iconApproch

My Approach to Therapy

Caring and compassion

My work rests on the foundation of a caring and compassionate therapeutic relationship. I do not view my clients as only their diagnosis or as somehow defective. Instead, I see them as unique individuals desiring to improve their lives. I look for the strengths that are inherent in each of us and seek to provide a supportive, respectful and trusting environment in which to solve problems.

What is cognitive-behavioral therapy (CBT)?

Cognitive-Behavioral Therapy (CBT) is a powerful tool that teaches you practical skills to identify and modify self-defeating patterns of thinking and behaving. Thoughts and behaviors are learned and can be unlearned. Thus, you can also learn new ways of thinking and behaving in challenging situations.  I will work with you to achieve tangible progress and improve your daily life.  CBT differs in this way from traditional talk therapy, which focuses mostly on self-knowledge and insight. The ultimate aim of CBT is to help you to become your own therapist, in part by practicing outside of sessions the techniques you learn in my office.

CBT is evidence-based. It has been extensively validated in rigorous clinical trials and has solid scientific support as an effective treatment for many problems and disorders. CBT has been shown to be as effective as medication for depression and anxiety disorders. Research also indicates that the changes that occur during CBT are long lasting. People who receive CBT rather than other psychological therapies or medication treatment alone are less prone to relapsing.

How I practice cognitive-behavioral therapy

As a cognitive-behavioral therapist, I carefully listen to you and then serve as your teacher and coach, helping you learn coping skills to challenge your patterns of thinking and behavior that contribute to anxiety, mood problems, and unhealthy habits. Our therapy is structured, action-oriented and focused on the present. I want you to achieve definite, measurable results.

We work together as a team to agree on the topics to cover in sessions and the most appropriate strategies that will be used in treatment.  I endeavor to make the therapy process as enjoyable as possible. We jointly decide how long your therapy will last and which self-help activities you will try between sessions. I believe it is essential to define clear and measurable goals from the start of therapy. This helps you to envision how your life will look once you have met your therapy goals. Goals may change throughout the course of therapy; therefore, we will frequently discuss how our work is going for you. At every session, I seek and provide feedback, which helps us fine-tune our methods and tailor treatment to your unique needs.

After setting concrete goals, we typically monitor progress to track how quickly your goals are being achieved. For example, I may ask you to complete a weekly symptom questionnaire which we review in sessions. We will work on an effective and cost-efficient treatment plan. We typically begin by meeting weekly and then less frequently when your self-help skills are established. The point of therapy is for you to feel better and to get on with your life — without the therapist.

Homework between sessions can help you bring your new skills and techniques into your daily life, and speed up your progress. We may decide, for example, to have you keep track of certain behaviors, moods or thoughts; gradually approach situations you have been avoiding; practice new behaviors or ways of thinking; or read particular handouts or books (see Books).

Flexibility is also important. That is why I may encourage you to check in by phone or e-mail; include family members in sessions; schedule longer or more frequent meetings; take walks together during our sessions; or accompany me to a variety of settings outside the office to help face situations that bring on anxiety. Some of my clients finish a piece of therapy work, and return at a later point for a brief “tune-up” or to focus on another issue. Others decide to extend the length of treatment in order to focus on another area.

Group support

Since 1980, I have conducted some sort of therapeutic group continuously, including one that met weekly for 17 years.  In 2001, I began offering a series of support groups to my patients and the general public. These groups meet with me one evening per month, and are designed for individuals with a range of anxiety and habit problems. Over 650 people have benefited from participation in these sessions.  I am dedicated to facilitating these groups in order for people to get together to work toward common goals, while enhancing self-acceptance and decreasing feelings of shame.

Many of the problems I work with can be very isolating.  I want you to know that you are not alone in your suffering. If you come to see me for help with panic attacks, phobias, fear of illness, obsessive-compulsive symptoms, social anxiety, or “body-focused repetitive behaviors” (e.g. compulsive hair pulling or skin picking), I will offer you the opportunity to meet other people who share your challenges, within the safety of a small support group (usually 4-8 individuals). Group members can benefit one another through exchanging support and understanding, offering resources and knowledge, and providing perspective and creative problem solving. Members discover that trying new, more productive coping strategies is often easier with the support of other individuals who know just how difficult it is to face one’s fears.  As an added resource, most of my groups are now utilizing social networking technology to extend the support that members experience between their monthly meetings.

Collaborating with other professionals

I am a team player who values collaboration with other professionals. Whenever it makes sense, and only with your permission, I will contact your primary care provider, prescribing psychiatrist, or couples counselor, in order to coordinate our efforts toward helping you. When we first meet, and again whenever needed, I can discuss with you the question of combining medication or other treatments with your therapy. I can also make referrals to trusted colleagues.

Please visit the Links page for more details on cognitive-behavioral therapy.

Please feel free to call me at 206-285-0900 or email me at dkosins@u.washington.edu if you have a question or wish to schedule an appointment.

All material provided on this website is for informational purposes only. Direct consultation of a qualified provider should be sought for any specific questions or problems. Use of this website in no way constitutes professional service or advice. David J. Kosins, Ph.D. © 2017