In the sometimes confusing world of talking therapy, understanding approaches and choosing a practitioner to work with can be a challenge. There is no one-size-fits-all when it comes to matching an approach with an individual, or matching a modality with a particular mental health challenge, so it can be helpful to consider the options and get a sense for what they can offer you in order to make an informed choice.
I think important to say that I'm writing this blog post from the perspective of a psychodynamic practitioner - so my understanding and description of this approach is likely to be more rounded than that of other approaches - but I hope this provides a starting point for exploration at least.
Psychodynamic psychotherapy explores the idea that our present thoughts, feelings, and behaviours may be influenced by unconscious processes shaped by past experiences, often stretching back to early childhood. In collaboration with the therapist, clients might hope to gain insight into unresolved conflicts, unconscious patterns, and the ways in which past experiences may continue to influence their current lives. The goal is not only symptom relief but a fundamental transformation in how individuals perceive and relate to themselves and others.
A relational psychodynamic therapist is also interested in the quality and nuances of therapeutic relationship between the client and the therapist. The relationship itself is seen as a live example of a client's relationship style - and is often a furtive area of exploration.
Psychodynamic psychotherapy proves particularly useful for individuals struggling with complex and longstanding emotional challenges. It is well-suited for addressing issues such as chronic anxiety, depression, relationship difficulties, and patterns of behaviour that are resistant to change. By being interested in what is behind emotional struggles, psychodynamic therapy works to uncover and untangle deep-seated conflicts, allowing individuals to develop a more profound understanding of themselves.
A heightened self-awareness can lead to more successful coping mechanisms, improved interpersonal relationships, and a greater capacity for self-compassion. Psychodynamic psychotherapy is a valuable tool for those seeking not only symptom alleviation but a comprehensive and lasting transformation in their psychological well-being.
Cognitive Behavioural Therapy (CBT)
Cognitive Behavioural Therapy, or CBT, is a widely practiced therapeutic approach focusing on the connection between thoughts, feelings, and behaviours. This approach offers practical coping strategies - it is symptom focused and is less suited to exploring underlying causes.
CBT is usually offered in a structured way - often with homework and tasks to complete between sessions. There are CBT strategies for many mental health challenges such as anxiety, phobias and compulsions.
One of the reasons for its popularity is that this approach to therapy focuses on outcomes and goals and is usually time-limited. A referral for CBT may be available through your GP, though waiting lists can be long. In the UK sessions are usually weekly or fortnightly, last 30 to 60 minutes and between 6 and 20 sessions are offered.
This approach is often called client-centred or person-centred and - as is common amongst many approaches to therapy - encourages individuals to explore their feelings, thoughts, and behaviours in a non-judgmental and supportive environment.
Humanistic therapists work from the position that everyone has an innate capacity for self-discovery and positive change. They suggest that through the therapeutic process, individuals can gain insight into their true selves, develop a stronger sense of identity, and align their lives with their core values. The goal of humanistic therapy is not just symptom reduction but the holistic development of the individual, fostering a deeper understanding of one's emotions and facilitating the journey towards realising their fullest potential.
Common problems that might be addressed with a humanistic therapist include issues related to self-esteem, personal identity, existential concerns, and difficulties in establishing and maintaining authentic and fulfilling relationships.
Integrative or Eclectic Approaches
Integrative or eclectic therapy just means that the therapist draws from multiple therapeutic modalities, tailoring the treatment to individual needs. This strategy may allow an experienced therapist to combine the strengths of different approaches, or to tailor an approach for a personalised therapeutic experience.
Mindfulness-based therapies works by heightening and exploring a deepened awareness of the present moment. This technique can offer relief in managing the symptoms of stress, anxiety, and depression. Integrating mindfulness into daily life can be a powerful supplement to traditional therapeutic approaches.
Narrative therapy centres on personal storytelling, helping individuals reconstruct and reshape their life narratives. By reframing experiences, individuals can empower themselves to overcome challenges and build resilience. Narrative therapy is well-suited for addressing issues related to identity, self-esteem, and the impact of personal and cultural narratives on an individual's perception of their life story and experiences.
Thinking about your personal preferences, goals, and specific challenges can help you as you choose someone to work with. The following checklist might help you think about this:
Choosing a therapeutic approach: A checklist
What are my specific goals for therapy? (e.g., managing anxiety, improving relationships, personal growth)
Are there particular challenges or patterns in my life that I want to address?
Have I gained a basic understanding of different therapeutic modalities? (e.g., CBT, psychodynamic therapy, humanistic approaches)
Do I resonate more with approaches that focus on the present moment, explore past experiences, or emphasise the relief of my symptoms?
Preferred Therapeutic Style
Am I seeking a more structured and solution-focused approach, or do I prefer a more exploratory and open-ended style?
Do I feel more comfortable with a therapist who takes an active role in providing guidance, or do I prefer a more collaborative approach?
Have I had any previous experiences with therapy, and if so, what aspects were helpful or less effective?
Are there specific therapeutic techniques or approaches I've found beneficial in the past?
Does the therapist specialise in areas relevant to my concerns or goals? (e.g., anxiety, trauma, relationship issues)
Have I considered seeking a therapist with expertise in specific therapeutic modalities?
Comfort and Trust
Do I feel a sense of comfort and connection with the therapist during initial consultations?
Do I sense that the therapist is empathetic, understanding, and non-judgmental?
Flexibility and Adaptability
Am I open to trying different therapeutic approaches or a combination of modalities?
Does the therapist show flexibility in tailoring the approach to my individual needs?
Cost and Logistics
Does the therapist's fee structure align with my budget, and are there options for financial assistance or insurance coverage?
Are the location, session duration, and frequency convenient for my schedule?
Can I envision building a positive and trusting therapeutic relationship with the therapist?
Does the therapist encourage open communication and collaboration in setting treatment goals?
Feedback and Adjustments
Am I comfortable providing feedback to the therapist and expressing if a particular approach doesn't feel effective?
Is the therapist open to adjusting the therapeutic approach based on my feedback and evolving needs?
Being ready to have an open and honest discussion with a potential therapist, perhaps bringing in some of the points above, will help you find a good fit. Your unique preferences and goals should guide the decision-making process, ultimately leading to a more enriching therapeutic experience.
Each modality offers a unique perspective and set of tools, and each journey is an entirely personal one. It can help to take some time to think about which therapeutic approach resonates with you most, but it's also absolutely fine not to know - and to use your first session to discuss these approaches with your therapist.
Feel free to leave a comment or reach out to me directly if you have any questions.