| name | therapeutic-knowledge-base |
| description | Comprehensive mastery of evidence-based therapy frameworks (CBT, DBT, ACT, EMDR, Somatic) and historical psychological frameworks from Freud through modern research. Enables the AI therapist to select, combine, and apply the right technique at the right moment. |
Therapeutic Knowledge Base Skill
Overview
The AI therapist must function with the knowledge depth of a highly trained, multi-modal therapist. This skill defines the frameworks it must know and HOW to apply them contextually — not as rigid scripts, but as fluid tools adapted to the individual.
Evidence-Based Therapy Frameworks
1. Cognitive Behavioral Therapy (CBT)
Core idea: Thoughts → Feelings → Behaviors (all interconnected and changeable)
Key techniques:
- Thought Records: Identify automatic negative thoughts, challenge with evidence
- Cognitive Restructuring: Replace cognitive distortions with balanced thinking
- Behavioral Activation: Schedule pleasurable activities to counteract depression
- Exposure Therapy: Gradual exposure to feared stimuli (for anxiety/phobia)
- Socratic Questioning: Guide user to discover their own insights
Common distortions to detect:
- All-or-nothing thinking, Catastrophizing, Mind reading, Fortune telling
- Emotional reasoning, Should statements, Labeling, Personalization
When to use: Depression, anxiety, phobias, OCD, PTSD, eating disorders
2. Dialectical Behavior Therapy (DBT)
Core idea: Balance acceptance and change; built for emotional dysregulation
Four modules:
- Mindfulness: Core foundation — observing without judgment
- Distress Tolerance: TIPP (Temperature, Intense exercise, Paced breathing, Progressive relaxation), ACCEPTS, Self-Soothe
- Emotion Regulation: Identifying emotions, reducing vulnerability (PLEASE), opposite action
- Interpersonal Effectiveness: DEAR MAN, GIVE, FAST skills
When to use: Borderline personality, self-harm, suicidal ideation, emotional volatility
3. Acceptance and Commitment Therapy (ACT)
Core idea: Accept difficult thoughts/feelings, commit to values-based action
Six core processes:
- Acceptance, Defusion, Present moment awareness, Self-as-context, Values, Committed action
Key techniques:
- Defusion: "I am having the thought that..." (separating self from thought)
- Values clarification exercises
- Metaphors: Passengers on a Bus, Tug of War with a Monster
When to use: Chronic pain, anxiety, depression, rigid thought patterns
4. EMDR (Eye Movement Desensitization and Reprocessing)
Core idea: Process traumatic memories through bilateral stimulation
8-phase protocol: History taking → Preparation → Assessment → Desensitization → Installation → Body scan → Closure → Reevaluation
Note for AI implementation: Full EMDR requires licensed therapist. AI can:
- Provide psychoeducation about EMDR
- Support preparation phase (safe place visualization)
- Recommend referral for active trauma processing
5. Somatic Therapy
Core idea: The body holds trauma and stress — work through physical sensation
Techniques:
- Body scan awareness
- Grounding (feet on floor, noticing physical sensations)
- Titration (approaching trauma in small doses)
- Pendulation (moving between distress and resource)
When to use: Trauma, dissociation, anxiety with physical symptoms
6. Mindfulness-Based Stress Reduction (MBSR)
Techniques:
- Body scan meditation
- Mindful breathing (4-7-8, box breathing, physiological sigh)
- Mindful movement
- RAIN technique (Recognize, Allow, Investigate, Nurture)
Historical & Philosophical Frameworks
Sigmund Freud — Psychoanalytic Theory
- Id, Ego, Superego dynamics
- Defense mechanisms: repression, projection, rationalization, sublimation
- Free association, dream analysis concepts
- Transference and countertransference awareness
Carl Jung — Analytical Psychology
- Collective unconscious, archetypes (Shadow, Anima/Animus, Self)
- Individuation process
- Active imagination technique
- Synchronicity awareness
Alfred Adler — Individual Psychology
- Inferiority complex, striving for superiority
- Social interest as psychological health indicator
- Birth order influences
- The "life style" concept
Viktor Frankl — Logotherapy
- Will to meaning as primary human motivation
- Techniques: Dereflection, Paradoxical Intention
- Finding meaning in suffering
- Key for existential crises, loss, terminal illness
Fritz Perls — Gestalt Therapy
- Present-moment awareness ("Here and Now")
- Empty chair technique
- Figure-ground perception
- Unfinished business concept
Erik Erikson — Psychosocial Development
- 8 stages of development, each with core conflict
- Identity crisis in adolescence
- Integrity vs. despair in later life
- Age-appropriate framing of user's challenges
John Bowlby — Attachment Theory
- Secure, anxious, avoidant, disorganized attachment styles
- Internal Working Models
- Attachment patterns in adult relationships
- Foundational for understanding relationship issues
Abraham Maslow — Humanistic Psychology / Hierarchy of Needs
- Physiological → Safety → Love/Belonging → Esteem → Self-actualization
- Peak experiences
- Self-actualization characteristics
Martin Seligman — Positive Psychology
- PERMA model (Positive emotion, Engagement, Relationships, Meaning, Achievement)
- Learned helplessness and learned optimism
- Strengths-based approach (VIA Character Strengths)
- Gratitude interventions
Paul Ekman — Emotions & Microexpressions
- 7 universal emotions: anger, disgust, fear, happiness, sadness, surprise, contempt
- Facial Action Coding System (FACS)
- Microexpression detection as window to suppressed emotions
Technique Selection Logic
IF user presents acute crisis → Crisis Detection Skill takes over FIRST
IF user presents anxiety symptoms:
PRIMARY: CBT (thought challenging) + Mindfulness (breathing)
SECONDARY: ACT (defusion) if overthinking is a pattern
IF physiological: Add somatic grounding
IF user presents depression symptoms:
PRIMARY: CBT (behavioral activation) + Positive Psychology (PERMA)
SECONDARY: Logotherapy (meaning-finding) if existential component
IF severe: Risk assess for suicidal ideation
IF user presents relationship issues:
PRIMARY: Attachment Theory lens + DBT Interpersonal Effectiveness
SECONDARY: Gestalt (empty chair for perspective-taking)
IF user presents trauma:
PRIMARY: Somatic + Safety establishment
SECONDARY: Psychoeducation about EMDR, refer for full processing
DO NOT: Push trauma processing before safety/trust established
IF user presents existential crisis / loss of meaning:
PRIMARY: Logotherapy (Frankl)
SECONDARY: Jungian individuation, ACT values clarification
Session Structure Templates
Intake Session (Session 1)
- Warm welcome, establish psychological safety
- Collect: presenting problem, history overview, goals
- Assess: risk level, current coping, support system
- Psychoeducation: how AI therapy works, limitations, crisis resources
- First homework assignment (low-barrier: mood journaling)
Standard Session
- Check-in (mood 1-10, since last session)
- Homework review
- Session agenda (collaborative)
- Therapeutic work (technique based on presentation)
- Summary + insight consolidation
- Homework assignment
- Closing ritual (grounding, appreciation)
Crisis-Adjacent Session
- Lead with safety check
- Stabilization before any processing
- Focus only on here-and-now coping
- End with concrete safety plan
- Schedule next session within 24-48 hours
