Modalities
Let’s begin with the fact that a warm, genuine and supportive relationship with a therapist is a foundational requirement to improving your mental health and wellbeing. Therapy will be collaborative and oriented towards addressing challenges that are important to you. Whichever methods are used will be a cooperative decision based on your interests and values, the evidence base for their effectiveness, and Fran’s expertise. Read on for some detailed explanations of what various modalities look like.
Inference-Based Cognitive Behavioral Therapy (I-CBT)
I-CBT is a game-changer for OCD treatment. Whether you’re a clinician or a patient, traditional Exposure-based therapies for OCD can be a challenge to engage with. They are effective, and often leave people feeling better, but not all the way back to themselves. Doubts linger or worries crop up in new areas, and more exposure work is usually prescribed.
I-CBT approaches OCD in a fundamentally different way, showing how OCD is a problem of reasoning and doubt that creates inferential confusion - where we take imagined possibilities and treat them as evidence of threats in the here and now. Importantly, I-CBT honors the content of one’s OCD, explaining how and why these worries matter so much to the sufferer, no matter their history or cultural background. Through a dedicated learning and application of the principles of I-CBT, clinicians and patients can help restore trust in the senses, including one’s own identity, purpose, intentions and desires. Free from doubt, people are able to return to their lives without the suffering OCD causes.
Avoidance is the disease. Anxiety feels terrible for a reason. Your brain and body don’t want you to forget that something in your life could be dangerous. When we avoid those feelings, we strengthen the anxiety and convince ourselves we were right to avoid it in the first place. Clinicians and patients can work together to reduce avoidance, over-accommodation, and fear of anxiety sensations in a gentle and affirming way. Having good reasons to do so can be enhanced by values-based work done in an Acceptance and Commitment (ACT) framework. We can help people teach their brains and bodies that there is no need for fear, and no need to fear the sensations of anxiety either.
Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT)
Research shows that among all the factors responsible for people’s improvement in their mental health, two stand out above the rest. Psychological flexibility and mindful awareness of present-moment experience are skills that are taught in Cognitive Behavioral and Dialectical Behavioral therapies. They support improvements in mental health across many disorders and conditions, and can be accessed throughout life to meet future challenges. CBT works by addressing the content of our thoughts and how that relates to how we see the world and ourselves. DBT helps us manage intense emotions while behaving effectively when we are alone and with other people. They can be used together to tease apart and make sense of complicated reactions to challenging situations where we want to be able to do better while feeling more in control of our minds and emotions.