Therapy

Your Guide to Psychotherapy Options

Which therapeutic modality is the right fit for you?

Posted Jan 30, 2015

If you're like most people, when you think of therapy, you probably have a very specific vision in mind. Perhaps you envision sitting on a couch as an old man takes copious notes and asks about your childhood. Or maybe you envision a more new-age approach, replete with meditation and mantras.

The truth is that therapy can be both, or neither. There are dozens of options for therapy, with different treatment approaches working best for different conditions.

The treatment approach your therapist uses is referred to as the therapeutic modality. Because there are dozens of therapeutic modalities, we can't cover them all in this guide. If your therapist offers a treatment modality with which you are unfamiliar, be sure to ask plenty of questions and do your own research. Know, though, that therapists are increasingly blending several different approaches to get a treatment plan tailored to your needs. This style is often referred to as either holistic or integrative therapy.

Psychoanalytic/Psychodynamic Therapy

Psychoanalytic therapy is probably what most people picture when they envision a therapy session. Originally developed by Sigmund Freud, psychoanalytic therapy has come a long way from the days of lying on a couch and talking about repressed memories. Psychoanalytic therapists focus on the past, on family relationships, on symbolic relationships and experiences, and on ways to resolve the conflicts of the past so you can avoid reliving them in the present.

Dialectical-Behavioral Therapy (DBT)

Dialectical-behavioral therapy was originally designed to help people with borderline personality disorder—a life-disrupting personality disorder—live normal and healthy lives. However, it has shown remarkable promise at helping people manage their emotions and cope with distress even when they don't have an underlying mental health diagnosis. This approach blends individual and group therapy with life skills training, mindfulness-based approaches, and an intensive focus on helping you better identify, understand, and regulate your emotions, reactions, and behaviors.

Cognitive-Behavioral Therapy (CBT)

Cognitive-behavioral therapy works on the premise that our thoughts affect our behavior, and that our behavior affects our lives. For example, a woman who is afraid of being abandoned by a romantic partner might become so clingy that her romantic partner ends the relationship, thus worsening the fear of abandonment. By working to control her feelings of fear, though, she can go onto have healthy relationships.

Through CBT you'll work to identify unhealthy and misleading thoughts, then replace them with healthier and more accurate ideas. CBT therapists often assign homework or even worksheets, so CBT works best when you're willing to do extensive work on your own, outside the walls of therapy.

Eye Movement Desensitization and Reprocessing Therapy (EMDR)

Eye Movement Desensitization and Reprocessing therapy was originally designed to help people cope with the aftereffects of trauma. Some therapists, though, use it to help you manage difficult emotions such as jealousy and anxiety, to better manage phobias, or to establish clear coping skills for an event you find frightening.

EMDR works by using a specific set of eye movements as you talk to your therapist. These eye movements help your brain process information slightly differently, making it possible for you to reintegrate traumatic memories, not be so controlled by fear, or work past irrational but strongly held beliefs, such as phobias and jealousy.

Emotionally Focused Therapy (EFT)

Emotionally Focused Therapy was first developed in the 1980s as a type of couples therapy that focused on developing strong attachments. Some therapists now use it with people who are experiencing relationship difficulties but who do not or cannot attend therapy with their partners. A smaller number of therapists use EFT with individuals, though this approach has not been as rigorously tested with individuals as it has with couples.

Relational Psychotherapy

Relational psychotherapy is built upon a rather obvious proposition: Relationships are central to human existence, and when your relationships improve, your quality of life does as well. This approach uses your relationship with your therapist as a springboard for dialogue, learning new skills, and mastering the art of relationships.

Other Potentially Effective Therapies

There are dozens of therapy options, so if something doesn't work for you the first time you try it, consider trying another method. Here are some additional approaches to therapy that, while less popular than some of the others mentioned in this guide, have been proven safe and effective:

Discredited Therapies

Some treatment modalities are objectively damaging. Conversion therapy, which aims to change a person's sexuality from homosexual to heterosexual, is one such approach. This approach is so dangerous that some states have taken measures to ban it. Other therapeutic modalities are ineffective or based on faulty science. While even discredited therapies may work for some people, these therapies have been heavily criticized by ethical therapists, disproved in clinical studies, or demonstrated to be potentially dangerous:

  • Rebirthing therapy
  • Conversion therapy
  • Primal scream therapy
  • Past life regression therapy
  • Reparative therapy
  • JoyTouch
  • Aura therapy
  • Orgone therapy
  • Tap therapy
  • Angel therapy
  • Chelation therapy (it is effective for lead poisoning, but not for any other purpose)
  • Recovered/repressed memory therapy (once a memory is gone, it cannot reliably be recovered, and attempting to recover it can cause you to “remember” events that never happened, including abuse)

Don't be afraid to ask your therapist about the approach he uses, and to even request data on its effectiveness. You are the consumer, after all, and you're entitled to spend your hard-earned money only on therapy that has the power to meet your needs and exceed your expectations.

References

About therapeutic modalities. (n.d.). Retrieved from http://therapytoronto.ca/modalities_in_psychotherapy.phtml

Efron, D., & Bradley, B. (2007). Emotionally Focused Therapy (EFT) and Emotionally Focused Family Therapy (EFFT): A Challenge/Opportunity for Systemic and Post-Systemic Therapists. Journal of Systemic Therapies, 26(4), 1-4. doi:10.1521/jsyt.2007.26.4.1

Norcross, J. C., Koocher, G. P., & Garofalo, A. (2006). Discredited psychological treatments and tests: A Delphi poll. Professional Psychology: Research and Practice, 37(5), 515-522. doi:10.1037/0735-7028.37.5.515

Scheflin, A. (1999, November 1). Ground lost: The false memory/recovered memory therapy debate. Retrieved from http://www.psychiatrictimes.com/articles/ground-lost-false-memoryrecovered-memory-therapy-debate