Social Media & the Teenage Brain: What Parents Need to Know (and What Actually Helps)

Apple CEO Tim Cook once said, “If I am looking at the device more than I’m looking into someone’s eyes, I’m doing something wrong.” This captures what most of us already know intuitively: our devices are powerful, useful, and connective, but they can also quietly pull us away from real human connection. If this is true for adults with fully developed brains, it’s even more true for teens. The reasons go far deeper than just “bad habits”.  They’re grounded in child development, neurobiology, and the changing social landscape today’s adolescents are being forced to navigate.

As therapists, we’re not anti-tech. Phones and social platforms are part of the world modern adolescents live in. But when 46% of teens report being online “almost constantly,” we’re looking at more than a trend, we’re looking at a developmental environment that has radically shifted in just one generation.

This blog breaks down why social media is hitting adolescents so hard, what healthy development actually requires, and what parents and therapists can do to support teens in the real world, not the digital one.

 

Healthy Development: What Teens Actually Need

To understand why screens hit teens so hard, we have to understand what teens actually need for healthy development. Adolescence is the stage where abstract reasoning, identity exploration, independence, and emotional resilience take shape. These skills cannot be learned through passive scrolling. They require real life peer interaction, face-to-face conflict and repair, risk-taking and exploration, non-parental role models and social opportunities.

Traditionally, teens built these muscles through rough-and-tumble play, sleepovers, after-school adventures, summer camp, part-time jobs, and unsupervised time with friends. These moments teach autonomy and competence. Over the past decade, screens have increasingly replaced these “training grounds.” The result: teens are missing the developmental reps required for competence and confidence, identity formation, and real-world resilience.

The Biology Behind It

Adolescence is a sensitive period of brain growth. The brain eliminates unused connections while strengthening the ones teens use most. This is where screens become disruptive. High screen use impacts teens brains by flooding the dopamine system with fast rewards and training the brain to prefer rapidly changing stimuli as opposed to sustained, low intensity tasks like completing assignments, drawing, or doing a puzzle. Screens and social media overwhelm our emotion-processing centers that are already under construction. This is not a lack of will power…it’s biology meeting technology.

 

Gen-Z Shift: Why This Generation Is Different

Throughout the 2010s socialization changed on a generational level. Face-to-face interactions dropped sharply while screen-based communication surged. That shift didn’t just affect individual teens, it reshaped the entire cultural norm. This caused both individual and group level impacts. Individually, teens who barely use social media may avoid the direct harms associated with it: higher rates of anxiety, depression, self-harm and suicidality or attention problems. At the group/generational level, if all peers socialize online, that teen now becomes isolated by default. So which is worse: no social media at all…or too much? The answer is in between. Emotion-processing regions of the brain are already vulnerable during puberty. Screens amplify that vulnerability.

 

Areas of Impact: What Screens Disrupt Most

Humans (especially adolescents) are wired to learn through face-to-face interaction. These social “reps” teach us how to read nonverbal cues, build empathy, practice vulnerability and engage in deeper, unedited conversation with peers. With the rise of social media and virtual interaction, teens have learned to “swipe away” discomfort in seconds. 

This instant relief device not only makes in person interaction difficult, but creates a series of attention problems. Many teens (and adults) now scroll through social media while watching TV, switching between apps every few seconds. The instant skip culture makes sustaining focus on tasks like homework, conversations, or even hobbies… feel nearly impossible. Teen brains already struggle with inhibitory control. But now they must resist a device that is literally designed to override it. 

 

What Teens Actually Need (and Are Missing)

Healthy development comes from:

• Risk-taking and rough-and-tumble play
• Same-age peer interaction
• Opportunities for independence without parents
• Feeling useful and needed
• Experiences of mastery and competence
• Exposure to new cultures, people, and environments

This includes:

• Sleepovers (no phones allowed)
• Activities away from parents’ eyes
• Summer camp
• Part-time jobs
• Driving

Babysitting, tutoring, coaching younger kidsIn short: experiences that build resilience, identity, and confidence.

 

The Conversations Parents Need to Have

 

Teens don’t need perfect parents, they need present ones.

Respect + Connection + Autonomy

Healthy conversations sound like:

• “Tell me what you like about being online.”
• “What makes social media hard for you?”
• “Where does it help you feel connected?”

No lecturing, just curiosity.  Use the validation sandwich: Validate → Guide → Encourage choice.

Model What You Want to See

Kids notice when adults:

• Scroll during dinner
• Check grades daily
• Text constantly
• Track their kids’ location 24/7

When kids got phones…so did parents. Overmonitoring makes autonomy plummet and trust harder to build.

 

Practical Guidelines for Healthy Screen Use

The “No’s”

• No phones at mealtimes or family outings
• Phones off and out of the bedroom 1 hour before bed
• Parental controls—not invasive reading of messages
• No scrolling during homework

The “Yes’s”

• Yes to FaceTime, Zoom, and video games with friends (boosts language + connection)
• Yes to active—not passive—screen use
• Yes to coordinated limits with other parents
• Yes to gradually loosening restrictions as teens show responsibility

Create checkpoints every few months:

• How is sleep going?
• Are grades stable without micromanagement?
• Are friendships happening offline, too?
• Is the phone leaving the bedroom at night consistently?

 

What Teens Can Try Today (Therapist Tools)

 

Urge Surfing

If your phone buzzes while doing homework:

• Wait 30 seconds before picking it up
• Then try one minute next time
• Then try keeping the phone in another room

Small exposures build inhibition.

Nighttime Wind-Down Challenge

Put the phone away an hour before bed and replace it with:

• Drawing
• Reading
• Journaling
• Music

Self-Reflection Questions

Encourage teens to ask:

• How do I feel after doomscrolling?
• What triggers me online?
• What parts of social media make me feel connected?
• Where am I most inauthentic online?

These questions build metacognition and identity.

 

When It’s Time for Professional Help

Seek therapy when:

• Screen use interferes with school, friendships, or sleep
• Teens want to stop scrolling but can’t
• Lying about screen use becomes chronic
• Social withdrawal or depression worsens
• Anxiety spikes around online interactions

Teens don’t need to be “off” screens entirely, they need balance, structure, and support.

 

Health Anxiety or OCD? Here’s Why It Might Be Both

Many people living with health anxiety don’t know just how much they have in common with someone with OCD. When you pay attention, the pattern sounds familiar: intrusive fears, repetitive checking, reassurance-seeking, and endless mental loops of “What if something’s wrong?”

It’s not that health anxiety and obsessive-compulsive disorder (OCD) are identical (at least in content), it’s that they run on the same psychological engine. Understanding that connection can be liberating because it points to treatments that actually work.

The Science: Why Health Anxiety and OCD Overlap

Research over the past two decades has shown that health anxiety and OCD share nearly identical cognitive and behavioral processes. Both involve intrusive thoughts, catastrophic misinterpretation of threat, and compulsive attempts to neutralize anxiety—a cycle that offers momentary relief but strengthens fear over time.1

Cognitive-behavioral models suggest that intrusive thoughts themselves are normal; what matters is how we interpret them. In both OCD and health anxiety, the mind tends to overestimate danger and underestimate coping. A fleeting thought like “What if this mole is cancer?” or “What if I spread germs to someone?” is misread as a genuine warning, setting off the same anxiety loop.

To quiet the distress, people engage in compulsions—behaviors or mental acts meant to feel safe again. In OCD, this might mean handwashing or checking locks. In health anxiety, it often looks like Googling symptoms, monitoring sensations, or asking for reassurance. The behavior brings short-term comfort but reinforces the idea that the thought was dangerous and must be controlled.2

Recent studies even conceptualize health anxiety as part of the OCD spectrum, with similar neural patterns in the orbitofrontal cortex and anterior cingulate cortex, areas linked to error detection and threat monitoring.34

The Loop: Intrusive Thought → Anxiety → Compulsion → Relief → Stronger Anxiety

Whether it’s a fear of contamination/harm/something bad happening/etc or of illness, the cycle is the same:

An intrusive thought or sensation appears. (“What if this pain means something’s wrong?”)

Anxiety spikes. (“I need to figure this out now.”)

A compulsion follows. (Checking your body, booking another test, seeking reassurance.)

Temporary relief. (“Okay, I feel better now.”)

Reinforcement. The brain learns that checking equals safety, so the next worry feels even more urgent.

It’s a trap built out of good intentions, the desire to be safe, but it keeps the brain from learning that anxiety naturally fades on its own.

Treatment: The Shared Path to Recovery

Because health anxiety and OCD rely on the same psychological loop, they respond to the same evidence-based treatment: Exposure and Response Prevention (ERP), a form of Cognitive Behavioral Therapy (CBT).5

ERP involves gradually facing feared thoughts, sensations, or situations without engaging in compulsions. Someone might read about an illness or sit with the uncertainty of a symptom without seeking reassurance. Over time, the brain learns that anxiety is tolerable—and that uncertainty doesn’t equal danger.

In other words, ERP retrains the brain to trust its own resilience instead of chasing reassurance.

Why Labels Matter Less Than the Pattern

Diagnostic categories like “illness anxiety disorder” and “OCD” can help organize symptoms, but from a treatment perspective, the distinction often matters less than the mechanism or function of the pattern. If you experience intrusive health-related fears and engage in repetitive checking or reassurance, you’re already in OCD territory, just under a different name.

If you’re dealing with health anxiety, you should look for an OCD expert. The same therapeutic tools that help people with OCD can help you. The more you practice sitting with uncertainty, the more your brain learns that peace doesn’t come from certainty, it comes from confidence built up through practice sitting with discomfort.

Living with Uncertainty

Health anxiety often feels “reasonable” because it hides under the banner of responsibility. After all, it is healthy to care about your body. But when vigilance turns into obsession, your life can shrink around the search for certainty.

True safety isn’t found in another test result, it’s built through the ability to feel unsure and keep living anyway.

When you stop fighting for absolute certainty, you uncover something far more powerful: trust in yourself and the freedom to live even when life doesn’t give you every answer.

Work with Us

Dallas CBT is a team of OCD and anxiety experts.  We help people living with OCD and health anxiety overcome their stuck patterns and live their most meaningful lives.  We’d be honored to work alongside you.  Reach out to schedule an intake appointment.  

The idea of finding “the right therapist” is a daunting one, but there are a few specific factors to focus on to help guide your choice.  Also, the truth is that there are many therapists who can help you reach your goals, you don’t need the “perfect therapist.”  The idea of a “perfect therapist” is likely a distraction and attempt to control that will just cost you time in the process of getting into good therapy.

One of the most important factors to consider when choosing a therapist is fit.  The fit between therapist and client is one of the strongest predictors of whether therapy will be helpful. In fact, decades of research show that the therapeutic alliance, which is the quality of the relationship and shared goals between therapist and client, accounts for more of the positive outcomes in therapy than the specific technique alone.  Again, this is not about perfectionism.  “Fit” generally means that you feel mostly confident that your therapist both understands your struggles and has a roadmap to help.  Personalities between therapist and client don’t have to be perfectly in sync, but it’s more important that there is mutual respect and appreciation.

Finding The Right Therapist: Where To Start 

The therapist’s expertise still matters, and is the easiest place to start your search. Especially if you are struggling with anxiety, OCD, trauma, ADHD, or other specific challenges, you’ll want someone who not only “gets you” but also knows the evidence-based strategies that actually work. The best way to learn about what a therapist specializes in is to read their bio.  Therapists typically discuss training and experience background, as well as the type of problems they work best with. 

Why Expertise Still Matters

The relationship is the foundation—but the tools matter too. Certain presenting conditions have been shown to respond best to structured, evidence-based treatments:

• OCD: Exposure and Response Prevention (ERP) has decades of data showing effectiveness.
• PTSD/Trauma: Therapies like Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), and EMDR are gold standards.
• ADHD: Cognitive-Behavioral Therapy (CBT) for adults with ADHD can improve organization, emotion regulation, and follow-through.
• Depression & Anxiety Disorders: Both CBT and Acceptance and Commitment Therapy (ACT) have extensive research support.

So, while the warmth of your therapist matters, choosing someone trained in approaches that work for your specific difficulties increases your chances of meaningful change.

What to Ask When Looking for a Therapist:

• What is your approach to therapy with my concern? Do you use evidence-based therapies for my concern?
• How do you measure progress in treatment?
• What does a typical session look like with you?

These questions give you a sense of whether your therapist will be both approachable and effective.

Our Approach at Dallas CBT

At Dallas CBT, we specialize in evidence-based therapies for anxiety disorders, OCD, depression, trauma, ADHD, and related challenges. Each of our clinicians brings expertise in CBT and ACT frameworks, with additional training in ERP, EMDR, and parent-focused interventions.

Our Practice Administrator’s #1 job is to match our clients with the therapist on our team who will be the best fit.  We do this based on a very thorough understanding of each of our therapists, their expertise, and the clients they tend to work best with.

What makes our practice a good fit:

• Personalized fit: We match clients with therapists based on presenting concerns and style.
• Focus on skills + insight: We believe therapy is most effective when it combines learning practical strategies with deeper self-understanding.
• Breadth of services: We work with children, teens, adults, and families—often bringing in parents or partners when appropriate.
• Community-minded: If we’re not the best fit, we’ll help you find someone who is.

Who Would Be a Good Fit at Dallas CBT?

• Adults and children with anxiety, OCD, depression, ADHD, or trauma symptoms.
• Parents seeking help with child or adolescent struggles.
• Professionals or students facing stress, burnout, or performance anxiety.
• Anyone looking for a therapist who combines compassion with a clear, evidence-based plan

The right therapist is someone you trust, who uses tools that work, and who helps you take steps toward the life you want. If you’re searching for a Dallas therapist or for online therapy in Texas and resonate with our approach, we’d be glad to walk alongside you.

References

Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2020). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 57(4), 450–464. https://doi.org/10.1037/pst0000313

Norcross, J. C., & Lambert, M. J. (2019). Psychotherapy relationships that work III. Psychotherapy, 56(4), 421–426. https://doi.org/10.1037/pst0000289

 

One of the more common questions we get from potential new clients is some version of “How long will this take?” It’s a reasonable question; people want to feel better soon, and therapy is an investment in time and resources. Thankfully, relief begins to happen quickly in therapy, though there is work to do to make sure those gains solidify.  Here’s an overview of the research on two of the main forms of therapy we practice at Dallas CBT: CBT and ACT.

What the Evidence Tells Us About CBT

Most research suggests that an appropriate “dose” of treatment is around 20 sessions, spread out over a several month period. Clients often experience some relief in the first 3 sessions or so as they name their struggles and learn more about how their symptoms are created or maintained After about 6 to 10 sessions, clients show more measurable decreases in symptoms and improvements in functioning as they are becoming more consistent with their therapy skills. Once we get into the 12 to 20 session range, research shows medium to large effect sizes across a host of disorders. At this latter stage in treatment clients are solidifying their gains and preparing to manage symptoms on their own. This leads to robust and sustained treatment gains well after treatment is discontinued.

Why Progress Speeds Up or Slows Down

Several factors influence the pace of improvement:

• Severity and complexity: Though it makes intuitive sense, research indicates that less severe and complex symptoms tend to respond more swiftly to treatment, while more severe and complex symptoms require more time and consistent work, even beyond 20 sessions
• Client engagement & Skills Practice: Therapy can help lead the proverbial horse to water, but it cannot make it drink. Consistently, the biggest predictor of treatment gains is how consistently the client engages in their therapy work between sessions.
• Therapeutic alliance: The quality of the relationship between therapist and client consistently predicts outcomes in treatment.
• Life context: Life stressors rarely stop and wait for us to engage in treatment, and often directly contribute to more of whatever it is we’re struggling with. This doesn’t mean treatment gains are unreachable while going through major life stressors, but they are often slow it down.

What About ACT?

Acceptance and Commitment Therapy (ACT) is a form of CBT that isn’t focused on symptom reduction alone—it’s about increasing psychological flexibility and taking valued action despite symptoms you’re experiencing. Research shows ACT to be effective across many disorders, with over 1,300 RCTs and multiple meta-analyses affirming its efficacy.

In clinical practice, clients often observe early shifts in the first few weeks of treatment—like greater openness to anxiety or a small return to meaningful activity. That said, deeper shifts—like living with less experiential avoidance—often become clearer over 8 to 16 sessions, depending on individual context. Clients often experience progress in waves, with large shifts in their experience of their symptoms coming after weeks of consistent practice.

Therapy is a Process

Therapy isn’t a quick fix—but CBT and ACT are not open-ended guesswork. Evidence shows that structured treatments like CBT and ACT can yield lasting change and that the effort put in predicts the outcome. CBT delivers tangible tools; ACT fosters flexible living in the face of anxiety. When paired with a supportive therapist, real relief isn’t just hoped for—it’s within reach.

If you are ready to give therapy a try with a compassionate specialist in anxiety, the therapists at Dallas CBT would be honored to be on this journey with you. Reach out to our office to paired with the therapist who is the best fit for you.

 

If you are considering therapy for anxiety for the first time, you might wonder: What do people actually do in there? It’s a fair question. Therapy can feel mysterious—one that promises relief, but leaves you unsure about what you’d be signing up for.

We know that for many of us with anxiety, it helps to have a good idea about what we’re getting into before we start. Here, we’re going to give you a general idea about what therapy at Dallas CBT often looks like.

When you sit down for therapy (whether that’s on a sofa in the therapy room or over video), the goal isn’t just to “talk about feelings.” Evidence-based approaches like Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) use structured, practical tools to help you understand your anxiety, change your relationship with it, and gradually reclaim your life.

Here’s What A Therapy Session For Anxiety Looks Like:

1. Clarifying the Map.

Early sessions usually focus on assessment and goal setting. Together, you and your therapist explore:

What situations trigger your anxiety.

How your body, thoughts, and behaviors respond.

What you’ve tried so far, and what hasn’t worked.

Think of this as building a “map” of your anxiety patterns. A clear map makes it easier to know where to intervene.

2. Learning the Tools.

CBT and ACT are both skills-based therapies—that means you’ll learn strategies to practice between sessions. For example:

CBT techniques might help you notice and test unhelpful thoughts. Instead of automatically believing, “If I speak up in the meeting, I’ll embarrass myself,” you learn to notice thoughts as they arise and ask: What’s the actual evidence? What else might happen?

ACT strategies focus less on changing thoughts and more on changing your relationship with them. You might practice “defusion”—noticing an anxious thought (“I’ll mess this up”) and labeling it simply as “a thought,” not a prophecy.

Both approaches also emphasize values: What matters to you enough that it’s worth facing anxiety to pursue?

3. Exposure Work (The Scary but Effective Part)

One of the most powerful tools for anxiety is exposure therapy, a CBT technique that’s often woven into ACT values work. Here’s how it works:

You and your local therapist identify anxiety-provoking situations that you may be avoiding. These can be situations that you’d really like to be able to do in your life, or simply situations where your avoidance of them is keeping anxiety alive. Examples are anything from making a phone call to riding in an elevator to speaking up for yourself.

Instead of avoiding those situations (which strengthens anxiety), you practice approaching them in gradual, manageable steps. Many times, we do this together in the therapy session.

Over time, your nervous system learns a new lesson: “I can handle this. Anxiety comes, and anxiety goes.”

Exposure isn’t about throwing you into the deep end. It’s a collaborative, carefully paced process that builds confidence.

4. Practicing in Session.

Therapy sessions aren’t just talking about anxiety—they often involve practicing skills right there in the room. That might look like:

Doing a brief mindfulness exercise to observe anxious sensations.

Role-playing a feared conversation.

Watching your own worry thoughts pass by like leaves on a stream.

This in-session practice helps bridge the gap between theory and real life.

5. Taking It Outside.

Anxiety therapy is most effective when what happens in session extends into your daily life. You’ll likely leave with homework—small, structured experiments to test new ways of responding to anxiety.

For example, if you’ve been avoiding driving, your homework might be to sit in the car for five minutes.

If you’re stuck in worry cycles, your assignment might be to schedule a daily 10-minute “worry time” and practice redirecting your attention the rest of the day.

Therapy is less about instant relief and more about building resilience through repeated practice.

6. Tracking Progress.

Along the way, you and your therapist will check in: Are symptoms decreasing? Are you living closer to your values? Are you gaining confidence in facing feared situations?

Progress is rarely linear—there are usually spikes and setbacks—but the overall trajectory tends toward greater freedom and flexibility.

The Bottom Line

A therapy session is a safe and supportive space where you and the therapist are on the same team. It’s an active, collaborative process: mapping patterns, learning tools, facing fears, and practicing new ways of relating to anxious thoughts and sensations.

CBT and ACT give you skills to change unhelpful thinking patterns and flexibility to live with anxiety without being ruled by it. Exposure helps you retrain your nervous system to stop running from fear.

Put simply: therapy isn’t just about talking—it’s about doing. And what you do in session can ripple into how you live your life outside it.

If you are ready to give therapy a try with a compassionate specialist in anxiety, the therapists at Dallas CBT would be honored to be on this journey with you. Reach out to our office to paired with the therapist who is the best fit for you.

It’s a common question: Is this anxiety, or is it just stress? The line between the two can feel blurry. Both involve tension in the body, racing thoughts, and feeling overwhelmed. Both can leave you lying awake at night, replaying the day or anticipating tomorrow. But clinically, there are some key differences worth paying attention to, because how we label the experience often shapes how we treat it.

Stress vs. Anxiety: Where They Overlap, and Where They Don’t

Stress is usually a response to an external situation—a deadline, a conflict, an exam. It tends to fade when the stressor passes. Stress can even be adaptive: it mobilizes your body’s fight-or-flight response, sharpens focus, and helps you perform.

Anxiety, on the other hand, doesn’t require an external trigger. It’s more internal, persistent, and disproportionate to the situation at hand. Anxiety disorders are marked by excessive worry, avoidance, and physiological symptoms (trembling, sweating, rapid heartbeat) that continue even when there’s no immediate threat. In other words, stress is situational; anxiety is longer-lasting.

What the Research Says

Our diagnostic guidelines (the DSM-5-TR) distinguishes anxiety disorders from stress reactions based on duration, intensity, and impairment in daily functioning. Research consistently shows that chronic stress can evolve into an anxiety disorder if the nervous system stays on high alert for too long (McEwen, 2007).

A useful marker is functional impairment. If worry or physical tension significantly interferes with work, school, sleep, or relationships, it’s more than stress—it’s likely an anxiety disorder. Self-report questionnaires, such as the GAD-7, can help screen for clinical levels of anxiety.

How Therapy Helps Both

Fortunately, whether you’re “just stressed” or living with an anxiety disorder, evidence-based therapies can help.

• Cognitive Behavioral Therapy (CBT) helps people identify distorted thought patterns (“What if I fail?” “What if something goes wrong?”) and replace them with more balanced, realistic thinking. CBT also includes behavioral experiments and exposure, which help retrain the nervous system’s response to fear.
• Acceptance and Commitment Therapy (ACT) prioritizes making space for difficult emotions while moving toward values-driven actions.  Instead of trying to control or eliminate worry, ACT helps change your relationship with stressful and anxious thoughts and feelings. This helps break the cycle of avoidance that often worsens both stress and anxiety.
• Mindfulness-based interventions (including Mindfulness-Based Stress Reduction, Kabat-Zinn, 1990) reduce both stress reactivity and anxiety by shifting attention away from rumination and toward present-moment awareness.
• EMDR (Eye Movement Desensitization and Reprocessing) helps with anxiety by reprocessing distressing experiences, calming the body’s overactive alarm system, and reshaping negative beliefs into healthier ones—allowing people to respond to stress with more flexibility and less fear.

Lifestyle and Sleep Hygiene

Clinical work is clear on this point: therapy is powerful, but it’s most effective when paired with supportive daily practices. Chronic sleep disruption, lack of exercise, and poor nutrition amplify both stress and anxiety. Evidence-based recommendations include:

• Keeping a consistent sleep schedule and limiting screen exposure before bed.
• Engaging in regular physical activity, which reduces physiological arousal.
• Building structured downtime into the day for recovery.

So, Do I have stress or anxiety?  

If you find that your distress is temporary, tied to clear external pressures, and improves when the stressor resolves, it’s likely stress. If it persists beyond circumstances, disrupts your functioning, or feels overwhelming despite your best coping efforts, it may be an anxiety issue.

The most important step isn’t the label itself, it’s reaching for support. Both stress and anxiety respond well to therapy, lifestyle adjustments, and evidence-based strategies that help restore balance to the nervous system.

Our specialists at Dallas CBT help people with stress and anxiety everyday get out of stuck patterns and start living the lives they are meant to be living.  If you are looking for the right support on your journey, reach out to schedule an appointment.

References

• American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).
• Harvard Medical School. (2021). Anxiety and exercise: The connection. Harvard Health Publishing.
• Kabat-Zinn, J. (1990). Full catastrophe living. Delta.
• McEwen, B. S. (2007). Physiology and neurobiology of stress and adaptation: Central role of the brain. Physiological Reviews, 87(3), 873–904.
• Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097.

 

Anxiety can feel like both the smoke alarm and the fire. Your chest tightens, thoughts loop, and then sleep starts to suffer, which makes it all that much harder. The experience of anxiety often feels strongly physical, which can prompt the question of whether there is a biological imbalance that must be addressed. If you’ve ever wondered, “Is there any way to calm down my anxiety without medication?” the answer is yes—though it requires patience, persistence, and a willingness to experiment.

Let’s go through some of the most effective, research-backed ways to manage anxiety—drawing from Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and everyday lifestyle shifts that often get overlooked.  We teach and tailor these strategies to our clients everyday, and can attest to the positive changes that come from committed practice.

1. Challenge the “What Ifs” and Catastrophizing (CBT)

Why do I always think the worst? An anxious brain can generate catastrophic predictions faster than you can fact-check them. Eventually, you stop even trying to fact check your predictions because they have become your default way of thinking.  They might even feel protective on some level.  CBT offers a systematic way to slow down and evaluate these thoughts.

• Catch the thought: Notice the catastrophic thought (“I’ll fail this project and lose my job”) and name the thought (this can be as simple as “there’s a thought”).
• Question it: Ask, “What’s the evidence for and against this?”  “But, is it really true right now?”
• Reframe it: Shift to something balanced (“This project is stressful, but I’ve completed challenging work before”).

This isn’t about toxic positivity; it’s about training your brain to separate probable outcomes from imaginative disasters. Over time, your mind will start producing fewer panic-inducing thoughts.

2. Stop Wrestling with Your Thoughts (ACT)

The CBT strategy above is about restructuring or reframing thoughts, while this ACT strategy is about relating differently to them. Sometimes, trying to challenge our thoughts can get us more stuck.  In that case, it is best to make space for the thoughts, instead of further engaging or fighting them.

Try this:

• Imagine your anxious thought as text scrolling across a movie screen. You don’t have to delete it, fix it, or interact with it—you just notice it and let it pass, staying in the observer role.
• Or picture yourself carrying anxious thoughts and feelings in a backpack. Heavy, yes, but you can still walk toward the things you care about, like relationships, career, or hobbies.

The paradox is that the less you struggle against anxiety, the more space you create for living fully.

3. Breathe to Calm Your Nervous System 

When you’re anxious, your body flips into fight-or-flight. You can help reset it with simple breathing practices:

• Box breathing (4-4-4-4): Inhale for 4, hold 4, exhale 4, hold 4.
• Physiological sigh: Two quick inhales through the nose, long exhale through the mouth.

Research shows slow, deep breathing helps regulate the vagus nerve, lowering heart rate and restoring balance to your nervous system.

4. Move Your Body

Exercise is not just for physical health—it’s one of the most reliable anxiety reducers we have. Aerobic activity (like brisk walking, cycling, swimming) can decrease anxious arousal, while strength training builds resilience. The best exercise for anxiety is sustainable and flexible.  The key is to pick something you don’t dread and have reasonable expectations. If it feels like punishment or a “should,” it can backfire and actually increase your anxiety.

5. Sleep Like It’s Your Job

This tends to be the hardest truth for our clients to accept: sleep plays such a critical role in your anxiety.  Cognitive performance, emotion regulation, and coping all tank when sleep suffers.

Try these sleep hygiene strategies:

• Keep a consistent bedtime—your brain loves rhythm.
• Reserve the bed for sleep (not for doomscrolling).
• Keep the room cool, dark, and quiet.
• If your mind spins at night, jot thoughts in a journal before bed.

6. Audit Your Habits (Gently)

Caffeine, alcohol, and scrolling at midnight are like jet fuel for anxiety. Instead of cutting everything cold turkey, try experimenting: reduce caffeine after noon, trade one late-night screen session for a calming activity, notice how your body responds. Again, be careful not to create a list of “shoulds” that you will be in trouble for not completing.  Try to slowly build in some healthy habits, and be gentle with yourself when you’re not perfect.

7. Anchor in Daily Practices

Small, steady rituals calm an anxious system:

• Mindfulness meditation (5-10 minutes of focusing on breath or sounds; Find a short guided meditation online that speaks to you).
• Journal your worries, then set them aside.
• Gratitude practice—name 3 things daily that your are grateful for and allow that to anchor you in the present.

Think of these not as immediate, magic fixes but as regular tune-ups for your nervous system.

Consider Therapy

Therapy can really help with these lifestyle changes.  Therapy helps you do the deeper work of thinking and behavioral patterns, but can also help you identify the best strategies for you and keep you accountable to them.  With consistent practice, anxiety can become a background character instead of the lead role in your life. 

The best treatment for anxiety includes CBT skills, ACT strategies (acceptance and values-based living), and lifestyle habits (movement, sleep, breathwork).  Therapy can help you make foundational changes in your experience of anxiety without relying on medication.

Progress with anxiety rarely arrives as one grand “cure.” It shows up in small victories: one night of deeper sleep, one thought you didn’t chase, one worry you let drift by without grabbing.

When should you consider medication for anxiety?  There is no right or wrong answer for this.  Medication is just one of many tools you might consider to help with your anxiety.  It can be helpful to talk this question over with your therapist.  Some people greatly benefit by medication, or the combination of medication and therapy.  It’s very personal and all about finding what is right for you.

If you would like to work with an anxiety specialist at Dallas CBT, please reach out.  We are honored to witness our clients gaining freedom from anxiety everyday. 

What’s the Best Therapy for Anxiety? A Closer Look at CBT, ACT, and EMDR

Anxiety doesn’t always show up as a racing heart or spiraling thoughts. Sometimes it looks like spending too much time or energy on trying to control or manage your anxiety.  Sometimes it’s constant muscle tension or a mind that just won’t turn off, even when everything seems fine. If anxiety is getting in the way of how you want to live, therapy can help. But with so many treatment options out there, where do you start?

Let’s walk through the evidence-based therapies that are most effective for anxiety—and how to know what might be right for you or someone you care about.

Cognitive Behavioral Therapy (CBT) for Anxiety: The Gold Standard

Cognitive Behavioral Therapy is one of the most well-established, well-studied treatments for anxiety. In CBT, the focus is on identifying patterns of thinking and behavior that fuel anxiety and then learning practical ways to shift them.

CBT is especially effective because it offers tools that are both evidence-based and easy to apply in daily life. You’ll learn to recognize unhelpful thinking (like catastrophizing or all-or-nothing thinking), gradually face feared situations, and build coping strategies rooted in your values and goals rather than fear.

How effective is CBT for anxiety?

CBT is considered a first-line treatment for a wide range of anxiety disorders, including:

• Generalized Anxiety Disorder (GAD)
• Social Anxiety Disorder
• Panic Disorder
• Specific Phobias
• Obsessive-Compulsive Disorder (with exposure and response prevention)

A meta-analysis by Hofmann et al. (2012) found that CBT is highly effective for anxiety, with large effect sizes across multiple conditions. Treatment benefits often last well after therapy ends—especially when clients practice skills outside of sessions.

 

Acceptance and Commitment Therapy (ACT) for Anxiety: A Mindful, Values-Driven Approach

Acceptance and Commitment Therapy (ACT) focuses on helping you change your relationship to your thoughts. ACT teaches psychological flexibility—your ability to stay present, open up to and move through difficult feelings, and take actions that reflect your values.

Instead of trying to eliminate anxiety altogether (which often backfires), ACT helps people learn to carry anxiety differently. You’ll practice noticing anxious thoughts without getting hooked by them, and take meaningful steps toward what matters most—even with anxiety along for the ride.

How effective is ACT for Anxiety?

ACT is effective for a wide range of anxiety presentations and is particularly helpful when:

• Anxiety is chronic or intertwined with life transitions
• You’ve tried to “get rid of” anxiety with limited success
• You struggle with avoidance or perfectionism
• You want therapy that incorporates mindfulness and values-based living

A review by Ruiz (2010) showed ACT to be comparably effective to CBT for anxiety, with added benefits in long-term psychological flexibility and quality of life.

 

Can EMDR help Anxiety?

Eye Movement Desensitization and Reprocessing (EMDR) is best known as a treatment for trauma, but it can also help reduce anxiety—especially when the anxiety is rooted in past experiences.

In EMDR, clients recall distressing memories while engaging in bilateral stimulation (often eye movements or tapping). Over time, this process helps the brain reprocess painful events, reducing their emotional intensity and associated anxiety.

EMDR may be particularly useful for:

• Anxiety rooted in past trauma
• Performance anxiety or phobias
• Medical or situational anxiety with known triggers

Although more research is still emerging, studies like Faretta (2013) have shown EMDR to be effective for panic disorder and phobias, and it can be a useful adjunct to CBT or ACT, especially when trauma is part of the picture.

 

Which is the best therapy for anxiety for you?

There’s more than one “right” answer when it comes to therapy for anxiety. All three of these therapies are grounded in research and can be adapted to your specific symptoms, history, and goals.

CBT may be the best starting point for learning immediate tools.
ACT is a great choice for building long-term flexibility and values-based living.
EMDR may be a fit when anxiety stems from unresolved past experiences.

You don’t have to figure it out alone. A therapist can help determine the best approach based on your unique experience.

At Dallas CBT, we specialize in evidence-based treatments for anxiety, including CBT, ACT, and EMDR. If you’re wondering where to begin, we’re here to help you take the first step.

 

References

Faretta, E. (2013). EMDR and CBT in treatment of panic disorder: A comparison. Journal of EMDR Practice and Research, 7(3), 121–131.
Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427–440.
Ruiz, F. J. (2010). A review of Acceptance and Commitment Therapy (ACT) empirical evidence: Correlational, experimental psychopathology, component and outcome studies. International Journal of Psychology and Psychological Therapy, 10(1), 125–162.

Deciding that it’s time to start therapy and looking for a therapist can already be vulnerable tasks. Now layer on the added stress of wondering whether they’ll truly see you—your identity, your story, your experience—not as something to diagnose, fix, or tiptoe around, but as real, worthy, and whole. For individuals in the LGBTQ+ community, therapy can be a space of powerful healing—but it must feel safe and affirming.

If you’ve ever found yourself scanning bios for keywords like “LGBTQ+ affirming” or “identity-inclusive” or searching for other clues that a therapist will be a fit, this post is for you.

What Does “LGBTQ+ Affirming” Really Mean?

An affirming therapist doesn’t just have the right education and training—they actively work to understand and celebrate the nuances of LGBTQ+ identities. That includes being trauma-informed about the impacts of heteronormativity, homophobia, transphobia, and systemic marginalization, and being clinically competent in treating anxiety, depression, trauma, and identity-related stressors that may be wrapped up in all of it.

Signs a therapist may be affirming include:

• They name LGBTQ+ populations explicitly in their bio
• They’ve actively sought out training and experiences with the LGBTQ+ community
• They acknowledge the role of social stigma in mental health.
• They are open to discussing identity, gender, and sexuality without pathologizing or tiptoeing.
  
  

Acceptance and Commitment Therapy for LGBTQ+ Therapy

At Dallas CBT, one of the supportive therapy models we use when working with LGBTQ+ individuals is Acceptance and Commitment Therapy (ACT). ACT helps you get unstuck from rigid self-stories so you can move toward what really matters to you.  

Here’s how ACT supports LGBTQ+ identity work:

1. Defusion (Unsticking) from harmful narratives

Many LGBTQ+ clients carry messages that were never theirs to begin with—internalized shame, inherited fear, perfectionism, or invisibility. ACT helps you notice these stories for what they are: thoughts, not truths. Instead of arguing with them or believing them blindly, you learn to hold them lightly.

2. Values-based living

ACT invites you to reconnect with your own core values. Not what society expects. Not what your family demanded. But what you want your life to stand for—whether that’s authenticity, creativity, connection, or anything else. Identity exploration is about discovering and living in alignment with who you are.

3. Psychological flexibility

ACT isn’t about feeling good all the time—it’s about becoming flexible in the face of pain. That’s especially helpful when navigating minority stress or living in environments that don’t always understand you. With ACT, you learn to stay grounded in your truth while still showing up fully in your life.

How to Find an LGBTQ+ Affirming Therapist

Finding the right therapist is part research, part intuition, and part trial and error. Here are a few tips to help with your therapist search:

1. Use filters on directories like Psychology Today, Therapy Den, or Inclusive Therapists to search for “LGBTQ+ affirming” or identity-competent clinicians.
2. Read between the lines. Do they name LGBTQ+ populations directly? Do they use inclusive language? Do they list modalities like ACT or trauma-informed care?
3. Ask directly. It’s okay to email or ask in a consult:
   “What’s your experience working with LGBTQ+ clients?” or
   “How do you integrate identity work into therapy?”
4. Trust your sense of safety. You should generally have a strong sense that your therapist cares about you and is on your team.  Therapists are human and make mistakes, but the relationship should be strong enough to hold any minor blips in the road. 

You Deserve More Than Just “Welcoming”

Your best bet is to find a therapist who has made identity work and LGBTQ+- related concerns central to their work.  That is not to say you cannot find an incredible fit in a therapist without this specialty– it is definitely possible, because so much rides on the strength and authenticity of the connection between the therapist and the client.

If you’re in Texas and looking for LGBTQ+ affirming therapy or want to learn more about how ACT can support identity work and emotional wellbeing, reach out to our team at Dallas CBT.  We will connect you with therapists who are committed to working within LGBTQ+ communities and who will help you step more fully into who you are.

Ready to start? Reach out for a consultation. We’d be honored to walk with you.

How To Speak Up: Therapy To Help You Overcome Fear of Public Speaking

It starts with a racing heart. Maybe a dry mouth. A sudden foggy brain where your perfectly prepared words used to be. If you’ve ever felt paralyzed before speaking in a meeting, presenting in class, or even introducing yourself at a social event, you’re not alone. Fear of public speaking—sometimes called glossophobia—is one of the most common fears. And for some, it’s more than just nerves—it’s a form of social anxiety that shrinks their life and their career goals.

As daunting as it may seem, this fear is able to be overcame– we see it all the time.  Exposure-based Cognitive Behavioral Therapy (CBT) can help you work through this anxiety in a practical and effective way. 

What’s Really Going On When You’re Afraid to Speak?

At the root of the fear is often a deeply human concern: the fear of being judged, humiliated, or seen as inadequate. Our minds can run wild with “What ifs”—What if I mess up? What if my voice shakes? What if people think I’m stupid? What if my mind goes completely blank?

These fears can become sticky. Your brain learns to associate public speaking with danger, and it begins to sound the internal alarm (your fight-or-flight response) even before you open your mouth. Over time, you might avoid speaking situations altogether, or tolerate them under certain conditions (e.g., you have to over-prepare for days, you must speak last, you must be drunk).  Avoidance provides short-term relief—but reinforces the belief that speaking is unsafe. That avoidance loop is how anxiety takes hold and grows.

How CBT and Exposure Therapy Break the Social Anxiety Cycle

CBT doesn’t just help you cope—it helps you change your relationship with fear. One of the most powerful CBT tools for social anxiety is exposure therapy, a method that helps retrain your brain to see feared situations as manageable rather than catastrophic.

Here’s how CBT works for fear of public speaking:

• Gradual Exposure: You won’t be thrown onto a TED Talk stage on Day 1. Instead, therapy starts with smaller, manageable steps—like reading aloud to your therapist or practicing a short speech. As you gain confidence, the challenges increase.
• Cognitive Restructuring: While you’re working through exposures, your therapist helps you identify and reframe the anxious thoughts that show up (“If I mess up, it means I’m a failure” becomes “Everyone makes mistakes; it doesn’t define my worth.”)
• Behavioral Experiments: You’ll test your fears in real time. What actually happens when you say “um” during a sentence? When you pause to collect your thoughts? These experiments help you update your brain’s predictions with actual data.
• Skills and Tools: You’ll learn practical strategies to ground yourself—like breathing techniques or posture shifts—and how to use your attention effectively when you’re speaking.

Does Therapy for Fear of Public Speaking Work?

Yes—decades of research support exposure-based CBT as a gold-standard treatment for social anxiety, including fear of public speaking. Meta-analyses (e.g., Acarturk et al., 2009; Mayo-Wilson et al., 2014) show that CBT leads to significant and lasting improvements in anxiety, self-confidence, and quality of life. Importantly, the change doesn’t just happen in your head—it often shows up in your body, too. Over time, the physical symptoms (heart rate, sweating, shakiness) begin to ease as your brain learns there’s no real danger.

You don’t need to become a fearless, spotlight-loving extrovert to overcome public speaking anxiety. You just need to learn how to be with the fear instead of ruled by it– and to get back in the driver’s seat of your own life.

Therapy can help you stop running from discomfort and start moving toward your values—whether that’s leading a meeting, advocating for your ideas, or giving a wedding toast with confidence.  

We believe your voice matters, and want to help it be heard.  Our therapists specialize in anxiety and offer both individual and group therapy for social anxiety and fear of public speaking.  Reach out to our office for more information. 

Facing the Fear: How Exposure Therapy Really Works

There’s a cruel irony in anxiety: the more we avoid what scares us, the scarier it becomes. You dodge a feared situation once, feel temporary relief, and your brain celebrates: “Avoidance worked! Let’s do it again.” Before you know it, your world is shrinking and the anxiety is growing.

Enter exposure therapy—a therapy approach built on the tried-and-true idea that the only way out of fear is through it.

Exposure therapy comes in many variations, and decades of research indicates it’s the most effective treatment for many anxiety-related disorders and Obsessive Compulsive Disorder (OCD).

What Is Exposure Therapy?

Exposure therapy helps people systematically and gradually confront the things they fear—whether those fears are about a situation, a thought, a memory, or a physical sensation. The goal isn’t to traumatize or overwhelm. It’s to teach the brain over time: “This isn’t dangerous, and I can handle it.”

Think of it like re-training your threat detection system. Anxiety disorders are often the result of a hyperactive alarm system—one that rings at full volume even when there’s no fire. Exposure therapy helps your brain re-organize what it considers to be a threat.  

How Exposure Works: The Mechanisms Behind the Method

So how does this actually work on a neurological level?

1. Extinction Learning: In classical conditioning terms, exposure therapy helps reduce the association between a feared cue and the perception of danger. When you face a fear (on purpose) without the dreaded outcome occurring, your brain learns a new association: feared thing = safe.

2. Habituation: With repeated exposure, the emotional intensity of fear responses tends to decrease. Your body learns not to overreact. That pounding heart or sweaty palm no longer screams emergency—it becomes a familiar, manageable signal.

3. Inhibitory Learning: Instead of just unlearning fear, exposure helps you form a new memory that competes with the fear memory. You’re not erasing old learning—you’re building stronger, more flexible alternatives.

4. Self-Efficacy: Perhaps most importantly, exposure therapy builds confidence. Clients often say: “I didn’t think I could do that—but I did.” That shift changes everything.

The Evidence Is Strong

Exposure-based therapies have been studied extensively and consistently rank among the most effective treatments for anxiety-related conditions.

• Exposure Therapy For Phobias and Panic Disorder: Exposure therapy (especially interoceptive exposure for panic) is a gold-standard treatment (Craske & Barlow, 2007).
• Exposure Therapy For PTSD: Prolonged Exposure (PE), developed by Edna Foa and colleagues, has shown remarkable efficacy in helping individuals confront trauma memories and regain control (Powers et al., 2010).
• Exposure Therapy For OCD: Exposure and Response Prevention (ERP) for OCD is the gold standard treatment, according to research. Clients are exposed to anxiety-provoking thoughts or situations without engaging in compulsions. Over time, the obsession loses its grip because the brain learns: “I can tolerate uncertainty. I don’t need to neutralize it.” Studies show that ERP significantly reduces obsessions and compulsions—even in treatment-resistant cases (Foa et al., 2005).
• Exposure therapy for Social Anxiety: Exposure has been shown to be highly effective for social anxiety disorder, particularly when combined with cognitive restructuring—helping individuals reduce avoidance and build confidence in social situations. 
• Exposure Therapy for Generalized Anxiety Disorder (GAD): Exposure techniques targeting worry triggers and uncertainty (especially imaginal exposure) can reduce anxiety severity and improve tolerance of distressing thoughts.

Types of Exposures

Not all exposure looks the same. Here’s a breakdown of the different types, each tailored to specific challenges:

1. In Vivo Exposure

Facing feared situations or objects in real life. For example, someone with a driving phobia might gradually work up to driving on a highway.

2. Imaginal Exposure

Used when the feared stimulus isn’t accessible or is internal (e.g., memories, thoughts, images). Clients vividly imagine the feared scenario to reduce avoidance and emotional reactivity.

3. Interoceptive Exposure

This involves deliberately triggering physical sensations associated with panic (e.g., dizziness, shortness of breath) to reduce fear of the sensations themselves.

But Isn’t Exposure…Horrible?

This is the biggest myth. Yes, exposure can be uncomfortable—but not intolerable. Therapists work collaboratively to build a hierarchy so that clients gradually work their way up to more feared situations. The goal is empowerment, not suffering.

In fact, most clients describe exposure therapy as surprisingly liberating. Once avoidance loses its hold, people begin to reclaim their lives.

Get support from Exposure Therapists at Dallas CBT

Exposure therapy isn’t about white-knuckling your way through fear. It’s about learning—emotionally, cognitively, and physically—that fear doesn’t have to rule your life. It’s an act of courage, yes—but also an act of healing.

If you’re struggling with OCD, panic, trauma, or phobias, exposure therapy might be one of the most helpful tools on your path forward.  And if you’ve tried everything else and nothing’s worked? It might be time to face the fear—in a safe, guided, evidence-based way.

Therapists at Dallas CBT specialize in exposure therapy for anxiety disorders and OCD.  Call us to schedule an appointment for help on your recovery journey.

References
Craske, M. G., Kircanski, K., Zelikowsky, M., Mystkowski, J., Chowdhury, N., & Baker, A. (2008). Optimizing inhibitory learning during exposure therapy. Behaviour Research and Therapy, 46(1), 5-27.
Foa, E. B., Liebowitz, M. R., Kozak, M. J., Davies, S., Campeas, R., Franklin, M. E., … & Tu, X. (2005). Randomized, placebo-controlled trial of exposure and ritual prevention, clomipramine, and their combination in the treatment of obsessive-compulsive disorder. American Journal of Psychiatry, 162(1), 151-161.
Powers, M. B., Halpern, J. M., Ferenschak, M. P., Gillihan, S. J., & Foa, E. B. (2010). A meta-analytic review of prolonged exposure for posttraumatic stress disorder. Clinical Psychology Review, 30(6), 635-641.
Craske, M. G., & Barlow, D. H. (2007). Mastery of your anxiety and panic: Workbook. Oxford University Press.

How do I stop overthinking and procrastinating?

Get to a next best step once you realize you are overthinking and procrastinating. Overthinking often breeds inaction. It’s a key maintaining factor in the process of procrastination. Here’s a personal example. I’ve been overthinking this blog post for 3 to 6 weeks. On the one hand, I’ve got ideas, but on the other, it just didn’t feel right. Maybe I hadn’t “figured it out.” Maybe something else.  Regardless, I was stuck and procrastinating.

Like, I’m capable of forming coherent thoughts at times, but on the other hand, I haven’t written one down…

What angle do I want to take?  What’s the purpose?  Will this or that be the most impactful? What is the the best approach?

 

Pause.

 

Overthinking may present itself in a couple of ways, but the behavioral pattern of thinking (and thinking and thinking) without action is present in many mental health disorders, and just at a basic human level. It’s a common cognitive response to anxiety and a method of trying to control an experience that often leads to good old-fashioned procrastination. Overthinking, especially when it leads to difficulty with planning, organization, and task completion, can also be a sign of executive dysfunction.  ADHD and anxiety are commonly linked to executive dysfunction– our brains just don’t do what we’d like them to all the time.

 

Why do I get stuck overthinking? 

Overthinking is self-reinforcing while not actually helping you move forward.Why is it so easy to get stuck in the pattern of overthinking and procrastinating? It’s likely because the pattern reinforces itself.  It feels good to overthink at times (e.g., “I’m almost there, I’ve almost cracked the code, if I can just think a little more”), or maybe it feels just less bad (e.g., “I’m scared of BLANK consequence, but maybe I can figure out a way around”), and sometimes less bad is enough to reinforce it. For me, overthinking feels like “I’m making progress,” which reinforces it positively, but also keeps me from having to do the thing that is stressful about writing: actually writing.

 

Try this to stop overthinking.

If you even think you might be overthinking, take a brief pause.  90 seconds.

Use a present-moment-focused skill (being in the present moment) like a breathing exercise for 90 seconds, and just try to be for that period.

There are other options here, of course, but this is my favorite first step in many cases.  For others, it may be 90 seconds of gentle physical movement, 90 seconds of sunshine, 90 seconds with a cold compress on your head.  Work with your therapist to identify what works as a pause for you.

Next, decide if you need one or two more rounds of a present-moment skill, or, if you’re ready, try one action.

 

Take an action; aka, what’s a next step? 

Identify something that would be a next best step. “Next best” here means something you’ll probably have to do anyway, even if it’s not the perfect next step. Just a next action that may help. Devote 5 minutes to DOING it. It doesn’t have to be perfect, it just has to be.

After this, devote another 5, or if you’re feeling it, 10 minutes to either this or another next best step. Once you need a break, take a brief 3 to 10 minute one, then try another 5 minutes.

If you need a longer break, take something that most would call a reasonable break, but commit to what time you’ll get re-started.

 

A real-life example: 

My favorite intervention with creative types who are stuck in writer’s block, for example, is: “Write a BLANK Story.” For perfectionists, it’s often “Write a BAD Story.”  For a Mr. or Ms. Smarty-pants Perfectionism, it’s “Write a DUMB Story.”  Write a quick stream-of-consciousness story.  The only point is to actually WRITE SOMETHING.  Engage in the behavior. That’s a next best step.

Get it done. We will do this with our clients in session (called body doubling), or we’ll do it separately and trade next week if that’s helpful.  The story doesn’t have to be long, but let’s agree to writing something that is a meaningful word count for that person.

Once you’ve done it, don’t focus on the product.  Try to hold the end product lightly and find appreciation for the action you took. What was it like to write?  What was it like to write without caring about the product?  Can we try it again next week, but as “Write a story you only kind of like with a beginning, a middle, and an end?”

 

Overthinking is common and easy for all of us to get stuck in.  Try a next best step once you can accept that you may not think your way out of the problem.

Evidence-Based Therapies for Trauma: What Works and Why

When you’ve lived through something traumatic—whether a single life-threatening event or chronic exposure to adversity—healing can feel complicated and uncertain. At this point in the field of psychology, we know more than ever about how trauma affects the brain and body, and we have treatments that work. If you’re looking for therapy that’s grounded in research and focused on real results, three approaches stand out: Cognitive Processing Therapy (CPT), Eye Movement Desensitization and Reprocessing (EMDR), and Prolonged Exposure (PE).

Each of these therapies has been studied extensively and shown to reduce trauma symptoms, help people regain a sense of safety, and improve daily functioning. In this blog, we’ll walk through how each treatment works and what the research says.

1. Cognitive Processing Therapy (CPT)

What it is:
CPT is a structured, time-limited therapy that helps people identify and challenge unhelpful beliefs related to a traumatic event. It’s especially effective for anyone struggling with guilt, shame, or a sense that they or the world are permanently damaged.

How it works:
CPT is based on the idea that trauma can change the way we think about ourselves, others, and the world. These changes, often called “stuck points,” can keep people trapped in cycles of fear, self-blame, withdrawal, or avoidance. CPT helps you recognize these patterns and develop more accurate, balanced thoughts.

Why it’s helpful:
By targeting the thoughts that fuel ongoing distress, CPT reduces trauma and PTSD symptoms and helps people re-engage with life. The bulk of CPT takes an average of 12 sessions, and often is delivered in the context of individual therapy that might include other treatment goals as well.

Research highlights:
Numerous randomized controlled trials have shown CPT to be effective in reducing trauma and PTSD symptoms, with gains maintained over time (Resick et al., 2017). It’s one of the top treatments recommended by the U.S. Department of Veterans Affairs and the American Psychological Association (APA).

2. Eye Movement Desensitization and Reprocessing (EMDR)

What it is:
EMDR is a therapy that helps people process traumatic memories using bilateral stimulation—usually eye movements, sounds, or tapping. Unlike some other forms of therapy,, EMDR doesn’t require detailed descriptions of the trauma.

How it works:
EMDR targets unprocessed memories that continue to trigger distress in the present. During sessions, clients briefly recall traumatic memories while engaging in bilateral stimulation. This process appears to help the brain “re-file” the memories so they no longer feel overwhelming or intrusive.

Why it’s helpful:
EMDR is often a good fit for people who have difficulty talking about their trauma, and it’s been shown to reduce both emotional distress and physical symptoms of trauma and PTSD. 

Research highlights:
Meta-analyses have found EMDR to be as effective as trauma-focused CBT in reducing trauma and PTSD symptoms (Watts et al., 2013). The World Health Organization recognizes EMDR as one of the frontline treatments for PTSD.

3. Prolonged Exposure (PE)

What it is:
PE is a form of cognitive-behavioral therapy that helps people face trauma-related memories and situations in a safe, structured way. It’s based on the idea that avoidance keeps PTSD symptoms going.

How it works:
In PE, clients gradually confront the trauma memory through imaginal exposure (retelling the trauma in detail during sessions) and in vivo exposure (approaching avoided situations in real life). Over time, this reduces fear and increases confidence in one’s ability to cope.

Why it’s helpful:
Avoidance may offer short-term relief, but it reinforces fear and limits functioning. PE helps retrain the brain to recognize that the trauma is over and that the present moment is safe.

Research highlights:
PE has one of the strongest evidence bases for treating PTSD. Studies show large reductions in symptoms, with improvements maintained for years (Powers et al., 2010). It’s considered a gold-standard treatment by the APA and VA.

What is the best trauma therapy for you?

Each of these therapies is effective, and the best choice depends on your preferences, history, and treatment goals. Some people prefer the structure of CPT, while others appreciate the less-verbal approach of EMDR. Still others find that facing their fears directly through PE is what helps most.

What they all share is a focus on processing trauma in a way that allows healing—not by forgetting, but by reducing its power over your present life.

Trauma can leave deep imprints on the mind and body, but it doesn’t have to define your future. Evidence-based therapies like CPT, EMDR, and PE offer proven paths toward relief and recovery. If you’re considering treatment, look for a specialist trained in these approaches, and don’t be afraid to ask about the process. Healing is possible—and it starts with the first step.

Trauma therapists at Dallas CBT offer CPT, EMDR, and PE for trauma.  Call our office for more information and to connect with one of our therapists.

 

References

• Resick, P. A., Monson, C. M., & Chard, K. M. (2017). Cognitive Processing Therapy for PTSD: A Comprehensive Manual. Guilford Press.
• Watts, B. V., Schnurr, P. P., Mayo, L., Young-Xu, Y., Weeks, W. B., & Friedman, M. J. (2013). Meta-analysis of the efficacy of treatments for posttraumatic stress disorder. Journal of Clinical Psychiatry, 74(6), e541–e550.
• Powers, M. B., Halpern, J. M., Ferenschak, M. P., Gillihan, S. J., & Foa, E. B. (2010). A meta-analytic review of prolonged exposure for posttraumatic stress disorder. Clinical Psychology Review, 30(6), 635–641.

Trauma Lives in the Body, Too

Most people know that trauma can leave emotional scars. But fewer people realize that trauma can also change how your body works—down to the level of your genes.

In recent years, scientists have uncovered powerful evidence that trauma doesn’t just live in our memories. It can change how genes are expressed in the body—a field of study called epigenetics. These changes can shape how our brains and bodies respond to stress, how we manage inflammation, and even how resilient we feel. And yes, those changes can stick with us for a long time—sometimes even across generations.

Trauma and the Stress Response

When something traumatic happens—whether it’s a single event or ongoing stress—the body kicks into high gear. This is your survival system doing its job. But when the stress is chronic or overwhelming, the system can get stuck in overdrive.

One key player in this system is the glucocorticoid receptor, which helps regulate your body’s stress hormone, cortisol. Research has shown that trauma can change the way this gene is expressed, making it harder for your body to turn off the stress response. Over time, this can lead to wear and tear on your immune system, sleep patterns, digestion, and even heart health.

How Does Trauma Affect the Body?

If you’ve ever wondered why trauma survivors often struggle with chronic pain, autoimmune issues, fatigue, or digestive problems—this is part of the reason. The biological stress from unresolved trauma can ripple through multiple systems in the body.

These epigenetic changes may help explain why some people feel like they’re constantly “on edge,” or why even small stressors feel overwhelming after a traumatic experience. In many ways, the body is reacting to the world as if the threat is still ongoing.

Trauma Across Generations

There’s also compelling research showing that these trauma-related changes can be passed from one generation to the next. Children of trauma survivors sometimes show similar epigenetic patterns—even if they didn’t experience the original trauma themselves.

This doesn’t mean trauma is destiny. But it does mean that healing isn’t just about “getting over it.” It’s about recognizing how deeply trauma affects both mind and body—and responding with care, patience, and evidence-based support.

What Can Help with Trauma?

Here’s the hopeful part: Just as trauma can shape our biology, healing experiences can too. Therapy approaches like Cognitive Processing Therapy, Prolonged Exposure, and Eye Movement Desensitization and Reprocessing (EMDR) have been shown to reduce the symptoms of PTSD and help rewire the brain’s response to stress. Early evidence even suggests that effective therapy can reverse some trauma-related epigenetic changes.

Other healing tools—like consistent social support, mindfulness practices, physical movement, and trauma-informed medical care—can also support the body’s return to a more balanced state.

If you’re carrying the invisible weight of trauma, it’s not just in your head—and you’re not alone. Healing is possible, and it often starts with understanding what’s really going on inside. Whether your symptoms are fresh or decades old, Cognitive Processing Therapy and Eye Movement Desensitization and Reprocessing (EMDR) are research-backed therapies that are a good place to start (for kids or adolescents, look into Trauma Focused Cognitive Behavioral Therapy: TF-CBT).  These therapies can help you move through the pain—on your terms, at your pace, and with support every step of the way.

Read more about therapy for trauma on our website, or contact us to get hands-on support from a trauma specialist at Dallas CBT. 

You’re out of the storm, but somehow still stuck in it.  That’s one of the most bewildering parts of trauma: the danger has passed, but your nervous system hasn’t gotten the memo. You may be physically safe, but mentally and emotionally? It can feel like you’re on high alert, waiting for the next wave to hit.  It can feel like your sense of happiness hasn’t fully recovered, waiting for more bad news.

So how do you move on after trauma?

“Moving on” doesn’t mean forgetting or pretending it never happened. It means healing—to the point where the trauma doesn’t control your reactions, your relationships, or your sense of self. It means anchoring in the storm and finding your footing again.

Two of the most powerful trauma treatments we use at Dallas CBT are Cognitive Processing Therapy (CPT) and Eye Movement Desensitization and Reprocessing (EMDR). Both are evidence-based, structured, and help people move forward with clarity and strength.  Below are some key tools learned in these therapies that can help start the loosening up of the effects the trauma has on your life:

1. Loosen the Stuck Thoughts in Trauma

Trauma often creates rigid, self-blaming thoughts—like “I should have stopped it,” or “The world isn’t safe,” or “I’m broken.”

Cognitive Processing Therapy helps you identify these trauma-related beliefs (called “stuck points”) and evaluate them:

• What beliefs or thoughts are causing you to feel “stuck”?
• How do these thoughts make you feel?
• Where did this stuck point come from?
• Is this belief 100% true? What is the evidence for and against this belief?
  
• What does holding on to this belief do for you?
  
• Is it helping me recover—or keeping me stuck?
• What would it be like to no longer hold onto this belief?
• What might a more balanced and helpful thought be?

A helpful exercise: Write out the belief and your answers to all of the questions above. It may take time to counter it with a more balanced thought. 

This process takes time, but it’s powerful. Repeatedly challenging unhelpful beliefs helps rebuild a more realistic and compassionate view of yourself and the world.

2. Soothe the Nervous System Daily

Daily nervous system regulation strategies are essential to helping your body shift out of the anxious, fight-or-flight mode caused by trauma.  Start with very small, doable goals, such as 1 small effort or 2 minutes of a practice per day.  Here are a few practices to experiment with, find what works best for you:

• Grounding exercises: Use your five senses to bring yourself back to the present. Try the 5-4-3-2-1 technique: What are 5 things you see? 4 things you can touch? 3 things you can hear? 2 things you can smell? 1 thing you can taste?
• Tapping: Tapping rhythmically on acupressure points can lower distress and increase a sense of safety. (There is new research support for this! Plus, it’s free)
• Body-based practices: Gentle yoga, walking, stretching, or rocking can reset the nervous system.
• Safe connection: Trauma often isolates. Safe relationships help rewire the brain for trust and connection. Consider what one small step toward increasing your sense of connection might look like today

3. Reprocess the Memory 

Therapies like EMDR or Cognitive Processing Therapy do not erase your trauma—it helps your brain refile it.

EMDR uses bilateral stimulation (often eye movements or tapping) to activate the brain’s natural information-processing system. This allows you to revisit the memory without reliving the panic, so your nervous system can finally complete the healing process.  Importantly, this process is best done with a trauma therapist, and the basic process involves:

• Recall the traumatic memory while tracking back-and-forth eye movements (or tapping).  You can also try walking in nature or bilateral beats to achieve bilateral stimulation.
  
• Notice what thoughts, emotions, or body sensations come up
  
• Let your mind make connections and remain open and accepting to whatever thoughts or meaning shows up. 

Over time, the memory becomes less emotionally charged, and new, adaptive beliefs can take root. 

4. Understand What Recovery Actually Means

Recovery isn’t about being “over it.” It’s about reclaiming your life, which can mean:

• Feeling more like yourself again
  
• Responding to stress in ways that fit the present, not the past
  
• Reconnecting with values, joy, and purpose
  
• Knowing the trauma happened, but not letting it define who you are

And for many people, therapy is a key part of that process. If you’re thinking about starting therapy, consider seeking someone trained in Cognitive Processing Therapy (CPT for Trauma), Eye Movement Desensitization and Reprocessing (EMDR), Prolonged Exposure Therapy (PE), or another evidence-based trauma approach.  You don’t have to do it alone—and you don’t have to stay stuck.

Trauma therapists at Dallas CBT are here to help you in your recovery from trauma.  Give us a call to schedule an appointment, and learn more about trauma therapy.

Attention-Deficit / Hyperactivity Disorder (ADHD) is more than what we usually see in pop culture. ADHD definitely involves issues like trouble paying attention and impulsive or hyperactive behavior, but there’s much more to it.

ADHD isn’t about lacking the ability to focus; in fact, those with ADHD have great ability to hyper-focus on things they are passionate about.  ADHD is about difficulty controlling what you pay attention to. Thinking of ADHD this way still explains why someone might seem easily distracted or quickly switch tasks, but it also highlights other, less obvious signs, such as:

1. Emotional Reactivity

Emotional Reactivity is one of the most common but overlooked signs of ADHD. People with ADHD often feel emotions intensely and have great difficulty shifting their attention away from them. Their emotions ramp up quickly, but can take much longer to fade away. Sometimes emotions linger for hours or even days, rather than just seconds or minutes. Anger or frustration is most common, but this pattern can happen with any emotion.

“Emotional dysregulation is a hallmark of ADHD and manifests as sudden mood shifts, irritability, frustration, and an exaggerated response to minor stressors.” — Shaw, Stringaris, Nigg, & Leibenluft (2014, p. 203)

2. Time Blindness

People with ADHD don’t just ignore time; they experience time very differently. They struggle to estimate how long tasks will take, notice the passing of time, feel urgency about deadlines, and learn from past timing mistakes. This leads to chronic lateness, procrastination, poor planning, and trouble reaching long-term goals.

“Those with ADHD are often ‘blind to time,’ failing to sense or use time effectively to guide their behavior, leading to difficulties with deadlines, appointments, and planning.” — Barkley, R. A. (2010, p. 253)

3. Chronic Chaos

Not occasional chaos—chronic chaos. People with ADHD don’t struggle to solve problems, but they have trouble planning and directing their actions toward future goals like others do. As a result, their impressive abilities often get wasted on constantly handling emergencies.

“Adults with ADHD often describe their lives as being in a constant state of disarray, struggling with disorganization, clutter, missed deadlines, and an inability to maintain structure in their daily routines.” — Solden & Frank (2019, p. 37)

Why It Matters

Recognizing ADHD in yourself or someone you love isn’t just about labels—it’s about understanding a brain that works differently and needs different approaches. When ADHD is untreated or misdiagnosed (often mistaken for anxiety, depression, or emotional “problems”), people blame themselves and miss out on useful strategies.

At Dallas CBT, we specialize in recognizing and supporting ADHD in adults who might have gone unnoticed for years. If you’re ready for answers and support, we’re here to help.  Learn more about therapy for ADHD.

5 Strategies for Coping with ADHD That Actually Work (with some practice)

Living with ADHD is no simple feat, at times. It can and will impact all aspects of your life at some point—sometimes all in the same day.

Setting up your environment and routine in order to manage your daily life is a crucial first step in coping behaviorally with ADHD. Practicing executive functioning skills that can help you better manage your symptoms is the path forward. Here are a few starters:

1. Visualize Time:

People with ADHD experience time differently than those without, which makes it very hard to stay on task for a set amount of time. Here are a few ways to visualize time for yourself to stay engaged:

• Use a literal timer that you place in front of you while you work. It helps to use an analog timer where you can physically see time move. You might also consider a Time Timer that shows time as a disappearing wedge.
• Use an organizer where you can block out activities by time of day. Use different colors for different activities.

2. Externalize Your Memory:

If you have ADHD, your memory does not function like other people’s, at least without external support. External systems reduce cognitive load, and writing it out tends to be better for processing. Simple tools can help, such as:

• Sticky notes
• Daily task journals
• Digital, paper, or wall calendar
• Digital apps like Todoist or Notion

3. Break it down:

The ADHD brain is motivated primarily by urgency, which leads to chronic procrastination when the task is “write that 15-page essay” that isn’t due for two weeks. Break the problem or project down into its component parts:

• “Write Essay”:
  1. Open laptop
  2. Open Word doc
  3. Type heading
  4. Find article to cite
• Bonus points if you add these tasks to your daily task list from Tip #2!

4. Get Your Body Involved:

ADHD is a neurodevelopmental condition, but it lives in the body too. Movement helps regulate attention and emotion. Even small amounts of movement can help “unstick” your brain when it’s in a fog. Try:

• Walking meetings
• Standing desks
• Fidget tools (putty, rings, chair bands)
• Taking a walk before or after work

5. Practice Self-Compassion, Not Just Self-Discipline:

ADHD often comes with a harsh inner critic. Years of hearing “You’re lazy,” “You just need to try harder,” or “Why can’t you just…” can internalize shame.

• ADHD is not a motivation problem—it’s a regulation problem. Beating yourself up doesn’t build skills. Self-compassion does.
• Learning to say, “This is hard because of how my brain works” makes space for curiosity, not just correction.

Looking for ADHD Therapy or Support?

If you’re looking for professional support, you’re not alone. At Dallas CBT, our team offers ADHD testing and ADHD therapy and coaching that blends evidence-based treatment (like CBT and ACT) with practical strategies tailored for ADHD brains. Whether you’ve just been diagnosed or have known for years, you deserve support that fits you.

Attention-Deficit / Hyperactivity Disorder (ADHD) is often misunderstood and overlooked as a diagnosis, even by those in the mental health community.  It is relatively common, with close to 1 in 10 children in the US being diagnosed (CDC, 2022).  Prevalence in adults is estimated at about 5%, though it is likely under-diagnosed (Kessler et al., 2006).  

If you’ve found yourself googling symptoms or felt validated by social media posts on ADHD, you’re not alone.  ADHD assessment can be the first step towards coping far more effectively with these differences.  Whether you’re searching for answers yourself, or for a loved one, here’s some info on how we go about diagnosing ADHD. 

Why ADHD Testing Matters

Getting an appropriate and valid diagnosis isn’t just about answering a couple of questions then getting stimulant medications.  ADHD often occurs with other mental health symptoms, like anxiety and depression; to complicate it, other conditions can also look like ADHD.  For example, one person may struggle with depressive symptoms as a result of their experiences coping with un-diagnosed ADHD, while another person may struggle with inattentiveness and concentration issues because of depression. 

The goal of a thorough assessment is to differentiate ADHD symptoms from other symptoms so that efforts to cope with them can be far more tailored and effective.

What Happens in ADHD Testing?

A comprehensive ADHD assessment typically includes several components:

• Clinical Interview: The psychologist will gather your developmental, academic, occupational, and emotional history. If the client is a child or young adult, parents or teachers may also be interviewed. 
• Symptom Checklists: These are standardized questionnaires used to assess ADHD  and other symptoms across different settings (home, work, school). 
• Cognitive Testing: These tests are meant to measure underlying abilities, such as verbal comprehension and the speed a person processes information. 
• Achievement Testing: These tests are meant to measure how effectively a person applies their underlying abilities to completing school- and work-like tasks 
• Rule-Outs: A thorough assessment includes evaluation of other symptoms that might look like ADHD (e.g., anxiety, depression, learning disorders). 
• Collateral Information: When possible and appropriate, reports and measures may be completed by parents, teachers, or other professionals to help understand how these symptoms present in different settings.

Who Can Diagnose ADHD?

In the United States, ADHD can be diagnosed by psychiatrists, neurologists, and certain medical doctors (e.g., pediatricians or family medicine doctors). However, the most thorough and evidence-based assessments are typically performed by licensed psychologists, especially those trained in psychoeducational or neuropsychological testing. 

What Does a Diagnosis Look Like?

Assessment results are interpreted by the psychologist, who will give any appropriate diagnoses based on these results.  

If appropriate, your psychologist will diagnose you with one of three subtypes of ADHD:

• Predominantly Inattentive Presentation 
• Predominantly Hyperactive-Impulsive Presentation 
• Combined Presentation

Each ADHD assessment results in a comprehensive report and a detailed feedback session to help walk you through it.  These reports include a detailed discussion of your results, diagnosis, and comprehensive recommendations to help you move forward and manage these symptoms more effectively.  These recommendations include treatment recommendations, as well as recommendations for academic or workplace accommodations (e.g., extended-time on testing, work supports).

A Note on ADHD in Women and Late Diagnosis

ADHD is still underdiagnosed in women and girls, in part because they often present with fewer hyperactive symptoms and more internalized struggles like overwhelm, disorganization, and mental fatigue. Many women aren’t diagnosed until adulthood—often after their child is diagnosed first.

If you’re a woman who always felt like you had to work harder just to stay afloat, it’s worth seeking an evaluation. You’re not making it up. You’re just long overdue for some answers.

Next Steps- ADHD Testing in Dallas

If you suspect ADHD, the best step is to connect with a licensed professional who can provide a comprehensive evaluation. At Dallas CBT, our psychologists specialize in the assessment and treatment of ADHD in both children and adults. We offer thoughtful, evidence-based evaluations that not only clarify diagnoses but also help guide meaningful treatment.

Curious whether an evaluation is right for you?

Learn more about our ADHD Testing here, and contact our office to schedule an appointment.

What is Social Anxiety Disorder?

Social anxiety is characterized by pervasive fear and anxiety manifested in social situations during which the individual is subjected to real or imagined scrutiny by others.  For teenagers, their peer group is often seen as a source of this judgement and as a result the teen often resists social engagement, performance, and asserting their needs due to an exaggerated fear of rejection. Occasional nervousness about peer judgment is to be expected during these years, however, pervasive patterns of avoiding developmentally appropriate social experiences—such as school dances, group outings, or initiating friendships—may signal social anxiety. While many teenagers certainly have a shy or timid temperament by nature, the degree to which this impairs social, emotional, and educational progress can provide insight into whether this behavior deviates from what is typically expected for their natural disposition.

Many teens with social anxiety also endorse overwhelming  intrusive thoughts related to social engagement.  Thoughts such as ““What if they don’t like me?” “What if I say something stupid?” or “What if I embarrass myself?” are frequently cited.  This negative self-talk further exacerbates fears of rejection, increasing the likelihood that the teen will avoid social engagement opportunities.

How Social Anxiety Affects Teen Development

Identity development is a normal and natural process in early adolescence. The great majority transition out of this stage with a newfound sense of self-worth, confidence, insight, and connectedness, often despite social bumps in the road.  However, this stage can be hindered by excessively impairing fears of rejection manifested as social anxiety.

Fear, apprehension, and excessive concern related to integrating into a social group is a common experience for many teenagers, and is generally accepted as a normal part of the developmental experience. However, for teenagers who struggle with social anxiety, initiating and maintaining friendships is like navigating a minefield – an overwhelming, high-stakes endeavor where any misstep seems to carry irreversible consequences. Socially anxious teens often perceive rejection, ridicule, and ostracization as inevitable outcomes of social miscues, even mundane and ordinary ones.  Fears that these outcomes will be permanent  often results in avoidance and isolation from important social experiences that help teens develop the requisite skills necessary to transition into adulthood. While some parents may attribute this isolation to typical teenage moodiness, persistent avoidance and distress in social settings may indicate clinically significant social anxiety.

Six Things Parents Can Do To Help Their Socially Anxious Teens

While these symptoms can be worrying for parents, there are several strategies caregivers can use to help encourage struggling youth to develop confidence in their ability to navigate challenging social situations:

1. Model assertiveness

   Throughout most of the developmental years, parental behaviors serve as a model for how to engage with social situations.  Children and teens are constantly incorporating new information into their social repertoire, and the language and behaviors that parents display in unfamiliar situations can help teens be prepared for these novel experiences themselves. Show them how in other words.

2. Verbalize your thought process While children and teens are able to observe and imitate assertive behavior, it is also important that they hear parents express the cognitive processes through which that behavior manifests.  Adults are no stranger to anxiety and being able to externalize healthy coping statements such as, “this is going to be an uncomfortable situation, but I know that I can handle it” will serve children well for developing their own internal dialogue when encountering similar situations.
3. “I do, we do, you do.”  Parents should take a graduated approach to helping their teen develop social confidence by first demonstrating a specific skill (“I do”), then encouraging the child or teen to join with the parent (“we do”), and then finally suggesting that the teen complete the task independently (“you do”).  This approach will help children to gradually gain confidence in their skillset and allow for parents to observe and correct any errors that may happen during the learning process.
4. Positive praise.  Socially anxious children and teenagers often have negative core beliefs about their abilities in social situations that have been reinforced over years of avoidance and stalled attempts to gain social competence.  Very rarely do they encounter evidence to their successes and innate abilities. Parents can help to foster a healthier pattern of internal dialogue for their teen by making an effort to praise and reward even the smallest displays of social engagement.  Many times this acknowledgement will challenge the teen’s negative core beliefs and motivate them to continue progressing toward even greater levels of social proficiency.
5. Individual Therapy.  Cognitive Behavioral Therapy (CBT) is a form of therapy that is shown to be an effective treatment for individuals struggling with social anxiety.  CBT focuses on identifying maladaptive thinking patterns and replacing them with a more helpful style of processing our real-work experiences. Teenagers who receive CBT will learn how to reappraise their thought processes and be taught to view their social miscues as learning opportunities.  CBT is an active form of therapy that takes a hands-on approach, with therapists working with the teen to confront real-world challenges.
6. Group Therapy.  Learning social skills and developing confidence in a group setting can also be an effective adjunctive therapy to further strengthen social development.  Group therapy at Dallas CBT utilizes cognitive-behavioral strategies similar to individual approaches but combines learning opportunities with peer engagement to increase the social validity and generalization of skills.  Group therapy also allows for teens to both give and receive feedback from same-age peers, helping to destigmatize their shared experiences.

When Should Your Teen Get Support From an Exposure Therapist?

While social anxiety can feel debilitating, with the right interventions and support, teens can develop the confidence and skills needed to navigate social situations successfully. By modeling assertiveness, providing gradual exposure, reinforcing positive social interactions, and seeking professional support when necessary, parents can play a crucial role in helping their teens overcome social anxiety and build meaningful connections.

If your teen struggles with social anxiety, our group therapy sessions provide a supportive environment where they can build confidence, develop skills, and connect with peers who understand their challenges.  Reach out today for more information or if you are interested in enrolling your child in any of our individual or group services.

— Jamarri Aikins, PhD —

Couples therapy can seem like a mystery until you’re sitting on the couch, wondering where to start. Whether you and your partner are facing communication struggles, trust issues, or recurring conflicts, research shows that therapy can be highly effective in helping couples build healthier, more fulfilling relationships. 

But does couples therapy work?  And how exactly does couples therapy work? Two of the most well-researched and successful approaches—The Gottman Method of Relationship Therapy and Emotionally Focused Therapy for Couples Therapy (EFT)—offer structured, evidence-based strategies to improve emotional connection, reduce conflict, and increase relationship satisfaction. 

Does Couples Therapy Work?

Let’s start with the most pressing question– does couples therapy work?  The short answer: Yes, when done with proven methods and commitment from both partners. 

Studies show that structured couples therapy approaches, such as Gottman-based interventions and EFT, have long-term positive outcomes. 

The effectiveness of therapy depends on factors like: 

• The severity of the issues 
• Willingness to engage in the process 
• Therapist experience and training in evidence-based methods 

How does couples therapy work?  

Let’s explore two of the most successful couples therapy models. 

The Gottman Method of Relationship Therapy is based on four decades of research on what makes relationships work. The therapy focuses on strengthening friendship, managing conflict, and creating shared meaning. Research shows that Gottman-based therapy significantly reduces conflict and improves relationship satisfaction.

Some key principles include: 

• The Sound Relationship House Theory is a model that helps couples build trust and emotional intimacy 
• Managing Conflict Effectively involves learning to navigate disagreements in healthy, productive ways rather than letting them spiral. 
• Reducing the “Four Horsemen,”  which are criticism, contempt, defensiveness, and stonewalling.  These four behaviors are the biggest predictors of relationship failure. Therapy helps replace these with healthier communication habits. 
• Turning Toward Instead of Away is a process of using small moments of emotional connection (e.g., responding to a partner’s bid for attention) to increase relationship longevity. 

Emotionally Focused Therapy (EFT), developed by Dr. Sue Johnson, is rooted in attachment theory.  The goal of EFT is to help couples repair emotional injuries and create a secure, connected bond. 

Three Stages of EFT:

1. De-escalation – Identifying negative cycles of conflict and understanding the underlying emotions driving disconnection. 
2. Restructuring Interactions– Helping partners become more open and responsive to each other’s emotional needs. 
3. Consolidation – Strengthening new patterns of connection and preventing old cycles from returning. 

What to Expect in Couples Therapy 

Regardless of the method used, couples therapy follows a structured process: 

1. Therapy Intakes: The therapist evaluates your relationship patterns and sets collaborative goals with both partners. It is common for the therapist to meet with both partners together first, and then to meet with each partner individually before resuming joint sessions,
2. Building Awareness: Couples learn about their conflict patterns and relationship or attachment needs. 
3. Skill Development: Techniques like active listening, de-escalation strategies, and rebuilding trust are introduced. 
4. Practice Between Sessions: Couples are encouraged to apply skills in daily life to strengthen their bond outside of therapy. 

The ultimate goals of couples therapy are stronger communication, deeper connection, and getting better at meeting each other’s emotional needs.  If you and your partner are feeling stuck, seeking therapy can be the best investment you make in your future together. You don’t have to wait until things fall apart, you can build a strong relationship now to prevent dissatisfaction later.  Our couples and relationship therapists at Dallas CBT practice couples therapy that works.  They use structured, research-backed couples therapy models and tailor it to your relationship needs. 

A research study showed that couples find their way into couples or relationship therapy years after serious problems have started (an average of 2.7 years, to be specific*).  We get it, couples therapy can be intimidating and expensive.  While therapy can be critical for some relationships to stay intact, putting the effort in before the relationship hits a breaking point is good preventative care.  

Enhancing your relationship doesn’t always require extensive therapy sessions; sometimes, simple, research-backed techniques can make a big difference. The Gottman Method of Couples Therapy offers practical tools to strengthen your bond. Studies have shown that the Gottman Method is highly effective in improving relationship satisfaction and communication. Here are three easy-to-implement skills to enrich your partnership:

1. The 5:1 Ratio: Balancing Positive and Negative Interactions

Research by Dr. John Gottman highlights the importance of maintaining a ratio of five positive interactions for every negative one during conflicts. This balance is crucial for relationship stability and happiness. Positive interactions can include expressing appreciation, sharing affection, or simply showing interest in your partner’s day. By consciously increasing these positive moments, you can lessen the impact of negative interactions and foster a more resilient connection.

2. Turning Toward Each Other: Building Emotional Connection

In daily life, partners make bids for each other’s attention, affection, or support. Responding to these bids by “turning toward” your partner—acknowledging and engaging with them—strengthens emotional bonds. For instance, if your partner comments on something they’re reading, showing interest in the topic reinforces your connection. Consistently turning toward each other in these small moments lays a foundation of trust and intimacy.

3. Softened Start-Up: Initiating Conversations Gently

How you begin a discussion, especially on sensitive topics, can set the tone for the entire conversation. The Gottman Method emphasizes the “softened start-up,” which involves bringing up issues gently and without blame. Instead of saying, “You never help around the house,” you might say, “I feel overwhelmed with the housework and would appreciate more help.” This approach reduces defensiveness and facilitates more productive dialogues.

By integrating these Gottman Method techniques into your relationship, you can enhance communication, deepen emotional intimacy, and build a more satisfying partnership. Remember, small, consistent efforts often lead to significant, lasting improvements.

If you or your relationship could use support in applying strategies like these to your relationship, schedule with one of our Couples and Relationship Therapists. Our Dallas therapists can tailor hands-on evidence-backed therapy strategies for your relationship to help you progress faster to a more fulfilling relationship. 

Citations

*Doherty WJ, Harris SM, Hall EL, Hubbard AK. How long do people wait before seeking couples therapy? A research note. J Marital Fam Ther. 2021 Oct;47(4):882-890. doi: 10.1111/jmft.12479. Epub 2021 Jan 7. PMID: 33411353.

5 Ways to Incorporate EMDR Into Your Daily Life

If you’ve heard about EMDR (Eye Movement Desensitization and Reprocessing), you might already know it’s a powerful, evidence-based therapy often used to address trauma. Our goal at Dallas CBT is to understand and incorporate the most effective techniques, such as EMDR and Cognitive Behavioral Therapy strategies, to help people heal quickly and live their best lives.  

How Does EMDR Work?

Our Dallas therapists also try to find the most effective “therapy homework” or daily practices for our clients to use at home.  Below are some great ways to adapt EMDR-inspired techniques for everyday stress and anxiety relief. Before we dive in, it’s important to note that these strategies aren’t a substitute for formal EMDR therapy with a licensed clinician, but they can complement professional care and help you build resilience in your daily routine.

Understanding EMDR vs. EMDR-Inspired Techniques

Traditional EMDR therapy involves structured sessions with a trained professional who guides you through memories, thoughts, and emotions while employing bilateral stimulation—often eye movements. By contrast, EMDR-inspired techniques are smaller-scale practices you can integrate into your day for self-soothing and grounding. Think of these strategies as gentle, user-friendly tools that borrow concepts from EMDR’s approach to reprocessing distressing thoughts and sensations.

1. Bilateral Stimulation in Everyday Tasks

Bilateral stimulation is a hallmark of EMDR, typically done via side-to-side eye movements. But you can tap into similar benefits in simpler ways—like taking a mindful walk, noticing your footsteps as you alternate left-right, or by listening to audio tracks that alternate from one ear to the other. Research suggests that this back-and-forth stimulation can help calm the nervous system, making everyday tasks a bit less stressful.

2. Self-Soothing with the “Butterfly Hug”

One of the most widely shared EMDR-inspired techniques on social media is the Butterfly Hug: cross your arms over your chest, then gently tap each side in an alternating rhythm. This can be especially helpful during moments of mild anxiety or when you need a quick self-soothing strategy. By focusing on the tapping and your breath, you help ground your body and mind in the present moment.

3. Safe or Calm Place Visualization 

A key phase in formal EMDR therapy involves imagining a secure or calm place. You can adapt this concept by taking brief “visualization breaks” throughout your day. Close your eyes, breathe deeply, and picture a scene that makes you feel at ease—a quiet beach, a peaceful forest, or even a cozy room from childhood. Pairing this visualization with gentle bilateral tapping or slow, rhythmic breathing can enhance its calming effect.

4. Journaling with Cognitive Interweave

In full EMDR sessions, therapists often use “cognitive interweaves,” based in cognitive therapy,  to challenge distorted thoughts and introduce more balanced perspectives. A home-friendly version of this is journaling. Write down distressing thoughts or situations, then actively reframe them by asking yourself what a more compassionate or rational viewpoint might be. For instance, if you’re worried about an upcoming presentation, you could replace “I always fail at these things” with “I’ve succeeded before and can learn from any mistakes.”

5. Tracking Emotional Shifts

Finally, keep a simple log—on paper or a phone app—of your daily emotional ups and downs. Note what triggered the changes and whether you used any bilateral stimulation or self-soothing technique. This isn’t just data collection; it’s a way to build awareness of how your mind and body respond to stress, which can guide you in using these EMDR-inspired strategies more effectively.

Putting It All Together 

While none of these practices replace the depth of formal therapy, they can help you manage everyday anxiety and stress. Feel free to experiment—one technique might resonate more than another. And if you find that old memories or overwhelming emotions come up, reach out to a mental health professional for additional support.

Incorporating EMDR-inspired techniques into your routine can offer gentle relief and a sense of control over stress and anxiety. By combining elements like bilateral stimulation, visualization, and cognitive reframing, you give yourself small yet powerful ways to steady your mind and body. Keep in mind that true EMDR therapy is best guided by a qualified therapist, but these daily practices can serve as a supportive complement to professional help—or simply a proactive way to nurture your well-being.

One of the most important early goals in exposure-based treatments for social anxiety is helping the client find a supportive environment in which they can push themselves socially. This goal is at the heart of Dallas CBT’s social anxiety group treatment program.

Christopher DuFour has done a great job with our adult social anxiety groups over the past several years, creating a warm and supportive atmosphere that still pushes his clients to do hard things.  As we prepare for a new round of his social anxiety group this January, we thought we’d get feedback from Chris’ recent group members on their experience with the program.

What was your experience with our social anxiety group?

“I can’t express how much the social anxiety group has helped me in my journey to overcome my fear of public speaking. Chris has done an amazing job providing a safe, non-judgmental space to share experiences and strategies to help manage anxiety in any social situation. I have made tremendous progress in building my confidence and facing challenges I once thought were impossible. I highly recommend joining!”– M.A.

“Along with Chris’s insightful guidance, getting a dedicated space to meet with others suffering from social anxiety was an absolute game changer. With the help from Dallas CBT, I was able to see with my own eyes that not only was I not alone in my struggles, but that I also had the power to change my own cognition and recognize unhelpful thought patterns I’d subconsciously cultivated. I learned how to replace them with more positive or neutral ways of thinking. Through exposure therapy I was able to put what was learned and discussed in regular meetings into action and further boost my journey to liberation from social anxiety. I’m forever grateful to Chris and Dallas CBT for helping me see the potential I had within me all along.”— JP

Chris was an amazing facilitator, and the group was really helpful for me. Here are some of the ways it helped me: Seeing other people who seemed confident but had social anxiety made me realize that it’s okay to have it and that it can be improved. When other members shared their experiences, I got a different perspective on my own issues and found some solutions. The group helped me change my attitude towards uncomfortable situations. I started seeing them as opportunities to grow instead of things to avoid.Chris gave me some great ways to think about situations. For example, when I said I always leave conversations early because I’m afraid they’ll go downhill, he suggested looking at it like a ‘Who wants to be a millionaire’ contest where I’m only at the first few questions and to keep going until I win the big prize. That really helped me.

— S

How To Deal with Seasonal Depression

It’s finally (hopefully?!) getting cooler in north Texas, but it comes with so much more darkness. That’s a huge net positive as we prepare for more hot days in the near future, but harder for those who tend to struggle with depressive symptoms. Here are some ideas to help you or someone you care about if they tend to struggle with these types of symptoms to help lessen the load.

1. First and foremost, help get some natural light.  Lack of enough natural light puts the “seasonal” in seasonal depression. Getting more light can be a big help in reducing the severity of depressive symptoms on a day-to-day basis. This may also help promote number 5 on this list.
2. Be patient, they’ll often need gentle support over time.  Think of it less as “snapping out of it,” and more of it as rehabbing an injury. It takes time and practice, and no one is more frustrated or sad about the progress than they are.
3. Help them problem solve; don’t just problem solve for them.  Problem solving as a skill goes way down during periods of depression.  It’s tempting to just do the problem solving for them (i.e., tell them what to do), but that won’t help them build their own problem-solving skills back up.  Helping them brainstorm, identify obstacles, and pick an idea to try goes a lot farther than handing those ideas to them.
4. Reach out and don’t let their symptoms discourage you.  Depression comes with a strong behavioral urge to withdraw.  Keep reaching out and offering connection and support and don’t take it personally when they aren’t always up for it.
5. Help increase physical activity and remember that small increases in activity are still increases!  They don’t want to go to the gym with you?  That’s fine, let’s go for a walk.  That’s a no go?  Let’s just shift to another room or move around inside!
6. Talk it through with them, but don’t go in for the “big talk” every time.  People struggling with depression are often already over-thinking their situation.  Sometimes talking about less important stuff and having an enjoyable conversation goes a long way in both helping their immediate mood, any may make it more likely that a “big talk” later on is more productive.
7. If they don’t want to go big, go to their home.  People without depression underestimate the profound fatigue that comes with it. It’s legitimately exhausting to feel depressed, which perpetuates withdrawal.  Being willing to meet up and hang out in lower-key environments can help reduce that withdrawal.
8. Encourage therapy. Good treatments for depression exist and can help your loved one build the skills to reduce these symptoms and better prevent their recurrence.

How To Help Someone With Depression

It’s hard seeing someone you care about struggle, especially when that struggle can involve them being so down.  Just be there for them and, in being there, know that you’re at least helping them reduce the withdrawal and isolation that is often maintaining their suffering.  Do it in person when you can, but when you can’t, do it in spirit.  Remind them that spring will come even if it doesn’t seem like it.

As we mark 10 incredible years of service at Dallas CBT, we’re excited to introduce a special initiative that embodies our dedication to improving mental health care access in the DFW community.

Announcing the 10 for 10 Therapy Scholarship Program!

To commemorate our anniversary, we are launching the 10 for 10 Therapy Scholarship Program. This initiative will provide 10 therapy scholarships for individuals from underserved communities in North Texas. Each scholarship covers up to 15 sessions of specialized cognitive-behavioral therapy, including exposure therapies, addressing critical issues such as anxiety, OCD,  ADHD, trauma, and depression.

The Importance of Access to Mental Health Care

Did you know that Texas ranks at the bottom nationally for access to mental health services? This reality makes our mission all the more vital. With your support, we can provide 150 therapy sessions that have the potential to transform lives and offer essential mental health resources to those in need.

How You Can Make a Difference

You can play a vital role in this initiative by contributing to the 10 for 10 Therapy Scholarship Program. Your donation will directly fund these scholarships, opening doors for individuals who need help accessing quality therapy.

Whether you are a potential applicant or someone looking to support a worthy cause, your participation is invaluable.

Consider making a donation today to help us achieve our goal!

Scholarship Application Information

If you know someone who would benefit from this program, please share this information with them. We invite applications from individuals who:

• Face financial hardships and other barriers to therapy.
• Represent diverse racial, ethnic, sexual, and gender identities.
• Would benefit from treatment in our specialized areas.
• Are eager and motivated to engage in therapy.

Starting October 10, 2024, applications will be accepted on a first-come, first-served basis until we are able to award all scholarships.

Let’s Create Positive Change Together!

As we celebrate this significant milestone, we invite you to join us in our mission to improve mental health care access for everyone. Together, we can foster meaningful change and uplift those in our community who need it most.

To find out more about the Dallas CBT’s 10 for 10 Therapy Scholarship Program and how to participate, please click here.

Our therapists get asked a lot “what can I do to get out of a panic attack?” or “how can I stop an anxiety attack from happening?”  For starters, let’s talk about terminology.  Anxiety and panic are related and overlapping terms. Typically, when someone is describing an “attack,” they are referring to a panic attack.  

What Does Anxiety Feel Like?

Anxiety can feel like a lot of things. Cognitively, it tends to feed into scary “what ifs,” predicting worst-case scenarios faster than you can shut it down. Physically, anxiety can feel like butterflies in the stomach, sweaty palms, a racing heart, muscle tension, tightness in your chest, etc. Essentially, your body is gearing up for a “fight or flight” response, even if the “threat” is just an awkward social interaction or an overwhelming to-do list.

Anxiety is largely fueled by your brain’s amygdala (a part of your brain responsible for processing emotions), which sends signals to get your body ready for action. It’s a helpful system when there’s actual danger, but it tends to go a bit haywire when the threat is something more abstract—like worrying about giving a presentation at work. Research shows that generalized anxiety can create an almost constant state of heightened arousal, where your nervous system is stuck in a loop of overreacting to potential dangers.

Anxiety vs. Panic Attacks: What’s the Difference?

If anxiety is the everyday grind of worrying about the little things, what’s a panic attack? While anxiety can be a slow build—a simmer of worry—panic attacks are more like a boiling pot that overflows without warning. Better yet, the pot that went from luke-warm to boiling instantly.  A panic attack can feel like a tidal wave of intense fear without a clear cause. Your heart races, your breathing becomes shallow, and you might even feel detached from reality.

In contrast to anxiety, which can last for hours or days, panic attacks come on suddenly, peak within about 10 minutes, and then subside. However, the lingering effects of a panic attack can last much longer, leaving people feeling exhausted and on edge.

Both anxiety and panic are triggered by similar brain mechanisms.  While anxiety is more of a long-term, low-grade stress response, panic attacks are acute episodes where your body goes into full “fight or flight” mode. Panic attacks can be largely driven by misinterpretations of bodily sensations (i.e., you feel your heart race and assume something is seriously wrong), which fuels the panic and reinforces the fear cycle. In CBT, we call this a “catastrophic misinterpretation,” and helping clients reframe these thoughts is a big part of treatment.

How Can I Stop Panic Attacks Immediately? 

Unfortunately, we don’t have an on-off switch for panic attacks.  There is also research that indicates trying to control panic can actually make it worse (more on this in a future blog).  However, here are some ways to reduce the intensity of your experience of a panic attack, or at least ride them out with more ease.

1. Cold Exposure:

Ever had a rush of cold water snap you back to reality? Splashing cold water on your face can activate the body’s parasympathetic system (the one responsible for calming you down). It’s called the “dive reflex,” and it can help slow your heart rate and curb that spiraling feeling. You can try placing an ice pack on your chest over your heart, on your inner wrists, or on your neck where you would take your pulse.  Others options are holding onto ice cubes until they melt, or going straight for dunking your face in ice cold water.

2. Paced Breathing:

Our bodies are built with a strong connection between our breathing rate and our heart rate, which, in turn, greatly affects our overall arousal level. During a panic attack, your breathing may become shallow and fast, which can make you feel more panicked. Focusing on elongating your exhale can slow your heart rate and ease symptoms. Try breathing in for 4, then out for 6, for example.

3. Move!

Shaking your arms, walking, push ups, or jumping up and down can help dispel the pent-up energy that comes with a panic attack. Physical movement helps signal to your body that it’s not in danger and doesn’t need to be in fight-or-flight mode.

Final Thoughts

Overcoming panic largely has to do with increasing acceptance and tolerance for these extremely uncomfortable feelings as a way of pulling power away from the discomfort.  There are helpful strategies in Cognitive Behavioral Therapy and Exposure Therapy that can help you practice building up a resilience for anxiety and panic, which in turn decreases anxiety and panic. 

Choosing the right career path in clinical psychology requires a deep understanding of your personal values and goals. Whether you’re drawn to the dynamic environments of hospitals and universities or the personalized touch of private practice, understanding the nuances of each setting is crucial. In this guide, we’ll explore the diverse opportunities for clinical psychologists, with a special focus on decision-making between job opportunities within the private practice world.  We will address a confusing part of therapist job openings in group private practices, which is understanding the differences between 1099 contract positions and W2 employment.

Clinical Psychologists or Therapists in Institutional Settings

Hospitals: Clinical psychologists in hospitals play a pivotal role in multidisciplinary teams, addressing the psychological aspects of medical conditions, conducting assessments, and providing therapy. This setting offers the chance to work closely with psychiatrists, social workers, other therapists, and other healthcare professionals, contributing to comprehensive patient care.

Universities: Working within a university setting, clinical psychologists engage in a blend of teaching, research, and, sometimes, direct clinical service. This environment is ideal for those passionate about shaping future generations of psychologists, conducting research, teaching, and publishing.

Clinical Psychologist or Therapist Roles in Private Practice

Private Practice: Venturing into private practice, whether solo or into a group private practice, allows therapists to specialize in areas of interest, such as anxiety disorders, family therapy, or OCD. This path offers significant autonomy, the flexibility to set one’s schedule, and the potential for a higher income, depending on the client base and the ‘track record’ of the practice.

Private practice is also a setting in which the particular degree of the therapist becomes less defining or important to the role, as individual clinicians can seek out the type of training and specializing that they want to cultivate, regardless of being a Clinical Psychologist, LPC, LMFT, or LCSW.

If private practice feels right for you, there is also the important decision of whether to open your own private practice or join an established group practice.  These are two very different experiences!  Starting your own practice is a significant entrepreneurial undertaking that is best for those who know that they would love to spend their time on the business– marketing, networking, administration, operations, etc.  About half of one’s time in their own private practice is spent doing clinical work, whereas the other half is spent on developing the business.  This can be very exciting and rewarding for the right type of person; on the other hand, if it is not a great fit, one can quickly feel unfulfilled with how they are spending their time at work.  

A solo private practice has other pros and cons: there is the potential to earn more income than in other settings, although the workload and responsibilities tend to be higher.  An individual private practice can potentially be experienced as isolating, but extra effort can be put into creating a community of other professionals to consult and debrief with.

Group Private Practice: Joining a group private practice is a great job option for therapists who want the flexibility, higher income, and ability to treat specific types of populations, but do not want to spend their time running a business.  Therapists within a group practice primarily spend their time doing clinical work.  Group private practice provides a collegial atmosphere where professionals share insights, resources, and support. This model fosters a sense of community, reduces the isolation often felt in solo practice, and offers operational benefits like shared administrative tasks and broader service offerings to attract a diverse client base. For clinical psychologists or therapists seeking a balance between autonomy and collaboration, group private practices offer the best of both worlds.

Choosing which group private practice is the best “home” for you can be a complicated decision.  They have all different types of cultures, expectations, and how the company sets up the structures of the job position itself can be different (i.e., 1099 vs W2), making it difficult to compare among job opportunities.

1099 Contract Position vs. W2 Employment

Understanding the distinction between being a 1099 contractor and a W2 employee is crucial for clinical psychologists and other therapists considering a career opportunity in group private practice.  

1099 Therapist Contract Position: As a 1099 contractor, psychologists have the freedom to work with multiple organizations, and at times, can negotiate their hours and rates. However, this comes without the benefits and security of employment, and contractors are responsible for their taxes and health insurance.  This can add up to a substantial amount of money that the therapist has to cover, reducing their net earnings.  Sometimes, these types of jobs can require many other responsibilities beyond clinical work, including marketing and some administrative work.

W2 Therapist Positions: W2 employees enjoy the stability of a more regular salary, benefits such as health insurance and retirement plans, and contributions to their taxes by their employer. While the starting income of a W2 therapist might be less than a 1099 therapist position, many times the income will actually net out to more because of how much the employer contributes to benefits and taxes.  

The journey to finding the right job in clinical psychology is deeply personal and influenced by individual preferences, lifestyle needs, and career aspirations. While institutional settings offer invaluable experiences and the chance to work within multidisciplinary teams, private practice provides a unique blend of autonomy, collaborative opportunities, and professional growth. Furthermore, weighing the pros and cons of 1099 contract positions versus W2 employment and understanding the culture of the group practice  are vital steps in carving out a fulfilling career path.

As you navigate these decisions, remember that each setting offers distinct advantages and challenges, and the best choice is one that aligns with your professional values, goals, and desired work-life balance.

See our blog “Considering a Job in a Group Therapy Practice?” for other important points to consider and questions to ask during an interview when trying to find a job as a clinical psychologist or therapist in group private practice.

We have seen an incredible decrease in the stigma around anxiety over the past several years, yet the path to managing still can seem shrouded in mystery. To shed light on this journey, it’s helpful to first understand the underlying models that explain why anxiety occurs and how therapy works on anxiety. We will look at Cognitive-Behavioral Therapy (CBT), a highly effective treatment for anxiety, and its models for understanding– and overcoming– anxiety.

Understanding Anxiety Through Cognitive and Behavioral Models

Cognitive Model:

A basic explanation of the cognitive model is that anxiety is fueled by our thoughts and perceptions. It suggests that distorted thinking patterns, such as catastrophic predictions or overestimation of danger, play a central role in the development and perpetuation of anxiety disorders. These mental habits skew our worldview and can make everyday situations feel overwhelming and threatening.

Behavioral Model:

The behavioral model focuses on our actions and reactions. It explains anxiety as a learned response to certain stimuli. For instance, if someone experiences a panic attack in a crowded place, they might begin to avoid crowded areas, reinforcing the anxiety through avoidance behaviors. This model highlights how our behaviors, and how our environment is paired with our anxious experiences, can either perpetuate or diminish anxiety.

How Cognitive-Behavioral Therapy Works For Anxiety

CBT is a therapeutic approach that combines the insights of both cognitive and behavioral models. Here’s a very basic overview of some of elements of CBT, and how they address anxiety:

Identifying and Challenging Negative Thoughts: CBT helps individuals recognize their pattern of unhelpful thinking and teaches them to rework these irrational thoughts. Through learning strategies to change their relationships with their thoughts, individuals learn to adopt a more balanced perspective.

Exposure Therapy:

Drawing from the behavioral model, CBT employs exposure therapy as a technique to gradually confront and gain more tolerance of distressing situations. Rather than avoiding anxiety-provoking scenarios, individuals learn to face them in a controlled and systematic way, reducing the fear associated with these situations over time.

Skill Development:

CBT equips individuals with coping skills for managing anxiety, including stress-management and relaxation techniques, problem-solving skills, and ways to tolerate uncertainty. These tools empower individuals to handle anxiety-inducing situations more effectively.

Behavioral Experiments:

These are used to test the beliefs about the feared outcomes of certain situations or behaviors, allowing individuals to realistically assess risk and develop a more accurate perception of their anxiety triggers.

Understanding the cognitive and behavioral underpinnings of anxiety is the first step toward overcoming it. Cognitive-Behavioral Therapy offers a structured, evidence-based approach that addresses the complex interplay of thoughts and behaviors at the heart of anxiety disorders. For anyone struggling with anxiety, CBT represents a path forward, offering not just relief but a renewed sense of control over their mental health.

If you or someone you know is battling anxiety, remember that help is available. With the right support and treatment, it’s possible to overcome the challenges posed by anxiety and lead a fulfilling life.

Unpacking the Effectiveness of Psychotherapy: Research Insights

Psychotherapy, often referred to as “talk therapy,” has long been heralded as an effective intervention for addressing a range of mental health concerns. Yet, questions linger: Does psychotherapy truly help, and if so, how long does it take to experience its benefits? Let’s delve into the research to explore these questions and shed light on the vital role therapists play in nurturing mental health.

Does Therapy Help?

Decades of research have consistently demonstrated the efficacy of psychotherapy in treating various mental health disorders, including depression, anxiety, OCD, PTSD, and substance use disorders. Meta-analyses and systematic reviews (studies about other studies) have confirmed that psychotherapy yields significant improvements in symptoms and functioning compared to no treatment or placebo conditions.

For example, a meta-analysis published in the Journal of Consulting and Clinical Psychology in 2018 examined the effectiveness of therapy across 206 studies involving over 15,000 participants. The results indicated that therapy led to moderate to large improvements in overall symptom severity across diverse populations and treatment modalities (like Cognitive Behavioral Therapy).

Moreover, therapy has been shown to produce enduring effects, with many individuals maintaining gains in symptom reduction and improved functioning over the long term. This underscores the value of therapy as a sustainable and transformative intervention for mental health concerns.

How Long Does it Take to Benefit from Therapy?

The timeline for experiencing benefits from therapy can vary depending on many factors, such as the nature of the presenting problem, treatment approach, and individual differences. While some individuals may notice improvements in symptoms after just a few sessions, others may require more time to experience significant changes.

Research suggests that the early phase of therapy is often characterized by symptom stabilization and building rapport with the therapist. As therapy progresses, clients typically gain insight into underlying patterns of thinking and behavior, develop coping skills, and experience symptom reduction.

A landmark study published in the Journal of Counseling Psychology in 2006 examined the timing of symptom improvement in psychotherapy. The findings revealed that the majority of clients experienced significant symptom reduction within the first eight sessions of therapy, with further improvements continuing over subsequent sessions.

Importantly, the therapeutic relationship plays a crucial role in facilitating positive outcomes in therapy. A meta-analysis published in the Journal of Counseling Psychology in 2019 found that the quality of the therapeutic alliance – characterized by mutual trust, collaboration, and empathy between therapist and client – was significantly associated with treatment outcomes across various psychotherapeutic approaches.

The Beneficial Role of Therapists

Therapists serve as compassionate guides and skilled facilitators in the therapeutic process, offering support, validation, and expertise to clients on their healing journey. Research consistently highlights the importance of therapist factors, such as empathy, warmth, and cultural competence, in fostering positive therapeutic outcomes.

A study published in Psychotherapy Research in 2017 examined the impact of therapist characteristics on treatment outcomes across 28 clinical trials. The results indicated that therapists’ ability to form a strong therapeutic alliance and provide effective treatment significantly predicted better outcomes for clients.

So Does Therapy Actually Work?

In conclusion, the research overwhelmingly supports the effectiveness of therapy in promoting mental health and well-being. While the timeline for experiencing benefits may vary, the therapeutic alliance and the expertise of therapists play pivotal roles in facilitating positive outcomes. As individuals embark on their therapeutic journey, they can take comfort in the knowledge that therapy holds the promise of profound healing and transformation.

 

For the corporate achievers out there dealing with social anxiety, performance anxiety, or public-speaking anxiety in the workplace, you’re not alone. Fortunately, there are evidence-based strategies grounded in Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) that can help you manage these challenges effectively. Let’s explore some of these strategies, along with insights from neurobiology research.

 

1. Cognitive Reframing: Shifting Perspectives

 

One of the key principles of CBT is cognitive reframing, which involves identifying and shifting negative thought patterns. When faced with anxiety at work, try reframing your thoughts. For example, instead of thinking, “I must not make any mistakes,” you could intentionally reframe it to, “I am prepared and capable of handling any challenges that come my way.” From a neurobiological standpoint, this process can help regulate the amygdala, the brain’s fear center, leading to a reduced anxiety response.

 

2. Mindfulness and Grounding Techniques: Anchoring in the Present

 

Mindfulness practices, such as square breathing and grounding techniques, can help anchor you in the present moment and reduce anxiety. Research indicates that mindfulness can modulate activity in the prefrontal cortex, improving cognitive flexibility and emotional regulation. Try incorporating short mindfulness exercises into your daily routine to build resilience against performance anxiety.

 

3. Exposure Therapy: Gradual Desensitization

 

Exposure therapy, a core component of CBT, involves gradually exposing yourself to anxiety-provoking situations. In the context of performance anxiety, this could mean starting with low-pressure scenarios, such as speaking up in a small meeting, and gradually working up to more challenging situations. Exposure therapy can lead to changes in the brain’s fear circuitry, reducing the intensity of anxiety responses over time.

 

4. Values Clarification: Aligning Actions with Values

 

ACT emphasizes the importance of clarifying your values and taking consistent action steps in line with those values. Reflect on your core values in the workplace, such as professionalism, creativity, or teamwork. When you align your actions with these values, you are more likely to feel a sense of purpose and fulfillment, even in the face of anxiety-inducing situations.

 

5. Acceptance and Defusion: Detaching from Negative Thoughts

 

ACT also teaches acceptance and defusion techniques to help you detach from negative thoughts and emotions. Instead of trying to eliminate anxiety, acknowledge it as a natural response to stress and not something you have to constantly “fight.” Defusing from your thoughts means creating space to notice them and choose how you respond to them, rather than being controlled by them.

 

In Conclusion

 

Incorporating these CBT and ACT strategies into your daily routine can help you manage and reduce performance anxiety in the workplace. Remember, it’s about progress, not perfection. By understanding the neurobiological mechanisms behind these strategies, you can empower yourself to navigate performance anxiety with confidence and resilience.  

 

It’s natural to benefit from help in building up your toolkit to cope with anxiety.  Our therapists at Dallas CBT specialize in anxiety using CBT, ACT, and exposure therapy.  Dallas CBT has a group therapy option customized for professionals and executives struggling with work-related social and performance anxiety.  This group therapy can be a powerful and efficient way to quickly make progress with anxiety by practicing within a group setting.  

Navigating Anxiety Alone: Can You Do CBT Without a Therapist?”

In the rapid pace, over-programmed times we live in, it’s not uncommon to find oneself grappling with anxiety. The question often arises: Can you effectively practice Cognitive-Behavioral Therapy (CBT) without the guidance of a therapist? Does the self-help approach to therapy actually work? Let’s explore the possibilities of self-guided therapy:

Understanding CBT: A Brief Overview

CBT is a widely recognized and evidence-based therapeutic approach that aims to identify and modify negative thought patterns and behaviors. It operates on the premise that our thoughts, feelings, and actions are all connected and influence each other, and by altering our thoughts and behaviors, we can positively impact our emotional well-being.

The Role of a Therapist in CBT

Traditionally, CBT is conducted in a therapeutic setting with the guidance of a trained professional – a therapist. The therapist helps individuals identify distorted thought and behavior patterns, develop coping strategies, and gradually develop healthier and more helpful thoughts and behaviors.  In anxiety, many times this involves helping the individual confront anxiety-provoking stressors through gradual exposure. 

The therapeutic alliance formed between the client and therapist is a cornerstone of effective CBT.  A CBT therapist has an experienced and nuanced understanding of how thoughts, feelings, and behaviors impact one’s psychological state. A CBT therapist’s job is to effectively customize the therapy to the individual to lead to insight and positive change.    

Self-Help Resources and Workbooks

Self-help resources and workbooks based on CBT principles are readily available, and these self-help resources offer reduced-cost and easily accessible opportunities to benefit from CBT.  These resources often mirror the structure of CBT sessions conducted by therapists, providing exercises and tools to challenge negative thoughts and modify behavior.

Engaging with CBT workbooks, either in print or digital formats, can be a valuable step in the self-guided journey to managing anxiety. These resources offer practical exercises and reflections designed to emulate the therapeutic process. However, it’s essential to approach this with commitment and consistency.

Self-help therapy resources were critical to increasing accessibility to therapy prior to the online therapy era.  Receiving good therapy in Dallas is not challenging, as they are numerous professionals based here.  Rural areas, however, often had to rely on self-help therapy options before online therapy became so readily available and increased access to therapy to anyone with a good internet connection.

Online CBT Programs

The digital age has ushered in innovative ways to access mental health support, even without physically sitting across from a therapist in Dallas. Online CBT programs are a type of self-help resource that has gained popularity, offering interactive modules and virtual guidance to users. These programs often use multimedia elements to simulate the interactive nature of therapy.

While online CBT programs lack the personalized touch of face-to-face therapy, they can be a viable option for individuals seeking a structured approach to managing anxiety independently. It’s crucial to choose reputable platforms that align with evidence-based CBT principles.

Challenges of DIY CBT

Despite the easy access and lower-cost nature of self-help resources and online programs, there are inherent challenges in attempting CBT without the direct guidance of a therapist. The therapeutic relationship fosters a safe space for individuals to explore and confront their anxieties, providing nuanced support tailored to their unique experiences.  It is not uncommon to go on to seek therapy with a professional after attempting a self-help program.  Many of the clients we see here at Dallas CBT have attempted some form of trying to recover on their own.  That is not to say that their attempts were not useful; often, there was great insight and progress made on their own.  However, entering into traditional CBT with a therapist is often important to reaching the extent of one’s goals. 

A potential challenge with self-guided CBT is the lack of external perspective. A therapist brings professional expertise to the table, offering insights that might be challenging to generate independently. Additionally, the accountability provided by regular therapy sessions can be a driving force in maintaining consistency and motivation.

Supplementing Self-Guided CBT with Professional Support

While exploring CBT independently is a commendable initiative, it’s essential to recognize when professional support becomes necessary. A therapist can offer personalized guidance, address deeper psychological issues, and provide a level of support that self-help resources may not fully replicate.

Consider self-guided CBT as a valuable adjunct to professional therapy rather than a replacement. Combining self-help resources with therapeutic sessions can create a comprehensive approach to managing anxiety, leveraging the strengths of both self-guided exploration and professional expertise. 

Schedule an Appointment with Our Therapists at Dallas CBT.

Prioritizing your mental health is an important and ongoing journey.  While self-guided CBT resources can offer valuable tools, the presence of a therapist remains a cornerstone of effective therapeutic intervention. Whether engaging with workbooks, exploring online programs, or seeking the support of a CBT therapist, the key lies in finding a path that resonates with your unique needs and aspirations for overall health.  Whether you’re in the Dallas-Fort Worth Metroplex, in rural Texas, or in other states and are open to online therapy, there are many customizable therapy options available to you. Our therapists at Dallas CBT are here to support you wherever you are in your journey.  Our therapists utilize effective and tailored resources in therapy to give the best benefit to our clients.

In the realm of mental health, the terminology can be confusing, including what we call our therapists. People often use the terms counselor, psychologist, and therapist interchangeably, but there are distinctions in professional roles in regards to specialties and areas of expertise. Understanding these differences can help you get the right kind of support for your needs.

What is a Therapist?

The term “therapist” is broad and inclusive.  It encompasses both counselors and psychologists, as well as other mental health professionals like marriage and family therapists (LMFTs) and social workers (LCSWs). Each type of therapist has its own training background and set of specialties.

What is a Psychologist?

Specialties: Psychologists are professionals who have specialized knowledge in the science of human behavior and psychological processes. They can offer a wide range of services, from clinical psychology (providing therapy) to conducting psychological assessments and research.  When providing therapy, Psychologists may take a “generalist” approach, where they treat a wide range of presenting concerns, or a “specialist” approach, where they only treat certain conditions.

Education: Psychologists hold a doctoral degree in psychology, such as a Ph.D. or Psy.D. They also complete supervised training, including pre-doctoral internships and post-doctoral supervision, and pass licensing exams. Psychologists may have specialties in clinical, counseling, school, industrial-organizational, or research psychology, among others.

Approach: Psychologists can provide therapy, including various therapeutic modalities, such as cognitive-behavioral therapy (CBT), psychoanalysis, or humanistic approaches. They often work with individuals who have diagnosable conditions or more complex or severe mental health concerns. 

What is a Counselor?

Specialties: Counselors, often referred to as licensed professional counselors (LPCs), specialize in providing counseling services to individuals, couples, families, and groups. Counselors tend to be more generalists, addressing various mental health concerns and life challenges.  However, a counselor may choose to seek out training and develop specific expertise areas and practice more as a specialist.

Education: Counselors typically need a master’s degree in counseling or a related field. Counselors must also complete supervised clinical experience and pass a licensing exam to practice independently.

Approach: Counselors employ talk therapy and counseling techniques to help clients address issues like relationship problems, grief, stress, anxiety, depression, and personal growth. They provide support, teach coping strategies, and assist clients in making positive life changes. Counselors might further develop expertise areas in a certain therapy modality, such as Cognitive Behavioral Therapy.

What is a Marriage and Family Therapist (LMFT)?

LMFTs– also known as Couples Therapist, Relationship Therapists, or Family Therapists, are therapists who receive specialty training in working with relationships and family dynamics. They work with couples and families to improve communication, resolve conflicts, and address issues related to marriage and family life. Many LMFTs also work with individual clients addressing many of the issues that counselors (LPCs) address, which include a range of life stressors and problems.  Like counselors, licensed marriage and family therapists may choose to seek out training and develop specific expertise areas and practice more as a specialist.

Education: Licensed Marriage and Family therapists need a master’s degree in counseling or a related field. They also complete supervised clinical experience in the field of relationship and family therapy and pass a licensing exam to practice independently. 

What is a Licensed Clinical Social Worker? 

LCSWs are therapists who are  trained to address mental health and social issues from a social and environmental perspective. They often work with individuals, families, and groups and may specialize in areas like child welfare or family therapy.  They may also develop specialities within a specific therapy modality or with treating specific presenting problems. 

When choosing a therapist, it’s important to consider your specific needs and goals. In general, our recommendation is to work with a therapist who has expertise in the specific area you are wanting help with.  Certain issues that bring us into therapy are more broadly treated and can be addressed by most therapists.  However, certain other mental health issues benefit from more specialized treatment, including OCD, Health Anxiety, ADHD, Autism, and Substance Abuse, among others.  Regardless of the title, the most important factor is finding a qualified and compassionate professional who can provide the support and guidance you require.

Anxiety can get overwhelming and at times feel like it’s in charge of our lives. Therapeutic exercises, like the ones we cover below, can help us regain our sense of control and once again take charge of our own lives.    

Cognitive-Behavioral Therapy (CBT) is a well-researched approach for addressing and managing anxiety. In this blog post, we’ll explore five effective CBT-based interventions that you can practice on your own or with your therapist.

 

Cognitive Restructuring

Cognitive restructuring is a core component of CBT for anxiety. It involves identifying and challenging unhelpful or distorted thought patterns that contribute to anxiety. Here’s how it works:

1 . Identify Unhelpful Thoughts:

Start by recognizing and labeling or recording your anxious thoughts. For example, if you’re anxious about giving a presentation, you might think, “I’ll mess up, and everyone will think I’m incompetent.”  As soon as you become aware of this thought, you can label it as “worry” or simply “thinking.”

2. Examine Evidence and Utility:

Consider the evidence supporting your negative thoughts. Are your fears based on reality? Can you think of any instances where this was not the case?  Consider how this thought may be affecting you.  Even if you can find evidence to support this thought, is the thought helping you get where you want to be?

3. Challenge Negative Beliefs:

Consider other perspectives. Bring in more balanced and realistic thoughts alongside the unhelpful thoughts. In the presentation example, you could balance the original negative belief with, “I’ve prepared for this presentation, and I have the knowledge to deliver it effectively.”

 

Practice Mindfulness 

Cultivating mindfulness can help you observe your thoughts without judgment. It’s a powerful technique for managing anxiety by staying present and avoiding catastrophic thinking.  It involves becoming aware that you are thinking while not making any interpretations or judgements about your thoughts.  

It is common in a mindfulness practice to pick something to narrow your focus on, such as your breath.  These techniques encourage awareness of the present moment.  As you focus on breathing, you try to become aware when you have a thought, and then let it go and return to your breath.  

 

Behavioral Activation

Behavioral activation is a CBT intervention that focuses on increasing engagement in rewarding and meaningful activities to combat anxiety. When individuals experience anxiety, they often withdraw from or avoid enjoyable activities. Here’s how behavioral activation can help:

1. Identify Avoidance Behaviors:

Recognize the activities or situations that you would like to have in your life that are not present currently. This could be social events, exercise, or hobbies. You might be avoiding some of these situations because there is fear associated with them; in this case, you may need to address them through exposure therapy (see below).

2. Set Goals:

Work with a therapist to set achievable goals for gradually reintroducing these activities into your life.

3. Create a Schedule:

Develop a daily schedule that includes these activities. As you engage in them, you’ll likely experience reduced anxiety and improved mood.

 

Exposure Therapy

Exposure therapy is an evidence-based approach for tackling specific fears and phobias. It involves gradually exposing yourself to anxiety-provoking situations in a controlled and systematic way.  Many people benefit from working with a therapist for exposures. 

1. Create a Hierarchy:

With the guidance of a therapist, you’ll create a hierarchy of feared situations, thoughts, sensations, and feelings. For example, if you have a fear of flying, the hierarchy might start with looking at pictures of planes, progress to visiting an airport, and ultimately lead to taking a short flight.

2. Gradual Exposure:

Begin with the least anxiety-inducing situation in your hierarchy and work your way up. This process allows you to confront your fears in a controlled manner and gradually build confidence.

3. Gradually Build Tolerance of Uncertainty:

Anxiety is fueled by discomfort with uncertainty or the unknown.  Over time, exposing yourself to fears will grow your tolerance to uncertainty and decrease your anxiety.  Certain mindfulness and cognitive strategies can also help pull the power away from scary thoughts and help you “lean into” uncertainty.

 

Relaxation and Stress-Reduction Techniques:

Learn relaxation methods to help calm your nervous system and manage general anxiety.  Here are some methods you can explore:

1. Progressive Muscle Relaxation:

This technique involves systematically tensing and then relaxing different muscle groups. It’s an effective way to release physical tension if practiced regularly..

2. Breathing Exercises:

Practicing diaphragmatic breathing can help calm the body’s stress response and reduce anxiety.  You might also practice square breathing, where you breathe in for 4 counts, hold for 4 counts, breathe out for 4 counts, hold for 4 counts, and repeat.

The above exercises are a few examples of CBT-based techniques that empower individuals to identify and challenge negative thought patterns, confront their fears in a systematic manner, re-engage in rewarding activities, and reduce physical symptoms of anxiety. By incorporating these interventions into your daily life, you can take significant steps toward managing and alleviating anxiety. Remember that seeking guidance from a qualified mental health professional can enhance the effectiveness of these interventions and provide tailored support for your specific anxiety concerns.

Parenting a child who is struggling with anxiety is challenging.  It can bring up parents’ own anxiety or may bring up critical thoughts about yourself as a parent. It is natural to not have all the answers for helping your kid with anxiety, and sometimes our very best efforts seem to hurt more than help.  There are many researched and practical strategies that parents can use to support their child and help them manage their anxiety. The following advice is based on recent research in psychology and is designed to help parents of anxious children:

1. Find your own calm: Calm is contagious. Find your own effective toolkit for managing stress and anxiety, and let your child see you [practicing these skills.
2. Encourage your child to face their fears: One of the most effective ways to help an anxious child is to find creative and playful ways to help them face their fears. This should be done gradually, starting with less intimidating situations and gradually working up to more challenging ones.  Make sure to acknowledge the feelings present, like fear or hesitation, and let the child know that it’s okay to have those feelings. Facing their fears can help your child build confidence and reduce their anxiety over time (Braswell, Albright, & Knapp, 2015).  If you need help with this, find a child therapist who specializes in exposure therapy for anxiety.
3. Teach coping skills: Coping skills help your child manage their anxiety when it arises. This can include deep breathing exercises, progressive muscle relaxation, and visualization techniques (Ginsburg & Schlossberg, 2014).
4. Provide a stable and predictable environment: Children who are struggling with anxiety need stable and predictable routines. This means having a consistent routine and schedule, preparing your child in advance for changes to that routine, and ensuring that your child feels safe and secure in their home environment (Braswell et al., 2015).
5. Validate your child’s feelings: It is important to validate your child’s feelings, even if they seem irrational to you. Acknowledging your child’s feelings and letting them know that their thoughts and emotions are normal and understandable can help them feel heard and understood (Ginsburg & Schlossberg, 2014).
6. Practice mindfulness: Mindfulness has been shown to be an effective tool for reducing anxiety in children and adults alike. Encourage your child to practice mindfulness by focusing on the present moment, paying attention to their breathing, and noticing their thoughts and feelings without judgment (Chu & Hayes, 2011).  Look into resources that provide age-appropriate ideas for mindfulness exercises for children.
7. Encourage exercise: Movement and exercise are effective ways to reduce anxiety across all ages. Encourage your child to participate in physical activity on a regular basis, such as going for a walk, playing outside, or participating in a sport (Chu & Hayes, 2011).
8. Encourage healthy habits: Encouraging healthy habits, such as getting enough sleep, eating a healthy diet, and avoiding excessive caffeine and sugar, can help reduce anxiety and promote overall well-being (Chu & Hayes, 2011).
9. Seek professional help: If your child’s anxiety is affecting their daily life and functioning, it may be necessary to seek professional help. This can include working with a therapist who specializes in anxiety disorders (Braswell et al., 2015).

It is important to note that each child is unique and will respond differently to different approaches. It may take some time to find the approach that works best for your child, but with patience and persistence, you can help your child manage their anxiety and live a happy, healthy life.

References:

Braswell, L., Albright, M., & Knapp, S. (2015). Handbook of child and adolescent anxiety disorders. Springer.

Chu, B. C., & Hayes, S. C. (2011). Acceptance and commitment therapy as a treatment for childhood anxiety. Journal of Clinical Child & Adolescent Psychology, 40(6), 824-835.

Ginsburg, G. S., & Schlossberg, M. C. (2014). Handbook of assessment and treatment planning for psychological disorders. Guilford Press.