Desiree Alvarado, LCSW

How therapeutic approaches translate to online care

Client-centered therapy focuses on the person’s own goals and priorities. In practice that means the therapist listens hard, reflects what she hears, and helps clients decide what to try next. It is useful for people who want collaboration and pacing that fits their comfort.

Cognitive behavioral therapy, or CBT, looks at the links between thoughts, actions, and feelings. Sessions often include short exercises and homework to test new ways of thinking. It can help with anxiety, depression, panic, and problems like impulsivity or codependency.

Dialectical behavior therapy, or DBT, teaches skills for managing intense emotions, reducing self-destructive behaviors, and improving communication. Skill coaching and steady practice are common parts of this work and can be helpful for mood instability and impulsive reactions.

Finding the right approach is part of the work. The therapist will talk with a client about goals, try methods that fit, and adjust the plan as progress and preferences become clearer. This is a collaborative process, not a one-size-fits-all prescription.

Online therapy makes the same methods accessible through video, phone, live chat, or text-based messaging. Video gives face-to-face interaction when helpful, phone calls can be easier on low bandwidth or when someone prefers not to be on camera, and chat or text supports quick check-ins or ongoing reflection between sessions. These options let people fit therapy into work, caregiving, or busy schedules and help keep momentum between sessions.