This is the first post of a 4-part Therapy 101 Series, designed to help anyone who’s interested in therapy, but doesn’t know where to start. I’ll continue this series with posts on how to find a therapist, what to ask the therapist early on, and how to advocate for yourself in therapy.
When someone says they’re in therapy, you might get an idea of them lying on a couch talking about their childhood to a therapist with tiny glasses who takes a lot of notes and never looks up. But the reality is that therapy is 1000% different than it was back in the days of Freud, and there are countless different techniques that the therapist may use.
Many therapists incorporate a variety of techniques into sessions, depending on what the client needs. But if you’re the client and you’ve never heard of any of these techniques or don’t have any preference, the therapist may just use what they prefer. These techniques can make therapy experiences completely different, so it’s important to have a basic idea of what you’re looking for!
These are a few of the most common techniques, or types, of therapy that you might run into, as well as when I recommend certain types vs. others. I hope it can be helpful for you!
A quick FYI: I am a Licensed Professional Counselor, and I believe it’s fair to say that I have a general knowledge about these theories, particularly more than Google or Wikipedia. That being said, I don’t claim to be an expert on each technique I’m going to describe, nor do I practice all of them on a daily basis. I’m happy to answer further questions as I can. The best experts in each technique are those who have gone above and beyond a general counseling or social work licensure and specialized in that technique.
CBT is short for Cognitive Behavioral Therapy, and it’s been very popular for several years now. I would bet that the vast majority of therapists, at least in the U.S., use elements of CBT. It revolves around the concept that what we think affects how we feel, which in turn affects what we do.
It can be really helpful, as it helps you distinguish your thoughts, feelings, and actions, which usually run together for all of us. One critique of CBT is that it can feel a bit judgmental, as you end up frequently labeling your thoughts as negative or wrong. If the client and therapist are not vigilant about taking a non-judgmental stance, it’s easy to end up thinking you are wrong at your core, and not just your thoughts.
It’s great for anyone who does well with therapy homework, as CBT lends itself to a lot of skill-based practices and tasks. If you enjoy practicing skills in between sessions, or learn better through homework, CBT will probably work well. It’s also good for anyone who is struggling to “get out of their head” whether that’s emotional or mental. If your inner critic is working overtime, give CBT a chance.
It’s not always great for someone who is deeply struggling with depression or anxiety. CBT can be great down the road, but its task and change-oriented focus can be overwhelming for someone who is just beginning the road to recovery. CBT is not the best treatment for those suffering from Borderline Personality Disorder either.
DBT stands for Dialectical Behavior Therapy. It was created in the 1970s by Marsha Linehan, and its primarily used to treat those with Borderline Personality Disorder. That being said, I think it’s really helpful for any struggling to manage an extreme range of emotions. It’s also helpful for anyone struggling with self-harm. I also think the skills taught in DBT are helpful for literally everyone to some extent.
DBT therapy is often done in a group, and tends to be very effective that way. DBT is best when it is the sole focus of the therapy, so you’ll typically hear about DBT groups rather than groups that involve a little DBT here and there. Many people engage in a DBT group along with separate individual therapy sessions.
EMDR stands for Eye Movement Desensitization and Reprocessing… huh? Basically, it takes some science and makes it useful for therapy, specifically the science that says traumatic memories tend to be less stressful when they’re processed correctly in the brain. Traumatic memories are often stored in one specific place in the brain and keep themselves at the forefront, tormenting the person with the memories.
EMDR is a process of helping people process their memories. It involves bilateral stimulation- making both sides of the brain work at the same time- while talking about the trauma. This process helps get those memories into safer places, and gives the person more relief.
EMDR is hugely popular these days, and everyone is saying they perform EMDR. If you’re interested, I would recommend carefully reviewing the qualifications of your potential therapist and make sure they’re fully certified. Otherwise you might end up feeling like you’re getting poorly performed hypnosis.
EMDR is really helpful for those who have experienced chronic high stress or trauma. It’s not as helpful if traumatic experiences aren’t really a part of your story.
Solutions-Focused Brief Therapy
Solutions-Focused Brief Therapy is often known as SFBT (are you starting to see that psychology loves acronyms?). SFBT’s focus is, unsurprisingly, on solutions. It’s not about your history, childhood, and it’s often not even focused on decreasing symptoms of mental illness. Rather, it’s focused on increasing symptoms of wellness, as well as finding and implementing solutions to the main stresses in your life.
SFBT is great when you want to tackle a specific problem, or if you’re financially limited on how many sessions you can attend. There’s a principle behind SFBT that every session could be the last one, so the therapist will work with you to identify the most important topic and help you identify quality “take-homes” to address on your own. Working with an SFBT therapist can help you cultivate critical skills to then get through difficult circumstances on your own.
SFBT is not great for processing past trauma or finding a mental health diagnosis. SFBT sometimes gets a reputation for only focusing on the positive. SFBT does not minimize the negative or the “problem,” but it doesn’t really focus on it either. If you want get into the nuts and bolts of a particular mental health concern, SFBT may not be the best place to start.
Acceptance and Commitment Therapy
Acceptance and Commitment Therapy, aka ACT, is another style that’s been growing in popularity for several years. Like SFBT, ACT doesn’t really focus on problem solving. Instead, ACT clinicians teach mindfulness, values identification, and other skills to help you shift your way of thinking about your physical or psychological pain. It focuses on the spectrum of human experience, instead of “problem” vs. “normal.”
ACT has been shown to be helpful for individuals experiencing chronic pain, psychosis, chronic depression, eating disorders, and substance abuse. I think anyone suffering from a chronic condition could benefit from ACT, as it provides tools you can utilize whether there’s a realistic “cure” for your condition or not.
I wouldn’t turn to ACT first for someone who is the victim of domestic violence or any abusive relationship, as the goal there is NOT to accept the condition. It also may not be the first choice for those coming to therapy to address specific circumstances and goals, as they are often looking specifically for a change. However, elements of ACT can be used in most circumstances.
The Gottman Method
The Gottman Method was designed by Drs. John and Julie Gottman, and is most often used for couples, although they do have a method for parents and children. With Gottman therapy, you will typically participate in a fairly structured curriculum designed to work through common issues that are the root of most perpetual relationship conflicts. Throughout the sessions, the common thread is to build trust and commitment to your partner.
The Gottman Method is, unsurprisingly, great for couples. I believe this method is helpful for a wide variety of couples and their concerns. At the end of the day, most couple conflicts aren’t as unique or complicated as the couple may think, and the Gottman Method addresses that. They also have a high success rate compared to many other couples’ therapy methods.
The Gottman Method isn’t great for couples who want help working through a divorce, or basically any couple who has already decided the relationship is going to end. Its general goal is to build up the relationship. If you’re in individual therapy, but discussing your relationship, the Gottman Method can provide useful skills. However, it’s designed for when both partners are going to therapy together, and it can only work when both partners are willing to participate.
Adlerian therapy is goal-oriented, humanistic, and psychodynamic in approach, and was developed by Alfred Adler. Adlerian therapy focuses on the individual within their specific context and community, making it an excellent choice for those practitioners who are aware of cultural sensitivity.
The process of Adlerian therapy often begins with an assessment of your early life and birth order, as Adler believed that many of our neurotic and problematic behaviors began in childhood. It also focuses on gaining insight and changing perspective, which then leads to making most positive choices. Adlerian therapists typically offer encouraging, strengths-based interactions with their clients, and focus on the client’s specific goals.
Adlerian therapy can be used with almost any age group and mental health condition. If you are willing to deeply dive into your past experiences and perspectives, it can be life-changing. It’s one of many humanistic approaches, with a fundamental value that human beings are capable of great things and have inherent value.
Adlerian therapy can take a lot of time, and so anyone that is looking for just a few sessions or a more immediate change may not prefer an Adlerian method. This might also apply if you’re working with an employer’s EAP and only have a few sessions paid for. It’s also not ideal if you have no interest in exploring your childhood or past experiences.
To Wrap Up
Although there are countless more types of therapy (I didn’t even touch dozens of them!), I hope that getting an idea of some of the more common ones can be helpful. Like I mentioned at the very beginning, many therapists use an integrated approach of several techniques, depending on what you need as a client and what the situation calls for. If you’re interested in meeting with a therapist who uses a specific method, Psychology Today is a great place to start searching for someone in your area. Sites like Talk Space and Better Help are great options if you’re looking for online therapy.
If you’re interested in how to get started successfully once you’ve chosen a therapist, stay tuned for the next 3 parts of the Therapy 101 series!
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