Precision Therapy: Targeting What Hurts to Heal What Matters

In this episode, I speak with Matt about his evolution as a therapist, researcher, and founder of New Harbinger Publications. Originally trained in Gestalt therapy, Matt transitioned to Cognitive Behavioral Therapy (CBT) after discovering its effectiveness in addressing his own anxiety—and its ability to offer more structured tools for change. From there, his work expanded into third-wave CBTs like Acceptance and Commitment Therapy (ACT) and Dialectical Behavior Therapy (DBT), especially as he sought to support clients experiencing complex emotional challenges, trauma, and persistent distress that weren’t always responsive to traditional CBT protocols. We discuss the development of a transdiagnostic and precision-based approach to therapy, centered on identifying specific mechanisms such as emotional and cognitive avoidance. Matt explains how treatment can be tailored using interventions like emotion exposure, mindfulness, and cognitive diffusion to address each client’s unique coping profile—an approach supported by his work on the Comprehensive Coping Inventory. Matt also talks about the founding and mission of New Harbinger Publications, which pioneered the self-help workbook format grounded in evidence-based therapies. He shares insight into their newest tool, Therapy Assist, a digital resource for therapists to assign skills-based, diagnostic-specific homework. We delve into his clinic’s current research on trauma treatment, including the effectiveness of combining ACT with EMDR and written exposure therapy. We also explore how trauma manifests physiologically and emotionally, and why traditional approaches often fall short when addressing complex PTSD, dissociation, or early attachment trauma. Matt reflects on integrating coping skills into ACT—an often debated topic—and describes his efforts to bridge therapeutic models like Schema Therapy and ACT. We explore how these integrations can support trauma clients in choosing value-based responses over automatic, schema-driven reactions. Throughout the conversation, we reflect on the growing movement toward precision therapy—individualized, mechanism-targeted, and empirically grounded. Dr. McKay’s work continues to shape how therapists understand suffering and resilience, and how they can empower clients with the tools to navigate both. Dr. Matthew McKay is a clinical psychologist, professor at the Wright Institute, founder of New Harbinger Publications, and author of research and over 40 books on CBT, ACT, trauma, and emotional healing, including Mind and Emotions, The Relaxation and Stress Reduction Workbook, and Emotion Efficacy Therapy. He cofounded the Haight Ashbury Psychological Services agency in 1979 and served as its Clinical Director for 25 years and is currently the co-director of the Bay Area Trauma Recovery Clinical Services (BATRCS). Matt's interests extend to writing poetry, fiction, and music, and he has a published novel and two books of poetry.