Counseling and Therapy A Local History Throughout the ages, people have sought an empathic ear during times of stress. Today this practice is called psychotherapy, and it has developed into specific forms that can help people recover from mood and anxiety disorders. The first therapy in America may have begun in Winston-Salem, North Carolina [1]. In addition to the town minister, the Moravian community of Old Salem had a full-time counselor to help people in distress. Today, our local region has played a key role in developing new therapies for mood disorders. You can read below about ACT, which originated at UNC-Greensboro, and CBASP, which was developed in nearby Richmond, Virginia. Therapies for Mood and Anxiety Effective therapy involves more than just talking. In fact, when therapy works it can bring about changes in the brain that are similar to the effects of medication. We believe that choosing the right therapy is as critical as choosing the right medicine, and specialize in therapies which have evidence to work for mood and anxiety. These are described below: Cognitive-Behavioral Therapy (CBT) Cognitive Behavioral Therapy is a focused, problem-solving psychotherapy that has been shown in over 375 studies to treat depression, anxiety, panic, anger and marital distress. It is also effective in medical conditions such as chronic pain, hypertension, and fibromyalgia. In CBT, the therapist and client work together as a team to identify and solve problems. Clients learn to overcome their difficulties through changing their thinking, behavior, and emotional response. Mindfulness-Based Therapy People who recover from depression are more likely to stay out of depression if they develop a way of thinking that has been called mindfulness. Jon Kabat-Zinn defines mindfulness as “Paying attention in a particular way: on purpose, in the present moment, and non-judgmentally.” It can be learned on its own and also forms the basis of the two therapies that follow: ACT and DBT. Mindfulness is effective not only for depression and anxiety but also for physical conditions including pain, high blood pressure, sleep disorders, irritable bowel syndrome, immune function and psoriasis. Acceptance and Commitment Therapy (ACT) ACT is an effective therapy for anxiety and depression which builds on the techniques of CBT and takes them in new directions. A recent article from Time Magazine compares the two therapies. Put simply, CBT draws on strengths from the “Left Brain”, or logical side, while ACT draws on the “Right Brain” or creative side. ACT aims to help people live more meaningfully and effectively in their present lives. Through exercises in the therapy room and in the outside world, people learn to meet the challenges of life with greater awareness, flexibility and focus. Dialectical Behavioral Therapy (DBT) DBT is one of a few therapies designed for borderline personality disorder. This complex disorder, which involves frequent problems with mood swings, impulse control and conflicted relationships, has similar symptoms to bipolar disorder and often overlaps with it. DBT uses many of the same principles found in CBT, ACT and Mindfulness (above). It differs in being more structured in teaching people skills to cope with the crises that severe mood swings can bring. DBT works best when people are in individual therapy and a separate DBT skills-training group. At the Mood Treatment Center, we offer individual DBT and help people find skills-groups in the local area. Cognitive Behavioral Analysis System of Psychotherapy (CBASP) for Chronic Depression Despite its awkward name, this therapy is a straight-forward approach to help people recover from depressions that have been long-standing or that keep coming back. When someone has been in depression for a long time, they can develop habits of thinking and relating that are hard to break. People usually aren’t aware of these habits or the effects they have on their lives and relationships. CBASP helps people to regain that awareness and develop new ways of living.	Old Salem, North Carolina, may have been the first place where professional counseling was practiced in America
Interpersonal Therapy (IPT) Therapists have often observed that major changes in life can bring about depression, particularly when these changes impact our relationships. Examples include losing a loved one, moving to a new city, starting a new job or having conflict in a marriage. Once depression sets in, it becomes even more difficult to cope with these stressors. IPT helps people recover their old strengths and develop new ones to better face the obstacles they’ve encountered. Interpersonal Social Rhythm Therapy (IPSRT) This is one of the few effective psychotherapies for bipolar disorder. It teaches people to reset the biological clock which drives their mood swings (also called the circadian rhythm). People achieve greater mood stability by closely watching their daily activities and the effects these activities have on their moods. Family Therapy for Bipolar Mood disorders can bring chaos and confusion to a family, and this therapy helps family members regain their strength by learning what they can, and can’t, do to help their relative. Close relationships have a powerful impact on stress hormones and brain chemistry, and family members can learn ways of relating that help the process of recovery.
Other Therapies Mood disorders often occur with other conditions that can benefit from specialized therapies. Below is a partial list of these possibilities with links to external sites: Cognitive-Behavior Therapy for OCD, Panic, Post-Traumatic Stress, Phobias and Suicidality. Motivational Interviewing for addictions. EMDR Post-Traumatic Stress. Imagery Rehearsal Therapy for Post-Traumatic Stress. Hypnotherapy for addictions, chronic pain and anxiety. Complicated Grief Therapy. Coaching for ADHD. Parenting Skills Training. References [1] Michael Shirley. From Congregation Town to Industrial City: Culture and Social Change in a Southern Community. NYU Press, 1997.