Going to therapy can be tough. That’s an understatement. There’s a great deal of stigma surrounding therapy and mental health issues, accessing a therapist can be expensive, and sometimes your therapist doesn’t really gel with you. Not to mention that it’s often difficult to talk about your experiences, thoughts, and fears. I’ve seen therapists off and on from the age of 13. My first therapist was more harmful than helpful, and she barely helped me with my post-traumatic stress disorder symptoms at all. I was afraid of approaching a second therapist because my first experience was so unhelpful. I’m glad that I eventually tried therapy again, because my second experience helped me a great deal. My new therapist used two kinds of therapy—cognitive behavioral and eye movement desensitization and reprocessing (EMDR)—which meant her approach was totally different from the first therapist. This approach helped me a great deal. If you discover that one type of therapy doesn’t seem to be helping you, don’t be put off therapy altogether.
What types of therapy are there?
There are numerous types of therapy, and while we can’t cover them all here, we can discuss some of the most common types of therapy.
Client-Centered Therapy (CCT)
Also known as person-centered therapy, client-centered therapy is a widely used form of therapy that was first conceptualized in the 1940s. The idea behind CCT is to constantly remember that the client is a person and that we have the power to heal ourselves—we just need a little support. The therapy focuses on the client; the therapist is there primarily to listen and empathize. While the therapist can give a little guidance, they encourage the client to make their own decisions and work through their own feelings.
Cognitive Behavioral Therapy (CBT)
Another fairly common type of therapy, cognitive behavioral therapy focuses on changing your thought patterns to help you develop healthier patterns of behavior. “Cognitive behavioral therapy revolves around the principle that our feelings result from our thoughts and that therefore the best way to improve how you feel is to work on changing your thoughts,” says Raffi Bilek. Bilek is a licensed clinical social work counselor and director of the Baltimore Therapy Center, as well as the director of the Montgomery County Abuse Intervention Program in Maryland. “This kind of therapy is usually practical, concrete, and directed.” Olivia Djouadi, a licensed psychotherapist and counselor, often uses the image of a triangle to help her clients navigate certain experiences. The three points of the triangle represent thoughts, feelings, and behavior, all of which she examines when helping a client work through an experience.
Dialectical Behavior Therapy (DBT)
Dialectical behavior therapy (DBT) includes helping the client change their behavior by developing new skills. These skills could include mindfulness, positive social skills, regulating your emotions, and tolerating distressing situations. If you’re prone to self-destructive behavior, or if you struggle with regulating your emotions, this could be a great form of therapy for you. Although DBT was originally used to treat people with borderline personality disorder, substance abuse issues, and/or suicidal thoughts, it’s also effective for a range of other mental health issues. Studies suggest that DBT can be helpful in eating disorder treatment, particularly for binge-eating disorder and bulimia.
Eye Movement and Desensitization Reprocessing Therapy (EMDR)
According to the EMDR International Association (EMDRIA), this type of therapy is helpful in processing trauma. If the memory of a trauma is greatly upsetting to you, EMDR can help you process the experience. This form of therapy can also be used to treat a range of other mood and personality disorders. An EMDR session might seem different from most types of talk therapy. In my case, my therapist would tap one knee and then the other while I had to imagine and recall the details of traumatic experiences. While this was hard, it ultimately helped. EMDRIA notes that the movement of the eyes during EMDR is like what happens when we dream. Our eyes move back and forth, which is why the dreaming phase of sleeping is called rapid eye movement or REM. We know that dreaming is important for storing and processing information, and it is thought that EMDR elicits a similar process.
Mindfulness-Based Cognitive Therapy
Mindfulness-based cognitive therapy (MBCT) can blend mindfulness practices with CBT. “Mindfulness broadly refers to the practice of being aware of your feelings, thoughts, and sensations in the present moment,” Bilek says. “This kind of therapy is aimed at helping you develop the skill of mindfulness, which can help you gain more control over your experience and thereby better achieve your goals.” Mindfulness-based therapy can also include using meditation and breathing exercises as tools. “It slows down the thinking patterns and can help people focus on the situation they have been through and start to accept what has happened,” Djouadi says. “Before discussing any trauma, I connect a client with a safe object, which may be a good memory or their phone. Some clients might not have ever had a safe feeling so I slowly introduce what one may be,” she explains. This exercise helps to ground them and help them feel safe. Studies have found that mindfulness-based therapy is effective in treating depression as well as bipolar disorder and anxiety disorders.
Play Therapy
Talking about your feelings and past experiences isn’t always easy, so expressive forms of therapy like play therapy can be useful. Djouadi says that play therapy, while often used with children, can also be used to treat adults. “I use play therapy when clients struggle with dissociation, as it begins to heal the developmental areas that were affected by early trauma,” she says.
Which type of therapy is right for me?
As you can see, there are so many types of therapy out there that it can be hard to choose one. The important thing to remember is that there are many different approaches to therapy, and you can seek another therapist or a different kind of therapy if one doesn’t work for you. “The best therapy to go with is the one that resonates with you the most.” —Raffi Bilek, LCSW