Psychotherapy Approaches

Person-centred counselling, a humanistic approach, accepts individuals can realise their full potential and achieve what is termed ‘self-actualisation’, an innate process accessible to everyone.

Sessions with a person-centred counsellor encourage clients to bring their own issues, with the counselling process being client-led rather than directed by the counsellor. A person-centred counsellor facilitates exploration of the client’s issues, feelings, beliefs, behaviour, and worldview, promoting self-awareness and independence. Therapists eradicate the belief that therapists are there to ‘fix’ the and remind clients to take ownership of this.

Six key factors are identified when fostering individual growth:

1. Therapist-Client Contact – A relationship between therapist and client must exist and is key for positive change.
2. Client Vulnerability – Discrepancies between self-image and experience leave clients unknowing of their vulnerability, along with their fears and anxieties.
3. Therapist Congruence – The therapist should be self-aware, genuine, and congruent within the therapeutic relationship. This facilitates trust within the relationship.
4. Therapist Unconditional Positive Regard (UPR) – The therapist accepts the client’s experiences without conditions or judgement, allowing for freedom and open sharing.
5. Therapist Empathy – The therapist demonstrates understanding of the client’s experiences without becoming emotionally involved.
6. Client Perception – The client perceives the therapist’s UPR and empathy to some extent, communicated through the therapist’s words and behaviours.

Cognitive Behavioural Therapy (CBT) is a form of psychotherapeutic intervention designed to help individuals identify and modify harmful or distressing thought patterns that negatively impact their behaviour and emotions.

CBT aims to replace maladaptive thinking patterns, unhelpful emotional responses, or negative behaviours, with more positive ones. Through CBT, unuseful thoughts are recognised, challenged, and substituted with more rational and realistic ones. The focus of CBT is on altering habitual thoughts that promote emotional difficulties that influence mood, like depression and anxiety.

Specific therapeutic approaches within CBT include:

1. Cognitive Therapy – This approach identifies and modifies inaccurate or distorted behaviours, thought patterns, and emotional responses.
2. Dialectical Behaviour Therapy (DBT) – DBT integrates strategies for emotional regulation and mindfulness, by tackling harmful thoughts and behaviours.
3. Multimodal Therapy – This method suggests that addressing psychological issues involves treating seven interconnected modalities: behaviour, affect, sensation, imagery, cognition, interpersonal factors, and drug/biological considerations.
4. Rational Emotive Behaviour Therapy (REBT) – REBT involves recognising irrational beliefs, actively challenging them, and learning to change these cognitive patterns.

All forms of CBT aim to target the underlying thought processes contributing to psychological distress.

Transactional Analysis (TA) therapy is based on the theory that each person has three ego-states: Parent, Child, and Adult. These ego-states are used to understand and analyse individual communication patterns and identify the interactions necessary for improved outcomes.

An ego state refers to the unique behavioural makeup of an individual, encompassing consistent patterns of thoughts, emotions, and actions:

1. Parental Ego State – This ego state develops from internalising the values and behaviours observed in one’s parents during childhood. Individuals often hold traits such as being impatient, protective, authoritative, and morally upright. They may offer advice and judgments, rely on rules, regulations, and expressions of disapproval. The Parental Ego State can manifest in two subtypes: nurturing and critical. The nurturing parent offers support and encouragement, while the critical parent tends to be evaluative and fault-finding.
2. Child Ego State – Influenced by emotions, spontaneity, anxiety, fear, and a desire for conformity, the Child Ego State reflects early childhood experiences. Individuals operating from the Child Ego State may lack strong self-regulatory abilities, however can be more receptive to change. This ego state has three variations: natural, adaptive, and rebellious.
3. Adult Ego State – The Adult Ego State involves the impartial weighing of pros and cons, and relies on logical reasoning and factual information. This is characterised by a rational, analytical approach to decision-making. This ego state reflects a balanced maturity, where individuals draw upon lessons from their Child Ego State and knowledge from their Parental Ego State.

EMDR therapy is regarded as a non-traditional form of psychotherapy, primarily used to treat PTSD, trauma responses phobias, anxiety, chronic pain and depression. This therapy is based on the premise that traumatic events are not adequately processed in the brain at the time they occur. As a result, they continue to impact individuals with symptoms such as nightmares, flashbacks, and persistent feelings of reliving the trauma long after the event has passed.

The brain is unable to distinguish between past and present experiences, therefore when something triggers the memory of the trauma, both the brain and body react as if the event is occurring in the present moment.

During treatment, individuals recall traumatic experiences while moving their eyes back and forth under the guidance of a therapist. The objective is to help individuals process and integrate these traumatic memories into their regular memory. The theory underpinning this method suggests that recalling distressing events while being distracted is less upsetting, a technique used with the notion that repeated exposure to these memories will diminish their impact over time.

Solution-focused therapy (SFT) is a therapeutic approach that emphasises a client’s capacity to solve problems, rather than exploring the origins of these problems. SFT focuses on goal-oriented questioning to help clients move toward a future-oriented direction, similar to the principles of positive psychology.

SFT has been applied with varying success in several areas, including: depression, relationship difficulties, drug and alcohol abuse, eating disorders, anger management, communication difficulties, and crisis intervention.

Key techniques used in SFT include:

1. Scaling Questions – Scaling questions help clients assess their experiences and motivation to change. They involve rating their situation on a scale, followed by a positive follow-up question.
2. Miracle Questions – The miracle question is a technique that helps clients envision a future where their problem is solved. It should be posed deliberately to allow clients to imagine the miracle taking place.
3. Presupposing Change Questions – These questions are designed to highlight the client’s resilience and ability to manage their situation.
4. Exception Questions – Exception questions focus on times when the problem did not occur, helping clients recognize their strengths and successes.
5. Coping Questions – Coping questions aim to reveal the client’s resilience and effective strategies they have used to manage their difficulties.

These techniques help clients focus on their strengths and resources, fostering a sense of empowerment and progress.

^{Gestalt  is a school of thought that posits our minds to perceive objects as whole elements rather than as a collection of smaller components. Our brains organise  individual pieces of an image to see the bigger picture, as a way of simplifying our perceptions. Consequently, we automatically fill in missing information, group similar items together, and focus on elements that stand out.}

^{Gestalt Theory identifies six key concepts:}

1. ^{Self-Awareness – According to Gestalt therapy, a lack of self-understanding, including an individual’s motivations to personal unhappiness, can hold individuals back. The therapy emphasises awareness of emotions, thought patterns, and physical sensations to the body to facilitate genuine contact, self-discovery and self-acceptance.}
2. ^{Here-and-Now – The past is relevant to the extent that it impacts present thoughts and behaviours and Gestalt therapy prioritises the present moment, focusing on one’s current feelings. In therapy sessions, clients may be encouraged to “re-experience” past events to explore their current feelings about them, supporting to  address  immediate concerns rather than future worries.}
3. ^{Paradoxical Change – This concept posits that genuine change occurs through acceptance of self not through forced efforts. Attempting to be something one is not can lead to stress and anxiety, whereas self-understanding and acceptance naturally facilitates personal growth.}
4. ^{Taking Responsibility – Gestalt therapy emphasises recognising the impact of thoughts and behaviours on experiences and relationships. Clients are encouraged to accept the consequences of their actions and avoid blaming others for their problems. This fosters more positive interactions and enables them to meet their own needs, supporting individuals to realise they have control over their lives, which ultimately leads to greater fulfilment.}
5. ^{Closure – The therapy suggests that unresolved emotions and past experiences can create present problems by distancing individuals from their true selves. Addressing this “unfinished business” allows for the release of held emotions, contributing to a sense of wholeness.}
6. ^{Mind-Body Connection – Gestalt therapy acknowledges attention to bodily sensations as indicators of emotional states. Therapists may inquire about physical feelings associated with emotions, recognising that resolving emotional issues can also alleviate related physical problems.}

Transpersonal therapy addresses mental, physical, social, emotional, creative, and intellectual needs, emphasising the role of a healthy spirit in healing. Transpersonal therapy integrates spiritual traditions and rituals, prioritising positive influences and role models rather than concentrating on negative experiences. This holistic treatment is founded on the belief that humans are more than just their mind and body, encompassing intangible, transcendent factors that constitute the whole person. The focus is upon understanding how a person achieves meaning, purpose, and happiness.

A transpersonal therapist typically guides clients by concentrating on key areas and employing the following techniques:

1. Meditation – involves focusing on breathing, sitting still, and creating a calm environment to clear the mind. This fosters inner peace and helps manage stress.
2. Drawing Mandalas – it serves as a creative outlet to promote mental clarity and emotional healing to trauma.
3. Journaling – Journaling enables individuals to identify and prioritise their problems, determining which issues require attention and energy. It also helps release unpleasant emotions.
4. Music Growth – This therapeutic approach includes dancing, creating, and listening to music to facilitate healing and personal growth.
5. Mindfulness Techniques – involves focusing on breathing, surroundings, and sensations to build self-awareness and achieve self-fulfilment.
6. Visualisation – is a form of guided meditation where one creates mental spaces of comfort and safety. This technique promotes emotional stability.
7. Hypnotherapy – the therapist guides the individual to a safe mental space to uncover hidden potentials or address underlying problems. This is achieved through altered states of consciousness, through deep psychological exploration and healing.