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Treatment Approaches 

We are committed to providing high-quality care through evidence-based treatment. We prioritize continuing education to ensure that our team stays informed with the latest developments in the field. 

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is a practical, evidence-based treatment that focuses on the connection between thoughts, feelings, and behaviors. The goal of CBT is to help clients identify unhelpful thought patterns, understand how those thoughts influence emotions and actions, and then learn new ways of thinking and responding that promote healthier coping and improved well-being.

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All of the therapists at TCR have a foundation in CBT and receive continuing education to improve their skills. 

Acceptance and Commitment Therapy (ACT)

Acceptance and Commitment Therapy (ACT) is an evidence-based approach that helps people relate differently to difficult thoughts and emotions rather than trying to eliminate them. Instead of focusing on “getting rid of” distress, ACT teaches skills to accept what is outside of one’s control and take committed action toward what truly matters.

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In sessions, clients learn mindfulness strategies, practice defusing from unhelpful thoughts, and identify personal values to guide behavior. The goal is to build psychological flexibility—the ability to stay present, open, and engaged in life even when facing challenges.

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ACT has been shown to be effective for anxiety, depression, OCD, trauma, chronic pain, and stress, and it empowers clients to live a life more consistent with their values while developing healthier ways of coping with emotional experiences.

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All the therapists at TCR have training in ACT!

Cognitive Processing Therapy (CPT)

Cognitive Processing Therapy (CPT) is a specialized form of cognitive-behavioral therapy designed to help people recover from trauma and post-traumatic stress disorder (PTSD). CPT focuses on how traumatic experiences can change the way a person thinks about themselves, others, and the world. These changes in thinking—sometimes called “stuck points”—can keep painful memories and emotions active long after the trauma has passed.

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In CPT, clients learn to identify and challenge unhelpful or distorted thoughts related to their trauma. Through guided practice, they work toward developing more balanced and accurate beliefs, which helps reduce the intensity of distressing emotions such as guilt, shame, anger, or fear.

 

CPT is structured, time-limited (often around 12 sessions), and highly effective. Research shows that it helps many people experience significant reductions in PTSD symptoms, improve daily functioning, and regain a greater sense of safety, control, and connection in their lives.

Trauma Focused Cognitive Behavioral Therapy (TF-CBT)

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based treatment created specifically for children and adolescents who have experienced trauma, as well as their caregivers. The approach helps young people process traumatic memories in a safe and supportive way while building skills to manage distressing thoughts, feelings, and behaviors.

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TF-CBT combines cognitive-behavioral strategies with trauma-sensitive interventions. Children and teens learn coping skills such as relaxation, emotional regulation, and identifying unhelpful thoughts. Over time, they are guided to gradually share and process their trauma story, which helps reduce the power of painful memories. Caregivers are also included in the process to support the child’s healing and strengthen family communication.

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Research shows TF-CBT is highly effective in reducing symptoms of post-traumatic stress, depression, anxiety, and behavioral difficulties. It also improves overall functioning and helps children and families regain a sense of safety and hope.

Exposure Response Prevention (ERP)

Exposure and Response Prevention (ERP) is a highly effective, evidence-based therapy for Obsessive-Compulsive Disorder (OCD) and related conditions. ERP helps people gradually face the thoughts, images, objects, or situations that trigger their anxiety (the “exposure”) while learning to resist the urge to engage in compulsive behaviors (the “response prevention”).

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Instead of avoiding triggers or performing rituals for relief, clients practice staying present with their anxiety until it naturally decreases. Over time, this retrains the brain to recognize that feared situations are not dangerous and that anxiety does not need to be controlled through compulsions.

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ERP is usually structured and collaborative, with the therapist and client working together to design personalized exposure exercises that build confidence step by step. Research shows ERP is one of the most effective treatments for OCD, with many people experiencing significant and lasting symptom reduction.

Inference Based Cognitive Behavioral Therapy (ICBT)

Inference-Based Cognitive Behavioral Therapy (ICBT) is a specialized treatment for Obsessive-Compulsive Disorder (OCD) that focuses on how intrusive doubts begin in the imagination rather than in real evidence. People with OCD often experience “inferential confusion”—a tendency to confuse imagined possibilities (“what if this happens?”) with actual, here-and-now reality. This leads to doubt, anxiety, and compulsive behaviors.

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ICBT helps clients learn to recognize when they are relying on imagined scenarios instead of real-world evidence. Through guided exercises, they practice grounding themselves in the present moment, evaluating facts, and building confidence in their senses and reasoning. Over time, clients develop alternative, more realistic explanations for their intrusive thoughts, which reduces doubt and lessens the urge to engage in compulsions.

Supportive Parenting for Anxious Childhood Emotions (SPACE)

Supportive Parenting for Anxious Childhood Emotions (SPACE) is a parent-based treatment program designed to help children and adolescents struggling with anxiety, OCD, and related difficulties. Unlike traditional therapy that works directly with the child, SPACE focuses on empowering parents to make changes in how they respond to their child’s anxiety symptoms.

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In SPACE, parents learn to reduce “accommodations”—the well-intentioned ways they may change routines, provide excessive reassurance, or help their child avoid feared situations. While accommodations can bring short-term relief, they often keep anxiety strong in the long run. Through supportive communication and gradual adjustments, parents help their child face fears, build independence, and develop healthy coping skills.

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Research has shown SPACE to be highly effective: many children improve significantly even without direct therapy sessions, and results are often comparable to individual child-based treatments. SPACE provides parents with practical tools to reduce family stress while fostering long-term resilience in their children.

Prolonged Exposure (PE)

Prolonged Exposure (PE) is a specialized, evidence-based treatment for post-traumatic stress disorder (PTSD) and trauma-related difficulties. The approach is based on the understanding that avoidance of trauma reminders—such as memories, feelings, places, or situations—keeps fear and distress alive. While avoidance may bring temporary relief, it prevents healing in the long term.

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In PE, clients work gradually and safely with a therapist to confront trauma memories and reminders instead of avoiding them. This process includes two main strategies: imaginal exposure, where clients repeatedly revisit and recount their trauma memory in a supportive setting, and in vivo exposure, where clients gradually face real-life situations they’ve been avoiding. Over time, these practices reduce the intensity of fear, build tolerance for distress, and help clients regain a sense of control and safety in daily life.

 

Research has shown PE to be one of the most effective treatments for PTSD, with many clients experiencing significant and lasting reductions in symptoms such as intrusive memories, avoidance, hyperarousal, and negative mood.

Eye Movement Desensitization and Reprocessing (EMDR)

Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based therapy designed to help people heal from traumatic experiences and distressing memories. EMDR is based on the idea that trauma can overwhelm the brain’s natural ability to process information, leaving memories “stuck” and continuing to trigger painful emotions, thoughts, and physical sensations.

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In EMDR, clients recall aspects of a traumatic memory while engaging in guided bilateral stimulation, such as following the therapist’s hand with their eyes or listening to alternating tones. This process helps the brain reprocess the memory, reducing its emotional intensity and allowing the person to integrate the experience in a healthier way.

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Unlike traditional talk therapies, EMDR does not require clients to give detailed descriptions of their trauma. Instead, it focuses on helping the brain resolve unprocessed memories so that they no longer cause the same level of distress.

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Research has shown EMDR to be highly effective in treating post-traumatic stress disorder (PTSD), as well as helpful for anxiety, depression, and other trauma-related conditions. Many clients experience significant symptom relief in a shorter time frame compared to some other therapies.

Written Exposure Therapy (WET)

Written Exposure Therapy (WET) is a brief, evidence-based treatment for post-traumatic stress disorder (PTSD) and trauma-related distress. The therapy focuses on helping people process traumatic memories through structured writing exercises rather than extended verbal recounting.

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In WET, clients are guided to write in detail about their traumatic experience during therapy sessions, focusing on thoughts and emotions connected to the event. This process allows the brain to revisit and re-organize the memory in a safe and supportive way. Over time, the repeated writing helps reduce the intensity of trauma-related symptoms such as intrusive thoughts, avoidance, and emotional distress.

 

WET is typically delivered in just five sessions, making it one of the most time-efficient treatments for PTSD. Research shows that it is highly effective, with many clients experiencing meaningful reductions in symptoms and improvements in quality of life. Because it is shorter and less intensive than some other trauma therapies, WET is often a good fit for individuals who prefer a more focused and streamlined approach.

Narrative Therapy 

Narrative Therapy is a collaborative, strengths-based approach that helps people view their lives through the stories they tell about themselves. Sometimes, painful experiences or problems can come to feel like they define who a person is. Narrative Therapy works to separate people from their problems, showing that “the problem is the problem” rather than the person being the problem.

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In sessions, clients are invited to explore how certain stories or beliefs developed and how these may be shaping their current identity and choices. Together with the therapist, they re-author their story in ways that highlight resilience, values, strengths, and preferred outcomes. This process can create space for new perspectives, greater empowerment, and healthier ways of responding to challenges.

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Narrative Therapy is especially helpful for individuals, couples, and families who want to make meaning of difficult experiences, reduce the weight of negative self-beliefs, and move toward more hopeful and empowering life narratives.

Emotionally Focused Individual Therapy (EFIT)

Emotionally Focused Individual Therapy (EFIT) is a therapeutic approach that helps people explore, understand, and transform their emotional experiences. Rooted in attachment theory, EFIT emphasizes the importance of emotional bonds—both with others and with oneself—and how these bonds shape identity, coping, and healing.

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In EFIT, clients learn to tune into their core emotions in a safe, supportive space. By identifying patterns of emotional avoidance or disconnection, clients can work through difficult feelings such as shame, fear, or grief. The therapist guides clients toward experiencing emotions in new ways, creating greater self-compassion, resilience, and the ability to build healthier relationships.

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Research supports EFIT as an effective treatment for depression, anxiety, trauma, and relationship distress. The approach helps clients not only reduce symptoms but also deepen their sense of connection, belonging, and personal growth.

Gottman Method

The Gottman Method is an evidence-based approach to couples therapy designed to strengthen relationships, improve communication, and rebuild trust. Developed by Drs. John and Julie Gottman through decades of research, this method focuses on both reducing conflict and deepening friendship and intimacy between partners.

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In therapy, couples learn practical tools to manage conflict in healthy ways, express needs and emotions more effectively, and repair breakdowns in communication. The Gottman Method emphasizes building a strong foundation of respect and understanding, enhancing emotional connection, and creating shared meaning in the relationship.

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Therapists trained in the Gottman Method use structured assessments and interventions tailored to each couple’s unique challenges. Research has shown this approach to be highly effective in improving relationship satisfaction, reducing distress, and supporting long-term stability.

Unified Treatment Approach for Eating Disorders

The Unified Treatment Approach for Eating Disorders is an evidence-based model that addresses the shared emotional and behavioral processes underlying all eating disorders, rather than focusing only on specific symptoms like restriction, bingeing, or purging. This transdiagnostic approach recognizes that struggles with eating often stem from difficulties in managing emotions, rigid thinking patterns, and unhelpful coping strategies.

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In therapy, clients learn to better understand the function of their eating disorder behaviors, develop healthier ways to regulate emotions, and practice flexibility in their thinking. Treatment often includes cognitive-behavioral strategies, mindfulness, and skills to reduce avoidance and increase tolerance of uncomfortable feelings. By focusing on the common roots of eating disorders, the unified approach can be adapted to each person’s unique symptoms while targeting the core difficulties that keep the cycle going.

 

Research shows that the unified approach improves eating disorder symptoms, reduces anxiety and depression, and helps clients build sustainable coping skills that support long-term recovery and well-being.

Unified Protocol (UP)

The Unified Protocol is an evidence-based cognitive-behavioral treatment designed to help people who struggle with a wide range of emotional disorders, such as anxiety, depression, OCD, and related difficulties. Instead of focusing only on the symptoms of one diagnosis, the Unified Protocol addresses the underlying patterns that many emotional disorders share—like difficulty managing strong emotions, avoiding uncomfortable feelings, and getting stuck in unhelpful thought patterns.

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In therapy, clients learn skills to become more aware of their emotions, accept them without judgment, and respond in healthier, more flexible ways. Treatment includes strategies such as mindfulness, identifying and challenging negative thinking, exposure to avoided situations or feelings, and building tolerance for distress.

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Research has shown that the Unified Protocol is effective across many different conditions, especially for people who experience more than one mental health concern at the same time. By targeting the common core of emotional difficulties, it helps clients reduce symptoms, improve functioning, and live more in line with their values.

Comprehensive Model of Behavior (COMB)

The Comprehensive Behavioral Model (ComB) is a specialized treatment approach for body-focused repetitive behaviors (BFRBs), such as hair pulling (trichotillomania) and skin picking (excoriation disorder). Unlike a “one-size-fits-all” method, ComB helps individuals understand the unique reasons behind their behaviors and tailors treatment to those factors.

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In ComB, clients and therapist work together to identify the different triggers that drive the behavior. These triggers may be sensory (touch or physical sensations), cognitive (thoughts), affective (emotions), motoric (habits), or environmental (situations or settings). Once the specific patterns are mapped out, treatment focuses on developing personalized strategies to interrupt the behavior and replace it with healthier responses.

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The ComB model empowers clients by giving them a clear understanding of why their behaviors happen and practical tools to reduce them. Research has shown ComB to be an effective and flexible treatment for BFRBs, helping many people reduce urges, increase control, and improve daily functioning.

Dialectical Behavioral Therapy

Dialectical Behavior Therapy (DBT) is an evidence-based treatment that helps people manage intense emotions, improve relationships, and build healthier coping skills. Originally developed for individuals with borderline personality disorder and chronic suicidal thoughts, DBT has since been shown to be effective for a wide range of concerns including depression, anxiety, trauma, eating disorders, and self-destructive behaviors.

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DBT combines acceptance and change strategies. Clients learn to accept themselves and their experiences while also making changes that support healthier functioning. The therapy teaches skills in four main areas: mindfulness (staying present in the moment), distress tolerance (managing crises without making things worse), emotion regulation(understanding and reducing vulnerability to strong emotions), and interpersonal effectiveness (building more stable and supportive relationships).

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DBT can be offered individually or in skills groups, and it emphasizes support, accountability, and practical tools that clients can apply in daily life. Research has consistently shown DBT to reduce self-harm, improve emotion regulation, and increase overall quality of life.

Internal Family Systems (IFS)

Internal Family Systems (IFS) is a compassionate, evidence-based therapy that helps people better understand and heal their inner world. IFS is built on the idea that our mind is made up of different “parts” or sub-personalities—each with its own feelings, thoughts, and roles. Some parts may carry painful emotions from the past, while others work hard to protect us, often through patterns like perfectionism, self-criticism, or avoidance.

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In therapy, clients learn to connect with their core “Self”—the calm, curious, and compassionate center of who they are. From this place, they can approach their parts with understanding rather than judgment. Over time, this process helps release burdens carried by wounded parts, reduce inner conflict, and foster a greater sense of harmony and self-leadership.

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IFS can be helpful for trauma, anxiety, depression, relationship challenges, and personal growth. Many people find it empowering because it honors all parts of themselves and promotes healing through self-compassion and integration.

Reality Therapy

Reality Therapy is a counseling approach that focuses on helping people take responsibility for their choices and build healthier, more fulfilling relationships. Developed by Dr. William Glasser, it is grounded in Choice Theory, which suggests that most psychological distress comes from unsatisfying or disconnected relationships.

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In therapy, clients are encouraged to look at what they want, what they are currently doing, and whether their behaviors are helping them move closer to or further from their goals. The focus is on the present and future, rather than dwelling on the past, and on practical steps that can improve daily life.

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Reality Therapy emphasizes personal responsibility, problem-solving, and building connections with others. By learning to make choices that better meet their needs for love, belonging, power, freedom, and fun, clients often find greater satisfaction and effectiveness in their lives.

Motivational Interviewing (MI)

Motivational Interviewing (MI) is a collaborative, person-centered counseling approach that helps people strengthen their own motivation and commitment to change. Rather than telling clients what to do, MI creates a supportive space where they can explore their values, goals, and ambivalence about change.

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Through open-ended questions, reflective listening, and affirmations, the therapist guides clients in identifying their reasons for change and building confidence in their ability to take steps forward. The focus is on partnership, respect, and empowering the client’s own choices.

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MI has been shown to be effective across a wide range of concerns, including substance use, health behaviors, anxiety, and lifestyle changes. Clients often find it helpful because it reduces resistance, increases self-awareness, and supports lasting, self-directed change.

Solution Focused Brief Therapy (SFBT)

Solution-Focused Brief Therapy is a goal-oriented approach that helps people focus on solutions rather than problems. Instead of spending a lot of time exploring what’s wrong or analyzing the past, SFBT emphasizes strengths, resources, and small steps that can move clients closer to their preferred future.

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In sessions, the therapist uses questions to help clients imagine what life would look like if their challenges were resolved, identify times when the problem is less intense, and build on what’s already working. The process is collaborative, positive, and practical, often leading to meaningful progress in a shorter period of time.

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SFBT has been shown to be effective for a wide range of concerns, including anxiety, depression, relationship challenges, and stress. Clients often appreciate its hopeful and empowering focus on what is possible rather than what is wrong.

Cognitive Behavioral Therapy for Insomnia (CBT-I)

Cognitive Behavioral Therapy for Insomnia (CBT-I) is the leading evidence-based treatment for chronic sleep difficulties. Unlike sleep medications, which often provide only temporary relief, CBT-I works by addressing the thoughts and habits that interfere with healthy sleep and helping people retrain their sleep patterns.

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In therapy, clients learn strategies such as improving sleep routines, reducing unhelpful thoughts and worries about sleep, and making lifestyle or environmental changes that promote rest. Techniques like stimulus control, sleep restriction, and relaxation training are commonly used to restore a more natural sleep rhythm.

 

Research has consistently shown CBT-I to be highly effective, with most people experiencing significant improvements in how quickly they fall asleep, how often they wake during the night, and how rested they feel during the day. Results are long-lasting, making CBT-I the gold standard for treating insomnia.

Mindfulness Based Stress Reduction (MBSR)

Mindfulness-Based Stress Reduction (MBSR) is an evidence-based program that helps people manage stress, anxiety, pain, and other challenges through the practice of mindfulness. Developed by Dr. Jon Kabat-Zinn, MBSR teaches participants to bring gentle, nonjudgmental awareness to the present moment.

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The program usually runs for eight weeks and combines guided meditation, gentle yoga, and mindfulness practices that can be used in everyday life. Participants learn how to notice thoughts, emotions, and body sensations without becoming overwhelmed by them, which reduces stress and promotes greater calm and resilience.

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Research has shown that MBSR can lower stress, improve mood, reduce symptoms of anxiety and depression, and even support better physical health outcomes. Many people find it helpful for cultivating balance, self-awareness, and well-being in their daily lives.

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Have a Question? 

Feel free to reach out to us with any questions about our training, certifications, and skill sets with any of the therapeutic approaches that we use. As a part of your treatment, your therapist will discuss which treatment approaches are used to treat your diagnosis and will develop a plan of care with you to meet your needs. 

THE CLINIC

948 Elm St. Suite 2

Bowling Green, KY 42101

Email: info@cognitiverefinery.com

Tel: 270-266-1188

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Hours:

Mon - Thurs: 8:30am - 7pm

Friday: 8:30am - 5pm

(other hours by appointment only)

Saturday: by appointment only​​​

Sunday: Closed

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