Mental Health Treatment: Psychotherapy Approaches

Have you ever considered seeking mental health treatment but were confused about which therapeutic approach might be right for you?

The abundance of approaches, from psychodynamic theories in psychotherapy to cognitive, dialectical, humanistic, existential, and schema-oriented interventions, may leave some people confused and lost.

Which therapy may be the one that suits your personality, goals, and objectives? Which one will be effective? Truth be told, It depends.

It depends on many factors, and some evidence suggests that the therapy approach might be less important than the actual alliance of therapist and client. Rapport, trust, and empathy are -in my opinion- non-negotiable for successful insight and the willingness to change.

Besides the therapeutic alliance, it is also essential to think about the ideal outcome.

If you’re looking for a relatively quick and evidence-based practice that doesn’t fully disclose your childhood experiences, you may prefer Cognitive-behavioural or dialectical approaches to therapy. These approaches tackle the here-and-now without a deep dive into your childhood experiences.

If you’re curious how your childhood and your relationship with your family influence your lived experiences today, you may benefit from Schema Therapy.

If you are interested in the unconscious processes of your mind, a psychodynamic intervention could interest you. Examples include the Jungian, Freudian or Adlerian approach and humanistic theories or psychotherapy.

This is just a tiny selection of the therapy approaches out there. You may also be curious about Gestalt therapy, existential therapy, art therapy, Buddhist therapy, mindfulness-based, or emotion-focused therapy approaches.

There are so many approaches out thereโ€”and just as every person is different, what works for one person may not be what another person needs or wants. It is helpful to get a glimpse into what a therapist has to offer. Do not shy away from asking how a therapist works, or what approach they use. Some therapists may specialise in a specific area, and although they may adapt from a variety of disciplines, there is still often one that predominates their intervention style.

So, build rapport before settling on a therapist, and ask them how they work, where they learned, and what they offer. Moreover, tell them what you expect from therapy. Is it to gain insight into the unconscious processes, working on childhood trauma, self-limiting beliefs, or coping better with stress?

In this article, I will briefly glimpse some popular therapy approaches and what therapists do to help their clients. Finally, I will provide a list of more and less well-known interventions. Familiarise yourself with the ones that interest you and see if you can find a therapist focusing on this approach.

Happy counselling!

Cognitive Behavioural Therapy as mental health treatment

Cognitive-behavioural therapy (CBT)

Cognitive-behavioural therapy, or CBT, is a common treatment for mental health. It examines how our thoughts, feelings, and actions are connected and aims to change negative patterns to help us feel better.

CBT has been studied a lot for depression and has been shown to be very effective. Studies have found that it can reduce depressive symptoms even after treatment. CBT Therapists encourage their clients to work on themselves after therapy and provide all the tools needed to empower their clients beyond treatment.

CBT has also been shown to help with PTSD. In one study, people who got CBT had fewer PTSD symptoms than those who got supportive counselling. For childhood neglect, a type of CBT called Trauma-Focused Cognitive-Behavioural Therapy (TF-CBT) has been found to help with trauma symptoms and improve overall functioning.

Because of its evidence-based approach and relatively short-term interventions, CBT is a popular method that helps clients with a wide range of symptoms, from anxiety to low self-esteem or depression. CBT has been shown to reduce symptoms in a wide range of topics.

It is important to note that CBT has been developed to be evidence-based (meaning measurable).

While other therapeutic interventions were hesitant to measure their effectiveness, it does not necessarily mean they are less effective. It simply means it wasn’t their focus to make their interventions measurable and quantify their results. Some therapists were concerned about handing out questionnaires and other tools, as they perceived it disturbing the process. Due to the demands of insurance companies and other medical providers, therapists have successfully shown that their treatment is in no way inferior. (So don’t take the evidence-based part as your sole judgement.)

Psychoanalytic Theory

Psychoanalytic theory, developed by Sigmund Freud, focuses on the unconscious mind, early childhood experiences, and the role of unconscious conflicts in shaping behaviour and mental health. It emphasises the exploration of the unconscious and the therapeutic relationship to gain insight into underlying conflicts and resolve them.

Carl Jung and Alfred Adler

Freud set the stage, but many others followed: Carl Gustav Jung and Alfred Adler were two more figures of the psychodynamic approach to therapy. C.G. Jung has become popular with his studies on archetypes, the anima and animus and the collective unconscious. He is a prevalent figure in the spiritual realms, and I will dedicate another article to his approach to psychotherapy.

He believed that mental illness was often the result of the disconnection between one’s conscious and unconscious mind, particularly when individuals fail to integrate the different aspects of their psyche.

Jung’s therapy, often termed Jungian Analysis, aims to harmonise this relationship through dream analysis, active imagination, and exploration of archetypes. Unlike Adler, Jung delved deeply into spirituality, mythology, and the universal experiences of human beings across cultures.

Alfred Adler was a pioneer in the field of individual psychology. He emphasised the importance of social factors, inferiority feelings, and striving for superiority as critical elements to drive human behaviour.

He believed that mental illness often arises from a sense of inferiority and an individual’s unsuccessful attempts to compensate for it.

Adler focused on the importance of early childhood experiences. Still, unlike Freud, he placed less emphasis on sexual drives and more on social and environmental factorsโ€”his therapeutic approach aimed at fostering social interest and helping individuals find their place in the community.

Acceptance and Commitment Therapy (ACT)

Acceptance and Commitment Therapy is a relatively newer approach that focuses on developing psychological flexibility by accepting unwanted thoughts and emotions while committing to actions aligned with one’s values.

ACT therapists believe that discomfort is part of the human experience, and instead of trying to avoid it, we need to learn to accept the discomfort and live with it.

It emphasises mindfulness, acceptance, and purposeful action in the face of distressing experiences.

ACT has shown promise in the treatment of depression. A meta-analysis of randomised controlled trials demonstrated that ACT was significantly more effective than no treatment and equally effective as other established treatments for depression.

In the context of PTSD, ACT has also been found to be effective. A study comparing ACT to a waitlist control found that ACT significantly reduced PTSD symptoms and improved psychological flexibility.

ACT takes from different disciplines and, therefore, offers lots of flexibility. It may be instrumental in treating anxiety and prolonged grief.

Evaluation and Comparison

As with everything, the different approaches have pros and cons, and there is no one-size-fits-all. If you are looking for a treatment that suits you, it is good to consider what each approach has to offer and its limitations.

  • CBT is highly structured, goal-oriented, and focuses on identifying and modifying specific thoughts and behaviours. It has a robust evidence base supporting its effectiveness in treating various mental health issues. However, it may not address deep-rooted emotional or interpersonal issues as extensively as other approaches.
  • Psychoanalytic Theory: Psychoanalytic therapy emphasises insight and exploring unconscious processes. While it has historical significance, empirical evidence supporting its effectiveness for specific mental health issues is limited.
  • ACT: ACT emphasises acceptance, mindfulness, and values-based action. It has shown promise in treating depression and PTSD. However, more research is needed to establish its efficacy across a wider range of mental health issues.

The American Psychological Association acknowledges that different therapies may be effective for different individuals and highlights the importance of tailoring treatment to the individual.

The choice of therapy should be based on a thorough assessment of needs and preferences, considering factors such as the nature of the mental health issue, treatment goals, and therapeutic relationship dynamics.

Therapists often learn a range of different approaches, but some may have their favourites. It can help to research a therapy intervention that speaks to you and inform yourself about the treatment provided by therapists in your area. And know that nowadays, teletherapy (meaning therapy that is conducted in the comfort of your home, either through the phone or a video call), is a wonderful alternative that does not limit you to therapists in your area. BetterHelp and other providers allow you to find therapists all over the world.

Don’t shy away from talking to an expert. There is so much to gain from it.

Curious about more therapy approaches?

Psychodynamic Therapies

  • Freudian (Psychoanalytic) Therapy: Focuses on unconscious processes and unresolved conflicts from childhood.
  • Jungian Therapy: Explores archetypes and the collective unconscious to promote personal growth.
  • Adlerian Therapy: Addresses social and community factors, aiming to help individuals overcome feelings of inferiority.
  • Object Relations Therapy: Focuses on interpersonal relationships and the impact of early attachments.

Cognitive and Behavioral Therapies

  • Cognitive Behavioural Therapy (CBT): Helps individuals identify and change negative thought patterns and behaviors.
  • Dialectical Behaviour Therapy (DBT): Combines CBT with mindfulness and acceptance strategies.
  • Rational Emotive Behaviour Therapy (REBT): Addresses irrational beliefs and teaches rational self-talk.
  • Acceptance and Commitment Therapy (ACT): Combines aspects of mindfulness and behavioural therapy to increase psychological flexibility.
  • Motivational Interviewing: A client-centred approach aimed at eliciting change by helping clients articulate their values and goals.
  • Behavioural Activation: Focuses specifically on helping individuals understand the connection between their behaviour, emotions, and thoughts.

Third-Wave Cognitive and Behavioural Therapies

  • Compassion-Focused Therapy (CFT): Combines cognitive-behavioural techniques with concepts from evolutionary psychology to develop self-compassion.
  • Mindfulness-Based Cognitive Therapy (MBCT): Integrates mindfulness practices with cognitive behavioural techniques to prevent relapse in depression.
  • Functional Analytic Psychotherapy (FAP): Uses the therapeutic relationship to examine and change problematic behaviours.

Humanistic Therapies

  • Person-Centered Therapy: Creates a non-judgmental space for the client to explore their own solutions.
  • Existential Therapy: Focuses on free will, self-determination, and responsibility.
  • Gestalt Therapy: Aims to integrate fragmented experiences into a cohesive whole.
  • Narrative Therapy: Focuses on reshaping the client’s story or narrative about their life.
  • Rogers’ Emotion-Focused Therapy: Uses emotion as a key to understanding and decision-making.
  • Transcendental Meditation: Incorporates meditation to alleviate symptoms of stress and improve mental well-being.

Family and Systemic Therapies

  • Family Systems Therapy: Treats the family as a system and looks at dynamics and communication within it.
  • Structural Family Therapy: Focuses on adjusting and strengthening the family system.
  • Couples Therapy: Addresses issues between romantic partners.
  • Bowenian Family Therapy: Emphasises the family unit and seeks to improve function by understanding each family member’s role.
  • Milan Systemic Therapy: Focuses on belief systems within a family and how they affect relationships.

Integrative and Eclectic Therapies

  • Multimodal Therapy: Tailors interventions from various theories to fit the client’s needs.
  • Transpersonal Therapy: Integrates spiritual experiences into the therapeutic process.
  • Feminist Therapy: Focuses on social, cultural, and political factors that contribute to a person’s problem.

Somatic and Experiential Therapies

  • Sensorimotor Therapy: Combines talk therapy with body-centered interventions.
  • Biofeedback: Teaches the client to control physiological functions.
  • Dance/Movement Therapy: Uses movement to help individuals achieve emotional, cognitive, and physical integration.
  • Somatic Experiencing: Focuses on the release of physical tension that accumulates in the body during traumatic experiences.
  • Body-Mind Centering: Utilises movement and touch as pathways for self-awareness and emotional release.

Less Known Therapies

  • Schema Therapy: Combines elements from cognitive, behavioural, and psychodynamic therapies to treat personality disorders.
  • Logotherapy: Focuses on the search for meaning in life.
  • Neuropsychological Therapy: Uses interventions based on brain-behavior relationships.
  • Morita Therapy: Based on Zen Buddhism, it teaches acceptance of emotions rather than trying to change feelings.
  • Naikan Therapy: A Japanese method that involves self-reflection on one’s relationships with others.
Journaling as a therapeutic tool

Modern Analytic Therapies

  • Interpersonal Neurobiology (IPNB): Incorporates neuroscience findings to inform therapeutic interventions.
  • Attachment-Based Family Therapy: Focuses on attachment patterns within families to resolve relational issues.

Holistic Therapies

  • Ecotherapy: A form of therapy that incorporates nature and outdoor activities.
  • Positive Psychotherapy: Builds on positive psychology principles to bolster strengths and virtues.
  • Equine-Assisted Therapy: Involves interactions with horses to facilitate emotional growth and learning.

Cultural Therapies

  • Indigenous Psychology Therapies: Incorporates traditional knowledge and rituals from various indigenous cultures.
  • Narrative Exposure Therapy: Designed for trauma victims, focusing on creating a chronological narrative of their lives.

Psychoeducational Therapies

  • Psychosexual Therapy: Focuses on resolving sexual issues through education and cognitive-behavioral approaches.
  • Bibliotherapy: Utilises self-help books as supplementary therapeutic tools.

Expressive Therapies

  • Art Therapy: Uses the process of creating art to improve mental well-being.
  • Music Therapy: Utilises music to address physical, emotional, cognitive, and social needs.
  • Drama Therapy: Incorporates role-playing and storytelling to facilitate emotional expression and integration.

Philosophical Therapies

  • Phenomenological Therapy: Focuses on individual experiences and the meanings derived from them.
  • Philosophical Counseling: Applies philosophical concepts to analyse and solve life’s dilemmas.

Experimental Therapies

  • Quantum Psychology: Attempts to integrate principles of quantum physics into psychological practice.
  • Neurofeedback: Utilises real-time brain activity monitoring to teach self-regulation of brain functions.

Integrative Therapies

  • Process-Oriented Psychology: Focuses on the process of experiencing over static psychological states.
  • Solution-Focused Brief Therapy: Concentrates on solutions rather than problems to facilitate change.

Mind-Body Approaches

  • Breathwork: Uses various breathing practices to support mental, physical, and spiritual health.
  • Eye Movement Desensitization and Reprocessing (EMDR): Focuses on reprocessing traumatic memories through guided eye movements.

Psychoeducational and Skill-Based Approaches

  • Social Skills Training: Designed to teach clients the skills to interact more successfully with other people.
  • Stress Inoculation Training: A CBT approach that focuses specifically on stress management.

Special Populations

  • Veteran’s Narrative Therapy: Tailored to help veterans by focusing on the narration and re-narration of life events.
  • Play Therapy: Used mainly with children to help them express their feelings, wishes, and thoughts through play.
  • Forensic Therapy: Therapy applied within the context of criminal justice systems.
  • Animal-Assisted Therapy: Incorporates animals like dogs or dolphins as part of the therapeutic process.

Technology-Based Therapies

  • Telemental Health: Covers a variety of remote mental health services, from telephone-based services to AI chatbot therapists.
  • Bioinformatics Therapy: An experimental approach that uses machine learning to identify and treat mental health conditions.
  • Virtual Reality Exposure Therapy: Utilises virtual reality to expose individuals to feared stimuli in a controlled setting.

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