This blog is dedicated to simplifying 7 frequently used theoretical orientations you might find in therapy. I believe in being an informed consumer. You know yourself best and what works for you! So let's jump in and take some of the guesswork out of therapy!
If you have ever been in search of a therapist, or if you are looking today, than you may have done a google search, checked out some online directories, or looked for a referral. You'll then look at the therapist's picture, check their fee, research their specialty and take the step to call for an appointment. One thing that you might have missed, one very important thing, is to research the therapist's theoretical orientation. This makes a big difference in how your interacts with you. You may be thinking, what in the world does insight-oriented, or process-oriented, or systemic, or strategic even mean anyway? And how do I know if that is for me?
Before I start breaking down these approaches, I will make references to some concepts which are important to understand. First up, insight-oriented vs. directive. Insight oriented therapy helps clients develop a deeper understanding of themselves, their thoughts, actions and the world in order to promote positive change. This could take days or months since the therapist is craftfully asking questions to help the client make interpretations, breakthroughs and insights on their own. On the other hand, A directive therapist may offer his/her own interpretations, be more hands on by giving assignments, and offering advice. Unlike insight oriented-therapy, directive therapy is usually short term and focuses on getting more immediate results. One could argue though, that the client does not come to these conclusions on their own, so the change is not as deep and lasting. Also, insight oriented therapies usually allow clients to focus on their past and history, where directive therapies are more about making changes in the here and now. Alright, insight, directive, past, present, short term, long term.... that makes sense right?
Cognitive Behavioral Therapy or CBT
This might be the most popular form of therapy. It is the most researched and is called an "evidence-based practice" (you might read that in a therapist's advert.) Most therapist's from big agencies will be using this approach. It is based on the theory that change occurs when we modify dysfunctional thought patterns or distorted thoughts. This type of therapy is directive, present-focused and short term. It can yield results pretty quickly. This therapy might be a good match for you if you struggle with automatic thoughts that you can't control or views of the world or yourself which you want to be more realistic and positive. There is also an emphasis on learning positive coping skills.
Strategic and Solution-Focused Therapy
These are two more here-and-now focused and directive therapies. Strategic therapy is focused on solving the problem and giving strategic homework assignments. Solution-focused therapy focuses heavily on solutions and not on problem-saturated talk and really hones in on client strengths. This kind of therapist might be a match for you if you are looking for something short term that yields quick results. Sometimes only one session is required.
This is an approach that emphasizes empathy and stresses the good in human behavior. It states that change occurs when a therapist shows unconditional positive regard for their client so they can develop a healthier sense of themselves. This approach promotes accountability and authenticity, and the therapist really believes in the client ability to grow and blossom into themselves. This is an insight oriented therapy, the therapist is non-directive, and may be longer term. This kind of therapist might be a good match if you are struggling with self-acceptance and want to feel safe with your therapist. Despite your actions, setbacks, or fears, this therapist will be a secure base for you to fall back on.
Object-Relations or Psychodynamic Therapy
This approach says that change happens within the relationship with the therapist. This type of therapist is reading into the way the client is interacting with them, and exploring projections which are associated with the client's view of themselves and others. These subconscious beliefs are keeping the client stuck in patterns in relationships. The therapist helps the client gain insight, and develop new constructs through the relationship with the therapist. This approach is non-directive, long term, and insight oriented. This approach might be great for you if you want to get to the deeper root of issues and develop a stronger sense of yourself, and stop living in a way that was conditioned by early experiences and relationships.
This approach focuses on helping the client to find their purpose in life. Change occurs when the client alters their basic life goals and premises of the world. This is what I call a big picture theory because it helps clients get out into the world, be more social, and conquer any inferiority through engaging in their social context. This might be a great match for you if you have felt lost, confused about your personal goals, or feeling a sense that you have not accomplished what you want to in life.
Any type of family therapy is going to be based in systems theory. This theory states that we humans are all interconnected and no man's an island. In families, no one person is to blame, even though we usually see one family member becomes the "problem" and everyone focuses on them. The therapist will be looking at the dynamic of the relationships (or the process) and unbalancing those patterns which keep the dysfunction going. This type of therapy is for families with generational patterns of addiction, divorce, abuse, cutoffs, etc. It is also great for families that find their kids have more power in the household than the parents.
Narrative theory is a post-modern approach to therapy. This theory states that as people growing up in the world, we develop a narrative or a story which we repeat to ourselves over an over about ourselves. We may have repeating tapes about how we are not capable, or that people seem to let us down. Change occurs when the therapist helps the client reauthor their story to focus more on their strengths and competencies. This type of therapy might be great for you if you want to reauthor your story so that a new story can emerge.
This is a post-modern approach which means it is relatively new in the field of psychology and is not as grounded in research. There may not be funding or the studies have not been conducted. Some other modern and post-modern approaches are self-psychology, dialectical behavior therapy, emotionally focused therapy, depth psychology, transpersonal therapy, EMDR, Ecotherapy, and Animal-Assisted Psychotherapy. And there are many other theorists and Freaudians all over are in the process of developing new types of therapy today.
I have an eclectic approach in my practice, where I blend Humanistic therapy with Cognitive Behavioral Therapy and Psychodynamic therapy. In a nutshell, I believe that change happens through the relationship between myself and client, through unconditional positive regard and support. I believe in deconstructing the past and helping my client's develop new insights about themselves and the world they interact with. I also incorporate animals within the context of these theoretical approaches, because they are a medium for healing and learning about ourselves in relationships. There is no one size fits all approach.
So those are 7 theoretical approaches to counseling individuals, couples, and families. I hope you feel empowered, better informed, and better equipped in your understanding about the types of therapy that are available to you! Please check out my reference for this blog below:
Basic Philosophies of the Major Counseling Theories