CBT is different from other kinds of psychotherapy or “talk therapy”. Whereas some therapies focus on helping the person to discover why they feel anxious or depressed, CBT emphasizes teaching the person how to manage these challenges, ways to approach barriers to treatment, and living the life they want. While some forms of therapy assume that the main reason people get better in treatment is because of the positive relationship between a clinician and patient, the CBT (and KCCAT) approach believes that good, trusting relationships with providers are an important factor—but not enough! Our team strives to develop and bring out the most effective and lasting skills within you!
The basic principle of CBT is that what a person believes influences his or her emotions and behavior. Treatment focuses on the inter-relationships between a person’s thoughts (cognitions), actions (behaviors), and feelings (affect) and the roles they play in a person’s symptoms, functioning, and quality of life. What allows CBT to be relatively brief is its highly instructional, problem-solving approach with distinct, tangible goals. Greater treatment continuity occurs with the use of between-session homework assignments. CBT therapists believe that people change when they learn to think and behave differently. Therefore, CBT focuses on actively teaching sets of skills that patients learn to use on their own.
Exposure consists of gradual exposure to various situations that are feared and avoided due to anxiety. At the same time, patients learn how to resist engaging in avoidance (“safety behaviors”) or compulsions, which is called Response Prevention (sometimes also called “Ritual Prevention”). The scientific rational behind ERP is that continuously confronting feared situations eventually leads to decreases in anxiety (known as habituation). Consider an analogy of watching a scary movie 25 times in a row—your body would actually become bored and stop responding as strongly to the frightening cues.
Patients are never asked to participate in an exposure situation that would be harmful to them, and participate in planning exposures that best match their symptoms. ERP with a properly trained therapist is very effective; depending on the study, a marked reduction in symptoms has been found to occur in 50-90% of individuals. Developed with OCD and phobias, variations have been found useful for all anxiety disorders.
Unfortunately, locating providers properly and consistently using evidence-based treatment is one of the main difficulties patients face across much of the country. National agencies including the National Institutes of Health, the Anxiety and Depression Association of America, and the International OCD Foundation recognize a need for greater use of these treatments and the proper training and supervision of more professionals. A motivated therapist with more limited training or self-directed learning about ERP may in some cases be the only option in a given community. Professionals can work to improve their skills and knowledge through use of readings, “tool-kit” seminars, and professional workshops (e.g., see details of upcoming Behavior Therapy Training Institute programs sponsored by the International OCD Foundation, and offerings at Center for the Treatment & Study of Anxiety at the University of Pennsylvania). However, these activities would be viewed by most experts as limiting what services or patient severity levels that a therapist would ethically and responsibly wish to offer before consulting or referring a patient elsewhere to a more experienced and comprehensive ERP program.
At KCCAT, we take pride in the fact that all of our therapists have received excellent training in CBT, are respected members of professional organizations, and adhere to a treatment model that emphasizes building a treatment plan with clear, specific treatment goals, transparency with patients when building this plan, and the ultimate goal of teaching patients all the tools necessary to be their own therapist.
Our new patient screen can be useful in helping patients decide on their best available treatment options both locally and nationally, dependent on a number of factors (e.g., history and past treatments, nature and severity of symptoms, resource and support options). Some facility-based programs, including KCCAT, can at times also provide appropriate components of treatment or aftercare through established tele-health systems in coordination with more local health providers.
Contact us for more information and further considerations when choosing treatment, and also read How to Find the Right Therapist from the International OCD Foundation.
CBT is considered among the fastest of psychotherapies in terms of results obtained and—with consistent application of skills—considered a buffer against symptom relapse of both psychological and medication treatments. The average number of sessions across all types of health problems is only 12-16. Many treatments for even significant OCD and anxiety problems can be accomplished within 25-30 sessions of appropriately-structured services. Some symptom presentations may respond well in as few as 4-6 sessions!
Some other forms of psychotherapy can take years. Before we conduct a thorough assessment and begin, it is impossible to determine exactly how many sessions or what kind of sessions will be most helpful to your own situation and goals. Following evaluation activities, we will be able to discuss an estimated time frame and structure of care options that we believe to most likely be of benefit for you. Such estimates are subject to change as we gain more information about your situation and assess your response to treatment exercises; you are always an active part in the decision-making process. If at any time we come to believe your needs are not best met at KCCAT, we will be candid about that and refer you to another provider or type of treatment as indicated.
At KCCAT, you can be confident that all of our therapy team members have supervised training backgrounds in specialty CBT, are respected members of professional organizations, and adhere to a model of treatment emphasizing an ultimate goal of your independent skill use for obtaining effective and lasting symptom relief. We are always here if you need us for booster sessions and aftercare, but our goal is you becoming your own therapist!
Completion of the initial assessment is necessary for an individual to become enrolled in active treatment services at our clinic. However, it is not uncommon for individuals with these conditions to exhibit reluctance or refusal for treatment. A consultation with parents/caregivers/spouse or other family members can be scheduled for discussing the situation with a clinical staff member. In some cases it is possible for the support system to begin working in consultation services focused on encouraging treatment access and readiness.
Please note on the screening form if this is an issue of concern so the assigned therapist can discuss this with you during initial planning steps.
Absolutely not! Treatments are completely individualized to level of need. In fact, we encourage families and other providers to consider KCCAT services as an aid to early intervention and even prevention.
Our thorough assessment procedures and consultation services may serve to detect and redirect potentially maladaptive approaches to general coping styles, parenting a child with an anxious temperament, resolving school or behavioral difficulties that stem from anxiety reactions, and other proactive strategies that may help to significantly reduce the probability of developing more impairing symptoms—before the time commitment and costs of full treatment are needed. Our new patient screen and consultation appointment options could be a great way to decide if a tailored, early intervention approach might be a good fit for your situation. We are always happy to provide educational and reading suggestions, too!
Yes! As the only dedicated anxiety center in our region offering multiple service levels, KCCAT regularly works with individuals traveling from outside the Kansas City area to obtain expert assessment and care recommendations. Patients who lack available CBT resources in their area may consider options for our Intensive/Accelerated Treatment Programs, and/or be directed towards appropriate alternatives when available.
We are also able to supplement our treatment protocols with phone or televideo sessions when appropriate. KCCAT has invested in a secure telemedicine system for the center, reducing travel needs and assisting with generalization to the home environment even when home visits are impractical due to distance. As appropriate to your location and clinical situation, televideo services may be available for portions of treatment or follow-up care in coordination with more local providers. We regularly work very closely with other therapists, physicians, and schools to ensure that your care is comprehensive.
The word “intensive” only means that treatment is delivered on a more frequent schedule (also called “accelerated” treatment). An intensive consists of daily or several times a week therapy (which, depending on symptoms, usually ranges from one to four weeks). Patients do not spend the entire day in session; rather, each session lasts several hours and patients spend additional time between sessions working on goals. If a patient is from outside the greater Kansas City area, they may stay at a local hotel (we have arrangements with several nearby) or with a local friend/family member.
As ERP is a learning-based therapy, there is some evidence that this format may be equally or more effective than spaced treatment for some patients, so even those who have not responded to past therapy may be successful with an intensive. Working more closely with your therapist allows you to receive immediate feedback and support. As we recommend mastery of increasingly difficult exposures for all patients, regardless of session frequency, intensive therapy should be thought of as more focused and possibly more effective, but not necessarily more difficult to do than weekly treatment. The good news is that many people finish these intensive treatments noticing dramatic improvements in symptoms and armed with new skills for continued improvement!
Even for those patients less severely impaired, some may find it more convenient to come for treatment for a briefer period of time, rather than stretch out their treatment. Besides those who come in from out of town, this may also be a good option for “jump starting” treatment for patients who have difficulty adjusting work or school schedules.
KCCAT works as an out-of-network facility for all insurance plans and does not file claims or accept payment from insurance. This means you will pay for services directly and be provided statements suitable for submitting to your insurance for reimbursement of any benefit amounts applicable to your specific policy. While many patients are successful in seeking reimbursement for at least a portion of their therapy fees, policies vary widely and you should check with your insurance directly regarding questions about coverage of out of network services.
KCCAT is also not a covered provider for either Medicare or Medicaid. If you choose to work with our staff, you will pay for each treatment session on a fee-for-service basis; you are not eligible to independently submit claims to Medicare or Medicaid for our services.
Our center does have a number of available options for addressing cost-control concerns, including trainee level therapists or group services (when available), and a unique no-fee and no-interest payment plan option. Our staff are happy to discuss your needs and try and connect you with options for accessing treatment, whatever your needs may be.
Managed care plans tend to place generic restrictions on coverage of behavioral health services, regardless of clinical severity or individual recommendations. For example, scientific evidence suggests some anxiety treatments—particularly for moderate to severe/extreme symptoms—may be more beneficial when sessions are longer in length (e.g., 90-120 minutes) and massed (e.g., daily or several times a week) rather than when they are shorter or spaced less frequently (e.g., weekly). Although a more efficient timeline of result-oriented CBT/ERP may result in briefer treatment windows and lower out of pocket costs in the long run, insurance may vary in payments for such sessions, as well as some portions of team based services such as those offered with supervised trainees at discounted rates. It is our philosophy that our commitment and time is best spent offering individualized services of the highest quality and confidentiality, while minimizing unnecessary bureaucratic details or delays in treatment.
Treatment is an investment of both time and finances that can be daunting for many. We aim to provide cost-effective care plans able to provide a lasting positive impact, with the goal of decreasing the burden and costs of future or ongoing needs. While in the short term KCCAT may seem more expensive than in-network psychotherapy or medication options alone, our focused specialty care can often result in lower out-of-pocket costs in the long term and may help reduce needs of ongoing or future treatments. Families must weigh the costs of treatment along with the current and potential costs and burdens of living with an untreated (or under-treated) disorder—which may also be quite significant over time. We are committed to providing you with high-quality treatment that is mindful of managing healthcare costs, including helping you explore available options or alternatives if they may be appropriate to your presentation. The true cost effectiveness of treatment is often best viewed both in terms of more immediate improvements in symptom interference as well as longer-term gains in future functioning.
For specific information on our current fees for treatment services, please see our Policies & Fees page.