Therapeutic Approaches: Understanding The Role of Therapist Orientation

There is a misconception that therapy is only about talking to someone. Yet, there’s more to therapy than just talking to someone. Yes, talking about yourself and what’s going on in your life or what’s troubling you is part of therapy. However, there’s more to it than that. As I wrote about a few blog posts ago, therapy is also about the therapeutic relationship. And part of what contributes to the quality of the relationship is the therapeutic approaches a therapist might use.

This is because the therapeutic approach and the modalities a therapist uses contributes to how they understand what’s going on for you. As well, it helps guide your treatment. Because of this, it can also help you to determine whether or not the therapist will be a good fit for working with you, which as you know, is important to the success of therapy.

Understanding the Therapeutic Approaches Out There

Therefore, I believe that it’s important that you understand a little about the therapeutic approach of a therapist before you start working with them. This is because it can help you to get a sense of how a therapist may understand you and what’s going on for you. As a result, this can also help you get a sense of what therapy could look like for you. For example, some approaches are more structured than others. Whereas other approaches are more collaborative and fluid. Understanding how a therapist works can help you determine whether or not working with this therapist will be a good fit for you.

So because of this, the focus of this post will be about the therapeutic approaches a therapist might take. I’ll highlight some therapeutic approaches and modalities you may come across in your search for a therapist. Following this, I’ll identify my own therapeutic approach and some of the therapeutic modalities I use or adapt in my work as a counselor and music therapist.

Different Therapeutic Approaches For Different Uses

Image shows the outlines of two abstract faces in profile with the caption, "What kinds of therapeutic approaches are right for you?"

There are different therapeutic approaches and modalities that you may come across while looking for a therapist. Some therapeutic approaches view mental health treatment through a specific kind of lens. For example, Cognitive-Behavioral Therapy looks at one’s mental health through the lens of their beliefs, thoughts, and behaviors. Whereas an integrative approach looks at all the different aspects that make us human. Still, other therapeutic approaches are designed or intended to treat specific issues, such as EMDR or Somatic Experiencing for trauma.

Because there are many options out there, I want to provide you with some information about the different therapeutic approaches you may come across while looking for a therapist. My intention in sharing this is so that you can make an informed decision about who you’d like to work with and how you’d like to work with them. Based on their therapeutic approach, do you think this person will be able to understand you? Do they speak a similar “language” as you? Can you view your situation through a similar lens? If your answer to any of these questions is, “Yes,” then they might be a good fit for you.

Therapeutic Approaches You May Encounter

Below are some therapeutic approaches you may come across when looking for a therapist. You may notice that some approaches tend to focus solely on the mind and one’s behavior, while some also look at the body and the person as a whole being. I want to stress that no one way is better than the others. Each approach and modality has its place and some people may resonate more with some approaches than with others. Read on to get a sense of what approach or approaches feel right for you.

Cognitive-Behavioral Therapy (CBT) and Mindfulness-Based Cognitive Behavioral Therapy (MBCT)

As I’ve written before, CBT looks at how a person’s cognition – that is, their thoughts, values, and beliefs, affect their behaviors. In this approach, mental distress is due to distorted thinking, such as how one sees themself, others, and the world. MBCT is an approach that incorporates mindfulness and meditation to CBT. [1]

Dialectical Behavior Therapy (DBT)

Another type of cognitive-behavioral therapy that incorporates mindfulness is DBT. Some main goals that DBT addresses are helping people learn how to live in the moment, cope with stress in healthy ways, better regulate their emotions, and improve their relationships with other people. [2] Part of the way DBT does this is through radical acceptance and accepting reality. This can involve learning how to sit in the discomfort of how things are in a given moment. And sometimes it can be about developing coping skills that you can use to distract yourself from the discomfort.

DBT was originally developed as a treatment for borderline personality disorder, but it’s also been shown to be useful in helping people engaging in self-injurious behavior like cutting, and in supporting stabilization following a suicide attempt or hospitalization. DBT is often used as part of intensive outpatient treatment groups and programs.

Acceptance and Commitment Therapy (ACT)

ACT is another behavioral approach that promotes mindfulness and encourages self-acceptance. By encouraging people “to embrace their thoughts and feelings rather than fighting or feeling guilty for them,” ACT seeks to help “patients create a rich and meaningful life and develop mindfulness skills alongside the existence of pain and suffering.” [3]

Motivational Interviewing

Motivational interviewing is a collaborative therapeutic communication style. It seeks to promote empowerment and change by exploring a person’s reasons for change and strengthening their motivation to change. [4] As such, it is a helpful approach for working with people in recovery, but it can also help those who want to make a change in their life.

Eye Movement Desensitization and Reprocessing (EMDR)

As I mentioned earlier, EMDR is useful in working with those who have experienced trauma. According to the EMDR Institute, Inc., “EMDR is a psychotherapy that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences.” The bilateral action of eye movement or some other form of bilateral stimulation a therapist may use plays a part in helping people process painful memories and the feelings associated with them. [5]

Somatic Experiencing

Unlike some of the other approaches I mentioned here, Somatic Experiencing is a somatic approach. Developed by Dr. Peter Levine, Somatic Experiencing “is based on the idea that traumatic experiences can lead to dysfunction in your nervous system, which can keep you from fully processing the experience… The goal of SE is to help you notice bodily sensations stemming from mental health issues and use this awareness to acknowledge and work through painful or distressing sensations.” [6] 

Biofeedback

Biofeedback also works with the body and the nervous system. With this approach, clients learn how to use their minds and become aware of what’s happening inside their bodies. With an emphasis on different relaxation exercises, such as deep breathing, progressive muscle relaxation, guided imagery, and mindfulness meditation, biofeedback can help with conditions such as chronic pain, migraines, incontinence, and high blood pressure. [7]

Client-Centered Therapy

In client-centered therapy, the therapist takes a non-directive approach and sees the client as an equal partner in the therapy process. Therapists using a client-centered approach will strive to create a comfortable therapeutic environment in which the client feels understood and doesn’t feel judged. Client-centered therapy can help people experiencing anxiety, dementia, depression, mood disorders, and negative thoughts related to PTSD. [8]

Narrative Therapy

Narrative therapy falls under the umbrella of “existential therapy.” It seeks to separate the person from the problem, which can make it easier for the person to engage in finding ways to solve their problems. This is because suddenly the problem isn’t something that’s “wrong” with them, but rather something external that can be resolved. Narrative therapy also looks at the stories that we create about ourselves as a way to discover or explore meaning and purpose. As with client-centered therapy and motivational interviewing, it is a collaborative approach. [9]

Attachment-Based Therapy

Attachment-Based Therapy is a brief and process-oriented therapeutic approach. It “is based on developing or rebuilding trust and centers on expressing emotions” within the therapeutic relationship. [10] Recognizing that the early attachment relationship one has with their caregivers has an impact on how that person develops as a teen and adult, attachment-based therapy can help reduce depression and anxiety, as well as improve relationships with others. People who may benefit from attachment-based therapy include adoptees, children in foster care, children of depressed mothers, and victims of trauma. This is especially true if the trauma was done by the hands of a caregiver. [10]

Interpersonal Therapy

Interpersonal Therapy (ITP) is a short-term treatment for depression. As such, it is also structured and manualized. Originally developed for working with depression in adults, ITP is also helpful for working with depression in teens. As an approach, it addresses interpersonal issues that can be affected by feelings of depression. The goals of ITP are to reduce symptoms of depression and to improve social adjustment. Eventually, the idea is that a person will be “better able to cope with and reduce depressive symptoms.” [11]

Relational Therapy

With this approach, it is thought that emotional well-being can be supported by “mutually satisfying relationships” [12] Sometimes called relational-cultural therapy, this approach takes into account the social factors that are relevant to a person’s life and looks at how they relate to the person’s life. It can be helpful to use this approach in those situations where a person is having problems in their relationships. As well it can help those experiencing mood disorders, such as anxiety or depression, and where these things are having a negative impact on their relationships. In this approach, the therapeutic relationship can serve “as a model to create healthier, longer-lasting relationships with others.” [12]

Integrative Therapy

Integrative therapy looks at the whole person and approaches therapy from that perspective. What this means is that it not only addresses the emotions, thoughts, and behaviors or actions of a person but also addresses the spiritual dimension. With this approach, all parts are seen as important and a goal is to help a person to integrate these parts within themselves.

Therapeutic Approaches I Use in My Work

So now that I’ve described some of these different therapeutic approaches, you may be wondering about my own. My therapeutic approach can be best described as integrative. This is because I understand that people and their mental health are holistic. I recognize that our experiences of health and well-being are multifaceted. How we feel physically plays a part, as does how we feel emotionally and mentally. As well, our social support systems impact our state of health. Likewise, spirituality can play a role in how we feel about ourselves and our place in the world.

Because of this, in my work, I may use a variety of therapeutic approaches and modalities. Some of these therapeutic modalities include:

  • CBT and MBCT
  • DBT
  • ACT
  • Motivational Interviewing
  • Narrative Therapy
  • Relational Therapy
  • Attachment-Based Therapy

How I Use These Approaches in My Work

These therapeutic approaches inform both how I work as a counselor and as a music therapist. Some of these approaches, such as attachment-based therapy, narrative therapy, and motivational interviewing, influence how I relate to clients as individuals. Having the understanding that we are complex creatures shaped by our lived experiences and family history, I can see people as who they truly are and not as a pathology or diagnosis.

While other therapeutic approaches, such as CBT/MBCT and DBT helps inform how I approach the work we do together in therapy. What can help you to feel more self-regulated and feel more comfortable or accepting of the uncertainty that is 21st-century life? How can you better understand how your thoughts, feelings, and behaviors are impacting your life? What needs to change and how can you do it?

Sometimes I use music to directly support or reinforce aspects of these different therapeutic approaches. But sometimes I don’t. Some of the concepts to these approaches align well with the use of music and others maybe not so much. In the future, I’ll be writing more blog posts that look specifically at how I use music to support some of these therapeutic approaches. Keep your eyes open here to the SoundWell Music Therapy blog if you’d like to read more about this.

Is My Therapeutic Approach Right For You?

So with that, I hope that this blog post helped you get a better understanding of the therapeutic approaches you might encounter when looking for a therapist. Likewise, I hope that this post was helpful to your better understanding of how I work as a therapist. If you would like to see about working together, reach out to me. I offer a free 15-minute online or phone consultation that you can schedule here.

References

[1] Mindfulness-Based Cognitive Therapy – VeryWell Mind
[2] Dialectical Behavior Therapy – VeryWell Mind
[3] How Does Acceptance and Commitment Therapy Work? – Positive Psychology
[4] Understanding Motivational Interviewing – Motivational Interviewing Network of Trainers
[5] What is EMDR? – EMDR Institute, Inc.
[6] How Somatic Experiencing Can Help You Process Trauma – Healthline
[7] Overview of Biofeedback – WebMD
[8] What Is Client-Centered Therapy? – VeryWell Mind 
[9] Narrative Therapy – GoodTherapy
[10] Attachment-Based Therapy – Psychology Today
[11] Interpersonal Therapy for Depression – WebMD
[12] Relational Therapy – Psychology Today
[13] What Is Integrative Psychotherapy? – Institute for Integrative Psychotherapy

Sign-Up for SoundWell Music Therapy’s Newsletter

Like what you've read? Sign-up to receive SoundWell Music Therapy's monthly newsletter.

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.