Bipolar Lifestyles

Types of Therapy

March 20, 2011

The popular conception of therapy is that of the classic talk therapy; a person, a couch and a psychologist with a notepad and pencil in hand. While some approaches do use this method, there are many types of therapy that can be used to help a person overcome problems. In all cases, the goal of therapy is to offer a non-judgmental environment that allows the person and therapy provider to work together towards a mutually agreed upon set of goals.

The following are just a few of the many different types of therapy available.

Psychoanalytic Therapy

What is Psychoanalytic Therapy?

Psychoanalytic therapy is one of the most well-known treatment modalities, but it is also one of the most misunderstood by mental health consumers.

Founded by Sigmund Freud, psychoanalytic therapists generally spend time listening to patients talk about their lives, which is why this method is often called “talk therapy.” The therapy provider will look for patterns or significant events that may play a role in the person’s current difficulties. Psychoanalysts believe that childhood events and unconscious feelings, thoughts and motivations play a role in mental illness and maladaptive behaviors.

Benefits of Psychoanalytic Therapy

While this type of therapy has many critics who claim that psychoanalytic therapy is too time consuming, expensive and generally ineffective, this treatment has several benefits as well. The therapist offers an empathetic and non-judgmental environment where the person can feel safe in revealing feelings or actions that have led to stress or tension in his or her life. Oftentimes, simply sharing these burdens with another person can have a beneficial influence.

Psychodynamic Therapy

Psychodynamic therapy is based upon the assumption that depression occurs because of unresolved — usually unconscious — conflicts, often originating from childhood. The goal of this type of therapy is for the patient to understand and better cope with these feelings by talking about the experiences which led to them.

Cognitive Therapy

What Is Cognitive Therapy?

Cognitive therapy makes the assumption that thoughts precede moods and that false self-beliefs lead to negative emotions. Cognitive therapy aims to help the patient recognize and reassess his patterns of negative thoughts and replace them with positive thoughts that more closely reflect reality.

What Are Cognitive Distortions?

Cognitive therapy recognizes 10 common patterns of faulty thinking, which are known as cognitive distortions.

  1. * All-or-Nothing Thinking: Failing to recognize that there may be some middle ground. Characterized by absolute terms like always, never, and forever.
  2. * Overgeneralization: Taking an isolated case and assuming that all others are the same.
  3. * Mental Filter: Mentally singling out the bad events in one’s life and overlooking the positive.
  4. * Disqualifying the Positive: Treating positive events like they don’t really count.
  5. * Jumping to Conclusions: Assuming the worst about a situation even though there is no evidence to back their conclusion.
  6. * Magnification and Minimization: Downplaying positive events while paying an inordinate amount of attention to negative ones.
  7. * Emotional Reasoning: Allowing your emotions to govern what you think about a situation and not objectively looking at the facts.
  8. * Should Statements: Rigidly focusing on how you think things should be and not finding strategies for dealing with how things are.
  9. * Labeling and Mislabeling: Applying false and harsh labels to oneself and others.
  10. * Personalization: Blaming yourself for things that are out of your control.

What Is Cognitive Therapy Used For?

Studies have shown that cognitive therapy is an effective treatment for depression. It is comparable in effectiveness to antidepressants and interpersonal therapy or psychodynamic therapy. The combination of cognitive therapy and antidepressants has been shown to be effective in managing severe or chronic depression. Cognitive therapy has also proven beneficial to patients who have only a partial response to antidepressants. There is good evidence that cognitive therapy reduces relapse rates. In addition, some evidence has shown that cognitive therapy is effective in treating adolescent depression.

What Is Behavior Therapy?

Behavior therapy is a type of psychotherapy that focuses on changing and gaining control over unwanted behaviors. Behavior therapy is based upon the principles of classical conditioning developed by Ivan Pavlov and operant conditioning developed by B. F. Skinner.

What Is Classical Conditioning?

Classical conditioning is best exemplified by a famous experiment conducted by Pavlov where he learned that ringing a bell close to dinner time caused dogs to associate the ringing of the bell with the arrival of food. Soon, the dogs learned to begin salivating at the sound of the bell even though no food was present.

An important principle in conditioned learning is that a conditioned response (salivating in the case of the dogs) decreases in intensity if the conditioned stimulus (bell) is repeatedly presented without the unconditioned stimulus (food). This process, called extinction, is useful in treating phobias, which are essentially cases where a person has learned to have an irrational fear of an object or situation because of some fear-inducing stimulus which accompanied it.

For example, a person might fear clowns because as a child they were frightened by the loud noises of the circus. Gradually exposing this person to stimuli that trigger his phobia — a process called desensitization–would eventually extinguish his fear.

What Is Operant Conditioning?

Operant conditioning is based upon the fact that behavior can be affected by rewards and punishments.

In explaining operant conditioning, B. F. Skinner gave an example of a hungry rat in a semi-soundproof box. For several days, food was delivered into a tray via an automatic dispenser. When the rat heard the dispenser he went to eat. Next, a small lever in the wall was slightly raised so that when the rat touched it with its paw, the food dispenser was delivered. Immediately after eating the food, the rat began to press the lever rapidly. The first time the rat touched the lever by accident, but the arrival of the food dispenser reinforced the behavior so he kept doing it.

Just like the rat, human behavior can be affected by reinforcement. Desired behaviors can be reinforced while undesired behaviors can be extinguished by not offering reinforcement.

What Is Behavior Therapy Used For?

Behavior therapy is effective for the treatment of health problems which need some sort of behavior change, such as quitting smoking or losing weight. It is also effective for anxiety disorders and phobias. It has been used with positive results in patients with developmental disabilities and with severely disturbed psychotic patients. It is the treatment of choice for severely ill patients who can’t participate in insight-oriented or cognitive therapies.

Cognitive-Behavioral Therapy

What is Cognitive-Behavioral Therapy?

Learning new behaviors — which can be anything a person thinks, feels or does — is a crucial part of DBT. There are four main strategies that are used to change behavior: skills training, exposure therapy, cognitive therapy, and contingency management.

  1. * Skills Training – Attending skills groups, doing homework assignments and role-playing new ways of interacting with people.
  2. * Exposure Therapy – Exposing oneself to feelings, thoughts or situations which were previously feared and avoided.
  3. * Cognitive Therapy – Recognizing and reassessing patterns of negative thoughts and replacing them with positive thoughts that more closely reflect reality.
  4. * Contingency Management – Identifying how maladaptive behavior is rewarded and how adaptive behavior is punished and using this knowledge to change behavior in a positive way.

Cognitive therapists tend to focus on specific problems. These therapists believe that irrational thinking or faulty perceptions cause dysfunctions. A cognitive therapist may work with a person to change thought patterns. This type of therapy is often effective for people suffering from depression or anxiety.

Behavioral therapists work to change problematic behaviors that have been trained through years of reinforcement. A good example of behavioral therapy would be a therapist working with a person to overcome a fear of heights. The therapist would encourage the person to gradually face their fear of heights through experience. The person might first imagine standing on the roof of a tall building or riding an escalator. Next, the person would slowly expose themselves to greater and greater levels of their fear until the phobia diminishes or disappears entirely.

For patients with borderline personality disorder, the process of cognitive behavioral therapy can cause a great deal of distress. The push for change feels to them as if it invalidates the emotional pain they are feeling. Linehan and her team found that by offering validation along with the push for change, patients were more likely to cooperate and less likely to suffer distress at the idea of change. The therapist validates that the person’s actions “make sense” within the context of his personal experiences without necessarily agreeing that they are the best approach to solving the problem.

Benefits of Cognitive-Behavioral Therapy

Cognitive and behavioral approaches can be highly effective when treating specific problems. Oftentimes, cognitive and behavioral approaches are combined when treating a disorder. A therapist treating a person with social anxiety may help the person form more accurate thinking patterns as well as focusing on specific behaviors, such as social avoidance.

Dialectical Behavior Therapy

What Is Dialectical Behavior Therapy?

Dialectical behavior therapy (DBT) is a type of cognitive behavioral therapy. Its main goal is to teach the patient skills to cope with stress, regulate emotions and improve relationships with others.

DBT is derived from a philosophical process called dialectics. Dialectics is based upon the concept that everything is composed of opposites and that change occurs when one opposing force is stronger than the other, or in more academic terms: thesis, antithesis and synthesis.

History of Dialectical Behavior Therapy

DBT was developed in the late 1970s by Dr. Marsha Linehan and colleagues when they discovered that cognitive behavioral therapy alone did not work as well as expected in patients with borderline personality disorder. Dr. Linehan and her team added additional techniques and developed a treatment which would meet the unique needs of these patients.

The Three Fundamentals of Dialectical Behavior Therapy

Dialectics makes three basic assumptions: (1) all things are interconnected (2) change is constant and inevitable and (3) opposites can be integrated to form a closer approximation of the truth. In DBT, the patient and therapist are working to resolve the seeming contradiction between self-acceptance and change to bring about positive changes in the patient.

What Is Dialectical Behavior Therapy Used For?

DBT is designed for use by people who have urges to harm themselves, such as those who self-injure or who have suicidal thoughts and feelings. It was originally intended for people with borderline personality disorder, but has since been adapted for other conditions where the patient exhibits self-destructive behavior, such as eating disorders and substance abuse.

Interpersonal Therapy

Interpersonal therapy is a type of therapy which focuses on past and present social roles and interpersonal interactions. During treatment, the therapist generally chooses one or two problem areas in the patient’s current life to focus on. Examples of areas covered are disputes with friends, family or co-workers, grief and loss and role transitions, such as retirement or divorce.

Group Therapy

What is Group Therapy?

Group therapy is a form of psychotherapy where two or more people work with one or more therapists or counselors. This method is a popular format for support groups, where group members can learn from the experiences of others and offer advice. This method is also more cost-effective than individual psychotherapy and is oftentimes more effective.

Benefits of Group Therapy

It is common for those suffering from a mental illness or problem behavior to feel alone, isolated or different. Group therapy can help people by providing a peer group of people that are currently experiencing the same symptoms or who have recovered from a similar problem. Group members can also provide emotional support and a safe forum to practice new behaviors.


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