What do the different types of therapy mean? As a new, or even therapy-experienced client, trying to make sense of the therapy world can be intimidating… all these labels, abbreviations, terminology and jargon. So, here is a brief word on eight of the more common forms of therapy available, all in the one place. Other forms of therapy are ususally closely related to something on this list, or a combination of two. It might help you identify what you want, or rule out what you don’t. My approach, pluralistic therapy, is the final one in the list.
Cognitive Behavioural Therapy (CBT)
I start with one of the most well-known forms. CBT is widely available, and preferred by many health services. This focuses more on the present (rather than your past), and aims to relieve negative or problematic thoughts, beliefs, feelings and behaviours. You may be given a lot of ‘homework’ between sessions in this active form of therapy. This may, for example, help you track how things feel across a typical week. Further, you are likely to be challenged to experiment with new behaviours. Your therapist may be more directive or motivational than others. Particularly appropriate if you just want to focus on ‘now.’
Person-centred Therapy
Again, widely available. Focuses on providing you with a non-judgmental yet honest relationship, so you can experience yourself as accepted without the conditions or limits of others (and what they need from you); through this, the relationship itself is healing. This is typically a warm, very human experience, and among other things will encourage you to balance your own needs with the demands of others. It will be patient, open, and non-directive, with space to explore any aspect of your experience. Most of these different types of therapy now borrow its ‘core conditions’ for how therapists should be – emotionally immediate, empathic, and non-judgmental.
Psychoanalytic (or, Psychodynamic) Therapy
Widely available. Difficult to summarise! But, to try… this will focus on how the past impacts you today, and how the ways you relate to important people in your life become patterns that transfer onto how you relate to others. Will help you explore your fantasy life, dreams, and the ways in which you defend against experiencing uncomfortable feelings. Generally very open, free for moment-to-moment explorations. There are many different kinds, so check with your therapist on the particular way they practice.
Existential Therapy
Reasonably widely available, in different specific forms. Primary focal points include helping you examine your attitude to life and what you want from it, challenging you to take full, uncompromising responsibility for it. Helps explore your room for action within your life circumstances. Considers your past, present and future, and your different dimensions of being (e.g., your physical self). Stresses that as human beings, we will inevitably suffer bad times as well as good, and our attitude in how we face hardship is what we can control.
Gestalt Therapy
Less widely available, but a powerful approach. Focal points include working to process ‘unfinished business,’ things we have not dealt with that continue to bother us. Will work with you exactly as you present yourself in the room, encourage you to stay with difficult feelings, and routinely check in on what you’re feeling in your body. You may experience the therapist as gently confronting.
Acceptance and Commitment Therapy
Increasingly available. A tailored approach to therapy that follows a set structure. This is aptly named. It focuses on accepting that life is often hard, painful, difficult and uncomfortable. It then works on clarifying your values and helping you commit to meeting them. Life can be more fulfilling and rewarding when, instead of seeking some indefinable state of happiness; we set ourselves into meaningful action in line with who we feel ourselves to be.
Narrative Therapy
Increasingly available. Narrative therapists see the ‘self’ as influenced by the stories we tell about ourselves. They use this as the primary site for your active work in therapy. Activities might include finding more neutral ways to tell painful parts of your story. Might help you create space from domineering, persistent thoughts and feelings through labelling them. An active, ‘doing’ form of the different types of therapy listed here. It may appeal to those interested in the very idea of narrative and story-telling.
Pluralistic Therapy
My own approach, gradually becoming more available. Research shows that all therapy types are, actually, of equal potential help. All of the types above have the potential to prove helpful to you. So, what else is happening? What is it that makes for a successful therapy process? It appears that the conditions you create around therapy are what matter. For example, a strong working relationship between client and therapist is critical. So, us pluralistic therapists concentrate on creating good connection with clients. It’s the single biggest predictor of helpful therapy. Further, therapy works best when you, the client, are fully invested in what’s happening. We therefore focus on collaboration, offering you choices in how you’d like to work. Therapeutic exercises and techniques are borrowed from other approaches, as necessary (and within the therapist’s skillset), and tailored to your own unique needs. The pluralistic approach then is guided by a set of research-informed principles, about how therapy should be run to be at its most effective.
In closing
Some final important words. Some fellow therapists might read my descriptions here as crude or incomplete (and they would probably be right!). However, I’ve written here for a prospective client that wants a basic lowdown for comparative purposes. There are many more specialist types of therapies, developed and refined for more specific treatment needs. A referral to these will often come through the health system. Bear in mind that all therapists will still practice with their own particularities that are true to them, their experience, and their outlook on what helps people heal or make therapeutic progress. Further, many therapists today are likely to combine elements of the different types of therapy, broadening their skillset across their professional career. Discuss with your prospective therapist how they are likely to work with you. If you would like to work with a pluralistic therapist, I welcome you to be in touch.
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