Types of Psychotherapy
As mentioned in a previous blog post, psychotherapy is both a science and an art. Psychotherapy is a meeting of the minds between a client, who is the expert on themselves, and the therapist, who is the specialist on human behavior. A psychotherapist (meaning a counselor, psychologist, social worker, or other professional) has extensive education and training in human behavior, human development, interpersonal dynamics, human physiology, systems, and other subjects. So, therapy is a place where a therapist will artfully deliver their scientific knowledge to serve their clients in reaching their goals, whatever those goals may be.
Psychotherapy differs from other types of therapies such as physical therapy or occupational therapy as its primary function is to explore and adapt the client’s psychological health, rather than one’s physical health or bodily abilities. In Western culture, psychotherapy usually takes the form of “talk therapy”, in which the client and therapist engage in conversation about the client’s experience. However, psychotherapy can also include art therapy, dance therapy, equine therapy, play therapy, and other types of therapy. Different types of talk therapy typically fall into a few different “orientations” or “schools” of therapy and share common themes with similar therapies from that orientation. For this blog post, we’ll examine the most common orientations of talk therapy below.
First, we’ll look at psychoanalytic and psychodynamic therapy. Popular media most often portrays this type of therapy as the client laying on the couch, talking about whatever pops into mind, with the therapist sitting behind them occasionally offering their reflections. This portrayal in the media is loosely based on older types of psychodynamic therapies, most notably Sigmund Freud’s psychoanalysis. Psychodynamic therapy began with Freud (although his methods are outdated and scientifically rebuffed) and continues to this day with more empirically backed styles like interpersonal therapy (IPT). These types of therapies are characterized by a strong alliance between client and therapist, and the pair use the interactions of the relationship to help the client learn about their thinking patterns, emotions, experiences, and the ways they interact with others. The common themes in psychodynamic therapy include exploration of the client’s past (in particular the client’s early relationships) and how it affects the present, an analysis of interactions in the therapeutic relationship, facilitation of insight, and healthy expression of emotions.
Next, let’s examine the humanistic-existential school of therapies. The H-E orientation is distinguished by its assumptions that the client is the expert on themselves, that every human needs empathy and unconditional positive regard to grow, and that humans have the ability to create their personal idea of meaning and fulfillment. Major focuses of H-E therapies include increasing attention to the present moment and building acceptance of one’s experience. Common H-E approaches include existential therapy, gestalt therapy, and person-centered therapy. H-E therapies can be particularly helpful for addressing relationship issues, feelings of worthlessness, feeling directionless, dealing with chronic health issues or pain, coping with grief, and managing self-compassion or esteem issues.
The third approach we will look at is the Cognitive-Behavioral Therapy approach. This is the type of therapy with the most research backing its effectiveness, and has been shown to treat depression, anxiety, trauma, insomnia, bipolar disorder, personality disorders, chemical dependency, eating disorders, and a multitude of other mental health concerns. CBT asks clients to observe how their thoughts, emotions, and behaviors affect one another, and work to change their negative thinking patterns or maladaptive behaviors to improve their experience. Common CBT approaches include behavioral analysis, mindfulness-based cognitive therapy (MBCT), Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and Functional Analytic Psychotherapy (FAP). Often, therapies from the CBT orientation will ask the client to practice coping skills or complete homework outside of the therapy session.
Systems therapy is talk therapy with a lens on how an individual or relationship is embedded in a bigger “system”. A system is a single or network of relationships, such a marriage, a family system, or a school. Therapists who use systems theory look at altering the group dynamic that is being observed, rather than asking one individual to adapt, in order to create effective change and improvement for all parties involved. Common forms of systems therapy include couples therapy and family therapy.
Finally, we come to integrative psychotherapy. None of the previously mentioned approaches to therapy perfectly fit every client’s experience, support every client in they way the client needs, nor offer comprehensive ideas and answers about how a client can create change in their life. With this in mind, most therapists adopt an integrative style to psychotherapy. This means that the clinician will blend various theories, approaches, and interventions from the previously mentioned orientations to meet whatever the client might need. This allows the therapist flexibility in how they respond to and support the client.
Talk with your therapist about what orientations they offer and if their approach fits your needs. If it feels like the style they use isn’t helping, be sure to let them know so they can either adapt to what you need or help you get connected to someone who fits what you are looking for. To learn more about which style might best support you, be sure to call or email CPGR to set up an appointment!
