Types of Therapeutic Approaches
- Vanessa Mukoo
- Dec 11, 2021
- 7 min read
Updated: Dec 12, 2021
image source: counsellingsydney.com
Contents on this page:
What is therapy? | Psychoanalysis Therapy | Person-Centered Therapy | Cognitive-Behavioural Therapy | Mindfulness-Based Therapy | Conclusion
Psychotherapy, or therapy, encompasses the treatment of mental health issues and behavioural problems through communication, expression of emotions, relationship factors, and skill building by a qualified mental health professional like a therapist or a psychologist. One may seek therapy for a variety of reasons such as dealing with complicated problems, coping with a significant transition in life, having vague and irrational thoughts, and being under excessive pressure. The benefits of therapy include:
Helping solidify communication patterns
Effectively developing appropriate coping strategies to manage mental health concerns
Helping you feel empowered
Learning how to properly take care of yourself
Releasing pent-up emotions and feelings
Getting rid of irrational fears and thoughts
Over the past century, various psychotherapeutic orientations have risen in popularity for treating mental illnesses. This article outlines some of the well-known therapeutic approaches and explains their methods, advantages and disadvantages.
Psychoanalysis Therapy
Psychoanalysis is the earliest organised therapy for mental disorders developed by Sigmund Freud in the early 20th century. This approach emphasizes that the root cause of mental health problems are unconscious conflicts and desires. Initially, Freud proposed that mental health problems occur due to attempts made to push inappropriate sexual desires out of conscious awareness. Later on, he suggested that psychological problems arise due to conflicts between different parts of the mind. Freud figured that bringing these unconscious thoughts into conscious awareness would resolve the stress of these conflicts. This became the very goal of psychoanalytic therapy.
Methods used
One of the common methods used by psychoanalysts is called free association. In free association, the patient is made to share every thought that crosses their mind in their raw form - meaning without censoring them or organising them in any way. The analyst then tries to observe their patient’s thoughts utilising their skills and expertise. Oftentimes, free associations are pertained to childhood memories because psychoanalysts believe that a person’s relationship with their caregivers as a child plays a huge role in their psychological makeup.
However, it can be quite difficult to consciously recall old memories. Therefore, psychoanalysts also resort to discussing their patient’s dreams. According to Freudian theory, dreams contain both manifest (literal) content and latent (symbolic) content. For example, if a patient dreams that they are going bald (losing their hair), it could be a reflection of the person’s unconscious concern of losing their attractiveness. Here, having dreams of going bald is the literal/manifest content of the dream and losing their attractiveness is the latent/symbolic content of the dream. In psychoanalytic therapy, the therapist’s primary role is to interpret their patient’s thoughts and feelings based on clinical experience and psychoanalytic theory. The key is to make the patients comfortable enough to disclose the conflicting content running through their mind.
Advantages and Disadvantages
Some of the advantages of psychoanalytic therapy include the inviting, safe, and non-judgmental environment which is quite appealing to patients. This intense self-examination where past memories and present thoughts are carefully examined can lead to higher self-awareness. Moreover, psychoanalytic therapy lets you confront painful memories and past traumas.
However, psychoanalytic therapy is often expensive because treatment can take a very long time, even years. Another disadvantage could be the emotional toll it can take on the patient - which many people find physically and mentally exhausting. Many critics such as American linguist Noam Chomsky and Austrian-British philosopher Karl Popper have suggested that psychoanalysis lacks scientific basis.
Nowadays, the amount of therapists practicing psychoanalytic therapy has been constantly decreasing. This is because of the fact that this approach is not appropriate for a lot of patients including those with an intellectual disability.
Humanistic and Person-Centered Therapy
Humanistic or person-centered therapy (PCT) was one of the next therapeutic approaches developed by American Psychologist Carl Rogers in the 1940s. This approach focuses on resolving the belief that mental health problems are a result of instability between a person’s behaviour and their true identity. Rogers, specifically, believed that everyone has the possibility to change and improve, and that the role of therapists is to foster self-understanding in an atmosphere where adaptive development is more prone to occur. Therefore, the goal of PCT became to help patients discover their self-worth, feel safe and comfortable exploring their identity, and modify their behaviour that better suits their personality. Rogers urged that the therapist and patient genuinely interact with each other in an environment that is nonjudgmental and empathetic.
Methods used
Just like psychoanalysis, PCT involves a highly unstructured conversation between the therapist and the patient. However, in PCT, the therapist plays a passive role leading the patient towards the path to their own self-discovery. Therapists solely provide a platform for their patient’s personal growth instead of trying to interpret and change their patient’s thoughts and behaviours. One important aspect to note in PCT is the unconditional positive regard for the patient’s behaviours and feelings. The therapist never disapproves or condemns whatever their patient does or thinks. They are only to express warmth and empathy and to provide an encouraging environment for the patient to explore themselves. Due to this known positive flexibility, the patients come to appreciate and value their therapist’s support.
Advantages and Disadvantages
One of the main advantages of person-centered therapy is how acceptable it is to patients. People tend to thrive in supportive, nonjudgmental, and empathetic environments free from any approval or disapproval. This helps patients behave in a way that is more congruent with their identity. One basic disadvantage is that good communication skills and motivation are required on the client’s part which may not be possible if the client is depressed. Further, the findings about the effectiveness of PCT are mixed merely because this approach is based on nonspecific treatment factors. This approach does not really utilise methods specific to the patient’s problem therefore, it cannot work for every person.
Cognitive Behavioural Therapy
Cognitive behavioural therapy (CBT) is a type of psychotherapeutic approach that has gained widespread popularity and support. Its main goal is to identify and change underlying destructive cognitions and behaviours. This approach was developed in the mid-20th century by Aaron T. Beck, a psychiatrist, and Albert Ellis, a psychologist. CBT has largely focused on changing the negative and harmful thoughts that directly contribute to emotional difficulties. Over the years, CBT has become a present-focused therapy that aims to solve a person’s mental illness through between-session homework assignments. For example, a therapist may give their patient an assignment in which the patient has to write down whenever they felt an urge to constantly wash their hands and what they did to avoid that urge. In the next therapy session, the patient and the therapist can review and analyse the homework together. This approach generally lasts 12-16 weeks and is closely tailored to match the needs of the specific patient and their mental illness.
Methods used
CBT uses a number of strategies to help identify negative thoughts and practice useful skills pertaining to the patient. For example, if a person studies really hard for an exam but on the day of examination, starts freaking out and thinks, “I’m going to fail this exam because I haven’t studied anything” then, the thought itself won’t be problematic but the idea that this thought might become a possibility is troublesome. CBT works to change maladaptive appraisals to adaptive ones (such as, “I’ll try my best because I do know the material of the exam!”). It is the therapist’s job to point out inaccurate and misleading thoughts through cognitive restructuring so that it helps the patient to get rid of these thoughts. Aside from thoughts, CBT tends to resolve maladaptive behaviours. As described above, whenever a person engages in a maladaptive behaviour (like constantly washing their hands), they are strengthening the validity of that behaviour thus, maintaining the psychological illness. CBT helps to alleviate these symptoms of a psychological illness through goal-setting, homework assignments, problem-solving, and self-monitoring. CBT incorporates a number of therapies for various psychological problems like Cognitive therapy, Dialectical behaviour therapy (DBT), Multimodal therapy, and Rational emotive behaviour therapy (REBT).
Advantages and Disadvantages
One key advantage of CBT is that it can be adapted to suit the needs of a person specific to their mental illness. It is a short-term treatment that helps us engage in healthy thinking patterns and behaviours and rectify the harmful ones. There is great empirical evidence showcasing CBT’s effectiveness. Perhaps a disadvantage of CBT is that it requires significant effort on the patient’s part because the patient is an active participant in treatment. Without the patient’s cooperation, a therapist cannot move forward with the treatment.
Acceptance and Mindfulness-Based Approaches
This type of therapeutic approach is born out of age-old buddhist and yoga practices. According to mindful.org, “mindfulness is the basic human ability to be fully present, aware of where we are and what we’re doing, and not overly reactive or overwhelmed by what’s going on around us.” Mindfulness, as a therapeutic approach, tries to cultivate a nonjudgmental and attentive mental state. Unlike other therapies that work to eradicate destructive thoughts and behaviours, mindfulness encourages us to nonjudgmentally accept them. Mindfulness is beneficial because it emphasizes on the present instead of focusing on the past and future stressors and promotes physical relaxation.
Methods used
Various types of mindfulness-based therapy (MBT) have gained popularity such as mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MBSR). MBCT focuses on a person’s inner thoughts and emotions and encourages practices such as meditation, yoga, and other inward-focused activities. MBSR, on the other hand, uses these practices to reduce stress. The goal is to allow the person to carefully observe their thoughts and evaluate them after reducing stress.
Advantages and Disadvantages
One of the notable advantages of MBT is its acceptance and accessibility to people. Meditation and yoga are already widely known practices and those with a stigma against seeking therapy can try these practices. MBT approaches are effective in treating anxiety and mood disorders. On the other hand, mindfulness requires effort and maintaining a flexible schedule which can be difficult for people with anxiety or depression. Because mindfulness persuades you to accept your feelings the way they are, it can cause you to feel even more anxious.
Conclusion
By understanding the various types of therapies available to us, we can make better choices and decide which approach suits us and our needs best. We can also educate other people so that they get the help they need. Currently, cognitive-behavioural therapy is most widely acceptable to people because of its high success rates and vast empirical research. At the same time, the usefulness of other therapeutic approaches cannot be dismissed. By efficiently utilising current therapies, we can hope for better therapeutic approaches to emerge in the future.
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