“CBT was amazing - it was so simple. My diagnosis is bipolar disorder and I had very low self-esteem and lack of confidence in my future. I had about 15 sessions over a year.
“The psychologist showed me how to notice what I was thinking and then how I felt afterwards, and to realise you can choose your own thoughts. I thought they were just random thoughts there to make my life a misery. But I learnt that at any time I could stop and say: “Why am I thinking that?”
“I had a pattern of thinking that I was educationally subnormal. CBT taught me that I was as intelligent as anyone else. So I put the thoughts on hold and said:
“I’m going to give it a go”. The main hurdles were looking at the prospectus, getting to the college and speaking to the tutor. But I signed up for a diploma and won student of the year.
CBT was the turning point for me to do that. The more I thought in that way, the more I started feeling better. And it’s a bit like riding a bike - once you’ve learnt it, it becomes part of you.”
Claire told us about her experience:
“I had a CBT therapist but I think she probably used lots of different things – in fact it didn’t feel like she was ‘using’ anything – it felt like a natural process rather than anything very medical or clinical.”
Back to top
DBT combines some of the methods of CBT with meditation techniques. It involves individual therapy and group therapy. NICE recommends DBT for persistent binge eating disorder and people with personality disorders who self-harm.
Back to top
How do they work?
By exploring how your personality and early life experiences influence your current thoughts, feelings, relationships and behaviour. Once you have this extra understanding, you can practise more skilful ways of dealing with difficult situations.
What are they based on?
Originally the ideas of the neurologist and psychotherapist Sigmund Freud, with many changes over the last 100 years.
What form do they take?
The therapist works with you to understand your thoughts, feelings, relationships, behaviour, dreams and fantasies.
How long do they take?
Usually between several months and several years, although shorter-term versions are available.
Where are they practised?
Often privately, and in some charities. They are available on the NHS in some areas.
What are they helpful for?
Depression, anxiety, post-traumatic stress, long-term physical health problems, eating disorders and addictions. NICE recommends psychodynamic therapy for people experiencing depression alongside other complex illnesses.
Who will they suit?
People interested in self-exploration who are willing to devote lots of time and energy to it.
What are some of the variations?
Psychoanalysis, psychoanalytic psychotherapy, psychodynamic psychotherapy, analytical psychology, Jungian or Freudian analysis, focal psychodynamic therapy (NICE recommends this for treating anorexia nervosa).
What you told us about psychodynamic psychotherapy
Liz is a 31-year-old GP who was referred for psychodynamic psychotherapy when she was at university:
“I was quite severely depressed as a teenager. I tried various antidepressants and some CBT-based stuff, but nothing was helping. Finally, my GP suggested that I try psychotherapy at my local mental health unit.
“At first I was sceptical. I couldn’t see how sitting in a room with a stranger was going to help. I was quite a nightmare, trying to prove to my therapist and myself that the therapy would fail.
But with psychodynamic therapy, the therapist is prepared to sit and wait out that part with you. She started helping me link the way I was thinking, feeling and behaving to what might have gone on when I was younger and that really made sense.
“Because she was there every week and accepted whatever I said and did, I started feeling I could really trust her. I had problems trusting people so the fact that I could build up this trusting relationship with someone long term – that was the turning point.”
Back to top
How do they work?
By taking a whole-person approach to your problem, using a range of theories and practices to help you develop.
Where did they come from?
They were developed to offer an alternative to psychodynamic and behavioural therapies, focused on developing your full potential.
What form do they take?
These therapies explore your relationship with different parts of yourself (such as your body, mind, emotions, behaviour and spirituality) and other people (for example family, friends, society or culture) and support you to grow and live life to the full.
How long do they take?
Therapy can be short or long-term depending on the issues you need to cover, but usually at least several months.
Where are they practised?
Therapists working for the NHS or charities and private therapists offer these therapies.
What are they helpful for?
Humanistic therapies tend to treat specific problems – such as depression, anxiety or addiction – as chances for you to develop and grow. Therapists work with any issue causing difficulties in your life.
Who will they suit?
They will suit people interested in exploring their lives and looking at their problems from a wide range of angles.
What are some of the variations?
Person-centred counselling (NICE recommends this for children and young people with mild depression and sometimes for people with schizophrenia), transpersonal psychology, body psychotherapy, gestalt therapy, psychosynthesis, integrative psychotherapy, existential psychotherapy, transactional analysis, psychodrama and personal construct therapy.
What you told us about humanistic therapy
Penny is 43 and worked with a person-centred therapist during her stay at an alcohol day unit:
“I was referred to a unit that deals with people who turn to alcohol because of psychological problems. I was in a state of constant panic and had been drinking to keep those feelings at bay.
“There wasn’t a set formula to the sessions. We’d just go and get a cup of coffee and I’d talk about what was bothering me. With person-centred counselling the therapist steers you through finding out more about yourself and developing confidence.
“My therapist believed in me from start to finish and you start to believe in yourself too. Sometimes he would throw in something that stopped me short and made things clear to me that I hadn’t seen before.
But you know you’re not being judged and that this person is for you, not against you. He was interested in getting me to the point where I felt strong and secure and able to go out there and life my life to the full.
“Eighteen months on, I’d run a half-marathon. Because of the therapy I also went to university and I’m just about to graduate.”
Back to top
Group therapies
In groups led by a facilitator (someone who helps to introduce members of the group to each other and who helps the conversation to flow), people find solutions together and learn from each other. NICE recommends group therapy for people with obsessive compulsive disorder and for children and young people with mild depression.
What you told us about group therapy:
“In group therapy you don’t just talk about yourself, you’re listening to other people – that takes the burden off your problems. You realise you’re not the only one.”
Couples, relationship or family therapies
Couples or families work with a therapist to sort out difficulties in their relationships. NICE recommends family therapy for anorexia nervosa, depression in children and families of people with schizophrenia. NICE recommends ‘couples therapy’ if partners have tried individual therapy and this has not helped.
Interpersonal therapy
This explores how to link mood with the way you relate to the people close to you. NICE recommends this for people with eating disorders and various forms of depression.
Mindfulness-based therapies
A therapy that combines talking therapies with meditation. It helps people reduce stress, switch off from difficult thoughts and feelings and make changes. NICE recommends this treatment to prevent people who have had depression from experiencing the same problems again. Other versions of this treatment include mindfulness based stress reduction and mindfulness-based cognitive therapy.
Eye movement desensitisation and reprocessing (EMDR)
A way of stimulating the brain through eye movements which seems to make distressing memories feel less intense. It is used for a range of traumas, including past sexual, physical or emotional abuse, accidents and injuries, phobias, addictions and fear of performing in public. NICE recommends for post-traumatic stress disorder.
Motivational counselling
A way of talking about things you may be sensitive about that doesn’t feel threatening. The therapy focuses on your hopes and ambitions and problems that could stop you reaching your goals. NICE recommends this for people with a mental health problem who have problems with alcohol or substance misuse.
Life coaching
This uses empowering, motivational methods to help you reach goals or make changes.
Arts therapies
These therapies encourage you to express how you feel through art (painting, drawing, music, theatre or dance). Art can help you work out how to tackle difficulties, release emotions and understand yourself better.
Telephone counselling
This offers an easy way of talking to a therapist if you do not want to meet a face-to-face counsellor or if you can’t find one. It is sometimes provided by employers and charities. Online or e-mail counselling is another option.
Computerised cognitive behavioural therapy - No talking required!
You work through a series of exercises on your computer screen and learn self-help techniques for managing problems in your life. NICE recommends ‘Beating the Blues’ for mild to moderate depression, and ‘FearFighter’ for panic and phobia.
Bibliotherapy
Health professionals ‘prescribe’ self-help books which you can borrow from your local library. They will usually offer you these alongside other treatment. NICE recommend these for anxiety and obsessive compulsive disorder, and sometimes for depression.
Back to top
Health advice and information
NHS Direct
NHS Choices website: www.nhs.uk
phone: 0845 4647
Relate
Offers relationship counselling face-to-face, by phone and through its website
Phone: 0300 100 1234
Website: www.relate.org.uk
Cruse
Promotes the wellbeing of bereaved people and helps them cope with loss
Phone: 0870 167 1677
Website: www.crusebereavementcare.org.uk
Witness
Helps people abused by health workers or social-care workers and works to prevent abuse
Phone: 08454 500 300
Website: www.popan.org.uk/index.htm
|
|
|
|
|
|
|
|
|
|
|
|
|
|
