WHAT ARE THE THEORETICAL APPROACHES AND WHICH ONE SHOULD I CHOOSE?
There are four main theoretical approaches—also called theoretical orientations or models—in psychotherapy. Most psychotherapists use more than one approach, or techniques drawn from different approaches. Do not hesitate to ask psychotherapists about the way they work with clients and make sure that it suits you. During the initial assessment, the psychotherapist may refer you to a colleague who uses a different theoretical approach, if this is more in line with what you are looking for. To illustrate the various approaches, we’ll use an example case. Julie is depressed. She has been suffering from insomnia for more than a month. She argues with her boyfriend every day. She hasn’t felt like seeing her friends and has lost interest in her usual activities. Julie is tired of feeling this way and has decided to begin psychotherapy.
In this approach, psychological difficulties are related to unhelpful thoughts and behaviours. In psychotherapy, cognitive-behavioural psychotherapists use various techniques and strategies to help their clients to modify their behaviours, thoughts, and emotions. What behaviours and thoughts is Julie finding troublesome? What is making her feel bad? A cognitive-behavioural psychotherapist will work with her on her behaviours, habits, and thoughts, and will suggest strategies to help her live a more happy life.
According to the existential-humanist approach, human beings have within themselves what they need to realize their potential. Humanist psychotherapists work on the present moment, on their clients’ ability to take stock of their current difficulties, understand them, and change their ways of being or acting. They help their clients believe in their own potential and make changes in their own lives. How does Julie feel today, right now? What does Julie think is the reason she is having these feelings? How can she cope with them? An existential-humanist psychotherapist will help Julie find meaning in her emotions and develop her own solutions.
Strongly influenced by psychoanalysis and the concept of the unconscious, this approach draws connections between clients’ present difficulties, their past experiences, and repressed and unresolved conflicts in their personal histories. Clients are led over time to become aware of the influence of these conflicts on their current functioning, in order to understand them and gradually break free of their influence. What is disturbing Julie so much? Has a recent event brought up painful memories? A psychodynamicanalytical psychotherapist will try to understand Julie’s life story, her past conflicts, her fears and traumas, and how they have shaped her perception of herself and her life. By becoming aware of her past, Julie will be able to gain some distance from the situation, to better understand it and be able to make choices.
In this approach, personal problems are thought of as arising and continuing as a result of the interactions between people and those around them (family, friends, colleagues, etc.). The goal of systemic-interactional therapy is to modify the relationships between clients and those in their lives. Often, this will involve meetings between the psychotherapist and important people in the client’s life. Among the people in Julie’s life, who is influencing her so much? How might Julie’s relationships with others be harmful for her? A systemic-interactional psychotherapist will analyze Julie’s relationships and the methods of communication and systems that have arisen between her and the people in her life.