Chapter 5: Psychotherapy Treatment Approaches
A treatment approach, or theoretical orientation as they’re sometimes called, is nothing more than a set of ideas about what makes people tick and how they change, and a set of techniques for helping people make those changes.
The last time anyone bothered counting them, there were more than 250 treatment approaches in all. By now, there are certainly many more. In fact, there are almost as many treatment approaches as there are therapists. This chapter will explore some of the most commonly available approaches available today.
Art therapy is based on the idea that the creative process can help you express emotions, work through traumatic experiences, manage stress, gain insight into how you interact with others, and enhance your self-awareness.
In this form of treatment, you are encouraged to engage in drawing, painting, sculpting, or photography. Your therapist guides you through the process and helps you explore the thoughts and feelings expressed through the art you create.
Art therapists believe that people can share ideas through visual art that they may find difficult to share in words. For this reason, you may be asked to complete art-based assessments designed to help your therapist learn about your feelings, problems, and personality.
In addition to what you learn about yourself through art, you may find the act of expressing yourself creatively therapeutic in itself.
Don’t avoid art therapy because you think you lack talent. Art therapy is not an art class. Your therapist works with people of all skill levels, and is not concerned with judging the technical merit of your work.
People of all ages can benefit from art therapy. Some art therapists report great success in using these techniques with older adults and even entire families.
Art therapy is most commonly practiced in agency settings, but can occasionally be found in hospitals, clinics, nursing homes, schools, and private practices.
You probably won’t be surprised to learn that this kind of therapy focuses on your behaviors. According to the behavioral approach, the best way to change your thoughts and feelings is by changing your behaviors.
Suppose you were seeking therapy because you have a crippling fear of dogs. Your therapist won’t ask you about your early experiences with dogs or probe for the unconscious roots of the problem. Instead, you’ll start gathering data and applying techniques to extinguish the fear.
Behavior therapy emphasizes the use of proven techniques designed to break the chain between unwanted behaviors and the triggers and reinforcers that maintain them.
In the example mentioned above, your therapist may begin by asking you to rate a variety of dog-related experiences in terms of how anxious they make you feel. You will then be taught relaxation techniques and asked to practice them while you’re exposed to increasingly anxiety-provoking situations until eventually, you can pet a dog without much anxiety.
This approach adopts a scientific viewpoint, but don’t make the mistake of assuming that all behavior therapists are cold, uncaring people in white lab coats.
Behavior therapy is practiced in hospitals, clinics, community agencies, school-based programs, and private practices. Because it is highly structured and time-limited, you may find that your insurance company is especially willing to reimburse for behavior therapy.
You’ll find that the cognitive-behavioral approach shares certain ideas and techniques with behavior therapy, but its primary focus is on thinking rather than behavior. This approach holds that your feelings are not caused by external events, but by your thoughts about those events.
Suppose a friend compliments you on your appearance. If you think, “That was nice of her. I guess I do look pretty good today,” you’ll probably feel happy and grateful. On the other hand, if you think, “She’s just saying that because she’s my friend. I look terrible,” you’re likely to feel sad and resentful.
Since your thoughts influence your feelings, persistent patterns of negative thinking can cause emotional and psychological problems. Cognitive-behavioral therapy teaches you to take charge of your feelings by taking charge of your thoughts.
Your therapist will start by helping you identify your thoughts and explore how they influence your feelings. Eventually you’ll learn to dispute negative thoughts and replace them with more helpful ones.
Cognitive-behavioral therapy is currently one of the most popular forms of treatment available and is commonly practiced in almost any setting.
You might also hear about rational-emotive behavior therapy, cognitive therapy, or dialectical behavior therapy. These are different “flavors” of cognitive-behavioral therapy, but they are all based on the same core ideas.
You’ll find that some therapists don’t identify with any single theory. Instead, they pick and choose ideas and techniques from multiple approaches. They may identify themselves as eclectic or integrative.
This can be a very effective approach, but it creates a challenge for potential clients. You may appreciate a therapist’s eclecticism but still want to get some idea of what therapy will be like before you make a decision.
Fortunately, most eclectic therapists are more than willing to share their ideas and talk to you about how they work. Just ask.