If you’ve been struggling with insomnia, you’re certainly not alone. Millions of adults face sleepless nights due to difficulty falling or staying asleep. One of the most effective evidence-based treatments for insomnia is Cognitive Behavioral Therapy for Insomnia (CBT-I). But how do you find the right CBT-I therapist to meet your needs? Let’s explore what CBT-I is, why it works, and how to choose a therapist who specializes in this first-line sleep intervention.

CBT-I is a structured, short-term therapy designed specifically to improve sleep. It targets the unhelpful thoughts, behaviors, and habits that keep people trapped in a cycle of poor sleep. Unlike medications, which provide temporary relief, CBT-I focuses on long-term solutions by addressing the root causes of insomnia.

• Sleep Education: Understanding how sleep works and why certain habits may undermine it.
  
• Stimulus Control: Breaking the association between your bed and wakefulness.
• Cognitive Restructuring: Challenging negative thoughts about sleep that fuel anxiety.
• Relaxation Techniques: Learning methods to reduce stress and calm the mind.
  
• Sleep Restriction: Limiting time in bed to strengthen your sleep drive.
  

Research shows that CBT-I can help people fall asleep faster, stay asleep longer, and feel more rested during the day.

While there are many self-help resources available, a trained CBT-I therapist provides tailored support that can accelerate your progress. These therapists have specialized expertise in treating insomnia and can adjust techniques to fit your unique sleep challenges.

CBT-I therapists also offer accountability, helping you stick with the program and troubleshoot any roadblocks along the way. If you've tried everything on your own but still feel stuck, working with a professional can make all the difference.

Finding a qualified CBT-I therapist involves a few key steps:

1. Search for Specialists: Look for therapists with specific training and certification in CBT-I. Many professionals list their qualifications on their websites, or you can use directories to search for therapists trained in CBT-I.
   
2. Check Their Credentials: A licensed psychologist, social worker, or counselor who has completed additional training in CBT-I is ideal.
   
3. Ask About Their Experience: During an initial consultation, ask how long they’ve been practicing CBT-I and whether they’ve worked with clients with similar sleep issues.
4. Consider Accessibility: Many CBT-I therapists now offer telehealth sessions, making it easier to fit treatment into your schedule, no matter where you live.
5. Evaluate Fit: Feeling comfortable with your therapist is crucial. A good CBT-I therapist will listen to your concerns, explain the treatment process clearly, and adapt their approach to your needs.
   
   

CBT-I typically involves 6-8 sessions over the course of 2-3 months, but may be shorter or longer depending on your individual needs. During this time, you’ll work with your therapist to identify and address the factors contributing to your insomnia. You’ll also receive a customized sleep plan, track your progress, and make adjustments as needed.

Some common goals during CBT-I include:

• Establishing a consistent sleep schedule.
• Reducing time spent awake in bed.
• Learning techniques to calm your mind at bedtime.
  
  

With commitment and practice, most people see significant improvements in their sleep within a few weeks.

Whether you’ve been dealing with insomnia for weeks or years, CBT-I offers the best path to better sleep. Working with a skilled CBT-I therapist can help you reclaim your nights and restore your energy during the day.

If you’re based in New York and seeking a CBT-I therapist, I specialize in evidence-based treatments for insomnia and other sleep challenges. I offer telehealth services for adults who are ready to break free from restless nights and rediscover restful sleep. Contact me today to schedule a consultation and take the first step toward better sleep.

If you've ever felt like your therapist talks to you like they're your boss, you're not alone -- this is unfortunately a common sentiment expressed on reddit and other forums. What is behind these posts is that people often feel like they're being directed rather than supported in therapy. But the therapeutic relationship should be a collaborative partnership, not a hierarchy. This post explores how you and your therapist can work together to achieve your goals, ensuring that you feel empowered and heard throughout the process.

Therapy is most effective when it's a two-way street. You bring your experiences, challenges, and goals, while your therapist provides tools, insights, and support. When these elements come together in a collaborative way, you're more likely to see meaningful progress.

However, if you feel like your therapist talks to you like they're your boss, it might be a sign that the partnership needs some adjustment. Therapy should never feel like a power struggle; instead, it should feel like a cooperative effort where both people contribute in a collaboratively way.

Collaboration in therapy ensures that your voice is central to the process. When therapists and clients work together as equals, it enhances the therapeutic alliance, which is one of the strongest predictors of positive outcomes in therapy. A collaborative approach also respects your autonomy and empowers you to take an active role in your healing process.

Some key benefits of a collaborative therapeutic relationship include:

• Empowerment: You feel more in control of your therapy and your life.
• Better Outcomes: Research shows that collaboration leads to more effective therapy.
• Increased Engagement: You’re more likely to engage with the therapeutic process when you feel like an active participant.
• Greater Satisfaction: A collaborative relationship often leads to higher satisfaction with therapy.

If you feel like your therapist talks to you like they're your boss, here are some strategies to foster a more collaborative relationship (if this doesn't work, there are also suggestions for finding a new therapist below):

1. Communicate Openly: Start by expressing how you feel. Let your therapist know if you feel like the dynamic is too directive. A good therapist will appreciate your honesty and work with you to adjust the approach.
   
2. Set Mutual Goals: Make sure that your therapy goals are set together. Your therapist should guide you based on their expertise, but the goals should reflect what you genuinely want to achieve.
3. Ask Questions: Don’t hesitate to ask why certain techniques or strategies are being recommended. Understanding the rationale behind your therapist’s suggestions can make you feel more involved and informed.
4. Give Feedback: If something isn’t working for you, say so. Therapy should be flexible, and your therapist should be willing to adapt their approach based on your feedback.
5. Be an Active Participant: Collaboration is a two-way street. Engage with the process, bring your thoughts and ideas to sessions, and take ownership of your progress.
   
   

Sometimes, despite your best efforts, you may continue to feel like your therapist talks to you like they're your boss. If that’s the case, it might be worth considering a different therapist who better matches your style. The right therapist for you will be someone who respects your input and collaborates with you to create a treatment plan that truly fits your needs.

Therapy is a relationship that you and your therapist navigate together. If you ever feel like your therapist talks to you like they're your boss, it’s important to address it. By fostering open communication, setting mutual goals, and being an active participant, you can build a strong therapeutic partnership that leads to meaningful change.

When it comes to managing anxiety, many people are prescribed medications like Xanax (alprazolam) to help ease their symptoms. While Xanax can provide temporary relief, it's essential to understand its potential long-term effects. As someone deeply familiar with evidence-based protocols for stress and anxiety, I'll shed light on whether Xanax might actually make anxiety worse over time.

Xanax belongs to a class of medications called benzodiazepines, which work by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA). This action helps to calm the nervous system, providing quick relief from anxiety and panic attacks. For many, this relief can feel like a lifesaver during acute moments of distress.

However, while Xanax can be effective in the short term, its long-term use raises several concerns:

1. Dependence and Tolerance: Over time, the body can develop a tolerance to Xanax, meaning higher doses are needed to achieve the same effect. This can lead to physical dependence, where the body requires the drug to function normally. Withdrawal symptoms, including heightened anxiety, can occur if the medication is reduced or stopped abruptly.
2. Avoidance and Short-Circuiting Therapy: One of the core principles of exposure therapy is gradually facing and tolerating anxiety-inducing situations without resorting to avoidance behaviors. Xanax can short-circuit this process by providing immediate, albeit temporary, relief. This may reinforce avoidance and hinder the long-term benefits of exposure therapy.
3. Potential for Rebound Anxiety: After the effects of Xanax wear off, some individuals experience rebound anxiety, which can be more intense than the initial anxiety. This phenomenon can create a vicious cycle, where increasing doses are needed to manage worsening anxiety.
   
   

Exposure therapy, a key component of cognitive-behavioral therapy (CBT), aims to help individuals confront their fears in a controlled and systematic way. By gradually exposing themselves to anxiety-provoking situations and learning to tolerate the discomfort, individuals can reduce their overall anxiety levels and gain confidence in their ability to handle distress. From this perspective, the use of Xanax can interfere with the therapeutic process in several ways:

• Disrupting Learning: Exposure therapy relies on the principle of habituation, where repeated exposure to a feared stimulus reduces the anxiety response over time. If Xanax is used to blunt the anxiety during exposures, the individual may not fully experience the discomfort necessary for habituation to occur.
• Reinforcing Avoidance: Relying on Xanax to manage anxiety can reinforce the idea that anxiety is unbearable and must be avoided at all costs. This mindset can undermine the goals of exposure therapy, which emphasizes building resilience and tolerating discomfort.
  

It's important to recognize that Xanax and other benzodiazepines have their place in anxiety treatment, particularly for short-term relief during acute episodes. However, for those seeking long-term solutions, especially through evidence-based therapies, a balanced approach is crucial.Here are a few considerations:

1. Work with a Healthcare Professional: If you're currently taking Xanax, it's essential to work closely with your prescribing doctor. They can help you develop a plan to manage your anxiety more effectively and reduce reliance on medication if desired.
   
   
2. Gradual Reduction: If appropriate, a gradual tapering off Xanax under medical supervision can help minimize withdrawal symptoms and rebound anxiety. This process should be tailored to your individual needs and done at a pace that feels manageable.
   
   
3. Embracing Exposure Therapy: Engage fully in exposure therapy with the guidance of a trained therapist. This approach can help you build confidence in your ability to face anxiety-provoking situations and reduce overall anxiety over time.
   
   
4. Consider Alternative Medications: In some cases, alternative medications with a lower risk of dependence and interfering with exposure therapy, such as selective serotonin reuptake inhibitors (SSRIs), may be considered. These can provide longer-term anxiety relief without the same risks associated with benzodiazepines.
   
   

While Xanax can provide quick relief from anxiety, its potential to make anxiety worse in the long run is a significant concern. By understanding the risks and working with healthcare professionals to find a balanced approach, you can achieve more sustainable and effective anxiety management. The goal is ideally not just to reduce anxiety in the moment, but to build long-term resilience and confidence in your ability to handle life's challenges.

Feel free to reach out to see if working together to treat your anxiety through exposure therapy may be a good fit.

In the quest for a fulfilling life, many of us strive for an ideal balance between work, family, leisure, and personal growth. But here's the truth: life is never perfectly balanced. Instead of holding ourselves to this perfect ideal, it's more helpful to take a longer outlook and consistently adjust how you spend your time to broadly align with your values over different time horizons—days, weeks, months, and years.

The idea of perfect balance suggests that every aspect of our lives should receive equal attention simultaneously. However, life is inherently dynamic, and our priorities often shift. There will be times when your career demands more focus, and other periods when family or leisure take precedence. This ebb and flow are natural and necessary for personal growth and well-being. The key is to be aware of and intentional about these shifts, and regularly check in with yourself to ensure you're not living on autopilot.

Rather than striving for constant equilibrium, consider whether your activities align with your core values over time. Reflect on how you spend your days, weeks, and months:

• Days: How are you spending the hours of your day? Do you feel like you are spending time on activities that are unhelpful, unnecessary or not important to you? Are you ok with this in the short term? What smaller shifts can you make?
  
• Weeks: While days might be filled more with one activity or another, how is your time spent over the course of a week? Are you spending time on most important life domains (which may include family, friendships, career, personal growth, community, physical well being, leisure, spirituality, and more)
• Months: Over the past month, have you pursued activities that align with your longer term goals?
• Years: Looking back over the past year, do you feel a sense of progress and fulfillment in key areas of your life? What changes would you like to make to readjust?

Finding life balance in therapy is about more than just managing your time; it's about living a life that's true to your values. By taking a longer view and embracing the natural fluctuations in your priorities, you can create a more fulfilling and meaningful life. Remember, it's not about achieving perfect balance every day—it's about ensuring that, over time, your actions reflect what truly matters to you.

Whether you're looking to realign your life with your values or need help navigating a significant life transition, you can reach out to see if working together might be a good fit.

Digital mental health consulting is when a subject matter expert translates clinical and scientific insights into accessible digital forms, by bringing together digital innovation and psychological expertise. Digital mental health consultants partner with companies that make digital therapy tools and wellness apps,  to make sure these products are not just cool tech gadgets but are also grounded in real science that can help improve mental health.

Why does this matter? Well, for starters, when a wellness app or digital therapy tool is backed by credible science, it is much more likely to be able to earn people's trust. And that's not just important for the person using the app; healthcare providers, insurance plans, and employers all want to know that these digital tools are grounded in evidence-based principles and have research demonstrating their clinical efficacy in addition to their return on investment. What sets these products apart in a crowded market is the fact that they're not just designed to sell; they're designed to work, based on actual evidence.

Now, one unique thing about this role is that it's not just about working within a clinical or science team at a particular company. I work with all kinds of teams across a company—like marketing, sales, product and legal/compliance—to make sure the clinical science is infused into strategic decision-making. It's a bit like being a translator: I take the relevant research base and approaches and help translate them into something that everyone on the team can understand and work with, which ultimately leads to more informed decision-making for the team.

Digital mental health consulting is a must-have for any digital health company that wants to create products that are both effective and trustworthy. In a world where tech is changing fast, this kind of expert guidance is key to making sure that innovation also leads to real, meaningful improvements in mental health.

You can learn more at my consulting website: MindFlex Health.

CBT is based on the premise that our thoughts, feelings, and behaviors are interconnected. If we can change one of these components, the others will follow suit. For example, if we can modify negative thought patterns, we can influence our feelings and behaviors in a positive way.
In contrast to psychodynamic therapy, which seeks to gain insight from events from our childhood and our unconscious thought patterns, CBT is generally more focused, time-limited, and oriented toward solving current problems.

CBT can further be broken down into other more specific therapies and techniques, one of which is known as exposure therapy. It's designed to help you confront your fear and anxiety. It's an effective treatment for conditions like phobias and post-traumatic stress disorder, but people do sometimes wonder, “Can exposure therapy make anxiety worse?” Initial stages of exposure therapy may heighten anxiety in the short term, as the process involves facing the fear head-on. However, under the guidance of a trained therapist, the anxiety generally diminishes over time, and you can gain confidence in navigating and coping with anxiety whenever it arises so that it no longer prevents you from living your life.

Another common question people ask is, "How long does therapy for anxiety take?" While it varies from person to person, CBT for anxiety is often more time-efficient than other forms of psychotherapy. Typically, a course may last anywhere from 6 to 20 sessions. The brevity of CBT doesn't mean it's a quick fix; rather, it's structured to provide you with coping mechanisms that you can utilize long after therapy ends.

If you're looking to deepen your understanding, there are myriad books on cognitive behavioral therapy that can provide an introduction. Whether you're a student, or a healthcare professional, or someone who is personally interested in self-guided help, literature on CBT can offer valuable insights into managing various mental health conditions. Titles like Feeling Good by David D. Burns or The Anxiety and Worry Workbook by David A. Clark and Aaron T. Beck are good starting points.

There are a number of factors to consider when looking for a therapist. You need to find someone who is licensed in your state, has availability, and has expertise in the types of therapeutic approaches that can address your needs. You’ll want to know if the therapist takes your insurance or if they are considered out-of-network (which means you will have to pay out of pocket, and then your health insurance will likely reimburse you for a portion of the expense).
It’s also very important to find a therapist that you feel comfortable opening up to. There are examples of people posting things they didn’t say in therapy because they didn’t feel comfortable with their therapist. No matter what type of therapy you are in, having an open and honest relationship with your therapist is a key component, so if you don’t feel that way, it might be time to explore finding a different therapist. Being transparent with your therapist can make a significant difference in the efficacy of any treatment, be it CBT or other forms of psychotherapy.

Cognitive behavioral therapy is a subset of psychotherapy that distinguishes itself with its practical, goal-oriented approach, particularly effective for conditions like anxiety. When considering therapy, it's always beneficial to educate yourself about the options available and ask questions of a potential therapist. The journey to mental well-being is a collaborative effort, and finding both the right therapeutic approach and the right therapist is a critical step in that journey.