What is CBT & Why is Finding The Right Therapy Path Important?

I’m a huge advocate for therapy and believe that everyone should participate in therapy of some kind. But it can be difficult knowing where to start and what type to do. 

For me, my experience with therapy began when I was a young teenager. There were some pretty intense things happening around then: my sister had just recently been born, and we had to put my childhood dog down. But the cherry on top was my parents’ divorce.

I didn’t handle it well at all and was reacting in unhealthy ways. I started seeing what I assume was a therapist for general purposes and I absolutely loved her. In hindsight, I realize that some of the symptoms/issues I have now were initially disregarded by her. Likely because I was young and may have not known better. But I got to the point where I was excited to see her. Then, she retired, so I stopped therapy altogether. 

I picked it back up again in 2019 after I made the very unhealthy decision to back to work for a company that was literally the poster child for Toxic Workplaces. Again, I assume I was seeing more of a generalized therapist. She helped me in a ton of ways, though. From her, I learned about boundaries and how to set them, and that I should be confident in any decisions I make for myself or my family. However, I didn’t learn how to create these new habits and sustain them–only that they should be present. 

I saw her for about 2-ish years and then stopped sometime after I went back to working from home. The commute was too far from our place when it was originally 5 minutes from my office. 

There was a time in between when I wasn’t seeing a therapist, but knew that I needed something to supplement the anti-anxiety meds that I was on. I didn’t it much more thought until I looked into testing my son for ADHD. I didn’t think that he had it, but with it running in my family, I wanted to catch it early if he did. My son never needed to be tested–all my answers to the questionnaire suggested he was not close to the ADHD side of attention and hyperactivity. His doctor and I were comfortable with that, and both agreed to revisit it if I see any signs developing later on. 

But as I was going through each question and example of a symptom of ADD/ADHD, I realized that more than half of them applied to me. So I started looking into testing for ADD/ADHD in adults. Turns out it isn’t commonly done—at least not in my area. I kept being referred to a psychiatrist so I could get a prescription. It was frustrating for me because I wanted to test first before adding another medication to my already long list. Luckily, I knew someone who was already established with a psychiatrist, so I decided to set up a consultation with that provider. 

It was a better consult than I was expecting. The provider recognized my desire to test before medication and, while there was still no test, he asked me in-depth questions about my family’s history and my own. What I learned helped to put things into perspective for me. 

He started by teaching me that ADD and anxiety have numerous similarities and can actually influence each other. He also taught me that, especially in adults, there is a base issue with an exacerbated symptom: either an ADD base and exacerbated anxiety symptoms, or an anxiety base with exacerbated ADD symptoms. In my case, he suspected that my base would be severe anxiety with exacerbated ADD symptoms. With the right medications and therapy, I would be able to learn to better manage both and eventually use those learned skills without the help of the medications (or, at worst, with very low dosage levels).

He asked me what type of therapist I had been seeing and I was confused. He asked if they had a specialization. Again, I was confused. And then I learned about different therapy types and specializations beyond the more commonly heard ones like couples counselors or child development. 

He said that I may benefit from finding a therapist who specializes in cognitive behavioral therapy (CBT). If I learned the correct way to manage my anxiety healthily, I would decrease my ADD symptoms and even better other health issues I was having. 

I was so excited to get home that day to look into everything I’d learned. And what I learned was that there is so much more to therapy than I ever could have imagined.

How many types of therapy are there?

The American Psychological Association (APA) recognizes five therapy types:

1. Pyschodynamic and Psychodynamic therapies

Changing problematic behaviors, feelings, and thoughts by discovering unconscious meanings and motivations

2. Behavior therapy

Identifying the role of learning in developing both normal and abnormal behavior (think classical conditioning, desensitizing, and operant conditioning).

3. Cognitive therapy

Emphasizing the theory that dysfunctional thinking is what leads to dysfunctional emotions and/or behaviors

4. Humanistic therapy

Emphasizing people’s capacity to make rational choices and develop to their maximum potential. Other major themes include concern and respect for others.

5. Integrative or Holistic therapy

A blending of all the above elements tailored to each client’s needs.

What exactly is Cognitive-Behavioral Therapy?

Why is it important to find the right type of therapy/therapist?

It can be exhausting to find the right therapist or therapy type. But there’s no shame in “shopping around.” In fact, you should shop around. A study completed in December 2021 looked into the outcomes of therapy for clients who were paired with the “right” therapist versus the “wrong” therapist. They found that, when paired with therapists who had experiences and focuses directly related to the client’s primary concern, the client achieved a more effective outcome based on their goal(s) for obtaining therapy. 

How do I start therapy?

I’m going to plainly state here that I am in no position to be giving out medical advice 😅What I’ll say instead is what I would have done in 2019 if I knew then what I know now. And that is that a significant first step is researching one of the 4 main therapy types listed above and seeing which appears to be the most appealing or helpful (or a combo, if that’s where it ends up going). 

Then I would set up an appointment with my primary care physician (PCP) to discuss issues I’ve been having and that I am seeking therapeutic help for them. This part is important because a therapist/psychologist cannot write prescriptions for any medications that you may need to take to aid in your therapy journey. Instead, your PCP or a psychiatrist must write the script. And, if your doctor is anything like my doctor, then she’ll be hesitant to send over a request to your pharmacy to fill a script for a high-dosage antidepressant without first knowing why in the world you’re asking her for it. Plus, your PCP will need to know what medications you are on to ensure none of them will cancel out the other. Or, you know, kill you accidentally. 

Finally, I’d look for a therapist/psychologist who specializes in the therapy type I think may be best for me and set up a consultation to determine if they are a fit for me. The connection and comfort are key factors–if I don’t sense a connection or understanding, I won’t feel comfortable with them and the sessions will not work. From here, deciding to see a provider in person or virtually is important. In the past, I thought that sessions would be best done face-to-face. But in the last couple of years, I’ve noticed how tense I get whenever I would have to drive somewhere. By the time I would get to my session, we would spend about 20 minutes just complaining about how people can’t drive. I was wasting my own time. 

When I was first looking for a provider who specialized in CBT, I was using a platform called Psychology Today. From there, I discovered a platform called Headway. I was able to choose a provider who had plenty of availability options, specialized in CBT, was in-network with my insurance, and was available virtually or in person.

How do I know which type of therapy is right for me?

Here’s how you determine if the therapy type is right for you: 

You wait. Attend your sessions, check in with your PCP regularly, and stick to any prescriptions that may be included in your treatment plan. Be patient! Progress can happen overnight, but that doesn’t mean that it will. One of my favorite quotes (actually, a book title) that I try to apply to each of my days is, “You can have it all, just not every day.” It helps keep me grounded and keeps things in perspective. As a perfectionist with severe anxiety and a very telling “all or nothing” perception, it’s natural that I would want to start something new and be a master at it by that same night. The consequence of this is that, when I fail, I want to give up entirely. But it’s exactly this type of dysfunctional processing that I’m learning to correct in the first place. 

I learned that CBT was the right type of therapy for me when I was able to notice differences in my levels of self-awareness and methods of emotional regulation. By no means am I done learning. But I’m now at the point where I can rationally identify when and why something triggered an anxious reaction in me. And now I can begin learning how to watch for the signs that come before the trigger fully sets in. 

This is how I (*cue cheesy reference to my slogan*) become a better me, day by day. 

Important Resources: