Therapy: Many of us have an image of it our minds -- whether it's Robin Williams tending to a wounded Matt Damon, Betty Draper lying on a couch or one of a great many New Yorker cartoons. But these popular depictions of therapy don't tell us what a session is like or whether psychotherapy is effective (though studies have found that it is effective and that the benefits it brings are real and lasting). And although the numbers tell us that psychotherapy has become a common feature of many people's everyday lives -- in 2008, 40 million adults in the U.S. received mental health treatment -- if you've never been, the actual experience of being in therapy can be somewhat mysterious, if not intimidating and downright off-putting.
For anyone who's considered therapy but didn't know where to start, or simply wants to understand what it's like once you're in the room, check out the guide below, which provides the need-to-know information for the most common kinds of psychotherapy.
What's Up, Doc? Mental Therapies And Their Uses
If you're picturing Tony Soprano opening up to Dr. Melfi, you're onto something. Psychodynamic therapy is all about talking. More specifically, the patient is guided to talk about his or her thoughts and feelings and free associate (i.e. talk uninterrupted about whatever comes to mind), with the goal of bringing unconscious patterns of behavior to the fore so they can more easily be addressed and (if it would be beneficial to the patient's health) changed.
What to Expect: Sessions take place once or twice per week and are unstructured. The patient is encouraged to guide the session by talking freely about whatever is on his or her mind.
Cognitive Behavioral Therapy
Based on the idea that we can make permanent changes in the way we behave by shifting our negative patterns of thinking, Cognitive Behavioral Therapy (CBT for short) is short-term and goal-oriented. The therapist and patient work together to identify the behaviors the patient wants to change and then come up with an action plan to do so.
Term Of Treatment Four to seven months, with meetings every one to three weeks
What To Expect: Sessions are structured and the relationship with the therapist can be more “business-like” than in other kinds of therapy. In other words, the patient and therapist will work together to identify and change problematic patterns of thinking and behaving. The patient is given "homework," which consists of keeping a record of his or her thoughts, feelings and behaviors between sessions.
Families are so much more than the sum of their parts, and can experience struggle and conflict singular enough to warrant a pop culture genre. Luckily, family therapy considers the family unit to be a system with its own unique dynamics (rather than just a collection of individuals who happen to be related). It may address specific problems like an addiction in the family or focus more generally on communication and members' relationships with each other.
Useful For: Families dealing with substance abuse, mental illness, eating disorders, abuse, financial worries and other problems
What To Expect: Typically the family is treated together, but members may also see the therapist (or a different one) on their own.
The more the merrier, right? Group therapy is useful for anyone who wants to explore the challenges and conflicts he or she is experiencing in relationships, work, life, etc., and do so in a supportive group setting with other people who are struggling with the same or similar things.
Useful For: People who are struggling with anything from depression and anxiety to loss or trauma and want to work through these issues in the company of others. The group setting offers unique opportunities to learn from others and get lots of feedback, and it tends to be cheaper than seeing a therapist one-on-one (making it a good option for those on a budget).
Term Of Treatment: Six to 20 weeks
What To Expect: The therapist will put together a group of five to 10 people who share the same problem or conflict. The group meets for 75 to 90 minutes for a conversation guided by the therapist.
Dialectical Behavior Therapy
Originally developed to treat individuals with suicidal thoughts, DBT has since been found to be an effective treatment for people with Borderline Personality Disorder (BPD) and BPD-like symptoms (which include unstable moods, extreme reactions like panic, depression, suicidal thoughts and fear of abandonment). DBT was designed to help these individuals understand their thoughts and behaviors as out-of-the-ordinary and extreme, and then learn coping and interpersonal skills that allow them to find more measured, moderate ways of acting and reacting.
Useful For: Anyone who experiences the kinds of feelings associated with Borderline Personality Disorder (even if they aren't diagnosed as such), including high emotional reactivity, rapid mood changes, and ongoing feelings of emptiness, especially as the result of trauma or abuse, eating disorders, substance abuse, or obsessive-compulsive disorder
Term Of Treatment: Although DBT typically lasts less than one year, the duration of treatment depends on how long it takes for the patient to experience improvement.
What To Expect: Weekly therapy sessions are focused around problem-solving and learning or improving interpersonal skills. Patients will also attend weekly group therapy sessions in order to learn additional skills, and will be given "homework" so they can monitor and evaluate their behavior over time.
No matter how many reasons there are to appreciate other people, relationships of all kinds can be tough. Typically used to treat those with depression, Interpersonal Therapy focuses on the patient's relationships with other people and how depression has affected the patient's ability to relate to and communicate with partners, friends, family and others.
Useful For: Individuals who suffer from depression
Term Of Treatment: Up to 20 weeks
What To Expect: After an initial assessment phase in which the therapist and patient work together to identify the patient's "problem areas," treatment is task-oriented and focused on improving the patient's interpersonal skills
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