Cognitive Behavioral Therapy in Florida
Cognitive Behavioral Therapy (CBT). Is a well-established, highly effective, and lasting treatment that focuses on identifying, understanding, and changing thinking and behavior patterns. Benefits are usually seen in 12 to 16 weeks, depending on the individual. This a preferred approach of the undersigned because the patient is actively involved in their own recovery and learns skills that will be useful throughout their life time. It involves patient education, record keeping between appointments and homework assignments that general benefit.
Exposure Therapy. A form of CBT, exposure therapy is a process for reducing fear and anxiety responses. In therapy, a person is gradually exposed to a feared situation or object, learning to become less sensitive over time. This type of therapy has been found to be particularly effective for phobia. This is often employed in combination with other interventions for driving phobias.
Acceptance and Commitment Therapy (ACT). Therapy uses strategies of acceptance and mindfulness (living in the moment and experiencing things without judgment), along with commitment and behavior change, as a tools to change what one dislikes about themselves and their environment. ACT involved clarifying your personal goals and what you are willing to commit to change.
Dialectical Behavioral Therapy (DBT). Integrates cognitive behavioral interventions with concepts from meditation to focus on acceptance and change. The focus is upon learning mindfulness, increasing ones ability to tolerate distress, learning to regulate one’s emotions and developing interpersonal skills.
Eye Movement Desensitization and Reprocessing (EMDR). Under certain conditions rapid eye movements reduce the intensity of disturbing thoughts. A treatment known as eye movement desensitization and reprocessing, or EMDR, helps one experience disturbing material in a less distressing way. Research has found this to be helpful for PTSD, panic attacks and phobia.
Biofeedback. Biofeedback is combined with relaxation therapies to help you learn to manage your physical and emotional reactions to stress and to reduce the intensity and frequency of your anxiety. This intervention has long lasting effects and is often a good alternative to medication.
We work to help patients understand that anger is a normal emotions, which only becomes problematic when they are aggressive and engage in behavior that causes damage or injury. We help them understand the cyle of anger by identifying their own early warning signs, events and situations which serve as triggers for them and negative thoughts that escalate their anger into aggression, emotinal reactions which fuel the situation and unhealthy behaviors. Next we help individuals learn important anger management skills including recognizing their anger early, various methods of self-calming, how to use time outs effectively, how to increase their resilience and anger threshold so they are not so easily upset, to anticipate consequences, how to express their anger assertively and how to brainstorm solutions to the problems that confront them.
The treatment plan for your depression depends on many factors. Our emphasis is on nonpharmacological approaches that develop healthy life style habits which mitigate depression and decrease recurrence. I emphasize patient education and behavioral activation. We employ cognitive behavioral therapy in combination with exercise. In some cases we also utilize the gentle intervention of transcranial electrotherapy as an alternative or supplement to medication. This is because transcranial electrotherapy does not have the side effects of antidepressants and there is no concern about medication interactions. I frequently recommend use of the
Alpha Stim AID for my patients who are struggling with anxiety, depression, pain, anger, and autism. From the layperson’s perspective, I believe the Alpha Stim can be compared to a pace maker for the heart. It sets a normal rhythm which guides the brain, so that faster rhythms slow down and slower rhythms speed up.
In reality, exactly how Alpha-Stim technology effects the changes it does is not understood. But, research suggests that Alpha-Stim produces its benefits when the microcurrent waveform activates groups of nerves located at the brainstem. These groups are responsible for the production of serotonin, a brain chemical associated with relaxation and contentment and acetylcholine, which a neurotransmitter which has anxiolytic effects. These cell groups control the activity of nerve pathways that run to and from the brain through the spinal cord. The Alpha-Stim AID alters the electrical and chemical activity of some nerve cells in the brainstem amplifying activity in the parasympathetic nervous system and diminishing activity in the sympathetic nervous system. This modulation, occurs concurrent with production of an alpha brain wave state which is accompanied by relaxation, calmness and focus. When in this state individuals have adecreased perception of pain, experience less agitation and find their mood is more stable. Patients report experiencing these effects after a sole treatment with repeated treatment increasing the strength and duration of the benefits. Technically, the Alpha-Stim® AID engages the serotonergic (5-HT) raphe nuclei of the brainstem. 5-HT inhibits brainstem cholinergic (ACh) and noradrenergic (NE) systems that project supratentorially. This suppresses thalamo-cortical activity, arousal, and agitation, alters sensory processing and induces EEG alpha rhythm. As well, 5-HT can act directly to modulate pain sensation in the dorsal horn of the spinal cord, and alter pain perception, cognition and emotionality within the limbic forebrain. Patient’s often ask why this is not a more commonly used intervention or why their physician is not familiar with it. The fact is that western medicine is dominated by the use of medications and this bias is fostered by large pharmaceutical companies. But, there is solid research data to support its benefits. In fact, approximately nine (9) out of ten (10) people receive significant results. Moreover, the level of benefit or effect size is generally quite large. Most anxiety and pain patient report feeling relief beginning with the very first treatment. Moreover, the effects are both cumulative and long lasting.
ALPHA-STIM® RESULTS AT A GLANCE PHYSICIAN POST-MARKETING SURVEY ON 500 ALPHA-STIM® PATIENTS
Condition N Worse No Change Slight <24% Fair 25-49% Moderate 50-74% Marked 75-99% Complete 100% Signi-ficant >25%
- Pain 286 .35% 1.75% 6.99% 16.78% 26.92% 37.76% 9.44% 90.91%
- Anxiety 349 0% 2.29% 4.01% 11.17% 25.5% 51.86% 5.16% 93.7%
- Depression 184 0% 4.35% 5.89% 16.85% 20.65% 44.57% 7.61% 89.67%
- Stress 259 0% 2.32% 4.63% 14.29% 27.03% 47.88% 3.86% 93.05%
- Insomnia 135 0% 11.85% 8.89% 12.59% 25.19% 33.33% 8.15% 79.26%
- Headache 151 .66% 5.3% 3.97% 16.56% 21.19% 41.72% 10.6% 90.07%
- Muscle Tension 259 .77% 2.32% 2.32% 16.22% 29.34% 42.86% 6.18% 94.59%
Results of using Alpha-Stim® technology as reported by healthcare practitioners.Total N = 500 patients with multiple symptoms. For additional information see the book: Kirsch, Daniel L. The Science Behind Cranial Electrotherapy Stimulation. Medical Scope Publishing Corporation, Edmonton, Alberta, Canada, 2002. Peer-Reviewed Outcomes on 2,500 Alpha-Stim® Patients Self-Reports
- Condition N Slight 24% Fair 25-49% Moderate 50-74% Marked 75-100% Significant >25%
- Pain (all cases) 1949 6.98% 31.97% 38.02% 23.04% 93.02%
- Back Pain 403 4.69% 27.05% 38.96% 29.03% 95.04%
- Cervical Pain 265 6.79% 26.04% 47.17% 20% 93.21%
- Hip/Leg/Foot Pain 160 3.75% 26.88% 33.13% 36.25% 96.25%
- Shoulder/Arm/Hand Pain 150 8.67% 27.33% 42% 22% 91.33%
- Carpal Tunnel 25 0% 20% 68% 12% 100%
- Arthritis Pain 188 5.85% 27.13% 46.81% 20.21% 94.15%
- TMJ Pain 158 10.76% 37.97% 37.97% 13.29% 89.24%
- Myofascial Pain 62 9.68% 29.03% 29.03% 32.26% 90.32%
- RSD 55 18.18% 29.09% 34.55% 18.18% 81.82% Fibromyalgia(alone) 142 9.15% 37%.32% 36.62% 16.9% 90.85%
- Fibromyalgia (with other) 363 9.09% 36.09% 41.87% 12.95% 90.91%
- Migraine 118 1.69% 41.53% 25.42% 31.36% 98.31% Headaches (all other) 112 17.86% 26.79% 21.43% 33.93% 82.14%
- Psychological (all cases) 723 8.44% 24.2% 32.78% 34.58% 91.56%
- Anxiety (alone) 128 10.16% 22.66% 32.81% 34.38% 89.84%
- Anxiety (with other) 370 8.92% 22.97% 32.97% 35.14% 91.08%
- Anxiety/Depression 58 5.17% 32.76% 32.76% 29.31% 94.83%
- Depression (alone) 53 13.21% 20.75% 43.4% 22.64% 86.79
- Depression (with other) 265 10.94% 23.02% 35.09% 30.94% 89.06%
- Stress 123 4.88% 24.39% 31.71% 39.02% 95.12%
- Chronic Fatigue 50 6% 60% 20% 14% 94%
- Insomnia 163 6.13% 28.83% 28.83% 36.2% 93.87%
Results of using Alpha-Stim® technology at least 3 weeks from consecutive warranty cards. Total N = 2,500 patients with multiple symptoms. For additional information see: Smith, Ray B. Is microcurrent stimulation effective in pain management? An additional perspective. American Journal of Pain Management, 11(2):62-66, 2001. The cost of the unit with shipping, handling and taxes is $850.00 (plus $33.00 if you use a credit card) payable at the time of ordering. There is a second unit, the Alpha Stim M which I recommend for those who have localized pain, as it treats anxiety, depression, insomnia and localized pain. This unit cost $1450.00 (plus $56.00 if you use a credit card) with taxes, shipping and handling.
I am not able to bill your insurance either of these units. So, it is an out of pocket expense. It takes about a week for me to receive the unit from the manufacturer. At the session after it arrives, I will review with you how to use the unit and how often you want to use it.