Approaches


Psychotherapy cannot be dismissed as simply a ‘one size fits all’ treatment. Indeed, most people are likely unaware that there are in fact dozens of options when it comes to prescribing therapy, each incorporating different treatment approaches, with some acting more effectively depending on the unique circumstances and needs of those seeking treatment. Techniques used are proven, researched and evidence-based so as to ensure the best possible outcome for the patient. The particular approach used and whether it be long or short-term, depends on the specific prerequisites of the person entering therapy. Therapy should, therefore, be custom made in order to best fit the needs of an individual. Consequently, therapists often take the approach of blending several different techniques in order to form a unique treatment plan tailored to a patient’s own particular requirements. This distinct approach is often referred to as ‘Holistic’ or ‘Integrative’ therapy.

Cognitive Behavioural Therapy


Cognitive Behavioural Therapy (CBT) is a relatively short-term, solution-directed approach that focuses on the relationship between one’s thoughts, feelings and behaviours in order to equip an individual with the skills needed to help manage their current difficulties. Patients invariably play an active role in this structured therapeutic process, enabling them to actively participate in the process of testing healthier alternatives to the potentially unhealthy thoughts and behaviours which have led to their current state of emotional distress. CBT has been researched extensively, and has proven effective in treating a variety of psychiatric difficulties. Patterns of thought such as self-judgment, catastrophic thinking, perfectionism and ‘all-or-nothing thinking’, for instance, can lead to one feeling not only unhappy; but can also result in ineffective coping skills, such as withdrawal and avoidance, that may interfere with the quality of one’s life. Through the application of CBT, one can begin to identify and isolate unhealthy and misleading thoughts. CBT works best when the patient actively engages in the process, and is willing to continue with the therapy by themselves; outside of sessions scheduled by their psychologist. CBT also incorporates desensitisation through exposure therapy, which has been proven effective in treating phobias, fears and trauma.

Dialectical Behavioural Therapy


Dialectical Behaviour Therapy (DBT) is also a type of behavioural therapy, however the focus here instead lies more in mindfulness, emotional regulation, and interpersonal skills. This form of therapy focuses on developing skills to cope with stress, to reduce mood swings and distress and to improve one’s relationships with others. There is a strong emphasis on learning how to balance acceptance and change within one’s life: recognising the distinction between knowing when to accept one’s life as it is, and when to attempt to change it, often brings considerable relief to an individual who finds themselves torn between action and inaction. Through mindfulness and skills training, a patient can develop a stable sense of self, learn to better regulate their emotions and, in doing so, better equip themselves to effectively interact with others. Mindfulness practices have been shown to be extremely efficacious in nurturing a general sense of well-being; and DBT in general has shown remarkable promise when it comes to better helping people manage their emotions and cope with distress, irrespective of whether they have any previous underlying mental health diagnosis.

Rational Emotive Behaviour Therapy


Rational Emotive Behaviour Therapy (REBT) is yet another behavioural therapy and, not unlike CBT, it also asserts that emotions and behaviour are predominantly engendered by one’s ideas, beliefs, attitudes and thinking.
In addition, however, REBT also explores the underlying reasons for the cognitive distortions as identified through CBT: it contends that we place demands and expectations upon ourselves that result in emotional distress. REBT also places value upon secondary disturbance, such as worrying about worrying. There is a larger overall focus within REBT upon the concept of self-acceptance; and even an acceptance of the potential use that emotions may have (even those emotions which are generally considered as negative). REBT tends to be more of a short-term approach, and is grounded in the idea that people generally want to do well in life: people want to achieve their goals and find happiness. However the intrusion of irrational thought may be getting in their way, influencing how they perceive their own circumstances and as a result leading to unhealthy actions and behaviours that may interfere with their current life goals. Once these irrational thoughts are identified and understood, REBT paves the way for skills development; such as problem-solving, assertiveness, improved social skills and conflict resolution capabilities. Such techniques can be achieved through mechanisms like rationalising techniques, guided imagery and visualisation, reframing, exposure to a feared situation as well as through disputing irrational thoughts. Furthermore, physical coping techniques are also explored, incorporating exercises such as meditation and progressive muscle relaxation. REBT also propagates the notion of unconditional self-acceptance (one has their flaws, but these do not in any way make them less worthy); unconditional other-acceptance (accepting that fact that others will not always treat one fairly); and finally unconditional life-acceptance (the acknowledgement that life will not always go to plan, and that one is equipped to bear life’s hardships).

Psychodynamic Therapy


Psychodynamic therapy is insight-orientated, and aims to explore and better understand the psychological roots of one’s emotional distress. Self-reflection is encouraged in order to better understand the influences of one’s past experiences upon their present patterns of thought; as well as their emotions, behaviours, self-concept and even their relationships. At times, detrimental life patterns can lead to painful emotions such as a feeling of being ‘stuck’ in one’s current situation. If adverse patterns of thought and behaviour that are rooted in past experiences are identified and understood then there is potential for these to be successfully and effectively resolved. Such a resolution is generally achieved through the exploration of past experiences and subconsciously held beliefs. Much of Psychodynamic Therapy focuses on the beliefs and presumptions we hold about ourselves, as well as our beliefs about others and our relationships with them. Psychodynamic Psychotherapy changes one’s relationship with themselves through a process of self-examination which fosters a greater sense of self-awareness and, in doing so, better equips one to resolve any obstacles that are interfering with them achieving their goals through the cultivation of a less fearful disposition. Within this process, one may even gain a clearer and deeper understanding of their own individual feelings and desires; and such an awareness may, in turn, enable this individual to develop a more empathic approach toward thinking about themselves. This change in one’s disposition can lead to a subject feeling more connected with themselves and others and, in doing so, their ability to deal with challenges may become more effective.

Person-centred Psychotherapy


The goal of Person-Centred Psychotherapy is to help individuals increase and enhance their self-actualising tendencies. Self-actualising tendencies refer to our innate capacity to find the order and structure we require within our own lives in order for us to reach our full potential. This can be achieved through congruence, unconditional positive regard and empathy. Congruence refers to the willingness of the therapist to be open and honest about their thoughts and feelings. This allows for a more genuine and authentic connection between them and their patient. In addition, this unconditional positive regard helps to foster an attitude of complete acceptance of the patient for who he or she truly is, thereby allowing the individual to reveal themselves openly and honestly without holding back due to a fear of being judged. Furthermore, this cultivated sense of empathy demonstrates the therapist’s genuine desire to understand the world from their patient’s perspective, and in doing so validates and contributes toward their patient’s willingness to share fully. Person-centred therapy therefore rejects the traditional paradigm in which a psychologist is the sole authority on their patient’s inner experiences, and instead embraces the idea that change is brought about in a collaborative and mutually respectful way.

Acceptance and Commitment Therapy


Acceptance and Commitment Therapy (ACT) utilises both acceptance and mindfulness strategies in conjunction with commitment and behavioural change strategies in order to increase one’s psychological flexibility. ACT can assist one in leading a happier and more meaningful life. Scientific evidence has shown that this particular psychotherapeutic approach can decrease symptoms of anxiety, depression, substance abuse, work burnout and even work-related stress. ACT is also a behavioural therapy, and consequently focuses upon imparting one with the tools they need in order to more efficiently become mindful. ACT is unique in that it is as much about action as it is about acceptance: whilst simultaneously becoming more accepting of one’s feelings and thoughts, one can also begin to take action toward achieving their goals in accordance with their own individual values. ACT invites one to open up to unpleasant feelings, teaches one not to overreact to them and also not to avoid situations within which they may feel provoked. This proactive approach assists a patient in achieving their goals and living according to their respective values, and in doing so imparts them with more vitality, satisfaction and meaning in their day-to-day lives.

Emotionally Focused Couples Therapy


Emotionally Focused Couples Therapy (EFT) is an evidenced-based approach that is used to improve attachment and bonding within adult relationships. It focuses upon the ways in which interpersonal interactions with our partner are organised into patterns and cycles. EFT encourages couples to access their core emotions and to share them with one another meaningfully, thus restructuring negative patterns into more positive ones. EFT promotes the awareness, acceptance, expression, utilisation, regulation and transformation of emotion; as well as the process of having a corrective emotional experience with one’s therapist. EFT’s approach is based on the theory of attachment, and how we need others in order to survive. The goal of this approach is to establish a secure attachment bond between both partners in a relationship so that they both can feel strong, both independently and when with their partner. I employ this approach in conjunction with Imago principles and Relational Psychotherapy. Relational Psychotherapy is built upon the proposition that relationships are central to human existence, and that when our relationships improve so shall the quality of our lives. This approach utilises one’s relationship with their therapist as a springboard for dialogue, learning new skills and indeed mastering the art of relationships. Imago is a form of relational therapy with the objective of developing a deeper sense of empathy with others whilst in addition practicing a variety of different communication techniques.

Many therapists don’t tie themselves to any one of these approaches: Integrative Therapy in of itself harnesses the blending of elements from a host of different psychotherapeutic approaches and techniques and then tailors an individual’s treatment according to their own unique circumstances and requirements.