Psychotherapy approaches

Choosing the ‘modality’ – a theory or philosophy, or a particular client group or method - that feels like the best fit will help you choose who to see, or what and where to study.

At UKCP different psychotherapeutic modalities are represented by our colleges, which are made up of members who share a philosophy of psychotherapy.

If you are seeking therapy for yourself, finding someone you connect and feel safe with is the most important thing, but doing some research about different philosophies and types of therapy can be very useful.

• Constructivist and existential psychotherapy
• Family and systemic psychotherapy
• Humanistic and integrative psychotherapy
• Outcome-oriented and hypno-psychotherapies
• Psychotherapeutic counselling and intersubjective psychotherapy
• Psychotherapy for children and young people
• Psychoanalysis and Jungian analysis
• Sexual and relationship psychotherapy

 

Constructivist and existential psychotherapy

Psychotherapists working in constructivist and existential approaches seek to help people become clearer about how they are experiencing and dealing with challenges that they face, empowering them to respond to these in a more informed and effective way.

Through such examination, a person will be able to find meaning, purpose, and ownership in how they live. In this way, and within the limitations imposed by society and our human condition, to be able to live a more fulfilling and satisfactory life.

Although we are not free to choose what happens to us, we have a degree of freedom in how we respond to it. Our behaviours are meaningful, and the clearer we get about how we behave, what we are doing, and what we are feeling, the more we can take ownership of these and live a life that is attuned to our fundamental values.

A constructivist or existential approach could be especially helpful if a client needs help in understanding what they are suffering from, be that physical, emotional, environmental, spiritual, or a combination of any of these.

Many constructivist and existential psychotherapists have expertise in specialised areas such as addiction, anxiety, and depression, but essentially these all fall within the broader area of human suffering that all constructivist and existential therapists are able to work with.

It could be a good fit for students who wish to examine the reflected and un-reflected assumptions that underpin established psychotherapeutic theories so that students can develop their own understanding and style within an ethos of constructive criticism.

It is primarily a talking therapy, often focused on embodiment, incorporating creative or contemplative suggestions between sessions. Work can be one-to-one, with couples, or groups. Therapists assimilate and incorporate any theoretical understandings or skills that might enable someone to bring their concerns to light and to effectively respond to them.

To find out more, please visit the UKCP Constructivist and Existential College

The following psychotherapies take a constructivist and existential approach:

 

Psychosynthesis

Psychosynthesis is an existential psychotherapy with spiritual goals and concepts, which is sometimes described as “psychology of the soul”.

It aims to integrate or “synthesise” a higher, spiritual level of consciousness with your thoughts and emotions. Different aspects of your personality are recognised and valued through techniques like painting and movement.

Italian psychiatrist Roberto Assagioli founded this approach. He used the term “superconsciousness” to describe the part of the psyche that contains our highest potential. Assagioli believed that if we repress this potential, we can experience psychological distress, as debilitating as repressing childhood traumas.

 

Transpersonal psychotherapy

Transpersonal psychotherapy describes any form of counselling or psychotherapy which emphasises the spiritual aspects of the human experience.

A transpersonal psychotherapist would work with you to explore your potential, and develop your inner resources and creativity.

You would develop your spiritual self, explore mystical experiences and practise meditation and visualisations. . As well as alleviating suffering, the ultimate goal of this type of therapy is to integrate the physical, emotional, mental and spiritual aspects of your wellbeing.

 

Neuro Linguistic Psychotherapy

Neuro Linguistic Psychotherapy (NLPt) is developed from Neuro Linguistic Programming. NLPt is based on the premise that we construct our own model of reality (a personalised map of the world) based on our experiences and how we represent them internally. Each person uses their own map to navigate themselves through life. Models can enhance fulfilment and success, or, at times, be limiting and restrictive.

NLPt explores the thinking patterns, beliefs, values and experiences behind problems or goals. This helps you to reduce limiting beliefs and decisions, overcome stuck emotional and behavioural states, and extend your existing skill base. The aim is for you to feel more control and have a greater ability to create the life you desire.

 

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Family and systemic psychotherapy

The terms “family therapy” and “systemic psychotherapy” are often used interchangeably. These psychotherapists work with people in any form of relationship, including couples, families, carers and colleagues.

This type of psychotherapy is based on the idea that each of us is part of a wider network or “system”. Our interactions with other people have an impact on how the system works.  Sometimes, systems grow and change and can become stuck. For example, when a child becomes a teenager, but their parents still treat them like a younger child.

The idea is that a problem lies within the group as a whole, rather than with a single person.  A family and systemic psychotherapist will look at how different factors affect people in the system, as well as the interactions of the group and its patterns and dynamics. They will help to emphasise the strengths, resilience and resources available and how everyone helps contribute to the functioning of the system. The aim is to help everyone understand each other and develop new ways to communicate. This can help people better support each other.

A skilled therapist using this approach has the ability to influence conversations to harness the strength and wisdom of all the people they are working with. They will support the system to change and address relationship patterns, rather than analyse subconscious impulses or childhood trauma.

This therapy is particularly effective for addressing problems between a child and adult. It’s also used in businesses, education, politics, psychiatry, social work and family medicine, as it helps groups to talk about difficult issues and build relationships.

To find out more, please visit the UKCP College of Family, Couple and Systemic Therapy

 

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Humanistic and integrative psychotherapy

‘Humanistic and Integrative’ is an umbrella term for a group of approaches that have developed over a period of more than seventy years, with strong academic and research-based foundations. Different theories and approaches are adapted and blended to suit the individual needs of each client.

What they have in common is an underlying humanistic philosophy, which emphasises the collaborative nature of the therapy relationship, seeking to understand the client’s experience of their world and their relationship to it. Rather than seeking to fix problems, therapists help their clients to evolve better ways of dealing with them, so that they may develop psychological resilience, and acceptance of the challenges and difficulties which we all face in life.

Clients seeking psychotherapy may be faced with confusing or painful situations, feelings of dissatisfaction, anxiety, stress or depression, painful losses, traumatic or unhappy memories, difficult decisions or feeling the need for change. Relationship issues, traumatic experiences, abuse, family dynamics and mental health problems are all examples of things that can be worked with.

Many humanistic and integrative psychotherapists work with traditional methods - often called ‘the talking cure’ - whilst others may use creative methods such as dance movement, breath work and body oriented therapies or art therapy.

If a student likes their learning to be experiential, participatory, process-based and action-based, and not primarily didactic, inviting challenge and dialogue; and if feeling and individuality are important to them; then humanistic and integrative psychotherapy would likely be a good fit for them.

Personal development throughout training is an essential part of becoming a psychotherapist within this tradition. Supervised clinical practice from the early stages of training allows the trainee practitioner to develop at their own pace and work within their capacity. This results in clinically proficient knowledgeable practitioners who have a high level of self awareness.

To find out more, please visit the UKCP Humanistic and Integrative Psychotherapy College

 

Person-centred psychotherapy

The assumption behind this approach is that someone seeking support to resolve a problem can engage in an accepting, non-judgmental relationship with a psychotherapist or counsellor. This allows them to freely express emotions and feelings.

A psychotherapist or counsellor using this approach would see you as the best authority of your experience and capable of achieving your own potential for growth and resolving problems. They provide favourable “conditions” to allow this potential to emerge. These include unconditional positive regard and empathic understanding. The conditions support you to come to terms with negative feelings and develop inner resources and the power and freedom to change.

 

Transactional analysis

Transactional analysis is an integrative approach to psychotherapy grounded in a humanistic philosophy.

“Transactional analysis” refers to the analysis of how people communicate and relate to each other, or how they “transact”. In sessions, you’d look at here and now interchanges (the interpersonal) to improve your communication and relationships and understand your personality (the intrapsychic or internal world).

The analysis of transactions is based on psychiatrist Eric Berne’s theory of ego states. He identified three different ways of being that shape our internal world and behaviour – parent, adult and child. These ego states are often developed in the past and re-created in the present. They maintain old, unhelpful patterns which you can become more aware of and change. The approach acknowledges the impact of relationships in shaping personality and the importance of the one you develop with your therapist to help you develop insight and change.

 

Gestalt therapy

“Gestalt” is a German word meaning the whole and the sum of all the parts, and the symbolic configuration or pattern of elements, that make up the whole.

Gestalt therapy draws on the belief that old patterns of behaviour and fixed ideas can create blocks which interrupt the natural cycle of wellness. This affects how someone communicates with others.

This approach looks at what is happening in the moment, bringing someone’s responses and interactions with others into focus. The idea is that being fully present in the here and now creates the potential for more excitement, energy, and courage to live life more freely.

A Gestalt therapist would look at how you might resist: contact in the here and now; change; and behaviours or symptoms that you think are undesirable or unsatisfactory. In sessions, you’d look at what is happening and being said as well as body language and repressed feelings. You may also act out scenarios and recall dreams.

 

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Outcome-oriented and hypno-psychotherapies

We understand that people seek psychotherapy because they want something to get better in their life. Whether that is to address difficult behaviours, heal painful experiences or improve relationships, this approach aims to facilitate you to make changes to live more healthily, fully and authentically.

This psychotherapy offers a more interactive relationship between client and therapist who work together to co-create ways forward based on the client’s unique experience, strengths and meaningful explorations. This may sometimes involve activities for you to experiment with in-between sessions so that you can get maximum benefit, making deep, sustainable adjustments to how you engage with the challenges you face.

This approach to psychotherapy considers human beings to be naturally inclined towards health and creativity even when some of our behaviours, thoughts and feelings might seem destructive or stuck.

When a person experiences difficulty, such as a situation, an emotional or behaviour pattern, a symptom or an over-whelming event, we see these as opportunities for healing and growth - even as we start to better understand and process the pain that these experiences have brought to our lives.

The basis for this positivity is not just wishful thinking but a solid theory and research base founded on the most ancient to most current studies of how people move beyond surviving to thriving. Recent western enthusiasm for altered state practices, such as mindfulness, have always been central to Hypno-Psychotherapy, reaching back into its pre-Freudian roots. More recent neuro-biological understanding of how the brain heals from trauma, finds peace and generates new healthy habits affirm and further enhance these practices.

Your psychotherapist will work with a range of integrative approaches. This incudes ways that you can learn to have a better a relationship with your thoughts and feelings so that you are able to access these as resources and inner guidance – even those feelings we find distressing. Often your psychotherapist will facilitate you to achieve a state of inner calm, relaxation or heightened creativity – a state that has been called ‘hypnosis’. This enjoyable state is something you can learn to achieve for yourself through therapy, either by self-hypnosis or by being more directly guided by the therapist’s voice and words. Sometimes there may be an emphasis on working with the content of your thoughts to meet life’s challenges in new ways.

How you and your therapist work together may change and develop as you progress together towards the meaningful outcomes you have come for.

Psychotherapy of this kind may be brief (less than and up to 12 sessions), mid-term (up to a year) or longer term. You might find the relationship with your therapist becomes a resource that you can make use of at different times in your life in progressive ways.

To find out more, please visit the UKCP College of Outcome-Oriented and Hypno-Psychotherapies

The following psychotherapies take an outcome-oriented and hypno-psychotherapies approach:

 

Behavioural therapy

This type of therapy is based on the theory that learnt behaviour in response to past experiences can be unlearnt or reformulated, without focusing on the reasoning for the original behaviour.

Individuals with compulsive and obsessive disorders, fears, phobias and addictions, may benefit from this type of therapy. The focus is on helping you to achieve your goals and modify extreme behavioural responses to problems such as stress or anxiety.

 

Cognitive analytical therapy (CAT)

CAT combines theories to explore links between language and thinking, and historical, cultural and social influences on how we function. It encourages you to use your own resources and develop skills to change destructive patterns of behaviour, and negative ways of thinking and acting.

The therapy is short-term (16 weeks), structured and directive. For example, you might be asked to keep a diary or use progress charts. Your therapist would work with you to focus on changing patterns of behaviour and teach alternative strategies for coping. You’d look at connections between behaviour developed in childhood and socially, and their impact on you as an adult.

 

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Psychotherapeutic counselling and intersubjective psychotherapy

What distinguishes psychotherapeutic counselling from traditional counselling is the emphasis it places on the in-depth therapeutic relationship jointly created by you and your therapist. This relationship is a central factor in this type of therapy.

Psychotherapeutic counsellors view human suffering holistically. They look at someone’s mind, body and soul in the context of their circumstances and where they are in their life.

To find out more, please visit the UKCP Psychotherapeutic Counselling and Intersubjective Psychotherapy College

 

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Psychotherapy for children and young people

Psychotherapists in this field help a child – and the adult they will become – by recognising the nature and impact of adverse experiences as early as possible and working creatively to reduce their impact. They sensitively attune to children and young people who may have experienced neglect, trauma and dysfunctional early relationships.

By providing a safe space and understanding the child’s perspective, they help children to work with painful or difficult experiences, and support their normal development. Psychotherapists in this field believe that children have the right to therapeutic support form a specialist practitioner who can understand them and help them to develop their well-being and enjoy a fulfilling life. They develop secure and trusting relationships with children and young people to support the healing process and develop their inner resources.

A reliable and inviting environment with opportunities for play and creativity form the foundation of this approach. The idea is that children need to feel safe to express and experience things that are difficult and painful. Children and young people in therapy may “act out”, be anxious, depressed or extremely angry. Therapists work with parents and carers to build relationships and facilitate understanding of the child’s emotional world.

To find out more, please visit the UKCP College for Children and Young People

 

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Psychoanalysis and Jungian analysis

Psychotherapists working in psychoanalytic practice work believe that our unconscious and early life experiences affect our development, current experience and relationship with ourselves and others.

In making the unconscious conscious, practitioners believe we will be more informed about ourselves and why we experience things as we do. This gives us the potential to make new choices about how we live, with greater awareness and less distress.

The relationship between you and the therapist is a central part of what Sigmund Freud called ‘the talking cure’. Working with the unconscious in psychoanalytic therapy may involve working with dreams and using free association alongside interpretations of symbolic experiences and material, as well as straightforwardly talking things through.

Classically, psychoanalytic psychotherapists may work with you on an individual basis and you may be offered a couch or a chair in their consulting rooms. They will also offer different models of attendance from once a week to twice or more times each week. Many therapists now also offer sessions online or by phone.

People seek psychoanalytic psychotherapy for help with a wide range of issues including depression and anxiety as well as more complex, deep-seated or historical issues. You may also be offered psychoanalytic therapy as a couple, within a group, or be offered child or family therapy. In addition, many therapists have different approaches to delivering therapy, such as art, drama, music and body therapy, all of which may also be informed by psychoanalytic theory.

Psychoanalytic practice includes Freudian, Jungian analytic, object relations based, psychodynamic, attachment based and relational approaches to working with the psyche. These are described in more detail below.

To find out more, please visit the UKCP Council for Psychoanalysis and Jungian Analysis

The following psychotherapies take a psychoanalytic approach:

 

Freudian psychoanalysis

A Freudian psychoanalyst would interpret your dreams and fantasies and sometimes ask you to speak in a stream of consciousness way, called 'free association'. Freud believed that unacceptable thoughts from early childhood are repressed in the unconscious mind but continue to influence our feelings, thoughts, emotions and behaviour. These repressed feelings often surface in adulthood as conflicts and depression, or in dreams and creative activities.

 

Jungian analysis and analytical psychology

Jungian analysis and analytical psychology involve you and the analyst working together to bring unconscious aspects of your psyche into conscious awareness. The aim is to achieve more balance, to discover meaning, to encourage positive development and to improve mental health by reducing suffering through increased self-knowledge. You will explore your interpersonal and collective experience, which can be largely unconscious.  That will often involve working with spiritual aspects of human experience and symbolic material including dreams.

 

Relational psychotherapy and psychoanalysis

Therapists that have “a relational approach” would prioritise the way you relate to others and see this as central to understanding yourself. They believe that understanding the way previous relationships inform current ones is important. The idea is that the therapeutic relationship creates a space to work through these relational dynamics so they can be understood and improved. Dynamics that occur in the here and now of the therapeutic relationship shed greater light on the way you relate to other people and can help you understand yourself more.

 

Attachment-based psychotherapy

This is a branch of relational psychoanalysis which explores attachment from birth onwards. You would look at early development and attachments which can be classified as secure, anxious, avoidant, ambivalent or disorganised. The idea is that problematic attachment experiences early on in life are re-enacted later in adult life.

Developing an attachment-based relationship with a psychotherapist allows you to mourn past losses, and explore the impact of important relationships on your life in the past and present.

 

Psychodynamic psychotherapy

Psychodynamic psychotherapy focuses on the unconscious and past experiences which are thought to determine current behaviour.

You would be encouraged to talk about your childhood relationships with parents or caregivers and other significant people. The aim is to help you process your unconscious thoughts and feelings to relieve emotional strain brought on by inner conflict or anxiety.

 Your therapist tries to keep their own personality out of the picture. They become a blank canvas onto which you can transfer and project deep feelings about yourself, parents and other significant people in your life. A therapist from this approach would focus on dynamics between you and them.

This is less intensive and briefer than psychoanalysis, and relies on the interpersonal relationship between you and your therapist. It can be used in individual, group and family therapy, and to understand and work with institutions and organisations.

 

Object relations therapy

The basis of this type of therapy is that the “ego-self”, an aspect of our personality, exists only in relation to other objects, internal or external ones. “The self” exists within the context of relationship, primarily to your parents or caregivers, but also taking home life, art, politics and culture into consideration.

The belief is that humans are social beings. So, contact with others is a basic need and our inner world is a changing dynamic process, made up of fixed and fluid patterns, conscious and unconscious. These dynamics effect how we perceive and experience reality.

Object relations therapists would explore your early childhood relationships and use their experience of how you relate to them in sessions to understand you more. In sessions, you’d have the opportunity to re-experience any loss, intimacy, control, dependency, autonomy and trust issues to help you heal from them.

 

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Sexual and relationship psychotherapy

Sexual and Relationship Psychotherapists are trained to work with individuals, or people together in relationships, who are experiencing difficulties or concerns about any aspect of sexual or gender identity, sexual functioning, intimate or other relational interactions.

These might include longstanding issues relating to how someone has learned about themselves, gender, relationships and sex, which could include the impact of attachment difficulties, trauma or abuse. It might also include addressing specific sexual and relationship concerns relating to confidence about sex, interest or desire for sex, or certain types of sex, compulsive sexual behaviours, and concerns with arousal or orgasm, including erectile or ejaculatory difficulties, difficulties with penetration or pain relating to sex. Any or all of these concerns might be located in the context of relationships in general or a particular relationship, and the training includes an integrated understanding of relationships and how to work with them therapeutically.

Sexual and gender health requires a positive and respectful approach to identity, sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences and intimate relationships free of coercion, discrimination and violence.

There is a reciprocity in psychosexual therapy: challenges in sexual and gender areas of our lives can have effects on our psychological abilities to begin or sustain relationships; or psychological challenges can create conditions leading to problems appearing or being maintained in sexual lives.

Sexual and relationship therapists are trained to work in an integrated way, drawing on a range of psychotherapeutic models including, but not limited to, attachment-based, cognitive behavioural therapy, EMDR, person centred, psychodynamic or systemic. Training also includes knowledge and integration of the psychological impact of physiological factors and the medical investigations and treatments that may be also be available for these.

To find out more, please visit the UKCP College for Sexual and Relationship Psychotherapy

 

If you’re looking to train to become a therapist, you can also…

• Find out more about training to be a psychotherapist in a university via the UKCP Universities Training College.
• Find out more about training to be a psychotherapist in a medical context via the UKCP College of Medical Psychotherapists