There are generally considered to be three main theoretical orientations within the field of psychotherapy:-
1. Cognitive Behavioural
2. Psychoanalytic
3. Systemic
Some people would also add:-
4. Integrative
Cognitive-behavioural
Cognitive Behavioural Psychotherapy is a fusion of cognitive and behavioural principles. Behaviourism goes back to the 1920s and was made famous by Pavlov and his dogs in 1927. However, the experiments of Pavlov did not take into account the role that thoughts could play in our psychological lives, and even in 1953 Skinner continued the tradition of isolating human behaviours from other variables such as thoughts and relationships. Nevertheless their work has been highly influential in the development of treatments for anxiety disorders. While these early behaviourists were not able to account for the complexity of human beings, in the 1960s and 1970s Bandura made some headway with his social learning theory which began to acknowledge the importance of interpersonal relationships and thoughts in behaviours. Also in this time Beck and Ellis were focussing on the role that thinking has on our emotional lives and behaviours. Although Beck was schooled in the psycho-analytic tradition, he believed that people’s thoughts were more readily accessible for change than their subconscious, and so developed Cognitive Therapy. Cognitive Behavioural Psychotherapy recognises the importance of both thoughts and behaviours in the maintenance of people’s problems and seeks to redress these.
Cognitive and Behavioural Therapies have expanded hugely in the last 10-20 years, embracing approaches such as Compassion Focussed Therapy, Mindfulness, Schema Therapy and Acceptance and Commitment Therapy.
Psychoanalytic
Psychoanalytic theory began with Sigmund Freud towards the end of the 1800’s. It has progressed and evolved ever since, and there are now many different types or ‘schools’ of psychoanalytic theory and practice. Jungians refer to themselves as ‘analytical psychologists’. Many psychoanalytic ideas and terms have now entered into everyday language and culture, for example “Freudian slip”. The basic idea underlying psychoanalytic theory is that we all have an unconscious part of our minds, and that the unconscious has a continuously powerful effect on ourselves and our everyday lives, even though – by definition – we are not consciously aware of it. The practice of psychoanalysis aims to attend to the small clues that exist from what we think, dream and do which tell us what may be going on in the unconscious. If we can make the unconscious more conscious then, the theory goes, we can understand ourselves better, and have more control over some of the things we feel, think and do. Many modern analytic approaches are relational and focus on the way our current lives are influenced by the internalised relationships from our infancy and childhood. If we can recognise these internalised patterns we can try to change them or at least limit their unhelpful effects.
The types of psychotherapy that rely on psychoanalytic theory are called either ‘psychoanalytic’ or ‘psychodynamic’ in type.
Systemic
Systems theory is, in Britain, the main theoretical basis used in family therapy. The idea is that human beings are always part of a system of human beings, and indeed each individual is usually a member of more than one system. For example, our family is a system, as is our neighbourhood, our school, our workplace, our town, our country, etc. Each system has its own set of rules and expectations. ‘Symptoms’ may appear in one member of a system either because that person is not conforming to the rules of that system, or because the symptom in some way produces an effect that acts to keep the entire system in balance (even if it is at some personal cost to the person who has the symptom).
Integrative
In addition to the three main types of theory described above, in recent years there has been a movement towards theories which aim to integrate aspects of the different main types of theory. Such attempts are called ‘integrative’. One example of an integrative therapy is Cognitive Analytic Therapy (CAT).
Thanks to Mary Barnett and Dr Jane Blunden for their contributions to this page.