Which Type of Therapy is Right for Me? How to Choose Between Different Approaches
Dr. Sheri Jacobson
March 4, 2023
Therapy can seem daunting, and it can be difficult to know what is best for you and how therapy works. It is can help to know what the various types of therapy are and how they work to help you see what may work for you and what you are dealing with.
Going to see a counsellor can be confusing, there are seemingly unlimited options and treatments out there and it can be difficult to decide on the right approach and counsellor. However, there are three main approaches to therapy and this article aims to give you a little insight into each one, what they may be useful for and how they work.
Cognitive Behaviour Therapy (CBT)
What is CBT?
The main focus of CBT is to address and work with dysfunctional emotions and behaviours through goal-orientated and task-based work. This work is based on the premise that changing negative or maladaptive thinking can facilitate changes in behaviour. The therapist will work with the client to aid them in changing thought patterns and beliefs such as catastrophising (the irrational thought that things are much worse than they actually are), magnification of the negative aspects of everyday life and over-generalising with more adaptive, realistic and positive thoughts and actions. This approach to therapy follows a structured model whereby specific techniques and concepts are presented during each session. Also, although this kind of therapy is directive the therapist will not tell you what to do, but will show you options of how to do it.
What issues can CBT be useful for?
In work with adults CBT has been shown to be beneficial in working with a range of presenting concerns such as:
- Anxiety disorders (Phobias etc.)
- Depression
- Eating disorders
- Substance misuse
- Personality disorders
CBT is widely available throughout the UK and often involves interactive computer-based tasks in conjunction with face-to-face work with a therapist. CBT tends to be briefer and more time-limited than some other options with the average duration of treatment being around 16 sessions.
The main focus of psychodynamic work is that the client has some maladaptive functioning developed in early life that has and continues to cause discomfort; this dissonance may be at least in part in the unconscious mind (processes that occur without introspection). There tends to be an emphasis on the conflicts between conscious and unconscious thought and how they relate to the clients development along with how thoughts that you may not be aware of can affect your life. Also, central to this approach, psychodynamic therapists believe that any negative emotional or behavioural aspects of the individual’s life are borne of early childhood experiences. Other areas of focus for this kind of therapy can be the effects and expression of emotion on the client, looking at recurring themes or patterns in the work or life of the individual, a developmental focus on past experiences and interpersonal relationships and exploring how a client may attempt to avoid distressing thoughts, events and feelings (often referred to as either resistance or the use of defence mechanisms).
What can Psychodynamic Therapy be useful for?
This approach to therapy has a wide range of applications and, for example, can be used when working with:
- Anxiety disorders (including GAD – Generalized Anxiety Disorder)
- Depression
Psychodynamic therapy tends to be much longer work due to the nature of working with the unconscious mind with short-term work usually lasting between 20 and 30 weeks.
This approach is mainly focused on the therapeutic relationship formed between the counsellor and client with the therapist aiming to provide that person with an environment and opportunity to develop a sense of self. This environment is a comfortable and non-judgemental place where the client can engage with another person in a non-directive manner and be aided in finding their own solutions to their problems. In this approach the counsellor will not give you tasks to do, or direct you in any way, the emphasis is on talking through feelings and experiences in order to gain clarity and insight into what it is that has brought the client into therapy. Person-centred therapists believe that a free and equal relationship exists between client and counsellor and each person’s perception of the other is important to the work, the counsellor is not the ‘expert’ the client knows their own feelings and emotions better than anyone. Therapists that work from this approach aim to offer a true empathic response rather than sympathy for the client’s situation, whereby the counsellor aims to see the concerns discussed in the sessions from the clients perspective.
What can Person-Centred Therapy be useful for?
Person-centred therapy is a widely used approach both in organisations and institutions as well as in private practice and has many applications, these include:
- Low self-esteem
- Relationship issues
- Depression
- Body-image issues
There tends to be no assumed length of work when working with a person-centred therapist although the approach is less structured than come others and scheduling can be adjusted according to the client’s expressed needs. The client determines when the work ends and this usually occurs when they feel the can cope better with the difficulties they initially faced.
Choosing Which Type is Best for Me
We have given you a brief insight into each of the main types of therapies and which issues they might be suitable for. From reading this, you might have a further idea of what type would be suitable for you. Alternatively, you might prefer to have a general consultation with a therapist trained in several approaches who can assist you with which type of therapy might be most appropriate. Many counselling psychologists are trained in a number of therapeutic modalities and are able to adapt their style of working according to your presenting issues. A final point to remember is that although the type of therapy may be important, arguably one of the most important factors in a good therapeutic outcome is the quality of the relationship that develops between yourself and the therapist.
Marc Brammer
