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. There are a lot of helpful metaphors used to help withconceptualizing various ACT concepts.
I’ve reviewed Steven Hayes’s book Get Out Of Your Mind and Into Your Life, which is an excellent way to get familiar with ACT. The MH@H Download Center also has a mini-ebook/workbook on the essentials of ACT.
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 problematic thinking patterns that cause distress and replacing them with more realistic thoughts. As well, new behaviours are practiced to reduce distress and promote more realistic thinking.
Some other important concepts in CBT include:
The MH@H Download Center has a mini-ebook on the essentials of CBT.has a mini-ebook on the essentials of CBT.
There are a number of different forms of therapy that are based on CBT. Here are just a few examples.
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.
ERP: Exposure and Response Prevention
ERP is used in the treatment of OCD, and involves exposure without resorting to the use of compulsions.
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
CFT describes three systems within the brain: the threat system, the drive system, and the caregiving system. The therapy aims to strengthen the care-giving system while toning down the threat system.
There’s more information about CFT on the Compassionate Mind Foundation.
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.
Wise mind is a really useful DBT concept that involves the overlap of rational mind and emotion mind. There’s nothing wrong with rational mind or emotion mind, but we make our best decisions when we have both engaged.
Some of the foundational assumptions on which DBT is built are quite profound, regardless of whether or not you choose to do DBT; I talk more about these in the post Wise Words from DBT Creator Marsha Linehan.
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.
The International Center for Excellence in EFT has more information about the therapy.
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.
EMDR is based on the idea that trauma memories are stored in an unintegrated manner in the brain, with a strong sensory element that’s disconnected from a narrative element. The goal of therapy is to process these memories so they can be stored in an integrated form like other memories.
The American Psychological Association goes into more detail in this article as part of their PTSD treatment guidelines. Counsellor Johnzelle Anderson has also done a guest post on EMDR for Mental Health @ Home.
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.
The IPT Institute site goes into some of the details of IPT.
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.
MBCT.com has more information about this form of therapy.
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.
The Institute for Solution-Focused Therapy has more information.
What types of psychotherapy have you tried? What was your experience like?
The Mental Health @ Home Blog Index has info on other therapy-related posts on MH@H.