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Psychotherapy: Four Different Approaches

Silver Hill Hospital

In the mental health world, people often refer to “therapy,” however, there are countless types of therapy. How do you know which approach is right for you? Here are four common types of therapy used to treat mental illness and addiction.

Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is one of the most widely used forms of therapy. CBT focuses on thoughts, feelings and behaviors; a person’s thoughts and attitudes directly affect how the person feels and behaves. The therapist works with the person to identify problematic thought patterns that may be causing self-destructive beliefs and behaviors. Once these patterns are uncovered, the therapist helps the person restructure their thoughts.

For example, people with depression often have low self-esteem also. They may say things to themselves like, “Nobody likes me so I’m not going to bother going to the party.” That untrue thought makes the person stay home. In turn, they feel worse because they believe nobody likes them and now they tell themselves more negative things as they sit at home; “I’m such a loser,” “everyone else has fun except for me.” This constant loop of negative thoughts continues to worsen the depression. In CBT, the therapist can help identify what thoughts are false and come up with ways to reframe them and help the person modify their behavior.

Patients typically meet with their therapist once a week for 50 minutes per session. CBT is used to treat a variety of conditions including, but not limited to anxiety/panic, depression, bipolar disorder, schizophrenia, addiction and eating disorders. Learn more about CBT.

Dialectical Behavioral Therapy
Dialectical Behavioral Therapy (DBT) is a cognitive behavioral therapy developed by renowned psychologist, Marsha Linehan in the 1980’s. Although it was originally developed to treat individuals with borderline personality disorder who were chronically suicidal, research has shown DBT is also effective for a variety of other mental health disorders including substance use, anxiety and eating disorders.

The goal of DBT is to provide patients with the skills necessary to regulate emotions, control self-destructive behaviors and improve interpersonal relations. Dialectical refers to integrating opposites; in this case it is finding balance between acceptance and change. Some people experience difficult situations in life and move forward with life despite the hardships. Others experience similar situations and feel intense negative emotions and don’t fully accept their reality. DBT helps a person accept distress in life by providing them with the tools to make positive behavioral changes in order to feel at peace with their reality.

There are five core modules to DBT: Mindfulness, Emotion Regulation, Interpersonal Effectiveness, Distress Tolerance and the Middle Path. Learn more about DBT.

Psychodynamic Therapy
Psychodynamic therapy focuses on the thoughts that exist in a person’s unconscious mind. It stems from Freudian psychoanalysis, which says behavior is affected by the unconscious mind and unresolved conflicts from the past. The goal of psychodynamic therapy is to find the root cause of the psychological problems. During the session, patients freely talk about any thoughts and feelings that come to mind. As the person does so, the therapist helps identify behavior patterns and feelings that have manifested in the unconscious mind over the years. Once these thoughts and behaviors are uncovered, the therapist helps the person understand how the patterns are affecting their life today and work with them to develop coping mechanisms.
Psychodynamic therapy is often a longer-term treatment; it can go on for over a year in some cases. It is helpful for treating depression, anxiety, panic and post-traumatic stress disorder. Learn more about psychodynamic therapy.

Interpersonal Therapy
Interpersonal therapy (IPT)  focuses on a person’s relationships. It was originally developed to treat depression, but has been modified to treat other conditions including, anxiety, eating disorders, addiction, bipolar disorder and post-traumatic stress disorder. The belief is a person’s mental illness improves when they strengthen the relationships with the people in their life; it helps build a support system. Unlike other approaches, IPT focuses more on the present situation. Past experiences are discussed, but they aren’t the main focus. The therapist helps the patient identify the source(s) of their emotions and come up with ways to better express them. Learn more about interpersonal therapy.