What are the main approaches to Therapy?

Posted December 2019 by John Sherk, B.S.W., B.S. Bible; MDiv.; 8 updates since. Reading time: 6 min. Reading level: Grade 10+. Questions on main therapy approaches? Email Toni at: editor@online-psychology-degrees.org.

Just like most other fields, a therapist’s perspective and work can be heavily influenced by where they went to school and who they read/study. They’re shaped by the approach(es) to therapy they’ve learned. This impacts how they see the human person, how they identify problems, the mode of solutions, and even their style.

It’s important to know some of the basics about these approaches in order to decide which one you’d like to learn. Then, you can find schools that teach that approach.

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Psychoanalysis

First established by Freud and later developed by Jung and others, psychoanalysis forms the basis for modern psychotherapy. However, Freud’s intellectual offspring took his thought into numerous divergent directions, including cognitive psychology.

Psychoanalysis most fundamentally concerns itself with the subconscious and unconscious mind; it sees one’s emotional distress and behavioral problems stemming from there. This can also be summarized in the following basic principles:

First, suppressed events from early childhood serve as the strongest factor in personal development, as opposed to genetic factors.
Second, the mind can be divided into three sections: the conscious, subconscious, and unconscious. The unconscious remains largely inaccessible, however, its drives determine most of our behavior and cognition.
Next, though the unconscious mind remains mostly unreachable, it often comes out in dreams, “Freudian slips,” quirks and mannerisms, etc.
Problems in life ultimately stem from conflicts between the conscious and unconscious, which can cause neurotic traits, neurosis, anxiety, depression, etc.
Psychoanalysis seeks to uncover what lies in the subconscious and unconscious, however, the mind tends to react protectively through defense mechanisms.
Nevertheless, psychoanalytic therapy endeavors to overcome defense mechanisms and bring the unconscious and subconscious to the conscious mind, which will bring liberation.
Last, the focus of treatment comes in the form of transference, through which clients alleviate their suppressed childhood experiences by projecting feelings of dependence, anger, love, and whatever else was involved onto the analyst.

Recent scholarship has undermined a great deal of what Freud claimed. Regardless, some of his more basic insights remain influential and are carried on to this day.

Behavior Therapy and Behaviorism

Behavior therapy and behavioral psychotherapy grounds itself in the insights from the classical conditioning of Ivan Pavlov and the work of B.F. Skinner. As the name suggests, treatment focuses on changing observable behavior, and less on addressing the subconscious mind, cognitive thought patterns, free will, etc. Some of its basic assumptions include:

First, behavior associated with one’s psychological problems evolves through the same processes of learning that affect the development of other behaviors.
Consequently, behaviorists consider behavior disorders as something learned rather than something someone has.
Behaviorists will employ techniques from operant conditioning, such as positive and negative reinforcement, to help their clients change their learned associations with the behavior, and thereby, change their behavior.
Furthermore, connected to operant conditioning, behaviorists will employ exposure therapy to treat people suffering from anxiety disorders and phobias.

The methods mentioned are consistent with an approach that sees problems rooted in learned behavior, and a solution that seeks to change that learned behavior through new experiences. In order for the client to be open to these experiences, a tremendous trust between client and therapist must be formed. Most recently, functional analytic psychotherapy developed to utilize the principles of behavior therapy, but to root it more directly in the therapeutic relationship.

A significant body of research exists that demonstrates the effectiveness of behavior therapy on certain disorders and conditions. Pure behavior therapy that focuses on conduct without much regard for cognition is hard to find. Instead, most therapists today practice cognitive-behavioral therapy (CBT), which combines principles from both behavior therapy and cognitive psychology. This approach identifies problem behaviors as rooted in problematic thought patterns and cognitive distortions. The solution is to change behavior by changing cognition. CBT still presupposes many of the same things as behavior therapy (such as behavioral problems and cognitive problems being learned) but seeks to alter what it sees as the source of problem behavior, rather than just the behavior itself.

Humanistic Therapy

Humanistic Therapy emphasizes one’s innate, human desire for self-actualization, and the fullest expression of one’s will. It developed formally by Carl Rogers to address some of the shortcomings in Freud and in response to the behaviorism of B.F. Skinner. Humanistic therapy is self-consciously built on five principles:

Human beings cannot be reduced to parts; they constitute more than the sum of their parts.
We have a unique consciousness. They’re aware of their own existence, and the awareness of the fact that they are aware. Human consciousness always involves an awareness of yourself in the context of other people.
Human beings exist in a uniquely human context, as well as in a cosmic ecology.
As human beings, we always have choices. Our lives are entirely of our own making. In an ultimate sense, we are responsible for ourselves.
Human beings are deliberate, have an innate drive manifesting in goals, can cause future events, and build meaning and value in their lives.

Humanistic therapy and psychology assume an existentialist worldview: that our existence precedes our essence. Thinkers like Kierkegaard, Nietzsche, Heidegger, and Sartre believed that human beings do not live in a pre-determined world that was created for a purpose. There is no “because” to existence; we simply exist. We have the absolute freedom to construct the meaning and value of our lives.

The goal of therapy is to embrace this freedom and use it to reach our fullest potential. Or, in the words of Abraham Maslow, to achieve self-actualization. Humanistic therapy has a fundamentally client-centered approach. Rather than holding a certain framework that assumes people’s problems come from the unconscious, behavior, or cognition, the client is the authority on the source of their problem. The client is also the authority on the solution. The therapist serves to offer a listening ear through which the client will arrive at key insights themselves. The therapist then helps the client empower themselves to utilize these insights to their own goals.

Holistic Therapy

Holistic therapy was first created in the mid-1970s, when holistic medicine first began to become popular. Yet, holistic therapy did not gain traction nationwide in the United States until recently. Due to this, extensive research on its effectiveness remains forthcoming.

Holistic therapy views human beings as trichotomous: possessing a mind, body, and spirit. Treatment ought to address the whole person; that is, their mind, body, and spirit. In order to accomplish this, holistic therapy combines methods of traditional psychotherapy (especially CBT), along with non-traditional methods (such as hypnosis, transpersonal psychology, or even energy medicine). A client will undergo typical talk therapy sessions, which serve as the norm in all of the other approaches we’ve discussed so far. Along with traditional talk therapy, a client might also use creative art, breathing techniques, mindfulness, guided imagery, and other techniques to help release negative energy, relax, and gain a more positive outlook.

As some of these practices gain greater mainstream popularity, one can expect holistic therapy to become more popular as well.

More Articles of Interest:

Psychoanalysis

Behavior Therapy and Behaviorism

Humanistic Therapy

Holistic Therapy

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