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What is Therapy: Understanding Different Types of Counseling Services


A therapist writing on a notepad

Most people are unsure of what to expect in mental health therapy. And understandably so, given that there is little awareness around it especially in the Eastern part of the world.


For many, therapy conjures up some images of you having to lie on a couch while an old man with a beard smokes a pipe on another chair and asks you about your childhood.


This image would have been quite accurate a few decades ago, but the field of counseling and psychotherapy has evolved since then (thankfully). Today, you can sit on your own couch at home and attend therapy sessions online, not all therapy discussions are about your childhood, and we have moved beyond all therapists being old men!


In the vast world of counseling, evidence-based therapies have emerged as the gold standard. These therapeutic approaches are rooted in empirical research, ensuring that clients receive interventions proven effective. Let's delve into some of the most prominent evidence-based counseling services and therapies: CBT, ACT, Solution-Focused Therapy, Client-centered therapy, Psychodynamic approaches, and DBT.


Evidence-based counseling services


1. Cognitive Behavioral Therapy (CBT)

Overview: CBT is a structured, goal-oriented therapy that focuses on identifying and modifying unhelpful thought patterns and behaviors. It aims to replace these with more adaptive ones.


Key Features:

  • Focuses on the here-and-now, rather than the past.

  • Engages clients in problem-solving.

  • Incorporates homework assignments to practice skills.

  • Effectively treats various issues, including anxiety, depression, and phobias.

Clients Appreciate:

  • Tangible tools and techniques that they can apply immediately in their daily lives.

  • The structured, goal-oriented nature which makes progress easy to track.

  • Shorter-term nature which can often lead to quicker results.


2. Acceptance and Commitment Therapy (ACT)

Overview: ACT encourages people to embrace their thoughts and feelings rather than fighting or feeling guilty for them. It fosters psychological flexibility and the ability to act in alignment with one's values.


Key Features:

  • Utilizes mindfulness and acceptance strategies.

  • Aims to increase psychological flexibility.

  • Assists clients to commit to actions in line with their values.

  • Often used for treating depression, anxiety, and stress.

Clients Appreciate:

  • The emphasis on acceptance, which can be liberating for those who have fought against distressing feelings.

  • Tools to understand and distance themselves from unhelpful thoughts.

  • Encouragement to act in line with personal values, leading to a more fulfilling life.


3. Solution-Focused Therapy (SFT)

Overview: SFT, or Solution-Focused Brief Therapy (SFBT), emphasizes finding solutions in the present and exploring future hopes instead of dwelling on past causes of problems.


Key Features:

  • Typically conducted over fewer number of sessions.

  • Highlights client strengths and resources.

  • Encourages setting specific, realistic, and achievable goals.

  • Effective for a range of issues, from relationship problems to behavioral disorders.

Clients Appreciate:

  • The positive and forward-looking focus.

  • Emphasis on their strengths, leading to increased self-esteem and empowerment.

  • Typically shorter-term, making it both cost-effective and efficient for many clients.


4. Client-Centered Therapy

Overview: Also known as Rogerian therapy, after its founder Carl Rogers, this therapy underscores a supportive environment wherein clients can reevaluate their life choices and actions.


Key Features:

  • Stresses the importance of the therapist-client relationship.

  • Values empathy, unconditional positive regard, and congruence (genuineness).

  • Trusts in the inherent tendency of clients towards self-actualization.

  • Suitable for a myriad of issues, particularly those related to self-worth and acceptance.

Clients Appreciate:

  • The non-judgmental and supportive environment which makes them feel deeply understood.

  • The therapist's genuine interest in their well-being, helping them feel valued.

  • The opportunity to lead the conversation and explore their feelings at their own pace.


5. Psychodynamic Approaches

Overview: Rooted in the work of Sigmund Freud, this approach posits that unconscious processes shape our behavior. It seeks to explore unresolved past conflicts and unconscious patterns.


Key Features:

  • Investigates early-life experiences and their current behavioral impact.

  • Emphasizes the therapist-client relationship, especially "transference."

  • Tends to be long-term, requiring more number of sessions.

  • Ideal for deep-seated emotional concerns, self-exploration, and understanding recurring patterns.

Clients Appreciate:

  • The depth of understanding they gain about themselves.

  • The emphasis on long-term change.

  • Insights into how past experiences shape current behaviors, providing a sense of clarity.


6. Dialectical Behavior Therapy (DBT)

Overview: Originally developed for treating borderline personality disorder, DBT is a cognitive-behavioral approach that stresses the psychosocial aspects of treatment.


Key Features:

  • Incorporates group and individual therapy.

  • Focuses on skills in four key areas: mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness.

  • Utilizes acceptance and change strategies.

  • Effective for a range of disorders, especially those associated with emotion dysregulation.

Clients Appreciate:

  • The balance between acceptance and change.

  • Skill-building, especially around emotional regulation and interpersonal effectiveness.

  • Group therapy components where they can learn from others and feel less isolated.


Conclusion

Choosing a therapy is a highly individual decision that hinges on your unique needs, the nature of your concerns, and your personal preferences. While this article provides a concise overview, it's essential to remember that each therapeutic method is intricate, with its nuances and variations. A conversation with a trained professional can offer guidance on the best therapeutic approach for you.


Diya John, Mental Health Therapist

If you're new here, I'm Diya John, a counselor and psychotherapist with a Masters in Psychology and a Diploma in Counselling from Australia. I founded Therapy Garden to make evidence-based counseling more accessible to expatriates, immigrants and the international community. I am based in Tokyo, but I work with clients in different parts of the world via online therapy. I typically use

a combination of CBT, ACT, Solution-Focused Therapy and Client-Centered Therapy, adapted to each client's individual needs. You can read more about my areas of specialisation and services here.



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