Therapy is a wonderful resource for people living and thriving with behavioral health conditions. However, it can be hard to know what kind of therapy is right for you. With hundreds of practices and specialties, finding the right therapy for you involves a lot of trial and error.
This blog post is a tour through some of the most common modes of therapy and treatment for behavioral health conditions. This list is by no means exhaustive; however, it is our hope that this information will be helpful to those of you seeking therapeutic care.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy is a short-term behavioral therapy that focuses on the way we process our thoughts. In other words, CBT aims to help people regain their confidence in challenging their patterns, both emotionally and behaviorally. The basis of CBT is that our thoughts and perceptions guide our behaviors, and through CBT we learn how to become aware of these processes without judgment.
A pillar of this form of therapy is awareness of cognitive errors and distortions. Through a process called cognitive restructuring, we can change our thoughts and thought patterns to be more constructive and less destructive. CBT involves a few main activities and techniques:
- Journaling
- Challenging beliefs
- Mindfulness
- Relaxation
- Social, physical, and thinking exercises
If you’ve been to therapy for any length of time, chances are you have been in CBT – insurance companies usually accept this kind of treatment because it is short-term, highly logical, and has been shown to be effective for many different people. However, CBT is largely focused on the present. Though this practice can be trauma-informed, the focus of CBT is on changing and accepting our thought processes in the present rather than revisiting trauma from the past.
There are many offshoots of this type of therapy, most notably Dialectical Behavioral Therapy.
Dialectical Behavioral Therapy (DBT)
Dialectical Behavioral Therapy is a more comprehensive, in-depth treatment plan that was developed to help those for whom other models of therapy have not been successful. Originally designed to treat those with severe and chronic mental health conditions, DBT treats self-harm, eating and food issues, addiction, post-traumatic stress, as well as borderline personality disorder. Like CBT, DBT finds its focus in problem-solving and acceptance – however, DBT offers a much more robust treatment protocol than CBT. DBT exists within a framework of dialectical methods – the term dialectical meaning the process that brings two opposing concepts together, such as acceptance and change.
DBT functions from three frameworks and perspectives: the biosocial model of chronic mental health conditions, the philosophy of dialectics, and Zen Buddhism. The biosocial model suggests that some people are born with heightened emotional vulnerability, which can lead to chronic behavioral health conditions. Mindfulness and Zen Buddhism are used to help the patient or client stay present and connected to their body, and dialectics help both the practitioner and the patient pull from both polarities of an issue.
DBT often involves:
- Capability enhancement
- Generalization
- Motivational enhancement
- Capability and motivational enhancement of therapists
- Structuring of the environment
Rational Emotive Behavior Therapy (REBT)
Rational Emotive Behavior Therapy (REBT) was first developed by Albert Ellis in 1955 and laid the foundation for what is now known as Cognitive Behavioral Therapy (CBT). REBT relies on rational thinking to facilitate healthy emotional processes and address behavioral and emotional issues. Early in life, we develop core beliefs and thought patterns about our lives, our selves, and the world around us. REBT seeks to disrupt these patterns, training the brain to reshape its pathways to form more constructive frameworks for the events of life.
The three guiding principles of REBT are the “ABCs”:
- Activating (or Adverse) Event
- Beliefs
- Consequences
These guiding principles help a client or patient identify their negative core beliefs and thought patterns, revealing the frameworks they are using to make judgments about their lives. REBT is all about rewriting our neural pathways to promote more constructive perspectives. With time and effort, REBT can help a person identify and address the negative core beliefs that are causing distress.
Cognitive Processing Therapy (CPT)
Cognitive Processing Therapy (CPT) is a cognitive behavioral treatment that focuses on helping those who are “stuck in their thoughts” in the wake of a traumatic event. Often used to treat PTSD, CPT is thought to be beneficial for challenging thoughts and beliefs about the world that stem from trauma. CPT identifies “stuck points” for clients and patients – places in cognitive processing where trauma has deeply affected the way a person thinks and sees the world.
During CPT, your therapist will guide you through discussions about your symptoms, educate you about the psychotherapeutic process of CPT, and offer you a safe place to engage with your trauma responses. Next, you will work with your therapist to become aware of your thoughts and feelings surrounding specific traumatic events. CPT uses cognitive restructuring skills to help a client or patient safely reprocess their trauma. CPT providers will focus on the following areas and work to rebuild positive associations in the brain:
- Esteem
- Intimacy
- Power or control
- Safety
- Trust
CPT is highly structured, with sessions occurring weekly for 12 weeks or more. You will write an impact statement at the beginning and the end of your sessions, then compare them to see the way your cognitive processing has evolved. This model of therapy is used most commonly to treat PTSD and other trauma-associated conditions.
Internal Family Systems (IFS)
Internal Family Systems (IFS) is a model of psychotherapy that uses Family Systems theory to develop and address a person’s internal community. Family Systems theory suggests that every person is made up of “sub-personalities” and parts that make up a larger internal community. IFS seeks to reveal these parts and “sub-personalities” in order to allow a client or patient to feel more connected to themselves. In IFS therapy, you will work to identify how each of these parts and sub-personalities are working together (and sometimes working against each other) to form the self. This allows the client or patient to address inner conflict.
Each internal part and personality has their own dislikes, likes, fears, and wants – the goal of IFS is to learn how to identify and integrate these parts. Within IFS, there are four distinct personalities:
- Managers
- Exiles
- Firefighters
- The Self
The Self is separate and distinct from the other parts, and functions as the coordinator of all the separate internal personalities. With consistent work, IFS helps to restore trust and heal deep emotional wounds that exist within the internal family system. When all the internal family members are validated, experienced, and healed, the Self can harmoniously coordinate the inner world.
Acceptance and Commitment Therapy (ACT)
Acceptance and Commitment Therapy (ACT) uses mindfulness techniques to help a person align their behavior with their core values. Participants of ACT observe the ways in which they try to control, suppress, or otherwise change their emotional experiences. ACT is all about acceptance of these experiences – when we try to change what we are experiencing, it often creates challenges behaviorally and emotionally. ACT can help a person to accept their emotional experiences and develop coping skills based in mindfulness.
Under the ACT model, our experiences of distress are not symptoms or problems – rather, they are just natural byproducts of our complex lives. ACT promotes a perspective of openness towards all of life’s experiences, including the emotionally difficult ones. ACT relies heavily on accepting things as they come. Rather than try to change or adjust negative thought patterns, ACT teaches that having a compassionate, loving attitude towards yourself and your thoughts can be helpful in managing distress.
ACT posits that when we remain open and compassionate to our experiences, we are then able to take action based on our values. Values are one of the key components of ACT – identifying personal value systems and then moving towards action that aligns with those values.
Somatic Therapy
Somatic therapy uses the connection between the body, the mind, and the spirit to heal emotional wounds and address behavioral health conditions. Rather than treating distress through the mind, somatic therapy treats the mind through the body – using techniques like movement and dance therapy, breathwork, meditation, and similar modalities, somatic therapy addresses distress from a body-centric perspective.
This type of therapy focuses on how and where the body holds chronic stress, working to release and let go of that tension. Somatic therapy uses a wide range of tactics to achieve mind-body positivity and acceptance, including:
- Sensorimotor psychotherapy
- The Hakomi Method
- Bioenergetic analysis
- Biodynamic psychotherapy
- Brainspotting
Narrative Therapy
Narrative therapy is a mode of therapy that encourages people to become experts in their own lives. This type of therapy explores the stories that we tell ourselves and others about who we are. Participants in narrative therapy examine the meaning that they make out of life events. What stories do we carry with us about the world around us? How do those stories shape us and our experiences?
Narrative therapy is a collaboration between the provider and the client or patient. The client brings their stories and the provider helps to sort the narrative into themes. By considering alternate stories and narratives, this type of therapy encourages participants to widen their perspectives. Narrative therapy can be helpful for anyone with entrenched beliefs or low self-esteem.
Here are some of the key concepts of narrative therapy:
- Respect
- Non-blaming
- The client is the expert
Eye Movement Desensitization and Reprocessing (EMDR)
Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based, research-supported practice used to treat those with trauma conditions and PTSD. EMDR sessions follow a specific structure. This model of therapy can be useful for any adverse experience, and often uses bilateral stimulation to aid the client in processing difficult memories.
The theory behind EMDR is the adaptive information processing (AIP) model. This theory posits that adverse or difficult life experiences may remain unprocessed due to the distress that the event or trauma created. EMDR seeks to revisit stored memories of traumatic events to allow for the patient or client to reprocess those memories in a safe and structured environment.
EMDR has been extremely effective in helping people resolve or address deeply embedded trauma. Working with an EMDR practitioner, patients or clients will go through a number of phases in their sessions. These phases include:
- History taking
- Preparation
- Assessment
- Desensitization
- Installation
- Closure
- Reevaluation
The goal of EMDR is to create new neural pathways and associations to alleviate the symptoms of distress. Most EMDR therapies have proven to be very effective, with nearly 100% of PTSD clients reporting lessened symptoms after six sessions.
If you would like to learn more about the many different models of therapy, please click here.
Additional Sources:
What is Brainspotting? – Viva Center (vivapartnership.com)
What is EMDR? – EMDR Institute – EYE MOVEMENT DESENSITIZATION AND REPROCESSING THERAPY
Types of Therapy | Psychology TodayTypes of Therapy | Psychology Today
