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Modes of Therapy
Modes of Therapy
Individual therapy is one-on-one therapy in which the therapist works directly with the individual who is the client. Because the therapist tailors therapy to the specific needs of the individual, one-on-one therapy can be a highly effective method for addressing a wide range of complex personal issues specific to one’s problems in life. The relationship is collaborative, so the therapist and client together set the goals for treatment. Individual therapy provides an opportunity to process complex problems, address underlying issues, and develop new life skills.
In couples/marriage therapy, the relationship becomes the client. The therapist helps the couple to work towards a relationship that is healthy, functional, and rewarding for both partners, as defined by both partners. The therapist will tailor therapy to the needs of the relationship and the changes each partner will need to make to achieve the desired relationship. Typically, both partners should expect to make some personal changes, but it is common for there to be individual challenges to do so. The therapist will work with each partner, addressing resistance and building new skills to overcome the challenges to create the desired change. Because the relationship is the client, couples therapy does not seek to find blame or put one partner’s wishes over the other; therapy simply focuses on what it takes to create the new healthy relationship.
In family therapy, the healthy functioning of the family is the client. Family members together define what constitutes a healthy, functional, and satisfying family dynamic for their family. That family dynamic becomes the client, and the therapist works with each family member to make the changes needed to create the healthier family. Again, each family member will experience their own challenges to making the necessary changes.
The therapist will work with each person to help them overcome their personal resistance and build new skills to bring them to where they need to be. The therapist does not seek to portion blame to any family member(s) or identify a problem person as the source for the issues. The aim is to identify and replace existing unhealthy behavior patterns with new skills to promote healthier family functioning. In order to make this happen, it typically requires all family members to make some changes in their individual behaviors and attitudes.
While family therapy can be more demanding and progress slower due to the number of people involved, it can create real meaningful change across the whole family in a way that individual therapy for multiple family members cannot. Family therapy addresses unhelpful underlying issues to build healthier life skills across all family members, thereby making change more sustainable and lasting.
Support groups aim to provide support for or address specific issues. For example: bereavement, parenting, addiction recovery, depression, anxiety, various medical conditions, etc. are just some common support groups. However, the number of groups available and the issues addressed are extensive. Their scope of therapy is well defined, focusing on the therapeutic needs of the whole group rather than specifically of the individual. Therefore, groups are not a place to address a wide range of personal issues.
Furthermore, while confidentiality parameters are established within the group, ensuring compliance from members of the group outside the meeting can be difficult, therefore, the scope of confidentiality is more limited in groups than what is provided in individual/couple/family therapy. Consequently, groups are not a place to address problems for which strict confidentiality maybe an important consideration.
However, groups have multiple benefits and can be source of valuable support; they can be educational, offer different perspectives on an issue, provide support as a shared experience, learn from the experience of others, develop communication skills to talk about the issue and emotions, and it can be a cheaper way to get therapy for a known and defined concern.
In Person, Face-to-Face Therapy
In Person, Face-to-Face Therapy
In person therapy is the most common type of therapy and the one familiar to most people. Therapy usually takes place in the office of the therapist, but not always as it could could be in the home or other suitable location. The therapist and client(s) are present together at the same time in the same room.
Online Video Therapy
Online Video Therapy
The use of online therapy is growing rapidly; and studies show it can be equally effective as in person therapy. Therapy is conducted via the Internet, using a computer or phone video connection. The therapist is responsible for providing a HIPAA compliant software tool for the video connection to ensure confidentiality. Online therapy offers multiple additional benefits.
With online therapy, there is a wider selection of therapists to choose from since location is not a limiting factor. This can be of particular benefit to individuals who live in an area offering a limited number of providers. The wider choice allows access to more therapeutic specialties to better serve the individual issues and better access to fulfill specific language, cultural, and population preferences. Many individuals are housebound for various reasons, such as age, disability, responsibilities to young children, or lack of transport. Online therapy can be a manageable and effective way to get the help needed without the requirement to leave home. For those with busy and full lives, online therapy can be an efficient way to get the help one needs because it saves time on travel to the therapist's office. Online therapy can also be more appealing to those unwilling to go to therapy due to social anxiety, social stigma, depression, anxiety, phobias, e.t.c.
However, online therapy is not suitable for clients who are emotionally or psychological unstable or fragile. For example, it is not suitable for individuals who are suicidal or have uncontrolled psychotic symptoms.
Email therapy is conducted through the exchange of emails between the therapist and the client. In order to protect confidentiality, the therapist will use end-to-end encrypted email. It is an asynchronous style of therapy; the communication exchange is not happening in same time as it does when one is chatting to someone on the phone or in person. Therefore, there is a time interval between responses to the emails. As a result, email therapy is not suitable for individuals who have suicidal thoughts, feel emotionally and psychologically vulnerable or fragile, or have uncontrolled psychotic symptoms. It is also not suitable for couples or family therapy.
Studies show that about 80% of communication occurs through body language and this is lost in email therapy. To compensate for this, effective email communication/therapy requires additional techniques to provide context to avoid misunderstandings. Emphasis is placed on the use of emojis, expressive punctuation, and other textual nuances to create effective communication between therapist and client. As a result, an individual considering email therapy needs to feel comfortable and confident in their ability to enhance their communication using these techniques. While the therapist will guide their clients to establish rapport and effective communication, email therapy may require a higher level of motivation and discipline by the client to maintain the therapy process.
However, for the right individual and under the right conditions, email therapy can be an effective alternative to face-to-face therapy. Email therapy can promote a deeper level of processing by allowing the individual to reflect and compose their responses, pace the communication exchange to their comfort level, and because there is a record of all the conversations, an individual can therapeutically revisit past conversations. It can also be useful to someone experiencing social or communication anxiety, or someone who finds it easier to express themselves in writing rather than talking. On the other hand, email therapy may not be as effective for someone not comfortable with email, fluent in the written English language, or not comfortable using a computer.
While still relatively uncommon, the provision and use of text therapy is increasing. It is similar to email therapy, offering the same advantages and limitations. However, it is important to note that because text exchanges are brief in content, text therapy is limited and not suitable for addressing complex issues. On the other hand, text therapy has been found to be useful and effective for supporting the management of behavioral issues such as anxiety and depression. Maintaining confidentiality is more challenging but achieved through the use of encrypted texting tools. Again, text therapy is not suitable for unstable or suicidal individuals.