Desiree Monroe, MD, LCPC

How therapeutic approaches fit into online care

Client-Centered Therapy focuses on understanding each person's goals and values. The therapist listens carefully, reflects what she hears, and helps people choose the next steps that feel right for them. This approach is useful for building trust and clarifying priorities. Cognitive Behavioral Therapy, or CBT, teaches people to notice unhelpful thoughts and test small behavior changes. It’s practical and problem-focused, often used for anxiety, depression, and mood concerns. Dialectical Behavior Therapy, or DBT, offers skills in emotion regulation, distress tolerance, and interpersonal effectiveness, which can help with intense emotions and impulsive behaviors. Deciding which approach to use is a collaborative process. The therapist will talk with each person about their goals, try out techniques, and adjust the plan based on what helps most. That shared decision-making makes it easier to find a good fit. Online sessions offer flexibility to fit therapy into busy lives. Video calls let people see facial cues and use worksheets together. Phone sessions work well when bandwidth is limited or when someone prefers not to be on camera. Live chat and text-based messaging allow shorter check-ins, ongoing reflection between sessions, and an option for people who prefer writing. These formats help make consistent work on skills and coping tools more manageable.