Xavier Fullerton, LCMHC

Approaches used in online sessions and what they help

Client-centered therapy focuses on listening and building a strong working relationship. The therapist follows the person’s lead, reflects what they say, and helps them find their own solutions; this approach supports people needing acceptance and clearer self-understanding.

Cognitive Behavioral Therapy, or CBT, breaks problems into thoughts, feelings, and actions. It teaches practical tools to challenge unhelpful thinking and change behaviors, which is helpful for anxiety, depression, panic, and sleep issues.

Dialectical Behavior Therapy, often called DBT, emphasizes emotional regulation, distress tolerance, and interpersonal skills. It is useful for intense emotions, impulsivity, anger, and self-harm urges.

Finding the right approach is part of the early work in therapy. The therapist will discuss goals and preferences and then try techniques that fit the person’s needs. That collaborative process helps shape a plan that mixes approaches as needed.

Online formats include video calls, phone sessions, live chat, and text-based messaging. Video calls are good for face-to-face conversation and practicing skills together. Phone sessions can work when bandwidth is limited or when someone prefers not to be on camera. Live chat and text-based messaging make brief check-ins and step-by-step coaching possible between sessions. These options give flexibility to fit therapy into work, caregiving, or busy schedules.