Your Brain Changes After "Talk Therapy"

colorful brain
As a Cognitive Behavioral Therapist, I am excited by any new research that demonstrates a biological brian change after patients undergo “talk therapy”.  A group of scientists just published a study showing:
  • biological brain changes after cognitive behavioral therapy
  • the effects of cognitive behavioral therapy can be studied empirically
The New York Times published an article by Eric R. Kandel on September 6, 2013 describing the biological basis of mental disorders.  He writes about scientists at Emory University who performed a study on depressed individuals looking for evidence of biological changes after psychotherapy and after anti-depressant medications.  They used brian scans before and after treatment to identify biological brain changes.  During this study, the scientists were able to accurately predict whether patients would respond to psychotherapy or medications for the treatment of their depression.
Dr. Kandel summarizes the significance of the study as:
First, the neural circuits disturbed by psychiatric disorders are likely to be very complex.
Second, we can identify specific, measurable markers of a mental disorder, and those biomarkers can predict the outcome of two different treatments: psychotherapy and medication.
Third, psychotherapy is a biological treatment, a brain therapy. It produces lasting, detectable physical changes in our brain, much as learning does.
And fourth, the effects of psychotherapy can be studied empirically. Aaron Beck, who pioneered the use of cognitive behavioral therapy, long insisted that psychotherapy has an empirical basis, that it is a science.
Other forms of psychotherapy have been slower to move in this direction, in part because a number of psychotherapists believed that human behavior is too difficult to study in scientific terms.  The entire article is posted on the New York Times website here.
Eric R. Kandel, a professor at the Mortimer B. Zuckerman Mind Brain Behavior Institute at Columbia, a senior investigator at the Howard Hughes Medical Institute and a recipient of the 2000 Nobel Prize in Physiology or Medicine, is the author of “The Age of Insight: The Quest to Understand the Unconscious in Art, Mind and Brain, From Vienna 1900 to the Present.”

New School Year: Easy Exercises for School Counselors

The Center for Greater Good at Berkeley has found that creating a Positive School Climate is so important because it:


decreases absenteeism, suspensions, substance abuse, and bullying, and increases students’ academic achievement, motivation to learn, and psychological well-being. It can even mitigate the negative effects of self-criticism and socioeconomic status on academic success. In addition, working in this kind of climate lessens teacher burnout while increasing retention. All really good stuff!”

While meeting their criteria for having a Positive School Climate can be challenging, small steps can be made relatively easily.  School counselors may want to consider the Behind Your Back exercise with student groups, faculty groups, and maybe even parents.

Here’s to happy, healthy, students, teachers, and administrators in the coming academic year!

Back to School Means Study Time

Are you or someone you know returning to school this week?  Here is a nice summary of efficient study skills from Scientific American.


Great Resource in Dallas

The National Alliance on Mental Illness (NAMI) has a Dallas Chapter.  This wonderful group of volunteers provides great services to those in the Dallas area affected by mental illness.  One of the most important things they do is facilitate and guide SUPPORT GROUPS.

If you are looking for a SUPPORT GROUP, here’s a link to their monthly newsletter:


You will find a list of SUPPORT GROUPS and other information about NAMI-Dallas.


Does Cognitive Behavioral Therapy Work? Will it Work for ME??


As a Cognitive Behavioral Therapist, I believe in what I do, see daily results, and know that Cognitive Behavioral Therapy (CBT) can change lives.  My confidence in this type of therapy was strengthened when I came across a scientific study analyzing the effectiveness of CBT.  Experts in the psychology field reviewed the therapeutic results of using CBT when working with patients with differing mental health disorders.  The study was published in the Clinical Psychology Review 26 (2006) under the title:  The empirical status of cognitive-behavioral therapy: A review of meta-analyses by Andrew C. Butler, Jason E. Chapman, Evan M. Forman, and Aaron T. Beck.

The psychologists found CBT to be an effective treatment for:

Cognitive behavioral therapy
  • depression
  • generalized anxiety disorder
  • panic disorder with or without agoraphobia
  • social phobia
  • posttraumatic stress disorder
  • childhood depressive and anxiety disorders
  • marital distress
  • anger
  • childhood somatic disorders
  • chronic pain

(Savannah Krantz (Greenhill, 2014) provides a comprehensive summary of the study at the end of this post.)

These results are so encouraging to patients and treatment providers who deal with the pain of mental illness everyday.  This wide-ranging, scientifically significant study gives confidence and hope to people entering therapy.  If you are reading this post, and looking for help with a mental health challenge, consider finding a Cognitive Behavioral Therapist.  You can find more information and details about the treatment process by going to the Beck Institute of Cognitive Therapy.

If you live in the Dallas area, and would like to talk about treatment with a Cognitive Behavioral Therapist, please read my web page at Holly Scott, MBA, MS, LPC.

Effectiveness of Treatment with Cognitive Behavioral Therapy

by Savannah Krantz (Greenhill, 2014)

therapy for depression 
Cognitive Behavioral Therapy, also known as CBT or CT, has been closely examined in many psychological studies relating to treatment results. The cognitive-behavioral treatment of mental disorders is often compared and contrasted with other treatments. CBT differs from behavioral therapy because it suggests that cognitive thoughts produce aberrant behavior, and therefore, CBT focuses on cognation. In an attempt to determine whether CBT has a higher success rate than other treatments, this study required a meta-analysis. This type of research pulls results from previous studies, works to sort out their differences, and essentially combines them. Meta-analysis measures what is called the effect size, which is the measure of strength in statistics. This process aims to estimate the effect size with a large sample of studies rather than a single study, which would only provide data drawn from a single set of circumstances. Similar to using a large sample size in an experiment, using meta-analysis sharpens the precision of the effect size because it eliminates the involvement of erroneous factors.

therapy for depression

This CBT study examined many mental disorders: adolescent and adult unipolar depression, generalized anxiety disorder, panic disorder, social phobia, obsessive-compulsive disorder, posttraumatic stress disorder, schizophrenia, anger, bulimia nervosa, internalizing childhood disorders, sexual offending, and chronic pain. Not only does the meta-analysis inspect the effects of CBT treatment, but the study also compares the results to other treatment results whenever possible. Out of these disorders, three used data from an uncontrolled effect size: obsessive-compulsive disorder, schizophrenia, and bulimia nervosa. Unlike a controlled effect size, the improvement was measured within its group, rather than being compared to other treatments and/or conditions.

In the results, the U3 score is provided next to the effect size. The U3 score is a percentage that indicates whether or not CBT was more successful than other treatments. If the U3 score is 50%, that means that on average, the CBT patient experienced the same results as the control patient who received other treatment. If the percentage is above 50% and the effect size is positive, the CBT patient’s outcome was superior. If the percentage is above 50% and the effect size is negative, the CBT patient’s outcome was inferior to the control. The higher the percentage, the more (if positive ES) or less (if negative ES) successful CBT was on average.

CBT was proved to be superior to all other treatments for adult and adolescent depression, but was only very slightly more successful than behavioral treatment, with a U3 score of 52%. CBT was more successful than all other treatments for general anxiety disorder, social phobia, obsessive-compulsive disorder, posttraumatic stress disorder, schizophrenia, anger, bulimia nervosa, internalizing childhood disorders, and sexual offending. Two exceptions, chronic pain and panic disorder (with and without agoraphobia), had either one or two elements that were proven to be less successful when treated by CBT.

couple couple

Overall, the meta-analysis proved that CBT appears to be the superior treatment for these sixteen mental disorders. This can be accredited in part to the fact that CBT differs from other treatments due to its ability to teach the patient therapeutic skills that the patient can then apply, without external assistance, into his or her everyday life.


Clinical Psychology Review 26 (2006), The empirical status of cognitive-behavioral therapy: A review of meta-analyses by Andrew C. Butler, Jason E. Chapman, Evan M. Forman, and Aaron T. Beck.


A View from the Roof | Rewire Me

Author Psychotherapist Pamela Milam shares inspirational thoughts on viewing others from a place of greater emotional generosity.

A View from the Roof | Rewire Mecounseling for happiness

I know someone who had a series of different jobs: clerk, cook, waitress, courier, even construction worker. She told me that she once had a stint as a roofer. She worked every day with the same guy, a blue-collar philosopher who used to take breaks sitting on the roof eating his sandwich and telling her stories: “People think they’re alone, that no one can see them, but up here I can’t help but see people living their lives—in their living rooms, bedrooms, backyards. The world’s a different place to me because of that.”

He felt a warmth and grace toward the people living in those houses, cooking barbecue, pushing swings for children, vacuuming rugs, fighting with spouses, clicking away on laptops, cooking spaghetti, or reading books by windows. He saw them in private moments and tried his best to honor that privacy. I might see, for instance, a client who is a tough businesswoman, but in fact is anxiety-ridden and worried about her young son’s autism diagnosis.

It struck me later that, as a therapist, my view can be similar. We are the roofers of the soul, seeing into hearts and minds and getting a look into the private lives and relationships of people who otherwise might seem like just “the guy in the next cubicle” or “that jogger I see every Saturday on the trail” or “the unassuming neighbor down the block.”

I might see, for instance, a client who is a tough businesswoman, but in fact is anxiety-ridden and worried about her young son’s autism diagnosis. Many of her colleagues write her off as being brusque and cold, but that’s nowhere near the truth. Or I meet the olive-skinned young model who radiates a golden beauty, but discover that he is wracked with self-doubt. I encounter the narcissist who admits that he feels empty in spite of his résumé of accomplishments, or the pregnant teen who pretends to look forward to motherhood but confesses that she’s terrified.

It’s helpful to get a different view, looking into their lives and seeing them, really seeing them live life: struggling, failing, succeeding, and managing to get through it all somehow.

Getting a new perspective—simply paying attention—helps me break free from assumptions or stale beliefs about neighbors, friends, colleagues, and even strangers.There’s a freedom that comes from getting an alternate view. The more you really notice other people, the less likely you are to write them off or pigeonhole them. Getting a new perspective—simply paying attention—helps me break free from assumptions or stale beliefs about neighbors, friends, colleagues, and even strangers.

For me, it’s important not to get locked into a mindset, one of judgment or negativity or willful oblivion. The key to unlocking my mind is the very same key to building good relationships: noticing people, taking my time, imagining how they might feel, making an effort to do no harm, and trying to do good when I can.

If I find myself taking a knee-jerk attitude toward a person or summing someone up based on one or two obvious traits, it’s a sure bet that I’m missing something that I might understand more clearly from a place of greater emotional generosity. I try to remember that I’m always free to take a fresh look. I’m the roofer casting a graceful look into their hidden lives.

Read about Pamela Milam.

– See more at:


Happiness and Belonging


How Do We Find Happiness?

Dallas author and psychotherapist, Pamela Milam, writes about finding happiness on the website  In her article, I love the way Pamela describes her thinking as a young adult in the line:

“I just went with the societal flow without examining how I really felt or what I really wanted.”

As a psychotherapist, I regularly treat clients who are struggling with life choices and decisions of all kinds (financial, career, family) that were made based on societal flow. They describe themselves as very successful and “having it all”, and state they cannot understand their overwhelming feelings of emptiness or sadness. During the therapy process, they often find relief by allowing themselves to explore what they really want and separating individual wants from societal influences. They are able to find joy by making changes in their lives to honor their true feelings.

Can you find a way to allow yourself to explore what you really want, change your thinking, and create happiness?

Anger and Divorce: a better way

Here is a great article by author and Licensed Professional Counselor, Pamela Milam, on reframing anger and other negative emotions following a divorce or break-up.

Feeling Stressed? READ!

Research shows taking just a 6 minute break to read something can significantly lower stress levels. 

happy teenagerIn this study, it took volunteers only 6 minutes of silent reading to lower heart rates and relax muscle tension. Next time you need a break, try reading.

This excerpt from Cynthia Cruz’s beautiful essay on describes the reading and relaxing process so well.

April 29th, 2013
So deep into this other world do I drop, I no longer notice, nor do I care, what’s happening outside the book, in the “real” world. Like a drug, the book seduces me. I can’t resist. And is this not a small simulation of death, of suicide? And suicide, let us not forget, is what this specific book is about. The confection-like seduction Adorjan creates for us, the warm promise of the other world inside the book, is an enactment of the seduction she imagines her grandmother and grandfather felt, their drive for the drug of death: a lozenge, a garden, an invisible lullaby only the two could hear. And isn’t this precisely what the experience of reading a book is?

Happy Reading!

Image courtesy of [image creator name] /



A recently-published study on the effects of altruism led by Michael J. Poulin of the University of Buffalo, followed 846 people over five years. The participants were all dealing with some level of stress in their lives.  The researchers tracked the amount of time these people spent helping others.  Dr Poulin summarizes the results of the study as, “we found that when dealing with stressful situations, those who had helped others during the previous year were less likely to die than those who had not helped others.”  For non-helpers, though, each stressful event increased the chance of dying over the next five years by 30 percent.

Wow.  Helping out others can significantly decrease your chance of dying!  Researchers do not yet understand why this relationship exists and continue to study possible causes.  They think the effect may come from the same biological mechanisms that drive parents to care for their children—such as the neurohormone oxytocin—which Dr. Poulin states, “can reduce certain physical responses to stress.” 

In the meantime, when you are feeling stressed, think about helping a friend, relative, or neighbor.  The act will distract your mind from the stressful situation, but also may help you live longer!

A more detailed review of the research study and a link to the study can be found in an article from The Greater Good.