Therapy 101: Theories and Approaches to Therapy

Breaking down therapeutic approaches

While the list of therapeutic theories and approaches is ever-growing, we can break them down into a few major categories of therapeutic approaches: psychodynamic approaches, behavioral theories, cognitive theories, a humanistic approach, and holistic or integrative therapy. While your therapist is constantly adapting to your needs in each therapy session—what therapists like to call the idea of "meeting the client where they're at"—they are absolutely basing their responses, questions, and overall approach in theory. In fact, trained therapists are ethically obligated to inform their therapy in some type, or types, of theory to ensure client success.

Each therapist hones their skills based on theories that most work for them, and every therapist is different. As a client of therapy, it is encouraged for clients to advocate for what works best for them – some clients work better with certain approaches over others, and that's okay! Read on to perhaps identify where your therapist is "coming from" in your own therapy...

Psychodynamic. Rooted in Sigmund Freud's work, psychodynamic therapy is rooted in the belief that much of our behavior is rooted in the unconscious. Psychodynamic approaches also pull a great amount from a client's childhood experiences, traumatic or otherwise, to identify deeply rooted beliefs, emotions and behaviors. Psychodynamic theories also promote as little intervention and discussing from the therapist as possible, to allow clients to speak freely without interruption or suggestion.

Behavioral. Behavioral theory states that all human behavior is learned. Have you ever heard of "Pavlov's dogs"? Ivan Pavlov, an originator of behavioral theory, conducted an experiment with dogs that focused on how dogs learned to salivate when they heard a stimulus that meant food was coming. In discussing rewarding behavior, positive and negative reinforcement of behavior, and behavior modification, therapists are likely coming from a behavioral approach to therapy.

Cognitive. As the word 'cognitive' suggests, this approach to therapy lies firmly in the way people think, and how their thinking affects emotions and behaviors. Opposed to psychodynamic theory which draws largely from a client's past, cognitive theories focus in the client's present, and hone in on how their thinking is affecting their lives. If you've ever heard of CBT (cognitive behavioral therapy)--and you probably have!--you have begun to understand the basis in cognitive therapy. CBT is possibly a most commonly used therapeutic modality as it is extremely evidence based in treating many mental health disorders including anxiety, depression, substance use, eating, and more.

Humanistic. This approach in therapy prioritizes a client's self-actualization, and focuses on seeing the goodness and potential of all clients. Carl Rogers coined the term "client-centered therapy", generally speaking to the idea that all therapists must hold clients in the highest regard, with extreme validation and focus on finding meaning and self-determination in life. In discussing existential therapy, we are discussing a very humanistic approach to the treatment of clients.

Holistic and Integrative. As mentioned earlier, most therapists will pull from a number of therapeutic modalities to create the most holistic care plan possible. The aforementioned therapies mentioned are also referred to as "talk therapies", and holistic and integrative therapies take that a step further. Art therapy, movement therapy, dance therapy, EMDR, hypnotherapy, guided imagery, yoga therapy and other nontraditional therapies serve to complement and guide more traditional talk therapies for a client's ultimate and most holistic healing.

At the end of the day, these theories are set and learned for guidance and informing of the therapist's work; ultimately, the most important factor of success in therapy is the relationship and rapport between the therapist and client.