What Kind of Psychotherapy Do I Need?

At some point in your life, you’ve decided or you’ve been convinced that you need therapy.  Not physiotherapy, not occupational therapy, not massage therapy, but therapy for your psyche—your soul, your life, your self. 

First of all, congratulations!  You’ve made it past one of the most difficult decision points in going to see a counsellor.  Yet now that you’ve decided that you might need some help, you may find that you’re not sure what kind of help you need.  As you scan websites and leaf through seemingly random recommendations, you’re probably wondering “who can I trust?” and “what is the difference between all these therapies?”

The answer is: it depends.  It depends on the kinds of difficulties you’re having and it depends on what your goals may be.  It depends on what kind of person you are and it depends on what expectations you have of what a counsellor should do or how they should behave.  What follows are some brief descriptions of the major “umbrellas” under which most psychotherapies will fall. 

The “gold standard” of psychotherapy for the last 30 years or so is cognitive-behavioural therapy (CBT).  This kind of therapy focuses on people as thinking-feeling-acting beings and can be very effective for people who are struggling with burdensome symptoms and need some immediate relief.  It utilizes action plans, journals, and homework and is usually very focused on finding solutions for the difficulty at hand.  It is often called the “gold standard” because it is the kind of therapy that is easiest to standardize across counselors to ensure a standard level of delivery.  That is, if you visit a therapist who uses CBT a great deal, you’re more likely to get a similar experience from one person to the next.  For this reason, and for the fact that CBT has by far the most empirical research done on its effectiveness, medical doctors and other medical practitioners tend to ask their patients to seek CBT.

Another kind of psychotherapy is psychodynamic or psychoanalytic therapy.  This is the kind of counselling that most people envision when they seek help because of the way its founders had their clients lay down on sofas and talk about their sex lives or mothers.  Although some of these elements remain the same, most clients don’t lay down on couches facing away from the counsellor. The particular concerns of counsellors who employ a psychodynamic perspective are significant life events, relationships, family, and the achievement of insight that can help you understand yourself and other people in a new way.

Yet another umbrella of therapies are known as “humanistic” therapy.  The concerns of psychoanalytic and humanistic therapies actually are very close together, but humanistic therapy generally values client direction, client strengths, and is intensely focused on the client’s experience of the therapeutic relationship as a whole.  All (good) counsellors will employ some form of humanistic therapy when they relate to their clients in a warm, caring, and respectful manner.  The ultimate goal of purely humanistic therapy is to help clients grow by helping them access internal resources they already possess. 

Although there are hundreds of kinds of different therapies with each therapist likely putting their own spin on it, what is most important is that you feel that you can “work” with the therapist on the difficulty you’re having.  If after a few sessions, you feel that you and your counsellor aren’t a good fit for each other, it may be worth your time to speak to that therapist about how therapy is going.  And if things don’t get better, it may be time to seek a new counsellor.  Hopefully, what you’ve learned from reading this will help you.  And even though it may be a frustrating process to find a suitable therapist for you, the benefits will be enormous.