Different therapies tend to emphasise either thoughts, feelings or behaviours in their approach. A change in any one aspect of a person usually leads to modification of the others as well.

Choosing a Therapist

There are plenty of choices when it comes to types of psychotherapy. One report I read estimated the number at close to 400. Many of these however are slight 'variations on a theme'. My own view is that there are probably around a dozen or so main 'themes' or approaches. Of course, in practical terms, most people seeking counselling are presented with a much smaller choice of options and especially if referred by your GP, it is quite likely that you won't even be aware of the choices available. As the Dept of Health acknowledges on its own web site "All too often, access to therapy is determined by irrelevant factors ... rather than evidence about benefit."

So, what are the main choices? What are the differences between them? And is one type better than the rest?

In this part of the website, I try to answer these questions and provide my perspective on different types of therapy. Obviously, I myself have a particular point of view. I've aimed to be informative and impartial, however, a therapist with a different background or training to me might see things differently. It's worth discussing your views and any concerns you have about your counselling, with the therapist or counsellor you are seeing or intend to see. Your GP may also be able to help.

What's the 'Best' type of therapy?

The best therapy is the one that is best for you. In research that has studied outcomes in therapy, the best outcomes occurred when the relationship between client and counsellor was rated highly by both client and counsellor. In other words, if you get on well and feel comfortable with your therapist and the way he or she is working then that is probably a good indication that you are working effectively. That's not to say that you should always like everything your counsellor says or that the relationship should always be happy. Indeed there may be times when you feel angry with your counsellor and this too can be an indication that your work is effectively 'touching the right spots'. My clients are often resistant at first to hearing some of the things I might want to say! However, overall, you should feel comfortable, feel that your therapist understands your feelings, feel s/he accepts you and feel that you have a good regard for them and they for you.

If this, or something like it, is the case then it is also a sign that you and they are working in a way that is both comfortable and suitable for you. 

Of course, within psychotherapy overall, there are different ways of working. I believe it is fair to say that some ways of working in therapy suit some people more than others. Different therapies tend to emphasise either thoughts, feelings or behaviours in their approach. As individuals we each tend to favour one of these three ways of being and so one approach may feel more comfortable to us than the others, especially in the early stages. Similarly, some of the things clients often bring to therapy may be more suited to one approach more than the others. For example, the feelings that can incapacitate a person following a loss or major life change may respond well to a feeling-orientated approach. Similarly, a disorder of thinking or a problem involving behavioural compulsions (such as is found in clients with obsessive compulsive disorder) may respond best to a cognitive-behavioural approach. As a final example, long standing problems in relationships that have their roots in childhood may benefit greatly from an insight-orientated approach (like psychodynamic therapy) which examines the past dynamics inherent in thinking and feeling in the present.

There is a great deal that I could write (and indeed that has already been written) about matching therapy to people and their issues. I go into greater (but by no means exhaustive!) detail on the next page. This information is really only for those who wish to try and understand this detail and it is by no means essential reading for those seeking a counsellor or psychotherapist. Other health professionals wishing to make informed choices when referring patients may find some of this detail useful however.

In summary ...

• Find the therapist that feels right for you because it is the relationship that helps therapy to be effective
  

• Ensure you work with a suitably trained and supervised therapist who is a member of British Association for Counselling & Psychotherapy, the UK Council for Psychotherapy or a clinical member of the British Psychological Society
  

• Ask all the questions you feel you need answered. If you wish, ask about the therapist's training and their arrangements for supervision. Don't be afraid to address any concerns you have. This is important as these issues may get in the way of your progress later on.
  

• If you believe one type of therapeutic approach may suit you over another or if you have had an approach recommended to you, you can get further information from the appropriate professional bodies. The Department of Health also publishes detailed guidelines about treatment choice. An excellent leaflet, designed for use by those seeking therapy, is available online in Adobe portable document (.pdf) format at http://www.doh.gov.uk/mentalhealth/choosing.htm or can be obtained by post, free of charge, by writing to DH Publications, PO Box 777, London SE1 6XH or by fax on 01623 724524 or by emailing doh@prolog.uk.com

My Own Approach

My own approach to therapy is called integrative. This means I have brought together a number of approaches to therapy, moulding them into a single working model, with due regard for any tensions or conflicts  between differing approaches. 

Over the years, I have studied two theoretical orientations in detail (person centred and psychodynamic) and a number of other types of therapy (cognitive behavioural therapy and gestalt, for example) at a level sufficient to give me a broad-based approach to my work. This enables me to work flexibly, engaging with the client in a way that feels comfortable for them and which will be effective, whilst being able to offer therapeutic options to meet my client's needs. It also enables me to recognise when a referral to a specialist therapist working in a different way to me might be useful. For example, I have undertaken a basic level of training in drama therapy. This training does not qualify me to practice this type of therapy yet I know sufficient about the approach to recognise when it may be useful and I can suggest a referral to a client with some degree of confidence that it will be helpful to them.