Types of Psychotherapy

What are the different types of psychotherapy?

While there are hundreds of schools of psychotherapy, they can generally be organized into a few major approaches. I’ve listed these below with a brief explanation about their defining characteristics. For clarification I have also included an example of a problem and how each form of psychotherapy might solve it.

• Cognitive Therapy – focuses on thoughts and how they affect emotions. The goal is to change the harmful thoughts that lead to our feeling bad or acting in unproductive ways. By thinking differently we can feel better and act in ways that meet our goals.

◦ Example: Lena has frequent panic attacks. Each time she feels a fluttering in her chest, she worries that she might be having a heart attack. Her anxiety then leads to rapid breathing, sweaty palms, and nausea. She interprets this as further “proof” she is having a heart attack and the cycle escalates. In Cognitive Therapy she and her therapist examine these thoughts. They help her replace her misperceptions with more accurate thoughts about her mind and body. This allows her to stop her Panic Attacks before they get started.

• Behavior Therapy – looks at what we do and how this affects us. Seeks to find ways of acting that will lead to better outcomes in terms of an individual’s emotions and goals.

◦ Example: James is lonely because his shyness prevents him from taking part in normal social interactions. Working with his Behavior Therapist he practices social skills that allow him to feel more comfortable with others. Next he practices these in situations where he feels minimally uncomfortable until his anxiety starts to decrease in those circumstances. He gradually approaches more and more difficult situations until he is able to interact socially with a minimal degree of anxiety.

• Psychodynamic Therapy – addresses internal conflicts and patterns of relating. People frequently practice the same patterns of interacting with others, even when those patterns don’t work very well. Psychodynamic therapy helps people change by looking at what is happening not only in the person’s life outside of therapy, but how they are interacting with the therapist him- or herself. By examining this, the therapist and patient work together to find different patterns that will lead to more healthy relationships.

◦ Example: Jenna is alone in her late thirty’s. She has been unable to find a satisfying long-term relationship. She finds that everyone is either critical of her or “a loser.” In trying to problem solve this situation, the therapist notices that Jenna is very critical of all of his suggestions. She avoids making suggestions of her own, because she doesn’t want to get “shot down” by the therapist. By examining these expectations the two are able to recognize Jenna’s pattern of assuming others will attack her and subconsciously attacking them as a way of protecting herself. Working through this with the therapist allows her to have relationships with others without misinterpreting them as attacking her or seeing them in a critical light.

This is a highly simplified overview of these approaches. Although listed separately, in reality, many therapists practice a combination of different methods. It will be helpful for you to talk to your therapist early in treatment about what their approach is. That way, the two of you can be sure you are on the same page.

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[Nicholas Schwartz, M.D.] [Contact Dr. Schwartz]