In the United States, more than 45 million people suffer from mental illness. But unlike other diseases, there’s no one-size-fits-all treatment.
“I think the world wants [it to be] an ‘if this then that,’ and I’m afraid in psychotherapy those days might be a little bit further away than we would all like to admit,” says Dr. Chris Barnes, a licensed clinical psychologist at Southwest Michigan Psychological Solutions. “The gold standard typically for psychological disorders is medication and psychotherapy. But that word psychotherapy has so many different interpretations. Psychotherapy is a blanket concept, and then there are these schools of thought underneath that.”
If you’re looking for a mental health care provider, it’s important to understand these different schools of thought, because it’ll shape the kind of care you receive. To learn more, we asked Dr. Barnes about the five main types of mental health therapy. Here’s what you need to know about each.
Modern psychotherapy grew out of Freudian psychoanalysis. This group of techniques was developed by Sigmund Freud in Austria in the 1890s, and is used to study and draw out the unconscious mind. Freud’s theories are centered around a few key theories: that development can be shaped by forgotten memories in childhood; that conflicts between conscious and unconscious desires can produce anxiety and neurosis; that human behavior is determined by irrational unconscious drives such as the id, ego, and super-ego; and that despite all of that, we can be liberated from feelings of depression and anxiety by bringing these issues to light.
Rogerian therapy was first developed by therapist Carl Rogers in the 1940s, and the ideas at the heart of his work continue to influence mental health treatment today. Rogerian therapists encourage their clients to lead the discussion and facilitate their own discovery. “This is the type of therapy we tend to see on TV, where the therapist says, ‘Tell me how you’re feeling,’” Dr. Barnes says. “We know it’s just about the backbone of all of the therapies. If you don’t have a connection with the person sitting across from you, you’re very unlikely to do anything that they recommend.”
Cognitive Behavioral Therapy
Cognitive behavioral therapy, or CBT, is considered one of the most effective forms of therapy. It’s based on the idea that dysfunctional thoughts cause dysfunctional emotions. CBT therapists teach patients to change their thoughts to change how they feel. “When I speak with physicians and they say, ‘What’s the most effective way to treat psychological conditions?’, I say CBT, because that’s what the research suggests,” Dr. Barnes says. “Many of the other therapies out there don’t have a lot of research, because the active ingredient is difficult to identify. Whereas with CBT, we’ve seen cases where, when we taught someone skill-building tools for eight weeks, we saw a reduction in their symptoms.”
Dialectical Behavioral Therapy
Dialectical behavioral therapy, or DBT, is an offshoot of CBT, and its effectiveness has also been supported by research. DBT is aimed at people who have extreme emotional reactions to stressful situations, self-harm behavior, and poor interpersonal relationships. (Research has shown it to be especially effective for borderline personality disorder.) “Dialectical behavior therapy teaches emotion regulation: how to moderate emotions more effectively, and how to increase the quality of personal relationships,” Dr. Barnes says. “Mindfulness is a really big component of it, so it’s teaching people to be more in the moment and to notice reactions and thoughts as they occur, but not necessarily having to have a concrete reaction to them.”
Neurofeedback, a form of biofeedback, is a newer form of therapy in which the body is trained to respond to stresses differently. In a typical therapy session, patients are connected to sensors measuring inputs like their heart rate, brainwaves, and respiration rate. Through practices like controlled breathing and meditation, patients are encouraged to try and slow these responses. Practitioners and patients can then track these inputs on a computer monitor. “It’s basically learning how to train your body to respond differently,” says Dr. Barnes. “There’s some compelling research to support the effectiveness.”