You have made a momentous decision: you will seek psychological treatment for your depression, anxiety, substance abuse, or other mental health issue.
Your mind then may turn to the question of what type of treatment would best suit you. To even ask this sophisticated question, you need to realise there are various types of psychological treatment. To make a wise choice, you must understand what each type of therapy provides.
Let’s look at several types of psychotherapy (also known as talking therapy) that have the potential to help with almost any mental health problem.
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1. Cognitive behaviour therapy
Cognitive behaviour therapy (CBT) is a common type of therapy where the therapist explores the thoughts and behaviours that relate to your therapy goal.
Let’s suppose you have been feeling depressed for months. Relevant thoughts might be that no one likes you and that you are worthless. Relevant behaviours might include staying in your home and avoiding contact with others.
The therapist would likely help you challenge the accuracy and usefulness of those thoughts and find replacement thoughts. The therapist might encourage you to do more for fun and to interact more with others.
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2. Acceptance and commitment therapy
In acceptance and commitment therapy, you would instead be asked to accept your negative thoughts as yours (regardless of whether they are accurate) and also accept your negative emotions.
The therapist would encourage you to look at your thoughts and emotions as separate from you so you can examine them more objectively. Acceptance might reduce your negative feelings about yourself.
The therapist would explore your values and encourage you to commit to acting according to them. If you value kindness, for instance, the therapist might encourage you to show kindness to others.
3. Psychodynamic therapy
A psychodynamic therapist would help you explore your childhood, searching for traumas and difficulties with your parents.
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If you felt unloved by your parents as a child, you would consider whether your parents provide a fair representation of the entire world.
You might consider to what extent you deserve love now as an adult. You might also gain insight into how your early experiences colour your current expectations, and affect your emotions and behaviour.
You might find yourself transferring to the therapist your feelings toward your parents and then realise that others are not your parents and you are no longer an unloved child.
4. Narrative therapy
In narrative therapy, you would explore the stories of your life, particularly the stories that seem to persist.
If you were an outsider in school, reluctant to join in social activities, you may think of yourself as a loner. As an adult, even though you engage fully and successfully in social interactions at work, you may continue to think of yourself as a loner.
In other words, the story you tell yourself remains unchanged despite your social success at work, and you feel depressed about being alone.
In becoming aware of the story of your life, you create distance from the story and you may find ways to change the story (the narrative). In essence, you rewrite the story in a realistic way to develop toward being the person you want to be.
5. Person-centred therapy
In person-centered therapy, sometimes called supportive counselling, the therapist would listen attentively, try hard to understand life as you experience it and try to understand and even feel your emotions.
The therapist would show caring and an interest in helping you, in the expectation that you can find your own way to overcome feeling depressed.
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A mix of styles to suit you
You can ask potential therapists what type of therapy they provide. Many will say they are eclectic, meaning they try to choose methods to suit each client and specific problem. They may combine methods of different therapy types.
They may also use popular methods such as mindfulness training that do not fit any specific therapy type. Mindfulness training involves focusing on your breathing and being aware of the here and now.
You can request an eclectic therapist to provide a certain type of therapy or certain therapy methods. Once the therapist gets to know you, you can discuss your preferences and decide on the therapy methods to use.
How can you decide which one?
You might wonder which type of therapy usually works best. The answer is unclear. Much depends on the specific client, the problem and the therapist.
Most types of therapy work moderately well for treating people with depression. Psychotherapy also appears to be reasonably effective for other types of psychological problems.
CBT has the strongest evidence for treating a broad range of psychological problems (including post-traumatic stress disorder). However, CBT has the most evidence in part because it is heavily studied (for example to treat specific phobias).
Acceptance and commitment therapy is also backed by substantial evidence, as is psychodynamic therapy.
The effects of narrative therapy and person-centred therapy have not been studied so much.
Some people, including those with depression or psychosis, can benefit by receiving psychotherapy and taking medication prescribed by a GP or psychiatrist.
If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.
