Talk therapies help individuals with mental illness. Patients converse with trained professionals on several topics, such as experiences, feelings, thoughts, and behavior. Talk therapy provides a safe space for discussing hopes, a better understanding oneself, and strategies for living with others.
The American Psychological Association defines five broad categories of talk therapy: behavioral therapy, cognitive behavioral therapy (CBT), humanistic therapy, psychodynamic therapy, and holistic or integrative therapy, which integrates two or more modalities.
Behavioral therapy focuses on unhealthy and self-destructive behaviors and introduces elements such as changes in routine and coping mechanisms to the discussion while reinforcing positive behaviors. The most common talk therapy, CBT, applies behavioral therapy principles and expands on them to eliminate unhealthy behaviors. It begins with identifying harmful and unproductive thought patterns and beliefs and replacing them with more realistic, socially acceptable, and stress-alleviating alternatives.
CBT requires a participatory approach or forging a collaborative therapeutic alliance between therapist and client. The therapist asks questions that help patients understand the life and emotional issues they seek to navigate. They aim to form a comprehensive understanding of cognitive conceptualization, which operates on three levels. The first is core beliefs or fundamental understandings that patients develop at an early age or reflect childhood experiences. Deeply ingrained, patients consider them “absolute truths” and rarely articulate them consciously.
The second level spans intermediate attitudes, assumptions, and rules. These involve judgments on specific outcomes and situations and behavioral prescriptions when problematic circumstances arise, continue, and repeat. Also considered are assumptions, or the likely way the situation will develop, given a patient’s behavior. A third level is automatic thoughts, which are unconsciously triggered when specific situations arise. People are often unaware of these but focus on the resulting raw emotions.
To enable relapse prevention, the patient learns techniques for understanding these types of cognitive conceptualization and acting as their own therapist during times of anxiety and stress. Instead of compounding a situation that is often challenging and may be out of their control, they learn to step back and consider the behavioral and thought pathways to improve the situation.
Humanistic therapy emphasizes greater fulfillment through self-actualization linked to what feels authentic to the patient. It involves a close analysis of individual lifestyle as the client receives control over many aspects of sessions. Client—centered therapy pairs self-discovery with empathetic understanding, acceptance, and respect for the client’s viewpoint. A type of humanistic therapy, gestalt emphasizes taking personal responsibility through “self-regulation adjustments” and incorporates environmental and societal contexts into behavioral prescriptions.
Psychodynamic therapy is a talk therapy distinguished by its focus on the unconscious motivations and meanings that underlie feelings and actions. The approach delves into a specific unsettling circumstance and the behaviors and thoughts that arose in response.
Whatever form talk therapy takes, the end aim is to assist patients in working through often conflicting thoughts and emotions and developing healthy behaviors and ways of conceptualizing challenges that they can consistently use in everyday life. It enables them to live more normal, connected lives in school, at home, or in the office.
