Types of Therapy

By Megan Jane, Featured Writer.

‘Time’ is a word that I am hearing a lot of at the moment when speaking with clients at work. Whether it be, “I have more time to think”, “I feel it is time to get support”, or “I didn’t have the time before”. One thing that this strange period has given everyone, in some way, is time. My current role is to complete mental health assessments and then recommend a treatment plan - the majority of the recommendations that I provide are for a form of talking therapy - and the majority of people that I provide a referral to are not entirely sure of the different types of therapy, or what the aims of different therapies are. And this is okay - why would people know this? I love it when people ask questions about their referral and want to know more. It’s not your job to know the different kinds of therapy available (it’s mine!), but I do think that it may be helpful to know of the many different types of therapy available. Therefore, I have collated information below on some of the talking therapies available, what they are, and what the aim of that therapy is.

Please know that the below is only a selection of therapies that can either be accessed through the NHS and/or funded privately. Please always use your GP as the first point of contact regarding therapy, and I would strongly recommend that if you are looking to privately fund therapy that you search for the practitioner in professional registers such as the HCPC, BACP and RCPsych.  

Counselling:

Counselling is a form of talking therapy that tends to be one to one where the professional is there to listen and support you in exploring what has impacted your wellbeing. Counselling can help explore difficulties such as divorce, bereavement, work stress, depression, fertility and many more. As mentioned, counselling is one to one, but there is also marriage and family counselling - this is where all members are included in the therapy session, and the professional mediates and helps the family or couple communicate effectively with one another. Counselling can average between 6 -12 sessions.

Psychotherapy:

Psychotherapy is similar to counselling in that the professional is there to listen and support you - however, Psychotherapy is a little more in-depth and explorative in that the way the practitioner will ask questions will help delve a little deeper to help you better understand the emotions being felt. With this exploration, the practitioner will then help you develop coping methods to feel more in control of such emotions moving forward. Psychotherapy can be a suitable therapy for when there are some difficulties within familial and social relationships, elements of low self-esteem linked with childhood, and some difficulties with attachment. Interpersonal Therapy (IPT) is a form of Psychotherapy that is specifically developed to help treat depression and focuses on you and your relationships with others. Psychotherapy can average between 8 -14 sessions.

Acceptance and Commitment Therapy (ACT):

Acceptance and Commitment Therapy (ACT) is used to support you when anxiety is stemmed from stress - this stress can either be workplace, exam or test provoked, social stress, and Depression. ACT works through such emotions by encouraging you to embrace them instead of fighting, avoiding or feeling guilt towards them. ACT also uses mindfulness techniques such as mediation as well as tools to help change behaviours towards such anxiety-provoking situations. The number of ACT sessions can differ depending on the required support needed and can be run as group sessions or as one to one.

Cognitive Behavioural Therapy (CBT):

Cognitive Behavioural Therapy (CBT) is a structured form of therapy that helps break down and better manage feelings of anxiety, panic and stress. CBT can either be online, one to one, or in a group environment. CBT aims to break down your patterns of thoughts and feelings which then result in specific behaviours. Allowing such a breakdown of thought, results in exploring the rationality of such thoughts - it helps ask questions such as: How much control do I have in this situation? Is this a real worry or a hypothetical worry? And in asking such questions, it breaks the cycle of catastrophising, ruminating thoughts and worry that has previously resulted in anxiety. In breaking down these negative thought cycles, the practitioner will then help you develop healthy coping methods and management skills to help you feel more in control of the anxiety and worry. Please know that the development of maladaptive coping methods is normal when feeling anxious and worried, and can include over-eating, smoking, gambling and elements of Obsessive-Compulsive Disorder (OCD). CBT can also support with the breaking down of negative thoughts about the self which can result in low self-esteem, Imposter Syndrome, panic attacks and phobias. CBT can average 12 - 20 sessions.  

Mindfulness-based Cognitive Therapy (MBCT):

Mindfulness-based Cognitive Therapy (MBCT) can support those who suffer from depression and addiction. MBCT combines elements of CBT and mindfulness in that thoughts and feelings are focused upon (CBT) and then mindfulness techniques such as meditation and breathing exercises are used to better manage such emotions. MBCT tends to be around 8 sessions and can be either group or one to one sessions.

Dialectical Behaviour Therapy (DBT):

Dialectical Behaviour Therapy (DBT) is a form of CBT (as above) that encourages you to live in the moment and supports the development of healthy ways to manage stress, regulate emotions and improve relationships with others. DBT differs from CBT in that it was developed to support those who feel extremally intense emotions. DBT aims to support you in the acceptance of who you are, encourage you to make positive changes as well as develop coping methods. DBT involves one to one sessions as well as group work and is a suitable form of therapy for those who self-harm, have thoughts of suicide, have a diagnosis of Borderline Personality Disorder and/or severe Depression. DBT can be used to support those with alcohol and/or drug addictions and offending behaviour. DBT on average can last up to 6 months.

Trauma-Focused Cognitive Behavioural Therapy (TF-CBT):

TF-CBT is a form of therapy that tends to be one to one and takes elements of CBT (as above) but focuses mainly on exploring the negative impacts of a traumatic experience and supports those who have symptoms of Post-Traumatic Stress Disorder (PTSD). Trauma is very much an umbrella term in that there are the ‘stereotypical’ traumas including being in a war zone, witnessing a crime, being the victim of a crime or in a car crash. However, trauma is individual to each person and so it is recognising that trauma can be stemmed from an event that you have experienced in your past that you feel is impacting your wellbeing, you may currently be having flashbacks or nightmares about this event, feel numb or detached from all other people and can easily startle. TF-CBT helps overcome the negative impacts of trauma through understanding that perceptions may be distorted due to the trauma, and so tools are developed to help such thought patterns be ‘redesigned’ to support you in moving past the event. TF-CBT can average between 6-12 sessions.  

Eye Movement Desensitisation and Reprocessing (EMDR):

EMDR is another form of therapy that supports those who have symptoms of Post-Traumatic Stress Disorder (PTSD). How EMDR works is through dual awareness - dual awareness allows the symptoms of PTSD to occur but in the safe environment of the therapist’s office. All of the sensations and emotions are identified and then reviewed by yourself and the therapist. As these are being reviewed, the practitioner provides an external stimulus for you to focus on (this can include the tapping of your arm, asking you to watch the therapist move two fingers) and after each set of movements, you are asked how you feel. This process continues until the memory is no longer distressing, altogether meaning that you have processed the traumatic event. EMDR can be a distressing form of therapy as it directly focuses on the traumatic event, encourages its exploration and then helps the brain to reprocess these memories to enable you to let go of such memories. It is therefore important that you have a good support network close by who are aware of EMDR. EMDR can average between 6-12 sessions.

Counselling Psychology:

Counselling Psychology is a form of therapy that helps improve a sense of wellbeing and can alleviate feelings of distress and help resolve the crisis through exploring physical, emotional and mental health difficulties. A counselling psychologist can support with feelings of depression, disordered eating, personality disorders, domestic violence, forms of abuse, psychosis and bereavement through considering how you relate to others, how you think and how you behave. Sessions with a counselling psychologist will also explore your experiences of the world and how you function in everyday life and can also include psychological assessments and the administration of diagnostic tests. Sessions with a counselling psychologist can be either one to one or group sessions. Counselling Psychology can average between 6-12 sessions.

Clinical Psychology:

A Clinical Psychologist is someone who will discuss and develop with you an individualised treatment plan that will incorporate different elements of talking therapies - so they can pull features from CBT, counselling, Psychotherapy and many other therapies to best support your current needs. A clinical psychologist will support individuals with complex and longstanding difficulties and can include those who have symptoms of Bipolar Disorder, Schizophrenia (not for medication purposes), Severe Depression and Anxiety, eating disorders, and PTSD. A clinical psychologist can diagnose some mental health illnesses but cannot prescribe medication. Clinical Psychology can average between 8-14 sessions.

Psychiatry:

A psychiatrist is a qualified doctor who has chosen to specialise in mental health. A psychiatrist can provide you with a diagnosis, can make recommendations for medication, therapy or a combination of the two, whichever will best support your needs. Psychiatrist support can be provided for those who suffer from severe OCD, Personality Disorders, Learning Disabilities, Dementia, Alzheimer’s, Anorexia, Bulimia, Addictions, PTSD and Schizophrenia. Psychiatry involves an initial appointment - and then sessions after this depend on the required treatment.

So that was just some of the therapies available - as I said before please do go to your GP as the first point of call for support with mental health and ensure to take on their recommendation and advice. Please be aware that The Samaritans are open 24/7 on 116 123 and if you feel that you cannot keep yourself safe call 999.

This really is a strange time and so take a moment to reach out to that friend or loved one that you haven’t spoken to in a while. Ensure to take some ‘me time’ whether that be having a bath, watching your favourite film, reading a book or going for a walk - whatever it is, take the time to do it. Stay safe and stay in touch.