Some studies have shown that the quality of the therapeutic relationship between client and therapist is a stronger predictor of therapeutic outcomes than the type of therapy used. However, it seems logical that the type of therapy should at least to some extent match up with how you tend to conceptualize the problems you’re experiencing. Here is a brief run-down of some different psychotherapy approaches. This is by no means an exhaustive list, and it doesn’t include things like humanistic approaches or those therapies that do a deep dive into past issues and attachment. GoodTherapy.org has a much more extensive list.
ACT: Acceptance and Commitment Therapy
ACT takes the perspective that resistance to thoughts and feelings is the main cause of distress. It addresses areas such as present moment awareness, acceptance, separating the self from thoughts, and taking committed action consistent with identified values.
CBT: Cognitive Behavioural Therapy
CBT is perhaps one of the best known counselling approaches. It considers the relationships between thoughts, feelings, and behaviours, and how each of those elements can be changed. Evidence for and against thoughts is examined with the goal of identifying cognitive distortions that cause distress and replacing them with more realistic thoughts. As well, new behaviours are practiced to reduce distress and promote more realistic thinking.
CPT: Cognitive Processing Therapy: This is a form of CBT for PTSD, and aims to change cognitions about the trauma that are keeping the person stuck and preventing them from fully processing the trauma. The post Creating a Trauma Account talks about how I borrowed a tool from CPT.
PE: Prolonged Exposure: This is a form of CBT that aims to decrease fear and trauma responses by exposing the person in a controlled way. This can be either in vivo (in person) or imaginal (the client is asked to vividly imagine a particular situation), or a combination of both. It progresses based on an identified hierarchy of feared stimuli.
TF-CBT: Trauma-Focused CBT: Like CPT, this is a form of CBT for trauma, but it is geared toward children and adolescents.
CFT: Compassion-Focused Therapy
DBT: Dialectical Behaviour Therapy
DBT was developed by Dr. Marsha Linehan to address some of the shortcomings of CBT for treating borderline personality disorder (BPD). The dialectic refers to the idea that the way the individual is doing things now is valid and they are doing the best they can, but they would still benefit from change. DBT is very skill-based, with modules covering areas of mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness.
EFT: Emotionally Focused Therapy
This type of psychotherapy considers emotions to be reflective of underlying needs, and classifies emotions as adaptive, maladaptive, reactive, and instrumental. Therapeutic tasks are identified based on the client’s particular emotional experiences.
Note: This isn’t the same thing as Emotional Freedom Techniques, also known as EFT or tapping.
EMDR: Eye Movement Desensitization and Reprocessing
EMDR is a type of trauma therapy. The client uses horizontal eye movements to track the therapists’ fingers, and while this is being done the client focuses on an identified distressing image and the bodily sensations associated with that distress. A Subjective Units of Distress (SUDS) scale is used to track progress, and as the SUDS score drops the therapist and client work on installing a new positive cognition.
IPT: InterPersonal Therapy
IPT is a short-term, structured approach that focuses on addressing interpersonal problems that contribute to problems with mental health, as well as building interpersonal communication skills. Research has supported its effectiveness in the treatment of depression.
MBCT: Mindfulness-Based Cognitive Therapy
This type of psychotherapy is focused on the use of mindfulness to address cognitive distress. It covers things like acting on autopilot, being mindful of the breath, allowing and letting be, engaging in self-care, and recognizing that thoughts aren’t facts.
SFBT: Solution-Focused Brief Therapy
SFBT works on identifying and developing the skills to create changes and achieve goals. The therapist asks particular types of questions to guide the client toward envisioning their future and identifying strengths and coping skills.
What types of psychotherapy have you tried? What was your experience like?