Differentiating Therapy Modalities

Did you know that there are hundreds of different types of therapy modalities? With all the acronyms and access to psychology via social media, it can get pretty confusing. Today, we’re going to break down the most popular therapy modalities and help with understanding how it may help. The different types of therapy modalities covered in this blog post are cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), acceptance and commitment therapy (ACT), internal family systems (IFS), motivational interviewing (MI), somatic experiencing therapy (SE),  eye movement desensitization and reprocessing therapy (EMDR), and psychodynamic therapy.

Cognitive Behavioral Therapy 

Most people have experienced cognitive behavioral therapy in some way, whether that’s doing therapy homework or engaging in mindful thoughts throughout the day. The focus of CBT is to help the individual identify thought patterns that are impacting their behaviors and mood. You typically talk about a triangle in which our thoughts impact our mood, which then impacts our behaviors, furthering those thought patterns as realistic or true. An example of this might be having a negative thought about going to the doctor’s office, which leads us to have an upsetting feeling, like anxiety or fear, and leads to unhelpful behaviors, like canceling appointments or avoiding help. When we can begin to recognize the thoughts leading to the emotions and behaviors, we can begin to change those thoughts through various activities and homework assignments. This can be a really beneficial initial step into therapy and is a great resource for many people who struggle with anxiety or depression. 

Dialectical Behavioral Therapy

Dialectical behavior therapy, or DBT, is another cognitive behavioral-focused modality. The goal of DBT is to build skills to help manage intense emotions, improve interpersonal skills, and have a kit of distress tolerance tools. When doing DBT homework and practicing exercises, it is crucial to actively improve. DBT is broken down into four sections: mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness. You work through each section to help build skills that aid you in the next section. This therapy was initially designed for people struggling with borderline personality disorder but has now been utilized with numerous other mental health concerns, such as depression, PTSD, eating disorders, suicidal ideation, and self-harm.

Acceptance and Commitment Therapy 

ACT therapy focuses on helping you align your values with the actions that you live out in your day-to-day life, even during painful or hard periods. Therapists focus on helping people accept thoughts and feelings without suppressing them. An ACT therapist will focus on how mindfulness and being present will help you engage in challenging moments effectively. The focuses are acceptance, value-based action, mindfulness practices, and psychological flexibility. A unique difference within ACT is that instead of trying to change negative thought patterns, we are learning to accept them as part of just being human. ACT can help you learn how to be flexible and adaptable to different environments and circumstances throughout life. This can be really beneficial for people struggling with grief, depression, anxiety, substance use, chronic pain, and OCD.

Internal Family Systems

Internal family systems, or IFS, view people as having multiple parts with unique perspectives and functions that impact how we engage. The idea is to heal these parts and connect to our “Self” to be compassionate and balanced. These are not different people from who you are, but different parts, like exiles who hold onto painful memories, firefighters who might protect us from pain, and managers who help control behaviors. Remember, these parts are all still you. During IFS, we work on identifying these different parts and help them work together to allow the full self to lead. This can help with phobias, panic, anxiety, depression, and early life traumas. This therapy may not be suitable for people who struggle with conditions like schizophrenia, delusions, paranoia, or dissociative identity disorder (DID).

Motivational Interviewing

Motivational interviewing focuses on collaboration and identifying strengths within the individual. These strengths are known as our internal motivation that can help us make positive changes in our behaviors, empowering individuals to identify their reasons for change without feeling pressured. A large part of motivational interviewing is learning to “roll with resistance” and help develop discrepancies in our thought patterns. This is just a fancy way of saying that the therapist is aiming to help the client see a gap between current behavior and their desired goals or values that may be in their way. You’ll learn about the stages of change and how to maintain these changes. This is really beneficial for people who struggle with substance abuse, have unhealthy relationships with food, or struggle with motivation or goal-oriented behavior. This modality is often used in therapy sessions as it helps people make positive changes they want in their lives.

Somatic Experiencing

Somatic experiencing is a body based trauma focused therapy. We move through physical sensations that are connected to past experiences of distress. In SE it is a holistic approach to engaging the body instead of just emotions and thoughts. Through bodily movement and sensations the goal is release energy stored in the body from past distressing experiences. In session you will be doing a lot of body scans, mindful breathing, and gentle movement to cultivate body awareness. This can be extremely helpful for people struggling with trauma, PTSD, depression, anxiety and chronic pain.

Eye Movement Desensitization and Re-processing

EMDR is a specific technique designed to help individuals process and move through traumatic and distressing experiences or emotions. EMDR cannot be done by all therapists and requires specific training. The process of EMDR is broken up into eight stages, with the first three focusing on history-taking, developing strategies to ensure comfort, and identifying what we’re processing. Then, we get to the desensitization phase, where we use back-and-forth movements to reduce stress. After that, we install positive beliefs to improve confidence, focus on body scans to alleviate any physical discomfort, work on closure to ensure the memory is processed, and then reevaluate in the following session to make sure there are no loose strands. This has been highly researched for assisting with PTSD, depression, anxiety, phobias, and OCD.

Psychodynamic Therapy 

Psychodynamic therapy focuses on understanding how our current behaviors and emotions are influenced by past experiences. As a therapist myself, I like to explain it as our root system. If we were to imagine ourselves as trees, healthy roots help us stay grounded and strong, even when facing strong winds. However, there might be roots that have gone unhealthy and need to be trimmed back so that they can grow back strong. A large focus is on understanding early life experiences, improving self-awareness, understanding attachment styles, and focusing on personal growth. This is where we start to see unconscious beliefs, thoughts, or feelings impacting our conscious level of functioning. We work on incorporating these into our awareness. This therapy could be used for people who struggle with anxiety, depression, relationship issues, trauma, or anyone who wants a better understanding of themselves. 

So, whether you’re seeking therapy for the first time or have seen a therapist before, I hope this guide was helpful in understanding some of the most common therapies and helps you advocate for yourself. It’s also a good reminder that there is a form of therapy for everyone, and sometimes we have to try out different ones to find what fits and helps us.