Psychotherapy Road Map
Updated: Feb 26, 2020
BACK TO BASICS
HELP! I'M SO CONFUSED ABOUT ALL THE HELPING PROFESSIONS OUT THERE (NOT TO MENTION ALL THE LETTERS AFTER THEIR NAMES)
You are not alone! Many people find navigating the system and all of the info out there totally overwhelming. Even mental health professionals themselves tend to get confused about the scope of practice of other similar professions, and their related terminologies.
In order to educate and break stigmas we will try to break things down as much as we can. In this series, we hope to unpack all the information you might need in order to access the best mental health supports you can.
To start off... let's go back to basics.
"Psychotherapist" in the Broadest Sense of the Word
Psychotherapist is a broad term used for a variety of different types of mental health professionals and supports such as psychologists, psychiatrists, clinical social workers, mental health nurses, coaches and counselors... to name a few. Regulations are different in each country, state or province, so familiarize yourself with the licenses and certifications that mean something in your area.
Here is a chart to get to know all different types of helping professions that might fall into the category.
Psychotherapy Methods in a Nutshell
There are literally thousands of psychotherapy methods and approaches, but for the sake of simplicity, we are going to break down the core psychotherapy approaches into six broader category groupings (but you will notice lots of overlap eventually when we get into specific modalities in subsequent posts);
Also known as “insight-oriented therapies”, this group of therapies places a strong emphasis on the importance of building a solid connection and working partnership between therapist and client. Guided by the therapist, clients explore symptoms that arise from past dysfunctional relationships, unresolved conflicts and the unconscious meanings and motivations behind their problematic behaviors, feelings, and thoughts, in order to effectively change them. As the oldest of all of the modern therapies, psychodynamic therapies are rooted in Freudian Psychoanalytic Theories. Ego Psychology, Object Relations, and Self Psychology are part of this foundation. There have been so many adaptations and alterations in modern practice that purists would take serious issue with calling many of the newer therapies “Freudian”. Regardless, the main goals of psychodynamic therapies include helping clients develop self-awareness and an understanding of how the past influences present behavior. So in that sense, the resemblance certainly passes.
Remember Pavlov’s famous dog? Funnily enough, Ivan Pavlov's experiments with his dog, gave incredible insights into human behavior. Concepts that came from his research, such as “classical conditioning” and “associative learning”, helped to lay the foundation for behavior therapy. For example, a therapist might help a client with a phobia by "desensitization" through the use of “classical conditioning”, meaning repeated exposure to whatever the source of that anxiety is. Another key player in the development of behavior therapies is Edward Lee Thorndike, who developed the idea of “operant conditioning”; the use of reward and punishment to help shape behavior. There are so many spin-offs of this type of therapy as we will learn in other parts of this informational series.
Cognitive therapy is founded on the belief that dysfunctional thinking patterns lead to dysfunctional emotions and behaviors... so by changing thoughts, we can change how we feel and what we do. A few key players have been responsible for developments within this field; Albert Ellis established Rational Emotive Behavior Therapy (REBT) which aims to resolve emotional and behavioral problems in order to help people to lead happier and more fulfilling lives. Although REBT is considered the precursor to CBT, Aaron Temkin Beck, the father of CBT, did not agree with Ellis's technique of psychoanalysis. Beck felt that it was imperative for long-term success that the client be empowered to discover their own issues, guided by the therapist. He felt that Ellis’ approach to tell the client what is wrong with them would not achieve the desired results, because people need to feel like they own and are responsible for their own healing. Beck’s contribution of the self-discovery aspect was pivotal to the modern practice of cognitive therapies.
Inspired by philosophers like Martin Buber and Søren Kierkegaard, this intuitive approach focuses on the understanding that people have a natural capacity to make rational choices and maximize their potential on their own. For example, “client-centered therapy” emphasizes that clients are the authorities on their own inner experiences, and therapists are merely there to guide that process. An extension of this would be Existential Therapy, which emphasizes the human condition, celebrates innate capacities and aspirations while also embracing human limitations. A healthy therapist–client relationship is key to this approach, as exploration of concepts like free will, self-determination and the search for meaning are done collaboratively. Gestalt therapy, founded by Fritz and Laura Perls (not to be confused with Gestalt Psychology, which is apparently TOTALLY different), is one of the experiential forms of humanistic therapy.
Many therapists don't want to tie themselves to any one particular approach, but rather blend elements from all different approaches. Integrative psychotherapy’s progressive nature is adaptive and flexible, combining different therapeutic tools from other approaches (above) to best fill developmental gaps and address the individual needs of each client. Holistic therapy is one example of a spin-off of this, where heart-centered hypnotherapy and breathwork is combined with more traditional approaches like psychoanalysis and CBT in an integrative mind, body, spirit approach to wellness. In this practice, the foundational idea is that each person is viewed as a whole being (meaning not-broken), which allows for a deeper understanding and acceptance of “self”.
Medical therapies (in regards to mental health) refer to the medications, methods and modalities that medical doctors use to support proactive mental health and treat mental illness. The ability to prescribe medications is what sets this category apart from the others. It’s not just psychiatrists that use medical therapies. In many countries, other MDs including family physicians, developmental pediatricians and GPs are involved in the first steps (and sometimes the only steps) of mental health care. That is a huge responsibility that many are not fully prepared for simply because they went to medical school 20 years ago. Basic training in med-school is often insufficient to meet the evolving needs of mental healthcare. It’s important to note that not all psychiatrists practice psychotherapy. Many will deal with medications and then refer out for other therapy needs. And to throw another curve-ball into the confusion... it’s very possible to find family doctors and GPs that are trained in psychotherapy methods. Ya it’s kind of confusing. Do your research. Now medical interventions for mental health not only includes medications & psychotherapy, it can include alterations to diet approach, specific types of physical activity, stress reduction techniques and more.
But the incredible thing is that research is constantly evolving and we are learning more and more about the relationship between mind, body and soul all the time!
Stay tuned for more posts in our "Back to Basics" series.