Frequently Asked Questions

  1. What is Cognitive Behavioral Therapy?

    Cognitive Therapy, or CT, was developed by Aaron Beck, MD. Cognitive Therapy is based on the cognitive
    model, which is, simply, that the way we perceive situations influences how we feel emotionally.
    For example, one person reading this might think, “Wow! This sounds good, it’s just what I’ve always
    been looking for!” and feels happy. Another person reading this might think, “Well, this sounds good
    but I don’t think I can do it.” This person feels sad and discouraged. So it is not the situation
    which directly affects how people feel emotionally, but rather, their thoughts in that situation.

    When people are in distress, they often do not think clearly and their thoughts are distorted in some
    way. Cognitive therapy helps people to identify their distressing thoughts and to evaluate how realistic
    the thoughts are. Then they learn to change their distorted thinking, and when they think more realistically,
    they feel better. The emphasis is consistently on solving problems and initiating behavioral change.

    Behavior Therapy, like Cognitive Therapy, is based on scientific research and is often effective in a
    brief period of time. Behavior Therapy focuses on how people learn and how what they have learned
    affects their behavior in various situations. Behavior Therapy is used to change/modify unwanted
    behaviors and is also used to treat many kinds of problems and disorders.

    Frequently, Behavior Therapy is combined with Cognitive Therapy to help people gain a better understanding
    of the relationship between their thoughts, feelings, and behavior. Frequently, this combined approach
    is referred to as “Cognitive Behavior Therapy,” or CBT.

    To learn more about cognitive-behavioral therapy please visit the following: Academy of Cognitive Therapy or the Association for Behavioral and Cognitive Therapies

  2. Is cognitive-behavioral therapy effective?

    Cognitive-behavioral therapy is one of the few forms of therapy that has been scientifically tested and shown to be effective
    in many clinical trials for many different disorders. You can contact the Academy of Cognitive Therapy
    at or the Association for Behavioral and Cognitive Therapies at for up-to-date research information on cognitive-behavioral therapy.

  3. What is Dialectical Behavior Therapy (DBT) ?

    Dialectical Behavior Therapy (DBT) is a specific type of cognitive behavioral therapy (CBT) that has
    been shown in rigorous and structured research trials to work better than other available treatments
    for treating self-injury, suicidality, and Borderline Personality Disorder.  Smaller trials have
    shown promise for using DBT to treat eating disorders and drug abuse.  Comprehensive DBT includes
    both training in DBT skills (often delivered in groups), and individual therapy by a DBT therapist.
    DBT skills for clients fall into 4 categories: Mindfulness (directing one’s own attention), Distress
    Tolerance (getting through a bad situation without making it worse), Emotional Regulation (how do
    emotions work and how to cope with them), and Interpersonal Communication (better methods of interacting
    with other people).

  4. Can you prescribe medication?

    Only a medical doctor, such as a psychiatrist or a family physician, or a specially licensed clinical
    psychologist in a few states (not NC), can prescribe psychiatric medication. Of our staff members,
    Dr. Signi Goldman is able to prescribe medications. However, when other staff members determine that
    medication may be the appropriate treatment or may be an effective adjunct to the treatment they
    provide, they will refer their clients to Dr. Goldman or another appropriate psychopharmacologist
    for a medication evaluation.

  5. Do you have any ongoing groups at the CBT Center?

    Yes. Currently, we have an adolescent and an adult Dialectical Behavior Therapy skills groups. For more
    information on these groups please
    visit the Dialectical Behavior Therapy (DBT) section of our website.

  6. Do you accept insurance?

    Yes, we accept most insurance. We are currently in network with Blue Cross/Blue Shield and Medicare.
    We accept most other insurance plans with out-of-network benefits. Please feel free to contact our
    office at 828‑350‑1177 with any questions you have about your insurance coverage.

  7. Do you accept Medicaid?

    No. We do not accept Medicaid at this time.

  8. Is therapy expensive?

    Therapy can be expensive. However, the benefits of psychotherapy cannot be measured solely in monetary
    terms. Psychotherapy often provides people with skills that they can use for the rest of their lives.

    Sometimes we can gain a clearer perspective on the value of psychotherapy by comparing the cost of therapy
    with the costs associated with other things we value. For example, consider what you pay for vacations,
    cars, and clothes. The monthly cost of therapy is roughly the cost of an average car payment. Do
    you value your emotional well being as much as your car? Many people can undergo 5-6 months of therapy
    for the cost of an average week long vacation. Vacations are nice, but which do you value more-your
    marriage or a vacation? Sometimes this type of comparison can provide an alternative perspective
    about the costs associated with psychotherapy.