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Psychological approaches and therapies

There are many, many different psychological approaches and therapies. However, many of these are variants of each other. Below are described some of the main approaches and therapies of which you may have heard. Although it is not usually regarded as a therapy per se, I have included mindfulness because it is a psychological process that is highly effective in promoting mental wellbeing.

Each of these psychological approaches and therapies has distinct benefits and applications to suit different types of problems and objectives and the style of therapy preferred by, and best suited to, the person being treated. In practice, therapists are seldom purists who stick to only one therapy model. Although therapists may have their own preferences and lean more towards some than others, they often draw on the principles and techniques of a variety of therapy models, depending on the particular problems and objectives at hand. Research clearly tells us that recovery from psychological distress is aided by psychotherapy. However, research is not so clear about recommending a particular type of therapy. Ultimately, research tells us that the quality of the relationship between the person being treated and the therapist makes a bigger difference to the outcome of therapy than the particular type of therapy used.

Psychodynamic therapy focuses on unconscious processes that are revealed in the person’s present behaviour, including the person’s relationship with the therapist. The main goal of psychodynamic therapy is to bring about greater understanding by the person of how past experiences are in constant dynamic interplay with present behaviour, thereby bringing about greater self-awareness. The therapist helps the person to identify and examine symptoms, or destructive ways of relating to others, that are rooted in past relationships, giving the person the opportunity to learn new, more helpful, ways of relating in the present.

Person-centred, or client-centred, therapy is based on the view that, given the right conditions, everyone has the capacity and desire for growth towards personal fulfilment and change. Rather than being seen as the expert and directing the therapy, the therapist helps the person to develop and grow in their own way by offering the person a relationship that is deeply understanding, accepting and genuine. The therapist’s role is to maintain a nondirective and supportive stance whilst clarifying what is said with a view to promoting the person’s self-understanding and growth.

Cognitive behavioural therapy (CBT) is a model of psychological therapy based on the idea that how we think, how we behave and how we feel are all inter-related and that changes to our thoughts and behaviours will influence our feelings. The therapy is collaborative, structured, educational and empirical. Therapy aims to modify the person’s thinking and behaviour system in an experimental way to see if this can have a positive effect on the person’s feelings, symptoms and underlying problems. The objective is to bring about enduring behavioural and emotional change.

Solution-focused brief therapy (SFBT) supports the person in using their existing competencies in order to achieve their desired vision of the future. The main focus of therapy is on identifying solutions that harness the person’s strengths, resources and previous successes and employing these to bring about change. This usually involves exploring previous solutions that can be applied to the current problem, exploring the reasons why the problem did not occur on previous occasions when it could have occurred and encouraging the person to do more of what is working. All the while, the person is encouraged to gently and progressively experiment with possible solutions.

EMDR (Eye movement desensitisation and reprocessing) is a psychotherapy that enables people to heal from the symptoms and emotional distress that have resulted from disturbing life experiences. It has been found that certain bilateral sensory inputs, such as side-to-side eye movements, can disrupt and reduce the negative emotion associated with traumatic memories that have been inadequately processed and stored in isolated neural networks. This is done by addressing the past, present and future aspects of a stored memory, requiring the person to recall distressing events while receiving bilateral sensory inputs.

Mindfulness is the psychological process of bringing attention to calm and unthreatening experiences occurring in the present moment. Research has shown that rumination and worry contribute to low mood, anxiety and other unhelpful behaviours and emotions. This occurs when we allow our lives to be unduly governed by the amygdala, the part of the brain that regulates how we respond to events that are potentially threatening. Regular practice of mindfulness curbs the influence of the amygdala and, instead, raises the influence of the prefrontal cortex, the conscious part of the brain that is capable of regulating unhelpful automatic reactions to sensory inputs.

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