There are so many kinds of psychotherapy that it can be overwhelming when exploring what therapy has to offer.
Whether taking advice from a friend about their experience or searching through the broad online descriptions, narrowing down what comes with therapy is a lot to absorb.
Before entering therapy, a good understanding of what you can expect in therapy and from a therapist can be very helpful.
Helping more people understand therapy could help reduce the stigma that exists around mental health. When we are ill, we see a doctor without a second thought. People know that going to a gym will improve their physical well being.
Mental well being is just as important, yet it often remains mysterious, feared, and often avoided. Therapy has evolved, and it’s time for cultural understanding of therapy to evolve as well.
Let’s take a closer look at therapy.
This article contains:
- A Look at Common Therapy Theories
- Examples of Therapy in Action
- 12 Skills that are a Must in Therapy
- 5 Therapy Techniques You Can Apply Today
- 5 Therapeutic Intervention Strategies
- 5 Worksheets and Activities to Use in Session (incl. pdf)
- 4 Useful Tests, Assessments, and Questionnaires
- 5 Interesting Therapy Ideas
- A Take-Home Message
A Look at Common Therapy Theories
Therapy is not a “one size fits all” approach to emotional healing. Finding the type of therapy that results in improvement for each individual starts with knowing what types exist.
Over 400 different types of psychotherapy are available. The following were chosen because they are the broadest categories of those 400 types.
Everyone is familiar with the name Sigmund Freud. His work developed into the field where therapists focus on the unconscious and how it manifests in a person’s behavior. The approach has shifted since the time of Freud and is one of the most widely utilized in therapy.
Psychodynamic therapy has been primarily used to treat major depression and other serious psychological disorders. It has been used to treat addiction, anxiety disorders, and eating disorders as well. Knowing that other theories are used for these same disorders, let’s take a look at what sets this approach apart.
The focus on repressed emotions and their role in behavior, interpersonal relationships, and decision-making give a patient a new way of understanding themselves. A therapist talks with each patient to help reveal these repressed emotions.
By allowing a patient to speak about whatever comes to mind freely, new insights can be revealed. The approach helps people who are aware of their problems but are not able to overcome them on their own.
Evolving from Pavlov’s, B.F. Skinner’s (Skinner, 1967), and John B Watson’s theories on conditioning, behavior therapy has found its place in the top 5 commonly used therapy approaches. Many psychologists have added to and influenced this theory, which is a highly effective approach to therapy. Another name for behavioral therapy is behavior modification.
It works from the belief that behavior is learned and that it can be modified through interventions with a therapist. Many different approaches operate under this umbrella term to treat many kinds of maladaptive behavior. Exposure Therapy, Applied Behavior Analysis, and Social Learning Theory are all major approaches that draw on Behavior Theory.
This approach is particularly practical with psychological disorders like obsessive-compulsive disorder, phobias, and anxiety. Through a supported change, a patient is given what they need to transform maladaptive behaviors. Behavior Therapy is not recommended for major psychological dysfunction, such as major depression or schizophrenia.
This type of therapy is based on the belief that spontaneous thoughts create beliefs that result in emotional response, psychological response, and behaviors. Cognitive Therapy aims at reducing or eliminating psychological distress.
Cognitive Behavioral Therapy weaves cognitive theory with behavioral theory to reduce psychological distress in addition to changing behavior. The theory focuses on present thinking and is solution-oriented. This type of therapy has been utilized and proven effective in a broad range of problems. Therapists have treated depression, anxiety, OCD, eating disorders, relationship dysfunction, and many other problems using this theory.
Humanistic Therapy Theory
Humanistic Therapy Theory evolved from Maslow’s hierarchy of needs and Roger’s person-centered approach to counter what was seen as limitations to psychoanalysis in the 1950s. These types of therapists believe that people are inherently motivated to solve their own problems. The overall motivation is for patients to achieve self-actualization through a personal approach to that height.
This approach works with the understanding that a person must be their authentic self to find fulfillment and purpose in their life. Therapists in this modality work with positive aspects of a patient’s whole self to better understand and improve a person’s well-being, as seen from the patient’s perspective.
The therapy incorporates a gestalt approach allowing the therapist to create an empathetic, supportive, and trusting environment where a patient can share without judgment.
Integrative or holistic theory
This approach to therapy is client-centered and utilizes tools and techniques from other approaches. Any therapist can integrate techniques from another modality. Patients are individuals and may respond to treatment in individual ways, hence the need to shift techniques to serve clients well.
Psychopharmacology therapy is the utilization of medicine to treat psychological dysfunction. It is commonly used to treat depression, anxiety, attention difficulties, and many more psychological problems. This approach works best in combination with another form of psychotherapy.
Examples of Therapy in Action
With stress, anxiety, and depression at epidemic levels across the world, therapy has become more commonplace. Therapy is available in schools, hospitals, and even churches. Many modalities are finding preventive therapy to be helpful in preventing high-risk behaviors (Singla, 2018).
Research has shown that only 25% of the population is flourishing (Niemic, 2017). A call to action has helped to shift mental health care, but not nearly enough. A deeper and widespread understanding of the benefits of therapy is called for in schools, workplaces, and medical facilities.
Some examples of where this action is already happening are:
- Inclusion of stress and depression related questionnaires in primary care offices.
- School counselor expansion of mindfulness and mental wellness education for students.
- Office place wellness benefits.
- Availability of apps to increase mental well being.
12 Skills that are a Must in Therapy
Therapists go through many hours of training to develop special skills to treat their patients. The following skills should be considered a “must-have” list.
Therapists must possess the ability to understand or feel what their client is experiencing.
Therapists sit with uncomfortable emotions regularly. Deeply understanding how providing therapeutic services might influence one’s emotional state is vital.
The ability to compartmentalize the emotions that are experienced in a therapeutic setting from one’s personal experience is important to the therapist’s well being.
3. Listening Skills
Therapists’ listening skills are finely tuned. Utilizing intuitive and active listening is necessary to serve patients in a transformative way. Through observation and fully attending to patients, a therapist creates an environment where they feel safe and heard.
4. Ability to set boundaries
Providing appropriate parameters within which a therapist works with a patient is foundational to therapeutic success. This skill enables professionalism to exist in the therapist/client relationship.
Once the boundaries are set, a therapist can show up for their client as their best self. With a warm and nurturing approach, a therapist can utilize humor and deep understanding to hold space for a patient to create change.
6. Unconditional positive regard
A good therapist cultivates the ability to attend sessions with their patients in a non-judgmental and caring capacity.
7. Concrete Communication
Making sure that the client is the focus of communication without a great deal of self-disclosure is important. Staying in a task-oriented communication focus will help the client move forward.
Interpretation is a skill that takes some practice to cultivate well. It is utilized to give clients perspective but should be used sparingly.
9. Solution collaboration
Considering self-determination theory (Deci & Ryan, 2012), a good therapist will know that solutions coming from a client are more effectively created.
However, once a client has exhausted their personal resources for finding a solution, a collaborative approach is helpful when forging solutions for behavior change.
10. Business management
Most therapists don’t get into this type of work to become millionaires. They begin their practice to help people. It is imperative to understand the business of therapy, however. You don’t have to become an MBA, but knowing how to run a successful business is necessary for a practice to survive.
11. Cultivated interest in others
A therapist who shows up as an arrogant “know it all” will likely have an empty waiting room. Developing an authentic interest in others will aid in creating a safe and trusted environment for clients.
5 Therapy Techniques You Can Apply Today
Therapists develop their skills to serve their patients best, using any of a multitude of techniques to reach each patient as an individual. Some of these techniques can, however, be used in your own life too.
Some clients are comfortable just being heard by their therapist. Others might be seeking a transformative process utilizing tools that are unique and come from other modalities. Therapists having open minds and consistently improving their approach, with an increased variety of techniques, will help more clients due to their individuality and personalized needs.
In Solution Focused Therapy, the Miracle Question is a powerful way for therapists to help their clients understand what they need on a deeper level. The technique can be used across types of therapy and is also used in coaching. We all want to believe in miracles, and they are incredibly subjective, yet powerful ways for clients to internalize what it would be like if their miracle occurred.
Like the use of the miracle question, open-ended questions are crucial in therapy. These types of questions allow clients to explore their minds without therapist presumptions. Along with open-ended questions, the following are communication techniques that should be in every therapist’s toolbox:
- appropriate use of silence
- rephrasing or paraphrasing
An intriguing technique developed from the theory by psychologists Hal and Sidra Stone is called Voice Dialogue. From their theory of Psychology of the Selves, we all operate from a multitude of selves working for or against us all the time. You’ve heard of the inner critic, the self-saboteur, and the inner child. This technique allows for these inner selves to have a voice.
By becoming aware of the presence of these alternate selves and allowing them to be heard, a client may find a more manageable balance in finding a new way of being in the world. Allowing for a dialogue with an inner self who has continuously been problematic can allow another self to stand up and be heard. It’s a creative and powerfully introspective technique that can help clients overcome self-limiting beliefs and behaviors.
The Hunger Illusion is an interesting technique that can be used across many forms of positive psychotherapy. It is a technique that anyone can use at home too. It helps clients to overcome habitual behavior. This helps clients become aware of unconscious motivations for behaviors by tuning into thoughts.
The technique works like this:
- Notice the moment you tend to act automatically.
- Don’t act automatically
- Keep track of thoughts and feelings that pop up in those “Don’t” behaviors
In Gestalt Therapy, the Empty Chair is an interesting way to allow clients to communicate their abstract thinking effectively. Gestalt Therapy focuses on the whole client, including their environment, the people in it, and the thoughts around the whole.
This technique opens up the ability to speak to a problem in a safe and supported way. It is especially useful for clients who are not verbalizing their abstract thinking concerning people in their environment. It is not as helpful for a client who is already adept at dramatically presenting their emotions.
The idea is creating a cue for a client to unleash their inner thoughts on an imaginary person sitting in an empty chair. The technique brings the client into a present moment experience. It offers clients a new way to interact with personal conflicts.
5 Therapeutic Intervention Strategies
Strategies will vary for the type, severity, and duration of therapeutic needs. Being well versed in intervention strategies gives therapists a full palette from which to paint their approach to helping clients heal. Here are a few of the most well known.
1. For Addiction
A commonly utilized approach to help an individual who has in the past refused to participate in changing habitual and harmful behavior is group intervention. A mediated, supportive, and gentle meeting is often staged to support this individual. Members of a client’s family, friends, and others from their environment will voice their concerns directly to the client.
2. Individual Behavioral Interventions
Strategies commonly utilized when working with youth. They include, but are not limited to positive reinforcement, time-limited activities, and immediate behavior reinforcement. When attempting to help a youth who has had difficulty with inappropriate reactionary behaviors in the past, these strategies are vital for safety and growth.
3. Crisis Intervention
When someone has suffered a trauma, a therapist or qualified professional can support a healthier processing of an extreme situation. Helping someone after a crisis occurs helps them to gain a clear perspective and support when it is most needed. This type of intervention takes special training and skills.
4. Psychopharmacology Interventions
These are typically used in patients presenting with more severe symptoms, although they seem to be used broadly. When in combination with effective psychotherapy, improvements can be made in a significant number of presenting psychological disruption. It does require the participation of a licensed prescriber.
5. Positive Psychology Interventions
A great deal of research has been done in supporting a patient in applying interventions in positive psychology into their life. Therapists with a deeper understanding of the benefits of these types of interventions can not only help patients return to health. They can also help patients lead lives that are more fulfilled. Here are the best Positive Psychology Interventions.
5 Worksheets and Activities to Use in Session (incl. pdf)
Providing therapy for children can be a very creative process. There are hundreds of ideas for helping kids effectively express their emotions.
Through art, writing, and interactive play, kids can find a new perspective for handling behavior change. Here a well-formed e-book of strategies and interventions are used in family and child therapy settings.
A broad and easy to use resource for finding worksheets and other therapeutic aids is Therapist Aid. There are many free forms you can download to use in many different settings. There are even self-esteem worksheets that anyone can access and utilize in personal development. An additional resource is Psych Point.
Here is a fantastic article on positive psychotherapy exercises complete with worksheets to apply today.
Another helpful and robust article that contains useful activities and worksheets to be used in group therapy.
4 Useful Tests, Assessments, and Questionnaires
Some of the initial assessments a person seeking therapy may be asked to complete are linked below. They are useful in helping a therapist understand why a patient is seeking help. There are various assessments for various symptoms.
Self-report tests can be helpful when deciding to enter therapy. Psychology Today has an abundance of these types of tests. Be mindful though, like WebMD, self-diagnosing can increase unnecessary anxiety. Most tests should be administered by a trained professional.
Here is a healthy living questionnaire. This is another self-report test that can reveal whether or not emotional difficulties are disrupting daily life.
Here is a sample questionnaire used in primary care to help with the referral process for patients presenting with stress.
The Global Mental Health Assessment Tool assists physicians in the referral process. Trained professionals administer it.
5 Interesting Therapy Ideas
Some of the most significant advances in mental health treatment have grown from unconventional approaches. Here are some of those unconventional ideas and their summaries. Talk therapy seems to be shifting in all sorts of ways.
1. Dance/ Movement Therapy
This approach has been used since the 1940s. The use of movement increases creative access to emotions. The movement seeks to improve psychological, physical, and social health.
2. Laughter Therapy
This approach improves well being by boosting positive mood and maximizing the benefits of laughter. Some of the benefits are listed below.
- reduction of pain tolerance
- increases trust in turn improving social relationships
- stimulates the release of endorphins
- reduces depression and anxiety
- boosts problem-solving skills and creativity
- improves sleep
- enhances memory
- broadens minds
3. Drama Therapy
Drama therapy is the use of theatrical techniques to promote positive mental health and foster personal development. Here’s another excellent article outlining drama therapy and the activities that go along with it.
This is guided hypnosis achieved by a licensed professional. This can be used in conjunction with other forms of therapy to treat many forms of habitual behavioral dysfunction. Anxiety, substance misuse, phobias, and sexual dysfunction are a few examples of the spontaneous behaviors that can be treated with hypnotherapy.
5. Music Therapy
Music therapy has long been seen as a tool for managing emotions, and handling an instrument can have positive implications in the abilities of the patient. Beneficial for stress management and improving the cognitive abilities of differently-abled children, music therapy is becoming a popular new approach.
A Take-Home Message
The more people understand the theories and practice of therapy, the more likely they are to seek help. Reducing uncertainty in the process can help create a reduction of the stigma around mental health care.
Just because a person is not ill, does not mean that they are flourishing and therapy can assist in moving people toward a thriving well being.
The more information people have about therapy, the stronger their ability to self-advocate. Help can come in many forms. Being open-minded about therapy is a great place to start.
Thanks for reading!
- Skinner, B. F. (1967). B. F. Skinner. In E. G. Boring & G. Lindzey (Eds.), The Century psychology series. A history of psychology in autobiography, Vol. 5, pp. 385-413. East Norwalk, CT, US: Appleton-Century-Crofts.
- Watson JB. Psychology as the Behaviorist Views It. In: Green CD, ed. Classics in the History of Psychology. Psychological Review. 1913;20:158-177.
- Singla, D. R., Raviola, G., & Patel, V. (2018). Scaling up psychological treatments for common mental disorders: a call to action. World Psychiatry, 17(2), 226–227. doi:10.1002/wps.20532
- Niemic, 2017. Character Strengths Interventions: A Field Guide for Practitioners, Boston: Hogrefe Publishing
- Deci, E. L., & Ryan, R. M. (2012). Self-determination theory. In P. A. M. Van Lange, A. W. Kruglanski, & E. T. Higgins (Eds.), Handbook of theories of social psychology (pp. 416-436). Thousand Oaks, CA, Sage Publications Ltd.