I was out for coffee with a friend of mine, and the topic of therapy came up.
I mean, what else do millennials talk about in 2024 other than their therapy sessions? As I was chatting with this friend, she shared that, for her, it was very overwhelming to find a therapist because of all the professional words we use, even on our websites, like CBT or psychodynamic. To her, as a non-therapist, she had no idea what this means and what type of therapy she might be looking for. She just needed someone to talk to!
That gave me the inspiration for this blog post, where I thought that we would take a deep dive into choosing the right counsellor, including what different therapies look like so that if you're searching for therapy, you can find a therapist who aligns with what you need and what you're looking for.
Theory, Modality and Intervention
Before we talk about very specific therapies, I want to explain to you a few really important words. And to do this, I want you to imagine a pyramid. At the bottom of the pyramid, we have our theory. In the middle of the therapy pyramid, we have our modality, and at the top of the pyramid, we have our intervention.
The theory that your counsellor uses is the way that they understand your problem. It's how they make sense of your struggle and understand what's going on.
For example, if someone uses a cognitive theory, they would understand that you are sturggling because of the thoughts you are having.
Sometimes when a counsellor is telling you how they work, they share their theory. But sometimes, they share their modality.
The modality is how your therapist is going to help you manage that problem. I like to think of the modality like the roadmap that says, "if you are here and want to get there, do this! ".
An example of a modality would be Cognitive Behavioural Therapy, which gives the thearpist a road map to understanding someone's behaviours and thoughts and how they may be a part of the problem that someone is facing.
The intervention is at the top of the pyramid. The intervention is the actual moment-by-moment thing that your therapist is going to do to shift things. This is the technique that your counsellor does to help shift things for you.
When we're talking about a therapist that fits with you and your needs, we want to make sure that you have a therapist who aligns both based on the theory they are coming from and the modality that they are using.
The 6 Main Theories of Counselling
Now that you know the difference between theory and modality, let's explore the main theories.
Humanistic counselling theories believe that people have within themselves all the resources that they need to live healthy functional lives and to heal from what they are going through. This theory believes that any problems that happen are because there are obstacles or restrictions that stop people from tapping into what they already know, allowing them to get better.
Counsellors who work from this theory often work with you to find your own solutions.
Cognitive theories believe that people experience psychological and emotional struggles when their thinking is out of sync with reality. So if you are thinking in a way that is not realistic or true, that is what creates struggles and issues, according to this theory.
Behavioural counseling theories state that people behave in ways that are problematic and that create the issues and struggles that they are experiencing.
So, for example, if someone is not behaving in alignment with their values, that is creating the struggles that they are experiencing. Alternately, if someone is not doing the things that are going to make them feel well, like getting enough movement in a day, that is going to make them feel unwell and have struggles.
Psychoanalytic models of therapy believe that all of the problems that people struggle with emotionally and mentally come from present-day influences from unconscious psychological drives stemming from past relationships and experiences.
What we have been through in the past creates unconscious motives and drives in us that create our current struggles.
Constructionist theories believe that everything in our world is merely invented or constructed and is not necessarily the reality. As such, we can shape the way that we construct and understand out world to better manage our struggles and experiences.
Systemic theories of counselling believe that our struggles are largely shaped by the pressures exerted on us by the social systems in which we live.
Systemic theories understand that because we live in oppressive systems, like capitalism and the patriarchy, we are going to experience certain struggles and counselling needs to help us understand and move differently through these systems.
Counselling Modalities
Once your therapist has their theory (i.e. what they believe causes the struggles you are experiencing), they then turn to a modality, which helps them understand how they are going to you work through their struggles.
Like I mentioned, theory tells us WHY someone is struggling, modality tells us HOW we can help someone through the struggle
There are literally hundreds of different modalities of counselling. But all of these modalities fit into the six main theories that we've already talked about. Because there are hundreds, I can't possibly in one article talk about all the different modalities.
What I thought we could do, though, is go over some of the key ones and look at how one person's struggles would be understood through a few different modalities.
So I want you to imagine someone named Sue. Let's say that Sue goes into counselling because she is feeling really depressed, she's feeling really burnt out, and overall just really unhappy and unfulfilled in life.
Let's now look at a few different modalities and see how they might look at supporting Sue.
CBT, or Cognitive-behavioral therapy, falls into the cognitive theory of counselling. This theory would believe that Sue is struggling because she's thinking in a way that is not serving her and is out of check with reality. A CBT counsellor would work with Sue to really understand what she's thinking in different situations, and help her change her thinking patterns.
For example, a CBT therapist might work with Sue to recognize that she feels very unfulfilled because she's always minimizing her own achievements. Whenever she does something impressive, the counsellor might notice, she brushes it aside and moves on without acknowledging her wins. This might leave her feeling very unfulfilled. A CBT therapist would help Sue slow down and really begin to notice and appreciate her wins so that she would feel better.
Emotionally Focused Therapy, also known as EFT for short, falls under the humanistic lens of therapy. Emotionally Focused Therapy is based on the idea of attachment and connection. It understands that when we are struggling, we're not struggling because there's something wrong with us but simply because we all need connection and struggle when we don't have it.
From an EFT lens, we might understand that Sue is struggling because she does not have the level of connection and attachment that she needs. EFT would then work with Sue to understand what's blocking her from getting the proper attachment and connection. EFT therapists also use the therapy relationship itself as a place where the client can begin to get the connection that they need, until they can get it outside of the therapy room.
Eye Movement Desensitization and Reprocessing therapy (EMDR) is a very different type of therapy that uses eye movements to help you process traumas in your past. EMDR is based in an understanding of how the brain stores memories to help process traumatic memories.
For a more in-depth explanation, check out this page on our website.
If an EMDR therapist looked at Sue, what they'd look for traumatic experiences Sue had in her past that aren't processed yet. So for example, has Sue experienced any really difficult events that are now leading her to feeling depressed and unfulfilled? If so, EMDR would process these experiences so that they are no longer a part of Sue's everyday life, and as such, she would no longer be feeling depressed and unfulfilled.
Parts therapy, often known by one particular type called IFS, comes from the understanding that we're all made up of various parts of our personality that have different desires, urges, and motivations. For example, you may have one part of you that wants to keep reading this article, while you have another part that thinks you should go wash the dishes. Parts therapy aims to help your parts be aligned in their goals and motivations.
Looking at Sue from this lens, we'd understand that parts of her are depressed and unfulfilled, but that other parts of her might actually feel very different ways. Part of her struggle may be that she doesn't know which part to listen to, when.
Feminist counselling is a systemic form of counselling that looks at the systems of the patriarchy in terms of the struggles that we are experiencing. This helps shift the focus away from the individual and more on to the systems that an individual is a part of to help create liberation, resistance, and change.
From a feminist lens, a counsellor might look at Sue's life and work to understand how uneven gender roles and pressures put on women might be influencing some of the struggles that Sue is currently experiencing. We would then work to change these gender roles see what makes Sue feel best, knowing we don't have to follow societal rules around what a woman "should" be.
Which Theory and Modality is Right for You?
At the end of the day, all theories and modalities are shown to be effective in research; thats why they exist!
So how do you choose? Here are a few options:
1. Choose a theory or modality that feels right to you and find a therapist that does that style of work. By exploring your world view and finding a therapist who thinks similarly, you'll likely resonate with your therapist and appreciate the work you do.
2. Some approaches to therapy are better suited to different conditions. For example, EMDR is great for trauma, but not effective for psychosis. Instead of choosing a theory or modality, find a therapist who specializes in what you are needing support with, then let them choose what approach to take.
2. Don't worry about the theory and modality and instead, find a therapist you like. If you "vibe" with the therapist, it's likely that their style and approach will align with your needs!
If you're looking for a Kamloops Counsellor (a virtual BC Counsellor!) reach out today and we'll match you with a counsellor who either has the style you like, or someone that you just "vibe" with!