Therapeutic Approaches: You mean they're not all the same?

For Professionals / For Professionals : Eleanor Haley



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We're trying to demystify the therapeutic approach here at 'What's Your Grief'.  We've had one installment of our series on grief models and recently we discussed mental health credentials (all those letters found after the names of counselors and therapists).  Today we'd like to talk a little bit about different types of therapies.  Did you even know there were different types? You're not alone, this isn't necessarily common knowledge!  That being said, the type of therapeutic approach a counselor or therapist ascribes to can be a pretty important thing to consider when looking for a therapist.

Our health plan covers half the therapy sessions I need so plan on me being half-insane.

Most mental health professionals are guided in their work with patients by a certain type of therapeutic approach.  Finding a therapist whose approach meets your needs will be one of the most important pre-requisites for productive treatment.  Problem is, most of us have absolutely no idea about the different types of therapy, which will meet our needs, and how to find out which approach(s) a therapist subscribes to.  This is a very basic overview, to get you started.

Psychoanalysis and Psychodynamic Therapies

This is the approach that most people think of when they imagine a “stereotypical” therapist or have heard something about Freud somewhere along the way.  This approach uses the uncovering of unconscious motivations in order to change thoughts and behaviors.  Much of the work in this type of therapy is focused on the therapeutic relationship and exploring interactions that occur within that relationship.  Within that relationship, the therapist helps the client uncover their motivations and the unconscious thoughts and experience that influence their behaviors.

Key Points:

  • This is often a long-term therapeutic approach
  • This approach is more abstract than some other approaches, in that it is non-directive.  The therapist's role is not to advise or give specific tools.

Behavioral Therapies

This approach is connected to role development in relation to behaviors (both normal and abnormal) and emerged in the 1950s.  With an emphasis on conditioning and learning through rewards and punishments, many are familiar with the contributions of Pavlov and Thorndike.   This approach is often associated with exposure therapy or “desensitization” in cases of anxiety disorders, obsessive-compulsive disorders, and specific phobias.

Key Points:

  • This is often connected with cognitive therapy, in the cognitive-behavioral approach (CBT).
  • These approaches are typically short-term and solution-focused, working on resolving a specific issue through skill development.

Cognitive Therapies

Cognitive therapy approaches look at dysfunctional thoughts and the connection of those thoughts to problematic feelings and behaviors.  Cognitive approaches emphasize changing thoughts and patterns of thinking, which will then result in changes in feelings and behaviors.

Key Points:

  • This is often connected with behavioral therapy, in the cognitive-behavioral approach (CBT).
  • These approaches are typically short-term, goal-oriented, and solution-focused.
  • Cognitive therapy addresses maladaptive emotions and behaviors through an examination of one’s thoughts and the development of concrete skills to change thinking and, in turn, emotions and behaviors.

Humanistic Therapies

(a.k.a. Gestalt Therapy, Client-Centered Therapy, Existential Therapy, Existential-Phenomenological Therapy)

These approaches focus on the human capacity for rational choice as the key to grow and achieve self-actualization.  This approach is heavily influenced by humanistic philosophy, specifically existentialists and phenomenologists.   These therapies put a heavy emphasis on the client as an expert on him/herself.  As such, the therapist is not the expert.  Rather, clients are encouraged to increase their personal awareness, personal responsibility, and to execute their free will and self-determination.

Key Points:

  • The client is at the center of these approaches, and is viewed as the expert.
  • A therapist practicing this approach is very focused on empathetic understanding, comforting the client, and focusing on the concerns the client feels are most important.

Integrative Therapists

Many therapists do no identify exclusively with one approach, and rather apply a blend of approaches based on the individual needs of the patient.  Even if not identifying with one specific approach, a therapist should be able to explain to a client their basic philosophy and the therapeutic approaches to which they are primarily predisposed.

Holistic Therapists

More and more mental health practitioners are becoming aware of the connection between mind and body.  Rather than focusing exclusively on the mind through traditional therapeutic approaches, these practitioners incorporate the physical body to increase one’s overall wellbeing.  Some holistic therapists may also have certifications in yoga, reiki, or even acupuncture, or work in practice with someone who does.  Their basic approach may be any of those above, with the addition of these alternative therapies.

Group Therapy

Groups can take a wide variety of shapes and sizes and are offered to address general grief and loss, or sometimes more specific losses (such as loss of a spouse, child, suicide, overdose, etc).  One important distinction between groups is if they are facilitated by a mental health professional, or if they are a “support” group which is people with a shared experience meeting to support each other, without a trained professional. You can read more about grief support groups here. Though not a rule, groups offered through hospices, hospitals, mental health clinics, and other health and wellness facilities typically are facilitated by a mental health counselor.  Groups that meet in the community, at churches or community centers, are often not lead by a counselor.  Both groups can be beneficial, though a group facilitated by a counselor may provide more evidence-based tools for coping with grief, whereas a “support” group will focus on the experiences of others in the group.  For any group, it is recommended to attend at least 3 sessions before determining if the group is a good fit.

Goodtherapy.org is a resource for reading far more in-depth about different kinds of therapy, and also includes a therapist locator.  To read about very specific therapy types or psychotherapy approaches, click here.

Therapy is just one way to cope with grief.  Subscribe to 'What's Your Grief' to hear more about therapy plus any and every type of coping mechanism we can think of. 

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