Most Common Types of Therapy/Counselling Explained
May 13, 2021 | by Callan Kelly
When seeking out support in a therapeutic setting, there are many different types of therapy to consider. Either you may not be aware of the different ways of working, or you could find yourself overwhelmed trying to choose what’s right for you. This brief overview aims to help you choose the right approach for you.
All the therapies listed below are talk therapies, with the exception of Art Therapy – and that too will almost always involve elements of conversation. Talking therapies are centred around the relationship between the therapist and client, regardless of which theoretical school of thought the therapist follows.
Therapy is often challenging, but with a good relationship between client and therapist, change can be achieved.
It’s absolutely possible to change therapist/counsellor if you feel that you need to, however, if you find yourself regularly wanting to change therapist then you should consider what this might be saying.
Therapist vs Counsellor
It’s very easy to get confused by the amount of technical information regarding the distinction between a therapist and a counsellor but, generally, a therapist will have spent a longer time training and achieving high level qualifications than a counsellor. Often though the technical distinctions are almost irrelevant, as long as the professional is competent, it is the relationship between a client and the therapist/counsellor which makes the most difference.
Wherever possible, you should try to find a counsellor/therapist who is accredited with a governing body such as the British Psychology Society (BPS), British Associations for Counselling and Psychotherapy (BACP) or British Association for Behavioural and Cognitive Psychotherapies (BABCP). This means that the professional must work within an ethical framework which is set out to ensure that clients receive the best treatment possible.
An important thing to know is that the terms “counsellor”, “therapist” and “psychotherapist” are not protected under law, so in theory, anyone can apply those terms to their practice.
Counselling frequently involves working with a mental health counsellor on a specific issue for a limited amount of time. For example, counselling can help you if you have difficulty managing stress and want guidance on tools you can use when you are stressed out, or if you’ve been struggling with low mood and feel that you would like some help getting back to your usual self.
Therapy can be more long-term and focuses on you as an individual — how you see yourself and your worldview, your thoughts, feelings and your behaviours, as well as the underlying patterns of why you do the things you do. For example, if you were suffering from depression, you and your therapist can explore how depression is impacting your life and how to develop coping strategies so that you can feel better. You usually go to therapy sessions on a more long-term basis.
Therapy can include counselling on specific issues that arise during your conversations with your therapist. On the other hand, if a counsellor sees deeper underlying patterns and concerns that affect the issues at hand, they may recommend that you start therapy. But there are exemptions. For example, a CBT psychotherapist might intervene and achieve good results within say, six or so sessions (eg: panic disorder).
However, the general principle would be that psychotherapy entails the longest involvement, as it is the modality often used to address complex presentations.
Types of Therapy/Counselling
The main focus of most behavioural therapies is on changing negative or unhelpful behaviours into more positive ones. There are many techniques within this approach, with Cognitive Behavioural Therapy and Dialectical Behaviour Therapy being the two which are most common.
Cognitive Behavioural Therapy (CBT) – A popular psychotherapy which is effective in treating both mental health and substance abuse issues. This approach focuses on how events, thoughts, feelings and behaviours are interconnected and can affect each other. A therapist using CBT will help the individual to identify negative or irrational thoughts, examine how true these thoughts are and then work with the client to modify these thoughts to more positive or realistic ones.It often involves “homework” between sessions where, for example, the therapist may ask you to keep track of some of your thoughts/feelings/behaviours so that they may be discussed at the next session.
Dialectical Behaviour Therapy (DBT) – DBT combines elements of talk therapy (Psychotherapy) and CBT. Used to treat a range of mental health issues, DBT teaches the client to recognise their thoughts and feelings and then to come up with a healthy response to triggers. Can be on a purely 1-to-1 basis but often involves an element of group work where it can be helpful to learn from peers and build support networks.
Cognitive Therapy is frequently confused with Cognitive Behavioural Therapy. While it does look at how thoughts influence feelings and behaviours, Cognitive Therapy focuses primarily on changing thought processes rather than behaviours.
Humanistic approaches focus on the individual, with the goal being to help the client develop and reach their full potential as a person. A belief that is central to this approach is that humans are inherently good, and given the right environment, can make the right choices for themselves.
Gestalt Therapy – A therapist working with this method will encourage you to look at your life and self in the present moment. For example, if you bring up past events or memories, your therapist may ask you to try and experience these in the present and examine how it makes you feel right now. Frequently involves a variety of techniques such as role-playing, re-enactment and guided fantasy.
Client or Person-Centred Therapy – As the name of this approach implies, it focuses on client. Rooted in the idea that the client must be able to freely express themselves without judgement, the therapists job is to provide the safe environment to facilitate that. The therapist will use techniques such as reflection, accurate empathy, congruence and unconditional positive regard to enable the client to feel comfortable opening up. The Person-Centred approach believes that the client is the expert in their own life and that given the correct environment, they will be able to self-actualise and grow into their authentic self.
Existential Therapy – Based on a philosophical approach, the fundamental concept behind this technique is that the individual makes their own meaning and purpose in life. Therapist working in this modality will help guide you towards making rational choices in order to reach your full potential. The key concepts of existential therapy are free will, self-determination, and the search for meaning.
Art therapies are a form of highly expressive therapy which use the process of creating something to help explore and understand a persons physical, mental and emotional state.
A common misconception is that this type of therapy is for children and young people. While children often respond well to the tactile nature of this approach, it can often be very useful for adults too. This is because it provides a different way of expressing yourself other than words. The use of non-verbal symbolism and metaphors can often allow clients to express concepts that may otherwise be very difficult to express.
This approach takes a holistic approach and uses different techniques to address each specific client’s individual needs. It’s known as Integrative Therapy as it brings together the different therapeutic methods and addresses the person as a whole.
These approaches are closely related: Psychoanalytic therapy focuses on unconscious thoughts and analysis of how they affect the individual.
Transactional Analysis (TA) – TA therapy recognises that we are greatly motivated by the reinforcement we get as children, and if this was dysfunctional, we are likely to adopt dysfunctional patterns of living as we get older. Another motivation recognised in transactional analysis is intimacy. It uses predominantly psychoanalysis school of thought of Back then, In here (the session) and Out there (in society)
Psychodynamic therapy is based in the same principles as Psychoanalysis but often the interventions are shorter, and also explore the clients external world, not just the internal processes.
Psycho-oncology works with the psychological reactions to the experience of cancer and treatment at all stages. It’s an interdisciplinary approach which deals with the psychological, physical, social and behavioural aspects of the cancer experience.