Cognitive Therapies
"The only way to make sense out of change is to plunge into it, move with it, and join the dance."
— Alan Watts,The Wisdom of Insecurity: A Message for an Age of Anxiety
What is a “Cognitive Therapy” approach?
The term “cognitive” simply refers to our internal mental processes such as thinking, understanding, learning, and remembering. Cognitive therapy approaches focus on understanding, accepting and/or modifying the ways our thoughts influence our feelings and behaviors.
There are a variety of cognitive therapies, each with its own set of methods. However, they all aim to equip one with tools and practical strategies to promote improved emotional resilience and healthier ways of coping with life’s challenges.
Isn’t this just “regular” talk therapy?
While these types of therapy approaches involve talking, they go beyond merely “venting” your concerns.
Each cognitive therapy approach is distinct and designed to target specific needs and skills, with your therapist steering the discussion to focus on your unique situation.
The holistic-integrated approach is all about using a variety of different methods to facilitate balance between the mind, body and spirit. Cognitive therapy approaches are one aspect of this larger picture of overall wellness.
When combined with experiential approaches, such as Expressive Arts and Somatic Therapy, the therapeutic process becomes deeper and richer, making way for a more personalized and meaningful healing journey.
View the sections below to learn about the types of Cognitive Therapy approaches offered by our team at Heartcore.
Acceptance and Commitment Therapy (ACT)
Acceptance and Commitment Therapy (ACT) is a mindfulness-based therapy that helps individuals accept difficult emotions, rather than avoiding or fighting them. This approach is aimed at increasing psychological flexibility, so that one can better connect with their personal values and commit to actions that align with them.
-
ACT uses six core processes:
Acceptance – Allowing emotions and thoughts to exist without judgment or avoidance.
Cognitive Defusion – Learning to detach or create distance from distressing thoughts to reduce their emotional weight. Techniques might involve labeling them as just words or images instead of absolute truths
Being Present – Cultivating mindfulness to stay engaged in the present moment. Observing thoughts and feelings as they arise without trying to change them can help to see things more clearly.
Self-as-Context – Recognizing that you are more than your thoughts and emotions. This is all about fostering a stable sense of self and identity outside of just what goes on in your mind.
Values – Identifying personal values that then guide intentional, meaningful actions.
Committed Action – Taking steps in line with values, even in the face of discomfort or fear.
Sessions may involve techniques such as mindfulness exercises, the use of metaphors and visualization, exploration of values, and planning committed action.
ACT is highly effective for individuals experiencing anxiety, depression, chronic pain, trauma & PTSD, stress and burnout. It’s also beneficial for those struggling with self-doubt, perfectionism, or difficulty making decisions.
Dialectical Behavior Therapy (DBT)
Dialectical Behavior Therapy (DBT) combines cognitive-behavioral techniques with mindfulness practices to help individuals manage intense emotions, improve relationships, and build coping skills for challenging situations.
-
DBT involves developing skills in four key areas:
Mindfulness: Helps individuals stay present and fully engage in the moment, reducing impulsivity and fostering self-awareness.
Distress Tolerance: Teaches techniques, such as self-soothing or distraction strategies, to manage difficult emotions instead of trying to avoid them or act in ways that make the situation worse.
Emotion Regulation: Provides tools to identify, understand, and manage intense emotions in healthier ways, promoting emotional balance.
Interpersonal Effectiveness: Focuses on building strong, healthy relationships by teaching assertiveness, boundary-setting, and effective communication skills.
DBT in an individual therapy session typically involves reviewing progress, setting goals, problem-solving, teaching and practicing coping skills together. An important part of DBT is applying these skills in daily life, so “homework”—such as keeping a mood journal or working towards specific goals—may be assigned to maintain progress between sessions.
DBT is most beneficial for those struggling with mood disorders and emotional dysregulation, trauma & PTSD, impulsive or high-risk behaviors, anxiety and depression, as well as addiction and substance use disorders.
Narrative Therapy
Narrative Therapy emphasizes curiosity and collaboration to help individuals rewrite the stories they tell about themselves. By separating the person from their problems, it allows for the creation of new, more empowering narratives that align with their values and goals.
-
Some of the key techniques used in narrative therapy include:
Externalization: Separating the problem from the person by framing it as something outside of themselves (e.g., "I’m struggling with anxiety" rather than "I am anxious").
Deconstructing Stories: Examining the dominant stories in one’s life to uncover how they’ve been influenced by societal or cultural factors.
Identifying Exceptions: Highlighting moments when the problem didn’t dominate, revealing strengths and alternative stories.
Re-authoring: Helping one create new, empowering narratives that emphasize their values, strengths, and abilities.
Thickening the Story: Adding depth and detail to these new narratives to reinforce their impact and meaning.
The role of the therapist in narrative therapy is to act as a compassionate and curious guide, not as an “expert.” By asking open-ended questions and listening closely to an individual’s personal perspective, the goal is to help one feel empowered to explore and reshape their own life story.
Narrative therapy can be helpful for many people, especially those coping with anxiety, depression, trauma, anger management, addiction, relationship challenges, grief and loss, self-esteem and identity struggles.
Rational Emotive Behavioral Therapy (REBT)
Rational Emotive Behavior Therapy (REBT) is a subtype of cognitive-behavioral therapy that helps individuals challenge and replace irrational beliefs with healthier, more constructive ones. It teaches that it’s not events themselves that cause emotional distress, but the beliefs we hold about them.
-
REBT uses the ABCDE framework:
A – Activating Event: Identifying the situation or event triggering distress.
B – Beliefs: Examining the irrational beliefs or thoughts about the event.
C – Consequences: Exploring the emotional or behavioral outcomes of these beliefs.
D – Disputing: Challenging and replacing irrational beliefs with rational alternatives.
E – Effect: Noticing the positive emotional and behavioral changes resulting from new, healthier beliefs.
Therapy sessions often include role-playing, thought experiments, positive visualization and journaling or reflection homework assignments to practice disputing irrational beliefs in real-life situations.
REBT can be helpful for individuals struggling with anxiety, depression, anger management issues, low self-esteem, and stress related to work, relationships, or life changes.
It also well suited to those dealing with perfectionism, fear of failure, procrastination, impulsivity, and addiction or substance use issues.
Cognitive Processing Therapy (CPT)
Cognitive Processing Therapy (CPT) is a structured, trauma-focused therapy grounded in cognitive-behavioral principles that helps individuals recognize, challenge, and reframe the impact of traumatic events.
-
CPT involves identifying and challenging "stuck points"— unhelpful beliefs and thoughts that arise after trauma. The process typically includes:
Education: Learning about PTSD, trauma’s impact on thoughts and emotions, and the goals of CPT.
Recognizing Stuck Points: Identifying unhelpful or distorted thoughts related to the trauma.
Challenging Unhelpful Beliefs: Using structured techniques to question and modify these beliefs.
Processing Trauma: Writing and/or discussing detailed accounts of the traumatic event to process and reframe its meaning.
Reframing Core Beliefs: Examining how trauma has influenced beliefs about safety, trust, control, and self-worth, and creating healthier perspectives.
CPT is well studied to be highly effective for individuals struggling with PTSD and complex or ongoing trauma, as well as anxiety and depression stemming from traumatic experiences. It can be greatly beneficial in remediating feelings of guilt or shame about past events, difficulties trusting others or maintaining relationships, and emotional numbness or avoidance.
Written Exposure Therapy (WET)
Written Exposure Therapy (WET) focuses on helping individuals confront and process traumatic memories through writing and self-reflection. By gradually confronting the traumatic memory in a controlled way, this approach helps reduce avoidance, decrease emotional distress, and promote healing without requiring extensive verbal discussion.
-
WET consists of several key components:
Writing Assignments: Individuals are guided to write about their traumatic experiences in as much detail as possible, focusing on thoughts, feelings, and sensory details.
Gradual Exposure: The writing process allows one to gradually confront their memories, reducing avoidance and anxiety associated with the trauma.
Reflection and Review: After writing, one is prompted to review their narrative and reflect on the emotions and thoughts that arise, promoting emotional processing and insight.
Feedback and Support: The therapist provides guidance and support throughout the process, helping one to navigate their experiences and develop coping strategies.
WET, like other types of exposure therapy, can feel distressing at first, but your therapist is there to guide you through each session to ensure you feel safe, supported, and in control the whole time.
The positive benefits of WET can be felt fairly soon, and can typically be completed in fewer sessions than other types of therapy.
WET is best suited for those coping with the effects of PTSD or trauma-related anxiety and depression. This approach uniquely shifts the focus away from the “talking” part of therapy, so it can significantly help those who may have difficulty discussing or processing memories related to traumatic events.
Benefits of Cognitive Therapies
While these cognitive therapy approaches are unique in their own way, they all share a focus on the interconnectedness of thoughts, emotions, and behaviors to develop healthier ways of navigating life’s challenges.
When woven into the therapeutic process alongside other holistic approaches— such as Expressive Arts and Somatic Therapy— and practices such as mindfulness, nutritious eating, social connection, and self-care, these cognitive therapies work to create a balanced and vibrant life inside and out.
Outcomes of implementing these types of therapies may include:
Greater ability to identify and reframe unhelpful thought patterns
Improved coping strategies and practical skills for better emotional regulation
Greater self-awareness
Stronger interpersonal relationships
Improved perception of self and personal identity
Increased confidence and empowerment to navigate life's challenges more effectively
Explore All Treatment Approaches
