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The Logic Behind Which Type of Therapy is Chosen

Published February 6th, 2024 by Alexandra Sredni, Psy. D., PLLC

When people from outside the professional world of psychology think about therapy, the general thought is usually simple: go get help from a licensed practitioner. “Not much more to it.” However, the reality is that there are a multitude of various treatment modalities available to psychologists – CBT, DBT, IPT, Psychoanalysis, Humanistic Therapy, etc.

“Woah, slow down! CBT? DBT? I’ve never heard of these terms!” That’s completely normal and understandable. But, while you aren’t expected to understand the differences between each of these types of therapy, you should at the very least understand the logic behind your therapist’s therapeutic modality.

For starters, it’s important to note that all of these therapies are built upon unique theoretical principles…which makes it interesting that for years, the central thought was that any of these types of therapies would be sufficient for anyone seeking psychological help. However, years of real-world, hands-on experience has not shown that this claim can be substantiated.

As is the case with everything in life, everyone has different sets of expectations. This is especially true when it comes to the intensive process of therapy. People are extremely unique and come with their own personalities and raw emotions. No two people are the same. Because personalities differ so much, the responsiveness to each type of therapy will vary greatly between people. Generally speaking, a psychologist will analyze your personal degree of tolerance to disappointment and frustration, where/how you locate your issues in life, and your level of autonomy prior to deciding whether or not their therapeutic approach is most effective modality for you.

Here’s a short example:

John Doe knows he needs psychological help. He walks into a mental health clinic and is evaluated by a psychologist. The determination of the most helpful type of therapy? Psychoanalytic therapy. This is because in John Doe’s psychological evaluation, he showed a variety of signs that support this type of therapy, such as:

  • He is honest with himself and the people around him.
  • He can face and accept the truth, which is of paramount importance in order to successfully better himself.
  • He considers himself personally accountable for his own life.
  • He also considers the prospect that he may not fully know certain aspects of himself.
  • He understands that instant gratification is not something that goes hand in hand with deep-meaning thoughts, actions and exercises like therapy, and that it will take time.
  • He demonstrates a capacity for insight.

The logic behind the therapist’s implementation of psychoanalytic therapy for John Doe is that the foundations of psychoanalytic therapy rest on several concepts:

  1. The source of emotional struggle largely comes from within and is unconscious.
  2. Therapy is based on complete dedication to the pursuit of inner truth, no matter how easy of difficult it may be to hear.
  3. The vast intricacy of the psyche needs time in order to facilitate real fundamental change.

All that said, there are instances in which a person who initially did not fit the criteria for psychoanalytic therapy will uncover hidden capacities as he or she evolves in their therapy sessions, which enables them to go deeper than previously expected. Similarly, for some people no matter how much they progress, one type of therapy will suit them no matter where they are in the process.

Ultimately, therapy is a very fluid process with many complexities behind your therapist’s training and the therapeutic lens through which they approach treatment.


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