Where would  we  be  without  therapy? 

D  e  b  o  r  a  h   A.   M  a  r  t  i  n, Inc.

 Licensed Clinical Social Workers and Associates

Therapies Part 2

Re-birthing 

Re-birthing is an alternative therapy technique used to treat reactive attachment disorder. This therapy uses a specific kind of breathing (breathwork) meant to help you release emotions.

Supporters of rebirthing claim that by participating in a “rebirth” as a child or adult, you can resolve negative experiences from birth and infancy that may be preventing you from forming healthy relationships. 


Some even claim to have memories of their birth during rebirthing.

In other words, supporters claim that the technique gives you a do-over of your entrance into the world, without the trauma or instability you originally experienced. The goal is to process blocked emotions and energy, leaving you free to form trusting, healthy attachments.

A new age spiritual guru named Leonard Orr developed the rebirthing technique in the 1960s. 


At the time, it focused only on breathwork. Since then, its definition has expanded to include other types of therapy that simulate birth.

Rebirthing therapy is controversial because there is little evidence of its merit. In some cases, it has proven to be dangerous.

Rebirthing technique

Rebirthing sessions can take several forms, depending on your age and your treatment goals. Sessions are usually led by trained instructors. 


They work with you one-on-one or two-on-one, coaching your breathwork and leading you through the technique.

The breathwork technique used in rebirthing is called conscious energy breathing (CEB).


With your instructor’s supervision, you’ll practice “circular breathing” — quick, shallow breaths without any breaks between an inhale and an exhale. You’ll do this for one to two hours, taking breaks if you need to.

During this time, participants are told to expect a release of emotions or a triggering of difficult memories from childhood.

The goal of this type of breathing is to inhale energy as well as oxygen. 


Practitioners of rebirthing claim that by breathing in energy, you’re healing your body.

Your session may consist of only breathwork, or it may include other techniques.


Some practitioners simulate birth by putting you in an enclosed environment meant to resemble a womb and coaching you to escape from it. This may involve blankets, pillows, or other materials.


 

Sand Tray Therapy


Sand tray therapy (which is also referred to as sandplay therapy) is often used with individuals who have experienced a traumatic event such as abuse. It’s most often used with children but it can also help teens and adults.

Psychotherapists may use sand trays to assess, diagnose, or treat a variety of mental illnesses. Research shows that sand tray therapy can help increase emotional expression while also reducing psychological distress in many populations.

What It Involves

Sand tray therapy is a combination of play therapy and art therapy. The therapist provides a tray or box filled with sand. The client is given miniature toys to create a play world. Toys may include anything from farm animals and dinosaurs to people and cars. Trees, fences, gates, doors, and buildings are common as well.

The client is free to choose which toys to incorporate into the tray and then the toys are arranged in any way that the client wants.

The therapist mainly serves as an observer and rarely interrupts. It’s thought that the client is able to create a world that represents their internal struggles or conflicts. After the sandplay is complete, the therapist and the client often discuss what was observed—the toys that were chosen, how they were arranged, and any symbolic or metaphorical meanings.

The client may then choose to rearrange the toys based on the discussion. Sand tray therapy may also include verbal therapy, play therapy, art therapy, or other types of treatment.


How It Helps

Sand tray therapy was developed by Dora Kalff and is derived from Margaret Lowenfeld’s “Worldtechnik,” Jungian theory and Buddhist contemplative practices.

It’s based on the notion that if a therapist provides the client with a safe space, the client will use the sand tray to create solutions to their problems on their own. 


Research shows that sand tray therapy reduces symptoms of many mental health issues and increases resilience.

Sand tray therapy is unstructured. It allows clients to experience healing through the therapeutic process. It provides the opportunity for clients to free themselves of deep-seated negative emotions by allowing them to express their inner thoughts and feel accepted by the therapist.

Sandplay can also be a pleasurable sensory experience. It facilitates the natural expression of emotions. It may be used as part of an individual, group, or family therapy.



Acceptance and Commitment Therapy


Acceptance and commitment therapy (ACT) is an action-oriented approach to psychotherapy that stems from traditional behavior therapy and cognitive behavioral therapy. Clients learn to stop avoiding, denying, and struggling with their inner emotions and, instead, accept that these deeper feelings are appropriate responses to certain situations that should not prevent them from moving forward in their lives. 


With this understanding, clients begin to accept their issues and hardships and commit to making necessary changes in their behavior, regardless of what is going on in their lives, and how they feel about it.



When It's Used

ACT has been used effectively to help treat workplace stress, test anxiety, social anxiety disorder, depression, obsessive-compulsive disorder, and psychosis. It has also been used to help treat medical conditions such as chronic pain, substance abuse, and diabetes.


What to Expect

Working with a therapist, you will learn to listen to your own self-talk, or the way you talk to yourself specifically about traumatic events, problematic relationships, physical limitations, or other issues. You can then decide if an issue requires immediate action and change or if it can—or must—be accepted for what it is while you learn to make behavioral changes that can affect the situation. You may look at what hasn’t worked for you in the past, so that the therapist can help you stop repeating thought patterns and behaviors that are causing you more problems in the long run. Once you have faced and accepted your current issues, you make a commitment to stop fighting your past and your emotions and, instead, start practicing more confident and optimistic behavior, based on your personal values and goals.


How It Works

The theory behind ACT is that it is not only ineffective, but often counterproductive, to try to control painful emotions or psychological experiences, because suppression of these feelings ultimately leads to more distress. 




Dialectal Behavioral Therapy


History:

DBT was developed in the late 1980s by Dr. Marsha Linehan and colleagues when they discovered that cognitive behavioral therapy alone did not work as well as expected in patients with borderline personality disorder. 


Dr. Linehan and her team added techniques and developed a treatment which would meet the unique needs of these patients.

DBT is derived from a philosophical process called dialectics. Dialectics is based on the concept that everything is composed of opposites and that change occurs when one opposing force is stronger than the other, or in more academic terms—thesis, antithesis, and synthesis. 

More specifically, dialectics makes three basic assumptions:

  • All things are interconnected.
  • Change is constant and inevitable.
  • Opposites can be integrated to form a closer approximation of the truth.

Thus in DBT, the patient and therapist are working to resolve the seeming contradiction between self-acceptance and change in order to bring about positive changes in the patient.


Another technique offered by Linehan and her colleagues was validation. Linehan and her team found that with validation, along with the push for change, patients were more likely to cooperate and less likely to suffer distress at the idea of change. The therapist validates that the person's actions "make sense" within the context of his personal experiences without necessarily agreeing that they are the best approach to solving the problem.


DBT as a Type of Cognitive Behavioral Therapy

DBT has now evolved into a standard type of cognitive behavioral therapy. When a person is undergoing DBT, they can expect to participate in three therapeutic settings: 

  • A classroom where a person is taught behavioral skills by doing homework assignments and role playing new ways of interacting with people
  • Individual therapy with a trained professional where those learned behavioral skills are adapted to a person's personal life challenges
  • Phone coaching in which a person can call their therapist to receive guidance on coping with a difficult at-the-moment situation

In DBT, individual therapists also meet with a consultation team to help them stay motivated in treating their patients and help them navigate difficult and complex issues.

Four Modules

People undergoing DBT are taught how to effectively change their behavior using four main strategies:

  • Mindfulness—focusing on the present ("living in the moment").
  • Distress Tolerance—learning to accept oneself and the current situation. More specifically, people learn how to tolerate or survive crises using these four techniques: distraction, self-soothing, improving the movement, and thinking of pros and cons. 
  • Interpersonal Effectiveness—how to be assertive in a relationship (for example, expressing needs and saying "no") but still keeping that relationship positive and healthy.
  • Emotion Regulation—recognizing and coping with negative emotions (for example, anger) and reducing one's emotional vulnerability by increasing positive emotional experiences.

Psychoeducational Therapy


Psychoeducation combines psychotherapy with education to help participants deal with a targeted problem in their life. It has been implemented in a variety of settings, ranging from mental health clinics to occupational training. 


Psychoeducation focuses on providing valuable information to clients, and helping them improve awareness, skills, and communication related to the target problem. Therapists serve as “facilitators” by setting the intervention goals and modifying the presentation of information to meet clients’ needs. 


Psychoeducation can be used with diverse cultural and ethnic groups, and can be adapted to a number of presentation formats. Empirical evidence has shown that psychoeducation is an effective intervention that improves clients’ lives by increasing knowledge, developing skills, and improving relationships.


This entry describes psychoeducation—what it is, how it differs from other modes of therapy, its basic principles and treatment components, how it is conducted, and its mechanisms of action. 


The entry discusses the development of psychoeducation and provides examples of the diverse settings in which this type of treatment can be used. In addition, it discusses the role of therapist as facilitator and addresses cultural concerns in psychoeducation, and concludes with a summary of the evidence supporting the use of psychoeducation.

What Is Psychoeducation?Development of Psychoeducation


The development of psychoeducation is related to the passage and implementation of the Community Mental Health Act of 1963, which resulted in deinstitutionalization. This act was developed to provide a more normalized way of living for individuals experiencing psychological disturbances who could be maintained on medications and treated through services in their community. 


Although the act was well intended, a majority of the community-based treatment was provided by overworked and understaffed community facilities. This resulted in poor or no treatment for many individuals. Deinstitutionalization failed in meeting its lofty goals and essentially abandoned those it was designed to help. This dilemma stimulated efforts to educate families on how to best care for relatives experiencing mental health difficulties. Psychoeducation was developed to fill the gap resulting from the negative effects of deinstitutionalization.

Another factor that promoted the development of psychoeducation was the shift in zeitgeist from a belief that mental illness was a result of family factors (i.e., “family blaming”) to alternative explanations of psychopathology. This in turn led to more family-focused treatments such as psychoeducation.