Initial release: AI Therapy Starter Kit
Local-first, privacy-focused toolkit for AI-assisted therapy and self-reflection. Features: - Persistent session memory via local markdown files - 3 therapeutic modalities (CBT, ACT, DBT skills) - 3 therapist personas (warm, direct, coach) - Optional AES-256 encryption (Mac/Windows) - Built-in safety protocols and crisis response - Cross-platform setup scripts Co-Authored-By: Claude Opus 4.5 <noreply@anthropic.com>
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Anthony Taglianetti
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## Acceptance and Commitment Therapy (ACT)
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**Core principle:** Psychological flexibility comes from accepting difficult thoughts/feelings while committing to values-based action. The goal is not to eliminate pain, but to live fully alongside it.
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### Six Core Processes
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**1. Acceptance**
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- Willingness to experience difficult thoughts and feelings
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- Not resignation, but active openness
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- "Make room for this feeling rather than fighting it"
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**2. Cognitive Defusion**
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- Creating distance from thoughts
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- Thoughts are mental events, not facts
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- Techniques: "I notice I'm having the thought that...", naming the story ("There's the 'I'm not good enough' story again")
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**3. Present Moment Awareness**
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- Mindful contact with the here and now
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- Noticing what's happening vs. being lost in past/future
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- Grounding techniques
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**4. Self-as-Context**
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- The observing self vs. the thinking self
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- "You are the sky; thoughts and feelings are weather"
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- Stable sense of self that can hold all experiences
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**5. Values Clarification**
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- What matters most to this person?
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- Values as directions, not destinations
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- Values vs. goals (values can't be "achieved")
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**6. Committed Action**
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- Concrete steps aligned with values
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- Willingness to experience discomfort in service of values
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- Building patterns of values-consistent behavior
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### Key Questions
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- "What would you do if these thoughts/feelings weren't in the way?"
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- "What does this situation look like through the lens of your values?"
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- "Is this action moving you toward or away from what matters?"
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- "What would you be willing to feel in order to have the life you want?"
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### When to Use ACT
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- Chronic pain or illness
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- Anxiety (especially when avoidance is prominent)
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- Depression
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- Grief and loss
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- Major life transitions
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- Perfectionism and self-criticism
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- When CBT "thought challenging" isn't landing
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### ACT Exercises
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- Values card sort or clarification
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- Defusion exercises (leaves on a stream, passengers on the bus)
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- Willingness scale (0-10, how willing are you to feel X to do Y?)
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- Committed action planning
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- Mindfulness practices
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## Cognitive Behavioral Therapy (CBT)
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**Core principle:** Thoughts, feelings, and behaviors are interconnected. Changing unhelpful thought patterns leads to changes in emotions and actions.
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### Key Techniques
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**Cognitive Restructuring**
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- Identify automatic negative thoughts
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- Examine evidence for and against the thought
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- Develop balanced, realistic alternative thoughts
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- Challenge cognitive distortions (catastrophizing, black-and-white thinking, mind-reading, etc.)
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**Behavioral Activation**
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- Identify activities that improve mood
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- Schedule positive activities, especially when motivation is low
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- Track activity and mood connections
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- Gradually increase engagement with rewarding activities
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**Exposure**
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- Gradually face avoided situations
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- Build exposure hierarchies (least to most anxiety-provoking)
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- Process what was learned after each exposure
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- Challenge avoidance patterns
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**Thought Records**
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When the client describes a difficult situation, guide them through:
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1. Situation: What happened?
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2. Automatic thought: What went through your mind?
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3. Emotion: What did you feel? (0-100 intensity)
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4. Evidence for: What supports this thought?
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5. Evidence against: What doesn't support it?
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6. Balanced thought: What's a more realistic view?
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7. Outcome: How do you feel now?
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### When to Use CBT
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- Anxiety (generalized, social, phobias)
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- Depression
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- Rumination and worry
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- Perfectionism
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- Procrastination
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- Negative self-talk
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### CBT Homework Examples
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- Daily thought record
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- Behavioral experiment ("Test your prediction")
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- Activity scheduling
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- Worry time (contained worry practice)
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- Graded exposure task
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## DBT Skills
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**Core principle:** Dialectical Behavior Therapy skills help with emotional regulation, distress tolerance, interpersonal effectiveness, and mindfulness. Originally developed for borderline personality disorder, these skills are useful for anyone struggling with intense emotions.
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### Four Skill Modules
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---
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### 1. Distress Tolerance
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Skills for surviving crisis moments without making things worse.
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**TIPP (Change Body Chemistry)**
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- **T**emperature: Cold water on face, ice cube in hand
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- **I**ntense exercise: Brief burst of physical activity
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- **P**aced breathing: Slow exhale longer than inhale
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- **P**rogressive muscle relaxation
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**ACCEPTS (Distract)**
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- **A**ctivities: Do something engaging
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- **C**ontributing: Help someone else
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- **C**omparisons: Perspective (could be worse, was worse before)
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- **E**motions: Generate different emotion (comedy, music)
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- **P**ushing away: Mentally set it aside temporarily
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- **T**houghts: Occupy mind with other thoughts
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- **S**ensations: Strong physical sensations (ice, strong taste)
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**Radical Acceptance**
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- Accepting reality as it is (not approving of it)
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- "It is what it is" as starting point for change
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- Fighting reality causes suffering; acceptance allows action
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---
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### 2. Emotional Regulation
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Skills for understanding and managing emotions over time.
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**Check the Facts**
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- What triggered the emotion?
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- What am I interpreting or assuming?
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- Does my emotional intensity fit the facts?
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- Is there another way to see this?
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**Opposite Action**
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- When emotion doesn't fit the facts or isn't effective
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- Fear → Approach
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- Anger → Gently avoid, be kind
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- Shame → Share with trusted person
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- Sadness → Get active, engage
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**PLEASE (Reduce Vulnerability)**
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- **P**hysical i**L**lness: Treat it
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- **E**ating: Balanced, regular meals
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- **A**void mood-altering substances
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- **S**leep: Consistent, adequate
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- **E**xercise: Regular movement
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**Build Positive Experiences**
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- Short-term: Pleasant activities daily
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- Long-term: Work toward life worth living goals
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---
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### 3. Interpersonal Effectiveness
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Skills for navigating relationships while maintaining self-respect.
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**DEAR MAN (Getting What You Need)**
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- **D**escribe: State facts without judgment
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- **E**xpress: Share feelings using "I" statements
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- **A**ssert: Ask clearly for what you want
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- **R**einforce: Explain positive outcomes of getting it
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- **M**indful: Stay focused, don't get derailed
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- **A**ppear confident: Body language, tone
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- **N**egotiate: Be willing to give to get
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**GIVE (Maintaining Relationship)**
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- **G**entle: No attacks, threats, judgment
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- **I**nterested: Listen, show interest
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- **V**alidate: Acknowledge their perspective
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- **E**asy manner: Light touch, humor if appropriate
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**FAST (Maintaining Self-Respect)**
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- **F**air: To yourself and others
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- **A**pologies: Don't over-apologize
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- **S**tick to values: Don't compromise what matters
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- **T**ruthful: Don't lie or exaggerate
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---
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### 4. Mindfulness
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Skills for present-moment awareness and wise action.
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**What Skills (What to Do)**
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- **Observe:** Notice without words
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- **Describe:** Put words to experience
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- **Participate:** Fully engage in the moment
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**How Skills (How to Do It)**
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- **Non-judgmentally:** No good/bad labels
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- **One-mindfully:** One thing at a time
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- **Effectively:** Do what works
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**Wise Mind**
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- Integration of emotional mind and rational mind
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- Intuitive knowing that considers both facts and feelings
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- "What does my wise mind say about this?"
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---
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### When to Use DBT Skills
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- Intense emotions that feel overwhelming
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- Urges to engage in harmful behaviors
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- Interpersonal conflict
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- Crisis moments
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- Chronic emotional dysregulation
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- Self-harm or suicidal urges (crisis skills)
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### DBT Homework Examples
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- Distress tolerance skill practice during urges
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- Emotion diary with intensity ratings
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- DEAR MAN planning for upcoming conversation
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- Daily mindfulness practice (even 2 minutes)
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- Opposite action experiment
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