I didn’t know there were different types of therapy…what therapy is best for me?

When you’re searching for a therapist in NYC, you may notice that many therapist profiles include a description about their therapy approach or that they’ve completed training in a specialized or “evidence-based” therapy. It can be a lot of jargon to muddle through, especially if this is your first time seeking therapy. If you’re wondering what all the lingo means for your sessions and unsure of what to expect - you’re not alone! That’s why we’ve included a list of common therapy approaches below and a brief description of each one.

If you’ve tried therapy before, you may be curious about what else is out there as you search for a new therapist. Or maybe you liked your last therapist a lot personally, but found that you weren’t quite getting what you wanted out of your sessions. Maybe you wanted more questions, or more structure, or more emphasis on getting to the “root” of things or understanding patterns. We completely encourage you to pay attention to your personal reactions and want to normalize that it takes times to figure out what actually works for you in therapy. It’s sometimes okay if you don’t feel great about your sessions. It may not be about you or “trying harder”, and it may not be your therapist - it could be the therapy approach that needs clarifying or change.

We know that deciding to find a therapist can be a big step. While it’s great to have so many therapists to choose from in a place like NYC, most people find their therapist search overwhelming. Often it is a complicated personal algorithm that hopefully results in someone who:

  • has the professional training and specialty expertise to help you with what brings you to therapy

  • is taking new patients and has the scheduling availability you need

  • you can afford

  • you can imagine opening up to after a first consultation based on personality or style

Whenever people use the term “good fit” with their therapist - this is what they mean, right? Definitely. We want to emphasize (and research shows again and again) that one of the most important factors to a satisfying therapy experience is the ability to build a safe, trusting, and genuine relationship with your therapist. We also believe that an important ingredient to good therapy is understanding what type of therapy suits you personally and what you’re hoping for from your sessions.

Why knowing about different therapy approaches matters

A common question our psychologists will ask (among many others) during a first session is “Have you been in therapy before and if so, what kind of therapy was it?” Frequently, our new patients have no idea what therapy approach their last therapist used. This isn’t surprising, as the psychology field started with traditional psychotherapy models where therapists often took a supportive backseat approach. This often didn’t include sharing with patients what they are doing or why in session.

At Manhattan Therapy Collective, we love therapy and believe in it. We also love and respect different therapy approaches, also called “theoretical orientations”. Furthermore, one of our practice values is mental health literacy - meaning we want our patients to learn about mental health and become more knowledgeable about how to care for their own emotional wellbeing. For that reason, we often share about our therapy approaches with our patients to the degree you want to know!

We believe every therapy approach brings something valuable to your session. Therapy approaches determine what kind of techniques or exercises your therapist may use, or what topics or themes you focus on. For example, a cognitive behavioral therapy approach will hone in on the connections between thoughts, feelings, and behaviors, whereas a trauma-informed approach will emphasize understanding the effects of past traumas on present-day emotional wellbeing. Some therapists use one therapy approach while others will integrate a few types of therapy in a session. This may reflect how a therapist was trained (sometimes graduate programs use a particular therapy approach overall) or be in response to your needs (some approaches work better for some symptoms than others). Many therapy approaches are “evidence-based”, meaning that research studies have shown the approach as effective for treating certain mental health concerns (e.g., anxiety, depression, trauma).

therapy swivel chair next to bookshelf

Choosing the best therapy approach for you

The truth is, most people benefit from having a weekly, dedicated time for emotional support from a mental health professional. However, this may not mean that you’re getting what you want out of your sessions or are addressing your concerns in a way that makes sense for you.

Here are some questions to reflect on when it comes to determining what therapy approach is right for you:

  • What expectations or goals do I have for therapy?

  • Are my therapy goals short-term or long-term? or Do I have an imagined timeline that would be worth sharing?

  • What does my ideal session look like and why?

  • What kinds of topics do I imagine my therapist and I focusing on?

  • How active of a role do I want my therapist play in my ideal session?

  • What’s an example of something that would change or be different that reflects the progress I’m hoping for?

  • Would I prefer to work on something in between sessions or prefer to leave it open-ended?

  • What have I found most helpful (or least helpful) in therapy before?

These questions can help you clarify what you are looking for in therapy and what therapy approach is most likely to meet your needs. Someone who is hoping to manage anxiety and learn exercises to try between sessions would likely appreciate a different approach to someone wants space to organize their thoughts and feelings after a breakup or loss. We highly encourage you to reflect on these questions and share your answers with your therapist. Our psychologists at Manhattan Therapy Collective will always work collaboratively with you and be open to feedback about how you feel like therapy is going. If you have any questions about your therapist’s approach, we want you to ask or contact us!

 

Types of psychotherapy

Below is a list and brief summary of some of the types of therapy that our psychologists use.

 

  • Cognitive Behavioral Therapy is an evidence based therapy that focuses on the relationship between your thoughts, emotions, and actions. A primary idea is that your perception and interpretation of a situation’s meaning has more to do with how you will react (or be affected by it) than the facts of the situation itself. CBT helps you slow down and mindfully identify your immediate thoughts in real time. By doing so, you can differentiate between helpful and unhelpful thoughts - the latter often being inaccurate, problematic, self-critical. Learning to tune into your regular thought life also helps you pinpoint patterns and deeper stories you may carry - with the intention of letting go of outdated narratives that don’t serve you. CBT also empowers you to problem solve and make actionable changes. If your thoughts influence how you feel and what you do - what you do differently can influence how you think and feel. Cognitive Behavioral Therapy can help with anxiety, depression, trauma, perfectionism, procrastination, and self esteem. To learn more about CBT.

  • Cognitive Behavioral Therapy for Insomnia is a short-term, evidence based form of CBT specifically targeting the thoughts, feelings, and behaviors surrounding sleep problems. Notably, CBT-I focuses on improving sleep without the use of medications (i.e., sleeping pills) - which means practices can be implemented for the long-term and you can take full credit for it. Sessions often include educating you about how sleep works and best sleep practices, helping you track your sleep, and creating a personalized plan to improve your sleep through consistent, targeted interventions. While the length of treatment can range according to your needs, Cognitive Behavioral Therapy for Insomnia often takes 4-8 sessions and is highly effective. To learn more about CBT-I.

  • The word “dialectic” from Dialectical Behavior Therapy means an integration of opposites. For example, a common dialectic in therapy is promoting self-acceptance and promoting personal responsibility to change. Another dialectic is valuing reasoning through logic and valuing being in touch with your emotions. DBT helps you get unstuck by combining seemingly opposite skills or perspectives so you can benefit from their combined value. By doing so, you experience greater balance instead of emotional extremes. Behavioral skills targeting mindfulness, distress tolerance, relationships, and emotional regulation are foundational to DBT. Dialectical Behavioral Therapy is an evidence based therapy and can be helpful for trauma, disordered eating or substance use behaviors, depression, and relationship conflict. To learn more about DBT.

  • Emotion Regulation Therapy, or ERT, is an evidence-based, manualized therapy approach that focuses on helping people identify, accept, manage, and use their emotions to create a values-driven life, rather than a reactive or avoidant one. ERT was created for the treatment of generalized anxiety and includes cognitive behavioral, mindfulness, and acceptance-based theories. For more information on ERT.

  • Feminist therapy is a paradigm that draws attention to the experience of gender and the realities of power dynamics. It is definitely not just for/about cisgender women. Feminist therapy works to challenge or uproot internalized sexism, patriarchy, or systems of oppression - especially where it undermines mental health and wellbeing. Feminist therapy also encourages an egalitarian relationship between therapist and patient where there is shared power and collaboration, rather than a traditional relationship of therapist as an authority figure. To learn more about feminist therapy.

  • Interpersonal Therapy, or IPT, is an evidence based therapy originally targeting depression that takes a close look at how your relationships affect your sense of wellbeing. Specifically, disruptions or unresolved challenges in your relationships often create longstanding emotional distress. IPT addresses four important challenges to relational health: grief, role disputes, role and life transitions, and social isolation. While Interpersonal Therapy was first created for depression but has also been adapted to help with bipolar disorder and perinatal mental health concerns (e.g., postpartum depression, infertility). To learn more about IPT.

  • Mindfulness Based Cognitive Therapy blends the focus on thoughts from cognitive therapy with mindfulness practices. It highlights the mind-body connection and being aware of your thoughts and physical sensations in real time without judgment. Learning skills like meditation, body scanning, and diaphragmatic breathing (belly breathing) are examples of exercises that encourage you to be present. MBCT is an evidence based approach and can be helpful with anxiety and depression and is often used in health psychology settings (e.g., hospitals). To learn more about MBCT.

  • Multicultural Therapy, or what is often known as “multiculturally competent” or “multiculturally sensitive” therapy integrates your specific social identities (e.g., race, gender, class, sexual orientation, religion/spirituality, age, generation, nationality, ability, etc) into the understanding of your mental health and life experiences. It rejects a “colorblind” or “one size fits all” approach to therapy. It also evolves past the predominantly White, heterosexual, male assumptions about mental health that shaped early psychological theories. A multiculturally responsive therapist acknowledges how social identities are deeply impactful - from being curious about intersectionality (e.g., what is it like to be a multiracial+able-bodied+cisgender female at your job) to discussing sociopolitical realities that undermine psychological wellbeing (e.g., racism, xenophobia, homophobia). Commitment to open and honest dialogue, exploring possible therapist or patient biases, and increased understanding are encouraged. To learn more about multicultural therapy.

  • While Psychodynamic Therapy has its roots in psychoanalysis, it has since evolved into a number of schools of thought. Generally speaking, psychodynamic therapy focuses on making connections between the past and present, emphasizing the importance of early life experiences, caregiver attachment, and developmental milestones. Another key characteristic of psychodynamic therapy is its exploratory, open-ended nature and overarching goal of bringing what is unconscious to the surface. Examples may involve gaining insight about your unintentional defense mechanisms and unconscious patterns of behavior in relationships.

  • Relational Cultural Therapy is a therapy model founded on feminist and social justice values. It emphasizes growth through and towards relationship throughout life rather than individuation and independence. It assumes a universal desire for connection, belonging, and social inclusion. RCT focuses on the goal of deepening relational awareness by understanding points of connection and disconnection with others. In RCT, deconstructing obstacles to mutual connection are explored. Central to RCT is recognizing that the various connection or disconnection strategies we may use are directly tied to our identities and social location. To learn more about RCT.

  • Most often utilized in family therapy, systems therapy is an approach that emphasizes understanding individual behavior within the context of a larger entity. This may be a a larger situation, relationship, family system, company, or social group/community. It is a holistic perspective that highlights understanding roles, dynamics, interaction, and the impact of one’s actions on a broader system, and vice versa. To learn more about Systems Therapy.

  • Trauma-informed Therapy explores the connections between how you are doing (and what you may be struggling with) through the lens of how traumatic experiences have impacted you. This type of approach is not just for veterans and PTSD. A popular way of describing trauma-informed therapy is shifting away from symptoms, or a “what’s wrong with you?” focus to asking “what happened to you?” By doing so, symptoms are reframed as a normal, even understandably adaptive response to an abnormal situation, instead of pathologizing the person as “broken” or “messed up”. For example, what may be classic symptoms of depression, like a lack of energy and social withdrawal may have been an adaptive, self-protective strategy to “shut off” and survive a chronically abusive relationship. A trauma-informed therapist will emphasize establishing trustworthiness, collaboration, empowerment, and choice. While there are many specific therapies that treat trauma, trauma-informed therapy is more like a general lens that is used to help make connections in therapy. To learn more about trauma-informed therapy.