The Most Common Types of Psychotherapy
What is psychotherapy?
Psychotherapy, sometimes called “talk therapy” or “counseling,” is a treatment approach for a wide variety of emotional, mental and life problems. The process consists of a series of meetings between the individual and a psychotherapist. In contrast to the usual types of conversations in our lives with friends or family, the “talking” in psychotherapy is focused on exploring the problem issues that are interfering with the one’s life and then finding alternative ways of coping with those problems. The goal is to render life’s problems to either a more manageable and less distressing level, or when possible, to eliminate them completely so that one can lead a more constructive and contented life. Psychotherapy can be conducted with or without simultaneous treatment with medications.
How does psychotherapy help?
From the very first psychotherapy session, an individual experiences some degree of immediate relief. Even if one has been grappling with a problem for a very long time, there is always a reason why help is sought there and then and that reason is invariably because of acute distress and/or pain that is no longer tolerable. In most cases individuals have been making attempts on their own to improve their lives but despite their efforts, the problems do not improve. By the very act of attending that first psychotherapy session, there is significant relief in acknowledging that prior efforts to resolve problems are insufficient and now one is taking a new path. This important step carries with it a renewed sense of hope.
During that very first meeting, even if one is in a great deal of pain, simply knowing that the person sitting across from you – the psychotherapist – is there exclusively for the purpose of understanding and helping you provides comfort and encouragement. The knowledge that your conversations are completely private and confidential, that the psychotherapist is non-judgmental, non-critical and has no self-interest in your decisions (unlike friends and family), and that you are no longer alone in your suffering has tremendous power. From this power in the psychotherapeutic relationship, one derives much strength to confront even the most difficult of life’s problems.
During the subsequent meetings, problems are re-examined and fresh, new perspectives permit new solutions, decrease distress and create a framework for lasting and enduring change. Thus long after an immediate problem is resolved and acute distress has passed, one is left with invaluable insights, tools and skills to use moving forward when new problems arise.
Most Common Types of Psychotherapy
Since “talk therapies” began in the early 1900s, literally hundreds of techniques have been developed. Up until the 1970s and 1980s, the various techniques arose from some underlying theory about how the mind works. However a shift occurred in the last decades as a growing body of evidence emerged as to what type of psychotherapy was most effective in treating specific problems. The following are the most common types of psychotherapy.
Behavioral Therapy is used most commonly used to help individuals overcome phobias, or fears, of specific situations such as heights, flying in airplanes, being in closed spaces or crowds, and animals. The therapist teaches skills to reduce anxiety and then exposes the individual gradually to the frightening situation until the fear reaction is greatly reduced or disappears. It’s not uncommon for the psychotherapist to physically accompany the patient to the fear-provoking situation. Treatment duration is usually up to ten sessions.
Cognitive-Behavioral Therapy or CBT is an approach that seeks to modify an individual’s thoughts (cognition) in order to change one’s emotional responses. The behavioral component of this approach involves imparting skills to lesson the impact of emotional distress to allow for restructuring of thought processes. This therapy requires “homework” by keeping a journal of experiences, thoughts and emotions. It has proven to be highly effective for, among other conditions, depression, anxiety, panic, substance abuse and post-traumatic stress disorder. Treatment duration is usually up to sixteen sessions.
Acceptance and Commitment Therapy or ACT is becoming increasingly popular and is used for the same conditions as Cognitive Behavioral Therapy. Unlike CBT where thoughts are modified to produce different emotional responses, ACT encourages individuals to embrace their thoughts and feelings and not to fight with them or experience guilt about them. This approach emphasizes mindfulness which is a core concept associated with Positive Psychology. ACT employs exercises to practice with less emphasis on “homework” which is more characteristic of CBT. Treatment duration is also usually up to sixteen sessions.
Interpersonal Therapy teaches depressed individuals new ways to both communicate and express feelings. The assumption is that maladaptive modes of communicating generate negative reactions in others and conflictual relationships and these in turn are at the core of an individual’s depression. It is also used to help individuals struggling with loss or grief. Treatment duration is between 10-20 sessions.
Psychodynamic Therapy examines how past life experiences, even those back to childhood, can even unconsciously affect the way an individual feels, thinks and behaves. Through a process of raising these past experiences into awareness, the individual can choose alternate ways to think and respond. The psychodynamic process can be quite lengthy lasting years with a usual frequency of one session per week. The approach is a much less intense than its origin, psychoanalysis, that involved three to five sessions each week spanning over years.
Dialectical Behavioral Therapy or DBT is a form of cognitive behavioral therapy specifically designed for individuals at high risk for suicidality, self-harm, precarious impulsivity, chaotic interpersonal relationships and severe mood instability. These individuals nearly always have what are called “personality disorders.” The treatment involves increasing tolerance to frustration, regulating mood, enhancing mindfulness and improving relationships with others. DBT follows a manual and has best results when done in a group format with a team of psychotherapists. Treatment duration is usually up to six months.
Supportive Psychotherapy is an approach for a very wide array of problems but is particularly helpful for those with distress about real life problems: family, relationship, job, finances, etc. The approach aims to neutralize the sense of helplessness, enhance a sense of self-efficacy and reduce distress in the setting of life’s struggles. Treatment duration can vary widely from several weeks to several years.
Couples Therapy is designed to both reduce distressing conflict as well as restore a sense of intimacy and hope in couples. In some cases, the focus of the therapy is on the sex life of the couple. During sessions, the couples therapist helps identify patterns that lead to conflict and assists the couple in developing new patterns that promote togetherness. The approach usually employs exercises for the couple to practice between sessions. The purpose of the exercises is to modify the way the partners communicate, behave and interact. Treatment duration is between several months up to one year.
Family Therapy is unique in that it treats the entire “family” as a unit as opposed to treating several individuals who comprise a family. This type of psychotherapy is designed to help families in which there is intense or frequent conflict, a lack of cohesiveness, and a sense of alienation for the individual family members. The therapist identifies maladaptive ways the family unit as a whole interacts and then provides alternative patterns that promote togetherness. Treatment duration is several months to one year.
Benefits of Psychotherapy
The benefits of psychotherapy are far-reaching and have the potential to lead to positive life changes and previously unimaginable personal growth. Although the process can be painful at times, the psychotherapist is there to remind you that substantive life change is never easy. However psychotherapy opens a door to experiencing life in a new and transformative way.