In Therapy

A user's guide to psychotherapy

The Ten Coolest Therapy Interventions, Honorable Mentions & Wrap Up

Ten Coolest Therapy Interventions: Wrap

You're cooler just for knowing the coolest interventions in psychotherapy. Here it is, the entire Top Ten list along with a few techniques that almost made it and some concluding thoughts.

Talking and listening are the foundation of therapy, but sometimes therapists shake things up with procedures to focus attention on specific elements of healing. A few weeks ago I introduced a buffet table of psychotherapy techniques: some old favorites in the field as well as newcomers. My goal was to give a sense of what therapy provides beyond mere conversation and illustrate some of the unique ways theory is applied.

Descriptions of our work tend to focus on the various psychological theories we use rather than the techniques. Discussing theory does help explain the ideas that underlie the process, but techniques are how many of these theories are put into practice. I thought the techniques needed a series of their own. Just to keep things interesting, I made this overview a Top Ten list.

I also said in the introduction that ranking therapy interventions was fun, but pretty ridiculous. What some clients find transformative others may regard as worthless bunk. And much to some readers' chagrin, effectiveness outcome research was not part of my criteria. Instead, I chose the list based on five factors: creativity, boldness, compassion, mystery and a cool name. I then found experts for each one to describe its coolness. This was the most fun for me, having experts describe the interventions in their own words. Based on my subjective standards, here are the ten interventions that measure highest on this ambiguous yardstick. (click through to see the full article)

The Ten Coolest Therapy Interventions:

  • 10. The Miracle Question - What: One simple question that moves clients toward a solution-focused outcome. Why cool? Immediately shifts the brain toward positive thinking. Guest: Linda Metcalf, author and Solution-Focused Therapy expert.
  • 9. The Empty Chair - What: Telling off your demanding boss, even if the chair opposite you is empty. Why cool? Enabled millions of people to practice expressing how they really feel. Guest: Dan Bloom, President of the Association for the Advancement of Gestalt Therapy.
  • 8. Paradoxical Interventions - What: By prescribing the very symptom you want to eliminate, somehow you gain power and control. Why cool? Insight and progress sneak through the back door. Guest: Cloe Madanes, pioneer of Strategic Family Therapy.
  • 7. Voice Dialogue - What: A summit meeting between conflicted parts of self. Why cool? Helps clients understand how complex they are and work toward integration. Guest: Hal and Sidra Stone, founders of the Psychology of the Selves.
  • 6. Hunger Illusion - What: Stop yourself before acting on habit and see what comes up. Why cool? Gives powerful insight into the unconscious with no therapist required! Guest: George Weinberg, venerable psychologist and Hunger Illusion creator.
  • 5. Head-On Collision - What: ISTDP therapists are essentially resistance exterminators who eliminate harmful defenses. Why cool? It's quick, it's bold, it's hardcore, it's punk rock. Guest: Allan Abbas, leading researcher in ISTDP.
  • 4. Sandplay - What: Using your hands, sand and plastic figures to communicate your internal world. Why cool? The psyche becomes a visible, tangible 3-D environment. Guest: Barbara Turner, prominent author and Sandplay therapist.
  • 3. Primal Therapy - What: Expressing emotions locked away from consciousness. Why cool? It confronts the deepest wounds to achieve profound results. And John Lennon did it. Guest: Arthur Janov, founder of Primal Therapy.
  • 2. Virtual Reality - What: Using a computer-generated environment to help soldiers and others work through emotional trauma. Why cool? Just re-read that last sentence. Guest: Cyber-psychology's bad boy, Skip Rizzo.
  • 1. Transference Interpretation - What: Ties together the past, the present and the therapy in one well-crafted statement. Why cool? Patience, understanding and insight collide in one life-changing sentence. Guest: Popular author and psychoanalyst Glen O. Gabbard. 

That's it. A survey of some of the most innovative, transformative interventions psychotherapy has to offer. But that's just the tip of the iceberg. Here are a few others that almost made the cut.

10CTI: Honorable Mentions

  • EMDR - Treating thousands of cases of PTSD, one eyeball at a time.
  • Equine Therapy - When the couch becomes a saddle for treating eating disorders, mood disorders, autism, even gang violence.
  • Here and Now - For some folks, this is the most difficult question ever: "How are you feeling here with me now?"
  • Doubling - This classic group therapy/psychodrama technique involves group members pitching in to help find a voice. 
  • Hypnosis - The original therapeutic technique has helped millions with such varied issues as smoking, pain management and putting
  • Mindfulness - Everyone's talking about it. Is it fad or fixture?
  • Art Therapy - Everything Cathy Malchiodi is saying in her blog series qualifies as cool.

Not every therapist uses specific interventions and not every client wants them. Some clients prefer therapy to be a place where they talk and feel heard by a supportive, insightful person with whom they have a trusting relationship. That's all they need to do productive work. Others are looking for tools that bring quick results or have issues that require a special intervention. It all depends on the client's goals.

As I've said before, these techniques require dozens to thousands of hours of training before therapists can use them ethically and successfully. Beyond accurate implementation, an additional skill is knowing when to use them and when to step back. Sure, I can suggest the empty chair (for example), but am I competent to do so? And is this the time and place for it?

If current clients find some of these techniques appealing I encourage them to discuss it with their therapist. Maybe the therapist has the training and hadn't thought to apply it. Maybe they can get the training or they have an opinion why it's not a good fit. It's also possible for a therapist to refer a client to a specialist in a certain technique (like EMDR). It's all about getting the best treatment for the client. 

So that's a wrap. My deep gratitude to all the busy experts who took the time to share their considerable wisdom with the masses. Stay cool.

Ryan Howes, Ph.D., is a clinical psychologist, writer, musician and professor at Fuller Graduate School of Psychology in Pasadena, California.

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