What Type of Therapy Do I Need

Learn about the most popular types of therapy to find what suits you

As a therapist, I have come across many clients who wonder, "What kind of therapy do I need?" While looking for a therapist, they feel overwhelmed and confused by the numerous treatment options available.

There are many types of treatment, each with its own approach and focus. It is not a one-fits-all treatment. Once you have finally decided on which therapy style, next comes picking out the right therapist (which is an article for another day).

Below is a detailed list of the main types of therapy.

Let’s dive right in.

Cognitive Behavioral Therapy (CBT):

CBT is one of the most widely practiced forms of therapy and one of the most well-known. It is a short-term approach to mental health treatment.

It focuses on identifying and modifying unhelpful thought patterns and behaviors that contribute to emotional distress. Therapists work with clients to challenge irrational beliefs and develop healthier coping strategies.

CBT encourages the client's active participation and usually includes homework between sessions. This type of treatment is problem-focused and action-oriented.

A CBT therapist will focus on the experience and what is observable. They identify patterns and work with the client to develop practical strategies to help them overcome them. Such strategies include:

• Developing and practicing new healthy coping skills
• Setting short- and long-term goals
• Developing new problem-solving skills
• Journaling and self-monitoring skills
• Developing stress-management skills

CBT primarily treats depression and anxiety disorders. It is one of the most effective treatments for substance abuse and co-occurring mental health disorders.

Within the CBT umbrella, there are several other common therapies:

· Dialectical Behavior Therapy (DBT):

Originally designed for individuals with borderline personality disorder, DBT has proven effective for managing intense emotions and improving interpersonal relationships. It combines elements of CBT with mindfulness techniques, teaching clients to regulate emotions, tolerate distress, and enhance communication skills.

DBT helps clients explore other people’s perspectives and truths in scenarios that are causing them distress. It allows clients to consider alternative views which are also valid.

It works well for clients who have difficulty managing and regulating their emotions and for clients with strong opinions and views about important topics.

· Eye Movement Desensitization and Reprocessing (EMDR):

EMDR was initially used to treat Post-Traumatic Stress Disorder (PTSD). It uses eye movement (or tapping) to change the way trauma memory is stored in the brain, allowing it to be processed healthily.  The World Health Organization only recommends  CBT  and EMDR for treating PTSD and trauma memories, as there are multiple studies that prove its effectiveness. Best used for:

• Trauma & PTSD
• Anxiety & Depression Disorders
• Phobias
• Panic attacks
• Recovering from prolonged grief
• Eating disorders
• Stress
• Performance Anxiety
• Sleep disturbances
• Substance Use Disorder

Psychoanalytic Therapy:

For those who are uninitiated, psychoanalytic therapy tends to be the association we have with therapy. We picture laying down on a couch talking in a monologue while the therapist scribbles away in the background our every word.

Psychoanalytic therapy is a form of talk therapy that explores how the unconscious mind influences thoughts, feelings, and behaviors. It examines how experiences (usually from childhood) may continue to influence current experiences and behaviors. This type of therapy generally has multiple sessions a week, over several years. It can include:

· Dream Interpretation: (most important psychoanalytic technique) as it interprets dreams as a way to gain insight into the working of the unconscious mind.

· Free Association: psychoanalyst encourages you to freely share your thoughts which can lead to the emergence of unexpected connections and memories.

· Transference: project your feelings about another person onto the psychoanalyst who can then understand how the client interacts with others.

Clients gain insight into their hidden motivations and emotional patterns through dialogue and interpretation. This type of therapy aims to foster self-awareness and facilitate personal transformation.

This type of therapy is declining in popularity. There is some controversy around its efficacy. For this type of treatment, the efficacy highly depends on the quality of the therapist.

Psychodynamic Therapy:

This therapy is similar to psychoanalysis, but it is usually applied in the short term. It is usually limited to once or twice per week, usually for less than 6 months. It explores unconscious processes and early life experiences. However, it places a stronger emphasis on the client's present-day relationships and how they impact emotions and behaviors. This therapy can help individuals understand recurring patterns and make meaningful changes.

Both psychoanalytical and psychodynamic therapies typically treat:

• Chronic depression
• Anxiety disorders
• Somatic disorders
• PTSD
• Substance use disorders
• Eating disorder
• Borderline personality disorder

Humanistic Therapy:

The goal of humanistic therapy is to let the client develop a stronger and healthier sense of self, also known as self-actualization. Humanistic therapy emphasizes self-discovery, personal growth, and self-actualization. Therapists provide a supportive and empathetic environment, allowing clients to explore their feelings and values.

This therapy aims to help clients reach their full potential by becoming more self-aware and accepting.

It allows clients to guide their treatment process, and humanistic therapists will trust their clients with how they want to approach each session.

· Person-Centered therapy:

This is centered on the client’s capacity for self-direction and understanding of their development. The therapist actively listens to the client without judgment, letting the client come to insights by themselves.

· Gestalt Therapy:

It focuses on the here and now. It focuses on process (what is happening) over context (what is being talked about). The emphasis is on what is being done, thought, and felt now, rather than what was, might be, could be, or should have been. It is an awareness practice (also known as “mindfulness”).

Schema Therapy

Schema therapy combines techniques and ideas from cognitive behavioral therapy, psychoanalysis, Gestalt therapy, and attachment theory. In schema therapy, a schema is thought of as an early maladaptive coping mechanism, which are patterns that develop in childhood because of not getting needs met. Schema therapy views that these unhealthy coping mechanisms can continue into adulthood and cause emotional distress and relational issues.  Schema therapy aims to help clients find ways to ensure their emotional needs are met in ways that are healthy and reduce the overall distress of the client.

Initially, this type of therapy was used to treat those with personality disorders or clients who had failed to progress in other treatments. Schema therapy may be beneficial to those with attachment difficulties or childhood trauma.

Marriage & Family Therapy:

Marriage and family therapy addresses the dynamic of behaviors of two or more people and the relationships between them. This form of therapy can be combined sessions (with both partners or all family members present) or one-on-one sessions between each individual.

The goal of marriage and family therapy is to identify communication issues and give the family members the tools they need to manage conflict. This therapy can focus on alleviating a specific issue or addressing additional issues that arise when dealing with a condition that has lasting effects on other members of the family.

Should I See a Psychologist or a Psychiatrist?

Psychologists are generally trained in varieties of talk therapy, and most are not permitted to prescribe medications. They provide psychotherapy, with can involve cognitive and behavioral interventions.

Psychiatrists are trained as medical doctors and can prescribe psychotropic medications. Their focus is on medical and pharmacological interventions.

Some people with mental health issues may need to see both a psychiatrist and a psychologist. Medication can help stabilize a person's extreme moods so that they can focus on talk therapy.

Some people can engage in talk therapy adequately without the need for medication.

In my practice, I recommend that clients do as much talk therapy as they can without medication. However, if I notice their extreme moods or suicidal thinking are persisting and blocking progress in the therapy, I will suggest that they see a psychiatrist. The psychiatrist will then determine if the client would benefit or not from medication. While the client is on medication, we proceed with the talk therapy aiming to get to a point where they do not depend on the medication.

There are exceptions to this though. In some cases, clients have severe hormone imbalances which continue despite progress in therapy or using healthy coping skills. Their hormone levels can’t balance out by themselves, and they may need to take the medication in the long term. However, this would be for a psychiatrist to determine.

Conclusion

When you are trying to answer, “What type of therapy do I need?” It can feel overwhelming and confusing when you come across many different types of treatment. By understanding the different therapies available, you can have a better understanding of what might suit you.

While this article does cover the main types of therapy, it did not cover them all. Check out this list if you want to explore other options.

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