How To Choose The Right Therapy For Me

You’ve made the difficult decision to seek help. Now what? It can be an uncomfortable experience to be vulnerable with a complete stranger. Even harder sometimes, to figure out what type of therapy is right for you.

You’ve probably heard a bunch of different terms like holistic, modalities, eclectic, CBT, DBT, EFT, EMDR. What does this all mean and how can it help you find a therapist?

There is no one-size-fits-all approach to therapy, and the professional that works well for someone else might not work as well for you. Here are 7 therapeutic modalities (approaches) to consider.

Cognitive Behavioural Therapy — CBT

CBT focuses on the development of personal coping strategies that target solving current problems and changing unhelpful cognitive patterns (e.g. thoughts, beliefs, attitudes, behaviours, emotions). CBT is an action-oriented form of therapy focusing on specific problems related to a diagnosed mental disorder. The therapist’s role is to assist the individual in finding and practicing effective strategies to address the identified goals and decrease symptoms of the disorder. CBT is based on the belief that though distortion and maladaptive behaviours play a role in the development and maintenance of psychological disorders (e.g. depression). Symptoms and associated distress can be reduced by teaching new information-processing skills and coping mechanisms.

Duration: A typical CBT program usually consists of 6–18 sessions. Some booster sessions (after 1–3 months) might follow.

Structure: Often brief, direct, and time-limited treatments for individual psychological disorders that are specific technique-driven.

Effective Treatment For: Depression, anxiety, post-traumatic stress disorder (PTSD), tics, substance abuse, eating disorders, borderline personality disorder, OCD.

Dialectical Behaviour Therapy — DBT

DBT is a therapy primarily designed to help people suffering from personality disorders. This approach works towards helping people increase their emotional and cognitive regulation by learning about the triggers that lead to reactive states and helping to assess which coping skills to apply in the sequence of events, thoughts, feelings, and behaviours to help avoid undesired reactions. DBT assumes that people are doing their best but lack the skills needed to succeed, or are influenced by positive or negative reinforcements that interfere with their ability to function appropriately

Duration: DBT is a longer-term therapy. The average length of time that an individual stays in the DBT program is 2 1/2 years. Sessions are aimed to help the person generalize their skills into their lives, support them while they do trauma work (if necessary), and get them closer to their long-term goals.

Structure: DBT focuses on the client acquiring new skills and changing their behaviours with the ultimate goal of achieving a “life worth living,” as defined by the client. Usually done through skills curriculum either in individual one-on-one or group sessions.

Effective Treatment For : DBT is used primarily in the treatment of suicidal ideation, borderline personality, self harm, substance dependence, eating and food issues, depression, and PTSD.

Emotionally Focused Therapy — EFT

EFT approach is based on scientific study of adult love and bonding processes in couples, and is designed to address distress in the intimate relationships. EFT is based on the premise that human emotions are connected to human needs, and therefore emotions have an innately adaptive potential that, if activated and worked through, can help people change problematic emotional states and interpersonal relationship.

Duration: EFT is usually a short-term treatment (8–20 sessions).

Structure: In EFT the therapist will encourage the person(s) to look at current emotional issues and then help discover feelings and emotions that the person(s) may not realize they have. Helping to direct new conversations and interactions based on these. EFT focuses on the present time to makes changes in the here and now.

Effective Treatment For — typically work with couples and families to help facilitate closeness, and connection in intimate relationships.

Eye Movement Desensitization and Reprocessing — EMDR

EMDR is a form of psychotherapy, which uses eye movements or other forms of types of visual, auditory, or tactile external stimuli occurring in a rhythmic pattern to assist clients in processing distressing memories and beliefs. It is commonly used for the treatment of post- traumatic stress disorder (PTSD). The theory behind the treatment assumes that when a traumatic or distressing experience occurs, it may overwhelm normal coping mechanisms. This therapy is based on the idea that negative thoughts, feelings and behaviours are the result of unprocessed memories.

Duration: The type of problem, life circumstances, and the amount of previous trauma will determine how many treatment sessions are necessary.

Structure: EMDR includes having the individual recall distressing images while receiving one of several types of visual, auditory, or tactile external stimuli occurring in a rhythmic pattern, such as side-to-side eye movements or hand tapping. Unlike CBT with a trauma focus, EMDR does not involve detailed descriptions of the event, direct challenging of beliefs, extended exposure or homework.

Effective Treatment For: PTSD, trauma

Interpersonal Psychotherapy — IPT

Interpersonal psychotherapy (IPT) is a brief, attachment-focused psychotherapy that centres on resolving interpersonal problems and symptomatic recovery. IPT is based on the principle that relationships and life events impact mood and vice versa. The aim of IPT is to help the person to improve interpersonal and intrapersonal communication skills within relationships and to develop social support networks with realistic expectations to deal with the crises precipitated in distress’ and to weather ‘interpersonal storms’.

Duration: Usually 12–16 weeks.

Structure: Highly structured and time-limited approach. Employs homeworkand structured interviews and assessment tools.

Effective Treatment For: Depressive disorders, substance use disorders, eating disorders, grief/loss, conflict in significant relationships, difficulties adapting to change, difficulties from social isolation.

Mindfulness- Based Therapy

Therapeutic approaches grounded in mindfulness promote the practice as an important part of good physical and mental health. Mindfulness-based stress reduction, Designed to deliberately focus a person’s attention on the present experience in a way that is non-judgmental. Mindfulness and mindfulness meditation focus on becoming aware of all incoming thoughts and feelings and accepting them, but not attaching or reacting to them. This process is known as “decentering” and aids in disengaging from self-criticism, rumination, and dysphoric mood that can arise when reacting to negative thinking patterns.

Duration: Can be done in individual one-on-one sessions or in a group session. Usually 8 sessions

Structure: Mindfulness-based approaches are most commonly delivered through the use of mindfulness meditation. During mindfulness meditation, the therapist will typically guide the client to direct their focus on the present moment.

Effective Treatment For: Addressing stress, chronic pain, cancer, anxiety, depression, eating and food issues, psychosis, bipolar, panic attacks, attention deficit hyperactivity , PTSD.

Solution Focused Brief Therapy — SFBT

SFBT is a goal-directed collaborative approach to psychotherapeutic. This therapy modality focuses on the present and future, focusing on the past only to the degree necessary to gain an accurate understanding of the persons concerns. Focus is on identifying the individuals goals, generating a detailed description of what life will be like when the goal is accomplished and the problem is either gone or coped with satisfactorily.

Duration: As the name implies therapy is brief. Average is usually 4- 8 sessions.

Structure: SFBT is future-focused, goal-directed, and focuses on solutions, rather than on the problems.

Effective Treatment For: Youth who are experiencing behavioural concerns or academic/school- related concerns. It has also proven effective as an approach to family therapy and couples counselling. SBFT may not be recommended for those who are experiencing severe mental health concerns

So as you can see there are several different approaches or modalities of therapy. Some therapists are trained in several different techniques and use an eclectic approach to therapy. In other words, they use elements from a range of therapeutic approaches, with the goal of establishing a course that is personally tailored to the client. One size does not fit all!! Many therapists take a holistic perspective, approaching the person as a whole being, helping them to gain awareness of the connections between emotions, thoughts, physical experiences, and spiritual understandings.

SHIFT has a variety of therapists trained in all these approaches and also offers a 15 minute free consultation phone call so you can determine the right therapy approach and therapist for you.

References:
CAMH. (2015). Interpersonal Therapy.
Geneva: World Health Organization. 2013. Guidelines for the management of conditions that are specifically related to stress.
Psych Central. (2016). An Overview of Dialectical Behaviour Therapy.
Hollon SD, Beck AT (2013). “Chapter 11 Cognitive and Cognitive-Behavioral Therapies”. In MJ Lambert. Bergin and Garfield’s Handbook of Psychotherapy and Behavior Change (6th ed.). Hoboken, NJ: John Wiley & Sons. pp. 393–394.
Johnson, S. M. (2008). Emotionally focused couple therapy. In A. S. Gurman (Ed.), Clinical handbook of couple therapy (pp. 107–137). New York, NY: The Guildford Press.
Jones, D. (2008). Becoming a Brief Therapist: Special Edition The Complete Works. p.451
Seligman & Reichenberg, Linda & Lourie (2014). Theories of Counseling and Psychotherapy. New Jersey: Pearson Prentice Hall. pp. 354–356.