Practical psychiatry. Real community change.

In one line: A practical, structured talking therapy that targets the links between thoughts, feelings and behaviour.

What it is. CBT is built on a simple but powerful idea: it is often not the situation itself that distresses us, but the way we interpret it. By learning to notice unhelpful thinking patterns and the behaviours that keep them going, people can change how they feel.

How it works. Therapy is collaborative, goal-focused and usually timelimited (often 8–20 sessions). Sessions involve identifying “thinking traps” (catastrophising, all-or-nothing thinking), testing those thoughts against evidence, and practising new behaviours through structured “homework” between sessions.

Where it helps most. Depression, anxiety disorders, panic, OCD, insomnia, and stress-related difficulties. It is one of the most extensively researched psychotherapies in the world.

In one line: A skills-based therapy for intense emotions — balancing acceptance of where you are with the change you want.

What it is. DBT was originally developed for people who experience emotions very intensely and struggle to regulate them. “Dialectical” refers to its core balance: accepting yourself as you are, while still working to change patterns that cause harm.

How it works. DBT typically combines individual therapy with a skills group across four modules: mindfulness, distress tolerance (getting through crises without making things worse), emotion regulation, and interpersonal effectiveness (asking for needs and setting boundaries).

Where it helps most. Difficulties with emotional regulation, self-harm urges, impulsivity, unstable relationships, and traits associated with borderline personality patterns. Skills are also widely useful for anyone who feels emotions strongly.

In one line: Learn to make room for difficult thoughts and feelings while moving towards what matters to you.

What it is. ACT (said as the word “act”) takes a different angle from classic CBT. Rather than trying to argue away or eliminate painful thoughts, it helps people change their relationship with those thoughts — holding them more lightly — and invest energy in a values-driven life.

How it works. Through metaphors and mindfulness-style exercises, ACT builds “psychological flexibility”: defusing from sticky thoughts, accepting uncomfortable feelings without being ruled by them, clarifying personal values, and committing to concrete action aligned with those values.

Where it helps most. Chronic pain, anxiety, depression, stress, and situations where struggling against difficult feelings has itself become the problem.

In one line: Training attention and awareness to relate to the present moment with less reactivity.

What it is. Mindfulness-based approaches (such as Mindfulness-Based Cognitive Therapy and Mindfulness-Based Stress Reduction) teach a particular skill: paying attention to the present moment, on purpose, without harsh judgement. The aim is not to empty the mind, but to notice experience clearly and respond rather than react.

How it works. Programmes are often group-based and run over about eight weeks, combining guided meditation, gentle body-awareness practices, and cognitive elements. Between sessions, short daily practice builds the “muscle” of attention.

Where it helps most. Preventing relapse in recurrent depression, managing stress and anxiety, chronic pain, and improving overall emotional resilience and focus.

In one line: Specialised, safety-first approaches that help the mind and body process overwhelming past experiences.

What it is. Trauma-focused therapies are designed for the aftermath of frightening or overwhelming events. They recognise that trauma is stored differently — in vivid sensory memories, body responses and a nervous system stuck on high alert — and that healing requires more than just talking about facts.

How it works. Approaches include Trauma-Focused CBT, Eye Movement Desensitisation and Reprocessing (EMDR), and Prolonged Exposure. They share a phased structure: first establishing safety and stabilisation skills, then carefully processing the traumatic memory, then reconnecting with life. Pacing and a sense of control for the client are central.

Where it helps most. Post-traumatic stress disorder (PTSD) and complex PTSD, the effects of abuse, accidents, violence, loss, and other distressing experiences.