CBT-informed therapy that turns insight into everyday change
CBT-informed psychotherapy in New York for people who want clear, practical tools for anxiety, low mood and unhelpful thinking, within care that sees the whole person.
Thoughts, emotions, body sensations and behaviours constantly influence one another, and sometimes they lock into loops that keep us stuck. Cognitive behavioural therapy helps you see those loops clearly and gently loosen them. I use CBT tools within an integrative practice, so practical strategies sit alongside deeper understanding, somatic awareness and, where it helps, psychiatric care, rather than being applied as a one-size-fits-all formula.
“A thought can feel like the truth simply because it arrives with conviction. Learning to question it, kindly, can change how the whole day feels.”
CBT does not ask you to think positively. It asks you to think accurately, with curiosity, and to test your assumptions against real experience.
How CBT-informed therapy works
Cognitive behavioural therapy (CBT) is a structured, collaborative approach that focuses on how what we think and do in the present shapes how we feel.
At its core, CBT maps the connections between a situation, the thoughts it triggers, the emotions and physical sensations that follow, and what we then do. A single anxious thought, such as assuming a colleague is annoyed with you, can spark tension, avoidance and rumination, which in turn seems to confirm the original fear. Seeing that cycle written down is often the first moment of relief.
CBT then offers ways to intervene: noticing and questioning unhelpful thought patterns, gradually facing what you have been avoiding, building routines that support mood, and running small experiments to test whether your predictions come true. It is active and practical, and many people appreciate leaving sessions with something specific to try.
I describe my work as CBT-informed because I use these tools flexibly within an integrative practice rather than delivering a fixed, manualised course. That lets us use CBT where it is genuinely useful while still making space for history, relationships, identity and the body.
Why integrate CBT rather than use it alone
CBT is excellent at changing what keeps a problem going, but it does not always explain why a pattern formed or why it feels so hard to shift. Some thoughts are not simply errors; they are old protections, shaped by trauma, discrimination or difficult relationships. By combining CBT with psychoanalytic, relational and somatic approaches, we can challenge unhelpful thinking without dismissing the experiences that produced it.
Bringing the body into CBT
Anxiety and low mood are felt physically as well as mentally: a racing heart, shallow breathing, heaviness or restlessness. As a somatic practitioner I help you notice these sensations and include them in your CBT map. Calming the body can make cognitive work easier, and noticing physical cues early can help you catch a spiral before it gathers speed.
CBT alongside psychiatric care
For some people, symptoms are strong enough that practical tools are hard to use without additional support. As a board-certified psychiatric nurse practitioner I can assess for conditions such as depression, generalised anxiety, panic or ADHD, and discuss whether medication or supplements may help. Medication decisions are made together, with gradual, carefully monitored changes, and CBT skills remain part of the plan.
CBT-informed therapy may suit you if you want
CBT-informed therapy suits people who like structure and want to see practical progress, as well as those who have tried talking therapy and want more concrete tools. It can be particularly helpful for anxiety, worry, panic, low mood and habits you want to change, and it combines naturally with deeper work when needed.
- Constant worry and what-ifs
- Panic attacks or fear of panic
- Avoiding situations that feel threatening
- Harsh self-criticism
- Low motivation and withdrawal
- Racing thoughts at night
- Perfectionism and procrastination
- Social anxiety and overthinking conversations
- Practical tools between sessions
- Clear, measurable goals
Structured tools, human pace
CBT sessions with me have a gentle structure: we review what has happened, focus on a specific pattern, practise a tool together and agree something to try. The longer session length means there is always space to talk about whatever else matters that week.
Mapping the cycle
We break down difficult moments into situation, thoughts, feelings, body sensations and actions. Seeing how each part feeds the next makes patterns visible and shows several points where a small change could interrupt the loop.
Working with thoughts
We identify recurring thinking traps such as catastrophising, mind reading or all-or-nothing judgements, and practise weighing the evidence for and against them. The goal is a more balanced view, not forced positivity.
Gradual exposure
Avoidance brings short-term relief but tends to make fear grow. Together we build a step-by-step plan to approach what you have been avoiding, at a pace that feels challenging but manageable, so confidence can return.
Behavioural experiments
Instead of debating whether a fear is accurate, we design small real-world tests. You predict what will happen, try something different, and compare. Experience often persuades where argument alone cannot.
Routine and activation
When mood is low, motivation tends to follow action rather than precede it. We plan small, meaningful activities and look at sleep, movement and daily rhythm, building momentum gently rather than demanding big changes.
Whole-person support
CBT here sits within holistic care. Where useful, I bring in mindfulness, somatic grounding, lifestyle evaluation, supplements reviewed for safety and interactions, or psychiatric medication, so practical tools are supported by a healthier foundation.
CBT-informed and standard CBT
Standard CBT is an effective model in its own right. A CBT-informed, integrative approach adapts its tools to fit a broader picture of you.
CBT-informed integrative therapy
- Tools adapted to your history
- Space to explore underlying causes
- Somatic and mindfulness elements included
- Psychiatric care in one relationship
- Flexible length and focus
Standard short-term CBT
- Follows a set protocol
- Focuses mainly on the present
- Primarily cognitive and behavioural
- Medication usually managed elsewhere
- Fixed number of sessions
Getting started with CBT-informed therapy
A clear, collaborative process that begins with a short conversation.
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1
Free consultation 15 minutes
We talk about what you would like to change and whether a practical, CBT-informed approach fits. You can ask how sessions are structured, what between-session practice involves, and how therapy might link with psychiatric support if relevant.
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2
Assessment and formulation 60 or 90 minutes
We explore your current difficulties, history, lifestyle and goals, and I can assess psychiatric symptoms if needed. Together we draw up a formulation: a shared map of what keeps your difficulties going and where to begin.
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3
Active practice
Sessions focus on specific tools: working with thoughts, gradual exposure, experiments and routine. You try things between sessions and we review what you learned. Progress is discussed openly so we can adjust if something is not helping.
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4
Consolidating and preventing setbacks
As things improve, we build a personal plan for maintaining progress and spotting early warning signs. We may also shift towards deeper exploration of underlying patterns, or reduce session frequency, depending on what you want next.
Francesca Rome-Marie, PMHNP-BC
I bring together psychiatry, psychotherapy, somatic work and whole-body health, informed by years in primary care and further study in gender theory, feminist thought, culture and visual art.
I keep a deliberately small caseload so that every client receives consistent, unhurried and genuinely attentive care, held within one relationship rather than split across several providers.
Clear, upfront rates
I don't accept insurance. Modern Holistic Psychiatry is an out-of-network provider, so sessions are paid for directly. Depending on your plan, you may be able to claim reimbursement through your out-of-network benefits.
Find out how much your insurance may coverNeed urgent support? If you're in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline) or call 911.
CBT Psychotherapy FAQs
What is CBT-informed therapy?
CBT-informed therapy uses the principles and techniques of cognitive behavioural therapy, such as mapping thought cycles, questioning unhelpful thinking, gradual exposure and behavioural experiments, within a broader integrative approach. Rather than following a single fixed protocol, I adapt CBT tools to your needs and combine them with other approaches. In my New York practice this can include somatic work, psychoanalytic understanding and psychiatric care.
Is CBT good for anxiety and panic?
CBT is one of the most widely used approaches for anxiety, worry and panic, because it targets the avoidance and catastrophic thinking that keep fear going. Many people find it helps them feel more in control. I cannot promise a particular result, but combining CBT tools with somatic grounding and, where appropriate, medication or supplements can offer a well-rounded way to address anxiety.
How many CBT sessions will I need?
Standard CBT courses are often fairly short, but because my work is CBT-informed and integrative, there is no fixed number. Some people come for a focused period to tackle a specific problem, such as panic or procrastination, while others continue longer to explore deeper patterns. We set goals together at the start and review progress regularly so the length reflects your needs.
Does CBT ignore my past?
Standard CBT tends to focus on the present, which can be very useful. In my integrative approach, we can also look at how past experiences shaped the beliefs you hold about yourself and others. Understanding where a belief came from can make it easier to challenge, and it helps ensure that CBT feels respectful of your history rather than dismissive of it.
Can I do CBT while taking or starting psychiatric medication?
Yes. CBT and medication are often used together. As a board-certified psychiatric nurse practitioner, I can assess whether medication might help, prescribe if appropriate, and adjust or taper it gradually over time. Having therapy and medication with the same clinician means we can see how both are working and make collaborative, carefully monitored decisions.
What does CBT homework involve?
Between sessions you might record a difficult moment using a simple thought record, try a small behavioural experiment, take one step on an exposure plan, or schedule a few meaningful activities. Practice helps skills transfer into real life, but I keep tasks realistic. If something feels too much or does not fit your life, we change it together.
Is CBT-informed therapy affirming for LGBTQIA+ clients?
Yes. CBT tools can be powerful, but they must be used with awareness of context. Some negative beliefs, such as expecting rejection, may reflect real experiences of homophobia, transphobia or discrimination rather than distorted thinking. I bring an affirming, LGBTQIA+ informed stance to CBT, so we can tell the difference between unhelpful thought patterns and accurate readings of an unfair world.
Start CBT-informed therapy in New York
If you want practical tools within care that understands the whole of you, book a free 15-minute consultation and we can plan the next step together.