Cognitive Behavioral Therapy « Private Practice

Private Practice in Cognitive Behavioral Therapy

We are experts in cognitive behavior therapy (CBT) and mindfulness-based cognitive behavior therapy (MBCBT), which are evidence-based, empirically supported, proven treatment in mental health care. On this site, when we refer to CBT, we are automatically referring to MBCBT.

We practice CBT because it works. Our direct experience with clients reflects the broader scientific perspective that CBT is a powerful approach. There are thousands of studies across a variety of disorders, which unequivocally show that CBT is as effective as medication in treating anxiety and depression and more effective than medication in keeping the benefits of treatment after treatment ends. CBT can be combined with medication to increase success. In most cases, it is preferable first to try CBT alone before adding medication. If medication is used with CBT, it may be optimal once symptoms improve to begin reducing medicine and, possibly, stopping it altogether.

Basic Principles of CBT and Mindfulness-Based CBT

Thoughts affect behavior.
Thoughts can be monitored and changed.
Actions or behaviors can be monitored and changed.
Emotions are strongly attached to language; paying attention to language can result in changes in emotion.
Meditation and similar practices help to train awareness and acceptance.

Important Things to Know About CBT

CBT combines behavior therapy and cognitive therapy – two very effective forms of therapy – to offer a wider range of tools and strategies for improved outcomes. Behavior therapy requires action, which is sometimes challenging, that weakens the association between a thought, situation, or trigger and your automatic (learned or habitual) response. By exposing yourself to your triggers in small steps, you alter the automatic response of your brain to the trigger, giving yourself more freedom to practice and eventually changing your experience completely. Behavior therapy teaches you to calm your mind and body, which allows clearer thought, better decisions, and improved well-being. Cognitive therapy addresses your patterns of thinking – your automatic and untruthful thoughts – that contribute to upsetting emotions and distorted responses. These thoughts contribute to limiting how flexible you can be in response to difficulties in your life. Cognitive therapy teaches you to recognize your pattern of illogical or distorted thoughts and to see how the thoughts can influence the way you see the world and your experiences. By combining cognitive and behavior therapy, CBT opens your life to a variety of new possibilities and gives you the freedom to act and decide without being limited by fears, worries, and distorted thoughts.

CBT Requires That You Pay Attention

Success in CBT requires you to develop your attention skills. How you pay attention to your experiences (what you think about them, how you respond to them) helps to shape who you are and can contribute heavily to distress and the symptoms you wish to alter in therapy. Paying attention is what the mindfulness component of CBT is all about. You will learn skills to help you attend to your emotions, thoughts, and actions. Learning new attention skills will help you decide which strategies to use to alter unproductive and upsetting thoughts, actions, and emotions.

Meditation training can be a very powerful tool to regulate attention, increase discernment skills, and promote staying in the present moment. Yoga postures or asanas specifically targeting anxiety and depression can augment meditation skills to further increase mindfulness skills. Dr. Saylor teaches Raja Yoga meditation and postures as part of attention training. If you seek deeper instruction, further training can be part of your treatment plan.

CBT is an Active Partnership

You and your therapist will collaborate, working together in an active problem-directed, goal-oriented, solutions-focused relationship to reach your goals. Your therapist will be an active participant in helping you resolve the issues that bring you to therapy. Together, you will develop a treatment plan that is specific, flexible, and targeted to your goals. The active partnership extends beyond your time in the therapy office to every hour of every day of your life. As a CBT participant, you will have structured, focused assignments that relate directly to your CBT sessions. Completing daily practice, effort in completing agreed-upon activities, and feedback to your therapist about practice will help you reach your goals more quickly.

We work with children, adolescents, and adults, modifying CBT treatment approaches to match maturity and the capacity to learn new and initially challenging skills. When we work with clients under 18 years of age, parents are included in understanding the treatment plan and in knowing the assignments related to the sessions. The level of active parental involvement is determined in discussion with clients and parents. The best outcomes occur when clients take as much responsibility as possible and practice independently. Often, however, parents benefit from learning new skills and can greatly increase treatment success by modifying their own patterns of response. Because the symptoms that bring people into therapy occur in the context of different circumstances and with various people, we implement strategies in as many environments with as many individuals as practical.

CBT Focuses on the Present

As you and your therapist complete the careful process of identifying your goals and deciding how to structure treatment, some focus on your past – on your life history – is important. It’s helpful to learn how the past continues to affect you actively as you begin therapy. Knowing about habits or patterns of reactions that were set sometimes years before beginning therapy may be helpful in explaining how symptoms happen but this knowledge rarely contributes to overcoming the symptoms. In CBT, you will learn strategies to alter your thinking and to face challenges clearly (and more calmly than before, but the calm you seek only occurs after much practice). CBT focuses on how to achieve change not on explaining why you feel the way you feel.

CBT is Relatively Short Term Treatment

A course of CBT can take just a few weeks, a few months, or longer. A great deal depends on how much active practice you contribute to treatment – how well you follow through with assignments and how much effort you put into developing and using the tools you learn. As a general rule, the more complex the problem, the longer the treatment duration. Most people see change within the first month of treatment. Sessions usually occur weekly (or sometimes twice weekly depending on urgency, severity, and available time) for a few months and then usually the time between sessions is increased to allow for greater practice. Sometimes individual sessions occur with group sessions – the frequency and combination is determined by careful discussion between you and your therapist. Sometimes more intensive treatment is advised — for example in OCD, intensive outpatient daily exposure is very helpful. In some cases we can arrange to do this locally. In other cases, we work with providers across the country to assure placement at a treatment facility that meets a clients needs.

Most people who enter CBT do not have clear stop dates. Once sufficient symptom relief and and new skills are established, treatment occurs less frequently. Eventually, appointments for treatment are intermittent and only occur if a “booster” session is needed to sharpen skills or address a new issue. Often, we see clients as they transition from one setting to another – for example from one stage of school to another or from one job to another or during relationship crises – all of these transitions often increase stress, which can be addressed by renewing or sharpening a focus on CBT skills.

More About CBT Treatment and Services at NeuroScience, Inc.

Dr. Saylor specializes in treating a wide range of anxiety disorders, ADHD (sometimes called ADD), and related problems for children, adolescents, and adults. Dr. Saylor has extensive experience treating OCD and has completed advanced training through the Behavior Therapy Institute sponsored by the Obsessive Compulsive Foundation (OCF). He emphasizes evidence-based treatment in CBT, which includes exposure therapy for OCD and other anxiety disorders. In addition to conducting sessions in the office, exposure sessions outside the office may be a routine aspect of treatment. Dr. Saylor routinely and actively collaborates with his colleagues, Dr. Robert Burns, Dr. Sajjad Khan, and Ms. Erin Kardel, to develop and coordinate intensive outpatient exposure treatment for OCD, Panic Disorder, Social Anxiety Disorder, and Specific Phobias (flying, needles and medical/dental procedures, insects, heights, driving, and many others).

Areas of Expertise Include:

Obsessive Compulsive Disorder (OCD) and disorders on this spectrum
Attention Deficit Hyperactivity Disorder (ADHD, ADD)
Specific Phobiasor Fears (including fear of flying, claustrophobia, fear of heights [including bridges], fear of health issues and vomiting, fear of insects [particularly bees], fear of animals [commonly dogs and snakes], and many other common and uncommon fears
Panic Disorder with or without Agoraphobia
General anxiety and dread
Social Anxiety Disorder

Support and therapy groups are offered periodically. Please call 703-787-9090 to learn more about start dates and enrollment in one or more of the following groups: