Which type of psychological therapy is best for me?

There are different theoretical and practical approaches when analyzing and treating a psychological problem. The best one for you depends fundamentally on your personality style, how you want the therapeutic relationship to be, and the reason that brings you to consultation.

Psychoanalytic Therapies

In a nutshell, Psychoanalysis explains psychological problems as a result of instinctual impulses that have been repressed by the consciousness. The psychoanalyst’s goal is to explore these aspects that patients tend to avoid (like painful or threatening aspects of experience, mainly originating in childhood), called defenses or resistances. They bring light into this through free association as the patient organically develops their discourse,with the interpretation of dreams as well as identifying the main individual's defense mechanisms or erroneous strategies to resolve the conflict. It is a non-directive or insight-oriented therapy, where the pace of the sessions is set by the patient, so its duration is usually medium to long, with primarily long-term results.

Psychodynamic Therapy

If its theoretical background in Freudian psychoanalysis, Psychodynamic therapy has been developed and questioned to offer more practical and useful tools for the current problems of individuals. The interventions here are shorter and more focused than in traditional "analytical cure," making sessions more dynamic. A key distinguishing feature is that, apart from focusing on the individual and their unconscious mind, this approach integrates insights from other relational approaches.

Cognitive-Behavioral Therapy (CBT)

This explains psychological problems by taking "dysfunctional" behavior as the fundamental unit of study and analyzing the thoughts and emotions linked to the appearance of that behavior. The goal then is to identify problematic behaviors (and thoughts, considered behaviors) and work to change both the inappropriate thought patterns and the beliefs underlying them. It is a directive therapy, where the professional usually assigns weekly homework, and its duration generally depends on the pace of resolving specific problems. Newer approaches like third-generation therapies and biofeedback are part of this paradigm as well.

Systemic Therapy

Whether treating families, couples, or individuals, this theoretical and practical orientation conceives psychological problems as expressions of alterations in interaction and communication patterns within the system in which the patient is immersed. This patient will be the symptom bearer of the dysfunctional dynamics of the family or belonging system, whose solution attempts end up perpetuating the problem instead of seeking a change in the overall system. Family sessions are usually held every 15 days, and initially, all system members must attend. Later, the family will be summoned together or certain members or subsystems separately, depending on the treatment goals, to question both the structure and the family's functioning style. It is a therapy that does not use labels, so it is not recommended for those seeking a specific diagnosis.

Humanistic Therapies

Globally speaking, this therapeutic orientation understands psychological problems as resulting from the blockage of the person's innate potential to grow, evolve, and self-actualize. The therapy focuses on receiving and accepting the person in their multidimensionality, giving relevance to each of their aspects: thoughts, body, emotions, and spiritual realm, to guide them in regaining their decision-making capacity and personal development. It is the least directive therapy of all, based primarily on listening and conversation. Special weight is given to the therapeutic bond, as this therapy understands problems or disorders as resulting from conflicts and sufferings that arose in previous relationships and have crystallized. Its positive vision seeks to delve into personal growth and self-knowledge. The most well-known are Psychodrama and Gestalt therapy.

EMDR Therapy (Eye-Movement Desensitization and Reprocessing)

Increasingly its popularity and demand, this is an integrative approach primarily based on the idea that certain psychological problems stem from dysfunctionally stored traumatic memories; therefore, the new processing of this material and its integration within adaptive memory networks will allow for its transformation and reconsolidation. The therapy focuses on the memories underlying current problems, their triggering factors, and the integration of positive memory patterns for future adaptive behavior. Working with trauma-associated memories includes elements of cognitive-behavioral therapy combined with certain types of stimulation (ocular, tactile, auditory).

Group Therapy

Group therapy involves treating multiple clients together, leveraging the dynamics of group interactions.

Facilitated by a therapist, it orbitates around having the participants share their experiences, reproduce and bring their common relationship patterns into the group and openly work on them, give and receive feedback, and develope social skills.

It is effective for a wide range of issues, including substance abuse, grief, and chronic illness management.

 The choice of therapy often depends on the individual client's needs, the nature of their issues, and the therapist's expertise. In clinical psychology practice, therapists may also integrate elements from multiple approaches to tailor treatment to the client's unique circumstances.

Dialectical Behavior Therapy (DBT)

Originally developed for Borderline Personality Disorder (Linehan) as a form of CBT, DBT was designed to help people change unhelpful patterns of behavior while also accepting who they are. This type of behaviour has proven to be effective with BPD and now used for a variety of mental health issues. Its techniques include skills training in mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness.

We know from Lambert's study (Lambert, M. J., 1986) that 30% of therapy effectiveness is due to common factors and the therapeutic relationship, 15% to the applied techniques, another 15% to the placebo effect. The remaining 40% of therapeutic improvement does not depend on the therapy but on changes in the patient or their interpersonal context.

Given all this, many psychologists over their experience have opted for an integrative approach, combining perspectives from different psychological approaches, or taking one as a base and complementing their interventions with aspects of others. They also opt for what is known as technical eclecticism, or using tools and techniques from different perspectives depending on the client's personality and conflicts. In the end, the best approach for each person is what works for them.

Bibliography:

Labrador, F. J., Vallejo, M. Á., Matellanes, M., Echeburúa, E., Bados, A., & Fernández-Montalvo, J. (2003). La eficacia de los tratamientos psicológicos. Infocop, nº 84, 2003.

Carr, A., & McNulty, M. (2016). The Handbook of Adult Clinical Psychology: An Evidence Based Practice Approach. Routledge.