Treatment relevance: anxiety, depression, chronic stressors, pain interference, avoidance.

ACT (pronounced "act") is particularly well-suited for people who struggle with being stuck in unhelpful thought patterns, avoiding painful emotions, or feeling disconnected from their values. Rather than trying to eliminate distressing thoughts and feelings, ACT helps people develop psychological flexibility—allowing them to engage with life more fully, even in the presence of difficult experiences.

Steven Hayes - Dealing with Panic Attacks

Cleveland Clinic - ACT

Treatment relevance: worry, self-doubt, rumination, hopelessness, anxiety, depression, PTSD, sleep.

CBT is structured, goal-oriented, and focused on developing practical skills to modify unhelpful thought patterns and behaviors. It is particularly well-suited for individuals who prefer a problem-solving approach to therapy. CBT can often be infused with mindfulness and acceptance-based approaches. As such, the focus shifts from trying to fix "problematic" thoughts to widening one's perspective and creating space for a more balanced internal dialogue. CBT is one of the most widely researched psychotherapy treatments and can be helpful for many psychological difficulties.

APA - What is Cognitive Behavioral Therapy?

Beck Institute - What is Cognitive Behavioral Therapy?

Treatment relevance: self-defeating behavior patterns, chronic invalidation, alienation, interpersonal inefficacy, dysregulated negative emotions, building a life worth living.

For people who experience intense emotions like anger, anxiety, or fear, life can feel like an emotional rollercoaster. If these emotions have been met with invalidation from others, it can create a cycle where stress leads to unhelpful coping strategies that make things worse over time. While people do their best to manage their emotions, they may unknowingly rely on strategies that bring short-term relief but lead to long-term difficulties. Dialectical Behavior Therapy (DBT) skills can help break this cycle.

I do not offer full-model DBT, which is a more intensive treatment designed for people whose emotional struggles put them at risk of harming themselves. However, DBT skills training can benefit many people by providing practical tools for managing emotions, tolerating distress, and improving relationships. These skills take the guesswork out of emotional regulation, offering structured and effective strategies that can be applied in everyday life. A unique feature of DBT is its integration of mindfulness, which helps people become more present and intentional in how they respond to their emotions. Also, see the 'Blueprint for Living Group.'

Marsha Linehan: Are DBT Skills for Everybody?

Marsha Linehan: Wise Mind

Treatment relevance: OCD, hoarding, panic disorder, phobias, social anxiety, PTSD.

Exposure and Response Prevention (ERP) is a potent and powerful psychological treatment. Many mental health conditions involve patterns of avoidance (e.g., compulsions, steering clear of trauma reminders, etc.). People withdraw from situations that trigger fear or discomfort because avoidance brings temporary relief. Over time, this pattern can take over, making fears feel even more powerful while shrinking the person’s world.

ERP works by breaking these cycles. Instead of relying on reassurance or avoidance, people gradually confront their fears in a structured way to test what actually happens. Will I crash if I drive over that bridge? Will I be harmed if I go out in public? Will I get sick if I use a public restroom? Will I lose my cherished memories if I throw something away?

ERP is not about reasoning your way out of fear—it is about learning, through experience, that you can handle discomfort and uncertainty. As people face their fears, their brains naturally begin to rewire and that sense of being obligated to respond to the fears begins to dissipate. Some of the most powerful moments in Dr. Marquardt's clinical work have come from watching people take these steps and celebrating with them when they come out stronger on the other side.

Facing a Driving Phobia with Exposure Therapy 

Using Exposure Therapy to Overcome Phobia

Treatment relevance: behavioral tics, skin picking, hair pulling, nail biting, self-control.

Habit Reversal Therapy (HRT) helps people become more aware of their repetitive behaviors and the situations or emotions that trigger them. Once these patterns are identified, people learn to replace the unwanted behavior with different, less harmful responses that satisfies a similar need. For example, someone who pulls their hair when stressed might practice occupying their hands with another activity. HRT also teaches strategies to reduce urges, such as increasing mindfulness and making small changes to daily routines that disrupt automatic habits. When combined with other cognitive and behavioral approaches, HRT can break long-standing patterns and improving self-control.

Cleveland Clinic - Habit Reversal Training

Treatment relevance: chronic nightmares.

Nightmares are often a natural response to difficult or traumatic experiences, serving as the mind’s way of processing the distress. However, for some people, nightmares persist long after the original event, replaying the same distressing scenes over and over. When this happens, it can feel like being stuck in a loop, making the nightmares even more likely to return.

Imagery Rehearsal Therapy (IRT) disrupts the nightmares by altering the "script" of the dreams while awake. By imagining new, less distressing endings, people can rewrite the dream in a way that reduces its emotional impact. Practicing this new version before sleep makes it more likely that the revised dream content will replace the old dreams. This process can be empowering, giving people a sense of control over their nightmares while also creating new meaning from the experiences that originally led to the nightmares.

Society of Behavioral Sleep Medicine - Imagery Rehearsal Therapy

Treatment relevance: most mental health concerns.

Mindfulness and acceptance are not specific treatment techniques but a way of approaching therapy and life. Rather than being a quick fix, these perspectives helps people engage more fully with their experiences, even when challenges remain. The goal is not to make problems disappear but to free people to reinvest in their lives in a meaningful way. This often begins with the courageous step of seeing reality as it is, without the filters of our own preconceived notions. While this approach takes effort, mindfulness and acceptance provide a practical path for developing greater awareness, resilience, and a deeper connection to the present moment.

Jon Kabat-Zinn - What is Mindfulness?

Treatment relevance: motivational ambivalence, behavior change, self-destructive patterns.

Change is hard, and if it were easy, most of us would have already done it. Making a real, lasting change in behavior can feel overwhelming, especially when we have mixed feelings about it. Motivational Interviewing (MI) and Motivational Enhancement Therapy (MET) are designed to help people work through this uncertainty in a supportive, nonjudgmental way. Originally developed to help people reduce harmful alcohol use, these approaches are now used for many types of behavior change. The goal is not to pressure or persuade but to help people uncover and strengthen their own reasons for change, making it easier to take meaningful steps forward.

What is Motivational Interviewing?

Treatment relevance: chronic depression, anhedonia (i.e., difficulty experiencing pleasure), low energy.

For people experiencing depression, life can feel dull and colorless. Activities and relationships that once brought joy may now seem distant or unfulfilling. Even when positive moments happen, they often feel muted or fleeting, reinforcing a cycle of withdrawal and disconnection.

Positive affectivity training / behavioral activation takes a different approach than many traditional therapies. Instead of focusing primarily on distress and negative emotions, it helps people recognize, cultivate, and fully experience positive emotions. By learning to notice and savor small moments of joy, warmth, and connection, people can begin to rebuild their capacity for positive feelings. Over time, this process helps counteract the cycle of depression, creating more opportunities for genuine engagement and well-being in everyday life. Also, see the 'Rekindling Joy Group.'

Cochrane Mental Health - What is Behavioral Activation?

Treatment relevance: PTSD symptoms (e.g., intrusive reexperiencing of trauma memories, avoidance of trauma reminders).

Prolonged Exposure (PE) therapy is one of the most effective treatments available for posttraumatic stress disorder (PTSD). After experiencing trauma, the mind and body naturally try to protect against further harm. However, this protective instinct can sometimes lead to unnecessary avoidance—avoiding certain places, memories, or even emotions—trapping people in a cycle where they must constantly push reminders of the trauma out of sight. Over time, this can make it harder to fully engage in life.

PE is designed to help people break free from this cycle. Rather than avoiding painful memories or feared situations, PE provides a structured, supportive way to gradually confront them. This process teaches the brain that these memories, while distressing, are not dangerous. With time and practice, avoidance loses its grip, allowing people to regain a sense of freedom, confidence, and control over their lives. Many people also find that, as they work through treatment, they gain a new understanding of their past—so that their trauma becomes one part of their personal history, rather than something that defines or overwhelms them.

VA - Prolonged Exposure for PTSD

Treatment relevance: relationships, anxiety, depression, dominance, interpersonal passivity.

Many people find themselves stuck in painful patterns of relating to others. They want closeness but also feel disconnected. They fear rejection, yet struggle to trust. Often, people end up repeating the same dynamics in relationships without fully understanding why. These patterns can be shaped by past experiences, which contribute to ongoing distress and loneliness.

Time-Limited Dynamic Psychotherapy (TLDP) is a collaborative and focused approach designed to help people recognize and shift these ingrained patterns. Rather than simply addressing surface-level symptoms, TLDP works to uncover the underlying relational themes that shape a person’s emotional life. Through the therapeutic relationship itself, patients have the opportunity to experience and explore these patterns in real time, gaining insight into how they play out while discovering new, more fulfilling ways of connecting with others. The goal is not just short-term relief, but lasting change that leads to deeper, more meaningful relationships and a greater sense of emotional wellbeing.

Time-Limited Dynamic Psychotherapy

Time-Limited Dynamic Psychotherapy: An Integrationist Perspective