What is this thing called therapy?

If you are a prospective client beginning the search for therapy and a therapist, the various approaches available can lead to much confusion. How to know which method is going to suit you and the issues you want to work through? I will attempt to explain in brief terms, the difference in approach that underpins some of these schools of therapy. [My apologies in advance for what may seem reductive to some!]

  • CBT [Cognitive Behavioural Therapy], DIT therapy [Dynamic Interpersonal therapy], EMDR [Eye Movement Desensitisation and Reprocessing], Solution Focused Brief therapy. These are often time- limited approaches to therapy. Clients and therapists will work in a structured and organised way focusing on particular problems that the client identifies. The CBT therapist may use worksheets and other tools to bring about helpful cognitive and behavioural change in the client. For individuals with OCD, panic disorder and phobia this can be a very useful approach. EMDR is evidence-based as effective in relieving symptoms in people suffering PTSD.
  • Person-centred or Humanistic therapy works from the premise that certain conditions offered by a therapist [warmth, congruence and non-judgemental acceptance] will enable a client to grow and self- actualise. There is a focus on the here-and-now rather than the past.
  • Psychodynamic and psychoanalytic therapy is grounded in the notion that an individual’s presenting difficulties may be rooted in past experience and particularly in early family life. It is curious about the idea of an unconscious, and the theory that we are sometimes unconsciously compelled to repeat dysfunctional patterns of behaviour and relationships. It is an approach that is generally less interested in focusing on ‘symptom management’ than exploring what underlies and creates the need for the symptom. By uncovering what underlies the symptom it is to be hoped that fundamental and lasting change can be effected.
  • Systemic therapy is often utilised by therapists working with couples, families and children. It looks at families and individuals as existing within some kind of family ‘system’. Difficulties in an individual or in a part of the family can be understood as having a ‘ripple out effect’, which negatively impacts others in that system. Trans-generational trauma is of interest.
  • Psychotherapy is generally open ended and for clients who are interested in exploring issues at some depth. Psychotherapists have had a rigorous four- year training which involves having their own long-term therapy and working with clients with complex presentations such as Bipolar disorder, or Borderline Personality Disorder.

Whatever the approach, all the evidence about what makes a therapy effective points to the strength of relationship between client and therapist as key. No single approach is better than another, and many experienced therapists use a ‘cross-modality’ approach where they draw from several models in order to meet the needs of the individual client.