email only please

What the Therapy?

So there a LOT of different therapies, and what the research tells us is that it’s anything up to 95% therapeutic alliance (or the relationship between the client and psychologist) that best determines outcomes of therapy. The following is an overview of some of the more common therapies used in Australia at the moment. 

But different therapies are based on different theories, models and/or frameworks. Here’s a brief run down of some of the ones you may have heard about. I use the concept of “anxiety” to help explain the differences between each therapeutic modality. As you’ll read, there is a lot of overlap and slight or nuanced difference in theoretical approach to difficulties. Disclaimer: very brief overview of how these therapies are similar/different and does not replace comprehensive psychoeducation relevant to an individual’s mental health needs.

Acceptance and Commitment Therapy (ACT): ACT aims to help individuals accept difficult thoughts and feelings while committing to actions aligned with their values. It emphasizes mindfulness, acceptance, and values-based living to promote psychological flexibility. In ACT, anxiety is conceptualised as a normal human experience. Rather than being pathologised, anxiety is seen as a natural response to perceived risks, aimed at alerting individuals to take action to ensure safety and well-being. Where anxiety is problematic, ACT identifies cognitive fusion or the tendency to become entangled and attached to anxious thoughts and then treat these thoughts as true and accurate representations of reality rather than viewing the anxiety as a passing ship. Lots of metaphors are used in ACT. (Stephen Hayes & Russ Harris)

Animal-assisted therapy involves incorporating animals (often dogs, horses, rabbits, even chickens and cats – but not altogether!) into therapeutic interventions to provide emotional support, facilitate social interaction, and improve overall well-being. It can be helpful for various conditions, including anxiety, depression, and trauma. AAT recognises that interactions with animals can have a calming effect on humans, and by lowering physiological arousal, including heart rate and blood pressure, which are often elevated when experiencing anxiety, interaction can provide comfort and a sense of security. (various contributors)

Art therapy involves using creative processes and art-making as a means of self-expression and exploration. It can help individuals access and process emotions, enhance self-awareness, and promote personal growth and healing. Art-making is used as an outlet for expressing intense emotions that an individual associates with anxiety; shapes, colours, images, scribbles provide a non-verbal means of self-expression, reflection, problem-solving, and insight. (various contributors)

Compassion-Focused Therapy (CFT) focuses on cultivating self-compassion and compassion toward others. It aims to alleviate self-criticism, shame, and difficulties in relating to oneself and others by fostering compassion, mindfulness, and emotional regulation skills. Similar to ACT, CFT conceptualises anxiety as a normal human experience. By cultivating self-compassion, individuals learn to regulate their physiological arousal and modulate their emotional responses to anxiety-provoking situations, through a process of compassionate exploration and understanding. (Paul Gilbert)

Cognitive-Behavioural Therapy (CBT): CBT focuses on identifying and modifying negative thoughts, beliefs, and behaviours that contribute to psychological distress. It emphasises the connection between thoughts, emotions, and behaviours. It is popular in part due to the ease of implementing CBT in randomised control trials, which are the gold standard of evidence based treatment effects. That is, there is a lot of “evidence” supporting the benefits of CBT to help a multitude of mental. health concerns. CBT is rooted in the cognitive model, which proposes that our thoughts (cognitions) influence our emotions and behaviors. CBT also incorporates principles from the behavioral model, which emphasises the role of learned behaviours in the development and maintenance of anxiety. Two main approaches in CBT for anxiety are cognitive restructuring, which involves identifying and challenging maladaptive thoughts and beliefs (aka change that thought!) and exposure therapy, which involves confronting fears in a controlled manner to allow individuals to experience anxiety without using avoidance or safety behaviours. (Judith Beck)

Dialectical Behaviour Therapy (DBT): DBT combines elements of cognitive-behavioural therapy with mindfulness techniques. It focuses on developing skills for emotional regulation, distress tolerance, interpersonal effectiveness, and mindfulness. The main difference in conceptualisation of something like anxiety, is that DBT recognises the impact of interpersonal relationships on emotional wellbeing. DBT considers the tension or dialectics of anxiety perhaps as an acceptance of the present-moment experience of anxiety without judgement or resistance, but also that it is important to actively work on changing dysfunctional patterns and apply helpful coping strategies. That is, DBT encourages change while validating and accepting painful experiences. (Marsha Linehan) 

Emotionally Focused Therapy (EFT) is a short-term, structured therapy approach primarily focused on couples. It aims to identify and transform negative emotional patterns in relationships and enhance emotional bonding and secure attachment. In EFT, individuals learn to express their feelings, seek comfort and support from their partner to engage in collaborative problem-solving, gradually reducing anxiety through the exploration and processing of painful emotions. (Sue Johnson) 

Eye Movement Desensitization and Reprocessing (EMDR): EMDR is a therapy primarily used to treat trauma-related disorders. It involves bilateral stimulation, such as eye movements or tapping, to help process distressing memories and alleviate associated symptoms. EMDR posits that past events (memories) are inadequately processed and stored in the brain, leading to the persistence of distressing symptoms such as anxiety. By using bilateral stimulation, both hemispheres of the brain are activated while the individual recalls the distressing memory, which is reprocessed, integrated and resolves associated emotional distress and anxiety. (Francine Shapiro) 

Intensive Short-Term Dynamic Psychotherapy (ITSDP): ITSDP is rooted in psychodynamic theory and views an individuals presenting difficulties as an adaptation to anxiety cause by intrapsychic conflicts. Intrapsychic conflicts are defined as defences against painful feelings which evoke anxiety. ITSDP focuses on the here-and-now, not the past; the ISTDP therapist helps the individual confront defences as they are activated. Simply put, ITSDP is an emotionally challenging therapy.

Internal Family Systems (IFS): IFS is an approach that views individuals as having various internal “parts” or subpersonalities. It focuses on fostering self-leadership and healing by understanding and resolving conflicts between these parts. So, anxiety is viewed as originating from inner conflicts between different parts of the psyche, there are protector parts which take on the role of managing and controlling an individual’s anxiety, and exiled vulnerable parts that have been pushed out of conscious awareness. IFS therapy facilitates the exploration and integration of the parts to reduce anxiety symptoms over time. (Richard Schwartz)

Family and couples therapy: Conflicts in relationships can contribute to symptoms. Recovery is supported by understanding and helping individuals within family and social systemss. Structured exploration as a couple/family/system unit aims to improve the boundaries, communication, and interactions between individuals.

Narrative Therapy focuses on helping individuals separate themselves from their problems by externalizing them through storytelling. It explores the stories we construct about ourselves and our experiences and aims to empower individuals to rewrite their narratives, emphasising strengths and agency. An individual is encouraged to question their story or narrative that has shaped their believes, values and societal influences relating to anxiety. (Michael White and David Epston)

Schema Therapy: Schema therapy is an integrative approach that combines elements of cognitive-behavioural, psychodynamic, and experiential therapies. It addresses long-standing patterns of maladaptive thoughts, feelings, and behaviours rooted in early life experiences. Where schemas are identified as contributing to anxiety, techniques and skills are taught to recognise triggers and implement self-soothing techniques.  (Jeffrey Young)