Approaches to Therapy
Therapists, regardless of discipline or professional title, use a variety of theoretical approaches and methods to work with people. Some are very focused on one approach while others are more eclectic, choosing tools from various methods. Here is a partial list of counseling approaches:
- Feminist therapists are concerned primarily with empowering women. This approach is non-judgmental and recognizes that our feelings and problems are not signs of weakness or sickness but normal ways of coping with difficult and complicated lives. Feminist therapy is concerned with helping women free ourselves from traditional molds that may be blocking our growth and development.
- Spiritual counselors assist people in dealing with anguish, fear, confusion, and crisis about moral matters and the meaning of life (either finding or making that meaning). They recognize that spiritual problems are often misinterpreted as psychological illnesses.
- Psychodynamic therapists, also called insight-oriented therapists, operate on the assumption that our unconscious minds store feelings too painful to be faced, and that while denial and other defense mechanisms we use to keep from knowing what we feel can be helpful, they sometimes do more harm than good. Psychodynamic therapists focus on helping you know what is really going on in your mind in order to lessen your painful feelings. This approach is often long term and involves the therapist interpreting the client’s words and behavior.
- Cognitive Behavioral therapists stress the role of thinking in how we feel and what we do, and focus on relieving painful feelings by changing the way that we think about or interpret situations. Cognitive Behavioral Therapy is quite structured and often includes homework assignments to help you become aware of your beliefs and assumptions. This therapy is often time-limited.
- Interpersonal therapists focus on exploring issues and problems in our relationships with other people. They believe that most relational issues are rooted in grief and loss, role disputes in relationships, or relational transitions. This therapy is structured and tends to be short term.
- Expressive training therapists focus on helping us identify and name our feelings, and tell others how we feel in clear nonjudgmental words, avoiding threats, demands, or criticisms.
- Family systems therapists look at the entire family as a system with its own roles, beliefs, rules and patterns, and believe each family member has a particular role in the system that affects her relationship within and outside of the family. This theory can be used in individual and family therapy.
- Solution-focused therapists assume that most problems are present and active in a person’s life only some of the time. This approach is focused on helping the individual notice when her troubling symptoms are diminished or not present at all, and to use this knowledge as a basis for recovery. This therapy is often short term and highly focused.
- Humanistic or Client-Centered Therapists assume that with an accepting environment an individual will feel free to speak about her problems and conflicts, and that doing so will help her gain insight. This type of therapy is nondirective, meaning that the therapist does not usually give advice or make interpretations of what a client says.
- Gestalt Therapists use an experiential approach focused on what is happening here and now to help the individual become more self-aware and to integrate her thoughts, feelings, and actions. This type of therapy includes the use of techniques such as role playing, confrontation, and the “empty chair”—a tool that allows dialogue between two parts of the personality.
- Transactional Analysts believe that our personality is divided into three states — the parent, adult, and child — and that these states influence our interactions with other people. This type of therapy involves uncovering the ways these three parts operate within ourselves and with others.
- Narrative therapists believe that people’s lives and relationships are shaped by the “stories” we tell ourselves about our own lives. These stories create beliefs about ourselves that then shape our actions. A narrative therapist can help us reshape and redirect our lives by discovering different, more productive, realistic, satisfying, or otherwise different stories about our lives.
- Body-oriented or expressive therapists may use any or all of the following approaches such as:
- art therapy, using creative activity to help us identify and heal emotional pain;
- Biofeedback, which involves monitoring functions such as heart rate, perspiration, and brainwaves to help the individual gain greater control over her physiological responses;
- Body work such as massage to help an individual come to terms with emotions and memories by exploring the effects they originally had and currently have on the body.
- Group therapy: Many of the therapies above can also be used in a group setting. Group therapy is facilitated by a trained practitioner and is more structured than a self-help group might be. Groups are usually offered to deal with specific issues like childhood sexual abuse and recovery from addictions or anxiety and allow people struggling with similar issues to meet. Groups are places not only to learn about an issue but also to receive support, reduce isolation, and brainstorm about and then practice ways to make positive changes. For many women, being in such a community of support is very empowering. Groups are also often less expensive than individual therapy.
Most therapy groups have an intake process that allows participants to meet the facilitator and find out how the group is run. Some groups are “open,” meaning that new people come into the group at intervals, while others are “closed,” meaning that once the group starts no new members will be joining. Groups may run for a set length of time (eight, ten or twelve weeks is common) or may be ongoing.
If you are considering therapy, it’s important to remember that most therapists use various approaches and methods in their practice, and that no one therapist or type of therapy is right for everyone. To find out more about choosing a therapist, see Finding a Caring, Competent Therapist, an excerpt from the new edition of Our Bodies, Ourselves.
Written by: Valerie Regehr, with special thanks to Paula Caplan.
Last revised: April 2005
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