Psychological Therapies

There are diverse types of intervention, all of which have been extensively trialled and empirically validated. The best-indicated approach for each person’s unique circumstances dictates the choice of technique: this is never a one -size –fits- all approach.

Cognitive Behavioural Therapy

CBT has a long history in treating a number of different mental health conditions. It is recognized for its effectiveness and its very comprehensive development and evaluation.

It is widely used to treat depression and anxiety, but it can also help people with:

obsessive compulsive disorder (OCD)
post-traumatic stress disorder (PTSD)
phobias
behavioural issues

CBT is highly logical and it helps to illustrate the connections between thoughts, feelings, habits, and actions.

You and your therapist will look atxs these areas to work out how different ways of connecting these can help to relieve symptoms and assist in better coping and lowering stress.

Mindfulness

Mindfulness training originally sprang from Buddhist and meditation practices. It enlarges our awareness of our thoughts and feelings as they happen from moment to moment. We become more aware of sensations and sounds, sights and fragrances.

As we become more aware of these we are also better able to understand how our thoughts come and go and how stress patterns arise and how they affect us. This training is very calming and it helps us to take control in varying situations. Stress and anxiety tend to affect us less over time and this therapy has been found effective for anxiety, stress, and recurrent depression.

Acceptance & Commitment Therapy

ACT has often been used in groups and it was developed to combine aspects of mindfulness, CBT and behavioural supports. Clients learn that while feelings and fears may be unpleasant they may be there for a reason and cannot always be avoided (Acceptance). Clients are encouraged to be more understanding of themselves in their situation.

Once this has occurred the person is more able to change how they choose to react to their thoughts, feelings, and experiences. They are encouraged to identify in detail what their values are and how these may shape future actions.

Finally, ACT techniques help people commit to actions that will assist them more positively whilst being consistent with the values they have identified (Commitment). The behavioural component of ACT helps people to find their new responses rewarding.

Schema Therapy

Schemas as a concept arose from cognitive theories of the way the mind works. Schemas are longstanding “pools” of ideas, beliefs and associated reactions which have built up gradually over time. For example, we may have a schema which says that we will feel uncomfortable and “on the outer” in a large group of people; we are socially unskilled and we will stand out in a negative way. Hence, we should stay on the outside, and attempt to be invisible in this situation.

Negative schemas such as this one can act as blocks to traditional forms of therapy (for example, for Social Anxiety). So, tackling the schemas themselves can be most helpful when someone feel stuck. Actively tackling negative schemas can break recurring patterns which the person has not sought to question before. Often, CBT techniques following on from this will then become more powerful.

Dialectical Behavioural Therapy

DBT was developed using aspects of CBT and behavioural techniques. It was originally intended mainly for people experiencing Borderline Personality Disorder. This issue means that sufferers often find themselves out of their depth in emotive situations: they suddenly lose all of their skills and lose control of the way that they feel, which can quickly spiral into conflict and crisis. DBT recognizes that people with this problem tend to become more quickly physiologically aroused (ie feeling disturbed) and that they have a lot of trouble managing to return to calm levels of emotion when this happens.

For many years there were no techniques to help people understand their patterns and cope when this occurred. But DBT teaches positive and adaptive skills tailored to the person’s triggers and patterns. Constant practice and evaluation are used to create a new skills base, while increased distress tolerance helps the person to manage in their crisis times. This produces improvements in the ultimate goals of better emotion regulation and an ability to cope much better in provoking situations without putting relationships and safety under such high levels of challenge.

Insight-oriented Psychotherapy

Also known as Psychodynamic therapy, insight-oriented therapy arose from the psychoanalytic therapies originally described by Sigmund Freud. This technique seeks to clarify how unconscious processes within the person interact with their attempts not only to manage but to disguise the struggles they are going through. It then goes on to illuminate how the person sees themselves, the beliefs they have built up, and the ways all of these influence their interactions and relationships. When people come to understand the ways these complex processes are influencing them ‘behind the scenes’ they gain increased insight and feel freed from the constraints they have constantly placed themselves under.

Emotion Coaching

Emotion coaching helps children to identify and communicate their feelings and to increase aspects of their social and emotional competence. It can be used for children where emotional outbursts or overwhelm are an issue. These may lead to challenging behaviours. The helpful adult uses empathy to support the child during an emotional “peak”. They help the child to name and become familiar with the feelings without fearing them. (It is essential that they help the child to feel secure.) When the feelings can be named, acknowledged and discussed without ’heat’ the child can participate in exploring more co-operative or appropriate behaviours with support.

Note: these techniques may be only partially indicated in children with developmental issues such as autism spectrum or ADHD.