Confused about the different approaches in therapy? Here's a guide to the main branches. 

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Different Types of Therapy Approaches

ACT is a cognitive behavioural method of psychology that teaches us to notice, accept and embrace our thoughts, feelings and actions. A critical assumption of ACT is that pain and suffering are a normal and unavoidable part of human experience and that it is our attempts to control and avoid these experiences that actually lead to more long-term suffering. Consequently, what ACT teaches us is to accept what is out of our control and instead commit to action that seeks to enrich our lives. The goal of therapy is not to eliminate certain parts of our experience but rather to learn how to deal with these painful events. During therapy you will learn the skills to recognise, recontextualise and eventually accept these events, and develop greater clarity about what values are important to you and commit to change.

Cognitive analytic therapy is a form of therapy that seeks to answer questions such as ‘why do I always end up feeling like this?'. It seeks to examine how problems and difficulties faced may be being worsened by our habitual coping mechanisms. These coping mechanisms may have been set up in childhood as a way of coping with emotional difficulties or deprivation. Together, you and your therapist will work to recognise these maladaptive strategies and work out how to use your strengths to bring about change.

Cognitive behavioural therapy is a form of psychotherapy which combines cognitive and behavioural therapies with the aim of helping individuals change how they think and behave. Unlike other forms of psychotherapy, CBT focuses specifically on the problems and difficulties we are facing in the present, rather than the past. CBT focuses on the thoughts, beliefs and attitudes we hold (our cognitive processes) and how this interacts with our behaviour to create our emotional problems. Fundamentally, CBT is based on the theory that it is not the events themselves that upset us, but the meanings we attach to them. Thereby, our thoughts can prevent us from seeing things that do not fit with what we believe is true. As such, CBT helps us to see the alternative explanation and enjoy the rewards of seeing events differently.

Counselling is an umbrella term that covers a range of talking therapies in which individuals are provided with a safe and supportive environment to explore problems they are experiencing in their lives. Problems faced may centre around a specific issue, numerous conflicts, or the need to simply gain greater confidence. Counselling can help overcome the feelings of embarrassment and fear of upsetting those we love that can sometimes make it difficult to talk to friends and family. Talking to a trained professional can help you look at problems from a different perspective and equip you with the necessary strategies to overcome problems effectively.

Dialectical behaviour therapy is a close relative of cognitive behavioural therapy; it was initially developed for individuals with borderline personality disorder who cope with distressing emotions by using self-destructive behaviours such as self-harm, substance misuse, and eating disorders. During therapy, the therapist uses acceptance strategies to explain to clients that their behaviour (e.g. self-harm, substance misuse, etc), is understandable as it is the only way they have learned to deal with intense emotions. However, the therapist will then explain that this method is not the best solution to these negative emotions and can begin to demonstrate more effective ways of dealing with intense negative emotion.

Existential therapy helps individuals deal with the problems of everyday living such as relationship difficulties, anxiety issues, body issues and others. Unlike other approaches, existential therapy acknowledges that within all our lives we may face times when our own particular struggles can feel overwhelming and we may behave in ways that seem irrational in response to these problems. By reflecting on these issues and by building self-knowledge and self-awareness clients are able to grow and overcome issues which may at times feel all-consuming. The role of the existential therapist is really to work alongside the client in exploring their values, assumptions and ideals and to make them feel like they choose their destiny through making the choices they want to make.

Gestalt therapy was first developed in the 1940s by Fritz Perls and literally translates as ‘whole’. It focuses on the whole of an individual’s experience including their thoughts, feelings and actions, with the main goal being that the individual becomes more self-aware. The therapist may use experiments such as creating patterns with objects and role-playing to help promote client’s awareness. As the individual talks through and explores their thoughts and feelings, they are also encouraged to notice their physical and emotional responses that may have provided barriers to communication with others thus exacerbating problems.

Person-centred therapy evolved in the 50s and 60s and views all individuals as capable of being loved, creative and knowledgeable. However, this approach also recognises that achieving our full potential requires favourable conditions and that sometimes in adverse conditions individuals may not be able to develop in ways they could. For example, sometimes we behave in ways that can elicit positive regard from the people around us but that we ourselves are not happy with and similarly we can elicit negative reaction when we do not behave as they expect. Over time, we may lose touch with what we really want and our ability to achieve our potential becomes stifled. During therapy, the therapist will aim to provide an environment in which the individual does not feel under threat or judged. This allows the individual to experience and accept more of them as a person and move towards recognising their potential. By demonstrating genuineness, empathy and unconditional positive regard, the therapist can create an environment where the patient finds their own solutions to their problems.

Integrative counselling is a term used to describe the integration of two or more therapies or counselling techniques. Integrative counselling is not aligned to any single type of therapy as its practitioners believe that no single approach works for every client in every situation. As humans we each think, feel and react in different, unique ways and so an integrative counsellor can work with each person to produce a unique therapy that is suited to their individual needs.

Internal family systems therapy is an integrative form of psychotherapy that incorporates systemic thinking (see Systemic Therapy) with a perspective that the mind is comprised of subpersonalities each with different characteristics. It was developed by Richard Schwartz and is used in therapeutic work with individuals, couples and families. Internal family systems therapy recognises that each of us has a true 'Self' which is inherently compassionate and curious about others and the different parts of our systems. An IFS therapist will facilitate the client's 'Self' in healing each internal part so that burdensome feelings and beliefs may be released.

Interpersonal therapy is a form of psychotherapy that explores the relationship between the individual’s interaction with other people and mental health issues. By exploring the individual’s interactions with other people it can be seen how these interactions make them feel. Often it is negative interactions that lead to negative emotions which then manifest in mental health problems. During therapy, the individual can learn how to best cope with tension and frustration that often results from negative interpersonal interactions, as well as build self-confidence and esteem that will allow them to not internalise so many of these reactions.

Mindfulness-based cognitive therapy uses simple breathing meditations and yoga stretches to help individuals become more aware of the present moment. This approach encourages people to be aware of each thought, so that they can prevent one negative thought leading to a chain of negative thoughts. These negative-thought chains succeed in prolonging and deepening the distress of the individual. By focusing on present thoughts mindfulness seeks to catch the first negative thought, thereby preventing the escalation of distress.

Positive psychology is the understanding of how people flourish, prosper and achieve happiness. This branch of psychology focuses on strengths, motivation and how we can cultivate them to achieve our goals. Positive psychology recognizes five fundamental aspects to human wellbeing. These are: positive emotion, engagement, relationships, meaning, and accomplishment. In practice, positive psychology can focus on a variety of 
life areas in order to work towards satisfaction and achievement.

The term ‘psychiatry’ literally means the ‘medical treatment of the mind’. It is concerned with the diagnosis and treatment of mental, emotional and behavioural disorders. In managing these conditions, psychiatrists have a number of methods at their disposal including pharmacological drug treatments, and psychological counselling. Unlike counsellors and psychologists, psychiatrists can prescribe medication in the treatment of problems.

Psychoanalytic psychotherapy is a therapeutic process which helps individuals understand and resolve their problems by increasing awareness of their inner world and its influence over relationships both past and present. Our early experiences are important in shaping the way we manage experience and how we cope in later life. With the therapist, individuals can come to understand these experiences and the strategies we have used to cope with them. This leads to a process of change, which takes place over the sessions. The relationship between the therapist and the individual is a crucial element in the therapy. The therapist offers a safe and supportive environment which facilitates a process where unconscious patterns of the patient’s inner world can be played out. This process helps patients gradually to identify these patterns and, in becoming conscious of them, to develop the capacity to understand and change them.

Psychodynamic therapy stresses the importance of the unconscious and past experience in shaping current behaviour. By encouraging individuals to explore unresolved issues and to talk about important people and relationships in their life they can increase their self-awareness and understanding of how the past is influencing present problems. Compared to psychoanalytic therapy, psychodynamic therapy seeks to provide a quicker solution for more immediate problems.

Like counselling, the term psychotherapy is used to describe a range of talking therapies and is used as a way of helping individuals overcome problems such as relationship issues, emotional difficulties and stress. The specific differences between counselling and psychotherapy are hard to pinpoint but the general understanding is that a psychotherapist can offer more in-depth work over a longer period of time. Psychotherapy itself, involves exploring in depth the feelings, beliefs and thoughts of an individual, including those from childhood, to come to a fuller understanding of the problem they face. Given the often sensitive nature of the issues discussed, developing a trusting relationship with the psychotherapist is paramount to effective treatment.

Rational emotive behaviour therapy holds that humans are prone to adopting irrational beliefs and behaviours which stand in the way of achieving their goals and purposes. These irrational attitudes take the form of dogmatic ‘musts’, ‘should’ or ‘oughts’, which often contrast with rational wishes, preferences and wants. During REBT therapy the therapist helps individuals to spot when they are distressing themselves with dogmatic beliefs and instead tries to replace these thoughts with more positive preferences.

This branch of therapy focuses on the present and the future, rather than the past. The fundamental implication is to find the solution to the problem rather than to focus on the origins to the problem. Brief therapy lasts for a limited number of sessions. Duration will depend on the needs of the client. Solution focused therapists work with the client to improve psychological wellbeing. A therapist may explore any difficulties or barriers and how to overcome these along the way. A therapist will be goal-directive and will support an individual in finding out what their goals are and how to achieve them in a healthy way.

Systemic therapy is a generic term for family therapy and helps understand how a family has become stuck in a pattern of interaction. It focuses on the context and networks of significant relationships within which people live their lives. This way of thinking sees the family as dynamic and the people who make up the family as changing and developing. The meanings created between individuals in the family are of particular interest in counselling. Counselling may explore how these meanings have evolved and been constructed by the people who make up the family. The counsellor may develop possibilities and interventions to help the family dynamic and deliver useful change.

Transactional analysis seeks to identify what goes wrong in communication and provide opportunities for individuals to change repetitive patterns that limit potential. It encourages individuals to analyse previous decisions they have made to understand the direction and patterns that limit their potential. It encourages individuals to analyse previous decisions they have made to understand the direction and patterns of their life for themselves. It also helps clients to trust their decisions and think and act as an individual, improving the way they feel about themselves.

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