Different Types of Talk Therapy | Does the Approach Matter?

Talk therapy is a highly effective treatment for depression^[1], but finding a therapist can feel daunting, especially with all the different specializations of therapy out there.

When looking for a therapist we may see many different approaches listed, but the most important thing is to find a therapist we have a good rapport with. To get the most out of therapy, we have to be open and honest about what’s going on in our lives, and in order to do that, we need to have a good relationship with our therapist.

The specific therapeutic approach a therapist uses is far less important than developing a good working relationship with our therapist. What matters most is that we invest effort in the therapeutic process with someone we trust and have a good connection with.

In fact, there is consistent evidence from decades of research indicating that all bonafide therapy approaches are generally similarly effective.^[2]

One explanation for this is that the different methods of therapy have common factors that make them successful. Essentially, the common factors explanation poses that it isn’t the type of therapy itself that’s crucially important, but the empathy a therapist has, the level of agreement on goals between client and therapist, the client being optimistic, and the bond between the client and the therapist.^[3]

There is evidence that these common factors account for the vast majority of effect that psychotherapies have on client outcomes.^[4] So, it’s important to pay attention to your personal connection with a therapist, rather than their approach alone.

Many therapists are able to do an informal 10-15 minute introduction call to discuss our needs, ask them about their practice, and provide us with an opportunity to see if there is the potential to connect well with them.

Therapy in Practice

While some therapists are strong proponents of one particular approach, many practice what is called “integrative therapy”, where they integrate a combination of approaches and tailor the blend to the needs of each client.

However, no single therapist is a complete jack of all trades, so if they believe that our issues or needs are outside of the “scope of their practice”, they are obligated to refer us to someone else. For example, if you begin therapy for depression but it later becomes clear to your therapist that you also have another mental health issue like OCD (obsessive-compulsive disorder) or an eating disorder and they don’t have experience in treating that, they need to refer you to someone who does.

Talk Therapy Approaches

Different types of therapy can still have unique features that one may find more or less appealing, and after trying one approach we may wish to ask our therapists about trying a different approach to therapy or finding a therapist who specializes in a different approach.

There are dozens of different types of therapy, not all of which are created equally or supported by research. While not an exhaustive list, below is a brief primer on some of the more common, evidence-based therapy approaches we may come across:

Psychodynamic Therapy

The type of therapy that most people think of when they hear the word ‘therapy’ is psychodynamic therapy. It is an approach that involves facilitating a deep understanding of one’s emotions and other psychological processes, and how past experiences influence the present. It works to help people gain greater insight into how they feel and think, so that they can make better, more adaptive decisions for themselves in the future.

Humanistic Therapy

Humanistic therapy focuses on the whole person, especially their positive characteristics and potential for growth, not only from the therapist’s viewpoint but from the client’s own personal sense of themselves. The emphasis in sessions is on a person’s positive traits and behaviours and developing their ability to use their instincts to find wisdom, growth, healing, and fulfillment.

Cognitive Behavioural Therapy (CBT)

CBT is based on the concept that our thoughts, behaviours, and feelings are all interrelated. In CBT, we work to identify and change maladaptive ways of thinking, such as catastrophizing (and other negative thinking patterns). CBT focuses on learning how to reframe negative thinking combined with taking action to change our habits (behavioural activation). CBT tends to avoid deep emotional exploration and examination of past influences; it mostly focuses on the here and now.

Dialectical Behavioural Therapy (DBT)

DBT a structured, skills-based approach and focuses on emotional control and acceptance. This is useful if you find yourself having considerable difficulty managing intense emotions. It was developed to help people who are struggling with borderline personality disorder. The term “dialectical” comes from the idea that bringing together two opposites in therapy — acceptance and change — brings better results than either one alone.

Acceptance and Commitment Therapy (ACT)

This approach helps clients learn to stop avoiding, denying, and struggling with their inner emotions and, instead, accept that these deeper feelings are appropriate responses to certain situations which should not prevent them from moving forward in their lives. With this understanding, clients begin to accept their hardships and commit to making necessary changes in their behaviour, regardless of what is going on in their lives and how they feel about it.

Mindfulness-Based Cognitive Therapy (MBCT)

Mindfulness-based cognitive therapy is a type of psychotherapy that involves a combination of cognitive therapy, meditation, and the cultivation of a present-oriented, non-judgmental attitude called “mindfulness”. A key component of mindfulness is teaching clients to consciously pay attention to their thoughts and feelings without placing any judgments upon them.

Eye Movement Desensitization and Reprocessing (EMDR)

In EMDR, clients discuss a traumatic memory from the past while shifting their eyes and focus from side to side. Gradually, the therapist will guide you to shift your thoughts to more pleasant ones. Some therapists use alternatives to finger movements, such as hand or toe tapping or musical tones. The belief is that this triggers certain pathways in the brain to help reprocess the negative event in a healthier way.

Wondering where to start?

We have a Directory of qualified therapists in cities across several countries around the world that have expertise in working with men. Our Guide to Talk Therapy for Men also includes more information on how to find a therapist, online therapy, and making the most of therapy.

References:

Cuijpers, P., Quero, S., Noma, H., Ciharova, M., Miguel, C., Karyotaki, E., Cipriani, A., Cristea, I., & Furukawa, T. (2021). Psychotherapies for depression: a network meta-analysis covering efficacy, acceptability, and long-term outcomes of all main treatment types. World Psychiatry, 20(2), 283- 293. https://doi.org/10.1002/wps.20860.
Budd, Rick, and Ian Hughes. “The Dodo Bird Verdict-Controversial, Inevitable and Important: A Commentary on 30 Years of Meta-Analyses.” Clinical Psychology & Psychotherapy, vol. 16, no. 6, 2009, pp. 510–522., https://doi.org/10.1002/cpp.648.
Wampold, Bruce E. The Great Psychotherapy Debate: Models, Methods, and Findings. L. Erlbaum Associates, 2001., https://doi.org/10.4324/9780203893340.
ibid.

Different Approaches to Talk Therapy: Does the Type Matter?