It's the therapeutic relationship that heals.

Simplyfying the Minefield of Therapeutic Approaches

Date posted: 16 August 2016

There are so many different types of therapy on offer it’s become a minefield! In fact, it is estimated that today there is an astounding 400 schools of therapy in existence. With so many to choose from it can become incredibly confusing, downright baffling and likely very off-putting. Afterall, how can you choose the right therapy for you (let alone the right therapist) if you are unclear of the different approaches, and who has the time to dedicate hours of research into the subject to find clarity? What a thing to have to do when you are likely to already be in distress!

This short article aims to help you with that. It provides a simple if somewhat basic explanation of the main approaches. This article doesn’t provide the scope to define each and every approach, but most are branches that emanate from the core schools of thought I reference here. I feel it is important though to remind you of my own way of working, which is within what is called ‘the humanistic tradition’ because this article is not completely without bias however much I attempt to be neutral.

Before I explain the main approaches though, I think at this point it might be useful for you to know that that there is very little evidence that any approach is more effective than another (Wampold, 2001). What is more evident is that both the expertise of the therapist and the relationship that you have with him/her will determine the success of your therapy. So when choosing your therapist, I recommend you spend time reading their profiles on the BACP/Counselling Directory website. If they are qualified, experienced and the profile connects with you more than others in your area, then I suggest arranging an initial consultation to meet him/her face to face (many therapists offer this at a reduced rate and some with no charge). If he/she is a person you feel you can trust and open up to, then he/she is likely to be the right therapist for you whatever their way of working. Of course this is very difficult to determine in just one meeting, so any good therapist will be open to you suggesting a few sessions to start and then review at say session 4 to see if you wish to continue. 

However, connection and therefore relationship with your therapist may well be easier if their approach to what it means to be human is similar to your own thinking. You may not have given this question much thought, but as you will read below, it is the different beliefs of what shapes us into who we are, and what we believe are the causes of human distress that are behind each school of therapy. None is right or wrong and all interlink, but it is the primary thinking that best fits with your own that is likely to offer the best therapy for you.

Until the first half of the 20th Centrury, there were really only two psychological “forces” which dominated, namely Behaviourisim and Psychoanalysis.

Behaviourism looks to foster positive behaviour change. The premise is that human behaviour is learnt and therefore can be unlearnt. Consequently behavioural therapy aims to help you learn new behaviours that will help minimise or eliminate your struggles. It is an approach that today is integrated for example into Cognitive Behavioural Therapy (CBT) and Cognitve analytic therapy (CAT). With this approach in mind, the issues that arguably respond best to this type of therapy are those that involve unwanted behaviours such as phobias, OCD and addictions especially if you believe that you have ‘learnt’ these behaviours through your own life experience.

Psychoanalysis founded by Sigmund Freud, is a theory of mind that focuses on an individual’s unconscious, deep-rooted thoughts often stemming from childhood. The stereotypical vision of this particular therapeutic practice is that of the client lying on the couch whilst the therapist interprets his deeply buried dreams and fantasies. Traditional psychoanalysis is not a practice that is dominant today, but it has evolved into other approaches such as Psychodynamic Therapy. The Psychodynamic approach still focuses on the unconscious, yet it seeks to discover how those thoughts are affecting our current behaviour and is more relevant than its parent approach to helping with immediate problems. Other therapies that stem from Psychoanalysis include Jungian Therapy and Psychoanlytical Therapy.

Both these aforementioned schools of thought could be viewed as ignoring how unique each of us are as individuals,  that we as human beings are inherently relational and that it is our subjective experiences in relationship that help shape who we are. This is why the Humanistic Approach evolved in the 1950s – as an antidote to the science-based theory of behaviourism and the theories of mind developed by Freud. Whilst the humanistic school of thought is in part an expansion of both, it takes on a more holistic, relational and positive view of human nature. Humanistic psychology is a philosophy of mind. The philosophies that underpin the humanistic tradition and influence practice are Phenomenology, Existentialism and Humanisim. Whilst the briefness of this article disallows describing these philosophies in any depth, together they create an approach that respects an individual’s unique subjective experience, believes that humans are motivated to reach their potential, and therefore trusts in the individual’s capacity for personal growth, self-awareness and creativity given the right support.  Consequently, humanistic therapists (believing in the autonomy of the individual) work in a collaborative relational way giving the client the space to come to understand their own strengths, creativity and choice. Although other therapeutic traditions have taken on more of this approach, the humanistic tradition takes on this stance in the purest of forms. Therapies that come under the banner of Humanistic Therapies include: Existential Therapy, Gestalt Therapy, Person-Centred Therapy, Transactional Analysis, Psychosynthesis and Solution-focused Brief Therapy to name just a few.

I work in what might be called an existentially informed person-centred way.  This means offering a therapeutic relationship that focuses on an individual’s self-worth and provides the conditions to help clients to accept who they are, reconnect with themselves and in so doing are able to heal and grow. It also means that my approach is informed by the fact that I believe as human beings the source of many difficulties in our lives are ultimately linked with existential concerns such as Freedom of Choice, Isolation (which paradoxically includes relationships), Anxiety, Meaning, Uncertainty and ultimately our Finitude.

I hope this has been helpful. For more information on the wide range of therapies available click here.

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