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Treatment models

 

Therapy models explained

 
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Emotion Focused Couples Therapy (EFT)

 

What is it?

The title pretty much sums it up: this form of couples therapy teaches partners to access core emotions and share them with one another effectively. EFT is based on the theory of attachment and how we need others to survive. The goal of this model is establish emotional security so we can feel strong independently and with our partner.

 

What to expect?

This is a fairly structured model of couples therapy that helps partners understand the emotions that organize you and your relationship, identify conflict styles in your relationship, and find ways to overcome fears share unspoken needs. This is not just a talk therapy or problem-solving approach, it is a model that  uses experiential techniques (i.e. not talking about the feeling or what you’re going to do, but instead experiencing the feeling and trying new ways of interacting in the moment). EFT has been shown to be one of the most effective forms of couples therapy: more than 70% of couples recover from relationship distress and 90% of couples improve their relationship in some way.

 

How long?

EFT is considered a short term treatment and is usually 8-20 sessions, however, treatment can last longer if needed.  

Learn more and find an EFT therapist at http://www.iceeft.com

 

Cognitive Behavioral Couples Therapy

 

What is it?

A very structured and solution focused couples therapy that involves identifying thoughts and behaviors and the ways that impacts the relationship. This therapy will use problem solving methods to identify goals and solutions for the conflicts in your relationship.

 

What to expect?

Treatment typically begins with an education, from a scientific perspective on the biological and psychological processes that underlie relationships and how certain interactions in your relationship have gone off track. If you like problem solving and troubleshooting, this may be your model. It’s all about identifying dysfunctional behaviors and patterns and practicing more effective behaviors and ways of thinking. Homework and worksheets are often assigned. Goals established in the therapy are concrete and able to assess. The good news is that research has found that over two thirds of couples with serious and chronic distress who complete cognitive behavioral couples therapy remain together and show improvement at the end of therapy. The bad news is that these gains were not always maintained after two years (Baucom Sevier, Edridge, Doss, & Christensen, 2011).

 

How long?

Short term treatment method that typically lasts 8-20 sessions, but can last longer if needed.

 

Relation Life Therapy (RLT)

 

What is it?

Helps partners resolve conflicts by developing personal accountability, establishing healthier boundaries, and fostering intimacy. If your relationship is having problems because of traditional gender role assumptions (conflict around domesticity, finances, differences in emotional expression), this may be a good fit for you and your partner.

 

What to expect?

Right from the start, RLT tries to dispel the societal and cultural myths that cause problems in modern relationships and establish a greater sense of balance in your relationship. Therapy identifies the role that each partner plays in the couple dynamic and holds you and your partner accountable for your actions. RLT therapists do not pussy foot around unhealthy behaviors and will call you out directly for acting inappropriately. Therapists from this model also tend to be more disclosing about their imperfections, because guess what - we all struggle to maintain healthy relationships! Unfortunately, there has been very little research conducted on this treatment model, but there is quite a bit of anecdotal evidence to support the benefits.  

 

How long?

Typically once a week with no time limit.

Learn more and find a RLT therapist at https://www.terryreal.com/

 

Psychodynamic Couples Therapy

 

What is it?

Psychodynamic couples therapy uses the same principles and theory as psychodynamic individual therapy—meaning interpreting and understanding the couples’ unconscious and conscious defenses and anxieties as well as examining how past relationships impact and recreate patterns in your current relationship.

 

What to Expect?

Lots of interpretation of conflicts, defenses, and basic anxieties. A psychodynamic couples therapist will often work with dreams and fantasies, asking both you and your partner to share your associations in order to reach the unconscious understanding of the relationship. Treatment involves helping you and your partner support and accept one another, identify relational issues, share feelings, dreams, fantasies, and detect unconscious factors (beliefs or past experience) that are unknowingly getting in the way of your relationship.

 

How long?

No time limit. Typically meets once a week. Although this is a long term model, psychodynamic couples therapy is often shorter than individual psychodynamic therapy and goals are often more defined.

 

The Gottman Method

 

What is it?  

A form of couples therapy based on the research and clinical wisdom of Dr. John Gottman, who has studied relationships for the last 3 decades. He developed his famous theory of the four horseman, identifying the four communication styles that predict the end of a relationship: criticism, contempt, defensiveness, and stonewalling, or when a partner shuts down and withdrawals from an interaction.

 

What to expect?

Structured sessions that focus on communications styles. Basically you are trying to move away from the four negative communication styles described above and increase empathy, respect, and affection. Your therapist will help you and your partner understand what makes the other tick and you will be encouraged to share fondness for each other. John Gottman posited that some issues in a relationship will never be resolved, but if you can laugh and take a more light hearted perspective, you and your partner will learn how to manage the problem better.

 

How long?

You and your partner decide with your therapist the frequency and duration of the sessions.


Learn more and find a Gottman method therapist at https://www.gottman.com

 

Imago Relationship Therapy

 

What is it?

The term imago is Latin for “image,” referring to the “unconscious image of familiar love,” meaning that there is often a connection between the frustrations we experience in adulthood relationships with our childhood experiences. So if you felt abandoned, smothered, or neglected as a child, you will likely feel that to some extent in your current relationship.

 

What to expect?

Therapy attempts to help you and partner understand each other’s childhood wounds in an empathic way so you can begin to heal yourself and help your relationship. The “Imago Dialogue” process is a central technique used in this therapy, which teachers empathic listening and reflecting through specific guidelines rather than blaming and reacting. Although the exercises can feel forced and awkward initially, the idea is that the more you practice, the more natural it becomes, and the more it fosters intimacy and connection in the relationship.  

 

How long?

Dependent on the therapist you work with and the initial agreement on frequency/duration.


Learn more and find an Imago therapist at http://imagorelationships.org/

 
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Psychoanalytic

 

What is it?

This is the old school form of therapy. Think Freud, analysis, a couch.

 

What to expect?

Although some analysts have chairs for their patients, you might find yourself laying on a couch. You can expect to free associate while your analyst listens intently. Your analyst will provide interpretations, helping you gain insight into the association between past experience and current behaviors (i.e. making the unconscious conscious).

 

How long?

Multiple times a week for several years. This form of therapy requires a substantial commitment of time and money.

 

Psychodynamic

 

What is it?

This is the modern form of psychoanalysis. Therapy is focused on the bringing the unconscious into consciousness through a process of exploration that may include exploring past experiences, the dynamics in your current relationships, and the dynamics that develop between you and your therapist. It highlights the limiting patterns we have developed, thereby limiting their power helping to answer questions like, “what holds us back?” “why do we feel and behave the way we do in our relationships?”

 

What to expect?

Your therapist will ask you lots of open-ended questions and provide interpretations. Once you and your therapist have gotten to know each other and a level of trust and safety has been established within the relationship, your therapist may start calling you out on your shit. This will help you to better understand the impact of how you relate to others and why you act the way you do.

 

 

How long?

Some psychodynamic therapies are brief (e.g. 10-20 sessions) while some may last years. It depends on your needs and how the therapist works. In a first session or ideally before starting therapy, ask the therapist how they typically work and how long they anticipate therapy to last.

 

Cognitive behavioral therapy (CBT)

 

What is it?

The central premise of CBT is that our thoughts affect our emotions and behavior. If we can change our dysfunctional thoughts, then our emotions and behaviors will change concordantly.

 

What to expect?

CBT may involve a mix of interventions aimed at exploring restructuring your thoughts and may also include behavioral interventions such as breathing exercises to help you regulate emotions and change behaviors. CBT is a structured form of therapy and provides concrete tools for coping. We recommend this form of treatment for anxiety disorders, including panic attacks and phobias.

 

 

How long?

CBT is typically a structured short term treatment, although this will all depend on your presenting concerns.

 

Eye movement desensitization and reprocessing (EMDR)

 

What is it?

This may sound crazy but it’s not – EMDR is a form of trauma therapy that uses eye movement exercises to minimize the power of a traumatic event.

 

What to expect?

Your therapist will start by doing a thorough intake and provide emotion regulation tools. Once you’re ready, your therapist will begin the process of EMDR. The therapist will move their fingers or another tool back and forth in front of your face and ask you recall the traumatic event. Sometimes instead of eye movements, tapping is used. EMDR is a powerful evidenced based tool that has helped many overcome anxiety and trauma symptoms. How does it work? There are several theories, but no one really understands yet.

 

How long?

EMDR is a time limited treatment. The number of sessions will vary depending on the presenting problem.

Learn more and find an EMDR Therapist at www.emdria.org

 

Internal Family Systems (IFS):

 

What is it?

Imagine that all the parts of you that emerge from different situations or are triggered by different events were different people inside of you with discrete sub-personalities. Imagine that each of these parts had a different set of viewpoints and qualities that at times prevented you from acting as successfully as you would like. IFS uses this concept to work with and reorganize your different parts so you can function as a healthier whole.

 

What to expect?

Your IFS therapist will gain access to these different parts, such as a wounded child from early traumas or a defensive part that protects against painful feelings, by talking to and understanding these parts. Your therapist may even have you imagine the part sitting in the room and responding. The goal of IFS is to develop a stronger relationship to yourself where your healthy adult or “true self” is the one in control.

 

How long?

No time limit, but dependent on the therapist’s timeframe and your own needs.


Learn more and find an IFS therapist at https://selfleadership.org/

 

Accelerated Experiential Dynamic Therapy (AEDP)

 

What is it?

This form of therapy is also all about emotional and relational experiences. The central goal is to understand and manage painful emotional traumas rather than using dysfunctional defensive strategies.

 

What to expect?

AEDP therapists tend to be warm, supportive, and emotionally expressive, playing a crucial role in undoing the sense of aloneness that many of us experience in our pain and past. Emotion is often explored by identifying where you store feelings in your body and tracking those sensations throughout the session. AEDP helps expose you to bad and good feelings (sometimes the hardest feelings to tolerate are the positive ones!) and help develop a sense a skill and empowerment to manage what may have been previously perceived as overwhelming.

 

How long?

This is a short term model of treatment, but is often extended as a long term treatment dependent on therapist availability and your needs.


Learn more and find an AEDP therapist at https://www.aedpinstitute.org/

 

Biofeedback

 

What is it?

This is a technique that attaches electrical sensors to different parts of your body measuring your physiological activity such as brain-waves, heart function, breathing, muscle activity, and skin temperature to you give you feedback so that you can learn techniques in order to gain control over involuntary bodily functions.

 

What to expect?

Your therapist will use techniques such as breathing exercises, meditation, changes in thinking, emotions, and behavior while measuring desired physiological changes in real time to give you feedback. The hope is that you can gain more control over functions like your heart rate, muscle tension, pain perception, and blood pressure. We recommend this form of therapy for pain management, high or low blood pressure, and managing stress and anxiety.

 

How long?

A session is usually 60-90 minutes and treatment varies depending on your condition. Biofeedback is typically short term and is often between 10-15 sessions.  

 

Humanistic Therapy

 

What is it?

An approach that emphasizes the study of the whole person and encourages self exploration. Humanistic treatment assumes people are basically good and well intentioned and provides special attention to an your sense of creativity, free will, and positive human potential.

 

What to expect?

Your therapist will often allow you to guide the session, asking questions or interjecting with comments to enhance self-awareness and reflection. Your therapist will encourage you to consider larger existential questions, dreams, and aspirations. Therapy also acknowledges that spiritual aspirations can be an integral part of the human psyche and can be woven into your treatment.

 

How long?

No time limit, but dependent on the therapist’s timeframe and your own needs.

 

GestalT

 

What is it?

An experiential and humanistic form of therapy developed by Fritz Perls, Laura Perls, and Paul Goodman in the 1940s guided by the principle that every individual is a whole (mind, body, and soul) and are best understood in relation to their current situation as he or she experiences it. The approach is designed to enhance awareness, freedom, and self-direction often using techniques that focus on the present.

 

What to expect?

Your therapist will help you to foster non-judgemental self-awareness in order to develop a unique perspective on life and become more aware of how you think, feel and act in the present. Common interventions used in Gestalt therapy is role-play and the “open chair” technique where the client sits opposite an empty chair and communicates with an imaginary being (real person or aspect of themselves) that is a source of conflict. The aim is for you to think about your emotions and attitudes as well as experience aspects of your inner conflicts in a new manner that help to process and overcome stressful past experiences.

 

How long?

No time limit, but dependent on the therapist’s timeframe and your own needs.

 
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When should I seek sex therapy?

According to the Cleveland Clinic, 43% of women and 31% of men report experiencing some form of sexual dysfunction. It’s normal to experience sexual problems or to have concerns about sex. Seeking treatment from a licensed professional can be useful in getting at the core of what is causing sexual dysfunction or concerns. Sex therapy can help address the underlying psychological and relational issues, as well as to provide practical tools to increasing sexual pleasure, comfort, and desire.

 

What types of issues do sex therapists treat?

Sex therapy can be helpful in treating a wide variety of issues including (but not limited to):

  • enhancing communication and desire in relationships
  • helping individual and partnered patients improve sexual skills
  • helping couples improve sex after children
  • identifying barriers to orgasm and exploring strategies for attaining orgasm
  • identifying strategies for relieving  pain during intercourse
  • helping explore sexual identity concerns
  • treating issues of sexual trauma
  • treating issues of sex addiction

 

Do I have to be partnered to seek sex therapy?

You do not have to be partnered to see a sex therapist. Singles, couples, and individuals in open or polyamorous relationships can all benefit from sex therapy when sexuality concerns arise. Sex therapy is for everyone regardless of sex, gender, and sexual orientation.

 

What can I expect from sex therapy?

Sex therapy is talk therapy (sorry no sex acts in session).

 

Where can I find a sex therapist?

We recommend visiting the American Association of Sexuality Educators, Counselors, and Therapists (AASECT). They have a searchable database of counselors and therapists in your area.

 

Questions to ask a sex therapist before starting treatment:

As with any type of therapy it’s important that you find a therapist that you feel comfortable talking to. Before committing to treatment, we recommend reaching out to a few therapists to get a sense of who they are and what they can offer. Here are a few questions worth asking:

  • What is your approach to therapy?
  • How long can I expect treatment to last?
  • What is your expectation of patients? (e.g. will I be assigned homework?)
  • What is your fee?
  • Do you accept insurance?
  • What type of license do you have? Are you credentialed by AASECT?
  • What is your degree?
  • What is your cancellation policy?

 

What can I expect from sex therapy?

Sex therapy primarily focuses on exploring thoughts and feelings. Sex therapy is talk therapy (i.e. no physical touch is involved), which works to address underlying psychological issues and provides concrete actionable steps to help resolve the presenting concerns. Sex therapy will typically start with a comprehensive exploration of the presenting concern and a sexual history taking in order to help the therapist understand the problem and provide clarity for patients about their presenting concern. Treatment may involve education related to the presenting concern, facilitating communication with your partner, exploring new modes of relating, and exploring exercises to improve sexual functioning. Treatment strategies will vary depending on the issue, severity of concerns, and if you are attending alone or with a partner or partners.

 

Is sex therapy effective?

Research →

Therapy requires a strong commitment from both the therapist and patients in order to be successful.

Orgasmic and sexual pain disorders are the most extensively studied disorders and those in sex therapy seem to have better outcomes.

Other problems such as lack or diminished sexual desire, one of the most frequent complaints among women, have little empirical evidence that sex therapy is effective in its treatment.

And when it comes to sexual dysfunctions, CBT has positive outcomes. One study even pointed out that CBT for other issues may be beneficial to sexual problems [41].