Types of Mental Health Therapy: How They Work

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Types of Mental Health Therapy: How They Work

Deciding to start therapy is a big, personal step toward prioritizing mental health and improving overall well-being. There are differing types of mental health therapy, from cognitive behavior therapy to play therapy.

It can be overwhelming to determine which type is the best fit. At its core, therapy provides a safe and nonjudgmental environment where patients can identify problems and work collaboratively with a therapist to achieve goals.

This article discusses the five major approaches to therapy, their subtypes, and how they work.

Verywell / Theresa Chiechi


A counselor or therapist is a professional with training in treating mental health conditions and concerns. This can include various mental health diagnoses, including but not limited to:

Psychoanalysis and Psychodynamic Therapies

Psychoanalysis, developed by Sigmund Freud, is one of the oldest treatment methods. In this approach, the primary focus is on uncovering and examining meaningful events or patterns from the past that may be influencing a person’s current state.

Freud believed that incidents from childhood, or thoughts and feelings lying below the surface, are the root of current unhealthy behaviors. Once unearthed, the priority becomes working to process the unconscious thoughts and feelings to change behavior. There have been many developments and advancements in psychoanalytical approaches since Freud.

While some may find this form of therapy beneficial due to deep exploration, psychoanalysis can be a significant time investment for patients.

Interpersonal Therapy

In an interpersonal therapeutic approach, the patient and therapist work together to identify the patient’s diagnosis and examine it within the context of their lives and experiences. Through conducting an inventory of experiences, the patient can begin to understand patterns and significant events in their lives and relationships.

Strengthening relationships and establishing and deepening support systems are essential in this type of therapy.

Interpersonal therapy can be effective for individuals living with mood disorders, such as depression.

Mentalization Therapy

Mentalizing refers to a person’s capacity to distinguish between their emotions and the feelings of others. This process can also help patients understand how their emotions are connected to their actions.

Mentalization therapy is most commonly implemented with patients who are diagnosed with borderline personality disorder, as a way to increase awareness of thoughts and emotions, and improve interpersonal functioning.

Family Therapy

Family counseling tackles problems that occur within the family system. This therapy can help family members give voice to issues, understand each other and how the issue impacts them as a unit, and create plans to resolve issues.

This method of therapy can help families learn to communicate and support each other, improve day-to-day interactions, and manage issues by taking action.

When to Seek Family Therapy

A family might want to reach out to a family counselor if:

  • A child is having a behavioral health issue.
  • A family member is managing a mental or physical health condition, like a drug addiction or eating disorder.
  • The family is going through a divorce.
  • The family is grieving the loss of a loved one.

Group Therapy

One or two clinicians typically facilitate group therapy which may have up to 15 participating patients. This format is excellent for support groups, developing skills, or education about specific topics (e.g., substance use, grief, stress management).

Group therapy provides an atmosphere of emotional safety and connects people experiencing similar challenges. Group members can often learn and receive support from both the therapist and each other.

Group therapy can be advantageous for people who need a more cost-effective way to get treatment.

Play Therapy

Play therapy can be a directive or non-directive expressive form of therapy that helps children cultivate communication and interpersonal skills. This can be helpful as children may not be able to express their emotional concerns directly through words.

In play therapy, children work closely with a therapist—who may be an active participant or an observer—to examine how a child expresses and manages themselves. This approach can enhance a child’s social skills and communication skills.

EMDR

Eye movement desensitization and reprocessing (EMDR) is a form of therapy that can help people heal after distressing or traumatic events. A therapist who utilizes EMDR will help the patient access stressful or difficult memories by pairing them with external stimuli, such as eye movement or EFT tapping.

EMDR incorporates aspects of cognitive-behavioral therapy. Research demonstrates that patients can create new associations during this process, which can help decrease psychological distress and improve functioning.

EDMR for Trauma

EMDR has been effective in helping veterans reduce PTSD symptoms, as well as demonstrating improvement in symptoms with people who have experienced other kinds of trauma. EMDR should only be performed with a licensed and certified professional due to the sensitive nature of revisiting trauma.

Behavior Therapy

Behaviorism suggests that people can change their behavior by focusing on what can be observed and using proper reinforcements. Therapists can help patients evaluate behaviors that are not serving them but have been reinforced by factors throughout their lives.

By naming a target behavior and exploring how they would like the behavior to change, patients and clinicians can develop a plan that allows the patient to improve negative or unhelpful behaviors while picking up new techniques to support them in creating sustainable change.

Classical Conditioning

In a famous experiment conducted by Ivan Pavlov, dogs were conditioned to associate the sound of a bell with food. This demonstrates the essence of classical conditioning.

Human beings can also make associations between two stimuli when paired, leading to a learned response. These responses can be adaptive (positive) or maladaptive (negative).

Because the association between stimuli can change, therapists can work with patients to form different mental relationships with the stimuli, such as ones that elicit a relaxation response instead of a fear-based response. This type of learning association can be applied to phobias, anxiety, and fear.

Operant Conditioning

This behavioral approach is centered around the notion of reinforcement. A person’s behavior can be influenced one way or another by the resulting consequences.

For instance, if a child is rewarded every time they clean their room, they may repeat the behavior because they have learned that positive reinforcement will follow the activity. Alternatively, a lack of reinforcement or an unwanted consequence can cause a decrease in a specific behavior.

A therapist can apply these principles when working with a child to reinforce wanted behaviors and extinguish unwanted behaviors.

Desensitizing

People who experience fear-based responses to a trigger may engage in avoidant behavior because they have learned that they are unsafe in certain situations or events.

Desensitizing is a technique for a person to change their relationship with fear, anxiety, and safety about a situation or event.

Eventually, patients recognize that they are safe and can manage strong emotions. Desensitizing can be especially effective with anxiety and phobias.

Desensitizing Strategies

When drawing on this approach, a therapist can teach relaxation strategies like deep breathing, grounding, body scanning, and progressive muscle relaxation to decrease tension. Gradual exposure to a distressing situation or event through imagery changes the association between the trigger and the response.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) is a popular form of psychotherapy that combines cognitive therapy and behavioral therapy to form a more holistic approach.

CBT teaches patients to recognize and challenge unhelpful or irrational thoughts that may influence their emotions and behaviors. The emphasis is on understanding the connection between thoughts, emotions, and actions and developing a more balanced perspective and response.

During sessions, patients can practice and hone new skills, as well as apply them outside of sessions through tracking or monitoring their thoughts and behaviors.

Disorders Treated With CBT

CBT is an evidence-based treatment that is effective with a variety of diagnoses, including anxiety disorders, mood disorders, stress management, interpersonal issues, and more.

There are few subtypes of CBT, which include dialectical behavioral therapy, rational emotive therapy, exposure therapy, and mindfulness-based therapy.

Dialectical Behavioral Therapy

Developed in the 1980s, this type of therapy teaches skills that improve emotional regulation, interpersonal effectiveness, and distress tolerance. It also incorporates mindfulness.

As the standard treatment for people with borderline personality disorder, patients are taught how to identify and accept their emotions and behaviors, self-validate, distinguish themselves and their experiences from others, and manage emotional distress or discomfort.

This treatment approach emphasizes expanding the skills in a person’s toolbox to help them navigate their thoughts, emotions, and relationships.

Rational Emotive Therapy

Rational emotive therapy prioritizes recognizing and challenging dysfunctional thought patterns. A principle of this treatment is that how a person views and interprets events can shape their emotions and behavior.

Therapists utilizing this approach aim to help patients replace irrational thoughts with rational thoughts, which can help them better evaluate their thoughts, feelings, and behaviors.

Exposure Therapy

Exposure therapy is an evidence-based treatment geared toward showing patients that their fears can be managed. Upon identifying situations or events that cause psychological distress, the therapist and patient work together to prioritize coping skills patients can use as needed, as well as create a plan to slowly begin exposing the patient to different levels or aspects of the trigger.

Implemented with individuals grappling with anxiety, phobias, trauma, panic attacks, or obsessive-compulsive symptoms, patients practice restructuring their thoughts about the situation or events, managing feelings of fear, anxiety, or panic, all while seeing that they are safe and can cope with distress as it arises.

Mindfulness-Based Therapy

This method is rooted in meditative practices and may incorporate cognitive behavioral therapy. It emphasizes mindfulness, or the ability to be aware and in the present.

Therapists can teach patients to tap into thoughts and feelings as they arise. Patients can gain perspective and put space between themselves and negative thoughts. Research demonstrates that mindfulness-based techniques are instrumental in decreasing symptoms of depression and anxiety.

Mindfulness Techniques

Mindfulness-based therapy techniques may include:

  • Deep breathing exercises
  • Meditation
  • Visualization
  • Guided imagery

Cognitive Therapy

This type of therapy stems from behavioral therapy. It focuses on the relationship between thoughts and feelings. When patients are able to detect dysfunctional or irrational thoughts and transform them into balanced thoughts, there is a significant emotional impact that can lead to healthier responses.

Adopting strategies to change thinking patterns is the focus here. This treatment approach is effective and can be used with patients who experience depression, anxiety, or phobias. Cognitive therapy may be combined with behavior therapy, which can provide a more comprehensive experience for patients.

Humanistic Therapy

In this approach to therapy, the patient is viewed as a whole and individual person. In examining their choices and behavior, therapists can aid patients in recognizing their strengths and capacity to take responsibility for themselves and their lives, and work toward evolving into a fuller version of themselves.

Part of this process is investigating how patients view the world and themselves within the world. Examining these connections keeps patients focused on the here and now and allows them to become active participants.

Existential Therapy

Through exploring a patient’s personal experiences, therapists can help patients identify and create meaning in their lives. Awareness and personal responsibility are emphasized in an existential approach.

In existential therapy, pain, suffering, anxiety, and free will are all recognized as aspects of life. Patients are encouraged to be flexible in their thinking and adaptive in how they meet what life throws their way. Ultimately, patients learn acceptance and to be accountable for themselves.

Person-Centered Therapy

Also referred to as client-centered therapy, this approach prioritizes helping patients achieve personal growth and create change in their lives. Patients are viewed as the experts on themselves, and therapists empower patients to make choices that align with their goals.

The therapist uses non-directive techniques to meet the patient where they are in their journey with authenticity, empathy, and unconditional positive regard. This therapy aims to support patients in harnessing their inner strength and reaching the best possible version of themselves.

Gestalt Therapy

This therapeutic approach encourages patients to be present and evaluate the here and now. Gestalt therapy is not concerned with the past but more about how patients are impacted presently.

A therapist utilizing this approach may work with patients on cultivating a sense of acceptance, awareness, and responsibility for where they are in their lives. How a person perceives and understands themselves and their life is valuable in this form of therapy, as it can shape how humans view and interact with the world.

Emotion-Focused Therapy (EFT)

Emotion-focused therapy (EFT) is a brief therapy that helps people better identify, experience, and manage their emotions more flexibly. Centered in the here and now, EFT works to pinpoint problems, identify changes that can occur in the present, and help individuals learn to have healthier interactions in the future.

EFT for Individuals

In addition to being beneficial for couples and families, EFT is effective in the treatment of depression and trauma for individuals. One study indicated that EFT decreased symptoms of depression in couples where one member of the couple was struggling with depression.

Integrative or Holistic Therapy

Instead of utilizing one treatment method, some therapists will tailor their therapeutic approach to the patient’s needs by introducing strategies and methods from two or more types of therapy.

In this approach, the patient and their concerns are viewed through a holistic lens, and interventions are selected to help patients achieve more meaningful results in therapy.

For instance, a therapist may utilize cognitive behavioral therapy to help patients identify, challenge, and develop healthier thinking patterns while also applying techniques from a mindfulness-based approach to assist patients with managing stress or emotional discomfort.

Holistic therapy can be supportive to patients managing anxiety, depression, trauma, or stress.

Animal-Assisted Therapy

The connection between animals and humans can create a sense of calm and safety. Exposure to animals can enhance psychological well-being, specifically decreasing anger and stress, improving social interactions, or helping soothe people affected by trauma.

Animal-assisted therapy has been shown to help individuals develop and strengthen their social skills, as animal-assisted therapy teaches people about empathy and bonding.

Different kinds of animals, including dogs and horses, may be used in animal-assisted therapy.

Art Therapy

Art therapy is an integrative form of therapy that involves working with different artistic mediums to facilitate self-expression.

Art therapy employs creative activities such as:

  • Drawing
  • Sculpting
  • Painting
  • Movement

This self-expression can be significant when helping patients cultivate a more profound sense of self or heal from life events. It can also enhance cognitive and motor skills.

Art therapy can be applied to a variety of populations, including children, adults, and group settings.

Summary

Many forms of therapy can treat specific mental health diagnoses and symptoms. You might consider going to therapy if you are looking to navigate daily stressors, work through a problem, improve your relationships, cope with a traumatic event, or notice new or worsening symptoms of a mental health disorder. Having a sense of your needs, personal goals, and what you hope to get out of therapy is essential as you explore options.

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