By Kate Reichman, CT
So you decided you wanted to go to therapy, and have begun the search process to find the right clinician. While this is an important first step, many find that the multitude of phrases that therapists, counselors, and mental health practitioners use to describe their styles can be confusing. The good news is that clinicians generally use the same or similar terms to describe the various aspects of their individual styles. This blog aims to decipher and educate readers on what these terms mean and the differences between them. Below is a chart that summarizes the terms
Theoretical Orientation:
The lens a clinician uses to conceptualize therapy
Counseling Technique or Therapy
Specific interventions or groups of interventions that target specific goals. Fall under theoretical orientations
Specialties
Advanced certifications or areas of expertise that clinicians can earn or focus on
Theoretical Orientation
When looking for therapists, you may often hear or see the term “theoretical orientation”. A clinician’s theoretical orientation is the “lens” they use to conceptualize therapy. In other words, it’s the philosophy that guides their practice (the glasses they see through). These categories of theoretical orientations are broad and contain many techniques and therapies (see next section) within each orientation. All professional counselors, psychologists, and family and marriage therapists are licensed and trained to utilize the theoretical orientations that they see fit. Many clinicians may lean toward a particular orientation, but can also blend multiple orientations (known as being “eclectic”) depending on their ideals and what is needed for the client. It is important to note that while some clinicians may seek advanced training in a particular orientation ( including gaining extra certifications), all clinicians are trained on the basic techniques within the common orientations.
Below are some brief descriptions on common theoretical orientations that you may see or hear clinicians describing:
Psychoanalytic: The psychoanalytic orientation emphasizes the unconscious mind as a driver to thoughts and motivations. It seeks to release repressed emotions and experiences in order to gain insight and promote growth. ( McLeod, 1970) Clients working with psychoanalytic clinicians may discuss past experiences such as childhood to untap these repressed emotions or experiences.
Existential: The existential orientation focuses on “the inevitable conditions humans face during life, such as death, responsibility, freedom, and purpose” (SOMMERS-FLANAGAN, 2018) . Existential clinicians talk about “big picture” concepts in order to identify themes in an individual’s life that need addressing.
Person-Centered: Person-centered therapy aims to provide a nonjudgmental atmosphere lead by the client as the main driver in discussion. The goal is for a client to come to discover their own solutions without the clinician interfering the process of self-discovery. (Person, n.d.) Most clinicians utilize various aspects of person-centered approaches along with other orientations.
Behavioral: The behavioral theory acts on the premise that all behavior has a purpose that develops due to what is learned over time. In other words, what we do is not random and can be altered through addressing the root cause of the behavior. Behavioral therapies aim to alter this through essentially “re-learning” behavioral responses.
Cognitive-Behavioral: Cognitive -behavioral (commonly referred to as CBT) , is a widely used orientation throughout therapy. Similar to behavioral therapy, CBT is based off the idea that humans behave due to what was learned and for a purpose. Furthermore, the cognitive part of CBT adds to this in looking at how our thoughts affect these behaviors. Cognitive- Behavioral therapies are often referred to as “evidence-based”; meaning they have been backed by extensive research and science to be effective in treating certain disorders (such as anxiety).
Family Systems: If you are working with a family or marriage therapist, they may work through a family systems lens. “Family systems approaches depart from the idea of treating individuals in isolation” ; rather they see issues and disorders through an individual’s relation with their family or support unit. (SOMMERS-FLANAGAN, 2018) Another terms you may hear that is similar to this, is a systemic approach.
Once again, the above descriptions are the orientations that you will most likely come across when looking at therapists; but there are many more. Furthermore, most therapists use a blend of multiple that they see fit for each individual client.
Counseling Techniques and Therapies
As stated in the previous section, theoretical orientations are the broad lenses that clinicians use to guide their practices. Within these orientations, however, are the techniques that are used to target specific goals. Often times techniques are clustered into established therapies. Below is a chart of techniques and therapies that you may see and the theoretical orientations that they fall under. Not all techniques and therapies are listed.
Theoretical Orientation
Techniques and Therapies
Psychoanalytic
Projective testing, dream analysis , free association, attachment-informed psychotherapy, focal psychotherapy
Existential
Paradoxical intention, existential integrative therapy, logotherapy, mindfulness-based existential therapy, philosophy-based counseling
Person-Centered
Motivational interviewing, actualization, emotion-focused therapy, nondirective play therapy, phenomenology
Behavioral
Applied behavioral analysis, assertiveness training, exposure therapy, functional behavioral analysis, progressive muscle relaxation, problem-solving therapy
Cognitive Behavioral
Dialectical Behavioral Therapy (DBT), Rational emotive behavioral therapy (REBT), self-instructional training, mindfulness -based CBT, trauma -focused CBT, automatic core belief analysis, collaborative interviewing, integrative behavioral couple therapy, cognitive processing therapy, schema therapy, acceptance and commitment therapy (ACT), exposure and response prevention therapy
Family systems
Structural family therapy, feminist family therapy, functional family therapy, human validation process model, inter-generational family therapy, symbolic experiential family therapy
Specialties
Lastly, many clinicians can work towards advanced certifications beyond their basic license. Some of the therapies listed above may require these extra certifications to practice fully. This person is known as certified. On the other hand, When a clinician does not have the full specialty certification, but still uses concepts from certain techniques or therapies, it is known as informed. A clinician, for example who is DBT (Dialectical Behavioral Therapy) certified has gone through the official training and certification needed to earn that title. A clinician who is DBT informed may not have gone through the official training, but still uses the techniques (just less in depth) in their practice. Whether or not a clinician must be certified and not just informed to practice depends on the specific technique or therapy. Eye-movement Desensitization Reprocessing (EMDR), for example, is one in which you must be certified (not informed) to use.
References
Mcleod, S. (1970, January 1). Psychoanalysis. Retrieved from https://www.simplypsychology.org/psychoanalysis.html
Person-Centered Therapy. (n.d.). Retrieved from https://www.psychologytoday.com/us/therapy-types/person-centered-therapy
SOMMERS-FLANAGAN, J. & R. (2018). Counseling and psychotherapy theories in context and practice: Skills, strategies, and techniques. Place of publication not identified: John wiley & Sons.