V
dark woods representing feelings associated with the beginning of therapy / counselling

Therapeutic Approaches Used

nueron signifying pschodynamic therapy / counselling

Psychodynamic Approach

V

Psychodynamic therapy is similar to psychoanalytic therapy in that it is an in-depth form of talk therapy based on the theories and principles of psychoanalysis. But psychodynamic therapy is less focused on the patient-therapist relationship, because it is equally focused on the patient’s relationship with his or her external world. Often, psychodynamic therapy is shorter than psychoanalytic therapy with respect to the frequency and number of sessions, but this is not always the case.

When It's Used

Psychodynamic therapy is primarily used to treat depression and other serious psychological disorders, especially in those who have lost meaning in their lives and have difficulty forming or maintaining personal relationships. Studies have found that other effective applications of psychodynamic therapy include addiction, social anxiety disorder, and eating disorders.

What to Expect

With help from the therapist, the patient is encouraged to speak freely about anything that comes to mind, including current issues, fears, desires, dreams and fantasies. The goal is to experience a remission of symptoms but also derive such benefits as increased self-esteem, better use of their own talents and abilities, and an improved capacity for developing and maintaining more satisfying relationships. The patient may experience ongoing improvements after therapy has ended. Although short-term therapy of one year or less may be sufficient for some patients, long-term therapy may be necessary for others to gain lasting benefits.

How it Works

The theories and techniques that distinguish psychodynamic therapy from other types of therapy include a focus on recognizing, acknowledging, understanding, expressing, and overcoming negative and contradictory feelings and repressed emotions in order to improve the patient’s interpersonal experiences and relationships. This includes helping the patient understand how repressed earlier emotions affect current decision-making, behavior, and relationships. Psychodynamic therapy also aims to help those who are aware of and understand the origins of their social difficulties, but are not able to overcome their problems on their own. Patients learn to analyze and resolve their current issues and change their behavior in current relationships through this deep exploration and analysis of earlier experiences and emotions.

Psychology Today 2021
person embracing the sunrise as part of therapy

Person Centered

V

Person-centered therapy uses a non-authoritative approach that allows clients to take more of a lead in discussions so that, in the process, they will discover their own solutions. The therapist acts as a compassionate facilitator, listening without judgment and acknowledging the client’s experience without moving the conversation in another direction. The therapist is there to encourage and support the client and to guide the therapeutic process without interrupting or interfering with the client’s process of self-discovery.

When It's Used

Anyone who would be better off gaining more self-confidence, a stronger sense of identity, and the ability to build healthy interpersonal relationships and to trust his or her own decisions could benefit from person-centered therapy. This approach, alone or in combination with other types of therapy, can also be helpful for those who suffer from grief, depression, anxiety, stress, abuse, or other mental health conditions. Person-centered therapists work with both individuals and groups. Since the client must do a lot of the work in person-centered therapy, those who are more motivated are likely to be more successful.

What to Expect

Person-centered therapy is talk therapy wherein the client does most of the talking. Your therapist will not judge or try to interpret what you say, but may restate your words in an attempt to fully understand your thoughts and feelings. When you hear your own words repeated back to you, you may then wish to self-edit and clarify your meaning. This may happen several times until you decide that you have expressed exactly what you are thinking and how you feel. There may be moments of silence to allow your thoughts to sink in. This client-focused process facilitates your self-discovery, self-acceptance, and a provides a means toward healing and positive growth.

How it Works

Person-centered therapy, also known as Rogerian therapy, originated in the work of the American psychologist, Carl Rogers, who believed that everyone is different and, therefore, everyone’s view of his or her own world, and ability to manage it, should be trusted. Rogers believed that all of us have the power to find the best solutions for ourselves and make appropriate changes in our lives. Person-centered therapy was a movement away from the therapist’s traditional role—as an expert and leader—toward a process that allows clients to use their own understanding of their experiences as a platform for healing. The success of person-centered therapy relies on three conditions:

  1. Unconditional positive regard, which means therapists must be empathetic and non-judgmental to convey their feelings of understanding, trust, and confidence that encourage their clients to make their own decisions and choices
  2. Empathetic understanding, which means therapists completely understand and accept their clients’ thoughts and feelings
  3. Congruence, which means therapists carry no air of authority or professional superiority but, instead, present a true and accessible self that clients can see is honest and transparent.
Psychology Today 2021
a person with labels covering his face associated with online counselling

Systemic Approach

V

The systemic approach has it's roots in 'Family Systems Therapy' although today, it doesn't need a family focus to be called 'Systemic'. Family systems therapy is a form of psychotherapy that helps individuals resolve their problems in the context of their family units, where many issues are likely to begin, although these days it is easily applied to all relationships. Each family member works together with the others to better understand their group dynamic and how their individual actions affect each other and the family unit as a whole. One of the most important premises of family systems therapy is that what happens to one member of a family happens to everyone in the family.

When It's Used

Many psychological issues begin early in life and stem from relationships within the family of origin, or the family one grows up in, even though these issues often surface later on in life. Families in conflict, as well as couples and individuals with issues and concerns related to their families of origin, can benefit from family systems therapy. This treatment approach can be helpful for such mental health conditions as depression, bipolar disorder, anxiety, personality disorders, addiction, and food-related disorders. Family systems therapy has also been shown to help individuals and family members better control and cope with physical disabilities and disorders.

What to Expect

During family systems therapy, the family works individually and together to resolve a problem that directly affects one or more family members. Each family member has the opportunity to express their thoughts and feelings about how they are affected. Together, the family works to help the individual in distress and to help relieve the strain on the family. Family members explore their individual roles within the family, learn how to switch roles, if necessary, and learn ways to support and help each other with the goal of restoring family relationships and rebuilding a healthy family system.

How it Works

American psychiatrist Murray Bowen began to develop his family systems theory in the mid-1950s while working as a psychiatrist at the National Institute of Mental Health. Based on his knowledge of family patterns and systems theory, which looks at the parts of a system (such as individual family members) in relationship to the whole (the family), Bowen believed that the personalities, emotions, and behaviors of grown individuals are a result of their birth order, their role within their family of origin and the coping mechanisms they have developed for dealing with emotional family issues. To understand the family system, the family must be viewed as a whole, and that what defines a family is more than the people who make it up but also how they interact with each other to create a unique family dynamic.

Psychology Today 2021
A background full of open books about online counselling

Narrative Approach

V

Narrative therapy is a form of counseling that views people as separate from their problems. This allows clients to get some distance from the issue to see how it might actually be helping them, or protecting them, more than it is hurting them. With this new perspective, individuals feel more empowered to make changes in their thought patterns and behavior and “rewrite” their life story for a future that reflects who they are, what they are capable of, and what their purpose is, separate from their problems.

When It's Used

Individuals, couples, and families can all benefit from narrative therapy. Those who define themselves by their problems, whose lives are dominated by such feelings as “I am a depressed person” or “I am an anxious person” can learn to see their problem as something they have but not something that identifies who they are.

What to Expect

Your therapist will encourage you to direct the conversation by asking what you prefer to talk about and, on an ongoing basis, checking to see if the topic, which is most likely a problem, is still something you are interested in discussing. After some time, your therapist will lead you to tell other, more positive stories from your life to help you discover inherent traits and skills that can be used to address your problems. The goal is for you to see how there are positive and productive ways to approach your life and your future when you stop identifying yourself by your problems.

How it Works

In narrative therapy, the events that occur over time in a person’s life are viewed as stories, some of which stand out as more significant or more fateful than others. These significant stories, usually stemming from negative events, can ultimately shape one’s identity. Beyond this identity, the narrative therapist views a client’s life as multitiered and full of possibilities that are just waiting to be discovered. The therapist does not act as the expert, but rather helps clients see how they are the experts regarding their own life and, as such, can uncover the dreams, values, goals, and skills that define who they really are, separate from their problems. These are the buried stories that can be rewritten and woven into the ongoing and future story of their lives.

Psychology Today 2021
a child hiding under cushions during counselling

CBT Approach

V

Cognitive behavioral therapy (CBT) is a form of psychotherapy that focuses on modifying dysfunctional emotions, behaviors, and thoughts by interrogating and uprooting negative or irrational beliefs. Considered a "solutions-oriented" form of talk therapy, CBT rests on the idea that thoughts and perceptions influence behavior.

Feeling distressed, in some cases, may distort one’s perception of reality. CBT aims to identify harmful thoughts, assess whether they are an accurate depiction of reality, and, if they are not, employ strategies to challenge and overcome them.

CBT is appropriate for people of all ages, including children, adolescents, and adults. Evidence has mounted that CBT can address numerous conditions, such as major depressive disorder, anxiety disorders, post-traumatic stress disorder, eating disorders, obsessive-compulsive disorders, and many others.

CBT is a preferred modality of therapy among practitioners and insurance companies alike as it can be effective in a brief period of time, generally 5 to 20 sessions, though there is no set time frame. Research indicates that CBT can be delivered effectively online, in addition to face-to-face therapy sessions.

When It's Used

CBT focuses on present circumstances and emotions in real time, as opposed to childhood events. A clinician who practices CBT will likely ask about family history to get a better sense of the entire person, but will not spend inordinate time on past events. The emphasis is on what a person is telling themselves that might result in anxiety or disturbance. A person is then encouraged to address rational concerns practically, and to challenge irrational beliefs, rumination or catastrophizing.

For example, a person who is upset about being single will be encouraged to take concrete measures but also question any undue negativity or unwarranted premise ("I will be alone forever") that they attach to this present-day fact.

What to Expect

CBT programs tend to be structured and systematic, which makes it more likely that a person gets an adequate “dose” of healthy thinking and behaviors. For example, a patient with depression may be asked to write down the thoughts he has when something upsetting happens, and then to work with the therapist to test how helpful and accurate the thoughts are. Repeated and focused practice is an integral part of CBT. CBT centers around building new habits—which we may know but need to remember and implement successfully.

Additionally, CBT programs can be standardized and tested so that the mental health field can identify which programs are effective, how long they take, and the benefits that patients can expect.

How it Works

CBT originally evolved to treat depression, but research now shows that it can address a wide array of conditions, such as anxiety, post-traumatic stress disorder, substance use disorder, and phobias. Versions have also been created to treat insomnia and eating disorders. But beyond treating clinical challenges, CBT can also provide the skills people need to improve their relationships, happiness, and overall fulfillment in life.

Psychology Today 2021
a picture of a statue.

Existential Approach

V

Existential therapy focuses on free will, self-determination, and the search for meaning—often centering on you rather than on the symptom. The approach emphasizes your capacity to make rational choices and to develop to your maximum potential.

The existential approach stresses that:

  • All people have the capacity for self-awareness.
  • Each person has a unique identity that can be known only through relationships with others.
  • People must continually re-create themselves because life’s meaning constantly changes.
  • Anxiety is part of the human condition.

When It's Used

What else is existential therapy recommended for? Psychological problems—like substance abuse—result from an inhibited ability to make authentic, meaningful, and self-directed choices about how to live, according to the existential approach. Interventions often aim to increase self-awareness and self-understanding. Existential psychotherapists try to comprehend and alleviate a variety of symptoms, including excessive anxiety, apathy, alienation, nihilism, avoidance, shame, addiction, despair, depression, guilt, anger, rage, resentment, embitterment, purposelessness, psychosis, and violence. They also focus on life-enhancing experiences like relationships, love, caring, commitment, courage, creativity, power, will, presence, spirituality, individuation, self-actualization, authenticity, acceptance, transcendence, and awe.

What to Expect

Here's what you can expect from a course of therapy. Existential psychotherapies use a range of approaches, but major themes focus on your responsibility and freedom. Therapists help you find meaning in the face of anxiety by choosing to think and act responsibly and by confronting negative internal thoughts rather than external forces like societal pressures or luck. Fostering creativity, love, authenticity, and free will are common avenues that help move you toward transformation. Similarly, when treating addiction disorders, the existential therapist coaches you to face the anxiety that tempts you to abuse substances and guides you to take responsibility. The goal: You learn to make more willful decisions about how to live, drawing on creativity and love, instead of letting outside events determine your behavior.

How it Works

This practice—due to its focus on existence and purpose—is sometimes perceived as pessimistic, but it’s meant to be a positive and flexible approach. At its best, according to 20th-century philosopher Paul Tillich, existential psychotherapy fairly and honestly confronts life’s "ultimate concerns," including loneliness, suffering, and meaninglessness. Specific concerns are rooted in each individual's experience, but contemporary existential psychotherapist Irvin Yalom says that the universal ones are death, isolation, freedom, and emptiness. Existential therapy focuses on the anxiety that occurs when you confront these inherent conflicts, and the therapist’s role is to foster personal responsibility for making decisions. Yalom, for example, perceives the therapist as a "fellow traveler" through life, and he uses empathy and support to elicit insight and choices. And because people exist in the presence of others, the relational context of group therapy is an effective approach, he says. The core question addressed in this kind of therapy is "how do I exist in the face of uncertainty, conflict, or death?”

Psychology Today 2021
three generations receiving counselling together

TA Approach

V

Transactional analysis, developed by psychiatrist Eric Berne, is a form of modern psychology that examines a person's relationships and interactions. Berne took inspiration from Sigmund Freud's theories of personality, combining them with his own observations of human interaction in order to develop transactional analysis. In therapy, transactional analysis can be used to address one's interactions and communications with the purpose of establishing and reinforcing the idea that each individual is valuable and has the capacity for positive change and personal growth.

When It's Used

Transactional analysis is frequently applied in the areas of medicine, communications, education, and business management as well as therapy. The mainstream appeal of this technique has attracted parents, professionals, social workers, and others who strive to achieve maximum personal development. Transactional analysis is considered to be one effective method of enhancing relationships with oneself and with others.

Studies show that transactional analysis, often used by counselors and clinicians to address issues currently faced by the person in treatment, can be an effective tool in the treatment of emotional and relationship difficulties that may develop as a result of chronic health challenges.

Transactional analysis is used widely in the educational arena, and this method can serve as a vessel through which educational principles and philosophy can be incorporated into the daily lives of students. This type of therapy can be administered to children and adults of all ages, regardless of social circumstances.

What to Expect

During family systems therapy, the family works individually and together to resolve a problem that directly affects one or more family members. Each family member has the opportunity to express their thoughts and feelings about how they are affected. Together, the family works to help the individual in distress and to help relieve the strain on the family. Family members explore their individual roles within the family, learn how to switch roles, if necessary, and learn ways to support and help each other with the goal of restoring family relationships and rebuilding a healthy family system.

How it Works

The atmosphere that supports transactional analysis is one of comfort, security, and respect. When a positive relationship is forged between the therapist and the person seeking treatment, this often provides a model for subsequent relationships developed outside of the therapy arena. Analysts who practice this form of therapy generally use a broad range of tools gathered from many disciplines including psychodynamic, cognitive behavioral, and systemic therapies.

GoodTherapy.org 2021
someone leaning back on a tree during online counselling

Mindfulness Approach

V

Mindfulness-Based Cognitive Therapy (MBCT) is a modified form of cognitive therapy that incorporates mindfulness practices such as meditation and breathing exercises. Using these tools, MBCT therapists teach clients how to break away from negative thought patterns that can cause a downward spiral into a depressed state so they will be able to fight off depression before it takes hold.

When It's Used

MBCT was developed for people with recurring episodes of depression or unhappiness, to prevent relapse. It has been proven effective in patients with major depressive disorder who have experienced at least three episodes of depression. Mindfulness-based relapse prevention may also be helpful for treating generalized anxiety disorders and addictions. MBCT has also been shown to improve symptoms of depression in some people with physical health conditions, such as vascular disease and traumatic brain injury.

What to Expect

MBCT is group therapy, with once-a-week, two-hour sessions, led by your therapist, as part of an eight-week program. You will learn meditation techniques as well as basic principles of cognition, such as the relationship between the way you think and how you feel. You will also have the opportunity to learn more about your depressive condition. On the days when there is no session, there is homework, which includes practicing breathing exercises and mindful meditation.

How it Works

Sometimes normal sadness is a powerful trigger for someone who has recovered from a depressive state to relapse into another bout of depression. Rather than try to avoid or eliminate sadness or other negative emotions, one learns to change their relationship with these emotions by practicing meditation and other mindfulness exercises. These activities rebalance neural networks, allowing the client to move away from automatic negative responses toward an understanding that there are other ways to respond to situations. By developing a routine meditation practice, clients can use the technique whenever they start to feel overwhelmed by negative emotions. When sadness occurs and starts to bring up the usual negative associations that trigger relapse of depression, the client is equipped with tools that will help them replace negative thought patterns with positive.

Psychology Today 2021
Someone looking paranoid during online counselling.

REBT Approach

V

Rational Emotive Behavior Therapy (REBT) is a short-term form of psychotherapy that helps you identify self-defeating thoughts and feelings, challenge the rationality of those feelings, and replace them with healthier, more productive beliefs. REBT focuses mostly on the present time to help you understand how unhealthy thoughts and beliefs create emotional distress which, in turn, leads to unhealthy actions and behaviors that interfere with your current life goals. Once identified and understood, negative thoughts and actions can be changed and replaced with more positive and productive behavior, allowing you to develop more successful personal and professional relationships.

When It's Used

REBT can help you with negative emotions such as anxiety, depression, guilt, and extreme or inappropriate anger. This approach is also used to help change stressful and self-defeating behaviors, such as aggression, unhealthy eating, and procrastination that get in the way of your quality of life and reaching your goals.

What to Expect

To help you manage and overcome difficulties or achieve life goals, the therapist will work with you to identify the beliefs and rigid thought patterns that are holding you hostage. The therapist will help you see how irrational these thoughts are and how they harm you. Through a variety of mental exercises, you will then learn how to reduce your negative thoughts and responses, and replace them with healthier, more constructive and self-accepting thoughts. REBT makes use of a variety of methods and tools, including positive visualization, reframing your thinking, and the use of self-help books and audio-visual guides, as well as assigned homework for reinforcement between sessions.

How it Works

REBT evolved from the work of psychiatrist Albert Ellis in the mid-1950s as the original form of cognitive-behavioral therapy. Ellis believed that most people are not aware that many of their thoughts about themselves are irrational and negatively affect the way they behave in important relationships and situations. According to Ellis, it is these thoughts that lead people to suffer negative emotions and engage in self-destructive behavior. At the same time, humans are capable of challenging and changing their irrational beliefs, if they are willing to do the work. While specific life events may contribute to mental health issues, REBT therapists believe that it is an individual’s own faulty and irrational belief system that causes the most problems. By letting go of negative thoughts and replacing them with positive beliefs, one is better able to accept one’s self and others and, in turn, live a happier life.

Psychology Today 2021

Find me at

facebook icon linking to jtortosa online counselling facebook page instagram logo to link back to JTortosaCounselling's Instagram account

@jtortosacounselling
#whenareyoutoday

Counselling Accreditation Logo counselling directory logo