The range of psychological therapies and treatments available today for mental illness can be overwhelming.
With new treatments and theories popping up all the time it can be difficult to know what will work best for you.
If you or someone you know is struggling with mental illness you should discuss with your GP or mental health professional what the best treatment options are for your individual circumstances and personality. But having a good working knowledge of the major types of psychological therapy and the theory behind them can help you understand your own circumstances and how best to go about getting treatment.
A guide to talking therapies
This guide will give you a brief overview of some of the most widely-used therapies; giving you insight into how they work, who they are for, and what you can expect in a typical session.
Cognitive Behavioural Therapy (CBT)
CBT works on the basis that while you can’t always change your circumstances, you can change the way you react to them. Identifying faulty or negative thought processes and training yourself to see the world more positively can have huge effects on your mood and behaviour.
CBT is widely regarded as one of the most successful treatments for a number of conditions including depression and anxiety. What’s more, CBT is a short-term treatment that focuses on giving you the tools to change your thinking through self-reflection and deliberate changes to your thoughts and behaviour. This makes it a powerful tool for long-term change.
Acceptance and Commitment Therapy (ACT)
Often those struggling with emotional trauma will go to great lengths to avoid confronting their pain. These avoidance strategies and “inner battles” can be far more destructive than the initial source of distress. ACT encourages clients to confront their distress rather than avoiding it and end the struggle with internal thoughts and emotions.
During ACT you will work with the therapist using introspection and thought exercises to make healthy connections with your thoughts and sensations and help you act more independently of them in service of your values. This approach has seen great success treating anxiety, depression, stress and even chronic pain.
Schemas are those deeply ingrained worldviews which are formed early in life and affect how we see ourselves and everything around us. Traumatic experiences in childhood can lead to the forming of maladaptive schemas which force a person to see the world in a highly negative light. This deeply rooted paradigm of self-defeating thought can have serious and long-term consequences.
Schema therapy is an intensive and long term therapy in which cycles of self-destructive behaviour and their root causes are exposed and re-written. Emotions, thoughts and behaviours are examined in detail to produce long-lasting change. Schema Therapy is highly effective in treating chronic conditions like Borderline Personality Disorder and in helping individuals who were previously considered untreatable.
Solution Focussed Brief Therapy (SFBT)
Individuals struggling with emotional distress can often develop their own ways of coping with their condition. These methods form the basis of SFBT, a goal-driven therapy which aims to empower the patient to use their own strengths and desire for change as a powerful means of recovery.
SFBT does not look into the underlying causes of emotional illness, instead focusing on developing goals and strategies for improvement over a short treatment period. SFBT is therefore a fast, effective and low-intensity treatment and a good first choice for a range of conditions.
Compassion Focussed Therapy (CFT)
Those struggling with depression and other illnesses often have difficulty seeing themselves positively and can have high levels of shame and self-criticism. Such patients can benefit from learning to have compassion for themselves through CFT.
In CFT inner mindfulness and powerful imagery is used to re-write those internal voices that are constantly criticising. Training yourself to react and think more positively can have great success in combating illnesses which stem from shame and low self-esteem.
Dialectical Behaviour Therapy (DBT)
DBT is an offshoot of CBT that developed to help those experiencing chaotic swings in emotion and an inability to cope with extreme feelings. Although initially developed with Borderline Personality Disorder in mind DBT has proven effective for a range of emotional difficulties.
Clients taking part in DBT develop skills in regulating their emotions and practice interacting with others in healthy, constructive ways through individual and group therapy. As in CBT, unhelpful thoughts are challenged and replaced with more positive alternatives.
Motivational Interviewing is a collaborative counselling technique that focuses on helping clients develop the motivation and drive to break themselves out of unhealthy behaviour. The therapist helps the client think about change and resolves any concerns or mixed feelings the client may have about changing their lifestyle.
Motivational Interviewing is a collaborative approach, valuing rapport between client and therapist and using the client’s internal motivations to drive change. This approach is mainly used to treat substance abuse and related disorders and is now established as an effective evidence-based treatment. It has also been applied successfully with anxiety treatment.
When people experience traumatic events, the consequences of the event and the person’s interpretations of them turn the event into a story or narrative. Narrative Therapy enables clients to look objectively on their narratives and gain new insight into their lives.
Narrative Therapy focuses on separating the person from the problem, externalising issues so that they can be viewed objectively and addressed more effectively. Narrative Therapy also helps clients see issues in the larger context of their life story and build new narratives for themselves to follow.
Different therapies work better for different individuals, depending on their personality, the type and severity of their condition and the amount of time they can commit to therapy. All of the above therapy types are evidence-based and draw upon years of scientific study to help understand mental illness from different perspectives. Each has been shown to be effective in treating disorders and emotional difficulties, and new research is constantly improving existing techniques, empowering clients to change the way they think.
We’re curious. Have you tried any of these therapies? What worked? What didn’t. We’d love to hear your experiences.
Angus Munro is a registered clinical psychologist and director of Angus Munro Psychology in Sydney. He excels in evidence-based therapies for a comprehensive range of Emotional and psychological challenges. One of his passions is engaging, educating and helping people work through all manner of mental health issues to live their best life.
Social Media links for Angus: Linkedin Twitter Facebook Google+
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ThAnkyou. Useful to have them all described succinctly.
Great article. Where is psychotherapy? Gestalt therapy? Would be brilliant to see these included as many of those mentioned draw from the grand traditions of approaches that were considered obscure or nonconventional.
I think that DBT should have several caveats. Therapists are taught that patients may try to interfere with the therapy (through ‘therapy-interfering behaviours’ such as self-harm, anger, or not talking to the therapist). It builds up an air that the therapist is infallible, and it attracts therapists who are religious, because it uses concepts from Zen Buddhism and Catholicism (the founder is Catholic). If you’d prefer to be free from religion, be aware that a therapist whose favourite thing ever is DBT may try to include ‘opening your mind to religion’ as a therapeutic goal. (Even though in the fine manual the founder says it’s important to connect the spiritual aspects of DBT to the client’s own practices.)
There was an interesting Guardian article a while ago: https://www.theguardian.com/lifeandstyle/2015/jul/03/why-cbt-is-falling-out-of-favour-oliver-burkeman
saying that every new therapy seems great at first and that it becomes less good as it becomes more popular, and it gives some reasons why.
Thanks for the run-down of therapies, gives me something to think about.
Another therapy that I have found effective is NLP- why is this it more commonly recommended?
That’s because NLP is pseudoscience and I don’t promote non-evidenced based therapies.
I think everyone needs constant “schema therapy” throughout their life as no one has a perfect schema. Learning/education is a form of schema therapy as it grows and betters your mental framework.
I have learned a lot of things over the years that improved some my negative views of the world and people around me, and I keep “treating” my schema by learning and growing mentally.
You have said that “CBT is widely regarded as one of the most successful treatments…” and I fully agree with you on that. My nephew underwent the cognitive behavioural therapy (CBT) locally and I would like to say that he has improved quite significantly. He was diagnosed with ADHD and his parents almost misunderstood the condition. Fortunately, the doc directed them to the local CBT therapy and as we speak the boy is doing quite well.