Just as there are many types of therapists or counsellors, there are many kinds and techniques of therapy. I would divide approaches into four main groups. However, this is somewhat arbitrary, and many therapists use a combination of approaches from the four groups.
The point of the below descriptions is not to confuse you more. It is to help you understand what your therapist will do, and what is available. Maybe it will help you to ask a potential therapist about the work they do if you have some understanding of what is available. If you went to five therapists with five different approaches for the same problem, they could each give a description of how to treat it from their perspective. If you come to see me, I want you to have an understanding of what we are doing and why.
Please also see the section “Choosing a Therapist.” As I say there, often it is not what the therapist does that will help you, it is who the therapist is, and the relationship you establish with them.
Cognitive Behavioural therapy helps people look at their thought patterns and behaviours and develop alternative ones that they then practice and apply. Very briefly (and not doing it justice), if someone is depressed, the therapist might ask them to think about the thoughts they are having, or that trigger the depressive feelings, and then develop alternative thoughts that can replace the original ones. Or if someone is having trouble with a workplace colleague, the therapist might help them develop strategies to deal with the colleague. Then practice those strategies in the therapists office until they are able to act and react differently. The Cognitive-Behavioural therapist might ask you to do “homework” or keep a journal or your thoughts and feelings.
Insight oriented therapies help people look at the underlying “cause” or triggers to problems. This might include, for example, traumatic events coming from an alcoholic or abusive family, or the divorce of one’s parents as a child . This does not mean understanding the “why” of some problem, it means being able to change what it meant to you and the reality that you developed because of it. It may mean re-experiencing the trauma or event to change it’s meaning or complete it for you. For instance, poor self image or low self esteem may be described as having a belief about yourself that you are not good enough. The belief may have developed originally because you believed something was your fault or you were not loveable for some reason. Insight oriented therapies help people change the basic belief about the self. They are sometimes said to work with the unconscious.
What we could describe as body centered therapies includes such things as breathwork, bodywork, Rolfing, Hellerwork, Massage Therapy, Bioenergetics, even acupuncture. These therapies help people resolve issues partially through releasing them where they are centered or stored or restrained in the body. For instance if you have ever gone to a massage therapist, you may have experienced a flash or emotion and a release through tears or joy. Basically, the massage therapist has touched on where some event or emotion was stored and experienced in your body, and helped you to release it.
Technique or approach based therapies include some types of Body Centered therapies, but also include some of the more specific ones such as Gestalt, Jungian, Psychodrama, Three in One, Alexander, Hypnosis, and others. If a person labels themselves as one of the technique based therapists, usually it means that they have had the majority of their training through this technique. It doesn’t necessarily say anything about their competence or effectiveness.
There are many other therapies, and even many of the above named, which cross definitions, or don’t quite fit the above categories. They include art therapy, dance therapy, therapies that are philosophy based such as feminist and existentialism, play therapy for children, and others.
The work I do with people uses both cognitive behavioural therapy and insight oriented therapy. I use some breathwork and body awareness. I also use different techniques, such as hypnosis, EMDR, Thought Field Therapy, and Emotionally Focused Therapy. Rather than try to fit you to a type of therapy, or one technique, I shape the work we do so it fits you. I take into consideration factors such as how you learn, how you change, and what seems to work for you.
Therapy can be either short term or long term. The length can depend on several factors. The simplest one is what you can afford. You may also be coming to a therapist through your EAP or EFAP (Employee Assistance Programme; Employee and Family Assistance Programme) and the number of sessions you are allowed is limited. You may also have counselling through extended health which limits the total coverage amount.
Short term therapy is often described as brief, or solution focused therapy. It looks at the “presenting” problem, and often not at the underlying issues that may have given rise to it. It may be that that is all you need. It may also be that there are no underlying issues. Some therapists would claim that the work they do effectively resolves “underlying” issues. If you have the choice, I would recommend that you choose your therapy based on what you and the therapist think you need, rather than on limitations placed on you by someone or something else. It is your life, and possibly your marriage, and your family’s happiness that you are working on. You deserve the best that you can give yourself.
The work I do varies given your limitations and the issues you wish to work on. I find short term therapy is useful for the resolution of practical and limited problems. Sometimes I help clients learn techniques and methods which they can then take and practice on their own. If you are coming through your EAP programme or paying with extended health coverage, we will discuss this and how it will affect the work we will do.
Often I find that therapy is more useful when someone has longer than six or eight sessions. The longer work helps with patterns of behaviour or issues that have developed over a long period of time. Some problems are also more severe or multi-faceted, and benefit from a longer term.
Marital/Couple therapy can also be brief, but, in my experience, is usually best managed when you have between twelve and twenty sessions. Sometimes it takes longer than that, based on the partners willingness to engage, listen, learn and change.
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