I initially trained to work as an Integrative Psychotherapist, and more recently as an ACT therapist. Many people won't get a great deal from reading that sentence, and if that was how you felt after reading it, hopefully the following will be useful!
The term 'psychotherapy' covers a variety of approaches to therapy, often described as 'talking therapies', helping people when they wish to make changes in their lives. They aim to help people gain insight into their problems or distress, then to develop skills and resources to cope, to become motivated, and to bring about change. Clients can explore their thoughts, feelings and life events within a safe, confidential environment, and with the help of a trained psychotherapist.
Sometimes there seems to be a bewildering variety of types of psychotherapy, hopefully the following information will help you to become orientated to the different approaches. However, please bear in mind that it's just a brief outline of basic distinctions, along with the answers to some frequently asked questions.
Psychotherapy approaches are often divided into four broad categories:
Humanistic (or Person-Centred),
Cognitive Behavioural Therapies (CBT),
Integrative (or Eclectic), the latter being some form of integration or combination of the others.
To summarise some of the key aspects of each approach: Psychodynamic therapy tends to be longer term, exploring the past, in particular childhood experiences. Humanistic approaches concentrate on the 'here and now' experiencing within therapy, which works with key elements of the therapeutic relationship to bring about change in the client. CBT focuses upon bringing about future changes, and tends to be more directive and therapist-led, with attention paid to making change over and above gaining insight into deep-rooted issues.
Psychodynamic therapy: The name refers to the dynamic of an active psyche, both an internal dynamic, (how the 'parts' of the mind relate) and an external dynamic, (how people relate to others and the world around them). This is a therapeutic process that works at depth, using an extensive theoretical model with a focus on childhood development, which can be used to explain the onset of psychological and relationship problems. This is then used to provide the client with the necessary insight and ability to cope. Although there are now a wide variety of psychodynamic approaches, including some short-term therapies, most are considered long-term.
Humanistic (Person-Centred) therapy is most closely associated with the work of Carl Rogers, who defined a set of conditions required for therapeutic change. The focus is upon the 'here & now', with less attention paid to developmental stages of life. The approach focuses attention upon the world of the client, over and above therapeutic techniques or theories, always accepting the uniqueness of each individual and their experiences. This uniqueness and the complexity of personality means that attempts to label or diagnose will always fall short, and are thus avoided. The result is a therapy which does not categorise people or their problems, nor does it offer 'text book' solutions. Both factors make research work difficult, as researchers need to ensure the client's problems fit within a particular definition, or that specific techniques and interventions are employed by the therapist.
Cognitive Behavioural therapy (CBT) developed from Behaviourism and Cognitive psychology; having a research-based background in psychology, CBT is an evidence based model, making it popular with health service providers such as the NHS. CBT therapists seek to help clients identify thoughts and behaviours that are unhelpful in their lives, and then to bring about change in these areas. Often involving homework for the client, CBT contains a strong element of psycho-education, where the therapist has knowledge and expertise to share with the client, in contrast to humanistic therapy where the therapist considers the client to have the required resources, accessed in therapy via the therapeutic alliance. CBT therapists do not tend to work with the unconscious drives or defences that are the focus of psychodynamic work, but instead bring attention to thoughts which are readily available to consciousness, but which may be on the edge of awareness, and tend to be accepted without question. It's worth bearing in mind that the term 'CBT' covers a wide range of therapies, rather than being one particular therapy, and there is a tremendous variation between these different types; how they're presented, undertaken or experienced. The latest 'wave' of CBT therapies include 'mindfulness-based' therapies such as Acceptance and Commitment Therapy (ACT), which can be fundamentally different to previous forms of CBT. Please use the link at the top of the page to read more about ACT.
Integrative/Eclectic therapies; the distinction between these descriptions has become blurred, and they are often used interchangeably, with integrative becoming more widely used. An Integrative therapy combines several other approaches to create a new approach with it's own theoretical model. Alternatively, an integrative therapist has trained in the use of more than one approach, and can use whatever is most suitable for their client's needs.
Whilst these brief outlines may be of help, they are only a starting point when deciding on therapy. It's worth bearing in mind that research into the efficacy of psychotherapy has shown psychotherapy does work, but it has also consistently suggested that in general usage there is little difference in how efficacious different psychological therapies are. In fact research suggests that the most important factors are the quality of the relationship that the therapist and client establish, and certain factors relating to the client or therapist.
Frequently Asked Questions:
Can Psychotherapy help me?
Psychotherapy has helped people deal with many difficulties and problems in life, including: Anxiety, stress, low self-esteem, lack of confidence, depression and sadness, mood swings, relationship problems (making, sustaining, or patterns of destructive relationships), grief and bereavement, eating disorders, obsessive behaviour, phobias and fears, panic attacks, addiction, sexual problems.
The quality of the relationship between the therapist and client is a major factor in successful therapy, so choosing a therapist you can trust and feel confident to work with is important.
What is the difference between psychotherapy and counselling?
Historically, psychotherapy was long-term, as was the training required for qualification, it was also generally considered to be able to help with a wider range of problems. However, the boundaries have become blurred, to the extent that the words are often used interchangeably: The same theoretical models may be employed, and the same problems may be alleviated. As a result, sometimes the most obvious distinction may come from the qualification that the practitioner has gained. Currently, several of the professional bodies in the UK are working to produce clear guidelines on the roles of psychotherapists and counsellors, which may create more clearly defined boundaries in the future.
Is psychotherapy confidential?
Yes, client confidentiality is taken very seriously. Everything within the psychotherapy relationship is considered to be confidential, although there are a few specific legal and health-related exceptions to this. Professional bodies require psychotherapist's to work with supervision throughout their careers, however supervisors are bound by the same rules of confidentiality. The need for confidentiality is why professional bodies for psychotherapists will usually prohibit the use of client testimonials. (More information on confidentiality and disclosure can be found on this page).