Types of psychological therapies

Most people who have not studied the Degree in Psychology, when they hear the word psychotherapy the first thing they imagine is a patient lying on the couch and an older man (the therapist) with a notebook writing down what he tells him.

There is a great lack of knowledge in the population about psychology and psychotherapy. Many do not know the difference between a psychologist, a psychoanalyst and a psychiatrist, wave difference between a psychologist and a coach, and they do not know the different types of therapy that exist.

Regarding this last point, the problem arises when they decide to go to psychological therapy and find themselves with the different professional categories: psychoanalytic therapist, cognitive behavioral therapist, systemic therapist... then they ask themselves: "What is that?"

In the world of psychological therapy there are different theoretical and practical perspectives that treat problems differently.

For those who would like to know what types of psychotherapy exist, in this article we collect and explain the different psychotherapeutic approaches through a summary of

the types of psychological therapy currently used.

The benefits of going to psychological therapy

Patients go to psychological therapy for different reasons. But it is not easy to make the decision to attend a therapist's consultation.

Unfortunately, there are still prejudices regarding this practice, especially because of false beliefs about what is the psychotherapy and to whom is it addressed. In addition, many individuals think that going to the psychologist is synonymous with being a weak person, although going to psychological therapy helps to be a emotionally stronger person and provides tools for better adaptation to complicated situations that may appear in the day to day.

In summary, psychological therapy provides these benefits:

• Improves well-being and helps you feel better
• Provides tools for better conflict management
• Helps change limiting beliefs
• Lets live in harmony
• Sessions are confidential, so secrets can be told
• The psychologist will provide support and is a person you can trust
• Advise a qualified professional
• Empowering in the face of life
• Helps to get to know each other better
• If you are curious to know more about the psychological benefits that psychotherapy brings, you can read the following article: "The 8 benefits of going to psychological therapy"

The reasons to go to psychological therapy

Psychotherapy is effective in overcoming many psychological problems and in improving well-being. Despite the many studies that support its effectiveness, there are people who, even needing help, are not aware that they have the problem or avoid facing reality.

The following list shows some signs that may indicate that it is time to go to the psychologist:

• Nothing you've done so far seems to work
• Your friends or family are already tired of listening
• You start to abuse substances to alleviate negative symptoms
• Your acquaintances are worried about you
• You don't stop thinking about the negative
• You feel an aggressiveness that you cannot control and you think that everyone is against
• You have trouble sleeping
• You don't enjoy things the same and nothing motivates you
• You can continue reading about the reasons to go to psychotherapy in this article: "The 8 reasons why you should go to the psychologist"

Types of psychological therapy

If you've never been to counseling before, the experience can be a bit mysterious at first and even intimidating, as there are different types of psychotherapy with different ways of solving problems, and it can be difficult at first to know how to navigate between these. Then we explain the psychotherapeutic approaches or models that exist.

1. Psychoanalytic and psychodynamic therapy

The psychoanalytic therapy has its origin in the theoretical model proposed by Sigmund Freud, father of psychoanalysis. His theory explains the behavior of human beings and is based on the analysis of unconscious conflicts that originate in childhood. To understand dysfunctional thoughts, psychoanalysis places emphasis on instinctual impulses that are repressed by consciousness and remain in the unconscious, affecting the subject.

The psychoanalyst is responsible for bringing out unconscious conflicts through the interpretation of dreams, failed acts and free association. The "free association" has to do with the emotional catharsis, and it is a technique that intends for the patient to express himself, in psychotherapeutic sessions, all his ideas, emotions, thoughts and images as they are presented to him, without repressing them. Once the patient has expressed himself, the psychoanalyst must determine which factors, within these manifestations, reflect an unconscious conflict.

This model of psychotherapy also focuses on defense mechanisms, which are incorrect ways of resolving psychological conflict and can lead to disturbances in the mind and behavior, and in the most extreme cases to the somatization of the psychological conflict and the physical dysfunctions that express.

If you want know more about psychoanalysis, we recommend the following readings:

• "Sigmund Freud: life and work of the famous psychoanalyst"
• "Defense mechanisms: 10 ways not to face reality"
• "The Theory of the Unconscious of Sigmund Freud"

Psychodynamic Psychotherapy

The psychodynamic therapy follow the line that picks up the psychoanalytic thinking of postmodernity. Therefore, it is derived from psychoanalysis, albeit more briefly, by focusing the intervention on certain outstanding conflicts in the current condition of the patient.

Since it leaves the classical vision behind, it collects contributions such as the analytical approach of the self or that of the object relations of the Kleinian current. In addition to the contribution of Melanie Klein, other psychologists such as Adler or Ackerman have participated in the development of psychodynamic therapy.

For the practice of this form of therapy, changes have been proposed in the ways of carrying out the therapy, however, the objective remains the same: help the client to gain insight into their underlying motives and conflicts. Currently, psychodynamic therapies still coexist with psychoanalytic ones, the latter continue focusing on Freud's vision and are called "counseling psychotherapies psychoanalytic ”.

The clearer differences between the two orientations They may be:

• In psychodynamic therapy the typical weekly frequency of sessions is 1 or 2, while in psychoanalytic therapy it is 3 or 4.
• The therapist takes an active and direct position in psychodynamic therapy. In the psychoanalytic orientation it is a neutral and non-intrusive approach.
• The psychodynamic therapist advises and reinforces non-conflictive aspects of the subject. The psychoanalytic therapist avoids giving advice and limits his interventions to interpretations.
• In the psychodynamic approach, a wide range of interventions including interpretive, educational and support techniques. The psychoanalytic approach emphasizes free association, interpretation, and analysis of dreams.

2. Cognitive behavioral therapy

From the cognitive-behavioral perspective thoughts, beliefs and attitudes are understood to affect feelings and emotions and behavior. Therefore, this form of therapy combines different methods derived from the cognitive therapy and of the behavioral therapy. That is, the cognitive behavioral therapy (CBT) consists in a series of techniques that focus on teaching the patient a series of skills to better cope with different problems.

CBT is based on the idea that what we think about different situations affects the way we feel and behave. For example, if we interpret a situation in a negative way, we will experience negative emotions as a result, and that will cause us to behave in a non-adaptive way. It is the treatment par excellence for anxiety disorders such as phobias, as it is understood that. in this case, a traumatic situation causes analogous situations to be interpreted as threatening. This causes the patient to avoid exposing himself to these situations due to the intense and irrational fear that he feels.

In CBT the patient works with the therapist to identify and change dysfunctional thought patterns. To identify the problem, the therapist performs what is known as functional behavior analysis. Functional behavior analysis attempts to find out the factors responsible for production or maintenance of behaviors classified as maladaptive and the contingency relationship established between they.

Once the problem has been detected and analyzed, different cognitive-behavioral techniques are used, such as social skills training, expository techniques, problem solving techniques, cognitive restructuring, etc. The objective of these forms of intervention is to modify behavior patterns both in the way of thinking and feeling and in the way of interacting with others and with the environment.

3. Humanist Therapy

The humanistic psychology is considered the third wave of psychology, contemplating the cognitive-behavioral and psychoanalytic perspectives as the two predominant forces prior to the humanist. This emerged in the mid-twentieth century, through the proposals and work of Abraham Maslow Y Carl rogers, mainly.

It is strongly influenced by the phenomenology and the existentialism. From the first one, the fact that we are never capable of experiencing "the reality itself" of directly, while the opposite occurs with those subjective aspects of which we are conscious. The legitimate sources of knowledge are intellectual and emotional experience. From existentialism, this form of therapy collects reflection on human existence itself.

Therefore, from this humanistic perspective the individual is a conscious, intentional being, in constant development, whose mental representations and subjective states are a valid source of self-knowledge. The patient is seen as the main main actor in the existential search for him. This search forces him to go through a series of subjective stages or states in which he asks the “why what ”of what happens to him, the meaning of what he is experiencing, and what he can do to improve his his situation.

The humanist therapist has a secondary role as a facilitator of the process, allowing the subject to find the answers that he seeks on his own. One of the key concepts of this type of therapy is the human self-realization.

Maslow's Pyramid and the self-realization of the human being

Maslow was the author of the Maslow's pyramid, which is a psychological theory that explains human motivation. According to Abraham Maslow, our actions are motivated to meet certain needs. That is to say, there is a hierarchy of human needs, and it defends that as the most basic needs are satisfied, human beings develop higher needs and desires. At the top of the pyramid are the needs for self-fulfillment.

• To learn more about Abraham Maslow's theory, you can read this article: "Maslow's Pyramid: The Hierarchy of Human Needs"

Carl Rogers and Person-Centered Therapy

Another famous humanistic psychologist, Carl rogers, developed what is known as person-centered therapy, whose goal is to allow the patient (whom Rogers prefers to call a client) have control of his own therapy.

Person-centered therapy allows the client to enter into a process of becoming aware of the real experience and restructuring of their self, through the establishment of a solid therapeutic alliance with the therapist and listening to the deep meanings of his own experience.

To accomplish this, the therapist is:

• Authentic / congruent. The therapist is honest both with himself and with the client.
• Empathic. The therapist places himself on the same level as the client, understanding him not so much as a psychologist but as a person he can trust. The therapist is able to put himself in the place of the other, and through active listening shows that he understands the client.
• Show unconditional positive regard. The therapist respects the client as a human being and does not judge him.

4. Gestalt therapy

The Gestalt therapy was developed by Fritz perls, Laura Perls and Paul Goodman in the 1940s, and it is a type of humanistic therapy, because it conceives the human being, his goals and his range of needs and potentialities. Therefore, from this position it is understood that the mind is a self-regulating and holistic unit, and is based on the basic principle of Gestalt Psychology that "the whole is more than the sum of the parts."

Gestalt Therapists use experiential and creative techniques to enhance the patient's self-awareness, freedom, and self-direction. This is a therapeutic model that not only has its roots in Gestalt Psychology, but is also influenced by the psychoanalysis, Reich's character analysis, existential philosophy, Eastern religion, phenomenology, and the psychodrama of Brown.

For many, Gestalt therapy is more than a therapeutic model, It is an authentic philosophy of life, which contributes positively to the way the individual perceives relationships with the world. The present moment and the self-awareness of the emotional and bodily experience are of great importance, and the individual is seen from a holistic and unifying perspective, integrating at the same time, its sensory, affective, intellectual, social and spiritual. That is to say, he understands the latter in his overall experience.

The therapy sessions revolve around “insight” regarding the patient's experiences, and encourage him to creatively explore how to find his own satisfaction in different areas of his life, and in this way, the patient can live and experience the new solutions. This is more of an educational approach than a medical one. The therapist is not directive, that is, he does not tell the patient what he should do, but uses the educational capacity of dialogue and is more concerned with the bond of trust with him, with the aim of increasing the authenticity of the relationship to allow the patient to explore the experience in his whole.

5. Systemic therapy

The systemic therapy takes into account the representation of reality seen from a holistic and integrative perspective, where the important thing is the relationships and the components that arise from them. In therapeutic sessions, relationship and communication is very important in any group that interacts and affects the patient (or patients), understood as a system.

It is applied in the treatment of conceptualized disorders such as the expression of alterations in interactions, relational styles and patterns communicational of a group, such as couples or families, but also to individual people, taking into account the different systems that make up its context.

It has a more practical than analytical approach to problem solving. It is not so important who has the problem (for example, who is aggressive), but rather focuses on identifying dysfunctional patterns within the behavior of the group of people, in order to redirect those patterns directly. That is, it is about the systems finding the balance.

Brief therapy (or brief systemic therapy)

The brief therapy it develops from systemic therapy. since in the early 1970s it was proposed that the systemic model could be applied to a single individual even if the whole family did not attend. This Marked the Birth of Palo Alto MRI Brief Therapy, which is a set of intervention procedures and techniques intended to help individuals, couples, families or groups to mobilize their resources to achieve their goals in the shortest time possible.

Brief therapy has brought about a radical change in psychotherapy, by developing a brief, simple, effective and efficient model to help people bring about change.

Other types of psychotherapy

The psychotherapy models proposed so far are the best known and most applied for psychological treatment. But they are not the only ones, as there are other forms of psychological therapy that have emerged recently and others that have evolved from the previous ones.

For example, the narrative therapy, acceptance and commitment therapy, cognitive-social therapy, hypnotic therapy, etc.

Bonus: Mindfulness Therapy

A model of psychotherapy that is rigorously current and has generated great interest in scientific circles is the Mindfulness Therapy. This collects concepts from the Buddhist philosophy and of the Acceptance and commitment therapy (ACT) and is located within what is known as the third generation or the third wave of psychological therapies.

The objective of Mindfulness is that the participants acquire a state of consciousness and calm that helps them self-regulate their behavior and get to know each other better. In addition to accepting yourself as you are and being in the present. But more than a set of techniques to be in the present moment, it is an attitude towards life. It is a coping style that boosts personal strengths.

Mindfulness provides patients with a method to learn to manage emotions, reactions, attitudes and thoughts so that they can face the situations that arise in their life, through the practice and improvement of mindfulness. With progress through the practice of mindfulness in the present moment and with an attitude of compassion towards oneself, certain positive attitudes in relation to the mental state and emotions, coming to control them from freedom, self-knowledge and acceptance.

Bibliographic references:

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• Haley, J. (1974). Family treatment. Barcelona: Toray.
• McNamee, S. and Gergen, K.J. (nineteen ninety six). Therapy as social construction. Barcelona: Paidós.
• O'Hanlon, W.H. (1989). Deep roots. Milton Erickson's Therapy and Hypnosis Basic Principles. Buenos Aires: Paidós.
• Silverman, D.K. (2005). What Works in Psychotherapy and How Do We Know?: What Evidence-Based Practice Has to Offer. Psychoanalytic Psychology. 22 (2): pp. 306 - 312.
• Strupp, H.; Binder, J. (1984). Psychotherapy in a New Key. New York: Basic Books.
• Wampold, B.E., Flückiger, C., Del Re, A.C., Yulish, N.E., Frost, N.D., Pace, B.T., et al. (2017). In pursuit of truth: A critical examination of meta-analyzes of cognitive behavior therapy. Psychotherapy Research. 27 (1): pp. 14 - 32.