Mental Health

Understanding Therapy Modalities: CBT, DBT, and EMDR in Vancouver

Therapist profiles can sometimes read like an alphabet soup. CBT, DBT, EMDR, ACT, IFS. Even if you know what these mean, it can still be difficult to know what happens in the room, or which one might fit you. In this article, we’ll attempt to describe these different approaches in plain language, describing what each approach does, and who they can help.

CBT (Cognitive Behavioural Therapy)

CBT is built on a simple idea: your thoughts, feelings, and actions are entwined together, and the story you tell yourself about a situation can shape how bad it feels.

Good news! These entanglements can be smoothed out in a way that makes more sense.

CBT is a structured, homework-based method. It’s known for providing quick, practical tools for alleviating issues such as anxiety, low mood, or burnout.

In a typical session, you might look at a specific moment from the week, identify the automatic thought that fired, and work out whether that thought holds up under scrutiny.

It is not about forcing positive thinking. It is about finding a more accurate read on things.

DBT (Dialectical Behaviour Therapy)

DBT is a skills-based approach for people who feel things intensely. It covers four areas: staying present, getting through hard moments without making them worse, naming and managing big emotions, and communicating without setting the relationship on fire. It suits people who go from calm to overwhelmed fast, or whose relationships are struggling with (or swinging between) extremes.

The word “dialectical” refers to balancing two things at once: accepting yourself as you are, while also working toward change. Working in that balance is a fine point of this approach.

EMDR (Eye Movement Desensitization and Reprocessing)

EMDR is a structured method for processing memories or past experiences that seem to have gotten stuck in the mind, body, emotions or the stories we tell ourselves. It uses bilateral stimulation (side-to-side eye movements, sounds or gentle taps) to help the brain make sense of those memories (or the absence of memories, in the case of neglect) so that it can file them away properly.

There are different perspectives on why EMDR works so effectively and efficiently compared to other approaches, but it is especially effective for post-traumatic stress, anxiety, panic, and long-held beliefs of unworthiness.

Unlike popular beliefs about trauma and therapy, in EMDR, you do not actually need to retell the full story or describe past memories or experiences in detail. The process works on what you know inside without actually having to speak it aloud. It works by helping your nervous system update its response to the memory, so that your brain, body and nervous system know that what happened is “back there and then”, and stops firing as though the danger is present in the “here and now”.

Somatic and Body-Focused Approaches

These approaches work from the idea that trauma and chronic stress live in the body, not just the mind. They help you tune in to physical sensations and build a calmer relationship with your own nervous system. Useful for anyone who has spent a long time running on high alert: tight chest, disrupted sleep, a constant sense of bracing.

ACT (Acceptance and Commitment Therapy)

Rather than confronting painful or challenging thoughts, ACT invites us to do the opposite: to stop fighting them. According to ACT, fighting them can make them louder. So instead, ACT, a newer approach that borrows from mindfulness, teaches you to hold difficult thoughts more loosely and to instead put your energy into what actually matters to you.

It suits people who have tried to think their way out of anxiety and found that the “trying” was making it worse: chronic anxiety, health anxiety, or a sense of being stuck no matter how hard you push.

Narrative Therapy

We all narrate our own lives, and have it narrated it to us (are born into a greater narrative), and the narration is not always fair. Narrative therapy starts there, helping you notice when you have been cast in a certain way (e.g. as ‘the difficult one’) and looking for the fuller version of that story. It can be particularly beneficial for people who feel like they have fallen through the cracks or been reduced to their worst chapter.

EFT (Emotionally Focused Therapy)

This approach works on emotional patterns in relationships, whether that is a romantic partnership, a family, or the relationship you have with yourself. EFT is attachment-based—that is, it looks past the surface to the deeper question underneath, something closer to ‘do I matter to you’ or ‘can I count on you.’

Parts Work / IFS (Internal Family Systems)

IFS is built on the idea that we all have different inner parts, each with its own feelings and history. Some parts carry old pain. Others work hard to protect us from ever feeling it again. The goal is not to get rid of the difficult parts, but to understand them and find a calmer sense of self underneath.

People dealing with self-criticism, inner conflict, or patterns they cannot seem to change despite wanting to often find this approach clarifying.

Neurodiversity-Affirming Approaches

These approaches start from the idea that ADHD, autism, and related traits are natural variations in how brains work, not flaws to correct. The goal is building a life that fits, instead of one that is constantly forced. This matters most for neurodivergent adults diagnosed later in life, many of whom may have spent years being told the problem was them.

How to Know Which Approach is Best for What You Are Dealing With

You do not need to arrive knowing which approach is best for you. Most therapists will do an intake assessment and recommend an approach, or blend a few, based on what you describe.

That said, a few patterns tend to hold:

If you are dealing with anxiety, overthinking, or low mood, CBT or ACT are common starting points. Both give you something practical to use between sessions.
If you are dealing with trauma, including childhood trauma, accidents, neglect or abuse, EMDR and somatic approaches have strong evidence behind them. So does parts work, especially for complex/relationship trauma, which can have many layers.
If you are dealing with intense emotions or relationship instability, DBT skills can be practical and effective.
If old relationship patterns keep resurfacing, whether with a partner, family, or yourself, EFT looks at the attachment needs underneath the surface.
If you are dealing with burnout or a nervous system that feels stuck in overdrive, body-focused approaches tend to work better than purely talk-based ones.
If you are dealing with neurodivergence, late diagnosis, or building a life that fits your brain, finding a therapist who is neurodiversity-affirming will be important.
If you feel defined by a hard chapter of your life or stuck in a story about yourself, narrative therapy or parts work may offer insight and a way through.

FAQ: General Questions About Therapy Approaches

Do I have to choose a modality before I start? No. Your therapist will guide that conversation during intake. It can help to have a sense of what you might prefer (or what you don’t like, if you’ve had previous experiences of therapy), but you do not need to arrive with a plan.

Can therapists blend approaches? Yes. Many do. A therapist might use CBT tools for daily anxiety management while moving into EMDR for healing an underlying trauma. The approaches are not mutually exclusive.

How do I know if the approach is working? After four to six sessions, you should have some sense of whether things are shifting. That might be a small change in how you respond to a stressor, or simply feeling less alone with something. If it feels like nothing is happening, that is worth raising directly with your therapist. Around twelve sessions is normally considered a typical course of therapy.

What if I have tried CBT and it did not help? CBT may not be the right fit for everyone. Also, it may not always be effective for deeper trauma or emotion dysregulation on its own. A different modality, or a different therapist, may be what is needed.

Therapy works best when the approach fits what you are actually dealing with, and when you feel enough trust to be honest in the room. Both of those things take some searching. It is worth the effort to find the right fit.

FAQ: How Safe Space Counselling Services Can Help

What approaches do Safe Space therapists use? Our team works with CBT, DBT, EMDR, ACT, somatic approaches, EFT, narrative therapy, parts work, and neurodiversity-affirming frameworks. Different therapists specialise in different areas. See below.

Who are your therapists and what do they focus on?

Kushal Gill works with clients from all backgrounds, and offers sessions in English and Punjabi. She brings particular experience with South Asian family dynamics, intergenerational tensions, and the space between honouring your roots and finding your own voice. She also has years of experience supporting parents with children or youth who are neurodivergent or autistic (e.g. ADHD, ASD).

Her training covers narrative therapy, EFT, and ACT, so if any of those approaches stood out to you above, she is a strong place to start.

Olivia Ng works with clients from all backgrounds, and offers sessions in English, Cantonese, and Mandarin. She brings particular experience with East Asian cultural context, family expectations, and mental health stigma. She is also able to support more complex mental health issues like OCD, psychosis, and bipolar disorder, while working collaboratively with a client’s medical team. Her approach draws on CBT, DBT, and EFT-informed work.

Daria Szwedowicz works with anxiety, burnout, relationship patterns, and trauma, including work-related stress and PTSD. She also supports immigrant and 2SLGBTQI+ clients navigating identity and belonging. She is sex positive and gender- and neuro-affirming in her approach. Her approach draws on EFT, ACT, EMDR, and DBT skills.

Marlae Vermeer focuses on family therapy, parenting support, and parent-teen mediation, alongside individual work on identity, belonging, anxiety, and burnout. She also has extensive experience supporting parents with children who are neurodivergent or autistic (e.g. ADHD, ASD), as well as supporting family members that have experienced significant conflict, stress and estrangement in their relationships. She draws on narrative therapy and emotion-focused family therapy.

Suzanna Campbell works in English and French. She focuses on couples and families with young children, using the Gottman Method alongside ACT and narrative therapy for communication, co-parenting, and everyday family patterns. She is particularly skilled at supporting parents with young children (age 12 and under) who are neurodivergent or autistic (e.g. ADHD, ASD).

What does a session cost? $150 to $235 per session for sessions with our Registered Clinical Counsellors (RCCs). We also offer low-cost therapy provided by our Master’s-level Practicum Student Counsellors for students, young adults, and anyone for whom finances may be a barrier.

Do you direct bill insurance? Yes. We may be able to direct bill to some insurance providers such as Canada Life, Manulife, Sun Life, and Pacific Blue Cross. We are also able to work with some funders such as WorkSafeBC, Autism Funding Unit (AFU), First Nations Health Authority (FNHA), Nisga’a Valley Health Authority (NVHA), and the Crime Victim Assistance Program (CVAP).

Where are you located? 200 – 1892 West Broadway (half a block West of Burrard), Vancouver (Kitsilano). We work on the unceded ancestral lands of the Musqueam, Squamish, and Tsleil-Waututh Nations.

Do you offer online therapy? Yes. Secure virtual sessions are available across BC, including Vancouver Island, the Fraser Valley, the Interior, and northern BC.

What languages do your therapists speak? English, Cantonese, Mandarin, Punjabi, Spanish, and French.

How do I get started? You can book a free 15-30 minute consultation at safespacecounselling.ca/contact. During the consultation, you can ask questions, describe what you are dealing with, and get a chance to meet the therapist. Often, this is the best and quickest way to find out which therapist is the right fit for you.

Book a free 15-30 minute consultation at safespacecounselling.ca/contact to begin exploring which therapist might be the best fit for you.

FAQ

General Questions About Therapy Approaches

Do I have to choose a modality before I start?

No. Your therapist will guide that conversation during intake. It can help to have a sense of what you might prefer (or what you don’t like, if you’ve had previous experiences of therapy), but you do not need to arrive with a plan.

Can therapists blend approaches?

Yes. Many do. A therapist might use CBT tools for daily anxiety management while moving into EMDR for healing an underlying trauma. The approaches are not mutually exclusive.

How do I know if the approach is working?

After four to six sessions, you should have some sense of whether things are shifting. That might be a small change in how you respond to a stressor, or simply feeling less alone with something. If it feels like nothing is happening, that is worth raising directly with your therapist. Around twelve sessions is normally considered a typical course of therapy.

What if I have tried CBT and it did not help?

CBT may not be the right fit for everyone. Also, it may not always be effective for deeper trauma or emotion dysregulation on its own. A different modality, or a different therapist, may be what is needed.

FAQ

How Safe Space Counselling Services Can Help

What approaches do Safe Space therapists use?

Our team works with CBT, DBT, EMDR, ACT, somatic approaches, EFT, narrative therapy, parts work, and neurodiversity-affirming frameworks. Different therapists specialise in different areas. See below.

Who are your therapists and what do they focus on?

Her training covers narrative therapy, EFT, and ACT, so if any of those approaches stood out to you above, she is a strong place to start.

What does a session cost?

$150 to $235 per session for sessions with our Registered Clinical Counsellors (RCCs). We also offer low-cost therapy provided by our Master’s-level Practicum Student Counsellors for students, young adults, and anyone for whom finances may be a barrier.

Do you direct bill insurance?

Yes. We may be able to direct bill to some insurance providers such as Canada Life, Manulife, Sun Life, and Pacific Blue Cross. We are also able to work with some funders such as WorkSafeBC, Autism Funding Unit (AFU), First Nations Health Authority (FNHA), Nisga’a Valley Health Authority (NVHA), and the Crime Victim Assistance Program (CVAP).

Where are you located?

200 – 1892 West Broadway (half a block West of Burrard), Vancouver (Kitsilano). We work on the unceded ancestral lands of the Musqueam, Squamish, and Tsleil-Waututh Nations.

Do you offer online therapy?

Yes. Secure virtual sessions are available across BC, including Vancouver Island, the Fraser Valley, the Interior, and northern BC.

What languages do your therapists speak?

How do I get started?

You can book a free 15-30 minute consultation at safespacecounselling.ca/contact. During the consultation, you can ask questions, describe what you are dealing with, and get a chance to meet the therapist. Often, this is the best and quickest way to find out which therapist is the right fit for you.

Book a free 15-30 minute consultation at safespacecounselling.ca/contact to begin exploring which therapist might be the best fit for you.

Interested in working with us?

We would be happy to hear from you and book a free consultation for you. If you want to get in touch, fill out our contact form and let us know if there was a counsellor you’d prefer to work with. We will do our best to accommodate requests based on counsellor availability and specialty.

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