Approaches to Psychotherapy
Randi Fredricks, Ph.D.
There are many different approaches to psychotherapy that therapists take, but all effective therapy shares common elements, such as helping the client to process life events and improve overall functioning. As to which type of therapy works best, there is no simple answer.
Just as people respond differently to various foods and drugs, the same therapeutic approach won’t work for every client, nor for every psychologist or psychotherapist. Many people find that a blended approach — one that draws on elements of different schools of psychology — works the best. In my practice counseling in San Jose CA, I am consistently using a number f different approaches.
The three main branches of counseling psychology are cognitive, behavioral, and psychodynamic. Psychotherapists and psychologists who follow the cognitive branch will look at dysfunctions and difficulties as arising from irrational or faulty thinking. In other words, we perceive the world in a certain way — which may or may not be accurate — and this results in acting and feeling a certain way.
There is also a school of thought that all approaches to therapy have common elements and that are responsible for a positive outcome. The quality of the therapeutic relationship regardless of the therapeutic orientation used is one factor that has been shown as necessary and sufficient for positive outcome.
There are also common therapist skills such as empathic listening, reflection, and teaching that are relatively neutral in theory, as necessary components. Also important are client factors such as motivation, application of learning outside of appointments, and the nature of the difficulty being addressed in therapy.
Psychotherapy and Human Change
Psychotherapy and human change is incredibly difficult to research in a manner that can conclusively answer the question of which approach is best. The research that has provided meaningful results has most often focused on limited, easily defined problems that can be measured objectively.
Psychotherapists and psychologists who lean toward a behavioral model look at problems as arising from behaviors that were learned over years of reinforcement. Finally, psychotherapists and psychologists in the psychodynamic camp draw from the teachings of theorists like Carl Jung and Sigmund Freud, looking at issues beginning in early childhood which motivate us as adults at an unconscious level.
Freud’s work in the early 1900s is generally considered to be the beginning of modern psychology and psychotherapy. In comparison to other methods of healing that have spanned centuries, psychotherapy is relatively new. Whichever approach a psychotherapist takes, the more important aspect of the of the therapy often lies in intuition.
Barnett, J. E. (2014). Sexual feelings and behaviors in the psychotherapy relationship: An ethics perspective. Journal of Clinical Psychology, 70(2), 170–181.
Binder, P., Holgersen, H., & Nielsen, G. H. (2009). Why did I change when I went to therapy? A qualitative analysis of former patients’ conceptions of successful psychotherapy. Counselling and Psychotherapy, 9(4), 250–256.
Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy, 16, 252–260.
Burlingame, G., McClendon, D., & Alonso, J. (2011). Cohesion in group psychotherapy. In J. C. Norcross (Ed.), Psychotherapy relationships that work (2nd ed., pp. 110–131). New York, NY: Oxford University Press.
About the Author
Randi Fredricks, Ph.D. is a practicing therapist, researcher and author specializing in the treatment of anxiety, depression, addiction, eating disorders, and related disorders. Dr. Fredricks is a best-selling author of several books on complementary and alternative treatments for mental health. For more information on Dr. Fredricks work, visit her practice website DrRandiFredricks.com.