Have you been feeling persistently sad for weeks or months? Perhaps you’ve been lacking motivation, or feeling irritable, or anxious, or constantly “on edge”. If symptoms like these are causing you concern and affecting your daily life – including your work, social life, or both – you might consider therapy.
If you’re experiencing persistent mental health symptoms, in the first instance you should consider speaking to your GP. You will be able to discuss your specific symptoms with them and possible treatments, including therapy.
If you decide psychological therapy is right for you, there are many different types available. It can be confusing to decide which one would work best for you, especially if it’s your first time seeking therapy.
So here’s a bit about some of the different options to help you work out what might suit you.
The options covered in this article are some of those used to treat mild depression, as recommended by health authorities in the UK and generally available for free via the NHS or mental health charities. But if you have a preference or want to specify your therapist, you may need to go private.
This article is part of Quarter Life, a series about issues affecting those of us in our twenties and thirties. From the challenges of beginning a career and taking care of our mental health, to the excitement of starting a family, adopting a pet or just making friends as an adult. The articles in this series explore the questions and bring answers as we navigate this turbulent period of life.
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1. Cognitive behavioural therapy
Cognitive behavioural therapy (CBT) is based on the theory that psychological problems stem from unproductive ways of thinking and learned patterns of unhelpful behaviour. One example is “all or nothing” thinking, where people believe that if one thing goes wrong in the day then the whole day is ruined, or if they answer one question badly during a job interview then the whole interview was a waste of time.
During CBT, the therapist guides the client to learn ways to cope and change their thinking patterns. This form of therapy focuses on the person’s current problems and doesn’t address wider problems such as family or underlying past issues.
CBT is highly structured and the skills learned, such as problem solving and re-framing unhelpful thoughts, are practical and can be incorporated into daily life. It also involves homework assignments, such as goal-setting worksheets, which people must be willing to complete to get the most out of treatment.
CBT is most commonly used to treat anxiety and depression, but can also help with other mental health problems, and can even help people cope with certain physical health conditions.
This approach may be suited to people who would like a structured, guided method with a specific focus on unhelpful thoughts and behaviour.
2. Short-term psychodynamic psychotherapy
Short-term psychodynamic psychotherapy seeks to target troubling thoughts and feelings that may be interfering with relationships, communication and daily life. A key goal is to change problematic relationship patterns.
It’s based largely on the belief that psychological problems are rooted in the unconscious part of the mind. So short-term psychodynamic psychotherapy aims to help the client identify the root causes of any problematic thoughts and feelings, such as unresolved or repressed trauma, and work through them.
The therapist does this by forming a trusting relationship with the client and exploring past and current events.
Similar to CBT, this approach teaches the client coping skills to help with future situations. But it’s less structured than CBT, and the client can direct what is discussed.
This type of therapy may therefore be suited to someone who wants a little more autonomy, and is keen to focus on interpersonal difficulties, such as loss or changing relationship dynamics, that may be associated with their depression or anxiety.
3. Behavioural activation
Behavioural activation focuses on the association between a person’s activities and their mood, and involves helping the client to use activities to influence their emotional state. For example, behavioural activation may be used for people with depression, who often lose interest in activities they used to enjoy.
Similar to CBT, this form of therapy looks at behavioural patterns and the therapist explores behavioural changes the client could make in their everyday life. It encourages clients to engage with activities that they enjoy but are avoiding, and explores the thoughts and feelings that have led to this avoidance.
For example, the client maybe avoiding exercise classes they used to enjoy as they feel low on energy and are worried the other class members won’t talk to them.
Behavioural activation focuses on the client’s current situation and environment and doesn’t explore past events. It doesn’t target unhelpful thoughts and beliefs so it may not suit people who want to address these aspects. It also requires motivation and discipline to be able to commit to the relevant activities (such as exercise on a Monday evening).
This approach may be most suitable for someone whose symptoms have led to social withdrawal and is engaging in fewer activities that bring them happiness. It will also be better suited to someone who is action-oriented (who wants to take practical action to deal with their problems).
4. Person-centred therapy
Person-centred therapy is based on the theory that people are inherently driven to achieve their potential. The client is the expert in their life and therefore they lead the direction of the therapy. This approach creates a supportive, flexible, and empowering environment for self-exploration.
The therapist uses reflections and questions to aid the client’s understanding of their own thoughts, feelings and actions. Person-centred therapy aims to improve self-esteem, self-efficacy (the belief in your ability to succeed) and ability to cope with everyday situations.
Because of the lack of direction from the therapist, person-centred therapy requires the client to be motivated and have the ability to self-reflect. It’s less problem-focused and the therapist doesn’t suggest coping strategies.
This approach may suit someone who wants the freedom to talk about the problems and issues they want to address in a supportive environment. It’s better for someone who wants less structure without specific techniques and homework to undertake.