CBT vs. DBT: When Is Each Type of Therapy Most Effective?

When someone is struggling with a behavioral health issue, there are a variety of therapeutic models that can be used to treat it. Each type of therapy approaches the treatment process from a unique perspective, and they have strengths and weaknesses based on the individual being treated.

Cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) are two popular models for treating mental health disorders. You might notice that these models have very similar names, which sheds some light into how they’re related. DBT is a modified form of CBT, but its approach to treatment is distinct enough from CBT that the two models are usually considered unique.

Both CBT and DBT are supported by research that proves their effectiveness, and they can each be used to treat a variety of mental health issues. However, several important factors may influence which model a therapist uses to treat a client.

Dr. Aarika V. White is a staff psychologist at Cummins who has experience using both CBT and DBT in therapy. She points out that a person’s specific mental health condition as well as their personal factors can determine which model will be most effective in treatment.

What the Research Says

Aarika V. White, Ph.D.

The most noteworthy difference between CBT and DBT is the kind of change they create for the client. CBT primarily helps clients recognize and change problematic patterns of thinking and behaving. By contrast, DBT primarily helps clients regulate intense emotions and improve interpersonal relationships through validation, acceptance and behavior change.

Because different mental health disorders affect cognition and behavior differently, the type of treatment that’s most effective for a given disorder also varies. This means that neither CBT nor DBT is the best option in all cases, as Dr. White explains with an anecdote. “For a long time, I thought DBT worked great for anxiety. Then I attended a conference on DBT, and the speaker shared that the research doesn’t support DBT for generalized anxiety disorder, at least not above and beyond anything else.”

For depression, anxiety, OCD, phobias and PTSD, research has shown that CBT tends to be the more effective treatment. For borderline personality disorder, self-harm behaviors and chronic suicidal ideation, DBT tends to be the better choice.

According to Dr. White, these differences are largely caused by the way each model creates change:

“In DBT, there’s not a heavy reliance on changing thoughts. There’s an implicit process that happens, so that as the client is mindful, as they’re more accepting, as they validate themselves and ask for validation, they start to change any resistance they may have. They start to be kinder to themselves, catastrophize less, ground themselves in reality and accept reality, but it’s not the active challenging process that happens with CBT.”

What the Client Says

Even when we know which therapeutic model is most effective for treating a disorder, it’s important to remember that every client is unique. Each individual who enters therapy brings with them “personal factors” like childhood experiences, education, personality, values, world views and cognitive biases.

Dr. White believes that every therapist should have a theoretical orientation (such as CBT, DBT, or another therapeutic model) from which they approach treatment. However, she also stresses that the interventions used with a particular client must be appropriate for their mental health condition and personal factors. “A therapist’s personal worldview should influence their theoretical orientation. That should influence what interventions they choose, but they also have to take into account the factors that the client brings into the room. For example, I always approach treatment from a DBT perspective, but I may not always apply DBT skills,” she says.

As an expert in behavioral health, the therapist’s job is to determine the best method of treating their client. This doesn’t mean the client should have no input in the process, though. In fact, research by the American Psychological Association found that clients are more successful in therapy if they can collaborate with their therapist and provide feedback about their treatment.

For this reason, client feedback should be used to inform treatment whenever possible. This might influence the therapist’s decision about which treatment model to use, or it could convince them to try a different model if their first choice isn’t yielding results. “I’ll always approach treatment from a DBT lens, but there might be a case where the individual hasn’t been responding to DBT or they tell me they don’t want DBT. Again, it kind of depends on what the client is bringing into therapy,” Dr. White says.

As a recipient of behavioral health care, you always have the right to discuss your treatment with your therapist or counselor. You can ask about the strengths and weaknesses of different therapeutic models, express your treatment preferences, and provide feedback about your treatment experience.

If you’re currently receiving treatment or are thinking about seeking treatment, ask your therapist if CBT, DBT, or another therapeutic model could be the best option for you!


Want to learn about other behavioral health services provided by Cummins BHS? Read our articles on peer recovery services and dialectial behavior therapy below!

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Acceptance and Change: Dr. Aarika V. White on the Role of Validation in DBT

How Avon Community School Corporation and Cummins BHS Are Supporting Students’ Mental Health

The school years are an exciting period of learning and growth for children and teens. It’s a time for young people to develop the personal, academic and social skills they’ll need to be successful in life. However, it can also be a challenging time in terms of mental and emotional wellness.

As students progress through the grades, they’re faced with many new responsibilities, societal expectations and relationships to navigate. These environmental stressors can be overwhelming for some youth, commonly resulting in feelings of anxiety or depression. Additionally, roughly half of all mental disorders manifest by a person’s mid-teens, making the school-age years rife with potential mental health concerns.

For these reasons, it’s vital that children and teens have access to comprehensive behavioral health care. This includes education about important mental health topics, training in preventative coping skills, and one-on-one therapy and counseling. Interventions like these help youth build resiliency and lesson their risk for serious mental health conditions later in life.

Fortunately, some school systems are taking steps to provide these services in their curriculums and on their school grounds. One such case is Avon Community School Corporation (ACSC), which has partnered with Cummins Behavioral Health Systems to provide support for all its students. We spoke with Krista Fay, Mental Wellness Coordinator at ACSC, to learn more.

Social-Emotional Learning: A Foundation for Wellness

"It's an exciting time. I think this is the beginning of a big shift toward integrative support," says Krista Fay, Mental Wellness Coordinator at ACSC.

Take a moment to think about everything children learn in school. You’ll probably think first about the various subjects they study in their classes: reading, writing, mathematics, history, world languages and the sciences, to name a few. However, the school environment also provides an opportunity for youth to learn many important “soft skills” that they’ll need to be successful in life.

“Those skills look like self-management, emotion regulation, social awareness, responsible decision making and time management,” Fay says. These all fall under the umbrella of social-emotional learning (or SEL), defined by The Collaborative for Academic, Social, and Emotional Learning (CASEL) as “the process through which children and adults understand and manage emotions, set and achieve positive goals, feel and show empathy for others, establish and maintain positive relationships, and make responsible decisions.”

Social-emotional learning is often an informal, unguided process, but research has shown that teaching SEL alongside academics increases students’ potential to succeed in school and throughout their lives. That’s why Avon Community School Corporation is working to integrate Universal Social-Emotional Learning Curriculums into its schools. Starting this year, students are receiving instruction on essential SEL concepts, as Fay explains:

“We’re teaching students conflict resolution skills and some basic emotional regulation strategies. For example, we’re doing a lot of work with kindergartners on identifying emotions like anger. What’s the difference between annoyance, anger and rage? The size of your feeling. You can show a child three different sizes of blocks, and now they have context to represent how big their anger is. If it’s a little anger, they can do these things, and if it’s a medium or big anger, they can do these other things. It gives them a framework for identifying their feelings and recognizing the cues they produce in the body.”

Small Group and Individual Counseling: Additional Help for Those Who Need It


Even with knowledge of social-emotional learning concepts and skills, there will always be children and teens who need additional support. ACSC partners with Cummins BHS to provide one-on-one counseling and therapy for students who have the greatest needs. This level of service allows for diagnosis and treatment of mental health issues within the school environment.

However, there’s a large divide between youth who need simple SEL lessons in the classroom and youth who need the support of individual therapy. ACSC is addressing this gap with its new Mental Wellness Team. “We hired four social workers, and they are providing small group services for kids. As counselors start to see mental health needs, they can refer to the social workers, and the social workers can put in a bumper level of support. For some kids, that may be enough to address their needs,” Fay says.

She continues,

“To be clear, we’re not diagnosing mental health needs through this program. We’re looking for how students are presenting in the learning environment. For example, a teacher or staff member may notice that a student appears upset or has expressed feeling worried about a particular subject or social situation. If we provide small group support with other kids who are experiencing the same thing, we have a better chance of getting them to recognize their emotions, regulate their behavior and apply wellness principles, which will help them be successful over a longer term.”

The benefit of providing all three tiers of service is a smoother transition from level to level. This is helpful when youth are moving up levels of service as much as when they’re moving down. “In the past, a student might have been very successful with Cummins—so successful that they discharged—and then when that support was gone, they struggled and had to immediately return to a high level of support. Now we have a way to walk-down services so that kids can not only maintain success, but also transfer those skills across lighter and lighter levels,” Fay says.


Although Avon Community School Corporation’s new mental health services program is still in its infancy, Fay is excited and optimistic about the impact it will have on students’ well-being. Cummins BHS is proud to be a community mental health partner with Avon schools in this initiative!


To learn more about how Cummins BHS is supporting mental health in schools and the community at large, read some of our other posts below!

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Acceptance and Change: Dr. Aarika V. White on the Role of Validation in DBT

Taking action to improve our mental health can be difficult. On top of the emotional work needed to change our thoughts and behaviors, we might also struggle with the feeling that other people don’t understand us. We might feel like our family, our friends, and even our therapists only want to make us change and don’t actually accept us for who we are.

Dialectical behavior therapy, or DBT, is a type of psychological therapy that aims to counteract these feelings. Created by psychologist Dr. Marsha Linehan in the 1980s, DBT is a modified form of cognitive behavioral therapy that emphasizes the importance of both acceptance and change in the therapy process. In DBT sessions, clients work not only to change harmful thoughts and behaviors they may have, but also to accept the benefits of doing so.

Of course, it’s easier for someone to accept that they must change their behaviors if they feel accepted by others in turn. This is why validation is an important part of DBT. Early in her development of the model, Dr. Linehan discovered that her clients who were most resistant to therapy were also raised in environments that were highly invalidating.

To better understand the role that validation plays in DBT, we spoke with Dr. Aarika V. White, a psychologist at Cummins who uses DBT as her theoretical framework. She breaks validation into two main categories: validation from the therapist and self-validation from the client.

Accepting the Value of Therapy

Aarika V. White, Ph.D.

One of the core tenets of DBT is that the client must accept that they need help. Uncooperative clients are unlikely to put in the emotional work that’s asked of them, which diminishes the effectiveness of treatment. The client must believe that therapy is the best option for them, and this is best achieved through validation.

According to Dr. White, validation is extremely important but sometimes misunderstood. “Sometimes people think giving validation means they have to tell the other person that they’re right,” she says. “That’s not what validation is. Validation is saying, ‘I can understand where you’re coming from. I can look at it from your point of view and see why you might have responded the way you responded, or why you might have had the interpretation you had.’ “

DBT aims to make the therapist an ally in the client’s treatment rather than an adversary. Using validation as a tool, the therapist builds trust with the client by acknowledging their thoughts and behaviors, but they also point out how changing these thoughts and behaviors can be beneficial. This dynamic can ultimately convince a resistant client to buy into treatment, as Dr. White explains:

“When you’re working with a client in a therapy setting, validation is one of the most important ways to ‘soften’ their attitude and get them in a headspace where they can hear what you’re trying to teach them. If a client comes in and they’re upset, angry or hurt because they’re not feeling validated, either by someone else or by the therapist, the skills work is not going to be effective because they’re not going to be able to hear what the therapist or the skills trainer is saying to them.”

Accepting the Value of Our Disorder

Even a disorderly and chaotic painting can seem beautiful from the right perspective.

Validation is crucial not only for convincing the client to engage with therapy—it’s also necessary for helping them accept their mental disorder or condition.

Due to the stigma surrounding mental illness, people who have mental health issues may believe something is wrong with them. Therapy models that focus solely on changing behaviors can inadvertently increase feelings of shame and guilt among some clients. “This is why Dr. Linehan created DBT,” Dr. White says. “People were getting the message that they were flawed, because they were being told, ‘Change your thinking, change your behavior, and your life will get better.’ She realized she needed to help them understand that they are the way they are for a reason, and that’s not wrong. They have to be able to accept who they are and why they are that way, otherwise they’re going to spend all their energy fighting it.”

If the therapist validates a client’s experience about their mental health and also helps them reframe these thoughts more positively, they can begin to erode the stigma the client feels. This can counteract feelings of denial or self-pity that prevent clients from making therapeutic progress, ultimately increasing the chances that they will embrace change.

As Dr. White says, “That’s where validation turns to self-validation. When you can remove that layer of worry, shame, embarrassment, or whatever comes with the client’s condition, then you can start to see more effective change.”


DBT skills training is one of the many services provided by Cummins Behavioral Health Systems. Our licensed therapists can help you with a variety of mental health needs, from psychiatric assessment to substance use treatment and crisis intervention. Please visit our services page to learn all the ways we can help!

Want to learn more coping skills for managing your mental health? Check out a few of our other posts below!

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What Do Food Critics Know About Savoring Life?

What Do Food Critics Know About Savoring Life?

On first thought, professional food critics don’t necessarily strike us as experts in mental health. While there’s no denying that eating makes us feel good, this wouldn’t lead us to believe food critics know something about mental wellness that the rest of us don’t.

The average food critic probably doesn’t possess any special knowledge about psychology, but they are exceptionally skilled at the art of savoring. Consider everything they pay attention to when tasting a dish, as summarized by one food blog:

  • The visual appearance of the dish, such as the colors, shapes, and arrangement of the food
  • The smell of the dish, including how many individual aromas can be detected and how enticing they are
  • The complexity and balance of all the flavors present in the dish
  • The texture and temperature of the food, and how these enhance or detract from the eating experience

As you can see, a food critic approaches the task of eating differently than most people. When they eat, they are living entirely in the moment. They’re focused on appreciating every element of their food and getting as much enjoyment from it as possible. In this way, food critics are masters at savoring—a coping skill you can use to increase your own appreciation of life.

Finding More “Spice” in Everyday Life

We’ve all heard the adage that “variety is the spice of life,” and yes, psychological research has shown that people are happiest when they experience a wide variety of positive situations. But we can also increase our enjoyment of things that we do on a daily basis. Just like food critics, savoring helps us detect the “spices” that are already present in the “food” that is our lives.

Savoring is closely related to mindfulness, but it takes the idea of living in the present an extra step. When we savor an experience, we focus our attention on what makes it pleasurable. We pay attention to everything that’s happening in the moment, and then we take the time to relish all the ways it gives us satisfaction.

In his book Enjoy Life! Healing with Happiness, psychologist Dr. Lynn Johnson refers to a person’s ability to enjoy life as their level of “zestfulness.” Someone who’s high in zestfulness is naturally good at savoring life’s pleasant events. Although people typically operate at their baseline level of zestfulness, Dr. Johnson argues that we can raise our zest for life by practicing the skill of savoring.

So, how can we begin to develop our savoring abilities? It’s not difficult—all you’ll need is a pen and paper.

An Exercise for Increasing Zest

Here’s an exercise that Dr. Johnson recommends to help attune your savoring skills.

First, choose a simple, everyday pleasure that you enjoy. This could be anything you like to do as long as it allows for quiet contemplation. Some examples might be going for a walk, sitting outside on a nice day, reading a book, practicing an art or craft, or eating your favorite meal.

Next, as you are experiencing this pleasant activity or situation, focus your attention on everything that’s happening around you. What sights, sounds, smells and sensations do you notice? Concentrate also on what you’re thinking and feeling. Do you feel content? Relaxed? Amused? Inspired? Grateful? Let your mind linger on the positive sensations and emotions you experience.

After the experience is over, take out a journal or diary and write down what you noticed. Write about your thoughts, feelings and sensations as vividly as possible so that you almost relive them as you write, and notice how you feel while doing so. Does reimagining the experience that you’re savoring make you feel happier?

If we practice savoring and writing about one pleasant experience every day, we’ll find that there are many small things in our lives that we appreciate. Over time, we can increase our zestfulness and enjoyment of life for what it is, not what it could or might be—and we’ll learn a thing or two about how to be a good food critic in the process!


Looking for more information to help you improve your mood and enjoy life? You might find these posts useful!

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Why Giving In to Anger Makes Us Dumber

“Anger dwells only in the bosom of fools.” — Albert Einstein

Everyone knows what it’s like to feel angry. Our heart beats faster. Our chest tightens. We become fixated on the person or thing that caused our anger, and we start thinking about how we can get even.

Anger is a natural human reaction to situations that we dislike, but it isn’t a very effective one. If we take a moment to think about the consequences of anger, we’ll realize that it rarely solves whatever problem provoked it. If we become angry about another person’s behavior, it probably won’t result in them changing that behavior. If we become angry about an unfavorable event that befalls us, our anger will do nothing to reverse what has happened.

What’s worse is that anger inhibits our ability to respond to the situation intelligently. Psychological studies have shown that people process information less thoroughly and judge others more harshly when they are angry. This can cause us to behave in ways that only perpetuate anger instead of addressing its cause.

In short, being angry makes us dumb. Fortunately, it’s possible to live without anger if we train our brains to respond to anger-inducing situations differently.

The Function of Anger, Then and Now


In his book Enjoy Life! Healing with Happiness, psychologist Dr. Lynn Johnson suggests that anger is closely related to our instinctual “fight or flight” response. Anger is marked by physiological activity that prepares our body to fight off an aggressor, such as the release of adrenaline in our brain and increased blood flow to our muscles.

For our earliest ancestors, Dr. Johnson argues, anger was a useful emotion. It helped them confront or kill animals or other humans who posed a threat to their life. Anger’s natural intensification of “us vs. them” thinking also might have been useful for protecting the tribe during conflict, thereby increasing the individual’s chances of long-term survival.

However, the survival benefits of anger have been rendered mostly obsolete by modern civilization. Physical assault and murder are not acceptable in our society,  nor are they necessary for day-to-day survival. To solve interpersonal disputes today, we must use logic, reason and understanding—which is much harder to do when we feel angry.

So, how can we become better at relying on these higher-level problem solving skills? By changing our thought patterns to weaken anger’s control over us.

Rewiring Our Brains for Calm


According to Dr. Johnson, anger is caused not only by what happens to us, but also by how we habitually think about these things. For example, if a stranger on the street makes a rude comment toward you, you can view it in one of two ways: as a personal attack on your character or as an outburst that reflects more on the speaker than on you. If you think about the situation in the first way, you are much more likely to become angered by it.

Fortunately, it’s possible to change our way of thinking so we’re less easily angered. The first step is to desensitize ourselves to our environmental “triggers.” Make a list of every situation you can think of that typically makes you angry, and then imagine these situations in your mind. As you picture each one, concentrate on taking slow, deep breaths and relaxing the muscles in your body. With practice, you’ll become much better at controlling your emotions and staying calm when confronted with these anger-inducing situations.

Once we’re desensitized to our anger triggers, we can work on reframing our thoughts about them. If we take some time to think about why we become angry, we’ll discover that it’s usually because we assume the worst intentions. Work on questioning these assumptions. Consider if there could be a positive intention behind the behavior, if there are compensating factors that make it more understandable, or if there might be a hidden benefit that comes out of the situation. In the above scenario, for example, you might consider that the rude person could simply be having a bad day. Alternatively, you might decide that their actions provide you with a good opportunity to practice compassion.

If we work on changing the way we think about situations that anger us, we’ll find in time that anger no longer controls us. This is the best way to help ourselves make smart, effective decisions in anger-inducing situations—instead of ineffective and dumb ones!


For more tips and information about dealing with life’s stressful situations, give these posts a read!

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Dr. Ashleigh Woods Explains How—and Why—to Get a Good Night’s Sleep

“The best bridge between despair and hope is a good night’s sleep.” — E. Joseph Cossman, American businessman and author

It’s hard to overstate the good that sleep does for the human body.

Sleep is our natural recovery period, when all of our bodily systems can recuperate and reenergize for continued use. It plays a pivotal role in the functioning of our endocrine and immune systems, and it’s essential for maintaining mood, memory and cognitive performance. Unfortunately, too many of us take for granted the benefits that sleep provides.

The average adult needs at least 7 hours of sleep every 24 hours. However, the CDC reported that 35.2% of all American adults did not meet this threshold in 2014. (In Indiana, rates of insufficient sleep surpassed the national average at 38.0–44.1 percent.) This is a worrying trend, because not getting enough sleep can lead to serious issues for physical and mental health.

To learn more about the connection between sleep and mental health, we spoke with Cummins psychologist Dr. Ashleigh Woods. Below, she explains some of the negative health consequences of chronic sleep deprivation and a few simple things we can all do to improve the quality of our sleep.

Dr. Ashleigh Woods on the Psychological Power of Sleep

Ashleigh Woods, Psy.D., HSPP, Staff Psychologist at Cummins Behavioral Health

Ashleigh Woods, Psy.D., HSPP, holds a degree in Clinical Psychology and is a staff psychologist at Cummins’ Indianapolis office. As part of her work, she helps clients who are struggling with insomnia and other sleep disorders.

“There’s a huge connection between mental health and sleep,” Dr. Woods says. “If you’re not getting enough sleep or good quality sleep, you’ll have a harder time managing your emotions, and you could have trouble focusing or thinking clearly. Let’s face it—everything is harder when you’re not well rested.”

In fact, research has shown that sleep deprivation is closely related with psychiatric disorders such as major depressive disorder, bipolar disorder, generalized anxiety disorder, PTSD, schizophrenia and alcoholism. Many people who have these conditions experience difficulty falling asleep and staying asleep, and evidence suggests that chronic sleep deprivation may even contribute to the development of some of these disorders.

However, it’s possible to break the vicious cycle of sleep deprivation and psychological impairment if we make an effort to follow good sleep practices. In many cases, treating a sleep disorder can alleviate the symptoms of co-occurring mental health conditions.

Best Practices for Falling (and Staying) Asleep

So, what can we do to improve our sleep habits? For the average, healthy person, the simplest and most obvious solution is to get enough sleep each night. Most adults need at least 7 hours of sleep every day, but this number could be higher or lower based on your individual physiology. As a general rule, if you don’t feel sleepy during the day, especially when sitting quietly, then you are getting enough sleep.

But what about people who have difficulty falling asleep or staying asleep? Fortunately, there are many interventions you can try for better sleep hygiene, as Dr. Woods explains:

“To get a good night’s sleep, be sure to use your bed for only sleep or sex. Reading or watching TV in bed keeps your brain active and makes your body associate your bed with wakefulness. Also be sure to create a good bed time routine to help your body wind down in the evening: limit screen time, use lamps instead of overhead lights, don’t drink caffeine past 2:00 p.m., limit alcohol and cigarette use before bed, and most importantly, add some relaxing activities to your evening, such as taking a warm bath or doing some gentle yoga stretches.”

Relaxation techniques such as autogenic training can also be helpful for falling asleep and promoting deep, restorative sleep. However, autogenic training should be performed with help from a mental health specialist before you try practicing it on your own.

For more tips and suggestions for healthy sleep habits, check out the following resources:


Want more easy mental health and wellness strategies from Cummins BHS? Take a look at the posts below!

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Training Ourselves to be Optimists: Positive Psychology

“Remember to look up at the stars and not down at your feet…Be curious. And however difficult life may seem, there is always something you can do and succeed at. It matters that you don’t just give up.” — Stephen Hawking, American physicist and author

Difficult life circumstances can contribute to mental illness, making hope of recovery seem unlikely. However, growing evidence shows that positive psychological attributes like optimism are associated with a longer and healthier life.

Optimism can be defined as the general expectation that good things will happen, or the belief that the future will be favorable because we can control important outcomes. This positive state of mind allows people in difficult professions to be more resilient when work becomes stressful, and leads to more fulfillment in life. Studies establishing the link between optimism and health beg the question: Is it possible to train ourselves to become optimistic?

Observing Depression in Dogs

sad dog

For starters, we know that it’s possible for people and animals to learn pessimism. In India, elephant trainers will tie up a baby elephant and let it struggle for days before it learns it is not strong enough to break the rope. This lesson stays with the animal long after it grows into a hulking adult. A fully grown elephant could easily break the rope and escape, but it never tries to do so.

These kinds of observations inspired formal experiments involving dogs who similarly stopped taking action, even when minimal effort on their part could prevent a painful electric shock. Dr. Martin Seligman was researching the causes of depression and pessimism in humans, and he demonstrated that these dogs had been conditioned to believe they had no hope of avoiding the pain they experienced. 

There was also some good news from these experiments: to Seligman’s surprise, some dogs were not dismayed so easily. As psychologist Dr. Lynn Johnson explains in his book Enjoy Life! Healing with Happiness, “What we learn from Seligman’s brilliant dog experiments is that suffering is separate from pain. We all feel pain. But how much does that pain bother us? How much must we suffer? It depends entirely on our own resiliency.”

Inspired by his findings, Seligman set out to determine what made some dogs more resilient. While we can only speculate about the inner workings of a dog’s mind, when something bad happens in our own lives, humans seek to explain it. Seligman and other researchers have identified three ways that humans do this: by making assumptions about how long pain will last (permanent/transient), whether we are responsible for it (personal/impersonal), and what areas of our life it affects (pervasive/local).

Relearning Optimism

In his book Learned Optimism, Seligman explains how pessimistic explanations lead to passivity and dejection while optimistic explanations lead to action and increased energy. Just as we can learn to view our stress response as helpful, we can learn to maintain positive emotions amidst negative events. However, it takes work. Seligman suggests looking at the link between our beliefs surrounding an adverse event and what we do in response to these beliefs. He argues that becoming aware of this link is the first step in changing our explanatory style.

Optimism fights depression. Seligman defines optimism as having three core tenants: 

  1. Good stuff lasts (bad stuff doesn’t)
  2. Good stuff is caused by me (bad stuff just happens)
  3. Good stuff spreads (bad stuff is isolated)

To practice bringing optimism to the forefront of one’s mind, Seligman recommends his “ABC” journaling exercise. In this exercise, a person records an Adverse event that happened to them, their Beliefs surrounding the event, and the Consequences of their actions based on those beliefs. 

You can try this exercise on your own. Whenever something bad happens to you over the next few days, write it down. These may be as small as, “I missed the bus,” or as large as, “My partner broke up with me.” Next, write down your beliefs about the event. Does it affect your life in the long-run? Is it your fault or someone else’s? Does it affect other areas of your life? Seligman says that activities like this can help us recognize our own reflexive feelings (like those of the shocked dogs) and change our actions in turn—hopefully allowing us to break free of ties that have seemed to bind us.

Cummins Behavioral Health Systems aims to inspire hope of recovery and to help those we serve achieve their goals and aspirations. Of course, self-talk is not the end. Problem solving, negotiating, and asserting yourself are also key to fighting depression. It all begins with these kinds of small steps, best attempted with help from a mental health professional.

Or, as Stephen Hawking once put it: 

“The message of this lecture is that black holes ain’t as black as they are painted. They are not the eternal prisons they were once thought. Things can get out of a black hole both on the outside and possibly to another universe. So if you feel you are in a black hole, don’t give up—there’s a way out.”


Looking for more posts that can help you learn optimism and resiliency? Here are some articles you might enjoy!

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Laughter: Do It Just for the Health of It!

“The human race has only one really effective weapon, and that is laughter.” — Mark Twain, novelist and writer

Take a moment to think about what you were doing the last time you laughed. Were you with someone or by yourself? Were you reading or watching something humorous, or simply remembering something that happened in the past? And were you already feeling happy when you laughed…or did the act of laughing make you feel happy?

Laughter is a peculiar and remarkable phenomenon of human behavior, and scientific research has shown that it can be beneficial for physical and mental health. For example, several studies have found that laughter can reduce feelings of distress, improve functioning of the immune system, and even help prevent heart disease.

Additionally, psychologists know that laughter is an effective coping mechanism for countering negative thoughts and emotions. According to Tom Kixmiller, a therapist and counselor at our Avon office:

“One of the best ways to heal the body in general is physical activity, and if you’ve ever belly laughed, it can leave you tired. Physical activity and laughter burn off stress and re-balance the body chemistry.

Tom Kixmiller, LMHC

But how can this help someone who is feeling anxious, upset or depressed? After all, we often think of laughter as something people do when they’re already feeling happy, not when they’re sad. While it’s true that we’re more disposed to laugh when we’re in a good mood, the physical act of laughing can also cause us to feel happy.

Laughter and the Facial Feedback Hypothesis


When we think about emotion, it’s easy to assume that physiological changes occur in our body as a result of the emotion we’re feeling. When we’re stressed, we take quicker breaths and our heart beats faster. When we’re sad, we feel lethargic and wear a frown on our face. And when we’re happy, we smile and laugh.

However, our physiological state can also be the cause of our emotions. This is why controlling our breathing can calm us down when we’re feeling overwhelmed, and it’s why the 19th-century psychologist William James famously concluded, “We don’t laugh because we’re happy—we’re happy because we laugh.” Tom elaborates:

“Your brain is constantly monitoring your body, which is why dialectical behavior therapy uses the premise of the ‘half-smile.’ If you make yourself smile, it can shift your mood. It isn’t going to fix everything, but it starts to move you in the right direction. Some studies have shown that even forced smiling or forced laughter can have a positive effect.”

Therefore, laughing can make us feel happy even if we weren’t before. Of course, it can be hard to find the motivation to make ourselves laugh if we’re struggling with a mental health issue like depression or anxiety. This is where humor and comedy can help.

Introducing Mental Health America’s “Laughing for the Health of It” Comedy Show!


Tammi Jessup is the Executive Director of Mental Health America of Hendricks County (MHAHC), a non-profit organization dedicated to promoting mental wellness in the community. The organization serves people who have mental health conditions through a combination of school-based and adult education programs, support groups, individual advocacy, and initiatives like its food pantry and holiday gift drive.

When facilitating a mental health support group, Tammi leverages the power of laughter whenever she can. “We talk about whatever is going on in each person’s life, whether they’ve had a good week or a bad week. And we laugh, intentionally, as much as possible. If you have your group of people together and you can get them to laugh about something, it has all those positive impacts on the body and mind.”

As part of its mission to promote mental health, MHAHC hosts an annual event called “Laughing for the Health of It.” One part speaker dinner and one part comedy show, “Laughing for the Health of It” aims to remind people that life can be joyful even with a mental health condition. Tammi explains:

“One in four people is going to have a mental health condition at some point in their lives. We want to help those people and their families lead their best and healthiest lives, and we feel like laughter is an important component of that. We want to help people realize that even when they have a mental health condition, they can still laugh and have a good time.”

Tammi Jessup, Executive Director of MHAHC

7th Annual “Laughing for the Health of It” Dinner and Comedy Show

Sponsored by: Cummins Behavioral Health Systems and Hendricks Regional Heath

When: September 21st, 5:30 p.m.–10:00 p.m.

Where: Hendricks County 4-H Fairgrounds & Conference Complex, North and South Halls


Comedian Brent Terhune, writer for the Bob & Tom Show

Jefferson Award Winner Nikki Ford

Live music by local band “No Criminal Record”

Catered dinner and cash bar

Silent auction, photo booth, and games & activities

To purchase tickets, click the button below or call the MHAHC office at (317) 272-0027


Supplement Your Journaling Routine with These Easy Therapeutic Exercises

In our last post, we spoke with Cummins therapist Mindy Frazee about the mental health benefits of keeping a journal. Studies have shown that journaling can have a wide range of physical and mental heath effects, from lowered heart rate to less distress and negative emotions. Although we covered a lot of the basics last time, there’s still so much more that can be said about journaling!

“Journaling helps us think in different ways,” Mindy says. “It aids in stress reduction, emotion regulation, increased awareness, but it also impacts and touches different parts of our brains, which is really fascinating.”

To help our readers supplement their journaling routine, we asked Mindy about her favorite ways to use journaling in a therapy setting. Here are a few exercises and prompts you can try for yourself!

Therapist Mindy Frazee on Her Favorite Journaling Exercises

Mindy Frazee considers herself a Rogerian, and as such, she doesn't believe in one-size-fits-all journaling therapy. "There's no manualized treatment for Carl Rogers, and I love that. So, for me, it's about whoever is sitting across from me. It's really tailored to what would work for that person," she says.

Self-Affirmation Journaling

“Some people that come into my office have very low self-evaluation and self-esteem, for a variety of reasons. One of the things I’ll do is tell them, ‘Write down everything you like about yourself.’

That’s really uncomfortable for people. Many of us don’t like to talk about ourselves. We’re in the Midwest; it’s not what we do. But on top of that, we may have been told negative things about ourselves. This exercise challenges those ideas. Then, if we read what we wrote out loud, it helps us accept those good things about ourselves. We think, ‘I wrote it about myself, I read it out loud, and then this person sitting across from me who’s completely unbiased accepts this about me. I guess I can accept that about me, too.’ “

Reframing Traumatic Experiences

“Usually in trauma work, I encourage the person to read their own words out loud in our sessions. And when they’re reading what they’ve written about a traumatic experience, I’ll pause them and ask, ‘What do you think about that experience right now? What is it like now, today, in this moment, to be saying these things?’

What was present then is often what trauma survivors fixate on. ‘I was so angry, I was so scared, I was these things.’ But as a therapist, I encourage them to think about what’s happening today, in this moment. This helps them be more present and stop living in the past, which is really pivotal and impactful in trauma work. They realize it’s OK to feel the way they did and that they’re not in that place anymore.”

Experimenting with Format

“Some people just don’t want to sit down and write, to be honest. Not everybody is going to say, ‘Dear diary, today…’ So, I try to meet those people where they’re comfortable. They can journal with logs or bullet points. They can write poetry and prose. It’s whatever makes sense for that person in their mind.

Another idea that’s really fascinating is photography as a way of journaling. Most people have some type of a phone, so I might ask them to capture pictures, but in a very focused way—with a specific quest, kind of. I’ll say, ‘Define this concept using photos throughout your day, and then bring them in and we’ll discuss them.’ “


We’d like to thank Mindy Frazee for sharing these exercises, which can be used in both clinical and personal settings. But you needn’t stop here! There are countless ways to express yourself through journaling—the only wrong way is a way that doesn’t feel right to you!

What are your favorite ways to journal?

If you’d like to read more about mental health and wellness strategies, check out some of our other posts below!

Wellness: What It Is and How to Achieve It
Stress Can Be Good For You (as in this picture of a woman doing her homework)
Remember This Next Time You're Feeling Stressed

Journaling: A Simple Way to Manage Stress, Anxiety and Depression

“In the journal I do not just express myself more openly than I could to any person; I create myself. The journal is a vehicle for my sense of selfhood. It represents me as emotionally and spiritually independent.”  — Susan Sontag, essayist, filmmaker and activist

Would you believe that spending a few minutes each day with a pen and paper can be highly beneficial for your mental health?

Journaling, which you might also call keeping a diary, is the practice of regularly recording your thoughts, feelings and life events. It’s a great way to get difficult thoughts and emotions “out of your head” and into a private, judgment-free space. In fact, psychologists have known for many years that journaling can work wonders for mental health.

In one influential paper on the topic, psychologist James Pennebaker found that people who participated in journaling exercises later reported less distress, depression and negative emotions. Amazingly, some people even experienced improvements in their physical health and behavior. In a few studies, people who journaled went on to earn higher grades in school or find a new job more quickly after being laid off from work.

So, how does journaling work in a clinical setting, and how does the exercise translate to mental health benefits? We spoke with therapist Melinda (“Mindy”) Frazee to find out.

Mindy Frazee on Journaling for Mental Health

Mindy Frazee is an outpatient therapist at our Crawfordsville office, where she finds journaling to be an invaluable tool in her work with clients. “It can aid in emotion regulation and increasing awareness. I do a lot of mindfulness-based work with clients, and it can help them become more aware, more present, more tuned-in to what’s happening to them internally instead of reacting to what’s happening externally,” she says.

According to Mindy, journaling can be an effective therapeutic exercise for just about anyone. However, she finds it particularly useful for people who have experienced trauma. In her therapy sessions, Mindy often asks clients to read aloud portions of what they have written in their journals, and then they discuss topics that either person thinks is important.

Mindy says that journaling forces us to confront our thoughts and feelings head-on rather than avoid them. Although this process can be uncomfortable at first, it’s often a crucial step on the journey toward self-discovery or psychological healing:

“When people first come to work with me, especially when they’ve experienced trauma, I compare it to looking down a very long hallway with a lot of doors shut. It’s scary and dark, and we don’t like to go down there. But in my office, we go down there. It’s very disorganized in that area of our minds, and journaling can help us start to organize it. We revisit the traumatic event, we look at it in a safe way, and we make a different sense of it.”

How to Start Your Own Journaling Routine

Keeping a journal is one of the easiest things you can do to improve your mental health. All you need to do is pick up a pen and start writing. You can write about anything you want, from the events of your day to something that has made you happy, sad, excited or nervous. If you keep up the routine long enough, you’ll start to know yourself better and work your way through problems that once seemed too difficult to approach.

Your journaling exercise will be most effective if you can make it a regular part of your day. “My recommendation is to be very intentional about when you’re going to journal,” Mindy says. “Sit down and walk through your schedule. When do you have 20 minutes where no one is interrupting you, you’re relaxed, and you’re able to just sit, think and write?”

Here are some other tips and suggestions to consider:

  • If at all possible, try to write in your journal every day. Be strict with yourself about maintaining your schedule.
  • Write whatever comes to mind. Don’t worry about things like sentence structure, grammar and spelling.
  • Don’t censor yourself or worry about what other people might think. Your journal is for your eyes only.
  • If you don’t know what to write about, try choosing weekly or monthly themes. Examples could include “joy,” “anger,” “memories” or “aspirations.”
  • Instead of keeping a written journal, you could also record audio or video logs. Any format that feels right to you is fine.

Journaling is one of the many client-specific behavioral treatments used by our therapists at Cummins BHS. While journaling is useful in clinical care settings, it can also be practiced outside of therapy for your general mental and emotional well-being.

We hope this post inspires you to start journaling for your own mental health! 


For more on wellness and simple exercises for improving mental health, give these other posts a read!

Wellness: What It Is and How to Achieve It
Calm Down Quick with This Simple Trick: Extended Exhale