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Psychoanalytic Therapy
The psychoanalytic approach views people as being significantly influenced by unconscious motivation, conflicts between impulses and prohibitions, defense mechanisms, and early childhood experiences. Because the dynamics of behavior are buried in the unconscious, treatment often consists of a lengthy process of analyzing inner confl icts that are rooted in the past. Longer-term analytic therapy is largely a process of restructuring the personality, which has broader treatment goals than most approaches. Brief psychodynamic therapy approaches address more modest goals in a limited time frame.
Person-Centered Therapy
The person-centered approach rests on the assumption that we have the capacity to understand our problems and that we have the resources within us to resolve them. Therapists focus on the constructive side of human nature and on what is right with people. Clients can move forward toward growth and wholeness by looking within rather than focusing on outside influences and by conducting their own problem-solving dialogues. They are able to change without a high degree of structure and direction from the therapist. Therapists provide understanding, genuineness, support, acceptance, caring, and positive regard.
Gestalt Therapy
The Gestalt approach is an existential and phenomenological approach based on the assumption that individuals and their behavior must be understood in the context of their ongoing relationship with the present environment. The therapist’s task is to support clients as they explore their perceptions of reality. The fundamental method to assist in this exploration is awareness of the internal (intrapersonal) world and contact with the external environment. Clients carry on their own therapy as much as possible by doing experiments designed to heighten awareness and to engage in contact. Change occurs naturally as awareness of “what is” increases. Interruptions in the process by which clients develop awareness and move toward contact with the environment are monitored. Heightened awareness can lead to a more thorough integration of parts of the client’s reality that were fragmented or unknown.
Existential Therapy
The existential perspective holds that we define ourselves by our choices. Although outside factors restrict the range of our choices, we are ultimately the authors of our lives. We are thrust into a meaningless world, yet we are challenged to accept our aloneness and create a meaningful existence. Because we have the capacity for awareness, we are basically free. Along with our freedom, however, comes responsibility for the choices we make. Existential practitioners contend that clients often lead a “restricted existence,” seeing few if any alternatives for dealing with life situations and tending to feel trapped or helpless. The therapist’s job is to confront these clients with the restricted life they have chosen and to help them become aware of their own part in creating this condition. As an outgrowth of the therapeutic venture, clients are able to recognize outmoded patterns of living, and they begin to accept responsibility for changing their future.
Solution-focused brief therapy moves from problem-talk to solution-talk and focuses on keeping therapy simple and brief. By talking about the exceptions to a problem, clients are able to conquer what seem to be major problems. Clients learn to pay attention to what is working, and then do more of this. Change is constant and inevitable, and small changes pave the way for larger changes. Little attention is paid to pathology or to giving clients a diagnostic label.
In narrative therapy the discussion centers on how a problem has been disrupting, dominating, or discouraging the person. The client is asked to find evidence to support a new view of being competent enough to escape the dominance of a problem and is encouraged to consider what kind of future could be expected from the competent person who is emerging.
Both solution-focused and narrative therapists adopt a “not-knowing” position, replacing the therapist-as-expert with the client-as-expert. Therapists do not assume that they know more about the lives of clients than clients themselves do. Clients are the primary interpreters of their own experiences. Therapists attempt to create collaborative relationships based on the assumption that collaboration opens up a range of possibilities for present and future change.