What Type of Therapy is Best for Me?

You guys, there are so many types of therapy. In fact, I’ve been dreading this oft-asked question because there’s just so much. I will definitely not cover them all here. What do I mean by type of therapy? Primarily-- theoretical orientation. In school or in trainings, we learn about theories of the mind and the ways in which we can intervene. Many of these theories do have quantifiable outcomes; however, emotions and connections are not really measurable. Behavior is measurable, but we all know too well that someone who appears “happy” could be miserable.

I’ve talked about the different kinds of psychotherapeutic clinicians here. I will focus on individual therapy. There are many types of Art therapies and Couple and Family-oriented therapies and although I’ve touched on those modalities, they may be a discussion for another time.


All of the theories I describe below are much more involved than the small blurb I’ve provided. If interested, let me know-- we’ll research together! Let’s just take some brief looks at this wild world.

Person-Centered

The other Mr. Rogers is Carl Rogers who developed a way of being with clients that rests on three principles: empathy, authenticity, and unconditional positive regard. When sitting with someone who radiates these three principles, the client is able to grow. At this point, it seems like this is the way most therapists are oriented and lay other therapeutic models on top of it.


The Who Am I’s and What Am I Doings or who are “we” as a culture?

Psychoanalysis comes in many forms but derives from many of Freud's initial theories. Psychoanalysis frequently uses free association to kick up the dust on the unconscious and uncover conflicts that keep you stuck in your patterns.

Existential Therapy looks at human suffering and the ways in which we can manage our existential anxiety by taking responsibility for the freedom that life may provide.

Narrative Therapy helps you re-write your story by identifying current narratives, determining your values and re-shaping the narrative based on those values. Sometimes, friends and family are part of this therapy as they fill out the narrative.

Play Therapy: Although often used with children, play therapy could potentially be used for all ages. In play therapy, actions performed in play hold symbolic representations of the unconscious. Both the relationship between the client and therapist as well as processing that occurs during play (which is akin to free association) are the mechanisms by which growth occurs.


Symptom Specific:

CBT: Cognitive Behavioral Therapy links thoughts to actions. This is where you find cognitive distortions. During therapy, you and the therapist work together to uncover and interrogate automatic thoughts and assumptions in order to combat unhelpful patterns of thought.

Behavior therapy works to change your behaviors with the thought that feeling better will follow. Recommending a behavior chart to help manage your child’s behavioral issues is an aspect of behavior therapy. Behavioral Activation is often used as an efficacious intervention for Depression; it has the client go out and do things that they value.

Mindfulness Based Cognitive Therapy: “Third Wave” CBT includes Mindfulness. We’re still looking at thoughts here, but it incorporates meditative practices.

Acceptance and Commitment Therapy (ACT) seeks to move you toward your values following accepting your current reactions, defusing the thoughts (this is a larger discussion), and finally taking a valued action.

Compassion-Focused Therapy incorporates mindfulness in an internal systems theory sort of way which allows for the alleviation of internalized shame.


We don’t have that kind of time

Solution-Focused Brief Therapy uses specific questions in order to focus on the concern at hand. This is more about meeting goals quickly than insight development.

Motivational Interviewing is often used as a tool for quick behavioral change by systematically pointing you toward the ambivalence between your behavior and your values.

Interpersonal Therapy: Unlike Solution-Focused and Motivational Interviewing, Interpersonal Therapy is an attachment-based therapy that combines elements of CBT and psychodynamic approaches. In therapy, the client’s typical “maladaptive patterns” are exhibited in their relationship with the therapist— and this can be corrected within that environment.


Trauma Specific

Cognitive Processing Therapy (CPT) is a very structured treatment that includes psychoeducation around thoughts, feelings, and trauma; lots of homework and re-tellings of the traumatic instance.

Eye Movement Desensitization and Reprocessing (EMDR) is slowly becoming a gold standard for focused PTSD treatment. The therapist works with you to develop coping skills that you can use when you begin to run through traumatic experiences while hooked up to a machine that uses “bilateral stimulation” to process and store memories in the “proper” way (as opposed to the stuckness that traumatic experiences often bestow.

DBT is not billed as a trauma specific therapy, but the more I think about it, maybe it is. It’s like the coping skills branch of therapy for trauma. Dialectical Behavioral Therapy is another structured therapy, initially created to treat Borderline Personality Disorder, which teaches distress tolerance and emotional regulation under the lens of dialectics. Two opposing ideas can be true. And that’s really hard to sit with.

Somatic Experiencing takes cues from physical, occupational and speech therapy and incorporates psychotherapy in order to work with the nervous system which is affected by trauma, but especially pre-verbal trauma which lurks in the body.

Many of the theories share similar ideas. However, like any industry, there is competition and enterprise involved in the creation of new theoretical orientation/interventions. It is consistently true that the most important indicator of positive outcomes in therapy is the relationship between the client and the therapist, regardless of theoretical orientation. There’s a chance you may be more trusting of your therapist if they practice from a particular model. Like life (and most science), there’s some trial and error in therapy. Often you don’t know until you’re looking back on the experience. That’s ok. That’s how it works.

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