Counseling Approaches We Use
What CBT, ACT, exposure-based work and behavioral activation involve, and when a referral makes more sense.
Cognitive Behavioral Therapy (CBT)
The National Institute of Mental Health (NIMH) explains that CBT helps people notice automatic thoughts that are inaccurate or harmful, question them, see how they shape feelings and actions and change patterns that work against them.
CBT is used across many of the conditions we see, including anxiety, depression and health worry. NIMH describes CBT as the best-studied talk approach for generalized anxiety disorder.
Exposure-Based CBT
NIMH describes exposure therapy as a form of CBT for anxiety in which a person spends short periods, with support, learning to tolerate the distress tied to certain objects, thoughts or imagined situations, so that the fear eases over time.
Our counselors use CBT with exposure elements for fears, panic, health worry and avoidance. For obsessive-compulsive disorder, a psychiatric nurse practitioner or therapist can use CBT with exposure elements or exposure-based therapy, or refer out to an ERP specialist when that fits better.
Acceptance and Commitment Therapy (ACT)
NIMH explains that ACT encourages accepting thoughts without judging them and putting energy into activities that matter to you, using tools such as mindfulness and goal setting. NIMH notes growing research support for ACT in generalized anxiety disorder.
Behavioral Activation
NIMH describes behavioral activation, used within CBT for seasonal affective disorder, as helping people find and schedule pleasant, engaging activities to offset a loss of interest. Our counselors use it for low mood and depression.
Techniques From CBT for Insomnia
The National Heart, Lung, and Blood Institute (NHLBI) describes cognitive behavioral therapy for insomnia (CBT-I) as a plan of about 6 to 8 weeks that helps people fall asleep sooner and stay asleep longer. Our clinicians use techniques from CBT-I alongside care for anxiety or depression when sleep is part of the problem.
Trauma-Informed Care and DBT-Informed Skills
Our counselors work in a trauma-informed way, which means keeping in mind how past trauma can affect how a session feels and letting you set the pace. They also draw on DBT-informed skills when those fit your goals.
When We Refer Out
We are open about what we do not offer. Structured programs for exposure and response prevention (ERP), dialectical behavior therapy (DBT) and the trauma-focused approaches EMDR, CPT and PE are referred out. The VA National Center for PTSD describes those trauma-focused approaches in plain terms: PE helps a person slowly return to places and situations they have been avoiding, CPT helps a person rethink painful beliefs about the trauma, and EMDR has a person work through the memory while paying attention to a side-to-side movement or sound. When one of these fits better, your provider can coordinate a referral and keep the rest of your care connected.
Choosing an Approach With You
NIMH suggests asking a therapist about their approach, its evidence base, the goals of treatment, how many sessions to expect and how progress is measured, and it notes that rapport and trust matter. Those are fair questions to ask us too. If you are looking for a particular approach, ask us when you call and we will tell you what we can offer.
Counseling can stand alone or work alongside medication management with one of our psychiatric nurse practitioners, when that is indicated and decided jointly with you.
In Person or by Video
Individual counseling is available at our West Ashley office and by secure video for adults anywhere in South Carolina. NIMH notes that some talk therapy can be delivered at a distance.
Getting Care in the Charleston Area
Charleston County has about one mental health provider for every 214 residents, compared with one for every 437 across South Carolina. Our office is on Gardner Road in West Ashley, and we also see adults anywhere in South Carolina by secure video, so you do not have to wait for a local opening or take time off to drive.
We accept Medicare, most major commercial plans, and all South Carolina Medicaid managed care plans except Select Health (First Choice). New patients are often able to be scheduled within a week of requesting an appointment.
Sources
The facts on this page come from: National Institute of Mental Health, Psychotherapies (reviewed February 2024); National Institute of Mental Health, Generalized Anxiety Disorder: What You Need to Know (revised 2025); National Institute of Mental Health, Seasonal Affective Disorder (revised 2023); National Heart, Lung, and Blood Institute, Insomnia: Treatment (2022); VA National Center for PTSD, Understanding PTSD Treatment (updated March 2025); CMS National Provider Identification file, 2024, via County Health Rankings & Roadmaps, 2025.
Treatment Options
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Frequently Asked Questions
Our licensed counselors use CBT, exposure-based CBT, ACT, behavioral activation, techniques from CBT-I, trauma-informed care and DBT-informed skills in individual sessions.
No. Structured ERP, DBT and EMDR programs, along with CPT and PE, are referred out. Your provider can coordinate the referral and keep the rest of your care connected.
It depends on what you are dealing with and what you want from counseling. Your counselor will talk it through with you, and you can ask about the evidence for any approach.
Yes. Individual counseling is available by secure video anywhere in South Carolina and in person in West Ashley.
Yes. Counseling can work alongside medication management when medication is indicated and decided jointly with you.