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Cognitive: We define this as any therapy that is based on the belief that our thoughts are directly connected to how we feel. The cognitive therapies include Rational-Emotive, Cognitive-Behavioral, Reality, and Transactional Analysis.
Therapists in the cognitive field work with clients to solve present day problems by helping them to identify distorted thinking that causes emotional discomfort. There's little emphasis on the historical root of a problem. Rather, what's wrong with my present thinking that it is causing me distress.
Common traits among the cognitive approaches include a collaborative relationship between client and therapist, homework between sessions, and the tendency to be of short duration. These therapies are best known for treating mild depression, anxiety, and anger problems.
Behavioral : This is based on the premise that primary learning comes from experience. The initial concern in therapy is to help the client analyze behavior, define problems, and select goals.
Therapy often includes homework, behavioral experiments, role-playing, assertiveness training, and self management training. Like its cognitive therapy cousins it utilizes collaboration between client and therapist, and is usually of short duration.
Psychoanalytic : The original so called "talking therapy" involves analyzing the root causes of behavior and feelings by exploring the unconscious mind and the conscious mind's relation to it. Many theories and therapies have evolved from the original Freudian psychoanalysis which utilizes free-association, dreams, and transference, as well other strategies to help the client know the function of their own minds. Traditional analysts have their clients lie on a couch as the therapist takes notes and interprets the client's thoughts, etc.
Many theories and therapies have evolved from the original psychoanalysis, including Hypno-therapy, object-relations, Progoff's Intensive Journal Therapy, Jungian, and many others.
One thing they all have in common is that they deal with unconscious motivation. Usually the duration of therapy is lengthy; however, many modern therapists use psychoanalytic techniques for short term therapies.
Adlerian: Named for its founder, Alfred Adler, it is also called individual psychology. Considered the first "common sense" therapy, the basic premise is that human beings are always "becoming," that we're always moving toward the future, and our concerns are geared toward our subjective goals rather than an objective past. We are constantly aiming towards what Adler calls superiority. When we have unrealistic or unattainable goals, this can lead to self-defeating behaviors and discouragement which may foster neurosis, psychosis, substance abuse, criminal behavior, or suicide.
The role of the therapist is to help the client identify mistaken goals, and to help the client do away with self-centeredness, egotism, and isolation, and to develop positive, meaningful interpersonal relationships.
Generally, a long term therapy, sessions involve the therapist listening and questioning towards the goal of knowing the client as fully as possible, so that the therapist can feedback the faulty objectives and behaviors of the client.
Person-Centered (Rogerian): Founded by Carl Rogers in the 1940's, like Adlerian therapy, a basic premise is that we are all "becoming;" we are all moving towards self-actualization. Rogers believed that each of us has the innate ability to reach our full potential. As infants we are born with it, but because of early experiences, we may lose our connection to it. The self concept we develop in response to our early experiences may tend to alienate us from our true self. In this theory there is no such thing as mental illness. It is just a matter of being disconnected from our self-potential. This therapy is often considered the most optimistic approach to human potential.
This often lengthy therapy is based on developing the client-therapist relationship. The therapist is to provide the conditions necessary for the client's growth: genuineness, unconditional positive regard, and empathic understanding. To be genuine the therapist must strive to be transparent, open, willing to express at opportune times their own identity in the relationship. There is no hiding behind expertise or degrees. Therapists must be constantly doing their own inventory. Unconditional positive regard is synonymous with acceptance and appreciation of the client for who the client is in the present. Empathic understanding is based on the therapist's ability to see the world through the client's eyes, to move into the client's world at the deepest levels and experience what the client feels.
If the process works, the client moves back toward self-actualization.
Gestalt Therapy: This term was first used as the title of a book in 1951, written by Fritz Perls,et.al. The therapy did not become well known until the late 1960's. "Gestalt," a German word meaning "whole," operates as a therapy by keeping the person in what is known as the here and now. Therapists help clients to be attentive to all parts of themselves: posture, breathing, methods of movement, etc. Unresolved conflicts are worked out in the therapy session as if they are happening in that moment. An emphasis is placed on personal responsibility for one's own well-being through being as aware as possible at all times of one's interactions with the environment.
This usually lengthy therapy is accomplished by the therapist asking questions and suggesting experiments which will increase the awareness and sensitivity to the many parts of the client's total self.
Brief Therapies: While most therapy approaches have developed short term versions (often in response to the demands of managed care), one specific model is called SOLUTION-FOCUSED BRIEF THERAPY. This short term work is based on 1. focusing on solutions instead of problems, 2. Exceptions suggest solutions, i.e. "We fight all the time." "Think of a time recently when you weren't fighting." 3. Change is occurring all the time. 4. Small changing leads to large changing. 5. Cooperation is inevitable between therapist and client. 6. People have all they need to solve their problems. The premise is that if one does a step by step process, following these and six other assumptions, the client can find quick solutions to whatever may be facing them. Like the cognitive-behavioral therapies this is short term therapy usually involves homework and clearly defined goals.
ADDITIONAL NOTE: While Solution focused therapy is aimed at short term interventions, it can be successfully used over a longer period. Not every counseling client is ready to move on in 3 - 8 sessions, it is perfectly feasible to follow the aims of solution focused therapy, on a multitude of issues over many sessions.
For instance, working with a client around their substance misuse issues, the client may well attain their goal of reduction or abstinence, but may need longer term work around regaining self esteem, getting a job/education, re-establishing family links etc.
As the counselor/client relationship develops (leaning toward the person centered), the client may become more and more accustomed to the counselors use of solution focused techniques; the client may adapt techniques for him/herself, i.e.: "Give a hungry man a fish and he eats today, but teach him to fish, and he eats for a lifetime".
Eclectic Therapy: When therapists are asked their theoretical orientation, this is the answer most often given. This is essentially a common sense approach to helping people by tailoring therapy to the needs of the individual client. While this seems like a good idea, there is so much to know to become an adequate therapist in any one of the schools, it is unlikely that any practitioner knows enough to utilize and integrate the vast complexities of the many theories of therapy out here. Instead, if you look just below the surface, there is probably a primary therapeutic orientation that is simply not strictly adhered to by the therapist.
For instance, he or she may start out as a person-centered therapist, but has found a way to add cognitive or reality therapy techniques to their personal approach. It's probably a good idea to check this out with the therapist. Certainly some practitioners would argue, however, that "no theory means poor theory." Therefore, the therapist may take the client down a number of blind alleys to dead ends because she/he doesn't have a clear idea where therapy's going themselves.