Types of talking treatment

Cognitive behaviour therapy
Cognitive behaviour therapy (CBT) aims to help people change patterns of thinking or behaviour that are causing problems. Changing how you think and behave also changes how you feel. It is a structured approach - you agree goals for treatment with your therapist and try things out between sessions. 

In particular, it can help with depression, anxiety, panic attacks, phobias, obsessive compulsive disorder and some eating disorders, especially bulimia. Most recently CBT has been used to treat aspects of schizophrenia, manic depression and other psychoses. 

Cognitive analytic therapy
Cognitive analytic therapy (CAT) involves a therapist and a client working together, by looking at what has held the client back in the past, in order to understand better how to move forward in the present. Questions like, "Why do I always end up feeling like this?" become easier to answer. CAT has been used across a wide range of disorders and difficulties - such as depression, anxiety, personal and relationship problems. More recently, longer term sessions of CAT have been shown to benefit people with personality disorders.

The focus is on recognising how these coping habits started and how they can be adapted and improved. Then using the client's own strengths and inner resources, plans are developed to bring about change. 

Dialectical behaviour therapy
Dialectical behaviour therapy (DBT) is a form of therapy that includes cognitive and behavioural therapy and is for people with borderline personality disorder. DBT maintains that, due to certain types of environments during upbringing and due to unknown biological factors, some people react abnormally to emotional stimulation.  DBT aims to:

• decrease high risk suicidal behaviours including self harm
• decrease responses that interfere with therapy
• decrease responses that reduce quality of life
• deal with post-traumatic stress disorder (PTSD) responses
• enhance self respect
• learn new behavioural patterns in the group
• achieve goals set out by the patient

DBT has proved successful during trials reducing self harming behaviours, increasing the effectiveness of therapy and decreasing both number and length of inpatient stays.

Psychotherapy
Psychotherapy is the provision by qualified practitioners of a formal and professional relationship within which the patient/client can explore difficult and often painful emotions and experiences beneficially. These may include feelings of anxiety, depression, trauma, or perhaps the loss of meaning in one's life. This therapy seeks to solve current problems and teach problem solving skills, and also to reduce current symptoms and consider prevention of symptoms recurring or worsening.

Psychotherapy is good for the treatment of anxiety disorders, personality disorders, depression, stress, bipolar disorder, relationship problems and psychological sexual problems. While psychotherapy is not always able to treat severe mental illness it can be helpful in:

• encouraging client to stay on medication
• improve social skills
• improve ability to deal with stress
• encouraging the client to accept that they have a disorder
• decreasing any trauma associated with the disorder

Family intervention
Family intervention was originally set up to help families deal with a family member suffering from drug, alcohol, gambling addictions, eating disorders or other self-destructive behaviour.

The family intervention programme has been adapted to deal with families coping with someone with schizophrenia, addictions and eating disorders. Family interventions for schizophrenia include the following assumptions:

• schizophrenia is an illness
• the family environment is not a factor in the cause of the illness
• support is provided and families are involved in delivery of therapy
• the interventions are part of a treatment package used in conjunction with routine drug treatment and outpatient clinical management

Research shows that family interventions are effective at delaying if not preventing relapse for people with schizophrenia who have significant family contact. Family intervention consists of psycho-education, behavioural problem solving, family support and crisis management.

Creative therapies
Creative therapies can be used for dealing with emotional conflicts, increasing self-awareness, developing social skills, managing behaviour, solving problems, reducing anxiety, aiding reality orientation, and increasing self-esteem.

Art Therapy - is a service which uses art materials and images, through the creative art process and client’s responses to the results as reflections of their development, abilities, personality, interests, concerns and conflicts. Because of its wide range of effects, art therapy is used in the treatment of a number of different mental illnesses. Art therapists are professionals trained in both art and therapy. Art therapists work with children, adolescents, and adults and provide services to individuals, couples, families, groups and communities. They often work as part of clinical teams.

Drama Therapy - is the use of drama/theatre processes to work towards the relief of symptoms, emotional and physical integration, and personal growth. Drama therapy is an active, experience led approach that encourages the client's ability to tell his/her story, solve problems, set goals, express feelings appropriately, achieve resolution, extend the depth and breadth of inner experience, improve interpersonal skills and relationships and strengthen the ability to fulfil their roles in life. Drama therapists are trained in theatre arts, psychology, psychotherapy and drama therapy.

Counselling
Many people find that they benefit from sharing their troubles with a trained counsellor. Being able to talk about thoughts and feelings, without fear of being judged or criticised, can be a tremendous relief. To feel valued and accepted by the counsellor and not told what to do can lead to a new energy and acceptance of yourself. A trained counsellor can help to unravel old and new conflicts alike, help someone decide what they want for themselves, without feeling guilty or obliged to others. Your counsellor should:

• treat you with respect
• allow you to talk without contradiction or advice
• be non-judgmental
• be warm and accepting
• be genuine
• keep your details confidential at all times
• maintain a professional boundary (not be a personal friend to you)
• see you in a safe and comfortable place, without interruptions

The existential approach to counselling is all about exploring meaning and value of a person’s life and learning how to live authentically, in accordance with your own ideals, priorities and values. ‘Authentic living’ means being true to you and honest about your own possibilities and limitations. Authentic living means taking action to live by these things.

Person-centred counselling views you as the best authority on what is happening to you and sees you as being fully capable of fulfilling your own potential for growth. It recognises however, that achieving potential requires favourable conditions and that under adverse conditions, you may well not grow and develop in the ways that you otherwise could.

Black and ethnic minorities and counselling The practice of trans-cultural counselling takes into account cultural beliefs and practices when starting counselling. Some people specialise in this area of counselling but more and more it’s an integral part of counselling courses.