A Therapist’s Mind

How does therapy work? How do therapists do their work? What framework do they use for therapy? In this blog, I’ll discuss some theories and techniques used by therapists.

Psychotherapy is a big umbrella. Underneath the umbrella of psychotherapy, there are various schools of thought on how to accomplish therapy. I’ll refer to these schools of thought as theories. Some of these theories are cognitive theory, behavioral theory, ego psychology, object relations, self psychology, attachment theory, relational theory, and psychodynamic theory. Then underneath these various theories, there are different off-shoots. For example, underneath Cognitive Theory, there is Mindfulness-Based Cognitive Theory. Underneath Psychodynamic Theory, there is Intensive Short-Term Dynamic Psychotherapy.

Each of these theories have hypotheses to help therapists make meaning out of our lives. These hypotheses serve as metaphors to help us organize the information, make patterns and offer perspective. These theories have been tested over time to show validation.

Some therapists specialize in specific theories and as a result, use techniques based on the specific theory. For example, a behavioral therapist believes that behaviors shape our lives so a behavior therapist may encourage an addict to attend AA meetings to help the addict stop drinking. A cognitive therapist believes that thoughts initiate feelings and actions, so they will focus on the thoughts going through ones’ mind before they have the urge to drink alcohol. A psychodynamic therapist believes that feelings initiate a thought and action so a psychodynamic therapist will look at the triggering situation and related feeling that instigated the urge to drink alcohol.

What theory has the best result? Over and over again, the most important factor shown for successful therapy is the importance of having a strong alliance between the therapist and client. What helps us build a strong alliance in therapy? When the therapist and client work together to meet the therapeutic goals.

I often tell my therapy students that it is best to keep therapy complicated. That’s right, complicated! Therapists can have a toolbox with as many tools as possible so they can meet the unique needs of their clients in each specific moment. We can build a strong alliance if we are meeting the client’s needs rather than sticking to the therapist’s pre-constructed agenda.

I try to keep my toolbox full and updated. As a result, I have many options but at the same time keep my mind open to listen to what my clients are presenting in the moment. Therefore, I am receptive to what my clients present and at the same time able to access a variety of techniques to meet my clients’ specific goals.

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