Different types of psychotherapy: choosing the one that works best for you!

There are as many approaches to therapy as there are therapists. We can distinguish 5 main types of psychotherapy, which differ in their origins, their understanding of human nature and the role they attribute to psychotherapy itself.

Why do we need psychotherapy? 

Whatever the type of psychotherapy, its aim is to restore the patient's self-determination. If it is behavioural therapy, the patient is said to be caught in his or her own thought patterns. If it is interpersonal therapy, the source of the problems is seen to be in interpersonal dysfunction. In contrast, analytical approach the therapist will point to the patient's unconscious conflicts.

In each case, psychotherapy helps the patient to overcome a mental configuration that restricts their ability to choose. It attempts to improve the patient's symptoms and quality of life through the use of words.

No psychotherapy provides universal keys or solutions. Nevertheless, therapists help patients find their own solutions through certain methods specific to each type of therapy.

It is important to know that psychotherapy is only one of many treatments that can be suggested for certain psychiatric conditions. A psychotherapist cannot establish a diagnosis. This is the role of a psychiatrist. Depending on the diagnosis, psychotherapy may be advised as part of treatment plan. It is not the only treatment possible or the first one used. It depends on the illness and the situation. But the treatment plan itself is always determined by a psychiatrist.

What are the major approaches to psychotherapy? 

Existential or humanistic approach 

The existential approach is centred on the present and focuses on the patient's ability to find their own solutions to problems and difficulties they experience, to direct their own life and to realise their full potential.

Psychotherapists facilitate self-exploration by establishing a climate of trust and respect aimed at experimenting with new ways of being or acting. The therapist-patient relationship is therefore egalitarian and non-directive.

The existential approach includes: non-directive psychotherapy, gestalt therapy, the various psycho-corporal approaches, the person-centred approach, transactional analysis and, for example, self-development.

Psychodynamic or analytical approach 

The psychodynamic-analytical approach is mainly influenced by psychoanalysis, whose founder was Sigmund Freud. This approach works around the notion of the unconscious.

Thus, the difficulties of the present have their origins in the unresolved conflicts from our childhood. Patients are led to gradually become aware of the influence of their own unconscious conflicts and to free themselves from them.

Generally, these are long-term therapies, although shorter term approaches have been developed, such as supportive therapy.

Cognitive and behavioural approach 

Cognitive behavioural therapy (CBT) is based on the observation of the link between the patient's thoughts, emotions and behaviours. In CBT, it is considered that the patient's psychological difficulties are linked to inappropriate thoughts or behaviours. The aim is to analyse them in order to free the patient and let him or her learn new, more appropriate behaviours.

Behavioural and cognitive approaches include: behavioural therapy, rational emotive behavioural therapy, Ericksonian hypnosis, neuro-linguistic programming (NLP) and dialectical behaviour therapy. 

Systemic or interactional approach

In the systemic or interactional approach, it is considered that the patient's symptoms or problems are the result of their interaction with the surrounding environment and of the complexity of the patients' interrelationships (friends, professional environment, family...).

After an in-depth analysis of the situation, a solution is found in order to reconcile the expectations of each person as best as possible.

The therapist can organise meetings with important members of the patient's entourage.

Family therapy, couple therapy and family constellation therapy are part of this approach.

Interpersonal approach 

This approach is highly developed and recognised in the United States and Canada, but less so in Europe.

It is a short-term, highly structured psychotherapy based on the idea that interpersonal problems contribute to the patient's psychological problems.

This approach promotes better adaptation to roles and situations. It is particularly effective in dealing with sadness, depression and bipolar disorders, as well as in bereavement and conflict resolution.

When and who to turn to? 

It usually becomes necessary to see a psychologist when the person's problems prevent him or her from having a satisfactory social life. This applies to both professional and personal relationships.

It is not necessary to have a medical prescription to see a psychologist. However, the patient's attending physician or psychiatrist may advise him or her to seek help from a psychologist.

The choice of a psychologist depends on their area of specialisation. During their training, psychologists specialise in one of the areas of psychotherapy: neuropsychology, general psychopathology, career and work counselling, etc. This specialisation determines their field of intervention.

A clinical psychologist, for example, specialises in psychopathology during their university studies and can offer psychotherapy sessions to his or her clients, while a cognitive psychologist is trained in cognitive behavioural therapy (CBT).

It is important to take this information into account in order to make an informed decision on the type of therapy you need. You can also ask your GP which health professionals they are used to working with. This may be reassuring and also allows for a good follow-up.

You do not need a referral from your GP to get a free counselling from the NHS, but you can, if you prefer it this way. Here is the link to the NHS talking therapies webpage where you can get more information about the free counselling sessions: NHS Talking Therapies.

If you prefer to see a private therapist, make sure they are well-qualified. The cost may vary from £10 to £70 depending on where you live.

Remember that psychotherapy can help you in many ways, and especially if you are suffering with depression, so do not hesitate to ask for help if you feel that things are getting out of control.