An Introduction to
Psychological Therapies
Goals of Psychological Therapy
Clients bring issues such as low self esteem, chronic problems with relationships, anxieties, problems with low mood and traumatic
memories to therapy.
Therapy can offer skills training, symptom reduction, self understanding, self empowerment and insight and validation of core emotions
depending on which model of therapy is being used.
Psychodynamic Therapy - the first form of talking therapy
Systemic and Family Therapies
Main principles – transference, defences, template theory.
Early relationships in childhood contribute to later difficulties
with relating to others and the self. Clients construct defences
against painful feelings that later become dysfunctional.
Systemic therapy is based on the idea that symptoms and
problems within individuals are often caused by factors in the
client’s surrounding environment.
Current applications of this approach include working with
clients who have problems with dysfunctional interpersonal
behaviour and personality disorders. Improvement is achieved
by increasing insight into the historical causes of the client’s
problems and by the reduction of dysfunctional interpersonal
behaviour driven by historical defence mechanisms.
Emphasis is placed on valuing the client’s perspective on their
difficulties rather than assuming that the therapist is always the
expert. This approach is a mainstay in work with children and
families
Third Wave Therapies
These approaches are derived from Buddhist philosophy about
the importance of accepting and tolerating distress and having
compassion for the self and others
Counselling Approaches
Person centred counselling - developed by Carl Rogers,
originated from the humanistic movement of the 1960s which emphasises the use of a warm, genuine therapeutic
relationship to encourage change.
Current applications include primary care counselling services
for clients with adjustment difficulties who have faced
difficulties with loss, change or major life decisions.
Improvement is achieved by enabling clients to find self
empowering solutions to their problems within a trusting,
safe, therapeutic environment.
Cognitive Behavioural Therapy (CBT)
The ‘cognitive’ element of CBT is based on the idea that
negative thinking patterns maintain emotional problems such
as anxiety and depression. This approach aims to modify
negative thinking and to change dysfunctional behaviour by
developing logical reasoning skills.
The ‘behavioural’ component refers to techniques such as
graded exposure that encourage clients to learn to face and
cope with previously feared or avoided situations
CBT is widely applied to common mental health problems such
as depression and anxiety. It is also used with trauma
symptoms (PTSD), eating disorders and psychosis.
Mindfulness, DBT and compassion based therapy are examples
from this therapy model.
Current Applications are very wide ranging - from primary care
anxiety management to working with severe and complex
personality disorders.
These new and innovative approaches are being used extensively
within the Trust.
Research limitations - flaws of randomised control trial studies
and NICE guidelines when working with complex cases with
multiple presenting problems.
Evidence Base
Evidence for psychodynamic therapy and personality pathology
(Roth and Fonagy 1996)
Extensive evidence for CBT and symptom reduction in depression,
anxiety and trauma.
Evidence for humanistic approaches – fundamental techniques of
counselling approach are associated with good outcomes (e.g.
Norcross 2011).
The future - context of the NHS – financial pressures create a
greater need for brief interventions, an emphasis on outcomes,
evidence based practice, cost effectiveness.