Cognitive Behavioral Therapy
CBT in Austin
Notice the thought, test the rule, practice a response that serves you better: that is cognitive behavioral therapy in one line. This page walks through what each step looks like when we do it together.
Step One: Notice the Thought
Thoughts move faster than you can catch them. You feel the drop in your stomach before you hear the sentence that caused it. The first step is slowing things down enough to hear that sentence: "They think I am incompetent." "If I say no, they will be done with me." Noticing a thought is not the same as believing it. Once it is out where we can both look at it, it becomes something you have rather than something you are, and that small bit of distance is where new choices become possible.
Step Two: Test the Rule Underneath
Underneath an anxious thought there is usually a rule, learned early and rarely questioned. Testing a rule does not mean arguing yourself out of it or being told you are wrong. We ask where it came from, what it protected you from, what it costs you now, and whether it is still true in the life you are actually living. Sometimes a rule is worth keeping in a softer form. Sometimes it is ready to retire. Rules worth testing might sound like this:
- Rest has to be earned first
- Other people's comfort comes before mine
- Anything less than excellent is failure
- If someone is upset, I caused it
- Needing help means I have failed
Possible Versus Probable
One of the most useful tools in CBT is slowing down a worst-case prediction and separating what is possible from what is probable. A short email from your manager could mean you are in trouble. That is possible. Is it probable, given everything else you know? Anxiety treats possible and probable as the same thing, which is exhausting. This is not positive thinking or pretending everything is fine. Sometimes the honest answer is that something hard really is likely, and then the work turns to how you want to meet it.
Step Three: Practice a Response That Serves You Better
Insight helps, but on its own it rarely changes a habit. So CBT includes practice. Between sessions you might catch one thought a day and jot down what you noticed, send a text without rewriting it four times, or say a small no and watch what actually happens. Nothing is graded, and a week when practice did not happen still tells us something useful. You bring back what you noticed, and we adjust the next step so it feels like a stretch rather than a leap.
How CBT Fits Anxiety, Perfectionism and People Pleasing
CBT is practical and repeatable, and the skills are yours to keep after therapy ends. That makes it a natural fit for concerns I care about deeply. With anxiety, it pairs with work on the body, so your system can come down from high alert while the catastrophic forecast loses some of its authority. With perfectionism, it puts a standard that moves every time you reach it under honest review. Present over Perfect is not a slogan here; it is something you practice. With people pleasing, it helps you hear the automatic yes before it leaves your mouth.
CBT Alongside Other Methods
I draw on several methods rather than one, because the person in front of me is not a diagnosis. CBT sits comfortably beside mindfulness-based therapy, which helps you come back into the body when the mind has raced ahead. When trauma is part of the picture, Trauma-Focused CBT adapts the same tools so that safety comes before breakthrough. And if you want your faith in the room, a rule can be tested against what you believe as well as against the evidence of your own life. Faith is part of this only if you want it.
Where We Meet and What It Costs
You can do this work in person at my office in Southwest Austin, where sessions are on Fridays and some select other times, outdoors as a walk-and-talk session, or by telehealth anywhere in Texas, in English or Spanish. Every service begins with an 80-minute initial assessment at $275. After that, individual sessions are $190 for 50 minutes or $275 for 80 minutes, and a sliding scale between $90 and $190 has limited spots. You do not need a diagnosis to start, and the rates page lists everything up front.
Common Questions
Is CBT just positive thinking?
No. The aim is accuracy, not cheerfulness. We look at a thought honestly, separate what is possible from what is probable, and practice a response that serves you better, even when the honest answer is that something hard is real.
Will there be practice between sessions?
Usually something small, like noticing a thought when it shows up or trying one different response. It is never graded. A week when practice did not happen still gives us something useful to talk about.
Do I need a diagnosis to start?
No. You do not need a diagnosis to start. A few honest sentences about what has been hardest lately are enough for the free 15-minute consultation, where we talk through fit, scheduling, cost and format.
Can CBT include my faith?
Yes, if you want it to. Faith is never assumed or introduced without your say-so. If it matters to you, we can test a rule against what you believe as well as against your own experience.
The consultation is free and there is no obligation on either side.
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