Note: The following is presented for informational purposes only. Assessment and treatment should always be directed through one-on-one consultation with a trained professional.


Relaxation training is a set of techniques that patients practice for 10-15 minutes a day to learn how to calm themselves. One of the most commonly used forms is called Muscle Relaxation, where you alternately tense and then relax each muscle group in your body. Another common form is Breathing Retraining, where you learn to use abdominal breathing to counteract the tendency to hyperventilate when stressed. A third form which my patients usually find helpful is Sensation Focussing, where you concentrate on current sights, smells, and sounds to take yourself "out of your head".


Behavioral activation addresses the tendency for people to "hibernate" when they are depressed. Most depressed people start being less productive, leaving their house less often, and associating with friends less frequently. In other words, depression induces them to start avoiding activities and pull back from their daily routines. Behavioral activation basically refers to steadily increasing someone's level of activity and re-engaging in daily routines. It turns out that the more someone does the better they start to feel.


Thought restructuring addresses a common experience of people when they are feeling anxious or depressed: they tend to have a series of repetitive self-deprecating or catastrophic thoughts. Thought restructuring is a specific form of journaling in which you write down these self-deprecating or catastrophic thoughts and practice "talking back" to them for 10-15 minutes. This exercise is practiced once a day for 2-3 weeks, after which most people start talking back to their thoughts automatically and start experiencing less anxiety and depression. The goal is that, instead of the cycle of self-deprecating or catastrophic thoughts lasting for hours, they last only a few minutes or not at all. This skill is hard to do at first, and often a therapist is necessary to help get it going.


Graded exposures are based on the fact that your mind habituates to (i.e. gets used to) anything that you repetitively and voluntarily expose yourself to. In graded exposures, you gently expose yourself to something that makes you A LITTLE anxious until the anxiety goes away. You then gradually (i.e. in "graded" steps) work your way up until you are able to do all of the things you want to be able to do without anxiety. The key to exposures is finding something easy to begin with, and then gradually working up. Believe it or not, this technique alone is 80-90% effective for OCD, Panic Disorder, Phobias, and Social/Performance Anxiety. However, we typically need to teach relaxation technique first before we can fully jump into it.


Lack of assertiveness is common in depression and anxiety but is also prevalent in people who are not particularly depressed or anxious. Assertiveness refers to the ability to accurately identify and effectively communicate your emotions. Practically speaking, it translates into the ability to firmly say no to things you don't want to do and to be able to tactfully tell people how you want them to change when they are bothering you. Assertiveness is taught through problem-solving and then practicing both in and outside of therapy.


Social skills training focuses on specific aspects of interpersonal relationships such as appropriate levels of eye contact, how to dress well, what to say to strangers,  how to put other people at ease, how to be an effective storyteller, how to be an engaging speaker, what to do on a date, and how to pick good friends as well as a good boyfriend/girlfriend/spouse.   Primarily useful for treating social anxiety but also relevant to people without shyness who are disatisfied with the quality of their social life.