Acceptance and Commitment Therapy

ACT is a type of therapy that helps you:

• Accept what’s out of your control,

• Commit to actions that align with your values, and

• Live a meaningful life, even with difficult thoughts and feelings.

Instead of trying to “get rid of” pain or anxiety, ACT teaches you how to change your relationship with those experiences—so they stop controlling you.

The main goal of ACT is to help you develop psychological flexibility—the ability to stay present, open up to uncomfortable experiences, and do what matters most.

There are 6 key components that we work on strengthening through ACT:

1. Acceptance
   Let thoughts and feelings come and go, even the tough ones, without fighting them.

2. Cognitive Defusion
   Learn to see your thoughts as just thoughts—not truths you have to obey.

3. Present Moment Awareness
   Be here now. Pay attention to the present rather than getting stuck in the past or future.

4. Self-as-Context
   Notice that you are not your thoughts or emotions—you’re the one observing them.

5. Values
   Clarify what really matters to you deep down—like love, honesty, creativity, or connection.

6. Committed Action
   Take steps, big or small, toward your values—even if uncomfortable thoughts or feelings show up.

Cognitive Behavioural Therapy

CBT works by making changes in the here and now to the way you think (cognitions) and the way you act (behaviours) to help impact the way you feel.

What is cognitive challenging?

The way you think about things can have a huge impact on how you feel, and the way you live your life. Cognitive challenging (or cognitive restructuring) is a core technique in CBT used to identify, question, and replace unhelpful or distorted thoughts.

Step 1: Identifying the Thought

• What was going through your mind just before you started feeling this way?

• What images or memories came up when the emotion hit?

• What did you think would happen?

Step 2: Evaluating the Thought

• What is the evidence for and against this thought?

• Am I confusing a thought with a fact?

• Have I had experiences that show this thought isn’t completely true all the time?

• If a friend had this thought, what would I say to them?

• Is this thought a cognitive distortion (e.g., catastrophizing, black-and-white thinking, mind reading)?

Step 3: Reframing the Thought

• Is there another way of looking at this situation?

• What’s a more balanced or realistic way to think about this?

• What would I tell a friend who was in this situation?

• What’s the worst, best, and most likely outcome?

Why do exposure therapy?

Anxiety is a natural response to perceived danger or threat, often involving worry, physical symptoms (like a racing heart), and heightened alertness. The ‘fight/flight/freeze’ response is the body’s automatic stress response designed to protect us from danger—but sometimes the brain overestimates threat or misfires in safe situations.

When we feel anxious, this means there is a natural pull to escape and avoid (or flee) the situation.

BUT avoidance is a short-term coping strategy. When we steer clear of the things that make us anxious (e.g., public speaking, crowded places, or thoughts of past trauma) it provides immediate relief, but it reinforces the fear long-term because the brain never learns that the feared outcome doesn’t happen—or that you can handle it.

Exposure therapy reverses the cycle of avoidance. By gradually facing feared situations, your brain:

1. Learns the situation is not as dangerous as it seemed.

2. Learns that anxiety naturally peaks and falls over time.

3. Builds confidence in your ability to cope with fear.

Over time, this retrains the brain to stop treating safe situations like threats—reducing anxiety and avoidance in everyday life.

Dialectical Behavioural Therapy

DBT is a skills based therapy that helps people manage intense emotions, improve relationships, and cope with distress in healthier ways.

It was originally developed for people with Borderline Personality Disorder (BPD), but it’s skills are helpful for everyone and is now widely used for depression, anxiety, self-harm, PTSD, and more.

What Does “Dialectical” Mean?

"Dialectical" means finding a balance between two opposites—like:

• Accepting yourself as you are and working to change.

• Validating your feelings and learning new ways to respond to them.

DBT teaches four main skill areas:

1 - Mindfulness

• Being present in the moment without judgment.

• Helps with focus, awareness, and reducing reactivity.

2 - Distress Tolerance

• Getting through a crisis without making it worse.

• Includes skills like grounding, self-soothing, and distraction.

3 - Emotion Regulation

• Understanding and managing intense emotions.

• Helps reduce emotional outbursts or shutdowns.

4 - Interpersonal Effectiveness

• Communicating clearly and assertively.

• Helps with setting boundaries, saying no, and building healthy relationships.

Eye Movement Desensitisation and Reprocessing Therapy

EMDR is a type of therapy that helps people heal from traumatic or distressing memories by reprocessing them in a way that reduces their emotional impact.

Rather than focusing heavily on talking about the trauma, EMDR uses bilateral stimulation (like eye movements or tapping) while the person recalls the distressing memory.

It’s most commonly used for PTSD, but it can also help with anxiety, phobias, grief, and other emotional difficulties linked to past experiences.

How does it work?

While you sleep, your brain processes and integrates the information from the day into your long-term memory networks in a way that will be adaptive for you in the future.

However, when you experience something very distressing, it can disrupt this natural integration process, and these memories become almost frozen in time.

You can tell if a traumatic memory is unresolved by these distinct qualities:

1. It is vivid, or can feel like “it happened just yesterday'“.

2. It still has a strong emotional charge when thought of or spoken about.

3. There is a negative belief about yourself that is attached to it (e.g. I’m unsafe, I’m helpless, I’m bad, I’m worthless etc)

4. Anything that reminds you of the memory, be it a similar detail or situation, feeling or belief about yourself can reactivate the memory and/or distress, which often leads to patterns of avoidance.

EMDR works by bypassing overthinking and tapping into the brain’s natural healing process—much like REM sleep helps us process memories. It works without needing to retell or analyze the trauma in detail, which can feel safer for many people.

All you need is the willingness to bring the memory to mind and experience the emotional sensations connected to the memory.

Then, while focusing on a specific memory, the therapist will guide you through 30-second sets of side-to-side eye movements, tapping, or sounds. After each set, you will be asked the same question, “What do you notice now?”, and proceed straight into another set - going with whatever you notice, until the memory feels resolved.

A resolved memory will feel distanced (in its time and place, or more difficult to bring to mind), and desensitized (emotionally neutral to think or talk about). It will also have a more adaptive, positive or helpful belief about yourself connected to it (e.g. I’m safe now, it was not my fault, I am strong etc.). It will feel like ‘just a memory’.

Whilst EMDR can be highly effective at resolving the impact of past traumas, it is not appropriate for everyone. Thorough assessment, preparation, and resourcing are an important part of the process. Clients need to be aware that strong emotions and disturbing thoughts can occur during processing, though they are generally relatively short.