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Psychotherapy

Psychotherapy

"What are the best types of psychotherapy?" I was asked a few weeks ago.

It's a loaded question, that's for sure. The answer is going to depend on who you ask and what their experience is. Given that there are LOADS of good psychotherapy systems, I decided to write a blogpost detailing a few of the popular ones.

What is psychotherapy? How many types are there?

This may irritate those of you who like a good, solid definition (me), but there isn't actually one definition for what psychotherapy is that's garnered itself universal acceptance.
Psychotherapy- this is why we can't have nice things!

But how can you define something that has over 500 (and growing) distinct variations?

Anyway, here's my go:

Psychotherapy:
- a fancy word mashup of 'psychological' and 'therapy'
- therapeutically using psychological (mental/emotional/cognitive/behavioural/+sometimes biological) techniques to help/assist a client in a way that the client AND the therapist agree is reasonable and desirable.
- Is informed by reputable, credible, and sensible theories and/or evidence (typically by trained professionals like psychologists and researchers)
- Follows legal/ethical principles and parameters
- Difficult to spell

How'd I do? Knowing that someone out there full-heartedly disagrees with me, I have copied Health Direct's definition below:

"Psychotherapy is a group of therapies provided by a psychologist, counsellor or psychiatrist. Psychotherapy, also known as or psychological therapies or talk therapies, explores your feelings, thoughts and behaviours that are distressing you and to work towards changing these. It can be used by people with mental health conditions, and it can also be used by people who want to understand themselves better."

Now, let's(s) move on.

Why are there so many?

To keep a long story short (and to get to the guts of this blogpost): different strokes, different folks.

It takes all kinds of people to make a world, and it takes all kinds of therapy to make a (good) world-of-therapists

Bottom line: it's a good thing!

What are the ones I should know about/might hear of?

It's been hard for me to decide which ones to talk about here. There are so many brilliant psychotherapies! However, I think these guys are the ones that seem to be all the buzz at the moment:

  • 1.Cognitive- Behavioural Therapies (CBT)
  • 2.Dialectical Behaviour Therapy (DBT)
  • 3.Acceptance and Commitment Therapy (ACT)

CBT

CBT is essentially a mash-up of Cognitive Therapy (CT) and Behaviour Therapy (BT), hence the name. There's actually more than one type of CBT, given there's plenty of separate Cognitive Therapies and Behaviour Therapies… But, essentially, they all mix:

  • -The ~Cognitive~ side: like recognising 'dysfunctional' thoughts ("I am either all good or all bad", "I really should have done/said/thought…", "Everything bad always happens to me!"), and strategies to cope with them, like thought stopping, treating them as hypotheses instead of facts, and substituting other thoughts.

  • -And the ~Behavioural~ side: often based in learning-theory (how people learn). This can include uses like: helping people engage in behaviours to lose weight, quit smoking or drinking; or other lifestyle changes; or even helping people modify behavioural responses when triggered by a traumatic memory, for example.

CBT has garnered a lot of empirical evidence and scientific attention. Practically, CBT is often time-limited to around 8-12 sessions. If you'd like to know more about CBT, try here: https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral (the American Psychological Association's description).

DBT

You're already familiar with BT (Behaviour therapy), but what does Dialectical (D) even mean?

"Dialectical" sounds like a really nonsense word, but that's just because it comes from really old words like dialegesthai and dialectica from Greek and Latin languages. Its meaning has evolved from:
to converse and the art of debate
to now meaning something along the lines of:
the art of investigating seemingly opposing truths.

In DBT, those seemingly opposite truths are the need for acceptance and the need for change.

Acceptance skills:

  • -Mindfulness skills
  • -Distress Tolerance skills

Change skills:

  • -Emotional Regulation
  • -Interpersonal effectiveness

DBT is can be helpful to people living with Borderline Personality Disorder, chronic suicidal ideation and/or behaviour, as well as those with substance use disorders; but DBT can be helpful for many other people, too.
Practically, DBT is often 12-24 weeks, and involves both individual and group therapy. If you'd like to know more about DBT, try here: https://www.sane.org/information-stories/facts-and-guides/dialectical-behaviour-therapy-dbt (the SANE Australia explanation).

ACT

Acceptance and Commitment Therapy has 6 central tenets.

  • 1.Mindfulness
  • 2.Defusion
  • 3.Acceptance
  • 4.The Observing Self
  • 5.Values
  • 6.Committed Action

This is already a very long blogpost, and though I would love to walk you through each one of these, I'm just going to focus on a few here. Let's start with Defusion.

Fusion is when two things fuse together (like when welding metals together). Cognitive fusion is just like that.
For example: if I say Lemon, you may think of sour, yellow, or the-less-good-version-of-lime (just me? Ok). This is to say that the word Lemon has been fused (joined together) with other words & meanings. These meanings are often different for different people (like how you probably didn't think Lemons are just overhyped Limes… but I did).

Engaging in Cognitive Defusion in ACT would include acknowledging that these fusions/ associations we have between ideas/words/emotions are not necessarily real, but that they often just come from experiences we've had.
For example: If being in an enclosed space is associated with anxiety, panic, fear, looming sense of doom, a psychotherapist using ACT would help you to de-fuse these connections.

Values and Committed Action are also important in ACT. Take a moment to think about what you value.

Committed action essentially refers to acting in accordance with those values (even when it's hard). We can use these values to make going through life easier, using them like a compass to help guide our decisions.

If you'd like to know more about ACT, try here: https://www.actmindfully.com.au/about-act/

What now?

Did anything I mentioned above make you go "Yes! I click with that!" ? Completely understandable if not. There's over 500 different types of psychotherapy, and I've only briefly described three…

Something you can do from here is find a psychotherapist, counsellor, psychologist, or other qualified professional who uses the kind of psychotherapy you think could help you. Try searching for a psychologist here: https://www.psychology.org.au/Find-a-Psychologist , or a counsellor here: https://www.theaca.net.au/find-registered-counsellor.php to start.

If you want any more information on psychotherapies, let us know! There are so many I couldn't cover in this blogpost. Let us know if you want more, and what you think :) 

(Image from Unsplash by Priscilla Du Preez)

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