Alternatives to CBT

Cognitive Behaviour therapy is a popular form of talk therapy, and even though its effectiveness has been consistently shown in studies, it may not be to every clients' liking. Here are some other forms of therapy that may resonate more with you, or be more adapted to treating what you suffer from. For example, EMDR (see below) is extremely effective for treating trauma and PTSD.

Today, many Cognitive Behaviour therapists prefer an eclectic approach to therapy and include other forms of therapy alongside CBT for the benefit of the client. For instance, a client who is going for individual counselling sessions may realise that they cannot make the changes they want in their life unless their otherwise critical spouse supports them in their endeavours. In such a situation, the therapist may offer the client and their spouse couples therapy.

In this post, let’s have a look at some of the other forms of therapies and which specific problems or disorders they are beneficial for.

Eye Movement Desensitisation and Reprocessing (EMDR)

Francine Shapiro developed this form of therapy in the 1980’s. The main aim of this therapy is to enable clients to overcome psychological trauma. It is a non-invasive method of psychotherapy which is backed by clinical evidence of its effectiveness. EMDR therapy is an eight-phase treatment programme based on the concept of adaptive information processing which identifies and addresses overwhelming traumatic experiences or harmful coping strategies. EMDR therapy helps in reprocessing traumatic information stored in the brain until it no longer affects the individual on a psychological level. EMDR thus helps the client to achieve insight and leads them towards a peaceful resolution to their problems.

Wake Therapy

Wake Therapy originated in Europe in the 1970’s. It is best known for alleviating depressive symptoms. Researchers found that prolonged periods of wakefulness, followed by restorative sleep shows an antidepressant effect. A rapid reduction of symptoms is seen in about 50-60% of patients. The positive effects are sustained over time when Wake therapy is combined with other complementary therapeutic interventions such as sleep phase advance, bright light therapy or pharmacologic interventions. The treatment varies in duration and ranges between 2-5 sessions depending on the number of sleep cycles used.

Couples Therapy

Originated way back in the 1920’s in Germany but gained popularity as a professional service only recently. In Couples therapy, the therapist acts like a mirror in order to enable clients to identify repetitive, negative patterns of behaviour and also to reflect the relationship’s difficulties. The goal is always to improve communication, reorganise emotional responses and empower both parties to take control of their relationship. The couple may decide to explore the potential of their relationship and look at the directions for change by learning new coping strategies. Couples therapy helps in developing a new perspective about the relationship in general and each other in particular. It can enhance intimacy and attachment between couples.

Gestalt Therapy

Frederick Fritz and Laura Perls in the 1940s developed this form of therapy. Gestalt therapy is a phenomenological-existential therapy which is becoming increasingly popular in clinical practice. At par with other therapeutical methods like CBT(Beutler,1999), it promotes personal well -being by increasing self -awareness and perception of physical sensations, mind states and orientation to surroundings. It is effective for releasing repressed emotional stress or tension which is ‘stored’ in certain areas of the body.

Gestalt therapy focuses on understanding the emotions involved in the dynamics of relations between people and their social environments. It has been proved to be effective for those clients who suffer from depression and have internalisation or self- punishing tendencies (Beutler,1991)

Family Focussed Therapy

Dr. Miklowitz developed the Family Focussed Therapy in 1990. It is Similar to psycho-education and Cognitive Therapy but includes the family in a major way. It teaches communication skills and focuses on communication within the family. It also prepares the entire family for potential relapse episodes.

Interpersonal psychotherapy

It is a popular form of therapy. Interpersonal issues are identified during therapy and ranked in order of priority. The Focus is on fostering understanding about how mental health issues affect relationships. Dysfunctional ways of relating to others is targeted and therefore it is very helpful for clients who want to change deep rooted relational patterns. Therapy consists of 12- 16 sessions usually.

Group Therapy

It was founded by J.H Pratt in 1905 and is still a very popular form of therapy. It originally gained importance during World War II when large number of soldiers required treatment for PTSD. Group therapy is an effective means of changing an individual’s style of processing emotions and responding to situations and other individuals in their lives.

A group may be homogenous or heterogeneous and therapy maybe carried out in organised groups of 3 or more people. Members may be of the same age or different and facing similar or different problems. Depending on the need, the therapist may let the group set its own agenda for discussion (non-directive approach). The main focus is on learning new behaviours and employing them in the real world. Group therapy provides emotional support and encouragement while reducing feelings of loneliness and isolation.

Reality Therapy

William Glasser developed this therapy in the 1960’s. Reality therapy maintains that an individual deviates from the norm when they are unsuccessful in attaining the basic human needs. According to Glasser, individuals do not suffer from mental illness rather they suffer from a universal human condition. Reality therapy is based on three R’s: Realism, Responsibility, and Right – Wrong. This type of therapy does not deal with the client’s past or their unconscious mental processes. Reality therapy focuses on the here-and-now and enables the client to solve problems and to appropriate actions. Contrary to its name, this therapy does not threaten clients by showcasing hard realities of life. During therapy clients are encouraged to take responsibility for their lives and to explore the choices they can make to create a better future.

Art Therapy

Art therapy formally got recognition as a psychotherapeutic method of treating mental health issues during the mid- 20^th century. It is based on the belief that artistic self-expression can be a healing process. Art therapy has the unique feature of facilitating non-verbal communication. Art therapists use a variety of creative medium such as painting, drawing, sculpting, and collage- making. It is action oriented and enables clients to express themselves, communicate their feelings, overcome stress and other negative emotions, and understand unknown aspects of their own personality. This form of therapy is also successfully used with people who are suffering from severe mental illnesses. Art therapy is different from joining art classes since therapy provides a safe place for the client to explore and express difficult emotions and the therapist is trained to manage such catharsis. The American Art Therapy Association oversees the certification of art therapists.

Animal Assisted Therapy

Animal assisted therapy is a unique form of therapy since it uses a variety of trained animals to bring about a healing response in clients. Most commonly used animals include dogs, cats, dolphins and horses. Research studies have reported that animal therapy can improve self-esteem, sociability, and trust, and thus enhance physical, emotional and social well-being. It has been found especially useful with special needs children, and seniors with depression or disabilities. This therapy allows clients to interact freely with animals, talk to them, pet them, and to give and receive non-judgemental affection.

Solution-focused therapy

It is a goal directed approach to therapy which focuses on enabling clients to achieve desired outcomes in life. The duration of the therapy is brief and can last anywhere between 6 – 10 sessions. In this form of collaborative therapy, goals are clearly identified and realistically conceptualised. Client’s strengths, resources, and past experiences of any success in the perceived problem area are explored. Existing coping strategies are evaluated and new coping strategies are taught. Hope and positivity is re-instilled and progress towards goals is monitored and supported throughout the brief course of the therapy.

Brief Psychodynamic Therapy

This approach to therapy enables the client to retrospect and see the influence of their past experiences on present behaviour. Thus, the focus is on increasing the clients understanding of unconscious processes and on enhancing self-awareness. The therapeutic relationship facilitates the client to explore unresolved conflicts and examine dysfunctional patterns in their relationships. The psychodynamic theory is well-developed and a large body of clinical research has supported the efficacy of this approach to therapy. Brief psychodynamic therapy usually involves 10-20 sessions.

Existential therapy

Existential therapy is a popular form of therapy that developed from the philosophy of Friedrich Nietzsche and Soren Kierkegaard. It posits that each individual experiences intra- psychic conflict due to their confrontation with certain human conditions or ‘givens’ such as death, isolation, meaninglessness and the responsibility that comes with freedom. This gives rise to what is known as existential anxiety or existential crisis. This anxiety is detrimental to an individual’s physical, psychological, social, and spiritual well-being.

Existential therapy acknowledges ‘free will’ and ‘personal responsibility’. It encourages clients to be aware of their human limitations but not overwhelmed or overpowered by it. The goal is to seek a balance by addressing emotional issues through accepting inner fears and taking personal responsibility for life choices that lie ahead. This form of therapy has been found to be useful in finding meaning and purpose in life and in the treatment of depression, anxiety, substance abuse/dependency, and trauma related stress.

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