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Therapeutic Modalities

Clinical Psychologist Aylesbury
Cognitive Behaviour Therapy (CBT) 

Cognitive Behaviour Therapy (CBT) is a structured, evidence-based psychological treatment grounded in the understanding that thoughts, emotions, physical sensations, and behaviours are closely interconnected. Negative thinking patterns can create and sustain cycles of emotional distress and unhelpful behaviour. CBT helps individuals identify and challenge these patterns, promoting more balanced thinking and healthier responses. The therapeutic process is collaborative, with therapist and client working together to develop practical strategies that address current difficulties. The focus is typically on the present, helping individuals to gain insight into how their thoughts and behaviours influence one another in the here-and-now. Over time, CBT equips individuals with a toolkit of skills and techniques designed to foster resilience and self-management. A core aim is to empower individuals to become their own therapist, so they can confidently apply what they have learned to manage future challenges. CBT is widely researched and has been shown to be effective in treating a broad range of mental health conditions, including depression, anxiety disorders, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD), among others.
 

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Trauma-Focused CBT (TF-CBT)

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Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) is an evidence-based psychological treatment designed to support individuals in recovering from the emotional and psychological effects of trauma. Integrating cognitive-behavioural strategies with trauma-informed principles, TF-CBT aims to help individuals process traumatic memories, challenge unhelpful thought patterns, and develop effective coping skills. Delivered in a structured and supportive manner, this approach seeks to reduce symptoms such as post-traumatic stress, anxiety, and depression, while fostering resilience, emotional regulation, and a renewed sense of safety and empowerment.

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Dialectical Behaviour Therapy (DBT) & (RO DBT)

Dialectical Behaviour Therapy (DBT) is a structured, evidence-based approach originally developed to support individuals who experience chronic suicidal thoughts, engage in self-harming behaviours, or find themselves using destructive coping mechanisms to manage overwhelming emotions. The term dialectical refers to the balance between two seemingly opposing forces—acceptance and change. The aim is to find a “middle path” that allows individuals to accept themselves as they are, while also working towards positive, meaningful changes in how they relate to themselves and others.​ DBT integrates key components of Cognitive Behavioural Therapy (CBT) with skills for emotional regulation, distress tolerance, interpersonal effectiveness, and mindfulness. It helps individuals learn how to better understand and manage intense emotions, navigate relationships more effectively, and develop greater psychological resilience.
 

Radically Open Dialectical Behaviour Therapy (RO-DBT) is a more recent adaptation of DBT designed for individuals who struggle with overcontrol—a personality style characterised by excessive self-restraint, perfectionism, emotional inhibition, and social withdrawal. While self-control can be adaptive, too much can lead to significant distress and difficulties in emotional expression and social connection.
 

RO-DBT targets five core features of overcontrol:

  • Inhibited or incongruent emotional expression

  • Overly detailed-focused or cautious behaviour

  • Rigid, rule-bound thinking and acting

  • Aloof or distant interpersonal style

  • Heightened social comparison or self-criticism
     

At the heart of RO-DBT is the concept of Radical Openness—a willingness to experience the discomfort of uncertainty, to learn from feedback, and to remain flexible in the face of life’s challenges. It fosters three core capacities essential to emotional wellbeing: openness to new experiences, psychological flexibility, and authentic social connectedness. This approach can be particularly helpful for individuals who feel emotionally constricted, socially isolated, or stuck in patterns of perfectionism and control that limit personal growth and meaningful relationships.

Mindfulness-Based Stress Reduction (MBSR)

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Mindfulness-Based Stress Reduction is an evidence-based, structured therapeutic program designed to help individuals manage stress, anxiety, depression, and chronic pain through the cultivation of mindfulness. MBSR combines mindfulness meditation, gentle movement practices such as yoga, and techniques for enhancing present-moment awareness. The approach encourages individuals to develop a non-judgmental, accepting attitude toward their thoughts, emotions, and bodily sensations, fostering greater resilience, emotional regulation, and overall well-being. MBSR is typically delivered over an eight-week period and is grounded in both psychological science and contemplative traditions, making it a widely respected and effective intervention for promoting mental and physical health.

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Compassion Focused Therapy (CFT)

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Compassion-Focused Therapy is a therapeutic approach that helps people develop a kinder, more supportive relationship with themselves. Many individuals who experience high levels of self-criticism, shame, or difficulties linked to trauma can find it hard to feel warmth or compassion toward themselves — and this can contribute to ongoing emotional distress. CFT works by helping you strengthen your inner capacity for compassion, both for yourself and for others. It draws on insights from psychology, neuroscience, and cognitive-behavioral therapy, using techniques like mindfulness, guided imagery, and practical exercises to activate the brain’s natural soothing systems. Through CFT, you can learn to respond to challenges with greater resilience, self-acceptance, and emotional balance, supporting deeper healing and personal growth.
 

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Psychodynamic-Informed Therapy

Psychodynamic informed Therapy is an evidence-based approach that focuses on how early experiences, relational patterns, and unconscious processes influence current emotional and relational difficulties. Through a collaborative and reflective therapeutic relationship, individuals are supported in gaining deeper insight into longstanding patterns of thinking, feeling, and behaving. By bringing these underlying dynamics into awareness, psychodynamic-informed work aims to foster greater self-understanding, emotional resilience, and the capacity for change. Therapy is paced sensitively according to each individual's needs, with the goal of promoting lasting psychological growth and improving overall well-being.

 

Clinical Supervision

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I provide clinical supervision to qualified psychologists, trainees, and assistant psychologists across a range of settings. Supervision is offered within a reflective, supportive, and collaborative space, with a focus on developing clinical skills, enhancing professional confidence, and promoting high-quality client care. My approach is informed by evidence-based frameworks and draws from a range of therapeutic models. Experience working with diverse and complex clinical presentations informs a flexible, integrative style of supervision, responsive to the needs of both the practitioner and the context they work in. Supervision is tailored to individual goals, whether that involves refining clinical formulations, strengthening intervention skills, or supporting professional development. Emphasis is placed on creating a safe space for reflective practice, exploration of challenges, and continuous learning.

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Areas of work​​
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  • Anxiety and Anxiety Disorders

  • Depression and low mood

  • Perfectionism

  • Post-Traumatic Stress Disorder (PTSD)

  • Interpersonal difficulties

  • Emotion regulation 

  • Anger management

  • Personality Difficulties

  • Low self-esteem and low confidence

  • Narcissistic Abuse

  • Loneliness

  • Stress​ and burnout

  • Major life changes

  • Relationships difficulties

  • Insomnia and nightmares

  • Bereavement

  • Adjustment Disorder

  • Autism and ADHD

  • Personality assessment

  • Cognitive assessment

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© 2025 by Maria Francesca Ciotta, CPsychol

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