Anxiety Treatment in Boston | Aviva Psychology

Anxiety Treatment in Boston: Compassionate, Evidence-Based Care

Allison Karthaus, PhD • March 13, 2026

Anxiety can show up in a myriad of ways. Anxiety is a natural human response to uncertainty and stress, but for many it goes beyond just butterflies in your stomach from time to time. Persistent worry, the kind that doesn’t respond to logical counter arguments, panic attacks that come out of nowhere, or a sense of dread in certain situations are signs of anxiety symptoms that are beyond typical worry that we all experience. For many people, anxiety builds gradually, and it can be hard to know when everyday experiences of normal stress have crossed into something that deserves clinical attention.

Whatever brought you here, one thing is clear: you're looking for answers. Seeking help for an anxiety disorder is one of the most meaningful steps you can take for your mental health and your life.

At Aviva Psychology Services, we provide outpatient anxiety treatment in Boston, Northampton, and online built on evidence-based approaches that actually work. Our team of experienced clinicians offer personalized therapy services for adults experiencing anxiety disorders, from generalized anxiety disorder and panic attacks to social anxiety, OCD, and anxiety tied to major life changes. Learn more about our approach to care and what sets Aviva apart.

Here's what this guide covers:

What anxiety disorders are and why they develop
The types of anxiety we treat at Aviva Psychology Services, including GAD, panic disorder, social anxiety, OCD, and phobias
Our evidence-based approach to anxiety treatment
What therapy services look like at Aviva
How to take the first step toward care

What Is an Anxiety Disorder and How Is It Different from Everyday Stress?

Anxiety is a natural response to uncertainty and stress. When you're facing something challenging, a difficult conversation, a major deadline, or an unexpected change, it's normal to feel some anxiety. Your brain is doing its job: preparing you to respond.

But an anxiety disorder is different. It's when that same alarm system stays activated even when there's no clear threat or responds far out of proportion to the actual situation. The worry becomes difficult to control. Fear starts to interfere with daily life. Avoidance becomes a coping strategy, and over time, the things you avoid tend to multiply.

According to the Anxiety and Depression Association of America , anxiety disorders affect about 19% of adults in the United States each year, making them one of the most common mental health conditions in the country. They are also among the most treatable. With evidence-based treatment, most individuals with anxiety experience significant improvement.

If anxiety has been affecting your daily functioning, your relationships, your work, or your sense of well-being, that's not a personal failing. It's a clinical reality, and it responds well to the right care.

What Causes Anxiety? Understanding Why It Develops

There's no single cause of anxiety disorders, and understanding what causes anxiety in your specific situation is part of what therapy helps you explore. That said, research points to a combination of factors that commonly contribute.

Biological factors play a role, including brain chemistry, genetics, and how your nervous system is wired to respond to threat. People who have a family history of anxiety or mood disorders are more likely to develop one themselves, though this is never a guarantee.

Life experiences shape anxiety significantly. Stressful or traumatic events, chronic stress, significant life changes, or patterns learned early in life can all contribute to how anxiety develops and what keeps it going over time.

Thought and behavior patterns also play a key role in maintaining anxiety. Differentiating anxiety versus an anxiety disorder is often based on the persistence of distress when the stressor is not present. Cognitive patterns, like catastrophic thinking, overestimating danger, and underestimating our ability to cope contribute to the maintenance of anxiety over time.

Equally important is behavioral avoidance. Behavioral avoidance occurs when we steer away from situations that trigger our anxiety. For example, if you had a panic attack at a grocery store, you might not want to go to that grocery store again. Avoiding that store and not having a panic attack reinforces the cognitive distortion that if you go to the store again you will have another panic attack. Behavioral avoidance reinforces the anxiety cycle over time and creates a loop where cognitive distortions create behavioral avoidance and then behavioral avoidance reinforces cognitive distortions.

Understanding your own anxiety, where it comes from, what maintains it, and what makes it better or worse is one of the most useful things that comes out of working with a skilled psychologist. You don't have to figure it out alone.

Anxiety and Related Conditions We Treat at Aviva Psychology Services

Our anxiety care at Aviva Psychology Services is designed to help adults with a wide range of anxiety-related concerns. Whether your experience fits neatly into a diagnostic category or feels more complex and layered, we have psychologists with specialized training to support you.

The types of anxiety and related disorders we treat include:

Generalized Anxiety Disorder (GAD): Persistent, hard-to-control worry across multiple areas of life, work, relationships, health, and finances that interfere with daily functioning and leaves you feeling chronically on edge.

Panic Disorder: Recurrent, unexpected panic attacks paired with ongoing worry about future episodes or significant changes in behavior to avoid them.
Social Anxiety Disorder: Intense fear of being judged, embarrassed, or rejected in social situations. Social anxiety disorder affects an estimated 15 million adults in the US (Anxiety and Depression Association of America), making it the second most common anxiety disorder (after specific phobias).
OCD and Related Disorders: Intrusive, unwanted thoughts (obsessions) paired with compulsive behaviors or mental acts intended to reduce distress. While OCD is a separate classification of disorders in the DSM-5, it shares many features with other anxiety disorders and there is often a cross in treatment approaches that work well for OCD and other anxiety related disorders. At Aviva Psychology Services, we use Exposure and Response Prevention, as well as other evidence based treatment approaches to treat OCD.Learn more about OCD treatment at Aviva Psychology Services.

Specific Phobias: A strong, disproportionate fear of a specific object or situation, such as heights, flying, medical procedures, or certain animals, that causes significant distress or avoidance.

Health Anxiety: Excessive worry about having or developing a serious illness, often accompanied by repeated checking, reassurance-seeking, or avoidance.

Anxiety and Depression: Anxiety and related mood disorders frequently co-occur. Many individuals struggling with anxiety also experience symptoms of depression. Our depression therapy in Boston is provided by the same team using the same integrated, evidence-based approach.
Anxiety tied to life changes: Major transitions, relationship shifts, career changes, infertility, or perinatal experiences, can trigger or intensify anxiety. Our perinatal therapy specialty clinic offers specialized support for anxiety during pregnancy and the postpartum period.

Our Approach to Anxiety Treatment at Aviva Psychology

Our approach to treatment is evidence-based, collaborative, and built around you as an individual. We don't use a one-size-fits-all model, because anxiety doesn't work that way, and neither do people.

When you come to Aviva Psychology Services, your psychologist begins by getting to know you: your history, your symptoms, and what matters most to you about your life and your recovery. From there, you and your psychologist work together to create a personalized treatment plan that reflects your specific anxiety disorder, your goals, and the approaches most likely to help.

Our treatment focuses on giving you real, practical tools, not just insight. We want you to leave each session with something you can actually use, and we track your progress over time to make sure the therapy is working. If something isn't helping, we adjust.

We also recognize that seeking help takes courage. We are unequivocally BIPOC and LGBTQIA2S+ affirming. Out psychologists are committed to providing identity-centered, culturally responsive care. Anxiety does not occur in a vacuum; cultural and systemic factors play a role as well.

Evidence-Based Treatment Options: How We Treat Anxiety

At Aviva Psychology Services, our psychologists use evidence-based treatment methods with strong research support. The approaches outlined below reduce anxiety symptoms and improve daily functioning over time.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is the most extensively researched treatment for anxiety disorders and is recognized by the American Psychological Association as an empirically supported, evidence-based treatment. CBT addresses both cognitive and behavioral aspects of anxiety. On the cognitive side, clients learn to identify and evaluate automatic thoughts and threat assessments that tend to overestimate danger and underestimate coping capacity. The focus here is building cognitive skills that are more flexible and reality-based. On the behavioral side, CBT uses gradual exposure to reduce avoidance patterns and safety behaviors that reinforce negative automatic thoughts. CBT is skills-based and goal-oriented, which means you leave sessions with concrete tools you can use between appointments.

Exposure Therapy

Exposure therapy is a core component of CBT and one of the most effective tools for treating anxiety. It involves gradually and systematically approaching feared situations, sensations, or thoughts, rather than avoiding them, in a safe, controlled therapeutic environment. During exposure exercises, the focus is building new learning and letting the brain develop updated expectations about what will happen in the face of a feared event or object. Avoidance is one of the primary factors in the maintenance of anxiety disorders and exposure therapy interrupts that cycle. Your psychologist designs exposure exercises in collaboration with you, always working within your tolerance and at a pace that makes sense for you.

Acceptance and Commitment Therapy (ACT)

Acceptance and Commitment Therapy (ACT) is part of the third-wave of CBT, with a focus on approaching valued actions rather than working directly with negative thoughts. ACT teaches you to relate to you thoughts differently. To notice them without being controlled by them. You also learn to clarify your values and take meaningful action even when anxiety is present. Many people find ACT especially helpful when anxiety is tied to perfectionism, chronic avoidance, or difficulty identifying what matters most.

ERP for OCD

For OCD and related disorders, Exposure and Response Prevention (ERP) is the gold-standard treatment approach. ERP is a specialized form of exposure therapy that helps individuals reduce compulsive behaviors while tolerating the distress of intrusive thoughts, ultimately breaking the OCD cycle. For some, a combination of medication and ERP is the most effective approach. Our psychologists who treat OCD have specific training in this approach and coordinate with prescribers, if needed

What Our Outpatient Therapy Services Look Like

Aviva Psychology provides outpatient individual therapy for anxiety in Boston from a collaborative, culturally informed and evidence-based perspective. Individual therapy allows you to work one-on-one with your clinician at a pace and depth that fits your needs.

Sessions are typically 53-55minutes and scheduled weekly, especially at the start of treatment. As you make progress and develop more confidence managing anxiety independently, the frequency may shift. Most people begin to notice meaningful changes within the first few months of consistent therapy.

We offer both in-person therapy in Boston and Northampton and telehealth therapy services for clients across Massachusetts. Online therapy is a flexible, accessible option that research shows is comparably effective to in-person care for anxiety disorders, and many people find it easier to access consistently.

When relevant, we also offer relationship and family counseling as part of a broader treatment plan. Anxiety doesn't exist in isolation, it affects relationships, and sometimes involving family members in the therapeutic process is part of what helps most.

How Anxiety Affects Daily Life And What Anxiety Care Can Change

One of the most important things to understand about anxiety disorders is how broadly they affect daily life. Anxiety rarely stays contained to one area, it tends to spread into relationships, work, sleep, physical health, and self-perception.

At work, anxiety can show up as perfectionism, procrastination, difficulty concentrating, or a persistent fear of making mistakes. It can make it hard to take on new challenges, speak up, or feel settled, even when you're objectively performing well.

In relationships, anxiety can create distance. You might withdraw to avoid situations that feel overwhelming, seek constant reassurance, or find it hard to be present because your mind is elsewhere. Anxiety can also intensify conflict or make honest communication feel risky.

Sleep is another area that anxiety affects deeply. Racing thoughts at bedtime, difficulty falling asleep, and waking in the middle of the night with worry are all extremely common among individuals with anxiety disorders, and chronic sleep disruption makes anxiety worse over time.

When anxiety treatment works, these ripple effects improve too. People manage their symptoms more effectively. Daily functioning improves. Relationships feel more connected. There's more room for the things that actually matter to you.

Mental Health Services for Anxiety and Related Conditions at Aviva

Aviva Psychology Services offers more than anxiety therapy. We provide mental health care for the full range of conditions that often co-occur with or complicate anxiety, and our team works collaboratively to make sure each person's treatment reflects their whole picture, not just one diagnosis.

The American Psychological Association recognizes anxiety disorders as highly treatable conditions. When anxiety co-occurs with depression, the feedback loop between avoidance behaviors and negative thoughts can be more entrenched. For individuals experiencing anxiety and depression together, our clinicians are experienced in treating both conditions in an integrated way.

We also offer specialized treatment for anxiety during the family planning, perinatal and postpartum period, through our infertility or perinatal specialty clinics. Our perinatal therapy team brings specific expertise to the particular emotional and relational demands of this life stage.

Our behavioral health specialty clinics also include support for individuals navigating disability & chronic illness or chronic pain, where anxiety is often a significant part of the experience. Living with medical uncertainty is genuinely hard, and our mental health care is designed to meet that reality with both clinical skill and human understanding.

Why Choose Aviva Psychology for Anxiety Treatment in Boston?

There are many places to seek anxiety care in the Boston area. Here's what makes Aviva Psychology different:

Specialized expertise: Our psychologists have deep training in anxiety disorders and the specific treatment methods that work best for them. This isn't generalist mental health treatment, it's specialized anxiety therapy delivered by doctoral-level psychologists who have dedicated their careers to this field.

Evidence-based: We use treatment methods with genuine research support. When we say evidence-based, we mean approaches that have been rigorously studied and consistently shown to help individuals with anxiety.

Personalized from day one: No two people's anxiety looks exactly the same. We create a personalized treatment plan for every client, one that reflects your specific anxiety disorder, your history, your goals, and your life.

A team that communicates: Aviva's psychologists work together, which means you benefit from health care professionals who can consult with one another, refer within the practice, and ensure your care is coordinated.

Compassionate from the start: We know that reaching out for help isn't easy. Our team is committed to making that first step, and every step after it, feel safe, respectful, and genuinely supportive.

What to Expect When You Start Anxiety Treatment at Aviva

Starting therapy can feel like a big unknown, especially if you've never done it before or have had experiences with mental health treatment that didn't quite fit. Here's an honest look at what beginning anxiety treatment at Aviva Psychology looks like.

Your first session is a comprehensive clinical intake, a structured conversation where your psychologist gathers informaiton about your symptoms, history, and what you hope to change. This assessment helps your psychologist develop an accurate diagnostic picture and treatment plan. You don't need to have everything figured out, this assessment is the first step to help with that. From there, you'll collaborate on goals for treatment. Your psychologist will explain their recommended approach and why, answer your questions, and help you understand what the process will look like. You're not a passive recipient of care here, you're an active participant in it.

Most people begin to feel meaningful improvement within the first few months of consistent treatment. Some experience shifts earlier; others take longer, particularly if anxiety has been present for a long time or is more complex. Your psychologist will be honest with you about what to expect and will track progress with you along the way.

Seeking help is not a sign that your anxiety is beyond managing. It's a sign that you're ready to take your mental wellness seriously, and that's exactly the right place to start.

Compassionate Anxiety Treatment: You Don't Have to Keep Managing This Alone

Anxiety is often a solitary experience. You can be surrounded by people who care about you and still feel like no one quite understands what it's like to be inside your own head. That isolation can make anxiety worse, and it's one of the reasons that working with a skilled clinician makes such a difference.

Therapy for anxiety isn't about being told to relax, or learning that your worries are irrational, or pushing yourself into uncomfortable situations without support. It's about having someone in your corner who genuinely understands how anxiety works, and who can help you build a different relationship with it.

If you've been struggling with an anxiety disorder and wondering whether treatment could actually make a difference, we believe it can. Explore our full range of anxiety therapy services in Boston, and reach out when you're ready.

Frequently Asked Questions About Anxiety Treatment

What types of anxiety disorders does Aviva Psychology treat?

We treat generalized anxiety disorder, panic disorder, social anxiety disorder, OCD and related disorders, specific phobias, health anxiety, and anxiety tied to life transitions, including perinatal experiences, chronic illness, relationship changes, and grief. We also frequently treat anxiety and depression together when both are present.

How do I know if my anxiety is serious enough to seek help?

If anxiety is interfering with your daily life, your work, relationships, sleep, or ability to do the things you care about, that's reason enough to reach out. You don't need to be in crisis, and you don't need a formal diagnosis before your first session. Many people wish they had sought help sooner.

What is the most effective treatment for anxiety disorders?

CBT is the most extensively researched and widely supported treatment for anxiety disorders, recognized by the American Psychological Association as an evidence-based treatment. ACT, exposure therapy, and ERP for OCD are also strongly evidence-based. Most people benefit from a combination of these approaches, tailored to their specific situation.

Does Aviva Psychology offer online therapy for anxiety?

Yes. We offer telehealth therapy services for clients across Massachusetts. Online therapy is flexible and accessible, and research shows it is comparably effective to in-person treatment for anxiety disorders. We'll help you decide which format makes the most sense for your situation.

How long does anxiety treatment typically take?

This varies depending on the type of anxiety disorder, its severity, and your personal goals. Many people begin to notice meaningful improvement within 8–16 sessions. Some benefit from shorter-term, focused treatment; others prefer longer-term support. Your psychologist will give you an honest picture of what to expect based on your specific situation.

Does Aviva accept insurance for anxiety treatment?

We work with several insurance plans. We are in-network providers with BCBS and Aetna. We also work with several out of network providers, filing claims for clients. We encourage you to reach out directly to confirm your coverage before your first appointment. If you have questions about costs, our team will help you understand your options clearly and honestly.

Ready to Take the First Step Toward Anxiety Treatment in Boston?

Anxiety is one of the most common mental health challenges people face, and one of the most treatable. The right anxiety care can change how you feel at work, how you show up in your relationships, how well you sleep, and how much space you have for the things that actually matter to you.

At Aviva Psychology Services, we provide outpatient anxiety treatment in Boston that is evidence-based, compassionate, and personalized. Whether you're dealing with a long-standing anxiety disorder or something that has emerged more recently, our team of psychologist is equipped to help you understand what's happening and build real, lasting change.

We're here to help. Contact Aviva Psychology Services today to schedule a consultation and take the first step toward the care you deserve.

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What is Cognitive Behavioral Therapy? A Boston Guide to CBT

By M.C. Barrett • February 25, 2026

Cognitive Behavioral Therapy (CBT) is one of the most widely used and researched treatments for a variety of mental health concerns. This evidence-based treatment focuses on the relationship between and impact of thoughts, feelings, and behaviors. CBT is one of the most effective forms of therapy, with evidence supporting it’s effectiveness with treating anxiety, depression, OCD, and trauma-related conditions. For people in Boston seeking mental health support, understanding cognitive behavioral therapy Boston providers offer can help you make informed choices. This article explains what CBT is, how it works, and how we integrate CBT Aviva Psychology Services. The history of Cognitive Behavioral Therapy, from theory to structured treatment. Cognitive Behavioral Therapy is based on one key idea: thoughts, feelings, and behaviors are connected. When one changes, the others change too. For example, challenging cognitive distortions, which are negative thoughts about a person, event, etc. can help reduce emotional distress. When we challenge these distortions, it often makes it easier to move towards the thing that made us anxious and potentially change how we think and feel about it over time. This connection is the foundation of CBT and interventions can start at any point on the triangle. CBT was originally developed by psychiatrist Aaron Beck in the 1960s and influenced by the work of psychologist Albert Ellis (who founded Rational Emotive Behavioral Therapy). Dr. Beck focused primarily on the cognitive distortions and created a structured treatment for depression. He believed that our interpretations of events shape our emotions, not the events themselves. Since the 1960’s, behavioral therapy has integrated with cognitive therapy, and Dr. Judith Beck, Aaron Beck’s daughter, founded the Beck Institute for Cognitive Behavioral Therapy , which continues to be one of the premier research hubs for this approach to mental health treatment. Modern CBT is used in a variety of treatment settings and can help with conditions across the psychological spectrum. It’s a present focused treatment, that involves identifying specific problems and setting clear goals. CBT treatment is full of practical skills that your psychologist teaches you and you begin to use between sessions relatively early in treatment. This structure works well for people who want clear treatment plans. At Aviva, we aim to always meet our clients where they are. We utilize both structured and flexible CBT techniques based on the specific needs and treatment plan of each client. Common Myths About Cognitive Behavioral Therapy Several myths about CBT persist despite strong research support. These beliefs create barriers to getting help. They cause harm by discouraging people from seeking effective treatment. Myth 1: CBT is just positive thinking This belief minimizes how evidence-based CBT actually is. CBT does not replace negative thoughts with fake positive ones. Research shows CBT teaches realistic thinking based on evidence. You examine thoughts for accuracy, not force optimism. For example, if you think "I will definitely fail this presentation," CBT does not replace it with "I will definitely succeed." Instead, you evaluate the evidence for and against this prediction. You consider other possible outcomes. You develop coping strategies for any result. This realistic approach is different from positive thinking. Myth 2: CBT ignores emotions This misconception suggests CBT is cold or dismissive. However, CBT directly addresses how thoughts and emotions relate. Understanding thought patterns helps you manage emotional responses better. CBT recognizes that emotions give important information about your needs. The approach does not suppress feelings. Instead, it helps you understand what triggers specific emotions. You develop skills for managing intense emotions when they arise. Some CBT methods focus specifically on emotional processing. Myth 3: CBT is a quick fix This belief creates unrealistic expectations about therapy timelines. Research shows CBT typically takes 12–20 sessions for most concerns. You need ongoing practice between sessions for lasting change. CBT is often shorter than some other therapy types, but it is not instant. Progress requires active work, including practicing skills outside therapy. Some concerns need more time, especially complex or long-standing difficulties. The structured nature of CBT reflects clear treatment targets, not rapid results without effort. How Cognitive Behavioral Therapy Works CBT follows a systematic process where you identify, examine, and modify unhelpful thought and behavior patterns. The approach has several connected steps that build throughout treatment. Identifying Thought Patterns CBT starts by identifying automatic thoughts . These are immediate mental responses in specific situations; our immediate raw thoughts about a situation (oh that was awful or I always screw that up). These thoughts often follow predictable patterns called cognitive distortions, systematic errors in thinking that skew our perception of reality. The Beck Institute provides a comprehensive worksheet listing common cognitive distortions and examples of how they appear in daily life. For example, all-or-nothing thinking means viewing situations in extremes. You see things as completely good or completely bad completely good or completely bad. Another negative automatic thought or cognitive distortion is catastrophizing, or expecting the worst outcome even when evidence suggests otherwise. Research shows recognizing these patterns is the first step to changing them. Other common distortions include overgeneralization (when one negative experience becomes a pattern you expect to repeat forever), mental filtering ( focusing only on negative details while ignoring positive information), mind reading ( assuming you know what others think without evidence), and fortune telling (making negative predictions about the future as if they are facts). These distortions happen automatically. However, we can begin to recognise and label these automatic negative thoughts as cognitive distortions. Examining and Testing Thoughts. Once you identify negative automatic thoughts, you begin labeling and evaluating them. Together with your psychologist, you start to examine evidence supporting and contradicting specific thoughts; you consider alternative explanations and conduct behavioral experiments to test predictions. For example, someone who believes "I cannot handle social situations" might attend a small gathering. They observe what actually happens. Research shows behavioral experiments are especially effective because they provide direct evidence that challenges old assumptions. During treatment you also evaluate the consequences of maintaining specific thought patterns. Often negative automatic thoughts aren’t totally out of the blue. There can be a little sliver of evidence that these cognitive distortions hold on to. While, a thought may be technically accurate in some narrow way. But it might still be unhelpful if it prevents action or creates unnecessary distress. CBT helps you distinguish between useful thoughts and problematic ones. Cognitive restructuring techniques help you develop more balanced interpretations and move towards behaviors and situations that align with your values and goals. Building Skills Beyond examining thoughts, CBT emphasizes skill development. Problem-solving strategies help you break down overwhelming situations into manageable steps. Coping techniques, such as breathing exercises and grounding techniques, provide tools for managing distress in the moment. Behavioral activation involves increasing engagement in valued activities. This is especially important for treating depression. Research shows behavioral activation alone can be as effective as full CBT protocols for some people with depression. One of the most essential skills in CBT is relapse prevention. Planning for a transition from treatment is an explicit part of skill development and is crucial as treatment nears completion. This involves identifying early warning signs that difficulties may return and developing strategies for managing setbacks. The goal is not to prevent all future difficulties. Instead, you gain skills for managing challenges independently and how to know when to reach out for additional support. Conditions and Concerns Addressed by Cognitive Behavioral Therapy Research shows CBT is effective for a wide spectrum of mental health disorders. It has been shown to effectively treat anxiety, depression, obsessive compulsive disorders, PTSD, insomnia, and the impacts of chronic pain. CBT is effective in treating anxiety, including generalized anxiety disorder, panic disorder, social anxiety, and phobias. Studies suggest 60–80% of people with anxiety disorders improve significantly with CBT . The approach helps you identify anxiety-triggering thoughts and gradually face feared situations through exposure techniques. This is done through developing coping strategies for managing anxiety symptoms, restructuring negative automatic thoughts, and setting up "experiments" to move towards the anxious triggers. CBT also works for depression. A comprehensive 2 023 meta-analysis of over 400 trials found CBT is as effective as antidepressant medication in the short term, with evidence suggesting even greater effectiveness over time. CBT for depression focuses on identifying and modifying negative thought patterns while increasing engagement in activities that provide pleasure or accomplishment. For severe depression, combining CBT with medication may work best. For Obsessive-Compulsive Disorder (OCD), a specific form of CBT called Exposure and Response Prevention (ERP) is the gold-standard treatment. Research shows ERP is highly effective for reducing OCD symptoms. At Aviva Psychology, our therapists are trained in ERP. We provide this specialized form of CBT for p eop le experiencing OCD . CBT is also used for Post-Traumatic Stress Disorder (PTSD), often with exposure-based techniques. For insomnia, Cognitive Behavioral Therapy for Insomnia (CBT-I) is the first-line treatment. Research suggests it is more effective than sleep medication for long-term outcomes. Aviva Psychology offers a specialized Insomnia Clinic where we provide CBT-I. Other concerns that may benefit from CBT include chronic pain, relationship difficulties, and adjustment to chronic illness. At Aviva Psychology Services, our Chronic Pain Clinic integrates CBT with clinical health psychology approaches. Our Perinatal Mental Health services incorporate CBT for postpartum depression and anxiety. Cognitive Behavioral Therapy and Related Approaches CBT differs from psychodynamic therapy in several ways. Psychodynamic approaches often focus on childhood experiences. CBT aims to briegly understand the childhood events that contribute to present thoughts, but focuses mainly on present concerns and thought patterns. CBT is typically time-limited with specific goals, where psychodynamic therapy is often more open-ended. However, neither approach is inherently superior. The best treatment depends on your preferences, concerns, and goals. Several therapy approaches build on CBT principles. Dialectical Behavior Therapy (DBT) extends CBT with skills for emotion regulation and distress tolerance. At Aviva Psychology Services, some therapists integrate DBT skills training with CBT when clients benefit from this combination. Acceptance and Commitment Therapy (ACT) is one of the foundations of the third wave of CBT therapy. ACT incorporates mindfulness and acceptance skills with cognitive and behavioral strategies. Rather than focusing on challenging thoughts directly, ACT emphasizes acceptance of difficult internal experiences and learning to cope and move through these difficult experiences. ACT focuses mainly on behaviors that are aligned with your personal values. Often, thoughts and feelings hold us back from pursuing valued actions. ACT focuses mainly on the valued actions and reducing avoidance of internal experiences that contribute to difficulties and distress. At Aviva Psychology, therapists may blend CBT with complementary approaches based on your needs and preferences. Treatment is tailored to your circumstances rather than following a rigid protocol. This flexibility allows integration of multiple evidence-based techniques while maintaining the structured nature of CBT. Learn more about our approach to therapy . What to Expect in Cognitive Behavioral Therapy at Aviva Initial Consultation CBT at Aviva Psychology Services begins with an initial consultation. We assess your concerns, goals, and history. Together, you and your psychologist develop a treatment plan and learn about the CBT framework. This treatment planning process helps determine whether CBT is appropriate for your concerns. It also helps you and your psychologist assess therapeutic fit. The American Psychological Association reports that the therapeutic relationship is one of the most important factors in treatment outcomes, regardless of therapy type. Typical Session Structure CBT sessions at Aviva Psychology last 53-55 minutes. Sessions typically start with a check-in about your experiences since the last session. You review any between-session practice or assignments. The middle portion focuses on skill-building or application work related to your goals. Sessions end with summarizing key points and assigning practice for the coming week. This structure provides consistency while remaining flexible for emerging concerns. Timeline and Frequency Research shows CBT typically involves 12–20 sessions for most concerns. The exact duration varies based on your needs and the complexity of difficulties. Sessions are usually scheduled weekly during initial phases. As skills develop and symptoms improve, sessions may be spaced to every other week. Regular progress evaluation ensures treatment stays aligned with your goals. Adjustments are made when needed in consultation with your psychologist. Between Sessions Practice between sessions is crucial in CBT. This may include monitoring thoughts in specific situations. You practice skills introduced in therapy. You conduct behavioral experiments. These assignments are opportunities to apply new learning in real-world contexts. Research shows people who engage in between-session practice improve more than those who only work on skills during therapy sessions. Aviva-Specific Features At Aviva Psychology Services, CBT can be conducted via telehealth or in person. Our group practice model allows us to match you with therapists whose specializations align with your needs. Aviva Psychology Services is unequivocally BIPOC and LGBTQIA2S+ affirming. Our therapists provide identity-centered, culturally responsive care. We understand that mental health concerns do not occur in isolation. Identity, culture, and systemic factors influence psychological well-being. Learn more about our approach to anxiety therapy . Is Cognitive Behavioral Therapy Right for You? CBT may help if you are seeking evidence-based treatment and prefer structured, goal-oriented approaches. It works well when you are willing to engage in active practice between sessions. The approach works best when you are ready to examine thought patterns and try new behaviors, even when uncomfortable. However, CBT is not the only effective therapy. It may not be the best fit for everyone. Some people prefer more exploratory or less structured therapy. Others may benefit from approaches that emphasize emotional processing or past experiences. These preferences are valid. There is no single correct path to mental health support. CBT can be combined with other approaches as needed. Some people benefit from starting with supportive, relationship-focused therapy before transitioning to structured CBT. Others may integrate CBT with medication management. At Aviva Psychology Services, we take a collaborative approach to treatment planning. An initial consultation clarifies whether CBT aligns with your goals and preferences. Treatment can be adjusted based on your response over time. If you have concerns about homework assignments due to energy limitations, cognitive difficulties, or time constraints, discuss this with your therapist. Assignments can be modified to be more manageable. Some CBT work can occur primarily within sessions. The goal is to find an approach that works for your circumstances. Finding a Cognitive Behavioral Therapy Provider in Boston When seeking a CBT therapist, several factors matter. Training and certification in CBT indicate a provider has received specific education in this approach. Experience with your specific concerns is important. CBT protocols differ across conditions. Cultural competence and identity-affirming practice matter, especially for people from marginalized communities. The therapeutic relationship and sense of trust influence treatment outcomes across all therapy approaches. At Aviva Psychology Services , our doctoral level clinicians utilize CBT in structured and flexible modalities to treat anxiety disorders , depression , OCD , and PTSD . Additionally, we have specialty clinics for insomnia, chronic pain, chronic illness, and perinatal mental health, all utilizing CBT as a part of the modality of treatment. Several of our psychologists have received specialized training in evidence-based CBT protocols. This includes Exposure and Response Prevention for OCD and Cognitive Behavioral Therapy for Insomnia. Our group practice model allows thoughtful matching between clients and therapists. Matching is based on clinical needs, identity considerations, and therapeutic style preferences. Meet our team of CBT-trained therapists. If you want to learn more about CBT at Aviva Psychology, contact us to schedule an initial consultation. The consultation provides an opportunity to discuss your goals and ask questions about our approach. You can determine next steps without any obligation to continue treatment. Conclusion Cognitive Behavioral Therapy is an evidence-based approach that helps people understand connections between thoughts, feelings, and behaviors. Research shows CBT works for many mental health concerns, from anxiety and depression to OCD and insomnia. At Aviva Psychology, our CBT-trained therapists provide identity-affirming, culturally responsive care adapted to individual needs. If you are considering therapy and want to explore whether CBT might be appropriate for your concerns, we are here to help .

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What Is an Anxiety Disorder and How Is It Different from Everyday Stress?

What Causes Anxiety? Understanding Why It Develops

Anxiety and Related Conditions We Treat at Aviva Psychology Services

Our Approach to Anxiety Treatment at Aviva Psychology