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Therapy Types and Modalities

While most types of therapy have a lot in common, they also fall into clusters that share core features, such as cognitive therapies or psychodynamic approaches. It is important to seek someone who practices evidence-based therapy, meaning one or more forms of treatment that have been scientifically evaluated and tested, and demonstrate consistent improvement for a majority of patients.

What are the best approaches to therapy?

Effective approaches to therapy are thought to share “common factors”—such as a therapist who treats the client with empathy, a rapport between the therapist and client (sometimes referred to as a therapeutic alliance), and agreement about the goals of therapy. For many kinds of distress, different types of therapy may have remarkably similar positive effects.

Should I seek a therapist who specializes in my concern?

It is common for therapists to develop an eclectic toolbox of skills that draw from multiple approaches. These often include techniques from major therapy types such as cognitive-behavioral therapy (CBT) or psychodynamic therapy. Some types of therapy are designed to treat particular mental health conditions: For example, Prolonged Exposure Therapy (PET) is often employed specifically to treat post-traumatic stress disorder, while Dialectical Behavior Therapy (DBT) was developed for treating borderline personality disorder.

What is cognitive behavioral therapy?

Cognitive behavioral therapy (CBT) involves challenging the negative and irrational thoughts that lead to dysfunctional behaviors and perpetuate distress. Therapists trained in CBT aim to help clients learn and practice ways of dealing with negative automatic thought patterns in more adaptive ways. CBT has been empirically studied for decades, and there is experimental evidence to support its use in the treatment of anxiety, depression, obsessive-compulsive disorder, eating disorders, and other conditions. A number of specialized forms of CBT target particular conditions (such as CBT-I, for insomnia).

What is psychodynamic therapy?

Psychodynamic approaches to therapy encompass a focus on better understanding oneself and examining inner conflicts as a way to alleviate distress and improve relationships and other aspects of one’s life. A therapist using a psychodynamic approach may draw connections between a patient’s current feelings and past experience and will identify common patterns in one’s thoughts, experiences, or relationships—including similarities between the therapist-patient relationship and relationships outside therapy. Psychodynamic therapy has its roots in traditional psychoanalysis, but modern evidence suggests it can be effective in treating depression, anxiety, and other conditions.

What is marriage and family therapy?

Marriage and family therapy addresses the behaviors of two or more people and the relationships between them. These forms of therapy include combined sessions with both people in a couple or all participating family members, but can involve one-on-one sessions between each individual and the therapist as well. While there are distinctions between family- and couple-centered therapies, a common goal is to improve communication between individuals. These forms of therapy can be used to alleviate conflict between partners or family members or to treat a mental health condition that may impact close others.

What is the difference between therapy, counseling and coaching?

The terms therapy and counseling are often used interchangeably. While there is overlap between them—both involve a relationship with someone who is trained to help people address difficulties in their lives, and therapists may opt to refer to themselves as counselors—counseling tends to be relatively brief in duration, and it can be used refer to less formal types of support that are not traditionally considered psychotherapy. These include, for example, drug and alcohol counseling for those recovering from substance-abuse problems and short-term counseling for bereavement. Coaching is distinct from both therapy and counseling in so far as it focuses on specific, goal-oriented outcomes, but does not attempt to treat or remedy mental illness or emotional disturbance.

What is the difference between a psychologist and a psychiatrist?

Many psychotherapists are clinical psychologists by training, meaning they are educated in the science and practice of clinical psychological approaches to treatment. Psychologists who attain a doctoral level of education conventionally earn a Ph.D. or Psy.D. Psychiatrists, in contrast, are trained as medical doctors—they typically earn a M.D. or D.O. degree and can prescribe psychotropic medications. While psychologists offer many varieties of talk therapy, they are generally not permitted to prescribe medications. (Therapists can also include social workers and other professionals.)

Can I receive any form of therapy online or by phone?

Yes. All therapeutic modalities can be delivered online or via telephone by a skilled clinician. In fact, remote therapy/telehealth, as it is increasingly known, offers a number of potential benefits, including increased access to individuals who are geographically remote or who are disinclined to enter a therapist’s office.

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