Types of therapy

Cognitive-Behavioural Therapy (CBT) states that your thoughts, emotions, and behaviour are interconnected. It especially empathizes the role of unhelpful thinking and learned patterns of action affect our mental health. According to the American Psychological Association, the three core postulates of CBT are:

1. Unhelpful ways of thinking play an important role in the development of psychological problems
2. Patterns of unhelpful previously learned behaviour also play an important role in the development of psychological problems
3. Finally, there are better ways of coping with psychological problems that people could learn, and those could (at least partially) alleviate their symptoms.

CBT often uses strategies to change these unhelpful patterns of thinking and coping. It typically starts by assessing what beliefs we hold (e.g., about ourselves, the world, others, etc.). Then, together with the client, the therapist explore ways to examine these patterns and finding ones that bring relief to the difficulties the client is facing. Then, using an array of different strategies, based on the assessment/formulation, the client and the therapist choose strategies (e.g., cognitive, behavioural) to address and change these patterns, find betters ones, develop skills, increase motivation, etc.

CBT is shown to be affective with many difficulties and disorders, such as anxiety disorders, depression, phobias. Thus, in my practice, I use these methods to both assess and help my clients, utilizing a range of skills that CBT provides, adjusting them to the situation and person I am working with.

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Schema Therapy (ST) has four main concepts:

• Basic emotional needs — needs such as safety, affection, connection, self-expression, play/fun, autonomy, fairness. Schema therapists believe that these are basic emotional needs that every person has.
• Early maladaptive schemas are developed during childhood when our basic needs are unmet, and often further elaborated during later years. They consist of emotional, cognitive, experiential and behavioural elements. The creator of Schema Therapy, Dr. Jeffrey E. Young, identified 18 schemas so far (here is a list of all schemas; more being currently researched).
• Coping styles. Dr. Young identified three general coping styles: Surrender (giving in to our schemas, repeating them again and again), Avoidance (escaping or blocking out our schemas), and Overcompensation (acting in a way that is opposite to the schemas we hold). Coping styles explain why different people react differently to the same situations. For example, one child with abusive parents might become overly shy and anxious, while other treated the same way can become aggressive and defiant. It is believed that this is partially connected to our temperaments at birth and partially with our environment (e.g., role models around us).
• Schema modes are the often a combination of schemas and coping styles. They are emotional states and coping mechanism that are “active” at the moment. Thus, most of them are inactive and are activated by certain life events or circumstances. Dr. Young identifies 10 such modes, while other researchers identify more.

Schema Therapy is especially effective, when working with attachment issues and traumas, as well as more ingrained coping mechanism that are unhelpful. But schema therapy is also found to be effective with depression and personality disorders, among others.

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Mindfulness is a collection of practices which aim to help us to become aware of our thoughts, emotions and body sensations. It is widely practised among varies areas — both in meditation/yoga, and in therapy. One such method is Mindfulness-based stress reduction program (MBSR), which combines mindfulness exercises with stress-management methods to help people deal with their stress better. Among others, MBSR was show to help with chronic pain, stress, depression symptoms, improves ability to concentrate, creativity, and improves the general sense of well-being.

I do teach MBSR course, both in groups and privately (see here). I also apply elements of mindfulness in my practice, helping my clients to connect with their experience of the present moment.

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Acceptance and Commitment therapy rest on a premise that pain, grief, disappointment, illness are normal, and thus inevitable part of human life. Instead of trying to avoid or block out these experiences, ACT helps clients to adapt to these challenges. This could take a form of improving psychological flexibility or understanding and pursuing one’s values, understanding the difference between thoughts and actions, being more mindful and accepting one’s thoughts and emotions. There are six core processes: acceptance, cognitive defusion, mindfulness, self as context, values, and commitment (more about them here and here).

In my work, I especially utilize the mindfulness, acceptance and values aspects of ACT, often helping my clients to better understand their values. This is often really important as value help us guide our actions.

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