Theoretical Approaches to Therapy

When asked about theoretical orientation, many therapists respond that they are “eclectic.” This essentially means that the therapist will tailor his or her approach to meet the needs of the individual client.

While this seems like a good idea, there is so much to know about any one type of therapy that it’s unlikely for any one therapist to know enough about them all to utilize and integrate them into a cohesive and useful tool. More often than not, the “eclectic” therapist has a primary therapeutic technique that is not strictly adhered to and which has been modified to include tools from other schools of thought. If random techniques are thrown together — haphazardly and without thinking — therapy can become an meandering process where neither the therapist nor the client knows where things are going. This can be very frustrating.

It may be important for you to talk with your therapist about his or her theoretical orientation and for you to understand the basic beliefs in that type of therapy. Listed below (in alphabetical order) are brief summaries of a few types of common therapeutic approaches.

Behavioral Therapy

In general, behavioral therapies rely on a fundamental belief that we learn how to be, and what to feel, through our life experience. In this type of psychotherapy, the primary concern is to evaluate your behavior, to define a set of problems that come from this behavior, and to select goals for behavioral change. In the process of this therapy, you may be encouraged to do “homework,” behavioral experiments, or role-playing. The therapist will likely take an active role in your sessions and the two of you will focus on your behavior and its attendant consequences. When the behavior in question is sufficiently changed, the process of therapy is concluded. Generally, behavioral therapy is shorter term.

Cognitive Therapy

Any therapy that is based on the idea that our thoughts are directly connected to how we feel is loosely defined as cognitive therapy. In this type of therapy, the emphasis is generally on solving present day problems though the identification of thoughts that cause emotional discomfort. Most often, there is little if any attention paid to the historical “root” of your problem as the focus remains in the “here and now.” Cognitive Therapies generally tend to be of shorter duration.

Collaborative Therapy

In this type of therapy, both the client and the therapist are “experts.” Clients are experts on their lives and their experiences. Clients know what they’ve been through and what it felt like to go through it. Clients are also familiar with what they’ve tried to do in order to resolve their concerns — they know what has not worked, what has worked, and what might work in the future. Therapists are experts at creating a context which facilitates positive change, using warmth, unconditional positive regard, empathy and careful attention to validate the client’s experiences and, simultaneously, explore possibilities for change.

Psychoanalysis

In this long term process, the focus is uncovering and analyzing the “root” cause of emotional discomfort and its associated behavior. This is done by exploring the unconscious mind and the conscious mind’s relation to it. Here, “free association,” dreams, and transference are utilized to help the client discover their own mind. Sigmund Freud is the most well known psychoanalyst though many other theories and therapies have arisen from this theory.

Relational Therapy

There are many types of relational therapy, though in general these are based in the belief that we are all “becoming more” and we are all moving toward self-actualization. In this type of therapy, the therapist is responsible for providing the conditions that are necessary for the client’s growth. Often, these conditions include genuineness, unconditional positive regard, and empathic understanding. For the therapist, there is no hiding behind degrees or expertise and there is a true appreciation for the client and who he or she is in the present moment.