In my last blog I invited readers to consider if they or someone they knew might benefit from therapy. If therapy seems to be indicated, the next step would be to decide what type would be most helpful.
There are many types of therapy, depending on specific needs. Medical News Today lists 14 types and provides specific information about each that you might find helpful.
- CBT – Cognitive Behavioral Therapy: the therapist works with unhealthful thought patterns (There is also a more specialized form of CBT: Trauma-Focused Cognitive Behavioral Therapy which incorporates principles of trauma in the therapy.)
- DBT – Dialectical Behavioral Therapy: very similar to CBT but also focuses on regulating emotions, being mindful, and accepting uncomfortable thoughts and feelings, finding balance between change and acceptance.
- EMDR – Eye Movement Desensitization and Reprocessing: a client recalls traumatic events through a process using specific eye movements. The goal is to change adverse reactions to painful memories.
- Exposure Therapy: another form of CBT in which the client literally goes into situations that intentionally cause triggering and practices using new approaches to respond to those triggers.
- Interpersonal Therapy: the focus is working on relationships with others. The therapist helps the client better understand and interact positively with others.
- Mentalization-Based Therapy: a technique called mentalizing is used that helps the person gain a sense of self and ways to connect with others by understanding their thoughts and feelings and the thoughts and feelings of others
- Psychodynamic Therapy: the goal here is to combat negative patterns of behavior by having the client freely respond to questions the therapist poses to identify and change negative patterns of behavior and thought
- Animal Therapy: trained therapy pets are used to reduce the client’s anxiety, help with PTSD and in general provide support or comfort, reduce stress
- Emotion-Focused Therapy: The main focus is on building awareness of emotions and then regulating and resolving them rather than suppressing them.
- Family Therapy: the therapist uses group process to help a family better understand and work through unhealthy, destructive patterns of behavior that may be the cause of underlying problems for individual family members.
- Group Therapy: people with similar issues join together to share their stories and receive acceptance and support from each other and have opportunities to discover they are not alone in their pain.
- Mindfulness-Based Therapy: using the principles and approach of becoming present in the moment and highly self-aware, i.e., mindfulness, the client can become more self-aware and more in charge of their thought processes. Issues and needs.
- Creative Arts Therapy: this therapy allows the client to express feelings through a variety of artistic mediums such as art, dance, music and poetry
- Play Therapy: used with children, a therapist helps a child talk about their feelings, share their stories while using play to dramatize their experiences more safely, often metaphorically
An important addition to this list is Bruce Perry’s Neurosequential Model that focuses on assessing specifically where in the brain a person, usually a child or adolescent, is not adequately wired and the various types of patterned, repetitive, somato-sensory activities that promote the growth or strengthening of neurons in that area of the brain.
Louis Cozolino in his book The Neuroscience of Psychotherapy consolidates the various therapies previously described and offers us more helpful descriptions of various therapeutic approaches:
- The first category incorporates psychoanalytic therapies, originally begun by Sigmund Freud. He says, “From the standpoint of neurobiology, most of Freud’s work address the discontinued discontinuities and dissociations between networks of conscious and unconscious processing. Freud focused on the role of overwhelming emotion is the cause of unintegrated neural processing.”
- The second category involves Rogerian therapies, also called client-centered forms of therapy. These focus on providing opportunities for the patient/client to experience self-discovery in the context of the therapeutic relationship. Within that relationship the patient/client experiences warmth, acceptance, genuineness, and unconditional positive regard.
- Thirdly are cognitive therapies that focus on ‘… a person’s thoughts, appraisals, and beliefs in guiding his or her feelings and actions.… Cognitive therapy focuses on the identification and modification of dysfunctional thoughts with the ultimate goal of improved affect regulation…. Using this technique helps clients who experience anxiety disorders understand that their feelings of dread are secondary to autonomic symptoms and should not be taken as seriously as they feel. A focus on understanding normal biological processes usually redirects the client away from catastrophic attributions that serve to increase anxiety.”
- The fourth category he describes is Systemic Family Therapy. Its effectiveness is based on the evidence that, “… neural networks throughout the brain are stimulated to grow and organize by interaction with the social environment… (We) organize our inner worlds when we are with others and when we are alone. Thus, we constantly experience ourselves in the context of others.”
- The fifth category is Systemic Family Therapies, based on the evidence that “… neural networks throughout the brain are stimulated to grow and organize by interactions with the social environment…… System therapists question the validity of diagnosing and treating people in isolation. They believe that in our day-to-day experience we simultaneously exist in two realities: our present families and our multigenerational family histories.”
- The final category incorporates Reichian, Gestalt and somatic therapy (Wilhelm Reich was one of Freud’s disciples). These therapies incorporate an appreciation for how the body often provides a more accurate expression of emotional wounding and uses that information to assist in guiding the patient/client in their therapy.
Some therapists are trained in one or more therapies and determine which approach might be the most effective given the specific traumas or excessive, toxic experiences a person has endured, individualizing their methods to address the specific needs created as a result of those experiences.
I believe the most important information Cozolino shares with regard to the outcomes of psychotherapy is the review he describes that looked at hundreds of studies in an effort to find the factors that seemed related to successful therapy. “They [the researchers] found that the quality of the emotional connection between patient and therapist was far more important than the therapist’s theoretical orientation.”
This research shows that for therapy to be effective in promoting recovery and healing, it comes down to the quality of the relationship between the therapist and the client/patient. The client needs to feel accepted, appreciated, cared for and seen as having the potential to learn, grow and change. If a person is not feeling these things during therapy, it probably is time to move on to a different therapist.
In my next blog I will invite you to consider how to be an objective critical thinker of a specific therapist’s approaches to your therapy. It turns out that there may be many therapists out there who do more damage than good or who are ineffective for a number of reasons.
Invitation for Reflection
- How familiar are you with the various therapies described in this blog? Have you or someone important to you been in one or more of them? How effective was the therapy?
- If you or someone important to you needs therapy, which one do you think might be the most helpful?
- How do you respond to research that states it is the quality of the relationship a person has with their therapist that determines if and how effective the therapy will be?
Diane Wagenhals, Director, Lakeside Global Institute