Cognitive therapy: A relatively short-term form of psychotherapy based on the concept that the way we think about things affects how we feel emotionally. Cognitive therapy focuses on present thinking, behavior, and communication rather than on past experiences and is oriented toward problem solving. Cognitive therapy has been applied to a broad range of problems including depression, anxiety, panic, fears, eating disorders, substance abuse, and personality problems.

Cognitive therapy is sometimes called cognitive behavior therapy because it aims to help people in the ways they think (the cognitive) and in the ways they act (the behavior). Cognitive therapy has, for instance, been used to help cocaine-dependent individuals become abstinent from cocaine and other substances. The underlying assumption is that learning processes play an important role in the development and continuation of cocaine abuse and dependence. These same learning processes can be used to help individuals reduce their drug use.

Cognitive-behavioral therapy is a relatively short-term, focused psychotherapy for a wide range of psychological problems including depression, anxiety, anger, marital conflict, loneliness, panic, fears, eating disorders, substance abuse, alcohol abuse and dependence and personality problems. The focus of this therapy is on how you are thinking, behaving, and communicating today rather than on your early childhood experiences. The therapist assists the patient in identifying specific distortions (using cognitive assessment) and biases in thinking and provides guidance on how to change this thinking.

Cognitive therapy helps the patient learn effective self-help skills that are used in homework assignments that help you change the way you think, feel and behave now. Cognitive-behavioral therapy is action-oriented, practical, rational, and helps the patient gain independence and effectiveness in dealing with real-life issues.

Many people wonder what to expect when they begin therapy. Although your individual experience will vary depending on the problems and goals that you have, many patients can expect the following

Initial Assessment: You will be asked to complete a number of self-report forms. These forms assess your presenting problem and your history of problems. These standardized questionnaires assess depression, anxiety, emotions, decision making, personality, relationship issues, substance abuse, and other problems. After your therapist has reviewed these forms you can work together to determine what areas need work and what your “symptom level” is prior to treatment. In this way, you can also assess whether you are making progress.

Periodic Assessments: Periodically your therapist may have you fill out additional forms in the course of treatment to see what is changing and what still needs to change. This allows you and your therapist the opportunity to see what is really going on. You can learn if your depression, anxiety or emotional responses are changing. You may also want to set some goals for your behavior—for example, projects that you want to get done or things that you are procrastinating on.

Self-Help: A great deal of research shows that patients who actively do self-help homework are more likely to improve and maintain their improvement. You and your therapist can develop techniques and interventions that you can practice outside of therapy sessions to help you feel more effective in handling your emotions, negative thoughts, relationships and behavioral problems. Self-help builds a sense of self-effectiveness.

Aren’t my emotions important? Our group uses the latest research on emotional processing to enhance the humane nature of your experience. We emphasize the importance of compassion and validation in therapy and encourage you to direct compassion and validation toward yourself when you are feeling down. In addition, our approach emphasizes how you think about and deal with your emotions. For example, we will examine if you feel ashamed or confused about the way you feel. We will also examine your beliefs that your emotions are out of control or dangerous. In fact, our view is that your emotions are the central part of your experience and they often contain information about what you need. Your therapist can help tailor your therapy to help you understand and respect your emotional experiences–without feeling overwhelmed by that experience.

Reading Material: You and your therapist can decide together what additional reading material can help you understand your problem. This website is an excellent source of information on a great number of issues—so you should take some time and examine the content of the extensive readings on this website. We also have books available for purchase and other reading material on a number of problems. We will try to suggest readings that reflect scientifically based approaches to depression, anxiety, relationship issues and other problems.

Plan of Treatment: You and your therapist can work together to set up a problem list or goals that you want to work on. These problems might include procrastination, self-esteem, sadness, inactivity, anxiety, relationship conflicts, or any problems that you think you need help with. Over the course of treatment you and your therapist can devise plans and techniques to address these problems.

Agenda-setting: Although you and your therapist will want to be open to dealing with your immediate concerns as they arise in the session, we recommend that you come to each session with one or two issues that you want to address for that meeting. In addition to your topics, you and your therapist will want to review your feelings about the last session, any self-help you used, and your plans for the coming week, including additional self-help.

Isn’t Medication Important? Medication can often help you get a better handle on your problems. Therefore, you will want to consider medication as part of your treatment. Not all patients need to take medication—in fact, for depression and anxiety, many people get better without medication. However, it may be a valuable additional tool that you can use. We can provide you with referrals to leading psychopharmacologists in the area for a medication consultation. Some patients — for example, those with bipolar disorder or schizophrenia — should consider medication as an essential part of their overall treatment program.