Running head: psychotherapy1

Psychotherapy: Therapy Types and Options

Stephnie A Schaap-Jones

University of the Rockies

10 March 2014
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Abstract

Therapists and the theories to which they adhere are as varied as the general population. When

selecting a therapist and course of therapy, an individual must make an informed decision

regarding what type of help they are looking for and what they expect from their therapist.

Psychoanalysts act more like doctors, while thought-based therapists act more like guides,

helping clients reach their own conclusions. Which route an individual chooses to take is a very

personal decision and must be considered carefully.

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Psychotherapy: Therapy Types and Options

When a client makes the decision to seek out a psychologist to help them with the

problems that are causing them distress, they rarely realize how vast and varied their options

really are. Depending on the amount of time and money the client has to dedicate to their

psychotherapy, their desired outcomes, their personal opinions and local availability, clients can

choose from psychoanalysis or thought-based therapies to help them deal with their irrationalities

and cognitive distortions in order to reshape their perceptions and behaviors. Regardless of the

choices that a client makes, the goal of therapy will be to utilize the techniques of the

psychologist’s chosen theory in order to help the client resolve their problems and to become

better, more productive members of society.

Therapies

Generally speaking, psychotherapy falls into two broad categories. Clients can elect to

undergo psychoanalysis/psychodynamic therapy or they can choose a thought-based therapy

such as person-based, gestalt or cognitive behavioral therapies (McCarthy & Archer, 2013). A

client’s preference in this decision will likely result from the role which they want the therapist

to play and the role that they perceive their past as playing in their current problems.

Psychodynamic theorists follow the same basic principles that Freud created with

psychoanalysis; that people have an unconscious mind that functions outside of their control, that

personality develops in early childhood and remains relatively static and that people often act on

instinct without conscious thought (McCarthy & Archer, 2013). Thought-based theorists prefer

to work under the assumption that people are under their own control and that they can alter their

personalities and responses at will (McCarthy & Archer, 2013). Basically, psychoanalysts and
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psychodynamic therapists work at helping clients find experiences in their past that may be

affecting their current actions without their knowledge, while thought-based theorists work at

helping clients to recognize problems with their perceptions and behaviors and helping them to

make a conscious decision to alter these.

Psychoanalytic theorists generally treat therapy in a very clinical manner, with the

therapist acting as a doctor or person of authority that analyzes the client’s past and then tells

them why they are behaving the way they are and how to fix the problems (McCarthy & Archer,

2013). Thought-based therapies, on the other hand, place the therapist in the role of a guide or

advisor who listens to the client and guides them to draw their own conclusions and alter their

own perceptions and behaviors (McCarthy & Archer, 2013). The client’s decision regarding this

basic preference should be based on whether they believe that their problems are seated in past

experiences beyond their control or in the present and within their control.

Irrational Beliefs

According to Albert Ellis's rational emotive behavior therapy (REBT), irrational thoughts

interfere with goals, causing psychological dysfunction (McCarthy & Archer, 2013). Ellis

devised a total of 12 irrational thoughts:

“Irrational Idea No. 1: The idea that it is a dire necessity for an adult human being
to be loved or approved by virtually every significant other person in his
community.

Irrational Idea No. 2: The idea that one should be thoroughly competent,
adequate, and achieving in all possible respects if one is to consider oneself
worthwhile.

Irrational Idea No. 3: The idea that certain people are bad, wicked, or villainous
and that they should be severely blamed and punished for their villainy.
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Irrational Idea No. 4: The idea that it is awful and catastrophic when things are
not the way one would very much like them to be.

Irrational Idea No. 5: The idea that human unhappiness is externally caused and
that people have little or no ability to control their sorrows and disturbances.

Irrational Idea No. 6: The idea that if something is or may be dangerous or

fearsome one should be terribly concerned about it and should keep dwelling on
the possibility of its occurring.

Irrational Idea No. 7: The idea that it is easier to avoid than to face certain life
difficulties and self-responsibilities.

Irrational Idea No. 8: The idea that one should be dependent on others and needs
someone stronger than oneself on whom to rely.

Irrational Idea No. 9: The idea that one’s past history is an all-important
determiner of one’s present behavior and that because something once strongly
affected one’s life, it should indefinitely have a similar effect.

Irrational Idea No. 10: The idea that one should become quite upset over other
people’s problems and disturbances.

Irrational Idea No. 11: The idea that there is invariably a right, precise, and
perfect solution to human problems and that It is catastrophic if this perfect
solution is not found.

Irrational Idea #12: The idea that you can give people (including yourself) a
global rating as a human and that their general worth depends upon the goodness
of their performances. (Ross, 2006)”

Each of these irrational thoughts prevents an individual from reaching their goals by

providing the individual with an unrealistic perception of the world around them and the

possibilities that exist (Ross, 2006). The result is that an individual selects unobtainable

goals with an unrealistic idea of what reaching their goals would mean.

Social Anxiety Disorder is a “marked fear or anxiety about one or more social

situations in which the individual is exposed to possible scrutiny by others (American

Psychiatric Association, 2013).” People with this disorder are likely to be preoccupied
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with not being liked or being rejected by those people that the individual may see as

important. An REBT therapist may attribute this condition to the first irrational thought

that they should be loved by everyone by assuming that the irrational thought that they

must be liked is resulting in a crippling fear that they may find someone who does not

like them.

Dependent Personality Disorder is another psychological dysfunction that can

easily be related to the idea of irrational thoughts. According to the DSM-5 (2013), this

disorder is “a pervasive and excessive need to be taken care of that leads to submissive

and clinging behavior and fears of separation, beginning by early adulthood and present

in a variety of contexts.” This disorder can easily be connected to Ellis’s eighth irrational

thought, that the individual must be dependent on others that are stronger than them. An

REBT therapist may approach this individual by helping them to see that they are strong

in their own right and that they can do things on their own that they did not believe that

they could.

It is easy to see how irrational thoughts can lead to psychological disorders and

how a therapist could connect nearly any disorder to an irrational thought pervading the

individual’s conscious mind. Whether or not an individual should seek REBT depends

heavily on whether the individual believes that they are being rational or irrational. In

some situations, it can be easy for a person to recognize that they are not being rational,

but if they believe that their thoughts are rational and based on facts or that their thoughts

are confusing, this may not be the best choice for the individual.

Cognitive Distortions
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Aaron Beck believed that individuals acted on “automatic thoughts”, and when these

automatic thoughts were faulty, they resulted in depression (McCarthy & Archer, 2013).

Depression, or depressive disorders, is characterized by “the presence of sad, empty, or irritable

mood, accompanied by somatic and cognitive changes that significantly affect the individual’s

capacity to function (American Psychiatric Association, 2013).” Beck referred to these “faulty”

thoughts as “cognitive distortions” and identified a total of 7 separate distortions; arbitrary

inference, selective abstraction, overgeneralization, magnification, minimization, personalization

and dichotomous thinking (McCarthy & Archer, 2013). Each of these distortions relies on the

individual to misinterpret, exaggerate or minimize past or incoming data in order to result in a

significant distortion of the truth.

Magnification, or “placing far too much importance on a particular event or situation

(McCarthy & Archer, 2013)” can easily be related Body Dysmorphic Disorder in which an

individual sees their body in an unrealistic way (American Psychiatric Association, 2013). For

example, an individual may hear someone comment that they have gained weight and

immediately conclude that they need to lose weight. The individual can then magnify this one

comment to mean that they are overweight and should diet. It is easy to see how this one

comment could be magnified by an individual until they find themselves restricting their food

intake or even resulting in Anorexia Nervosa or Bulimia.

Arbitrary inference, or “coming to a conclusion inappropriately when there is really no

evidence, or even contrary evidence, for the conclusion (McCarthy & Archer, 2013)” is another

distortion that can easily be linked to a common psychological dysfunction, Obsessive-

Compulsive Disorder (OCD). Individuals with OCD suffer from obsessive or compulsive

thoughts or behaviors that cause them to do things out of habit or superstition, in spite of
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evidence that their obsession or compulsion is irrational and interferes in their daily life

(American Psychiatric Association, 2013). For example, an individual may believe that they

must wash their hands after they touch anything outside of their home to prevent getting sick, in

spite of the conscious knowledge that other people touch many things outside of their homes and

do not get sick.

Behavioral Based Therapies

Behavioral based therapies focus on altering the behaviors of an individual (Murphy,

2011). Two methods that behavioral therapists use to alter behaviors are “shaping” and “token

economies” (Murphy, 2011). While related, they each have distinct characteristics and

differences, as well as different ideal settings.

Shaping involves breaking the process of altering a negative behavior into small stages

and rewarding an individual for each stage they complete (Murphy, 2011). For example, if an

individual wants to control their temper, the therapist may break this into stages such as not

harming people, avoiding violent outbursts, avoiding raising one’s voice, and finally remaining

calm. When the individual gets angry, but does not harm anyone, they may be rewarded with

money, dinner out or some other thing that they want. Once they have mastered this step, they

would continue on to the next stage in the same manner until they have reached the final stage.

This is a method that can be used easily in a variety of settings, but lends itself well to an

outpatient therapy setting in which the individual simply reports back to the therapist.

Token economies are better suited to a residential setting (Murphy, 2011). Token

economies offer individuals tokens or points for good behavior and individuals lose tokens or

points for negative behaviors (Murphy, 2011). For example, a teacher may provide students with

tokens for good behavior and charge students tokens for negative behavior. Students would then
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be allowed to spend their tokens on rewards (i.e. prizes, early releases, etc.). In this way, the

students are rewarded for positive behaviors (i.e. taking turns, turning in assignments, etc.) and

deterred from negative behaviors (i.e. talking in class, being late, etc.).

Conclusion

Individuals seeking help with psychological dysfunctions or behavior problems have a

plethora of options available to them. Selecting which type of therapy to seek is a very personal

decision and requires the individual to think about what type of therapy they feel would best help

them. Their decision may be limited by time, money or options available in their area.

However, with the proper forethought, there is no reason why an individual should not be able to

find a therapist that will work for them and yield positive results.
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References

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental

Disorders, Fifth Edition, DSM-5. Arlington, VA: American Psychiatric Publishing.

McCarthy, C. J., & Archer, J. J. (2013). Theories of counseling and psychotherapy. San Diego,
CA: Bridgepoint Education, Inc.

Murphy, B. C. (2011). Interviewing in action in a multicultural world (4th ed.). Belmont, CA:
Brooks/Cole.

Ross, W. (2006). What is Irrational? Retrieved March 20, 2014, from REBT Network:
http://www.rebtnetwork.org/library/ideas.html