If you’ve been considering seeking out different types of therapy for the first time, you’ve likely wondered what treatment looks like. Is it like the movies? Will I need to recline on a velvet couch while a man in a suit takes notes about my weird dreams? Probably not, but while most talk therapy is rooted in the same fundamental training, there is a wide range of approaches and modalities practitioners use for different issues, degrees of mental health, and personality types. Therapy is not one-size fits all. What works or one person might not be effective for another.
The treatment approach your potential therapist uses is referred to as the therapeutic modality, and there are many different available options that exist. When you’re looking for the right fit in a new therapist, you’ll want to consider their specializations and if they align with your goals. If your therapist offers a treatment modality with which you are unfamiliar, be sure to ask plenty of questions and do your own research. It’s also likely that a therapist will cherry pick different aspects from several approaches to create a holistic, integrative and personal treatment plan for you.
Let’s dig into common types of therapy you could explore in your treatment.
Though it is much more evolved than the aforementioned picture of laying on a couch revealing repressed childhood memories. Psychoanalytic therapists do focus more on the past, family relationships, and symbolic relationships and experiences than other modalities might. They are also more concerned with working with you to resolve the conflicts of the past to avoid reliving them in the present. This approach focuses on changing problematic behaviors, feelings, and thoughts by discovering their unconscious meanings and motivations.
Psychodynamic therapy is similar to psychoanalytic therapy in that it is an in-depth form of talk therapy based on the theories and principles of psychoanalysis, created by Sigmund Freud. But psychodynamic therapy is less focused on the patient-therapist relationship, and more interested in exploring the patient’s relationship with his or her external world. It’s more common for psychodynamic therapy to have a shorter duration than psychoanalytic therapy with respect to the frequency and number of sessions, but this is not always the case.
Both methods of psychotherapy are characterized by a close working partnership between therapist and patient. Patients learn about themselves by exploring their interactions in the therapeutic relationship.
Behavioral therapies are focused on changing behavioral patterns and actions like classical conditioning, or associative learning. This form of therapy seeks to identify and help change potentially self-destructive or unhealthy behaviors. Its foundation of learning is built upon the idea that all behaviors are learned and that unhealthy behaviors can be changed. The focus of treatment is often on existing problems and how to change them.
Behavioral therapy is used to treat a wide range of symptoms and diagnosis, but is most commonly used for mental illness such as anxiety, depression, obsessive compulsive disorder, phobias, anger, and eating disorders.
Cognitive behavioral therapy is a fairly popular form of behavioral therapy that combines behavioral therapy with cognitive therapy. Treatment is focused on how someone’s thoughts and beliefs can influence their actions and moods. In most cases, cognitive behavioral therapy techniques are often used to treat an existing and acute issue, with the long-term goal being to shift a person’s thinking and behavioral patterns towards healthier ones.
CBT techniques can include journaling, using writing to work through issues with mindfulness. Cognitive behavioral therapists might also use guided discovery, in which the therapist will acquaint themselves with the patient’s viewpoint before asking questions designed to challenge their beliefs and broaden their thinking.
System desensitization is another technique that relies heavily on classical conditioning. It’s often used to treat phobias. People are taught to replace a fear response to a phobia with relaxation responses. A person is first taught relaxation and breathing techniques. Once mastered, the therapist will slowly expose them to their fear in heightened doses while they practice these techniques.
Another common CBT technique is aversion therapy, which is often used to treat more serious problems such as substance abuse and alcoholism. The approach is to teach people to replace a stimulus that’s desirable but unhealthy with an extremely unpleasant stimulus. The unpleasant stimulus may be something that causes discomfort. For example, to treat substance abuse disorders a therapist may teach you to associate alcohol with an unpleasant memory.
Behavior modification is closely related to cognitive behavioral therapy, but instead of focusing on negative thinking patterns or ideas, behavior modification therapy focuses on sequences of behavior. The assumption is that instead of thoughts leading to a specific outcome, actions can be altered to lead to specific outcomes. Essentially, it’s all about positive or negative behavioral reinforcement.
Behavior modification is an approach that, over time, may correct unwanted actions, and turn them into more desirable behaviors. This type of therapy is based on the principles of behaviorist B.F. Skinner’s operant conditioning, which purports that reinforced behavior tends to be repeated and behavior that isn’t reinforced tends to wane. In this type of behavior therapy, this means that desired behaviors and outcomes are reinforced after the fact, therefore encouraging repeat behavior.
Cognitive restructuring focuses on negative thought patterns like over-generalizations, getting mired in the details, or catastrophic thinking. Much of this line of thinking this way can affect everyday life even become a self-fulfilling prophecy. During treatment, your therapist will ask you to walk them through your thought process in certain situations to identify negative patterns. Once they’ve been revealed, your therapist will work with you to learn how to reframe those thoughts to be more positive and productive.
One of the most expedited forms of therapy is Solution-Focused Brief Therapy (SFBT), which concentrates on finding solutions in the present, while also exploring opportunities to find quicker resolutions in the future. SFBT was developed by Milwaukee psychotherapists Steve De Shazer and Insoo Kim Berg in the late 1970s, early 1980s out of an interest in paying more attention to what people want and what works best for the individual, in contrast to more traditional psychotherapies that presume to know what works for different types of problems.
This modality approaches treatment assuming the patient that already knows what needs to be done to make improvements with the appropriate coaching and questioning. SFBT can stand alone as a therapeutic intervention, or can be used as part of an integrative therapy treatment. A SFBT therapist leverages techniques such as specific questioning, 0-10 scales, empathy and compliments that help a person to recognize one’s own virtues. Patients then learn to focus on what they can do, rather than what they can’t, which allows them to find solutions and make positive changes more quickly.
SFBT can be used to treat people of all ages, across a wide range of issues, including child behavioral problems, family dysfunction, domestic or child abuse, addiction, and relationship problems. It’s also sometimes used as part of a comprehensive plan for more serious psychiatric disorders such as depression or schizophrenia. SFBT has potential to help improve quality of life for those who suffer from these conditions.
These are just some examples of common types of therapy available, but there are many more specializations and approaches. And again, many therapists take elements of different modalities to create customized treatments. If you’re looking for a therapist with a specific background or treatment specialization, Advekit can help you get matched with the right therapist today.
Alison LaSov, LMFT
Alison LaSov is a Licensed Marriage & Family Therapist with experience treating clients struggling with anxiety and depression. She predominantly focuses on mental health intervention for children and adolescents, particularly those who are in crisis. She has worked within the Los Angeles education system treating students with Individualized Education Plans (IEPs), as well as supervised a non-profit Teen Crisis Hotline out of Cedars-Sinai Hospital. Alison earned her B.A. from UCLA and M.A. from Pepperdine University. She is a native to Los Angeles and co-founder at Advekit.