Therapy is not one-size-fits-all. In my practice, treatment is tailored to the person, the problem, the nervous system, and the goals we are working toward. Some clients benefit from structured skill-building. Others need trauma processing, relational repair, body-based regulation, or a combination of approaches.

​

Below are several therapy approaches I may draw from in treatment. These are not rigid “packages.” They are tools we use thoughtfully, depending on your needs, readiness, symptoms, and goals.

​​

Cognitive Behavioral Therapy (CBT)

 

What it is

Cognitive Behavioral Therapy, or CBT, is a structured, practical approach that helps clients understand how thoughts, emotions, body sensations, and behaviors influence each other. CBT does not mean “just think positive.” It means learning to identify patterns that keep distress going and testing more accurate, flexible, and helpful responses.
 

Common goals

CBT may help clients:

• Reduce anxiety, depression, avoidance, and rumination

• Challenge unhelpful thought patterns

• Change behaviors that maintain distress

• Build coping skills and problem-solving strategies

• Improve confidence through practice

• Develop more accurate self-talk

 

What sessions may look like

CBT sessions are usually active and goal-focused. We may identify a recent situation, examine thoughts and emotions, look at behavioral responses, test assumptions, develop coping strategies, and practice new behaviors between sessions.

 

Frequency and duration

CBT is often weekly or bi-weekly and time-limited. Many CBT protocols range from 8 to 20 sessions, though treatment may be longer when concerns are chronic, complex, or connected to trauma, eating disorders, ADHD, or medical stress.
 

Evidence basis

CBT has one of the strongest research bases among psychotherapy approaches. The American Psychological Association notes that many studies suggest CBT can significantly improve functioning and quality of life. A major review also describes the evidence base for CBT as very strong across many psychiatric disorders, while noting that effectiveness varies by condition and study quality.
 

Expected outcomes and success metrics

Progress may include:

• Reduced anxiety or depressive symptoms

• Less avoidance

• Improved coping and problem-solving

• More balanced thinking

• Better daily functioning

• Increased confidence handling triggers

 

Progress may be tracked with tools such as symptom questionnaires, thought records, behavioral goals, exposure practice, sleep or activity tracking, and client-rated confidence.

 

Example scenario

A client avoids social situations because they think, “Everyone will judge me.” In CBT, we would examine the belief, identify avoidance patterns, test predictions gradually, and build skills so the client can participate in life without anxiety making every decision.

​​

Accelerated Resolution Therapy (ART)

​

What it is

Accelerated Resolution Therapy, or ART, is a trauma-focused therapy that uses eye movements, imagery, and memory reconsolidation techniques to help reduce the emotional and physical distress connected to painful memories.

 

ART does not require clients to describe every detail of a traumatic event out loud. The goal is to help the brain and body process the memory so it feels less distressing, less vivid, or less controlling in daily life.

 

Common goals

ART may help clients:

• Reduce distress connected to traumatic memories

• Decrease intrusive images or emotional triggers

• Improve sleep and reduce nightmares

• Reduce anxiety or physiological reactivity

• Change how distressing images are stored and experienced

• Increase a sense of control over trauma reminders

 

What sessions may look like

ART sessions are more structured than traditional talk therapy. A session may involve identifying a target memory or image, using guided eye movements, noticing body sensations, and using imagery-based techniques to reduce distress and create a more adaptive emotional response. Clients remain awake, aware, and in control throughout the process.

​

Frequency and duration

ART is often described as a brief therapy. Some studies report improvement in a small number of sessions, though this varies by client, trauma complexity, dissociation, safety, and co-occurring symptoms. In practice, ART may be used as part of a broader treatment plan rather than as the entire therapy.

​

Evidence basis

ART has emerging evidence, including randomized controlled trials for PTSD symptoms. One randomized clinical trial examined ART for PTSD and related symptoms, and a 2024 review concluded that ART shows promise as a time-efficient treatment for adult PTSD symptoms, while also noting that more high-quality studies are needed.
 

Expected outcomes and success metrics

Progress may include:

• Lower distress when recalling a memory

• Reduced nightmares or intrusive images

• Fewer trauma triggers

• Improved sleep

• Less body activation when reminded of the event

• Increased ability to talk or think about the memory without becoming overwhelmed

 

Success may be tracked using distress ratings before and after processing, PTSD symptom measures, sleep quality, trigger frequency, and functional goals.

 

Example scenario

A client feels flooded every time they remember a medical trauma, accident, assault, or humiliating event. In ART, we may target the most distressing image and use eye movements and rescripting techniques to reduce the emotional charge, so the memory becomes something that happened rather than something the client keeps reliving.

 

Somatic Therapy

What it is

Somatic therapy uses the body as part of the therapy process. It helps clients notice physical sensations, tension, breath, posture, impulses, shutdown, agitation, and numbness. The goal is not to “think your way out” of distress, but to help the nervous system recognize safety, regulate activation, and process experiences that may be stored physically as well as emotionally.

 

This can be especially useful when clients say things like, “I know logically that I’m safe, but my body doesn’t believe it.”

 

Common goals

Somatic therapy may help clients:

• Recognize body signals before becoming overwhelmed

• Reduce panic, shutdown, dissociation, or chronic tension

• Increase tolerance for emotion

• Build grounding and regulation skills

• Process trauma without becoming flooded

• Reconnect with the body in a safer, less judgmental way

 

What sessions may look like

Sessions may include tracking body sensations, noticing changes in breathing or muscle tension, grounding exercises, movement-based awareness, pacing emotional material, and learning how to move in and out of distress without becoming overwhelmed.

​

This is not forced exposure. A good somatic approach should be paced, consent-based, and collaborative.

 

Frequency and duration

Somatic work is often done weekly or every other week. Duration varies widely. Some clients use somatic strategies as part of broader therapy, while others may focus on nervous system regulation for several months or longer.

 

Evidence basis

The evidence base for somatic approaches is promising but not as strong as CBT for many diagnoses. A randomized controlled trial of brief Somatic Experiencing found benefits for PTSD symptoms and fear of movement in clients with chronic low back pain and comorbid PTSD symptoms, though the authors noted the effects were smaller than expected and clinical importance should be interpreted cautiously. A broader systematic review of body psychotherapy found potential benefits across several types of psychological distress, while also emphasizing the need for higher-quality studies.

 

Expected outcomes and success metrics

Progress may include:

• Improved ability to calm the body after stress

• Less avoidance of body sensations

• Reduced panic intensity or frequency

• Better sleep or less muscle tension

• Increased emotional tolerance

• Greater ability to stay present during difficult conversations or memories

 

Progress can be tracked through symptom ratings, nervous system awareness, body-based distress scales, panic frequency, sleep quality, and the client’s ability to recover after activation.

 

Example scenario

A client becomes tense, nauseated, or numb whenever they discuss trauma or conflict. Instead of pushing through the story, we slow down and help the body recognize manageable amounts of sensation, safety, grounding, and choice. Over time, the client becomes less afraid of their own physical reactions.

 

Polyvagal-Informed Therapy

 

What it is

Polyvagal-informed therapy uses concepts from Polyvagal Theory to help clients understand nervous system states, especially fight-or-flight, shutdown, freeze, and social connection. The practical focus is on recognizing when the body feels safe, threatened, mobilized, or collapsed.

 

This approach can help clients stop interpreting nervous system responses as personal failure. For example, shutdown is not laziness. Panic is not weakness. Numbness is not “not caring.” These may be protective body responses.

 

Common goals

Polyvagal-informed therapy may help clients:

• Identify nervous system states

• Build tools for regulation and recovery

• Increase access to connection and calm

• Reduce shame about trauma responses

• Understand triggers through a nervous system lens

• Improve flexibility between activation, rest, and engagement

 

What sessions may look like

Sessions may include mapping your nervous system patterns, identifying cues of safety and threat, practicing grounding or orienting exercises, using breath and sensory strategies, exploring co-regulation, and noticing what helps you return to a more connected state.

 

Frequency and duration

This work can be integrated into weekly or biweekly therapy. It is often used alongside other approaches rather than as a stand-alone treatment protocol.

​

Evidence basis

Polyvagal Theory has influenced trauma-informed care, somatic therapy, and nervous system education, but polyvagal-informed therapy itself does not have the same level of direct clinical trial evidence as CBT, DBT, or established trauma-focused treatments. A 2025 review describes clinical applications focused on autonomic flexibility, vagal function, and bottom-up regulation strategies, while other reviews emphasize related research on vagal tone, mindfulness, parasympathetic activity, and trauma symptoms.

​

Expected outcomes and success metrics

Progress may include:

• Better awareness of fight, flight, freeze, or shutdown

• Faster recovery after stress

• Less shame about emotional or physical reactions

• Improved ability to stay connected during conflict

• Better use of grounding and regulation skills

• Increased sense of safety in the body

 

Success can be measured through self-report, session tracking, ability to identify nervous system states, reduction in avoidance, improved relational functioning, and fewer episodes of prolonged dysregulation.

 

Example scenario

A client shuts down during conflict and later criticizes themselves for “being immature.” In polyvagal-informed therapy, we would identify shutdown as a nervous system response, learn early warning signs, and practice ways to return to connection without forcing the client to override their body.
 

Interpersonal Psychotherapy (IPT)

​

What it is

Interpersonal Psychotherapy, or IPT, is a structured therapy approach that focuses on how relationships, life transitions, grief, role changes, conflict, isolation, and unmet emotional needs affect mental health.
 

Rather than assuming symptoms exist “just inside you,” IPT looks at the real-life relationship patterns and stressors that may be contributing to depression, anxiety, eating concerns, or emotional distress.

​

Common goals

IPT often helps clients:

• Understand how current relationships affect mood, eating patterns, anxiety, or self-worth

• Improve communication and emotional expression

• Navigate grief, role changes, or identity shifts

• Reduce isolation

• Clarify needs and boundaries

• Build healthier relational patterns

 

What sessions may look like

Sessions usually involve identifying one or two core interpersonal themes. For example, we may focus on grief, conflict, a major life transition, or difficulty asking for support. We may review recent interactions, practice communication, identify emotional patterns, and develop specific relational experiments between sessions.

 

Frequency and duration

IPT is often offered weekly and may be time-limited, commonly around 12 to 20 sessions, though duration can vary depending on clinical complexity and goals.

 

Evidence basis

IPT has a strong evidence base for depression and has also been studied in eating disorders, especially concerns involving binge eating. Reviews of IPT for eating disorders describe it as a leading evidence-based treatment for eating disorders where binge eating is present, though CBT may produce faster symptom improvement for some eating disorder symptoms.

 

Expected outcomes and success metrics

Progress may include:

• Fewer depressive or anxiety symptoms

• Less emotional eating, binge eating, or avoidance

• Improved communication

• Increased social support

• Clearer boundaries

• Reduced conflict or distress in key relationships

 

When appropriate, progress may be tracked with symptom measures, session review, goal ratings, relationship satisfaction, eating behavior logs, or mood tracking.

 

Example scenario

A client notices that binge eating increases after conflict with their partner or after feeling ignored by family. In IPT, we would look at the relationship pattern, the emotions underneath it, and new ways to communicate needs before distress turns into self-criticism, withdrawal, or food-related coping.

 

How We Choose the Right Approach

 

Most clients do not fit neatly into one therapy model. Treatment may combine approaches depending on what is most helpful.

​

For example:

• CBT may help with anxious thoughts and avoidance.

• DBT may help with emotional intensity and crisis patterns.

• Somatic or polyvagal-informed work may help when the body stays on high alert.

• IPT may help when symptoms are tied to grief, conflict, isolation, or relationship stress.

• ART may help when specific memories remain highly distressing.

 

The approach is chosen collaboratively, based on your goals, symptoms, readiness, and what is actually helping.

​

How We Measure Progress
 

Therapy should not be vague forever. While progress is not always perfectly linear, we should be able to tell whether treatment is helping.
 

Depending on your goals, we may track:

• Symptom reduction

• Frequency and intensity of distress

• Emotional recovery time

• Sleep, appetite, concentration, or daily functioning

• Relationship patterns

• Eating disorder behaviors or body image distress

• Trauma triggers, nightmares, or intrusive memories

• Skill use outside of session

• Confidence handling real-life stressors

• Quality of life and values-based action
   

The goal is not just to feel better in session. The goal is to function better, relate better, recover faster, and feel more able to live your actual life.