face of slow relationship development.
- **Reduced conflict** with children and improved tolerance for their emotional ambivalence.
- A more stable and **emotionally available adult presence** in the home.
- Deeper **alignment with the parenting partner** on values, expectations, and coping.
- Increased **personal well-being** and sense of purpose in the family system.

#### Final Notes

Adjunct step parent counseling is not a sign that therapy has failed—it’s a sign that the system is being treated holistically. By empowering stepparents to **step in with clarity, compassion, and flexibility**, step family therapy supports the long-term health of the entire group.

## Conclusion

There’s no manual for being a blended family or a stepparent, but there is support. Whether you’re feeling stuck, overwhelmed, or simply seeking clarity, blended family therapy and step parent counseling can provide the insight, strategies, and emotional grounding you need to thrive. When integrated thoughtfully with family or couples therapy, this focused work becomes a cornerstone of lasting family growth and development.

Every family has the potential to thrive, regardless of its origins. If you’re ready to invest in healthier dynamics, deeper connections, and the well-being of you and your new family, I invite you to reach out. Wherever you are in your journey, you don’t have to navigate it alone. Therapy for blended families can be powerful and productive, and stepparenting therapy can be a perfect adjunct.

For information about blended or step family therapy, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Frequently Asked Questions: Blended Family Therapy and Step-Parent Counseling

Common questions about therapy for blended families and stepparents — what it involves, who it helps, and how to get started.

   How long does it typically take for a blended family to feel like a family? + Research on blended family development consistently shows that building genuine cohesion takes significantly longer than most couples expect — typically four to seven years from the time of remarriage or cohabitation. [The Stepfamily Foundation](https://www.stepfamilies.info/) notes that unrealistic expectations about the pace of bonding are one of the primary drivers of blended family stress and dissolution. The “microwave vs. slow cooker” distinction matters here: attempts to rush attachment — forcing affection, insisting children call a stepparent “Dad” or “Mom,” expecting instant loyalty — typically backfire and slow the process. The most successful blended families develop what researchers call a “new normal” that honors each member’s history rather than trying to replicate a first-family structure. Therapy accelerates this process by helping families understand the developmental stages involved, manage the friction of the early period, and build the communication tools that transform coexistence into genuine connection. The case examples on this page illustrate meaningful progress within 12 sessions — not because the family became “finished,” but because they developed the tools to keep growing.

   What is the stepparent role, and why is it so difficult to navigate? + The stepparent role is one of the most structurally ambiguous positions in family life — and that ambiguity is a primary source of the stress stepparents experience. Unlike biological parents, stepparents have no established cultural script to follow, no automatic authority, and no biological bond to fall back on when relationships are strained. They are frequently expected to function like parents while children make clear they do not see them that way. They are often caught between wanting to connect with stepchildren and facing rejection or indifference, between supporting their partner and feeling unsupported when parenting decisions become contested. The [American Psychological Association](https://www.apa.org/topics/parenting/step-families) recognizes that stepparents face a uniquely challenging set of role demands with little preparation or social support. Stepparenting therapy provides a structured space to process these dynamics, develop realistic expectations, and find a role definition that works — one that is neither “trying to be a parent” nor “staying out of it entirely,” but something more nuanced, appropriate, and sustainable.

   My stepchild rejects me no matter what I do. Can therapy actually help? + Yes — and stepchild rejection is one of the most common and most painful presentations in blended family therapy. It is important to understand that rejection from a stepchild is rarely personal in the way it feels; it is almost always an expression of loyalty conflict, grief over the original family, anxiety about change, or developmentally appropriate resistance to new authority figures. Children who reject a stepparent are often simultaneously grieving a family structure they didn’t choose to lose. [Attachment-based therapy](https://dralanjacobson.com/attachment-therapy/) is particularly effective here: it slows the process down, focuses on low-pressure, attuned interactions rather than authority or bonding milestones, and creates small shared experiences that build trust incrementally. The dyadic stepparent-stepchild sessions described in the case examples on this page — the “trust tree” with Marcus and Elijah, the drawing activities with Jessica and Ava — illustrate exactly how this works in practice. Progress is often nonlinear, but it is reliably possible when the stepparent is willing to take the long view and the biological parent actively supports the relationship.

   How does blended family therapy handle conflict between the couple about parenting? + Parenting disagreements between partners in a blended family are among the most common and most corrosive sources of conflict — and they are almost always driven by something deeper than differing opinions about rules or discipline. When couples disagree about how to handle a stepchild, they are often also navigating loyalty, fear, guilt, and the feeling of being unsupported by the person who was supposed to be their partner. Therapy addresses this at both the practical and emotional levels. Practically, couples develop explicit shared agreements about rules, consequences, and the stepparent’s authority — reducing the “good cop / bad cop” dynamic that undermines both the relationship and the children’s sense of stability. Emotionally, [Emotionally Focused Couples Therapy (EFT)](https://dralanjacobson.com/eft-therapy-for-couples/) helps partners understand the attachment needs driving their reactions — the biological parent’s protectiveness, the stepparent’s need to feel valued — and respond to each other with more empathy and less defensiveness. A strong couple alliance is the foundation of a functioning blended family; the work on parenting disagreements is ultimately the work of strengthening that alliance. See also the [co-parenting therapy](https://dralanjacobson.com/co-parenting-therapy/) page for situations where the conflict extends to the other biological parent.

   How does blended family therapy work differently with teenagers versus younger children? + The two case examples on this page illustrate this distinction clearly. With younger children, therapy uses more playful, creative, and attachment-focused methods — drawing activities, storytelling, emotion identification tools like the Feelings Thermometer — that meet children at their developmental level and build connection through shared experience. Younger children are generally more adaptable to new family structures when given appropriate support and clear, consistent boundaries. With teenagers, the work shifts significantly. Adolescents have more developed identities, stronger existing attachments, and a natural developmental drive toward autonomy that can make authority from a stepparent feel particularly threatening. [Bowenian family systems approaches](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/) are especially useful with teens to address triangulation, loyalty conflicts, and the over-functioning that older stepchildren sometimes take on as emotional mediators. [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/) helps teens externalize and reframe their “outsider” story. Teens also require — and benefit from — more direct voice in the therapeutic process; their resistance is taken seriously rather than bypassed.

   Does the other biological parent (ex-spouse) need to be involved in therapy? + No — and in most cases blended family therapy proceeds entirely without the other biological parent’s direct involvement. The work focuses on the household and the relationships within it. That said, the other biological parent is always present in some sense — in children’s loyalty conflicts, in co-parenting disagreements, in the patterns children bring from one home to the other — and therapy helps the family navigate these dynamics whether or not that person is at the table. When the co-parenting relationship with an ex-partner is itself a significant source of stress or conflict, [co-parenting therapy](https://dralanjacobson.com/co-parenting-therapy/) is a natural complement and can sometimes include the other biological parent when both parties are willing. When the ex-partner’s behavior is actively destabilizing the blended family — undermining the stepparent, manipulating children’s loyalty — therapy helps the family develop strategies and boundaries to minimize that impact. The research on co-parenting in blended families consistently shows that the quality of inter-household communication is one of the strongest predictors of children’s adjustment.

   Can blended family therapy be done online when family members are in different locations? + Yes — and virtual delivery is particularly well-suited to blended family therapy for several reasons. Blended families with older children or stepchildren in college often have members scattered across different cities or states — online sessions eliminate the logistical barrier of coordinating everyone in the same physical space. Dr. Jacobson provides blended family therapy entirely via secure video and is a [PSYPACT](https://psypact.org/)-participating psychologist licensed in 44 states, which means he can work with family members across most of the country in the same session. Session configurations are flexible: whole-family video calls, couple sessions, individual stepparent or stepchild sessions, and dyadic stepparent-stepchild work can all be delivered virtually and combined in whatever sequence the treatment plan calls for. For more on how virtual sessions work in practice, see the [virtual therapy guide](https://dralanjacobson.com/virtual-therapy-guide/) and the overview of [online therapy approaches and outcomes](https://dralanjacobson.com/therapy-online-approaches-techniques-and-outcomes/).

   How do we get started with blended family therapy or step-parent counseling? + The first step is a free 20-minute consultation — typically with the couple or with one partner — to discuss what’s been happening, who is involved, and what the primary areas of difficulty are. From there, Dr. Jacobson will recommend a starting structure: whether to begin with couple sessions, whole-family sessions, individual stepparent counseling, or a combination, and in what sequence. There’s no commitment required, and the consultation itself is often clarifying — many couples arrive uncertain whether their situation “qualifies” for therapy and leave with a much clearer picture of what’s happening and what can be done. Related pages worth reviewing depending on your situation: [co-parenting therapy](https://dralanjacobson.com/co-parenting-therapy/), [couples therapy](https://dralanjacobson.com/couples-therapy/), [marriage counseling](https://dralanjacobson.com/marriage-counseling/), [divorce counseling](https://dralanjacobson.com/divorce-counseling/), [family therapy](https://dralanjacobson.com/family-therapy/), and the [guide to choosing a family therapy approach](https://dralanjacobson.com/which-type-of-family-therapy-is-right-for-you/).

 There’s no manual for blended family life — but there is support.

Schedule a free 20-minute consultation with Dr. Jacobson — a practical conversation about where your family is and what therapy might offer.

 [ Schedule a Free Consultation ](https://www.picktime.com/scheduleaconsult) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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](https://www.instagram.com/appliedpsychological) [ ![social network 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](https://www.linkedin.com/company/psychologicalscience/)

---

### [ADHD Treatment for Teens: Holistic, Effective Approaches](https://dralanjacobson.com/adhd-treatment-for-teens/)

**Published:** May 11, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Parenting teens with ADHD can be challenging, especially when you see your child’s strong potential despite the day-to-day symptoms. This is why ADHD Treatment for teens can be powerful and effective. Knowing how to help teens with ADHD involves seeing how bright, creative, and full of potential they are, even though they feel like they’re constantly falling behind. Many parents come to me feeling frustrated, helpless, or even blamed, unsure why their child seems so capable one moment and completely overwhelmed the next. Treatment for ADHD in teens involves realizing the diagnosis is not a discipline issue or a motivation problem—it’s a **neurological difference in how the brain processes attention, emotion, and executive function**.

### Get ADHD Treatment for Teens

When puberty, academic pressures, and social dynamics are added to the mix, adolescents with an attention deficit can struggle in deeply misunderstood ways. But there is hope. Combining [evidence-based](https://en.wikipedia.org/wiki/Evidence-based_practice) therapy with family education and [parent coaching](https://dralanjacobson.com/parent-coaching/) can help teens build the tools they need to succeed and help those parenting teens with ADHD feel more empowered, connected, and effective. [Contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime to learn more.

---

## ADHD in Teens ![ADHD Treatment for Teens](https://dralanjacobson.com/wp-content/uploads/2025/05/unaffiliated-2-300x201.jpg "unaffiliated 2 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Here’s a comprehensive **overview of ADHD in teens**, including symptoms, gender differences, how ADHD creates challenges, and some surprising strengths or benefits often associated with the condition:

### Overview of ADHD in Teens

Attention-Deficit/Hyperactivity Disorder is a [**neurodevelopmental disorder**](https://www.verywellmind.com/neurodevelopmental-disorders-definition-symptoms-traits-causes-treatment-5221231) characterized by persistent patterns of **inattention**, **hyperactivity**, and/or **impulsivity**. It often presents in more complex ways in adolescents than in younger children due to increased academic, social, and emotional demands.

#### Core Symptom Domains

Symptoms are generally categorized into three types:

1. **Inattentive Symptoms**
    - Difficulty sustaining attention in class or while doing homework
    - Forgetfulness in daily activities (e.g., losing items, missing deadlines)
    - Trouble following through on instructions
    - Easily distracted by internal or external stimuli
    - Avoidance of tasks that require sustained mental effort
2. **Hyperactive-Impulsive Symptoms**
    - Fidgeting, tapping, or restlessness
    - Difficulty staying seated or still
    - Excessive talking or interrupting others
    - Impulsive decisions or risky behaviors
    - Difficulty waiting their turn
3. **Combined Type**
    - Many teens show a mix of inattentive and hyperactive-impulsive symptoms.

#### Differences in Girls

[ADHD in girls](https://dralanjacobson.com/therapy-for-girls-with-adhd/) is often **underdiagnosed** and **misunderstood**, especially in adolescence.

**Common Traits in Girls:**

- More likely to present with **inattentive type**
- Symptoms include: 
    - Daydreaming, zoning out
    - Low self-esteem or anxiety
    - High emotional sensitivity
    - Quiet disorganization (e.g., messy backpack, unfinished assignments)
    - Perfectionism masking the difficulties

**Why It’s Often Missed:**

- Girls may not be as disruptive, so their symptoms are less noticeable.
- They’re often labeled as “spacey” or “emotional” instead of being evaluated for ADHD.
- Masking behavior is common—girls try to overcompensate or blend in socially, hiding their struggles.

#### Challenges an Attention Deficit Creates

1. **Academic**

- Incomplete assignments or poor time management
- Struggles with sustained focus on lectures or tests
- Easily overwhelmed by complex tasks or multitasking
- Poor grades despite high intelligence

2. **Social**

- Interrupting conversations, trouble reading social cues
- Difficulty keeping friendships due to impulsivity or emotional reactivity
- Peer rejection or being labeled as “immature”

3. **Emotional and Behavioral**

- Mood swings, frustration, or low tolerance for stress
- Defiance or argumentativeness (often due to frustration or feeling misunderstood)
- Increased risk of anxiety, depression, and low self-worth

4. **Family**

- Parenting teens with ADHD creates conflict about chores, homework, or rules
- Need for constant reminders and supervision
- Sibling tension due to perceived “special treatment”

5. **Risk-Taking Behaviors**

- Teens with untreated ADHD are at higher risk for: 
    - Substance use
    - Reckless driving
    - Unsafe sexual behavior
    - Legal trouble

#### Possible Strengths and [Benefits of ADHD](https://psychologicalassessments.com/benefits-of-adhd/) in Teens

Despite the challenges, many teens with the diagnosis have **distinct strengths,** especially when supported well:

1. **Creativity and Innovation**

- Out-of-the-box thinkers who generate unique ideas
- Good at making novel connections between concepts

2. **Hyperfocus (in Areas of Interest)**

- Can concentrate deeply for long periods on topics they are passionate about
- Useful in coding, art, gaming, writing, building, etc.

3. **High Energy and Enthusiasm**

- Often enthusiastic, lively, and engaging personalities
- Great for leadership, sports, and performance

4. **Resilience**

- Many develop strong problem-solving skills and emotional insight after facing adversity.

5. **Intuition and Empathy**

- Especially in girls, ADHD may come with high emotional sensitivity, making them empathetic friends and emotionally intelligent individuals.

#### Summary Table

**Aspect****Key Details****Symptoms**Inattention, hyperactivity, impulsivity**Differences in Girls**More internalized symptoms, often overlooked, emotional sensitivity**Challenges**Academic struggles, peer issues, family conflict, risk-taking behavior**Benefits**Creativity, hyperfocus, energy, resilience, empathy---

## ADHD Treatment for Teens

Treatment for ADHD in Teens involves a multimodal approach that usually combines **behavioral therapy**, **psychotherapy**, **parent and school interventions**, and in many cases, **medication**. Below is a detailed breakdown of the primary [**therapy methods**](https://dralanjacobson.com/types-of-therapy/) used for ADHD in teens, including how each method works and why it’s helpful:

### [Cognitive Behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) ADHD Treatment for Teens (CBT)

**What it is:**
A structured, goal-oriented form of talk therapy that focuses on identifying and changing negative thought patterns and behaviors.

**How this ADHD treatment for teens helps:**

- **Improves executive functioning**: Helps teens develop better organization, time management, and planning skills.
- **Enhances emotional regulation**: They learn to identify emotional triggers and apply strategies to manage frustration, anxiety, and impulsivity.
- **Builds coping mechanisms**: Teaches specific tools (like breaking tasks into steps or using reminders) to deal with everyday challenges.
- **Boosts self-esteem**: [CBT for ADHD](https://dralanjacobson.com/cbt-for-adhd/) can address feelings of failure or low self-worth common with ADHD in teens by reframing negative self-beliefs.

### Behavioral ADHD Treatment for Teens

**What it is:**
A reward-and-consequence-based system to shape desired behaviors and reduce problematic ones. Often involves parents and teachers.

**How this ADHD treatment for teens helps:**

- **Increases desired behavior**: Reinforces behaviors like homework completion or respectful communication using positive rewards.
- **Reduces disruptive behavior**: Clearly outlined consequences help reduce impulsivity, defiance, or rule-breaking.
- **Creates structure and consistency**: Teens with ADHD thrive on predictable routines; behavioral therapy supports consistency across home and school.

### Parenting Teens with ADHD Using Behavior Management (PTBM)

**What it is:**
Coaching sessions for parents to learn strategies to manage their child’s behavior and support emotional development.

**How this ADHD treatment for teens helps:**

- **Equips parents with tools**: Parents learn techniques like token systems, praise, planned ignoring, and time-outs.
- **Reduces conflict**: Parents learn to communicate more effectively with their teen, decreasing yelling, punishments, and power struggles that often come when parenting teens with ADHD.
- **Improves outcomes**: Research shows better parent involvement improves behavior, school performance, and emotional regulation.

### [Executive Function Coaching](https://dralanjacobson.com/executive-functioning-coaching/) / Skills Training

**What it is:**
Specialized coaching or therapy that focuses on developing skills like organization, working memory, task initiation, and impulse control.

**How this ADHD treatment for teens helps:**

- **Targets core deficits**: Helps adolescents manage schoolwork, chores, and social demands through structured strategies.
- **Supports independence**: Adolescents gain tools to plan ahead, keep track of tasks, and regulate their attention.
- **Often includes tech tools**: Apps, planners, and digital reminders may be used as part of training.

### Treatment for ADHD in Teens: Social Skills Training

**What it is:**
Group or individual therapy that teaches skills like reading social cues, handling conflict, and starting/maintaining friendships.

**How this ADHD treatment for teens helps:**

- **Improves peer relationships**: Many teens with ADHD struggle with impulsivity or interrupting, leading to social rejection.
- **Teaches empathy and listening**: Therapists model and role-play conversations and interactions.
- **Builds confidence**: Positive social experiences increase self-esteem and decrease isolation.

### [Family Treatment](https://dralanjacobson.com/family-therapy/) for ADHD in Teens

**What it is:**
Therapy sessions involve the teen and family members to improve communication, relationships, and emotional support.

**How this ADHD treatment for teens helps:**

- **Reduces blame and frustration**: Symptoms can cause family stress; therapy fosters understanding and problem-solving.
- **Enhances communication**: Families learn how to talk about challenges constructively.
- **Supports family unity**: Encourages collaboration rather than conflict when addressing symptoms, improving the skills of those parenting teens with ADHD, and helping the adolescent feel understood.

### [Mindfulness-Based Cognitive Treatment](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) for ADHD in Teens

**What it is:**
Uses mindfulness techniques (e.g., meditation, breath work, body scans) to help adolescents become more aware of their thoughts and emotions.

**How this ADHD treatment for teens helps:**

- **Improves focus and attention**: Regular mindfulness practice has been shown to reduce distractibility in teens with ADHD.
- **Enhances emotional control**: Helps teens pause and respond thoughtfully rather than reacting impulsively.
- **Reduces anxiety and stress**: Adolescents often experience co-occurring anxiety; mindfulness supports relaxation and resilience.

### Academic Interventions ([Educational Therapy](https://therapeutictutoring.com/educational-therapy/))

**What it is:**
Support through academic coaches, [therapeutic tutors](https://therapeutictutoring.com/), or learning specialists trained in therapeutic educational strategies.

**How this ADHD treatment for teens helps:**

- **Boosts academic performance**: Helps manage homework, study skills, and test preparation.
- **Reduces school-related anxiety**: Adolescents feel more competent and less overwhelmed.
- **Builds self-advocacy**: Encourages adolescents to seek help, use accommodations, and talk to teachers about their needs.

### ADHD Treatment for Teens Combining Therapy with Medication

While therapy addresses behavioral, emotional, and social challenges, **stimulant or non-stimulant medications** are often used to manage core symptoms of inattention, impulsivity, and hyperactivity. When combined with therapy, medical ADHD treatment for teens helps in three ways

- Kids are more receptive to learning new skills.
- Behavioral and emotional gains are greater.
- Academic and social functioning improves more significantly.

---

## Parenting Teens with ADHD: Tips

Parenting teens with ADHD can be both deeply rewarding and intensely challenging. Adolescence already involves growing independence, emotional volatility, and social pressures, but when combined with certain symptoms, it can lead to more conflict, stress, and misunderstandings at home. Below is a **detailed guide to parenting teens with ADHD**, including strategies, communication tips, and ways to build a strong relationship.

### Key Principles for Parenting Teens with ADHD

#### Understand the Diagnosis as a Brain-Based Condition

- ADHD is not a choice or laziness. It’s a **neurological condition** involving executive function deficits.
- Your teen likely struggles with impulse control, time management, and memory—even if they *want* to improve.

#### Common Challenges When Parenting Teens with ADHD

- **Forgetfulness**: Missed assignments, lost items, ignoring chores
- **Impulsivity**: Blurting out, risky behavior, poor decisions
- **Emotional reactivity**: Mood swings, sensitivity to rejection (rejection-sensitive dysphoria)
- **Oppositional behavior**: Defiance may stem from frustration or feeling misunderstood

#### Effective Strategies for Parenting Teens with ADHD

1. #### Create Structure and Routines

- Use calendars, whiteboards, phone reminders, or visual schedules.
- Keep daily routines predictable (wake-up, meals, study time, bedtime).
- Break tasks into steps with built-in breaks.

2. #### Use Clear and Consistent Expectations

- Be specific: Instead of “Clean your room,” say “Put dirty clothes in the hamper and make your bed.”
- Use natural consequences consistently, but avoid punitive or emotional punishment.

3. #### Implement Positive Reinforcement

- Reward systems (points, privileges, praise) work better than punishment.
- Celebrate effort, not just results, when parenting teens with ADHD.
- To reinforce habits, offer specific praise (“I appreciate you starting your homework on time”).

4. #### Coach, Don’t Control

- Teens need **executive function coaching**, not micromanaging.
- Teach planning and problem-solving instead of doing tasks for them.
- Collaboratively brainstorm strategies when issues arise.

5. #### Focus on Emotional Connection

- ADHD teens often feel criticized. Make time for *positive connections* (shared interests, humor, listening without fixing).
- Validate their feelings even if their reactions seem extreme.
- Teach emotional regulation techniques like deep breathing, mindfulness, or journaling.

6. #### Pick Your Battles When Parenting Teens with ADHD

- Prioritize safety, health, and major responsibilities (e.g., school).
- Don’t nitpick every behavior; focus on the *most important* goals at a time.
- Avoid power struggles over minor issues like clothing choices or room decor.

#### More Tips for Parenting Teens with ADHD:

##### Communication

- Use a calm tone—even when your teen is emotional or reactive.
- Don’t lecture. Teens tune out long explanations.
- Give one instruction at a time.
- Check for understanding by asking: “What’s your plan for getting that done?”
- Use visual reminders rather than repeating instructions verbally.

##### Support Academic Success

- Help them use planners or apps (like Google Calendar, myHomework, or Notion).
- Encourage self-advocacy—teach them to ask teachers for help or accommodations.
- Explore IEPs or 504 Plans if ADHD significantly impacts school performance.
- Set up an organized, distraction-free homework space.

##### Support Self-Regulation

- Encourage exercise and outdoor time.
- Help with [sleep hygiene](https://health.clevelandclinic.org/sleep-hygiene): consistent bedtime, no screens 1 hour before bed.
- Support good nutrition (protein-rich meals, limited sugar and caffeine).
- Consider therapy (CBT, executive functioning coaching) for emotional and behavioral skills.

##### Partner with Others

- **Teachers**: Maintain open communication, attend IEP/504 meetings.
- **Mental Health Professionals**: Professionals like me can support you and your teen.
- **Other Parents**: Join support groups or online communities to learn from others and reduce isolation.

#### The Long Game: Focus on Connection, Growth, and Resilience

- **Your child is not their behavior.** Help them separate their identity from their challenges.
- **Empower independence** gradually. Let them experience natural consequences while guiding them toward responsibility.
- **Model self-regulation**—your reactions teach more than your words.
- **Apologize and repair** after blowups. It teaches emotional intelligence and builds trust.

### Final Encouragement

Parenting a teen with ADHD often feels like running a marathon on an obstacle course, but your support, consistency, and belief in their strengths can make all the difference. Your child can grow into a resilient, creative, and capable adult with the right tools and connections.

---

## Case Example of ADHD Treatment for Teens

Sofia is a bright, artistic 10th-grade student. Her teachers described her as “sweet but spacey.” She often turned in assignments late, zoned out during class, and had messy, disorganized notes. She was moody, easily overwhelmed at home, and had difficulty starting or finishing tasks. Her parents initially thought she was just anxious or lazy.

After repeated academic struggles and emotional meltdowns, she was evaluated and diagnosed with **Attention Deficit Hyperactivity Disorder, predominantly inattentive type**.

### Treatment Plan Using a Multimodal Therapy Approach

#### Cognitive Behavioral ADHD Treatment for Teens (CBT)

**Therapy Focus:** Managing negative self-talk, anxiety, and procrastination

- I helped her recognize self-critical thoughts like “I’m just not smart enough.”
- She learned to reframe these into realistic statements: “I need to break this into smaller steps.”
- CBT was also used to build **coping strategies** for overwhelm, like setting timers for 10-minute work bursts and using deep breathing for anxiety.

***Impact:* Reduced school-related anxiety, improved self-esteem, and greater ability to initiate tasks without shutting down.**

#### Executive Function Coaching / Skills Training

**Focus:** Building organization, time management, and task planning

- Weekly sessions focused on: 
    - Creating a **homework routine** with start times and visual checklists
    - Organizing her backpack and digital folders
    - Using Google Calendar and a homework tracking app
- Sofia practiced breaking down long-term projects into manageable chunks with deadlines.

***Impact:* Sofia began submitting more assignments on time and felt less overwhelmed by big projects.**

#### Behavioral Parent Training

**Focus:** Creating a supportive home environment without nagging or micromanaging

- Parents learned about parenting teens with ADHD, including: 
    - Give one instruction at a time
    - Use praise for effort, not just results
    - Set up a **point system** for following routines (e.g., screen time after homework)
    - Let natural consequences (like low grades) happen occasionally to build responsibility

***Impact:* Reduced yelling and frustration at home; Sofia felt more trusted and motivated.**

#### [Academic Accommodations](https://psychologicalassessments.com/testing-for-educational-accommodations/) (504 Plan)

**Focus:** Addressing executive function challenges in school

- Sofia’s school implemented: 
    - Extended time on tests and assignments
    - Preferential seating at the front of the classroom
    - Use of a digital planner shared with teachers and parents
    - Regular check-ins with a guidance counselor

***Impact:* Teachers were more understanding, and Sofia felt less embarrassed asking for help.**

#### Social-Emotional Skills Building

**Focus:** Navigating peer dynamics and perfectionism

- In group therapy, Sofia explored themes of: 
    - Peer comparison and feeling “behind” others
    - Assertiveness and asking for help
    - Dealing with emotional dysregulation without isolating herself
- She practiced scripts for managing group work stress and peer misunderstandings.

***Impact:* Improved friendships, less shame about her differences, and more confidence speaking up.**

#### Optional: Treatment for ADHD in Teens with Medication

After several months of therapy and coaching, Sofia and her family opted to try a **low-dose stimulant medication** under psychiatric supervision.

- Medication helped her sustain attention in class and manage transitions more smoothly.
- Sofia reported she “felt like I could finally *start* things without a giant wall in front of me.”

**I*mpact:* When paired with skills therapy, medication boosted progress significantly.**

### Outcome After 6 Months of ADHD Treatment for Teens

**Domain****Before****After**AcademicDisorganized, overwhelmed, late workSubmitting work on time, using toolsEmotionalAnxious, ashamed, meltdownsCalmer, using coping skills, more confidentSocialWithdrawn, afraid to ask for helpEngaged with friends, advocating for needsFamilyFrequent conflict over tasksMore cooperation, less tension#### Key Takeaway

Sofia’s success didn’t come from one approach, but from **a combination** of:

- **[Individual therapy](https://dralanjacobson.com/individual-therapy/) to build emotional skills**
- **Practical coaching for executive function**
- **Parents learning about parenting teens with ADHD involvement**
- **School accommodations**
- (Eventually) **medication as a supportive tool**

Her journey reflects how a previously undiagnosed ADHD teen—especially a girl—can thrive with the right support system in place.

---

## How to Help Teens with ADHD

If you have arrived at this post as a friend or relative of someone with ADHD, here’s a **peer-friendly guide** on how to help teens with ADHD, designed especially for friends, classmates, and teammates. It’s supportive, easy to follow, and encourages understanding and inclusion.

### How to Help Teens with ADHD: A Peer and Family Guide

#### 1. Understand What the Diagnosis Is (and Isn’t)

- The diagnosis affects focus, memory, impulse control, and energy levels.
- It’s **not** about being lazy, dumb, or intentionally disruptive.
- People with the diagnosis often have **incredible creativity, energy, and determination** — they just process things differently.

#### 2. Communicate Clearly and Kindly

- Be patient if they get off track or interrupt. It’s often unintentional.
- Give reminders in a **friendly** way, like:
    
    *“Hey, we were talking about the project — want to circle back?”*
- Use humor or signals to keep things on track without embarrassing them.

#### 3. Be a Supportive Study Buddy

- Break things into **smaller steps** together.
- Help them set **reminders** or **timers**.
- Study in short bursts — like 25-minute sessions with breaks (Pomodoro technique).
- Try active learning: quiz each other, talk it out, or walk while reviewing.

#### 4. Be Flexible in Group Work

- ADHD can make **organization** or **time management** harder.
- Help plan or assign roles matching their strengths (like creativity, idea generation, speaking).
- Avoid sarcasm or blame — offer support instead:
    
    *“Want help figuring out a plan?”*

#### 5. Respect How Their Brain Works

- They might fidget, doodle, or zone out. That doesn’t mean they’re not listening.
- Let them stim or move as long as it’s not hurting anyone — it helps them focus.
- Accept that focus comes in waves — some days are harder than others.

#### 6. Be a Friend, Not a Fixer

- Their diagnosis is a part of them, not a problem to be solved.
- Encourage their strengths and celebrate small wins.
- If they’re struggling emotionally, help them find a trusted adult—you’re a friend, not a therapist.

#### 7. Avoid These Common Mistakes

- Don’t say “just focus” or “try harder.” It’s not that simple.
- Don’t talk down to them or do everything for them.
- Be wary of making jokes at their expense, even if they seem okay with it.

Congratulations on wanting to know more about how to help teens with ADHD for the sake of your relationship!

---

## Conclusions and My Work

ADHD treatment helps support teens and brings out their wonderful strengths and potential. It’s not about fixing them—it’s about understanding them. When we shift our focus from trying to control behavior to **building skills, empathy, and structure**, families often notice remarkable changes in connection, confidence, and calm.

The path to effective parenting teens with ADHD includes realistic expectations, collaboration, and consistent support, both emotionally and practically. With the right strategies and compassionate guidance, teens with ADHD can thrive—not just in school, but in life. Every teen deserves to be seen not just for their challenges, but for their strengths, and every parent deserves support in learning how to bring out the best in them. I provide a subspecialty involving[ therapy for teen girls with ADHD](https://dralanjacobson.com/teenage-girls-with-adhd/) and follow-on [college ADHD coaching](https://dralanjacobson.com/adhd-coaching-for-college-students-effective-enduring/).

For more information about the treatment for ADHD in teens I can provide, or if you have general questions about this and other [strength-based therapy](https://dralanjacobson.com/strength-based-therapy/) methods, don’t hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Frequently Asked Questions: ADHD Treatment for Teens

Common questions from parents about teen ADHD treatment — what it involves, how long it takes, and how to get started.

   How is ADHD treatment for teens different from treatment for younger children? + Teen ADHD treatment differs from child-focused treatment in several clinically important ways. Adolescents have greater cognitive capacity for insight-based work, which means [CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) and [executive functioning coaching](https://dralanjacobson.com/executive-functioning-coaching/) can be delivered at a more sophisticated level than is possible with younger children. The stakes are also higher — poor academic performance in high school has college implications, and social struggles during adolescence carry lasting effects on self-esteem and identity. At the same time, teens require more autonomy in the therapeutic relationship: treatment that feels imposed rather than collaborative is rarely effective. The therapeutic frame shifts from parent-directed behavioral management toward a partnership in which the teen is an active agent in their own change. Parent involvement remains important but takes a different form — less direct management, more coaching on communication and structure. The American Academy of Child and Adolescent Psychiatry emphasizes multimodal treatment for adolescents that accounts for developmental stage.

   My teen was recently diagnosed. Where does treatment start? + A recent diagnosis is both a relief and a starting point — and the first priority is translating the diagnostic findings into practical, immediate action. Treatment typically begins with psychoeducation for both the teen and their parents: understanding what ADHD actually is neurologically, why the specific struggles they’ve been experiencing are predictable consequences of the diagnosis rather than character failures, and what the evidence says about effective intervention. From there, the focus shifts to identifying the most pressing areas of impairment — academic functioning, emotional regulation, family conflict, or social difficulties — and building targeted strategies for each. A formal diagnosis also opens the door to [school accommodations](https://psychologicalassessments.com/testing-for-educational-accommodations/) such as a 504 Plan or IEP, which can be transformative for academic performance and reduce daily stress significantly. Dr. Jacobson can provide referrals for comprehensive testing through [Precision Psychological Assessments](https://psychologicalassessments.com/adhd-testing/) if a formal evaluation has not yet been completed.

   Should my teen be on medication for ADHD, and how does therapy fit with medication? + The decision about medication is a medical one made in collaboration with a psychiatrist or physician — not something therapy alone determines. What research consistently shows is that the combination of medication and behavioral therapy outperforms either alone for adolescents with ADHD. [CHADD](https://chadd.org/about-adhd/treatment-of-adhd/), the leading national ADHD organization, identifies multimodal treatment — combining medication management, behavioral therapy, and educational support — as the current standard of care. Medication, when appropriate, reduces the intensity of core symptoms (inattention, impulsivity, hyperactivity), making the teen more available to learn and practice the skills that therapy builds. Therapy, in turn, addresses what medication cannot: the self-critical thinking patterns that have accumulated over years of struggling, the organizational habits that need to be explicitly taught, the emotional regulation deficits, and the family communication dynamics. For teens whose families prefer to begin without medication, therapy and coaching alone can produce meaningful gains — particularly for milder presentations.

   My teen also has anxiety or depression alongside ADHD. How does treatment address both? + Co-occurring anxiety and depression are extremely common in teens with ADHD — and frequently go unrecognized because they are assumed to be separate conditions rather than predictable consequences of years of struggling with an unidentified neurological difference. The [National Institute of Mental Health](https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd) recognizes that the majority of individuals with ADHD have at least one co-occurring condition. Treatment addresses both simultaneously rather than sequentially. [CBT for ADHD](https://dralanjacobson.com/cbt-for-adhd/) targets the self-critical, catastrophizing thinking patterns that fuel both anxiety and depression alongside the executive functioning deficits. [Mindfulness-based approaches](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) reduce emotional reactivity and improve tolerance of distress. When [teen anxiety](https://dralanjacobson.com/therapy-for-teen-anxiety/) or [depression](https://dralanjacobson.com/therapy-for-depression/) is significant, these dimensions receive dedicated clinical attention within the same integrative treatment frame rather than being treated as afterthoughts to the ADHD work. Dr. Jacobson’s background as a licensed clinical psychologist means he can hold all three dimensions simultaneously.

   How do I get my teenager to engage with therapy when they’re resistant? + Teen resistance to therapy is common and developmentally understandable — adolescence is a stage of asserting autonomy, and being sent to a psychologist can feel like being told something is wrong with you. Several things help. First, framing matters enormously: therapy for ADHD is not about fixing a broken person; it is about building skills and getting strategies that actually work for the way your brain operates. Many teens respond well to this reframe. Second, giving the teen genuine input into the goals and structure of therapy — rather than presenting it as a parental mandate — increases buy-in significantly. Third, the first session is usually the critical juncture: most teens who are genuinely resistant going in are at least curious coming out, particularly when the therapist meets them where they are rather than reinforcing the sense that they are the problem. If significant resistance persists, parent sessions can begin the work productively while the teen warms to the idea. Dr. Jacobson has extensive experience working with reluctant adolescents and adjusts his approach accordingly.

   What role do parents play in teen ADHD treatment? + Parent involvement is a significant predictor of positive outcomes in teen ADHD treatment — but the form it takes matters. At the adolescent stage, effective parent involvement is less about direct behavioral management and more about creating the environmental conditions that support the teen’s developing self-regulation: consistent routines, clear and calm communication, appropriate structure without micromanaging, and a home atmosphere that emphasizes the teen’s strengths rather than cataloguing their failures. Behavioral Parent Training (BPT) is a specific evidence-based component of treatment in which parents receive coaching on these skills directly. Research published in [peer-reviewed journals](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3724232/) consistently shows that parent training improves teen outcomes across academic, behavioral, and emotional domains. Dr. Jacobson incorporates parent consultation sessions — either alongside teen sessions or separately — to ensure the home environment actively supports rather than inadvertently undermines the work being done in therapy. For more on the parenting dimension, see the detailed tips in the parenting section above and the [parent coaching page](https://dralanjacobson.com/parent-coaching/).

   How long does ADHD treatment for teens typically take, and what does progress look like? + Treatment length varies depending on severity, the presence of co-occurring conditions, and how quickly skills generalize from session to daily life. A focused course of CBT and executive functioning coaching for a teen with a relatively straightforward ADHD presentation typically runs 16–24 sessions over 4–6 months. More complex presentations — significant anxiety or depression alongside ADHD, longstanding self-esteem damage, or family conflict requiring dedicated attention — generally take longer. Early progress tends to show up as practical gains first: more assignments submitted on time, less morning chaos, fewer homework battles. Deeper gains in emotional regulation and self-concept typically emerge over a longer arc. As illustrated by Sofia’s case example on this page, meaningful progress across academic, emotional, social, and family domains is achievable within 6 months of consistent multimodal treatment. Treatment also dovetails naturally with the transition to college for older teens — the [ADHD coaching for college students](https://dralanjacobson.com/adhd-coaching-for-college-students-effective-enduring/) page describes how the work continues and evolves in that next stage.

   How do we get started — and can teen ADHD treatment be done online? + Yes — teen ADHD treatment is fully compatible with online delivery, and virtual sessions offer specific practical advantages: teens can attend from home without losing travel time, sessions can be scheduled around demanding school and activity schedules, and the familiar home environment is often where the challenges being addressed actually occur. Dr. Jacobson is a [PSYPACT](https://psypact.org/)-participating psychologist licensed in 44 states, making virtual teen ADHD treatment accessible nationwide. The first step is a free 20-minute consultation — typically with the parent or parents to start, and often including the teen depending on age and readiness. That conversation covers what you’re observing, how long it has been going on, what has been tried, and what your goals are. There is no commitment required. Related pages worth reviewing: [therapy for girls with ADHD](https://dralanjacobson.com/therapy-for-girls-with-adhd/), [teen girls with ADHD](https://dralanjacobson.com/teenage-girls-with-adhd/), [teen anxiety therapy](https://dralanjacobson.com/therapy-for-teen-anxiety/), [ADHD coaching for college students](https://dralanjacobson.com/adhd-coaching-for-college-students-effective-enduring/), and [ADHD testing](https://psychologicalassessments.com/adhd-testing/) through Precision Psychological Assessments.

 Your teen’s potential is real — ADHD doesn’t have to stand in the way of it.

Schedule a free 20-minute consultation with Dr. Jacobson — a practical conversation about what your teen is experiencing and what a treatment plan might look like.

 [ Schedule a Free Consultation ](https://www.picktime.com/scheduleaconsult) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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](https://www.instagram.com/appliedpsychological) [ ![social network 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](https://www.linkedin.com/company/psychologicalscience/)

---

### [Finding Therapy in New York | Dr. Alan Jacobson](https://dralanjacobson.com/therapy-in-new-york/)

**Published:** January 11, 2026
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: August 3, 2026

 # Therapy in New York

A guide to getting therapy in New York state that is the best fit for you and your family. As a New York therapist, I work to connect with community norms, current opportunities and challenges, and cultural differences.

 [Get In Touch](https://dralanjacobson.com/contact/)[Schedule a Consult](https://www.picktime.com/scheduleaconsult#book/services)

### Therapists in New York

In a vast state and complex state, the process of finding New York therapy can feel confusing, especially when you’re dealing with stress, anxiety, or emotional pain. New York has one of the most diverse and dense therapeutic ecosystems in the world. It offers a wide range of options, from in-person offices to specialized telehealth providers, low-cost clinics, and [advanced trauma care](https://dralanjacobson.com/trauma-informed-care/). There are couples, individual, and [family therapists](https://dralanjacobson.com/family-therapy/) in New York, using a wide variety of approaches.

This guide walks you through how to find services starting with a Q&A format, focusing on individual and family therapy in New York (including couples).

### New York Therapy Guide

Wherever you live—whether it’s Manhattan or a rural part of upstate New York—you deserve to find a therapist in New York that meets you where you are. Thanks to [telehealth therapy](https://dralanjacobson.com/telehealth-therapy-teletherapy/), more people than ever can find high-quality, culturally affirming, and flexible New York therapists. Knowing how to find New York therapy that fits is easier than ever, but the number of choices may seem overwhelming.

I believe the process of finding New York Therapy works best when it’s built around your life, not the other way around. If you’re feeling unsure about where to begin, remember: the first step is asking for support, and you’ve already taken it.

01

## Q: How to Find Therapy in New York: Getting Started

## ![How to find therapy](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "research | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

The best place to start to find a therapist in New York is with clarity and a sense of curiosity. Ask yourself:

- *What do I want help with right now?*
- *Am I looking for support with anxiety, trauma, relationships, ADHD, burnout, grief, or identity questions?*
- *Would I feel more comfortable with someone of a certain gender, race, religion, or cultural background?*

Next, when considering how to find therapy in New York or elsewhere, consider logistics:

- Do I want in-person sessions with a therapist in New York, or is [online therapy](https://dralanjacobson.com/virtual-therapy-guide/) more convenient?
- Am I using insurance, or paying out of pocket?
- Do I need to find a therapist in New York who has evening/weekend availability?
- What borough (or region) am I in (for in-person choices of a therapist in New York)?

Once you have those answers, explore these trusted platforms that can be key pieces of how to find a therapist in New York:

- [Psychology Today](https://www.psychologytoday.com/us/therapists/alan-jacobson-old-westbury-ny/982114?msockid=160b4fcfa83f69d31d2f5ab5a9cf68c1) can help you locate New York therapists. It is the largest national directory. Use filters for issue, identity, insurance, and more.
- [Zencare](https://zencare.co/provider/therapist/alan-jacobson) – High-quality listings of New York therapists with intro videos and interview-style bios.
- [Inclusive Therapists](https://www.inclusivetherapists.com/) – Designed for marginalized and underserved communities.
- [Open Path Collective](https://www.openpathcollective.org/) – Sliding scale therapy nationwide ($40–$70 per session).
- Alma / Headway – Matches New York therapists who accept your insurance and offer online or in-person sessions.

As far as New York therapy, you’ll also find hospital-affiliated clinics, college counseling centers, and nonprofit organizations that provide therapy at reduced rates.

02

## Q: How to Find Therapy in New York That is Specialized?

Nearly every major therapeutic modality is represented in New York, and many New York therapists employ integrative or evidence-based approaches tailored to your specific needs.

Here are common types of therapy in New York you’ll find:

- [Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT): Focused on identifying and changing unhelpful thoughts and behaviors. Effective for depression, anxiety, OCD, and panic.
- [Dialectical Behavior Therapy](https://dralanjacobson.com/dbt-for-teens/) (DBT): Combines cognitive techniques with mindfulness and emotion regulation. Often used for BPD, self-harm, and high emotional sensitivity.
- [Psychodynamic Therapy](https://dralanjacobson.com/psychodynamic-therapy/): Explores unconscious patterns, early relationships, and core beliefs. Helps with long-term personality patterns and insight.
- Eye Movement Desensitization and Reprocessing ([EMDR](https://www.emdr.com/what-is-emdr/)): Specialized for trauma, PTSD, and distressing life events.
- [Internal Family Systems](https://dralanjacobson.com/internal-family-systems-therapy-ifs/) (IFS): Helps identify and harmonize different “parts” of the self.
- [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/), [Creative Therapy](https://dralanjacobson.com/creative-counseling/), and Culturally Responsive Therapies: NYC is a hub for creative and culturally informed therapists.

Many clinicians will combine these techniques based on what’s most effective for your situation. I cover family therapy in New York later on. You don’t have to know exactly what [form of therapy](https://dralanjacobson.com/does-therapy-help-what-form-of-therapy-works-best/) you need, but a general sense can be helpful.

03

## Q: How do I Find the Right Therapist in New York for Me?

Finding the right therapist in New York isn’t just about credentials. You want someone who gets you, supports you, and helps you grow.

Here’s how to find the [best psychotherapist](https://dralanjacobson.com/choosing-the-best-therapist-for-you/) for you:

- Specialty experience: Choose someone who has regularly worked with your concerns.
- Therapeutic style: Some therapists in New York are warm and supportive; others are more structured or direct.
- Identity alignment: It may be helpful to work with someone who shares or affirms your race, gender, culture, or lived experiences.
- Licensing: Ensure they’re licensed in New York State (if you live in New York), even if they’re providing telehealth from a different part of the state.

*Tip: Most therapists in NYC offer a [free 10–15 minute consultation](https://www.picktime.com/scheduleaconsult), which provides a great starting point for finding the right match.* Come prepared with questions like:

- What does a typical session look like?
- How do you work with \[my concern\]?
- Do you offer virtual sessions?
- Do you take my insurance or offer a sliding scale?

04

## Q: How to Find a Specialist for Teens

Teenagers need therapists who specialize in adolescent development, communicate clearly, and create a safe, nonjudgmental environment. Look for an individual and family therapist in New York who:

- List “Children/Adolescents” as a specialty or something even more specific, like “[Therapy for teen anxiety](https://dralanjacobson.com/therapy-for-teen-anxiety/).”
- Have experience with school stress, peer issues, identity development, and emotional regulation
- Use creative modalities like art therapy, CBT, DBT skills, or games
- Offer family involvement when appropriate

You can search for individual adolescent or family therapy in New York through:

- Psychology Today or Zencare
- Your child’s school counselor or pediatrician
- Clinics like [The Child Mind Institute](https://childmind.org/), [Mount Sinai Adolescent Health Center](https://www.mountsinai.org/locations/adolescent-health-center), or [NY Foundling](https://www.nyfoundling.org/)

Many adolescents actually prefer telehealth—it feels less intimidating, and they can talk from a familiar space.

05

## Q: How Do I Find Family Therapy in New York?

Family therapy in New York or anywhere can be a vital resource when there are parenting struggles, conflict, divorce, loss, or generational tensions. There are many experienced New York therapists who specialize in a wide range of issues.

Start your search by:

- Using a platform like Psychology Today or Zencare, filtering for “Family Therapy” or “Families.”
- Looking for providers with credentials such as:
    - LMFT (Licensed Marriage and Family Therapist)
    - LCSW (Licensed in Clinical Social Work)
    - [Clinical Psychologists](https://dralanjacobson.com/what-is-a-clinical-psychologist/)

### Well-known Family Therapist in New York in Group Practice:

- The [Ackerman Institute for the Family](https://www.ackerman.org/) – One of the nation’s leading family therapy training centers.
- [The Family Center](https://www.thefamilycenter.org/) – Family therapists in NYC who provide services for families coping with illness, trauma, or loss.
- [Northside Center](https://www.northsidecenter.org/) – Culturally responsive family therapists in NYC for families of color.

Sessions may involve all family members or select individuals, depending on the issue.

06

## Is Telehealth Therapy in New York a Good Option?

Telehealth individual or family therapy in NYC is often ideal.

While an in-person therapist in NYC may be available across the five boroughs, telehealth has expanded access to thousands of qualified therapists throughout the state and elsewhere. You’re no longer limited to those within a subway ride.

### Telehealth Therapy in New York (or anywhere) is especially helpful if:

- You live in a borough with fewer providers (Staten Island, the Bronx).
- Your job work long or unpredictable hours.
- You feel more comfortable in your own space.
- You’re parenting, caregiving, or managing disability or chronic illness.

Each therapist in NYC uses secure platforms like Psychology Today, SimplePractice, Zoom for Healthcare, or Doxy.me, and some offer hybrid options (e.g., monthly in-person with weekly virtual sessions)

07

## Q: Where do New York Therapsists Practice

New York therapists practice in a wide variety of settings:

- [Private Practice](https://dralanjacobson.com/finding-a-private-practice-therapist/) Offices: Found throughout Manhattan, Brooklyn, Queens, and other boroughs. Some are solo offices; others are part of group practices or wellness collectives.
- Home Offices or Fully Remote Practices: Many therapists have gone entirely virtual.
- Hospitals and Academic Centers: NYU Langone, Columbia, and Mount Sinai offer outpatient therapy services with specialized care.
- Nonprofits and [Federally Qualified Health Centers](https://www.fqhc.org/what-is-an-fqhc/) (FQHCs): Affordable or insurance-based therapy, often bilingual and community-centered.
- College/University Counseling Centers: Free or low-cost for enrolled students.
- Telehealth-Only Platforms: A therapist in New York can work from anywhere in New York State or anywhere as long as they are licensed in the state, serving clients citywide.

About

If you’d like help with the [best way to find a therapist](https://dralanjacobson.com/the-best-way-to-find-a-therapist-using-therapist-finders-word-of-mouth-and-other-therapy-resources/) in New York for individual or family therapy or anywhere else, I’m happy to refer you to resources or talk through your options. [Contact me](https://dralanjacobson.com/contact/) or [book a consultation](https://www.picktime.com/scheduleaconsult), I’ll help you find a therapist in New York, whether I am the best fit or not. I can also assist you in finding [psychological testing](https://psychologicalassessments.com/), [therapeutic tutoring](https://therapeutictutoring.com/), and executive coaching services.

## Case Example: Maya’s Journey to Therapy in New York

**Background:**

Maya, a 26-year-old graphic designer living in Brooklyn, had been feeling overwhelmed for over a year. She was struggling with anxiety, burnout from her job, and unresolved feelings from a difficult breakup. Although she had always considered herself high-functioning, the pandemic and the pressures of adulthood had caught up with her. She found herself crying more often, withdrawing from friends, and having trouble sleeping.

### How She Searched New York Therapists

Maya decided to try therapy after confiding in a friend. She started by browsing the **Psychology Today** website, filtering for therapists in NYC who specialized in anxiety and relationship issues. Her preference was someone who took her insurance and had experience with young adults.

She found me and was glad to see that I was a licensed clinical psychologist who offered telehealth sessions. Maya was drawn to my biography, the evidence-based treatment approaches, and the paragraph about [helping young people navigate transitions](https://dralanjacobson.com/therapy-for-college-students/).

### The Process:

Maya scheduled a free 15-minute phone consultation with me, during which she felt heard and comfortable. We began weekly sessions using a combination of **Cognitive Behavioral Therapy (CBT)** and **psychodynamic talk therapy**. Early sessions focused on building trust and identifying patterns in Maya’s anxiety.

Over time, Maya began to unpack some long-standing self-critical thoughts and learned grounding techniques to manage panic. We explored her past relationships and how early family dynamics shaped her current emotional responses. I helped her set healthy boundaries at work and challenge the perfectionism that was driving her stress.

### **New York Therapy: Positive Outcomes**

After six months of therapy:

- Maya reported fewer panic episodes and better sleep.
- She started seeing friends more regularly and rekindled her interest in photography.
- She felt more confident navigating dating and had begun to explore what she wanted in future relationships.
- Most importantly, Maya felt like she had a “toolbox” of strategies to regulate her emotions and stay connected to herself.

### **Current Status:**

Maya continues therapy bi-weekly for maintenance and deeper work around identity and self-worth. She sees it as an investment in herself and has even encouraged a few friends to seek help, breaking the stigma she once felt about mental health.

## Case Example: Family Therapist in New York

### **Background:**

The Johnsons—a family of four living in Queens—were going through a rough patch. The parents, Dana and Marcus (both in their early 40s), had been arguing frequently, and their two kids, 15-year-old Jaden and 11-year-old Zoe, were acting out in school and at home. Communication had broken down, and dinner time often ended in silence or shouting.

Dana began to notice that Zoe was becoming increasingly withdrawn, while Marcus observed Jaden getting into trouble at school for being defiant with teachers. The parents realized that whatever was happening in the family system was affecting their kids deeply.

### How They Searched for Family Therapy in New York:

At the recommendation of a pediatrician, Dana looked into **family therapists who specialized in communication and adolescent issues**. She used the [**Therapy for Black Girls**](https://therapyforblackgirls.com/) directory and **Psychology Today** to narrow down providers of Family therapy in New York who worked with families and had evening or weekend hours. She also called me, knowing I provide family therapy in NYC, but unsure if I was the best fit for her.

I helped them find a licensed marriage and family therapist in Brooklyn who specialized in working with Black and multiracial families. Her profile emphasized collaboration, emotional safety, and working with teens and parents together.

### The Treatment Process:

The family began **biweekly sessions**, both virtually and in-person. Jasmine started with full-family sessions, helping everyone express their concerns without blame. She then did rotating sessions—sometimes seeing the parents alone, other times just the kids, and often bringing them all back together.

- She helped the parents understand how their conflicts were impacting their children emotionally and behaviorally.
- With the kids, Jasmine used creative tools like drawing, roleplay, and family mapping to make therapy approachable.
- The family practiced communication tools in session, like using “I” statements and taking breaks before escalating arguments.

### Family Therapy in New York: Positive Outcomes

After four months of consistent therapy:

- Dana and Marcus reported fewer arguments and had learned how to “pause and regroup” rather than lash out.
- Jaden was no longer getting in trouble at school and felt “heard” at home for the first time in years.
- Zoe became more open, shared her feelings more, and even asked to continue therapy “just to talk sometimes.”
- The family started having weekly game nights and eating dinner together again—something they hadn’t done regularly in years.

#### Current Status:

They now attend monthly “check-in” sessions to stay connected. Jasmine remains a trusted figure the kids feel safe reaching out to. The Johnsons say therapy gave them “a shared language” and “a way back to being a team.”

### Final thoughts on THerapy in New York

## A Note from Dr. Jacobson

As a dedicated psychologist serving the rich and diverse tapestry of New York, I recognize that the mental health landscape mirrors the variety of the communities that flourish here. My unwavering commitment to understanding cultural nuances, community norms, and the distinct challenges our residents encounter enables me to customize my therapeutic methodologies to effectively address the unique needs of children and adolescents.

By fostering meaningful connections with fellow New York therapists throughout the state, I ensure that my clients receive holistic support, which can include timely referrals to specialists or collaborative initiatives that deepen our collective insights into effective treatment strategies.

Together, we can skillfully navigate the complexities of emotional regulation, identity formation, and the formidable pressures of academic life, empowering young individuals to flourish on their personal paths. In this dynamic state, I wholeheartedly celebrate the abundant opportunities for growth and healing that exist within our diverse communities, and I am truly honored to play a role in this transformative journey.

 ![Therapist in New York](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "Me | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

 [ ![social network 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](https://www.facebook.com/appliedpsychologicalscience) [ ![social network icon](data:image/svg+xml;base64,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) ](https://www.instagram.com/appliedpsychological) [ ![social network icon](data:image/svg+xml;base64,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)](https://www.linkedin.com/company/psychologicalscience/)

---

### [Sports Psychology](https://dralanjacobson.com/sports-psychology/)

**Published:** December 26, 2023
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: August 2, 2026

 # Sports Psychology

I provide Sports Psychology for High School, College, and Professional Athletes. Working with an online sports psychologist (also called an “athletic psychologist”) can help you perform your best, be in the zone, and get more enjoyment out of your athletic career. Performance psychology is powerful and effective.

 [Schedule a Free Consultation](https://www.picktime.com/scheduleaconsult)

## Sports Psychology Services:

**Sports Psychology** is designed to help in several important ways:

1. Peak Performance and Flow: Reach “flow” (being “in the zone”) more frequently and perform better through sports psychology services. Develop the best pre-match routine and in-match strategies for success.
2. Reduce Stress and Anxiety: Overcome performance anxiety and pressure in general and a specific aspect of your sport. This can help you derive more enjoyment from competition.
3. Generalize Gains: Ensure that the feelings of confidence, competence, and success transfer to other aspects of life. Feel more confident in your abilities and potential.
4. Maintain High Performance: Building enduring confidence helps you maintain high performance over a long season and break out of slumps and plateaus.

 ![Sports Psychology Process](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "cropped-sports-psychology-client-3webp | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## More about Sports Psychology Services

A specialty service for youth, college, and professional athletes.

 ![athletic psychologist](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "Sports | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

##### What is Sports Psychology?

I provide a full range of Sports Psychology Services for athletes that want to achieve peak performance in competition and beyond. My services generally work to help each athlete achieve “[Athletic Flow](https://dralanjacobson.com/flow-state/)” as often as possible. It is also designed to reduce barriers such as anxiety and pressure.

Almost all youth athletes compete not only for the love of the game and enjoyment of competition but also for other important reasons. This may include learning how to be a great teammate and leader, achieving academically, and scheduling their time so they can have fun and try new things. More about Sports Psychology: Highly Rated WebMD.

[Counseling for athletes](https://dralanjacobson.com/counseling-for-athletes/) can usually effectively be provided remotely by video. That said, we will do a quick assessment to ensure you would not be better served by receiving a performance assessment from someone local to you. In that case, I may be able to refer you to a qualified and experienced practitioner in your area.

##### What Are the Benefits

Sports Psychology services may be helpful for any student-athlete from middle school through college and beyond. Services can start any time during those years. This approach is designed to help quickly, helping athletes achieve peak performance in general and, when possible, “flow” (also known as being “in the zone”) as frequently as possible.

As a result of sports psychology therapy, confidence increases, enjoyment of the sport increases, and other areas of the athlete’s life also improve. In short, effective sports therapy can have wide-ranging positive effects! The following outlines the [sports therapy process](https://dralanjacobson.com/sports-performance-psychology/). As with any therapy, everything is uniquely and individually tailored to each person.

##### How Does It Work

There are several ways that Sports and Performance Psychology services can be delivered:

### Individual Sports Psychology

Individual Performance Therapy My sports psychology services use proven theories and techniques in performance psychology. Together we will work toward [performance improvement](https://dralanjacobson.com/athletic-performance-improvement/) or the achievement of peak performance in your sport.

The results of [sports performance psychology](https://dralanjacobson.com/sports-performance-psychology/) should be relatively fast, measurable, and meaningful. We will design a treatment plan that estimates how quickly this progress will happen. You are then in charge of your treatment. It is up to you when you feel you have progressed as far as you wanted.

For some, just a time-limited assessment of what may be getting in the way of you achieving peak performance is all that is needed. I’ll provide an assessment and then design a program around your specific goals. How can you best reach those goals using scientifically proven [performance improvement](https://dralanjacobson.com/sports-performance-improvement-innovations/) techniques? These assessments are designed to stand independently. They will give you the ideas and suggestions you need to work on the improvements immediately.

### Sports Psychology Workshops for Groups

 I also provide workshops for coaches, trainers, and sports administrators who want to learn how best to integrate the theory and practice of sports psychology into their work. These workshops are designed to briefly present the science behind sports psychology. The goal is that they can then help their players achieve peak performance and flow.

### Training for Teams

 I can provide training for teams looking to maximize performance individually and collectively. This [performance psychology](https://dralanjacobson.com/sports-performance-psychology/) training is designed to help the group achieve peak performance and improve their enjoyment and feeling of accomplishment as a team.

### Sports Psychology Services for Coaches

I would be happy to meet with any coach or group of coaches as part of my sports psychology services to teach you how to integrate the principles of peak athletic performance into your work. You will learn how to best connect with, motivate, and respond to athletes. For those coaching a team, we will go over team-building exercises and general ways to bring people together for a common goal. Sometimes, sports psychology services for coaches are delivered due to a particular challenge or obstacle, and other times, they become a part of the coaching routine.

##### Will Sports Psychology Work For Me?

I offer a free consultation so you can see whether my sports psychology services are a fit for you or your team, whether you are an athlete or a coach. We can review how working with an athletic psychologist can benefit you both on and off the field of play. You can try my [athletic performance improvement self-help](https://dralanjacobson.com/athletic-performance-improvement/%20) first if you want to get an idea of what it will be like.

## Why Work with an Athletic Psychologist

 ![Sports Psychologist](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "check mark | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

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##### An athletic psychologist can help you achieve peak performance and flow

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##### An athletic psychologist can raise your enjoyment of your sport

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##### Your work with an athletic psychologist can carry over into other areas of your life

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##### An athletic psychologist can deliver effective services virtually (see below) 

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##### Most of the methods and techniques we use are scientifically proven and empirically-based

[Sports performance psychology](https://dralanjacobson.com/sports-performance-psychology/) has many benefits, whether delivered virtually or in-person. Please use the [contact form below](https://dralanjacobson.com/contact/) if you’d like more information or want to run by your specific situation to see you this treatment approach might help.

### Final thoughts

## How Does an Online Sports Psychologist Provide Services?

An [online sports psychologist like me](https://dralanjacobson.com/my-bio/) provides athletes with mental health and performance enhancement services via virtual platforms. The work of an online sports psychologist involves the following key activities:

1\. Performance Enhancement: An online sports psychologist helps athletes improve their performance by teaching mental skills such as visualization, focus, goal setting, and relaxation techniques. By working virtually, it allows us to integrate certain apps and other technology to our work with you.

2\. Mental Health Support: We address issues such as anxiety, depression, stress, and burnout that can affect [athletes’ well-being and performance](https://dralanjacobson.com/athletic-performance-improvement/). This is one way an online sports psychologist uniquely qualifies to help the whole athlete.

3\. Motivation and Confidence Building: An online sports psychologist helps athletes develop and maintain motivation and confidence, which are crucial for consistent performance.

4\. Team Dynamics and Communication: I often work with whole teams or coaches to improve communication, cohesion, and overall team dynamics.

5\. Athletic Career Transition: An online sports psychologist supports athletes through transitions such as moving to a higher level of competition, retirement, or dealing with life after sports.

An online sports psychologist delivers their services using various methods, including video calls, phone calls, messaging, and digital resources. This allows an athletic psychologist to reach athletes regardless of geographical location and provides flexibility in approach and scheduling.

 ![Online sports psychologist](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "Website")

## Frequently Asked Questions: Sports Psychology

Common questions about sports psychology services — what they involve, who they help, and how to get started with an online sports psychologist.

  What does a sports psychologist actually do — and how is it different from coaching? +A sports psychologist helps athletes develop the mental skills that translate ability into consistent, high-level performance — and addresses the psychological barriers that prevent it. The work spans performance enhancement (visualization, focus, pre-competition routines, managing pressure), mental health support (anxiety, burnout, depression, athletic identity), motivation and confidence building, and career transitions. This is distinct from what a coach does: a coach develops technical skill and strategy; a sports psychologist works the mental and emotional layer that either amplifies or limits that skill. The [American Psychological Association](https://www.apa.org/ed/graduate/specialize/sports) recognizes sport psychology as a specialty area within professional psychology, requiring both clinical training and applied performance knowledge. Dr. Jacobson's background as a licensed clinical psychologist means he can address both peak performance goals and the mental health dimensions — such as [performance anxiety](https://dralanjacobson.com/therapy-for-teen-anxiety/), [depression](https://dralanjacobson.com/therapy-for-depression/), and [career transition](https://dralanjacobson.com/life-transitions-therapy/) — that a performance coach alone is not trained to handle.

  What is "flow" in sports, and how does sports psychology help athletes get there? +Flow — commonly called being "in the zone" — is the psychological state in which performance feels effortless, attention is fully absorbed in the task, self-consciousness disappears, and execution happens at or beyond the athlete's best level. It was first described systematically by psychologist [Mihaly Csikszentmihalyi](https://en.wikipedia.org/wiki/Mihaly_Csikszentmihalyi) and is now one of the most studied phenomena in performance psychology. Flow cannot be forced, but it can be made more likely through deliberate psychological preparation: developing consistent pre-competition routines that prime the right mental state, building the attentional control to stay present rather than evaluating performance in real time, managing anxiety to keep it in the performance-enhancing range, and building the self-efficacy that allows an athlete to trust their training. Dr. Jacobson's sports psychology work is organized around helping each athlete identify and reliably recreate the conditions that bring them closest to [athletic flow](https://dralanjacobson.com/flow-state/).

  Which athletes benefit from sports psychology — only elite or professional athletes? +Sports psychology is valuable at every level of competition — not just elite or professional. High school athletes navigating the pressure of varsity competition, college athletes managing the dual demands of sport and academics, club and recreational athletes who want to perform more consistently and enjoy their sport more, and professional athletes managing high-stakes performance environments all benefit from this work. The mental demands of sport — managing anxiety, recovering from setbacks, staying focused under pressure, competing through slumps — are present at every level. Dr. Jacobson works with athletes from middle school through professional competition across a wide range of sports. For student-athletes specifically, the skills developed in sports psychology — focus, resilience, confidence under pressure — also transfer directly to academic performance and are addressed in the overlap with [ADHD coaching for college athletes](https://dralanjacobson.com/adhd-coaching-for-college-students-effective-enduring/) and [therapy for college students](https://dralanjacobson.com/therapy-for-college-students/).

  What specific mental skills does sports psychology build? +Sports psychology builds a portfolio of evidence-based mental skills tailored to each athlete's sport and specific performance challenges. Core skills include visualization and mental rehearsal — using detailed, process-focused imagery to prime movement patterns and build competitive confidence; attentional control and focus — developing the ability to direct attention precisely and recover it quickly when distracted; pre-competition routines — structured sequences that reliably activate the athlete's optimal performance state; arousal regulation — managing pre-competition anxiety and energy levels to stay in the performance-enhancing zone rather than over- or under-arousal; self-talk and cognitive restructuring — replacing the automatic negative thoughts that surface under pressure with performance-supportive internal language; and goal-setting frameworks that build motivation and create clear benchmarks for improvement. The [research literature on mental skills training](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6027933/) consistently shows significant improvements in competitive performance, consistency, and athlete wellbeing when these skills are developed systematically. See also the [sports performance psychology](https://dralanjacobson.com/sports-performance-psychology/) page for a deeper look at the process.

  How does sports psychology help with performance anxiety and competitive pressure? +Performance anxiety is one of the most common and most directly treatable issues in sports psychology. A key insight is that anxiety itself is not the problem — every competitive athlete experiences pre-competition arousal. The problem is when anxiety crosses into a range that disrupts focus, tightens movement, and triggers avoidance behaviors like "tanking" to reduce pressure or avoiding high-stakes situations altogether. Sports psychology addresses this at multiple levels: physiologically, through breath control, progressive muscle relaxation, and arousal regulation techniques; cognitively, through [cognitive restructuring](https://dralanjacobson.com/cognitive-restructuring/) to challenge the catastrophic thinking patterns that amplify pressure; and behaviorally, through graduated exposure to pressure situations in training and competition. Where performance anxiety is severe enough to meet clinical criteria for [social anxiety](https://dralanjacobson.com/therapy-for-social-anxiety-disorder/) or a specific performance phobia, Dr. Jacobson's clinical background allows him to address the deeper clinical dimensions alongside the performance work — something a non-licensed performance coach cannot do.

  Can sports psychology help with injury recovery, athletic burnout, or career transitions? +Yes — these are three of the most clinically significant situations in an athlete's career, and all three are well within the scope of sports psychology. Injury recovery involves managing the psychological aspects of being sidelined — grief over lost training time, fear of reinjury, identity disruption when sport is central to self-concept, and maintaining motivation and mental sharpness during physical recovery. Athletic burnout — the combination of emotional exhaustion, depersonalization, and reduced sense of accomplishment that develops from chronic overtraining and pressure — is increasingly recognized as a serious concern at all levels of sport, with [research showing it affects a significant proportion of student-athletes](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5819051/). Career transitions — moving to a higher level of competition, retiring from sport, or navigating life after an athletic career ends — often involve profound identity shifts that benefit from structured psychological support. These situations connect naturally with Dr. Jacobson's clinical work in [grief therapy](https://dralanjacobson.com/grief-therapy/), [life transitions therapy](https://dralanjacobson.com/life-transitions-therapy/), and [depression treatment](https://dralanjacobson.com/therapy-for-depression/).

  How does online sports psychology work — is it as effective as in-person? +Yes — and virtual delivery is particularly well-suited to sports psychology work. Mental skills training does not require physical presence: visualization exercises, focus training, self-talk work, pre-competition routine development, and goal-setting frameworks all translate fully to video sessions. The flexibility of virtual delivery is also a practical advantage for athletes with demanding travel and competition schedules — sessions can happen from a hotel room, a locker room, or a training facility before or after practice. Dr. Jacobson is a [PSYPACT](https://psypact.org/)-participating psychologist licensed in 44 states, making online sports psychology services accessible to athletes throughout the country regardless of location. Research on telehealth-delivered psychological services consistently supports its equivalence to in-person treatment for the types of work involved in sports psychology. See the [virtual therapy guide](https://dralanjacobson.com/virtual-therapy-guide/) for more on how sessions are structured.

  How do I get started with sports psychology services? +The first step is a free 20-minute consultation — a practical conversation about the athlete's sport, their specific performance goals and challenges, and how sports psychology services might be structured for their situation. Consultations are available for individual athletes, parents of youth athletes, coaches, and teams. There's no commitment required. Dr. Jacobson will assess whether individual sessions, a time-limited performance assessment, or a team or coach workshop format is the best fit. For athletes who want a sense of the approach before reaching out, the [athletic performance self-help page](https://dralanjacobson.com/athletic-performance-improvement/) provides an introduction to the key concepts. Related pages worth reviewing: [sports performance psychology](https://dralanjacobson.com/sports-performance-psychology/), [flow state](https://dralanjacobson.com/flow-state/), [counseling for athletes](https://dralanjacobson.com/counseling-for-athletes/), and [sports psychotherapy outcomes](https://dralanjacobson.com/sports-psychotherapy-outcomes/).

The mental game is where championships are won — and lost.

Schedule a free 20-minute consultation with Dr. Jacobson — a practical conversation about your performance goals and how sports psychology can help you get there.

 [ Schedule a Free Consultation ](https://www.picktime.com/scheduleaconsult)

 ## Contact Me

We can discuss your hopes and needs regarding **sports psychology** and how my services can help if you’d like. I can provide[ sports psychotherapy](https://dralanjacobson.com/sports-psychotherapy-outcomes/) services to individuals and groups and train coaches in how to incorporate these principles into their work. I have delivered these services to high school, college, and professional athletes. A consultation is always free!

### Call

(617)-680-5488

### Email

hello@dralanjacobson.com

### Address

In person: Westwood, MA & Lee, NH

Virtual: Serving 40 states

### Hours

Inquire

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---

### [Therapy for Phobias](https://dralanjacobson.com/therapy-for-phobias/)

**Published:** September 17, 2024
**Author:** Dr. Alan Jacobson

**Content:**

I provide therapy for phobias both in person and virtually. This approach can have powerful and lasting results, helping you reduce symptoms, enjoy life more once the symptoms end, and learn new things about yourself. The two major types of therapy I provide in this area are CBT for phobias and mindfulness treatment for phobias. Exposure therapy for phobias, always done at a pace you are comfortable with, is part of CBT.

### Therapy for Phobias in My Practice

The following provides an overview of therapy for phobias, including a deeper look at the primary approaches. If you have specific questions about how this method may work for you or a loved one, please feel free to [contact me](https://psychologicalassessments.com/contact-us/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Types of Therapy for Phobias

Therapy for phobias often involves psychological approaches aimed at reducing fear and anxiety associated with specific triggers. Here are the most common therapeutic methods used in treatment for phobias:

### 1. CBT (Including Exposure Therapy for Phobias):

- **How it works**: CBT helps individuals challenge and change irrational beliefs and thoughts related to their fears. The therapy focuses on recognizing the negative thought patterns contributing to the fear and replacing them with more rational ones.
- **Exposure Therapy for Phobias**: A subset of CBT, exposure therapy for phobias gradually exposes the person to the feared object or situation in a controlled and systematic manner. This exposure helps desensitize the person over time.
- **Virtual Reality Therapy**: Sometimes, [virtual reality is used for exposure](https://www.forbes.com/health/mind/virtual-reality-therapy/), especially when direct exposure is difficult or impossible.

### 2. Systematic Desensitization:

- **How it works**: A close cousin of exposure therapy for phobias, this technique combines relaxation exercises with gradual exposure to the phobic trigger. The goal is to slowly reduce the anxiety response through step-by-step encounters with the fear while practicing [relaxation techniques](https://psychcentral.com/lib/relaxation-exercises-and-techniques).

### 3. Mindfulness-Based Treatment for Phobias

- **How it works**: [Mindfulness techniques](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) help individuals become more aware of their present thoughts and sensations without judgment. By focusing on the present, individuals may reduce the fear and anxiety associated with anticipating the phobic stimulus or doing exposure therapy for phobias.

### 4. Eye Movement Desensitization and Reprocessing (EMDR):

- **How it works**: Originally developed for trauma, [EMDR](https://en.wikipedia.org/wiki/Eye_movement_desensitization_and_reprocessing) involves using guided eye movements or other stimuli while recalling the fear or traumatic event. This method helps reprocess distressing memories or fears more adaptively. I do not do EMDR, but I can help you find someone who does.

### 5. Group Therapy for Phobias

- **How it works**: [Group therapy](https://dralanjacobson.com/group-therapy/) allows individuals with similar fears to support one another while working through their fears. This approach can provide a sense of community and shared experiences.

Each method can be tailored to fit the specific fear and your needs.

## CBT for Phobias ![Therapy for phobias](https://dralanjacobson.com/wp-content/uploads/2024/09/public-speaking.jpg "public speaking | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Cognitive therapy for phobias is one of the most effective treatments. It focuses on identifying and changing the thought patterns and behaviors that contribute to intense fear or anxiety. Here’s how CBT works:

### Key Components of CBT for Phobias:

#### 1. [Cognitive Restructuring](https://dralanjacobson.com/cognitive-restructuring/):

- Objective: This part of CBT for phobias helps you identify irrational or distorted beliefs and replace them with more realistic and balanced thoughts.
- Example: A person with a [fear of flying](https://dralanjacobson.com/fear-of-flying-therapy/) might think, “If I get on a plane, it’s going to crash.” In cognitive restructuring, they learn to challenge this thought by recognizing the statistical rarity of airplane accidents and acknowledging that their worry is exaggerated.

#### 2. Exposure Therapy for Phobias (A Core Component of CBT):

- Objective: Gradual and repeated exposure to the object or situation helps desensitize you, reducing the intensity of the response over time.
- How It Works: Exposure therapy for phobias is done in a controlled, step-by-step manner, starting with less threatening encounters and progressing to more direct exposure. It always goes at a pace you are comfortable with.
- Example: For someone with a fear of dogs, therapy might start by looking at pictures of dogs, followed by watching videos, and eventually standing near or petting a calm dog.
- Types of Exposure: 
    - **In Vivo Exposure**: Direct exposure to the object or situation (e.g., being around spiders for someone with that object).
    - **Imaginal Exposure**: Visualizing the object or situation in detail if direct exposure is not feasible.
    - **Virtual Reality Exposure**: Using technology to simulate environments or scenarios where direct exposure is challenging (e.g., fear of flying).

#### 3. Behavioral Experiments in CBT for Phobias

- Objective: Behavioral experiments test your catastrophic predictions in real-life situations to demonstrate that the feared outcome is unlikely.
- Example: A person [afraid of public speaking](https://dralanjacobson.com/public-speaking-anxiety/) might predict that they’ll “freeze up” or that people will laugh at them. Through gradual exposure (like [practicing a small speech](https://dralanjacobson.com/fear-of-public-speaking-therapy-process/)), they learn that these outcomes don’t usually happen.

#### 4. Relaxation and Coping Techniques:

- Objective: You learn relaxation techniques like deep breathing, progressive muscle relaxation, or [mindfulness techniques](https://dralanjacobson.com/mindfulness-therapy/) to help reduce physical symptoms of anxiety when faced with triggers.
- How It Helps: These techniques allow you to stay calmer and manage your emotional and physiological responses during exposure therapy for phobias.

#### 5. Challenging Negative Thoughts:

- Objective: CBT for phobias emphasizes the role of unhelpful or irrational thinking patterns. A key part of therapy is helping you challenge your automatic negative thoughts.
- Example: Someone with social anxiety may think, “Everyone will think I’m stupid if I say something wrong.” CBT for phobias helps challenge this thought by considering alternative, more balanced perspectives, like, “Most people are focused on themselves and won’t notice small mistakes.”

#### 6. Homework Assignments in CBT for Phobias

- Objective: To reinforce what is learned during therapy sessions, you will be given tasks to practice between sessions, such as exposure exercises, keeping a thought journal, or testing beliefs.
- Example: After learning relaxation techniques, a person with a fear of elevators might be tasked with riding an elevator while using those techniques to manage anxiety.

### Steps in CBT for Phobias:

1. **Assessment and Goal Setting**: I assess the severity of symptoms and set clear, measurable goals for treatment.
2. **Psychoeducation**: I explain the nature of the anxiety, the role of anxiety, and how CBT for phobias can help.
3. **Cognitive Interventions**: Identifying, challenging, and modifying negative thought patterns associated with the phobia.
4. **Exposure Therapy**: Gradually facing the object or situation, with the intensity increasing over time.
5. **Skill Building**: Learning and applying coping strategies (like relaxation or mindfulness).
6. **Review and Reinforcement**: Ongoing evaluation of progress and reinforcing the skills learned to prevent relapse.

### Effectiveness of Cognitive Therapy for Phobias:

Research shows that CBT, particularly exposure therapy for phobias, is highly effective. It helps reduce avoidance behaviors and builds confidence in managing anxiety. With consistent practice, many people see significant improvements in their ability to handle previously fear-inducing situations.

## Mindfulness Treatment for Phobias

Mindfulness-based treatment for phobias is increasingly being used to help you manage your fear and anxiety through awareness and acceptance of your present experiences. Unlike traditional approaches that focus on changing thoughts or avoiding the phobic trigger, mindfulness encourages you to observe your thoughts and feelings without trying to change or avoid them. This can reduce the power and intensity of the anxiety over time.

### Key Components of Mindfulness Treatment for Phobias:

#### 1. Mindfulness Meditation:

- **Objective**: To train you to focus on the present moment without judgment, allowing you to observe your responses without becoming overwhelmed.
- **How it works**: Mindfulness meditation focuses on the breath, bodily sensations, or the environment while acknowledging any thoughts or feelings that arise. The goal is to observe these thoughts without reacting or engaging with them.
- **Example**: When exposed to heights, a person with a fear of heights might practice mindfulness by noticing how their body reacts (e.g., rapid heartbeat, sweaty palms) and focusing on observing these sensations without panicking.

#### 2. Non-Judgmental Awareness:

- **Objective**: To help you notice their fear and anxiety without labeling them as “bad” or trying to push them away.
- **How it helps**: Often, people experience a secondary fear of the fear itself, which amplifies anxiety. Mindfulness teaches you to accept that the response is natural, reducing this secondary anxiety.
- **Example**: If a person with [public speaking anxiety](https://dralanjacobson.com/public-speaking-anxiety/) begins to feel anxious, they might acknowledge the anxiety (“I’m feeling anxious right now”) without trying to suppress it or catastrophize.

#### 3. Decentering from Thoughts:

- **Objective:** Mindfulness teaches you to see your thoughts as temporary mental events rather than facts or truths that must dictate your behavior.
- **How it helps**: By recognizing that thoughts about the phobic trigger (e.g., “I’m in danger” or “This is unbearable”) are just thoughts, you can prevent your automatic fear responses from taking over.
- **Example**: A person with a [fear of flying](https://dralanjacobson.com/fear-of-flying-therapy/) might have thoughts like, “This plane is going to crash.” In mindfulness, they would acknowledge that this is just a thought, not an inevitable reality.

#### 4. Exposure with Mindful Awareness:

- **Objective**: Mindfulness-based exposure therapy involves gradually exposing you to your phobia while maintaining mindful awareness throughout the process. This helps you experience the fear fully, without avoidance or over-reaction.
- **How it works**: During exposure therapy for phobias, you are encouraged to focus on the sensations, emotions, and thoughts that arise and observe them with curiosity rather than avoidance.
- **Example**: For someone with a fear of spiders, exposure might start with looking at pictures of spiders. During this exposure, they would focus on their emotional and physical reactions, observing them in a non-judgmental way until the anxiety naturally subsides.

#### 5. Breathing and Relaxation Techniques:

- **Objective:** [Mindful breathing](https://positivepsychology.com/mindful-breathing/) helps you regulate your physiological responses to anxiety, such as rapid breathing or increased heart rate, by bringing your attention back to the present moment.
- **How it works**: When anxiety arises, focusing on slow, deep breaths helps anchor you to the present and create a sense of calm, reducing the immediate fear response.
- **Example**: During exposure to a feared object, you may practice mindful breathing to stay grounded and manage the physical symptoms of fear.

#### 6. Acceptance of Discomfort:

- **Objective**: Mindfulness treatment for phobias encourages the acceptance of uncomfortable sensations and emotions as a normal part of the human experience, rather than something to avoid or eliminate.
- **How it helps**: Accepting discomfort instead of resisting it can reduce the intensity of the fear response. By embracing the anxiety as a temporary state, you learn that they can tolerate and survive the experience.
- **Example**: Someone with [social phobia](https://dralanjacobson.com/therapy-for-social-anxiety/) might accept that nervousness and sweating are part of public speaking, rather than fearing these symptoms or seeing them as something catastrophic.

### Steps in Mindfulness Treatment for Phobias:

1. **Psychoeducation**: You learn about mindfulness and how it can help you observe their phobic responses without reacting to them.
2. **Mindfulness Training**: I teach mindfulness exercises, such as breath awareness, [body scanning](https://health.clevelandclinic.org/body-scan-meditation), or [mindful walking](https://positivepsychology.com/mindful-walking/), to help you develop a non-reactive awareness of your emotions and sensations.
3. **Exposure with Mindfulness**: Gradual exposure to the phobic trigger is paired with mindfulness exercises, allowing you to experience fear without avoidance.
4. **Building Acceptance**: I help you practice acceptance of fear, anxiety, and discomfort as normal experiences that can be tolerated rather than fought against.
5. **Long-Term Integration**: Mindfulness becomes a tool for daily life, helping you maintain calmness and reduce the intensity of fear responses over time.

### Benefits of Mindfulness Treatment for Phobias

- **Reduces Avoidance Behaviors**: Mindfulness treatment for phobias involves practicing nonjudgmental awareness, which teaches you to face your fears rather than avoid them.
- **Enhances Emotional Regulation**: Mindfulness helps you stay present, which reduces overreacting to phobic triggers.
- **Prevents Relapse**: The skills learned in mindfulness treatment for phobias can be used in a wide range of situations, helping prevent future anxiety or flare-ups.
- **Improves Tolerance of Anxiety**: Instead of trying to eliminate anxiety, mindfulness helps you learn to accept and live with it, decreasing its control over you.

### Effectiveness of Mindfulness Therapy for Phobias:

Studies show that mindfulness treatment for phobias is effective in reducing anxiety and phobia-related symptoms. When combined with exposure therapy for phobias, mindfulness can enhance the treatment’s long-term effects by helping individuals develop a healthier relationship with their fears.

## FAQ

### What is a phobia?

A **phobia** is an intense, irrational fear of a specific object, situation, or activity that poses little to no actual danger. People with phobias often go out of their way to avoid the feared object or situation, which can interfere with their daily life.

### Which therapy is used for treating phobias?

The most commonly used and effective therapies include:

- **Cognitive Behavioral Therapy (CBT for phobias):** Helps you change negative thought patterns and behaviors.
- **Exposure Therapy (a type of CBT for phobias):** Gradually exposes you to the source of your fear in a controlled way.
- **Systematic Desensitization:** A step-by-step technique where relaxation is paired with gradual exposure to the trigger, often used in combination with CBT for phobias.
- **[Virtual Reality Therapy](https://en.wikipedia.org/wiki/Virtual_reality_therapy) (VRT)** Uses simulated environments to safely expose someone to their fears (e.g., flying, heights, spiders)**.** It is especially useful when real-life exposure is impractical or too intense.
- **Eye Movement Desensitization and Reprocessing (EMDR):** Often used for trauma-related fears. Involves recalling the feared object/situation while performing guided eye movements to reduce emotional intensity.
- **[ Hypnotherapy](https://www.medicalnewstoday.com/articles/hypnosis-for-anxiety):** Uses guided relaxation and focused attention to help reframe irrational fears. It is not as evidence-based as CBT, but it can be effective for some people when used alongside other treatments.
- **[ Acceptance and Commitment Therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) (ACT):** Focuses on accepting fearful thoughts instead of avoiding them, while committing to actions aligned with personal values. Teaches mindfulness and psychological flexibility.
- **[ Psychodynamic Therapy](https://dralanjacobson.com/psychodynamic-therapy/):** Explores unconscious conflicts or early experiences that may underlie the fear. Less structured than CBT and not as commonly used as a treatment for phobias, but can help in complex or deep-rooted cases.
- **Group Therapy:** Involves sharing experiences and practicing coping strategies with others who have similar fears. Encourages support, accountability, and social learning.

### How to overcome phobias?

To overcome these unrealistic fears, you can:

- Seek **professional treatment for phobias**, especially CBT or exposure therapy.
- Practice **relaxation techniques** like deep breathing or mindfulness during fear-triggering moments.
- Gradually **face your fear** in small steps, under guidance.
- Educate yourself about your phobia to reduce the sense of mystery or perceived threat.
- **Avoid avoidance**—the more you avoid a fear, the stronger it becomes.

### What is exposure therapy for phobias?

**Exposure therapy** for phobias involves gradually and repeatedly exposing a person to the source of their fear in a safe and controlled environment. The goal is to **desensitize** the individual, helping their brain learn that the feared object or situation is not actually dangerous. Exposure therapy for phobias can be done in real life (in vivo), through visualization (imaginal exposure), or virtual reality.

### What causes a phobia?

Phobias can be caused by:

- **Traumatic experiences** (e.g., being bitten by a dog can lead to cynophobia – fear of dogs)
- **Learned behavior** (e.g., observing a family member’s fear or a neutral object becomes associated with fear)
- **Genetics and brain chemistry** (some people are more prone to anxiety or fear)
- **Childhood experiences** (overprotective parenting or frequent exposure to fear-inducing information. Lack of exposure to normal risks or challenges may make unfamiliar situations feel more threatening later.)
- **Neurotransmitter imbalances** (like low serotonin or GABA levels) can make someone more prone to anxiety.
- **Cultural and Social Influences** (culture shapes what people fear. For example, in some cultures, spirits or specific animals may be more common triggers. Media exposure (e.g., horror films, sensational news) can also create exaggerated fear responses.
- **[Evolutionary Perspective](https://psychcentral.com/health/evolutionary-psychology) (**Some fears may be **hardwired** into us because they once served a survival function. for example, fear of snakes, heights, or darkness might have evolved to protect early humans from danger.

## Summary and My Work

I provide CBT for phobias along with exposure therapy if desired. In my [integrative therapy](https://dralanjacobson.com/integrative-therapy/) practice, I mix mindfulness techniques to help you feel comfortable and speed up the process and other specific methods such as [therapy for panic disorder](https://dralanjacobson.com/panic-attack-treatment/). If you have specific questions about how this method may work for you or a loved one, please feel free to [contact me](https://psychologicalassessments.com/contact-us/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## More Frequently Asked Questions: Phobia Treatment

Additional questions about phobia therapy — treatment timelines, specific phobias, online delivery, and getting started.

   How long does phobia treatment typically take? + Specific phobias are among the most treatment-responsive conditions in clinical psychology — which means many people see significant improvement in a relatively short timeframe. A focused course of CBT with exposure therapy typically runs 8–16 sessions for a straightforward specific phobia. More complex presentations — phobias with a long avoidance history, significant life impairment, or co-occurring anxiety or depression — generally require more time. The [American Psychological Association](https://www.apa.org/ptsd-guideline/treatments/cognitive-behavioral-therapy) recognizes CBT and exposure-based treatment as among the fastest-acting evidence-based interventions available for anxiety-related conditions. Progress is typically measurable within the first few sessions as the hierarchy of exposures begins. For context on treatment timelines more generally, see the [how long does therapy take guide](https://dralanjacobson.com/how-long-does-therapy-take/).

   Can phobia therapy be done online — and does virtual exposure therapy actually work? + Yes — and online delivery offers a genuine clinical advantage for phobia treatment specifically. When exposures happen in the client’s real environment — their home, car, neighborhood, or workplace — the treatment has higher ecological validity than in-office work. A person with a driving phobia can practice exposures from behind the wheel; someone with a contamination fear can work with actual triggers in their own kitchen. Dr. Jacobson provides phobia treatment entirely virtually via secure video and is a [PSYPACT](https://psypact.org/)-participating psychologist licensed in 44 states, making online phobia therapy accessible nationwide. Research on telehealth-delivered exposure therapy consistently supports its equivalence to in-person treatment. For more on how virtual sessions are structured, see the [virtual therapy guide](https://dralanjacobson.com/virtual-therapy-guide/) and the overview of [online therapy approaches and outcomes](https://dralanjacobson.com/therapy-online-approaches-techniques-and-outcomes/).

   What specific phobias do you treat? + Dr. Jacobson treats a wide range of specific phobias using CBT, exposure therapy, and mindfulness-based approaches. Common phobias treated include fear of flying (aviophobia), heights (acrophobia), driving, medical procedures and needles (trypanophobia), vomiting (emetophobia), storms, insects and animals, elevators and enclosed spaces (claustrophobia), and choking or swallowing. Two areas of particular specialty are [fear of flying therapy](https://dralanjacobson.com/fear-of-flying-therapy/) — one of the most common and most treatable phobias — and [fear of public speaking](https://dralanjacobson.com/public-speaking-anxiety/), which is among the most prevalent phobias in the general population. The [National Institute of Mental Health](https://www.nimh.nih.gov/health/statistics/specific-phobia) estimates that specific phobias affect approximately 12% of U.S. adults at some point in their lives. If your specific phobia is not listed, please reach out — the treatment framework is highly adaptable to virtually any phobic trigger.

   I’ve had my phobia for decades. Is treatment still effective after so many years of avoidance? + Yes — and this is one of the most important things to understand about specific phobia treatment. Unlike many psychological conditions, specific phobias do not become harder to treat simply because they have been present for a long time. The avoidance that sustains a phobia is behavioral, not structural — it keeps the fear alive by preventing the brain from ever learning that the feared object or situation is not actually dangerous. Exposure therapy directly targets this avoidance, and the learning that occurs during exposure is available to the brain regardless of how many years the phobia has been maintained. Many clients who have lived with a phobia for 20 or 30 years experience dramatic reduction in fear within a relatively brief course of treatment. Duration of avoidance affects how much a phobia has organized a person’s life around it — the planning required to avoid airports, the social costs of avoiding events — but it does not reduce the brain’s capacity to unlearn the fear response. See the overview of [best types of therapy for anxiety](https://dralanjacobson.com/best-types-of-therapy-for-anxiety/) for related context.

   Will I be forced to confront my fear before I’m ready? + No — and this is the most common misconception about exposure therapy that keeps people from seeking treatment for phobias they could resolve. Exposure therapy is never done by throwing someone into the deep end. Instead, it follows a carefully constructed hierarchy — starting with the least anxiety-provoking step and progressing only when the client is ready and the anxiety at the current step has meaningfully reduced. The pace is always collaborative and client-directed. For a fear of flying, this might begin with looking at photos of planes, then watching videos, then visiting an airport, long before any actual flight is involved. For a fear of needles, it might begin with discussing needles in conversation before any visual exposure occurs. The gradual, systematic nature of the approach is precisely what makes it effective — flooding or forcing exposure before the client is ready is not evidence-based practice and is not what happens in Dr. Jacobson’s work.

   What is the difference between a phobia and general anxiety or a panic disorder? + A specific phobia involves intense, disproportionate fear that is reliably triggered by a specific object or situation — and that is present even when the person intellectually knows the fear is irrational. General anxiety ([Generalized Anxiety Disorder](https://dralanjacobson.com/therapy-for-generalized-anxiety-disorder/)) involves persistent, pervasive worry across many domains of life rather than a single trigger. [Panic disorder](https://dralanjacobson.com/panic-attack-treatment/) involves recurrent, unexpected panic attacks — sudden surges of intense fear not necessarily tied to a specific object — along with worry about future attacks. These conditions often co-occur: a person may develop a phobia of driving after having a panic attack in a car, or may have both a specific phobia and generalized anxiety. The distinction matters for treatment because specific phobias respond especially well to focused, exposure-based work, while GAD and panic disorder each have their own evidence-based treatment protocols. A clinical assessment in the initial consultation will clarify which conditions are present and how treatment should be structured.

   Do I need medication to treat a phobia, or can therapy alone be effective? + For most specific phobias, therapy alone — particularly CBT with exposure — is not only sufficient but is actually the preferred first-line treatment. Medication is rarely indicated for straightforward specific phobias and can in some cases interfere with the learning that makes exposure therapy work: if anxiety is pharmacologically suppressed during exposure, the brain receives less of the corrective information it needs to update its threat response. The [National Institute of Mental Health](https://www.nimh.nih.gov/health/topics/anxiety-disorders) supports psychotherapy as the primary treatment for specific phobias. Where medication may play a role is in situational use — for example, a person with severe flight anxiety who must fly for an important trip before completing a full course of therapy. In those cases, Dr. Jacobson works collaboratively with the client’s physician or psychiatrist to coordinate care. For co-occurring conditions like GAD or depression that accompany a phobia, medication may be more relevant and is discussed on a case-by-case basis.

   How do I get started with phobia therapy? + The first step is a free 20-minute consultation with Dr. Jacobson — a practical conversation about what your phobia involves, how it has been affecting your life, what you’ve tried, and what a focused course of treatment might look like for your specific situation. Many people find the consultation itself relieving: having a clinician name the mechanism of the fear, explain why avoidance sustains it, and outline a clear, paced treatment path removes much of the uncertainty that keeps people from starting. There’s no commitment required. Related pages worth reviewing depending on your specific phobia: [fear of flying therapy](https://dralanjacobson.com/fear-of-flying-therapy/), [fear of public speaking](https://dralanjacobson.com/public-speaking-anxiety/), [social anxiety therapy](https://dralanjacobson.com/therapy-for-social-anxiety-disorder/), [panic disorder treatment](https://dralanjacobson.com/panic-attack-treatment/), and the [guide to best types of therapy for anxiety](https://dralanjacobson.com/best-types-of-therapy-for-anxiety/).

 A phobia that has limited your life for years can often be resolved in months.

Schedule a free 20-minute consultation with Dr. Jacobson — a practical conversation about your phobia and what a focused course of treatment might look like.

 [ Schedule a Free Consultation ](https://www.picktime.com/scheduleaconsult) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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### [Holiday Anxiety](https://dralanjacobson.com/holiday-anxiety/)

**Published:** November 21, 2024
**Author:** Dr. Alan Jacobson

**Content:**

I provide **therapy for holiday anxiety** caused by many factors related to this season. **Anxiety and the holidays** often go hand-in-hand, as travel pressures, family get-togethers, and work issues often make this time of year stressful. For some, holiday depression and anxiety are severe and require a deep dive into challenges. For others, just a brief and solution-focused course of therapy tends to provide great benefits. This post explores holiday stress and anxiety, my services, some self-help tips, and a case example. If you have more specific questions or want to discuss how therapy might benefit you or a loved one experiencing holiday stress, don’t hesitate to [get in touch with me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Holiday Anxiety Therapy ![Holiday anxiety therapy](https://dralanjacobson.com/wp-content/uploads/2024/11/Office-5-300x200.jpg "Office 5 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Therapy can be a powerful tool for addressing holiday anxiety, providing strategies to navigate stressors and build resilience. [Individual therapy](https://dralanjacobson.com/individual-therapy/), [couples therapy](https://dralanjacobson.com/couples-therapy/), and [family treatment](https://dralanjacobson.com/family-therapy/) may all be helpful. Here’s an overview of what you can do about anxiety and the holidays.

### Therapeutic Approaches for Holiday Anxiety

The following are the most common [types of therapy](https://dralanjacobson.com/types-of-therapy/) I use for holiday depression and anxiety. These approaches can be mixed, and there are others we can add.

1. **[Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT)**
    - **Challenge negative thoughts:** Therapy can help identify unhelpful beliefs like “Everything has to be perfect” or “People will judge me negatively” and replace them with healthier perspectives.
    - **Reframe expectations:** Focus on meaningful moments rather than perfection and not predict negative responses related to anxiety and the holidays.
2. [**Mindfulness-Based Therapy**](https://dralanjacobson.com/mindfulness-therapy/)
    - Learn to stay present during this time instead of worrying about the past or future.
    - Practice relaxation techniques to reduce anxiety in social or family settings.
3. **[Acceptance and Commitment Therapy](https://dralanjacobson.com/act-psychotherapy/) (ACT)**
    - Explore ways to accept stress as part of the experience without letting it dominate your emotions.
    - Use your values to guide decisions, like prioritizing connections over material aspects.
4. **[Interpersonal Therapy](https://dralanjacobson.com/interpersonal-therapy/) (IPT)**
    - If family dynamics are a major source of stress, IPT can help improve communication and set boundaries.
    - Role-playing can prepare you for difficult conversations related to anxiety and the holidays.
5. [**Trauma-Informed Therapy**](https://positivepsychology.com/trauma-informed-therapy/)
    - If this time brings up painful memories or unresolved trauma, I can help you work through these triggers and develop coping strategies.

Other approaches to anxiety and the holidays include [logotherapy](https://dralanjacobson.com/logotherapy/) when issues are existential and deep and [psychodynamic therapy](https://dralanjacobson.com/psychodynamic-therapy/) when internal conflicts are causing stress.

---

### Common Topics to Explore in Holiday Anxiety Therapy

People come in hoping to explore, resolve, or gain insight into many topics related to the holidays and anxiety. Here are a few examples.

- **Boundary setting** with family and friends.
- Navigating **grief or loss** during the holidays.
- Managing **social anxiety** at gatherings.
- Dealing with **financial stress** related to gift-giving and events.
- Handling feelings of loneliness or isolation.
- Finding [healthy work-life balance](https://dralanjacobson.com/therapy-for-work-life-balance/)

---

### Homework to Help with Anxiety and the Holidays

Given that there is often a bit of time pressure when the reason for therapy is anxiety and the holidays, I often give homework for my client to do outside of the session. Here are some examples.

- **Develop a Coping Plan:** Identify triggers and work with your therapist to create strategies for managing them.
- **Role-Play Scenarios:** Practice responses to difficult family dynamics or social situations.
- **Journaling Exercises:** Reflect on what’s causing anxiety and what you can control.
- **Visualization:** Use guided imagery to prepare for challenges mentally.
- [**Behavioral Activation**](https://dralanjacobson.com/behavioral-activation/): Doing things that bring joy, even if you don’t always feel like it.

---

### Finding the Right Therapist

I would welcome seeing you to help you manage anxiety and the holidays, but if you would prefer to see someone near you, look for therapists experienced in treating anxiety or specializing in holiday stress. You might also consider [group therapy](https://dralanjacobson.com/group-therapy/) sessions focused on managing seasonal stressors.

## Anxiety and the Holidays Toolkit

Holiday anxiety is common and can stem from a variety of sources, including social obligations, financial pressures, family dynamics, or simply the disruption of daily routines. Here are some strategies to help manage holiday stress and anxiety:

---

### 1. Plan Ahead for Holiday Anxiety

- Set a schedule for shopping, decorating, and attending events to avoid last-minute stress. It may be helpful for families to devise this schedule together because sometimes, the urgency from those who have fallen behind can create stress for everyone.
- Budget for gifts and travel to prevent financial strain.
- Know your limits and don’t overcommit to activities, including parties. At the same time, realize that attending some social events can reduce holiday stress by connecting—and maybe commiserating—with others.

---

### 2. Practice Self-Care to Reduce Holiday Anxiety

- Maintain regular sleep, exercise, and healthy eating habits despite the festivities.
- Take short breaks to breathe or engage in mindfulness practices, even for just 5 minutes.
- Schedule time for activities that relax and recharge you, like reading, journaling, or going for a walk. The holidays put a lot of pressure on people to be social, which can be good. But it would be best if you still had time for yourself.

---

### 3. Manage Expectations

- Accept that not everything has to be perfect. Focus on what matters most and realize that the task list may never be complete.
- Set boundaries with family or friends if certain dynamics feel overwhelming. It’s okay to say no. Permit them to say no to you, too.
- Realize that some degree of stress and anxiety is expected and set goals to have lower but not zero stress this year.

---

### 4. Simplify When Possible

- Consider alternatives, like drawing names for gifts instead of buying for everyone.
- Host potluck meals to share the workload if you’re entertaining.
- Limit your time at events that feel draining. You may even want to set this up ahead of time. Tell the host that you’re likely to have to leave early, and then if you are enjoying yourself, you can always stay.

---

### 5. Prioritize Mental Health

- Practice grounding techniques, like [deep breathing](https://positivepsychology.com/deep-breathing-techniques-exercises/) or focusing on your surroundings if you feel overwhelmed by holiday anxiety.
- Reflect on what this season means to you, and let that guide your decisions.
- Reach out for support if needed—talk to trusted friends, family, or a mental health professional.

## Holiday Depression and Anxiety Case Example

Here’s a fictitious case example illustrating how therapy can address holiday depression and anxiety. This happens to be an individual, but therapy for holiday depression and anxiety can also be delivered to couples and families.

---

### Holiday Depression and Anxiety: Taylor, 28-year-old Teacher

#### Presenting Issues:

Taylor reports increased anxiety and sadness during this season. Stressors include financial pressures, strained family relationships, and loneliness after moving to a new city for work. Taylor has been avoiding family events and experiencing difficulty sleeping, overeating, and low energy.

#### Holiday Depression and Anxiety Therapeutic Goals:

1. Reduce symptoms of depression and anxiety.
2. Develop healthy coping mechanisms for family interactions and financial stress.
3. Build social connections and identify ways to find joy in the season.

---

### Holiday Depression and Anxiety Therapy Process

#### Session 1: Initial Assessment and Goal Setting

- Key Stressors Identified: 
    - Anxiety around family gatherings due to past conflicts.
    - Financial worries about gift-giving and travel costs.
    - Loneliness and a lack of a local support system.
- Taylor rates their depression as a 7/10 and anxiety as an 8/10.
- I normalize Taylor’s feelings and collaborate on a plan to address these stressors.

---

#### Session 2: [Cognitive Behavioral Therapy](https://dralanjacobson.com/cbt-for-depression/) for Depression and Anxiety (CBT)

- Challenging Cognitive Distortions: 
    - Taylor believes, *“If I don’t go home for the holidays, my family will think I don’t care,”* and *“I have to buy expensive gifts to show I value people.”*
    - I help Taylor reframe these thoughts, focusing on the following: *“Caring is shown through connection, not just presence or presents.”*
- Action Plan: Taylor sets boundaries around which family events to attend and creates a budget for gift-giving.

---

#### Session 3: Mindfulness and Stress Reduction

- Mindfulness Techniques: I introduce grounding exercises, such as deep breathing and a 5-senses check-in, to manage anxiety during family events.
- Relaxation Practice: Taylor learns [progressive muscle relaxation](https://positivepsychology.com/progressive-muscle-relaxation-pmr/) when feeling overwhelmed with holiday stress.

---

#### Session 4: Grief and Loneliness

- Taylor opens up about missing old traditions with friends and feeling disconnected in their new city.
- Coping with Loss: I help Taylor create new traditions, like hosting a brunch with coworkers or joining a local volunteering group.
- Building Connections: Taylor commits to attending a community holiday event to meet new people.

---

#### Session 5: Family Dynamics and Assertive Communication

- Boundary Setting: I use role-playing to help Taylor practice setting limits with a critical family member. 
    - Example phrase: *“I’d prefer not to talk about that topic. Let’s focus on enjoying the meal.”*
- Emotion Regulation: Taylor identifies calming strategies before and after family interactions, such as journaling or a short walk.

---

#### Session 6: Holiday Stress Review and Maintenance

- Taylor and I reviewed the progress made: 
    - Taylor reports reduced anxiety (4/10) and feels more in control of plans.
    - New traditions and connections have lessened feelings of loneliness.
- A relapse prevention plan is developed, emphasizing self-care and continued social outreach.

---

### Outcomes:

Taylor successfully navigates the season with fewer symptoms of depression and anxiety, feels empowered to set boundaries with family, and finds joy in new traditions and connections. Therapy concludes in January, and Taylor plans to return for follow-ups as needed.

## Holiday Anxiety in Teenagers Case Example

### Background

Emma is a 15-year-old high school student referred to therapy by her school counselor. She reports feeling overwhelmed and anxious every year as winter approaches. Emma describes the holidays as “too much” due to her parents’ divorce, unrealistic expectations to maintain high grades during finals, and pressure to socialize at family gatherings. She also mentions the financial strain on her family, which adds guilt around asking for gifts and her holiday depression and anxiety in general.

### Presenting Problem: Holiday Depression and Anxiety

- **Anxiety Triggers:** Crowded gatherings, loud environments, family conflict, and feeling torn between spending time with both parents create significant stress.
- **Symptoms:** Holiday stress causes trouble sleeping, irritability, difficulty concentrating on schoolwork, and physical symptoms like headaches and stomachaches.
- **Coping Mechanisms:** Avoiding family discussions, procrastinating on school assignments, and withdrawing from friends.

### Therapeutic Goals: Reduce Holiday Anxiety

1. Our work together is designed to help Emma identify specific triggers for her holiday anxiety.
2. I will help Emma learn practical skills to manage overwhelming feelings during the season.
3. We will discuss healthier ways to communicate and set boundaries with family members.

### Therapeutic Approach

1. **Cognitive Behavioral Therapy (CBT):**
    - **Cognitive Restructuring:** We will explore Emma’s thought patterns related to anxiety and the holidays, like “I have to make everyone happy,” and replace them with more balanced thoughts, e.g., “It’s okay to prioritize my needs.”
    - **Behavioral Activation:** We will develop a plan to include activities Emma enjoys during this time, like baking or watching movies with friends, to create positive associations.
2. **Mindfulness and Relaxation Techniques:**
    - I will teach Emma [mindfulness-based stress reduction exercises](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/), such as deep breathing or progressive muscle relaxation, to use when she feels holiday depression and anxiety.
    - We will use guided imagery, such as imagining a “calm moment,” to help her cope with stressful gatherings.
3. **[Family Systems Therapy](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/):**
    - **Parent Sessions:** We will have [family therapy](https://dralanjacobson.com/family-therapy/) sessions to reduce conflict during shared planning and encourage understanding Emma’s needs.
    - **Boundary Setting:** I will help Emma set gentle but firm boundaries, such as deciding how much time to spend with each parent.
4. **Social Skills Training:**
    - Emma will practice assertive communication for situations like declining invitations or managing difficult conversations at family gatherings.
5. **Gratitude Exercises:**
    - I introduce a gratitude journal to help Emma focus on the positive aspects of the season and shift her attention away from stress.

### Therapy for Holiday Anxiety Outcome

Over several sessions, Emma learns to manage her holiday anxiety by reframing her expectations and utilizing coping strategies. Her physical symptoms related to anxiety and the holidays decrease, and she feels more confident navigating family dynamics. Emma also discovers a new tradition of volunteering during the season, which gives her a sense of fulfillment and perspective.

## Summary and My Work

I provide therapy for holiday stress and anxiety, starting at any point of the year. For some people, holiday stress starts well before the winter holidays; for others, it persists well into the new year. I usually see people individually for holiday anxiety therapy. Still, I do sometimes see [couples for therapy](https://dralanjacobson.com/couples-therapy/) or families when they are facing similar stress, or holiday stress affects relationships. This can include instances of [political stress](https://dralanjacobson.com/therapy-for-political-anxiety/) causing arguments.

I also offer adjunctive [parent coaching](https://dralanjacobson.com/parent-coaching/) when these issues intersect with parenting stress, and specific [single parent therapy](https://dralanjacobson.com/therapy-for-single-moms-and-dads/) and [co-parenting therapy](https://dralanjacobson.com/co-parenting-therapy/) when people are raising children independently. Often, therapy for holiday depression and anxiety is a part of ongoing [individual therapy](https://dralanjacobson.com/individual-therapy/) as well since it can upset and intensify existing challenges. It can also be a subset of other treatments, such as [therapy for social anxiety](https://dralanjacobson.com/therapy-for-social-anxiety-disorder/).

I hope this post was helpful and informative. If you have more specific questions or want to talk more about how therapy for holiday anxiety might benefit you or a loved one, please feel free to [get in touch with me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Frequently Asked Questions: Therapy for Holiday Anxiety

Common questions about holiday stress and anxiety — what causes it, when therapy helps, and how to get started.

   Why do so many people feel more anxious and depressed during the holidays? + Holiday anxiety is genuinely common — not a sign of ingratitude or weakness — and it has well-documented causes. The [American Psychological Association](https://www.apa.org/topics/stress/holiday-tips) has consistently found that the holiday season increases stress for a significant majority of Americans, driven by a combination of financial pressure, disrupted routines, social obligations, family conflict, and heightened expectations for happiness that often don’t match reality. For people who have experienced loss — a death, a divorce, estrangement from family — the holidays amplify grief by highlighting absences that feel sharper against a backdrop of forced celebration. For those with pre-existing [social anxiety](https://dralanjacobson.com/therapy-for-social-anxiety-disorder/), [depression](https://dralanjacobson.com/therapy-for-depression/), or [generalized anxiety](https://dralanjacobson.com/therapy-for-generalized-anxiety-disorder/), the season often intensifies existing symptoms. Shorter days and reduced sunlight also play a role — [Seasonal Affective Disorder (SAD)](https://dralanjacobson.com/seasonal-affective-disorder-treatment/) peaks during the winter months and is frequently confused with, or compounded by, holiday-specific stress.

   What are the most common sources of holiday anxiety that therapy addresses? + The most common presenting concerns fall into several distinct clusters. Family dynamics — navigating difficult relationships, managing conflict, or splitting time between families after divorce — are among the most frequent triggers. Financial stress around gift-giving, travel, and hosting creates significant pressure, particularly when social expectations feel disconnected from actual budgets. Social anxiety around gatherings, parties, and performance expectations is another major driver. Grief and loss — missing someone who has died or an estranged relationship — intensify during a season centered on togetherness. Loneliness and isolation, especially for those who have moved to a new city or whose social network has changed, can be acute. For teenagers and college students, the pressure of finals coinciding with family obligations and social scrutiny creates its own compounded stress. Therapy addresses all of these — individually, in [couples sessions](https://dralanjacobson.com/couples-therapy/), or through [family treatment](https://dralanjacobson.com/family-therapy/) depending on the source of stress.

   What therapeutic approaches are most effective for holiday anxiety? + The approach is tailored to each person’s specific triggers and goals, but several methods are particularly effective. [Cognitive Behavioral Therapy (CBT)](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) is the primary tool for challenging the perfectionism, catastrophizing, and all-or-nothing thinking that drive holiday stress. [Mindfulness-based techniques](https://dralanjacobson.com/mindfulness-therapy/) help people stay present during gatherings rather than ruminating about what went wrong or anticipating what might. [Acceptance and Commitment Therapy (ACT)](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) helps clients accept that some stress is inevitable and redirect energy toward what actually matters to them. [Interpersonal Therapy (IPT)](https://dralanjacobson.com/interpersonal-therapy/) is highly effective when family communication and boundary-setting are the core issues. For those whose holiday distress is rooted in unresolved loss or trauma, [grief therapy](https://dralanjacobson.com/grief-therapy/) and [trauma-informed approaches](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/) provide the deeper processing that self-help strategies alone cannot.

   How is holiday anxiety different from clinical anxiety — and when does it require professional help? + Situational holiday stress — feeling stretched thin, mildly irritable, or overwhelmed by a full calendar — is normal and typically resolves when the season ends. Professional help is warranted when symptoms are significantly impairing functioning: difficulty sleeping, inability to concentrate, physical symptoms like headaches or stomach upset, persistent low mood, social avoidance, increased use of alcohol or food as coping strategies, or anxiety that starts well before the holidays and lingers well into the new year. It is also worth seeking support when holiday stress is clearly triggering or worsening an underlying issue — [depression and anxiety](https://dralanjacobson.com/therapy-for-depression-and-anxiety/), [codependency](https://dralanjacobson.com/codependency-therapy/), or [political anxiety](https://dralanjacobson.com/therapy-for-political-anxiety/) that surfaces in family conflict. The [National Institute of Mental Health](https://www.nimh.nih.gov/health/topics/anxiety-disorders) notes that anxiety disorders affect nearly 20% of U.S. adults — many of whom experience their worst episodes in high-demand social seasons. Even 4–6 focused sessions before or during the holiday season can produce meaningful relief.

   Can therapy help if my holiday anxiety is really about family conflict or difficult relationships? + Yes — and this is one of the most common and clinically rich presentations. Holiday family conflict rarely appears from nowhere; it typically reflects longstanding relational patterns — old roles, unspoken grievances, communication habits formed decades ago — that get activated by forced proximity and heightened emotion. In the short term, therapy builds practical skills: boundary-setting language, assertive communication strategies, plans for de-escalating specific recurring arguments, and exit strategies for situations that become overwhelming. For families where multiple members are willing to participate, [family therapy](https://dralanjacobson.com/family-therapy/) or [adult family therapy](https://dralanjacobson.com/adult-family-therapy/) can address the dynamics directly. For those navigating divorced-family complexity, [co-parenting therapy](https://dralanjacobson.com/co-parenting-therapy/) and [blended family therapy](https://dralanjacobson.com/blended-family-therapy-step-parent-counseling/) offer targeted support.

   How can therapy help teenagers with holiday anxiety? + Teenagers experience holiday anxiety through a distinct and often compounding set of pressures: academic stress from finals, social anxiety around family gatherings and peer expectations, the complexity of navigating divorced or blended family dynamics, financial guilt about gifts, and the developmental challenge of feeling neither fully adult nor fully child in family settings. [Teen anxiety therapy](https://dralanjacobson.com/therapy-for-teen-anxiety/) during the holiday season addresses these layers using age-appropriate CBT techniques, mindfulness practices, assertive communication training, and, where relevant, [family systems work](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/) to reduce the pressure teenagers absorb from adult conflict. Parent sessions are often included to help parents understand their teenager’s experience and adjust their own responses. The [American Academy of Child and Adolescent Psychiatry](https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Helping-Teenagers-With-Stress-066.aspx) recognizes that adolescent stress during high-demand periods requires targeted, developmentally sensitive support.

   Is it too late to start therapy if the holidays are already here — or approaching quickly? + It is never too late — and starting therapy mid-season or just before a major gathering is entirely appropriate and clinically effective. Holiday anxiety therapy is often intentionally brief and solution-focused: a course of 4–8 sessions can cover the most pressing triggers, build immediate coping tools, address the specific situations causing the most distress, and provide a relapse prevention plan for the rest of the season. Many people return in subsequent years for brief booster work, treating it the way they might treat other seasonal health maintenance. Dr. Jacobson provides virtual sessions nationwide — no waiting for an available appointment in your zip code and no travel required to start. See also the [Therapy FAQs](https://dralanjacobson.com/therapy-faqs/) for general information about what to expect when starting therapy.

   How do I get started with therapy for holiday anxiety? + The first step is a free 20-minute consultation with Dr. Jacobson — a practical, low-pressure conversation about what’s been triggering your anxiety, what you’ve already tried, and what a brief or ongoing course of therapy might look like. Sessions are conducted virtually via secure video, making it easy to attend from home regardless of how busy the season gets. Dr. Jacobson is a [PSYPACT](https://psypact.org/)-participating psychologist licensed in 44 states. Holiday anxiety therapy can be individual, include a partner in [couples sessions](https://dralanjacobson.com/couples-therapy/), or involve family members when the dynamics are relational. Related pages that may be relevant: [social anxiety therapy](https://dralanjacobson.com/therapy-for-social-anxiety-disorder/), [grief therapy](https://dralanjacobson.com/grief-therapy/), [Seasonal Affective Disorder treatment](https://dralanjacobson.com/seasonal-affective-disorder-treatment/), [therapy for political family conflict](https://dralanjacobson.com/politics-and-family-therapy/), and [work-life balance therapy](https://dralanjacobson.com/therapy-for-work-life-balance/).

 The holidays don’t have to feel like something to survive.

Schedule a free 20-minute consultation with Dr. Jacobson — a practical conversation about what’s driving your stress and what even a brief course of therapy might do for this season.

 [ Schedule a Free Consultation ](https://www.picktime.com/scheduleaconsult) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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](https://www.linkedin.com/company/psychologicalscience/)

---

### [Life Transitions Therapy](https://dralanjacobson.com/life-transitions-therapy/)

**Published:** November 15, 2024
**Author:** Dr. Alan Jacobson

**Content:**

I offer **Life Transitions Therapy**, a type of psychotherapy that focuses on helping individuals cope with significant changes or challenges in their lives. These changes, or “transitions,” can be anything from starting college, career shifts, relationship changes, moving to a new place, or navigating a major life event like a diagnosis, loss, or identity change. **Therapy for life transitions** can help you navigate changes effectively, feel more in control and content, and develop new insights. Life transition therapy is a cornerstone of my practice.

The following provides an overview of life transitions therapy, but if you want to discuss how this approach might specifically benefit you or a loved one, please do not hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Life Transitions Therapy Overview ![Life transitions therapy](https://dralanjacobson.com/wp-content/uploads/2024/11/decisions-300x200.jpg "decisions | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

The following is an overview of therapy for life transitions

### Core Goals of Life Transitions Therapy

1. **Understanding the Change:**
    - I help each client explore the nature of the transition, why it feels difficult, and what specific factors are causing stress or anxiety.
2. **Processing Emotions:**
    - It’s common to experience grief, anxiety, uncertainty, or even excitement during transitions. In life transition therapy, I help clients process these emotions in a safe and non-judgmental space.
3. **Building Coping Strategies:**
    - Developing skills to manage stress, anxiety, and uncertainty during the transition period is a big part of life transition therapy. This can include [mindfulness therapy](https://dralanjacobson.com/mindfulness-therapy/) practices, time management skills, or finding new routines.
4. **Identity and Self-Exploration:**
    - Many life transitions impact our sense of self. Therapy for life transitions can help explore changes in identity and self-perception, offering a chance to redefine oneself in a healthy and constructive way.
5. **Goal Setting:**
    - Life transition therapy can also involve setting realistic, actionable goals to help move forward and adjust to new circumstances.

### Examples of Transitions:

Life transitions are significant changes or shifts in a person’s life that often require adaptation and adjustment. Here are examples of life transitions, categorized by type:

#### Personal Milestones

- **Birth or Adoption of a Child:** Adjusting to parenthood.
- **Marriage or Partnership:** Starting a new relationship with a partner.
- **Divorce or Separation:** Ending a relationship and restructuring life. ([Single parent therapy](https://dralanjacobson.com/therapy-for-single-moms-and-dads/) is also available.)
- **Death of a Loved One:** Coping with loss and grief.
- **Coming Out:** Disclosing sexual orientation or gender identity.

#### Educational Transitions

- **Graduating from High School:** Going to college, joining the workforce, or other pursuits.
- **Entering College or University:** Adjusting to academic and social experiences away from home.
- **Graduating from College:** Entering the workforce or pursuing further studies.

#### Career Transitions

- **Starting a New Job:** Adjusting to a new workplace or role (thus pairing well with [therapy for work-life balance](https://dralanjacobson.com/therapy-for-work-life-balance/)).
- **Promotion:** Taking on new responsibilities and challenges.
- **Retirement:** Ending a career and redefining life purpose.
- **Career Change:** Switching industries or job roles.

#### Health-Related Changes

- **Diagnosis of a Chronic Illness:** Adapting to new medical needs or limitations.
- **Recovering from an Injury or Surgery:** Physical and emotional adjustments.
- **Mental Health Journey:** Addressing mental health conditions or starting therapy.

#### Geographical Transitions

- **Moving to a New City or Country:** Adapting to a different culture or environment.
- **Immigration or Refugee Status:** Adjusting to new legal, cultural, and social realities.
- **Returning Home After Living Abroad:** Readjusting to familiar surroundings.

#### Developmental Stages

- **Becoming an Empty Nester:** Children moving out, requiring parents to adapt.
- **Midlife Changes:** Reflecting on accomplishments and reevaluating priorities.
- **Aging:** Adjusting to physical and lifestyle changes in later years.

#### Social Changes

- **Building New Friendships or Social Circles:** Following a move or change in interests.
- **Losing a Friendship:** Coping with the end of an important relationship.
- **Adopting New Identities or Roles:** Becoming a caregiver, mentor, or community leader.

#### Unexpected Changes

- **Losing a Job:** Managing financial and emotional challenges.
- **Natural Disasters or Emergencies:** Rebuilding life after unforeseen events.
- **Global Events:** Adjusting to the impact of events like pandemics or economic shifts.

Each of the above can come with unique challenges, opportunities, and growth experiences.

## Life Transition Therapy Approaches:

Life transition therapy focuses on helping individuals navigate major life changes, whether planned or unexpected. Here are some common approaches I use when delivering life transition therapy:

---

### 1. Cognitive Behavioral Therapy (CBT)

**[Cognitive Behavioral Therapy ](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/)**(CBT) helps identify and challenge negative thought patterns. CBT can reduce irrational, negative, or exaggerated thoughts that are causing anxiety or uncertainty and help replace them with more confident and open feelings.

Techniques include:

- Identifying triggers of stress or anxiety.
- Developing coping strategies and actionable plans to address challenges.
- [Behavioral activation](https://dralanjacobson.com/behavioral-activation/), which is doing activities that bring a sense of joy or mastery

---

### 2. Acceptance and Commitment Therapy for Life Transitions

**[Acceptance and Commitment Therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) f**ocuses on being present and accepting the emotions associated with the changes. These techniques help you stay in the present without being overwhelmed with the fear of what is to come or overly involved with what you leave behind. ACT emphasizes accepting emotions and committing to actions aligned with personal values.

- Mindfulness practices to help individuals stay present.
- Identifying core values to guide decisions during change.

---

### 3. Narrative Life Transitions Therapy

**[Narrative Therapy ](https://dralanjacobson.com/narrative-therapy/)**helps clients rewrite their personal stories to include the changes as a meaningful part of their journey. This approach allows you to write a new and exciting chapter in your journey and find ways to make it happen. This approach encourages individuals to reframe their personal stories.

- Exploring the narrative around the changes and opportunities.
- Building an empowering story of resilience and growth.

---

### 4. Strength-Based Counseling

Focuses on identifying and leveraging personal strengths to handle challenges.

- Encourages self-reflection to uncover past successes in overcoming adversity.
- Helps foster a sense of confidence and capability.

---

### 5. Psychoeducation as Therapy for Life Transitions

Educating clients about the psychological effects helps normalize their experiences.

- Teaching about stress responses and adaptation phases.
- Providing resources for further learning or support.

---

### 6. Trauma-informed Therapy for Life Transitions

For transitions triggered by traumatic events, this approach ensures a safe, supportive environment.

- Prioritizes emotional safety and self-compassion.
- Builds resilience through grounding and coping techniques.

---

### 7. Solution-Focused Brief Therapy (SFBT)

Goal-oriented [solution-focused therapy](https://dralanjacobson.com/solution-focused-therapy/) emphasizes what’s possible rather than dwelling on problems.

- Identifies immediate, small steps toward adapting to the change.
- Encourages visualization of a positive outcome.

---

### 8. Holistic Approaches to Life Transitions Therapy

These approaches integrate [mind-body practices](https://www.nccih.nih.gov/health/mind-and-body-practices) for overall well-being:

- **[Mindfulness Meditation](https://www.mindful.org/mindfulness-how-to-do-it/):** Helps manage stress and stay focused during uncertainty.
- **Yoga or Movement:** Supports emotional regulation.
- **Art or Music:** Provides non-verbal outlets for processing emotions.

---

### 9. Career or Life Coaching

Coaching provides actionable strategies and support for goal achievement during changes related to work, school, or life purposes.

- **Leadership Coaching**: Helps people in leadership roles become more effective and confident
- **Life Coaching**: More generally helps people make good decisions, reach new insights, and enjoy transitions

---

### 10. Group Life Transitions Therapy

[Group psychotherapy](https://dralanjacobson.com/group-therapy/) settings offer a shared space for processing and learning from others undergoing similar changes.

- Enhances a sense of connection and reduces isolation.
- Fosters mutual encouragement and idea-sharing.

---

In my [integrative psychological practice](https://dralanjacobson.com/integrative-therapy/), I often combine the above and other therapeutic approaches, usually following a [third-wave psychotherapy](https://dralanjacobson.com/third-wave-psychotherapy/) path.

## Therapy for Life Transitions Case Examples

Three case examples illustrate how life transitions therapy might work for different scenarios. These examples are fictional but based on common issues my clients face.

### Case Example 1: Life Transition Therapy for Going to College

Sarah, an 18-year-old, recently started college. She is struggling with the transition from high school to college life, experiencing feelings of homesickness, [social anxiety](https://dralanjacobson.com/therapy-for-social-anxiety/), and overwhelm due to increased academic demands. Sarah was recently diagnosed with ADHD and has difficulties adjusting to the less structured environment of college.

#### Life Transition Therapy Approach:

1. **Assessment and Understanding:**
    - I begin by understanding the specific challenges Sarah is facing, including the impact of ADHD on her time management and focus in the new college environment.
    - We also explore Sarah’s social and emotional struggles, especially her feelings of homesickness and difficulty making new friends.
2. **Emotion Processing:**
    - Sarah expresses sadness about missing her family and anxiety about not being “good enough” for college. I use **Emotion-Focused Therapy** techniques to help her process these feelings, validating her emotions and normalizing the transition challenges.
3. **Skill-Building in Life Transition Therapy:**
    - Together, we work on strategies for managing ADHD, such as creating structured study schedules, using reminder apps, and implementing self-advocacy to seek accommodations from her college’s disability services.
    - We also explore relaxation techniques, such as deep breathing and mindfulness techniques, to help Sarah manage her anxiety.
4. **Social Support and Building Connections:**
    - I help Sarah develop a plan for increasing her social connections, such as joining student groups that align with her interests or seeking support from an ADHD student group on campus.
    - We discuss ways to stay connected with her family while also establishing her independence.
5. **Therapy for Life Transitions and Identity Exploration:**I support Sarah in exploring her changing sense of self, especially her new identity as a college student and a person with ADHD. We discuss her strengths, potential career interests, and how her diagnosis can be viewed as part of her unique experience rather than a limitation.

#### Outcome:

After several months of [individual therapy](https://dralanjacobson.com/individual-therapy/) for life transitions, Sarah feels more adjusted. She has found a routine that works better for her, started making new friends, and feels more confident in managing her ADHD. She reports less anxiety and is more engaged with her classes and campus activities.

---

### Case Example 2: Therapy for Life Transitions in Midlife

John, a 45-year-old, has been working in corporate finance for 20 years. He recently left his job, feeling burned out and desiring a more meaningful career. He wants to transition to a role in the nonprofit sector but is overwhelmed by self-doubt and fear of starting over.

#### Life Transitions Therapy Approach:

1. **Exploration of Values:**
    - I help John identify his core values and what he finds meaningful. We use techniques from **Acceptance and Commitment Therapy (ACT)** to explore why he felt unfulfilled in his previous job and what he hopes to gain from a career change.
2. **[Cognitive Restructuring Techniques](https://dralanjacobson.com/cognitive-restructuring/):**
    - John frequently expresses fears like, “I’m too old to start over,” or “I won’t be successful in a new field.” I use **Cognitive Behavioral techniques (CBT)** to challenge these negative thought patterns, encouraging John to see his experience and skills as assets.
3. **Goal Setting and Planning:**
    - Together, we break down the overwhelming task of a career change into smaller, actionable steps: updating his resume, networking in the nonprofit sector, and taking relevant courses or certifications.
    - We also address John’s fears about financial stability by creating a transitional plan, such as part-time consulting work.
4. **Addressing Identity Shifts:**
    - John struggles with losing identity, as his self-worth was closely tied to his corporate success. I use **Narrative Therapy** for life transitions to help John reframe his story, focusing on the courage to make a life change and how this decision aligns with his authentic self.

#### Outcome:

John gradually builds confidence in his new path. He secures a volunteer position that leads to part-time work in a nonprofit, easing his transition. Through life transitions therapy, he feels renewed purpose and reports improved mental health and life satisfaction.

---

### Case Example 3: Life Transitions Therapy for Retirement and Loss

#### Background:

Mary, a 68-year-old woman, recently retired after 40 years as a schoolteacher. Six months ago, her husband passed away unexpectedly. Mary is struggling with grief, loneliness, and a loss of purpose after retirement.

#### Clinical Approach:

1. **Grief Counseling:**
    - I provide a safe space for Mary to process her grief. I use elements of [**Grief Therapy**](https://dralanjacobson.com/grief-therapy/) to help her work through the pain of losing her spouse, encouraging her to express her emotions without judgment.
2. **Finding New Meaning:**
    - Mary feels a deep loss of identity, both from the death of her husband and her retirement. Through life transition and [quality of life therapy](https://dralanjacobson.com/life-therapy/), I help her explore new roles and activities that could bring a sense of fulfillment, such as volunteer work, hobbies, or joining social groups for retirees.
3. **Coping with Loneliness:**
    - We discuss practical ways to address loneliness, such as reaching out to old friends, joining a grief support group, and connecting with family. I also introduce [self-compassion exercises](https://positivepsychology.com/self-compassion-exercises-worksheets/) to help Mary be kinder to herself during this difficult time.
4. **Redefining Goals:**
    - Mary sets small, achievable goals, like joining a book club and learning to cook her favorite dishes, to give her a sense of progress and enjoyment in her day-to-day life.

#### Outcome:

Over time, Mary feels less isolated and more hopeful about her future though life transition therapy. She forms new social connections and discovers activities she enjoys. While she still misses her husband deeply, she finds a new sense of purpose and joy in her retired life.

---

## Summary and My Work

These three fictional examples illustrate how life transition therapy can be tailored to different life stages and challenges, providing support and strategies for navigating major changes. I offer therapy for life transitions in individual and [couples therapy](https://dralanjacobson.com/couples-therapy/) (where [EFT Therapy](https://dralanjacobson.com/eft-therapy-for-couples/) can be a great fit), and it can even have utility in [family treatment](https://dralanjacobson.com/family-therapy/), such as [family systems therapy](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/). Finally, it can be used as part of [parent therapy](https://dralanjacobson.com/parent-coaching/) when parental transitions are central, [discernment therapy](https://dralanjacobson.com/discernment-counseling-pre-engagement-counseling/) when partners are struggling to decide whether to commit, and [divorce counseling](https://dralanjacobson.com/divorce-counseling/).

Of course, these techniques are also often interwoven with my specialty areas, such as [therapy with college students](https://dralanjacobson.com/therapy-for-college-students/) and even in treatment [fears of public speaking](https://dralanjacobson.com/public-speaking-anxiety/) and [flight anxiety](https://dralanjacobson.com/flight-anxiety-self-help/) because they often arise during transitional periods. They are also used in more general [Quality of Life Therapy](https://dralanjacobson.com/quality-of-life-therapy/).

Many people who enter psychotherapy for various reasons find that a life transition, whether current or past, is having an effect today. Thus, life transition therapy is often an underlying part of many of my techniques, particularly in my [life therapist services](https://dralanjacobson.com/life-therapists/).

If you have any questions about life transitions therapy or want to discuss how it might benefit you or a loved one, please do not hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Frequently Asked Questions: Life Transitions Therapy

Common questions about therapy for life transitions — what it addresses, how it works, and whether it’s right for your situation.

   What is life transitions therapy, and who is it for?Life transitions therapy is a form of psychotherapy specifically focused on helping people navigate significant changes — whether anticipated or unexpected, positive or painful. It draws on multiple evidence-based approaches to help clients understand what a transition means for their identity and sense of self, process the emotions it brings up, build practical coping strategies, and move forward with clarity and purpose. The [American Psychological Association](https://www.apa.org/topics/resilience) recognizes that psychological resilience during major life changes is a learnable skill — not a fixed trait — and that structured support significantly improves outcomes. Life transitions therapy is for anyone navigating a change that feels larger than their current coping resources can absorb: from starting college or a new career, to divorce or retirement, to grief, illness, relocation, or a shift in identity. The case examples on this page illustrate how the approach adapts across very different life stages and circumstances.

  What kinds of life transitions does therapy help with?Therapy for life transitions spans a wide range of circumstances. Common presenting situations include educational transitions — starting college, graduating, entering the workforce; career changes, promotions, burnout, or retirement; relationship shifts such as marriage, divorce, becoming a parent, or becoming an empty nester; [grief and loss](https://dralanjacobson.com/grief-therapy/) from a death, estrangement, or ended friendship; health-related changes including a new diagnosis or recovery from illness; and geographical moves that require rebuilding social and professional networks from scratch. Less visible but equally significant transitions — shifts in identity, midlife reevaluation, or the aftermath of global events like economic disruption — also bring people to therapy. What these situations share is that they require adapting to a new reality while managing the emotional weight of what has changed or been lost. For couples navigating transitions together, [couples therapy](https://dralanjacobson.com/couples-therapy/) and [EFT for couples](https://dralanjacobson.com/eft-therapy-for-couples/) can be valuable complements to individual work.

  Why do even positive life transitions — like a promotion or having a child — sometimes feel so hard?This is one of the most common and least discussed aspects of life transitions. Positive changes carry real psychological weight because they involve loss alongside gain — the loss of a prior identity, a familiar role, a predictable routine, or relationships that were defined by who you used to be. A promotion means leaving behind the competence and comfort of a known role. Becoming a parent means losing autonomy, sleep, and a version of your relationship with your partner. Moving for a dream job means leaving behind your social fabric. Research in developmental psychology, including foundational work by [William Bridges](https://www.williambridges.com/), distinguishes between the external *change* (what happens) and the internal *transition* (the psychological process of adapting to it) — and notes that the internal transition is often the harder and slower of the two. Therapy creates space to honor both dimensions: to celebrate what the change represents while also naming and processing what it costs. [ACT](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) and [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/) are particularly effective here.

  How does life transitions therapy address identity — not just practical adjustment?Identity is often the most clinically significant dimension of a major life transition, and it is the one most likely to be underestimated by the person going through it. Many transitions strip away or fundamentally alter the roles, relationships, and contexts through which we have defined ourselves — “I am a corporate professional,” “I am part of this marriage,” “I am a parent with children at home” — and leave people uncertain about who they are in the new chapter. This identity disruption is not weakness; it is a predictable consequence of meaningful change. Therapy directly addresses it through [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/) — helping clients examine the stories they’ve built around their identity, what still holds true, and what needs to be consciously rewritten. [Existential Therapy](https://dralanjacobson.com/existential-therapy/) and [Logotherapy](https://dralanjacobson.com/logotherapy/) are also used when meaning and purpose are at the center of the transition, as they often are in midlife and retirement. [Personal growth counseling](https://dralanjacobson.com/personal-growth-counseling/) can extend this work beyond the immediate transition into a broader exploration of who the client wants to become.

  What therapeutic approaches are used in life transitions therapy?Dr. Jacobson takes an integrative approach, selecting and combining methods based on the nature of the transition and each person’s goals. [Cognitive Behavioral Therapy (CBT)](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) targets the negative thought patterns — catastrophizing, all-or-nothing thinking, self-doubt — that commonly accompany transitions. [ACT](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) helps clients stay present with uncertainty and act in alignment with their values even when the path forward isn’t clear. [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/) helps clients rewrite their personal story to incorporate the transition as a meaningful chapter. [Mindfulness-based approaches](https://dralanjacobson.com/mindfulness-therapy/) reduce the anxiety that often accompanies significant change. [Solution-Focused Brief Therapy (SFBT)](https://dralanjacobson.com/solution-focused-therapy/) is used for clients who want efficient, goal-directed work focused on actionable next steps. For transitions involving trauma or loss, [grief therapy](https://dralanjacobson.com/grief-therapy/) and trauma-informed approaches provide the deeper processing that practical strategies alone cannot deliver. The blend evolves as the transition progresses and the client’s needs shift.

  How is life transitions therapy different from general therapy or life coaching?Life transitions therapy sits at the intersection of clinical depth and practical forward-momentum — which is part of what distinguishes it from both general psychotherapy and life coaching. General therapy often focuses on understanding historical patterns, processing emotions, and treating clinical conditions; life transitions therapy does all of this but is organized around a specific change and its demands. Life coaching, by contrast, is focused primarily on goal-setting, accountability, and performance — and typically does not address the emotional, identity, or clinical dimensions of transitions. Dr. Jacobson’s background as a licensed clinical psychologist means he can hold both dimensions simultaneously: addressing the grief, anxiety, or identity disruption that a transition brings while also building the practical plans, skills, and self-management systems that help clients move forward. When career-related transitions are central, [executive coaching](https://dralanjacobson.com/executive-coaching/) or [early career coaching](https://dralanjacobson.com/early-career-coaching/) may be a useful complement alongside therapy. For more on what distinguishes different types of clinicians, see the [therapist vs. psychologist guide](https://dralanjacobson.com/therapist-vs-psychologist-therapist-vs-psychotherapist/).

  How long does life transitions therapy take?Treatment length varies considerably depending on the nature of the transition, the presence of co-occurring conditions like anxiety or depression, and the client’s goals. For acute, well-defined transitions — starting a new role, adjusting to a move, navigating a relationship change — a focused course of 8–16 sessions is often sufficient to stabilize functioning, build coping skills, and develop a clear path forward. More complex situations — grief compounded by retirement loss, midlife identity crisis, or transitions that have reopened historical trauma — typically require more time and a deeper course of work. Many clients also return for brief booster periods when subsequent transitions arise, having established a working relationship and a foundation of skills they can build on quickly. The [how long does therapy take guide](https://dralanjacobson.com/how-long-does-therapy-take/) provides broader context, and Dr. Jacobson discusses realistic timelines in the initial consultation based on each client’s specific situation and goals.

  How do I get started, and can life transitions therapy be done online?Yes — life transitions therapy is fully compatible with online delivery and in many cases is enhanced by it. Virtual sessions mean that clients navigating a geographical move, a new city, or a demanding life stage don’t need to find a new therapist every time their circumstances change. Dr. Jacobson is a [PSYPACT](https://psypact.org/)-participating psychologist licensed in 44 states, which means he can continue working with clients regardless of where they relocate. The first step is a free 20-minute consultation — a practical conversation about what transition you’re navigating, what you’ve already tried, and what a course of therapy might look like for your specific situation. There’s no commitment required. Related pages worth reviewing depending on your situation: [grief therapy](https://dralanjacobson.com/grief-therapy/), [depression and anxiety therapy](https://dralanjacobson.com/therapy-for-depression-and-anxiety/), [therapy for college students](https://dralanjacobson.com/therapy-for-college-students/), [divorce counseling](https://dralanjacobson.com/divorce-counseling/), [personal growth counseling](https://dralanjacobson.com/personal-growth-counseling/), and [work-life balance therapy](https://dralanjacobson.com/therapy-for-work-life-balance/).

 Every transition is also a beginning.

Schedule a free 20-minute consultation with Dr. Jacobson — a practical, low-pressure conversation about what you’re navigating and what therapy might offer at this stage of your life.

 [ Schedule a Free Consultation ](https://www.picktime.com/scheduleaconsult) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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icon](data:image/svg+xml;base64,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) ](https://www.linkedin.com/company/psychologicalscience/)

---

### [Adult Family Therapy](https://dralanjacobson.com/adult-family-therapy/)

**Published:** December 22, 2024
**Author:** Dr. Alan Jacobson

**Content:**

Adult family therapy focuses on improving communication, resolving conflicts, and strengthening relationships within a system when some or all children are grown. It is beneficial when families face significant life transitions, persistent conflicts, or challenges such as mental health issues, addiction, trauma, or grief. I offer family therapy for adults virtually, allowing everyone to participate even if they don’t live in the same place. There are many reasons families choose this [type of treatment](https://dralanjacobson.com/types-of-therapy/), and I provide three common ones at the end of this post: Family transitions, sibling therapy, and failure to launch therapy. There are other examples of this type of adult family counseling, such as when families want to improve relationships or communication, resolve longstanding differences, or work out a specific disagreement.

If you want to discuss how family therapy for adults would help you, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

---

### Common Approaches in Adult Family Therapy

![Adult Family Therapy](https://dralanjacobson.com/wp-content/uploads/2024/12/sunlight-path-1-300x200.jpg "sunlight path | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")I use the following methods in family therapy for adults:

#### [Structural Family Therapy](https://dralanjacobson.com/structural-family-therapy/) for Adults (SFT)

- **Focus:** Organization, hierarchies, and boundaries.
- **Goal:** Restructure dynamics to improve relationships and establish healthier boundaries.
- **Example:** I may work to redefine roles if one person is overburdened with responsibilities.

#### Systemic Family Therapy

- **Focus:** Systems and patterns of interaction are the focus of this type of family therapy for adults.
- **Goal:** Understand the family as an interconnected system where one person’s behavior affects the whole group.
- **Example:** Addressing how one member’s anxiety might cause stress for everyone else.

#### [Family Systems](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/)

- **Focus:** Differentiation of self and understanding intergenerational patterns.
- **Goal:** Help individuals balance independence and connection.
- **Example:** [Couples therapy](https://dralanjacobson.com/couples-therapy/) to explore how unresolved conflicts with parents might affect a person’s marriage.

#### Narrative Adult Family Therapy

- **Focus:** The stories families tell about their experiences.
- **Goal:** [Narrative family therapy](https://dralanjacobson.com/narrative-family-therapy/) helps them reframe their stories in a more empowering way.
- **Example:** Instead of seeing a member as “the problem,” the narrative shifts to how the family can collectively address challenges.

#### [Solution-Focused Brief Family Therapy](https://dralanjacobson.com/solution-focused-family-therapy-focusing-on-positive-change/) (SFBT)

- - **Focus:** Present and future solutions rather than past problems.
    - **Goal:** Identify and amplify existing strengths and resources to solve problems.
    - **Example:** Instead of analyzing why arguments happen, focus on moments when communication worked well.

#### Psychoeducational Family Therapy

- - **Focus:** Educating families about mental health conditions, addiction, or other specific issues.
    - **Goal:** Reduce blame, increase understanding, and develop coping strategies.
    - **Example:** Educating families about ADHD and how it affects adult relationships.

#### [Cognitive-Behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) Family Therapy for Adults (CBFT)

- - **Focus:** Thought patterns and behaviors that contribute to conflict.
    - **Goal:** Help members change unhelpful thoughts and behaviors.
    - **Example:** Identifying and addressing negative assumptions between members.

#### [Emotionally Focused](https://dralanjacobson.com/eft-therapy-for-couples/) Family Therapy for Adults (EFFT)

- - **Focus:** Emotional bonds and attachment needs are central to this type of family therapy for adults.
    - **Goal:** Create secure emotional connections and address unresolved emotional wounds.
    - **Example:** A parent and adult child working through feelings of neglect or abandonment.

---

### When to Consider Adult Family Therapy

- Frequent, intense, or unresolved conflicts
- Life transitions (e.g., divorce, remarriage, illness, death)
- Addiction or substance abuse issues
- Mental health challenges affecting dynamics
- Communication breakdowns
- Unresolved past traumas or significant stresses
- Estrangement for any reason
- [Family therapy for political differences](https://dralanjacobson.com/politics-and-family-therapy/) is needed

## Case Example 1: Sibling Therapy

**Case Overview:**
The Martinez family consists of two parents and three adult siblings—Laura (42), Miguel (38), and Sofia (35). After their parents moved to a condo, they began arguing over the family home, and unresolved emotional conflicts from their childhood resurfaced. Laura feels she was forced into a caretaker role, Miguel resents feeling overlooked, and Sofia feels she was always treated as the baby of the family and never taken seriously. They agree to attend *adult sibling therapy* to improve communication and resolve ongoing tensions.

---

### Sibling Therapy Process

**1. Initial [Adult Sibling Therapy](https://dralanjacobson.com/adult-sibling-therapy/) Session: Establishing Goals and Ground Rules**

- I create a safe and neutral environment for open discussion during sibling therapy.
- Each sibling shares their perspective: 
    - *Laura* expresses frustration about carrying family responsibilities alone.
    - *Miguel* discusses feeling ignored in decisions.
    - *Sofia* talks about feeling dismissed and underestimated.
- Goal: Improve communication, address long-standing resentments, and agree on a plan for the family home.

**2. Identifying Family Patterns and Roles**

- I explore roles established in childhood: 
    - *Laura* was the “responsible caretaker.”
    - *Miguel* was the “forgotten middle child.”
    - *Sofia* was the “baby who needed protection.”
- These roles, while once functional, are now causing friction in adulthood.

**3. Addressing Underlying Emotions**

- I use *Emotionally Focused Family Therapy for Adults (EFFT)* techniques to help each sibling express vulnerable emotions. 
    - Laura admits she feels unappreciated for her sacrifices.
    - Miguel shares feelings of invisibility and resentment.
    - Sofia expresses her frustration with not being seen as capable.
- This emotional honesty helps reduce blame and build empathy among them.

**4. Practicing Healthy Communication**

- I introduce *Cognitive-Behavioral Adult Sibling Therapy* techniques to improve communication: 
    - Active listening exercises
    - “I” statements to express feelings without assigning blame (e.g., “I feel hurt when my opinions are dismissed”).
- The siblings practice these tools in real-time discussions.

**5. Developing a Plan for Moving Forward**

- I guide the siblings in creating an agreement regarding the family home.
- They also discuss boundaries and expectations for their relationships moving forward.
- For example: 
    - Regular family check-ins to discuss important matters.
    - Respect for each sibling’s emotional space and independence.

**6. Sibling Therapy Closure and Reflection**

- In the final sibling therapy sessions, I review progress.
- Each sibling reflects on personal growth and commits to maintaining open communication.
- I provide tools for managing future conflicts constructively.

---

### Key Outcomes of Sibling Therapy:

- **Improved Communication:** The siblings learn to express their needs without falling into old patterns of blame or defensiveness.
- **Emotional Resolution:** Unspoken grievances and childhood resentments are acknowledged and addressed.
- **Practical Agreements:** A clear plan for managing the family home and respecting individual boundaries is established.
- **Renewed Connection:** The siblings feel closer, more respected, and more confident in handling future disagreements.

## Case Example 2: Failure to Launch Therapy

David, a 27-year-old man, lives with his parents, Carol and Mark. Despite graduating from college three years ago, David has not pursued a stable job or moved out. He spends most of his time playing video games and avoiding discussions about his future. Carol feels guilty and enables David by doing his laundry and cooking for him, while Mark feels frustrated and often withdraws from conversations. They decide to seek *Failure to Launch Therapy* to address their challenges.

---

### Failure to Launch Therapy Process

#### 1. Initial Assessment and Goal Setting for Failure to Launch Therapy

- **My Role:** Understand the family dynamics, David’s emotional state, and the contributing factors behind his lack of independence.
- **Family Insights:**
    - *David* admits he feels overwhelmed by adult responsibilities and fears failing.
    - *Carol* reveals she feels responsible for David’s struggles and avoids confrontation to “keep the peace.”
    - *Mark* expresses frustration and a sense of helplessness.
- **Failure to Launch Therapy Goal:** Help David build confidence and independence while addressing enabling behaviors from his parents.

---

**2. Addressing Emotional Barriers (Individual and Family Failure to Launch Therapy Sessions)**

- *David:* In individual failure to launch therapy, David works on his low self-esteem and fear of failure. I use *Cognitive Behavioral Therapy (CBT)* techniques to challenge his negative self-talk (e.g., “I’ll fail anyway, so why bother trying?”).
- *Carol and Mark:* In failure to launch therapy sessions, Carol learns to set boundaries and reduce enabling behaviors while Mark practices expressing his frustrations constructively.

**Example Activity:**

- I ask Carol to gradually stop doing tasks David can do himself (e.g., laundry, cooking).
- David practices small, manageable goals, like applying to one job per week or creating a daily routine.

---

**3. Building Life Skills and Independence**

- I introduce *Solution-Focused Failure to Launch Therapy* techniques to help David identify small, actionable steps toward independence. 
    - Create a resume and apply for jobs.
    - Set weekly goals (e.g., budgeting finances, cooking one meal a day).
- David also starts attending a [group therapy session for young adults](https://dralanjacobson.com/group-therapy-for-young-adults/) facing similar struggles, which reduces his sense of isolation.

---

**4. Addressing Family Dynamics and Boundaries**

- I work on shifting roles: 
    - *Carol:* Stops micromanaging and learns to let David face natural consequences.
    - *Mark:* Re-engages in discussions and supports Carol in maintaining boundaries.
    - *David:* Learns to communicate his needs and frustrations openly rather than withdrawing.

**Example Exercise:**

- They practice role-playing scenarios, such as David asking for support without relying on his parents for everything.

---

**5. Transition Plan and Support System**

- I collaborate with David to create a plan for moving out within a realistic timeframe.
- Carol and Mark set clear expectations for financial contributions and household responsibilities.
- David identifies support systems outside his family (e.g., friends, mentors, or career counselors).

---

**6. Closure and Reflection**

- In the final failure to launch therapy sessions, the family reflects on their growth: 
    - *David:* Feels more confident and motivated to pursue his goals.
    - *Carol:* Feels less guilty and more empowered to let David face challenges.
    - *Mark:* Feels more connected and hopeful about the family’s future.
- I provide tools for ongoing communication and conflict resolution.

---

### Failure to Launch Therapy Outcomes:

- **David:** Builds self-confidence, secures a part-time job, and begins planning to move out.
- **Carol:** Stops enabling behaviors and respects David’s independence.
- **Mark:** Communicates his frustrations more constructively.
- **Family:** Improved communication, healthier boundaries, and a more balanced family dynamic.

## Case Example 3: Adult Family Counseling for Transitions

Linda (60) and her son Alex (32) have been estranged for three years. Their relationship became strained after repeated arguments about Alex’s life choices, including his decision to change careers and move out of state. Linda feels abandoned and hurt, while Alex feels judged and emotionally drained by their interactions. At Linda’s suggestion, they agree to explore the possibility of reconciliation in adult family counseling.

---

### Adult Family Counseling Process

#### 1. Initial Adult Family Counseling Session: Establishing Goals and Safe Communication

- **My Role:** Create a neutral adult family counseling space for both parties to feel heard without judgment.
- **Linda’s Perspective:** She shares feelings of abandonment and grief over the loss of closeness with Alex.
- **Alex’s Perspective:** He expresses frustration over feeling criticized and invalidated by Linda.
- **Shared Goal:** Both agree to work towards understanding each other’s perspectives and rebuilding trust.

---

#### 2. Identifying Patterns and Root Causes

- **Therapist’s Insight:** I help them identify recurring patterns in their communication. 
    - *Linda:* Tends to offer unsolicited advice and struggles to accept Alex’s autonomy.
    - *Alex:* Withdraws emotionally when he feels criticized.
- **Exploration of Past Events:** They discuss key moments that contributed to the estrangement, including an argument when Alex felt his career choice was dismissed.

**Example Adult Family Counseling Activity:**

- I ask both to share their perspectives on a past argument, focusing on their feelings rather than assigning blame.

---

#### 3. Addressing Emotional Wounds and Misunderstandings

- I use *Emotionally Focused Therapy (EFT)* techniques to help Linda and Alex express their core emotions: 
    - *Linda:* Admits her controlling behavior stemmed from fear of losing connection with Alex.
    - *Alex:* Shares that his withdrawal was not out of rejection but self-protection.
- Both acknowledge the emotional impact their actions have had on each other.

**Example Adult Family Counseling Exercise:**

- I facilitate a “Letter of Understanding” exercise where both write letters to express their feelings without interruption.

---

#### 4. Establishing Healthy Boundaries and Expectations

- I help them outline clear boundaries to avoid repeating past patterns. 
    - *Linda:* Agrees to offer advice only when asked.
    - *Alex:* Agrees to communicate regularly in a way that feels manageable for him.
- Both discuss expectations about visits, phone calls, and sharing aspects of their lives.

**Example Adult Family Counseling Activity:**

- They create a “Communication Agreement” outlining what feels safe and respectful for both parties.

---

#### 5. Rebuilding Trust Through Consistent Effort

- They work on rebuilding their relationship gradually, focusing on small, positive interactions.
- I emphasize that reconciliation is a process, not a single event.

**Example Adult Family Counseling Exercise:**

- Weekly “check-in” calls with structured conversation topics to prevent misunderstandings.

---

#### 6. Reflection and Closure

- I help Linda and Alex reflect on their progress in family therapy for adults and celebrate small victories.
- They discuss tools for managing future conflicts constructively.
- Both express hope and a renewed commitment to their relationship.

---

### Key Outcomes of Adult Family Therapy:

- **Improved Communication:** Both Linda and Alex learn to communicate feelings without falling into defensive patterns.
- **Emotional Awareness:** They understand how past wounds influenced their behavior and communication styles.
- **Healthy Boundaries:** Clear guidelines for interactions prevent future resentment.
- **Gradual Reconnection:** Both agree to continue building trust at a safe and respectful pace.

---

[Adult family counseling](https://dralanjacobson.com/family-therapy/) often focuses on healing emotional wounds, improving communication, and redefining the parent-child relationship to respect both parties’ autonomy.

## Summary and My Work

Unlike [individual therapy](https://dralanjacobson.com/individual-therapy/), adult family therapy views problems as existing within the family dynamic rather than being caused by one person, even when, and perhaps especially when, the family no longer lives in the same place. The goal is to help family members understand each other’s perspectives, build empathy, and develop healthier ways of interacting. I provide specific types of adult family therapy, including adult sibling therapy, specific relationship approaches such as [mother-daughter therapy](https://dralanjacobson.com/mother-daughter-therapy/), [emotionally focused family therapy](https://dralanjacobson.com/emotionally-focused-family-therapy/), [attachment-based family therapy](https://dralanjacobson.com/attachment-therapy/), parental or [sibling estrangement](https://dralanjacobson.com/family-estrangement-therapy/), and failure-to-launch treatment, as well as more general treatment when a family is facing a barrier or challenge, such as needing [therapy for political anxiety](https://dralanjacobson.com/therapy-for-political-anxiety/) due to conflict. [I provide these services virtually](https://dralanjacobson.com/virtual-therapy-guide/).

### Contact me for Adult Family Therapy

If you want more information about adult family therapy or how these approaches could help you, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Frequently Asked Questions: Adult Family Therapy

Common questions about how adult family therapy works, who it helps, and what to expect from virtual sessions when family members live in different places.

   What is adult family therapy, and how does it differ from therapy with younger children? + Adult family therapy focuses on improving communication, resolving conflicts, and strengthening relationships within a family system when some or all of the children are grown. Unlike child-focused [family therapy](https://dralanjacobson.com/family-therapy/), which often centers on parenting strategies and behavioral management, adult family therapy treats all participants as autonomous adults with fully formed identities, histories, and perspectives. The work tends to involve direct examination of longstanding patterns — intergenerational dynamics, unresolved childhood wounds, and the renegotiation of roles that no longer fit — rather than skill-building around parenting. The [American Psychological Association](https://www.apa.org/topics/parenting/adult-children) recognizes that parent-adult child relationships carry unique complexity, particularly around autonomy, shifting power dynamics, and expectations that were never made explicit. Adult family therapy creates a structured space to address exactly these dynamics.

   What are the most common reasons adult families seek therapy? + The most common presenting situations fall into several clusters. Major [life transitions](https://dralanjacobson.com/life-transitions-therapy/) — a parent’s aging or death, divorce, remarriage, a serious illness, or a significant financial change — often expose communication breakdowns and unresolved tensions that managed to stay hidden during more stable periods. Persistent conflict that cycles without resolution is another common trigger, as is [estrangement](https://dralanjacobson.com/family-estrangement-therapy/) between a parent and adult child or between siblings. “Failure to launch” situations — where an adult child is struggling to achieve independence — are increasingly common and frequently involve enabling patterns the whole family system has developed together. Other families come because they simply want a better relationship: more closeness, clearer communication, and less walking on eggshells — even without a specific crisis. All of these are valid entry points, and all respond to treatment.

   What is “failure to launch” therapy, and how does it work? + Failure to launch therapy addresses situations where an adult child — typically in their 20s or 30s — has not achieved the developmental milestones of independence: stable employment, financial self-sufficiency, and separation from the parental home. Importantly, the treatment is rarely just about the adult child’s individual struggles; it addresses the full family system that has often, with the best intentions, developed patterns that inadvertently sustain the dependence. Treatment combines individual work with the adult child — typically using [CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) for anxiety, low self-efficacy, and avoidance — with family sessions that shift parental roles, establish clear expectations, and create a structured transition plan. [Group therapy for young adults](https://dralanjacobson.com/group-therapy-for-young-adults/) is often a valuable complement, reducing isolation and building peer accountability. See also the [life transitions therapy](https://dralanjacobson.com/life-transitions-therapy/) page for related context.

   How does adult family therapy address a parent-adult child estrangement? + Parent-adult child estrangement is one of the most painful presentations in family therapy and one of the most common. Research from Cornell sociologist Karl Pillemer suggests family estrangement affects tens of millions of Americans and is significantly underreported due to stigma. Therapy can begin with individual sessions for one or both parties — processing grief, clarifying what each person actually wants, and building readiness for structured dialogue before joint sessions begin. When joint sessions occur, the work focuses on understanding the communication patterns that drove the rupture and establishing conditions under which contact can feel safe. Reconciliation is not presumed as the goal — for some families, limited contact or a redefined relationship is the healthiest outcome. For more, see the dedicated [family estrangement therapy](https://dralanjacobson.com/family-estrangement-therapy/) page.

   What therapy approaches are used in adult family therapy? + Dr. Jacobson draws from a range of evidence-based models tailored to each family’s situation. [Family Systems Therapy](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/) examines intergenerational patterns, differentiation, and how each member’s behavior affects the whole. [Emotionally Focused Family Therapy (EFFT)](https://dralanjacobson.com/emotionally-focused-family-therapy/) targets the attachment cycles and emotional wounds that drive conflict and distance. [Structural Family Therapy](https://dralanjacobson.com/structural-family-therapy/) addresses hierarchies, boundaries, and role imbalances. [Narrative Family Therapy](https://dralanjacobson.com/narrative-family-therapy/) helps families examine and rewrite the stories they’ve constructed about each other. [Solution-Focused Brief Therapy (SFBT)](https://dralanjacobson.com/solution-focused-family-therapy-focusing-on-positive-change/) is used when families want efficient, goal-directed work. These approaches are rarely used in isolation — the blend is always determined by what each family’s situation calls for.

   Can adult family therapy be done virtually when family members live in different places? + Yes — and virtual delivery makes adult family therapy significantly more accessible than it has historically been. Geographic distance is one of the primary barriers to this type of treatment: siblings, parents, and adult children frequently live in different cities or states, making it logistically impossible to attend the same in-person office. Dr. Jacobson provides adult family therapy entirely virtually via secure video. He is a [PSYPACT](https://psypact.org/)-participating psychologist licensed in 44 states, allowing him to work with family members across most of the country in the same session. Research on telehealth family therapy consistently supports its clinical equivalence to in-person treatment. For more on how virtual sessions work, see the [virtual therapy guide](https://dralanjacobson.com/virtual-therapy-guide/) and the overview of [online therapy approaches and outcomes](https://dralanjacobson.com/therapy-online-approaches-techniques-and-outcomes/).

   Does every family member need to participate, or can therapy help if only one person attends? + Therapy can be highly effective even when only one family member participates — and this is often how adult family therapy begins. Because family dynamics are systemic, a meaningful change in how one person communicates, sets limits, or responds emotionally tends to shift the pattern for others, even without their direct participation. Individual work in a family context — sometimes called [family of origin therapy](https://dralanjacobson.com/family-of-origin-therapy/) — helps a person understand the roles and patterns they inherited, develop healthier responses, and clarify what they want from each relationship. When other family members become willing to join, sessions can transition to joint work. Dr. Jacobson also offers flexibility in session structure: individual, dyadic, and larger group sessions can be combined in whatever configuration serves the family’s needs at each stage.

   How do we get started with adult family therapy? + The first step is a free 20-minute consultation — typically with one family member, though others are welcome to join. That conversation covers what’s been happening, who is willing to participate, and what the primary goals are. From there, Dr. Jacobson will recommend a starting structure — individual sessions, joint sessions, or a combination — and discuss a realistic timeline. Most families find the initial consultation itself relieving: having a clinician name what’s been happening and outline a clear path forward reduces the uncertainty that often keeps families stuck and avoidant. Related pages for specific situations: [adult sibling therapy](https://dralanjacobson.com/adult-sibling-therapy/), [mother–daughter therapy](https://dralanjacobson.com/mother-daughter-therapy/), [family estrangement therapy](https://dralanjacobson.com/family-estrangement-therapy/), [therapy for political differences](https://dralanjacobson.com/politics-and-family-therapy/), and the [guide to choosing a family therapy approach](https://dralanjacobson.com/which-type-of-family-therapy-is-right-for-you/).

 Your family doesn’t have to stay stuck.

Schedule a free 20-minute consultation with Dr. Jacobson — a low-pressure conversation about what’s happening and whether adult family therapy is the right next step.

 [ Schedule a Free Consultation ](https://www.picktime.com/scheduleaconsult) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.linkedin.com/company/psychologicalscience/)

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### [Personal Growth Counseling Across the Lifespan](https://dralanjacobson.com/personal-growth-counseling/)

**Published:** August 17, 2025
**Author:** Dr. Alan Jacobson

**Content:**

I often meet individuals who are not suffering from a diagnosable disorder, but instead want support in navigating life’s challenges, transitions, and opportunities. Personal growth counseling is not about symptom relief; it’s about unlocking potential, increasing self-awareness, and moving toward a more meaningful, satisfying life. People look to personal counseling services when they feel stuck, uncertain, or ready for change, and together we create a plan to move forward purposefully, with the goal of improved contentment and purpose. A personal counselor uses the same innovative and powerful [strength-based therapy techniques](https://dralanjacobson.com/strength-based-therapy/) that are used with all clients, but they are adapted to focus less on symptoms.

## Overview of Personal Growth Counseling ![Personal counseling services](https://dralanjacobson.com/wp-content/uploads/2025/08/lightbulb-j-300x156.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

The following overview covers the field of Personal Growth Counseling, followed by some case examples that elucidate the techniques and methods used.

### History of Personal Growth Counseling Services

Personal growth counseling emerged during the rise of [**humanistic psychology**](https://dralanjacobson.com/humanistic-therapy/) in the mid-20th century. [Carl Rogers](https://en.wikipedia.org/wiki/Carl_Rogers) emphasized the healing power of empathy, authenticity, and unconditional positive regard, while [Abraham Maslow](https://en.wikipedia.org/wiki/Abraham_Maslow) introduced the concept of [**self-actualization**](https://www.simplypsychology.org/self-actualization.html)—the natural human drive toward meaning and fulfillment. This shifted the focus from merely treating mental illness to fostering strengths, growth, and resilience. Over time, personal growth counseling has drawn from multiple traditions:

- [**Positive psychology**](https://dralanjacobson.com/positive-psychology-powerful-benefits/) ([Seligman](https://en.wikipedia.org/wiki/Martin_Seligman), [Csikszentmihalyi](https://en.wikipedia.org/wiki/Mihaly_Csikszentmihalyi)): identifying and enhancing character strengths.
- **[Cognitive-behavioral](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) approaches**: reshaping negative thinking patterns that block growth.
- **Mindfulness and [acceptance-based therapies](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/)**: cultivating awareness and presence.
- **Coaching and [solution-focused models](https://dralanjacobson.com/solution-focused-therapy/)**: practical strategies for achieving goals.

### Techniques Used

Personal growth counseling blends several techniques tailored to the client’s needs:

1. **[Person-Centered Approaches](https://dralanjacobson.com/client-centered-therapy/) (Carl Rogers)**
    - Empathy, reflective listening, and unconditional positive regard.
    - Helps clients feel safe, validated, and understood, creating the foundation for self-exploration.
2. **Cognitive-Behavioral Strategies (CBT)**
    - Identifying limiting beliefs (“I’m not good enough,” “I’ll fail anyway”).
    - Challenging and reframing unhelpful thoughts.
    - Building practical coping strategies for setbacks.
3. **Mindfulness & Acceptance Practices**
    - Breathing techniques, guided meditation, and grounding exercises.
    - Cultivates present-moment awareness, reducing anxiety about the future and regret about the past.
    - Helps clients make intentional choices instead of reactive ones.
4. [**Narrative Therapy**](https://dralanjacobson.com/narrative-therapy/)
    - Exploring the personal “stories” people live by (e.g., “I’ve always been the failure in my family”).
    - Encouraging clients to rewrite those stories in empowering ways.
    - This may include [Tree of Life Narrative Therapy](https://dralanjacobson.com/tree-of-life-therapy/)
5. [**Strengths-Based Interventions**](https://dralanjacobson.com/strength-based-therapy/) (e.g., [Resilience Training](https://dralanjacobson.com/therapy-for-self-esteem-and-resilience-training/)) 
    - Identifying personal talents and character strengths (e.g., creativity, perseverance, kindness).
    - Using these strengths as tools for overcoming challenges and pursuing goals.
6. **Goal-Setting and [Motivational Coaching](https://dralanjacobson.com/motivational-interviewing/)**
    - Clarifying values and long-term aspirations.
    - Breaking down large goals into smaller, manageable steps.
    - Tracking progress and celebrating milestones.
7. [**Creative and Experiential Techniques**](https://dralanjacobson.com/creative-counseling/)
    - Journaling, expressive arts, vision boards, and role-playing scenarios.
    - Helps clients access emotional insight and motivation in ways beyond talk alone.
8. **Relational and Communication Skills Training**
    - Assertiveness training, conflict resolution, and boundary-setting.
    - Particularly useful for those seeking growth in interpersonal relationships.

## Personal Growth Counseling Methods Across the Lifespan

Personal growth counseling services evolve depending on the stage of life a client is navigating. While the core philosophy remains the same, including facilitating authenticity, resilience, and fulfillment, the goals and methods used by the personal counselor shift to reflect developmental needs:

### Personal Counseling in Adolescence (ages 12–18)

- Primary Goals: Identity development, building confidence, managing academic/social pressures, reducing perfectionism, and encouraging healthy risk-taking.
- Techniques Emphasized by the Personal Counselor: Person-centered therapy (for trust), CBT for perfectionism/anxiety, strengths exploration, role-playing for social confidence, and narrative therapy to reshape negative identity stories.
- Example Outcome: A teen learns to see herself as more than her grades and begins exploring creativity and friendships.

### Personal Counseling in Young Adulthood (ages 18–30)

- Primary Goals: Career direction, independence, self-identity, managing family expectations, and forming healthy relationships.
- Techniques Emphasized: [Values clarification exercises](https://dralanjacobson.com/values-clarification-therapy/), [motivational interviewing](https://dralanjacobson.com/motivational-interviewing/), action planning, CBT for self-limiting beliefs, [strengths-based career exploration](https://psychologicalassessments.com/career-testing/), and assertiveness training.
- Example Outcome: A college graduate gains confidence to pursue a passion-driven career path and sets boundaries with family.

### Personal Counseling in Midlife (ages 30–65)

- Primary Goals: Work–life balance, parenting, marital satisfaction, rediscovering personal passions, coping with “midlife crisis” or feeling stuck.
- Techniques Emphasized: [Mindfulness journaling](https://positivepsychology.com/journaling-for-mindfulness/), relational communication training, [existential exploration](https://dralanjacobson.com/existential-therapy/), strengths assessment, narrative reframing (“I’m stuck” → “I can reinvent”),[ insight therapy](https://dralanjacobson.com/insight-therapy/).
- Example Outcome: A parent reclaims creativity, rebalances family roles, and restores passion in her life.

### Personal Counseling in Later Adulthood & Retirement (ages 65+)

- Primary Goals: Redefining purpose after career, legacy, managing aging-related fears, maintaining social connections, and creating new structures for daily life.
- Techniques Emphasized: [Life review,](https://dralanjacobson.com/life-therapy/) [existential therapy](https://dralanjacobson.com/existential-therapy/), [mindfulness for anxiety](https://psychcentral.com/anxiety/using-mindfulness-to-treat-anxiety-disorders), strengths-based legacy planning, and goal-setting for hobbies and volunteering.
- Example Outcome: A retiree shifts from fearing irrelevance to mentoring others and pursuing meaningful passions.

### Key Insight:

Personal growth counseling adapts to each life stage, but at every point, it emphasizes self-awareness, resilience, and purposeful living. Personal counseling services are adaptive and can be used for brief periods as a person gets older and faces new opportunities.

## Personal Counseling Case Examples

The following four examples show how personal growth counseling can evolve over a person’s lifespan.

### Case Example 1: Adolescent Personal Growth Counseling

Maya, an honors student, was plagued by perfectionism and self-doubt. Her identity was wrapped tightly around grades, and she avoided trying new things for fear of failure. She hoped that a personal counselor might help her feel free of doubt and full of potential.

#### Techniques Used in Personal Counseling:

- Person-Centered Foundations: The first sessions focused on building trust through empathy, active listening, and unconditional positive regard. This gave Maya permission to be vulnerable.
- CBT for Perfectionism: Maya kept a thought journal, writing down her automatic thoughts (“If I don’t get an A, I’m worthless”) and rating their intensity. Together, we challenged these distortions and generated alternative thoughts (“One grade does not define my intelligence or value”).
- Mindfulness Practices: Short breathing exercises before tests reduced her anxiety. She also practiced [mindful self-compassion](https://positivepsychology.com/mindful-self-compassion/), such as responding to mistakes with kindness instead of criticism.
- Strengths Exploration: A [VIA Character Strengths inventory](https://www.viacharacter.org/) helped Maya see creativity and humor as part of her identity, not just achievement.
- Narrative Therapy: Maya externalized perfectionism as a “critical voice” and practiced speaking back to it, reframing her story as one of courage and growth.
- Role-Playing: In-session exercises helped her practice social risk-taking (e.g., starting a conversation, disagreeing respectfully in class).

#### Outcome of Personal Counseling Services:

Over three months, Maya’s anxiety decreased. She began painting, joined a club she had previously been too nervous to try, and reported that she felt “like a whole person, not just a grade.”

### Case Example 2: Young Adult

Daniel, a college graduate, was unmotivated in a corporate job chosen for security. He felt guilty for wanting change and feared disappointing his parents. He hoped that a personal counselor could help him find empowerment and happiness.

#### Techniques Used in Counseling:

- Values Clarification Exercises: Daniel created a “values map” ranking freedom, creativity, and meaningful connection. His current job misaligned with these, providing motivation for change.
- Narrative Therapy: He unpacked the story “I must stay on the safe path,” and rewrote it to “I can choose a meaningful path while still honoring my family.”
- Strengths-Based Exploration: Through reflective exercises, Daniel identified persistence, design thinking, and empathy as his strongest skills.
- Motivational Interviewing: We explored his ambivalence about leaving his job, weighing the pros and cons, and strengthening his intrinsic motivation for pursuing change.
- CBT for Self-Limiting Beliefs: We addressed thoughts like “I’ll fail if I take risks,” testing them against real experiences where he succeeded when taking chances.
- Coaching/Action Planning: He set weekly goals (e.g., updating his portfolio, applying to five jobs). We tracked progress and reinforced achievements.
- Assertiveness Training: We practiced scripts for conversations with family, allowing him to explain his career pivot confidently and without guilt.

#### Personal Counseling Outcome:

Daniel transitioned to a design career, experienced renewed energy, and reported healthier family dynamics. He learned to balance honoring his roots with embracing his individuality.

### Case Example 3: Adult Personal Growth Counseling

Sophia, a married mother of two, described her life as “fine but unfulfilling.” She longed for more meaning and creativity, but feared disrupting the stability of her family life. She hoped that a personal counselor would help her find the contentment she was looking for without disappointing her family.

#### Techniques Used:

- Mindfulness Journaling: Daily writing exercises helped Sophia slow down and notice her suppressed desires, like her passion for storytelling.
- Strengths Assessment: Through structured exercises, Sophia identified empathy, curiosity, and creativity as underutilized strengths.
- Narrative Therapy: Sophia reframed her story from “I’m just a mother and wife” to “I am a creative individual who contributes meaningfully to my family and the world.”
- CBT for Guilt and Fear: We challenged beliefs like “I’m selfish for wanting more” and reframed them as “Nurturing my passions models authenticity for my children.”
- Relational Growth Work: Role-play and communication scripts helped Sophia assert her needs to her spouse. We used Gottman-style techniques (e.g., using “I statements”) to reduce defensiveness in conversations.
- Goal Setting: Sophia developed an action plan: attending a weekly writing group, writing for 20 minutes daily, and submitting work to a local magazine.

#### Personal Growth Counseling Outcome:

Sophia reignited her passion, felt revitalized, and strengthened her marriage through honest communication. She reported a sense of purpose and balance she hadn’t felt in years.

### Case Example 4: Older Adult Personal Growth Counseling

James, a successful engineer, was six months from retirement. While financially secure, he felt anxious about losing structure and feared becoming “irrelevant.” He expressed loneliness and uncertainty about how to use his time meaningfully. He hoped that a personal counselor would help him reach new levels of life satisfaction and meaning.

#### Techniques Used:

- Life Review and Narrative Therapy: We explored James’s personal story, identifying themes of mentorship, problem-solving, and creativity that had defined his career.
- Strengths-Based Reflection: James realized his greatest joys came from teaching younger engineers and volunteering in community projects.
- Existential Exploration: Together, we discussed questions of legacy, purpose, and mortality. This allowed James to acknowledge fears while clarifying what he wanted his retirement years to stand for.
- Mindfulness for Anxiety: Breathing and grounding techniques helped James reduce worry about the unknown future.
- Coaching/Goal Planning: We created a retirement plan including part-time teaching, volunteering, and starting a woodworking hobby he had postponed for decades.
- Relational Growth: Counseling also explored strengthening his connection with his wife, who was eager for shared adventures. They created joint goals (travel, community service).

#### Outcomes:

James entered retirement with enthusiasm rather than dread. He began teaching part-time at a community college and mentoring young professionals, while pursuing woodworking as a creative outlet. He reported that counseling turned “fear of irrelevance” into “excitement for a new chapter.”

## Integration of Personal Counseling Services

Personal counseling services can be integrated with other therapeutic services, including:

### Combining Personal Counseling Services with Couples Therapy

Personal growth counseling often dovetails with [couples therapy](https://dralanjacobson.com/couples-therapy/). For example:

- An individual learning assertiveness in personal counseling may bring these skills into couples sessions to improve communication.
- Exploring identity and self-esteem in [individual sessions can strengthen one’s role](https://dralanjacobson.com/individual-therapy/) in the relationship.
- [Marriage counseling](https://dralanjacobson.com/marriage-counseling/) can address relational patterns, while personal counseling focuses on individual growth, creating synergy.

### Combining Personal Counseling Services with Group Therapy

[Group therapy](https://dralanjacobson.com/group-therapy/) formats allow clients to practice growth in a supportive, interactive environment. Benefits include:

- Peer Feedback: Group members provide new perspectives and encouragement.
- Skill Practice: Communication, boundary-setting, and vulnerability can be practiced in real-time.
- Shared Normalization: Recognizing that others face similar struggles can help reduce feelings of shame and isolation.

For example, an adolescent may do personal growth counseling individually, then join a group focused on confidence-building with peers. Adults may pair individual counseling services with a personal counselor with a career development or mindfulness group.

### Virtual Delivery

Technology has made personal growth counseling more accessible and flexible:

- [Virtual Therapy](https://dralanjacobson.com/virtual-therapy-guide/) Platforms: Video sessions allow clients to receive counseling from home, which reduces barriers like travel and scheduling.
- Blended Models: Clients may alternate between in-person and online sessions for convenience.
- Digital Tools: Secure apps allow clients to journal, track goals, and complete exercises between sessions.
- Effectiveness: Research shows that online therapy can be as effective as in-person, especially for personal growth, goal-setting, and cognitive-behavioral interventions.

#### Advantages of Seeing a Virtual Personal Counselor:

- Accessibility for those in rural or underserved areas.
- Lower costs compared to traditional in-person sessions.
- Easier scheduling, reducing cancellations, and missed appointments.
- Greater privacy for clients hesitant to be seen entering a therapist’s office.

## Conclusion

Across life stages, including adolescence, young adulthood, midlife, and later life, personal growth counseling services provide a safe, structured, and empowering environment for transformation. By integrating empathy, [cognitive restructuring](https://dralanjacobson.com/cognitive-restructuring/), mindfulness, strengths exploration, narrative work, and goal-setting, clients learn not only to overcome obstacles but also to embrace opportunities for meaning and fulfillment. My role as a psychologist and personal counselor is to help clients discover that growth is possible at any age, and that it is never too late, or too early, to create a life that feels authentic, purposeful, and thriving.

### What Does a Personal Counselor Do?

Personal growth counseling services are about creating possibilities, not just treating problems. I have seen adolescents release the grip of perfectionism, young adults find purpose in their careers, and midlife adults rediscover passions they thought were lost forever. The work is empowering, forward-looking, and deeply human. Each client’s journey is unique, but the outcome is the same: a greater sense of clarity, strength, and fulfillment. My role as a psychologist is not to direct the journey, but to walk alongside my clients as they learn to thrive. You can read more about a similar approach in my posts about [Life Therapy](https://dralanjacobson.com/quality-of-life-therapy/) and [Life Therapists](https://dralanjacobson.com/life-therapists/).

If you’d like more information about personal growth counseling or any of my [therapy approaches](https://dralanjacobson.com/types-of-therapy/), don’t hesitate to [get in touch](https://dralanjacobson.com/contact/) with me or [schedule a consultation](https://www.picktime.com/scheduleaconsult#services/service) anytime.

## Frequently Asked Questions: Personal Growth Counseling

Common questions about personal growth counseling — what it is, who it helps, and how it differs from traditional therapy.

   What is personal growth counseling, and how is it different from therapy for mental illness? + Personal growth counseling is not about treating a diagnosable disorder — it is about unlocking potential, deepening self-awareness, and moving toward a more meaningful and fulfilling life. It emerged from the [humanistic psychology](https://dralanjacobson.com/humanistic-therapy/) tradition, built on Carl Rogers’ insight that empathy and unconditional positive regard create the conditions for genuine self-exploration, and Abraham Maslow’s concept of [self-actualization](https://www.simplypsychology.org/self-actualization.html) — the natural human drive toward meaning and fulfillment. Unlike symptom-focused treatment, personal growth counseling uses the same powerful techniques — [CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/), [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/), [strengths-based interventions](https://dralanjacobson.com/strength-based-therapy/), mindfulness — but adapts them toward growth, purpose, and self-actualization rather than symptom relief. It is for people who feel stuck, uncertain, or ready for change — not just those in crisis.

   Who typically seeks personal growth counseling — and do you need a “problem” to start? + No — you do not need a diagnosable problem to benefit from personal growth counseling. The people who seek it out are often high-functioning individuals who sense a gap between where they are and where they want to be: a teenager paralyzed by perfectionism, a young adult drifting in a career that doesn’t fit, a midlife parent who has lost touch with personal passions, or a retiree anxious about purpose and relevance. What they share is not dysfunction but a readiness for something more — more clarity, more authenticity, more intentionality. [Positive psychology research](https://www.apa.org/topics/personality/positive-psychology) by Seligman and Csikszentmihalyi consistently demonstrates that structured support for flourishing — not just symptom reduction — produces meaningful and lasting improvements in wellbeing, life satisfaction, and resilience. Personal growth counseling serves this population directly.

   What techniques are used in personal growth counseling sessions? + Personal growth counseling draws on a wide range of evidence-based approaches, always tailored to the individual. Core techniques include [CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) for identifying and reframing the limiting beliefs that block growth (“I’m not good enough,” “It’s too late to change”); [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/) to help clients examine and rewrite the personal stories shaping their self-concept; [strengths-based interventions](https://dralanjacobson.com/strength-based-therapy/) using tools like the [VIA Character Strengths inventory](https://www.viacharacter.org/) to identify underutilized assets; [Motivational Interviewing](https://dralanjacobson.com/motivational-interviewing/) to clarify values and resolve ambivalence about change; mindfulness and acceptance practices to reduce reactivity and increase intentionality; and goal-setting and action planning to translate insight into concrete forward movement. [Creative and experiential techniques](https://dralanjacobson.com/creative-counseling/) — journaling, expressive arts, vision work — are also used where they help clients access insight beyond what talk alone surfaces.

   How does personal growth counseling differ across life stages? + The core philosophy stays constant — facilitating authenticity, resilience, and purposeful living — but the focus shifts meaningfully at each life stage. In adolescence (12–18), the work centers on identity development, managing perfectionism, and building confidence. In young adulthood (18–30), it addresses career direction, independence, self-limiting beliefs, and forming healthy relationships. In midlife (30–65), the focus shifts to work-life balance, rediscovering passion, navigating parenting and partnership, and addressing the “I feel stuck” experience that often surfaces at this stage. In later adulthood and retirement (65+), the emphasis moves to redefining purpose, legacy, managing aging-related fears, and building meaningful structure for daily life. As illustrated in the four case examples on this page — Maya, Daniel, Sophia, and James — the same integrative toolkit produces very different conversations at each stage. See also the [life transitions therapy page](https://dralanjacobson.com/life-transitions-therapy/) for closely related work focused specifically on major change points.

   How is personal growth counseling different from life coaching? + Both personal growth counseling and life coaching focus on forward movement rather than pathology — but there are important distinctions. Life coaching typically focuses on goal-setting, accountability, and performance, and is generally delivered by practitioners without clinical training or licensure. Personal growth counseling is delivered by a licensed psychologist who can simultaneously address the emotional, cognitive, and relational dimensions that often underlie feeling stuck — the limiting beliefs, the identity confusion, the unresolved past experiences — while also building practical forward momentum. This matters because growth goals are rarely blocked by a simple lack of strategy; they are often blocked by deeper psychological material that coaching alone is not trained to address. Dr. Jacobson’s background as a licensed clinical psychologist with 25 years of experience means he can recognize and work with that deeper layer while keeping the focus forward-looking and growth-oriented. For more on how different types of clinicians differ, see the [therapist vs. psychologist guide](https://dralanjacobson.com/therapist-vs-psychologist-therapist-vs-psychotherapist/).

   Can personal growth counseling be combined with other services like couples therapy or group therapy? + Yes — and the combination often produces stronger outcomes than either service alone. Personal growth counseling frequently dovetails with [couples therapy](https://dralanjacobson.com/couples-therapy/): skills developed individually — assertiveness, emotional regulation, clearer self-knowledge — transfer directly into the relational work of [marriage counseling](https://dralanjacobson.com/marriage-counseling/). [Group therapy](https://dralanjacobson.com/group-therapy/) provides a parallel track where clients can practice growth skills — vulnerability, communication, boundary-setting — in a real-time social environment with peer feedback. Some clients also benefit from combining personal growth counseling with [executive coaching](https://dralanjacobson.com/executive-coaching/) or [early career coaching](https://dralanjacobson.com/early-career-coaching/) when professional growth goals are central. The integration is always built around what each individual client needs at their particular stage, and Dr. Jacobson coordinates across modalities to ensure the work is coherent rather than fragmented.

  ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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icon](data:image/svg+xml;base64,PHN2ZyB3aWR0aD0iMTYiIGhlaWdodD0iMTYiIHZpZXdCb3g9IjAgMCAxNiAxNiIgZmlsbD0ibm9uZSIgeG1sbnM9Imh0dHA6Ly93d3cudzMub3JnLzIwMDAvc3ZnIj4KPHBhdGggZD0iTTEyLjI2MzUgNC42ODE0MUMxMS43MzM3IDQuNjgyNDUgMTEuMzAyOSA0LjI1MzQ3IDExLjMwMTggMy43MjM2NUMxMS4zMDA4IDMuMTkzODQgMTEuNzI5OCAyLjc2MzA1IDEyLjI1OTggMi43NjIwMUMxMi43ODk5IDIuNzYwOTcgMTMuMjIwNyAzLjE5MDIxIDEzLjIyMTcgMy43MjAwMkMxMy4yMjI1IDQuMjQ5ODQgMTIuNzkzNSA0LjY4MDM4IDEyLjI2MzUgNC42ODE0MVoiIGZpbGw9IiM0MzQ5NjAiLz4KPHBhdGggZmlsbC1ydWxlPSJldmVub2RkIiBjbGlwLXJ1bGU9ImV2ZW5vZGQiIGQ9Ik04LjAwNzY1IDEyLjEwNzNDNS43MzkzOSAxMi4xMTE3IDMuODk2NzMgMTAuMjc2NiAzLjg5MjM0IDguMDA3NzdDMy44ODc5MiA1LjczOTQ4IDUuNzIzNTcgMy44OTY1NCA3Ljk5MTg0IDMuODkyMTNDMTAuMjYwNiAzLjg4NzczIDEyLjEwMzUgNS43MjM5MyAxMi4xMDc5IDcuOTkxOTdDMTIuMTEyMyAxMC4yNjA4IDEwLjI3NjIgMTIuMTAyOSA4LjAwNzY1IDEyLjEwNzNaTTcuOTk0NjkgNS4zMzM1N0M2LjUyMjQ0IDUuMzM2MTYgNS4zMzA2MyA2LjUzMjM5IDUuMzMzMjIgOC4wMDQ5MkM1LjMzNjA3IDkuNDc3NzIgNi41MzI1NSAxMC42NjkzIDguMDA0OCAxMC42NjY0QzkuNDc3NTggMTAuNjYzNiAxMC42Njk0IDkuNDY3NjEgMTAuNjY2NSA3Ljk5NDgxQzEwLjY2MzcgNi41MjIwMiA5LjQ2NzIyIDUuMzMwNzIgNy45OTQ2OSA1LjMzMzU3WiIgZmlsbD0iIzQzNDk2MCIvPgo8cGF0aCBmaWxsLXJ1bGU9ImV2ZW5vZGQiIGNsaXAtcnVsZT0iZXZlbm9kZCIgZD0iTTIuNzQ2MTQgMC40MzA5ODZDMy4yNTQxNyAwLjIzMTkxNyAzLjgzNTU2IDAuMDk1NTc0OCA0LjY4Njc3IDAuMDU1Mzk4OEM1LjU0MDA3IDAuMDE0NDQ4NCA1LjgxMjQ4IDAuMDA1MTE0MDEgNy45ODQ1OCAwLjAwMDk2ODQxNEMxMC4xNTcyIC0wLjAwMzE3NzE5IDEwLjQyOTYgMC4wMDUxMTI0MSAxMS4yODI5IDAuMDQyOTU1NkMxMi4xMzQ0IDAuMDc5NzYyIDEyLjcxNiAwLjIxNDAzMiAxMy4yMjUxIDAuNDExMDI5QzEzLjc1MTggMC42MTM5ODMgMTQuMTk4NyAwLjg4NzE4OCAxNC42NDQgMS4zMzA2OUMxNS4wODkzIDEuNzc0NyAxNS4zNjM1IDIuMjIwMDEgMTUuNTY5IDIuNzQ1OTRDMTUuNzY3OSAzLjI1NDUgMTUuOTA0MiAzLjgzNTM3IDE1Ljk0NDYgNC42ODcxMkMxNS45ODUxIDUuNTQwMTUgMTUuOTk0OSA1LjgxMjMxIDE1Ljk5OTEgNy45ODQ3QzE2LjAwMzIgMTAuMTU2OCAxNS45OTQ0IDEwLjQyOTUgMTUuOTU3MSAxMS4yODMzQzE1LjkyIDEyLjEzNDMgMTUuNzg2IDEyLjcxNjIgMTUuNTg5IDEzLjIyNUMxNS4zODU1IDEzLjc1MTcgMTUuMTEyOCAxNC4xOTg2IDE0LjY2OTQgMTQuNjQzOUMxNC4yMjU5IDE1LjA4OTUgMTMuNzggMTUuMzYzNSAxMy4yNTQxIDE1LjU2OTNDMTIuNzQ1NiAxNS43Njc4IDEyLjE2NDcgMTUuOTA0MiAxMS4zMTM1IDE1Ljk0NDlDMTAuNDYwMiAxNS45ODUzIDEwLjE4NzggMTUuOTk0OSA4LjAxNDkxIDE1Ljk5OUM1Ljg0MzA2IDE2LjAwMzIgNS41NzA2NSAxNS45OTQ5IDQuNzE3MzcgMTUuOTU3M0MzLjg2NTg4IDE1LjkyIDMuMjgzOTggMTUuNzg2IDIuNzc1MTcgMTUuNTg5MkMyLjI0ODQ4IDE1LjM4NTUgMS44MDE2MSAxNS4xMTMxIDEuMzU2MyAxNC42NjkzQzAuOTEwNzQgMTQuMjI1NiAwLjYzNjI1NyAxMy43OCAwLjQzMDk3MiAxMy4yNTQxQzAuMjMxOTA1IDEyLjc0NTggMC4wOTYwNzE0IDEyLjE2NDYgMC4wNTUzODE4IDExLjMxMzdDMC4wMTQ2OTA2IDEwLjQ2MDEgMC4wMDUxMDMzOCAxMC4xODc0IDAuMDAwOTU5Mzc2IDguMDE1MjlDLTAuMDAzMjAwNjIgNS44NDI5IDAuMDA1MzU3NzggNS41NzA3NCAwLjA0MjY3NzggNC43MTc0NEMwLjA4MDI2NjYgMy44NjU3IDAuMjEzNzU4IDMuMjg0MDQgMC40MTA3NTMgMi43NzQ3MUMwLjYxNDIxOSAyLjI0ODI2IDAuODg2ODk3IDEuODAxNjUgMS4zMzA5MSAxLjM1NjA5QzEuNzc0NCAwLjkxMDc3NiAyLjIyMDIyIDAuNjM2MDEyIDIuNzQ2MTQgMC40MzA5ODZaTTMuMjk0MzYgMTQuMjQ1M0MzLjU3NjYzIDE0LjM1MzkgNC4wMDAxNSAxNC40ODM1IDQuNzgwMDkgMTQuNTE3NEM1LjYyNDA1IDE0LjU1NCA1Ljg3Njc2IDE0LjU2MiA4LjAxMjMyIDE0LjU1NzlDMTAuMTQ4NiAxNC41NTQgMTAuNDAxNCAxNC41NDQ5IDExLjI0NTEgMTQuNTA1MkMxMi4wMjQyIDE0LjQ2ODIgMTIuNDQ3OCAxNC4zMzcgMTIuNzI5MiAxNC4yMjcxQzEzLjEwMjggMTQuMDgxMiAxMy4zNjg3IDEzLjkwNjcgMTMuNjQ4MSAxMy42MjcxQzEzLjkyNzUgMTMuMzQ2MyAxNC4xMDA0IDEzLjA3OTYgMTQuMjQ1MSAxMi43MDYxQzE0LjM1MzkgMTIuNDIzNiAxNC40ODMzIDExLjk5OTggMTQuNTE3MiAxMS4yMTk4QzE0LjU1NDMgMTAuMzc2NCAxNC41NjIgMTAuMTIzNCAxNC41NTc5IDcuOTg3M0MxNC41NTQgNS44NTE3MSAxNC41NDQ5IDUuNTk4NzMgMTQuNTA0OCA0Ljc1NTAzQzE0LjQ2OCAzLjk3NTYgMTQuMzM3MSAzLjU1MjA1IDE0LjIyNjkgMy4yNzA4MkMxNC4wODEgMi44OTY3OSAxMy45MDcxIDIuNjMxMzcgMTMuNjI2NiAyLjM1MTY5QzEzLjM0NjEgMi4wNzIgMTMuMDc5NCAxLjg5OTYzIDEyLjcwNTQgMS43NTVDMTIuNDIzNiAxLjY0NTg4IDExLjk5OTYgMS41MTY3OSAxMS4yMjAyIDEuNDgyODRDMTAuMzc2MiAxLjQ0NTc3IDEwLjEyMzIgMS40MzgyNSA3Ljk4NzE3IDEuNDQyNEM1Ljg1MTYyIDEuNDQ2NTUgNS41OTg5MSAxLjQ1NTEgNC43NTUyMSAxLjQ5NTAyQzMuOTc1NTMgMS41MzIwOCAzLjU1MjUxIDEuNjYyOTggMy4yNzA1IDEuNzczMTRDMi44OTcyNSAxLjkxOTA3IDIuNjMxMzEgMi4wOTI0OCAyLjM1MTY0IDIuMzczMkMyLjA3MjQ3IDIuNjUzOTEgMS44OTk1OSAyLjkyMDEyIDEuNzU0OTYgMy4yOTQ0MUMxLjY0NjYyIDMuNTc2NDMgMS41MTYyMyA0LjAwMDQ4IDEuNDgyOCA0Ljc3OTkxQzEuNDQ1OTkgNS42MjM4NyAxLjQzODIyIDUuODc2ODYgMS40NDIzNiA4LjAxMjQ0QzEuNDQ2MjYgMTAuMTQ4NSAxLjQ1NTMyIDEwLjQwMTUgMS40OTQ5OCAxMS4yNDQ3QzEuNTMxNTMgMTIuMDI0NyAxLjY2MzQ1IDEyLjQ0NzcgMS43NzMxMSAxMi43Mjk5QzEuOTE5MDMgMTMuMTAyOSAyLjA5Mjk2IDEzLjM2ODkgMi4zNzMxNSAxMy42NDg2QzIuNjUzODcgMTMuOTI3MiAyLjkyMDU5IDE0LjEwMDYgMy4yOTQzNiAxNC4yNDUzWiIgZmlsbD0iIzQzNDk2MCIvPgo8L3N2Zz4K) ](https://www.instagram.com/appliedpsychological) [ ![social network icon](data:image/svg+xml;base64,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) ](https://www.linkedin.com/company/psychologicalscience/)

---

### [College Admissions Counseling](https://dralanjacobson.com/college-admissions-counseling/)

**Published:** December 26, 2023
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: July 31, 2026

 # College Admission Counseling

Help with the admission process that is grounded in powerful performance psychology.

 [Schedule a Free Consultation](https://www.picktime.com/scheduleaconsult)

## College Admissions Counseling Service Overview

 **Interview Help**

If you experience [anxiety during interview situations](https://dralanjacobson.com/public-speaking-anxiety/), **college admissions counseling** will work on building your confidence. This will include general [public speaking](https://dralanjacobson.com/public-speaking-anxiety/) help and specifics like anticipating and practicing the questions admissions, a coach, or an alum ask you. We can reduce the anticipatory anxiety and the stress of the actual interviews,

### **Essay Prep**

The admissions essay is about capturing something about yourself and portraying it in a way that makes them want you there as a student. Choosing a topic and then writing about it well is something we’ll work on. I work closely with a highly regarded proofreader who can make sure the writing is perfect.

### **Application Preparation**

Beyond your essay, your application also captures who you are. It describes your chosen activities and, often, asks short answer questions about them. I can help you make this powerful and meaningful to the reader.

### **Choosing the Right Fit**

In most cases, you’ll have several schools to choose from. How will you decide which one you want to spend four years at? We will review your choices and decide which one(s) might best suit you.

 ![College admission Specialty Service](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "Active College Students | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

 [Learn More](https://dralanjacobson.com/contact/)

## College Admissions Counseling FAQ

##### What is College Admission Consulting?

I offer **College Admission Counseling services** that are grounded in the tents of [Performance Psychology](https://www.apa.org/education-career/guide/subfields/performance) and [Cognitive therapy](https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610). Those techniques will be tailored to your needs throughout the entire process. The goal is to have you present yourself in the most compelling way.

You want admissions to feel that you fit the person they seek. This specialty service can be quite helpful in the process.

##### How Can College Admissions Counseling Help?

There are three distinct (though related) ways that the College Admission Process can benefit from this approach:

#### College Admissions Counseling and the Interview

The interview and other contact points with the [college during the admission](https://dralanjacobson.com/college-admission-help/) process require the applicant to project clarity, confidence, and a fit for what the university is looking for. Performance Psychology techniques can fully prepare the student. Cognitive therapy can reduce anxiety and stress.

#### College Admissions Counseling and the Application

The application itself needs to capture who the student is. This includes what they have accomplished and why they are a fit. Performance psychology is quite helpful in helping the student truly get this section to hit home with the reader.

#### College Admissions Counseling and Your Essays

Your essays need to capture you in a deeper and more meaningful way. The psychology involved is significant and vital. We can make sure that the essay is memorable and important. This is the core of the [college admissions help](https://dralanjacobson.com/college-admission-help/) I provide.

It also helps in other ways. For example, I use [motivational interviewing techniques](https://dralanjacobson.com/motivational-interviewing/) for the student who feels stuck and is having trouble with one of the steps in the application process.

##### What Does the Service Provide

This service uses empirically proven effective methods that are known to help with [college and private school admissions](https://dralanjacobson.com/college-admission-help/). We will also regularly use information gathered from those conducting these interviews and pass along what they seek. I offer 24/7 support so that you can get that boost, reminders, and support right before specific occurrences, such as an interview or meeting with a coach.

### What I Do Not Provide

I should note that there are three aspects of the [college admission](https://dralanjacobson.com/college-admission-help/) process that I do not do:

– As far as your essay, I will help you develop a good idea (unless you already have one) and then provide a first proofread. However, some people have direct professional experience and expertise in writing. I can refer you to someone in my trusted network.

– When we build your list, we will not prioritize sports ahead of academics. I know that playing sports in college can increase the enjoyment of the four-year experience and lead to wonderful growth and life lessons. However, I need evidence that you are choosing a school based on academics and sports.

– Also, and related to this, I cannot help with the financial part of the decision-making. Your parents and you need to have that discussion before I am involved – where can you afford to go, and under what circumstances regarding scholarships and other financing?

##### What is the goal of college admissions counseling?

The goals of college admissions counseling are threefold: First, I want to help you present your most compelling self to the admissions departments and everyone involved (coaches, alumni, etc.). Second, I want you to learn and grow from the process, understanding your hopes, dreams, and challenges. Then, when you do attend college, you are truly ready. Finally, I want to help you distress during the process. This includes learning coping strategies to manage the inevitable anxiety and frustration that you encounter.

##### What are the results

I cannot guarantee that you will get into the college that is your top choice. The [college admission](https://dralanjacobson.com/college-admission-help/) process is incredibly competitive and unpredictable. I can say that I can give you the best chance to present the best application you can. In doing so, you will represent who you are, what you are capable of, and why they would be proud to have you there.

I can help you reduce your anxiety and stress during the [process and perform](https://dralanjacobson.com/sports-performance-psychology/) at your best on tests, interviews, sports ID camps, alumni meetings, etc. We will work together on building your case, and then, hopefully, you can relax after getting your application in and doing the appropriate follow-up, knowing that you’ve put your best foot forward.

### More About College Admissions Counseling from my Blog

##  [College Admissions Self-Help](https://dralanjacobson.com/college-admissions-self-help/)

by [Dr. Alan Jacobson](https://dralanjacobson.com/author/alanjacobson/ "Posts by Dr. Alan Jacobson") | Jun 27, 2023

---

### [Contact](https://dralanjacobson.com/contact/)

**Published:** December 26, 2023
**Author:** Dr. Alan Jacobson

**Content:**

# CONTACT INFO

Serving most of the United States Virtually
[📞 +1 (617) 680-5488](tel:+16176805488)
[✉️ hello@dralanjacobson.com](mailto:hello@dralanjacobson.com)

66 Fairview St, Westwood, MA 02090

99 Stepping Stones Rd, Lee, NH 03861

## Questions I Can Answer

R

##### Wondering if Virtual Therapy can be effective for your concern

R

##### Get a basic idea of the therapeutic approaches I'd use

R

##### Ask questions about a particular clinical approach 

R

##### Ask about fees, insurance coverage, and anything about the payment process

R

##### Ask to schedule a consultation to talk more

R

##### Ask about my background, experience, training, or expertise

I’d be happy to talk to you about any of these topics so you can decide [if I am a good match](https://dralanjacobson.com/my-bio/) or if therapy is a good choice, whether with me or someone else. We will not get into too much detail before treatment starts, but I can share enough general information to help you find answers and make decisions.

## Questions I Cannot Answer

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##### Questions about specialties I do not provide (although I may be able to refer you to someone who can answer)

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##### Questions about medication or medical treatments

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##### Questions you are asking on behalf of someone else who is not your dependent, except for very basic inquiries

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##### Inquiries about legal matters

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##### Inquiries made during an emergency. Please contact 911 or your local emergency providers

When you contact me through this site, remember that we are [not establishing a clinical relationship](https://dralanjacobson.com/practice-policies/), so I cannot provide information about specific techniques or methods you should try. This also means that you should contact a local emergency service provider if your concern is urgent or an emergency. This page and the consultation sign up page are designed for inquiries about possible therapy, and no therapeutic relationship is made until and unless we decide to start treatment.

## Website Disclaimer – Important Notice

### Informational Purposes Only

The content on this website is provided for general educational and informational purposes only. It is not intended to diagnose, treat, cure, or prevent any mental health or medical condition, and it is not a substitute for individualized professional advice, diagnosis, or treatment. Always seek the guidance of a qualified mental health professional with any questions you may have regarding a mental health condition.

### No Therapist–Client Relationship

Browsing this website, submitting a contact form, or exchanging preliminary emails or phone messages does not create a therapist–client (or psychologist–patient) relationship. A clinical relationship begins only after mutual agreement, completion of intake procedures, and execution of a signed informed consent and service agreement.

### Not for Urgent or Emergency Situations

This website, its contact form, email address, and voicemail are not monitored continuously and must never be used to report a crisis, an emergency, or an urgent safety concern.

**If you or anyone else is in immediate danger, or you are experiencing a mental health crisis:**

- Call 911 or go to your nearest emergency room.
- Call or text 988 to reach the Suicide & Crisis Lifeline (available 24/7 across the U.S.).
- Text HOME to 741741 to reach the Crisis Text Line.
- Contact your local emergency services or crisis line if you are outside the U.S.

Do not wait for a response through this website, email, or voicemail if you are in crisis. Messages sent through this site are not reviewed in real time.

### Confidentiality of Electronic Communication

Standard email, text messages, and website contact-form submissions are not encrypted and cannot be guaranteed to be fully secure or HIPAA-compliant. Please avoid sending protected health information, detailed clinical history, or other sensitive personal information through this website’s contact form or unencrypted email. Secure communication channels are used only after a formal service relationship and consent process have been established.

### No Guarantee of Outcomes

Therapy outcomes vary by individual and depend on many factors outside a therapist’s control. Nothing on this website should be construed as a guarantee or promise of any specific therapeutic result.

### Professional Credentials & Licensure

Dr. Alan Jacobson, Licensed Psychologist, is licensed to provide psychological/therapeutic services in 44 states in the US. Services are provided only to individuals located in jurisdictions where Dr. Jacobson is licensed and authorized to practice.

*Last reviewed/updated: July, 2026. This disclaimer is reviewed periodically and may be updated without notice.*

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### [ADHD Therapy for Adults](https://dralanjacobson.com/adhd-therapy-for-adults/)

**Published:** June 14, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**ADHD therapy for adults** is a core service I provide. I have seen people make incredible gains in overcoming barriers and realizing some of the positive attributes of Attention-Deficit/Hyperactivity Disorder, particularly when they better manage challenges. **Cognitive behavioral therapy for adult ADHD** is my usual approach, but I also mix in other **adult attention deficit treatments** customized for each individual.

## ADHD Therapy for Adults Overview

The following is a general overview of adult attention deficit treatments. Please also see my post, which is specific to [women with an attention deficit](https://dralanjacobson.com/women-with-adhd/), and my related post about [ADHD treatment for teens](https://dralanjacobson.com/adhd-treatment-for-teens/).

### ADHD Therapy for Adults: Clinical Approaches

Cognitive Behavioral Therapy for Adult ADHD helps people address problematic thoughts and behaviors, improve self-esteem, and develop skills to manage everyday tasks. Key components include learning time management and organizational skills, coping mechanisms for stress and frustration, and strategies to reduce procrastination and improve task completion. I will go over cognitive behavioral therapy for adult ADHD in depth in a later section.

### Coaching and Support

Part of ADHD therapy for adults involves helping clients develop personalized strategies for managing daily life, improving organization, and achieving personal goals. I often assist people in creating structured environments at home and work to reduce distractions and increase productivity. My work includes helping people develop better time management, task prioritization, and effective communication.

### Mindfulness and Lifestyle Approaches

I teach [mindfulness practices](https://dralanjacobson.com/mindfulness-therapy/), such as meditation, which can help improve focus, reduce stress, and increase overall well-being. Integrating mindfulness exercises can improve focus and awareness of the present moment. For some, meditation can reduce impulsivity and improve attention.

I also often review lifestyle modifications supporting adult attention deficit treatments, such as regular physical activity that can improve mood, focus, and cognitive function and a balanced diet with adequate nutrients to support brain health.

### Technology and Apps to Support ADHD Therapy for Adults

Various apps are designed to help adults manage symptoms by setting reminders and alarms, organizing tasks and schedules, and tracking habits and progress. Apps can also provide education that enhances understanding and support. This involves learning about the disorder’s nature, its impact on daily life, and effective management strategies.

### Adult Attention Deficit Treatments and Relapse Prevention

To maintain progress, I help clients develop strategies to preserve the gains made during therapy and prevent relapse. This may include creating plans to handle future setbacks or stressful situations.

## Cognitive Behavioral Therapy for Adult ADHD

[Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) (CBT) is a highly effective approach for managing ADHD in adults. It focuses on changing unhelpful thinking and behavior patterns and developing coping strategies for daily challenges. Here’s a detailed look at how cognitive behavioral therapy for adult ADHD works.

### Core Components of Cognitive Behavioral Therapy for Adult ADHD

1. Psychoeducation: Educating individuals about ADHD, its symptoms, and how it affects their daily lives is key to helping them understand their symptoms and ways to manage them. This includes increasing awareness of how ADHD manifests in their thoughts, feelings, and behaviors. The result is better communication and interpersonal skills to navigate social interactions and reduce misunderstandings.
2. Cognitive Restructuring: The main goal of cognitive behavioral therapy for adult ADHD is to help clients recognize negative thought patterns contributing to frustration, failure, or low self-esteem. This is followed by teaching techniques to challenge and reframe these negative thoughts into more positive and realistic ones.
3. Specific cognitive techniques such as “[Thought Records](https://positivepsychology.com/thought-records/),” which involve keeping a diary of thoughts, feelings, and behaviors to identify patterns and triggers, and Socratic Questioning, which uses structured questioning to challenge and reframe negative thoughts, are helpful.
4. Behavioral Interventions: Through cognitive behavioral therapy for adult ADHD, you will develop strategies to manage time effectively, such as breaking tasks into smaller steps, setting priorities, and using timers or alarms. You might also learn methods to organize physical spaces (e.g., home, office), tasks (e.g., to-do lists, calendars), and techniques to overcome procrastination, such as setting short-term goals and using rewards.

You’ll also learn to create and maintain daily routines to provide structure and reduce the likelihood of forgetting important tasks and techniques for developing positive habits and breaking negative ones.

Cognitive Behavioral Therapy for Adult ADHD provides practical tools and strategies for managing symptoms and improving quality of life. Individuals can better control their symptoms and lead more productive and fulfilling lives by changing unhelpful thoughts and behaviors and developing new skills.

### Adjunctive Adult Attention Deficit Treatments

Methods such as deep breathing, [mindfulness techniques](https://dralanjacobson.com/mindfulness-therapy/), and relaxation exercises can help clients cope with stress and anxiety. Strategies to manage emotions and respond more calmly to frustrating situations are also used.

## Effectiveness of ADHD Therapy for Adults

I have seen that ADHD therapy for adults has many benefits, including:

- Improved focus and attention
- Better organizational and time management skills
- Reduced procrastination and avoidance behaviors
- Enhanced emotional regulation and stress management
- Increased self-esteem and confidence
- Improved overall functioning and quality of life

## Adult Attention Deficit Treatments in My Practice

Combining several approaches often yields the best results, and this is what I try to do with adult attention deficit treatments in my integrated practice. [I work with each client](https://dralanjacobson.com/individual-therapy/) to develop a comprehensive treatment plan tailored to their needs and preferences.

### ADHD Therapy for Adults Example

Here is a fictitious example of therapy for adult ADHD, woven together from actual treatment courses in my practice

#### Assessment and Goal Setting

Jen is a 34-year-old concerned that her lack of focus, poor short-term memory, and disorganization affect her work. She works as a paralegal and has had excellent job reviews, but now she has been promoted to a more demanding position. It is a great opportunity for her, but she realizes the new job responsibilities could tap into her weaknesses more than her prior job. She is also concerned because, at home, she realizes that her symptoms make it hard for her to keep track of her children’s busy schedules and help them with their homework.

My first step is to do a comprehensive evaluation of Jen’s ADHD symptoms. We identify specific areas of difficulty, which include time management, organization, and a lack of focus. We create clear, measurable, achievable goals for therapy, including reducing procrastination, improving focus and [working memory](https://en.wikipedia.org/wiki/Working_memory), and enhancing organizational skills.

#### ADHD Therapy for Adult ADHD Psychoeducation

Once we have developed the treatment plan, the next step is to educate Jen about attention deficit hyperactivity disorder and its symptoms, how it affects daily life, and where it comes from. We’ll explore how symptoms impact work, relationships, and self-esteem in more detail.

We’ll discuss common myths and misconceptions about the diagnosis and go over its positive aspects, including increased energy, creativity, resilience, and hyper-focus on tasks she is most interested in.

#### Cognitive Restructuring

Next, we will identify negative thoughts that Jen has that come automatically but are irrational or distorted. These thoughts impact her self-esteem and create additional distractions that interfere with her focus. These distorted thinking patterns contribute to feelings of inadequacy or frustration. She realizes that she often has thoughts about failing due to her symptoms, being an “imposter” in her new role, and letting people down.

It will be important for Jen to challenge and replace these automatic thoughts. For homework, she’ll focus on noticing them as they occur and challenging them by replacing them with more realistic and positive ones. This will include replacing thoughts of how her attention deficit negatively impacts her with thoughts about how it can work in her favor, confronting her imposter thoughts with the fact that even before entering therapy for adult ADHD, she received very positive evaluations, and explaining how her treatment will successfully improve her organization skills.

Part of her homework will be to keep a journal to track negative thoughts and practice reframing them. This homework will help her work on challenging negative thoughts while providing an example of staying organized. Adult attention deficit treatments often include homework like this so you can practice skills in real-time.

#### Behavioral Interventions

Along with cognitive behavioral therapy for adult ADHD, Jen needs to work on skill development that will help her manage her symptoms. We break up this learning into three categories:

1. Time Management: Jen will learn to create schedules, set priorities, use timers, and incorporate tools such as planners and task lists. She will use an app that helps organize all of these goals.
2. Organization Skills: I teach Jen skills such as decluttering, developing better e-filing systems, using organizational apps, and staying organized through labeled storage and color-coding.
3. Procrastination Reduction: Jen will break tasks into smaller steps, setting deadlines, using self-rewards (she only gets Starbucks the next day if she completes the tasks she had assigned herself, for example), and using task breakdown charts.

#### Skills Training

As part of therapy for adult ADHD, we will also work on specific skills in three categories:

1. Problem-Solving Skills: Jen will learn to proactively identify short- and long-term challenges she may face in her new professional role, generate solutions, and evaluate outcomes.
2. Social Skills Training: Jen realizes that sometimes she talks fast and interrupts people when excited about expressing an idea. We work on enhancing her communication skills.
3. Impulse Control: Jen wants to work on jumping from one task to another or one topic to another before she has successfully completed the one prior. We talk about delay strategies (e.g., counting to 10 before moving on) and using physical reminders of what she needs to get done.

#### Stress Management and Relaxation Techniques

Jen decides to learn mindfulness and relaxation techniques such as deep breathing, progressive muscle relaxation, and guided imagery. I help with some of this and point her toward meditation apps, yoga classes, and relaxation recordings. She also decides to engage in regular physical activity, which reduces her symptoms.

Adult attention deficit treatments like the one described above are structured and goal-oriented, focusing on building practical skills and strategies to manage symptoms and improve daily functioning. Regular practice and reinforcement of these skills can significantly improve quality of life. That example was general, and we can work on developing a plan that fits your unique needs.

Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) to discuss ADHD therapy for adults or any aspect of my practice further. I also provide [natural treatment for ADHD in adults](https://dralanjacobson.com/natural-adhd-treatment-for-adults/) that is more holistic and [CBT for ADHD](https://dralanjacobson.com/cbt-for-adhd/) in adolescents. I also have a subspecialty in [therapy for girls with ADHD](https://dralanjacobson.com/therapy-for-girls-with-adhd/).

## Frequently Asked Questions: ADHD Therapy for Adults

Common questions about adult ADHD treatment — what it involves, how long it takes, and how to get started.

   Does ADHD therapy for adults actually work — and how is it different from therapy for children?Yes — and the evidence base for adult ADHD treatment is substantial and growing. The [National Institute of Mental Health](https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd) recognizes psychotherapy — particularly Cognitive Behavioral Therapy (CBT) — as an effective treatment for ADHD across the lifespan. Adult ADHD therapy differs from child-focused treatment in several important ways. Adults typically carry a longer history of accumulated consequences — professional setbacks, relationship difficulties, damaged self-esteem — that become central to the therapeutic work. Adults also have more autonomy in designing and implementing change, which means therapy can move faster and be more immediately practical. The focus shifts from parental management and school accommodation toward self-management, executive functioning in complex work environments, relationship functioning, and emotional regulation. Many adults find that therapy helps them not only manage symptoms but also reframe their understanding of their own history — what looked like failure often turns out to have been undiagnosed ADHD.

  What is CBT for adult ADHD, and why is it the primary approach?[Cognitive Behavioral Therapy (CBT)](https://dralanjacobson.com/cbt-for-adhd/) for adult ADHD is a structured, skills-based approach that targets both the thinking patterns and the behavioral habits that sustain ADHD-related impairment. On the cognitive side, this means identifying and restructuring the automatic negative thoughts — “I’m lazy,” “I’ll never get organized,” “I always fail at this” — that accumulate over years of unmanaged symptoms and erode self-efficacy. On the behavioral side, CBT builds concrete systems for time management, task initiation, organization, and procrastination reduction. Research published in peer-reviewed journals including [the Journal of the American Academy of Child and Adolescent Psychiatry](https://www.jaacap.org/) consistently shows that CBT for adult ADHD produces significant improvements in executive functioning, emotional regulation, and quality of life — particularly when combined with medication where indicated. It is the primary approach because it is both evidence-based and highly practical: clients leave sessions with tools they can apply immediately.

  What other approaches are used alongside CBT in adult ADHD treatment?Dr. Jacobson takes an integrative approach, combining CBT with additional methods tailored to each client’s needs. [Mindfulness-based techniques](https://dralanjacobson.com/mindfulness-therapy/) — including breath-focused attention training and body scan practices — improve sustained attention and reduce impulsive reactivity. [Acceptance and Commitment Therapy (ACT)](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) is particularly useful for clients whose ADHD-related shame and self-criticism have become barriers to engaging with treatment; ACT helps clients defuse from unhelpful thoughts and act in alignment with their values even when symptoms are present. [Executive functioning coaching](https://dralanjacobson.com/executive-functioning-coaching/) addresses the practical scaffolding of daily life — calendar systems, organizational tools, workflow design — in a structured, accountability-based format. For clients whose ADHD intersects with anxiety, [Schema Therapy](https://dralanjacobson.com/schema-therapy/) and [cognitive restructuring](https://dralanjacobson.com/cognitive-restructuring/) address the deeper belief systems that developed in response to years of struggling. The blend evolves as treatment progresses and the client’s needs shift.

  I was recently diagnosed with ADHD as an adult. Is therapy still useful if I’m already on medication?Absolutely — and for most adults, therapy and medication together outperform either alone. Medication can significantly reduce symptom intensity, improving the signal-to-noise ratio in daily functioning. But medication does not teach the skills, habits, and cognitive patterns that sustained ADHD management requires. A newly diagnosed adult typically carries years of accumulated avoidance strategies, organizational workarounds that no longer scale, and deeply internalized beliefs about their own capability — none of which medication addresses directly. Therapy provides the structure to understand how ADHD has specifically shaped your professional and personal history, build systems that fit your actual neurology rather than

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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---

### [Adult Sibling Therapy](https://dralanjacobson.com/adult-sibling-therapy/)

**Published:** January 4, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Sibling relationships are often the longest-lasting family connections in a person’s life. However, they can also be complex, shaped by childhood dynamics, family roles, and life transitions. **Adult sibling therapy** offers a space to address these dynamics, heal past wounds, and build healthier, more supportive relationships. I provide **family therapy for adult siblings**, and my virtual approach allows me to see people who live in different places. This post goes over some common reasons people seek this form of treatment and some common **exercises for adult siblings in therapy** to give you an idea of what treatment might be like.

## Adult Sibling Therapy Overview ![Adult Sibling Therapy](https://dralanjacobson.com/wp-content/uploads/2025/01/pathway3.jpg "pathway3 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

The following provides a basic overview of family therapy for adult siblings. As you will see, most of the techniques and exercises for adult siblings in therapy follow other family therapy methods but are uniquely tailored to sibling dynamics.

---

### Why Adult Sibling Therapy

1. **Unresolved Childhood Dynamics:** Rivalry, favoritism, or competition can linger into adulthood.
2. **[Life Transitions](https://dralanjacobson.com/life-transitions-therapy/):** Events like aging parents, inheritance disputes, or caregiving responsibilities can strain relationships.
3. **Communication Breakdowns:** Misunderstandings and poor communication habits formed in childhood can persist.
4. **[Grief and Loss](https://dralanjacobson.com/grief-therapy/):** Losing a parent or other family member can bring families closer or drive them apart.
5. **Estrangement or Distance:** Therapy can help reconnect estranged relationships or navigate intentional distance.

### Goals of Adult Sibling Therapy

- Improve communication skills
- Heal past emotional wounds
- Understand and redefine sibling roles
- Navigate caregiving and family responsibilities
- Foster empathy and mutual respect
- Build healthier boundaries

### Therapeutic Approaches Commonly Used:

1. **[Family Systems Therapy](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/):** Explores family roles and how they impact sibling relationships.
2. **[Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT):** Helps reframe negative thought patterns.
3. **[Narrative Therapy](https://dralanjacobson.com/narrative-therapy/):** Encourages siblings to share their perspectives and rewrite their shared “family story.”
4. **[Emotionally Focused Therapy](https://dralanjacobson.com/emotionally-focused-family-therapy/) (EFT):** Focuses on creating secure emotional bonds between siblings.

The techniques and exercises for adult siblings in therapy I choose are often a mix of the above, uniquely formulated to the family’s needs.

---

### Signs It Might Be Time for Therapy:

- Frequent misunderstandings or arguments
- Long periods of estrangement
- Difficulty discussing emotional topics
- Feeling like you “walk on eggshells” around each other
- Wanting closeness but not knowing how to achieve it
- A life transition has occurred

---

### How to Start Adult Sibling Therapy:

1. **Discuss Goals Openly:** Identify what you hope to achieve from therapy (this can be done in the first session.
2. **Decide on Individual vs. Joint Sessions:** Sometimes, it’s helpful to start individually before meeting together.
3. **Commit to the Process:** Healing relationships takes time and effort. You may get homework exercises for adult siblings in therapy that everyone must do.

## Family Therapy for Adult Siblings Experiencing Conflict

Conflict between adult siblings is common and can stem from deep-rooted dynamics, life transitions, or current disagreements. Therapy for adult siblings can provide tools to address these conflicts constructively, rebuild trust, and improve communication.

---

### Common Causes of Conflict

1. **Childhood Roles and Rivalries:** Old patterns (e.g., the “golden child” vs. the “rebel”) can resurface in adulthood.
2. **Parental Favoritism:** Perceptions of unequal treatment by parents can create long-term resentment.
3. **Inheritance and Financial Disputes:** Disagreements over wills, estates, or financial responsibilities often cause tension.
4. **Caregiving Responsibilities:** Uneven distribution of care for aging parents can lead to feelings of unfairness.
5. **Life Choices and Values:** Differing lifestyles, parenting styles, or values may cause judgment or friction.
6. **Communication Breakdowns:** Poor communication habits can escalate minor issues into major rifts.
7. **[Unresolved Trauma or Grief](https://www.choosingtherapy.com/unresolved-grief/):** Shared family traumas or loss can bring up emotions that manifest as conflict.

---

### How Adult Sibling Therapy Can Help Resolve Conflict

1. **Facilitating Open Communication:** I create a neutral space where both sides can express their feelings without interruption or judgment.
2. **Identifying Core Issues:** The process uncovers the root causes of the conflict rather than just surface-level arguments.
3. **Setting Boundaries:** Learning to set and respect healthy emotional and physical boundaries is key to preventing further conflict.
4. **Developing Empathy:** Families can learn to see situations from each other’s perspectives. Several exercises for adult siblings in therapy are explicitly designed to do this.
5. **Conflict Resolution Skills:** I provide tools for managing disagreements without escalating tension.
6. **Healing Old Wounds:** Addressing past hurts and validating each other’s experiences can lead to forgiveness.

---

### Sibling Therapy Approaches to Manage Conflict

- **Family Systems Therapy:** Examines how family roles and structures influence sibling conflict.
- **Mediation-Based Therapy:** A structured approach focusing on compromise and resolution.
- **Cognitive-behavioral therapy (CBT):** Helps reframe negative assumptions about each other.
- **Emotionally Focused Therapy (EFT):** Strengthens emotional bonds by addressing attachment needs.

---

### Exercises for Adult Siblings in Therapy Due to Conflict Conflict

1. **Reflect on Your Role:** Acknowledge your contributions to the conflict.
2. **Reach Out with Openness:** Express a willingness to resolve the issue without blame.
3. **Focus on Specific Issues:** Exercises for adult siblings in therapy often address one problem at a time instead of generalizing.
4. **Set Clear Boundaries:** Know your limits and communicate them respectfully.
5. **Prioritize Active Listening:** Make an effort to hear others’ perspectives truly.
6. **Agree on Ground Rules:** Establish discussion guidelines (e.g., no yelling, taking breaks when needed).

---

## Adult Sibling Therapy for Caretaking and Loss

When aging parents require care or after a significant family loss, relationships can be deeply affected. These situations often reveal old patterns, unspoken resentments, and emotional vulnerabilities. Family therapy for adult siblings can provide tools for siblings to work together, manage responsibilities, and support each other through grief.

---

### Common Challenges in Caregiving and Grief

1. **Unequal Division of Responsibilities:** One person may feel burdened while others contribute less.
2. **Differing Expectations:** There may be contrasting views on caregiving approaches or funeral arrangements.
3. **Old Family Roles Resurfacing:** Childhood roles (e.g., the responsible one, the carefree one) can re-emerge.
4. **Resentment and Guilt:** Feelings of guilt for not doing enough or resentment towards others perceived as absent can fester.
5. **Emotional Responses to Grief:** Everyone grieves differently—some may withdraw, while others might become overly controlling.
6. **Financial Disputes:** Costs related to caregiving, funerals, or inheritance can cause tension.

---

### How Exercises for Adult Siblings in Therapy Can Help with Caregiving and Grief

1. **Facilitating Open Dialogue:** Family therapy for adult siblings provides a neutral space for siblings to share feelings and frustrations.
2. **Clarifying Roles and Responsibilities:** Families can define clear caregiving tasks together.
3. **Processing Grief Together:** Family therapy for adult siblings helps validate different grieving styles and foster emotional connection.
4. **Managing Resentment and Guilt:** Addressing these emotions prevents them from causing further damage to relationships.
5. **Improving Communication Skills:** I teach each member to express needs and boundaries respectfully.
6. **Creating a Unified Plan:** Family therapy for adult siblings can help siblings agree on care strategies or financial arrangements.

---

### Key Exercises for Adult Siblings in Therapy for Caregiving and Grief

#### 1. Open and Honest Communication:

- Regular family meetings to discuss updates and responsibilities.
- Share feelings without judgment.

#### 2. Acknowledge Different Grieving Styles:

- Understand that everyone processes grief uniquely.
- Avoid criticizing how another sibling expresses (or suppresses) their grief.

#### 3. Share Responsibilities Fairly:

- Play to each other’s strengths (e.g., one might handle finances while another provides emotional support).
- If possible, involve professional caregiving to help reduce the burden.

#### 4. Address Financial Concerns Early:

- Be transparent about expenses and inheritance expectations.
- Use a mediator if disagreements arise.

#### 5. Show Compassion for Each Other:

- Remember that stress and sadness can make emotions run high.
- Extend grace and understanding during difficult moments.

---

### Sibling Therapy Approaches for Caregiving and Grief Conflicts

- **Family Systems Therapy:** Addresses family roles and how they impact caregiving and grief dynamics.
- **[Grief Counseling](https://dralanjacobson.com/grief-therapy/):** Helps the family process loss together.
- **Mediation Therapy:** Supports resolving practical disputes (e.g., financial concerns).
- **Emotionally Focused Therapy (EFT):** Strengthens emotional bonds during vulnerable times.
- **[Attachment-based therapy](https://dralanjacobson.com/attachment-therapy/)**: When there has been trauma in the family dynamic

---

### Tips for Starting the Conversation

- Choose a neutral time and space to talk.
- Use “I” statements (e.g., “I feel overwhelmed with caregiving duties”).
- Be clear about your needs and ask about theirs.
- Suggest adult sibling therapy if conversations become too tense or unproductive.

---

## Adult Sibling Therapy to Improve Closeness and Communication

Family therapy for adult siblings and intentional effort can help siblings rebuild trust, deepen emotional bonds, and communicate more effectively.

---

### What’s Behind the Struggle with Closeness and Communication?

1. **Busy Lives:** Careers, relationships, and parenting often leave little time for connection.
2. **Childhood Patterns Persist:** Roles established in childhood can prevent authentic adult relationships.
3. **Unresolved Conflicts:** Past grievances, even unspoken ones, can create emotional distance.
4. **Different Communication Styles:** Individuals may express themselves in vastly different ways.
5. **Geographical Distance:** Living far apart can make maintaining closeness challenging.
6. **Fear of Vulnerability:** Opening up emotionally might feel risky, especially if past attempts weren’t well-received.

---

### Benefits of Sibling Therapy for Adults Struggling with Closeness and Communication

- Increased emotional support during life’s challenges
- Stronger family connections for future generations (e.g., cousins bonding)
- Reduced resentment or misunderstandings
- Enhanced ability to collaborate during family transitions (e.g., caregiving for parents)

---

### How Family Therapy for Adult Siblings Can Help

1. **Facilitating Safe Conversations:** I create a neutral, judgment-free space for open dialogue.
2. **Addressing Misunderstandings:** Past miscommunications are clarified and reframed.
3. **Identifying Emotional Barriers:** The group explores what prevents them from opening up or staying connected.
4. **Teaching Active Listening Skills:** Members learn to listen without interrupting or dismissing feelings.
5. **Practicing Vulnerability:** Adult sibling therapy encourages honest emotional expression in a safe setting.
6. **Establishing Boundaries:** Healthy boundaries foster respect and reduce unnecessary conflict.

---

### Exercises for Adult Siblings in Therapy to Strengthen Closeness and Communication

#### 1. Make Time for Regular Connection:

- Schedule phone calls, video chats, or meetups.
- Celebrate milestones (e.g., birthdays, promotions).

#### 2. Practice Active Listening:

- Listen without interrupting.
- Reflect back what you hear (e.g., “It sounds like you felt hurt when that happened”).

#### 3. Address Resentments Directly:

- Bring up old hurts calmly and with a focus on resolution.
- Use “I” statements to express your feelings (e.g., “I felt left out when…”).

#### 4. Share More About Your Life:

- Open up about your challenges and successes.
- Invite your sibling to do the same.

#### 5. Accept Differences:

- Respect others might have different values, parenting styles, or life choices.
- Focus on what connects you rather than what divides you.

#### 6. Create New Traditions:

- Plan sibling trips, game nights, or regular dinners.
- Build rituals that create positive shared memories.

---

### Sibling Therapy Techniques for Closeness and Communication:

- **Family Systems Therapy:** Examines how past family roles impact present dynamics.
- **Emotionally Focused Therapy (EFT):** Builds emotional safety and connection.
- **Narrative Therapy:** Helps siblings reframe shared stories in a healthier light.
- **Conflict Resolution Therapy:** Provides tools to navigate disagreements constructively.

---

## Adult Sibling Therapy Case Example

Maria (35) and Alex (38) are adult siblings who have been increasingly distant over the past five years. Growing up, Alex was seen as the “responsible” older sibling, while Maria was labeled the “free spirit.” Their parents unintentionally reinforced these roles, often relying on Alex for serious matters and dismissing Maria’s concerns as overly emotional.

Recently, their mother has started requiring more care. Alex, who lives nearby, has taken on most of the caregiving responsibilities, while Maria, who lives in another state, contributes financially but visits infrequently.

---

### The Conflict:

- **Alex’s Perspective:** Alex feels overwhelmed and abandoned by Maria, believing she isn’t pulling her weight in caring for their mother. Alex feels unappreciated and resentful.
- **Maria’s Perspective:** Maria feels excluded from decisions and judged by Alex for not living closer. She believes her financial contributions go unnoticed and feels hurt when Alex brushes off her emotional concerns.

Their interactions have become strained, with conversations often escalating into arguments or ending in silence.

---

### Adult Sibling Therapy Techniques Chosen

1. **Family Systems Therapy:**
    - I helped them recognize how their childhood roles (responsible vs. free spirit) were still influencing their interactions.
    - Maria expressed feeling dismissed in family discussions, while Alex admitted to feeling burdened by always being the responsible one.
2. **Conflict Resolution Techniques:**
    - Both siblings learned to express concerns using “I” statements instead of accusations (e.g., “I feel overwhelmed when I’m the only one managing Mom’s care” instead of “You never help”).
    - They created a shared caregiving plan where Maria committed to scheduled visits and remote tasks (e.g., managing bills, coordinating medical appointments).
3. **Emotional Processing:**
    - Maria shared her feelings of guilt for not living closer and her fear of being seen as “less caring.”
    - Alex admitted to feeling lonely in their shared responsibilities and afraid of asking for help.
4. **Communication Tools:**
    - They established weekly check-in calls to discuss caregiving updates and emotional needs.
    - They agreed to approach disagreements with curiosity rather than defensiveness.

---

### Outcome of Family Therapy for Adult Siblings

Over time, Alex began to trust Maria’s contributions, and Maria felt more included in caregiving decisions. Both acknowledged their mutual efforts and validated each other’s challenges. They started rebuilding their relationship with more empathy, open communication, and a shared sense of responsibility.

---

### Key Takeaways from This Case:

- [Childhood roles](https://dralanjacobson.com/family-of-origin-therapy/) can persist into adulthood and affect dynamics.
- Open, structured communication can reduce misunderstandings.
- Caregiving responsibilities must be distributed fairly based on each person’s capacity.
- Emotional validation fosters trust and reduces resentment.

## Summary and My Work

I provide family therapy for adult siblings virtually so everyone can attend, even if they live in different places. I also define “siblings” somewhat generally since there may be close cousins or others who would be included. This [psychotherapy approach](https://dralanjacobson.com/psychotherapy/) is active and moves fast, often with meaningful results coming quickly. The fact that I often assign homework exercises for adult siblings in therapy speeds the process but also requires a commitment from all.

For more information about adult sibling therapy or any type of [family therapy](https://dralanjacobson.com/family-therapy/), please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Frequently Asked Questions: Adult Sibling Therapy

Common questions about how adult sibling therapy works, who it helps, and what to expect from virtual sessions.

   What is adult sibling therapy, and how is it different from regular family therapy?Adult sibling therapy is a specialized form of [family therapy](https://dralanjacobson.com/family-therapy/) focused specifically on the relationship between siblings — addressing the communication patterns, childhood role dynamics, and relational histories that shape how adult siblings interact with each other. While general family therapy may involve the whole family system or focus on a parent-child relationship, sibling therapy centers the sibling bond itself as the unit of treatment. It is particularly useful because sibling relationships are often the longest-lasting family connections a person has — research on adult development, including work summarized by the [American Psychological Association](https://www.apa.org/topics/parenting/sibling-relationships), consistently shows that sibling relationships remain significant across the lifespan and have meaningful effects on wellbeing. Sibling therapy uses many of the same evidence-based frameworks as family therapy — [family systems therapy](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/), [Emotionally Focused Therapy (EFT)](https://dralanjacobson.com/emotionally-focused-family-therapy/), [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/), [CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) — but applies them specifically to the sibling dynamic.

  What issues most commonly bring adult siblings to therapy?The most common presenting issues fall into three broad clusters. First, unresolved childhood dynamics — rivalry, favoritism, role assignments like “the responsible one” or “the free spirit” — that never got named or processed and now surface under stress. Second, major life transitions that create new pressure on the sibling relationship: aging parents requiring caregiving, inheritance or estate disputes, a parent’s death, or a sibling’s serious illness. Third, a gradual drift into distance or a specific rupture — an argument that went too far, a perceived betrayal, or a period of estrangement — that left the relationship hollow or tense. [Grief and loss](https://dralanjacobson.com/grief-therapy/) often sit at the center of all three clusters, whether grief for a parent, for the family that existed in childhood, or for the closeness that once seemed possible. All of these are valid and responsive to treatment.

  Can sibling therapy help if we live in different states?Yes — in fact, virtual delivery is one of the defining features of Dr. Jacobson’s adult sibling therapy practice, and it directly solves the most common logistical barrier to this type of treatment. Siblings rarely live in the same city in adulthood, which has historically made joint family therapy difficult or impossible to sustain. Dr. Jacobson is a [PSYPACT](https://psypact.org/)-participating psychologist licensed in 44 states, which means he can typically work with each sibling wherever they are located — whether that’s Massachusetts, California, New York, or anywhere else in the PSYPACT compact. Sessions are conducted via secure video and follow the same clinical structure as in-person appointments. For more on how virtual sessions are structured, see the [virtual therapy guide](https://dralanjacobson.com/virtual-therapy-guide/).

  How does sibling therapy handle caregiving disputes and aging parent situations?Caregiving situations are among the most clinically rich — and most emotionally charged — scenarios that bring adult siblings to therapy. When a parent begins requiring care, old family roles resurface with new urgency: the sibling who always managed things feels burdened and alone; the sibling who lives farther away feels excluded from decisions or judged for contributing differently. Therapy addresses this at two levels simultaneously. Practically, it helps siblings create fair, explicit division of responsibilities based on each person’s capacity — geographic proximity, financial resources, emotional bandwidth — rather than assumptions or resentment. Emotionally, it surfaces the grief, guilt, and unspoken fears that are almost always running underneath the logistical conflict. The National Institute on Aging recognizes that caregiver conflict within families is extremely common and that structured communication significantly improves outcomes for both the caregivers and the parent receiving care. See also the page on [adult family therapy](https://dralanjacobson.com/adult-family-therapy/) for broader family caregiving contexts.

  What if one sibling is willing to come to therapy but the other isn’t?This is a common situation and therapy can still be highly valuable. When only one sibling is willing to participate, individual sessions can focus on that person’s role in the dynamic, their emotional responses to the relationship, and the communication strategies they can use to shift the pattern from their side — because relational patterns are circular, a meaningful change in one person’s behavior often creates measurable change in the other’s response over time. Individual work also helps the willing sibling process grief, clarify what they actually want from the relationship, and develop boundaries that are sustainable regardless of whether the other sibling ever engages. If both siblings eventually become willing to participate, sessions can transition to joint work. Dr. Jacobson’s practice also works with siblings who define the relationship broadly — close cousins or others who function in a sibling-like role are included. For individual support in a family context, see [individual therapy](https://dralanjacobson.com/individual-therapy/) and [family of origin therapy](https://dralanjacobson.com/family-of-origin-therapy/).

  How does therapy address childhood roles that siblings are still playing out as adults?Childhood role assignments — “the responsible one,” “the difficult one,” “the golden child,” “the baby” — are among the most persistent and least examined forces shaping adult sibling relationships. They were assigned before anyone was old enough to question them, often reinforced by parents without conscious intention, and they create invisible constraints on how siblings see and treat each other decades later. [Family systems therapy](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/) is particularly effective at making these roles visible — naming them, tracing where they came from, and examining what each sibling gained and lost by occupying them. [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/) then helps each person construct a more accurate and autonomous self-narrative — one that isn’t defined by a role assigned to a child. Research on [sibling relationships across the lifespan](https://www.sciencedirect.com/science/article/abs/pii/S0047235217300600) consistently shows that role rigidity is one of the primary drivers of adult sibling conflict and distance. Identifying and loosening these roles is often the most transformative work in sibling therapy.

  Can sibling therapy help repair an estranged relationship, or is it only for siblings who are still in contact?Sibling therapy can be useful at any point on the estrangement spectrum — from strained but ongoing contact, to significant emotional distance, to periods of complete cutoff. For siblings who are currently estranged, therapy can begin with individual sessions to help each person process the grief and clarify what, if anything, they want from the relationship going forward — without presupposing that reconciliation is the goal. If both parties become willing to engage jointly, structured dialogue sessions can create a safe and paced environment for approaching difficult history. For siblings still in contact but experiencing chronic conflict or growing distance, therapy works to interrupt the patterns before estrangement occurs. Dr. Jacobson’s [family estrangement therapy](https://dralanjacobson.com/family-estrangement-therapy/) page addresses the full spectrum of estrangement — including situations where limited or no contact is ultimately the healthiest outcome — and is worth reviewing alongside this page.

  How do we get started, and what does the first session look like?The first step is a free 20-minute consultation — typically with one sibling, though both are welcome — to discuss what’s been happening, what each person hopes to get from therapy, and whether individual or joint sessions make more sense to start. The first full session gathers background from each person’s perspective on the relationship: its history, the patterns that feel most stuck, and the goals each sibling is bringing. Most siblings find the initial session both clarifying and relieving — having a structured, neutral space to say what has felt unsayable in their actual interactions is itself a meaningful first step. Dr. Jacobson’s approach moves actively and tends to produce meaningful movement relatively quickly, particularly when homework exercises are completed between sessions. You can review the general [Therapy FAQs](https://dralanjacobson.com/therapy-faqs/) and the [guide to choosing a family therapy approach](https://dralanjacobson.com/which-type-of-family-therapy-is-right-for-you/) for additional context before reaching out.

 Ready to rebuild — or finally repair — your sibling relationship?

Schedule a free 20-minute consultation with Dr. Jacobson. A low-pressure conversation about where things stand and whether sibling therapy is the right next step.

 [ Schedule a Free Consultation ](https://www.picktime.com/scheduleaconsult) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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---

### [Best Types of Therapy for Anxiety: Sorting Out the Options](https://dralanjacobson.com/best-types-of-therapy-for-anxiety/)

**Published:** July 20, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Anxiety takes many forms, from constant worry to panic attacks to fear of social situations, and each individual’s experience is shaped by their history, personality, and current life context. There is a range of different types of therapy for anxiety disorders, including [Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT), [Acceptance and Commitment Therapy](https://dralanjacobson.com/act-psychotherapy/) (ACT), [Exposure-Based treatments](https://dralanjacobson.com/exposure-therapy-for-anxiety/), and [mindfulness-based strategies](https://dralanjacobson.com/mindfulness-therapy/), adapting these frameworks to match the client’s style and preferences. When a client’s needs fall outside the scope of my expertise or when a more specialized approach would be beneficial, I draw on a trusted network of clinicians, psychiatrists, and other professionals to ensure they are connected with the proper care.

## Best Type of Therapy for Anxiety Disorders

Here is an overview of the different types of therapy for anxiety organized by category:

### Cognitive-Based Types of Therapy for Anxiety

#### Cognitive Behavioral Therapy (CBT)

**Introduction:**
CBT is the most empirically supported kinds of therapy for anxiety. It focuses on identifying, challenging, and changing irrational thoughts and beliefs that fuel negative thoughts, while gradually exposing individuals to feared situations in a safe and structured way.

- **Best type of therapy for anxiety** that is generalized**,** Social Fears, [Panic Disorder](https://dralanjacobson.com/panic-attack-treatment/), [Specific Phobias](https://dralanjacobson.com/therapy-for-phobias/)
- **What to expect:** 12–20 structured sessions with psychoeducation, [cognitive restructuring](https://dralanjacobson.com/cognitive-restructuring/), exposure, and homework
- **Can be combined with:** Medication, exposure therapy, and ACT. (And it has specific types, including Rational Emotive Behavior Therapy or [REBT](https://dralanjacobson.com/rational-emotive-behavior-therapy-rebt/))

#### [Mindfulness-Based Cognitive Therapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) (MBCT)

**Introduction:**
Originally developed to prevent depressive relapse, MBCT is increasingly used for anxiety. It teaches clients how to observe their thoughts and sensations without judgment, reducing reactivity and helping them stay present.

- **Best type of therapy for anxiety** that is generalized, Panic Disorder, residual stress after other treatments
- **What to expect:** 8-session group program, includes meditation, breathing, body scan, and mindful movement.
- **Can be combined with:** CBT, ACT, other mindfulness

### Behavioral Types of Therapy for Anxiety

#### Exposure Therapy (including ERP for OCD)

**Introduction:**
Exposure-based approaches help reduce symptoms by gradually and repeatedly confronting feared situations or thoughts, teaching the brain that stress will diminish without avoidance. For OCD, this approach is called [Exposure and Response Prevention](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/) (ERP).

- **Best type of therapy for anxiety** related to OCD, Phobias, Panic Disorder, PTSD
- **What to expect:** Hierarchy of feared situations; repeated, controlled exposure; home-based assignments
- **Can be combined with:** CBT, ACT

#### [Dialectical Behavior Therapy](https://dralanjacobson.com/dbt-for-teens/) (DBT)

**Introduction:**
DBT was developed for [emotional dysregulation](https://psychologicalassessments.com/emotional-dysregulation-testing/) and is effective for impulsivity, intense mood swings, or self-harm. It teaches mindfulness and distress tolerance to reduce the intensity of emotions.

- **Best type of therapy for anxiety** with emotional dysregulation, trauma histories, or self-destructive behavior
- **What to expect:** Weekly individual, skills group, phone coaching, and long-term program
- **Can be combined with:** [EMDR](https://www.emdr.com/what-is-emdr/), trauma-informed, ACT

#### [Biofeedback and Neurofeedback](https://www.drakeinstitute.com/biofeedback-vs-neurofeedback)

**Introduction:**
These [evidence-based interventions](https://positivepsychology.com/evidence-based-therapy/) use real-time monitoring of physiological activity (like heart rate or brain waves) to help individuals learn to control symptoms. They are often used as adjunctive treatments to enhance self-regulation.

- **Best types of therapy for anxiety** with physiological symptoms, panic, performance anxiety, [stress-related somatic symptoms](https://psychcentral.com/anxiety/somatic-anxiety)
- **What to expect:** Sessions using monitoring equipment to develop self-regulation skills
- **Can be combined with:** CBT, mindfulness training

### Emotion-Based Types of Therapy for Anxiety

#### Acceptance and Commitment (ACT)

**Introduction:**
ACT treats symptoms by fostering acceptance of difficult thoughts and feelings rather than fighting them. It emphasizes mindfulness and encourages individuals to take action guided by their values, even when symptoms are present.

- **Best type of therapy for anxiety** that is generalized, social, performance-related, or involves chronic worry
- **What to expect:** Focus on acceptance, values clarification, mindfulness, and committed action
- **Can be combined with:** CBT, exposure therapy, MBCT

#### [Psychodynamic](https://dralanjacobson.com/psychodynamic-therapy/)

**Introduction:**
Psychodynamic therapy explores how unconscious patterns and past experiences influence current emotions. It helps individuals gain insight into internal conflicts that contribute to anxious thoughts, often offering deep emotional healing.

- **Best type of therapy for** anxiety that is chronic, unexplained worry, stress rooted in early attachment or relationship patterns
- **What to expect:** Exploratory, insight-oriented dialogue over medium to long-term
- **Can be combined with:** CBT, ACT, Logotherapy

#### Eye Movement Desensitization and Reprocessing (EMDR)

**Introduction:**
EMDR is trauma-focused and can reduce anxiety symptoms stemming from disturbing experiences. Reprocessing traumatic memories can alleviate anxiety that is stuck in the nervous system.

- **Best type of therapy for** PTSD, phobia-like stress after trauma, panic triggered by past events
- **What to expect:** Phased protocol using bilateral stimulation to reduce distress associated with memories
- **Can be combined with:** DBT, psychodynamic therapy

### Other Kinds of Therapy for Anxiety Disorders

#### Interpersonal (IPT)

**Introduction:**
Although IPT was developed for depression, it can be highly effective for anxiety that stems from relational difficulties or life transitions. IPT focuses on improving communication, navigating social roles, and managing conflict or grief.

- **Best tyoe of therapy for** Social Anxiety, Adjustment Disorder, symptoms linked to loss or role transitions
- **What to expect:** Weekly sessions focused on one or more interpersonal problem areas; usually 12–16 weeks.
- **Can be combined with:** CBT, group therapy, [Internal family systems](https://dralanjacobson.com/internal-family-systems-therapy-ifs/)

#### Somatic Kinds of Therapy for Anxiety (e.g., Somatic Experiencing, Sensorimotor Psychotherapy)

**Introduction:**
[Somatic therapies](https://dralanjacobson.com/somatic-therapy/) address how anxiety manifests in the body. These therapies help clients increase body awareness and regulate physiological responses such as tension, hypervigilance, or dissociation.

- **Best type of therapy** for panic attacks, somatic symptoms
- **What to expect:** Gentle, body-centered techniques to release stored tension and reestablish safety
- **Can be combined with:** EMDR, ACT, DBT

#### [Group Therapy](https://dralanjacobson.com/group-therapy/)

**Introduction:**
Group meetings provide a structured and supportive environment where clients can share their experiences, learn practical coping skills, and practice exposure in [social settings](https://dralanjacobson.com/therapy-for-social-anxiety-disorder/). It is particularly helpful for people who feel isolated or stigmatized.

- **Best type of therapy for** social, generalized, performance, or situational symptoms
- **What to expect:** Weekly sessions; may be skills-based, psychoeducational, or process-focused
- **Can be combined with:** [Individual therapy](https://dralanjacobson.com/individual-therapy/), CBT, ACT

### How Different Types of Therapy for Anxiety Disorders Can Be Combined

**Combination Types of Therapy for Anxiety****Why It Works****CBT + Exposure Therapy**Core treatment for phobias, OCD, and social fears**ACT + Mindfulness**Helps reduce worry and increase present-moment engagement**Psychodynamic + CBT**Combines insight with active coping strategies**DBT + EMDR**Targets emotion regulation and trauma simultaneously**Group + Individual**Combines peer support with personalized treatment**Somatic + Talk Therapy**Addresses both physical and cognitive-emotional symptomsAnxiety manifests differently in each person. Some struggle with racing thoughts, others with physical symptoms, avoidance, or trauma responses. The best kinds of therapy for anxiety depend on the **type**, **severity**, **personal preference**, and whether there are co-occurring concerns like trauma or depression.

An [**Integrative approach**](https://dralanjacobson.com/integrative-therapy/) is often most effective, integrating different types of therapy for anxiety disorders, especially when treatment is integrated with [psychoeducation](https://dralanjacobson.com/psychoeducation/), mindfulness, body-based strategies, or medication as needed.

## What Kind of Therapist Do I Need for Anxiety?

A therapist’s [interpersonal style](https://dralanjacobson.com/how-to-choose-the-right-therapist/) can either help soothe anxious clients or unintentionally heighten their worry. The best therapists for treating anxiety tend to be:

1. **Calm and Grounded**

- Conveys emotional steadiness and regulation, which helps reduce client anxiety
- Models composed responses to distress and uncertainty

2. **Reassuring Yet Challenging**

- Validates the client’s fear but gently pushes them to face avoidance and discomfort
- Helps build confidence without over-accommodating

3. **Organized and Structured**

- Provides a clear framework for sessions and treatment goals
- Helps anxious individuals feel secure by reducing ambiguity

4. **Empathic and Supportive**

- Builds a strong [therapeutic alliance](https://pmc.ncbi.nlm.nih.gov/articles/PMC6493237/)
- Offers encouragement without rescuing or reinforcing anxious patterns

5. **Encouraging and Solution-Focused**

- Celebrates progress, even small wins
- Motivates clients to apply coping strategies and confront fears

#### Therapist Orientation

The [best therapists for anxiety](https://dralanjacobson.com/choosing-the-best-therapist-for-you/) are trained in evidence-based approaches that address both cognitive and physiological symptoms. The best-fitting [types of therapy](https://dralanjacobson.com/types-of-therapy/) may depend on the type and severity of symptoms. Answering, “What kind of therapist do I need for anxiety?” requires consideration of the following modalities.

1. **Cognitive Behavioral (CBT)**

- **Best for:** GAD, social fears, panic disorder, phobias
- **Focus:** Identifying irrational fears, cognitive distortions, and avoidance behaviors; learning new thought patterns and coping strategies
- **Ideal Therapist:** Direct, goal-oriented, teaches tools, and assigns homework

2. **Exposure Therapy / Exposure and Response Prevention (ERP)**

- **Best for:** OCD, phobias, health worries, panic attacks
- **Focus:** Systematic exposure to feared stimuli to reduce avoidance and fear response
- **Ideal Therapist:** Courageous, encouraging, structured, and willing to guide clients through discomfort

3. **Acceptance and Commitment (ACT)**

- **Best for:** GAD, social fears, performance stress, chronic worry
- **Focus:** Acceptance of thoughts and feelings, mindfulness, and values-based living
- **Ideal Therapist:** Reflective, flexible, nonjudgmental, comfortable with paradox and complexity

4. **Dialectical Behavior Therapy (DBT)**

- **Best for:** Emotional dysregulation, trauma, or impulsivity. Excellent [therapy for teen anxiety](https://dralanjacobson.com/therapy-for-teen-anxiety/).
- **Focus:** Mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness
- **Ideal Therapist:** Structured, validating, assertive, skills-based

5. **Psychodynamic**

- **Best for:** Long-standing symptoms rooted in relational or early life patterns
- **Focus:** Insight into unconscious fears, defense mechanisms, and relational templates
- **Ideal Therapist:** Insightful, emotionally attuned, curious, relationally focused

6. **Somatic or Body-Based Therapies**

- **Best for:** Strong physical symptoms, panic, or trauma history
- **Focus:** Calming the nervous system and improving body awareness and regulation
- **Ideal Therapist:** Calm, attuned, comfortable with silence and nonverbal work

### Best Locations and Settings

The environment in which therapy is delivered can influence how safe and engaged a client feels.

1. **In-Person**

- **Best for:** Individuals needing structure, grounding, and a sense of personal connection
- **Benefit:** Face-to-face interaction helps with social and relational fears
- **Ideal Therapist Setting:** Calm, predictable, minimally stimulating office

2. **Teletherapy (Online)**

- **Best for:** Individuals with agoraphobia, social fears, or logistical barriers
- **Benefit:** Comfortable home setting may reduce initial avoidance
- **Ideal Therapist Setting:** Clear visuals, calm voice, organized sessions

3. **Hybrid Model**

- **Best for:** Clients needing flexibility or gradual exposure to in-person contact
- **Benefit:** Builds comfort and transition readiness while maintaining consistency

4. **Group**

- **Best for:** Social, performance, or generalized
- **Benefit:** Builds exposure, shared understanding, and interpersonal skills
- **Ideal Group Leader:** Directive, warm, ensures equal participation and safety

5. **Somatic/Nature-Based or Walk-and-Talk Kinds of Therapy for Anxiety**

- **Best for:** Panic, restlessness, and other body symptoms
- **Benefit:** Movement and nature regulate the nervous system
- **Ideal Therapist:** Flexible, present-focused, trauma-informed

### Summary: What kind of therapist do I need for anxiety?

**Dimension****Ideal Qualities****Personality**Calm, organized, supportive, gently challenging, validating**Therapy Approach**CBT, ERP, ACT, DBT, psychodynamic, or somatic, depending on anxiety type**Location/Setting**In-person (for social connection), [teletherapy](https://dralanjacobson.com/telehealth-therapy-teletherapy/) (for accessibility), group or hybrid**Therapist Role**Coach, educator, and compassionate guide toward tolerating discomfort and fearAnxiety thrives in **uncertainty, avoidance, and disconnection,** so the best therapist is one who provides clarity, consistency, and a safe space to move through fear rather than away from it. Whether the client prefers deep exploration, skill-building, or gentle exposure, the most important predictor of success remains a **strong, trusting therapeutic relationship**.

## Best Type of Therapy for Anxiety: Homework or In-Session Focus?

One choice you have when deciding what the best types of therapy for anxiety might be for you is whether you’ll be asked to do some of the work outside the session.

### Therapies for Anxiety Disorders That Include Homework:

These therapies are **structured, skills-based, and action-oriented**, providing clients with specific tools and exercises to practice outside of sessions. They’re ideal for clients who like structure, accountability, and practical coping strategies.

1. **Cognitive Behavioral (CBT)**

- **Homework Focus:** Thought records, worry logs, behavioral experiments, and gradual exposure tasks
- **Best For:** Generalized Anxiety Disorder (GAD), social anxiety, panic disorder, phobias
- **Style:** Structured and educational; emphasis on changing thinking and behavior patterns
- **Goal:** Equip clients to manage symptoms independently

2. **Exposure (including ERP for OCD)**

- **Homework Focus:** Hierarchical exposure exercises (e.g., facing feared situations, reducing safety behaviors)
- **Best For:** Phobias, OCD, panic disorder, health worries
- **Style:** Systematic and measurable; therapist guides exposure plan and evaluates progress
- **Goal:** Reduce avoidance and recondition fear responses

3. **Acceptance and Commitment (ACT)**

- **Homework Focus:** Mindfulness practice, values-based action plans, acceptance exercises
- **Best For:** GAD, performance and social anxiety, chronic worry
- **Style:** Flexible, experiential; supports clients in relating differently to irrational thoughts
- **Goal:** Build psychological flexibility and reduce struggle with internal experience

4. **Dialectical Behavior Therapy (DBT)**

- **Homework Focus:** Daily skills practice for mindfulness, emotion regulation, and distress tolerance
- **Best For:** Mood swings, trauma history, or self-destructive behavior
- **Style:** Highly structured; often includes group skills training and tracking sheets
- **Goal:** Increase emotional stability and reduce reactive behavior

5. **Mindfulness-Based Cognitive Therapy (MBCT)**

- **Homework Focus:** Formal mindfulness meditations, body scans, and mindful awareness of thoughts
- **Best For:** Relapse prevention, GAD, residual symptoms
- **Style:** Group-based; combines mindfulness with CBT strategies
- **Goal:** Prevent automatic spirals by observing thoughts nonjudgmentally

### Therapies for Anxiety That Focus on In-Session Work

These types of therapy for anxiety disorders focus more on **emotional processing, insight, and relational dynamics**. Homework is optional, minimal, or purely reflective, and most of the therapeutic change occurs through dialogue and in-the-moment awareness.

1. **Psychodynamic Therapies for Anxiety**

- **In-Session Focus:** Uncovering unconscious sources, exploring childhood patterns, relational templates
- **Best For:** Symptoms rooted in early experiences, relationship difficulties, or internal conflict
- **Style:** Insight-driven and relational; may be long-term
- **Goal:** Resolve underlying causes and increase self-awareness

2. **Interpersonal (IPT)**

- **In-Session Focus:** Addressing symptoms linked to role transitions, grief, or conflict in relationships
- **Best For:** Social anxiety, adjustment-related fears, anxiety co-occurring with depression
- **Style:** Structured, time-limited, but experiential and communication-focused
- **Goal:** Improve interpersonal functioning to reduce symptoms

3. **[ Emotion-Focused](https://dralanjacobson.com/emotionally-focused-individual-therapy/) (EFT)**

- **In-Session Focus:** Identifying, experiencing, and transforming maladaptive emotional responses
- **Best For:** Anxiety tied to unresolved emotional pain, shame, or internal conflict
- **Style:** Emotionally intensive; in-the-moment processing and validation
- **Goal:** Increase emotional awareness and transform anxiety into adaptive feelings

4. **[ Humanistic](https://dralanjacobson.com/humanistic-therapy/) / [Person-Centered](https://dralanjacobson.com/client-centered-therapy/) Therapies for Anxiety**

- **In-Session Focus:** Emphasizing empathy, acceptance, and authentic self-expression
- **Best For:** Clients needing a safe, affirming space to explore and identify triggers
- **Style:** Client-led, reflective; minimal directive structure
- **Goal:** Foster self-acceptance and personal meaning to reduce inner conflict

5. **[ Somatic Experiencing](https://dralanjacobson.com/somatic-therapy/) / [Sensorimotor Psychotherapy](https://sensorimotorpsychotherapy.org/)**

- **In-Session Focus:** Tracking and regulating bodily sensations and physiological responses
- **Best For:** Panic, trauma-related anxiety, chronic tension
- **Style:** Gentle, body-centered, experiential
- **Goal:** Restore nervous system balance and increase somatic resilience

Some clients **thrive on structure and between-session accountability**, while others require a space where emotional and somatic work can occur **in the room** without pressure to “perform” outside. The ideal types of therapy for anxiety disorders depend not only on diagnosis, but on your readiness, temperament, and learning style.

## Summary and Conclusion

Therapy can help you develop the confidence, skills, and insight necessary to lead a more grounded and fulfilling life. Whether through our work together or through a well-matched referral, I am committed to making sure each client receives the highest quality support. Choosing among the different types of therapy for anxiety is not just about the treatment method; it’s about feeling supported and understood and experiencing meaningful and measurable positive effects. [Does therapy work](https://dralanjacobson.com/does-therapy-work/) for anxiety? Yes!

If you have questions about the types of therapy for anxiety disorders that you can choose from, or the therapies for anxiety that I provide, please do not hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult#services/service) anytime.

## Frequently Asked Questions: Types of Therapy for Anxiety

Common questions about choosing the right therapy approach for anxiety — answered clearly so you can move forward with confidence.

   What is the most effective type of therapy for anxiety?[Cognitive Behavioral Therapy (CBT)](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) is the most extensively researched and empirically supported treatment for anxiety disorders across the board. The [American Psychological Association](https://www.apa.org/ptsd-guideline/treatments/cognitive-behavioral-therapy) recognizes CBT as a first-line treatment for generalized anxiety, social anxiety, panic disorder, and specific phobias. However, “most effective” is not a universal designation — it depends heavily on the type of anxiety, the presence of co-occurring conditions like trauma or depression, and the individual’s temperament and learning style. For OCD, [Exposure and Response Prevention (ERP)](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/) is the gold standard. For trauma-related anxiety, EMDR or [somatic approaches](https://dralanjacobson.com/somatic-therapy/) often outperform CBT alone. An [integrative approach](https://dralanjacobson.com/integrative-therapy/) that combines methods is frequently most effective, particularly for complex presentations.

  What is the difference between CBT and ACT for anxiety?Both are evidence-based and effective for anxiety, but they take meaningfully different approaches to anxious thoughts. [CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) works by identifying irrational or distorted thoughts and actively challenging and replacing them — the goal is to change the content of thinking. [ACT (Acceptance and Commitment Therapy)](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) takes a different stance: rather than fighting anxious thoughts, it teaches clients to observe them without fusing with them, and to take action aligned with their values even when anxiety is present. CBT tends to appeal to people who prefer structured, problem-solving approaches. ACT tends to resonate with people who have found that trying to suppress or argue with anxious thoughts makes them worse — a common experience. Many therapists, including Dr. Jacobson, draw on both frameworks depending on what each client needs at any given point in treatment.

  How do I know which type of therapy is right for my specific anxiety?The match between anxiety type and treatment approach matters significantly. As a general guide: [generalized anxiety](https://dralanjacobson.com/therapy-for-generalized-anxiety-disorder/) responds well to CBT, ACT, and [Mindfulness-Based Cognitive Therapy (MBCT)](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/); [social anxiety](https://dralanjacobson.com/therapy-for-social-anxiety-disorder/) is best addressed with CBT combined with exposure; [panic disorder](https://dralanjacobson.com/panic-attack-treatment/) responds strongly to CBT with interoceptive exposure; [OCD](https://dralanjacobson.com/therapy-for-ocd/) requires ERP specifically; and anxiety rooted in trauma calls for EMDR or somatic approaches. Beyond diagnosis, your temperament matters: some people thrive with homework-based, structured approaches; others need more exploratory, in-session-focused work. The [guide to choosing a therapy approach](https://dralanjacobson.com/which-type-of-therapy-is-right-for-you-a-practical-guide/) walks through this in more detail, and a consultation with Dr. Jacobson can provide individualized guidance based on your specific presentation.

  Does therapy for anxiety require homework between sessions?It depends on the approach. Structured, skills-based therapies like CBT, ERP, ACT, and [DBT](https://dralanjacobson.com/dbt-for-teens/) typically involve between-session practice — thought records, exposure exercises, mindfulness practice, or behavioral experiments. This homework is a meaningful driver of outcomes in those models: the [research literature on CBT](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3842996/) consistently shows that homework completion is associated with better treatment outcomes. Other approaches — psychodynamic therapy, [Emotionally Focused Therapy](https://dralanjacobson.com/emotionally-focused-individual-therapy/), humanistic and somatic approaches — focus primarily on in-session processing and do not rely on formal homework. The right balance depends on your learning style: clients who value structure and accountability often do best with homework-based models; those who find external assignments stressful may do better with approaches where the work happens in the room.

  Is therapy or medication better for anxiety?Both are effective, and for many people the combination outperforms either alone. The [National Institute of Mental Health](https://www.nimh.nih.gov/health/topics/anxiety-disorders) recognizes psychotherapy — particularly CBT — and medication (such as SSRIs or SNRIs) as established first-line treatments for anxiety disorders. Medication can reduce the intensity of symptoms quickly, which can lower the threshold for engaging in therapeutic work. Therapy addresses the underlying cognitive, behavioral, and emotional patterns that sustain anxiety over time, producing gains that tend to be more durable after treatment ends. For mild to moderate anxiety, therapy alone is often sufficient. For more severe presentations, co-occurring depression, or panic disorder, a combined approach with a psychiatrist or prescribing physician is frequently recommended. Dr. Jacobson works collaboratively with prescribers when medication is part of a client’s care.

  How long does therapy for anxiety typically take?Treatment length varies significantly by approach and severity. Structured protocols like CBT for generalized anxiety or specific phobias are typically 12–20 sessions. ERP for OCD is often delivered over 12–20 sessions as well, though complex cases may take longer. [MBCT](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) is an 8-session group program. ACT and DBT vary more widely. Psychodynamic and exploratory approaches are typically longer-term by design. Most clients with mild to moderate anxiety notice meaningful improvement within 8–12 weeks of consistent work. More complex presentations — long-standing anxiety, significant avoidance, trauma history, or co-occurring conditions — generally require more time. The [guide on how long therapy takes](https://dralanjacobson.com/how-long-does-therapy-take/) provides additional context, and Dr. Jacobson discusses realistic timelines in the initial consultation based on each client’s specific situation.

  Can anxiety therapy be done effectively online?Yes — and for many anxiety presentations, online therapy offers a clinically meaningful advantage. Delivering exposure-based treatment in the client’s real environment — their home, car, workplace — is often more ecologically valid than practicing in a therapist’s office and hoping skills generalize. This is particularly relevant for [specific phobias](https://dralanjacobson.com/therapy-for-phobias/), [social anxiety](https://dralanjacobson.com/therapy-for-social-anxiety-disorder/), [OCD](https://dralanjacobson.com/therapy-for-ocd/), and [panic disorder](https://dralanjacobson.com/panic-attack-treatment/). A substantial body of research supports the equivalence of online and in-person CBT and exposure therapy for anxiety. Dr. Jacobson is a [PSYPACT](https://psypact.org/)-participating psychologist licensed in 44 states, making online anxiety treatment accessible regardless of where you are located. For more on how virtual sessions are structured, see the [virtual therapy guide](https://dralanjacobson.com/virtual-therapy-guide/) and the detailed overview of [online therapy approaches and outcomes](https://dralanjacobson.com/therapy-online-approaches-techniques-and-outcomes/).

  How do I get started with anxiety therapy?The first step is a free 20-minute consultation with Dr. Jacobson. In that conversation, you’ll describe what you’ve been experiencing — the type of anxiety, how long it’s been present, what you’ve tried, and what your goals are — and receive a candid assessment of which approaches are likely to fit best. There’s no commitment required and no pressure. Many people find the consultation itself relieving: having an experienced clinician name what’s happening and outline a clear path forward reduces the uncertainty that often keeps people stuck. You can also review the [Therapy FAQs](https://dralanjacobson.com/therapy-faqs/) and the [guide to choosing a therapy approach](https://dralanjacobson.com/which-type-of-therapy-is-right-for-you-a-practical-guide/) before reaching out. Specific anxiety concerns also have dedicated pages: [social anxiety](https://dralanjacobson.com/therapy-for-social-anxiety-disorder/), [generalized anxiety](https://dralanjacobson.com/therapy-for-generalized-anxiety-disorder/), [panic disorder](https://dralanjacobson.com/panic-attack-treatment/), [OCD](https://dralanjacobson.com/therapy-for-ocd/), and [teen anxiety](https://dralanjacobson.com/therapy-for-teen-anxiety/).

 Not sure which approach is right for you?

Schedule a free 20-minute consultation with Dr. Jacobson. A straightforward conversation about your anxiety, your goals, and which treatment path makes the most sense.

 [ Schedule a Free Consultation ](https://www.picktime.com/scheduleaconsult) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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](https://www.instagram.com/appliedpsychological) [ ![social network 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](https://www.linkedin.com/company/psychologicalscience/)

---

### [Blog](https://dralanjacobson.com/blog/)

**Published:** July 18, 2018
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: July 23, 2026

 # Therapy Blog

I work to keep my **therapy blog** updated with the latest innovations and ideas in the field of psychotherapy and the latest news about my practice. I also contribute to other The Foresight Psychological Institute blogs including regarding [Therapeutic Tutoring](https://therapeutictutoring.com/blog/), [Psych testing](https://psychologicalassessments.com/blog/), and Leadership Coaching. Please note that all advice and self-help offered is not a substitute for consulting with a professional.

## [Long-Distance Relationship Therapy: Managing and Enjoying Love From Afar](https://dralanjacobson.com/long-distance-relationship-therapy-managing-and-enjoying-love-from-afar/)

by [Dr. Alan Jacobson](https://dralanjacobson.com/author/alanjacobson/ "Posts by Dr. Alan Jacobson") | September 11, 2026 | [Couples Therapies](https://dralanjacobson.com/category/couples-therapies/) | 0 Comments

Practical, evidence-based support for long-distance couples and long-distance marriages —...

[Read More](https://dralanjacobson.com/long-distance-relationship-therapy-managing-and-enjoying-love-from-afar/)

## [Perfectionism and Its Link to Anxiety and Burnout](https://dralanjacobson.com/perfectionism-and-its-link-to-anxiety-and-burnout/)

by [Dr. Alan Jacobson](https://dralanjacobson.com/author/alanjacobson/ "Posts by Dr. Alan Jacobson") | September 8, 2026 | [Symptom Relief](https://dralanjacobson.com/category/symptom-relief/) | 0 Comments

Perfectionism · Anxiety & Burnout High standards aren't the problem. It's the specific...

[Read More](https://dralanjacobson.com/perfectionism-and-its-link-to-anxiety-and-burnout/)

## [College Counseling Centers vs. Private Therapy: Working Together](https://dralanjacobson.com/college-counseling-centers-vs-private-therapy-working-together/)

by [Dr. Alan Jacobson](https://dralanjacobson.com/author/alanjacobson/ "Posts by Dr. Alan Jacobson") | September 5, 2026 | [Young adults and College Students](https://dralanjacobson.com/category/young-adults-and-college-students/) | 0 Comments

College Mental Health · How the Two Systems Fit Together College counseling centers and...

[Read More](https://dralanjacobson.com/college-counseling-centers-vs-private-therapy-working-together/)

## [Signs Your Family Would Benefit from Therapy](https://dralanjacobson.com/signs-your-family-would-benefit-from-therapy/)

by [Dr. Alan Jacobson](https://dralanjacobson.com/author/alanjacobson/ "Posts by Dr. Alan Jacobson") | August 31, 2026 | [Family therapies](https://dralanjacobson.com/category/family-therapies/) | 0 Comments

For Families & Adult Relatives Every family has friction. This is about telling the difference...

[Read More](https://dralanjacobson.com/signs-your-family-would-benefit-from-therapy/)

## [Signs You Might Benefit From Therapy](https://dralanjacobson.com/signs-you-might-benefit-from-therapy/)

by [Dr. Alan Jacobson](https://dralanjacobson.com/author/alanjacobson/ "Posts by Dr. Alan Jacobson") | August 30, 2026 | [Finding therapy](https://dralanjacobson.com/category/finding-therapy/) | 0 Comments

Getting Started With Therapy You don't need a diagnosis or a crisis to benefit from therapy — just...

[Read More](https://dralanjacobson.com/signs-you-might-benefit-from-therapy/)

## [People-Pleasing and Boundary-Setting: Why ‘No’ Feels So Hard](https://dralanjacobson.com/people-pleasing-and-boundary-setting/)

by [Dr. Alan Jacobson](https://dralanjacobson.com/author/alanjacobson/ "Posts by Dr. Alan Jacobson") | August 28, 2026 | [Symptom Relief](https://dralanjacobson.com/category/symptom-relief/) | 0 Comments

Relationships & Self-Worth If saying "no" fills you with guilt, and you can name everyone else's...

[Read More](https://dralanjacobson.com/people-pleasing-and-boundary-setting/)

## [Is Therapy Tax-Deductible? Using HSA/FSA for Sessions](https://dralanjacobson.com/is-therapy-tax-deductible-using-hsa-fsa-for-sessions/)

by [Dr. Alan Jacobson](https://dralanjacobson.com/author/alanjacobson/ "Posts by Dr. Alan Jacobson") | August 18, 2026 | [Finding therapy](https://dralanjacobson.com/category/finding-therapy/) | 0 Comments

[Read More](https://dralanjacobson.com/is-therapy-tax-deductible-using-hsa-fsa-for-sessions/)

## [How Superbills Work: Get Reimbursed for Out-of-Network Therapy](https://dralanjacobson.com/how-superbills-work-out-of-network-therapy/)

by [Dr. Alan Jacobson](https://dralanjacobson.com/author/alanjacobson/ "Posts by Dr. Alan Jacobson") | August 17, 2026 | [Finding therapy](https://dralanjacobson.com/category/finding-therapy/) | 0 Comments

[Read More](https://dralanjacobson.com/how-superbills-work-out-of-network-therapy/)

## [Rejection-Sensitive Dysphoria: Why Criticism Feels Unbearable (And What Helps)](https://dralanjacobson.com/rejection-sensitive-dysphoria/)

by [Dr. Alan Jacobson](https://dralanjacobson.com/author/alanjacobson/ "Posts by Dr. Alan Jacobson") | August 16, 2026 | [Symptom Relief](https://dralanjacobson.com/category/symptom-relief/) | 0 Comments

[Read More](https://dralanjacobson.com/rejection-sensitive-dysphoria/)

## [Imposter Syndrome: Why High Achievers Feel Like Frauds](https://dralanjacobson.com/imposter-syndrome/)

by [Dr. Alan Jacobson](https://dralanjacobson.com/author/alanjacobson/ "Posts by Dr. Alan Jacobson") | August 15, 2026 | [Symptom Relief](https://dralanjacobson.com/category/symptom-relief/) | 0 Comments

[Read More](https://dralanjacobson.com/imposter-syndrome/)

[![Long-Distance Relationship Therapy: Managing and Enjoying Love From Afar](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs=)](https://dralanjacobson.com/long-distance-relationship-therapy-managing-and-enjoying-love-from-afar/)##  [Long-Distance Relationship Therapy: Managing and Enjoying Love From Afar](https://dralanjacobson.com/long-distance-relationship-therapy-managing-and-enjoying-love-from-afar/)

by [Dr. Alan Jacobson](https://dralanjacobson.com/author/alanjacobson/ "Posts by Dr. Alan Jacobson") | Sep 11, 2026 | [Couples Therapies](https://dralanjacobson.com/category/couples-therapies/)

Practical, evidence-based support for long-distance couples and long-distance marriages — delivered virtually, nationwide. Long-distance relationships get a bad reputation they often don't deserve. In my practice, I work with couples who are dating long-distance,...

---

### [Therapy for Social Anxiety Disorder](https://dralanjacobson.com/therapy-for-social-anxiety-disorder/)

**Published:** November 26, 2023
**Author:** Dr. Alan Jacobson

**Content:**

I provide therapy for social anxiety disorder, also known as social phobia treatment, for teenagers and adults. It is a common reason why people contact me, with symptoms ranging from general anxiety to anxiety that only strikes in specific situations. Social anxiety treatment can be incredibly helpful in learning how to manage and cope with the challenges it presents. Social phobia treatment requires you to find a therapist with whom you click, whose approach fits your style and what you are looking for, and who can put together the best therapy for social anxiety for your unique needs. The therapy may take some time. However, you should feel that it is working and that you are making gains.

The following is an overview of therapy for social anxiety disorder, including a deeper look at CBT for social phobia — one of the most effective and commonly used approaches — to help you become an educated consumer.

## What is this Phobia All About?

Interpersonal anxiety, also known as [social phobia](https://www.mayoclinic.org/diseases-conditions/social-anxiety-disorder/symptoms-causes/syc-20353561), is a condition characterized by an intense fear of interpersonal situations and interactions. People with these fears often experience significant distress or anxiety in various settings. These include meeting new people, [speaking in public](https://dralanjacobson.com/public-speaking-anxiety/), attending parties or gatherings, or being the center of attention. This type of fear can start at any age and often includes intense [anticipatory anxiety](https://www.medicalnewstoday.com/articles/anticipatory-anxiety) that is sometimes even worse than the actual experience.

### Common Symptoms

1. Fear of Judgment: A pervasive fear of being negatively evaluated or judged by others, leading to avoidance of many situations. Often, these fears are stuck from earlier times when the issue arose. However, you have trouble realizing that these evaluations are unlikely in your current life.
2. Physical Symptoms: These may include rapid heartbeat, sweating, trembling, blushing, nausea, or feeling dizzy or lightheaded. Some people experience these symptoms only when contemplating a new group experience and not when the experience happens.
3. Avoidance: Avoidance of certain situations or enduring them with extreme distress is a common symptom. The avoidance can lead to increasing anxiety, like a snowball rolling down a hill.
4. Negative Self-Evaluation: Excessive self-consciousness, often accompanied by negative thoughts about oneself. These thoughts may carry over well after the group experience as irrational and exaggerated worry about having said or done something “wrong.”
5. Difficulty with Interpersonal Interactions: Difficulty initiating or maintaining conversations, feeling awkward or out of place in group situations.

These symptoms can significantly impact various aspects of life. These include work, school, and relationships. It can lead to [isolation, loneliness, and even depression](https://dralanjacobson.com/treating-major-depression/) if left untreated. Therapy can help greatly.

### Causes of Symptoms

This disorder can arise due to a combination of factors:

- Genetics: There might be a [genetic predisposition](https://pubmed.ncbi.nlm.nih.gov/34955514/), as it tends to run in families. If someone in your family has any form of anxiety, you might be more likely to develop it.
- Brain Structure: Differences in brain structure and function, particularly areas associated with fear and anxiety responses, might contribute to this discomfort.
- Environmental Factors: Traumatic or embarrassing social experiences, especially during childhood, can contribute to the development of this type of anxiety. Bullying, teasing, or being consistently judged can significantly impact.
- Learned Behavior: Observing fearful behaviors or attitudes toward certain situations from parents or peers can influence one’s response to interpersonal interactions.
- Personality Traits: Certain personality traits, such as being more introverted or having a tendency toward perfectionism, might increase the likelihood of developing interpersonal fears.
- Other Mental Health Conditions: This form of discomfort can also coexist with other mental health issues like depression and other anxiety disorders.

The development of these fears often results from a combination of these factors rather than a single cause. Understanding these potential factors can help me tailor my use of the approaches listed next to determine the best therapy for social anxiety for you.

## Best Therapy for Social Anxiety Disorder Approaches

Some of the best types of therapy for social anxiety disorder include:

### Cognitive Behavioral Therapy for Social Anxiety Disorder

This is one of the most widely used approaches for these fears and often my front-line approach. [CBT Treatment](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) focuses on identifying and changing negative thought patterns and behaviors associated with anxiety. The first step typically involves recognizing negative thought patterns, such as catastrophizing (assuming the worst will happen in group situations), and [identifying avoidance behaviors](https://psychcentral.com/health/types-of-avoidance-behavior) (such as avoiding these situations altogether). From there, CBT helps you challenge irrational and exaggerated thoughts — for example, reframing “Everyone will think I’m boring” into “Some people might not find me interesting, but others will” — and replace them with more realistic, balanced alternatives.

I often use this cognitive work in combination with having you gradually engage in [exposure therapy](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/) — facing feared social situations in a controlled and supportive environment — along with behavioral experiments that test the accuracy of your negative beliefs. For instance, if you believe others will notice and judge your nervousness, a behavioral experiment might involve acknowledging you’re a little nervous because the group is impressive, then observing how people actually respond. These exposures and experiments are always done step-by-step at a comfortable pace, often alongside skill-building work like relaxation techniques and [assertiveness training](https://positivepsychology.com/assertiveness-training/). CBT is widely considered the best therapy for social anxiety disorder if you want one specific stand-alone treatment.

### Mindfulness-Based Therapy for Social Anxiety Disorder

Practices like [mindfulness therapy](https://dralanjacobson.com/mindfulness-therapy/) can help reduce fearfulness by increasing your awareness of the present moment. This allows you to observe and accept your thoughts and feelings without judgment. Mindfulness therapy can effectively manage social worries by helping you become more aware of your thoughts, bodily sensations, and emotions related to certain situations. This awareness is the first step in managing anxiety triggers. Then, through mindfulness practice, you learn to observe your anxious thoughts and feelings without immediately reacting. This allows for a more measured response rather than an impulsive reaction driven by anxiety. [Mindfulness combined with CBT](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) is a combination that is often considered the best therapy for social anxiety disorder.

### Acceptance and Commitment Therapy for Social Anxiety Disorder

This approach focuses on accepting your thoughts and feelings rather than trying to control or eliminate them. It helps you clarify your values and take action that aligns with those values, even in the presence of symptoms. [ACT therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) can be validating and empowering. It often starts with defusion techniques to help you distance yourself from your thoughts, seeing them as passing mental events rather than accurate reflections of reality. This can help you detach from self-critical or anxious thoughts about group situations.

ACT doesn’t aim to eliminate anxiety entirely but rather to change the individual’s relationship with the fears. Adding all three of these methods is what an integrated psychological practice like mine considers the best therapy for social anxiety disorder!

### What About Medication?

Sometimes, medication prescribed by a psychiatrist or primary care physician can help alleviate the symptoms. I always suggest that medication be used in conjunction with therapy for social anxiety disorder and not alone. The question of whether to pursue medication is a personal one, and the only times I strongly suggest it is when therapy has not worked, or you are missing out on activities that you will significantly regret missing. Even in these cases, medication will not be a cure, but it can help enough to make our work even more successful.

## Social Anxiety Treatment Outcomes

Social anxiety treatment outcomes can vary depending on several factors, including the severity of the disorder and commitment to therapy. Here are some general outcomes associated with different treatment approaches:

### Social Anxiety Treatment with Cognitive-Behavioral Therapy (CBT)

Research suggests that CBT is one of the best therapy for social anxiety choices, with around [60–80% of individuals](https://www.sciencedirect.com/science/article/abs/pii/S088761852200113X) who undergo CBT experiencing significant improvement or remission of symptoms. CBT typically involves cognitive restructuring (identifying and challenging irrational thoughts), exposure therapy (gradual exposure to feared situations), and skills training (learning confidence-building skills and relaxation techniques). Social anxiety treatment with CBT is a cornerstone of my practice. [Neuroimaging research](https://pmc.ncbi.nlm.nih.gov/articles/PMC9112423/) even suggests CBT can produce measurable changes in the brain circuits involved in fear and threat detection, such as the amygdala — evidence that these gains aren’t just subjective.

### Exposure Therapy Techniques for Anxiety

[Exposure therapy](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/), a component of my CBT approach, involves gradually facing feared situations. Studies have shown that exposure therapy can lead to significant reductions in symptoms. We’ll make sure to move at a pace you are completely comfortable with. Social anxiety treatment with exposure therapy does not have to be uncomfortable to work.

### Mindfulness-Based Social Anxiety Treatment

Mindfulness-based therapies, such as [mindfulness-based stress reduction](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) (MBSR) or [mindfulness-based cognitive therapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) (MBCT), have each shown promise as social anxiety treatments. These approaches focus on cultivating present-moment awareness and acceptance of one’s experiences. I have found mindfulness treatment the best therapy for social anxiety disorder for individuals who struggle with rumination and worry.

Individual responses to social anxiety treatment can vary widely, and what is the best therapy for social anxiety for one person may not work as well for another. Thus, my approach to social anxiety treatment is to work closely with you to find an approach that meets your needs and is comfortable for you.

## Social Phobia Treatment Process

My treatment process for social phobia typically involves several steps aimed at reducing symptoms and improving overall functioning. Here’s an overview of the typical treatment process:

### Step 1: Social Phobia Treatment Assessment

The first step in social phobia treatment is obtaining an accurate diagnosis. This involves discussing your symptoms, their severity, and their impact on daily functioning. The assessment may include an interview, self-report questionnaires, and self-observation — where I present hypothetical situations and ask how you’d respond, or assign homework to face certain situations and observe your reactions.

### Step 2: Therapy for Social Anxiety Disorder Goal Setting

Once a diagnosis is made, we’ll create treatment goals based on your specific symptoms, needs, and preferences. Common social phobia treatment goals include reducing anxiety in certain situations, improving social skills, increasing self-confidence, and enhancing overall quality of life. The goals we set will be measurable and meaningful.

### Step 3: Social Phobia Treatment Planning

Based on the assessment and treatment goals, I’ll develop a personalized treatment plan incorporating various therapeutic approaches and techniques tailored to your needs. The plan may include cognitive-behavioral therapy (CBT), exposure therapy, medication, mindfulness-based interventions, and skills training. I aim to provide the best therapy for social anxiety for you.

### Step 4: Therapeutic Interventions

Therapy sessions typically involve learning and practicing coping strategies to manage symptoms and build confidence. When the work is cognitive, this often means recognizing automatic negative thoughts (ANTs) and common distortions — like mind reading or catastrophizing — and using techniques such as [Socratic questioning](https://en.wikipedia.org/wiki/Socratic_questioning) to test and replace them with more balanced alternatives. In addition to therapy, we can discuss lifestyle changes and self-care practices that can play a crucial role in managing your symptoms. These may include regular exercise, healthy eating, adequate sleep, stress management techniques, and engaging in enjoyable activities.

### Step 5: Maintenance and Relapse Prevention

Once your symptoms have improved, the focus shifts to maintaining treatment gains and preventing relapse. This may involve ongoing but less frequent therapy sessions, practicing coping strategies in real-life social situations, and developing a relapse prevention plan.

Overall, the therapy for social anxiety is individualized and should lead to measurable and meaningful results, with significant improvement in your symptoms and quality of life.

## Therapy for Social Anxiety Disorder Case Example

Alex is a 21-year-old college student who experiences intense worry in social settings, such as [speaking in class](https://dralanjacobson.com/fear-of-public-speaking-therapy-process/), initiating conversations, or attending group activities. Physical symptoms include sweating, trembling, and a racing heart. These symptoms have caused Alex to avoid many situations, leading to academic underperformance and loneliness.

### Initial Assessment

- Alex meets the criteria for Social Anxiety Disorder (SAD)
- Alex reports a fear of being judged, criticized, or embarrassing himself.
- Many interactions provoke severe anxiety, which leads to avoidance.
- A self-report scale ([Liebowitz Social Anxiety Scale](https://nationalsocialanxietycenter.com/liebowitz-sa-scale/)) indicates moderate to severe symptoms.

### Best Therapy for Social Anxiety for Alex

**1. Psychoeducation**

- **Objective:** Help Alex understand the cycle of his symptoms (thoughts → physical symptoms → avoidance).
- **Intervention:** Educate Alex on how anxiety works and normalize the experience. Example: “Many people experience these fears, but they can improve with practice.”

**2. Cognitive Behavioral Therapy (CBT)**

- **Objective:** Challenge distorted thoughts and reduce avoidance behaviors.
- **Cognitive Restructuring:** Alex identifies and challenges negative automatic thoughts, such as “Everyone will think I’m stupid if I speak up.” He learns to reframe this as “I may not be perfect, but people aren’t always focused on judging me.”
- **Behavioral Experiments:** Gradual exposure to feared situations paired with tests of Alex’s negative beliefs. Alex starts with small tasks, such as saying hello to classmates, then progresses to larger goals, like giving a short presentation. In one experiment, Alex deliberately mentions feeling a little nervous during a group discussion, just to see whether people react as negatively as he fears — they don’t.

**3. Exposure Therapy (Systematic Desensitization)**

- **Objective:** Gradually reduce symptoms by facing fears in a controlled way.
- **Hierarchy of Exposure:** A list of feared situations from least to most anxiety-provoking — (1) making eye contact with a stranger, (2) asking a question in class, (3) attending a social event, (4) giving a short presentation.
- **Progress:** Alex practices these tasks repeatedly, using relaxation techniques like deep breathing to manage symptoms.

**4. Mindfulness and Relaxation Techniques**

- **Objective:** Reduce physical symptoms of anxiety and improve present-moment awareness.
- Deep breathing exercises (e.g., box breathing).
- Body scans to release physical tension.
- Mindfulness meditation to prevent spiraling thoughts.

**5. Social Skills Training**

- **Objective:** Improve Alex’s communication skills to build confidence.
- Role-playing conversations.
- Practicing assertiveness skills (e.g., making requests, saying no).

### Outcome

After 12 weeks of therapy for social anxiety disorder: Alex reports reduced symptoms and feels more confident initiating conversations and asking questions in class. Alex has successfully attended gatherings and completed a class presentation. Anxiety has not disappeared but is manageable, and avoidance behaviors have significantly decreased.

This fictitious case demonstrates the [integrative psychological](https://dralanjacobson.com/integrative-therapy/) use of CBT, exposure therapy, and skills training to address symptoms effectively.

## Frequently Asked Questions

**What are some CBT techniques for social anxiety?**

Cognitive Behavioral Therapy includes a range of techniques specifically designed to reduce social anxiety:

- [Cognitive restructuring](https://dralanjacobson.com/cognitive-restructuring/): This involves identifying automatic negative thoughts (e.g., “I’ll embarrass myself,” or “They’ll think I’m stupid”) and replacing them with more balanced, realistic alternatives. You’ll learn to challenge distorted thinking using evidence rather than assumptions.
- Behavioral experiments: These are exercises where you test out feared beliefs in real-life situations. For example, if you fear people will laugh at you for asking a question in a meeting, a behavioral experiment may involve trying it and noting what actually happens.
- [Exposure therapy](https://dralanjacobson.com/exposure-therapy-for-anxiety/): One of the most effective CBT techniques for social anxiety. You’ll create a hierarchy of feared social situations (e.g., making small talk, giving a presentation) and gradually face them in a controlled and supportive way. Repeated exposure helps reduce anxiety over time.
- Safety behavior reduction: Many people rely on “safety behaviors” such as avoiding eye contact, over-rehearsing, or remaining silent. CBT helps identify and reduce these behaviors to break the cycle of anxiety.
- Relaxation and mindfulness: CBT techniques for social anxiety, like deep breathing, progressive muscle relaxation, and mindfulness meditation, help manage physical symptoms of anxiety and increase present-moment awareness.

**What are some CBT strategies for social anxiety I can try myself?**

While working with a therapist is ideal if your symptoms are moderate to severe, there are several CBT-based strategies you can start using on your own:

- Thought journaling: Track anxious thoughts before, during, and after feared situations. Then evaluate them using questions like: “What evidence supports this thought?” or “What would I tell a friend in this situation?”
- Graded exposure: List situations that make you anxious and rate them from least to most anxiety-provoking. Begin practicing with lower-stress situations and gradually increase the intensity. Repeated practice helps reduce avoidance.
- Self-compassion techniques: Social anxiety often involves harsh self-judgment. Practice speaking to yourself with kindness. For example, replace “I looked so stupid” with “It’s okay to make mistakes; everyone does.”
- Imagery rescripting: If you dwell on past mishaps, try visualizing the event in a new, more empowering way. This can help reduce the emotional intensity of memory.
- Assertiveness practice: Practice saying “no,” expressing preferences, or initiating conversation. These small behavioral shifts can build confidence.

Self-help CBT workbooks can also guide you through these processes step-by-step.

**How effective is CBT for social anxiety?**

Numerous research studies have shown that CBT is highly effective for treating social anxiety disorder. In fact, it is considered the first-line psychological treatment by organizations like the [American Psychological Association](https://www.apa.org/).

- Effectiveness rates: Studies show that 60–80% of people with social anxiety experience significant symptom reduction with CBT.
- Long-lasting results: Unlike medication, which may only help while taken, CBT teaches lifelong skills. Many people continue to improve after therapy ends, especially if they maintain their practice.

CBT’s effectiveness improves when individuals are actively engaged, complete homework assignments, and gradually face their fears.

**Is CBT for teenage social anxiety effective?**

Yes, CBT has been adapted successfully for children and teenagers struggling with social anxiety. It is considered one of the most effective treatments for adolescents.

- Teen-friendly formats: CBT for teenage social anxiety includes age-appropriate language, interactive activities, and sometimes group therapy formats that allow peer support.
- Parental involvement: In many cases, parents are included in sessions to help support the teen’s progress at home and encourage engagement.
- Focus on identity and peer pressure: Teen CBT for social anxiety addresses common adolescent themes like fear of judgment, school performance, and social media-related anxiety.

Research shows that [therapy for teens](https://dralanjacobson.com/therapy-for-teens/) using CBT leads to significant improvements in school performance, peer relationships, and self-esteem.

## Therapy for Social Anxiety Disorder in My Practice

It’s important to find a therapist who specializes in treating your symptoms, with whom you feel comfortable, and who can pull together the best therapy for social phobia for your unique needs. Social phobia treatment may involve a combination of approaches tailored to your symptoms and preferences, so you should ask questions about what a prospective therapist might provide. Progress might take time, so patience and persistence are key. However, you should see meaningful and measurable results along the way. I also offer [therapy for generalized anxiety disorder](https://dralanjacobson.com/therapy-for-generalized-anxiety-disorder/) when symptoms are more broad, and [treatment for severe anxiety](https://dralanjacobson.com/treatment-for-severe-anxiety/) when they are particularly intense.

### My Therapeutic Approach

I would be happy to discuss how my [clinical approach](https://dralanjacobson.com/types-of-therapy/) might help you reduce your symptoms and what the best therapy for social phobia might be for you, whether or not I will be treating you. My [integrative approach](https://dralanjacobson.com/integrative-therapy/) works well for those who want to combine different techniques, such as CBT, mindfulness, and ACT, or work on other things beyond social anxiety treatment. I can provide therapy for social anxiety in [couples treatment](https://dralanjacobson.com/couples-therapy/) and with [families](https://dralanjacobson.com/family-therapy/) with older children when one or more people involved suffer from these fears, and I can also deliver it as part of specialty services such as [Fear of Public Speaking](https://dralanjacobson.com/public-speaking-anxiety/) and [speech anxiety treatment](https://dralanjacobson.com/speech-anxiety-treatment/). If you’re looking for in-person therapy and you’re not in Massachusetts or New Hampshire, I may be able to help you find a provider.

Feel free to schedule a [free consultation](https://dralanjacobson.com/contact/) that may provide you with a jump-start of advice and guidance, whether or not you choose to see me for your therapy for social anxiety.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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---

### [Therapy for Girls with ADHD](https://dralanjacobson.com/therapy-for-girls-with-adhd/)

**Published:** December 29, 2024
**Author:** Dr. Alan Jacobson

**Content:**

Attention-Deficit Hyperactivity Disorder often presents differently in girls compared to boys, leading to underdiagnosis or misdiagnosis. While boys are more likely to display externalized symptoms like hyperactivity and impulsivity, **girls with ADHD** often show internalized symptoms that can be mistaken for being anxious, shy (or the opposite – overly social), or unmotivated. Also, **understanding girls with ADHD and anxiety** (since symptoms are often interwoven) requires knowing the inner strength and resilience girls have, often overcoming symptoms enough to achieve well enough to escape notice. Knowing **early ADHD symptoms** in general and the **signs of ADHD in girls** is key.

It should be noted, of course, that whenever we talk about gender-specific signs or symptoms, there is always overlap. Some girls present with “traditional” symptoms, while many boys present in the ways described below. I would happily discuss your child’s needs and what therapy could provide. Feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Girls with ADHD Overview

The following is an overview of ADHD symptoms in girls, their challenges, and strengths. Understanding girls with ADHD involves knowing these facets of their experience.

### Common ADHD Symptoms in Girls

Girls with ADHD and anxiety often have unique symptoms, including:

- **Inattention:** Difficulty focusing, easily distracted, daydreaming, trouble completing tasks.
- **Hyperactivity (less obvious):** More likely to show restlessness (e.g., fidgeting, tapping) rather than running or climbing excessively.
- **Impulsivity:** Speaking without thinking, interrupting conversations, and emotional outbursts.
- **Emotional Dysregulation:** Intense emotions, mood swings, difficulty managing frustration.
- **Perfectionism:** Overcompensating for struggles by trying to meet unrealistic standards.
- **Masking:** Girls with ADHD often become experts at hiding their symptoms to fit in socially.

### Challenges Girls with ADHD Face

Girls with ADHD and anxiety often face challenges that can go unnoticed or underappreciated.

- **Social Struggles:** Early signs of ADHD in girls include difficulty maintaining friendships and feeling left out.
- **Low Self-Esteem:** Frequent undeserved criticism or feelings of failure can damage self-confidence.
- **Academic Challenges:** ADHD symptoms in girls lead to trouble staying organized, following instructions, or completing homework.
- **Late Diagnosis:** Many are not diagnosed until adolescence or adulthood because too few adults truly understand the diagnosis and the early ADHD symptoms.

### Strengths Often Seen in Girls with ADHD

Understanding requires knowing the [strengths and advantages](https://psychologicalassessments.com/benefits-of-adhd/) many girls with the diagnosis have. This is just a partial list.

- Creativity and out-of-the-box thinking
- Strong empathy and emotional insight
- High energy and enthusiasm
- Adaptability to new situations

### Support Strategies

Designing an effective support strategy also involves understanding girls with ADHD and their unique challenges.

- **Structure and Routine:** Consistent daily schedules.
- **Positive Reinforcement:** Celebrate successes and small achievements.
- **Break Tasks into Steps:** Manage overwhelm by tackling smaller tasks.
- **Therapy or Coaching:** Behavioral therapy and coaching can help build coping mechanisms. For adolescents, [cognitive-behavioral therapy](https://dralanjacobson.com/cbt-for-adhd/) or [mindfulness-based treatment](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) can be a good choice.
- **Medication (if needed):** Stimulants or non-stimulants may help manage symptoms.

## Understanding Girls with ADHD

For a deeper dive on the teenage-specific presentation, treatment options, and case examples, see [Teenage Girls with ADHD](https://dralanjacobson.com/teenage-girls-with-adhd/).

The key to understanding is recognizing that their symptoms often present differently from the stereotypical image (typically based on hyperactive boys). This difference can lead to late diagnoses, misunderstandings, and struggles with self-esteem.

### Signs of ADHD in Girls

#### 1. Inattention (The Quiet Symptom)

- One of the most prominent signs of ADHD in girls is difficulty focusing on tasks or conversations, though it is often missed.
- Easily distracted, daydreaming, or zoning out
- One of the early signs of ADHD in girls is that they have trouble following multi-step instructions despite high intelligence.
- Frequently losing items (e.g., keys, homework)
- One of the most misunderstood signs of ADHD in girls is procrastination and difficulty starting tasks, leading to unwarranted negative feedback.

#### 2. Hyperactivity (Often Internalized)

- Instead of being outwardly hyperactive (like running or climbing), they might: 
    - Talk excessively
    - Fidget (e.g., tapping, doodling, playing with hair)
    - Feel intense internal restlessness, even if they manage it

#### 3. [Emotional Dysregulation](https://psychologicalassessments.com/emotional-dysregulation-testing/)

- Intense emotional reactions to minor setbacks
- Frequent mood swings are common signs of ADHD in girls
- Difficulty calming down after emotional outbursts

#### 4. Social Struggles

- Difficulty maintaining friendships due to impulsivity (e.g., blurting things out, interrupting)
- Trouble reading social cues are signs of ADHD in girls, especially when social skills are otherwise good
- Understanding girls with ADHD includes realizing where their fear of rejection or social anxiety comes from

#### 5. Masking

- Girls often become skilled at **masking** their symptoms to fit in socially or meet expectations.
- They might over-prepare, over-apologize, or mimic others to hide their struggles.
- Masking is exhausting and can lead to burnout or anxiety.
- These are core signs of ADHD in girls that keep the diagnosis hidden

### Common Misunderstandings About Girls with ADHD

- **“She’s just shy or quiet.”** → Understanding girls with ADHD means knowing that inattention is mistaken for being introverted.
- **“She’s just emotional.”** → Emotional dysregulation is seen as oversensitivity.
- **“She’s lazy or not trying hard enough.”** → Executive dysfunction makes starting or finishing tasks hard, but it’s not about effort.
- **“She’s a perfectionist.”** → Overcompensating for struggles can lead to burnout.

### Strengths and Potential

- **Creativity:** Unique problem-solving and artistic talents
- **Empathy:** Strong [emotional intelligence](https://psychologicalassessments.com/emotional-intelligence-testing/) and ability to connect with others
- **Hyperfocus:** When engaged in something they love, they can achieve deep focus and productivity
- **Adaptability:** Ability to thrive in dynamic or changing environments

### Supporting Girls with ADHD

- **Listen Without Judgment:** Create a safe space for them to share their experiences.
- **Encourage Breaks:** Short breaks during tasks can improve focus.
- **Provide Clear Instructions:** Break down tasks into smaller, manageable steps.
- **Normalize Conversations:** Help them understand their symptoms are not a flaw but a different way of thinking.
- **Seek Professional Help:** Counseling, therapy, or coaching can provide valuable tools.

## Early ADHD Symptoms in Girls

Symptoms often appear in early childhood, typically before age 12. Early recognition and overall understanding of girls with ADHD are crucial for effective support and intervention.

### Early ADHD Symptoms in Girls in Preschool

#### 1. Inattention Symptoms:

- Difficulty focusing on tasks or activities, even those they enjoy
- Easily distracted by noises, sights, or other stimuli
- Trouble following instructions or completing multi-step tasks
- Frequently losing toys, school supplies, or personal items
- Avoiding tasks that require sustained mental effort (e.g., homework, puzzles)

#### 2. Hyperactivity Symptoms:

- Constant movement (e.g., running, climbing in inappropriate places)
- Difficulty sitting still (e.g., fidgeting, tapping, squirming)
- Talking excessively, often interrupting others
- Seeming “on the go” or unable to relax
- Trouble playing quietly or engaging in calm activities

#### 3. Impulsivity Symptoms:

- Acting without thinking about the consequences
- Interrupting conversations or games
- Difficulty waiting their turn in group activities or conversations
- Blurting out answers before a question is finished
- Emotional outbursts and difficulty managing frustration

### How Symptoms Differ in Girls vs. Boys Early On:

- **Boys:** Often show more **hyperactive-impulsive** behaviors (e.g., running, climbing, acting out).
- **Girls:** More likely to display **inattentive** symptoms (e.g., daydreaming, trouble focusing) and **emotional sensitivity**. They are more prone to **masking** behaviors to fit social expectations.

### Signs of ADHD in Girls to Watch For:

- **Preschool Age (3-5 years):** Symptoms include hyperactivity, trouble following simple instructions, impulsive behavior
- **Early Elementary (6-9 years):** Difficulty focusing on schoolwork, emotional outbursts, poor organizational skills
- **Middle Childhood (10-12 years):** Forgetfulness, low frustration tolerance, academic struggles despite effort

### What to Do if You Notice Early ADHD Symptoms

1. **Document Behaviors:** Keep track of patterns and triggers to those early symptoms.
2. **Talk to Teachers or Caregivers:** Share observations to see if early symptoms occur in multiple settings.
3. **Consult a Pediatrician or Specialist:** Early evaluation can lead to proper diagnosis and intervention.
4. **Explore Support Strategies:** Tools like timers, visual schedules, and task lists can help with focus and structure.

## Girls with ADHD and Anxiety: A Complex Overlap

Attention-Deficit Disorder and anxiety often co-occur, creating a unique set of challenges. The emotional struggles linked to the attention deficit (e.g., impulsivity, forgetfulness, disorganization) can lead to anxiety, while anxiety can worsen attention deficit symptoms by increasing overthinking and indecision. Understanding girls with ADHD involves realizing this vicious cycle.

### Girls with ADHD and Anxiety: Why Symptoms Co-Exist

- **Late Diagnosis:** Many are diagnosed later in life because people miss the early symptoms, leading to years of unmet needs and emotional stress.
- **Masking Symptoms:** Constantly trying to hide symptoms (e.g., inattentiveness, impulsivity) creates chronic stress and anxiety.
- **Fear of Failure:** Struggling to meet academic or social expectations can lead to performance anxiety.
- **Emotional Sensitivity:** Both diagnoses heighten emotional responses, making everyday stressors feel overwhelming.

### Girls with ADHD and Anxiety: How Symptoms Overlap

  Attentional SymptomsAnxiety Symptoms   Easily distractedExcessive worry about making mistakes ProcrastinationOverthinking simple decisions ImpulsivityFear of consequences Emotional outburstsIrritability, nervousness Trouble starting or finishing tasksAvoidance of tasks due to fear of failure Girls with ADHD and anxiety often feel **mentally exhausted** from trying to meet expectations while managing their symptoms.

### Unique Challenges Faced by Girls with ADHD and Anxiety

- **Social Anxiety:** Fear of saying the wrong thing or being judged.
- **Perfectionism:** Obsessive focus on avoiding mistakes to prevent criticism.
- **Sleep Issues:** Racing thoughts combined with hyperactivity can make falling asleep difficult.
- **Low Self-Esteem:** Constantly feeling like they are “not good enough.”

### Strategies for Managing Both Sets of Symptoms

#### 1. Build Structure and Predictability

- Use planners, visual schedules, and reminders.
- Break tasks into smaller, manageable steps.

#### 2. Emotional Regulation Techniques

- Practice **mindfulness exercises** (e.g., deep breathing, grounding techniques).
- I often teach girls with ADHD and anxiety coping strategies like journaling or using fidget tools.

#### 3. Cognitive Behavioral Therapy (CBT)

- Helps girls with ADHD and anxiety manage negative thought patterns.
- Teaches girls with ADHD and anxiety problem-solving skills and emotional regulation.

#### 4. Medication (if recommended)

- Some medications (e.g., stimulants or SSRIs for anxiety) can help manage symptoms.

#### 5. Encourage Open Communication

- Create a safe space for girls with ADHD and anxiety to talk about feelings without judgment.
- Validate their experiences and emotions.

### Strengths of Girls with ADHD and Anxiety

- **Empathy:** They often have a deep emotional understanding of others’ feelings.
- **Creativity:** Innovative problem-solving skills and imagination.
- **Resilience:** Adaptability and determination despite challenges.

Understanding girls with ADHD and anxiety requires patience, empathy, and tailored strategies.

## Case Example: 14-Year-Old Ava

### Background:

Ava is a 14-year-old middle school student who has always been described as *“bright but scattered.”* Her teachers noticed she often seemed lost in thought during lessons, forgot to turn in her homework, and struggled with following multi-step instructions. Her parents observed her constant procrastination, messy room, and frequent emotional outbursts at home over seemingly small issues.

### Early ADHD Symptoms

- She has difficulty focusing on schoolwork unless it’s a topic she’s deeply interested in.
- She frequently loses her school supplies and forgets assignments.
- Early symptoms included restlessness, fidgeting with her hair, or tapping her pencil during class.
- She struggles to start tasks and feels overwhelmed by large projects.

### Anxiety Presentation:

- She worries excessively about grades and being liked by her peers.
- She avoids participating in class discussions for fear of saying the wrong thing.
- Overthinks simple decisions, such as choosing what to wear to school.
- Experiences stomachaches and trouble sleeping before tests or presentations.

### Masking:

Ava is highly aware of her struggles and works hard to hide them. She writes detailed to-do lists but becomes paralyzed by the fear of forgetting something. At school, she avoids asking for help to prevent looking *“stupid.”*

### Impact on Daily Life:

- **Academics:** Falling behind in assignments despite spending hours on homework.
- **Friendships:** Feels socially anxious, afraid her friends will reject her if she says the wrong thing.
- **Self-Esteem:** Frequently calls herself *“lazy”* and *“dumb.”*

### Intervention Plan:

1. **[Academic Accommodations for ADHD](https://psychologicalassessments.com/testing-for-adhd-accommodations-for-school-and-work/):**
    - Extra time on assignments and tests.
    - Seat placement in a low-distraction area.
    - Clear, step-by-step instructions for tasks.
2. **Therapy ([CBT for ADHD](https://dralanjacobson.com/cbt-for-adhd/)):**
    - Help Ava challenge negative thought patterns (e.g., *“If I don’t get this perfect, I’ll fail.”*).
    - Teach coping strategies for anxiety (e.g., deep breathing, grounding exercises).
3. **Home Support:**
    - Use a visual schedule for daily routines.
    - Break chores and homework into smaller steps.
    - Praise effort over outcomes to reduce fear of failure.
4. **Medication:**
    - After consultation with a pediatric psychiatrist, Ava starts a low-dose stimulant for attention and an SSRI for anxiety.

**Progress After 6 Months:**

- Ava feels more confident asking for help when she doesn’t understand something.
- Her academic performance improves with structure and reduced anxiety.
- She reports fewer emotional breakdowns and enjoys spending time with friends without constant worry.

This case highlights how important understanding girls with ADHD is, in this case, how anxiety and attentional symptoms can intertwine, creating a cycle of frustration and self-blame. Addressing both conditions simultaneously through therapy, accommodations, and support can lead to meaningful improvement. Knowing the signs of ADHD in girls provided an important first step.

## My Work with Girls with ADHD

I provide specialized therapy for girls with ADHD and consultation to parents and teachers about early ADHD symptoms and signs in girls. I can also arrange [psychological testing](https://psychologicalassessments.com/) to provide a detailed assessment. For college students and over, please refer to my posts about [ADHD treatment for teens](https://dralanjacobson.com/adhd-treatment-for-teens/) and [ADHD in women](https://dralanjacobson.com/women-with-adhd/). [Individual therapy](https://dralanjacobson.com/individual-therapy/) can be effective virtually, depending on the child’s age and comfort with virtual methods. However, with younger children, the services I provide often revolve around [family therapy](https://dralanjacobson.com/family-therapy/) or parent consultation.

If you want more information about understanding ADHD in girls or would like to talk about therapy for your child, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Frequently Asked Questions: Therapy for Girls with ADHD

Answers to common questions parents and families have about ADHD in girls, from early childhood through the teen years — including how it presents, why it’s often missed, and how therapy helps. For a deeper look at the teenage-specific presentation, treatment options, and case examples, see [Teenage Girls with ADHD](https://dralanjacobson.com/teenage-girls-with-adhd/).

### Why do girls with ADHD so often develop anxiety as well?

The co-occurrence of ADHD and anxiety in girls is well-documented and reflects a reinforcing cycle that often starts young. ADHD symptoms — forgetfulness, impulsivity, difficulty keeping up — create repeated experiences of falling short, being criticized, and feeling out of step with peers, sometimes as early as preschool or elementary school. Over time this generates chronic stress and anxiety. Masking compounds this: constantly monitoring and suppressing symptoms to appear “normal” is cognitively and emotionally exhausting, and that exhaustion itself fuels anxiety. Meanwhile, anxiety worsens ADHD symptoms by increasing overthinking and indecision, making it harder to initiate tasks or tolerate uncertainty. Effective treatment addresses both simultaneously rather than treating them in sequence. For older girls whose ADHD trends toward depression rather than anxiety, see the co-occurring-depression discussion on the [Teenage Girls with ADHD](https://dralanjacobson.com/teenage-girls-with-adhd/) page.

### How does therapy address the low self-esteem and self-blame that often develops in girls with ADHD?

This is frequently the most clinically important part of the work. Girls who have spent years being told — or telling themselves — that they are lazy, disorganized, too emotional, or not trying hard enough carry significant psychological weight by the time they reach treatment. Therapy creates a reframe: the struggles are not character flaws but the predictable result of a neurological difference that was never properly identified or supported. Work focuses on building an accurate and compassionate self-narrative, recognizing genuine [ADHD strengths](https://psychologicalassessments.com/benefits-of-adhd/) — creativity, empathy, hyperfocus, adaptability — alongside practical skills, and dismantling the perfectionism that often develops as a coping strategy. For many girls, understanding their diagnosis for the first time is itself profoundly relieving.

### At what age should a girl be evaluated or start therapy for ADHD?

Early intervention produces the best outcomes. ADHD symptoms can appear in preschool — difficulty following multi-step instructions, emotional outbursts, trouble with transitions — though diagnosis before age 5 is typically made with caution. In early elementary school (ages 6–9), inattention, poor organization, and emotional sensitivity often become more visible as academic demands increase. Many girls are not identified until middle school or later, when masking breaks down under the weight of social complexity and heavier coursework. If parents or teachers notice a consistent pattern of struggles that seem disproportionate to ability, an evaluation is warranted at any age. [Comprehensive psychological testing](https://psychologicalassessments.com/) can clarify the diagnosis and distinguish ADHD from anxiety, learning disabilities, or both.

### Does my daughter need a formal ADHD diagnosis before starting therapy?

Not necessarily — therapy can begin before a formal diagnosis is in place and can itself be part of a broader assessment process. Many of the skills taught in therapy (emotional regulation, task initiation strategies, self-monitoring) are helpful regardless of diagnosis. That said, a formal evaluation is strongly recommended because it clarifies the clinical picture, rules out other contributing factors, and opens the door to academic accommodations that can be transformative. Dr. Jacobson can provide both clinical therapy and referrals for [ADHD testing](https://psychologicalassessments.com/adhd-testing/) through Precision Psychological Assessments, allowing families to pursue both tracks efficiently. For teens and college students, see also the pages on [ADHD treatment for teens](https://dralanjacobson.com/adhd-treatment-for-teens/) and [ADHD in women](https://dralanjacobson.com/women-with-adhd/).

### How do I get started — and what does the first conversation look like?

The first step is a free 20-minute consultation. For younger girls, this conversation typically involves parents; for teens and older adolescents, it may include the young person directly. Dr. Jacobson will ask about what you’re observing, how long it’s been going on, what’s been tried, and what your goals are. The conversation is practical and low-pressure — there’s no commitment required. Many parents feel significant relief simply from speaking with someone who recognizes the specific presentation they’ve been trying to describe to teachers, pediatricians, and others who may have missed it. You can also review the broader [Therapy FAQs](https://dralanjacobson.com/therapy-faqs/) for general information before reaching out.

You’ve seen the signs. Let’s talk about what to do next.

Schedule a free 20-minute consultation with Dr. Jacobson — no commitment, no pressure. A conversation designed to give you clarity, not more questions.

[Schedule a Free Consultation](https://www.picktime.com/scheduleaconsult)

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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---

### [Fear of Public Speaking Groups](https://dralanjacobson.com/fear-of-public-speaking-groups/)

**Published:** February 25, 2024
**Author:** Dr. Alan Jacobson

**Content:**

\[et\_pb\_section fb\_built="1" fullwidth="on" admin\_label="Header" \_builder\_version="4.23.2" background\_image="https://dralanjacobson.com/wp-content/uploads/2024/02/business-04.jpg" parallax="on" custom\_padding="|||" animation\_style="slide" animation\_direction="top" animation\_intensity\_slide="2%" global\_colors\_info="{}"\]\[et\_pb\_fullwidth\_header title="Fear of Public Speaking Groups" subhead="Open | Virtual" button\_one\_text="Sign Up Now" button\_one\_url="https://dralanjacobson.com/contact/" button\_two\_text="Other Therapy Groups" button\_two\_url="https://dralanjacobson.com/group-therapy/" background\_overlay\_color="rgba(255,255,255,0.6)" content\_max\_width="700px" content\_max\_width\_tablet="100%" content\_max\_width\_phone="" content\_max\_width\_last\_edited="on|desktop" \_builder\_version="4.27.4" title\_font="Roboto|300|||||||" title\_font\_size="60px" title\_line\_height="1.4em" content\_font="||||||||" subhead\_font="|600|||||||" subhead\_font\_size="20px" subhead\_line\_height="1.8em" background\_color="rgba(255,255,255,0.3)" background\_image="https://dralanjacobson.com/wp-content/uploads/2024/02/dots-3.png" custom\_button\_one="on" button\_one\_text\_size="14px" button\_one\_text\_color="#ffffff" button\_one\_bg\_color="#8300e9" button\_one\_bg\_color\_gradient\_direction="90deg" button\_one\_bg\_color\_gradient\_stops="#d883f8 0%|#352DBE 100%" button\_one\_bg\_color\_gradient\_start="#d883f8" button\_one\_bg\_color\_gradient\_end="#352DBE" button\_one\_border\_width="10px" button\_one\_border\_color="rgba(0,0,0,0)" button\_one\_border\_radius="100px" button\_one\_letter\_spacing="3px" button\_one\_font="Roboto|700||on|||||" custom\_button\_two="on" button\_two\_text\_size="14px" button\_two\_text\_color="#ffffff" button\_two\_bg\_color="#06c8ff" button\_two\_border\_width="10px" button\_two\_border\_color="rgba(0,0,0,0)" button\_two\_border\_radius="100px" button\_two\_letter\_spacing="3px" button\_two\_font="Roboto|700||on|||||" background\_layout="light" custom\_margin="-70px||||false|false" custom\_padding="12vw||12vw||true" custom\_padding\_tablet="250px||250px||true" custom\_padding\_last\_edited="off|desktop" hover\_enabled="0" title\_font\_size\_tablet="40px" title\_font\_size\_phone="32px" title\_font\_size\_last\_edited="on|desktop" button\_one\_text\_color\_hover="#ffffff" button\_two\_text\_color\_hover="#ffffff" button\_one\_letter\_spacing\_hover="3px" button\_two\_letter\_spacing\_hover="3px" global\_colors\_info="{}" button\_one\_text\_size\_\_hover\_enabled="off" button\_two\_text\_size\_\_hover\_enabled="off" button\_one\_text\_color\_\_hover\_enabled="on" button\_one\_text\_color\_\_hover="#ffffff" button\_two\_text\_color\_\_hover\_enabled="on" button\_two\_text\_color\_\_hover="#ffffff" button\_one\_border\_width\_\_hover\_enabled="off" button\_two\_border\_width\_\_hover\_enabled="off" button\_one\_border\_color\_\_hover\_enabled="off" button\_two\_border\_color\_\_hover\_enabled="off" button\_one\_border\_radius\_\_hover\_enabled="off" button\_two\_border\_radius\_\_hover\_enabled="off" button\_one\_letter\_spacing\_\_hover\_enabled="on" button\_one\_letter\_spacing\_\_hover="3px" button\_two\_letter\_spacing\_\_hover\_enabled="on" button\_two\_letter\_spacing\_\_hover="3px" button\_one\_bg\_color\_\_hover\_enabled="off" button\_two\_bg\_color\_\_hover\_enabled="off" sticky\_enabled="0"\]

A unique approach that combines group therapy with public speaking lessons. The result is an online public speaking class that helps you become a better orator and feel far less anxiety when you do talk in front of others (and beforehand!). This approach provides a supportive environment where you can share your experiences, fears, and successes with others who are facing similar challenges.

\[/et\_pb\_fullwidth\_header\]\[/et\_pb\_section\]\[et\_pb\_section fb\_built="1" admin\_label="conference" \_builder\_version="4.16" global\_colors\_info="{}"\]\[et\_pb\_row column\_structure="1\_2,1\_2" padding\_top\_bottom\_link\_1="true" padding\_left\_right\_link\_1="true" \_builder\_version="4.16" global\_colors\_info="{}"\]\[et\_pb\_column type="1\_2" \_builder\_version="4.16" background\_image="https://dralanjacobson.com/wp-content/uploads/2024/02/column-background-02.png" custom\_padding="50px|50px|50px|50px" custom\_padding\_tablet="50px|50px|50px|50px" custom\_padding\_phone="20px|20px|20px|20px|true|true" custom\_padding\_last\_edited="on|phone" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_image src="https://dralanjacobson.com/wp-content/uploads/2023/06/cropped-public-speaking-jpg.webp" alt="Fear of Public Speaking Group" title\_text="flying fear" align\_tablet="center" align\_phone="center" align\_last\_edited="on|desktop" \_builder\_version="4.23.2" animation\_style="zoom" animation\_intensity\_zoom="10%" box\_shadow\_style="preset1" box\_shadow\_vertical="32px" box\_shadow\_blur="100px" box\_shadow\_color="rgba(0,0,0,0.15)" global\_colors\_info="{}"\]\[/et\_pb\_image\]\[/et\_pb\_column\]\[et\_pb\_column type="1\_2" \_builder\_version="4.16" custom\_padding="200px|||" custom\_padding\_tablet="0px|||" custom\_padding\_phone="0px|||" custom\_padding\_last\_edited="on|desktop" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.23.2" text\_font="||||||||" header\_font="||||||||" header\_2\_font="Roboto|300|||||||" header\_2\_font\_size="50px" header\_2\_line\_height="1.4em" custom\_margin="-100px||||false|false" header\_2\_font\_size\_tablet="40px" header\_2\_font\_size\_phone="32px" header\_2\_font\_size\_last\_edited="on|phone" global\_colors\_info="{}"\]## Benefits of Fear of Public Speaking Groups?

Overall, fear of public speaking groups provide a supportive and structured environment for individuals to overcome their fear, gain confidence, and learn lessons that combine to improve their confidence in talking in front of others.

Individually, public speaking lessons and group therapy for anxiety about speaking in front of others work well. Combined there is a [powerful effect that is also time and cost effective](https://dralanjacobson.com/telehealth-therapy-teletherapy/).

Sharing experiences and coping strategies with peers can help you feel less isolated and more empowered. The public speaking group is probably the safest and most comfortable place you can talk in front of, and the confidence you build will carry over.

\[/et\_pb\_text\]\[/et\_pb\_column\]\[/et\_pb\_row\]\[/et\_pb\_section\]\[et\_pb\_section fb\_built="1" admin\_label="Schedule" \_builder\_version="4.23.2" background\_color="#eeef8b" max\_width\_tablet="" max\_width\_phone="100%" max\_width\_last\_edited="on|phone" custom\_margin="|||" custom\_padding="54px|0px|100px|0px|false|false" global\_colors\_info="{}"\]\[et\_pb\_row \_builder\_version="4.16" custom\_margin="||60px|" global\_colors\_info="{}"\]\[et\_pb\_column type="4\_4" \_builder\_version="4.16" custom\_padding="|||" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.23.2" text\_font="||||||||" header\_font="||||||||" header\_2\_font="Roboto|300|||||||" header\_2\_font\_size="50px" header\_2\_line\_height="1.2em" text\_orientation="center" max\_width="700px" max\_width\_tablet="" max\_width\_phone="" max\_width\_last\_edited="on|desktop" module\_alignment="center" header\_2\_font\_size\_tablet="40px" header\_2\_font\_size\_phone="32px" header\_2\_font\_size\_last\_edited="on|phone" global\_colors\_info="{}"\]## Fear of Public Speaking Groups Schedule

Sample

\[/et\_pb\_text\]\[/et\_pb\_column\]\[/et\_pb\_row\]\[et\_pb\_row column\_structure="1\_4,1\_4,1\_2" \_builder\_version="4.16" max\_width="900px" custom\_margin\_tablet="|||" custom\_margin\_phone="|||" custom\_margin\_last\_edited="on|desktop" animation\_style="zoom" animation\_direction="top" animation\_intensity\_zoom="10%" border\_color\_all="rgba(51,51,51,0.05)" border\_width\_bottom="2px" use\_custom\_width="on" custom\_width\_px="900px" global\_colors\_info="{}"\]\[et\_pb\_column type="1\_4" \_builder\_version="4.16" custom\_padding="|||" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.23.2" header\_font="||||||||" header\_6\_font="Roboto|||on|||||" header\_6\_font\_size="20px" header\_6\_line\_height="1.2em" global\_colors\_info="{}"\]###### 6:00 pm

\[/et\_pb\_text\]\[/et\_pb\_column\]\[et\_pb\_column type="1\_4" \_builder\_version="4.16" custom\_padding="|||" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.16" text\_font="||||||||" header\_font="||||||||" header\_3\_font="||||||||" header\_4\_font="||||||||" header\_5\_font="Roboto||||||||" header\_5\_text\_color="#00b2e5" header\_5\_line\_height="1.4em" header\_6\_font="||||||||" global\_colors\_info="{}"\]##### Check-In

 \[/et\_pb\_text\]\[/et\_pb\_column\]\[et\_pb\_column type="1\_2" \_builder\_version="4.16" custom\_padding="|||" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.23.2" text\_font="||||||||" header\_font="||||||||" header\_6\_font="Roboto||||||||" header\_6\_text\_color="#00b2e5" header\_6\_font\_size="20px" header\_6\_line\_height="1.2em" global\_colors\_info="{}"\]Prior to things starting, you check in and, just like in-person, you can informally chat with others if you'd like, post your questions, or just wait for things to start.

\[/et\_pb\_text\]\[/et\_pb\_column\]\[/et\_pb\_row\]\[et\_pb\_row column\_structure="1\_4,1\_4,1\_2" \_builder\_version="4.16" max\_width="900px" custom\_margin\_tablet="|||" custom\_margin\_phone="|||" custom\_margin\_last\_edited="on|desktop" animation\_style="zoom" animation\_direction="top" animation\_intensity\_zoom="10%" border\_color\_all="rgba(51,51,51,0.05)" border\_width\_bottom="2px" use\_custom\_width="on" custom\_width\_px="900px" global\_colors\_info="{}"\]\[et\_pb\_column type="1\_4" \_builder\_version="4.16" custom\_padding="|||" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.23.2" header\_font="||||||||" header\_6\_font="Roboto|||on|||||" header\_6\_font\_size="20px" header\_6\_line\_height="1.2em" global\_colors\_info="{}"\]###### 6:10 pm

\[/et\_pb\_text\]\[/et\_pb\_column\]\[et\_pb\_column type="1\_4" \_builder\_version="4.16" custom\_padding="|||" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.23.2" text\_font="||||||||" header\_font="||||||||" header\_3\_font="||||||||" header\_4\_font="||||||||" header\_5\_font="Roboto||||||||" header\_5\_text\_color="#00b2e5" header\_5\_line\_height="1.4em" header\_6\_font="||||||||" global\_colors\_info="{}"\]##### Welcome and Public Speaking Lessons

\[/et\_pb\_text\]\[/et\_pb\_column\]\[et\_pb\_column type="1\_2" \_builder\_version="4.16" custom\_padding="|||" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.23.2" text\_font="||||||||" header\_font="||||||||" header\_6\_font="Roboto||||||||" header\_6\_text\_color="#00b2e5" header\_6\_font\_size="20px" header\_6\_line\_height="1.2em" global\_colors\_info="{}"\]The public speaking group therapy session often begins with welcoming new members and quick public speaking lessons. This breaks the ice in a comfortable way.

\[/et\_pb\_text\]\[/et\_pb\_column\]\[/et\_pb\_row\]\[et\_pb\_row column\_structure="1\_4,1\_4,1\_2" \_builder\_version="4.16" max\_width="900px" custom\_margin\_tablet="|||" custom\_margin\_phone="|||" custom\_margin\_last\_edited="on|desktop" animation\_style="zoom" animation\_direction="top" animation\_intensity\_zoom="10%" border\_color\_all="rgba(51,51,51,0.05)" border\_width\_bottom="2px" use\_custom\_width="on" custom\_width\_px="900px" global\_colors\_info="{}"\]\[et\_pb\_column type="1\_4" \_builder\_version="4.16" custom\_padding="|||" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.23.2" header\_font="||||||||" header\_6\_font="Roboto|||on|||||" header\_6\_font\_size="20px" header\_6\_line\_height="1.2em" global\_colors\_info="{}"\]###### 6:15 pm

\[/et\_pb\_text\]\[/et\_pb\_column\]\[et\_pb\_column type="1\_4" \_builder\_version="4.16" custom\_padding="|||" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.23.2" text\_font="||||||||" header\_font="||||||||" header\_3\_font="||||||||" header\_4\_font="||||||||" header\_5\_font="Roboto||||||||" header\_5\_text\_color="#00b2e5" header\_5\_line\_height="1.4em" header\_6\_font="||||||||" global\_colors\_info="{}"\]##### Member Updates

\[/et\_pb\_text\]\[/et\_pb\_column\]\[et\_pb\_column type="1\_2" \_builder\_version="4.16" custom\_padding="|||" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.23.2" text\_font="||||||||" header\_font="||||||||" header\_6\_font="Roboto||||||||" header\_6\_text\_color="#00b2e5" header\_6\_font\_size="20px" header\_6\_line\_height="1.2em" global\_colors\_info="{}"\]Members can volunteer to share their personal experiences. This sharing helps all participants feel understood and less alone in their struggles.

\[/et\_pb\_text\]\[/et\_pb\_column\]\[/et\_pb\_row\]\[et\_pb\_row column\_structure="1\_4,1\_4,1\_2" \_builder\_version="4.16" max\_width="900px" custom\_margin\_tablet="|||" custom\_margin\_phone="|||" custom\_margin\_last\_edited="on|desktop" animation\_style="zoom" animation\_direction="top" animation\_intensity\_zoom="10%" border\_color\_all="rgba(51,51,51,0.05)" border\_width\_bottom="2px" use\_custom\_width="on" custom\_width\_px="900px" global\_colors\_info="{}"\]\[et\_pb\_column type="1\_4" \_builder\_version="4.16" custom\_padding="|||" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.23.2" header\_font="||||||||" header\_6\_font="Roboto|||on|||||" header\_6\_font\_size="20px" header\_6\_line\_height="1.2em" global\_colors\_info="{}"\]###### 6:25 pm

\[/et\_pb\_text\]\[/et\_pb\_column\]\[et\_pb\_column type="1\_4" \_builder\_version="4.16" custom\_padding="|||" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.27.4" text\_font="||||||||" header\_font="||||||||" header\_3\_font="||||||||" header\_4\_font="||||||||" header\_5\_font="Roboto||||||||" header\_5\_text\_color="#00b2e5" header\_5\_line\_height="1.4em" header\_6\_font="||||||||" global\_colors\_info="{}"\]##### Updates from former members 

\[/et\_pb\_text\]\[/et\_pb\_column\]\[et\_pb\_column type="1\_2" \_builder\_version="4.16" custom\_padding="|||" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.23.2" text\_font="||||||||" header\_font="||||||||" header\_6\_font="Roboto||||||||" header\_6\_text\_color="#00b2e5" header\_6\_font\_size="20px" header\_6\_line\_height="1.2em" global\_colors\_info="{}"\]Hearing success stories from former members of my public speaking groups can be motivating. I hope you will stay in touch as well after you overcome your fears.

\[/et\_pb\_text\]\[/et\_pb\_column\]\[/et\_pb\_row\]\[et\_pb\_row column\_structure="1\_4,1\_4,1\_2" \_builder\_version="4.16" max\_width="900px" custom\_margin\_tablet="|||" custom\_margin\_phone="|||" custom\_margin\_last\_edited="on|desktop" animation\_style="zoom" animation\_direction="top" animation\_intensity\_zoom="10%" border\_color\_all="rgba(51,51,51,0.05)" border\_width\_bottom="2px" use\_custom\_width="on" custom\_width\_px="900px" global\_colors\_info="{}"\]\[et\_pb\_column type="1\_4" \_builder\_version="4.16" custom\_padding="|||" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.23.2" header\_font="||||||||" header\_6\_font="Roboto|||on|||||" header\_6\_font\_size="20px" header\_6\_line\_height="1.2em" global\_colors\_info="{}"\]###### 6:30 PM

\[/et\_pb\_text\]\[/et\_pb\_column\]\[et\_pb\_column type="1\_4" \_builder\_version="4.16" custom\_padding="|||" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.23.2" text\_font="||||||||" header\_font="||||||||" header\_3\_font="||||||||" header\_4\_font="||||||||" header\_5\_font="Roboto||||||||" header\_5\_text\_color="#00b2e5" header\_5\_line\_height="1.4em" header\_6\_font="||||||||" global\_colors\_info="{}"\]##### CBT Therapy Techniques

\[/et\_pb\_text\]\[/et\_pb\_column\]\[et\_pb\_column type="1\_2" \_builder\_version="4.16" custom\_padding="|||" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.23.2" text\_font="||||||||" header\_font="||||||||" header\_6\_font="Roboto||||||||" header\_6\_text\_color="#00b2e5" header\_6\_font\_size="20px" header\_6\_line\_height="1.2em" global\_colors\_info="{}"\]This is the core part of my fear of public speaking groups. I will teach you cognitive-behavioral (CBT) and exposure-response-prevention (ERP) methods. These techniques will be integrated with public speaking lessons for a powerful approach.

\[/et\_pb\_text\]\[/et\_pb\_column\]\[/et\_pb\_row\]\[et\_pb\_row column\_structure="1\_4,1\_4,1\_2" \_builder\_version="4.16" max\_width="900px" custom\_margin\_tablet="|||" custom\_margin\_phone="|||" custom\_margin\_last\_edited="on|desktop" animation\_style="zoom" animation\_direction="top" animation\_intensity\_zoom="10%" border\_color\_all="rgba(51,51,51,0.05)" border\_width\_bottom="2px" use\_custom\_width="on" custom\_width\_px="900px" global\_colors\_info="{}"\]\[et\_pb\_column type="1\_4" \_builder\_version="4.16" custom\_padding="|||" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.23.2" header\_font="||||||||" header\_6\_font="Roboto|||on|||||" header\_6\_font\_size="20px" header\_6\_line\_height="1.2em" global\_colors\_info="{}"\]###### 7:00 pm

\[/et\_pb\_text\]\[/et\_pb\_column\]\[et\_pb\_column type="1\_4" \_builder\_version="4.16" custom\_padding="|||" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.27.4" text\_font="||||||||" header\_font="||||||||" header\_3\_font="||||||||" header\_4\_font="||||||||" header\_5\_font="Roboto||||||||" header\_5\_text\_color="#00b2e5" header\_5\_line\_height="1.4em" header\_6\_font="||||||||" hover\_enabled="0" global\_colors\_info="{}" sticky\_enabled="0"\]##### Summarizing and Homework

\[/et\_pb\_text\]\[/et\_pb\_column\]\[et\_pb\_column type="1\_2" \_builder\_version="4.16" custom\_padding="|||" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.23.2" text\_font="||||||||" header\_font="||||||||" header\_6\_font="Roboto||||||||" header\_6\_text\_color="#00b2e5" header\_6\_font\_size="20px" header\_6\_line\_height="1.2em" global\_colors\_info="{}"\]Here, we will summarize the fear of public speaking lessons learned today and in recent sessions. Like any online public speaking class, you may be given homework assignments, often integrating with CBT or ERP techniques. You'll always be able to go at a pace you are comfortable with.

\[/et\_pb\_text\]\[/et\_pb\_column\]\[/et\_pb\_row\]\[et\_pb\_row \_builder\_version="4.23.2" \_module\_preset="default" global\_colors\_info="{}"\]\[et\_pb\_column type="4\_4" \_builder\_version="4.23.2" \_module\_preset="default" global\_colors\_info="{}"\]\[et\_pb\_text \_builder\_version="4.23.2" \_module\_preset="default" header\_3\_font\_size="32px" global\_colors\_info="{}"\]### Public Speaking Groups and Participation

One important note about the schedule above: Each member is free to share as much or as little as they want during each step. You can join in on discussion at whatever pace feels most comfortable. Some people feel more comfortable participating more during the more formal fear of public speaking lessons, while others share their own experiences.

### Online Public Speaking Class Requirements

I ask that you identify yourself with at least your first name and keep your camera on for each session. I also ask that you attend the online public speaking class each week until you have accomplished your goals. You should be in a place where you are unlikely to be interrupted, and I ask that you face your computer away from where others could see your screen.

\[/et\_pb\_text\]\[/et\_pb\_column\]\[/et\_pb\_row\]\[/et\_pb\_section\]\[et\_pb\_section fb\_built="1" admin\_label="The Location" \_builder\_version="4.16" background\_image="https://dralanjacobson.com/wp-content/uploads/2024/02/bg-4.png" background\_size="initial" background\_position="bottom\_left" custom\_padding="54px|0px|54px|0px|false|false" global\_colors\_info="{}"\]\[et\_pb\_row column\_structure="1\_2,1\_2" padding\_top\_bottom\_link\_1="false" padding\_top\_bottom\_link\_2="false" padding\_left\_right\_link\_2="true" \_builder\_version="4.16" custom\_padding="0px|0px|0|0px|false|false" global\_colors\_info="{}"\]\[et\_pb\_column type="1\_2" \_builder\_version="4.16" custom\_padding="10%||40px|" custom\_padding\_tablet="0px||0px|" custom\_padding\_phone="0px||0px|" custom\_padding\_last\_edited="on|desktop" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.16" text\_font="||||||||" header\_font="||||||||" header\_2\_font="Roboto|300|||||||" header\_2\_font\_size="50px" header\_2\_line\_height="1.2em" max\_width="700px" max\_width\_tablet="" max\_width\_phone="" max\_width\_last\_edited="on|desktop" module\_alignment="center" header\_2\_font\_size\_tablet="40px" header\_2\_font\_size\_phone="32px" header\_2\_font\_size\_last\_edited="on|phone" global\_colors\_info="{}"\]## Group Coverage Area

You can join my fear of public speaking groups from any of the states in green on the map to the right.

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custom\_padding\_last\_edited="on|phone" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[et\_pb\_image src="https://dralanjacobson.com/wp-content/uploads/2024/11/PsyPACT-Map-1.png" alt="online public speaking class" title\_text="PsyPACT Map" align\_tablet="center" align\_phone="center" align\_last\_edited="on|desktop" \_builder\_version="4.27.4" animation\_style="zoom" animation\_intensity\_zoom="10%" box\_shadow\_style="preset1" box\_shadow\_vertical="32px" box\_shadow\_blur="100px" box\_shadow\_color="rgba(0,0,0,0.15)" global\_colors\_info="{}"\]\[/et\_pb\_image\]\[/et\_pb\_column\]\[/et\_pb\_row\]\[/et\_pb\_section\]\[et\_pb\_section fb\_built="1" admin\_label="Subscribe" \_builder\_version="4.23.2" use\_background\_color\_gradient="on" background\_color\_gradient\_direction="90deg" background\_color\_gradient\_stops="#D883F8 0%|#352DBE 100%" background\_color\_gradient\_start="#D883F8" background\_color\_gradient\_end="#352DBE" background\_image="https://dralanjacobson.com/wp-content/uploads/2024/02/dots-2.png" custom\_margin="|||" custom\_padding="101px||101px||true|" saved\_tabs="all" global\_colors\_info="{}"\]\[et\_pb\_row \_builder\_version="4.23.2" \_module\_preset="default" global\_colors\_info="{}"\]\[et\_pb\_column type="4\_4" \_builder\_version="4.23.2" \_module\_preset="default" global\_colors\_info="{}"\]\[et\_pb\_heading title="Public Speaking Lessons" \_builder\_version="4.23.2" \_module\_preset="default" title\_level="h2" title\_text\_align="center" title\_text\_color="#FFFFFF" title\_font\_size="52px" global\_colors\_info="{}"\]\[/et\_pb\_heading\]\[/et\_pb\_column\]\[/et\_pb\_row\]\[et\_pb\_row column\_structure="1\_3,1\_3,1\_3" use\_custom\_gutter="on" gutter\_width="1" \_builder\_version="4.23.2" max\_width="1200px" border\_color\_top="#FFE7AF" border\_width\_right="8px" border\_color\_right="#FFE7AF" border\_color\_left="#FFE7AF" locked="off" global\_colors\_info="{}" custom\_padding\_\_hover\_enabled="off|desktop" custom\_padding\_\_hover="20px|20px|20px|20px|true|true"\]\[et\_pb\_column type="1\_3" \_builder\_version="4.16" custom\_padding="20px|20px|20px|20px|true|true" custom\_padding\_tablet="0px|0px|0px|0px|true|true" custom\_padding\_phone="" custom\_padding\_last\_edited="on|tablet" link\_option\_url="#" border\_width\_all="4px" border\_color\_all="rgba(0,0,0,0)" global\_colors\_info="{}" border\_color\_all\_\_hover="#353752" border\_color\_all\_\_hover\_enabled="on|hover"\]\[et\_pb\_blurb title="Improve Your Delivery" icon\_alignment="left" content\_max\_width="100%" \_builder\_version="4.23.2" header\_level="h3" header\_font="Heebo|900|||||||" header\_text\_color="#FFFFFF" header\_font\_size="18px" header\_line\_height="1.3em" custom\_padding="||10px|||" header\_font\_size\_phone="20px" header\_font\_size\_last\_edited="off|desktop" body\_font\_size\_tablet="14px" body\_font\_size\_last\_edited="off|desktop" locked="off" global\_colors\_info="{}" custom\_padding\_\_hover\_enabled="off|hover" custom\_padding\_\_hover="10px|20px|10px|20px|true|true"\]Fear of public speaking lessons will improve your delivery, cutting out any quirks you have and helping you look and feel confident in front of a group. This part of the service functions as a high-level public speaking class and would be valuable even if you had no anxiety.

\[/et\_pb\_blurb\]\[/et\_pb\_column\]\[et\_pb\_column type="1\_3" \_builder\_version="4.16" custom\_padding="20px|20px|20px|20px|true|true" custom\_padding\_tablet="0px|0px|0px|0px|true|true" custom\_padding\_phone="" custom\_padding\_last\_edited="on|tablet" link\_option\_url="#" border\_width\_all="4px" border\_color\_all="rgba(0,0,0,0)" global\_colors\_info="{}" border\_color\_all\_\_hover="#353752" border\_color\_all\_\_hover\_enabled="on|hover"\]\[et\_pb\_blurb title="Reduced Anxiety and Stress" icon\_alignment="left" content\_max\_width="100%" \_builder\_version="4.23.2" header\_level="h3" header\_font="Heebo|900|||||||" header\_text\_color="#FFFFFF" header\_font\_size="18px" header\_line\_height="1.3em" locked="off" global\_colors\_info="{}"\]When you feel more competent and prepared your anxiety and stress naturally lessen. Even those with anxiety who may not look to join a therapeutic group report that taking a public speaking class helps reduce stress. Of course we'll also do the therapeutic group exercises below.

\[/et\_pb\_blurb\]\[/et\_pb\_column\]\[et\_pb\_column type="1\_3" \_builder\_version="4.16" custom\_padding="20px|20px|20px|20px|true|true" custom\_padding\_tablet="0px|0px|0px|0px|true|true" custom\_padding\_phone="" custom\_padding\_last\_edited="on|tablet" link\_option\_url="#" border\_width\_all="4px" border\_color\_all="rgba(0,0,0,0)" global\_colors\_info="{}" border\_color\_all\_\_hover="#353752" border\_color\_all\_\_hover\_enabled="on|hover"\]\[et\_pb\_blurb title="Develop Your Style" icon\_alignment="left" content\_max\_width="100%" \_builder\_version="4.23.2" header\_level="h3" header\_font="Heebo|900|||||||" header\_text\_color="#FFFFFF" header\_font\_size="18px" header\_line\_height="1.3em" custom\_padding="||0px|||" locked="off" global\_colors\_info="{}"\]Public speaking lessons are not one size fits all, and instead you will develop your own unique style in this online public speaking class. Many people get worried when they see a strong orator because they feel they cannot emulate that style, but that's okay. Develop your own comfortable style.

\[/et\_pb\_blurb\]\[/et\_pb\_column\]\[/et\_pb\_row\]\[et\_pb\_row \_builder\_version="4.23.2" \_module\_preset="default" global\_colors\_info="{}"\]\[et\_pb\_column type="4\_4" \_builder\_version="4.23.2" \_module\_preset="default" global\_colors\_info="{}"\]\[et\_pb\_text \_builder\_version="4.23.2" \_module\_preset="default" header\_2\_text\_color="#FFFFFF" header\_2\_font\_size="52px" global\_colors\_info="{}"\]## Combined With Therapeutic Techniques

\[/et\_pb\_text\]\[/et\_pb\_column\]\[/et\_pb\_row\]\[et\_pb\_row column\_structure="1\_3,1\_3,1\_3" use\_custom\_gutter="on" gutter\_width="1" \_builder\_version="4.23.2" max\_width="1200px" border\_color\_top="#FFE7AF" border\_width\_right="8px" border\_color\_right="#FFE7AF" border\_color\_left="#FFE7AF" locked="off" global\_colors\_info="{}" custom\_padding\_\_hover\_enabled="off|desktop" custom\_padding\_\_hover="20px|20px|20px|20px|true|true"\]\[et\_pb\_column type="1\_3" \_builder\_version="4.16" custom\_padding="20px|20px|20px|20px|true|true" custom\_padding\_tablet="0px|0px|0px|0px|true|true" custom\_padding\_phone="" custom\_padding\_last\_edited="on|tablet" link\_option\_url="#" border\_width\_all="4px" border\_color\_all="rgba(0,0,0,0)" global\_colors\_info="{}" border\_color\_all\_\_hover="#353752" border\_color\_all\_\_hover\_enabled="on|hover"\]\[et\_pb\_blurb title="Cognitive Behavioral Therapy" icon\_alignment="left" content\_max\_width="100%" \_builder\_version="4.23.2" header\_level="h3" header\_font="Heebo|900|||||||" header\_text\_color="#FFFFFF" header\_font\_size="18px" header\_line\_height="1.3em" custom\_padding="||10px|||" header\_font\_size\_phone="20px" header\_font\_size\_last\_edited="off|desktop" body\_font\_size\_tablet="14px" body\_font\_size\_last\_edited="off|desktop" locked="off" global\_colors\_info="{}" custom\_padding\_\_hover\_enabled="off|hover" custom\_padding\_\_hover="10px|20px|10px|20px|true|true"\]Fear of public speaking groups often center around CBT, both to help lessen anticipatory anxiety and anxiety just before and during your speech. [Cognitive behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) can also work to help you relax and notice other thoughts causing other anxiety in your life. [Therapy for speech anxiety](https://dralanjacobson.com/speech-anxiety-treatment/) provides a valuable toolkit!

\[/et\_pb\_blurb\]\[/et\_pb\_column\]\[et\_pb\_column type="1\_3" \_builder\_version="4.16" custom\_padding="20px|20px|20px|20px|true|true" custom\_padding\_tablet="0px|0px|0px|0px|true|true" custom\_padding\_phone="" custom\_padding\_last\_edited="on|tablet" link\_option\_url="#" border\_width\_all="4px" border\_color\_all="rgba(0,0,0,0)" global\_colors\_info="{}" border\_color\_all\_\_hover="#353752" border\_color\_all\_\_hover\_enabled="on|hover"\]\[et\_pb\_blurb title="Exposure and Response Prevention " icon\_alignment="left" content\_max\_width="100%" \_builder\_version="4.23.2" header\_level="h3" header\_font="Heebo|900|||||||" header\_text\_color="#FFFFFF" header\_font\_size="18px" header\_line\_height="1.3em" locked="off" global\_colors\_info="{}"\][ERP therapy](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/) asks you to expose yourself to the feared experience so that you can learn to prevent the anxious reaction. When it comes to my fear of public speaking groups it is important to note that you'll never be asked to move faster than you are comfortable. You'll go at your own pace and get great support while supporting other members.

\[/et\_pb\_blurb\]\[/et\_pb\_column\]\[et\_pb\_column type="1\_3" \_builder\_version="4.16" custom\_padding="20px|20px|20px|20px|true|true" custom\_padding\_tablet="0px|0px|0px|0px|true|true" custom\_padding\_phone="" custom\_padding\_last\_edited="on|tablet" link\_option\_url="#" border\_width\_all="4px" border\_color\_all="rgba(0,0,0,0)" global\_colors\_info="{}" border\_color\_all\_\_hover="#353752" border\_color\_all\_\_hover\_enabled="on|hover"\]\[et\_pb\_blurb title="Mindfulness " icon\_alignment="left" content\_max\_width="100%" \_builder\_version="4.23.2" header\_level="h3" header\_font="Heebo|900|||||||" header\_text\_color="#FFFFFF" header\_font\_size="18px" header\_line\_height="1.3em" custom\_padding="||0px|||" locked="off" global\_colors\_info="{}"\][Mindfulness, relaxation, and meditation](https://dralanjacobson.com/mindfulness-therapy/) techniques are all helpful to have in your toolbox as you work to conquer your anxiety. We will go over these techniques and you can share what has worked for you if you'd like. These strategies can work to reduce anticipatory anxiety ahead of time and stress that day.

\[/et\_pb\_blurb\]\[/et\_pb\_column\]\[/et\_pb\_row\]\[/et\_pb\_section\]\[et\_pb\_section fb\_built="1" admin\_label="Quote" \_builder\_version="4.23.2" background\_image="https://dralanjacobson.com/wp-content/uploads/2022/11/cropped-sunlight-path-1-scaled-1.jpg" background\_position="top\_right" custom\_margin="|||" custom\_padding="0px|0px|100px|0px" box\_shadow\_style="preset7" box\_shadow\_horizontal="0px" box\_shadow\_vertical="100px" box\_shadow\_color="#ffffff" global\_colors\_info="{}"\]\[et\_pb\_row column\_structure="1\_2,1\_2" \_builder\_version="4.27.4" custom\_padding="0px|0px|27px|0px" animation\_style="slide" animation\_direction="bottom" animation\_intensity\_slide="10%" animation\_starting\_opacity="100%" global\_colors\_info="{}"\]\[et\_pb\_column type="1\_2" \_builder\_version="4.27.4" background\_color="gcid-9d5d11f9-d654-432d-8206-34ad20a6d54e" custom\_padding="4%|5%|3%|5%" global\_colors\_info="{%22gcid-9d5d11f9-d654-432d-8206-34ad20a6d54e%22:%91%22background\_color%22%93}" custom\_padding\_\_hover="|||"\]\[et\_pb\_text \_builder\_version="4.27.4" text\_font="||||||||" header\_font="||||||||" header\_2\_font="Playfair Display||||||||" header\_2\_font\_size="38px" header\_2\_letter\_spacing="1px" header\_2\_line\_height="1.4em" header\_3\_font="Poppins|700||on|||||" header\_3\_text\_color="#edbb5f" header\_3\_font\_size="14px" header\_3\_letter\_spacing="1px" header\_3\_line\_height="2em" background\_layout="dark" max\_width="550px" animation\_direction="bottom" locked="off" global\_colors\_info="{}"\]### open and simple

## Joining My Fear of Public Speaking Groups is Easy

\[/et\_pb\_text\]\[et\_pb\_divider color="#edbb5f" divider\_weight="2px" \_builder\_version="4.16" max\_width="60px" module\_alignment="left" height="2px" locked="off" global\_colors\_info="{}"\]\[/et\_pb\_divider\]\[et\_pb\_text \_builder\_version="4.27.4" text\_font="||||||||" text\_letter\_spacing="1px" background\_layout="dark" max\_width="550px" locked="off" global\_colors\_info="{}"\]Here are the steps involved in joining one of my fear of public speaking groups:

Fear of public speaking groups referral: The first step is referring yourself by [contacting me](https://www.picktime.com/scheduleaconsult). We'll figure out the best fit if I have more than one group.

Joining In: The next step in joining the group itself. Members always welcome newcomers; you can participate as much or as little as you want. You can sit back and take in the lessons or actively participate.

Aftercare: After completing the group therapy program, participants may have access to [individual follow-up sessions](https://dralanjacobson.com/individual-therapy/) or support. I also hope you'll continue to pass along what you learned in real situations to help others reduce their [presentation anxiety](https://dralanjacobson.com/presentation-anxiety/).

\[/et\_pb\_text\]\[/et\_pb\_column\]\[et\_pb\_column type="1\_2" \_builder\_version="4.16" custom\_padding="|||" global\_colors\_info="{}" custom\_padding\_\_hover="|||"\]\[/et\_pb\_column\]\[/et\_pb\_row\]\[/et\_pb\_section\]\[et\_pb\_section fb\_built="1" \_builder\_version="4.23.2" \_module\_preset="default" custom\_margin="||-199px|||" custom\_padding="23px|||||" global\_colors\_info="{}"\]\[et\_pb\_row \_builder\_version="4.23.2" \_module\_preset="default" global\_colors\_info="{}"\]\[et\_pb\_column type="4\_4" \_builder\_version="4.23.2" \_module\_preset="default" global\_colors\_info="{}"\]\[et\_pb\_heading title="Fear of Flying Lessons Learned in Group " \_builder\_version="4.23.2" \_module\_preset="default" title\_level="h2" title\_text\_align="center" title\_text\_color="#FFFFFF" title\_font\_size="42px" global\_colors\_info="{}"\]\[/et\_pb\_heading\]\[/et\_pb\_column\]\[/et\_pb\_row\]\[/et\_pb\_section\]

---

### [Fear of Flying Group](https://dralanjacobson.com/fear-of-flying-group/)

**Published:** February 24, 2024
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: July 3, 2026

 # Fear of Flying Group

 Open | VirtualGroup therapy for fear of flying can be highly effective as it provides individuals with a supportive environment to share their experiences, fears, and coping strategies with others who are facing similar challenges. This format can be powerful, providing significant confidence as you see others overcome their challenges and learn how they did it. You’ll feel supported and understood like never before, and you can take things as a pace you are comfortable with.

 [Join Now](https://dralanjacobson.com/contact/)[Other Therapy Groups](https://dralanjacobson.com/group-therapy/)

 ![Fear of Flying Course](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "flying fear | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## Why Join a Group Fear of Flying Course?

Overall, group therapy for [flight anxiety](https://dralanjacobson.com/category/fear-flying/) provides a supportive and structured environment for people to overcome their fear, gain confidence, and ultimately regain control over their lives and pursue the opportunities they’ve been missing.

A group fear of flying course can provide valuable emotional support, encouragement, and practical tips from others who understand their struggles. Sharing experiences and coping strategies with peers can help you feel less isolated and more empowered to overcome your anxiety.

## Fear of Flying Group Therapy Schedule

Sample

###### 6:00 pm

##### Check-In

Prior to the fear of flying group starting, you check in and can informally interact with others, or just sit back and wait for group to start.

###### 6:10 pm

##### Welcome and Fear of Flying Lessons

The session often begins with welcoming new members and lessons about flight anxiety, its causes, and common symptoms.

###### 6:15 pm

##### Fear of Flying Member Updates

Members can choose to volunteer to share their personal experiences, including barriers they’ve overcome and their current worries. This sharing helps all participants in the fear of flying course feel understood and less alone in their struggles.

###### 6:25 pm

##### Former Member Updates

Hearing success stories from others who have overcome their anxiety can be highly inspiring and reassuring, so this part of the fear of flying course includes any updates I’ve received from former members.

###### 6:30 PM

##### Therapy Techniques

This is the core part of the fear of flying course you are embarking on. I will teach you cognitive-behavioral, exposure-response, and other [therapy techniques for overcoming flight anxiety](https://dralanjacobson.com/fear-of-flying-therapy/).

###### 7:00 pm

##### Summarizing Fear of Flying Lessons and Homework

Here we will summarize the fear of flying lessons learned today, and you may be given homework assignments to practice relaxation techniques, challenge negative thoughts, or gradually expose themselves to stimuli outside of therapy sessions. This helps reinforce the skills you learned in therapy and promotes gradual progress.

### Fear of Flying Group Participation

One important note about the schedule above: Each member is free to share as much or as little as they want during each step. You can join in on discussion at whatever pace feels most comfortable. Some people choose to be reserved yet supportive, while others choose to share. Some people are more active during the [experiential phase](https://www.merriam-webster.com/dictionary/experiential) of the group, while other participate more during the more educational fear of flying lessons. There is no “right” way, and all are welcome.

### Member Requirements

I do ask that each member identify themselves with at least their first name, keep your camera on for each session, and avoid distractions. I also ask that you attend each week until you feel that you have accomplished your goals. You should not mention the real names of anyone outside of the group, and you should be in a private place where other members of your household cannot see or hear what is going on.

## Group Coverage Area

You can join from any of the states in green to the right

 [More about online therapy](https://dralanjacobson.com/virtual-therapy-guide/)

 ![Group Counseling Service Area](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "PsyPACT Map | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## We'll Combine Fear of Flying Lessons...

### Improved Quality of Life

Of the many fear of flying lessons you can learn in group, enhancing your quality of life by allowing you to travel more freely for work, leisure, and personal reasons may be the most poignant. It opens up opportunities for experiencing new places, cultures, and adventures without being limited by fear.

### Reduced Anxiety and Stress

Fear of flying lessons cover the reasons for anxiety and distress and this increased understanding can help you learn coping strategies, leading to greater peace of mind and emotional well-being. THis improvement can open uhelp you in with other life stresses too!

### Improved Relationships

Fear of flying can sometimes strain relationships, particularly if loved ones don’t understand or share the fear. Overcoming this fear can improve relationships by enabling individuals to travel with family, friends, or partners and share meaningful experiences together.

## …with Therapeutic Techniques

### CBT for Fear of Flying

Group therapy often incorporates [cognitive-behavioral techniques](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) to help participants challenge and reframe their negative thoughts and beliefs about airplanes. This may include identifying and challenging irrational beliefs, learning relaxation techniques, and practicing exposure therapy in a gradual and supportive manner.

 [More about CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/)

### ERP Therapy 

[Exposure and response prevention therapy](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/) involves gradually exposing individuals to the feared stimulus (flying) in a controlled and systematic way. This can be done through imagination or in real-life situations (in vivo exposure). Over time, repeated exposure helps reduce anxiety and desensitize individuals to triggers.

 [More about ERP](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/)

### Relaxation and Coping Skills

Relaxation techniques such as [deep breathing, progressive muscle relaxation, and visualization](https://dralanjacobson.com/mindfulness-therapy/) can help individuals manage anxiety symptoms associated with [flight anxiety](https://dralanjacobson.com/flight-anxiety-self-help/). Practicing these techniques regularly can help reduce overall anxiety levels and increase feelings of calmness and control when on a plane.

 [More about Relaxation](https://dralanjacobson.com/mindfulness-therapy/)

## Fear of Flying Course Steps

Here are the steps involved in joining a group:

Fear of Flying Group Referral: The first step is referring yourself or having your current therapy provider refer you to the group.

Joining In: The next step in joining the group itself. Members always welcome newcomers; you can participate as much or as little as you want.

[Flight anxiety self-help techniques](https://dralanjacobson.com/flight-anxiety-self-help/) will be suggested for times in between group meetings

Fear of Flying Group Aftercare: After completing the program, participants may have access to follow-up [individual therapy](https://dralanjacobson.com/individual-therapy/) sessions or support groups to maintain their progress and continue sharing experiences with others who understand their struggles.

 ![Fear of Flying Therapy](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "plane-sunset-sunrise-wing | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

 [ ![social network icon](data:image/svg+xml;base64,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) ](https://www.facebook.com/appliedpsychologicalscience) [ ![social network 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### [Group Therapy for Young Adults](https://dralanjacobson.com/group-therapy-for-young-adults/)

**Published:** February 29, 2024
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: July 3, 2026

 # Group Therapy for Young Adults

 Open | Virtual | Ages 20-29Young adult therapy groups can be highly effective as they provide a supportive environment to share your experiences and coping strategies with others facing the same pressures, fears, and opportunities. My young adult group is open, meaning you can join any time, and virtual, which allows you to connect with peers from all over. Group therapy for young adults is powerful and effective.

 [Join Now](https://dralanjacobson.com/contact/)[Schedule a Consult](https://www.picktime.com/scheduleaconsult)

 ![Group Therapy for Young ASdults](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "consutant-02 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## Why Group Therapy for Young Adults

Young adult therapy groups provide a supportive, warm, and understanding environment for those transitioning into new careers, relationships, and social structures to share their excitement, fears, and anxieties.

This experience can provide emotional support, encouragement, and practical tips from others. Sharing experiences in a young adult group can help you feel less isolated, more empowered, and more connected.

## Young Adult Group Schedule

Sample

###### 6:00 pm

##### Check-In

Prior to the session starting, you check in and can informally interact with others. You can also just sit back and wait for things to start or submit ideas and questions for that day’s session.

###### 6:10 pm

##### Welcome New Members

The session often begins with welcoming new members. People can feel free to talk about their background and what they hope to get out of the experience, or just say their name and share at their own pace.

###### 6:15 pm

##### Member Updates

Young adult group members can choose to volunteer to share their latest news, from career, to relationship, to other accomplishments. They can share new challenges and barriers as well. Like all other participation, this sharing is voluntary.

###### 6:30 PM

##### Therapy Techniques

This is the core part of group therapy for young adults. I will teach you cognitive-behavioral (CBT), humanistic, solution-focused, and other therapy techniques that help you develop new coping strategies, inner strength, and greater contentment.

###### 7:00 pm

##### Summarizing and Homework

Here we will summarize the therapeutic lessons learned today.

### Young Adult Group Participation

One important note about the schedule above: Each member is free to share as much or as little as you want. You’ll never be pressured to share, and certainly never be pressured to share more than you want. You can join in on the discussion at whatever pace feels most comfortable. Some members in a therapy group for young adults choose to be relatively quiet yet supportive. Others choose to be more talkative and sharing. There is no “right” or “wrong” way.

### Group Therapy for Young Adults Member Requirements

I do ask that each young adult therapy group member identify themselves with at least their first name. I’d also ask that you keep your camera on for each session and stay focused. You should attend each week until you feel that you are ready to leave, and when you are ready to leave that you let people know in what you think is your last session. You should not mention even the first names of anyone in the young adult group outside of the session.

## Coverage Area

You can join therapy group for young adults from any of the states in green to the right.

 [About Virtual Therapy](https://dralanjacobson.com/virtual-therapy-guide/)

 ![Young Adult Group](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "PsyPACT Map | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## Therapeutic Techniques

### Cognitive-Behavioral Therapy (CBT)

The primary approach for a young adult therapy group is cognitive-behavioral therapy, given that this approach is [scientifically proven](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3584580/), powerful, and effective, and works well in this environment. As you develop your own toolkit of strategies to build resilience, learn new coping strategies, and feel more content, you can share them with the other members.

 [More about CBT Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/)

### Solution-Focused Therapy

People come to a therapy group for young adults with specific goals in mind, often to feel more content, grounded, and positive about where things are headed. This often includes wanting to feel more in-control of outcomes, and satisfied with work and social prospects. [Solution-focused therapy](https://positivepsychology.com/solution-focused-therapy/) can target these areas and it also works well in a young adult group.

 [More about Solution-Focused](https://dralanjacobson.com/solution-focused-therapy/)

### Humanistic Therapy

Various humanistic approaches work well in a young adult therapy group. These approaches share a common theme of focusing on the future and not the past, and emphasizing strength and possibilities. In group therapy for young adults you want a non-judgmental space where peers are rooting for your success and happiness, and humanistic approaches bring that out.

 [More about Humanistic Therapy](https://dralanjacobson.com/humanistic-psychology/)

### Adlerian Therapy

Adlerian therapy uncover the unique “life style” each teen has developed – the beliefs, thought-patterns, and goals that guide their choices. Then, in group, they rewrite their own story to something that feels like a better, more genuine fit.

 [More about Adlerian Therapy](https://dralanjacobson.com/adlerian-therapy/)

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---

### [Leadership Coaching](https://dralanjacobson.com/leadership-coaching/)

**Published:** June 22, 2026
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: June 24, 2026

 # Leadership Coaching

**Executive leadership coaching** helps leaders of established companies maximize the effects of their leadership efforts.

An **executive leadership coach** can work with individuals or groups, and established leaders or up-and-coming prospects.

01

## Executive Leadership Coaching Assessment

The first step is a comprehensive assessment. We want to know our client’s work history and the strengths, weaknesses, and leadership styles. If desired, this can involve [360-degree feedback](https://www.thebalancemoney.com/360-degree-feedback-information-1917537) from colleagues and superiors to understand how the leader is perceived. Most importantly, we ask what the client wants to accomplish through leadership coaching for executives. This includes how they would like to improve as a leader, get more joy out of work, and the skills they hope to learn.

02

## Executive Leadership Coaching

## Goal Setting

With all of the information from the assessment, we set specific, measurable, achievable, relevant, and time-bound ([SMART objectives](https://www.forbes.com/advisor/business/smart-goals/)) goals for the executive leadership coaching engagement. These goals align with the areas where our client wants to improve and the [organization’s expectations for her performance](https://www.dralanjacobson.com/sports-performance-improvement-innovations/). This plan will change and evolve as we work together. At the beginning, it serves as a starting point for our work together. As part of the goal setting, we will include measurable and time-bound goals that we can check in on at certain intervals. leadership coaching for executives should produce measurable and meaningful change. Checking in as time goes along will help ensure this.

03

## Executive Leadership Coaching

## Services

The executive leadership coaching sessions are typically one-on-one meetings. These sessions take place in person and virtually, depending on the schedule of the given week. We use active listening, questioning, and role-playing exercises to help clients explore challenges, identify potential solutions, and enhance their skills. We ensure that we are working on barriers and weaknesses and enhancing and nurturing her excellent natural strengths.

#### Hours of Service Delivered

#### Executives Served

#### Groups Served

#### Years Of Experience

## What to Expect from Executive Leadership Coaching

Leadership Coaching for Executives Methods:

During the sessions, we work to help people develop specific skills required for their role, such as clearly communicating vision, delegating effectively, becoming comfortable making high-level decisions, and team-building capabilities.

Some specific techniques we will use include:

R

##### Active Listening and Questioning

We employ active listening skills to understand our client’s challenges, aspirations, and thought processes. We may ask thought-provoking questions that encourage self-reflection and deeper insights. This might include, “What job would you not want at this company, and why, and how can you change that?” Another example is, “Who on your team is least satisfied with their work, why, and are there ways to make them more satisfied?”

R

##### Behavioral Change and Skill Development

Much of our work together may involve introducing new perspectives. This is evident in the questions above. Role-playing, simulations, and [experiential learning](https://www.bu.edu/ctl/guides/experiential-learning/) exercises will help our clients practice and integrate new behaviors. They will also help them develop new insights.

R

##### Conflict Resolution and Emotional Intelligence (EI)

We assist clients in seeing whether they may have blind spots or other holes in their emotional intelligence. For example, if they have trouble navigating conflicts effectively with some people we will explore those situations with the goal of improvement. We may even do some psychological testing for [emotional intelligence](https://www.psychologicalassessments.com/emotional-intelligence%20-testing/).

R

##### Feedback and Feedforward: 

Much of our leadership coaching for executives engagement will be used to collect information from our clients about how they are doing. These discussions will provide detail and data while also assessing for distortions. These feedback sessions provide insights into progress and areas for adjustment. We use [positive psychology](https://www.dralanjacobson.com/positive-psychology-powerful-benefits/) techniques to emphasize future-oriented suggestions for improvement.

R

##### Networking and Relationship Building:

We guide clients in developing and maintaining meaningful professional relationships. This will enable them to expand their networks and enhance collaboration. For example, with newer executives who find themselves intimidated by those who have been in their roles for longer than them, we will specifically work to reduce that anxiety.

R

##### Culture and Organizational Alignment

We may spend some time at the company to better understand [organizational culture](https://www.britannica.com/topic/organizational-culture). This will help us assist clients in aligning their style with company values. In turn, they will be able to foster an environment conducive to growth and innovation.

We also use the executive leadership coaching sessions to do some general work, such as teaching clients relaxation and stress management techniques, refining time-management methods, and helping them avoid burnout by taking care of themselves.

 ![executive presence coaching](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "cropped-corporation-JPG | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

### Leadership Coaching for Executives: Accountability 

We hold clients accountable for implementing the action plans and between-session work. We continually review progress, address any challenges, and make adjustments to the leadership coaching for executives service.

 Get Started

### Executive Leadership Coaching: Evaluating Impact

At the end of the engagement, we evaluate progress made and the impact of the coaching on abilities and overall performance. This evaluation helps determine if any additional development is needed.

 Get Started

### An example

## Executive Presence Coaching

Executive presence coaching focuses on developing the qualities and skills that enable individuals to project confidence, authority, and credibility. This type of service helps those at various organizational levels to enhance their leadership capabilities, improve communication, and effectively influence and inspire others. Here are some key aspects typically covered in executive presence coaching:

### Key Aspects of Executive Presence Coaching

1\. Self-Awareness and Emotional Intelligence
– Understanding personal strengths and weaknesses.
– Managing emotions and understanding their impact on others.
– Developing empathy and building strong interpersonal relationships.

2\. Communication Skills
– Enhancing verbal and non-verbal communication.
– Learning to articulate thoughts clearly and persuasively.
– Improving public speaking and presentation skills.

3\. Confidence and Composure
– Building self-confidence and maintaining poise under pressure.
– Developing strategies to stay calm and composed in challenging situations.

4\. Appearance and Body Language
– Understanding the importance of professional appearance.
– Using body language effectively to convey confidence and authority.

5\. Decision-Making and Problem-Solving
– Enhancing decision-making skills.
– Developing a strategic approach to problem-solving.

6\. Influence and Persuasion
– Learning techniques to influence and persuade stakeholders.
– Building a strong presence to inspire and motivate teams.

### Benefits of Executive Presence Coaching

– Enhanced Skills: Improved ability to lead and manage teams effectively.
– Career Advancement: Increased potential for promotions and career growth.
– Improved Relationships: Better interpersonal relationships within and outside the organization.
– Greater Influence: Enhanced ability to influence and inspire others, driving organizational success.

### Choosing an Executive Presence Coach

When selecting an executive presence coach, consider the following:

– Experience and Expertise: Look for a coach with a proven track record in executive presence coaching and relevant industry experience.
– Coaching Style: Ensure the clinician’s style aligns with your learning preferences and professional goals.
– References and Testimonials: Seek feedback from previous clients to gauge the clinician’s effectiveness.
– Certifications and Training: Check for relevant certifications and training in executive presence coaching.

 ![executive leadership coach](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "business-coach-0037 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

 ![Blue chalk-drawn analytics illustration: a partial pie chart, an upward curved arrow, and a three-bar chart.](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "cropped-cropped-cropped-performance-psychology-2jpg | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## YOur Executive leadership Coach 

 ![Decorative horizontal divider with a diamond centerpiece in the middle of the line.](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "attorney-1 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Your executive leadership [coaching experience](https://www.dralanjacobson.com/leadership-coaching-process/) will be based on your unique hopes and needs. This includes the areas where you want to enhance your strengths and the challenges you want to address. Your executive leadership coach can deliver services to a small group, members of a Board of Directors, or up-and-coming leaders who may not be in the executive suite yet.

If you or someone you work with could benefit from working with an executive leadership coach, please [contact us](https://www.dralanjacobson.com/contact/) to discuss further.

### **A Leadership Coach’s View**

**Leadership coaching** involves developing skills, enhancing self-awareness, and achieving personal and professional goals. The process we offer typically consists of several stages.

## Leadership Coaching Initial Steps

At the beginning of the leadership coaching relationship, we engage in an initial assessment. This can be provided formally through management testing, or more informally where we gather information about your current abilities, strengths, areas for improvement, and specific goals you want to achieve. We might use [leadership assessment tools](https://psychologicalassessments.com/best-management-testing-and-personality-testing-for-teams/) or specific [business personality tests](https://psychologicalassessments.com/business-personality-tests/) in this process. We will set clear and measurable goals for the coaching engagement. These goals could be related to skills development, career advancement, improving communication, building [high-performing teams](https://psychologicalassessments.com/best-management-testing-and-personality-testing-for-teams/), or other leadership-related objectives.

We can provide comprehensive [leadership qualities testing](https://psychologicalassessments.com/best-management-testing-and-personality-testing-for-teams/) to start your journey, or [management testing](https://psychologicalassessments.com/best-management-testing-and-personality-testing-for-teams/) for an entire group.

### Leadership Coaching Plan

The second initial step involves creating a detailed action plan. This plan outlines the steps and strategies that we will take to achieve your goals. You are in charge of this part of the process, while we will be there to provide support, guidance, and feedback. During this process, we will establish a strong relationship based on trust, confidentiality, and open communication. This rapport is crucial for the process to be effective and for you to be fully committed. We will also provide feedback based on the assessment, highlighting strengths and areas for improvement. We will begin to collaboratively gain insights into your leadership behaviors, beliefs, and patterns that might be impacting your effectiveness.

Remember that as we progress, we will be flexible to accommodate changes in your goals, needs, and circumstances. We will always adjust the plan as necessary to ensure its relevance and effectiveness.

## Leadership Coaching Ongoing Process

After we have taken those initial steps, we move into our regular one-on-one sessions. The frequency and duration of these sessions may vary depending on our agreement. During these sessions, we will discuss progress, challenges, successes, and any adjustments needed to the action plan. We will provide feedback based on observations, assessments, and our discussions. Your reflection is an essential part of the process. It helps us gain insights into your leadership style, behaviors, strengths, and areas for improvement.

### Tools and Goals

We will work on developing and refining specific skills through targeted exercises, role-playing, simulations, and real-life scenarios. We will guide you in adopting new behaviors, approaches, and techniques. We will continually review specific development tools, resources, and techniques to enhance your skills and capabilities. We will hold you responsible for taking action toward your goals and encourage you to stay committed to the full process.

One goal of this process is to encourage you to self-reflect regularly. This will deepen your understanding of your style, values, and impact on others, helping you identify and manage potential blind spots or biases.

### Specific Leadership Coaching Techniques

Leadership coaching techniques can vary depending on your specific needs, but here are some common methods and strategies we use in leadership coaching:

1. Active Listening: Effective services begin with active listening. We listen attentively to your concerns, challenges, and goals without interrupting, providing a safe and supportive environment for you to express yourself.
2. Powerful Questions: We use open-ended, thought-provoking questions to encourage self-reflection and help you gain deeper insights into your style, values, and goals.
3. Feedback: We aim to provide constructive and honest feedback, highlighting areas where you excel and areas for improvement. This feedback is often based on observations and assessments. We hold you accountable for your commitments and actions. We help you stay on track and adjust your plans as circumstances change.
4. Strengths-Based: We help you recognize and leverage your unique strengths to enhance your effectiveness throughout your coaching journey.
5. Behavioral Assessments: We may use various assessments like personality assessments (e.g., [Myers-Briggs Type Indicator](https://psychologicalassessments.com/best-management-testing-and-personality-testing-for-teams/)), [360-degree feedback](https://psychologicalassessments.com/best-management-testing-and-personality-testing-for-teams/), or [emotional intelligence assessments](https://psychologicalassessments.com/best-management-testing-and-personality-testing-for-teams/) to provide insights into your strengths and areas for growth.
6. Role Modeling: We work to demonstrate effective leadership behaviors and communication techniques, helping people learn by example. We all have been C-level leaders which helps us be authentic.
7. Conflict Resolution and Communication Skills: In leadership coaching, we assist people in improving their communication and conflict resolution skills, which are crucial for effective leadership.
8. Stress Management and Well-Being: As psychologists, we often address stress management and well-being to ensure your health and resilience while dealing with demands.
9. Cultural and Inclusivity Training: In today’s diverse workplaces, we work to improve cultural competence and inclusivity, ensuring you lead in a way that values and respects differences.
10. Motivation and Inspiration: We help you find sources of motivation and inspiration, aligning your values with your style to inspire and engage your teams.
11. Time Management and Prioritization: Effective leaders must manage their time and prioritize tasks. In leadership coaching, we provide strategies to help you maximize their productivity.
12. Self-Reflection and Mindfulness: Encouraging people to practice self-reflection and mindfulness can help them better understand their thoughts and emotions, leading to better decision-making and self-awareness.
13. Socratic Questioning: This technique involves asking thought-provoking questions to challenge assumptions and encourage critical thinking and problem-solving.

The specific techniques used in leadership coaching will depend on your needs. An effective engagement is a dynamic collaborative process that evolves as the your goals and challenges evolve.

## Leadership Coaching Later Steps

We will evaluate your progress toward the set goals and determine if any adjustments to the coaching plan are necessary. Eventually, you’ll have met your goals. As the engagement ends, there is a closure phase where we review progress, discuss the outcomes achieved, and evaluate the overall experience. This stage helps ensure you can continue your leadership journey with newfound insights and skills.

### Celebrating Progress

During this later stage, we will celebrate achievements and milestones. This will boost motivation, reinforce the value of the process, and possibly lead to ideas for further progress. Sometimes, we will gather feedback about progress from colleagues, team members, and others who interact with you. We can use this feedback to adjust the coaching approach and address emerging challenges. This information can also help you decide when you’ve reached your goals.

### Ending the Leadership Coaching Engagement

When the engagement nears its end, we will have a reflective conversation about your progress, growth, and the lessons learned. We’ll work to ensure you’ve successfully integrated your refined or newfound skills and insights into your work. We will discuss ending the engagement once you feel you have the skills, toolkit, and insights you need.

After we’ve finished, we offer post-coaching support to ensure that you continue to apply your learnings and sustain and improve your growth over time.

## Summary and our Services

It’s important to note that leadership coaching is a personalized process tailored to the individual needs and goals of the client. The effectiveness relies heavily on your commitment to the process and your willingness to engage in self-reflection and growth. Your [coaching course](https://psychologicalassessments.com/best-management-testing-and-personality-testing-for-teams/) will be uniquely tailored to your goals and hopes, but you can still look at our [leadership coaching example](https://psychologicalassessments.com/best-management-testing-and-personality-testing-for-teams/) and the [self-help tips](https://psychologicalassessments.com/best-management-testing-and-personality-testing-for-teams/) we provide here to get more of a sense of what this experience will be like.

Of course, we also offer a free consultation if you’d like to see if our **[leadership coaching](https://psychologicalassessments.com/best-management-testing-and-personality-testing-for-teams/)** services match what you are looking for. [Contact us](https://psychologicalassessments.com/best-management-testing-and-personality-testing-for-teams/) if you’d like to discuss this further.

 ![Leadership coaching](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "Office 5 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

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---

### [Therapy for Depression](https://dralanjacobson.com/therapy-for-depression/)

**Published:** November 25, 2023
**Author:** Dr. Alan Jacobson

**Content:**

**Therapy for depression** can be incredibly beneficial. I provide several types of therapy that have been shown to be effective. Our route will depend on your unique symptoms and possibly the causes of your sadness. The choice may also be determined by how quickly you want relief and your personal preference in how you prefer to communicate. If you need major depressive disorder treatment that works quickly, we can take a more urgent approach. Major depression therapy provides fast results but requires a deeper commitment. Please feel free to [contact me](https://dralanjacobson.com/contact/) any time if you want to discuss how major depression treatment might benefit you, but here is an overview that may be helpful first.

## What is Depression?

Depression is a mental health condition characterized by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in activities. It’s more than just feeling down for a brief period; it’s a prolonged and pervasive state of low mood that can significantly impact daily life.

### Key Features

1. Persistent Sadness: Feeling sad, empty, or tearful most of the day, nearly every day.
2. Loss of Interest: Losing interest or pleasure in hobbies, activities, or relationships once enjoyed.
3. Feelings of Guilt or Worthlessness: Feeling guilty, worthless, or experiencing excessive self-blame.

### Symptoms

1. Difficulty Concentrating: Having trouble concentrating, making decisions, or remembering things.
2. Negative Thoughts: Persistent negative thoughts about oneself, life, or the future.
3. Slowed Thinking or Movement: Feeling mentally or physically slowed down.
4. Changes in Sleep: Insomnia (difficulty sleeping) or oversleeping, disruptions in sleep patterns.
5. Changes in Appetite: Significant weight loss or gain, changes in appetite.
6. Fatigue: Feeling constantly tired or lacking energy, even after rest.
7. Isolation: Withdrawing from social activities, friends, or family.
8. Irritability: Feeling irritable, restless, or agitated without a clear cause.
9. Suicidal Thoughts: Having thoughts of death or suicide.

You may also want to see my post about [myths and facts about depression](https://dralanjacobson.com/myths-about-depression/).

### Types of Depression

There are several types of this diagnosis, each with its own specific symptoms, duration, and triggers. Some common types include:

- Major Depressive Disorder (MDD): This involves persistent feelings of sadness, hopelessness, or a loss of interest in once-enjoyable activities.
- Persistent Depressive Disorder (PDD) or Dysthymia: PDD is a chronic form of depression that lasts for two years or more. Symptoms may not be as severe as MDD but are persistent and can interfere with daily functioning.
- Seasonal Affective Disorder (SAD): [Seasonal Affective Disorder](https://dralanjacobson.com/seasonal-affective-disorder-treatment/) is a type that occurs seasonally, usually in the fall and winter months when there’s less sunlight.
- Postpartum Depression: Experienced by some women after giving birth; this type involves intense feelings of sadness, anxiety, and exhaustion that may make it difficult to care for the baby.
- [Psychotic Depression](https://en.wikipedia.org/wiki/Psychotic_depression): This type includes severe depressive symptoms coupled with [psychotic disorder](https://en.wikipedia.org/wiki/Psychosis) symptoms, such as delusions or hallucinations

Understanding the specific type of depression a person is experiencing is important for tailored major depressive disorder treatment. It’s also possible for individuals to have a combination of these types or experience symptoms that don’t fit neatly into one category.

## Approaches to Therapy for Depression

I use the following clinical approaches when providing therapy for depression, often in combination.

### Cognitive Behavioral Therapy for Depression

CBT focuses on [identifying and changing negative thought patterns](https://dralanjacobson.com/cbt-for-depression/) and behaviors contributing to the problem. This is often a first-line approach for people whose symptoms have been with them for a long time or started during a specific life transition. While knowing what started the symptoms initially is helpful, CBT can be done even when the cause is elusive. Sometimes, we can weave [CBT techniques](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) with [mindfulness](https://dralanjacobson.com/mindfulness-therapy/) practices. This can prevent relapse. CBT is almost always the first-line approach for major depression therapy. This may include specially areas such as [CBT for insomnia](https://dralanjacobson.com/cbt-i-for-sleep-difficulties/).

### Psychodynamic Approaches to Depression

Another good approach to longstanding symptoms is [psychodynamic therapy](https://dralanjacobson.com/psychodynamic-therapy/). This therapy explores how past experiences and unconscious thoughts impact current emotions and behaviors. An important aspect of psychodynamic therapy is exploring how an individual interacts with others and the recurring relationship patterns they experience. Understanding these dynamics can reveal how they contribute to depressive symptoms. Psychodynamic therapy often takes longer than other approaches. However, it can provide deep insights that prove invaluable.

This major depression treatment often focuses on past experiences, particularly in childhood, and how they influence current thoughts and behaviors. Unresolved issues or traumas from the past can impact present feelings of depression. Exploring these can lead to a better understanding of their origins. Psychodynamic therapy helps individuals recognize and understand defense mechanisms they may unconsciously use to cope with difficult emotions. Awareness of these mechanisms can facilitate healthier ways of dealing with depressive feelings.

### Client-Centered Therapy for Depression

[Client-centered therapy](https://dralanjacobson.com/client-centered-therapy/) is an excellent choice when something has happened to cause these feelings. This approach provides a safe space to discuss emotions and concerns, offering support and guidance as the person heals. In this therapy, I provide a nonjudgmental, empathetic environment where individuals feel accepted and valued unconditionally. For someone experiencing depression, this supportive atmosphere can be profoundly validating.

Person-centered major depression treatment encourages self-exploration and self-awareness. Individuals are guided to look within themselves to identify and understand their feelings and experiences. This process can lead to increased self-understanding and self-acceptance. Person-centered approaches emphasize an individual’s inherent capacity for growth and self-actualization.

### Narrative Therapy for Depression

[Narrative therapy](https://dralanjacobson.com/narrative-therapy/) is a powerful approach to addressing depression. It focuses on understanding the stories we tell ourselves about our lives and experiences. Narrative therapy helps individuals separate themselves from their symptoms. Rather than seeing depression as a part of who they are, it encourages viewing it as a separate entity or a problem to be explored and addressed. By separating the individual from the problem, narrative major depression treatment helps regain a sense of agency and control. It empowers individuals to take an active role in reshaping their own stories and identities.

### Gestalt Therapy for Depression

[Gestalt therapy](https://dralanjacobson.com/gestalt-therapy/) is another approach that can be effective in addressing symptoms. This therapy emphasizes the present moment, encouraging you to become more aware of your thoughts, feelings, and behaviors in the ‘here and now.’ It emphasizes personal responsibility and self-awareness. By taking responsibility for one’s thoughts, feelings, and actions, individuals can regain a sense of control and empowerment, which can be crucial in managing depression.

Gestalt major depression treatment employs various techniques like role-playing, [empty chair work](https://psychcentral.com/health/empty-chair-technique) (where the individual speaks to an empty chair representing someone or something), and [guided imagery](https://en.wikipedia.org/wiki/Guided_imagery). These techniques can help individuals gain new perspectives, process unresolved issues, and explore different aspects of themselves.

There are other approaches as well, as you can see in the case example below.

## Major Depressive Disorder Treatment

Major depression therapy is a step up from traditional therapy in that people present with symptoms that are more severely affecting their daily lives. I like to provide a comprehensive approach when providing major [depressive disorder treatment](https://dralanjacobson.com/best-treatment-for-depression/) that includes:

Major depression therapy typically involves a combination of [medication, psychotherapy, and lifestyle changes](https://dralanjacobson.com/treating-major-depression/). Here’s an overview of the common approaches:

### Major Depression Therapy with Medication

When a diagnosis of MDD has been reached, it is sometimes a good idea to be at least [evaluated for major depression therapy](https://dralanjacobson.com/treatment-resistant-depression/) with antidepressants. Certain medications are usually the first line of treatment for MDD, including SSRIs ([Selective Serotonin Reuptake Inhibitors](https://www.drugs.com/drug-class/ssri-antidepressants.html)) and SNRIs ([Serotonin and Norepinephrine Reuptake Inhibitors](https://my.clevelandclinic.org/health/treatments/24797-snri)). I never require anyone to take medications, but I encourage people to get at least evaluated for what medication could do, along with major depressive disorder treatment.

### Major Depressive Disorder Treatment Psychotherapy

When a client comes in for major depressive disorder treatment, there is an urgency for results. Thus, while we might take a different approach as symptoms lift and you want to understand why they were so severe in the first place, Cognitive Behavioral Therapy (CBT) is one of the most common forms of major depressive disorder treatment because it tends to work quickly and therein provide hope. It helps individuals identify and change negative thought patterns and behaviors. [Mindfulness-Based Cognitive Therapy](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/) (MBCT) is also a front-line major depression therapy as it combines elements of CBT with mindfulness techniques to prevent relapse.

### Adjunctive Approaches to Major Depression Therapy

In addition to formal major depressive disorder treatment, we’ll talk about lifestyle changes you can make. These may include regular exercise at a comfortable pace since [physical activity has been shown to improve mood](https://www.health.harvard.edu/mind-and-mood/more-evidence-that-exercise-can-boost-mood) and reduce symptoms of depression. We can also talk about your dietary habits since eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support overall well-being.

We’ll talk about how you can establish a regular sleep schedule and how practicing good sleep habits can help improve mood and energy levels. Finally, you’ll learn techniques such as mindfulness meditation, deep breathing exercises, and progressive muscle relaxation, which can help manage stress and reduce symptoms.

When major depressive disorder treatment is needed, I provide a more comprehensive approach that looks to give you hope by tackling symptoms quickly. After the initial major depression therapy, we can adjust things into a deeper exploration of what caused the symptoms and what can be done to prevent relapse.

## Therapy for Depression In My Work

It’s important to find a therapy type that suits your needs and preferences so that I can go over all the possible major depression [therapy approaches](https://dralanjacobson.com/types-of-therapy/) with you and braid them together in ways that we feel will be effective. My [integrative approach](https://dralanjacobson.com/integrative-therapy/) allows us to change things if an approach is not working or you need a boost. Therapy for depression can be a stand-alone service or part of a more [comprehensive therapy](https://dralanjacobson.com/) plan designed to address other challenges and goals as well. If major depressive disorder treatment is needed, we’ll go over a more comprehensive and urgent plan.

In other posts, I discuss how you can choose the [best treatment for depression](https://dralanjacobson.com/best-treatment-for-depression/) for your unique needs and [therapy for anxiety and depression](https://dralanjacobson.com/therapy-for-depression-and-anxiety/), which often co-occur.

### Major Depression Treatment Example

**Client:** Sarah, a 32-year-old woman
**Presenting Problem:** Sarah has been experiencing persistent sadness, fatigue, low motivation, and feelings of worthlessness for over six months. She reports difficulty concentrating at work and withdrawing from friends and family. She has a history of depression and had a relapse after a recent breakup.

#### Assessment & Diagnosis

Sarah has no history of mania or psychosis but struggles with ruminative thoughts and self-criticism. We agree that major depression treatment that uses third-wave therapies is the best choice for her. She sets specific treatment goals that are meaningful to her and will have measurable effects, and then we decide on a plan for how fast she should see results.

#### Major Depression Treatment Plan

I chose [third-wave approaches](https://dralanjacobson.com/third-wave-psychotherapy/), including CBT, ACT, DBT, and MBCT, and explained to her what each method would entail. She agrees with the plan.

**1. [Acceptance and Commitment Therapy](https://dralanjacobson.com/act-psychotherapy/) (ACT)**

- **Defusion Techniques:** Sarah learns to separate herself from negative thoughts. Instead of believing “I am worthless,” she practices saying, “I notice I am having the thought that I am worthless.”
- **Values-Based Action:** Instead of withdrawing, Sarah identifies core values (e.g., connection, creativity) and sets small, meaningful goals to engage with them.
- **Mindfulness Exercises:** She practices grounding techniques, such as focusing on her breath when overwhelmed.

**2. [Dialectical Behavior Therapy](https://www.simplypsychology.org/dialectical-behavior-therapy.html) (DBT)**

- **Distress Tolerance:** Sarah learns “radical acceptance” to reduce suffering over her breakup. Instead of resisting painful emotions, she practices self-soothing techniques.
- **Emotional Regulation:** She tracks her moods and identifies triggers that worsen her depression. Skills like “opposite action” help her engage in small pleasurable activities even when she feels unmotivated.

**3. [Mindfulness-Based Cognitive Therapy](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) (MBCT)**

- **Mindful Awareness:** Sarah practices daily mindfulness meditation to break the cycle of rumination.
- **Self-Compassion:** She replaces harsh self-judgment with kind, nonjudgmental awareness, using techniques such as the “loving-kindness meditation.”

#### Major Depression Treatment Outcome

Over 12 weeks, Sarah reports improved mood, better emotional regulation, and increased engagement in valued activities. While she still experiences sadness at times, she no longer feels stuck in it and has developed greater psychological flexibility. She considers her major depression treatment a success based on the fact that she experienced measurable, meaningful, and clear benefits.

---

This case highlights how third-wave therapies can empower individuals with depression by fostering mindfulness, acceptance, and value-driven action. This combination is a common way I approach major depression treatment in my [integrative practice](https://dralanjacobson.com/integrative-therapy/).

### Next Steps

I can provide therapy for depression to individuals or [couples](https://dralanjacobson.com/couples-therapy/) and [families with older children](https://dralanjacobson.com/family-therapy/) (where one person is depressed, but the partner or family can help them feel better). For major depression therapy, some people find medication in conjunction with therapy helpful in managing their symptoms, and I can refer you to a trusted provider in my network. I would be happy to [talk to you](https://dralanjacobson.com/contact/) about how **therapy for depression** might be helpful for you and the possible therapeutic approaches we might take.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.linkedin.com/company/psychologicalscience/)

---

### [Therapy for Political Anxiety](https://dralanjacobson.com/therapy-for-political-anxiety/)

**Published:** February 22, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Psychotherapy for anxiety about politics, or political therapy for short, is designed for everyone, regardless of your political beliefs. Politics is now ever-present, infiltrating our news feeds, conversations, and even our dreams. While staying informed is essential, the constant barrage of political news can be overwhelming. For many, this leads to increased anxiety, stress, and a sense of helplessness. If you find yourself avoiding the news, having underlying stress all the time, or feeling tense during social events, I may be able to help. Understanding and addressing political stress is crucial for maintaining your mental well-being. Therapy for political anxiety can provide a significant boost.

### Therapy for Political Anxiety Key Takeaways

- Constant stress can significantly impact your daily life and mental health.
- Therapy for political anxiety options like [Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT) and [mindfulness therapy](https://dralanjacobson.com/mindfulness-therapy/) techniques can help manage political stress.
- Other [third-wave therapies](https://dralanjacobson.com/third-wave-psychotherapy/), such as [acceptance and commitment](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/), can also help.
- Support groups offer a community of understanding individuals experiencing similar challenges.
- Finding the right [treatment approach](https://dralanjacobson.com/types-of-therapy/) is crucial for effective relief.
- Case examples below highlight the transformative power of psychotherapy for anxiety about politics.

## Understanding Political Stress ![Therapy for Political Anxiety](https://dralanjacobson.com/wp-content/uploads/2025/02/political-parties.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Political stress is a real phenomenon affecting countless individuals. This type of anxiety can seep into every aspect of your life, from your sleep patterns to your relationships. You might obsessively check the news, only to feel a looming dread and helplessness. Political events can stir up intense emotions, leaving you frustrated and overwhelmed.

When this anxiety takes hold, it can manifest in various [*anxiety symptoms*](https://www.healthline.com/health/anxiety) such as restlessness, irritability, or even physical ailments like headaches or stomach issues. The relentless news cycle can elevate *stress levels*, leading to sleepless nights and constant worry. In some cases, this anxiety can strain personal relationships, as differing views spark tension among friends and family.

Recognizing political stress is the first step toward managing it effectively. By acknowledging the distress and fear that certain situations trigger, you can begin taking proactive steps to protect your mental health. Remember, it’s not about ignoring the world around you but rather finding healthier ways to engage with it. Your mental well-being is worth prioritizing, especially in these times.

### Impact on Mental Health

The impact of politics on your *mental health* is more significant than you might think. Constant exposure to news can elevate your *stress levels*, leaving you feeling drained and anxious. In today’s digital age, it’s easy to become consumed by the latest debates, leading to emotional distress and a sense of being constantly on edge.

Discussions, whether in-person or online, can trigger anxiety and exacerbate existing *mental health issues*. You might avoid conversations or withdrawing from social interactions to escape disagreements. This withdrawal can lead to feelings of isolation, further impacting your mental well-being.

Understanding how political stress affects mental health is essential for knowing when to seek help. Acknowledging the toll that situations take on your emotions can help you better navigate these stressful times. Finding ways to manage political stress can lead to a more balanced and fulfilling life, allowing you to engage with the world without sacrificing your peace of mind.

## Political Therapy Options

When political stress becomes overwhelming, seeking therapy for political anxiety can be a game-changer. Various options are available to help you manage and alleviate it effectively. I offer personalized strategies to help you cope, providing a safe space to express your fears and frustrations.

### Cognitive Behavioral Therapy for Political Anxiety

**Cognitive Behavioral Therapy (CBT)** stands out as a highly effective [type of psychotherapy for anxiety](https://dralanjacobson.com/best-types-of-therapy-for-anxiety/) about politics. This therapy helps you identify and challenge the negative thought patterns that fuel your anxiety. In CBT, you can develop healthier responses to political stress and learn to navigate discussions without feeling overwhelmed.

A key component of CBT-based psychotherapy for anxiety about politics is gaining insights into how your thoughts and emotions interact. I will guide you in recognizing triggers and developing strategies to manage anxiety during political discussions. This process involves building skills to control your emotions, enabling you to engage without feeling consumed by fear or distress.

Many individuals find relief through the structured CBT approaches I offer. Our sessions will focus on empowering you to face political stress confidently, transforming anxiety into manageable, constructive responses. By participating in this type of psychotherapy for anxiety about politics, you can take significant steps toward regaining control over your mental well-being.

### Mindfulness Techniques for Managing Political Stress

[Mindfulness-based stress reduction](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) for anxiety about politics offers a powerful way to manage political stress by improving emotional regulation and promoting relaxation. Techniques such as meditation and deep breathing exercises can help reduce your reaction to news, fostering a sense of calm amidst the chaos.

Regular mindfulness activities encourage a balanced perspective on current events, allowing you to stay grounded during tumultuous times. Practicing mindfulness can reduce tension and maintain clarity, even when faced with challenging discussions.

Mindfulness isn’t just about relaxation; it’s a way to cultivate awareness and acceptance of the present moment. Incorporating mindfulness into your daily routine can enhance your ability to cope with political stress and maintain your mental well-being.

### Acceptance and Commitment Therapy for Political Anxiety

Acceptance and Commitment Therapy (ACT) can be quite helpful for managing political anxiety. ACT focuses on accepting thoughts and feelings rather than fighting them while committing to actions that align with your values. Here are some key components of ACT that might help with political anxiety:

1. **Acceptance**: Recognize and accept your feelings of anxiety related to politics. Instead of pushing these feelings away, allow yourself to feel them without judgment.
2. **Cognitive Defusion**: This political therapy technique involves distancing yourself from anxious thoughts. For example, instead of thinking, “I can’t handle this,” you might say, “I have the thought that I can’t handle this.” This helps you see your thoughts as just thoughts rather than facts.
3. **Present Moment Awareness**: Focus on the here and now. Mindfulness can help you stay grounded and reduce anxiety about future events.
4. **Values Clarification**: Identify what truly matters to you in politics. This can help you focus your energy on actions that align with your values rather than get overwhelmed by anxiety.
5. **Committed Action**: Take meaningful steps toward your values, even if you’re feeling anxious. This could involve volunteering, advocating for a cause, or constructively discussing current events.
6. **Self-Compassion**: Be kind to yourself. Acknowledge that feeling anxious is common and that it’s okay to struggle.

A subset of this approach, [acceptance and forgiveness therapy](https://dralanjacobson.com/forgiveness-therapy-steps-and-integrations/), helps people release resentment and anger when they feel wronged.

### Logotherapy: Deep-Seated Psychotherapy for Anxiety About Politics

[Logotherapy](https://dralanjacobson.com/logotherapy/), developed by [Viktor Frankl](https://en.wikipedia.org/wiki/Viktor_Frankl), is a form of existential therapy that emphasizes finding meaning in life, even in challenging circumstances. It can be particularly effective for addressing anxiety by helping individuals find purpose and a sense of control in a complex landscape. Here are some key concepts and techniques from logotherapy that can help with political stress:

1. **Finding Meaning**: Explore what is meaningful to you. This could involve identifying your values, causes you care about, or ways you want to contribute to society. Finding meaning can help shift your focus away from anxiety and toward purposeful action.
2. **Responsibility**: Logotherapy emphasizes personal responsibility. While you may not control current events, you can control your responses. Reflect on how you can take responsible actions that align with your values.
3. **Attitude Adjustment**: Frankl believed that while we cannot change our circumstances, we can change our attitudes toward them. Practice reframing your thoughts about issues. Instead of feeling overwhelmed, focus on how you can respond constructively.
4. **Suffering as a Path to Growth**: Understand that anxiety and suffering can lead to personal growth and deeper insights. Reflect on how your anxiety might inspire you to learn more, engage in advocacy, or connect with others who share your concerns.
5. **Self-Transcendence**: Move beyond self-focused concerns by connecting with a cause greater than yourself. Engage in community service, activism, or dialogue that promotes understanding and change. This can help you feel more empowered and less anxious.
6. **Creating a Meaningful Future**: Set goals that reflect your values and aspirations. This could involve volunteering, educating yourself and others, or advocating for change. Working towards these goals can provide a sense of purpose and reduce anxiety.
7. **Reflection and Journaling**: Consider keeping a journal to reflect on your thoughts and feelings related to politics. Writing about your experiences can help you process your emotions and clarify what matters most.

### Support Groups for Political Stress

Support groups provide a community of understanding individuals who share similar experiences. You can find emotional relief in these groups by sharing your journey and listening to others’ stories. Group discussions offer valuable insights into coping strategies, allowing you to learn from diverse perspectives.

Joining a support group can also foster new friendships, create a sense of belonging, and reduce feelings of isolation. In a supportive environment, you can express your fears and frustrations without judgment, finding comfort in the shared experiences of others.

Support groups emphasize care and empathy, providing a safe space to explore your anxiety. By participating in these groups, you can build resilience and develop strategies to navigate political stress more effectively.

## Therapy for Political Anxiety Case Example 1

- Name: Sarah
- Age: 25
- Education: Recently graduated with a degree in psychology
- Occupation: Works as a community organizer
- Background: Sarah grew up in a politically active family and has always been passionate about [social justice issues](https://simplicable.com/society/social-justice). Recently, she has felt overwhelmed and anxious about the current climate, which has impacted her mental health and motivation.

### Presenting Issues:

- Sarah expresses feelings of hopelessness and frustration regarding the state of the world. She feels that her activism efforts are not making a significant impact and worries about the future.
- She experiences [anxiety attacks](https://dralanjacobson.com/panic-attack-treatment/) when engaging in discussions, especially online, due to the hostility and divisiveness she encounters.
- Sarah reports difficulty maintaining her relationships, as these discussions often lead to conflicts with friends and family.

### Therapy for Political Anxiety Goals:

1. Process Emotions: Help Sarah identify and process her feelings of anxiety, frustration, and hopelessness related to her beliefs and activism.
2. Empowerment: Work on developing a sense of agency in her activism, focusing on small, manageable actions that can lead to positive change.
3. Communication Skills: Improve Sarah’s communication skills to help her engage in discussions without escalating conflicts, promoting understanding and respect.
4. Self-Care Strategies: Incorporate self-care practices to manage anxiety and promote mental well-being, emphasizing the importance of balance in activism and personal life.

### Political Therapy Approach:

- [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/) for Political Anxiety: Encourage Sarah to share her story and explore her identity as an activist. This can help her understand how her experiences shape her feelings and actions.
- Cognitive-Behavioral Therapy for Political Anxiety (CBT): Work on reframing negative thoughts about her impact and the current landscape. Challenge her beliefs about activism and discuss realistic outcomes.
- Mindfulness Techniques: Introduce mindfulness exercises to help Sarah manage anxiety and stay grounded during stressful discussions.

#### Sample Session Activities:

1. Journaling: Sarah keeps a journal to track her feelings, thoughts, and experiences related to activism and politics, allowing her to reflect on her progress.
2. Role-playing: Practice having difficult conversations with friends or family, focusing on active listening and non-confrontational communication techniques.
3. Goal Setting: Identify specific, achievable goals for her activism, such as organizing a small community event or volunteering with a local organization, reinforcing her sense of agency.

### Outcomes of Therapy for Political Anxiety

Over time, therapy for political anxiety helps Sarah feel more empowered in her activism, experience reduced anxiety when discussing politics, and strengthen her relationships by engaging in respectful dialogue. She also develops coping strategies to navigate the emotional challenges of engagement.

This case example illustrates how psychotherapy for anxiety about politics can address the unique mental health needs of individuals navigating the complexities of involvement and activism.

## Therapy for Political Anxiety Case Example 2

Here’s a hypothetical case example of a young woman who identifies as a Republican and is seeking political therapy:

- Name: Emily
- Age: 27
- Education: Bachelor’s degree in business administration
- Occupation: Works in finance at a corporate firm
- Background: Emily grew up in a conservative household and has always held strong Republican values. Recently, she has struggled with feelings of isolation and frustration regarding her beliefs, particularly in environments where her views are not respected.

### Presenting Issues:

- Emily feels increasingly marginalized in her social circles, where liberal views dominate discussions. She experiences anxiety when attending gatherings or events where certain topics may arise.
- She expresses frustration about the portrayal of Republicans in the media and among her peers, feeling that her values are often misunderstood or misrepresented.
- Emily struggles with divisiveness in these discussions, which has led to conflicts with friends and colleagues and resulted in a sense of loneliness and disconnection.

### Therapeutic Goals:

1. Validate Emotions: Psychotherapy for anxiety about politics will help Emily acknowledge and process her feelings of frustration and isolation related to her political identity.
2. Enhance Communication Skills: She’ll work on developing effective communication strategies for discussing her beliefs respectfully and constructively.
3. Build Resilience: Psychotherapy for anxiety about politics will foster Emily’s resilience to manage external criticism and reinforce her sense of identity and values.
4. Cultivate Supportive Relationships: Encourage Emily to seek out like-minded individuals or groups to build a support network.

### Methods Chosen:

- Cognitive-Behavioral Political Therapy (CBT): This core psychotherapy for anxiety about politics will address the negative thoughts Emily has about herself and her beliefs, helping her reframe these thoughts into more constructive perspectives.
- Narrative Political Therapy: Explore Emily’s political story, including her values and experiences and how they have shaped her identity. This can help her articulate her beliefs more confidently.
- Logotherapy and [existential therapy](https://dralanjacobson.com/existential-therapy/): We’ll explore some of her deeper identity structures and help her validate them even though others constantly present challenges.
- Skills Training: As part of the above, I will teach Emily effective conflict resolution skills and techniques for navigating political discussions, promoting understanding, and reducing tension.

#### Political Therapy Session Activities:

1. Values Clarification: Emily engages in political therapy exercises to clarify her core values and beliefs, which can help her communicate her views more effectively and authentically.
2. Role-playing: In psychotherapy for anxiety about politics, she practices scenarios where she encounters opposition or misunderstanding regarding her beliefs, focusing on remaining calm and assertive.
3. Identifying Allies: Work on identifying potential allies in her social or professional life and strategies for connecting with them, whether through clubs, social media, or local events.

### Psychotherapy for Anxiety About Politics Expected Outcomes:

Over time, Emily may develop greater confidence in expressing her beliefs, feel more connected to others who share her values, and navigate discussions more easily. She will also cultivate a sense of resilience, allowing her to engage with differing perspectives without feeling overwhelmed or isolated.

This political therapy case example demonstrates how political therapy can assist individuals with conservative views in managing the emotional challenges associated with their identity in a diverse and often polarized environment.

## Frequently Asked Questions

### What is political stress?

Political anxiety is stress, fear, or unease caused by current events, discussions, or news. It can manifest as physical symptoms such as increased heart rate, difficulty sleeping, or feeling overwhelmed by the current political climate.

### How can therapy for political anxiety help?

Political therapy can provide a safe space for individuals to explore and process their feelings. I can help you identify triggers, develop coping strategies, and work through any underlying issues that may be contributing.

### What type of therapy is recommended for political anxiety?

Cognitive-behavioral political therapy (CBT) is often recommended as a key psychotherapy for anxiety about politics. CBT helps individuals challenge and change negative thought patterns, develop healthier coping mechanisms, and build resilience in political stressors.

### Are there any self-care political therapy strategies I can try?

Political therapy self-care strategies such as mindfulness, exercise, deep breathing, and limiting exposure to news and social media can help manage political anxiety. It’s important to prioritize self-care and seek support from friends, family, or a therapist when needed.

## Conclusion and My Work

Political anxiety is a growing concern, affecting countless people as they navigate the complexities of today’s climate. By exploring political therapy options such as CBT, mindfulness techniques, logotherapy, ACT, and support groups, you can take proactive steps toward managing your anxiety and enhancing your mental well-being. The bottom line is that you’re not alone, and help is available. Addressing political anxiety can help you reclaim your peace of mind and engage with the world in a healthier, more balanced way.

I offer psychotherapy for anxiety about politics to individuals and in couples therapy (whether current events are causing stress for them together or because they disagree, and this causes conflict). I also offer it in many specific ways, including mixing [politics and family therapy](https://dralanjacobson.com/politics-and-family-therapy/) when there is family estrangement. Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you would like to learn more about therapy for political anxiety.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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---

### [ADHD Coaching for College Students: Effective, Enduring](https://dralanjacobson.com/adhd-coaching-for-college-students-effective-enduring/)

**Published:** November 2, 2025
**Author:** Dr. Alan Jacobson

**Content:**

ADHD symptoms that begin in childhood, such as difficulty sustaining attention, time-blindness, executive functioning gaps, and emotional reactivity, can become amplified in the college environment. College brings more unstructured time, higher academic demands, and new social and living responsibilities. Without the proper support, bright and talented students can struggle to translate ability into consistent performance. ADHD coaching for college students is a practical, skills-focused, strengths-based intervention that helps students translate intention into action. It sits alongside clinical treatments (medication, therapy) rather than replacing them. My work as an ADHD coach for college emphasizes concrete strategies, [habit-building](https://dralanjacobson.com/executive-functioning-coaching/), and environmental design tailored to the demands of coursework, labs, internships, and campus life.

---

## ADHD Coaching for College Students Online: Overview ![ADHD Coaching for College Students](https://dralanjacobson.com/wp-content/uploads/2025/11/College-ADHD-300x200.png "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

The following is intended for college students and their parents and provides an overview of the service.

### Who benefits from Online ADHD coaching in college?

Online ADHD coaching for college students is helpful for students who experience one or more of the following:

- Difficulty starting and completing assignments on time (procrastination related to initiation or activation).
- Chronic time misestimation (underestimating how long tasks take).
- Working-memory overload (struggling to keep steps, instructions, or deadlines in mind).
- Poor planning and organization (managing multiple classes, assignments, and group projects).
- Problems with sustained attention for reading/lectures and test preparation.
- [Emotional dysregulation](https://psychologicalassessments.com/emotional-dysregulation-testing/) that interferes with studies (anxiety, frustration, shutdown).
- Difficulty with transitions (e.g., moving between classes, home life, and job).
- Students recently diagnosed who need applied strategies to bridge assessment to daily functioning.

An ADHD coach for college also benefits a wide range of students: high-achieving students whose grades don’t reflect effort, students with co-occurring anxiety or depression (when stable), [neurodivergent](https://www.verywellmind.com/what-is-neurodivergence-and-what-does-it-mean-to-be-neurodivergent-5196627) students who want non-medical supports, and student-athletes or performers who need performance- and time-management supports.

### Core Goals of College ADHD Coaching Online

1. **Increase task initiation and completion—**turn intentions into completed work.
2. **Improve time management and planning** — realistic schedules, deadline mapping, and pacing.
3. **Build sustainable routines and habits** — morning/evening study routines, weekly planning.
4. **Optimize study tactics** — active reading, spaced practice, exam prep planning.
5. **Environmental and workload design** — redesign study spaces and reduce friction.
6. **Self-awareness and metacognition** — help students notice patterns, triggers, and strengths.
7. **Support motivation and emotional regulation** — use values, rewards, and micro-goals.

### Techniques Commonly Used in ADHD Coaching for College Students

Below are the practical techniques of online college adhd coaching, explained so they can be applied immediately.

1. #### Executive-function scaffolds

- [**Chunking**](https://www.verywellmind.com/chunking-how-can-this-technique-improve-your-memory-2794969): break large assignments into discrete, time-bound subtasks (e.g., Research — 2 sessions of 50 minutes; Outline — 60 minutes).
- **Checklists and templates —** assignment checklists, lab report templates, and project flow charts— reduce [working memory](https://www.sciencenewstoday.org/what-is-working-memory-and-how-does-it-work) load.
- **Externalization**: moving tasks from head to external systems (calendar, to-do app, paper planner).

2. #### Time management interventions

- **Time-blocking with buffer zones**: schedule study blocks plus small buffers to reduce overrun.
- **[Pomodoro](https://en.wikipedia.org/wiki/Pomodoro_Technique) and modified sprints**: 25–50 minute focused work intervals followed by 5–15 minute breaks; adapt lengths to the student’s attention rhythm.
- **Timesheet monitoring**: logging real hours spent on tasks for 1–2 weeks to calibrate time estimates.

3. #### Planning and prioritization tools

- **Weekly planning ritual**: 30–45 minute weekly session to map tasks, priorities, and energy levels across the week.
- **Priority matrix**: urgent vs. important sorting to avoid doing only urgent but low-value work.
- **Backward planning**: start from the due date and plan steps backwards with check-in dates.

4. #### Environmental engineering

- **Study space design**: reduce visual/auditory stimuli, create “do not disturb” boundaries, use ambient cues to signal focus times.
- **Device management**: app blockers, do-not-disturb profiles, and notification pruning.
- **Public commitment**: study with peers or in a visible place to increase adherence.

5. #### Cognitive and metacognitive strategies

- **Active reading**: [SQ3R](https://e-student.org/sq3r-study-method/) (Survey, Question, Read, Recite, Review), margin notes, and summarizing to improve retention.
- **Self-monitoring**: short periodic check-ins during study (rate attention 1–5) to notice drift.
- **Error-aware practice**: practice under exam-similar conditions and analyze errors rather than only re-reading.

6. #### Accountability systems

- **Built-in accountability**: scheduled check-ins with the coach, study-buddy systems, or public micro-commitments.
- **Progress tracking**: visual charts of completed study blocks or tasks to create momentum.

7. #### Motivation and reward engineering

- **Values-driven goals**: link tasks to personal values (career goals, identity).
- **Immediate reinforcement**: pair tasks with small, consistent rewards; use variable rewards for bigger milestones.

8. #### Emotional regulation and stress management

- **Short mindfulness or [grounding techniques](https://health.clevelandclinic.org/grounding-techniques)**: 3–5 minute practices to interrupt overwhelm before task start.
- **[Cognitive restructuring](https://dralanjacobson.com/cognitive-restructuring/) for task-related anxiety**: address catastrophic thinking that fuels avoidance.
- **Crisis microplans**: step-by-step action plans for meltdown or shutdown states (who to contact, immediate steps).

9. #### Skill generalization and fading supports

- **Gradual fading**: supports (reminders, structured sessions) are decreased as skills take hold.
- **Transfer exercises**: apply a technique learned for one course to another to increase generalization.

### What outcomes are typically seen?

Outcomes of online adhd coaching for college students vary, but reliably reported improvements include:

- **Higher on-time assignment completion rates** and fewer last-minute crises.
- **Improved GPA or stabilization of grades** when coaching is combined with appropriate medical and academic supports.
- **Reduced academic stress and improved confidence** in handling workloads.
- **Better adherence to study plans and improved task initiation**.
- **Improved self-awareness and realistic time estimation**.
- **Increased independence** — sustained benefit when students internalize planning rituals and environmental designs.

Quantitatively, research and clinical audits commonly show medium-to-large improvements from online college ADHD coaching in self-reported executive functioning, task completion, and academic self-efficacy when ADHD coaching for college students is consistent (e.g., weekly to biweekly) across a semester. (Coaching works best as part of a multi-pronged approach, including medication when indicated and therapy for co-occurring mood or anxiety problems.)

### How I help students who were recently diagnosed

A recent diagnosis can be both liberating and disorienting. ADHD coaching for college students translates diagnostic insight into daily functioning.

#### Practical bridging steps

1. **Education translation**: An ADHD coach for college explains test results in plain language — what specific executive function patterns mean for study habits.
2. **Immediate, concrete interventions**: Then, the ADHD coach for college starts with “low-hanging fruit” — a simple daily planner, a 2-step ritual to begin studying, and one environmental change. Quick wins build confidence.
3. **Medication coordination**: An ADHD coach for college doesn’t prescribe, but they can help students track symptom changes and build data to share with prescribers (e.g., when attention or sleep shifts).
4. **Emotional processing**: We then work to normalize grief, relief, or anger about late diagnosis; coach for [self-compassion and identity reformation](https://dralanjacobson.com/therapy-for-college-students/).
5. **Advocacy and campus resources**: An ADHD coach for college helps connect students to disability services, counseling, tutoring centers, and [college accommodations](https://psychologicalassessments.com/college-accommodations/). Provide scripts for requesting extensions or arranging support.
6. **Prevent relapse into old coping**: Throughout the course of online college ADHD coaching, we build routines that counteract avoidance patterns (e.g., immediate micro-commitment when overwhelmed).

---

## ADHD Coaching for College Students: Case Examples

Of course, every student is unique, so I devise a college ADHD coaching plan collaboratively with you that will work best. Here are three case examples to give you an idea of what might be involved.

### ADHD Coaching for College Students Online: STEM student, high potential, chronic procrastination

**Presentation:** Maya is a freshman engineering major who scored well on entrance exams but submitted lab reports late and consistently underestimated the time required for studying. She felt overwhelmed by long-term projects and tended to binge-study before exams.
**College ADHD coaching plan:** Weekly 45-minute coaching sessions for the semester. Interventions: time-tracking for one week; chunking and backward planning for her semester project; weekly planning ritual; Pomodoro sprints tailored to 40-minute focus windows; study space redesign in dorm.
**Outcome:** By midterm, Maya moved from submitting lab reports 2–3 days late to on-time submissions. She reported less stress from all-nighters and better sleep. Her midterm grades improved, and she continued using time-blocking independently.

### An ADHD Coach for College: ADHD + anxiety, juggling job and classes

**Presentation:** Carlos works 15–20 hours/week and is starting a major that requires heavy reading. He had difficulty sustaining reading sessions and experienced anxiety about falling behind. Medication helped with attention somewhat, but not with planning or stress.
**College ADHD coaching plan:** Biweekly 60-minute sessions alternating with brief 20-minute “accountability” check-ins. Interventions: priority matrix for his week, micro-study blocks during work breaks, [cognitive reframing for catastrophic thinking](https://dralanjacobson.com/cbt-for-adhd/) before large readings, and negotiation skills for workplace flexibility. The ADHD coach for college coordinated (with permission) brief contact with the campus disability office for accommodations.
**Outcome:** Carlos reported reduced panic about readings, used micro-blocks to steadily complete readings, and got his first A on a major research paper. Anxiety decreased with better structure; he maintained job hours by negotiating shifts.

### Online College ADHD Coaching: Recently diagnosed, nontraditional student and parent

**Presentation:** Aisha returned to college after a multi-year break to finish a degree while parenting. She was recently diagnosed with ADHD during intake and felt a mix of relief and uncertainty about practical steps.
**Online College ADHD coaching plan:** Initial sessions focused on translating diagnostic feedback into daily strategies: prioritizing childcare, identifying study windows, creating simple routines (prep-for-study ritual), and low-tech planners. The psychologist modeled brief acceptance-based coping for shame and connected Aisha to peer support for nontraditional students.
**Outcome:** Aisha felt validated by the diagnosis and used coaching to create a sustainable study rhythm (two focused evening blocks per week + 90 minutes on Sundays). She completed capstone work while maintaining childcare routines and described coaching as “practical therapy for school.”

---

## Delivering ADHD Coaching for College Students Online

**Online college ADHD coaching can be as effective as in-person coaching when intentionally structured**.

1. **Platform & session design**

- An online ADHD coach for college uses a reliable video platform with screen-sharing and session-recording options (with consent) so students can review planning boards and shared documents.
- Online college ADHD coaching Sessions: typically 30–60 minutes. Frequency: weekly or biweekly early in the semester, tapering as skills stabilize.
- An online ADHD coach maintains a shared, editable workspace (Google Docs, Notion, Trello) for plans, checklists, and calendars.

2. **Structured session flow (30–60 min)**

1. Quick mood/energy check (2–5 min).
2. Review of wins and barriers since last session (5–10 min).
3. Update weekly plan and micro-goals (10–20 min).
4. Co-create the following action steps with explicit timing and predicted durations (10–15 min).
5. Accountability setup and wrap-up (5 min). Optionally set an immediate “activation” task during the session (e.g., start an outline for 15 minutes).

3. **Tools & routines for o**nline college ADHD coaching****

- **Shared calendars** with color-coded blocks.
- **Automated reminders** via apps or email for check-ins.
- **Asynchronous accountability** (brief message reports, photo of completed work, or a simple checklist) between sessions.
- **Session recordings or written summaries** so students can re-run strategies.
- **Screen-sharing coaching** where the coach and student build an outline, schedule, or template together in real time.

4. **Engagement strategies**

- An online ADHD coach for college uses short, targeted homework (micro-tasks) to avoid overwhelm.
- They use visual progress trackers and celebrate small wins.
- An online ADHD coach for college also adapts the modality: some students prefer chat-based check-ins, others prefer voice/video. Be flexible.

5. **Privacy and accessibility**

- Ensure confidentiality and compliance with privacy standards.
- Offer captioning or transcript options for students with sensory needs.
- Keep tools low-cost or free where possible to avoid barriers.

---

## Final Thoughts and Conclusion

Students often notice practical improvements through online college ADHD coaching in 2–6 weeks (with consistent practice) and more durable habit change across 8–16 weeks. Early focus is on stabilization; later, on generalization and independence.

### Working with campus structures (disability services, faculty, and peers)

- **Coaching and disability services**: Psychologists can help prepare [ADA accommodation](https://psychologicalassessments.com/disability-accommodations/) requests (documentation summaries, recommended accommodations) and mentor students on how to use approved supports (extended time logistics, lecture capture).
- **Faculty communication**: Role-play or scriptwriting for students to request extensions or discuss group-work roles.
- **Peer supports**: Creating study groups with clear role assignments and accountability rituals increases follow-through.

### When to combine Online ADHD coaching for College Students with Other Treatments

- Combine with **medication management** if attention or hyperactivity symptoms significantly impair functioning; then the work helps translate medication effects into practical gains.
- Integrate with [**psychotherapy**](https://dralanjacobson.com/psychotherapy/) when mood, trauma, or severe anxiety co-occur and interfere with consistent functioning.
- Use of academic supports ([therapeutic tutors](https://therapeutictutoring.com/), learning specialists) when content mastery is the primary barrier.

### Online ADHD Coaching for College Students: Measurement and Progress Tracking

- Simple metrics: assignment submission rate, number of missed deadlines, hours studied vs. planned, self-rated attention scores, and stress ratings.
- Use short pre-/and post-measures of executive functioning or self-efficacy to track broad change. Collect qualitative feedback (what’s easier now?) every month.

### Common Challenges an ADHD Coach for College Faces

- **Inconsistent attendance** — use micro commitments and asynchronous accountability.
- **“All or nothing” thinking** — plan for imperfect days; normalize reduced productivity and plan for restart strategies.
- **Over-reliance on the coach** — build fading strategies so supports are internalized.
- **Technology overwhelm** — pick one or two tools and learn them well rather than dozens.

Online ADHD coaching for college students is a pragmatic, empowering approach that turns psychological insight into day-to-day success. It honors students’ strengths while teaching concrete strategies that reduce chaos, increase predictability, and improve academic outcomes. Whether a student is newly diagnosed or has navigated symptoms for years, Online college ADHD coaching helps bridge the gap between what they intend to do and what they actually do—one realistic plan, one micro-habit, and one completed assignment at a time. With a supportive coach, clear tools, and measured practice, students can reclaim time, reduce stress, and finish their degrees with confidence.

If you have any questions or would like to learn more about ADHD coaching for college students, please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult#services/service) anytime.

## Frequently Asked Questions: ADHD Coaching for College Students

Practical answers about what ADHD coaching involves, who it helps, and how to get started.

 ### What is ADHD coaching for college students, and how is it different from therapy?

ADHD coaching is a practical, skills-focused intervention designed to help students translate intention into action — building habits, systems, and strategies for managing academic demands. It differs from [ADHD therapy](https://dralanjacobson.com/adhd-therapy-for-adults/) in that it is primarily forward-looking and performance-oriented rather than focused on processing emotions or treating co-occurring conditions like anxiety or depression. Coaching and therapy are complementary: many students benefit from both simultaneously, with coaching handling the day-to-day academic scaffolding while therapy addresses deeper emotional and psychological factors. Coaching also sits alongside medication management rather than replacing it.

 ### Which college students benefit most from ADHD coaching?

ADHD coaching is helpful for a wider range of students than many people expect. It is a strong fit for students who struggle with procrastination and task initiation, chronic time misestimation, working memory overload, difficulty planning across multiple courses, or [executive functioning](https://dralanjacobson.com/executive-functioning-coaching/) gaps that affect organization and follow-through. It also serves high-achieving students whose grades don’t reflect their actual effort or ability, students recently diagnosed who need applied strategies, [neurodivergent](https://www.verywellmind.com/what-is-neurodivergence-and-what-does-it-mean-to-be-neurodivergent-5196627) students who prefer non-medication supports, and student-athletes managing demanding schedules. Co-occurring anxiety or depression does not disqualify a student, as long as those conditions are reasonably stable.

 ### How is online ADHD coaching structured? What does a typical session look like?

Sessions are typically 30–60 minutes and held weekly or biweekly, with frequency tapering as skills stabilize across the semester. A standard session follows a consistent structure: a brief mood and energy check-in, a review of wins and barriers since the last session, an update to the weekly plan and micro-goals, co-creating the next set of action steps with explicit timing, and an accountability wrap-up. Between sessions, students may use shared digital tools — such as Google Docs, Notion, or a simple calendar — along with brief asynchronous check-ins to maintain momentum. Some students also do a brief activation task at the end of the session itself to build immediate follow-through.

 ### What specific strategies does ADHD coaching use?

The core techniques include chunking large assignments into time-bound subtasks, backward planning from due dates, time-blocking with buffer zones, and modified [Pomodoro sprints](https://en.wikipedia.org/wiki/Pomodoro_Technique) calibrated to each student’s attention rhythm. Coaching also addresses study environment design (reducing friction and distraction), active reading methods like [SQ3R](https://e-student.org/sq3r-study-method/), priority matrix sorting, and self-monitoring during study sessions. For motivation and emotional regulation, coaching draws on values-based goal setting, immediate reinforcement strategies, and [cognitive restructuring](https://dralanjacobson.com/cognitive-restructuring/) for the task-related anxiety that frequently fuels avoidance in students with ADHD.

 ### How soon can a student expect to see results from ADHD coaching?

Most students notice practical improvements — more on-time submissions, less crisis-mode studying, better sleep — within 2–6 weeks of consistent coaching. More durable habit change typically takes 8–16 weeks, as students internalize planning rituals and environmental systems rather than relying on external prompts. Early work focuses on stabilization and quick wins; later work emphasizes generalization and independence. Research and clinical data consistently show medium-to-large improvements in self-reported executive functioning, task completion, and academic self-efficacy when coaching is consistent across a semester — particularly when paired with appropriate [CBT for ADHD](https://dralanjacobson.com/cbt-for-adhd/) and medication management where indicated.

 ### My student was recently diagnosed with ADHD. Is coaching the right first step?

A recent diagnosis is actually an ideal time to start coaching. The first priority is translating diagnostic findings into practical daily strategies — explaining what specific [executive function patterns](https://psychologicalassessments.com/emotional-dysregulation-testing/) actually mean for study habits, then building immediate, concrete systems to address them. Early coaching also helps students work through the emotional response to a late diagnosis (relief, grief, uncertainty) and connect with campus resources like disability services, tutoring centers, and [academic accommodations](https://psychologicalassessments.com/college-accommodations/). Coaching can also help students collect symptom and attention data to share with prescribers when medication is part of the picture.

 ### Can ADHD coaching help if my student is also dealing with anxiety or depression?

Yes — co-occurring anxiety or depression is common among college students with ADHD, and coaching can be highly effective when those conditions are reasonably stable. Coaching addresses the practical and behavioral layer: reducing academic overwhelm, building structure, and breaking avoidance cycles that anxiety often creates. When mood or anxiety concerns are more significant, [therapy for college students](https://dralanjacobson.com/therapy-for-college-students/) can run alongside coaching, with each service addressing a different layer of functioning. Dr. Jacobson’s background as a licensed clinical psychologist means he can hold both dimensions in view — supporting the practical work of coaching while recognizing when clinical concerns need direct attention.

 ### How do I get started with ADHD coaching for my student (or for myself)?

The first step is a free 20-minute consultation. This is a straightforward conversation about what the student is experiencing, what approaches have or haven’t worked, and whether coaching — and this particular fit — makes sense. There’s no commitment required and no pressure. Many students and parents are surprised by how practical and grounded the conversation is. You can also explore the broader range of [support services for college students](https://dralanjacobson.com/therapy-for-college-students/) and the related [Therapeutic Tutoring](https://therapeutictutoring.com/) program for students who also need content-area academic support alongside coaching.

 Ready to help your student build real academic momentum?

Schedule a free 20-minute consultation with Dr. Jacobson — no commitment required. We’ll talk through what’s happening and what a practical plan might look like.

 [ Schedule a Free Consultation ](https://www.picktime.com/scheduleaconsult) 

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.linkedin.com/company/psychologicalscience/)

---

### [How Long Does Therapy Take to See Significant Results?](https://dralanjacobson.com/how-long-does-therapy-take/)

**Published:** December 5, 2024
**Author:** Dr. Alan Jacobson

**Content:**

Therapy can be a transformative journey, offering a path to healing and self-discovery for many. Yet, one of the most common questions is the time commitment involved. **How long does therapy take** to see meaningful and tangible results? While everyone’s experience is unique, understanding the typical timeline and influencing factors can help manage expectations. Knowing what lies ahead can provide clarity and peace of mind whether you’re considering treatment or are already in the process. This post gives information about **How long psychotherapy takes** and the **length of therapy sessions** it takes to get there. I also answer, “**How long does couples therapy take**?” because it can differ.

If you would like to talk about your unique situation and get a general idea of how long psychotherapy takes in similar situations, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## How Long Does Therapy Take: Overview ![How long does therapy take](https://dralanjacobson.com/wp-content/uploads/2024/12/Calendar-300x300.png "Calendar | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

The following overview helps with the question, “How long does therapy take to show positive and powerful results?”:

### How Long Does Therapy Take: Key Takeaways

- Treatment should be life-changing, and the results should be obvious
- Personal goals and commitment significantly shape how long psychotherapy takes
- The [type of therapy](https://dralanjacobson.com/types-of-therapy/) and the approach we choose impact how long psychotherapy takes
- The length of [individual therapy](https://dralanjacobson.com/individual-therapy/) sessions is usually 45 to 60 minutes, typically every week. [Couples therapy](https://dralanjacobson.com/couples-therapy/) and [family treatment](https://dralanjacobson.com/family-therapy/) may last longer.
- Significant improvement is often seen after 6 to 10 sessions, with new goals becoming possible.
- Consistency and active participation are vital for maximizing effectiveness.

### Factors Affecting the Length of Therapy

How long psychotherapy takes isn’t one-size-fits-all; it’s as varied as the individuals who seek it. Your personal goals are crucial in determining the amount of time you’ll spend. Each goal can require a different approach and length of treatment. Some people find resolution in a few sessions, while others may undergo treatment for years. Even in the latter case, you should experience meaningful and powerful results along the way, but you add new goals as you see the results. You have some control over answering the question, “How long does therapy take?”

Your commitment level is also pivotal in answering the question, “How long does psychotherapy take to work?” Attending sessions regularly, completing any homework assigned, and genuinely engaging in the process can accelerate your progress. The process is akin to a partnership; the more you put into it, the more you benefit.

The clinical approach chosen is another determining factor in determining how long psychotherapy takes. [Cognitive-behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) and [solution-focused therapy](https://dralanjacobson.com/solution-focused-therapy/), for instance, often involve a more structured and shorter timeline, whereas [psychodynamic therapy](https://dralanjacobson.com/psychodynamic-therapy/) or [existential approaches](https://dralanjacobson.com/existential-therapy/) might be more open-ended. I provide an [integrative psychological approach](https://dralanjacobson.com/integrative-therapy/), tailoring the methods and your treatment plan to fit your unique needs, streamlining the process.

Complex mental health issues that have been with you for some time or have not responded to prior treatment naturally extend the length of treatment. Conditions like PTSD, [personality disorders](https://www.verywellhealth.com/personality-disorders-5100910), or long-term anxiety might require a more prolonged and [intensive psychological treatment](https://dralanjacobson.com/intensive-therapy-and-specialty-services/) approach. This isn’t to say progress won’t happen; it just might be more gradual, requiring patience and perseverance.

## Average Length of Therapy Sessions

The usual length of therapy sessions is between 40 to 50 minutes. This time frame is designed to provide enough space for meaningful conversation without overwhelming you with too much information or emotional processing at once. For some, the length of therapy sessions may be extended, such as couples and family treatment, which often require longer. For others, such as [treatment with college students](https://dralanjacobson.com/therapy-for-college-students/) and certain specialties that involve a lot of “homework,” such as [sports psychology](https://dralanjacobson.com/sports-psychology/), the length of therapy sessions may be shorter.

Weekly sessions are the norm, allowing you to delve into your thoughts and feelings regularly. However, the frequency of sessions can vary based on your needs and schedule. I see some clients in bi-weekly or monthly meetings, especially after they’ve experienced significant gains and met some of their major goals. Others might require more frequent sessions, especially at the beginning. This is particularly true in my [intensive treatment](https://dralanjacobson.com/intensive-therapy-and-specialty-services/) offerings, where shorter sessions can be effective for more frequent, focused check-ins.

## How Long Psychotherapy Takes to Work?

The million-dollar question: how long does therapy take to work? The answer often lies in your goals. Most people start noticing changes after just a few sessions. These changes might initially be subtle, like feeling more hopeful or less anxious. Interestingly, the people around you are often the first to notice positive changes!

For most, significant improvement is generally observed after 10 to 12 sessions. Research supports this timeline for how long psychotherapy takes, showing that many people experience marked progress within these sessions. However, the timeline can stretch longer for more ingrained issues, where layers of complexity need unraveling.

Consistent attendance is key to accelerating progress. Skipping sessions or attending sporadically can disrupt the therapeutic momentum, slowing your journey to well-being. Treatment might take longer for deep-seated issues, but every session brings you closer to understanding and resolution. [Virtual therapy](https://dralanjacobson.com/virtual-therapy-guide/) helps with this.

Ultimately, the duration of your care is highly individual. It depends on your commitment, the severity of the issues, and the therapeutic techniques employed. But rest assured, every step you take is a step toward positive change. Many who come in wondering how long it takes for psychotherapy to work are pleasantly surprised.

### Maximizing the Effectiveness of Therapy

Active participation is crucial to getting the most out of your sessions. The more you engage, the more you’ll benefit. Think of treatment as a collaborative effort—a partnership where your input shapes the outcomes.

Setting clear goals can focus your efforts and provide direction. We’ll align your treatment plan with your aspirations. Being open and honest fosters a trusting relationship, paving the way for meaningful progress. Be bold. Our work together can be life-changing and more powerful than you may expect.

Don’t underestimate the power of homework assignments. These might include journaling, practicing new behaviors, or reflecting on session discussions. Completing these tasks can significantly boost your progress between sessions.

Feedback is another crucial element. During your sessions, share your thoughts with me about what works and what doesn’t. This dialogue informs necessary adjustments to your treatment plan, ensuring it remains effective and relevant. Therapists are not sensitive to feedback; quite the opposite, we welcome it!

### How Long Does Therapy Take? The Importance of Consistency

Consistency is the backbone of effective treatment. Regular attendance strengthens the therapeutic relationship, building a foundation of trust and understanding. This connection is vital for delving into deeper issues where vulnerability is often required.

Consistent sessions build momentum, making each session more impactful. Attending sessions regularly makes you less likely to lose the thread of your progress. Irregular attendance, on the other hand, can slow down the therapeutic process, often leading to frustration.

Your commitment often correlates with more effective results. It signals that you’re serious about your well-being. Consistency also helps in maintaining the benefits long after the sessions have ended, providing a lasting impact on your life.

## How Long Does Therapy Take for Different Mental Health Conditions

Different mental health conditions require varying lengths of treatment. For the [treatment of depression and anxiety](https://dralanjacobson.com/therapy-for-depression-and-anxiety/) where there is a specific focus, such as [treatment of a phobia](https://dralanjacobson.com/therapy-for-phobias/), [fear of public speaking](https://dralanjacobson.com/public-speaking-anxiety/), [discernment counseling](https://dralanjacobson.com/discernment-counseling-pre-engagement-counseling/), or [flight anxiety](https://dralanjacobson.com/flight-anxiety-self-help/), a short-term course is often effective. Certain methods, like cognitive-behavioral therapy (CBT), can provide tools to manage symptoms relatively quickly.

A depressive mood that has been around for a while might require several months of consistent sessions, as do existential worries and [life transitions](https://dralanjacobson.com/life-transitions-therapy/) that are severe. The depth of the condition often necessitates a more extended approach to uncover underlying causes and develop coping strategies. Chronic conditions like [childhood PTSD](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/) might involve long-term treatment, focusing on trauma processing and management.

Personality disorders generally require extended treatment, often involving a combination of therapeutic approaches to address complex patterns of behavior and thought. How long psychotherapy takes depends on the seriousness of the condition and how long it has been with you.

### How Long Does Therapy Take: Setting Realistic Expectations

It’s essential to approach treatment with realistic expectations. Think of it as a journey, not a quick fix. Progress might be slow but steady, requiring patience and commitment. Open communication can help set the right expectations, including getting an upfront estimate of how long psychotherapy takes when your presenting concerns are involved.

Flexibility in your goals can accommodate changing needs. Your goals might evolve as you progress, reflecting new insights and aspirations. Treatment often involves trial and error to find what works best for you, so be open to adjusting your approach as needed.

## Speeding Up How Long Psychotherapy Takes

Arriving prepared can maximize the effectiveness of sessions. Bringing specific topics or questions can guide the session, ensuring you cover what’s most important to you. Being forthcoming with your encourages better support and understanding.

Reflecting on past sessions can enhance your insight and reveal patterns or progress you might not have noticed. Setting small, achievable goals can boost your confidence and provide a sense of accomplishment.

Active listening during sessions facilitates a deeper understanding of the topics discussed. Engage fully in the conversation, and don’t hesitate to ask questions or seek clarification.

## Frequently Asked Questions

### How long does therapy take, on average?

The duration varies depending on the individual and the goals. On average, treatment can last from a few weeks to several months or even years. The length of psychotherapy is often determined by the progress made and your needs.

### How long is the average person in therapy?

The length of time a person spends can vary greatly. Some may only need a few sessions to address specific concerns, while others may benefit from longer-term treatment to work through deeper issues. It is important to work with me to determine the best course of treatment for your unique situation.

### What is the usual duration of therapy?

Your progress and goals typically determine the duration. Some clients may see results in a few sessions, while others may require more time to achieve their desired outcomes. Communicating your expectations openly with me is important, and we’ll set realistic goals.

### What is the initial length of therapy sessions?

The length of the therapy sessions at the start can vary depending on your needs. Typically, an initial session lasts 45 minutes to 90 minutes. During the first session, I will gather information about your background, concerns, and goals. It is important to use this time to discuss what you hope to achieve.

I also answer questions about [therapy vs. psychotherapy](https://dralanjacobson.com/therapist-vs-psychologist-therapist-vs-psychotherapist/) and counseling vs. therapy in a separate post.

## How Long Couples Therapy Take

How long psychotherapy takes for couples depends on the issues being addressed, our approach, and your goals. Here’s an overview that should help answer the question, “How long does couples therapy take?”:

### How Long Does Couples Therapy Take: Typical Timeframes

When answering, “How long does couples therapy take?” we can look at the reasons and the methods to come to a general answer, for example:

1. **Short-Term (6–12 sessions)**: 
    - Focused on addressing specific issues, such as communication challenges or a recent conflict.
    - Often uses structured approaches like **Cognitive Behavioral** (CBT), [Brief Strategic Family Therapy](https://dralanjacobson.com/strategic-family-therapy-powerful-positive-time-limited/), or [**Emotionally-Focused Therapy for Couples**](https://dralanjacobson.com/eft-therapy-for-couples/) (EFT).
2. **Medium-Term (3–6 months)**: 
    - For deeper issues like trust-building after infidelity or long-standing conflicts.
    - This may include addressing individual emotional patterns that impact the relationship.
    - [Systemic Family Therapy](https://dralanjacobson.com/family-systems-therapy-powerful-effective-and-meaningful/) or [adult family therapy](https://dralanjacobson.com/adult-family-therapy/) for more engrained issues.
3. **Long-Term (6 months to a year or more)**: 
    - For complex issues such as long-standing emotional distance, trauma, or co-dependency.
    - Often used for couples seeking ongoing support to sustain healthier patterns and include
    - **[Imago Relationship Treatment](https://dralanjacobson.com/imago-relationship-therapy/) or Psychodynamic Approaches**:

### Length of Therapy Sessions Last for Couples

Sessions are typically weekly or biweekly, but this may taper off as progress is made. The length of therapy sessions is between 45-60 minutes, and sometimes more. This time frame provides enough space for both partners to express themselves and have a meaningful conversation about that content. Sometimes, the length of therapy sessions for couples may be extended when there is much to cover or positive momentum that should be continued.

### How Long Does Couples Therapy Take: Factors

Three main factors are related to the question, “How long does couples therapy take?”:

- **Couples’ commitment to change**: Progress depends on how actively partners engage with the process. In short, it takes the commitment of both members
- **The severity of issues**: More entrenched issues may require extended treatment, as do particularly severe issues.
- **Clinical approach**: The two factors above often guide the approach we’ll choose, which in turn affects the length of therapy sessions for couples

So, how long does couples therapy take? You should feel it is working fairly quickly, but how long it takes to reach your goals depends on the above factors.

## Summary and My Work

I hope this post helped answer the question, “How long does therapy take?” or, for partners, “How long does couples therapy take?” including the length of therapy sessions and the duration of treatment. Of course, everyone’s experience is unique. I also have a related post that answers the question, “[What is therapy like](https://dralanjacobson.com/talking-to-a-therapist/)?”

If you have more specific questions about how long psychotherapy takes for someone with your unique goals and hopes or have more general questions about my practice or [how to find therapy](https://dralanjacobson.com/how-to-find-therapy-in-new-york-or-anywhere-a-guide-to-getting-started/) in general, please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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---

### [Therapist vs. Psychologist? Therapist vs. Psychotherapist?](https://dralanjacobson.com/therapist-vs-psychologist-therapist-vs-psychotherapist/)

**Published:** March 12, 2025
**Author:** Dr. Alan Jacobson

**Content:**

When navigating behavioral health care, it can be confusing to differentiate between therapists, psychologists, psychotherapists, psychiatrists, and clinical psychologists. Each professional has a unique role in providing support, from talk therapy to psychological assessments and medication management. Understanding these differences can help you choose the right specialist based on your needs—whether you’re looking for emotional support, a formal diagnosis, or medical treatment. Professionals can be in multiple categories in many cases, and the services you receive can evolve as your clinician gets to know you. Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you’d like to learn more.

## Therapist vs. Psychologist

People often wonder whether a therapist vs. a psychologist best fits them. Both provide mental health support but have different training, education, and roles. Also, while a [clinical psychologist can be a therapist](https://dralanjacobson.com/what-is-a-clinical-psychologist/) (as I am), a therapist cannot be a psychologist without specific education and training.

### What is a Therapist

- “Therapist” is a broad term that includes various professionals (counselors, social workers, marriage and family therapists, etc.).
- A therapist can have different degrees (master’s or doctorate) in fields like social work, counseling, or psychology.
- They provide many types of therapy therapy, coping strategies, and emotional support.
- They may specialize in areas like [trauma therapy](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/), [relationship therapy](https://dralanjacobson.com/relationship-therapy/) (for those who are partners), or addiction.
- Most cannot prescribe medication (unless also a psychiatrist or [nurse practitioner](https://www.aanp.org/about/all-about-nps/whats-a-nurse-practitioner)).
- All have received at least two years of formal education and training plus two additional years of supervised work.

### What is a Psychologist

- A psychologist is a clinician with a doctoral degree, usually a Ph.D. or Psy.D.
- They are trained in research, assessments, and clinical practice (such as therapy).
- Many conduct [psychological testing](https://psychologicalassessments.com/) (e.g., ADHD, autism, [personality assessments](https://psychologicalassessments.com/personality-testing/)).
- Some, like me, provide therapy, but others focus on research or teaching.
- They cannot prescribe medication in most states (except a few with extra training).
- All have received at least three years of formal education and training plus three additional years of supervised work.

### What is the Difference Between a Therapist and a Psychologist

A therapist (licensed counselor, social worker, or psychologist) could be a good fit if you’re looking for most types of therapy. A psychologist might be best if you also need psychological testing, a more formal [comprehensive assessment](https://psychologicalassessments.com/the-comprehensive-psychological-evaluation/), or a deeper diagnostic analysis.

### Therapist vs. Psychologist? Who Should I See?

Whether you should see a **therapist** or a **psychologist** depends on your needs. Here’s a breakdown to help you decide:

#### See a Therapist (who may be a psychologist) If:

- You need [**talk therapy**](https://dralanjacobson.com/psychotherapy/) to manage stress, anxiety, depression, trauma, or relationship issues.
- You’re looking for **coping strategies** and emotional support.
- You want to work through personal challenges in a safe, structured environment.
- You don’t need formal psychological testing.

#### See a Psychologist If:

- You need [**psychological testing** for ADHD](https://psychologicalassessments.com/testing-for-adhd/), autism, personality disorders, or [cognitive assessments](https://psychologicalassessments.com/iq-testing/).
- You’re dealing with **severe or complex mental health concerns** that require a more clinical approach.
- You want therapy with someone who has experience with the **research behind your treatments.**
- You might need a formal **diagnosis** to guide treatment, accommodations, or a legal matter.

**Therapist vs. Psychologist: Which One is Right for You?**

- If you’re looking for **general therapy**, a **therapist** (who could be a licensed counselor, social worker, psychotherapist, or psychologist) is a great choice.
- If you need **testing, a diagnosis, or treatment for complex mental health conditions**, a [**clinical psychologist**](https://dralanjacobson.com/what-is-a-clinical-psychologist/) might be the better option. In another post, I cover [how to find a good psychologist](https://dralanjacobson.com/how-do-you-find-a-psychologist-offering-affordable-therapy/).

## Therapist vs. Psychotherapist

Choosing between a **therapist** vs. **psychotherapist** is often subtle – you’ll have a similar experience with each, but there’s a slight difference in how the terms are used.

### What is a Therapist?

- “Therapist” is a broad term that includes many professionals who provide mental health support.
- They can be a counselor, social worker, psychologist, [marriage and family therapist](https://www.verywellmind.com/what-is-a-marriage-and-family-therapist-2795654), etc. All of these professionals are well-trained.
- They focus on helping people with emotional, behavioral, and psychological issues.

### What is a Psychotherapist

- A type of therapist who specifically provides **psychotherapy** (talk therapy).
- They use deeper psychological techniques to help with mental health conditions, trauma, or emotional difficulties.
- They often have specialized training in specific therapy approaches (e.g., [CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/), [psychodynamic therapy](https://dralanjacobson.com/psychodynamic-therapy/), [EMDR](https://www.emdr.com/what-is-emdr/)).

### Psychotherapist vs. Therapist – What is the Difference?

Essentially, all psychotherapists are therapists, but not all therapists are psychotherapists. A psychotherapist would be the right choice if you’re looking for someone who does in-depth talk therapy. If you need broader mental health support, a **therapist** (which could include counselors, social workers, etc.) might also be helpful.

### Should I see a Therapist or a Psychotherapist

It depends on the type of support you’re looking for.

#### See a Therapist If:

- You need **general mental health support**, such as coping strategies for stress, anxiety, or relationships.
- You’re looking for **guidance and emotional support** rather than deep psychological work.
- You want a broader range of therapy options, including coaching or short-term counseling.

#### See a Psychotherapist If:

- You want **in-depth talk therapy** to explore emotions, behaviors, and past experiences.
- You’re dealing with **trauma, deep-seated emotional issues, or long-term mental health concerns**.
- You want a therapist trained in **specific psychotherapy methods** like Cognitive Behavioral Therapy (CBT), [Dialectical Behavior Therapy](https://dralanjacobson.com/dbt-for-teens/) (DBT), or [Psychoanalysis](https://en.wikipedia.org/wiki/Psychoanalysis).

#### Therapist vs. Psychotherapist: Which One is Right for You?

- **All psychotherapists are therapists**, but not all therapists are psychotherapists.
- If you need **deep psychological work**, a **psychotherapist** is the better choice.
- A therapist will work well if you’re looking for general guidance and coping tools.

## Clinical Psychology vs. Therapy

Both **clinical psychology** and **therapy** focus on mental health, but they differ in scope, training, and approach.

**Clinical Psychology**

- A branch of psychology that focuses on diagnosing and treating mental illnesses.
- Clinical psychologists typically have a **Ph.D. or Psy.D.** and are trained in psychological assessments, research, and evidence-based treatments.
- Often involves more complex mental health conditions.
- Encompasses both therapy and psychological testing (e.g., for ADHD, autism, or mood disorders).

**Therapy**

- A broad term for mental health treatment provided by various professionals (counselors, social workers, psychologists, etc.).
- Focuses on helping individuals navigate emotional, relational, or situational challenges (e.g., stress, grief, relationships).
- Therapists may have a **master’s or doctoral degree** in counseling, psychology, social work, or related fields.
- They provide **talk therapy** but don’t typically conduct formal psychological testing.

### Key Differences in Clinical Psychology vs. Therapy

**Feature****Clinical Psychology****Therapy****Education**Ph.D. or Psy.D.Master’s or higher**Focus**Diagnosing & treating mental disordersEmotional support & coping strategies**Approach**Research-based assessments + therapyTalk therapy**Psychological Testing**YesRarelyIf you’re looking for a formal diagnosis or treatment for a mental illness, a **clinical psychologist** may be best. A therapist might be better if you need emotional support, coping strategies, or help with life challenges.

### Which is best for you?

Whether you need **clinical psychology vs. therapy** depends on your mental health needs. Here’s how to decide:

#### Choose Clinical Psychology If:

- You need a **formal diagnosis** for a mental health condition (e.g., ADHD, autism, personality disorders).
- You require **psychological testing or assessments** to understand cognitive or emotional difficulties.
- **Severe or complex mental health concerns** are emerging or present(e.g., schizophrenia, major depression, OCD).
- You want therapy that includes **research-backed treatments** and a clinical approach.

#### Choose Therapy If:

- You need **emotional support** to navigate life challenges (e.g., stress, relationships, grief).
- Developing **coping strategies** for anxiety, depression, or everyday struggles is a core goal.
- You prefer **talk therapy** without needing a formal diagnosis.
- Your concerns are **not severe or require medical intervention**.

#### Clinical Psychology vs. Therapy: Which One is Right for You?

- If you need **a diagnosis, testing, or treatment for a complex mental health condition**, a **clinical psychologist** is best.
- If you’re looking for talk therapy and emotional support, a therapist (who may be a psychologist) is likely the right choice.

## What is the Difference Between a Psychotherapist and a Psychologist

Both **psychologists** and **psychotherapists** help with mental health, but they have different training, roles, and approaches. So, what is the difference between a psychotherapist and a psychologist?

**Psychologist**

- Has a **Ph.D. or Psy.D.** in psychology.
- Can specialize in **clinical, counseling, or research psychology**.
- Often conducts **psychological testing** (e.g., ADHD, autism, personality assessments).
- Can provide therapy but may also focus on research, teaching, or assessments.
- Cannot prescribe medication (except in some states with extra training).

**Psychotherapist**

- A general term for a professional who provides **talk therapy**.
- Can be a **psychologist, licensed counselor, social worker, or psychiatrist** (as long as they provide psychotherapy).
- Uses various therapeutic approaches (e.g., CBT, psychoanalysis, EMDR) to help with emotional and psychological issues.
- Does not necessarily conduct psychological testing.

### Summary of the Difference Between a Psychotherapist and a Psychologist

**Feature****Psychologist****Psychotherapist****Education**Ph.D. or Psy.D.Master’s or higher (varies)**Focus**Diagnosing, testing, therapy, researchTalk therapy**Psychological Testing**YesNo**Therapy Provided?**SometimesYes## Should I See a Therapist or a Psychiatrist

Here’s a breakdown:

**See a Therapist If:**

- You want **talk [therapy techniques](https://dralanjacobson.com/therapy-techniques-for-depression-anxiety-and-phobias/)** to work through emotions, stress, relationships, or trauma.
- You need help with **coping strategies** for anxiety, depression, ADHD, etc.
- You’re looking for ongoing **emotional support and personal growth**.
- You prefer non-medication approaches like **CBT, DBT, EMDR, or [mindfulness techniques](https://dralanjacobson.com/mindfulness-therapy/)**.

**See a Psychiatrist If:**

- You think you might need **medication** for mental health conditions (e.g., ADHD, anxiety, depression, bipolar disorder).
- **Severe symptoms** are interfering with daily life (e.g., psychosis, suicidal thoughts, extreme mood swings).
- You need a **diagnosis** and treatment plan for a serious mental health disorder.
- You’ve tried therapy but feel like you need additional medical support.

### Can I See Both?

Many people see a **therapist for talk therapy** and a **psychiatrist for medication management**. They often work together to give you the best care.

## Therapy or Counseling: What’s the Difference?

Both **therapy** and **counseling** involve talking to a mental health professional, but they differ in depth, focus, and duration.

#### Choose Counseling If:

- You need **short-term** support for a specific issue (e.g., stress, career decisions, relationship problems).
- You want **practical advice and coping strategies** to manage current challenges.
- Your concerns are **situational** rather than deep-rooted emotional issues.
- You prefer a more **goal-oriented approach** to problem-solving.

#### Choose Therapy If:

- You need **long-term** support for deeper emotional or psychological concerns.
- You want to explore **past experiences, patterns, and behaviors** that impact your mental health.
- You’re dealing with **trauma, depression, anxiety, or other mental health conditions**.
- You want to focus on **personal growth and emotional healing**.

#### Therapy or Counseling – Which One is Right for You?

- Counseling is a great option if you’re dealing with a specific problem and need guidance.
- If you need **deeper emotional work or ongoing support**, **therapy** might be better.

## What is the Difference Between a Therapist and a Counselor

Although the terms therapist and counselor are often used interchangeably, there are some differences in how they are typically defined.

**Therapist**

- General term for any mental health professional who provides therapy.
- Can have various qualifications, such as a master’s or doctorate in fields like social work, psychology, or counseling.
- Typically provides long-term therapy to address a range of emotional or psychological issues (e.g., depression, trauma, anxiety).
- May use a variety of therapeutic approaches like CBT, DBT, or psychoanalysis.
- Often works with more complex issues like deep emotional or psychological challenges.

**Counselor**

- Often a specialized type of therapist focusing on short-term therapy or specific issues (e.g., career counseling, relationship issues, or grief).
- Usually holds a master’s degree in counseling or a related field.
- May focus on providing advice and guidance for immediate, practical issues.
- Less likely to deal with severe mental health conditions like trauma or personality disorders.

### What is the Difference Between a Therapist and a Counselor: Summary

**Feature****Therapist****Counselor****Focus****Long-term emotional support****Short-term guidance and practical advice****Training****Broad range of degrees****Typically a master’s in counseling****Common Issues****Trauma, depression, anxiety****Career, relationships, life transitions****Approach****In-depth therapy techniques****Practical advice, coping strategies**Which One Should You Choose?

- A therapist might be more suited if you need long-term emotional support for deeper issues.
- A counselor could be a good fit if you’re facing specific life challenges or need practical guidance.

## Summary and Conclusions:

Choosing the right mental health professional depends on your specific concerns. A therapist or psychotherapist may be best if you need emotional support and coping strategies. A psychologist could be helpful if you’re seeking a formal diagnosis, have a complex mix of symptoms, or need psychological testing. For those considering medication, a psychiatrist is the right choice. In some cases, a combination of therapy and medical treatment works best. Regardless of your path, seeking help is crucial for better mental well-being, and you have many qualified, compassionate, and effective choices. There is a separate post that describes what each of these professions is like in [private practice](https://dralanjacobson.com/finding-a-private-practice-therapist/) and another that talks about how to find [affordable therapy](https://dralanjacobson.com/how-do-you-find-a-psychologist-offering-affordable-therapy/).

Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) if you’d like to learn more about me or my practice.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

 [ ![social network 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](https://www.facebook.com/appliedpsychologicalscience) [ ![social network icon](data:image/svg+xml;base64,PHN2ZyB3aWR0aD0iMTYiIGhlaWdodD0iMTYiIHZpZXdCb3g9IjAgMCAxNiAxNiIgZmlsbD0ibm9uZSIgeG1sbnM9Imh0dHA6Ly93d3cudzMub3JnLzIwMDAvc3ZnIj4KPHBhdGggZD0iTTEyLjI2MzUgNC42ODE0MUMxMS43MzM3IDQuNjgyNDUgMTEuMzAyOSA0LjI1MzQ3IDExLjMwMTggMy43MjM2NUMxMS4zMDA4IDMuMTkzODQgMTEuNzI5OCAyLjc2MzA1IDEyLjI1OTggMi43NjIwMUMxMi43ODk5IDIuNzYwOTcgMTMuMjIwNyAzLjE5MDIxIDEzLjIyMTcgMy43MjAwMkMxMy4yMjI1IDQuMjQ5ODQgMTIuNzkzNSA0LjY4MDM4IDEyLjI2MzUgNC42ODE0MVoiIGZpbGw9IiM0MzQ5NjAiLz4KPHBhdGggZmlsbC1ydWxlPSJldmVub2RkIiBjbGlwLXJ1bGU9ImV2ZW5vZGQiIGQ9Ik04LjAwNzY1IDEyLjEwNzNDNS43MzkzOSAxMi4xMTE3IDMuODk2NzMgMTAuMjc2NiAzLjg5MjM0IDguMDA3NzdDMy44ODc5MiA1LjczOTQ4IDUuNzIzNTcgMy44OTY1NCA3Ljk5MTg0IDMuODkyMTNDMTAuMjYwNiAzLjg4NzczIDEyLjEwMzUgNS43MjM5MyAxMi4xMDc5IDcuOTkxOTdDMTIuMTEyMyAxMC4yNjA4IDEwLjI3NjIgMTIuMTAyOSA4LjAwNzY1IDEyLjEwNzNaTTcuOTk0NjkgNS4zMzM1N0M2LjUyMjQ0IDUuMzM2MTYgNS4zMzA2MyA2LjUzMjM5IDUuMzMzMjIgOC4wMDQ5MkM1LjMzNjA3IDkuNDc3NzIgNi41MzI1NSAxMC42NjkzIDguMDA0OCAxMC42NjY0QzkuNDc3NTggMTAuNjYzNiAxMC42Njk0IDkuNDY3NjEgMTAuNjY2NSA3Ljk5NDgxQzEwLjY2MzcgNi41MjIwMiA5LjQ2NzIyIDUuMzMwNzIgNy45OTQ2OSA1LjMzMzU3WiIgZmlsbD0iIzQzNDk2MCIvPgo8cGF0aCBmaWxsLXJ1bGU9ImV2ZW5vZGQiIGNsaXAtcnVsZT0iZXZlbm9kZCIgZD0iTTIuNzQ2MTQgMC40MzA5ODZDMy4yNTQxNyAwLjIzMTkxNyAzLjgzNTU2IDAuMDk1NTc0OCA0LjY4Njc3IDAuMDU1Mzk4OEM1LjU0MDA3IDAuMDE0NDQ4NCA1LjgxMjQ4IDAuMDA1MTE0MDEgNy45ODQ1OCAwLjAwMDk2ODQxNEMxMC4xNTcyIC0wLjAwMzE3NzE5IDEwLjQyOTYgMC4wMDUxMTI0MSAxMS4yODI5IDAuMDQyOTU1NkMxMi4xMzQ0IDAuMDc5NzYyIDEyLjcxNiAwLjIxNDAzMiAxMy4yMjUxIDAuNDExMDI5QzEzLjc1MTggMC42MTM5ODMgMTQuMTk4NyAwLjg4NzE4OCAxNC42NDQgMS4zMzA2OUMxNS4wODkzIDEuNzc0NyAxNS4zNjM1IDIuMjIwMDEgMTUuNTY5IDIuNzQ1OTRDMTUuNzY3OSAzLjI1NDUgMTUuOTA0MiAzLjgzNTM3IDE1Ljk0NDYgNC42ODcxMkMxNS45ODUxIDUuNTQwMTUgMTUuOTk0OSA1LjgxMjMxIDE1Ljk5OTEgNy45ODQ3QzE2LjAwMzIgMTAuMTU2OCAxNS45OTQ0IDEwLjQyOTUgMTUuOTU3MSAxMS4yODMzQzE1LjkyIDEyLjEzNDMgMTUuNzg2IDEyLjcxNjIgMTUuNTg5IDEzLjIyNUMxNS4zODU1IDEzLjc1MTcgMTUuMTEyOCAxNC4xOTg2IDE0LjY2OTQgMTQuNjQzOUMxNC4yMjU5IDE1LjA4OTUgMTMuNzggMTUuMzYzNSAxMy4yNTQxIDE1LjU2OTNDMTIuNzQ1NiAxNS43Njc4IDEyLjE2NDcgMTUuOTA0MiAxMS4zMTM1IDE1Ljk0NDlDMTAuNDYwMiAxNS45ODUzIDEwLjE4NzggMTUuOTk0OSA4LjAxNDkxIDE1Ljk5OUM1Ljg0MzA2IDE2LjAwMzIgNS41NzA2NSAxNS45OTQ5IDQuNzE3MzcgMTUuOTU3M0MzLjg2NTg4IDE1LjkyIDMuMjgzOTggMTUuNzg2IDIuNzc1MTcgMTUuNTg5MkMyLjI0ODQ4IDE1LjM4NTUgMS44MDE2MSAxNS4xMTMxIDEuMzU2MyAxNC42NjkzQzAuOTEwNzQgMTQuMjI1NiAwLjYzNjI1NyAxMy43OCAwLjQzMDk3MiAxMy4yNTQxQzAuMjMxOTA1IDEyLjc0NTggMC4wOTYwNzE0IDEyLjE2NDYgMC4wNTUzODE4IDExLjMxMzdDMC4wMTQ2OTA2IDEwLjQ2MDEgMC4wMDUxMDMzOCAxMC4xODc0IDAuMDAwOTU5Mzc2IDguMDE1MjlDLTAuMDAzMjAwNjIgNS44NDI5IDAuMDA1MzU3NzggNS41NzA3NCAwLjA0MjY3NzggNC43MTc0NEMwLjA4MDI2NjYgMy44NjU3IDAuMjEzNzU4IDMuMjg0MDQgMC40MTA3NTMgMi43NzQ3MUMwLjYxNDIxOSAyLjI0ODI2IDAuODg2ODk3IDEuODAxNjUgMS4zMzA5MSAxLjM1NjA5QzEuNzc0NCAwLjkxMDc3NiAyLjIyMDIyIDAuNjM2MDEyIDIuNzQ2MTQgMC40MzA5ODZaTTMuMjk0MzYgMTQuMjQ1M0MzLjU3NjYzIDE0LjM1MzkgNC4wMDAxNSAxNC40ODM1IDQuNzgwMDkgMTQuNTE3NEM1LjYyNDA1IDE0LjU1NCA1Ljg3Njc2IDE0LjU2MiA4LjAxMjMyIDE0LjU1NzlDMTAuMTQ4NiAxNC41NTQgMTAuNDAxNCAxNC41NDQ5IDExLjI0NTEgMTQuNTA1MkMxMi4wMjQyIDE0LjQ2ODIgMTIuNDQ3OCAxNC4zMzcgMTIuNzI5MiAxNC4yMjcxQzEzLjEwMjggMTQuMDgxMiAxMy4zNjg3IDEzLjkwNjcgMTMuNjQ4MSAxMy42MjcxQzEzLjkyNzUgMTMuMzQ2MyAxNC4xMDA0IDEzLjA3OTYgMTQuMjQ1MSAxMi43MDYxQzE0LjM1MzkgMTIuNDIzNiAxNC40ODMzIDExLjk5OTggMTQuNTE3MiAxMS4yMTk4QzE0LjU1NDMgMTAuMzc2NCAxNC41NjIgMTAuMTIzNCAxNC41NTc5IDcuOTg3M0MxNC41NTQgNS44NTE3MSAxNC41NDQ5IDUuNTk4NzMgMTQuNTA0OCA0Ljc1NTAzQzE0LjQ2OCAzLjk3NTYgMTQuMzM3MSAzLjU1MjA1IDE0LjIyNjkgMy4yNzA4MkMxNC4wODEgMi44OTY3OSAxMy45MDcxIDIuNjMxMzcgMTMuNjI2NiAyLjM1MTY5QzEzLjM0NjEgMi4wNzIgMTMuMDc5NCAxLjg5OTYzIDEyLjcwNTQgMS43NTVDMTIuNDIzNiAxLjY0NTg4IDExLjk5OTYgMS41MTY3OSAxMS4yMjAyIDEuNDgyODRDMTAuMzc2MiAxLjQ0NTc3IDEwLjEyMzIgMS40MzgyNSA3Ljk4NzE3IDEuNDQyNEM1Ljg1MTYyIDEuNDQ2NTUgNS41OTg5MSAxLjQ1NTEgNC43NTUyMSAxLjQ5NTAyQzMuOTc1NTMgMS41MzIwOCAzLjU1MjUxIDEuNjYyOTggMy4yNzA1IDEuNzczMTRDMi44OTcyNSAxLjkxOTA3IDIuNjMxMzEgMi4wOTI0OCAyLjM1MTY0IDIuMzczMkMyLjA3MjQ3IDIuNjUzOTEgMS44OTk1OSAyLjkyMDEyIDEuNzU0OTYgMy4yOTQ0MUMxLjY0NjYyIDMuNTc2NDMgMS41MTYyMyA0LjAwMDQ4IDEuNDgyOCA0Ljc3OTkxQzEuNDQ1OTkgNS42MjM4NyAxLjQzODIyIDUuODc2ODYgMS40NDIzNiA4LjAxMjQ0QzEuNDQ2MjYgMTAuMTQ4NSAxLjQ1NTMyIDEwLjQwMTUgMS40OTQ5OCAxMS4yNDQ3QzEuNTMxNTMgMTIuMDI0NyAxLjY2MzQ1IDEyLjQ0NzcgMS43NzMxMSAxMi43Mjk5QzEuOTE5MDMgMTMuMTAyOSAyLjA5Mjk2IDEzLjM2ODkgMi4zNzMxNSAxMy42NDg2QzIuNjUzODcgMTMuOTI3MiAyLjkyMDU5IDE0LjEwMDYgMy4yOTQzNiAxNC4yNDUzWiIgZmlsbD0iIzQzNDk2MCIvPgo8L3N2Zz4K) ](https://www.instagram.com/appliedpsychological) [ ![social network icon](data:image/svg+xml;base64,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) ](https://www.linkedin.com/company/psychologicalscience/)

---

### [Intensive Therapy and Specialty Services](https://dralanjacobson.com/intensive-therapy-and-specialty-services/)

**Published:** December 26, 2023
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: June 17, 2026

 # Intensive Therapy and Specialties 

I offer some intensive therapy and specialty services that provide more flexibility in terms of frequency, timing, and approaches. These intensive outpatient therapy services are designed for when there is significant urgency.

## Unique Intensive Therapy & Specialty Services

Below are my **intensive therapy** and **specialty services**. Each can be had as traditional 2-4 times per month scheduled treatment. You can also have more intensive services, including:

1\. **Check-ins outside of regularly scheduled sessions** when you need a boost, quick advice, or a reminder about a technique you learned because you are facing a challenge. These check-ins can be as simple as an e-mail or a text or as involved as a phone call or video connection.

2\. **Scheduled sessions more frequently** than the typical weekly sessions if we determine that that might help you reach your goals and overcome obstacles more quickly.

3\. **Homework outside of sessions**, which might include watching a tape of a performance or talking to someone in your life.

4\. **Nontraditionally scheduled meetings** may be shorter or longer than traditional 45-minute therapy.

## Current Intensive Therapy and Specialty Service Listing:

## Executive Coaching Specialty Service

**Braiding business principles and performance psychology**

For this intensive outpatient therapy service, I tap into my experience as a [C-level executive](https://resources.workable.com/hr-terms/c-level-executive) for ten years and my MBA training, in combination with my experience and training as a psychologist, to help executives reach peak effectiveness.

##### Find Your Flow

One goal of executive coaching is to help people find “flow” at work, the feeling of being highly effective and in the zone as they make decisions and provide vision and leadership.

##### Eliminate barriers

We’ll learn about the barriers to your full success as a leader and address them with powerful and proven psychological techniques.

##### Optional 24/7 Services

If desired, I can provide a boost before an important meeting, be a sounding board when important decisions need to be made in real-time or provide team-building or related services.

 [More about Executive Coaching](https://www.performancepsychology.net/executive-coaching/)

## Sports Psychology Intensive Therapy

**Intensive Outpatient Therapy can help improve performance and enjoyment and reduce anxiety.**

I work with high school, college, and professional athletes to improve performance and [Athletic Flow](https://dralanjacobson.com/flow-state/). For high school athletes, I also help translate performance concepts into the classroom and [college admissions](https://dralanjacobson.com/college-admissions-counseling/) process. Intensive outpatient therapy for sports performance can make a huge difference.

##### Find Athletic Flow

Flow is feeling completely in the game and performing at your peak. I work with athletes to help them [find and maintain athletic flow](https://dralanjacobson.com/sports-psychology/).

##### Carry the Benefits Over

The same feelings of peak performance, high motivation, and enjoyment can carry over into the classroom and other activities. Our work together will include that goal.

##### Optional 24/7 Services

My optional services include coverage when you need it most, such as reminders of strategies and confidence builders right before events and debriefing right afterward.

 [More about Sports Psychology services](https://dralanjacobson.com/sports-psychology/)

## Fear of Flying Intensive Therapy

**Conquer your anxiety and fly without fear with this intensive outpatient therapy service**

If you are afraid to fly, whether it is so severe that you cannot even get on an airplane or just significant and uncomfortable anxiety when you do, this is something that I can help with. I will use [cognitive therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) and visualization techniques to help you fly without fear, and you will also feel much less anxiety ahead of time. Intensive outpatient therapy can be helpful if you have a flight coming up you are concerned about.

##### Trace the emergence of your fear

We’ll work to understand why you fear flying and how it has emerged over time. This understanding may bring surprises and will guide our treatment choices.

##### Learn Powerful Techniques

You’ll learn specific, proven, and powerful techniques for [reducing your fear of flying](https://dralanjacobson.com/fear-of-flying-therapy/), no matter what your specific fears are.

##### Optional 24/7 Services

I can be available the day you fly or the day before to help you lower your anticipatory anxiety and address irrational fears so you are ready to fly.

 [More about Fear of Flying services](https://dralanjacobson.com/fear-of-flying-therapy/)

## College Admissions Specialty Service

**Help with the vital parts of the process**

The college admissions process is quite stressful, possibly including taking anxiety related to [standardized tests](https://en.wikipedia.org/wiki/Standardized_test), writing an essay that captures who you are, and trying to ace the interview (or conversations with coaches and others). I can help you present yourself in a way that matches what the college seeks. You also get intensive outpatient therapy to help you manage the stress and anxiety that comes with the process.

##### Present yourself in a compelling way

Through your essays, overall application, interviews, and other communications, our work together will help you [present yourself in the best way possible](https://dralanjacobson.com/college-admission-help/).

##### Overcome anxiety

We’ll work on specific anxieties and sources of stress to make the process more productive and to help make you more successful.

##### Optional 24/7 Services

I am available if you need a boost or to talk through strategies right before an interview, standardized test, meeting a coach, or pressing submit on the application.

 [More about College Admissions services](https://dralanjacobson.com/fear-of-flying-therapy/)

## Psychological Testing Specialty

**Assessments and evaluations that can deepen your insights, get you the accommodations you need, and lead to personal growth**

I provide psychological assessments that provide deep and meaningful insights into your skills, abilities, strengths, and challenges. My [psychological testing services](https://dralanjacobson.com/locations/) include standard personality, IQ, mental health, and vocational assessments, as well as specialties in assessing for ADHD, Autism, compatibility, and more.

##### Learn to enhance your strengths

Psychological testing is designed to not just point out problems but also show how one can maximize one’s strengths and overcome barriers.

##### Find new pathways

The insights you gain from psychological testing can help you develop new coping strategies and ways to feel more content.

##### Optional 24/7 services

Psychological testing can be enhanced if we can measure how you do in real-world situations in real time.

 [More about Psychological Testing services](https://www.psychologicalassessments.com)

## Public Speaking Fear Intensive Therapy

**Overcome your fears and develop confidence in your skills.**

Whether you have a fear of public speaking you want to overcome or [be more effective at speaking in front of a group](https://www.scienceofpeople.com/how-to-improve-speaking-skills/), I can help. My public speaking services are designed for anyone who has to speak in front of others.

##### Learn the Roots

Understanding the unique reasons for your fear of public speaking is a significant step in addressing it. We’ll work to bring new insights.

##### Custom tailored techniques

We’ll work on easy-to-implement techniques proven to reduce or eliminate public speaking fears.

##### Optional 24/7 services

I can be available by phone, video, or text the day of your talk for strategy updates and confidence builders and afterward to help process your success!

 [More about Public Speaking services](https://dralanjacobson.com/public-speaking-anxiety/)

## Intensive Outpatient Therapy for College Students

**Overcome barriers and challenges, achieve at your potential, and enjoy your experience.**

College is a time where you experience new stressors, important challenges, and [pressure to perform](https://dralanjacobson.com/therapy-for-college-students/). It is also a wonderful time of new experiences, opportunities for fun and excitement, and great learning. Intensive outpatient therapy can ensure you enjoy it all to the fullest.

##### Overcome barriers

Learning new ways to cope, tap into your strengths, and meet challenges are often a goal of this intensive therapy.

##### Custom tailored techniques

We’ll combine techniques to provide the biggest positive impact. Whether we use CBT, dynamic, existential, or other proven techniques, it can all be wrapped up in a positive, safe, and client-centered environment.

##### Optional 24/7 services

I can be [available by phone, video, or text](https://dralanjacobson.com/my-bio/) if you face an unexpected stress, need a boost, or want to work on something that comes up.

 [More about intensive therapy for college students](https://dralanjacobson.com/therapy-for-college-students/)

 ## NEW: Assessments for Emotional Support Animals

I now provide [assessments for Emotional Support Animals](https://dralanjacobson.com/emotional-support-animals-esa/)

[Click Here](https://dralanjacobson.com/emotional-support-animals-esa/)

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---

### [Group Therapy](https://dralanjacobson.com/group-therapy/)

**Published:** February 22, 2024
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: June 17, 2026

 # Group Therapy

 Open | VirtualGroup therapy is a form of psychotherapy where a small number of people who share a challenge or barrier meet together to discuss and work through their struggles and emotions. I am there to offer the same strategies we would pursue in individual therapy, using techniques including [cognitive behavioral therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/), [mindfulness methods](https://dralanjacobson.com/mindfulness-therapy/), and [humanistic treatment](https://dralanjacobson.com/humanistic-therapy/). In group counseling you also learn from each other.

[Virtual Group therapy](https://dralanjacobson.com/virtual-therapy-guide/) is an effective treatment option for a wide range of mental health concerns. It can be used alongside individual therapy or by itself.

 [Join Now](https://dralanjacobson.com/contact/)[Start with Individual](https://dralanjacobson.com/individual-therapy/)

 ![Virtual Group Therapy](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs=)

## About Virtual Group Therapy

I choose to do this form of treatment because this support can be powerful and effective as you learn how many others you share your challenges with, pool your strength, and share what has worked. Everyone lifts each other up and provides deeper support and understanding than almost any other form of treatment.

Virtual group therapy offers even greater confidentiality and privacy than in-person, but it’s important for everyone to participate as much as they are comfortable.

The only requirements for [teletherapy](https://dralanjacobson.com/teletherapy-groups/) are that you have your camera on, you stay for the entire time, and as much as possible you go to every group counseling session until you’ve reached your goals.

## About Open Concept Group Therapy

I offer group therapy services with an [open concept](https://www.apa.org/topics/psychotherapy/group-therapy), meaning you can join for as long as you want and at any time. This prevents the need to wait until a new cycle starts, end group counseling before you are ready, or stay in even after your challenges are resolved. This page goes over the basics, and then more information about my specific offerings can be found on other pages.

 ![Online Group Therapy](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "group | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## Benefits of Group Therapy



#### Interpersonal Learning

This [form of therapy](https://dralanjacobson.com/does-therapy-help-what-form-of-therapy-works-best/) provides opportunities for individuals to explore their [interpersonal patterns and dynamics](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10313098/) within a safe and supportive environment. Members can receive feedback from others and learn how their behaviors impact others.

[](#)

#### [Universality](#)

Hearing others share similar struggles can help individuals feel less alone and normalize their experiences, which is a hallmark of group counseling. You’ll also share what has worked, and what has not, giving members shortcuts to improvement and relief!

[](#)

#### [Social Dynamics](#)

This form of treatment allows individuals to interact with others experiencing similar challenges. This group counseling dynamic can provide support, validation, and different perspectives on the discussed issues. You’ll truly feel heard and understood.

[](#)

#### [Skill Building](#)

Group therapy sessions may focus on teaching specific skills, such as communication techniques, stress management strategies, or coping skills. I use methods that are designed to provide measurable, meaningful, and obvious positive results.

## Sample Group Counseling Session

###### 5:00 pm

##### Check-In

You’ll wait in a waiting room that allows for chat – just like in an in-person waiting room. You can remain private, however.

###### 5:10 pm

##### Welcome

We’ll welcome new members first. You can identify yourself however you want – many people choose first name only. You can say where you’re from if you’d like.

###### 5:15 pm

##### Sharing

In this part of treatment, members can share any updates such as achievements and experiences. All sharing of this kind is completely optional.

###### 5:25 Pm

##### Education

This is the educational portion of group counseling, where I will share techniques and ideas for overcoming barriers.

###### 5:45 pm

##### Planning

In this portion of group counseling, I may give general “homework,” and people are free to share their own plans or what they are worried about to get support.

###### 6:00 PM

##### Check out

This optional portion of group therapy gives you a chance to talk to others virtually, again, just like you might in person afterwards.

## Virtual Group Therapy FAQ

Here are some of the common questions people ask about group therapy. You can also contact me or schedule a consultation to get more information.

 Contact Me

 [Schedule a Consultation](https://www.picktime.com/scheduleaconsult)



#### How Long will group therapy Last?

Virtual group therapy sessions last around an hour, often with some optional unstructured time at the beginning and end.



#### What are the results of group therapy?

I choose therapy topics that have been proven to be effectively treatment with group counseling. You should see meaningful and measurable results.



#### Does virtual group therapy work?

Online group therapy is as effective as in person as long as members have the same level of commitment to attending.



#### Can group therapy be combined with individual?

Yes! Virtual group therapy can be combined with individual therapy, and this works particularly well if your treatment providers follow the same general philosophies.

## Virtual Group Therapy Locations

I can serve members in the states in green to the right. You have to be physically located in one of those states to participate.

 ![Group Counseling Service Area](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "PsyPACT Map | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## Sign Up for Group Therapy

Use the links below to inquire about current online therapy groups.

## Fear of Flying

### Ongoing

All ages

[Inquire](https://www.picktime.com/scheduleaconsult#book/services)

## Public Speaking

### Ongoing

All ages

[Inquire](https://www.picktime.com/scheduleaconsult#book/services)

## Young Adults (Open)

### Ongoing

[18-27 year olds](https://dralanjacobson.com/group-therapy-for-young-adults/)

[Inquire](https://www.picktime.com/scheduleaconsult#book/services)

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---

### [Fear of Flying Therapy](https://dralanjacobson.com/fear-of-flying-therapy/)

**Published:** December 26, 2023
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: June 9, 2026

 # Fear of Flying Therapy

**Treatment for fear of flying** can help you overcome your anxiety. **Fear of flight therapy** goes at a pace you are comfortable with, allowing you to understand your anxiety and then confront it. **Fear of flying therapy** is a core service and can be done with adolescents as young as 14.

 [Schedule a Fear of Flight Therapy Consultation](https://www.picktime.com/scheduleaconsult)

## Fear of Flying Therapy Overview

The **fear of flying therapy** specialty service is designed to be intensive and short-term.

**Understand your fears and worries**: Realizing that your fear has its roots in anxieties that have nothing to do with flying can be a significant first step in treatment for fear of flying.

**Reduce anticipatory anxiety**: Often, the anxiety that precedes getting on the plane can be much worse than the anxiety you feel on the flight.

**Fear of flight therapy techniques**: I will teach you, and we will practice specific techniques that have been shown to reduce your anxiety.

**24/7 response**: I may be available by phone, video, or text before your flight and that day to provide fear of flight therapy support when you need it.

Treatment for fear of flying works!

 ![Fear of Flying Therapy](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "plane-sunset-sunrise-wing | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## Fear of Flying Therapy Q&A

 ![Treatment for Fear of Flying](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "psychologist-12-1 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

##### What is Fear of Flying Therapy?

Most people can overcome their fear of going on an airplane, but it takes work and practice. Flying is an incredibly safe way to get to many places and is vitally important in many ways. Flight fear affects 20-25% of people, so you are not alone!

### Fear of Flying Therapy First Steps

The first step in treatment for fear of flying is understanding your irrational fears that are triggering your anxiety. Yes, they are irrational because flying is much safer than probably a list of other things you do daily! Of course, you may realize that, and your rational mind has probably reviewed the statistics and data, but this probably does not relieve you.

##### What Causes Fear of Flying

Your fears likely have two levels of triggers: First, in a larger sense, you may be experiencing a life transition, such as having kids, that has made you more aware of your mortality or just the importance of your safety; and Second you may be specifically triggered by specific thoughts, images, or sensations that occur when you fly. These triggers may include turbulence, turning, taking off, being up high, etc.

The cause of your anxiety may be insignificant since the treatment strategy will likely not focus on the cause but rather the effect. However, many people can get even more out of therapy when they understand the cause since it may affect them in other ways. Treatment for fear of flying can often help reduce other anxieties as well!

### Flying Fear Triggers

Many triggers cause people to come to treatment for flight anxiety, and while some people have a combination, others find that one part of being on an airplane is the problem. In either case, fear of flying therapy works for most!

Here are some of the common triggers:

Turbulence: Many people fear turbulence. Even though it is a normal part of flying and rarely dangerous, turbulence can make people feel that something terrible could happen, or they don’t like the sensation it causes.

Loss of control: Similar to the anxiety caused by turbulence, some fear losing control of the aircraft or any situation that could happen.

Claustrophobia: The confined space of an airplane cabin can trigger fear in those with claustrophobia.

Fear of heights: A fear of heights can be exacerbated when looking out of an airplane window or considering the altitude at which an airplane flies.

Previous traumatic experiences: A past negative experience during a flight can lead to fear in future trips.

Media coverage and movies: Dramatic news stories about airplane accidents can heighten fear, as can visual representations seen in movies.

As you can see, I separated the “causes” section from the “triggers” section. Often, the cause of the fear of flying is psychological and can be addressed separately from the trigger itself.

##### What are the Symptoms of Fear of Flying

People experience anxiety in many different ways. For some, it is panic while in the air, while others experience weeks of anticipatory anxiety. Many people experience physical symptoms of their fear; for others, it is mental. Interestingly, few anxieties start with something that happened on a prior flight!

### Treatment for Fear of Flying Can help

In the short run, fear of flying therapy can target certain symptoms and reduce their severity. Still, the main goal is to address what is causing the anxiety so that the symptoms naturally disappear.

##### What is the goal of treatment for fear of flying?

We will work together in fear of flight therapy to address your symptoms and get you to the point where you are no longer avoiding travel – since avoidance actually makes your anticipatory anxiety worse!

### Treatment for Fear of Flying Steps

We will work on ways to reduce your fears well ahead of time, help you manage the day of the flight, and deal with your anxiety during the flight. As part of flight fear therapy, I will also provide education, including facts about turbulence that will calm your irrational fears, the reasons for certain noises and bumps, the incredible number of redundant safety features on your plane, and what keeps the plane steady.

If the fear has generalized a bit, and other situations bring up the same anxiety, we will also work on those areas.

##### What are the results

The results of fear of flying therapy should be obvious!

### Fear of Flying Therapy Outcomes

Whether you experience painful anticipatory anxiety or panic while flying, the fear of flying is treatable with mental health therapy. My regular flying fear therapy services provide the basic treatment many people need, but I also offer [intensive therapy services](https://dralanjacobson.com/intensive-therapy-and-specialty-services/) that can give 24/7 support. The Hill recently published a great article about the fear of flying.

## Treatment for Fear of Flying

Here are the treatment methods I use to help people overcome their fear of flying

You can also [contact me or schedule a consultation](https://dralanjacobson.com/contact/) to get more information.

 [Contact Me](https://dralanjacobson.com/contact/)

 [Schedule a Consult](https://www.picktime.com/scheduleaconsult)



#### Education to Correct Irrational Fears

As part of treatment for fear of flying, I will provide education about the safety of airplanes and flight in a way that may reduce irrational fears. The cornerstone of fear of flight therapy is helping dissolve irrational and exaggerated fears. You’ll begin to see the real meaning behind your fears, realize why they are there, and know that they don’t really portend danger when you fly.



#### Cognitive-Behavioral Therapy

[CBT is a widely used therapeutic approach](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) for treating phobias. It involves identifying and challenging irrational thoughts and beliefs about flying. In treatment for fear of flying, I help you replace these negative thoughts with more realistic and balanced ones. This can help not only the day of the flight but also greatly reduce anticipatory anxiety.



#### Exposure and Response Prevention

[Exposure therapy](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/) gradually exposes individuals to the feared situation—in this case, being on a plane—in a controlled and systematic way. [exposure can be done through imagination](https://dralanjacobson.com/flying-anxiety-treatment/), virtual reality programs, or actual flights. Over time, repeated exposure helps desensitize you to your fear and reduces anxiety responses. We will move at a comfortable pace.



#### Relaxation to Reduce Stress

Learning relaxation techniques such as deep breathing, progressive muscle relaxation, and [mindfulness can help you manage anxiety symptoms](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/) associated with flying. These techniques can be practiced before and during flights to promote a sense of calmness and control. You may be surprised how quickly and easily some of these techniques can be learned.

## Fear of Flying Therapy Example

Fear of Flight Therapy can take many forms, but here is one example to give you a general idea.

Matt came in for Fear of Flight Therapy after developing the fear when he took a new job that would involve frequent travel. Until then he did not have to fly very much. Here is how I would hypothetically help Matt with flight fear therapy techniques.

We start Fear of Flight Therapy with a comprehensive assessment. This includes understanding Matt’s specific fears, triggers, and the extent of his anxiety. We discuss past experiences, pinpointing specific concerns (such as turbulence, claustrophobia, loss of control), and exploring any underlying anxieties or traumas related to being on an airplane.

The second step in fear of therapy involves psychoeducation. I work to help Matt understand [how airplanes work](https://www.explainthatstuff.com/howplaneswork.html), the safety measures in place, statistics regarding flight safety, and the irrationality of certain fears. This helps in demystifying the [mechanics of flying](https://en.wikipedia.org/wiki/Aircraft_flight_mechanics) and providing factual information to counteract irrational beliefs.

It is now time to begin the direct treatment for fear of flying involving cognitive behavioral techniques. I help Matt identify and challenge negative thought patterns and beliefs related to flying. This involves using thought records to reframe catastrophic thoughts, gradual exposure techniques, and relaxation exercises to manage anxiety. As part of treatment for fear of flying, Matt and I will work together to gradually expose him to the feared object or situation in a controlled and safe environment. This starts with simply looking at pictures of planes, then watching videos of take-offs and landings, followed by him visiting an airport, and ultimately taking short flights.

As an adjunct to the CBT fear of flight therapy, Matt will learn relaxation and mindfulness exercises to help manage anxiety during exposure to flying-related stimuli. Deep breathing, progressive muscle relaxation, or guided imagery techniques can be beneficial in reducing physiological arousal. I might also use virtual reality technology to simulate flying experiences in a controlled setting. This allows Matt to gradually expose himself to the sensations and environment while still in a therapist’s office, making it a powerful fear of flight therapy tool for desensitization.

Becuse Matt signed up for my intensive treatment for fear of flying, I provide support and strategies right before actual flights. This involves creating a personalized ‘flight plan’ with relaxation exercises, distraction techniques, or specific self-talk strategies to manage anxiety while in the air. I also incorporate [motivational interviewing](https://dralanjacobson.com/motivational-interviewing/) so he keeps up his efforts to get on a plane.

 ![Fear of Flight Therapy](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## Now Offering a Fear of Flying Group

I am offering a [fear of flight group therapy course](https://dralanjacobson.com/fear-of-flying-group/) for anyone in the states I serve. Treatment for fear of flying in a group format helps you get support and encouragement and a nice exchange of ideas from others. It can be quite powerful and helpful.

[More Information](https://dralanjacobson.com/fear-of-flying-group/)

 ## Contact Me About Treatment for Fear of Flying

Please use my contact page to discuss your hopes for treatment of fear of flying and see if I may be a fit to help. I’d be happy to provide some advice and tips even if we do not meet.

You can also try my [Flight Anxiety Self-Help](https://dralanjacobson.com/flight-anxiety-self-help/) strategies, but if they don’t work, fear of flying therapy can help!

I look forward to speaking to you.

### Call

(617)-680-5488

### Email

hello@dralanjacobson.com

### Address

In person: Westwood, MA & Lee, NH

Virtual: Serving 44 states

### Hours

Inquire

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### [Trauma-Informed Care](https://dralanjacobson.com/trauma-informed-care/)

**Published:** March 10, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Trauma-informed care (TIC) is an approach that recognizes and responds to the effects of psychological injury on individuals. It aims to create environments where people feel safe, supported, and empowered. I run a trauma-informed practice, believing that healing begins with **safety, choice, and connection.** Whether you’re navigating the aftermath of a difficult experience, struggling with relationships, or simply trying to make sense of your feelings, my role is to work at your pace, without judgment. I’ll use trauma-informed therapy techniques that build skills for grounding, self-compassion, and reconnecting with parts of yourself that may feel lost or distant. You can see a bit about my work as a trauma-informed psychologist in the case examples at the end of this post.

## What is Trauma-Informed Care?

### Key Principles of a Trauma-Informed Psychologist

1. **Safety** – A trauma-informed practice ensures physical, emotional, and psychological safety. This includes creating spaces where individuals feel secure and respected.
2. **Trustworthiness and Transparency** – A trauma-informed psychologist builds trust by being clear, consistent, and honest about what will happen and why.
3. **Peer Support** – Encouraging support networks and relationships among peers with similar experiences to promote healing.
4. **Collaboration and Mutuality** – Avoiding power imbalances between a trauma-informed psychologist and you means working together and valuing your input.
5. **Empowerment, Voice, and Choice** – A trauma-informed psychologist empowers you by emphasizing your strengths and allowing you to choose your care or support.
6. **Cultural, Historical, and Gender Awareness** – A trauma-informed psychologist recognizes the impact of cultural, historical, and systemic emotional pain (such as racism, oppression, or discrimination) and ensures care is sensitive and responsive to these factors.

### Why Is Trauma-Informed Care Important?

- Painful wounds can impact individuals’ engagement with services or systems, such as healthcare, education, or therapy. Trauma-informed therapy recognizes and responds to that.
- People who have experienced this type of emotional pain may struggle with trust, boundaries, or certain triggers.
- By understanding the effects, a trauma-informed psychologist can promote healing and recovery.

### How Trauma-Informed Care Looks in Various Fields

- **Healthcare:** Doctors and nurses with trauma-informed practice might ask about a patient’s comfort and provide clear explanations before procedures.
- **Education:** Teachers may use trauma-informed practice techniques such as calming spaces or avoidance of punishment that could trigger certain responses.
- **Social Services:** Caseworkers may use trauma-informed practice to focus on collaboration and offer choices to avoid making individuals feel powerless.

## My Role as a Trauma-Informed Psychologist

I center my work around safety, trust, and empowerment while being deeply aware of how psychological wounds can impact a person’s mental health, behavior, and relationships. I aim to support a person’s healing and resilience actively. Here are some ways I implement trauma-informed care in my practice.

### Basic Tenets of a Trauma-informed Practice

#### Creating Emotional Safety

- **Emotional safety** means fostering a space where clients feel accepted, not judged, and in control.
- A trauma-informed practice validates their experiences without minimizing them.
- I remain mindful of how power dynamics play out (especially if the client has experienced abuse or control in the past).
- Letting clients know they can pause sessions, take breaks, or step outside if they feel overwhelmed.

#### Prioritizing Trust and Transparency

- **Explaining everything:** I explain the trauma-informed therapy process, confidentiality, and what to expect, reducing the client’s uncertainty.
- **Predictability:** Start and end sessions on time, maintain clear boundaries, and follow through on promises.
- **Transparency about treatment:** Being clear about trauma-informed therapy methods and why they’re used and giving the client the option to opt out or modify.

Trauma-informed Therapy Example:

*“Today I’m thinking of using a grounding exercise to help with anxiety — how does that sound to you?”*
*“I’ll always check with you before trying anything new in therapy.”*

#### Empowerment, Choice, and Control

These wounds often leave people feeling powerless. A trauma-informed practice **gives control back** to the client in any way possible.

- Offering **choices** in trauma-informed therapy sessions, like: 
    - *“Do you want to discuss what happened today or focus on grounding techniques?”*
    - *“You can stop or pause at any time.”*
- Encouraging **self-advocacy** by asking the client to identify their own needs or goals in [individual therapy](https://dralanjacobson.com/individual-therapy/).

#### Understanding Responses and Triggers

A trauma-informed practice recognizes **how the effects appear** in behavior, cognition, and emotions. This means:

- Recognizing **fight, flight, freeze, or fawn** responses during trauma-informed therapy sessions.
- Understanding that “difficult” behaviors (like avoidance, dissociation, emotional shutdown, or anger) are responses and not “bad behavior.”
- Responding with compassion rather than frustration when clients seem disengaged, avoidant, or reactive.

Trauma-informed practice example:

If a client suddenly disconnects, I might say: *“I noticed you seem really distant right now. Would you like to take a break or do a grounding exercise?”*

#### A Trauma-informed Psychologist Avoids Re-traumatization

This happens when a client feels powerless, invalidated, or out of control — similar to their original experience.

- **A trauma-informed psychologist avoids forcing you to talk about anything** if you’re not ready.
- I never use confrontational language like *“You need to face this head-on”* or *“You have to talk about this eventually.”*
- I avoid using terms that imply blame or judgment (e.g., *“Why did you do that?”*).
- The client always has the option to *leave* or *pause* trauma-informed therapy sessions if overwhelmed.

Trauma-informed Practice Example:
*“We don’t have to go there today — it’s totally up to you.”*
*“I’ll follow your lead.”*

#### Recognizing the Impact of Historical, Cultural, and Systemic Factors

Deeply negative feelings can come from systemic oppression, discrimination, and cultural violence (such as racism, sexism, homophobia, etc.). A trauma-informed psychologist:

- Is aware of systemic oppression and validates how those experiences impact mental health.
- Avoids making assumptions about a client’s identity or background.
- Affirms cultural identity as a source of strength.

Trauma-informed practice example:

- - If a client experiences racial injustice, I might say: *“It makes sense that you feel anxious in certain spaces. Racism is emotionally scarring — and your feelings are valid.”*

#### Using Trauma-Informed Therapy Approaches

A trauma-informed psychologist might choose therapeutic approaches designed for recovery, such as:

- [**Somatic Therapy**](https://dralanjacobson.com/somatic-therapy/) – Helping clients connect with their bodies and calm the nervous system.
- **[Trauma-Focused CBT](https://dralanjacobson.com/cbt-for-trauma/) (TF-CBT)** – Trauma-informed care through [cognitive restructuring](https://dralanjacobson.com/cognitive-restructuring/) without pushing the client too fast.
- **[Internal Family Systems](https://dralanjacobson.com/internal-family-systems-therapy-ifs/) (IFS)** – Helping the client understand different “parts” of themselves (such as the inner critic, wounded child, protector, etc.) in a non-shaming way.
- [Forgiveness Therapy](https://dralanjacobson.com/forgiveness-therapy-steps-and-integrations/)-Helping clients forgive to release pent-up resentment and anger.

The key to a trauma-informed practice is to **move at the client’s pace** and never rush processing.

#### Supporting Resilience and Growth

A trauma-informed psychologist doesn’t just focus on the negative — we also focus on **strengths, resilience, and growth.**

- Helping the client see their strengths and how they’ve survived.
- Encouraging the client to build a support network.
- Helping them [find meaning or purpose](https://dralanjacobson.com/existential-therapy/), if appropriate.

Trauma-informed practice example:

*“I see a lot of strength in the way you’ve protected yourself.”*
*“You’ve already come so far — I’m wondering what’s been helping you get through this.”*

### Summary of a Trauma-Informed Care Practice

**Principle****How It Looks in a Trauma-Informed Practice****Safety**Safe, calm environment; clear exit; client can leave anytime.**Trust**Clear communication, no surprises in treatment.**Empowerment**Offering choices, not pushing too hard.**Collaboration**Working *with* the client, not *doing things to* them.**Cultural Awareness**Validating systemic, historical, or cultural effects.### Avoiding Common Pitfalls

I avoid:

- **Pathologizing responses.** Instead of *“You’re being avoidant,”* I say, *“Your nervous system is protecting you.”*
- **I push clients to share details. Processing is not about reliving something—**it’s about regaining control and safety.
- **Ignoring the body.** Painful feelings are stored in the body, so grounding, movement, and sensory interventions can be key to healing.

## Trauma-informed [Therapy Techniques](https://dralanjacobson.com/therapy-techniques-for-depression-anxiety-and-phobias/)

Here’s how **trauma-informed care (TIC)** can be applied within each of the therapeutic modalities I commonly use:

### 1. Trauma-Focused [Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (TF-CBT)

**Goal:** Change unhelpful thought patterns and reduce distress.

**How TF-CBT Differs:**

Traditional CBT often focuses on **changing negative thoughts**, but in TF-CBT:

- I **normalize responses** (instead of pathologizing them).
- Focus shifts from *“What’s wrong with you?”* to *“What happened to you?”*.
- **Pacing is slow** to avoid triggering an unnecessary response.

**Techniques in TF-CBT:**

- **Psychoeducation:**
    - Teach the client how emotions affect the brain (fight/flight/freeze response).
    - Normalize their symptoms as adaptive survival responses, not personal failures. 
        - *“Your brain did exactly what it needed to do to keep you safe.”*
- **Cognitive Restructuring (but gently):**
    - Instead of pushing for cognitive shifts too quickly, I might say: 
        - *“What’s a small shift you’d feel comfortable making today?”*
        - *“Can we find a kinder story to tell yourself about what happened?”*
- **Grounding Techniques:**
    - Teach body-based strategies like [5-4-3-2-1 grounding](https://www.verywellmind.com/5-4-3-2-1-grounding-technique-8639390), paced breathing, or movement to help regulate the nervous system.
    - Encourage physical safety first, cognitive work second.
- **Window of Tolerance:**
    - Educate the client about **hyperarousal (fight/flight)** and **hypoarousal (freeze/dissociation)**.
    - Help them build skills to stay within their “window of tolerance” (the state where they feel safe and connected).

### 2. Trauma-informed Care with [Acceptance and Commitment Therapy](https://dralanjacobson.com/acceptance-and-commitment-therapy-act/) (ACT)

**Goal:** Help the client accept difficult emotions and build a life aligned with their values.

**How Trauma-Informed Care with ACT Differs:**

- Emotional scarring often creates **rigid avoidance** of painful emotions, sensations, and memories.
- In TIC-ACT, the focus is on making space for those experiences without overwhelming them.
- I avoid **pushing clients to accept pain too quickly** — safety comes first.

**Techniques in TI ACT:**

1. **Safe Exposure to Emotions:**
    - Use metaphors like *“You can carry this pain without letting it control you.”*
    - [Small, gradual exposures](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/) to difficult memories if the client consents.
2. **Self-Compassion Work:**
    - Help the client develop a more compassionate inner voice.
    - Example: *“Can you speak to yourself like you would speak to a friend?”*
3. **Grounding in Values:**
    - Increase awareness of meaning and purpose.
    - Help clients reconnect with their **values** (relationships, creativity, safety).
    - Example: *“Even when the emotions are present, what’s one small thing you can do that aligns with your values?”*
4. **Consent-Based Defusion:**
    - Instead of pushing the client to detach from painful thoughts, invite them to consent.
    - Example: *“Would it be okay if we gently looked at that thought together?”*
    - This re-establishes a **sense of choice**, crucial for trauma survivors.

### 3. Narrative Trauma-Informed Therapy

**Goal:** Help the client reclaim control over their story and identity.

**How TI [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/) Differs:**

- Trauma often *fragments* a person’s sense of self (identity, worth, agency).
- TIC-Narrative therapy helps clients **re-author their stories** to emphasize **strength, survival, and agency.**

**Techniques in TI Narrative Therapy:**

1. **Externalizing:**
    - Separate the client from their emotional pain.
    - Example: *“What happened isn’t you — it’s something that happened to you.”*
    - Name the response: *“It sounds like your nervous system is still in survival mode.”*
2. **Reclaiming Power:**
    - Help the client highlight *acts of resistance*.
    - Example: *“Even though you felt powerless, you found a way to survive — how did you do that?”*
    - Shift the story from *victim* to *survivor*.
3. **Post-Traumatic Growth Narrative:**
    - Help the client write a new story about themselves.
    - Example: *“What do you want your life to look like now, despite what happened?”*
4. **Slow Storytelling:**
    - **Never force** the client to tell their story if they’re not ready.
    - Instead, say: *“You can share as much or as little as you want. Your story belongs to you.”*

### 4. Schema Trauma-Informed Therapy

**Goal:** Identify and heal early maladaptive schemas.

**How TI [Schema Therapy](https://dralanjacobson.com/schema-therapy/) Differs:**

- Trauma (especially in childhood) creates **core schemas** like: 
    - *“I am unlovable.”*
    - *“I can’t trust anyone.”*
- Instead of **challenging these schemas directly**, a trauma-informed care approach seeks to **validate why the schema exists** and gently offers an alternative.

**Techniques in TI Schema Therapy:**

1. **Limited Reparenting:**
    - Act as a secure, validating presence.
    - Example: *“It makes sense that your brain created this belief to protect you.”*
    - Offer small corrective experiences during sessions.
2. **Mode Work:**
    - These early experiences often split people into different “modes” (child, protector, critic).
    - Help the client differentiate between: 
        - **Vulnerable Child** (wounded, scared part).
        - **Protective Mode** (shutdown, dissociate, avoid).
        - **Healthy Adult** (grounded, compassionate).
    - Build a connection between **Healthy Adult** and **Vulnerable Child.**
3. **Imagery Rescripting:**
    - Guide the client in visualizing a painful memory — but change the ending.
    - Example: *“Imagine someone stepping in to protect you — what would you want them to do?”*
    - This helps *reprocess* memories without re-traumatizing them.

### 5. Trauma-Informed Practice of Gestalt Therapy

**Goal:** Help the client stay present and process unresolved trauma stuck in the body.

**How TI Gestalt Differs:**

- Trauma disconnects people from their bodies and emotions.
- TIC-Gestalt focuses on **reconnecting to the body** without overwhelming the client.

**Techniques in TI [Gestalt Therapy](https://dralanjacobson.com/gestalt-therapy/):**

1. **Body Awareness Work:**
    - Gently ask: *“Where do you feel that in your body?”*
    - Help the client describe the sensation (tightness, heat, heaviness).
    - Avoid pushing if the client seems dissociated.
2. **Two-Chair Work (modified):**
    - Use two-chair work if the client has inner conflict (like shame vs. worth).
    - Modify it to avoid overwhelm:
        *“Would it feel okay to speak to that part of yourself today?”*
        *“We can stop anytime.”*
3. **Regulating the Nervous System:**
    - Before processing trauma, always bring the body into a regulated state.
    - Use grounding (breath, touch, movement) to build **safety in the body.**

### Key Trauma-Informed Care Adjustments (for all modalities):

**Principle****Trauma-Informed Care Adjustment****Pacing**Move slowly; never rush processing.**Choice**Always ask consent before any intervention.**Safety**Build physical/emotional safety first.**Strengths-Based**Focus on survival strengths, not pathology.**Empowerment**Help the client regain control, choice, and agency.## Trauma-informed Care Example: Adolescent with Childhood Trauma

- **Name:** Sarah
- **Age:** 15
- **Presenting Issue:** Severe anxiety, difficulty trusting adults, emotional numbness, dissociation during conflict.
- **History:** Sarah experienced physical neglect and emotional abuse from ages 5-10. She was often blamed for her parents’ fights and learned to stay invisible to avoid conflict.

### Building Safety and Externalizing (Narrative Therapy + CBT)

**Me (or any trauma-informed psychologist):** *“I know this can feel scary, but you don’t have to tell me everything right now. We’ll go slow, and you can decide what you’re ready to share. I’ll follow your lead.”*

**Why This Works:**

- I prioritize **choice and safety**, preventing re-traumatization.
- Sarah begins to **regain control** by deciding the pace.

**Grounding Exercise:** I teach Sarah a 5-4-3-2-1 grounding technique to help when she dissociates.

### Naming the Protective Parts (Schema Therapy)

**Me:** *“I wonder if there’s a part of you that’s really good at shutting off your feelings when things get scary. Do you think that part was trying to protect you back then?”*

**Sarah:** *“…Maybe. It’s like I just go numb so I don’t get hurt.”*

**Intervention:**

- I **validate the protector part** rather than framing it as a “problem.”
- I say: *“That part of you was really smart — it kept you safe.”*
- This reduces shame and builds self-compassion.

### Re-authoring Her Story (Narrative Therapy + Cognitive Restructuring)

**Me:** *“What would you say to that little girl if you could go back?”*

**Sarah (crying):** *“I’d tell her it wasn’t her fault.”*

**Me:** *“Can we write that down? Like a letter to your younger self?”*

**Intervention:**

- Sarah writes a letter to her younger self, reclaiming power and self-compassion.
- This slowly shifts her core schema from *“I am bad”* to *“I was a child in a bad situation.”*

**Outcome:**

- Sarah begins experiencing fewer dissociative episodes.
- Her new internal narrative shifts from *“I’m broken”* to *“I survived something really hard.”*
- I continually offer **control, choice, and empowerment.**

## Trauma-Informed Care Example 2: Adult with Relational Trauma

- **Name:** Alex
- **Age:** 32
- **Presenting Issue:** Relationship conflict, fear of abandonment, over-apologizing, avoiding confrontation.
- **Trauma History:** Grew up in a household where expressing anger or needs resulted in punishment or rejection. Partner often says, *“You never tell me what you need.”*

### Building Safety (ACT + Gestalt Trauma-Informed Therapy)

**Me (or any trauma-informed psychologist):** *“When conflict comes up, do you notice anything happening in your body?”*

**Alex:** *“My stomach feels tight, and I just want to leave.”*

**Me:** *“Your body is trying to protect you from something it learned long ago.”*

**Intervention:**

- **Body awareness** is used to help Alex stay present.
- The therapist doesn’t push for cognitive reframing yet — **safety comes first.**

### Naming the Schema (Schema Therapy)

**Me:** *“It sounds like when your partner’s upset, this voice shows up that says, ‘You’ll be abandoned if you mess up.’ Do you know that voice?”*

**Alex:** *“Yes! It’s like, if I don’t keep everyone happy, I’ll lose them.”*

**Intervention:**

- I gently identify the **Abandonment Schema**.
- Instead of challenging it, they **validate why it exists.**

**Me:** *“That belief kept you safe as a kid. It’s not your fault you still feel that way.”*

### Externalizing the Schema (ACT + Schema Trauma-Informed Therapy)

**Me:** *“Can we give that voice a name? Like ‘The People Pleaser’?”*

**Alex:** *“Yeah… it’s like a scared little kid.”*

**Me:** *“Exactly. So when your partner gets upset, it’s not you — it’s that scared little kid reacting. Would it feel okay to talk to that part of you?”*

**Intervention:**

- Alex imagines speaking to the scared inner child.
- This creates **distance from the schema** and reduces shame.

### Defusing from the Response (ACT + Gestalt Trauma-Informed Therapy)

**Scenario:** Alex’s partner expressed frustration, and Alex immediately shut down.

**Me:** *“What did you notice happening in your body during that moment?”*

**Alex:** *“My stomach flipped, and I just froze.”*

**Me:** *“That’s your nervous system going into ‘freeze mode.’ Would it be okay if we practiced grounding first before analyzing it?”*

**Intervention:**

- I use a **grounding exercise** (cold water on hands, deep breathing).
- I never rush Alex to *analyze* the trauma response until **the body is regulated.**

### Reclaiming Power (Schema + ACT Trauma-Informed Therapy)

**Me:** *“What would it be like to ask your partner for something, even if it’s small?”*

**Alex:** *“…Terrifying.”*

**Me:** *“That makes sense. Your brain learned that asking for things leads to rejection. But what if we tried just one small thing?”*

**Intervention:**

- Alex practices asking their partner to do something small (e.g., “Can you make me coffee today?”).
- Each time Alex **asks without over-apologizing,** they challenge the Abandonment Schema.
- I repeatedly emphasize **choice, safety, and pacing.**

**Outcome:**

- Alex slowly learns to stay grounded during conflict.
- His schema shifts from *“I’ll be abandoned if I mess up”* to *“I’m allowed to take up space in this relationship.”*
- Alex’s relationship improves, and their trauma response diminishes.

## Summary and My Work

I believe deeply in your capacity to heal, not because I am the expert on your life but because **you have already survived the hardest parts.** Now, it’s about learning how to live and grow beyond survival. Together, we will work toward helping you feel more grounded, connected, and empowered in your life. You may have days where you feel strong and hopeful and others where you feel stuck or overwhelmed. Both are valid. Both are part of healing.

I am a trauma-informed psychologist, providing trauma-informed care in everything I do, including integrative [creative therapy](https://dralanjacobson.com/creative-counseling/) techniques as needed. Sometimes, this care is a central part of why clients come in; others, it is a secondary issue to a current challenge or barrier during [life transition therapy](https://dralanjacobson.com/life-transitions-therapy/), for example. It can also be a backdrop in [couples therapy](https://dralanjacobson.com/couples-therapy/) or [family therapy](https://dralanjacobson.com/family-therapy/).

Please [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) to hear more about these approaches and how they might benefit you or a loved one.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.linkedin.com/company/psychologicalscience/)

---

### [Practice Policies and Informed Consent](https://dralanjacobson.com/practice-policies/)

**Published:** September 1, 2025
**Author:** Dr. Alan Jacobson

**Content:**

**Practice Policies and Informed Consent**

Last updated: September 1, 2025

This page describes policies and procedures regarding service delivery in my practice.

### Appointments & Cancellations

- Sessions are typically **45 minutes**. If you arrive late, the session may be shortened.
- Please cancel/reschedule **48 hours in advance**. Cancellations made less than **24 hours in advance** may be charged the full fee.
- Termination is part of the therapeutic process. Treatment may end when goals are met or if therapy is no longer effective.

### Communication & Accessibility

- Contact me by voicemail or text. I will return messages within **24 hours on weekdays**.
- In emergencies, please call **911 or go to the nearest emergency room**.
- Do not include confidential information in texts or emails.
- To [protect your privacy](https://dralanjacobson.com/privacy-policy/), I do not accept friend or connection requests on social media from clients.

### Telehealth & Electronic Communication

- Services by phone, video, or email are considered **telemedicine**. All confidentiality protections apply.
- Benefits include convenience and access to care; risks include technical interruptions. If a session is disrupted, there will be no charge for lost time.
- Do not share your telehealth appointment link with unauthorized persons.

### Confidentiality

Your privacy is protected, with exceptions required by law:

1. Risk of serious harm to self or others.
2. Suspected abuse/neglect of children, elders, or vulnerable adults.
3. Valid court order.

Parents/guardians may be legally entitled to some information. I will discuss with you what is shared and what remains private.

If we meet outside of sessions, I will not acknowledge you unless you approach me first, to ensure your confidentiality is safeguarded.

### External Providers

To enhance services, I sometimes use secure external platforms such as **Upheal**. Upheal provides automated notes and analytics and, as a HIPAA-compliant **Business Associate**, safeguards all protected health information (PHI).

I have signed a **Business Associate Agreement (BAA)** with Upheal, ensuring your data is protected under the HIPAA Security and Privacy Rules with appropriate safeguards.

## Concerns & Complaints

If you have concerns, you may contact your **state’s Board of Psychology**: [https://www.asppb.net/page/BdContactNewPG](https://www.asppb.net/page/BdContactNewPG?utm_source=chatgpt.com)

---

### Payment Information

- Payment is processed via **Stripe** at the time of session.
- Your card may be charged for late cancellations or missed sessions.
- You may request paper statements at any time.
- This authorization remains in effect until revoked in writing.

---

### Federal “No Surprises” Act

You are entitled to a **Good Faith Estimate (GFE)** of service costs.

- You will receive a clear description of services, frequency, and fees.
- If fees change, a new estimate will be provided with an explanation.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.linkedin.com/company/psychologicalscience/)

---

### [Privacy Policy](https://dralanjacobson.com/privacy-policy/)

**Published:** October 7, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Privacy Policy**

Last updated: October 07, 2024

This Privacy Policy describes my policies and procedures regarding collecting, using, and disclosing your information when you visit my webpage. It also tells you about your privacy rights and how the law protects you.

**Types of Data Collected**

**Personal Data**

I do not collect personal data that can be used to contact or identify you unless you submit information through a contact form or schedule a consultation. If you choose to do so, you are only required to submit your first name, at least one form of contact, and a sentence or two about what you are looking for. If you would prefer, you can call me at 617-680-5488. Please do not text me any [clinical or personal information](https://dralanjacobson.com/practice-policies/).

**Usage Data**

Usage Data is collected automatically and may include information such as your browser type and version, the pages you visit, the time and date of your visit, and the time spent on those pages. I use this information in the aggregate to improve my site and make it more helpful, but I do not look at this data relative to individual visits.

When you access the Service by or through a mobile device, the site may automatically collect certain information, including, but not limited to, the type of mobile device you use, your mobile operating system, the type of mobile Internet browser you use, and other diagnostic data. Again, this data is used only so I can improve the site.

**Tracking Technologies and Cookies**

I use Cookies and similar tracking technologies to track activity and store certain information. Tracking technologies are beacons, tags, and scripts to collect and track information and improve and analyze the site. The technologies the site uses may include:

- **Cookies or Browser Cookies.** A cookie is a small file placed on your device. You can instruct your browser to refuse all cookies or indicate when a cookie is being sent. Unless you have adjusted your browser settings so that it will refuse cookies, I may use cookies to improve your experience.
- **Web Beacons.** Certain sections of this site and our emails may contain small electronic files known as web beacons (also referred to as clear gifs, pixel tags, and single-pixel gifs) that permit me, for example, to count users who have visited those pages and for other related website statistics (for example, recording the popularity of a certain section and verifying system and server integrity).

Cookies can be “Persistent” or “Session” Cookies. Persistent Cookies remain on Your personal computer or mobile device when you go offline, while Session Cookies are deleted as soon as You close Your web browser. Learn more about cookies on the [Privacy Policies website](https://www.privacypolicies.com/blog/privacy-policy-template/#Use_Of_Cookies_Log_Files_And_Tracking) article.

I use both Session and Persistent Cookies for the purposes set out below:

- **Necessary / Essential Cookies**

Type: Session Cookies

Administered by: Me

Purpose: These Cookies are essential to providing you with services available through the Website and enabling you to use some of its features. They help to authenticate users and prevent fraudulent use of user accounts. I do not collect personal data about visitors from these cookies.

Type: Persistent Cookies

Administered by: Me

Purpose: These Cookies identify if users have accepted cookies on the Website.

- **Functionality Cookies**

Type: Persistent Cookies

Administered by: Me

Purpose: These Cookies allow us to remember your choices when you use the website, such as your login details or language preference. The purpose of these Cookies is to provide you with a more personal experience and to avoid having to re-enter your preferences every time you use the Website. I do not collect personal data from these cookies.

**Use of Your Personal Data**

- **I do not collect personal data unless you intentionally submit it**

**Links to Other Websites**

This site may contain links to other websites not operated by me. If you click on a link, you will be directed to that party’s site. I strongly advise you to review the Privacy Policy of every site you visit.

I have no control over and assume no responsibility for the content, privacy policies or practices of any other sites.

**Changes to this Privacy Policy**

I might update Our Privacy Policy from time to time. I will notify you of any changes by posting the new Privacy Policy on this page.

I will inform you via email and/or a prominent notice on this page before the change becomes effective, and update the “Last updated” date at the top of this Privacy Policy.

You are advised to review this Privacy Policy periodically for any changes. Changes to this Privacy Policy are effective when posted on this page.

**Contact Me**

If you have any questions about this Privacy Policy, you can contact me by email: hello@dralanjacobson.com

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.linkedin.com/company/psychologicalscience/)

---

### [Test-Taking Anxiety](https://dralanjacobson.com/test-taking-anxiety/)

**Published:** August 31, 2024
**Author:** Dr. Alan Jacobson

**Content:**

**Test-taking anxiety** is a common issue that can affect anyone, from students to professionals. It can cause a variety of physical and emotional symptoms, such as nervousness, sweating, difficulty concentrating, and even panic attacks. I provide **test-taking anxiety treatment** both virtually and in person for people of all ages. This post provides an overview of **anxiety and test-taking** and then gives some test-taking anxiety strategies you can try. If you would like more intensive and extensive help, please do not hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

## Test-Taking Anxiety Treatment ![Test-taking anxiety](https://dralanjacobson.com/wp-content/uploads/2024/08/learning-300x200.jpg "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Here are some effective treatments and strategies to manage and reduce test-taking anxiety:

### Cognitive-Behavioral Therapy (CBT)

- **Description**: [CBT is a therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) that helps you identify and challenge negative thoughts and beliefs and replace them with more positive, realistic ones. It is the cornerstone [clinical approach](https://dralanjacobson.com/types-of-therapy/) I use for this challenge in my practice.
- **Benefits**: This test-taking anxiety treatment can help reduce stress by changing your thoughts about the exam situation.

### Mindfulness for Test-Taking Anxiety

- **Mindfulness**: Focus on the present moment without judgment using [mindfulness techniques](https://dralanjacobson.com/mindfulness-based-stress-reduction-mbsr/). This can help you avoid worrying about the future or ruminating on past test experiences.
- **Meditation**: Regular meditation can help improve focus and reduce worry over time, and I can show you how to do meditation that is quick, easy and focused.
- **Deep Breathing**: We will work on practicing [deep, slow breathing exercises](https://positivepsychology.com/deep-breathing-techniques-exercises/) to calm your mind and body.
- **Progressive Muscle Relaxation**: On the day of the test, tensing and [slowly relaxing each muscle group](https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.stress-management-doing-progressive-muscle-relaxation.uz2225#:~:text=How%20do%20you%20do%20progressive%20muscle%20relaxation%3F%201,bring%20your%20focus%20back%20to%20the%20present.%20) will release physical tension.
- **Visualization**: Picture a calm and relaxing scene, which can help reduce stress levels before and during the exam.

### Group Treatment for Test-Taking Anxiety

- **Support Groups**: I can help you find a clinical [group therapy program](https://dralanjacobson.com/group-therapy/) to connect you with peers who also experience these symptoms. These shared experiences can be comforting; you can learn from what worked for others.
- **Informal Groups**: Getting help in your peer group can also help you feel less alone and more supported.

### Test-Taking Anxiety Treatment with Medication

- **Short-Term Use**: In some cases, a healthcare provider may prescribe medication for short-term test-taking anxiety treatment, mainly if it is severe and you need improvement fast.

## Test-Taking Anxiety Strategies

The following are some strategies to use on your own, whether in conjunction with individual therapy with me or someone else or alone.

### Anxiety and Test-Taking Preparation and Study Habits

- **Structured Study Schedule**: Instead of cramming, break down your study material into manageable chunks over a period of time.
- **Practice Tests**: Taking practice exams under similar conditions can reduce fear of the unknown and improve confidence.
- **Time Management**: Develop good time management skills to ensure you have enough time to study without feeling rushed. If your exam is in school, some teachers and professors will help you by advising you how long to spend on each part.

### Healthy Lifestyle for Test-Taking Anxiety

- **Exercise**: Regular physical activity can reduce overall stress and improve mood.
- **Sleep**: [Ensuring you get adequate sleep](https://dralanjacobson.com/cbt-i-for-sleep-difficulties/) is important for cognitive function. However, as long as you get reasonably good sleep in the days leading up to the exam, don’t worry if that last night does not have high-quality sleep due to worries.
- **Diet**: Eat balanced meals and avoid excessive caffeine, which can have a negative effect concerning anxiety and test-taking.

### Positive Self-Talk for Test-Taking Anxiety

- Replace negative thoughts like “I’m going to fail” with positive affirmations such as “I am prepared” or “I can do this.”
- Remind yourself of past successes and your effort to prepare for the exam.

### Anxiety and Test-Taking that Day

- **Arrive Early**: Give yourself ample time to settle and avoid last-minute rushing.
- **Bring Everything You Need**: Double-check that you have all the necessary materials, such as pencils, calculators, and ID.
- **Read Instructions Carefully**: Take a moment to read the instructions and understand the format before starting.

### Anxiety and Test-Taking Afterward

- **Reflect, Don’t Dwell**: Once the test is over, avoid replaying it excessively. Instead, reflect on what went well and areas for improvement, then move on.
- **Learn**: No matter how the exam goes, learn from the experience to improve the next. Which techniques worked and which didn’t? Do you need to increase the degree to which you address this by coming in for therapy, for example?

Managing test-taking anxiety involves both mental and physical preparation. Consistent practice of these strategies can decrease stress levels, leading to better performance and a more positive experience.

## Anxiety and Test-Taking Treatment Example

The following is a fictitious example of how I might treat test-taking anxiety in my practice. It is fairly straightforward and designed to give you an idea of the test-taking anxiety strategies I might give.

**Client:** A college student named Sarah experiences intense fear before and during exams, leading to difficulty concentrating, [physical symptoms](https://dralanjacobson.com/panic-attack-treatment/) like sweating and nausea, and a fear of failing. She hopes test-taking anxiety treatment will bring her back to the way she was in high school when these symptoms did not occur.

---

### Session 1: Understanding Test-Taking Anxiety

**Therapist:** “Sarah, let’s start by talking about your experience with anxiety and exams. Can you describe what happens when you think about an upcoming exam?”

**Sarah:** “As soon as I know there’s one coming up, I start to feel really nervous. I can’t stop thinking about everything that could go wrong, like forgetting everything I’ve studied or completely blanking out.”

**Me:** “It sounds like your anxiety starts even before the test itself. What kinds of thoughts are going through your mind when this happens?”

**Sarah:** “I keep thinking I’m not prepared enough, even if I’ve studied. I worry that I’ll fail the test, and then fail the class, which will ruin my chances of getting into a good graduate program.”

**Me:** “These thoughts are quite distressing, and they seem to trigger your anxiety. In CBT, we call these ‘catastrophic thoughts,’ where you’re imagining the worst possible outcomes. Our goal in therapy will be to identify these thoughts and learn how to challenge and change them.”

---

### Session 2: Identifying Negative Thought Patterns

**Me:** “Last session, we discussed the thoughts contributing to your fears. Let’s explore some of these thoughts about anxiety and test-taking a bit more. When you think, ‘I’m not prepared enough,’ what evidence do you have that supports this belief?”

**Sarah:** “Well, I guess I do study a lot, but I always feel like it’s never enough.”

**Me:** “It’s common to feel like there’s always more to learn. But let’s also look at the evidence against this thought. How do you usually perform on exams?”

**Sarah:** “I usually do okay, actually. I’ve never failed, but it still feels like I could.”

**Me:** “So even though you’ve never failed, the fear of failure still looms large. This is an example of how anxiety and test-taking can work, distorting our perception. Next time you have this thought, try reminding yourself of your past successes and the effort you’ve put into preparing.”

---

### Session 3: Challenging and Reframing Negative Thoughts

**Me:** “Now that we’ve identified some of the thoughts that trigger you, let’s work on challenging and reframing them. When you think, ‘I’m going to fail,’ what could you say to yourself instead?”

**Sarah:** “Maybe I could tell myself that I’ve prepared well and that even if I don’t get a perfect score, it’s not the end of the world.”

**Me:** “Exactly. This is called cognitive restructuring, replacing negative thoughts with more balanced, realistic ones. Over time, this can help reduce the intensity of your fear.”

---

### Session 4: Developing Test-Taking Anxiety Strategies

**Me:** “Let’s also focus on some practical test-taking anxiety strategies you can use on the exam day. Have you tried any relaxation techniques before?”

**Sarah:** “I’ve tried deep breathing, but I’m unsure if I’m doing it right.”

**Me:** “Let’s practice it together now. Take a deep breath in through your nose, hold it for a few seconds, and then slowly exhale through your mouth. Focus on the feeling of your breath. You can use this technique before and during the exam to help calm your nerves. I’ll also show you how to use progressive relaxation strategies”

---

### Session 5: Gradual Test-Taking Anxiety Exposure

**Me:** “Another strategy we can use is gradual exposure. This means gradually exposing yourself to exam-like conditions to reduce fear. For example, you could start by practicing in a quiet environment, then gradually add time limits or other stressors.”

**Sarah:** “That sounds helpful. I think practicing in a way that mimics the real test environment could make the actual exam feel less intimidating.”

**Me:** “Exactly. The more you practice your test-taking anxiety strategies under realistic conditions, the more your fear will decrease because you’ll feel more prepared and in control.”

---

### Session 6: Reflecting on Progress and Planning for the Future

**Me:** “You’ve been working hard on these test-taking anxiety treatment strategies, Sarah. How do you feel about your upcoming exams?”

**Sarah:** “I still feel a little nervous, but it’s not as overwhelming as before. I’ve been using the deep breathing exercises and noticed that my mind doesn’t spiral into worst-case scenarios as much.”

**Me:** “That’s great progress. Remember, it’s normal to feel some worry, but now you have the tools to manage it effectively. Keep practicing these test-taking anxiety strategies, and over time, they’ll become second nature.”

---

**Outcome:** Through this test-taking anxiety treatment, Sarah learns to identify and challenge her negative thoughts, develop effective coping strategies, and gradually reduce her fears. She approaches her exams with more confidence and less fear, leading to better performance and a more positive experience overall. She developed a toolkit of test-taking anxiety strategies.

---

This example shows how therapy can help someone with test-taking anxiety by addressing the thoughts and behaviors that contribute and teaching practical skills to manage it.

## Test-Taking Anxiety Accommodations

Test-taking anxiety is common and can impact performance, but accommodations can help create a supportive environment. Often, people who see me for test-taking anxiety treatment need [exam accommodations](https://psychologicalassessments.com/gre-mcat-gmat-and-lsat-accommodations/) to ensure that they have equal footing with their peers when it comes to taking standardized exams such as the SATs, ACT, GRE, LSAT, and more. In these cases, I work closely with colleagues who provide [psychological testing](https://psychologicalassessments.com/) to provide the evidence that the sponsor of each test needs. I can also help those in test-taking anxiety treatment with me get accommodations at school.

Here are some effective accommodations for managing test-taking anxiety:

1. **Extended Time**: Providing [extra time on exams like the SAT](https://psychologicalassessments.com/testing-for-extended-time-on-the-sat/) can reduce pressure and allow students to focus more on accuracy than speed. For many, this reduces the anxiety and test-taking connection and helps them produce the work they are capable of.
2. **Alternative Environment**: A quieter, private room can help reduce distractions and triggers that connect anxiety and test-taking.
3. **Breaks**: Short breaks are an accommodation and one of the test-taking anxiety strategies that can help students recharge and manage stress during longer exams.
4. **Use of Fidget Tools or Stress Balls**: Allowing discreet stress-relief items can help calm nerves without disturbing others.
5. **Pre-Exam Preparation Sessions**: Schools may offer sessions to review test-taking anxiety strategies, breathing techniques, or relaxation exercises.
6. **Separate Schedule**: Taking exams at a different time may help students who feel less pressured when not surrounded by others. Another option is taking the exam at the same time but in a different location.
7. **Access to Notes or Formula Sheets**: This can help students focus on applying knowledge rather than memorizing under pressure.
8. **Encouragement of Familiarity with Format**: Practice exams or sample questions can help reduce the unknown, which often fuels anxiety.

These accommodations can typically be arranged through a school’s counseling or disability services office and tailored to meet individual needs. I can help make these accommodations formal and required.

## Summary and My Work

I provide test-taking anxiety [treatment for adolescents](https://dralanjacobson.com/therapy-for-teens/) and adults, both virtually and in person. I provide test-taking anxiety strategies that become a toolkit you can use each time the fear arises. This [therapeutic approach](https://dralanjacobson.com/types-of-therapy/) can be used as a stand-alone or as a more [comprehensive therapy](https://dralanjacobson.com/individual-therapy/) for other challenges, such as [therapy for a learning difference](https://dralanjacobson.com/therapy-for-people-with-learning-disorders/).

If you have questions about anxiety and test-taking, or want to inquire about my services, please do not hesitate to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation.](https://www.picktime.com/scheduleaconsult)

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

 [ ![social network icon](data:image/svg+xml;base64,PHN2ZyB3aWR0aD0iMTYiIGhlaWdodD0iMTYiIHZpZXdCb3g9IjAgMCAxNiAxNiIgZmlsbD0ibm9uZSIgeG1sbnM9Imh0dHA6Ly93d3cudzMub3JnLzIwMDAvc3ZnIj4KPGcgY2xpcC1wYXRoPSJ1cmwoI2NsaXAwXzM0M18xMDE2KSI+CjxwYXRoIGQ9Ik03Ljk5OTk5IDBDMTIuNDE4MyAwIDE2IDMuNTgxNzMgMTYgNy45OTk5OUMxNiAxMi4wOTAyIDEyLjkzMDMgMTUuNDYzIDguOTY5MjEgMTUuOTQxNFYxMC40NDQ3TDExLjEzMzQgMTAuNDQ0N0wxMS41ODIzIDhIOC45NjkyMVY3LjEzNTM5QzguOTY5MjEgNi40ODk0NSA5LjA5NTkxIDYuMDQyMjYgOS4zODY1NyA1Ljc1NjU2QzkuNjc3MjYgNS40NzA4NCAxMC4xMzE5IDUuMzQ2NjIgMTAuNzg3OCA1LjM0NjYyQzEwLjk1MzggNS4zNDY2MiAxMS4xMDY2IDUuMzQ4MjcgMTEuMjQyMiA1LjM1MTU3QzExLjQzOTQgNS4zNTYzOCAxMS42MDAxIDUuMzY0NjcgMTEuNzEyIDUuMzc2NDRWMy4xNjAzMkMxMS42NjczIDMuMTQ3ODkgMTEuNjE0NSAzLjEzNTQ3IDExLjU1NTQgMy4xMjMyNEMxMS40MjE0IDMuMDk1NTQgMTEuMjU0OCAzLjA2ODgzIDExLjA3NTcgMy4wNDUzN0MxMC43MDE2IDIuOTk2MzYgMTAuMjcyOSAyLjk2MTU0IDkuOTcyOTIgMi45NjE1NEM4Ljc2MTYgMi45NjE1NCA3Ljg0NjE0IDMuMjIwNjggNy4yMDcxMyAzLjc1NzQ2QzYuNDM1OTIgNC40MDUyNyA2LjA2NzM5IDUuNDU3NDggNi4wNjczOSA2Ljk0NjU5VjcuOTk5OTlINC40MTc3MlYxMC40NDQ3SDYuMDY3MzlWMTUuNzY0NEMyLjU4Mjg4IDE0Ljg5OTkgMCAxMS43NTE4IDAgNy45OTk5OUMwIDMuNTgxNzMgMy41ODE3MyAwIDcuOTk5OTkgMFoiIGZpbGw9IiM0MzQ5NjAiLz4KPC9nPgo8ZGVmcz4KPGNsaXBQYXRoIGlkPSJjbGlwMF8zNDNfMTAxNiI+CjxyZWN0IHdpZHRoPSIxNiIgaGVpZ2h0PSIxNiIgZmlsbD0id2hpdGUiLz4KPC9jbGlwUGF0aD4KPC9kZWZzPgo8L3N2Zz4K) ](https://www.facebook.com/appliedpsychologicalscience) [ ![social network icon](data:image/svg+xml;base64,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) ](https://www.instagram.com/appliedpsychological) [ ![social network icon](data:image/svg+xml;base64,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) ](https://www.linkedin.com/company/psychologicalscience/)

---

### [Therapy FAQs](https://dralanjacobson.com/therapy-faqs/)

**Published:** March 6, 2026
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: June 9, 2026

# Integrative Therapy FAQs

### Transform Your Life with Expert Therapy

Explore my comprehensive therapy services designed to foster insight, growth, and performance. Whether you’re seeking individual, couples, or family therapy, I can help guide you on your journey to mental wellness, a deeper sense of meaning and purpose, and greater resilience.

 [Start Your Journey](https://www.picktime.com/scheduleaconsult#book)

 ![](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "1080x600 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## Your Therapy Questions Answered

Find clarity and understanding with our expert insights into therapy and psychotherapy.

##### How do I know if my therapist is good?

The [best therapist for you](https://dralanjacobson.com/choosing-the-best-therapist-for-you/) listens actively, demonstrates empathy, and creates a safe, supportive environment where clients feel understood. Effective therapy also involves constructive feedback and clear goals. Progress should be meaningful and measurable, helping individuals develop healthier coping strategies, improved insight, and greater emotional well-being.

##### How do therapists help?

Therapists help individuals manage emotions, overcome challenges, and develop healthier coping strategies. They use [types of therapy](https://dralanjacobson.com/types-of-therapy/) that provide guidance and support that foster self-understanding, meaningful personal growth, and progress toward important life goals.

##### How effective is psychotherapy?

[Psychotherapy](https://dralanjacobson.com/psychotherapy/) is supported by extensive research demonstrating its effectiveness in improving mental health, coping skills, and overall well-being. A supportive therapeutic relationship allows individuals to openly explore challenges, develop healthier strategies for managing stress, and gain deeper self-awareness. Over time, therapy can strengthen resilience, improve relationships, and contribute to lasting personal growth and life satisfaction.

##### What Kind of Therapists Are There?

Psychologists, psychiatrists, counselors, clinical social workers, and marriage and family therapists are common types of therapists. Each has different training and specialties. [Clinical psychologists](https://dralanjacobson.com/what-is-a-clinical-psychologist/) provide complex psychotherapy and psychological testing, psychiatrists are medical doctors who can prescribe medication, and counselors or social workers primarily provide talk therapy to help people manage emotions, relationships, stress, and life challenges.

##### What Do I Talk About in Therapy?

You can talk about anything that affects your thoughts, emotions, or daily life. Common topics for [therapy online](https://dralanjacobson.com/therapy-online-approaches-techniques-and-outcomes/) or in-person include stress, anxiety, relationships, work or school challenges, past experiences, major life changes, and personal goals. Therapy is a confidential space where you can explore concerns openly, gain insight into patterns in your life, find deeper meaning and purpose, and develop healthier ways of coping and moving forward.

 ![](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "800x1080")

## Why Do People Go into Therapy?

**People go to therapy to better understand themselves, manage emotional challenges, and improve their overall well-being.** Therapy helps individuals explore their thoughts and feelings, develop healthier coping strategies, strengthen relationships, and navigate stress or major life changes. It also supports personal growth by increasing self-awareness, building resilience, and helping people make meaningful changes that improve their quality of life.

 ![](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "1-3415e459-3c73-4d5a-a4e9-48c631bc1224-512x512 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

 ![](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "1-3415e459-3c73-4d5a-a4e9-48c631bc1224-512x512 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## How Does Psychotherapy Work?

Psychotherapy works through a collaborative relationship between the therapist and client that promotes trust, insight, and positive change. Through open conversation and guided reflection, individuals gain a better understanding of how thoughts, emotions, and past experiences influence current behavior. Therapy also helps people develop practical coping strategies, healthier perspectives, and skills that support emotional well-being, stronger relationships, and greater resilience in daily life.

## How does therapy help?

**Psychotherapy helps by providing a safe, supportive environment where individuals can explore their thoughts, emotions, and life challenges.** Through guided conversation and reflection, therapy helps people understand the underlying causes of anxiety, depression, and relationship difficulties. It also promotes self-awareness, healthier coping strategies, and new perspectives that support emotional well-being, stronger relationships, and meaningful personal growth.

 ![](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "1-3415e459-3c73-4d5a-a4e9-48c631bc1224-512x512 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## What Kinds of Therapy Are There?

[![](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "0-2bf9e332-278e-4ef7-924f-7860a14a78bb-800x600 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")](https://dralanjacobson.com/individual-therapy/)

#### [Individual Therapy](https://dralanjacobson.com/individual-therapy/)

Experience personalized care tailored to your unique needs, helping you navigate life’s challenges and achieve personal growth.

 Learn More

[![](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "0-7283277b-f067-4532-bb56-3d9f76c36cf9-800x600 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")](https://dralanjacobson.com/couples-therapy/)

#### [Couples Therapy](https://dralanjacobson.com/couples-therapy/)

[Strengthen your relationship](https://dralanjacobson.com/couples-therapy/) with expert guidance, fostering communication and understanding between partners.

 Discover More

[![Family Therapy](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "IMG_0474 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")](https://dralanjacobson.com/family-therapy/)

#### [Family Therapy](https://dralanjacobson.com/family-therapy/)

[Enhance family dynamics](https://dralanjacobson.com/family-therapy/) and resolve conflicts with supportive sessions designed to bring families closer together, even when the children are adults.

 Explore Options

## How to Get Started with Therapy

 

#### Step 1

[#### Initial Consultation](https://www.picktime.com/scheduleaconsult#book)

Begin your journey with a comprehensive consultation to understand your needs and set therapy goals.

 

#### Step 2

#### Personalized Treatment Plan

Receive a customized plan that addresses your specific concerns, ensuring effective and targeted therapy sessions.

 

#### Step 3

#### Ongoing Support

Engage in regular sessions with continuous support, adapting strategies to ensure progress and well-being.



### How Can Counseling Help Me?

Counseling can help you better understand your thoughts and emotions while developing healthier ways to manage life’s challenges. Working with a therapist provides support, guidance, and practical strategies for improving relationships, coping with stress, and building resilience. Counseling can also promote self-awareness, personal growth, and greater overall well-being.

Ready to explore how therapy can enhance your life? Connect with me to [learn more about our personalized therapy services](https://dralanjacobson.com/intensive-therapy-and-specialty-services/). Whether you’re seeking [individual, couples, or family counseling](https://dralanjacobson.com/), I am available to support your journey toward insight, growth, and improved performance.

 [Schedule Your Appointment](https://www.picktime.com/scheduleaconsult#book)

## More Information

#### **Mental Health America** – Research on the science behind therapy: 

#### **National Institute of Mental Health (NIMH)** – Overview of psychotherapies:

#### Mayo Clinic – What psychotherapy is and how it works: 

#### **American Psychological Association (APA)** – Psychotherapy effectiveness:

 [ ![social network 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### [Which Type of Family Therapy Is Right for Your Family?](https://dralanjacobson.com/which-type-of-family-therapy-is-right-for-you/)

**Published:** June 8, 2026
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: June 8, 2026

# Which Type of Family Therapy Is Right for Your Family? A Practical Guide

Family therapy isn't one-size-fits-all. Different situations call for different models, and the approach that helps a blended family navigate a new stepparent is not the same one best suited for adult siblings healing years of estrangement. This guide maps the most common family challenges to the approaches that work best for each — so you can walk into the process with clarity and confidence. (For a broad overview of the research behind family and couples interventions, the [American Association for Marriage and Family Therapy](https://ftm.aamft.org/evidence-base-update-on-the-efficacy-and-effectiveness-of-couple-and-family-interventions-2010-2019/) maintains an ongoing evidence base review.)

**Not sure where your family fits?** [Schedule a free consultation](https://www.picktime.com/scheduleaconsult) and we'll figure it out together.

 **Quick Navigation**- [Communication breakdown and conflict cycles](#communication)
- [Parent–teen conflict and adolescent struggles](#parent-teen)
- [When the children are grown](#adult-children)
- [Estrangement and cutoffs](#estrangement)
- [Adult sibling conflict](#siblings)
- [Blended families and stepfamily challenges](#blended)
- [Grief, loss, and major life transitions](#grief-transition)
- [When individual therapy meets family context](#individual-in-family)
- [Overview: all approaches at a glance](#overview)

## Communication Breakdown and Chronic Conflict

Most families entering therapy aren't dealing with one big rupture — they're caught in repeating cycles where the same arguments happen again and again, each person feeling unheard, and nothing ever gets resolved. These structural patterns are exactly what family systems approaches are designed to address. [Research published in the Journal of the American Academy of Child and Adolescent Psychiatry](https://www.apa.org/monitor/dec05/disorders) and reviewed by the APA underscores that family-inclusive treatment is effective across a wide range of presenting problems precisely because it targets the system rather than the individual in isolation.

### Structural Family Therapy

Structural family therapy focuses on the organization of the family itself — who holds authority, where the alliances are, which boundaries are too rigid or too blurred. When families are stuck in conflict, it's often because the structure is out of alignment with what the family actually needs. Therapy works by identifying those misalignments and actively reshaping them, not just talking about them.

**Best for:** Chronic conflict, unclear boundaries between parents and children, enmeshment, disengagement, families where one member carries all the stress

### Strategic Family Therapy

Strategic therapy is directive and problem-focused. The therapist takes an active role in designing specific interventions — sometimes including homework, behavioral experiments, or deliberate shifts in how family members interact around a particular problem. It works quickly and is well-suited for families who want a clear path forward rather than open-ended exploration.

**Best for:** Specific recurring problems, power struggles, families who want action-oriented guidance

### Gottman Method Principles (Applied to Family Work)

While the Gottman Method is best known in couples therapy, its core principles — building rapport during low-stakes moments, recognizing and de-escalating negative communication cycles, and responding to bids for connection — translate meaningfully into parent-child and family relationships. Families who fight hard often struggle equally with repair; these principles address both.

**Best for:** Families with harsh conflict, poor repair after arguments, difficulty expressing needs without escalation

[→ Talk to me about communication and conflict work](https://www.picktime.com/scheduleaconsult)

## Parent–Teen Conflict and Adolescent Struggles

Adolescence creates predictable and sometimes severe family stress. Teens are developmentally wired to push toward autonomy, and parents are wired to protect — when these forces collide without a productive channel, the relationship can fracture quickly. Family therapy during this period isn't about taking sides; it's about building a bridge both parties can actually use.

### Functional Family Therapy (FFT)

[FFT](https://www.fftllc.com/fft) is one of the best-researched models for adolescents and their families. It works by interrupting the negative interaction patterns that are maintaining the problem, improving communication and connection, and then building the specific skills the family needs to sustain those changes. It's active, structured, and evidence-based.

**Best for:** Parent-teen conflict, oppositional behavior, adolescent anxiety or depression with family dynamics component, behavioral concerns

### Attachment-Based Family Therapy (ABFT)

ABFT focuses on rebuilding the attachment relationship between parent and adolescent when it has been damaged by conflict, trauma, or disconnection. The premise is that a repaired emotional bond is the most powerful protective factor for adolescent wellbeing. Therapy alternates between individual sessions with the teen and joint sessions that work toward relational repair. [Multiple clinical trials published in peer-reviewed journals](https://pubmed.ncbi.nlm.nih.gov/27541199/) have established ABFT as an empirically supported treatment specifically designed for adolescent depression and suicidality.

**Best for:** Teens struggling with depression, anxiety, or suicidality in the context of family disconnection; families with significant emotional distance or ruptures

### Multisystemic Therapy (MST) Principles

For adolescents whose difficulties extend beyond the family into school, peer, or community systems, approaches grounded in multisystemic thinking address all the relevant contexts at once rather than treating the teen in isolation. This is especially relevant when an adolescent's behavior is being shaped by multiple competing influences.

**Best for:** Teens with behavior problems across multiple settings, school-related crises, peer influence concerns

[→ Talk to me about parent-teen family work](https://www.picktime.com/scheduleaconsult)

## When the Children Are Grown

A significant part of my family therapy practice involves [adult family therapy](https://dralanjacobson.com/adult-family-therapy/) — work with parents and their adult children who want to improve or repair their relationships. This is an area where virtual therapy offers a real practical advantage: family members in different cities or time zones can all be in the same session.

Adult family dynamics are distinct from parent-teen work. The power differential has shifted. Adult children have their own lives, identities, and sometimes their own families. The old roles — parent as authority, child as dependent — no longer map cleanly onto reality, and navigating that shift is often the heart of the work.

### Bowen Family Systems Theory

[Bowen Theory](https://dictionary.apa.org/bowen-family-systems-theory) is one of the most comprehensive frameworks for understanding adult family dynamics. It introduces concepts like differentiation of self (the ability to be emotionally connected to family while maintaining your own identity and perspective), triangulation (how two-person tensions tend to pull in a third), and multigenerational transmission (how family patterns are passed down across generations). For adults trying to understand why their family works the way it does — and how to respond differently — this framework is often revelatory.

**Best for:** Adults trying to understand their family of origin patterns, families with entrenched roles, multigenerational conflict, self-differentiation work

### Emotionally Focused Family Therapy (EFFT)

Based on [attachment theory as developed by the International Centre for Excellence in Emotionally Focused Therapy (ICEEFT)](https://iceeft.com/what-is-eft/), EFFT works by identifying the negative cycles that keep family members feeling disconnected or unsafe with each other, and then creating new experiences of emotional accessibility and responsiveness. For adult families, this often means moving past the surface argument to the underlying fear, grief, or longing that's actually driving it.

**Best for:** Emotional distance between adult children and parents, unresolved grief or loss within the family, families where connection has been replaced by obligation or conflict

[→ Learn more about adult family therapy](https://dralanjacobson.com/adult-family-therapy/)

## Estrangement and Family Cutoffs

Family estrangement — when one or more members have severed contact — is more common than most people realize, and among the most painful experiences a family can go through. The goals for estrangement therapy vary. Some families want to reconcile. Others want to understand what happened. Some want to grieve a relationship that may not return. All of those are valid, and therapy can support each path.

I offer dedicated [family estrangement therapy](https://dralanjacobson.com/family-estrangement-therapy/) as a specialized service. The work is careful, paced, and attentive to both parties' experiences — it rarely benefits anyone to rush toward forced reconciliation.

### Narrative Therapy

[Narrative therapy](https://www.psychologytoday.com/us/therapy-types/narrative-therapy) helps families examine the stories they've built about each other — and about themselves in relation to each other. In estrangement situations, both parties often hold a version of events that feels entirely true and irreconcilable with the other's account. Narrative approaches create space to hold multiple stories simultaneously, separating the person from the problem and opening possibilities that feel closed when everyone is defending their version of history.

**Best for:** Estrangement, long-term ruptures, families with contradictory accounts of shared history, situations where one person has been scapegoated

### Internal Family Systems (IFS) in a Family Context

IFS originally developed as an individual therapy model, but its insights map powerfully onto family systems. The parts language — the idea that we all have multiple internal voices or "parts," some of which are protective and some of which carry old wounds — helps family members develop curiosity about their own reactivity rather than projecting it outward. In estrangement work, IFS often helps people access the part that still longs for connection, even when another part insists the door must stay closed.

**Best for:** Estrangement, intense emotional reactivity, families where someone feels fundamentally misunderstood, supporting the reconciliation-or-acceptance decision

[→ Learn more about family estrangement therapy](https://dralanjacobson.com/family-estrangement-therapy/)

## Adult Sibling Conflict

Sibling relationships are the longest of our lives, and they carry more history — more shared reference points, more accumulated grievances, more unspoken comparisons — than almost any other. When adult siblings are in conflict, the intensity often surprises them. It shouldn't: the stakes are high, the attachment is deep, and the old family dynamics tend to reassert themselves the moment siblings are in the same room.

I offer [adult sibling therapy](https://dralanjacobson.com/adult-sibling-therapy/) as a dedicated service, including for siblings navigating caregiving decisions for aging parents, inheritance conflicts, or long-standing rifts.

### Contextual Family Therapy

Contextual therapy, developed by Ivan Boszormenyi-Nagy, addresses the ledger of fairness and loyalty that runs beneath most sibling conflict — the sense that burdens were distributed unequally, that one sibling was always the favorite, that obligations were never acknowledged. Bringing this implicit ledger into the open often shifts the conversation from blame to something closer to genuine grievance and repair. The [AAMFT's Family Therapy Magazine has noted](https://ftm.aamft.org/family-therapy-has-always-evolved-now-includes-sibling-therapy/) the growing recognition of sibling work as a distinct and important area within the family therapy field.

**Best for:** Adult sibling conflict, perceived unfairness or favoritism, families navigating inheritance or caregiving decisions

### Emotion-Focused approaches for siblings

Many sibling conflicts that appear to be about logistics — who does more for mom, who got more as a child, who is making better decisions now — are actually about emotion: hurt, grief, fear of abandonment, or longing to feel seen by the person who knew you first. Moving into the emotional layer of a sibling conflict, carefully and with both parties willing, often produces movement where years of surface-level negotiation have not.

**Best for:** Estranged siblings, siblings with deep grief or loss in the relationship, sibling dynamics following a parent's death

[→ Learn more about adult sibling therapy](https://dralanjacobson.com/adult-sibling-therapy/)

## Blended Families and Stepfamily Challenges

Blended families are built on love and hope — and on complexity. Children grieve the original family even when they're fond of a stepparent. Loyalty conflicts are real and often unspoken. Discipline and authority become fraught. The timeline for bonding is longer than most blended families expect, and rushing it usually backfires.

### Structural and Strategic approaches for blended families

Stepfamily challenges are often structural at their core: the parental couple needs to function as a united executive team while also respecting the pre-existing parent-child bonds that developed before the new family formed. Structural and strategic approaches are particularly effective here because they address the system's organization directly — helping the adults establish appropriate authority while stepparents build their own relational capital with stepchildren over time, rather than borrowing it from the biological parent.

**Best for:** New blended families, stepparent integration challenges, co-parenting across two households, loyalty conflicts in children

### Collaborative Problem-Solving (CPS)

CPS is built on the premise that children (and adults) do well when they can — and that behavioral problems in blended families often reflect lagging skills or unmet needs rather than defiance. The model is collaborative rather than punitive, and it's particularly useful in blended families where children are navigating difficult adjustment periods and traditional disciplinary approaches are backfiring or deepening resistance.

**Best for:** Blended family adjustment, stepchildren with behavioral concerns, co-parenting disagreements about discipline, reducing power struggles

[→ Talk to me about blended family therapy](https://www.picktime.com/scheduleaconsult)

## Grief, Loss, and Major Life Transitions

Families don't grieve in lockstep. When a parent dies, a sibling is lost, or a major disruption reshapes the family's structure, different members process at different rates and in different ways. The grief that goes unacknowledged in a family system — or is processed in isolation — often surfaces as conflict, distance, or somatic symptoms that no one connects to the original loss.

### Grief-Informed Family Systems Work

Loss is rarely just about the person or thing that's gone. It reorganizes the entire family system — roles shift, old dynamics resurface, alliances change. Therapy that attends to this reorganization, rather than treating grief as a purely individual process, helps families navigate the transition together and reduces the secondary losses (relationship ruptures, estrangements, long silences) that often follow major deaths or transitions.

**Best for:** Families following a death, families facing a member's serious illness, divorce aftermath, major transitions (empty nest, relocation, retirement)

### Trauma-Informed Family Therapy

Some families carry shared or intersecting traumas — a sibling's addiction, a parent's illness, abuse that happened and was never named, losses that were minimized rather than mourned. Trauma-informed family work creates safety first, understands each member's nervous system response to perceived threat, and works toward a shared account that doesn't require anyone to be the villain in order for the harm to be acknowledged.

**Best for:** Families with shared trauma history, families where one member's trauma affects the whole system, families in which "don't talk about it" has been the rule

[→ Talk to me about grief and transition work](https://www.picktime.com/scheduleaconsult)

## When Individual Therapy Meets Family Context

Sometimes the most important work a person can do in individual therapy involves inviting a family member into the room. This might mean bringing a parent in for a few sessions to work through an old dynamic, asking a sibling to join to address something that's been unsaid, or having a partner attend to address something that's become a stuck point.

 **How this works in my practice:** If you're an existing individual therapy client and there's a relational issue that would benefit from the other person being present, we can invite them for a limited number of sessions within your ongoing treatment. This is different from starting full family therapy — it's a targeted, contained piece of work within an individual frame.

This format is often ideal for:

- Adult clients working on differentiation from their family of origin
- Clients preparing to have a difficult conversation and wanting support in the room
- Addressing a specific rupture that has remained unresolved
- Clients whose partners or family members want to understand what the person is working on

The individual client remains the primary client in this format — the invited family member is participating in service of the individual's therapeutic work.

[→ Talk to me about this format](https://www.picktime.com/scheduleaconsult)

## Overview: All Approaches at a Glance

ApproachBest For**Structural Family Therapy**Communication patterns, unclear boundaries, enmeshment/disengagement**Strategic Family Therapy**Specific recurring problems, power struggles, action-oriented work**Functional Family Therapy (FFT)**Parent-teen conflict, adolescent behavioral concerns**Attachment-Based Family Therapy (ABFT)**Adolescent depression/anxiety with family disconnection**Bowen Family Systems Theory**Adult family dynamics, differentiation, multigenerational patterns**Emotionally Focused Family Therapy (EFFT)**Emotional distance in adult families, attachment repair**Narrative Therapy**Estrangement, contradictory family histories, scapegoating**Internal Family Systems (IFS)**Intense reactivity, estrangement, helping members access ambivalence**Contextual Family Therapy**Adult sibling conflict, loyalty binds, inheritance/caregiving disputes**Collaborative Problem-Solving (CPS)**Blended family adjustment, stepchildren's behavioral concerns**Grief-Informed Family Systems**Loss, death of a family member, major transitions**Trauma-Informed Family Therapy**Shared or intersecting family trauma, unspoken family historiesAs an integrative psychologist, I rarely use a single model in isolation. The approaches above are frameworks — ways of seeing and organizing what's happening in a family system. In practice, good family therapy draws on whichever combination of methods fits your family, your situation, and what you're trying to accomplish together.

The best starting point is almost always a conversation. [Schedule a free consultation](https://www.picktime.com/scheduleaconsult) and we'll talk through where your family is and what approach makes the most sense.

 [← Back to Family Therapy Overview](https://dralanjacobson.com/family-therapy/) | [Individual therapy approach guide →](https://dralanjacobson.com/which-type-of-therapy-is-right-for-you-a-practical-guide/)

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---

### [My Approach](https://dralanjacobson.com/types-of-therapy/)

**Published:** December 26, 2023
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: June 6, 2026

 # Types of Therapy

The The Foresight Psychological Institute approach is integrative, meaning that it braids together the most powerful and effective techniques to create the most uniquely potent and effective method for you. You will be part of the decision-making when it comes to the types of psychotherapy we will use together. I am trained in many different types of therapy that are proven to help.

 [Schedule a Consultation](https://www.picktime.com/scheduleaconsult)

## The Different Types of Therapy

Welcome! I am a [clinical psychologist](https://dralanjacobson.com/what-is-a-clinical-psychologist/) who founded [The Foresight Psychological Institute](https://foresightpsychology.org/) to provide treatment to individuals, couples, and families as well as [psychological testing](https://psychologicalassessments.com/), executive and leadership coaching, and [Therapeutic Tutoring](https://therapeutictutoring.com/).

The following information is about the **different types of therapy** I provide in my [private therapy practice](https://dralanjacobson.com/finding-a-private-practice-therapist/) and my overall clinical approach. You can also find information about some of the terms I use on this site, including [therapist vs. psychologist](https://dralanjacobson.com/therapist-vs-psychologist-therapist-vs-psychotherapist/), therapist vs. psychotherapist, and counseling vs. therapy.

### **Overarching Treatment Philosophy**

In general, I like to stay **future-oriented, positive, and goal-focused**. These are also the basic tenets of all The Foresight Psychological Institute services. We will dig into the past, but only if it might be helpful to see where certain prior events or periods are causing current challenges and barriers. In other words, at times, we might try to discover the complex roots of a problem, but only when it can be helpful to the here-and-now, and not when it runs the risk of leading to conjecture and uncertainty that gets in the way of feeling better now and reaching goals. Sometimes it is worth looking for deeper-seated, complicated reasons that block success and happiness. Still, if we find that those reasons are elusive or that knowing them does not help fix things, that is okay, and we can still pursue powerful and meaningful here-and-now solutions through the different types of therapy for which I am trained.

### **Grounding the Different Types of Therapy**

The six techniques listed below are all wrapped up in a **Humanistic Psychology [strength based therapy](https://dralanjacobson.com/strength-based-therapy/) approach that looks at how you understand and perceive the world and make meaning from that perception**. The goal is to see what drives your decision-making, how the world creates your mood, and what needs you can meet to feel better and more fulfilled. In other words, the Humanistic approach does not suggest that “you were born that way” or that you are merely a product of past experiences (though we will still explore the past as it influences the here and now). Instead, Humanistic Psychology provides hope and motivation. Most of the different types of psychotherapy I use stem from a humanistic approach.

### Positive Psychology

Positive psychology describes an approach that reduces the focus on challenges and problems and increases the focus on possibilities and opportunities. This is one of the types of psychotherapy is perfect for those who feel blocked, where despite knowing that they have the potential to be happy and reach goals, today, those feelings seem out of reach. The [benefits of positive psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/) are well known, and this approach mixes well with others.

[Learn more about Positive Psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/)

### Cognitive-Behavioral

Cognitive-Behavioral or CBT changes your perspective by changing your thought patterns. We will find and try to change automatic thoughts that occur when you face challenges that present doubt and uncertainty. We will look for the irrational or exaggerated negative thinking that can underlie depression and anxiety. I also offer specific types of CBT, such as [Rational Emotive Behavior Therapy](https://dralanjacobson.com/rational-emotive-behavior-therapy-rebt/), [CBT for depression](https://dralanjacobson.com/cbt-for-depression/) and [CBTI for sleep problems](https://dralanjacobson.com/cbti-for-sleep-difficulties/).

[Learn more about CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/)

### Narrative Approaches

Narrative therapy is an approach that focuses on the stories or “narratives” people construct about their lives. I use narrative methods in my work with individuals, couples, and families. This treatment is based on the idea that people’s identities are shaped by the stories they tell themselves. Narrative methods aim to help reframe and reauthor these stories to strengthen and empower them. This is one of the different types of therapy that mixes well with others.

[Learn more about Narrative Therapy](https://dralanjacobson.com/narrative-therapy/)

### Psychodynamic

 Psychodynamic approaches emphasize the importance of the unconscious mind and the influence of early life experiences on an individual’s psychological functioning. This is one of the different types of therapy that works well for those who want to gain insight into their unconscious processes and how they impact thoughts and behaviors. It can uncover repressed emotions, unresolved conflicts, and deep-seated motivations contributing to current issues.

[Learn more about Psychodynamic Therapy](https://dralanjacobson.com/psychodynamic-therapy/)

### Solution-Focused

Solution-focused types of psychotherapy start with creating clear short—and longer-term goals and uses techniques designed to help you stick closely to a plan to address them. We look for meaningful and measurable results that you feel are bringing you closer to reaching your goals and contentment, and as you do reach them, we’ll set new ones. Solution-focused approaches are entirely future-oriented, designed to bring out your existing strengths.

Learn more about Solution-Focused Therapy

### Gestalt Methods

Gestalt methods emphasize the present moment and your subjective inner experience. It is centered around the idea that you should strive to understand yourself and your experiences as a whole, integrated entity rather than a collection of separate parts. This is one of the different types of psychotherapy that is a great approach for those primarily seeking personal growth, improved relationships, self-acceptance, and to be ready to make meaningful changes.

[Learn more about Gestalt Therapy](https://dralanjacobson.com/gestalt-therapy/)

## Other Types of Psychotherapy I use

### [Schema Psychology](https://dralanjacobson.com/schema-therapy/)

Schema methods are one of the types of psychotherapy that integrates elements of cognitive-behavioral therapy (CBT), psychoanalytic therapy, attachment theory, and emotion-focused therapies. I commonly use this approach for those who have not responded well to traditional forms of therapy. Schema therapy focuses on identifying and changing deeply entrenched patterns or themes in thinking, feeling, and behavior, known as “schemas.”

### Interpersonal (IPT)

Interpersonal Therapy (IPT) is a time-limited, evidence-based form of treatment that focuses on improving interpersonal relationships and communication patterns to help alleviate psychological symptoms, particularly those associated with mood disorders such as depression. I use IPT to help people address specific problem areas in relationships that are contributing to challenges and barriers.

### Existential and Logotherapy

Existential types of psychotherapy and logotherapy are both approaches that emphasize the search for meaning and the human condition. They provide valuable frameworks for helping individuals navigate the complexities of human existence and find purpose in their lives. I use this approach when people have a general sense of malaise despite many aspects of their life going well. This is one of the [best types of therapy for anxiety](https://dralanjacobson.com/best-types-of-therapy-for-anxiety/).

### Emotionally Focused (EFT)

[Emotionally Focused Therapy](https://dralanjacobson.com/emotionally-focused-individual-therapy/) (EFT) is a structured, short-term form of treatment that focuses on adult relationships and attachment/bonding. EFT is grounded in attachment theory and aims to create [stronger, healthier emotional bonds](https://dralanjacobson.com/couples-therapy/) between partners or family members. I use EFT with couples and families where the children are adults.

### Acceptance and Commitment (ACT)

Acceptance and Commitment Therapy (ACT) is another of the types of psychotherapy that integrates two other approaches. It combines mindfulness skills with the practice of self-acceptance. ACT is part of the [third wave](https://dralanjacobson.com/third-wave-psychotherapy/) of cognitive-behavioral therapies and focuses on helping individuals live meaningful lives while accepting the inevitable pain that comes with them. I use ACT with people who have challenges that may persist.

### Other Third-Wave Psychotherapies

- [Family of origin therapy](https://dralanjacobson.com/family-of-origin-therapy/) explores how early relationships shape emotions, relationships, and sense of self in adulthood which is key to healing past trauma, building confidence. breaking generational patterns, and developing healthier relationship styles.
- [Motivational interviewing](https://dralanjacobson.com/motivational-interviewing/) helps when people are having difficulty finding the inner strength, energy, or motivation to change.
- [Somatic Therapy](https://dralanjacobson.com/somatic-therapy/) integrates all of the types of therapy on this page with the body sensations that can be a part of your symptoms, and your solutions.

### Adlerian Therapy

- Adlerian Therapy is a powerful, robust, and effective approach that uncover the unique “life style” each individual has developed, including the engrained beliefs and thought patterns that guide their choices. Then they work to rewrite their own story to develop greater contentment and feelings of purpose.

## Specialty Types of Therapy

In addition to the more general services, I offer some [specialty intensive services](https://dralanjacobson.com/intensive-therapy-and-specialty-services/). These types of psychotherapy services offer 24/7 support and other advantages.

#### College Admissions

The [college admissions](https://dralanjacobson.com/college-admissions-counseling/) process is stressful and difficult, but it also offers opportunities for growth and learning. I help with most aspects of the process in a way that taps into strengths to improve admission chances. This virtual service is quite flexible.

[More about College Admissions](https://dralanjacobson.com/college-admissions-counseling/)

#### Executive Coaching

With my background in both business and psychology, I enjoy providing positive, focused, and effective executive leadership coaching to current and emerging leaders, both as individuals and in groups. This service can be [provided in person or virtually](https://dralanjacobson.com/virtual-therapy-guide/)

More about Executive Coaching

#### Fear of Flying

Many people fear flying; for some, this fear affects their ability to travel for important family and work responsibilities. For others who do fly, the anxiety is bothersome both before and after the flight. Many different types of therapy can help.

[More about Fear of Flying Services](https://dralanjacobson.com/fear-of-flying-therapy/)

#### Sports Psychology

I help high school, college, and professional athletes achieve peak performance and flow.” Sports Psychology is actually several different types of therapy that provide a powerful and effective way to help you reach true potential on and off the field of play.

[More about Sports Psychology](https://dralanjacobson.com/sports-psychology/)

#### Fear of Public Speaking

Treatment can help you feel more confident, reduce the stress that precedes times you need to speak in front of others, and reduce anxiety during the event. It can also reduce the anxiety beforehand. These methods are powerful and many find success.

[More about Public Speaking](https://dralanjacobson.com/public-speaking-anxiety/)

#### Psychological Testing

I provide psychological testing to help you know whether you have a certain diagnosis, understand yourself better, develop new coping strategies, and learn how to capitalize on your strengths. Testing can pair with many different types of therapy.

[More about Psychological Testing](https://www.psychologicalassessments.com/)

## Do You Need Treatment?

A common question people ask is, “Do I need therapy?” or “[Can therapy help me](https://dralanjacobson.com/does-therapy-help-what-form-of-therapy-works-best/)?” People often wonder if they need treatment even though they are successful in many areas of their lives or if they are unsure whether what they are going through is just a phase. People often ask themselves if they need [couples or family counseling](https://dralanjacobson.com/family-therapy/) even though they feel they should be able to work things out on their own or even though there are still good times in their relationships.

I suggest that “benefit from” is more accurate than “need” regarding individual, couples, or family treatment. Defining whether someone “needs” a psychologist is difficult but knowing who would benefit from psychotherapy is easy.

### Why Pursue Any of These Types of Therapy?

Therapy, whether individual, couples, or family counseling, is designed to help you reach your potential and improve your mood and outlook. Thus, almost anyone can benefit from therapy. The question is more about degrees. Suppose you feel that something is hampering your ability to achieve in school or at work fully, or your family or social life is not providing the inherent benefits that it should, or as a couple or family, you are finding that conflict is increasing in frequency or intensity. In that case, therapy may be vital.

Many people also benefit when they generally feel “okay” but have a mild but lingering sense of malaise or existential stress. Others seek self-discovery that might deepen their relationships, increase feelings of meaningfulness, or discover new strength and resilience. Therapy can be life-changing in these instances, even if not urgent.

### What Types of Therapy Will Work Best

When we meet, we will discuss the different types of psychotherapy that might best help you alleviate symptoms and reach your goals. My integrative practice means that I can choose from many proven, effective, and powerful methods, and we can work together to create the most powerful approach for you. I choose among the types of therapy listed above and others, and I continually look to stay up-to-date regarding the latest practice innovations in clinical psychology.

Your results should be obvious, measurable, and clear, and as therapy progresses we will work together to make sure that this is true and remains that way.

In my blog I also cover [how long psychotherapy takes ](https://dralanjacobson.com/how-long-does-therapy-take/)to see meaningful results, [how to choose the right therapist for you](https://dralanjacobson.com/how-to-choose-the-right-therapist/), what [talking to a therapist](https://dralanjacobson.com/talking-to-a-therapist/) is like, and what are the [therapist terms](https://dralanjacobson.com/what-is-a-therapy-appointment-like-go-to-therapy-feeling-confident-and-know-common-therapist-terms/) you should know.

 ## Contact Me About the Types of Therapy I Use or any Foresight services

Thank you for visiting, and I hope you might decide to call. In your initial call, I can answer any questions you have about the [types of therapy](https://dralanjacobson.com/) I provide, and then our first meeting can help you decide whether my approach is a good fit for you. With therapy, there is never any obligation to continue after that initial visit. Even if everything you read here suggests that I may be a good fit for what you are looking for, you should still use that first session to assess that in person. We can also talk about other The Foresight Psychological Institute services such as Therapeutic Tutoring, Psychological Testing, and Executive and Leadership Coaching.

(617)\_680-5488

**Addresses:**

In person: Westwood, MA & Lee, NH

Virtual: Serving 40 states

 [ ![social network 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](https://www.facebook.com/appliedpsychologicalscience) [ ![social network 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](https://www.instagram.com/appliedpsychological) [ ![social network 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---

### [Which Type of Therapy Is Right for You? A Practical Guide](https://dralanjacobson.com/which-type-of-therapy-is-right-for-you-a-practical-guide/)

**Published:** May 30, 2026
**Author:** Dr. Alan Jacobson

**Content:**

One of the most common questions people ask before starting therapy is: **which type of therapy is actually right for me?** It’s a great question — and the honest answer is that it depends on what you’re dealing with, how you tend to think and process, and what kind of results you’re hoping for.

As an integrative psychologist, I draw from many evidence-based approaches and combine them in ways that fit each individual. But understanding the options can help you feel more confident walking in — or reaching out. Below is a practical guide to the approaches I use most, organized by what they’re best suited for.

**Not sure where to start?** [Schedule a free consultation](https://www.picktime.com/scheduleaconsult) and we’ll figure it out together.

---

## **Quick Navigation**

- [If you’re dealing with anxiety, OCD, or fears](https://www.claudeusercontent.com/?domain=claude.ai&parentOrigin=https%3A%2F%2Fclaude.ai&errorReportingMode=parent&formattedSpreadsheets=true#anxiety)
- [If you’re dealing with depression or low mood](https://www.claudeusercontent.com/?domain=claude.ai&parentOrigin=https%3A%2F%2Fclaude.ai&errorReportingMode=parent&formattedSpreadsheets=true#depression)
- [If you’re searching for meaning or feeling stuck](https://www.claudeusercontent.com/?domain=claude.ai&parentOrigin=https%3A%2F%2Fclaude.ai&errorReportingMode=parent&formattedSpreadsheets=true#meaning)
- [If you’re struggling with relationships or family](https://www.claudeusercontent.com/?domain=claude.ai&parentOrigin=https%3A%2F%2Fclaude.ai&errorReportingMode=parent&formattedSpreadsheets=true#relationships)
- [If you’ve experienced trauma or childhood wounds](https://www.claudeusercontent.com/?domain=claude.ai&parentOrigin=https%3A%2F%2Fclaude.ai&errorReportingMode=parent&formattedSpreadsheets=true#trauma)
- [If you have ADHD or executive functioning challenges](https://www.claudeusercontent.com/?domain=claude.ai&parentOrigin=https%3A%2F%2Fclaude.ai&errorReportingMode=parent&formattedSpreadsheets=true#adhd)
- [If you’re struggling with sleep](https://www.claudeusercontent.com/?domain=claude.ai&parentOrigin=https%3A%2F%2Fclaude.ai&errorReportingMode=parent&formattedSpreadsheets=true#sleep)
- [If you want to improve performance or reach goals](https://www.claudeusercontent.com/?domain=claude.ai&parentOrigin=https%3A%2F%2Fclaude.ai&errorReportingMode=parent&formattedSpreadsheets=true#performance)
- [If you want deeper self-understanding](https://www.claudeusercontent.com/?domain=claude.ai&parentOrigin=https%3A%2F%2Fclaude.ai&errorReportingMode=parent&formattedSpreadsheets=true#self-understanding)
- [Overview: all approaches at a glance](https://www.claudeusercontent.com/?domain=claude.ai&parentOrigin=https%3A%2F%2Fclaude.ai&errorReportingMode=parent&formattedSpreadsheets=true#overview)

---

## **Dealing with Anxiety, OCD, Phobias, or Specific Fears**

Anxiety is one of the most treatable conditions in therapy — but the right approach matters. These are the methods with the strongest track record:

### [**Cognitive-Behavioral Therapy (CBT)**](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/)

The gold standard for anxiety, CBT works by identifying and changing the distorted thought patterns that fuel worry, avoidance, and panic. It’s structured, practical, and typically produces results faster than most other approaches. If you want a clear framework and measurable progress, CBT is often the right starting point.

**Best for:** Generalized anxiety, panic disorder, social anxiety, health anxiety, phobias, OCD

### [**ERP: Exposure and Response Prevention**](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy-for-anxiety/)

ERP is a specialized form of CBT considered the most effective treatment for OCD and many anxiety disorders. It works by gradually and safely exposing you to feared situations while resisting the urge to respond with avoidance or compulsion. The result is a reduction in the anxiety response itself, not just the ability to cope with it.

**Best for:** OCD, specific phobias, social anxiety, panic

### [**Exposure Therapy**](https://dralanjacobson.com/exposure-therapy-for-anxiety/)

A core component of both CBT and ERP, exposure therapy systematically reduces fear by helping you face avoided situations in a controlled, supported way. It’s the basis of my [fear of flying](https://dralanjacobson.com/fear-of-flying-therapy/) and [public speaking anxiety](https://dralanjacobson.com/public-speaking-anxiety/) programs.

**Best for:** Phobias, fear of flying, fear of public speaking, social anxiety

### [**ACT: Acceptance and Commitment Therapy**](https://dralanjacobson.com/act-acceptance-and-commitment-therapy/)

ACT takes a different angle than traditional CBT. Rather than trying to eliminate anxious thoughts, ACT teaches you to hold them differently — to observe them without being controlled by them — while moving toward what matters most to you. Many people find this approach more freeing than trying to fight their anxiety directly.

**Best for:** Anxiety, worry, avoidance, people who feel stuck in their own heads

### [**Mindfulness-Based Cognitive Therapy (MBCT)**](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/)

MBCT combines mindfulness practices with CBT techniques to interrupt the ruminative thinking cycles that drive anxiety and depression. It’s particularly effective for people who have experienced repeated episodes or whose anxiety involves a lot of mental “spinning.”

**Best for:** Anxiety with rumination, recurrent depression, stress-driven worry

[**→ Talk to me about anxiety treatment options**](https://www.picktime.com/scheduleaconsult)

---

## **Dealing with Depression or Low Mood**

### [**CBT for Depression**](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/)

CBT is among the most well-researched treatments for depression, targeting the negative automatic thoughts and behavioral patterns that maintain low mood. It’s active, skill-building, and gives you tools you keep long after therapy ends.

**Best for:** Mild to moderate depression, negative thinking patterns, low self-worth

### [**Behavioral Activation**](https://dralanjacobson.com/behavioral-activation-for-improved-mood-and-meaningfulness/)

When depression leads to withdrawal and inactivity — which then makes depression worse — behavioral activation breaks the cycle by gradually reintroducing meaningful, rewarding activity. It’s deceptively simple and remarkably effective.

**Best for:** Depression with withdrawal, low energy, loss of interest

### [**Positive Psychology**](https://dralanjacobson.com/positive-psychology-powerful-benefits/)

Rather than focusing primarily on what’s wrong, positive psychology builds on existing strengths, values, and sources of meaning. It’s not about forced optimism — it’s about shifting the balance of attention toward what’s working and what’s possible.

**Best for:** Depression, low motivation, people who feel they’ve lost themselves

### [**Schema Therapy**](https://dralanjacobson.com/schema-therapy/)

Schema therapy addresses deeply held core beliefs — often formed in childhood — that drive chronic depression, low self-esteem, and self-defeating patterns. If you’ve tried CBT and found it helpful but not quite enough, schema work may reach the deeper layer.

**Best for:** Chronic or treatment-resistant depression, deep-seated self-worth issues

### [**Treatment-Resistant Depression**](https://dralanjacobson.com/treating-major-depression/)

For people who have tried other approaches without sufficient relief, I offer more intensive and specialized treatment combining multiple modalities tailored to your specific presentation.

[**→ Talk to me about depression treatment options**](https://www.picktime.com/scheduleaconsult)

---

## **Searching for Meaning, Purpose, or Feeling Stuck at a Crossroads**

### [**Existential Therapy**](https://dralanjacobson.com/existential-therapy/)

Existential therapy confronts the big questions: What gives my life meaning? How do I live authentically? How do I face uncertainty, loss, or mortality? It’s not about symptom reduction — it’s about living more deliberately and honestly. If you feel like something is fundamentally missing even when nothing is obviously wrong, this may be what you’re looking for.

**Best for:** Existential questions, midlife transitions, grief, identity, loss of purpose

### [**Logotherapy**](https://dralanjacobson.com/logotherapy/)

Developed by Viktor Frankl, logotherapy is built on the premise that the primary human drive is the search for meaning — not pleasure or power. When people can find meaning even in suffering, they can endure almost anything. This is a profound approach for people facing serious loss, illness, or a sense that life has lost its direction.

**Best for:** Loss of meaning, grief, trauma, major life transitions, spiritual questions

### [**ACT**](https://dralanjacobson.com/act-acceptance-and-commitment-therapy/)

ACT’s focus on values-clarification makes it a natural fit for people who feel disconnected from what matters to them. It helps you identify your core values and take committed action toward them — even in the presence of fear, uncertainty, or pain.

**Best for:** Feeling stuck, values confusion, avoidance driven by fear

### [**Values Clarification Therapy**](https://dralanjacobson.com/values-clarification-therapy/)

A focused approach for people who need help identifying what truly matters to them — separate from what others expect or what they think they “should” want. A powerful tool when you’re facing major decisions or feel pulled in too many directions.

**Best for:** Career crossroads, relationship decisions, identity questions

### [**Life Transitions Therapy**](https://dralanjacobson.com/life-transitions-therapy/)

Major transitions — divorce, career change, relocation, retirement, loss — can destabilize even emotionally healthy people. This work is tailored to helping you navigate change with clarity and intentionality.

**Best for:** Major life changes, uncertainty, grief, new phases of life

[**→ Talk to me about finding meaning and direction**](https://www.picktime.com/scheduleaconsult)

---

## **Struggling with Relationships, Couples, or Family**

### [**Couples Therapy**](https://dralanjacobson.com/couples-therapy/)

A range of approaches are available for couples, depending on where you are and what you need — from communication skills to deeper emotional repair.

### [**EFT: Emotionally Focused Therapy for Couples**](https://dralanjacobson.com/eft-therapy-for-couples/)

EFT is one of the most research-supported couples therapy approaches, focusing on the emotional bonds and attachment patterns that drive conflict and disconnection. Rather than just improving communication tactics, EFT addresses the underlying emotional needs that make communication break down in the first place.

**Best for:** Couples with emotional distance, recurring conflicts, attachment injuries

### [**Relational Life Therapy (RLT)**](https://dralanjacobson.com/relational-life-therapy-rlt/)

RLT is a direct, challenging approach developed by Terry Real that addresses the relational patterns — often rooted in family of origin — that damage partnerships. It’s honest, sometimes confrontational, and often transformative for couples where one or both partners carry grandiosity or one-up/one-down dynamics.

**Best for:** Couples with entrenched patterns, narcissistic dynamics, power imbalances

### [**Family Therapy**](https://dralanjacobson.com/family-therapy/)

When the issue involves the family system rather than any one individual, family therapy addresses patterns, roles, and communication across the whole unit.

### [**Family Estrangement Therapy**](https://dralanjacobson.com/family-estrangement-therapy/)

For families dealing with estrangement — whether you are the parent, sibling, or adult child — this work addresses the grief, anger, and complexity of broken family bonds, with or without reconciliation as the goal.

**Best for:** Estrangement, difficult parent relationships, sibling conflict

### [**Family of Origin Therapy**](https://dralanjacobson.com/family-of-origin-therapy/)

Much of who we are in relationships was shaped before we knew it was happening. Family of origin work explores how your early family experiences created the patterns showing up in your adult relationships today.

**Best for:** Repeating relationship patterns, adult children of difficult parents, self-understanding

### [**Internal Family Systems (IFS)**](https://dralanjacobson.com/internal-family-systems-therapy-ifs/)

IFS is a powerful model that views the mind as made up of different “parts” — inner critics, protectors, exiles — each with its own perspective and role. Healing comes from the Self learning to lead and care for those parts rather than being driven by them. This is a deeply compassionate approach, particularly for people who feel conflicted within themselves.

**Best for:** Inner conflict, self-criticism, complex trauma, parts that “take over”

[**→ Talk to me about relationship or family therapy**](https://www.picktime.com/scheduleaconsult)

---

## **Trauma, Childhood Wounds, or Deep Emotional Pain**

### [**Psychotherapy for Childhood Trauma**](https://dralanjacobson.com/psychotherapy-for-childhood-trauma/)

Childhood experiences — even ones that weren’t dramatic — can leave lasting imprints on how we think, feel, and relate. This work addresses those roots with care and precision.

### [**Trauma-Informed Care**](https://dralanjacobson.com/trauma-informed-care/)

All of my work is conducted through a trauma-informed lens — meaning I understand how trauma affects the body, mind, and behavior, and I create a safe environment that doesn’t inadvertently re-traumatize.

### [**Schema Therapy**](https://dralanjacobson.com/schema-therapy/)

For trauma that has become embedded in core beliefs — “I am unlovable,” “The world is dangerous,” “I must be perfect to be accepted” — schema therapy reaches the level where those beliefs live and reworks them.

**Best for:** Complex trauma, CPTSD, chronic self-defeating patterns rooted in childhood

### [**Psychodynamic Therapy**](https://dralanjacobson.com/psychodynamic-therapy/)

Psychodynamic therapy explores how unconscious processes, early relationships, and past experiences shape current feelings and behavior. It tends to be a longer, deeper process — appropriate for people who want to truly understand themselves, not just feel better in the short term.

**Best for:** Complex history, self-understanding, recurring patterns, depression with unclear causes

### [**Somatic Therapy**](https://dralanjacobson.com/somatic-therapy-exercises-and-somatic-experiencing-techniques/)

Trauma lives in the body as much as in the mind. Somatic approaches work with physical sensations, breath, and body awareness to process and release what talking alone sometimes cannot reach.

**Best for:** Trauma held in the body, anxiety with physical symptoms, people who feel disconnected from their bodies

[**→ Talk to me about trauma-focused therapy**](https://www.picktime.com/scheduleaconsult)

---

## **ADHD and Executive Functioning Challenges**

### [**ADHD Therapy for Adults**](https://dralanjacobson.com/adhd-therapy-for-adults/)

ADHD in adults often looks different than the hyperactive child stereotype — it shows up as chronic disorganization, emotional dysregulation, difficulty finishing projects, and a persistent gap between potential and performance. Therapy addresses the emotional and psychological dimensions of ADHD that medication alone doesn’t touch.

**Best for:** Adults with diagnosed or suspected ADHD, emotional dysregulation, executive dysfunction

### [**CBT for ADHD**](https://dralanjacobson.com/cbt-for-adhd-in-adolescents-and-adults/)

CBT adapted for ADHD targets the specific cognitive and behavioral patterns that make ADHD management difficult — procrastination, avoidance, impulsivity, and negative self-talk. It’s skills-based and practical.

**Best for:** ADHD with anxiety or depression, adolescents and adults who want concrete strategies

### [**Executive Functioning Coaching**](https://dralanjacobson.com/executive-functioning-coaching/)

For people whose main challenge is organization, time management, task initiation, and follow-through — coaching focused on executive skills can be more targeted and faster-acting than traditional therapy.

**Best for:** ADHD, students, professionals with performance challenges

### [**ADHD Coaching for College Students**](https://dralanjacobson.com/adhd-coaching-for-college-students/)

College is where unmanaged ADHD often causes the most damage — the structure of high school disappears and self-management suddenly matters enormously. This specialized coaching addresses the unique academic and social challenges of college with ADHD.

**Best for:** College students with ADHD, struggling academically or socially

### [**ADHD in Women**](https://dralanjacobson.com/women-with-adhd/)

ADHD in women is frequently missed or misdiagnosed because it tends to present differently — more internalizing, more anxiety, more masking. If you’ve spent years feeling like you’re not living up to your potential without understanding why, this may be worth exploring.

**Best for:** Women with suspected or diagnosed ADHD, late diagnosis, anxiety with ADHD features

[**→ Talk to me about ADHD and executive functioning**](https://www.picktime.com/scheduleaconsult)

---

## **Struggling with Sleep or Insomnia**

### [**CBT-I: Cognitive Behavioral Therapy for Insomnia**](https://dralanjacobson.com/cbti-for-sleep-difficulties/)

CBT-I is the first-line recommended treatment for chronic insomnia — recommended over sleep medication by the American College of Physicians. It addresses the thoughts, behaviors, and habits that perpetuate poor sleep, and produces lasting results that medication typically cannot. If you’ve been relying on sleep aids or simply suffering through poor sleep, CBT-I is worth knowing about.

**Best for:** Chronic insomnia, difficulty falling or staying asleep, early waking, sleep anxiety

**Timeline:** Often produces significant improvement in 6–8 sessions

[**→ Talk to me about CBT-I for sleep**](https://www.picktime.com/scheduleaconsult)

---

## **Improving Performance or Reaching Goals**

### [**Sports Psychology**](https://dralanjacobson.com/sports-psychology/)

For athletes dealing with performance anxiety, slumps, injury recovery, or the mental side of competition. I use evidence-based performance psychology methods including HRV biofeedback, visualization, and focus training.

**Best for:** Competitive athletes, performance blocks, pre-competition anxiety

### [**Executive Functioning Coaching**](https://dralanjacobson.com/executive-functioning-coaching/)

For professionals and executives who want to sharpen focus, decision-making, and performance under pressure — without the clinical framework of traditional therapy.

### [**Fear of Flying Program**](https://dralanjacobson.com/fear-of-flying-therapy/)

A structured, intensive program with a strong track record. Many clients resolve their fear of flying in a focused short-term engagement rather than open-ended weekly therapy.

### [**Public Speaking Anxiety Program**](https://dralanjacobson.com/public-speaking-anxiety/)

Structured therapy and group options for people whose fear of public speaking is limiting their career or professional presence.

[**→ Talk to me about performance-focused work**](https://www.picktime.com/scheduleaconsult)

---

## **Wanting Deeper Self-Understanding**

### [**Psychodynamic Therapy**](https://dralanjacobson.com/psychodynamic-therapy/)

For people who aren’t in crisis but want to understand why they are the way they are — why they keep repeating certain patterns, making certain choices, or feeling certain ways without understanding why. This is deeper, longer-term work for people who want insight, not just relief.

### [**Narrative Therapy**](https://dralanjacobson.com/narrative-therapy/)

Narrative therapy examines the stories we tell about ourselves — and asks whether those stories are accurate, helpful, or inherited from others. Reauthoring your story can be a profound form of self-understanding and change.

**Best for:** Identity questions, self-concept, people shaped by difficult family narratives

### [**Gestalt Therapy**](https://dralanjacobson.com/gestalt-therapy/)

Gestalt therapy emphasizes present-moment awareness and the integration of thought, feeling, and behavior. It’s experiential — meaning it goes beyond talking about emotions to actually experiencing and processing them in session. People often find it more alive and immediate than purely talk-based approaches.

**Best for:** People who feel disconnected from their emotions, unfinished business, self-awareness

### [**Internal Family Systems (IFS)**](https://dralanjacobson.com/internal-family-systems-therapy-ifs/)

IFS provides a remarkably detailed map of the inner world. For people who want to understand their own complexity — why part of them wants one thing while another part resists — IFS offers both insight and a clear path to inner harmony.

### [**Humanistic Therapy**](https://dralanjacobson.com/humanistic-therapy/)

The foundation beneath most of my work. Humanistic therapy believes in your inherent capacity for growth, self-direction, and meaning-making. It’s the orientation that shapes how I approach every client regardless of which specific techniques we use.

[**→ Talk to me about insight-oriented therapy**](https://www.picktime.com/scheduleaconsult)

---

## **All Approaches: At a Glance**

**Approach****Best For****Style**[CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/)Anxiety, depression, OCD, phobiasStructured, practical, skill-building[ACT](https://dralanjacobson.com/act-acceptance-and-commitment-therapy/)Anxiety, avoidance, feeling stuck, valuesMindfulness-based, flexible[CBT-I](https://dralanjacobson.com/cbti-for-sleep-difficulties/)Insomnia, sleep difficultiesStructured, time-limited[ERP](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy-for-anxiety/)OCD, phobias, panicActive, exposure-based[Exposure Therapy](https://dralanjacobson.com/exposure-therapy-for-anxiety/)Phobias, fear of flying, public speakingGradual, structured[Psychodynamic](https://dralanjacobson.com/psychodynamic-therapy/)Self-understanding, recurring patterns, complex historyExploratory, insight-oriented[Schema Therapy](https://dralanjacobson.com/schema-therapy/)Deep-seated beliefs, chronic depression, traumaIntegrative, deep[IFS](https://dralanjacobson.com/internal-family-systems-therapy-ifs/)Inner conflict, self-criticism, complex traumaParts-based, compassionate[EFT (Couples)](https://dralanjacobson.com/eft-therapy-for-couples/)Couples disconnection, attachment injuriesEmotion-focused, relational[Relational Life Therapy](https://dralanjacobson.com/relational-life-therapy-rlt/)Entrenched couple patterns, power dynamicsDirect, challenging[Existential Therapy](https://dralanjacobson.com/existential-therapy/)Meaning, identity, transitions, mortalityPhilosophical, honest[Logotherapy](https://dralanjacobson.com/logotherapy/)Loss of meaning, grief, sufferingMeaning-centered, hopeful[Narrative Therapy](https://dralanjacobson.com/narrative-therapy/)Identity, self-story, family narrativesCollaborative, reauthoring[Gestalt Therapy](https://dralanjacobson.com/gestalt-therapy/)Present awareness, emotional disconnectionExperiential, immediate[Humanistic Therapy](https://dralanjacobson.com/humanistic-therapy/)Growth, self-direction, meaningWarm, strengths-based[Positive Psychology](https://dralanjacobson.com/positive-psychology-powerful-benefits/)Depression, low motivation, blocked potentialStrengths-focused, future-oriented[MBCT](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/)Anxiety with rumination, recurrent depressionMindfulness, structured[Somatic Therapy](https://dralanjacobson.com/somatic-therapy-exercises-and-somatic-experiencing-techniques/)Trauma held in the body, anxietyBody-based, experiential[Behavioral Activation](https://dralanjacobson.com/behavioral-activation-for-improved-mood-and-meaningfulness/)Depression with withdrawalAction-oriented, practical[ADHD Therapy](https://dralanjacobson.com/adhd-therapy-for-adults/)Adult ADHD, emotional dysregulationSkills-based, supportive[Executive Functioning Coaching](https://dralanjacobson.com/executive-functioning-coaching/)ADHD, organization, performanceCoaching-oriented, practical[Values Clarification](https://dralanjacobson.com/values-clarification-therapy/)Decisions, direction, identityFocused, exploratory---

## **How I Actually Use These Approaches**

Reading this list might make therapy sound more compartmentalized than it really is. In practice, I rarely use just one approach. My training is integrative — meaning I draw from multiple methods in a single session, combining them in ways that fit you specifically.

Someone dealing with anxiety, for example, might benefit from CBT techniques to challenge distorted thinking, ACT to relate differently to intrusive thoughts, mindfulness to calm the nervous system, and existential work if the anxiety connects to deeper questions about their life. The approaches work together, not in isolation.

The best way to figure out what’s right for you is to talk. I offer a free consultation where we can discuss what you’re dealing with and what approaches are likely to help.

[**Schedule a Free Consultation →**](https://www.picktime.com/scheduleaconsult)

There’s no obligation and no pressure — just a conversation about whether we’re a good fit.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.instagram.com/appliedpsychological) [ ![social network 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](https://www.linkedin.com/company/psychologicalscience/)

---

### [Therapy and Psychological Testing Services by Location](https://dralanjacobson.com/locations/)

**Published:** January 12, 2026
**Author:** Dr. Alan Jacobson

**Content:**

### Serving Most States Virtually

Services are provided in accordance with state licensure and PSYPACT regulations, based on your physical location at the time of care. Services are offered in accordance with the laws governing the client’s location at the time of care. I would be happy to provide more information about telehealth guidelines in your state. I offer telehealth services in all the states in blue below

![](https://dralanjacobson.com/wp-content/uploads/2024/11/PsyPACT-map-300x220.png "PsyPACT map | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

#### Not Seeing Your State?

Even if your state is not listed, you may still be eligible for services based on licensure and telehealth regulations. You’re encouraged to request a consultation to review available options.

---

### Serving California, New York, Massachusetts, and New Hampshire — Virtual and In-Person

Dr. Alan Jacobson, Psy.D., MBA, is a licensed clinical psychologist providing psychological testing, individual therapy, couples therapy, and specialty services to clients across four states. With more than 20 years of clinical experience, Dr. Jacobson brings deep familiarity with each state’s educational systems, professional licensing environments, insurance landscape, and cultural context — not just a general telehealth platform that happens to serve multiple states.

Services are delivered **virtually via HIPAA-compliant telehealth** across all four states, with **in-person services available in San Diego, CA and greater Boston, MA**. All telehealth services are provided in accordance with [PSYPACT regulations](https://psypact.org/mpage/psypactprocess) and each state’s licensure requirements, based on the client’s physical location at the time of care.

---

## California

### Psychological Testing and Teletherapy for CA Residents

California is home to one of the most complex and competitive academic and professional environments in the country — and one of the highest concentrations of underdiagnosed ADHD, particularly among high-achieving adults, women, and college students. Dr. Jacobson provides comprehensive [ADHD evaluations](https://psychologicalassessments.com/locations/california/), learning disability assessments, twice exceptional (2e) evaluations, and accommodations documentation for California schools, UC and CSU universities, the California State Bar, and major testing organizations including LSAC and [AAMC](https://students-residents.aamc.org/taking-mcat-exam/mcat-accommodations).

**Therapy services** include individual therapy for anxiety, depression, ADHD, life transitions, burnout, and performance-related stress, as well as therapy for college students at UC, CSU, and private California universities, couples therapy, sports psychology, and executive coaching.

**California cities served (virtual):** Los Angeles, San Diego (also in-person), San Francisco, Sacramento, Oakland, San Jose, Orange County, Riverside, Fresno, Santa Barbara, Berkeley, Palo Alto, and all other California communities.

[View full California services →](https://dralanjacobson.com/therapy-in-california/)

---

## New York

### Psychological Testing and Teletherapy for NY Residents

New York — and New York City in particular — has one of the most diverse and dense mental health ecosystems in the world, yet demand for doctoral-level psychological testing and specialty therapy consistently outpaces supply. Dr. Jacobson provides comprehensive ADHD evaluations, twice exceptional assessments, learning disability evaluations, and accommodations documentation for New York schools, CUNY and SUNY campuses, private universities, the New York Bar Exam (UBE), LSAC, and AAMC.

**Therapy services** for New York residents include individual therapy for anxiety, depression, ADHD, trauma, and life transitions; therapy for college students at NYU, Columbia, Fordham, and other New York universities; couples therapy using EFT and Gottman-informed approaches; sports psychology; fear of flying therapy; and public speaking anxiety treatment. Dr. Jacobson also offers group therapy programs open to New York residents statewide.

New York City’s density, long commutes, and high-pressure professional culture create a distinct set of stressors. Telehealth makes high-quality doctoral-level care accessible across all five boroughs and throughout the state without the friction of in-office visits.

**New York areas served (virtual):** Manhattan, Brooklyn, Queens, The Bronx, Staten Island, Long Island, Westchester, Buffalo, Albany, Rochester, Syracuse, and all other New York communities.

[View full New York services →](https://dralanjacobson.com/location/new-york/)

---

## Massachusetts

### Psychological Testing and Teletherapy for MA Residents | In-Person Greater Boston

Massachusetts has one of the most sophisticated — and regulated — mental health environments in the country, shaped by world-class medical institutions, elite universities, and complex insurance and licensure standards. Dr. Jacobson provides psychological testing and therapy to Massachusetts residents both virtually and **in-person in the greater Boston area**.

**Psychological testing** includes comprehensive ADHD evaluations, twice exceptional assessments, learning disability evaluations, and accommodations documentation for Massachusetts K–12 schools, the Massachusetts public university system, Harvard, MIT, Boston University, Boston College, and other private institutions.

**Therapy services** for Massachusetts residents include individual therapy for anxiety, depression, ADHD, burnout, trauma, and life transitions; therapy for college students; couples therapy; sports psychology; fear of flying therapy; public speaking anxiety; and executive coaching. Dr. Jacobson understands the particular pressures of Massachusetts’s academic and professional culture — the high-achievement expectations common in Greater Boston, the academic intensity of the Route 128 corridor, and the specific documentation standards of Massachusetts institutions.

**Massachusetts areas served:** Boston, Cambridge, Newton, Brookline, Somerville, Lexington, Concord, Worcester, Springfield, and all Massachusetts communities via telehealth.

[View full Massachusetts services →](https://dralanjacobson.com/therapy-in-massachusetts/)

---

## New Hampshire

### Teletherapy for NH Residents

New Hampshire residents have access to Dr. Jacobson’s full range of online therapy and psychological testing services. New Hampshire’s mental health provider shortage — particularly for doctoral-level psychologists — makes telehealth an especially important access point for NH residents seeking high-quality, evidence-based care without long wait times or extensive travel.

**Services available virtually to New Hampshire residents include:** individual therapy for anxiety, depression, ADHD, trauma, and life transitions; therapy for college students and adolescents; couples therapy; sports psychology; fear of flying therapy; public speaking anxiety treatment; executive coaching; and comprehensive psychological testing including ADHD evaluations, learning disability assessments, and accommodations documentation for New Hampshire schools and universities.

**New Hampshire areas served (virtual):** Manchester, Nashua, Concord, Portsmouth, Dover, Keene, and all other New Hampshire communities.

---

## Services Available Across All Four States

Regardless of which state you are in, the following services are available via telehealth:

**Psychological Testing**

- Comprehensive ADHD evaluations (school, workplace, and exam accommodations)
- Twice exceptional (2e) evaluations
- Learning disability assessments (dyslexia, dyscalculia, written expression)
- Psychoeducational evaluations

**Individual Therapy**

- Anxiety, depression, trauma, and stress
- ADHD therapy (CBT, mindfulness, holistic approaches)
- Life transitions and burnout
- Performance and academic stress
- Therapy for college students and adolescents

**Specialty Services**

- Couples therapy (EFT, Gottman-informed, CBT)
- Sports psychology
- Fear of flying therapy (individual and group)
- Public speaking anxiety (individual and group)
- Executive and leadership coaching
- College admissions counseling
- Therapeutic tutoring
- Emotional Support Animal (ESA) documentation

**Therapeutic Approaches** CBT · ACT · EFT · IFS · MBCT · MCT · Mindfulness · Interpersonal Therapy · Narrative Therapy · Positive Psychology · Schema Therapy · Motivational Interviewing · Integrative Therapy

---

## Why Telehealth Works — and Why State Familiarity Matters

In most cases, virtual telehealth services are as effective as traditional in-office care for psychological services and also enhance access, comfort, and the real-world accuracy of assessment and treatment. Clients often find that working in their natural environment improves openness, reduces performance anxiety, and enables more authentic evaluation of daily functioning. It is also helpful for saving time and travel expenses, and some people prefer the greater level of confidentiality.

Research published by the [American Psychological Association](https://www.apa.org/practice/programs/dmhi/research-information/telepsychology-effectiveness) consistently shows that telehealth is as effective as in-person therapy for anxiety, depression, ADHD, trauma, and most other concerns. Clients often report that working in their own environment improves openness, reduces performance anxiety, and allows for more authentic clinical insight.

But telehealth is only part of the picture. What separates Dr. Jacobson’s multi-state practice from a generic teletherapy platform is **state-specific expertise**. The documentation standards for a UC disability services office differ from those at a CUNY campus. The Massachusetts Bar Exam has different requirements than the California State Bar. The professional culture of Boston differs meaningfully from that of New York City or Los Angeles. These distinctions matter clinically — and Dr. Jacobson brings genuine familiarity with each state’s systems, not just a license to practice there.

---

## Frequently Asked Questions

**Q: Which states does Dr. Jacobson serve?** A: Dr. Jacobson provides therapy and psychological testing to clients in California, New York, Massachusetts, and New Hampshire via telehealth. In-person services are available in San Diego, CA and greater Boston, MA. He also holds licenses that allow telehealth services in additional states — contact the practice to confirm availability in your location.

**Q: Does Dr. Jacobson accept insurance?** A: Dr. Jacobson does not accept insurance directly. He provides a detailed superbill after each session or evaluation that you can submit for potential out-of-network reimbursement. Many PPO plan holders in California, New York, and Massachusetts receive partial reimbursement. Call your insurer in advance to ask about out-of-network psychological testing and therapy benefits.

**Q: Is telehealth therapy as effective as in-person therapy?** A: Yes. Research consistently shows telehealth is as effective as in-person care for anxiety, depression, ADHD, trauma, and most other concerns. Dr. Jacobson uses a fully encrypted, HIPAA-compliant video platform. Many clients find working from their own environment reduces anxiety and improves the authenticity of the clinical work.

**Q: Can I receive both therapy and psychological testing from the same provider?** A: Yes. Dr. Jacobson’s integrated practice offers both comprehensive psychological evaluations and ongoing therapy. Having one clinician who understands your test results and your day-to-day functioning produces better clinical insight and more coherent treatment — particularly for clients with ADHD, anxiety, or learning differences.

**Q: Can therapy continue when I travel between states?** A: Telehealth is governed by where you are physically located during the session. If you are in a state where Dr. Jacobson is licensed, sessions can continue. If you travel to a state outside his licensure, sessions may need to pause. This is especially relevant for college students who split time between states — Dr. Jacobson discusses this at intake with all relevant clients.

**Q: Does Dr. Jacobson provide psychological testing for school or exam accommodations?** A: Yes. Comprehensive evaluations include the documentation required for K–12 504 Plans and IEPs, university disability services offices, the LSAT, MCAT, GRE, SAT, ACT, bar exams, and ADA workplace accommodation requests. Reports are specifically formatted to meet each organization’s documentation standards.

**Q: How long does it take to get an appointment?** A: Free 30-minute consultations are typically available within one to two weeks. Wait times for evaluations and ongoing therapy vary by service type and scheduling availability. Contact the practice or schedule online for current availability.

**Q: What is the difference between a psychologist and other therapists?** A: Psychologists hold doctoral degrees (PhD or PsyD) and have the most advanced training in both psychotherapy and psychological assessment. Only psychologists are qualified to administer and interpret the comprehensive cognitive testing required for ADHD, learning disability, and accommodations evaluations. Other licensed therapists — LCSWs, LMFTs, LPCCs — provide excellent therapy but cannot conduct full psychological testing batteries.

**Q: Does Dr. Jacobson provide ADHD therapy in addition to ADHD testing?** A: Yes. Dr. Jacobson provides both comprehensive ADHD evaluations for diagnosis and accommodations documentation, and ongoing ADHD therapy using CBT, mindfulness, and holistic approaches. Many clients begin with an evaluation, then continue with therapy to build practical management skills.

**Q: What should I expect in a free consultation?** A: The free 30-minute consultation is a no-obligation conversation where Dr. Jacobson learns about your concerns and goals, explains what the evaluation or therapy process will involve, and helps you determine whether this practice is the right fit. There is no commitment required after the consultation.

---

## Schedule a Free Consultation

**Call:** (617) 680-5488 **Email:**  **Schedule online:** [Book a free consultation](https://www.picktime.com/scheduleaconsult)

*Virtual services available in CA, NY, MA, and NH · In-person in San Diego and greater Boston · PSYPACT licensed · HIPAA-compliant telehealth*

### State-Specific Therapy Services

I provide both in-person and telehealth services across three states, allowing clients to benefit from not only flexible access to care but also from my in-depth familiarity with each state’s professional regulations, educational systems, and licensing environments. These are regions where I maintain stronger professional networks, deeper insight into local referral pathways, and a more nuanced understanding of the academic, occupational, and cultural factors that shape performance and well-being.

**California**
Psychological Testing & Teletherapy for CA Residents
[View California Therapy Services](https://dralanjacobson.com/therapy-in-california/)

**New York**
Psychological Testing & Teletherapy for NY Residents
[View New York Therapy Services](https://www.dralanjacobson.com/locations/new-york)

**Massachusetts**
Psychological Testing & Teletherapy for MA Residents
[View Massachusetts Therapy Services](https://dralanjacobson.com/therapy-in-massachusetts/)

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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](https://www.instagram.com/appliedpsychological) [ ![social network 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](https://www.linkedin.com/company/psychologicalscience/)

---

### [Therapy for Teen Anxiety: Building Strength, Comfort, and Understanding](https://dralanjacobson.com/therapy-for-teen-anxiety/)

**Published:** August 4, 2025
**Author:** Dr. Alan Jacobson

**Content:**

Adolescence is a time of profound change, emotionally, cognitively, and socially. Teens are navigating a complex world filled with academic pressure, shifting social dynamics, identity development, and the ever-present influence of social media. Amid these challenges, anxiety has become one of the most common mental health concerns among youth. While occasional worry is a natural part of growing up, persistent or intense symptoms can interfere with a teen’s functioning, self-esteem, and quality of life. I provide therapy for teen anxiety to help adolescents navigate this challenging time and develop comfort, confidence, and contentment. Anxiety therapy for teens can be done virtually, adding convenience and privacy.

Anxiety disorders in adolescents often go unnoticed or are mistaken for shyness, defiance, or physical health complaints. Many teens suffer silently, internalizing distress to avoid judgment or because they lack the words to express what they’re feeling. Left untreated, anxiety can disrupt school performance, social development, and emotional well-being, and increase the risk for depression, substance use, and other long-term mental health issues.

### Treatment is Effective!

Fortunately, anxiety in teens is highly treatable. [Evidence-based](https://www.cdc.gov/genomics/media/pdfs/2024/04/Evidence-Based_Practice_508.pdf) anxiety therapy for teens can help teens learn to manage anxious thoughts, tolerate uncertainty, confront fears, and reconnect with the people and activities they care about. What follows is an overview of anxiety symptoms in teens, the most effective types of treatment and techniques used, and two in-depth case studies illustrating how anxiety therapy for teens can make a profound difference.

Of course, you are always welcome to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult#services/service) to talk about your or your child’s challenges and how I might be able to help.

---

## Anxiety Symptoms in Teens

Anxiety disorders in adolescents often manifest across emotional, cognitive, behavioral, and physical domains. Some symptoms may be overt, while others are subtle or masked.

### Emotional and Cognitive Anxiety Symptoms in Teens

- Chronic worry, especially about performance, relationships, or future events
- Fear of embarrassment or making mistakes
- Intrusive or obsessive thoughts
- Difficulty concentrating or making decisions
- Feeling “on edge” or unable to relax

### Behavioral Symptoms of Anxiety in Teens

- Avoidance of situations (e.g., presentations, parties, buses)
- Withdrawal from friends or previously enjoyed activities
- Reassurance-seeking (“Are you sure everything’s okay?”)
- School refusal or frequent requests to leave class
- Perfectionism and overpreparation

### Physical Symptoms of Anxiety in Teens

- Headaches, stomachaches, nausea
- Racing heart, shortness of breath, dizziness
- Muscle tension or shakiness
- Sleep difficulties (falling asleep, nightmares)
- Panic attacks (sudden, intense episodes of fear and physical symptoms)

---

## Evidence-Based Therapy for Teen Anxiety

The following are the main types of therapy for teen anxiety, all of which can be combined.

### Cognitive Behavioral Therapy for Teen Anxiety

[CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) is the most well-researched and effective therapy for teen anxiety. A subset of CBT that works well with teens is called [Rational Emotive Behavior Therapy](https://dralanjacobson.com/rational-emotive-behavior-therapy-rebt/). It teaches teens how their thoughts, feelings, and behaviors are connected, and how to:

- Challenge irrational or catastrophic thinking
- Engage in gradual exposure to feared situations
- Build problem-solving and emotion regulation skills
- Monitor anxiety triggers and avoidance patterns

### Exposure Therapy for Teen Anxiety

A subset of CBT focuses specifically on confronting fears, rather than avoiding them. [Exposure therapy](https://dralanjacobson.com/exposure-therapy-for-anxiety/) involves structured, repeated encounters with feared situations to reduce stress through:

- [Desensitization](https://en.wikipedia.org/wiki/Desensitization_(psychology)) (reduced fear over time)
- Disconfirmation of catastrophic predictions
- Increased sense of mastery

### [Acceptance and Commitment](https://dralanjacobson.com/act-psychotherapy/) Therapy for Anxiety in Teens

ACT helps adolescents change their relationship with anxious thoughts and sensations:

- Uses mindfulness and values-based action
- Encourages willingness to experience discomfort without avoidance
- Ideal for teens with rigid thought patterns or avoidance of uncertainty

### Dialectical Behavior Therapy for Teen Anxiety ([DBT for Teens](https://dralanjacobson.com/dbt-for-teens/))

Originally developed for emotional dysregulation, DBT is an effective therapy for teen anxiety and co-occurring mood symptoms, self-harm, or interpersonal difficulties. Focus areas include:

- Distress tolerance
- Emotion regulation
- Mindfulness
- Interpersonal effectiveness

### Family Therapy for Teen Anxiety

[Family therapy](https://dralanjacobson.com/family-therapy/) can be essential, especially when:

- Parents are inadvertently reinforcing avoidance
- Family conflict contributes to symptoms
- Parental modeling or emotional availability plays a role

### What About Medication?

In moderate to severe cases, or when therapy alone is insufficient, [SSRIs](https://en.wikipedia.org/wiki/Selective_serotonin_reuptake_inhibitor) such as sertraline or fluoxetine may be used under psychiatric supervision. Medication is most effective when combined with outpatient treatment.

---

## Effective Therapy Techniques for Teen Anxiety

Therapeutic approaches are most effective when tailored to the specific symptoms, developmental level, learning style, and emotional needs of the client. Below are the core therapy techniques for teen anxiety commonly used, along with how they are applied in clinical practice.

### Cognitive Restructuring Therapy Techniques for Teen Anxiety

#### Goal of [Cognitive Restructuring](https://dralanjacobson.com/cognitive-restructuring/):

Help teens identify, evaluate, and modify irrational or maladaptive thoughts that fuel fears.

#### Used in:

Cognitive Behavioral Therapy (CBT)

#### How Cognitive Restructuring Works:

- Clients are taught to recognize [*automatic negative thoughts*](https://www.healthline.com/health/mental-health/stop-automatic-negative-thoughts) (ANTs), such as “Everyone will laugh at me” or “I can’t handle this.”
- I guide teens in *thought-challenging* exercises, where they learn to evaluate evidence for and against these beliefs.
- Clients generate *balanced alternative thoughts*, such as “Even if I mess up, most people will forget” or “It’s okay to be nervous.”
- Techniques include [*Socratic questioning*](https://www.verywellmind.com/socratic-questioning-8350838), *thought logs*, and [*cognitive distortion identification*](https://positivepsychology.com/cognitive-distortions/) (e.g., catastrophizing, mind reading, black-and-white thinking).

Example: A girl afraid of class presentations might write down, “I’ll stutter and people will think I’m stupid.” I help her examine past evidence, challenge this belief, and replace it with a more realistic thought: “I’ve done fine before. Even if I mess up a little, most people will understand.”

### Exposure Therapy for Teen Anxiety

#### Goal of Exposure Therapy for Teen Anxiety:

Reduce avoidance and desensitize them to feared situations or physical sensations.

#### Used in:

CBT, ERP ([Exposure and Response Prevention](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/)), sometimes ACT

#### Types of exposure therapy for teen anxiety:

- Graded (In Vivo) Exposure: Facing anxiety-provoking situations in a planned, stepwise fashion. A hierarchy is built based on the intensity of fear.
- [Interoceptive Exposure](https://positivepsychology.com/interoceptive-exposure/): Purposefully inducing feared physical sensations (e.g., dizziness, heart pounding) to reduce fear of bodily experiences common in panic disorder.

#### How it works to lower anxiety in teens:

- We collaboratively create a fear hierarchy, ranked from least to most fear-provoking.
- Exposures are done repeatedly until distress decreases ([habituation](https://en.wikipedia.org/wiki/Habituation)).
- The focus is on staying in the situation long enough to disconfirm feared outcomes and build mastery.
- Homework assignments reinforce exposures outside of sessions.

Example: A boy with social fears might start by saying hello to a peer, then progress to joining a group conversation, then giving a speech in class. Another with panic disorder might practice spinning to induce dizziness, learning that the sensation is uncomfortable but not dangerous.

### Behavioral Experiments for Anxiety in Teens

#### Goal of behavioral experiments as an anxiety therapy for teens:

Test beliefs through real-life actions to gather disconfirming evidence.

#### Used in:

CBT for social anxiety in teens, panic disorder, and generalized worries

#### How behavioral experiments for anxiety in teens work:

- Clients identify a prediction (e.g., “If I ask a question in class, people will roll their eyes”).
- They conduct a real-world test (e.g., ask a teacher a question) and observe the actual outcome.
- Results are reviewed in session to help weaken rigid or catastrophic beliefs.

Example: A socially anxious girl believes that others will laugh if she stumbles during a presentation. She gives a short talk while being videotaped, then watches it and rates how noticeable her errors were versus how she imagined them.

### Relaxation and [Somatic Regulation Techniques](https://dralanjacobson.com/somatic-therapy/)

#### Goal of relaxation techniques:

Reduce physiological arousal and improve emotional self-regulation.

#### Used in:

CBT, DBT, [trauma-informed approaches](https://dralanjacobson.com/trauma-informed-care/), treatment for social anxiety in teens.

#### Relaxation and somatic regulation techniques include:

- [Diaphragmatic breathing](https://psychology.uga.edu/sites/default/files/CVs/Clinic_Diaphragmatic_Breathing.pdf): Slows heart rate and reduces hyperarousal.
- [Progressive muscle relaxation](https://www.verywellmind.com/how-do-i-practice-progressive-muscle-relaxation-3024400) (PMR): Teaches individuals to tense and relax specific muscle groups, reducing overall body tension.
- Guided imagery: Uses calming visualizations to help shift attention away from stressful thoughts.
- [Biofeedback](https://en.wikipedia.org/wiki/Biofeedback) (in some settings): Provides real-time physiological feedback to help them learn self-regulation.

Example: A boy with test anxiety learns to take deep belly breaths before and during exams to prevent panic symptoms.

### Mindfulness and Acceptance Strategies for Anxiety Symptoms in Teens

#### Goal of Mindfulness and Acceptance:

Increase present-moment awareness and help teens observe thoughts without judgment or avoidance.

#### Used in:

ACT (Acceptance and Commitment Therapy), DBT, [mindfulness-based CBT](https://dralanjacobson.com/mindfulness-based-cognitive-therapy/)

#### How Mindfulness and Acceptance Work:

- Clients are guided to *notice thoughts* rather than believe or suppress them (e.g., “I’m having the thought that…”).
- Practices like body scans, five senses grounding, and breath awareness help disengage from anxious loops.
- They are encouraged to *move toward valued actions* even when anxiety is present, rather than waiting for it to disappear.

Example: A girl afraid of saying the wrong thing in social situations practices observing that fear (“There’s the thought again”) while choosing to engage anyway, aligning with her value of friendship.

### Emotion Regulation Skills for Anxiety Symptoms in Teens

#### Goal of emotional regulation:

Help identify, label, and manage intense emotions without becoming overwhelmed or avoidant.

#### Used in:

DBT, trauma-informed CBT, emotion-focused approaches

#### Emotional regulation skills include:

- Emotion identification and labeling: Using tools like emotion wheels or daily logs
- Opposite action: Doing the opposite of the urge driven by a strong emotion (e.g., attending a class rather than avoiding it when anxious)
- Distraction vs. distress tolerance: Learning when to temporarily shift attention versus when to sit with emotions and ride the wave

Example: A girl who feels overwhelmed before a performance uses “TIP skills” from DBT (Temperature change, Intense exercise, Paced breathing) to reduce distress before stepping on stage.

### [Values Clarification Therapy](https://dralanjacobson.com/values-clarification-therapy/) for Teen Anxiety

#### Goal of values clarification as anxiety therapy for teens:

Motivate adolescents to take action in line with their values, rather than avoiding it due to anxiety.

#### Used in:

ACT, [Self-esteem Therapy](https://dralanjacobson.com/therapy-for-self-esteem-and-resilience-training/)

#### How values clarification therapy for teen anxiety works:

- Clients explore their core values (e.g., friendship, creativity, honesty) and identify how anxiety is interfering with living those values.
- Therapy emphasizes willingness to experience discomfort in the service of meaningful goals.
- *Metaphors*, visual tools, and journaling exercises are used to deepen understanding.

Example: A boy avoids joining a soccer team due to the fear of embarrassment. Through ACT, he connects with his value of teamwork and decides to participate despite those fears, redefining success as living by his values.

### Social Skills and Communication Training

#### Goal of social skills training:

Build confidence and competence in social interactions that cause symptoms.

#### Used in:

CBT (especially for social anxiety in teens), group therapy

#### Social skills training components:

- Teaching assertiveness (e.g., making requests, setting boundaries)
- Practicing active listening, turn-taking, and initiating conversations
- Role-plays and video feedback to rehearse and refine skills

Example: In group CBT, a girl with social anxiety practices initiating conversations and receives feedback and support from peers in a structured, safe setting.

### Self-Monitoring and Tracking Therapy for Teen Anxiety

#### Goal of tracking:

Increase awareness of anxiety patterns and treatment progress.

#### Used in:

CBT, ACT, and most evidence-based approaches

#### Tools:

- Thought records to track triggers, thoughts, feelings, behaviors, and outcomes
- Symptom charts to monitor frequency and intensity
- Mood and exposure diaries to reinforce homework and reflection

Example: A boy uses a daily tracker to log anxious events, triggers, and the coping skills used. This builds insight and helps reinforce new behaviors.

### Integrated Use of Therapy Techniques for Teen Anxiety

Most therapy for teen anxiety is integrative. I may:

- Use CBT as a foundation
- Incorporate ACT principles to increase willingness to experience discomfort.
- Add DBT skills for emotional regulation and mindfulness
- Provide parent coaching to reduce accommodation and increase autonomy
- Collaborate on exposures and behavioral experiments as central change tools, such as with social anxiety in teens

The success of [integrative treatment](https://dralanjacobson.com/integrative-therapy/) lies not only in choosing the proper techniques but in creating a warm, collaborative space where teens feel understood, respected, and empowered to face their fears, one step at a time.

---

## Case Example 1: Therapy for Social Anxiety in Teens

**Client:** *Maya, age 15, high-achieving high school sophomore*

**Presenting Concerns:** Maya’s parents described her as kind, intelligent, and conscientious, but noted growing isolation and emotional distress. Maya dreaded any situation involving public speaking, class participation, or unstructured social interaction. She avoided the cafeteria, never raised her hand in class, and had dropped out of extracurricular activities that involved group work. She reported nausea, shaking, and intrusive self-critical thoughts whenever she imagined being judged.

**Assessment Findings:** Maya met the criteria for [**Social Anxiety Disorder**](https://www.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-shyness). Her fears had worsened during remote schooling and became entrenched as school reopened. She was highly self-aware, perfectionistic, and described feeling like “everyone’s watching and waiting for me to mess up.” She endorsed cognitive distortions like mind-reading (“They think I’m weird”) and catastrophizing (“If I stutter, it’ll be the end of my reputation”).

### Treatment Approach for Social Anxiety in Teens

Maya participated in **16 sessions of CBT** with integrated exposure work. The therapy focused on:

- [**Psychoeducation** about anxiety](https://dralanjacobson.com/psychoeducation/) and its maintenance cycles
- Building a **fear hierarchy** ranging from low-stress social interactions (e.g., making eye contact with a peer) to high-stress ones (e.g., presenting in front of the class)
- Weekly **exposures**, including real-world social experiments such as ordering at a café, starting a conversation with a classmate, and reading aloud in front of the therapist
- **Cognitive restructuring** using thought logs and role-playing to challenge automatic thoughts like “They’ll think I’m boring”
- Use of **video feedback** to help Maya see that her anxious behaviors (e.g., blushing, hesitating) were less noticeable than she feared
- **Assertiveness training** and work on identifying her values to shift the focus from perfection to meaningful engagement

**Family Involvement:** Her parents attended sessions to learn how to avoid reinforcing avoidance behaviors (e.g., calling teachers on her behalf) and to support exposures at home.

### Outcome:

By the end of treatment, Maya was consistently participating in class, had rejoined the school debate team, and had formed new friendships. She still felt anxious at times, but reported it as manageable. She no longer avoided the cafeteria and gave a successful class presentation with only moderate discomfort. Her self-report measures showed a 60% reduction in symptom severity.

Social anxiety in teens is treatable, and helps adolescents like Maya develop new skills and confidence.

---

## Case Example 2: Anxiety Therapy for Teens with Panic Attacks

**Client:** *Jaden, age 16, athletic and academically capable junior*

**Presenting Concerns:** Jaden reported sudden episodes of intense fear, chest pain, dizziness, and a sense of impending doom. These panic attacks seemed to occur “out of nowhere,” often during gym class or on the school bus. After several episodes, he began avoiding enclosed spaces, assemblies, elevators, and eventually, school itself. Medical workup ruled out physical causes. He described feeling “trapped in my own body,” unable to breathe, and terrified that he might die or go crazy.

**Assessment Findings:**
Jaden met the criteria for [**Panic Disorder with Agoraphobia**](https://pmc.ncbi.nlm.nih.gov/articles/PMC7387026/). He showed no signs of depression or trauma, but reported high expectations from family and mounting academic pressure. He feared the physical symptoms of panic more than the situations themselves, leading to a classic panic-avoidance cycle.

### Treatment Approach For Panic Disorder

Jaden engaged in a **12-week CBT protocol** with a strong emphasis on **interoceptive and situational exposure**. The treatment included:

- **Psychoeducation** about the fight-or-flight system, anxiety physiology, and the panic feedback loop
- **Interoceptive exposure** to feared physical sensations (e.g., spinning in a chair to induce dizziness, running in place to mimic a racing heart) to teach him that these symptoms were safe and tolerable
- Gradual **in vivo exposures** to avoided settings, beginning with short walks near school, then sitting on the bus with an escape plan, and eventually staying through full assemblies
- **Cognitive restructuring** to challenge catastrophic beliefs (“If my heart races, I’ll pass out”)
- **Breathing retraining** using diaphragmatic breathing and paced respiration
- **Mindfulness-based grounding** for use during early panic symptoms
- Development of a **relapse prevention plan** to prepare for future stressors

**Family Involvement:** His parents were coached on how to validate his fears without enabling avoidance. They helped create exposure opportunities and encouraged independence.

### Outcome

Jaden’s panic attacks decreased in both frequency and intensity. He resumed taking the bus to school, rejoined his basketball team, and went on a field trip without distress. He reported increased confidence, saying, “I still get nervous, but now I know I can ride it out.” His panic severity rating dropped by over 70%, and he no longer met criteria for agoraphobia.

Therapy techniques for teen anxiety are [effective for panic attacks](https://dralanjacobson.com/panic-attack-treatment/), often bringing relief fairly quickly.

---

## Summary and Conclusion

Anxiety in teens is deeply real, often hidden, and entirely treatable. Through well-structured, evidence-based therapy and with the right blend of support, challenge, and skill-building, adolescents can reclaim their confidence and regain access to the world around them. Whether the symptoms are rooted in fear of judgment, intense physical symptoms, or generalized worry, therapy offers both the tools and the roadmap for healing. With early identification and skilled intervention, we can help teens not just manage anxiety but thrive despite it. I offer therapy for social anxiety in teens, panic disorder, generalized symptoms, and specific phobias. I also offer treatment for issues that often co-occur, such as [therapy for ADHD in teens](https://dralanjacobson.com/adhd-treatment-for-teens/).

Please feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult#services/service) to talk about your or your child’s challenges with anxiety. Therapy for teen anxiety can be highly effective and enduring.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

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---

### [Traditional Services](https://dralanjacobson.com/psychotherapy/)

**Published:** December 26, 2023
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: May 5, 2026

 # Psychotherapy Services

I offer **psychotherapy services** for individuals, couples, and families. This page outlines the methods I use in **psychotherapy sessions** and how they can benefit you. It talks about the goals and benefits, and lists the ways these services can be used. It also has a section that dimply describes “**What is psychotherapy**?” As always please feel free to contact me with any questions. I look forward to meeting you.

Psychotherapy Services are powerful and effective and should not be a mystery. Results should be:

### 1. Meaningful

The results of psychotherapy services should be highly meaningful to you. We will discuss your unique goals to bring relief, happiness, and deeper understanding. That meaningfulness should motivate you as we move forward in your treatment experience.

### 2. Measurable

Whenever possible, we will make goals measurable. It should not be a mystery or hard to know whether the process works; it should be evident and apparent to you and those around you. You will be able to track your progress.

### 3. Important

The goals of psychotherapy you set and the path you pursue should be critical to you. These methods can help with more minor challenges and more significant life issues. We will work on both, and in the end, you should see important positive change.

 ## About Psychotherapy Sessions

**Psychotherapy** is a powerful tool for promoting mental and emotional well-being, personal growth, and improved mental health. Here are some key aspects of the power and potential of these methods. I also answer the question, “What is psychotherapy?” below.

### Psychotherapy Sessions and Enhanced Self-Understanding

Psychotherapy encourages self-reflection and self-awareness. Through introspection and exploration, you can better understand yourself, your behaviors, your motivations, and your needs. The process can help you build self-confidence, set and achieve goals out of reach, and cultivate a sense of purpose and meaning. The general goals of psychotherapy are to further your feelings of contentment and reduce the effects of barriers and challenges.

### Eliminate Negative Thoughts and Think Positively

My [strengths based ](https://dralanjacobson.com/strength-based-therapy/)approach is designed to change maladaptive behavior and thought patterns. For example, cognitive-behavioral (CBT) or it’s cousin [Rational Emotive Behavior Therapy](https://dralanjacobson.com/rational-emotive-behavior-therapy-rebt/) helps the people I serve to identify and replace negative thought patterns and behaviors with healthier alternatives. These strategies help you build resilience and enhance coping skills as time passes. This will help you address potential issues before they become more severe. [Adlerian Therapy](https://dralanjacobson.com/adlerian-therapy/) is another example of a strengths-based approach that focuses on possibilities and positive change.

### Psychotherapy for Improved Relationships

These approaches can also benefit relationships, both romantic and familial. They provide a platform for communication, conflict resolution, and developing healthier relationship dynamics. Even if you do not engage in couples or family treatment, we can still work on how you can make the relationships in your life deeper, more understanding, and more meaningful.

### Long-Term Benefits and a Toolkit

You will leave your treatment course with a toolkit to help you manage stresses and opportunities moving forward. For example, we might discuss stress management and relaxation strategies or develop specific coping skills. The benefits of psychotherapy can extend far beyond the duration of treatment. The hope is that you will acquire lifelong skills and insights that continue to benefit you in various aspects of your life.

### More Information

Choosing a therapist who is the right fit for you is important. You want to ensure that [their therapeutic approach is appropriate](https://dralanjacobson.com/types-of-therapy/) for the questions or concerns you are coming in with and that their style matches the kind of psychologist you would work well with. I hope this site can help you determine whether I might be a match. I’d be honored to work with you, but I can also refer you to a trusted colleague if you feel there would be a better match elsewhere.

More below, in the section called, “What is psychotherapy?” There is also another post about finding a [private practice therapist](https://dralanjacobson.com/finding-a-private-practice-therapist/) and one about what [going to therapy](https://dralanjacobson.com/what-is-a-therapy-appointment-like-go-to-therapy-feeling-confident-and-know-common-therapist-terms/) is like.

## Traditional Psychotherapy Services

I [offer services in my Westwood](https://dralanjacobson.com/), Massachusetts office and virtually.

 [Schedule a Call](https://www.picktime.com/scheduleaconsult)

##### Individual Psychotherapy

This treatment can benefit almost anyone who wants to improve their insight into their current challenges. If you suffer from more sadness, anxiety, regret, or anger than you would like, I can probably help. Services would be a fit if you experienced trauma, are going through an expected or unexpected life transition, or are generally not getting the joy and pleasure out of life that you would like.

##### Couples Psychotherapy

If you and your partner find that you fight too much, are having trouble communicating, or are just not connecting as meaningfully as you used to, I can help. I see those who have been married for many years and are hitting a rough patch, newlyweds who are putting their new lives together, and couples who have decided to get married. [Couples therapy](https://dralanjacobson.com/couples-therapy/) often comes with homework.

##### Family Psychotherapy

Family treatment involves two or more members working together to reduce conflict, improve communication and closeness, or work out specific challenges. This treatment can involve adult children and their parent or parents, sibling groups, and parents who meet without the child present. [Family psychotherapy](https://dralanjacobson.com/family-therapy/) often lends itself to virtual so everyone can join. I use various techniques, including [narrative therapy for families](https://dralanjacobson.com/narrative-family-therapy/) and systems treatment.

## Time-Limited Psychotherapy Services

I also offer other unique services in person and virtually.

 [Schedule a Call](https://www.picktime.com/scheduleaconsult)

##### Single Session Assessment

Sometimes, all that is needed is a single session where a comprehensive assessment leads to suggestions to remediate a concern. You may be looking to know whether you have a specific diagnosis or want some advice on handling things on your own. I am happy to provide you with a comprehensive evaluation in these cases. I can also provide referrals based on the assessment.

##### Parent Training

While I do not see clients younger than 16, I am trained in family treatment and can provide parents with ideas, information, and techniques to help their child and the entire family. This type of treatment is often helpful when the child is also seeing their own therapist. This service can also be provided for parents looking to remain close to their adult children.

##### Psychological Testing

I can provide [psychological testing](https://www.psychologicalassessments.com/) and assessment for a variety of concerns. Some examples include diagnostic evaluation for ADHD in adolescents and adults, vocational assessment for adults, the nature and cause of depression or anxiety, and [sports performance](https://dralanjacobson.com/sports-performance-psychology/) evaluation. These evaluations usually take 2-4 hours, and I’ll have a report to you or your therapist within two weeks.

## Specialty Services

Services for specific needs.

 [Schedule a Call](https://www.picktime.com/scheduleaconsult)

##### **[Fear of Flying](https://dralanjacobson.com/fear-of-flying-therapy/)**

##### **[Fear of Public Speaking](https://dralanjacobson.com/public-speaking-anxiety/)**

##### **[College Admissions Counseling](https://dralanjacobson.com/college-admissions-counseling/)**

##### **[Sports Psychology](https://dralanjacobson.com/sports-psychology/)**

##### **Executive Coaching**

##### **[Emotional Support Animals](https://dralanjacobson.com/emotional-support-animals-esa/)**

## What is Psychotherapy?

 ![What is Psychotherapy?](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "cropped-cropped-Office.jpg | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

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##### Psychotherapy sessions help you identify and clarity the challenges holding you back

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##### Psychotherapy sessions help you share your hopes, fears, wishes, and anxieties in a safe place

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##### Psychotherapy sessions give you a chance to put aside time to focus on your needs and possible solutions 

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##### Psychotherapy sessions give you a toolkit to use in your everyday life to help you feel more content and fulfilled

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##### Psychotherapy sessions are designed with powerful, proven and effective clinical approaches

The answer to the questions, “What is psychotherapy?” or “[What is therapy like](https://dralanjacobson.com/talking-to-a-therapist/)?” are often unique for each person. It is designed to help you overcome barriers, reduce challenges, and increase your sense of meaningfulness and contentment. The therapeutic path to get you there will be uniquely designed. When we meet, we will ask, “What is Psychotherapy for you?”

## Goals of Psychotherapy

The **goals of psychotherapy** extend beyond symptom relief. While these methods can reduce anxiety, depression, and stress, its deeper purpose is to help individuals develop insight, emotional resilience, and a more meaningful, well-aligned life.

Psychotherapy is a collaborative process in which a licensed psychologist helps clients understand themselves more fully, navigate challenges effectively, and make lasting, constructive changes.

### **Core Goals of Psychotherapy:**

#### Improve Self-Understanding and Insight

One of the primary goals of psychotherapy is to increase self-awareness. It helps individuals recognize patterns in thoughts, emotions, behaviors, and relationships—often uncovering the roots of current difficulties.

#### Develop Healthier Coping Skills

Treatment supports the development of adaptive coping strategies for managing life’s challenges. Clients learn tools to respond more flexibly to stress, uncertainty, and emotional intensity.

#### Strengthen Relationships and Communication

Many people pursue treatment to improve relationships. These approaches help clarify boundaries, enhance communication, and foster more secure, authentic connections with others.

#### Support Personal Growth and Meaning

Beyond symptom reduction, one of the deeper goals of psychotherapy is personal growth. It can help individuals clarify values, reconnect with purpose, and move toward a life that feels intentional and fulfilling.

#### Reduce Psychological Distress

Another key goal of psychotherapy is alleviating symptoms such as anxiety, depression, chronic stress, emotional overwhelm, and burnout. This treatment provides evidence-based strategies to improve emotional regulation and psychological stability.

#### Change Unhelpful Thoughts and Behaviors

A central goal of psychotherapy is helping individuals identify and modify unhelpful beliefs, habits, and behavioral patterns that interfere with well-being, performance, or relationships.

#### Increase Confidence and Emotional Resilience

Through treatment, individuals often experience improved self-confidence, self-trust, and resilience—allowing them to navigate challenges with greater steadiness and clarity.

####  **Enhance Psychological Flexibility**

These methods help individuals increase psychological flexibility—the ability to think clearly, consider multiple perspectives, tolerate ambiguity, and choose responses aligned with long-term values rather than short-term relief.

### **What Are the Goals of Psychotherapy Overall?**

In summary, the goals of psychotherapy include:

Improved emotional well-being

Greater self-understanding

Healthier coping and decision-making

Stronger relationships

Increased resilience and meaning

The goal is not about becoming “perfect” or eliminating all discomfort. Rather, its goal is to help individuals live more effectively, authentically, and aligned with what matters most to them.

 [Contact Me for More Information ](https://dralanjacobson.com/contact/)

 ## Get In Touch

I’d be happy to provide a [deeper insight](https://dralanjacobson.com/therapy-faqs/) into, “What is psychotherapy”, answer any questions you have about the psychotherapy services listed above, or anything else about my practice. You can also find related information, such as an answer to the common questions, “[How long does therapy take](https://dralanjacobson.com/how-long-does-therapy-take/)?” and “[Does therapy help](https://dralanjacobson.com/does-therapy-help-what-form-of-therapy-works-best/)?” as well as information about [how to find therapy](https://dralanjacobson.com/how-to-find-therapy-in-new-york-or-anywhere-a-guide-to-getting-started/) in my blog.

While my telehealth services are offered nationwide, I do offer state specific services. More info:

[California Therapy](https://dralanjacobson.com/therapy-in-california/)

### Call

(617)-680-5488

### Email

hello@dralanjacobson.com

### Address

In person: Westwood, MA & Lee, NH

Virtual: Serving 40 states

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---

### [Finding Therapy in California](https://dralanjacobson.com/therapy-in-california/)

**Published:** January 13, 2026
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: January 19, 2026

 # Therapy in California

Looking for therapy in California can feel overwhelming. With thousands of providers across the state, dozens of license types, and rapidly changing telehealth rules, it’s hard to know where to begin. Whether you’re searching for a therapist in California for anxiety, trauma, ADHD, family conflict, or life transitions, finding the right match is about far more than availability or insurance—it’s about working with someone who understands the state’s unique clinical, cultural, and legal landscape. A California therapist doesn’t just offer therapy. They work inside one of the most complex mental-health systems in the country.

 [Get In Touch With Me](https://dralanjacobson.com/contact/)[Schedule a Consult](https://www.picktime.com/scheduleaconsult#book/services)

### About Therapy in California

Finding the right therapy in California is one of the most empowering decisions you can make. With the right California therapist by your side—someone who knows the state, the systems, and the human side of growth—you’re not just getting support. You’re creating the conditions for lasting change.

We also offer [Psychological Testing in California](https://psychologicalassessments.com/locations/california/) that is state-specific.

 ![Therapy in California](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "California transparent | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

### **Why It’s Vital to Use a California Therapist**

California therapy isn’t like other states.

- The state has some of the strictest privacy laws in the country (including CA-specific confidentiality and minor consent standards).
- Teletherapy is governed by where the client is physically located at the time of service—not where the therapist lives.
- School systems, medical networks, court systems, and insurance panels all operate with state-specific procedures.

A therapist in California who is deeply connected locally understands how to coordinate care with school districts, pediatricians, universities, attorneys, and workplace programs. They know how to navigate IEP teams, Section 504 plans, workers’ compensation referrals, and that state’s distinctive cultural diversity—from Silicon Valley tech stress to Central Valley agricultural communities to the entertainment industry in Los Angeles.

### **Why State-Specific Guidelines and Ethics Matter**

Using a California therapist who knows the state’s regulatory environment protects you in ways you might not expect:

- **Informed consent & documentation:** The state has additional requirements around minors, parental involvement, record keeping, and access to notes.
- **Duty to protect /[Tarasoff standards](https://legalclarity.org/tarasoff-v-california-and-the-duty-to-protect/):** CA originated some of the nation’s most important duty-to-warn laws, and missteps here can have serious consequences.
- **Telehealth compliance:** If your therapist isn’t licensed or properly authorized to provide California therapy while you’re physically in the state, your care—and even your insurance coverage—could be invalid.
- **Mandated reporting nuances:** A California therapist has unique thresholds for reporting abuse, neglect, and threats.

A therapist in California who truly knows these rules isn’t just protecting themselves—they’re protecting you.

01

## Q: What is the **Best Process to Find the Right Therapist in California**

If you want California therapy that truly fits, here’s the process that works:

1. **Search intentionally.** Use phrases like *therapist in California* or *California therapist* to filter out out-of-state providers.
2. **Confirm licensure.** Make sure your therapist is licensed in in the state and experienced with your specific concerns.
3. **Ask about systems.** A good therapist in California should understand schools, employers, medical systems, or courts relevant to your situation.
4. **Assess the connection.** The right therapist doesn’t just have credentials—they get you, your context, and your goals.
5. **Look forward, not just backward.** California therapy at its best is not only about healing the past, but about building momentum, clarity, and meaningful change for the future.

01

## Q: Is every **CA Clinician the same as far as education and training?**

Not at all. The state licenses several different mental health professions, each with its own training model and scope of practice:

- **[Clinical Psychologists](https://dralanjacobson.com/what-is-a-clinical-psychologist/) (PhD or PsyD):** Doctoral-level clinicians with extensive training in therapy psychological assessment, diagnosis, research-based treatment, performance improvement, and complex case formulation. Psychologists often specialize in testing, ADHD and [learning evaluations](https://psychologicalassessments.com/learning-style-assessment/), trauma, personality assessment, and high-acuity mental health conditions.
- **Licensed Marriage and Family Therapists (LMFTs):** Master’s-level clinicians trained in systems theory, relational dynamics, couples therapy, and family-based interventions. They frequently work with relationship conflict, parenting issues, and family transitions.
- **Licensed Clinical Social Workers (LCSWs):** Master’s-level clinicians with strong backgrounds in mental health treatment plus social systems, case management, community resources, and advocacy. They are particularly helpful when therapy overlaps with housing, healthcare, disability services, or public systems.
- **Licensed Professional Clinical Counselors (LPCCs):** Master’s-level clinicians trained in a wide range of counseling and psychotherapy approaches, often with strong focus on individual therapy, career development, trauma recovery, and life-transition work.

Each of these professionals can be an excellent California therapist—but choosing the right one depends on whether your needs are more diagnostic, relational, systems-based, or skills-focused.

02

## Q: **Is online therapy effective?**

Yes. Research consistently shows that [teletherapy](https://dralanjacobson.com/telehealth-therapy-teletherapy/\) is as effective as in-person therapy for most concerns, including anxiety, depression, trauma, ADHD, and family stress. Many people actually benefit more from online therapy because it removes barriers like traffic, long commutes, childcare logistics, and scheduling challenges. A California therapist who understands state-specific telehealth regulations ensures your virtual care is not only convenient, but fully compliant and clinically sound.

03

## Q: How Do You Find Specialized California Therapy?

In a state as vast as CA, you can find just about every major therapy modality. I and many other therapists employ an integrative model so we can tailor treatment to your needs.

### Common approaches to California therapy:

- [Cognitive Behavioral Therapy](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt/) (CBT): Focuses on identifying irrational and exaggerated thoughts that are negatively affect behavior. CBT Is a good choice for depression, anxiety, OCD, and panic disorder.
- [Dialectical Behavior Therapy](https://dralanjacobson.com/dbt-for-teens/) (DBT): Combines CBT with mindfulness. Often used for certain forms of depression, social difficulties, and emotional reactivity.
- [Psychodynamic Therapy](https://dralanjacobson.com/psychodynamic-therapy/): Explores unconscious patterns that may have formed as a result of early relationships. Helps with a general sense of a lack of meaning and desire for greater insight.
- [Internal Family Systems](https://dralanjacobson.com/internal-family-systems-therapy-ifs/) (IFS): A relatively new form of therapy which helps identify and integrate “parts” of your self.
- [Narrative Therapy](https://dralanjacobson.com/narrative-therapy/), [Creative Therapy](https://dralanjacobson.com/creative-counseling/): These powerful and creative therapies are often mixed in to help deepen the experience.

I combine these and other techniques based on your unique needs and hopes. I cover family therapy in California below. You’re very welcome to do your own research ahead of time, but you don’t have to know exactly what [form of therapy](https://dralanjacobson.com/does-therapy-help-what-form-of-therapy-works-best/) you’d like because most therapists will review all of this and empower you to make decisions when you meet.

04

## Q: How do I Find the Right Therapist in California for Me?

Finding a therapist in California isn’t just about credentials or how fancy their website is. Instead, you should look for someone that you feel understands you and can help you grow.

### Finding the [best psychotherapist](https://dralanjacobson.com/choosing-the-best-therapist-for-you/) for you:

- Specialties: Choose someone who has regularly worked with people with similar concern and hopes.
- Therapeutic approach: Some therapists in California focus on warmth and support; others take a more structured and challenging approach.
- Identity: Some people prefer to work with someone who shares an important aspect of your identity, such as your race, gender, age, cultural background, or lived experiences.
- Licensing: Ensure they’re licensed in the state, even if they’re providing online therapy from a different place.

Tip: Most therapists in California offer a [free 10–15 minute consultation](https://www.picktime.com/scheduleaconsult), in order to answer questions and allow you to get a feel for their style. You may want to ask:

- What will a typical session be like?
- How much experience do you have with \_\_\_\_\_\_\_\_\_\_?
- Do you offer telehealth?
- Do you take my insurance, or can you help me get reimbursed if possible?

05

## Q: How to Find California Therapy for Teens

Adolescents need therapists who understand their developmental milestones, communicate welly, and create a nonjudgmental environment. If you or your child is looking for California therapy, you may want to focus on one who:

- List “Adolescents” as a specialty or something even more specific, like my “[Therapy for teen anxiety](https://dralanjacobson.com/therapy-for-teen-anxiety/) post”
- Have specific experience with what is going on, such as academic stress, peer anxiety, identity development, ADHD, etc.
- Use creative methods if you or your child desires them, such as art therapy, or therapeutic games
- Offer family involvement if desired, even if it is not the main approach

### Searching for teen therapy in California:

- Psychology Today or Zencare
- Your teen’s school psychologist or pediatrician

Many teens actually prefer telehealth—it feels more comfortable, less disruptive when they are busy, and easier to talk from a familiar space.

06

## Q: How Do I Find Family Therapy in California?

Family therapy in California can be essential to address parenting challenges, interfamily conflict, divorce or separation, or generational tensions and communication issues. There are many experienced family therapists who use a wide variety of methods.

### Search for [family therapy](https://dralanjacobson.com/family-therapy/) in California

- Using a platform like Psychology Today or Zencare
- Look for:
    - LMFT (Licensed Marriage and Family Therapist)
    - LCSW (Licensed in Clinical Social Work)
    - [Clinical Psychologists](https://dralanjacobson.com/what-is-a-clinical-psychologist/) with experience in family therapy
    
    Sessions may involve all family members or select individuals, depending on the issue.

07

## **Can minors consent to therapy in California?**

In certain circumstances, yes—but the rules are highly specific. A therapist in California must understand exactly when minors can self-consent, when parents must be involved, and how documentation and confidentiality are handled under state law. The rules are complex and different than many other states, so this may need to be part of your decision-making

08

## Q: Can I see a California Therapist while Traveling

Only if you are physically located in the state at the time of your session. Teletherapy is governed by where the client is sitting, not where the therapist lives. Thus, an important decision point when looking for California therapy is whether they are also licensed in other states. This is an important distinction, for example, with college students who live or go to school outside of CA.

## Case Example: Finding Teen Therapy in California

The Rivera family in Orange County was struggling with their 15-year-old son’s school refusal, irritability, and emotional shutdown. They had previously worked with a national teletherapy platform, but progress stalled. Their therapist didn’t understand local school law, had never attended an IEP meeting, and gave generic advice that didn’t translate to the family’s district.

When they sought out a California therapist, everything shifted. Their new provider understood the local school district’s policies, joined an IEP meeting, explained the family’s rights under the state’s education code, and helped craft accommodations that actually worked. Therapy expanded beyond symptoms into advocacy, systems navigation, and family resilience. The difference was night and day.

## Case Example: Finding an Individual Therapist in California

**Background:**

Melissa, a 34-year-old product manager in San Jose, started searching “find California therapy” after months of insomnia, panic attacks, and constant pressure at work. She initially booked with an out-of-state provider who offered telehealth, but after three sessions she learned the therapist wasn’t licensed in California. Her insurance denied the claims and the provider abruptly discontinued care.

Frustrated, Melissa decided to find a California therapist who understood her environment. She searched for a therapist in California who specialized in high-performing professionals and tech burnout. Her new therapist immediately recognized the pressure cooker culture of Silicon Valley, integrated stress-performance frameworks, and helped Melissa navigate state-specific workplace protections when her anxiety began affecting her job performance.

Within weeks, Melissa had both emotional relief and a realistic plan for work accommodations—something that would have been impossible with a therapist unfamiliar with state systems.

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### [Therapy for OCD](https://dralanjacobson.com/therapy-for-ocd/)

**Published:** November 24, 2023
**Author:** Dr. Alan Jacobson

**Content:**

I provide **therapy for OCD** to adolescents and adults. Treatment for Obsessive-Compulsive Disorder typically involves a few different approaches that can be incredibly effective. As with the rest of my practice, I often use an [integrative approach](https://dralanjacobson.com/integrative-therapy/), which I feel gives me the greatest chance to choose the **best therapy for OCD** for you. Here is an overview to help you be an informed client, whether you choose me or anyone else. I also include an alternative therapy for OCD since there are approaches you can take outside of our sessions that I can weave into your treatment.

## What is Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by two main components: [obsessions and compulsions](https://www.healthline.com/health/obsession-vs-compulsion).

1. **Obsessions:** These are intrusive, persistent, and unwanted thoughts, urges, or images that cause significant anxiety or distress. They can be about a wide range of situations. These include fear of contamination, doubts about safety or security, aggressive or taboo thoughts, or a need for symmetry or order.
2. **Compulsions:** These are repetitive behaviors or mental acts that a person feels driven to perform in response to an obsession or according to rigid rules. These actions are aimed at reducing or preventing anxiety or distress. However, they are not realistically connected to the issue they are meant to address. Common compulsions include excessive cleaning or handwashing, checking and rechecking, counting, arranging things in a particular order, or mental rituals like silently repeating phrases.

These symptoms affect people differently, and its severity can vary widely. For some, symptoms can significantly interfere with daily life, relationships, work, and overall functioning. Others may experience milder symptoms that still cause distress but are more manageable.

Having obsessive thoughts or engaging in repetitive behaviors occasionally doesn’t necessarily mean someone has obsessive-compulsive disorder. Almost everyone has them. Diagnosis involves considering the frequency, intensity, and impact of these thoughts and behaviors on a person’s life. OCD is treatable through therapy, so you’ve come to the right place.

## Best Therapy for OCD

I use three commonly used approaches when trying to put together the best therapy for OCD for my clients.

These can be used alone or in combination, depending on the individual’s needs and the severity of their symptoms. They are often most effective when tailored to the specific challenges and goals of the person seeking treatment.

### Cognitive Behavioral Psychotherapy for OCD

[CBT](https://dralanjacobson.com/cognitive-behavioral-therapy-cbt-fast-measurable-results/) is often my first-line treatment since it is often the best therapy for OCD if you haven’t tried it. It involves a structured approach to identifying and changing thought patterns and behaviors that contribute to anxiety and compulsions. Within [CBT for OCD](https://dralanjacobson.com/cbt-for-ocd/), [Exposure and Response Prevention](https://dralanjacobson.com/erp-exposure-and-response-prevention-therapy/) (ERP) is particularly effective. ERP involves gradually exposing oneself to the thoughts, images, or situations that trigger obsessions while refraining from engaging in the compulsive behaviors associated with them. Over time, this helps reduce anxiety and weakens the connection between the obsession and the compulsion.

### Mindfulness-Based Therapy for OCD

[Mindfulness techniques](https://dralanjacobson.com/mindfulness-therapy/) can help clients with OCD learn to observe their thoughts and feelings without judgment, which can reduce the distress caused by obsessions. Practices like mindfulness meditation can help individuals become more aware of their irrational and exaggerated thoughts. Mindfulness-based interventions can complement other therapies.

### Acceptance and Commitment (ACT)

ACT focuses on accepting thoughts and feelings rather than trying to eliminate them and committing to behavior change in alignment with personal values. ACT is another approach to psychotherapy for OCD that can be delivered in addition to other approaches.

### Dialectical Behavior (DBT)

DBT incorporates elements of CBT with mindfulness techniques. It aims to help individuals regulate emotions, tolerate distress, and improve relationships while addressing symptoms. While it’s not the first-line treatment specifically tailored for OCD, some aspects of DBT can be beneficial in managing symptoms, particularly when they co-occur with other issues like emotion dysregulation or difficulties managing stress.

### Psychodynamic Psychotherapy for OCD

This approach explores how past experiences and unconscious thoughts may contribute to current symptoms. It involves exploring deep-seated emotions and patterns of behavior. [Psychodynamic psychotherapy](https://dralanjacobson.com/psychodynamic-therapy/) for OCD often takes longer than other approaches, but for people whose anxiety is chronic or has clear roots in childhood experiences, it can be very powerful. It may not be the best therapy for OCD by itself, but in combination with other treatments, it can be very powerful.

### Couples and Family Treatment

These symptoms can impact entire [families with older children](https://dralanjacobson.com/family-therapy/) or couples, and involving family members can help improve understanding, support, and communication within the family unit. It is not uncommon for a therapist to see an individual for most sessions but to bring in family members to help implement strategies at home. Sometimes, an alternative therapy for OCD can be a fun and productive activity for families and [couples in treatment](https://dralanjacobson.com/couples-therapy/).

### What About Medication?

In some cases, medication, usually selective serotonin reuptake inhibitors ([SSRI medications](https://en.wikipedia.org/wiki/Selective_serotonin_reuptake_inhibitor)), may be prescribed to help manage OCD symptoms. Medication can be particularly useful when used in conjunction with outpatient treatment. In those cases, medication provides enough relief to allow the strategies above to be used effectively.

## Alternative Therapy for OCD

Obsessive-Compulsive Disorder can be challenging to manage, and while traditional treatments like the above may be the best therapy for OCD for you, some people may seek alternative therapy for OCD, and I am very open to that. Here are some examples of an alternative therapy for OCD that I can integrate into your therapy:

### Yoga as an alternative therapy for OCD

Yoga combines physical postures, breath control, and meditation to promote relaxation and reduce stress. Some people find that regular yoga practice helps manage symptoms of obsessive-compulsive disorder by promoting a sense of calm and reducing anxiety. I can work directly with your yoga instructor to mix in some of the techniques above as you do yoga so your yoga can be an alternative therapy for OCD.

### Acupuncture as an alternative treatment for OCD

Acupuncture, a traditional Chinese medicine practice involving the insertion of thin needles into specific points on the body, may help alleviate anxiety and stress associated with these symptoms for some individuals. Again, I do not provide acupuncture, but there may be ways for me to work with your provider so that you mix in some of the best therapy for OCD techniques into their work with you.

### Diet and Nutrition

While diet alone is unlikely to be the best therapy for OCD, some people find that certain dietary changes, such as reducing caffeine and sugar intake or increasing omega-3 fatty acids found in fish oil, can help improve mood and reduce anxiety symptoms. I suggest that you see a registered dietician or nutritionist for this, but I can share some information about what I’ve seen work for other clients in my practice.

Some herbs and supplements, such as St. John’s Wort, passionflower, and chamomile, are believed to have calming effects and may help reduce anxiety symptoms. However, I do not provide direct suggestions about this – it’s essential to use caution and consult with an expert in herbal remedies before taking any herbal supplements, as they can interact with medications and have side effects.

### Art as an Alternative Therapy for OCD

Engaging in creative activities like painting, drawing, or sculpting can provide a therapeutic outlet for expressing emotions and reducing stress associated with obsessive-compulsive disorder symptoms.

### ESA Therapy for OCD

Spending time with animals, such as dogs or cats, can have a calming effect and reduce feelings of anxiety and isolation for some people with obsessive-compulsive disorder and thus is an excellent alternative therapy for OCD, even though it is unstructured. This is one reason why I also offer [assessments for emotional support animals](https://dralanjacobson.com/emotional-support-animals-esa/).

It’s important to note that while these alternative therapies may offer benefits for some individuals, they may not be a substitute for [evidence-based treatments](https://positivepsychology.com/evidence-based-therapy/) like CBT. However, in my integrative practice, I am happy to help you develop a comprehensive treatment plan tailored to your specific needs and preferences.

## OCD Treatment Outcomes

The therapies for Obsessive-Compulsive Disorder listed above can have positive outcomes, such as:

### Therapy for OCD and Symptom Reduction

Of course, the main goal of therapy for OCD is decreased obsessions and compulsions. Therapy helps in reducing the frequency and intensity of obsessive thoughts and a decrease in compulsive behaviors. You’ll feel like you have better control over your actions. Even the obsessions and compulsions that do come will be less intense and easier to resist.

### OCD Treatment and Improved Coping Skills

Therapy for obsessive-compulsive disorder gives you tools and techniques to manage anxiety and handle triggers more effectively. Lower underlying anxiety ensures that the obsessions and compulsions will stay low in intensity. In addition, you’ll learn problem-solving skills that can assist in dealing with challenging situations without the intensifying anxiety that leads to compulsions. Thus, therapy for OCD can produce more results than just reducing specific symptoms.

### Increased Quality of Life

As symptoms decrease, you’ll find it easier to engage in daily activities without them interfering. Reduced symptoms can lead to healthier interactions and improved relationships with family, friends, and colleagues. You’ll be able to travel without interference and participate in more activities.

### Personal Empowerment Through OCD Therapy

Successfully managing symptoms through therapy can boost self-confidence and a sense of empowerment. Therapy can also foster a deeper understanding of obsessive-compulsive disorder and help individuals accept themselves without judgment.

Factors such as the severity of symptoms, individual differences, commitment to therapy, and the [quality of the therapeutic relationship](https://www.apa.org/monitor/2019/11/ce-corner-relationships) all play a role in determining the success of treatment. You’ve taken a good first step in reading this information and becoming informed, and I wish you the best of luck whether you contact me or someone else. The best therapy for OCD requires a good match between you and the therapist.

## Psychotherapy for OCD in my practice

I provide psychotherapy for OCD that starts with a treatment plan tailored to each individual’s needs. The severity of symptoms can vary, so finding the right approach for each person is crucial. In some cases, treatment is combined with other goals that the person wants to pursue, while in others, people want the best therapy for OCD alone. Sometimes, we even touch on obsessive-compulsive disorder strategies in [Sports Therapy](https://dralanjacobson.com/sports-psychology/) and Executive Coaching since high-powered people often develop obsessive-compulsive disorder.

In my integrative practice, I can also work with outside providers who can add an alternative therapy for OCD.

### Post-Therapy Options

In-person and [online therapy for OCD](https://dralanjacobson.com/therapy-online-approaches-techniques-and-outcomes/) often includes strategies to prevent relapse and maintain progress even after treatment has concluded. I sometimes hear back from clients who want a refresher or are facing significant stress and want to be sure they are prepared. Many have been able to rid themselves of obsessions and compulsions but want to continue to apply the skills and insights gained to address other life challenges beyond OCD. When that happens, I am happy to help, possibly with a more integrative approach.

Please [contact me](https://dralanjacobson.com/contact/) if you’d like to learn more about what **therapy for OCD** might entail or if you are interested in any of [my services](https://dralanjacobson.com/).

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

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### [Emotional Support Animals (ESA)](https://dralanjacobson.com/emotional-support-animals-esa/)

**Published:** January 11, 2024
**Author:** Dr. Alan Jacobson

**Content:**

✓Clinically Reviewed by [Dr. Alan S. Jacobson, Psy.D., MBA](https://www.dralanjacobson.com/my-bio/), Licensed Clinical Psychologist | Last reviewed: July 13, 2025

 # Emotional Support Animals

## Providing ESA Assessments

I can provide an assessment that may allow you to have **emotional support animals** in your apartment, condo, or dorm.

 [Contact Me About the ESA Process](https://dralanjacobson.com/contact/)

## About Emotional Support Animals

Emotional support animals (ESAs) are companion animals that provide therapeutic benefits to individuals with emotional challenges. A psychologist like me can help you register your pet as part of a plan to help alleviate symptoms associated with conditions such as anxiety, depression, and post-traumatic stress disorder.

Unlike service animals, which are specially trained to perform specific tasks for individuals with physical disabilities, emotional support animals do not require specific training. The mere presence of an ESA positively impacts the individual’s emotional well-being. Common types of emotional support animals include dogs, cats, rabbits, and even smaller animals like hamsters.

In my blog I provide [two examples of emotional support pet services](https://dralanjacobson.com/emotional-support-pet-example/).

 [Schedule a Consult](https://www.picktime.com/scheduleaconsult)

 ![Emotional Support Animals](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "dog-breeder_10 | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## Benefits of Emotional Support Animals

### Emotional Support

The primary benefit of an ESA is the emotional support and companionship they offer. The presence of your companion can help alleviate feelings of loneliness, anxiety, and depression.

### Stress Reduction with an ESA

The act of petting, playing, or simply being in the company of an ESA can trigger the release of oxytocin, a hormone associated with bonding and stress reduction.

### Anxiety Relief

ESAs may help individuals cope with anxiety and [panic attacks](https://dralanjacobson.com/panic-attack-treatment/). The calming presence of the companion and the routine of caring for them can contribute to a sense of stability.

### Emotional Support Animals and Mood

Spending time with an ESA can elevate mood and bring joy. The unconditional love and non-judgmental nature of animals can have a positive impact on one’s overall emotional well-being.

### Social Interaction and Emotional Support Animals

ESAs can facilitate social interactions. Taking a dog for a walk or visiting pet-friendly spaces may increase socialization, helping individuals connect with others and reduce feelings of isolation.

### Sense of Purpose with Emotional Support Animals

Caring for a pet provides a sense of purpose and can contribute to a person’s overall sense of identity and self-worth. Being responsible and having a routine are powerful benefits.

## ESAs: A Quick History

The concept of emotional support animals (ESAs) has a history rooted in recognizing the therapeutic benefits of human-animal interactions. The use of dogs and cats for emotional support dates back centuries, but the modern understanding and formal recognition of emotional support animals gained prominence in recent decades.

### Historical Roots of Emotional Support Animals

Historically, various cultures recognized the positive impact of pets on human well-being. Animals were often used for companionship and comfort. In the 19th century, [Florence Nightingale](https://en.wikipedia.org/wiki/Florence_Nightingale), a pioneer in nursing, observed the positive effects of dogs on patients’ mental health in hospitals. The formalization of using dogs and cats for therapeutic purposes gained momentum in the mid-20th century. Hospitals and mental health institutions began incorporating pet therapy as part of treatment.

In the 1990s, the concept evolved, and the focus shifted from general pet therapy to the specific role of dogs and cats in providing emotional support. This was particularly notable in the context of mental health issues. Studies started to emerge supporting the idea that pets could alleviate symptoms of anxiety, depression, and other emotional conditions.

### Legal Recognition and Emotional Support Animals

While the ESA process is not covered under the [Americans with Disabilities Act](https://www.ada.gov/) (ADA), other laws, such as the Fair Housing Act (FHA) recognizes the need for emotional support animals in specific contexts. The Fair Housing Act (FHA) allows individuals with disabilities to request reasonable accommodations for ESAs in housing, even in properties with no-pet policies.

### ESA Controversies and Challenges

Recently, the increasing prevalence of people getting an emotional support animal letter has led to concerns about people abusing the system to circumvent pet-related restrictions. Ongoing discussions and legal debates surround the legitimacy and [regulation of emotional support animals](https://www.petmd.com/dog/emotional-support-pets-and-service-pets-what-law-says-about-each). This is why psychologists like me cannot guarantee that our assessment will lead to a positive result. I do a [quick screening](https://www.picktime.com/scheduleaconsult) before you pay to provide information about the likelihood of a positive result.

The history of emotional support animals reflects society’s evolving understanding of the connection between pets and emotional well-being, leading to increased recognition and debates on the appropriate use of ESAs in various settings.

 ![registering an ESA](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "ESA Cat | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

## Emotional Support Animals FAQs

Common questions people have about the emotional support animal letter process and ESAs in general.

 ![ESA Assessments](data:image/gif;base64,R0lGODdhAQABAPAAAMPDwwAAACwAAAAAAQABAAACAkQBADs= "Free public domain CC0 photo | Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

##### What laws govern Emotional Support Animals?

In the United States, the [Fair Housing Act](https://en.wikipedia.org/wiki/Housing_discrimination_in_the_United_States) (FHA) allows individuals with ESAs to have their animals live with them in housing that has a “no pets” policy.

##### Why Do I Need an Evaluation

There has been some controversy and debate around the legitimacy of emotional support animals, with concerns about abuse of the system to obtain special privileges. It is true that some people have exploited the concept and have gone on to registering an ESA without a genuine need. For this reason, a professional evaluation for an emotional support animal letter is necessary, and I cannot guarantee you will qualify.

##### How Long Does the ESA Process Take?

You can consult my [home page](https://dralanjacobson.com) for approximate wait times for your initial emotional support animal letter assessment. Usually the appointment itself takes between 45-90 minutes, and then I will have your letter, if you qualify, within 10 days.

##### Are the results of an ESA Assessment guaranteed?

No, a practitioner cannot guarantee the results of an assessment for an emotional support animal. There are strict guidelines in place that we use to determine whether you qualify. However, I do a free 20-minute consultation where I try to learn enough to let you know the chances that you will be approved.

##### Can the emotional support animal assessment be transferred if I get a new pet?

The short answer is yes; if you qualify, you can very likely transfer the approval to a new pet. However, you may need a new emotional support animal letter if the type of animal changes, the number of pets changes, or sometimes if it is a different breed or size.

 ## Registering an ESA

Registering an ESA involves a few steps, though it’s important to note that there isn’t a formal registration process like there is for service animals. This is why qualified professionals like myself can help you with **registering an ESA**. The **ESA process** is quite simple, and if you qualify, you get an **Emotional Support Animal letter** that you can show your landlord if there are other restrictions regarding pets where you live. You may also be able to travel with your pet.

The following is a general guide to the ESA Process, but you are also welcome to contact me or schedule a consultation if you want to discuss any of this further. I offer a free consultation to give you a general idea of your chances of qualifying before you pay anything.

### Qualifications for Registering an ESA

Psychologists with the right experience and expertise can guide you through the ESA process. You’ll need to show that you have an [emotional or psychological challenge that an emotional support](https://dralanjacobson-com-649569.hostingersite.com/emotional-support-pet-example/) animal can help. The challenge must significantly impair one or more major life activities. Not everyone qualifies for registering an ESA. Here are some general qualifications:

**Presence of a Mental Health Disability**: To get an emotional support animal letter, you must have a diagnosed mental health condition that substantially impacts your daily life activities. These conditions may include anxiety disorders, depression, post-traumatic stress disorder (PTSD), bipolar disorder, and other psychological challenges.

**Evaluation from a Licensed Mental Health Professional**: A qualified mental health professional, such as a licensed psychologist, must evaluate your condition and determine that having an ESA would benefit your mental health treatment.

**Need for Emotional Support**: The pet must provide emotional support that alleviates symptoms of your mental health condition. This support could include companionship, reducing anxiety, providing comfort during stressful situations, or helping with emotional regulation.

**Ability to Care for the Animal**: You must be able to care for the pet’s well-being, including meeting its physical and emotional needs. This includes providing food, water, shelter, veterinary care, and a suitable environment for the animal’s health and happiness.

#### Before Registering an ESA

Before you get your emotional support animal letter, it’s essential to understand your rights and responsibilities under federal laws such as the [Fair Housing Act](https://www.hud.gov/program_offices/fair_housing_equal_opp/fair_housing_act_overview). This includes knowing where your pet can accompany you and how to provide necessary documentation when required. Additionally, it’s important to know any local ordinances or housing rules regarding ESAs. While federal law provides certain protections, there may be specific regulations in your area that you need to follow.

Meeting these qualifications is essential for obtaining an ESA letter and ensuring that you and your animal can benefit from the support and companionship they provide while also respecting the rights of others. As part of my services, I will ensure you understand the rules and regulations where you live.

#### Registering an ESA “Formally”

There is no official registry or certification process for ESAs. While some organizations offer optional registration services, these registries are not legally recognized and do not grant additional rights or privileges.

### The Emotional Support Animal Letter

If I agree that registering an ESA would be beneficial, I will provide you with an emotional support animal letter on my official letterhead. This letter will include specific language stating that you have a disability and that the animal is part of your treatment plan.

The ESA letter provides certain rights under the Fair Housing Act and the Air Carrier Access Act. These rights include living with your animal in housing with a “no pets” policy and traveling with your pet in an aircraft cabin without paying additional fees.

#### How to Use the Emotional Support Animal Letter

Once you’re done registering your ESA, inform your landlord or housing provider. Provide them with a copy of your emotional support animal letter and any other documentation they may require. Sometimes, they may have their own specific form, and I’d be happy to fill that out as part of the ESA process.

### ESA Process Restrictions

While registering an ESA affords you certain rights, there are limitations. For example, your pet is not allowed in all public places like service animals are, and they are not granted access to places where pets are generally prohibited, such as restaurants and grocery stores. They also have limited access to transportation.

While the ESA Process exempts you from “no pets” housing policies under the Fair Housing Act, landlords and housing providers can enforce certain exceptions and rules and may impose reasonable accommodation guidelines. Pets are expected to be well-behaved and under control at all times. If a pet exhibits disruptive or aggressive behavior, the owner may be asked to remove the animal from the premises or transportation.

#### ESA Process and Pet Care

While your qualified pet provides emotional support, they must comply with health and safety regulations. This includes keeping vaccinations current, ensuring the animal does not threaten others, and maintaining cleanliness and hygiene.

Understanding these restrictions is essential to ensure you comply with applicable laws and regulations while also respecting the rights and needs of others.

### Summary and My Services

If you qualify, I can provide you with an emotional support animal letter and walk you through the ESA process from start to finish. There is a one-time cost, and I cannot provide a refund if you do not qualify. I would be happy to talk to you beforehand to give you an idea of the likelihood that you will qualify for registering an ESA. Please feel free to [contact me](https://dralanjacobson.com/contact/) anytime or [schedule a consultation](https://www.picktime.com/scheduleaconsult).

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---

### [What is a Clinical Psychologist?](https://dralanjacobson.com/what-is-a-clinical-psychologist/)

**Published:** July 7, 2024
**Author:** Dr. Alan Jacobson

**Content:**

When choosing a therapy provider, you have many choices, including clinical psychologists, [social workers](https://socialwork.buffalo.edu/admissions/is-social-work-right-career-for-me/what-is-social-work.html), and marriage and family therapists. All these professions are solid choices, with high training, education, and expertise standards. A clinical psychologist specializes in diagnosing and treating mental, emotional, and behavioral disorders. We use a variety of therapeutic techniques to help individuals cope with issues such as anxiety, depression, stress, and other challenges. We use many approaches, and I will go over what a humanistic psychologist, a cognitive psychologist, and a Gestalt psychologist do since these are the approaches I commonly use.

I am a clinical psychologist, and this post is designed to help you understand what that means regarding my professional and educational background. In another post, I cover [how to find a psychologist](https://dralanjacobson.com/how-do-you-find-a-psychologist-offering-affordable-therapy/) that matches your needs.

## Clinical Psychologist Overview ![Clinical Psychologist](https://dralanjacobson.com/wp-content/uploads/2024/07/Logo-300x272.gif "| Dr. Alan Jacobson, Psy.D., MBA, Clinical Psychologist")

Here is a general overview of what it means to be a clinical psychologist (see also the clinical psychologist vs. therapist section below):

### Clinical Psychologist Education and Training

Each of us holds a doctoral degree in psychology (Ph.D. or Psy.D.), which they earn after three years of formal study, around 1600 hours of pre-degree supervised training, and 2000 hours of post-degree clinical training. Those who want to practice independently, as I do, must also get an additional 2000 hours of supervised training and pass a rigorous licensing exam. This ensures we have appropriate assessment, diagnosis, treatment planning, and delivery expertise.

Even after getting their license, each clinician must get [continuing education](https://www.apa.org/education-career/ce) hours to stay up-to-date on the latest treatment methods, ethical considerations, and practice standards. The number of hours varies by state. I usually get 10-20 hours of new educational experiences per year.

### Clinical Psychologist Key Roles

Key roles and responsibilities include:

1\. Assessment and Diagnosis: Evaluating patients through interviews, empirical tests, and observations to diagnose mental health conditions.
2\. Therapy and Treatment: Providing individual, group, or family therapy using evidence-based therapeutic approaches such as cognitive-behavioral therapy (CBT), [psychodynamic therapy](https://dralanjacobson.com/psychodynamic-therapy/), and others. I cover three major categories of these approaches in the sections that follow
3\. Research: Conducting scientific research to understand mental health conditions and improve therapeutic techniques. While I do not participate in clinical research much, I do benefit from the great work of others as I design my practice methods.
4\. Consultation: We provide expert advice on psychological issues to other healthcare professionals, organizations, or institutions. I have done much of this type of work in my career, including supervising other therapists.
5\. Education and Training: I have also done a significant amount of this work in the past, teaching and supervising students and trainees.

We do not prescribe medication; instead, we collaborate with psychiatrists and other medical professionals who can provide pharmacological treatment if necessary.

I have worked in various settings, including hospitals, academic institutions, and community health centers. Currently, I work in my private practice, and I also founded and run a [psychological testing practice](https://psychologicalassessments.com/).

## A Humanistic Psychologist

A humanistic psychologist is a professional who practices an approach that emphasizes people’s inherent goodness, the importance of free will, and the human potential for personal growth and self-actualization. Humanistic psychology arose in the mid-20th century as a reaction to the limitations of psychoanalysis and behaviorism. Those approaches were seen as too deterministic and reductionist. Key figures in the development of humanistic psychology include [Carl Rogers](https://en.wikipedia.org/wiki/Carl_Rogers) and [Abraham Maslow](https://en.wikipedia.org/wiki/Abraham_Maslow). I am a humanistic psychologist since this approach encompasses my integrated practice.

### Humanistic Theory

The following are the principles that a humanistic psychologist adheres to

1. Self-Actualization: Realizing and fulfilling one’s potential and capabilities is a [cornerstone of humanism](https://dralanjacobson.com/humanistic-psychology/). Abraham Maslow described it as the highest level of psychological development where personal growth and peak experiences are achieved.
2. Holistic Approach: A humanistic psychologist views the individual as a whole person rather than just a collection of behaviors or a repository of unconscious drives. This approach considers a person’s physical, emotional, social, and spiritual dimensions.
3. Free Will and Personal Responsibility: This concept emphasizes that individuals have the power to make choices and are responsible for their actions and the direction of their lives.
4. Positive Regard: Carl Rogers introduced the concept of unconditional positive regard, in which a humanistic psychologist provides a nonjudgmental, accepting environment that fosters client growth and self-discovery.
5. Authenticity: A humanistic psychologist encourages individuals to be true to themselves and live according to their values and beliefs.

### Humanistic Psychologist Therapeutic Approaches

A [humanistic psychologist focuses](https://dralanjacobson.com/humanistic-psychology/) on the individual’s subjective experience and personal growth. Key therapeutic approaches include:

1. [Client-Centered Therapy](https://dralanjacobson.com/client-centered-therapy/): Developed by Carl Rogers, this approach involves creating a supportive and empathetic environment where clients feel accepted and understood, allowing them to explore and resolve their issues.
2. [Existential Therapy](https://dralanjacobson.com/existential-therapy/): Focuses on exploring the human condition, including themes such as meaning, freedom, isolation, and mortality. This approach helps individuals confront and embrace the realities of existence.
3. [Gestalt Therapy](https://dralanjacobson.com/gestalt-therapy/): Although it has its roots in Gestalt psychology, it shares many principles with the humanistic approach, such as focusing on the present moment and personal responsibility. I will cover this approach more in the next section.

A humanistic psychologist might work in various settings, including private practices, counseling centers, educational institutions, and healthcare facilities. Our primary goal is to help individuals achieve greater self-awareness, self-acceptance, and personal fulfillment.

## Gestalt Psychologist

A Gestalt psychologist specializes in a school of thought that focuses on understanding the human mind and behavior as a whole. [Gestalt psychology ](https://dralanjacobson.com/gestalt-therapy/)emerged in the early 20th century, primarily through the work of psychologists [Max Wertheimer](https://en.wikipedia.org/wiki/Max_Wertheimer), [Wolfgang Köhler](https://en.wikipedia.org/wiki/Wolfgang_K%C3%B6hler), and [Kurt Koffka](https://en.wikipedia.org/wiki/Kurt_Koffka). A Gestalt psychologist emphasizes that the mind perceives objects as part of a greater whole and as elements of more complex systems rather than isolated parts.

### Gestalt Theory

A Gestalt psychologist uses the following rules to interpret human thinking and behavior:

1. The law of Prägnanz states that people will perceive and interpret ambiguous or complex images in the simplest form(s) possible. A gestalt psychologist uses this principle, also known as the law of simplicity.
2. Figure-ground perception refers to distinguishing an object (the figure) from its background (the ground).
3. Proximity refers to objects close to each other and tend to be perceived as a group.
4. Similarity suggests that objects with similar appearance are often perceived as part of the same group.
5. Closure means the mind fills in missing information to create a complete, whole object.
6. Continuity refers to the preference for continuous figures rather than disjointed ones.

### Gestalt Psychologist Therapeutic Approaches

A Gestalt psychologist applies these principles to understand how people perceive visual stimuli, solve problems, and interpret their experiences. In therapy, A Gestalt psychologist focuses on the individual’s experience in the present moment and the context of their environment.

Gestalt therapy, developed by Fritz Perls, Laura Perls, and Paul Goodman, emphasizes personal responsibility and encourages clients to experience and become aware of their thoughts, emotions, and actions in the here and now. A Gestalt psychologist uses a therapeutic approach involving experiential techniques such as role-playing, dialogue, and creative expression to help individuals gain self-awareness and insight into their behaviors and relationships.

## Cognitive Psychologist

A cognitive psychologist is a professional who studies mental processes such as perception, memory, reasoning, problem-solving, and language. Cognitive psychology focuses on how people understand, think, and remember information. It emerged as a major field in psychology during the mid-20th century, influenced by computer science, linguistics, and neuroscience developments. Usually, when people seek a cognitive psychologist, they refer to a desire for [cognitive-behavioral therapy](https://dralanjacobson.com/cbt-for-depression/) (CBT), which many of us commonly use.

### Cognitive Theory

A cognitive psychologist uses the following framework in understanding human behavior and emotions:

1. Perception refers to how people interpret sensory information to understand the environment. This includes visual and auditory processing used to make sense of a situation.
2. Memory is the process involved in encoding, storing, and retrieving information. This includes short-term memory, long-term memory, and working memory. All of these processes affect perception.
3. Attention is how people focus on specific stimuli while ignoring others. Selective attention affects cognitive processes.
4. Language refers to how people understand, produce, and use language. This includes the study of syntax, semantics, and language development and involves what we say aloud and to ourselves.
5. Problem-solving and decision-making is how people approach and solve problems, make decisions, and evaluate options.
6. Learning involves acquiring new knowledge and skills, including classical and operant conditioning and more complex forms of learning.

A Cognitive Psychologist uses various methods to understand the underlying mechanisms of cognitive processes in the people they serve. Their work has applications in various fields, including education, artificial intelligence, cognitive therapy, and human-computer interaction.

### Cognitive Psychologist Therapeutic Approaches

Overall, a cognitive psychologist aims to understand how the mind works and apply this knowledge to improve human functioning in various aspects of life. A cognitive psychologist who does not provide therapy may work to conduct research to advance theoretical knowledge, develop and test interventions to improve cognitive functions, such as memory training programs for older adults, or work in applied settings, such as designing user-friendly interfaces or educational programs based on principles of cognitive psychology.

A cognitive psychologist like me who provides therapy uses cognitive-behavioral therapy (CBT), which combines cognitive principles with behavioral therapy to treat anxiety, depression, and other challenges.

## Clinical Psychologist vs. Therapist

The terms **clinical psychologist** vs. **therapist** are often used interchangeably in everyday conversation, but they refer to different roles, training, and scopes of practice. Here’s a breakdown:

### Clinical Psychologist

#### Education & Training:

- Holds a **Doctorate (PhD or PsyD)** in psychology.
- Trained extensively in assessment, diagnosis, and treatment of mental health disorders.
- Schooling includes at least three years plus two additional years of closely supervised practice.
- Can administer psychological testing (e.g., [IQ tests](https://psychologicalassessments.com/iq-testing/), diagnostic assessments) and provide different [types of therapy](https://dralanjacobson.com/types-of-therapy/).

#### Scope:

- Works with complex mental health conditions and less severe issues
- Can do research, teaching, and clinical work.
- May work in hospitals, private practice, universities, or clinics.

#### Can they prescribe medication?

- **Usually no** — except in a few U.S. states or military settings with extra training.

### Therapist (or “Counselor”)

#### Education & Training:

- This is a **broad term** that includes: 
    - Licensed Professional Counselors (LPC)
    - Licensed Clinical Social Workers (LCSW)
    - [Marriage and Family Therapists](https://www.aamft.org/LEARN_About_MFTs/default.aspx?hkey=c640ae7e-29d8-48a5-86ca-c2b9b4fea0f2) (MFT)
    - Psychologists (yes, they’re therapists too, so clinical psychologist vs. therapist is actually sometimes not a comparison!)
- Typically has a **Master’s degree** (MA, MS, MSW, or MFT) which involves two years of formal education.
- Require at least one additional year of full time closely supervised practice.

### Scope:

- Provides talk [therapy for issues like anxiety and depression](https://dralanjacobson.com/therapy-for-depression-and-anxiety/), relationship problems, stress, trauma, etc.
- May specialize in certain approaches (CBT, EMDR, DBT, etc.).
- Often more accessible for day-to-day issues or ongoing support.

### Clinical Psychologist vs. Therapist Summary Table:

**Role****Degree****Can Diagnose?****Can Prescribe?****Specialty****Clinical Psychologist**PhD or PsyDYesNo (except some exceptions)Assessment, diagnosis, complex disorders, talk therapy, life issues, trauma, anxiety**Therapist**MA/MS/MSWYesNoTalk therapy, life issues, trauma, anxietyIf you’re looking for help, the question of a clinical psychologist vs. therapist depends on your needs.

- Want a formal diagnosis despite a complex set of symptoms and concerns or a deep psychological assessment? → **Clinical psychologist**.
- Want someone to talk to weekly about stress, life transitions, symptom relief, or emotions? → **Both**

## My Integrated Practice

I am a clinical psychologist who uses all three of the above specialties in my integrated practice. I’d be happy to talk to you if you’d like to learn how my approach might work for you, whether you are looking for [individual therapy](https://dralanjacobson.com/individual-therapy/), [couples treatment](https://dralanjacobson.com/couples-therapy/), or [family therapy](https://dralanjacobson.com/family-therapy/). I also use these techniques in several specialty areas, including my work with [college students](https://dralanjacobson.com/therapy-for-college-students/), executive coaching, [executive functioning coaching](https://dralanjacobson.com/executive-functioning-coaching/), and [sports psychology](https://dralanjacobson.com/sports-psychology/). These approaches can be used virtually and in person so that I can deliver services to [many states in the U.S.](https://dralanjacobson.com/) If a different profession might better serve you, I’d be happy to refer you. You can read more about [therapy vs. counseling](https://dralanjacobson.com/therapist-vs-psychologist-therapist-vs-psychotherapist/) and therapist vs. psychotherapist in another post. There is also a post dedicated specifically to what a [private practice therapist](https://dralanjacobson.com/finding-a-private-practice-therapist/) is and another about [what a therapy appointment is like](https://dralanjacobson.com/what-is-a-therapy-appointment-like-go-to-therapy-feeling-confident-and-know-common-therapist-terms/).

If you have any questions or want help finding a clinician that fits your needs, feel free to [contact me](https://dralanjacobson.com/contact/) or [schedule a consultation](https://www.picktime.com/scheduleaconsult) anytime.

 ![author avatar](https://dralanjacobson.com/wp-content/uploads/2024/11/Me.png) 

 Dr. Alan Jacobson Founder and President 

 Dr. Alan S. Jacobson, Psy.D., is a licensed psychologist and certified health service Psychologist and Founder of the Foresight Psychological Institute. He has been practicing for 25 years and is licensed in 44 states. He provides evidence-based psychotherapy for adolescents and adults. His clinical work focuses on anxiety, depression, executive functioning challenges, life transitions, and performance-related stress. Dr. Jacobson integrates cognitive-behavioral, insight-oriented, and values-based approaches to help clients build clarity, resilience, and measurable psychological growth.  [See Full Bio](https://dralanjacobson.com/my-bio/) [    ](https://dralanjacobson.com/my-bio/) 

 Psychology Therapy Psychotherapy Family therapy Couples therapy Mental Health Psychological Science 

 [ ![social network 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](https://www.facebook.com/appliedpsychologicalscience) [ ![social network 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](https://www.instagram.com/appliedpsychological) [ ![social network 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](https://www.linkedin.com/company/psychologicalscience/)

---


## Categories

### [Sports Psychology](https://dralanjacobson.com/category/sports-psychology/)

**Description:** Sports psychology therapy services help athletes from high school to pro develop better focus, achieve flow, and succeed both on and off the field.

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### [Fear of Flying Services](https://dralanjacobson.com/category/fear-flying/)

**Description:** Information about therapy for fear of flying, how it works, what it involves, and what you can expect regarding results. Fear of flying services are proven.

---

### [Public Speaking Fear](https://dralanjacobson.com/category/public-speaking/)

**Description:** Information about therapy for public speaking fear, including what it involves, how it works, and what you can expect as far as positive results.

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### [Therapy Approaches](https://dralanjacobson.com/category/therapy-approaches/)

**Description:** General types of therapy from tried-and-true methods that have been around for some time, to newer innovations and the latest techniques.

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### [College Admissions Services](https://dralanjacobson.com/category/college-admissions/)

**Description:** Psychological services are designed to help with the college admissions process, including ways to present yourself in the most compelling way possible.

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### [Therapy Specialties](https://dralanjacobson.com/category/specialties/)

**Description:** Specialty therapy services include flying fear, fear of public speaking, sports performance, executive coaching, life transitions, college admissions & ESAs.

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### [Types of Therapy](https://dralanjacobson.com/category/types-of-therapy/)

**Description:** Information about the types of therapy I provide, the methods I use for each, and the ways they can be combined for the most positive effect.

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### [Mental Health Diagnoses](https://dralanjacobson.com/category/diagnoses/)

**Description:** Information about specific mental health diagnoses that can be treated through therapy can reduce symptoms and help you overcome challenges.

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### [Symptom Relief](https://dralanjacobson.com/category/symptom-relief/)

**Description:** Specific symptoms that can be addressed through therapy and the results you can expect. Diagnoses are not as important as addressing the underlying symptoms.

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### [Young adults and College Students](https://dralanjacobson.com/category/young-adults-and-college-students/)

**Description:** I have a clinical specialty in serving young adults and college students, focusing on this unique, exciting, and challenging period of life, including all the decisions and transitions that come with it.

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### [Couples Therapies](https://dralanjacobson.com/category/couples-therapies/)

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### [Virtual](https://dralanjacobson.com/category/virtual/)

**Description:** Learn about online therapy, virtual counseling, teletherapy, telehealth psychology services, and how remote treatment can support emotional well-being and personal growth.

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### [Family therapies](https://dralanjacobson.com/category/family-therapies/)

**Description:** Articles and resources on family therapy, parenting, communication, conflict resolution, co-parenting, blended families, and evidence-based strategies for creating stronger, healthier family relationships.

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### [Finding therapy](https://dralanjacobson.com/category/finding-therapy/)

**Description:** Looking for a therapist? Learn how to find the right fit, what questions to ask, and how to choose a therapy approach that aligns with your goals, needs, and preferences.

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