People often confuse psychology with psychotherapy. Psychotherapy involves the application of evidence based processes, techniques, and modalities which are informed by psychological research. What accredited clinical psychologists, counsellors, social workers, etc. do is psychotherapy.
Psychotherapy is talk therapy, as distinct from say, prescription of medication, to assist with mental wellness challenges. The medical model works something like this; The patient presents with signs or symptoms. signs are what can be readily observed. The open wound is a clear sign. The patient reporting a headache is reporting a symptom. Often, the signs and symptoms, in combination, point to the nature of treatment. Dress the wound and provide pain relief, simple!
In psychotherapy, there are usually only symptoms. The patient, or client, describes their felt experiences and the clinical psychologist or psychotherapist , or counsellor, or social worker, or teacher, assesses the story provided by the client at intake and beyond. Such assessment identifies the client’s strategies, their perceptual errors, prejudices, cognitive distortions and possibly their pathologies..
From this point there is questioning, positing possible alternative perceptions to explain something called ‘reality’. Over a series of sessions, sometimes interspersed with ‘homework’ where the client is encouraged to read some useful information, watch some relevant video content, execute some manageable tasks such as making a phone call that has been avoided because of fear.
So, clinical psychologists “do” psychotherapy. Research psychologists provided evidence-based tools for the rest of us to use as we do psychotherapy with clients. The psychotherapist/client relationship is ideally a partnership, a collaboration. I say ‘ideally’ because there are times when the expectations of the client are one-way. The client expects the psychotherapist to ‘fix me’.
Types of psychotherapy
Psychotherapy (talk therapy) seeks to support individuals (children, youth, adults) couples, and families. The goal of psychotherapy is help people address and manage challenges such as; anxiety, stress, unresourceful habits (e.g. exessive alcohol consumption), relationship struggles etc. There are many strands or points of emphasis in psychotherapy. Below is a very brief list of only some modalities devoted to helping people return to purposeful and resourceful functioning.
- Psychoanalytic therapy: This form of therapy involves exploration of early childhood experiences as impacting current functioning (1)
- Cognitive behaviour therapy (CBT): CBT enjoys significant popularity among psychotherapists and is easily understood by clients (2). It operates through the questioning of unhelpful thought processes. CBT starts from the premise that thoughts influence feelings and feelings influence behaviour. The CBT model often refers to ABC, where, A is the activating agent or triggering event. B refers to the beliefs about this event, and C, consequential feelings or behaviours. A causes B, which causes C. There are several variations on this general foundation.
- Human Givens therapy: (3) A relatively recent addition to the psychotherapeutic community. Human Givens is based on their ‘APET‘ model. In APET, A refers to the activating agent, P, refers to pattern matching – the instinctive unaware seeking of similarities to the activating agent (reflecting the discovery that emotion precedes reason). E, refers to emotion generated by P, which influence thinking. Unhelpful pattern matching gives rise to mental wellness challenges according to the original proponents of Human Givens.
- Psychodynamic therapy: (4) involves a more holistic focus than behavioural symptom-addressing therapies. There is an exploration of the person’s narrative over their life’s journey to identify patterns to assist with more global than specific change in the client. There is a focus on unconscious influences on client behaviour.
- Clinical Hypnosis and psychotherapy: (5) The application of clinical hypnosis to support change work in psychotherapy is fairly common. Psychotherapeutic interventions are supported because hypnosis can help amplify experience, manage symptoms, build resourcefulness, enhance flexibility. In talk therapy where clinical hypnosis is employed there is the cultivation of focused absorption, deep relaxation, and curiosity around shifting the client’s perspective, changing unhelpful habits, such as smoking, pain management, anxiety etc.
- Family constellation therapy: (6) Seen as an alternative, experiential modality, where the client’s inherited inhibiting forces are accessed and addressed. Family Constellation permits the client to not only to see and feel the dynamics at play in their narrative and helps access newer perspectives which support better solutions. This therapeutic modality involves a group of people who may represent family members of relevance to the issue being addressed by the client, with the therapist as guide in the process.
- Acceptance and commitment therapy (ACT) : (7) ACT involves refraining from resisting or avoiding unresourceful thoughts or denying uncomfortable feelings. It is more about establishing curiosity and acceptance or ‘expansion’ of the undesired feelings. The client is invited to scan their body, observing the location of particular experience related to the distressing experience. The curiosity explores the detail of the physical experience. There is no contest with the undesired emotion or feeling. staying fully present is another feature of ACT. The ‘observing self’ serves to provide a certain distance from any immediate connection to feelings of victimhood.
- Dialectical Behaviour Therapy (DBT): (8) This psychotherapy was devised in the 1980s by someone with lived experience of borderline prsonality disorder (BPD). Since then, it has achieved much wider application. Fundamentally, DBT involves considerable psycho-education and supports rigorous self-management. That said, DBT involves regular support for clients with individual sessions as well as group work. Strengths are identified and unresourceful thinking styles (cognitive distortions) are replaced with more appropriate behaviours where possible. From the original challenges with emotional regulation (stereotypically in BPD), coping is fostered and day by day personal management supports new directions.
- Art and Play therapies: (9)
Frequently considered more in the realm of ‘child psychology’, art and play therapies include an array of expressive and experimental modalities. Not exclusively to support children, Art and play uses a variety media from movement (e.g. dance, to sand pit play, and music (e.g. drumming). There is a constellation of possibilities when it comes to art and play therapy. Art, movement, dance, sand play, painting, music etc. all support often indirect communication of feeling states in a safe context where outright confrontation might be unhelpful.
- Humanistic and integrative psychotherapies (HIT): (10) Humanistic and integrative psychotherapy supports an attitude of curiosity and exploration as the psychotherapist supports the client with choosing their path in life. Making resourceful and self-respectful choices within an understanding that pull of negative forces in life is key to HIT. HIT seeks to support connection to personal value, abilities and resourcefulness. As a methodology, it is flexible and adaptive to the needs of the individual client.
- Mirroring Hands: (11) Mirroring Hands is a very recent addition to the psychotherapeutic landscape. Emerging mainly in 2017 but informed by a considerable body of research from Ernest Rossi. Richard Hill and Ernest Rossi collaborated on this client-responsive approach to personal problem-solving and mind-body healing. The therapist is encouraged to “do less” and foster the internal excursion of the client as they permit their own personal understanding and solutions to emerge.
Of course there are a myriad of psychotherapy schools and modalities and what has been presented here is just a very brief glimpse into just a few of them. Talk therapy, psychotherapy, clinical psychology, counselling are all very similar in many ways and what distinguishes some is their level of regulation and standardisation. By standardardisation, I mean the level of professional standards expected of practitioners. Some are university qualified and post-graduate qualified with supervised clinical experience. Others may simply decide they are a counsellor and proceed to practice with little or no regulation beyond the common law of the land. Caution is advisable when availing of help and the quality of the relationship between psychotherapist and client has proven to be a very strong influence on therapeutic outcomes.
- https://www.psychologytoday.com/au/therapy-types/psychoanalytic-therapy According to one survey, 77 percent of clients reported significant improvement after completing psychoanalytic therapy. At a one-year follow-up, 80 percent reportedly experienced improvements(see link)
- https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/cognitive-behaviour-therapy .
- https://www.hgi.org.uk/resources/delve-our-extensive-library/mental-health-services-nhs-cbt-psychotherapy/apet-model .
- https://psychcentral.com/lib/psychodynamic-therapy/ .
- https://yapko.com/ways-to-use-hypnosis-in-psychotherapy/ .
- https://www.goodtherapy.org/learn-about-therapy/types/family-constellations .
- https://www.aipc.net.au/articles/six-principles-of-acceptance-and-commitment-therapy/ . There are several aspects to ACT (as with all psychotherapeutic modalities) and ultimately, the fit between client, the therapist, and modality employed will determine therapeutic outcomes.
- https://psychcentral.com/lib/an-overview-of-dialectical-behavior-therapy/ .
- https://www.uktherapyguide.com/therapy-type/humanistic-and-integrative-therapy/ttc1023 .
- I’ve written about Mirroring Hands in a just little more detail here: http://bondihypnotherapyclinic.com.au/mirroring-hands/ .