Therapy Approaches / Theoretical Orientations

The following descriptions briefly describe the most common approaches and styles of psychotherapy. They are by no means comprehensive, but give a flavor of what to expect when working with a therapist that adheres more to one or another model of psychotherapy. Please do not hesitate to ask any therapist with whom you are considering working about his or her approach to therapy and theoretical orientation.

Psychodynamic psychotherapy refers to an approach and theory that assumes that early life experience informs and shapes our current relationships and emotional state. It is loosely related to the theory and practice of psychoanalysis (see below). In psychodynamic therapy, the relationship and interaction with the therapist is seen as a primary mode of effecting positive or developmental change. Therapy tends to involve exploration of both current as well as past experiences, often uncovering aspects of a persons thoughts and emotions that were not fully realized or understood. It is through this new understanding and emotional exploration that negative or stuck states of mind and/or relationships are healed, resolved or developed.

Cognitive behavioral therapy focuses primarily on the here and now with particular attention to a person’s negative thoughts and behaviors. Therapy often includes very organized assessment of patterns of thinking and behaving, with specific exercises and regimens designed to alter the patterns that contribute towards negative emotions, poor relationships, and lack of success in life.

Psychoanalysis or psychoanalytic psychotherapy has a long and varied history going back to Sigmund Freud. As its basic premise, psychoanalysis assumes that people are often unaware of the factors that contribute to their mental and emotional state, and that uncovering these unconscious processes and assumptions leads to wellness. The way it is practiced today, there is a wide variety of approaches and styles in psychoanalysis (i.e. Freudian, Jungian, Object-Relations, Relational) that can look and feel quite different from the stereotype of the silent analyst saying only “Mmm Hmm” as the patient talks. Psychoanalysis is distinguished from psychoanalytic psychotherapy by both the frequency and setup of therapy. In psychoanalysis the patient usually comes in 2 – 5 times per week and often lays on a couch facing away from the therapist, whereas psychoanalytic psychotherapy incorporates the same theories and methodology of analysis without the same level of involvement. Psychoanalysts are required to undergo an additional educational training that often lasts for many years before being able to be called an analyst and perform analysis, whereas many therapists work from psychoanalytically-informed perspective and are well-trained in a psychoanalytic approach.

Finally, not all therapists categorize themselves as having one particular theory or approach. Integrative therapists tend to draw from many styles and points of view, tailoring the treatment to the needs and interests of the patient. The above list is by no means exhaustive or comprehensive. Many therapists borrow from Eastern traditions such as Buddhism and Meditation as well as traditions in family therapy, social justice, existentialism, and more.