Understanding Different Mental Health Therapies 9/25/2020

Psychotherapy is a mainstay treatment for many mental health conditions. In the primary care setting, it is helpful to have a basic understanding of the common therapies that might be recommended to help guide patients as they are accessing treatment.

  1. Cognitive Behavioral Therapy (CBT): This is one of the most common types of psychotherapy and is used in a wide variety of clinical situations. It is typically a short-term, structured, present-oriented therapy that aims to help with problem solving by changing a person’s unhelpful and often automatic thinking that adversely impacts his/her emotional reaction and behavioral response to a situation. It has been found to be an effective treatment for depression, anxiety and insomnia. CBT is based on the cognitive model, which states that the way that individuals perceive a situation is more closely connected to their internalized ideas than to the presenting situation itself.   A goal of CBT is to help the individual more clearly identify and become aware of the linkages between their thoughts, emotions and behaviors, with the aim of being able to respond to situations more objectively and less automatically. Cognitive Behavioral Therapy
  2. Trauma-focused CBT (TF-CBT): This is a specific CBT framework to help children and adults with trauma. Core components include: psychoeducation, emotional regulation and cognitive re-processing of the trauma. Some therapists have special certification in TF-CBT.
  3. Exposure Response Prevention (ERP): This is a CBT model that is primarily used for OCD (obsessive compulsive disorder). It involves the person with OCD facing his/her fears and then refraining from doing the ritual linked to that fear. It can be anxiety provoking at first but the goal is for the anxiety to wane over time. Exposure Response Prevention
  4. Habit Reversal: – This is a CBT model that is used for tic disorders. It involves helping the patient develop awareness of a premonitory urge of a tic coming on and creating competing response training. Habit Reversal CBT
  5. Dialectical Behavioral Therapy (DBT): This is a CBT-model that is useful for borderline personality disorder and chronic suicidal ideation/non-suicidal self-injury. It combines elements of CBT with mindfulness and improving distress tolerance. Dialectical Behavior Therapy (DBT)
  6. Psychodynamic therapy: This is a more long-term and in-depth form of therapy which relies more heavily on the relationship between the client and therapist. The goal is to unveil and/or reveal the internalized unconscious content of a client’s thoughts and interpersonal dynamics.
  7. Family therapy: This is a form of psychotherapy that works with couples and families to foster change and development, viewing change in terms of the system of interactions among family members. Family Therapy
  8. Applied Behavioral Analysis (ABA): This is a model that is used specifically for individuals with Autism Spectrum Disorder. It is based on rewarding desired behavior and not rewarding undesired behavior. IT seeks to teach individuals new more complex skills but breaking them down into smaller steps. Applied Behavioral Analysis
  9. Relationship Development Intervention (RDI): This is a newer model that is used for Autism Spectrum Disorder that uses a guide-apprentice relationship between a parent and child, where the parent is trained to help the child learn desired developmental and social skills.
  10. Parent training (includes parent-child interaction therapy or PCIT): This primarily involves parent education to change parenting practices and increase positive reinforcement to help with symptoms of ADHD and ODD (disruptive behavior, aggression, tantrums) and is utilized most often with younger children.
  11. Eye Movement Desensitization and Reprocessing (EMDR): This is a therapy used for PTSD that uses an eye movement component to help reduce the distressing memories after a trauma by engaging the brain’s natural coping mechanisms. EMDR
  12. In home behavioral therapy (ex. Therapeutic Behavioral Services-TBS): In home behavior therapy can be used in conjunction with individual or family therapy to help generalize concepts learned in therapy into the home setting. This is particularly helpful when a child presents with more challenging behaviors in the home setting. TBS SD County
  13. Wraparound services: This is an even more intensive service that involves a combination of therapy, family partner, case management and team meetings. This is a service often used to help avoid hospitalization or out of home placement for children with complex emotional and behavioral problems. Wraparound Service

As primary care providers, if you have patients (adult and pediatric) who could benefit from psychotherapy, it is helpful to be able to guide them in an appropriate direction for what specific type of therapy to pursue. Feel free to refer patients to our SmartCare BHCS Patient/Parent Line at 858-956-5900 for more individualized support and guidance in obtaining appropriate referrals.

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