Art therapy involves the use of creative techniques such as drawing, painting, collage, coloring, or sculpting to help people express themselves artistically and examine the psychological and emotional undertones in their art. With the guidance of a credentialed art therapist, clients can “decode” the nonverbal messages, symbols, and metaphors often found in these art forms, which should lead to a better understanding of their feelings and behavior so they can move on to resolve deeper issues.

When It’s Used

Art therapy helps children, adolescents, and adults explore their emotions, improve self-esteem, manage addictions, relieve stress, improve symptoms of anxiety and depression, and cope with a physical illness or disability. Art therapists work with individuals, couples, and groups in a variety of settings, including private counseling, hospitals, wellness centers, correctional institutions, senior centers, and other community organizations. No artistic talent is necessary for art therapy to succeed, because the therapeutic process is not about the artistic value of the work, but rather about finding associations between the creative choices made and a client’s inner life. The artwork can be used as a springboard for reawakening memories and telling stories that may reveal messages and beliefs from the unconscious mind.

What to Expect

As with any form of therapy, your first session will consist of your talking to the therapist about why you want to find help and learning what the therapist has to offer. Together, you will come up with a treatment plan that involves creating some form of artwork. Once you begin creating, the therapist may, at times, simply observe your process as you work, without interference or judgment. When you have finished a piece of artwork—and sometimes while you are still working on it—the therapist will ask you questions along the lines of how you feel about the artistic process, what was easy or difficult about creating your artwork, and what thoughts or memories you may have had while you were working. Generally, the therapist will ask about your experience and feelings before providing any observations.

How It Works

Art therapy is founded on the belief that self-expression through artistic creation has therapeutic value for those who are healing or seeking deeper understanding of themselves and their personalities. According to the American Art Therapy Association, art therapists are trained to understand the roles that color, texture, and various art media can play in the therapeutic process and how these tools can help reveal one’s thoughts, feelings, and psychological disposition. Art therapy integrates psychotherapy and some form of visual arts as a specific, stand-alone form of therapy, but it is also used in combination with other types of therapy.

Many people advertise themselves as Christian counselors or offer Christian counseling as part of their specialties, and many clergy members or ministers will recommend to their members that they seek out Christian counseling.  However, there are many differing ideas as to what Christian counseling actually looks like.  To get a better understanding of what a potential client needs, it is important to talk to a counselor who offers a similar-sounding therapeutic approach to what a client is actually seeking. 

What to Expect

Unofficially, there are three general approaches to Christian counseling. Even within these three approaches there can be a great deal of difference depending on the training and background of each therapist. These three categories are:

1. A counselor who also identifies himself as a Christian, but provides standard psychological interventions without integrating his understanding of the Christian faith into these interventions. In this case, the client would be seeking the comfort of knowing that his counselor shared a common faith, but not seeking for an element of that faith to be influenced or regularly discussed as a part of treatment. (Most counselors, whether they identify as Christian or not, should be accepting of a client’s spiritual beliefs and respect the influence that it has on the client’s life, but some clients feel more comfortable in this relationship if the counselor shares the same religion.)
2. A counselor who not only identifies himself as a Christian, but allows core principles of this religion to influence and inform standard psychological interventions. This counselor intentionally integrates core Christian values with understanding of research-based human psychology. This counselor does not integrate these beliefs into the counseling interventions or discussions with the client unless the client shares or requests this religious/spiritual element be a part of treatment.
3. A counselor who claims to provide “Nouthetic” or “biblical” counseling approaches treatment from an understanding or belief that pain, turmoil, and suffering in a person’s life are a result of the presence of sin. The interventions provided by this counselor would be grounded predominantly in an understanding or conviction that the Bible is a sufficient guide for counseling most, or even all issues. Counselors providing this treatment attempt to confront what they see as sin in the life of the client. They would provide this intervention believing that it is done out of care for the client and that biblical mandates for living, if followed, would correct the symptoms in the life of the client.

Cognitive behavioral therapy (CBT) is a short-term form of psychotherapy directed at present-time issues and based on the idea that the way an individual thinks and feels affects the way he or she behaves. The focus is on problem solving, and the goal is to change clients’ thought patterns in order to change their responses to difficult situations. A CBT approach can be applied to a wide range of mental health issues and conditions.

When It’s Used

CBT is appropriate for children, adolescents, and adults and for individuals, families, and couples. It has been found to be highly or moderately effective in the treatment of depression, generalized anxiety disorder, post-traumatic stress disorder, general stress, anger issues, panic disorders, agoraphobia, social phobia, eating disorders, marital difficulties, obsessive-compulsive disorder, and childhood anxiety and depressive disorders. CBT may also be effective as an intervention for chronic pain conditions and associated distress.

What to Expect

In CBT you will first learn to identify painful and upsetting thoughts you have about current problems and to determine whether or not these thoughts are realistic. If these thoughts are deemed unrealistic, you will learn skills that help you change your thinking patterns so they are more accurate with respect to a given situation. Once your perspective is more realistic, the therapist can help you determine an appropriate course of action. You will probably get “homework” to do between sessions. That work may include exercises that will help you learn to apply the skills and solutions you come up with in therapy to the way you think and act in your day-to-day life.

How It Works

CBT integrates behavioral theories and cognitive theories to conclude that the way people perceive a situation determines their reaction more than the actual reality of the situation does. When a person is distressed or discouraged, his or her view of an experience may not be realistic. Changing the way clients think and see the world can change their responses to circumstances. CBT is rooted in the present, so the therapist will initially ask clients what is going on in their mind at that moment, so as to identify distressing thoughts and feelings. The therapist will then explore whether or not these thoughts and feelings are productive or even valid. The goal of CBT is to get clients actively involved in their own treatment plan so they understand that the way to improve their lives is to adjust their thinking and their approach to everyday situations.

Dialectical behavior therapy (DBT) provides clients with new skills to manage painful emotions and decrease conflict in relationships. DBT specifically focuses on providing therapeutic skills in four key areas. First, mindfulness focuses on improving an individual’s ability to accept and be present in the current moment. Second, distress tolerance is geared toward increasing a person’s tolerance of negative emotion, rather than trying to escape from it. Third, emotion regulation covers strategies to manage and change intense emotions that are causing problems in a person’s life. Fourth, interpersonal effectiveness consists of techniques that allow a person to communicate with others in a way that is assertive, maintains self-respect, and strengthens relationships.

When It’s Used

DBT was originally developed to treat borderline personality disorder. However, research shows that DBT has also been used successfully to treat people experiencing depression, bulimia, binge-eating, bipolar disorder, post-traumatic-stress disorder, and substance abuse. DBT skills are thought to have the capability of helping those who wish to improve their ability to regulate emotions, tolerate distress and negative emotion, be mindful and present in the given moment, and communicate and interact effectively with others.

What to Expect

DBT treatment typically consists of individual therapy sessions and DBT skills groups. Individual therapy sessions consist of one-on-one contact with a trained therapist, ensuring that all therapeutic needs are being addressed. The individual therapist will help the patient stay motivated, apply the DBT skills within daily life, and address obstacles that might arise over the course of treatment.

DBT skills group participants learn and practice skills alongside others. Members of the group are encouraged to share their experiences and provide mutual support. Groups are led by one trained therapist teaching skills and leading exercises. The group members are then assigned homework, such as practicing mindfulness exercises. Each group session lasts approximately two hours, and groups typically meet weekly for six months. Groups can be shorter or longer, depending on the needs of the group members. DBT can be delivered by therapists in many ways. For instance, some people complete the one-on-one therapy sessions without attending the weekly skills group. Others might choose the group without regular one-on-one sessions.

How It Works

DBT is a cognitive-behavioral treatment developed by Marsha Linehan, Ph.D., in the 1980s to treat people with borderline personality disorder. Those diagnosed with BPD often experience extremely intense negative emotions that are difficult to manage. These intense and seemingly uncontrollable negative emotions are often experienced when the individual is interacting with others—friends, romantic partners, family members. People with borderline often experience a great deal of conflict in their relationships.

As its name suggests, DBT is influenced by the philosophical perspective of dialectics: balancing opposites. The therapist consistently works with the individual to find ways to hold two seemingly opposite perspectives at once, promoting balance and avoiding black and white—the all-or-nothing styles of thinking. In service of this balance, DBT promotes a both-and rather than an either-or outlook. The dialectic at the heart of DBT is acceptance and change.

EMDR is a unique, nontraditional form of psychotherapy designed to diminish negative feelings associated with memories of traumatic events. Unlike most forms of talk therapy, EMDR focuses less on the traumatic event itself and more on the disturbing emotions and symptoms that result from the event. Treatment includes a hand motion technique used by the therapist to guide the client’s eye movements from side to side, similar to watching a pendulum swing. EMDR is a controversial intervention, because it is unclear exactly how it works, with some psychologists claiming it does not work. Some studies have shown, however, that EMDR is effective for treating certain mental-health conditions.

When It’s Used

EMDR was originally developed to treat the symptoms of post-traumatic stress disorder, anxiety, and phobias. Some therapists also use EMDR to treat depression, eating disorders, schizophrenia, sexual dysfunction, and stress caused by chronic disease.

What to Expect

In the early stages of therapy, you will discuss your problems and symptoms with your therapist, but you won’t necessarily have to reveal all the details of your traumatic experience(s). Instead, your therapist will help you focus on related negative thoughts and feelings that you are still experiencing, and decide which of these beliefs are still relevant and which ones you would like to replace with positive thoughts and beliefs. You will learn techniques to help you deal with disturbing feelings. Your therapist will then guide you through a process known as desensitization. While keeping the memory of a painful or traumatic event in mind, you will follow the therapist’s back-and-forth finger movements with your eyes. The purpose of this technique is to help you fully process your negative feelings and begin to recognize that you no longer need to hold on to some of them. Future sessions are devoted to reinforcing and strengthening positive feelings and beliefs until you get to a point where you can bring up memories of the traumatic event without experiencing the negativity that brought you to therapy in the first place.

How It Works

The goal of EMDR is to fully process past experiences and sort out the emotions attached to those experiences. Negative thoughts and feelings that are no longer useful are replaced with positive thoughts and feelings that will encourage healthier behavior and social interactions. Ultimately, clients learn to handle stressful situations themselves. EMDR therapy occurs in eight phases:

1) History and treatment planning
2) Preparation, to establish trust and explain the treatment in-depth
3) Assessment, to establish negative feelings and identify positive replacements
4) Desensitization, which includes the eye movement technique
5) Installation, to strengthen positive replacements
6) Body scan, to see if the client is now able to bring up memories of trauma without experiencing negative feelings that are no longer relevant, or if reprocessing is necessary
7) Closure, which occurs at the end of every session
8) Re-evaluation, which occurs at the beginning of every session

Family systems therapy is a form of psychotherapy that helps individuals resolve their problems in the context of their family units, where many issues are likely to begin. Each family member works together with the others to better understand their group dynamic and how their individual actions affect each other and the family unit as a whole. One of the most important premises of family systems therapy is that what happens to one member of a family happens to everyone in the family.

When It’s Used

Many psychological issues begin early in life and stem from relationships within the family of origin, or the family one grows up in, even though these issues often surface later on in life. Families in conflict, as well as couples and individuals with issues and concerns related to their families of origin, can benefit from family systems therapy. This treatment approach can be helpful for such mental health conditions as depression, bipolar disorder, anxiety, personality disorders, addiction, and food-related disorders. Family systems therapy has also been shown to help individuals and family members better control and cope with physical disabilities and disorders.

What to Expect

During family systems therapy, the family works individually and together to resolve a problem that directly affects one or more family members. Each family member has the opportunity to express their thoughts and feelings about how they are affected. Together, the family works to help the individual in distress and to help relieve the strain on the family. Family members explore their individual roles within the family, learn how to switch roles, if necessary, and learn ways to support and help each other with the goal of restoring family relationships and rebuilding a healthy family system.

How It Works

American psychiatrist Murray Bowen began to develop his family systems theory in the mid-1950s while working as a psychiatrist at the National Institute of Mental Health. Based on his knowledge of family patterns and systems theory, which looks at the parts of a system (such as individual family members) in relationship to the whole (the family), Bowen believed that the personalities, emotions, and behaviors of grown individuals are a result of their birth order, their role within their family of origin and the coping mechanisms they have developed for dealing with emotional family issues. To understand the family system, the family must be viewed as a whole, and that what defines a family is more than the people who make it up but also how they interact with each other to create a unique family dynamic.

Marriage and Family Therapy (MFT) is a form of psychotherapy that addresses the behaviors of all family members and the way these behaviors affect not only individual family members, but also relationships between family members and the family unit as a whole. As such, treatment is usually divided between time spent on individual therapy and time spent on couple therapy, family therapy, or both, if necessary. MFT may also be referred to as couple and family therapy, couple counseling, marriage counseling, or family counseling.

When It’s Used

The range of physical and psychological problems treated by MFT include marital and couple conflict, parent and child conflict, alcohol and drug abuse, sexual dysfunction, grief, distress, eating disorders and weight issues, children’s behavior problems, and issues with eldercare, such as coping with a parent’s or grandparent’s dementia. MFT practitioners also work with mental-health issues such as a family member’s depression, anxiety, or schizophrenia, and the impact these issues have on the rest of the family.

What to Expect

MFT is normally short-term therapy consisting of an average of 12 solution-focused sessions. More sessions may be required, however, depending on the nature and severity of the problem(s). In couple or marriage counseling, the therapist will begin by meeting with both partners and then spend some time with each individual. In family therapy, the therapist will also begin by meeting with the entire family and then, if appropriate, meet separately with individual family members. The first session is generally for information gathering, so the therapist can learn about the problem that brought you to therapy, get the thoughts of everyone involved, and observe couple/family dynamics. At the same time, you should be able to get a clear sense of the therapist’s role and competency, the goals of treatment, and any “rules” to be observed in and out of sessions, such as who should attend which sessions and confidentiality of any information shared between and among partners or family members and the therapist. Over time, you will identify individual family roles and behaviors that contribute to conflicts, identify specific challenges, and explore ways to actively resolve issues.

How It Works

While traditional therapy focuses more on the individual, MFT examines how an individual’s behavior affects both the individual and their relationship as part of a couple or family. The theory behind MFT is that regardless of whether a problem appears to be within an individual or within a family, getting other family members involved in the therapeutic process will result in more effective solutions. MFT is goal-oriented and works toward an established end result. In recent years, MFT practitioners and groups have called for expanded approaches to traditional MFT training that incorporate more “real world” practices to integrate other therapies and become more inclusive of non-heterosexual couples and families.

Although sometimes used with adults, play therapy is a psychotherapeutic approach primarily used to help children ages 3 to 12 explore their lives and freely express repressed thoughts and emotions through play. Therapeutic play normally takes place in a safe, comfortable playroom, where very few rules or limits are imposed on the child, encouraging free expression and allowing the therapist to observe the child’s choices, decisions, and play style. The goal is to help children learn to express themselves in healthier ways, become more respectful and empathetic, and discover new and more positive ways to solve problems.

When It’s Used

Therapeutic play helps children with social or emotional deficits learn to communicate better, change their behavior, develop problem-solving skills, and relate to others in positive ways. It is appropriate for children undergoing or witnessing stressful events in their lives, such as a serious illness or hospitalization, domestic violence, abuse, trauma, a family crisis, or an upsetting change in their environment. Play therapy can help children with academic and social problems, learning disabilities, behavioral disorders, anxiety, depression, grief, or anger, as well as those with attention deficit disorders or who are on the autism spectrum.

What to Expect

The parent or caregiver plays an important role in play therapy for children. After conducting an initial intake interview with the parent, when the therapist collects information about the child, and, often, a separate interview with the child, the therapist can make an assessment prior to beginning treatment. An assessment allows the therapist to decide the best treatment approach for the child. In the playroom, the child is encouraged to play with very specific types of toys that encourage self-expression and facilitate the learning of positive behaviors. Arts and crafts, music, dancing, storytelling, and other tools may also be incorporated into play therapy. Play therapy usually occurs in weekly sessions for an average of 20 sessions lasting 30 to 45 minutes each.

How It Works

Play therapy responds to the unique developmental needs of young children, who often express themselves better through play activities than through verbal communication. The therapist uses play and other creative activities to communicate with the child and observe how the child uses these activities to express thoughts and feelings that are not expressed in words. There are two approaches to play therapy:

1. Nondirective play therapy is based on the principle that children can resolve their own issues given the right conditions and the freedom to play with limited instruction and supervision.
2. Directive play therapy uses more input from the therapist to help speed up results. Play therapists use both approaches, depending on the circumstances.

Psychoanalytic therapy is a form of in-depth talk therapy that aims to bring unconscious or deeply buried thoughts and feelings to the conscious mind so that repressed experiences and emotions, often from childhood, can be brought to the surface and examined. Working together, the therapist and client look at how these repressed early memories have affected the client’s thinking, behavior, and relationships in adulthood.

When It’s Used

People with depression, emotional struggles, emotional trauma, neurotic behavior patterns, self-destructive behavior patterns, personality disorders, or ongoing relationship issues, may benefit from psychoanalytic therapy. One small study found that 77 percent of patients reported significant improvement in symptoms, interpersonal problems, quality of life, and well-being upon completing psychoanalytic therapy. At a one-year follow-up, 80 percent reportedly experienced improvements.

What to Expect

Some very specific techniques are used in psychoanalytic therapy: Free association uses spontaneous word association. The client says whatever first comes to mind when the therapist says a word. The therapist then looks for and interprets patterns in the client’s responses so they can explore the meaning of these patterns together. Dream analysis uncovers repressed feelings that may be hidden in symbols that appear in the client’s dreams. The therapist helps the client discover the meaning and significance of those symbols. Transference analysis explores the transfer of the client’s feelings and emotions from one person to another. For instance, the client’s repressed childhood feelings toward a parent may be transferred to a partner in an adult relationship later in life, or to the therapist during the psychoanalytic process.

How It Works

Based on Sigmund Freud’s theories of psychoanalysis, psychoanalytic therapy uses analytic techniques to help release repressed thoughts, experiences, and emotions, but it is a modified, generally briefer, and less intense version of early Freudian analysis. The therapist-patient relationship is central to the healing process, as are the original theories of attachment, which focus on the quality of bonding between infant and parent; transference, the transfer of earlier emotions and needs to people and events in the present time; and resistance, the stage of therapy when the client becomes overwhelmed by the release of painful, repressed feelings and tries to avoid dealing with them. Eventually, as patients become more comfortable and less resistant to facing their issues and are able to understand their own motives and behavior, healing can begin.

Psychodynamic therapy is similar to psychoanalytic therapy in that it is an in-depth form of talk therapy based on the theories and principles of psychoanalysis.  But psychodynamic therapy is less focused on the patient-therapist relationship, because it is equally focused on the patient’s relationship with his or her external world. Often, psychodynamic therapy is shorter than psychoanalytic therapy with respect to the frequency and number of sessions, but this is not always the case.

When It’s Used

Psychodynamic therapy is primarily used to treat depression and other serious psychological disorders, especially in those who have lost meaning in their lives and have difficulty forming or maintaining personal relationships. Studies have found that other effective applications of psychodynamic therapy include addiction, social anxiety disorder, and eating disorders.

What to Expect

With help from the therapist, the patient is encouraged to speak freely about anything that comes to mind, including current issues, fears, desires, dreams and fantasies.  The goal is to experience a remission of symptoms but also derive such benefits as increased self-esteem, better use of their own talents and abilities, and an improved capacity for developing and maintaining more satisfying relationships. The patient may experience ongoing improvements after therapy has ended. Although short-term therapy of one year or less may be sufficient for some patients, long-term therapy may be necessary for others to gain lasting benefits.

How It Works

The theories and techniques that distinguish psychodynamic therapy from other types of therapy include a focus on recognizing, acknowledging, understanding, expressing, and overcoming negative and contradictory feelings and repressed emotions in order to improve the patient’s interpersonal experiences and relationships. This includes helping the patient understand how repressed earlier emotions affect current decision-making, behavior, and relationships. Psychodynamic therapy also aims to help those who are aware of and understand the origins of their social difficulties, but are not able to overcome their problems on their own. Patients learn to analyze and resolve their current issues and change their behavior in current relationships through this deep exploration and analysis of earlier experiences and emotions.

Unlike traditional forms of therapy that take time to analyze problems, pathology and past life events, Solution-Focused Brief Therapy (SFBT) concentrates on finding solutions in the present time and exploring one’s hope for the future to find quicker resolution of one’s problems. This method takes the approach that you know what you need to do to improve your own life and, with the appropriate coaching and questioning, are capable of finding the best solutions.

When It’s Used

SFBT can stand alone as a therapeutic intervention, or it can be used along with other therapy styles and treatments. It is used to treat people of all ages and a variety of issues, including child behavioral problems, family dysfunction, domestic or child abuse, addiction, and relationship problems. Though not a cure for psychiatric disorders such as depression or schizophrenia, SFBT may help improve quality of life for those who suffer from these conditions.

What to Expect

Goal-setting is at the foundation of SFBT; one of the first steps is to identify and clarify your goals. The therapist will begin by questioning what you hope to get out of working with the therapist and how, specifically, your life would change when steps were taken to resolve problems. By answering these types of questions, you can begin to identify solutions and come up with a plan for change. One of the key questions the therapist asks is called the miracle question: “If a miracle occurred while you were asleep tonight, what changes would you notice in your life tomorrow?” This opens up your mind to creative thinking and, again, to setting goals and developing a clear plan that will lead to life-changing solutions.

How It Works

SFBT was developed by Milwaukee psychotherapists Steve De Shazer and Insoo Kim Berg in the late 1970s, early 1980s out of an interest in paying more attention to what people want and what works best for the individual, in contrast to more traditional psychotherapies that presume to know what works for different types of problems. One of the original beliefs of SFBT therapists was that the solution to a problem is found in the “exceptions,” or those times when one is free of the problem or taking steps to manage the problem. Working from the theory that all individuals are at least somewhat motivated to find solutions, SFBT begins with what the individual is currently doing to initiate behavioral and lifestyle changes. The therapist uses interventions such as specific questioning techniques, 0-10 scales, empathy and compliments that help a person to recognize one’s own virtues, like courage and strength, that have recently gotten the person through hard times and are likely to work well in the future. Individuals learn to focus on what they can do, rather than what they can’t, which allows them to find solutions and make positive changes more quickly.