Counselling in Melbourne’s clinical psychologists, general psychologists and counsellors use a number of different therapies, depending on their particular practice background, the issue and your individual needs.
A key focus for our team and clients is the client-practitioner relationship and as the relationship develops, the practitioner might decide to use a combination of evidence-based therapies rather than one core therapy.
Briefly summarised below are some of the core therapies used by our psychologists.
If you would like to know more about the approaches, therapies and treatments which may be used in your session, please consult with your therapist.
Cognitive Behaviour Therapy (CBT) is a relatively short-term, focused approach to the treatment of many types of emotional, behavioural and psychiatric problems. The application of CBT varies according to the problem being addressed; however is essentially a collaborative and individualised program that helps individuals to identify unhelpful thoughts and behaviours and learn or relearn healthier skills and habits. CBT has been practised widely for more than 30 years. It has been researched extensively and has demonstrated effectiveness with a variety of emotional psychological and psychiatric difficulties. It is also continually evolving, and a third wave of CBT therapies such as Mindfulness-Based Cognitive Therapy (MBCT), Acceptance and Commitment Therapy (ACT), Dialectical Behaviour Therapy (DBT), Schema Therapy and others are increasingly being used for a variety of emotional, behavioural and psychiatric problems.
The benefits of CBT
- CBT has been extensively investigated in rigorous clinical trials and has empirical support.
- CBT is structured, goal oriented and focuses on immediate difficulties as well as long-term strategies and requires active involvement by the client.
- CBT is flexible, individualised, and can be adapted to a wide range of individuals and a variety of settings.
Solution focused therapy is a goal-directed collaborative approach to psychotherapeutic change that is conducted through direct observation of clients’ responses to a series of precisely constructed questions. Based upon social constructionist thinking and Wittgensteinian philosophy SFT focuses on addressing what clients want to achieve exploring the history and provenance of problem(s).
SF therapy sessions typically focus on the present and future, focusing on the past only to the degree necessary for communicating empathy and accurate understanding of the clients concerns.
Assertiveness training means tactfully, justly and effectively expressing our preferences, needs, opinions and feelings, as distinguished from being unassertive (weak, passive, compliant, self-sacrificing) or aggressive (self-centered, inconsiderate, hostile, arrogantly demanding).
Because some people want to be “nice” and “not cause trouble,” they “suffer in silence,” “turn the other cheek,” and assume nothing can be done to change their situation. The rest of us appreciate pleasant, accommodating people but whenever a nice person permits a dominant person to take advantage of him/her, the passive person is not only cheating him/herself but also reinforcing unfair, self-centered behaviour in the other person.
Assertiveness is the antidote to fear, shyness, passivity, and even anger, so there is an astonishingly wide range of situations in which this training is appropriate. Research into assertiveness has suggested several kinds of behaviour are involved:
- To speak up, make requests, ask for favours and generally insist that your rights be respected as a significant, equal human being. To overcome the fears and self-deprecation that keeps you from doing these things.
- To express negative emotions (complaints, resentment, criticism, disagreement, intimidation, the desire to be left alone) and to refuse requests.
- To show positive emotions (joy, pride, liking someone, attraction) and to give compliments.
- To ask why and question authority or tradition, not to rebel but to assume responsibility for asserting your share of control of the situation — and to make things better.
- To initiate, carry on, change and terminate conversations comfortably. Share your feelings, opinions and experiences with others.
- To deal with minor irritations before your anger builds into intense resentment and explosive aggression.
Acceptance and commitment therapy (ACT), is a form of clinical behaviour analysis (CBA) used in psychotherapy. It is an empirically-based psychological intervention that uses acceptance and mindfulness strategies mixed in different ways with commitment and behavioural change strategies, to increase psychological flexibility. The approach was originally called comprehensive distancing.
ACT aims to help the individual clarify their personal values and to take action on them, bringing more vitality and meaning to their life in the process, increasing their psychological flexibility.
The objective is not happiness; rather, it is to be present with what life brings us and to “move toward valued behaviour”.
An ACT acronym commonly used is:
- Accept your reactions and be present
- Choose a valued direction
- Take action
The aim of mindfulness therapy is to help you learn to be aware of your thoughts and bodily sensations and in so doing be able to better cope with day to day emotions and problems.
Meditation is a simple way of relating to our experience, which can have a profound impact on painful, negative experiences we encounter. Mindfulness involves stopping, paying attention, becoming aware of present moment realities, and not judging whatever is happening as ‘good’ or ‘bad’.
Instead of letting your life pass you by, mindfulness means living in the moment and awakening to experience.
Mindfulness practice is being employed in psychology to alleviate a variety of mental and physical conditions, such as bringing about reductions in depression symptoms, reducing stress, anxiety and in the treatment of drug addiction.
What are Relaxation Techniques?
Relaxation techniques are processes, procedures, or activities that help a person to relax, and attain a state of increased calmness.
Your body can respond to worrying situations and anxious thoughts with muscle tension. Long-term and constant muscle tension can have all sorts of unpleasant consequences, from anxiety, stress, anger, and headaches through to sleeping and heart problems.
Relaxation techniques are often employed as one element of a wider stress management program and can decrease muscle tension, lower the blood pressure, slow the heart and breathing rates, among other health benefits
So, learning relaxation techniques can be a real asset in managing stress and anxiety.
Different relaxation techniques work better for different people. However, learning basic relaxation techniques is easy.
Relaxation techniques can include:
- Deep Breathing
- Progressive Muscle Relaxation (PMR)
- Creative Visualisation
- Mandala Circles
Schema focus therapy is an innovative psychotherapy developed by Dr Jeffrey Young for personality disorders, chronic depression, and other difficult individual and couples problems.
SFT elements of cognitive therapy, behaviour therapy, object relations, and gestalt therapy into one unified, systematic approach to treatment.
SFT has recently been blended with mindfulness meditation for clients who want to add a spiritual dimension to their lives.
The four main concepts in the SFT model are; Early Maladaptive Schemas, Core Emotional Needs, Schema Mode, and Maladaptive Coping Styles.
In SFT, schemas specifically refer to early maladaptive patterns, defined as “self-defeating life patterns of perception, emotion, and physical sensation”.
As an example, if a person with an abandonment schema could be hypersensitive (have an “emotional button” or “trigger”) about his/her perceived value to others, which in turn could make him/her feel sad and panicky in his/her interpersonal relationships.
Initial studies indicate SFT to be effective in the treatment of personality disorders, particularly Borderline Personality Disorder (e.g. Jacob and Arntz, 2013).
The goal of SFT is to help patients meet their basic emotional needs by helping the patient learn how to:
- heal schemas by diminishing the intensity of emotional memories comprising the schema and the intensity of bodily sensations, and change the cognitive patterns connected to the schema; and
- replace maladaptive coping styles and responses with adaptive patterns of behaviour.
A psychologist who is also a life coach can be defined as a helping professional who can identify psychological issues and apply the techniques and science of psychology within a coaching relationship to support clients in leading happier, more successful or satisfying lives.
Life coaching combines the power and depth of evidence-based psychology with the focus of active change and accountability — to help you get the results you want.
Life coaching uses a range of communication skills (such as targeted restatements, listening, questioning, clarifying etc.) to help clients shift their perspectives and thereby discover different approaches to achieve their goals. Goals may range from health concerns, personal, professional, sport, social, family, political, spiritual dimensions, etc. There may be some overlap between types of coaching activities.
Life coaching focuses on practical issues including how to set tangible goals and achieve results within a specific timeframe. Objective feedback, perspective, encouragement and new ways of tackling situations are the key benefits of personal coaching.
Behaviour therapy is a broad term referring to psychotherapy, behaviour analysis, or a combination of the two therapies. In its broadest sense, the methods focus on either just behaviours or behaviours in combination with thoughts and feelings that might be causing them.
Behaviour therapy assumes that behaviour associated with psychological problems, develops in the same way as behaviours associated with constructive learning. They do not look at behaviour disorders as something a person has, but rather as reflecting how learning has influenced a person to behave in a certain way in certain situations.
Psychologists use behaviour therapy as a core intervention based on a functional analysis by endeavouring to replace bad habits with good ones. The therapy also helps you cope with difficult situations.
Although behaviour therapy is based on the general learning model, it can be applied in a lot of different treatment packages, including intimacy in relationships, forgiveness, chronic pain, stress-related behaviour problems, alcoholism, anorexia, chronic distress, substance abuse, depression, anxiety, insomnia and obesity. However, you don’t have to be diagnosed with a mental health disorder to obtain a benefit. Behavioural therapy is a teaching method to help cope with everyday life. Depending on individual needs, a person may only need it on a short-term basis. The exact length of a treatment plan depends on individual goals and progress made.
A highly effective therapeutic approach within which therapist and client work together to deeply explore the client’s emotional and interpersonal experiences. This approach aims to identify and resolve complex feelings which have been repressed or avoided during a person’s development or as a result of painful life experiences.
We often cope with difficult and complex feelings by developing psychological, emotional and interpersonal or defences against them. In turn, by preventing us from fully and genuinely experiencing our emotions, our defences interfere with our capacity to form close, healthy and intimate relationships with others and to live in a way which is authentic and fulfilling.
ISTDP therapists seek to help individuals to address the historical roots of their emotional problems, by encouraging them to overcome their unhelpful defences against feelings, to experience and integrate their feelings fully and to take responsibility for change in their lives.
Research into the effectiveness of ISTDP shows this approach to be consistent with the latest neuroscientific studies about the ways in which the adult brain changes and adapts. ISTDP is shown to be highly effective in the treatment of mood and anxiety disorders, somatic symptom disorders and personality disorders, with large effect sizes which are sustained at long-term followed up demonstrated in meta-analytic studies (e.g. Abbass et al, 2012). More detailed information can be found at istdpinstitute.com or www.istdp.com.au.
Compassion Focused Therapy (CFT) involves the use of approaches intended to bolster self-compassion.
CFT was developed to deal with the universal human problems of shame, guilt and self-criticism.
A leading advocate of CFT, Prof Gilbert states:
“CFT is built around the neuroscientific premise that we are “at our most flourishing” – in terms of maximal functioning of our frontal cortex, immune, cardiovascular and stress management systems – when we have;”
- Experienced and feel we are cared for, wanted and or valued
- Are caring, helping and valuing others
CFT is especially appropriate for people who have high levels of shame and self-criticism and who have difficulty in feeling warmth toward, and being kind to, themselves or others. Such problems of shame and self-criticism are often rooted in a history of abuse, bullying, neglect, and/or lack of affection in the family. CFT can help such people learn to feel more safety and warmth in their interactions with others and themselves.
Numerous methods are used in CFT to develop a person’s compassion. For example, people undergoing CFT are taught to understand compassion from the third person, before transferring these thought processes to themselves.
Sources: Compassionate Mind Australia
DBT utilises a focused and structured approach to address self-destructive behaviours and patterns, including self-harming behaviours, drug and alcohol abuse as a way to control emotions, eating problems (including binging and purging) and unstable or conflictual relationships. DBT also focuses on helping patients to build skills in the areas of emotional regulation, distress tolerance, mindfulness and interpersonal effectiveness.
The DBT therapist continually balances acceptance-oriented strategies with strategies which encourage change; as such, we strive to convey an attitude of acceptance and validation to each client and to encourage each client to accept him- or herself, while simultaneously encouraging growth.
The efficacy of DBT for the treatment of Borderline Personality Disorder is well supported by research. Subsequent randomised controlled trials also support the efficacy of DBT in the treatment of Eating Disorders (e.g. Bankoff, et al, 2012).