Fort Refuge - Abuse Survivors Support Group

Therapeutic Modalities


Therapist is a mental health professional licensed to practice psychotherapy. It may be a psychiatrist, psychiatric nurse, psychologist, or licensed clinical social worker (LCSW). There are also counselors with various credentials (if any) but no license (for example, hotline volunteers, trauma counselors who receive a 6-week training only, etc). And then there are various organizations of "alternative" practitioners, some of them are large and offer credentials to their members - for example, in NLP (neuro-linguistic programming). Such credentials might or might not be recognized by other organizations, but they are not recognized by the government or any of the health insurances.

Therapists practice different approaches, based on their beliefs on what would be most helpful to their clients. No approach works for everyone. There was research a while back that determined that therapy does help if there's a good rapport between the client and the practitioner, but modality used is of less importance. So just look for a therapist you're comfortable with, this list is for general curiosity purposes only.

Psychodynamic Therapy:

Assumes that your distress is due to a deep subconscious conflict you're not aware of. That you're a capable adult, have the basic skills to resolve any practical inconvenience you're having, so if the problem isn't getting resolved - it's because you're not aware of the underlying issues you have with it. If things were as simple as saying no to something you don't want to do, or as getting motivated to do something you know you have to do - you would have resolved them on your own, without the need for professional help. Psychodynamic therapy gives good solid results if successful, but takes years or even decades - to uncover all those secret conflicts and resolve them. It's also the most expensive therapy, as training takes decades as well. Helpful when you're not sure what the problem is, and are willing to spend years exploring your psyche. Emphasis is made on free associations & dreams, as this is how your subconscious manifests itself, but little attention is paid to developing better skills in practical life, due to the belief that, once your subconscious problems are resolved, you'll be able to handle practicalities on your own. Psychodynamic modalities include: Psychoanalysis (aka Freudian Psychotherapy), Jungian psychotherapy, Psychodynamic psychotherapy, Object relations therapy, Dreamwork, Transactional Analysis.
Example: if you're in a domestic violence situation, psychodynamic therapist might help you explore what keeps you attached to this relationship (since you would have left if there was no reason to stay), what subconscious need are you meeting here, was your dad physically abusive too, etc.

Behavioral Therapy:

Assumes that, whatever your subconscious conflict might be (if any), your current distress rarely calls for such deep explorations, and can be cured by modifying your behavior instead. Main idea is that what you think influences how you feel, and how you feel influences what you do, and what you do influences what you think, in its turn. So to break a dysfunctional pattern you need to start thinking differently, that would make you feel differently, that would make you act differently, and when you act differently you'll think differently of yourself as well, and feel better as a result. Emphasis is made on teaching you practical skills in handling stressors. Behavioral therapy is usually brief (a few months to a year), and is very helpful when the problem is clear, specific, and practical, for example - when your PTSD interferes with your work performance, and you want to learn specific skills to cope with it better. The drawback of behavioral therapy is that sometimes the problem is deeper than that, and needs to be resolved rather than coped with. Behavioral modalities include: ACT (Acceptance and Commitment Therapy), CBT (Cognitive Behavior Therapy), DBT (Dialectical Behavior Therapy), Schema therapy, Solution Focused Brief Therapy.
Example: if you're in a domestic violence situation, behavioral therapist might teach you better boundary-setting skills, assertiveness, seeing the connection between how you feel and what you do, and changing the broken pattern.

Humanistic Therapy:

Assumes that all you need is a supportive, healthy, and positive environment, to work through whatever problems you have; once the right environment is established - you'll be able to solve them. Emphasis is made on fully experiencing your thoughts and feelings, as that's what allows you to be conscious of your situation and get motivated to change it, if needed. You are allowed to do or not do anything you want, but are encouraged to take responsibility for your choices. Mirroring what you're saying back to you is commonly used, as simply hearing what you just said is often all it takes to decide on things or to change your mind. Helpful when you don't want to dedicate years to exploring your subconscious drives, and don't want to be taught what to do, but are willing and able to work through your problem - with professional support, but without being led anywhere. Humanistic modalities include: Gestalt therapy, Rogerian psychotherapy, Adlerian therapy, Existential therapy.
Example: if you're in a domestic violence situation, experiential therapist might ask you to express your thoughts and feelings and encourage you to make your own choices based on what you just said. Old joke about humanistic therapists goes - the lightbulb will change itself when it's ready to.

Expressive Therapy:

Encourages self-expression through music, art, creative writing, etc. This is different from art classes because focus is on expressing emotions that trouble you, not on polishing your artistic techniques. Expressive therapy is invaluable when you can't or won't express yourself verbally through traditional talk therapy. Here's a quote from a client talking of her therapist - "I never wished to share my true thoughts and feelings, so I thought she would be able to make sense of how I felt by how smooth/rough the lines were, what colours I used, and how neat the piece was. If I used lots of angry colours, she could see I was feeling angry; or sad colours - I was sad, and it goes on." Good thing is that expressing painful emotions allows you to release them, so they don't continue contaminating your life. Bad thing is that sometimes painful emotions are not the only problem there is, so expressive therapy is most helpful in combination with any of the above approaches rather than on its own. Very successful in a group format as well. Expressive modalities include: Psychodrama, Art therapy, Dance therapy, Narrative therapy, Play therapy, Drama therapy.
Example: if you're in a domestic violence situation, expressive therapist might encourage you to draw your fear, write your life story, or do primal scream to release your frustration.

Systemic Therapy:

Treats not you, but the group of people you're a part of (such as a family, an office, or a school class), as a whole. Various modalities may be used, but the focus is on the intergroup relationships, not improvement of any specific individual's mental health. Not to be confused with group therapy format - in group therapy each individual is working on their personal issues, while in systemic therapy the focus is on the relationship between group members rather than anything else. Great modality to resolve interpersonal problems and improve communication, but if you don't wish to invest into the relationship anymore, and are seeking help on getting the strength to leave it - systemic therapy might not be your best choice. Systemic modalities include Family Therapy, or any other therapy involving a group of people related to each other somehow, such as in a school/work environment.
Example: if you're in a domestic violence situation, systemic therapist might encourage you both to express your feelings and thoughts that lead to violence, educate you on better coping skills, emotions management, boundaries, agreements, and healthy communication.

Alternative Therapy:

This is a blanket term for all sorts of non-traditional modalities not covered above. How helpful these are depends greatly on how good a fit they are for you - some work well for some people, others work for others. Overall, it's a good idea to use this as an addition to more traditional therapy, rather than a stand-alone approach. Alternative modalities include: Autogenic training, Biofeedback, EMDR (Eye Movement Desensitization & Reprocessing), Family constellations, Guided Imagery, Hypnotherapy, Nude psychotherapy, Recovered memory therapy.

Eclectic Therapy:

Simply means that a therapist mixes up different modalities depending on what works best for you at the moment.


Focuses mostly on educating you on the issue and on options available to you. It rarely resolves your internal struggles, but provides solid resources to solve the situational stressors you have. Counseling doesn't have to be done by a licensed mental health professional with a college degree. For example, when you call a hotline, you're speaking with a counselor that had some sort of training, but probably doesn't have an LSCW license. Some of the forms of counseling are: Career Counseling, Pastoral Counseling, Relationship Counseling.
Example: if you're in a domestic violence situation, a counselor might educate you on dynamics of domestic violence, suggest an escape plan, talk of safety, boundaries, when to call police, legal status of things, and resources available to you, such as domestic violence shelters, lawyers, therapists, and financial support until you find a job.

Psychiatrists are not on this list because they very rarely do talk therapy, but they can prescribe psychiatric medications to help alleviate your symptoms so that you can function better until the problem is resolved, if ever. If you're in a domestic violence situation, psychiatrist might be able to prescribe you an anti-depressant.

Peace cannot be kept by force; it can only be achieved by understanding.
~ Albert Einstein
This page was last updated on June 17th, 2013
© 2008-2016 Fort Refuge. Please don't reproduce without permission.