What Are The Different Types Of Psychotherapy?
By: Nadia Khan
Updated June 05, 2020
Medically Reviewed By: Aaron Dutil
Types Of Psychotherapy
There are dozens of different types and approaches to psychotherapy that are used by mental health professionals depending on the kind of illness or disorder the patient is seeking to treat.
- Equine assisted psychotherapy: using horses (the caring of and doing activities with horses) as part of an individual's treatment plan to treat a psychological illness or disorder. Horses are generally viewed as therapeutic and working with them creates a healing bond between the patient and the horse.
- Transference-focused psychotherapy: used as a treatment method for Borderline Personality Disorder. Studies have shown the use of this type of therapy has led to a decrease in BPD symptoms, such as suicidal thoughts and violent, angry impulses.
- Art therapy: using any kind of creative technique (painting, drawing, sculpting, etc.) to express an emotion. The art is then examined to understand the underlying psychological issue at hand. It's an especially effective technique with children and youth and can help with addictions, depression, stress, and anxiety.
- Dance therapy: is the use of movement as therapy to relieve stress, manage mood, increase self-esteem and promote positive body image.
The above-listed types of psychotherapy, while effective, are very specific to certain types of illnesses and patients. Those interventions may not be widely used by all psychotherapists. For this article, we will look at a few broader types of psychotherapy, which are more widely used for treating a variety of illnesses and issues. They are as follows:
- Interpersonal Psychotherapy (IPT):
IPT is a fairly new type of psychotherapy as it has only been around for just over two decades and it was originally designed as a way to treat Major Depressive Disorder. However, over time it has been used to successfully treat several other disorders as well, such as drug and alcohol addiction, eating disorders, bipolar disorder, several types of depression, etc. Due to its success and popularity, the use of IPT as a reliable psychotherapy treatment continues to grow, and studies have shown its effectiveness is comparable to using medication.
There are four key issues and problems that Interpersonal Psychotherapy can target and help with:
- If a patient is struggling with interpersonal deficits - how and what is lacking in their social interactions? What aspect of their interpersonal relationships feels unfulfilled and empty?
- If the patient is struggling to deal with unresolved emotions of grief and loss - if the unhappiness the patient is experiencing stems from a death or a loss.
- If the patient is having a difficult time managing and resolving conflicts with co-workers, family members, their significant other, friends, people in general, etc.
- If the patient is having a difficult time dealing with a significant change in their life such as losing a job, going through a separation or divorce, etc.
As the name suggests, the main purpose of IPT is to arm the patient with strategies and mechanisms on how to improve their interpersonal relationships in the hopes it will decrease the stressors in their life incurred as a result of poor interpersonal relationships. The treatment for IPT is based on a specific timeline and lasts anywhere from twelve to sixteen weeks; therapy sessions are primarily done individually but can also be conducted in a group setting depending on the issues at hand. The first few sessions are devoted to understanding and assessing the patient's symptoms and concerns. Once a clear pattern has been established, the following sessions are dedicated to providing the patient ith the appropriate strategies to deal with and resolve those issues.
For treatment to be successful, the patient has to put in a certain amount of work such as doing homework, on-going assessments, and interviews, since IPT follows a specific structure. In Interpersonal Psychotherapy, the focus is not so much on past events, but what is happening in the present and its goal is to change the patterns in the patient's interpersonal relationships. As the treatment evolves, the strategies may change and evolve.
- Cognitive Behavioural Therapy (CBT):
Invented during the 1960s, CBT is a combination of behavioral therapy and cognitive based psychotherapy. It is often used by therapists in conjunction with other types of therapies to treat an illness. A wide range of disorders and issues can be treated with CBT, including but not limited to:
- Eating Disorder;
- Anxiety, Depression and Mood Disorders;
- Anger Management;
It is short-term therapy, lasting typically from three to ten months with one session a week, with a specific goal that has to be reached at the end of the treatment period.
The focus of CBT is not to dwell on the upsetting events faced by an individual but rather the emotional and physical importance the patient places on the upsetting events. It is based on the idea that if an individual is too focused on the negative aspect of things it hinders them from seeing the full picture with an open mind and thereby may lead to missed opportunities.
For example, someone suffering from anxiety may be reluctant to attend a work event because they are worried they won't get along with their co-workers or won't be liked by them. As a result of this negative thought, the individual avoids all team building and work events but by doing so they are missing an opportunity to bond and socialize with their colleagues and thus making their initial (baseless fears) come true because her colleagues now view the individual as cold, aloof and unwilling to mingle with them.
Many times these negative thoughts are automatic patterns for individuals and stem from past experiences. For instance, if a child only got love from their parents if they did well in school or exhibited good behavior, they will likely grow up terrified of failing at something because they will think nobody will love them unless they are perfect and successful.
CBT extends beyond just talking things through, and a treatment plan often includes techniques and exercises such as writing in a journal, engaging in relaxation and mindfulness activities or taking part in physical and social activities. It is important to note that while treatment is short term, it is not a quick and easy process and requires expertise from the therapist and a firm commitment and active participation from the patient to work together towards their common goal. CBT is also not the most effective method when it comes to treating severe mental disorders and illnesses, while it can form a part of the treatment plan, it is rarely used as the only treatment plan.
- Dialectical Behavioural Therapy (DBT):
Developed in the 1970s, DBT was initially used to treat individuals who were chronically preoccupied with suicidal thoughts or suffering from Borderline Personality Disorder. It has since become one of the preferred types of psychotherapy to treat individuals who suffer from very severe emotional dysregulation and for individuals who have found very little or no success at all with other types of therapy.
Treatment using DBT is based on the idea of problem-solving and allowing the patient to accept or come to terms with their situation and uses dialectical (two opposite concepts such as change and acceptance, coming together) methods to do so.
DBT uses a combination of individual therapy, group therapy, team consultation as well as coaching over the phone. The therapist uses the individual sessions to bond with the patient; to understand their unique needs and the problems they face, while group work enables the patients to enhance their behavioral skills and practice what they have learned. It also allows them to feel motivated and provides a support system. Patients also know they can reach their therapists over the phone whenever they some additional help to overcome a difficult situation. The creation and use of a consultation team are very important in DBT due to the illnesses and disorders the therapists' treat. Team consultation supports them when dealing with complex and difficult cases and patients.
DBT is broken up into four different stages to ensure that every concern is dealt with and the patient's issues are treated in order of importance and severity. The four stages are as follows:
- Stabilization: This is a crucial first step since most of the patients DBT therapists see are dealing with very severe mental health issues where there is a risk of suicide, self-harm, violence, and addiction. It is imperative to manage the current crisis, intervene if necessary and stabilize the situation to remove any immediate threats. The first step emphasizes arming the patient with ways to exert some control over their behavior since many people report feeling completely helpless with no light at the end of the tunnel.
- Emotional Pain: During the second stage, once the individual behavior is more stable, the therapist will encourage the patient to face the emotional pain they have been repressing. Traumatic and painful events are revisited in a safe, controlled environment so the individual can confront it, accept it and then move past it.
- Quality of Life: The third stage is designed to help the individual increase their quality of life by maintaining the progress they have made in therapy and by setting realistic, achievable goals for themselves. The goal in this stage is to increase happiness and set the stage for the final step.
- Next Steps: Stage four touches upon the successes of stage three and the goal is for the individual to maintain stability, security, and happiness on an on-going basis by incorporating the skills and lessons they learned in therapy in their daily lives.
Most studies and research indicate DBT has a high rate of success and efficacy, however, due to the complexity of the disorders this therapy treats there is still room for improvement and further research is needed to determine the long term therapeutic gains of DBT.
Is Psychotherapy Effective?
It is a common misconception that therapy is only for people who are suffering from a serious mental disorder or condition. It is this belief that can lend an aura of taboo to the subject of counseling or therapy.
While psychotherapy is a very effective way to deal with mental disorders and more often than not forms a significant part of a patient's treatment plan, it is becoming more common and more socially acceptable for individuals to seek out the services of a mental health professional for a number of non mental disorder related issues such as:
- Learning how to cope with a significant life event such as losing employment, a death in the family, the end of a relationship, the birth of a child, moving to a different city or country, etc.
- Learning how to resolve conflicts successfully;
- Learning how to cope with and recover from a traumatic experience such as physical or sexual abuse;
- Learning how to relieve stress and anxiety;
- Learning how to be more confident or gain a better understanding of self.
In short, therapy is not just for mental illnesses, and the dozens of different types of psychotherapy options are a testament to that. We are lucky to live in a time when awareness surrounding mental health is increasing, so there is help for almost anything you are going through.
If you find yourself struggling with something and feel it would be helpful to speak to a neutral, third party then consider speaking to a therapist, psychotherapy is not a risky treatment method; it has a very high rate of success and can only serve to benefit you. Don't let your mental health cripple you, rather gain the tools and skills to take control and live the life you were meant too! The Internet is also a great place to gather information and resources and even therapy sessions.
If you are someone who already suffers from a pre-existing mental health disorder and feel that your life may be spiraling out of control or you find yourself consumed with thoughts of suicide or violence, get some help immediately. Speak to a family member, a friend or your doctor about accessing treatment.
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