Different Types of Counselling Approaches
Curious about what type of therapy to try? Here is a brief description of popular therapeutic approaches, compiled by Harley Therapy™, to help you choose.
Acceptance and commitment therapy is from the 'third wave' of cognitive behavioural therapies, action-focused therapies that work on your current issues by looking at your thinking and behaviours. A critical assumption of ACT is that pain and suffering are a normal and unavoidable part of human experience. It is our attempts to control and avoid what we see as difficult experiences that actually lead to more long-term suffering. ACT teaches you to instead accept what is out of your control, then commit to take action where you can so that a situation can improve. You will learn to recognise the difference between what you can and can't change, clarify what your personal values are, and then make values-based decisions that move your life forward. The end result is more resilience, and a more meaningful and productive life. This therapy can be short or long-term, and uses the popular tool of mindfuless in its process.
Learn about our London-based acceptance and commitment therapy (ACT) services.
Cognitive analytic therapy (CAT) is a short-term therapy. It's main focus is on your relationships. As its name implies, it combines cognitive elements (troubleshooting your thinking and behaviours) with psychoanalysis (looking at the past to find and understand the patterns you now find yourself stuck in). So it looks at how your current ways of relating with friends, family, colleagues, and partners formed from the ways you coped as a child. And it looks at the link between your moods, choices, and your relationships. How could better relating strategies help your thinking, behaviours, and moods? Recommended by the National Institute of Health and Care Excellence (NICE) for both eating disorders and borderline personality disorder (BPD), it can also help with addictions, anger management, anxiety, depression, low self-esteem, and, of course, relationship struggles.
Learn about our London-based cognitive analytic therapy (CAT) services.
Cognitive behavioural therapy (CBT) is one of the most popular forms of therapy in the UK, and is the most offered therapy should you choose to go through the NHS. A short term therapy often recommended for anxiety and depression, it looks at the link between your thoughts, feelings, and behaviours. The idea is that by working to change either our thinking or the choices we take action on, we can break the cycle that leads to low moods. CBT's focus is on your present day issues, and questions about your past are infrequent after your initial assessment. Note that it is a very practical and methodical therapy that does involve written exercises and homework.
Learn about our London-based cognitive behavioural therapy (CBT) services.
Here in the UK, 'counselling' is often used as an umbrella term for all talk therapies, and can be used interchangeably with the term 'psychotherapy'.
But at the same time, the training to be a 'counsellor' or a 'psychotherapist' is very different. Counselling school tends to be at colleges, and is generally a three-year program. Psychotherapy schools tend to be independent or held at universities, and are at least a four-year program (although some psychotherapists may take up to seven years or more to complete what can be a very rigorous and intense training).
And while someone who has only trained as a counsellor can't then call themselves a psychotherapist, some people who trained as a psychotherapist might choose to call themselves counsellors if they feel it suits their clientele more. Note that many who train as counsellors then go on to take a university MA program in psychotherapy, after which of course they are free to call themselves psychotherapists.
As for what the difference is in working with someone who has only trained as a counsellor, or who has trained as a psychotherapist? General counselling tends to be around one exact issue, such as 'grief counselling', or to be for general issues like stress, anxiety, anger management, depression, and life change. Deeper issues like personality disorders, trauma, or impulse disorders are best worked through with a trained psychotherapist, unless a counsellor has chosen to specialise and gained specific experience with such clients.
Dialectical behaviour therapy (DBT) was initially developed for individuals with borderline personality disorder, but is also helpful for anyone who struggles to control their emotions and impulses, or is very emotionally sensitive and/or suicidal. It teaches four main skills, which are how to stay present, how to get along with others, how to control you emotions, and how to tolerate distress and not meltdown when it comes. You learn to recognise and accept what you can't change but make positive steps to change what you can, so that you start to create a life you want to stay alive for. A practical therapy, you will be given worksheets to do, and sometimes have homework exercises. DBT is often offered in a combination of one-to-one sessions and group sessions, but can also work just as an individual therapy if group therapy is not for you.
Learn about our London-based dialectical behaviour therapy (DBT) services.
Existential therapy is quite different than other types of psychotherapy. Instead of looking to psychology as the answer to wellness, it looks to philosophy. It believes that many mental health issues have at their root a feeling of disconnectedness, arising from a lack of meaning and purpose. The existental approach believes that even if the world around us seems chaotic, we are responsible to use our freedom of choice to create a life that has value and meaning. By asking philosophical questions about life and death, and freedom and responsibility, we gain clarity on who we are, and what we we can only accept vs what we can change. Then we can make values-based decisions and actively create a life we want to be in.
Learn about our London-based existential therapy services.
Gestalt therapy is yet another renegade in the psychotherapy community, and comes under the 'humanistic' umbrella, therapies that focus on your innate potential. First developed in the 1940s by Fritz Perls, it is all about looking at ways you can be more self-aware and integrated. Gestalt translates as 'whole' and 'pattern'. So unlike other therapies that look at just your thinking and emotions, Gestalt also takes into acount your body, your spiritual experiences, and your unique 'lived' experience from moment to moment. It's very present-focused and holistic, and uses interesting tools such as its famous 'chair' technique, which sees you sitting facing and dialoguing with an empty chair that can be representing another person or another part of yourself. This form of psychotherapy is known for building self-awareness, understanding, and confidence.
Stefan Walters specialises in Gestalt therapy alongside other psychological therapies.
The humanistic movement came after the psychodynamic movement, which itself arose from psychoanalysis. Unlike these two predecessors, humanistic therapy makes the therapist and client equal, doing away with the 'doctor patient' power dynamic. And it sees the client as powerful and resourceful, not 'sick'. It's just that some of us did not grow up in the environments that helped us develop our potential. Humanistic therapies help you recognise your inner resources and put them to work so you can feel better about who you are and start to create a life that you feel good being in.
For more on the humanistic approach see 'person-centred therapy'.
Integrative counselling means your therapist is trained in several different psychothearpeutic appraoaches and either has one exact approach they use that carefully combines different approaches, or tailors therapy to you the client, drawing from different approaches. TThey might have gone to a school that taught different approaches together from the very start, or undergone several different training programs that each taught one different approach. These days it's very common that a therapist is integrative, as many therapists continue to take professional development courses even if their original training was in one approach so that they can best serve clients and compete in a competitive market.
For further information about our London-based services, see integrative counselling.
Perhaps the best way to see internal family systems therapy is like group therapy for all the different parts you consist of. This form of psychotherapy was created by a family therapist namd Richard Schwartz, who in his work with clients realised that we all identify as being composed of different inner parts or sub personalities. So he started applying family therapy concepts to individuals. Instead of helping family members communicate and get on the same page, he looked at getting individuals to communicate with their different inner parts, uniting them with their true 'Self', the part of us that is compassionate and curious about all these other inner voices. This creates a more balance and inner calm and can help us with things like depression, anxiety, trauma, and general wellbeing. It is not however recommended from those who suffer psychosis such as those with schizophrenia, where the sense of self is fractured beyond reality.
Learn more about Leila Steeds whose work is inspired by IFS (internal family systems therapy) among other approaches.
Interpersonal therapy is a form of psychotherapy that focuses on interrelating. The idea is that it is when our interactions with others are always going wrong that we end up suffering mental health issues. So by troubleshooting our relating skills and how we approach socialising in general we can build more self-esteem and confidence, have more rewarding relationships, and feel better about ourselves and our lives. This therapy focuses more on recent life challenges than the past, is a short-term therapy, and can help with things like anxiety, loneliness, depression, substance abuse, eating disorders, bipolar disorder, PTSD, life changes, and, of course, relationship problems.
Learn more about our London-based interpersonal therapy services.
Mindfulness-based cognitive therapy (MBCT) is similar to CBT therapy in that it does look at how your thinking might be affecting your moods. But whereas CBT agressively seeks to change your thinking through repeat exercises, MBCT focuses on accepting your thinking and taking away it's power by not fixating on it. By learning to hear but not buy into our negative thoughts, they start to lessen and we feel better. A key tool of MBCT is of course mindfulness, were we focus on being in the present moment, aware of the thoughts, feelings, and bodily sensations we are having here and now. MBCT is a short-term therapy and is helpful for anxiety and depression and general mental health issues.
For further information about our London-based services, see mindfulness-based cognitive therapy (MBCT).
Positive psychology is the understanding of how people flourish, prosper and achieve happiness. This branch of psychology focuses on strengths, motivations, 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.
Psychiatry is the medical treatment of the mind. A psychiatrist is someone who trained as a medical doctor then decided to go on to study mental health and mental disorders. While in America psychiatrists are sometimes also talk therapists, here in the UK most psychiatrists only deal with the diagnosis and treatment of mental, emotional and behavioural disorders. They will create a treatment plan then refer you onwards to talk therapy as required, and you will go back to see your psychiatrist for prescription renewal and adjustments to your treatment. Note that in the UK it is only doctors and psychiatrists that can provide pharmacological treatment. This is outside the scope of counsellors, psychotherapists, and psychologists.
Harley Therapy connects you with highly experienced professionals, read more about these London psychiatrists.
Psychoanalytic psychotherapy is the oldest form of talk therapy, established by Freud but later expanded on by other psychoanalysts like Adler and Klein. It believes that the roots of our current day issues lie in our past, and that we don't understand our issues as we tend to hide our painful experiences, thoughts, and feelings in our 'unconscious', a part of our mind we are not aware of. Often we hide pain with the 'defence mechanisms' we developed as a child, such as denial (denying things happened) and repression (hiding things in our mind). Psychoanalysis uses some famous techniques, such as 'free association' (saying whatever comes to mind without editing), transference (looking at how your feelings toward your therapist are actually your feelings toward people from your past) and dream anaylsis. Now debated as to its value, some people still find it suits them as a talk therapy. It's a long-term and open ended therapy that can go on for years. Note that many of the concepts of psychoanalysis are used in psychodynamic therapy, the type of talk therapy that arose in reponse to psychoanalytical thought.
For further information about our London-based services, see psychoanalytic psychotherapy.
Psychodynamic therapy arose in response to psychoanalytical thought. Like psychoanalysis it believes in looking to our past for solutions to current day problems, and believes we can hide painful experiences in the unconsious mind. It looks to help you explore patterns and unresolved issues in past experiences and relationships so you can increase your self-awareness and make better choices in the present. Unlike psychoanalysis it does look at the present as well as the past, and considers how your conscious thinking also affect things, not just your unconscious. It is a long-term therapy, although there are now forms of therapy based on psychodynamic therapy that are short-term that can be referred to as 'brief psychodynamic therapy', such as DIT, dynamic interpersonal therapy.
For more information about the London-based therapists offering this approach see Psychodynamic therapy.
Psychotherapy describes a range of talking therapies designed to help individuals gain self-awareness and find answers for the issues they are struggling with. These days there are more than fifty forms of psychotherapy, but they all involve talking with a therapist to feel better about yourself and more capable of dealing with life. Here in the UK the term 'counselling' and 'psychotherapy' are often used interchangeably. But counsellors have less training than psychotherapists unless they went on to do a MA in psychotherapy after their counselling certification. And psychotherapists are more trained at dealing with mental health disorders than counsellors, who tend to focus on general issues like stress, or a certain popular issue like bereavement or redundancy.
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. A solution-focused 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.
To learn more about this approach and the London-based therapists available, see solution focused brief therapy.
Systemic therapy is a professional term for family therapy and group therapy. It sees a family or group as a system, and works to understand how the family or group has become stuck in a pattern of interaction. So it does not see one person as causing the problem, but each member as contributing to the whole, where the problem is. It focuses on the interactions between members, and the way meaning is being created or attributed. Your systemic counsellor will help the members of your group or family to listen and communicate better with each other, to recognise how each person plays their part in dysfunctional patterns, and to together create more useful ways of behaving and interacting that mean your family or group functions in healthier ways.
Transactional analysis (TA) has been around since the 1950s. It believes that our issues in life stem from our social interactions, and both the roles we play and the ways we relate. Many of us act differently around different people because of the unconscious social patterns we are stuck in. By looking at the ways you think and feel and the choices you make when relating, you can start to experiment with more helpful approaches. The idea is that when our social relationships improve we feel better about ourselves and our lives. TA is an open-ended therapy that is seen as helpful not just for relationship problems, but for things like anxiety, depression, and borderline personality disorder (BPD).
For more information about this approach and the London-based therapists see transactional analysis (TA).
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