Evidence-based therapy
About these approaches
These are the evidence-based approaches Sarsha draws on most. You don't need to know about any of them before you come in. They're here if you're curious, and if something stands out, you're welcome to bring it up in a session.
So which approach is right for me? There are many effective ways to approach the same problem. Different ones can suit different times in our lives, or different needs. The research consistently finds that one of the most important factors in whether therapy helps is the relationship shared with the therapist: feeling safe, understood, and that you're working with someone who gets you.
Sarsha works integratively, drawing on several of these approaches depending on what's happening for you.
Schema Therapy
Sometimes we notice the same patterns showing up in our lives again and again. It might be that we always put others first. That we pull away when people get too close. That we feel guilty when we do something for ourselves. A belief that whatever we do, we're not enough, no matter how much we try.
These patterns often have roots in our early experiences. The messages we heard from the world around us, about who we are, what we deserve, how much space we're allowed to take up, gradually become the messages we play to ourselves. Over time, they stop feeling like something we were taught. They start feeling like the truth.
Schema Therapy is a way of exploring those deeper patterns together. We look at where they came from, and especially at how they're showing up in your life right now. At your own pace, we begin to find new ways of responding, ones that feel more like you, and less like old survival strategies you no longer need.
Something to consider…
Schema Therapy is generally a longer term approach. While elements of this work can be woven into shorter term therapy, it often takes upwards of 10 sessions.
Cognitive Behavioural Therapy (CBT)
CBT is built on the idea that our thoughts, feelings and behaviours are all connected, and that changing one can ripple through the others.
In CBT, we look closely at those connections. We look at the stories we tell ourselves and ask whether they are accurate and helpful, or just familiar. Then, together, we practise small, concrete shifts in how we think and what we do, which gradually change how we feel. Because thoughts, feelings and behaviours are linked, a change in whichever one feels most workable tends to bring the other two with it.
Dialectical Behaviour Therapy (DBT)
DBT is built on combining two things that might sound like opposites: acceptance and change. The idea is that in order to change something, we often have to accept it first. It is not that we agree with it. Sometimes we just have to acknowledge that this is where we are right now.
This is what the word dialectical means: the idea that two things can be true at the same time.
DBT helps us sit with that tension rather than collapse into it or oscillate between both, finding the 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.
“The curious paradox is that when I accept myself just as I am, then I can change.”— Carl Rogers
DBT is a skills-based therapy that helps people manage intense emotions, improve relationships and cope with distress in healthier ways.
The skills cover four areas: mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. In practice, that can look like learning to move through big emotions without being consumed by them, or learning to ask for what you need in ways that land with the people around you.
Acceptance and Commitment Therapy (ACT)
Out there in the world, we tend to get a pretty consistent message: that we should feel good and avoid bad feelings, and that if we are doing life right, we should be constantly productive, and life should be making us perfectly happy.
ACT takes a different approach. The aim isn't to feel good all the time. Rather than trying to get rid of anxiety, self-doubt, painful memories or uncomfortable feelings, we learn to change our relationship with what we feel. ACT asks: how can you make room for what is difficult right now while still moving towards the life you want to live? This means making room for difficult thoughts and emotions, even ones we don't like or agree with, because when we stop fighting them, something can shift.
Over time, the aim is not perfect control over your inner world, but more freedom in how you respond to it.
What does ACT involve?
ACT brings together six interconnected processes. They aren't really six separate skills to master, but different ways of developing greater flexibility.
Acceptance
Learning to make room for uncomfortable thoughts, emotions and sensations when fighting with them is keeping you stuck. Acceptance doesn't mean liking, approving of or resigning yourself to something.
Defusion
Learning to unfuse from your thoughts. Rather than experiencing them as the truth, we can take a step back and observe them without being swept away.
Being present
Practising bringing your attention back to what is happening here and now, particularly when your mind becomes caught in worry, rumination or replaying the past.
Perspective-taking
Developing a sense of yourself that is larger than any particular thought, feeling, diagnosis or story about who you are. You can notice these experiences without being defined by them.
Values
Getting clear on what matters to you. When we get clear on our values, they act as a compass. They give us a direction to move toward, even when the hard feelings are still there.
Committed action
Taking steps towards what matters to you, including when anxiety, uncertainty or other difficult experiences come along for the ride.
In therapy, ACT might involve learning when to step back from an unhelpful thought, making room for discomfort rather than organising your life around avoiding it, noticing where your attention has gone and gradually doing more of what matters to you. Sarsha hopes to help clients forge a sense of self that is fulfilling because it's authentic, nuanced, and expansive.
Mindfulness
Where is your mind right now? In the present moment, in the past, or in the future?
It is easy for most of us to not be in the present moment at any given time. However, the present moment is the only time we ever actually exist in.
Mindfulness is the practice of paying attention to the present moment, on purpose, and without rushing to judge or fix what you notice. Or, as Jon Kabat-Zinn puts it, paying attention as if your life depended on it. Because it does.
It sounds simple, but it takes practice, because most of us spend a lot of time somewhere else: replaying the past, rehearsing the future or planning the next thing while only half present. This is normal, and it doesn't mean we are doing anything wrong. Our minds are busy problem-solving machines, and part of the practice is gently bringing our attention back to the present moment.
In therapy, mindfulness isn't about clearing your mind or feeling calm all the time. It's a way of building a different relationship with your thoughts and feelings, one where you can notice what's happening in your body and mind without immediately being pulled into it.
Mindfulness is not a stand-alone therapy so much as it's a thread that runs through many others. Sarsha weaves mindfulness into sessions where it's useful, as a grounding tool and as a skill you can build over time and use outside the therapy room.