Cognitive-behavioral techniques in psychotherapy are presently popular among therapists. One reason is these approaches have great success in treating clients. Research shows that 80% of anxiety/panic-attack clients treated with cognitive behavioral techniques achieved and maintained panic-free status. One study of behavioral therapy for a variety of behavior problems showed that 96% of patients remained in remission for at least two years, 78% percent for at least five years, and 67% for at least seven. Treatment of phobias stressing development of social skills and cognitive restructuring was successful for about two-thirds of clients.
Despite this demonstrated effectiveness for cognitive/behavioral approaches, many therapists use other techniques, and many use only one theoretical approach in their practice. It seems reasonable to ask, therefore, “Does the theoretical and therapeutic orientation of the therapist make a significant difference in treatment outcome?” Based on research in this area, the best answer at this time is, all therapeutic orientations produce successful outcomes, but it appears that some approaches are best suited for certain types of problems. That being the case, when entering therapy, it can be helpful for you to ask the therapist what approach they prefer. The four main therapeutic models are as follows:
(1) Clients experiencing difficulties with lack of meaning in life, existential anxieties, and lack of insight into the dynamics of their behavior tend to work best with an emotion-based, directive, relationship-oriented counseling style. These approaches generally fall into the category of existential therapy, which can be quite challenging and even confrontational, but very effective with bright and curious people. (2) Clients who do not need much direction in therapy respond well with a non-directive approach. They need to be listened to with empathy and allowed to find themselves. Such non-directive approaches are referred to as humanistic therapy. Relatively decisive, independent, and healthy people respond best to this approach. They do not require interpretation as they tend to find their own answers when given the proper therapeutic environment. (3) Clients who want and need a high degree of guidance in therapy respond best to structured therapeutic styles that are therapist driven, and cognitively and behaviorally based. These therapies include behavioral, and cognitive-behavioral approaches. People with specific behavioral problems like speech anxiety, phobias, lack of assertiveness, poor parenting, weak relationship skills, addictions, poor health habits, or social-skill deficiencies respond best to this type of therapy. (4) Finally, some clients benefit from advanced cognitive behavioral therapy. This relatively new approach blends humanistic and existential orientations with traditional cognitive behavioral therapy. It is particularly useful for people who have suffered from chronic anxiety, depression, and other conditions. Two well-known types of treatment are Acceptance and Commitment Therapy (ACT) and Dialectical Behavior Therapy (DBT). Advanced cognitive behavioral approaches can be used effectively with clients who need to see that they have been trying to control the uncontrollable, and must accept there is little they can do about it.
Some therapists are eclectic in their therapeutic orientation; that is, they use a wide variety of techniques derived from several theoretical orientations to help clients. Eclectic therapists attempt to match a therapeutic style and orientation to the needs of the client. Many clients prefer the flexibility that eclectic therapists bring to the counseling table.
Psychology and Stress 