Integrated CBT, ACT & DBT Skills Counseling in Louisville, KY for Kids, Teens and Adults

A specialized, neurodiversity-affirming approach for clients who need more than one-size-fits-all therapy.

At Closer Horizons, therapy is not limited to a single method or a rigid protocol. We use an integrated therapeutic approach that combines modified CBT, Acceptance and Commitment Therapy, and Dialectical Behavior Therapy skills training to support children, teens, adults, and families in Louisville, KY.

This approach was developed through Dr. Kenya Guarnieri’s clinical experience working with neurodivergent individuals, families, schools, and young adults who often arrive carrying years of shame, guilt, masking, emotional exhaustion, and unmet support needs.

Many clients have been told, directly or indirectly, that they are too sensitive, too intense, too scattered, too rigid, too emotional, too much, or not enough. They have been asked to function in environments that did not fully understand their needs — and then blamed when those environments became unsustainable.

At Closer Horizons, therapy is designed to offer something different: a fresh, clinically grounded, skills-based, neurodiversity-affirming approach that helps clients understand themselves more clearly, regulate more effectively, communicate more directly, and move through life with greater confidence and self-advocacy.

A Therapy Approach Unique to Closer Horizons

The integrated CBT, ACT, and DBT skills approach used at Closer Horizons reflects Dr. G’s specialized training, clinical judgment, and years of experience supporting neurodivergent children, teens, adults, and families.

While CBT, ACT, and DBT are established therapeutic approaches, the way they are blended at Closer Horizons is intentionally individualized. Therapy is adapted to the person’s developmental stage, neurotype, emotional regulation needs, sensory profile, executive functioning, communication style, family context, and real-life demands.

This is not therapy by worksheet. It is not generic coping skills. It is not a script.

It is an integrated experience that combines evidence-based tools with clinical depth, practical skills training, and respect for the whole person.

Who May Benefit from Integrated CBT, ACT & DBT Skills Therapy

This approach may be helpful for clients who are navigating:

  • ADHD, autism, or other neurodevelopmental differences

  • Anxiety, chronic stress, or emotional overwhelm

  • Burnout, shutdown, or exhaustion from years of overfunctioning

  • Masking, people-pleasing, or chronic self-monitoring

  • Shame, guilt, or the feeling of never quite measuring up

  • Difficulty with emotional regulation or distress tolerance

  • Executive functioning challenges, task initiation, or follow-through

  • Sensory overwhelm or difficulty recovering after high-demand situations

  • Communication challenges at home, school, work, or in relationships

  • Difficulty identifying needs, setting boundaries, or advocating for support

  • Adjustment after a new diagnosis or late diagnosis

  • Family stress related to regulation, routines, expectations, or misunderstood behavior

This approach can be especially meaningful for neurodivergent clients who have tried therapy before but felt that it did not fully fit how they think, process, communicate, or experience the world.

Why Combining These Methods Matters

Each therapeutic approach contributes something different.

Modified CBT helps clients understand patterns among thoughts, feelings, behaviors, body responses, and daily functioning. ACT helps clients loosen the grip of shame, clarify values, and make choices that align with who they are. DBT skills training gives clients practical tools for emotional regulation, distress tolerance, mindfulness, and communication.

Together, these approaches create a more complete therapeutic experience.

Many clients do not need one tool. They need a thoughtful blend of insight, acceptance, skill-building, regulation, self-understanding, and real-life practice.

That is what this integrated model is designed to offer.

Modified CBT: Understanding Patterns and Building Practical Change

Cognitive behavioral therapy, often called CBT, helps clients understand the connection between thoughts, feelings, behaviors, and body responses. At Closer Horizons, CBT is modified to better fit neurodivergent clients and individuals who may need more structure, concrete examples, emotional regulation support, or real-life application.

Modified CBT may help clients:

  • Identify anxiety, avoidance, or shutdown patterns

  • Understand how thoughts and body responses affect behavior

  • Reduce all-or-nothing thinking and perfectionism

  • Build more realistic self-talk

  • Develop practical routines and supports

  • Connect insight to daily follow-through

  • Understand how executive functioning affects emotional wellbeing

For neurodivergent clients, modified CBT is most helpful when it does not treat difference as distortion. Instead, it asks what is actually happening, what demands are exceeding capacity, and what supports would make functioning more sustainable.

ACT: Moving from Shame Toward Values-Based Living

Acceptance and Commitment Therapy, or ACT, helps clients build psychological flexibility — the ability to notice difficult thoughts and feelings without being controlled by them, and to move toward what matters even when discomfort is present.

At Closer Horizons, ACT is especially helpful for clients who have spent years carrying shame and guilt related to being different, needing support, masking, or not meeting unrealistic expectations.

ACT may help clients:

  • Notice shame-based thoughts without treating them as truth

  • Separate responsibility from self-blame

  • Clarify personal values and priorities

  • Make choices based on what matters rather than fear or performance

  • Develop a more compassionate relationship with themselves

  • Recognize when masking is automatic rather than intentional

  • Choose when, where, and how to use masking as a tool rather than a default way of functioning

For many clients, ACT becomes a bridge between self-understanding and meaningful change.

DBT Skills Training: Regulation, Communication, and Distress Tolerance

Dialectical Behavior Therapy, or DBT, is a skills-based therapy approach that focuses on helping people manage intense emotions, tolerate distress, stay present, and communicate more effectively.

At Closer Horizons, DBT skills are infused into therapy in practical, developmentally appropriate ways. The goal is not to place every client in a rigid DBT protocol. The goal is to teach skills that support real-life regulation, advocacy, relationships, and recovery.

DBT skills may support:

  • Emotional regulation

  • Distress tolerance

  • Mindfulness and present-moment awareness

  • Interpersonal effectiveness

  • Communication and boundary-setting

  • Repair after conflict

  • Reducing impulsive responses during overwhelm

  • Identifying what is needed before shutdown or escalation

For neurodivergent clients, DBT skills can be especially useful when they are taught with attention to sensory needs, processing style, executive functioning, and the client’s actual environment.

Reducing Masking and Building Intentional Self-Advocacy

Many neurodivergent clients learn to mask in order to survive environments that were not built with them in mind. Masking may involve hiding sensory discomfort, suppressing movement, scripting conversations, forcing eye contact, pretending to understand, over-preparing, or appearing calm while internally overwhelmed.

Masking is not always wrong. Sometimes it is a tool that helps a person navigate a specific situation. The problem is when masking becomes the default place of functioning — the automatic setting that operates even when the person is safe, exhausted, or unsure of what they actually need.

The integrated approach at Closer Horizons helps clients become more aware of when they are masking, why they are masking, what it is costing, and whether another response is possible.

Clients often report growth in areas such as:

  • Recognizing overload earlier

  • Naming needs more clearly

  • Communicating more directly at home, school, or work

  • Advocating for accommodations or support

  • Reducing automatic masking

  • Using masking more intentionally when needed

  • Feeling less shame around difference

  • Experiencing greater confidence and life satisfaction

The goal is not to remove every challenge. The goal is to help clients live with more awareness, more choice, and less self-abandonment.

Healing from Years of Shame, Guilt, and Unrealistic Expectations

Many clients come to therapy carrying painful stories about themselves.

“I am lazy.”

“I am too much.”

“I should be able to handle this.”

“Everyone else can do this, so what is wrong with me?”

These stories often develop after years of being misunderstood. A child who could not tolerate noise may have been called dramatic. A teen who shut down under pressure may have been called unmotivated. An adult with ADHD may have been told they lack discipline. An autistic adult may have spent decades performing competence while privately exhausted.

Therapy at Closer Horizons helps clients examine those stories with compassion and accuracy. Modified CBT helps identify the patterns. ACT helps create distance from shame-based beliefs. DBT skills help clients regulate enough to respond differently.

Together, these methods support healing that is both emotional and practical.

A Highly Specialized Approach for Neurodivergent Clients

This integrated treatment approach is a signature part of care at Closer Horizons. It reflects Dr. G’s specialty training, clinical experience, and continued commitment to bringing current research, fresh clinical thinking, and neurodiversity-affirming practice to individuals who have too often been told they do not belong.

Dr. Kenya Guarnieri is a Licensed Psychologist and Licensed School Psychologist with a Ph.D. in School Psychology and 15 years of experience across school and clinical settings. Her background includes extensive work with neurodivergent individuals, ADHD, autism, executive functioning, anxiety, burnout, emotional regulation, family systems, and school-based supports.

Her clinical lens is shaped by evidence-based care, specialized training, supervision of psychology trainees, and a deep respect for the lived experience of neurodivergent clients.

At Closer Horizons, the work is both clinically informed and deeply human. Clients are not treated as problems to fix. They are supported as whole people whose patterns make sense when understood in context.

What Integrated Skills-Based Therapy May Include

Depending on the client’s needs, therapy may include:

  • Modified CBT for anxiety, avoidance, and thought-behavior patterns

  • ACT for shame, values, masking awareness, and psychological flexibility

  • DBT skills for emotional regulation, distress tolerance, mindfulness, and communication

  • Skills training for self-advocacy, executive functioning, and daily routines

  • Support for sensory overwhelm, shutdown, or burnout recovery

  • Parent consultation or family support when helpful

  • Communication tools for home, school, work, and relationships

  • Strategies for reducing automatic masking and increasing intentional choice

  • Real-life practice with boundaries, advocacy, repair, and regulation

  • Support in building a more sustainable and satisfying life

The work is structured, but not rigid. It is practical, but not shallow. It is evidence-informed, but never disconnected from the person sitting in the room.

Integrated Therapy in Louisville, KY and Surrounding Areas

Closer Horizons provides integrated CBT, ACT, and DBT skills therapy in Louisville, KY for children, teens, adults, and families. This approach may be especially helpful for clients navigating ADHD, autism, anxiety, burnout, emotional dysregulation, executive functioning challenges, masking, shame, self-advocacy, and neurodivergent identity.

Located in the Louisville area, Closer Horizons serves clients from Jefferson County, Jeffersontown, Middletown, East Louisville, Oldham County, and surrounding communities.

If traditional therapy has felt too generic, too surface-level, too focused on compliance, or not fully connected to how you or your child actually functions, this approach may offer a better fit.

Helpful Research and Resources

For individuals and families who want to learn more, these research-based resources may be helpful:

These resources support the use of adapted CBT, ACT-informed approaches, and DBT skills for neurodivergent individuals when therapy is thoughtfully tailored to the person’s needs. They are not a substitute for individualized therapy, counseling, or consultation with a qualified clinician.

Frequently Asked Questions About Integrated CBT, ACT & DBT Skills Therapy

What is integrated CBT, ACT, and DBT skills therapy?

It is a therapeutic approach that blends modified cognitive behavioral therapy, Acceptance and Commitment Therapy, and Dialectical Behavior Therapy skills training. At Closer Horizons, these methods are adapted for the client’s developmental stage, neurotype, emotional regulation needs, sensory profile, executive functioning, and real-life demands.

How is this different from regular therapy?

This approach is more intentionally layered. It does not rely on one model or one set of worksheets. It combines insight, acceptance, emotional regulation, practical skills, self-advocacy, and values-based action in a way that is individualized to the client.

Can this help with masking?

Yes. Therapy can help clients become more aware of when they are masking, what purpose masking is serving, and when it may be costing too much. The goal is not to shame masking, but to help it become a conscious tool rather than an automatic default.

Can this approach help with shame and guilt?

Yes. Many clients carry shame related to years of feeling different, misunderstood, inconsistent, overwhelmed, or unable to meet unrealistic expectations. This integrated approach helps clients understand those patterns, reduce self-blame, and build skills for regulation, communication, and values-aligned action.

Is this approach helpful for ADHD and autism?

It can be. Many ADHD and autistic clients benefit from therapy that combines practical skills, emotional regulation support, neurodiversity-affirming care, and a deeper understanding of masking, executive functioning, sensory needs, and burnout.

Is this approach used with children, teens, and adults?

Yes. The approach is adapted across development. Children may need more concrete, visual, and family-supported skills. Teens may need support with identity, school stress, masking, and self-advocacy. Adults may need support with burnout, relationships, work demands, parenting, late diagnosis, and rebuilding a life that better fits their capacity.

Do you provide integrated therapy near Jeffersontown, Middletown, or East Louisville?

Yes. Closer Horizons provides integrated CBT, ACT, and DBT skills therapy in Louisville, KY and serves clients from nearby areas including Jefferson County, Jeffersontown, Middletown, East Louisville, Oldham County, and surrounding communities.

Related Services

If you are looking for additional support, Closer Horizons also provides:

  • Modified CBT therapy in Louisville, KY

  • Acceptance and Commitment Therapy in Louisville, KY

  • Autism counseling in Louisville, KY

  • ADHD counseling in Louisville, KY

  • Anxiety therapy and burnout counseling

  • Executive functioning support

  • Neurodiversity-affirming therapy

  • Therapy for children, teens, and adults

  • ADHD evaluations in Louisville, KY

  • Autism evaluations in Louisville, KY

  • Psychoeducational evaluations and learning disability testing

Ready to Experience Therapy That Fits Differently?

If you or your child has spent years feeling misunderstood, masking, overfunctioning, or trying to meet expectations that were never built with your needs in mind, Closer Horizons can help.

Our integrated CBT, ACT, and DBT skills approach offers practical, neurodiversity-affirming therapy in Louisville, KY for clients who are ready for support that is both evidence-informed and deeply individualized.

Schedule a consultation to learn whether this approach may be a good fit.