Different therapy approaches emphasize different mechanisms of change. The most appropriate approach depends on the presenting concern, severity, safety needs, evidence base, personal preferences, treatment goals, and therapeutic fit. Many clinicians integrate more than one approach.
| Approach | Core focus | Commonly considered for |
|---|---|---|
| CBT Cognitive Behavioral Therapy | How thoughts, behaviors, emotions, and situations influence one another. Builds practical skills to test beliefs and change patterns. | Anxiety, depression, panic, behavioral avoidance, coping with stress, some trauma-related symptoms, and many other concerns. |
| DBT Dialectical Behavior Therapy | Mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness while balancing acceptance and change. | Emotion dysregulation, chronic self-destructive patterns, borderline personality disorder, intense interpersonal conflict, and distress-tolerance difficulties. |
| ACT Acceptance & Commitment Therapy | Psychological flexibility: making room for difficult internal experiences while choosing behavior guided by values. | Anxiety, depression, chronic pain, stress, avoidance, adjustment concerns, and situations where struggling with thoughts or feelings has become part of the problem. |
| MFT / Systemic Therapy Marriage & Family Therapy | Examines patterns between people, roles, communication, boundaries, and the broader family or relational system. | Relationship conflict, family transitions, parenting concerns, communication problems, couple distress, and concerns strongly shaped by relational patterns. |
| IFS-informed work Internal Family Systems | A parts-based framework that explores protective, vulnerable, and conflicting internal experiences with curiosity and compassion. | Internal conflict, trauma-related patterns, shame, self-criticism, and identity-related work. Evidence is growing, but it is not equally established for every condition. |
What therapy may feel like
CBT often feels structured and skill-focused. DBT often includes direct skills practice and coaching around high-intensity emotions. ACT often emphasizes values, acceptance, mindfulness, and changing your relationship with thoughts. Systemic approaches often map relationship patterns and cycles. IFS-informed work often uses curious, compassionate exploration of different internal “parts.”
How I use these ideas
My work is integrative and individualized. I draw from evidence-based CBT, trauma-focused CBT, ACT, DBT-informed skills, motivational interviewing, person-centered therapy, and solution-focused strategies, while also using systemic and parts-informed concepts when clinically appropriate.
