URMC / BHP / BHP Blog / February 2021 / Psychotherapy 101

Psychotherapy 101

By: Sara Hanson, BSW

Psychotherapy is the process of providing psychological treatment, sometimes referred to as "talk therapy". Psychotherapy can be used on its own or paired with medication to treat a variety of issues, like depression, anxiety, or stress. As with medication, a person may respond better to one type of therapy than another, so it can be helpful for individuals to know the options that are available when seeking help. You many find a psychotherapist who is trained in more than one method of treatment, while some methods require more specialized training, certification, or a support structure that some individual practitioners may not be able to provide. Having an idea of your treatment goals, or what you are hoping to get out of therapy, will help you to identify a good therapy match. Multiple treatment options can be overwhelming if you are already struggling. This article is meant to aide in the basic understanding of the more common, evidence based treatments available in psychotherapy today.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy focuses on the relationships between thoughts, feelings and behaviors. Negative thoughts can cause an increase in emotional distress and behavioral problems. During CBT, a therapist will work with their client to uncover unhealthy patterns of thought and how they may be negatively impacting behaviors and beliefs. The client is an active participant in a process to test and challenge negative thought patterns and to create changes in behavior related to those thoughts. Along with therapy sessions, a client may be given worksheets to do in between sessions to practice skills or log their thoughts and feelings. Cognitive behavioral therapy is widely supported in research studies for a variety of mental disorders, and many mental health professionals are trained in this model, making it effective and accessible for most clients.

Dialectical Behavioral Therapy (DBT)

Dialectical behavior therapy was originally developed to treat borderline personality disorder (BPD). Over time, DBT has been adapted to treat people with multiple different mental illnesses, such as major depressive disorder. DBT is based on similar principles to CBT, but focuses on skill building to assist in the management and acceptance of uncomfortable thoughts, feelings and behaviors. The therapist works with their client to balance this acceptance with coping and change-oriented strategies. Skill building is the foundation of DBT treatment. These skills include mindfulness practices, interpersonal effectiveness, and distress tolerance. Similar to CBT, clients are asked to practice and complete homework between sessions. Standard DBT treatment includes weekly individual therapy, weekly group skills training, and a therapist consultation team.

Eye Movement Desensitization and Reprocessing Therapy (EMDR)

Eye movement desensitization and reprocessing therapy (EMDR) is used to treat post-traumatic stress disorder (PTSD). During therapy, an individual stimulates the brain with back and forth eye movements while simultaneously recalling a traumatic event. This dual processing reduces the negative emotional reactions or side effects related to difficult memories. Additional benefits of this form of treatment are that a client is not required to verbalize their traumatic event or complete homework that includes a description of their experience. A number of studies support the use of EMDR in the reduction of emotional distress and negative symptoms that stem form traumatic memories and experiences.

Cognitive Processing Therapy (CPT)

Cognitive processing therapy (CPT) is another treatment for post-traumatic stress disorder. It is a short term, about twelve sessions in length, and combines cognitive therapy with written accounts of the traumatic event to reduce symptoms. A primary goal of CPT is to help clients who have developed negative or inaccurate thought patterns due to their traumatic event. Examples of these thoughts include excessive guilt, self-blame, or hypervigilance. Trauma focused therapy is supported by research findings that reveal a reduction in these negative thought patterns after treatment completion.

Exposure Therapy

Exposure therapy is a type of cognitive behavioral therapy that frequently used in the treatment of obsessive-compulsive disorder, post-traumatic stress disorder, and phobias. In Exposure Therapy, clients work to confront the trigger of their symptoms in a safe environment in order to develop coping skills and strategies for managing them. This treatment can be done in different ways, with reducing sensitivity to the trigger being a primary goal to help improve stability and overall function.

Interpersonal Therapy (IPT)

Interpersonal therapy focuses on how relationships and interpersonal experience impact mood. In IPT, the therapist helps the client work through social interactions to recognize negative patterns, while assisting them in gaining strategies for understanding and interacting positively with others. Research shows that depression can be caused by a negative change in relationships, such as the loss of a loved one, end of a relationship, or even the physical distancing that happens when someone moves or becomes ill. Depression can also be the catalyst of relational issues, as a common side effect of depression is the lack of interest or pleasure in doing things we normally enjoy doing. Whether life events follow or precede mood changes, the patient's task in therapy is to resolve the disturbing life event(s), building social skills and helping to organize his or her life.

Psychodynamic Psychotherapy

The goal of psychodynamic therapy is to identify negative patterns of thinking and behavior that are rooted in past experiences. The focus is on reflection, examination, and using the relationship between the therapist and client to work through troublesome relationship patterns in the client’s life. The therapist works with the client to find links between unconscious patterns of negative thinking or behavior with past experiences and unresolved feelings.

Acceptance and Commitment Therapy (ACT)

ACT is used to increase awareness to difficult experiences, how they are negatively impacting a client in the moment, and to facilitate behavioral changes based on the client’s core values. Rather than trying to control how an individual thinks about their thoughts and feelings, ACT aims to help individuals change their relationship to these experiences. Research has found ACT to be effective in treating mental disorders such as depression and anxiety, as well as physical health problems like chronic pain.

Solution Focused Therapy

Solution-focused therapy is a strengths-based approach, emphasizing the resources and strengths an individual has and how they can be used to affect change. A therapist works with the client to identify these resources by discussing times when the problem was not causing so much disruption, or when the client has coped successfully with similar problems. In solution-focused therapy, clients are encouraged to find the solutions that fits their life and worldview, as they are the expert in that area.

While Behavioral Health Partners does not offer all forms of psychotherapy, we are able to assess and provide support while getting you connected to the treatment you need.

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References

https://www.nami.org/About-Mental-Illness/Treatments/Psychotherapy

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3584580/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2756751/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5769281/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4471961/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3951033/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2963469/

https://bpded.biomedcentral.com/articles/10.1186/s40479-019-0102-7

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414693/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4454449/