A simple question, without a simple answer.
The most important factor
Consistently, research has demonstrated that the single most important factor in determining treatment success with any psychotherapeutic approach, is the quality of the therapeutic alliance.
This term represents the collaborative relationship between a patient and their therapist in supporting the patient through their journey of personal growth. According to Bordin (1979), the therapeutic alliance has three essential features:
- Mutual agreement on treatment goals
- Mutual agreement on treatment tasks
- Formation of a relational bond between patient and therapist that consists of mutual positive regard and belief in one another
Bordin also discusses the therapeutic alliance as being two-pronged in its benefits in that not only is the bond between therapist and patient, “healing in it’s own right,” but that it also acts as a powerful catalyst for the patient to agree, adhere, and have faith in the treatment plan.
A Brief List of Some Helpful Psychotherapeutic Approaches
ACT | Acceptance and Commitment Therapy
CBT | Cognitive Behavioural Therapy
DBT | Dialectical Behavioural Therapy
EFT | Emotion Focused Therapy
MET | Motivational Enhancement Therapy
AEDP | Accelerated Experiential Dynamic Psychotherapy
Psychodynamic Psychotherapy
EMDR | Eye Movement Desensitization and Reprocessing Therapy
Somatic Psychotherapy (ex. Hakomi, Somatic Experiencing, Sensorimotor Psychotherapy, etc.)
IFS | Internal Family Systems
What Approach is the Best?
Truthfully, there is no single approach that is the best or the ‘definitive’ approach. In reality, most individuals benefit from working with a therapist who is familiar with a variety of approaches from which they are able to draw from when working with people. This can be summarized as a therapist having an “eclectic” approach.
Which Approaches are the Most Helpful?
Well, this depends on the individual and their particular treatment needs and presenting concerns.
That being said, the following approaches are often quite beneficial for many people:
- Psychodynamic psychotherapy
- Somatic Psychotherapy
- Emotion Focused Therapy
- Internal Family Systems
- Accelerated Experiential Dynamic Psychotherapy
Are Certain Approaches More Helpful in Addiction Treatment?
Yes, in addition to the five modalities listed above, you can add the following:
- Motivational Enhancement Therapy and Motivational Interviewing
- Twelve Step Facilitation
- Cognitive Behavioural Therapy
- Dialectical Behavioural Therapy
- Adjunctive Somatic Therapies (ex. Yoga, Breathwork, etc.)
Are Certain Approaches More Helpful in Treating Trauma?
Yes, in addition to the five modalities listed previously that are helpful for most people, you can add the following:
- Polyvagal Theory as an adjunct
- Eye Movement Desensitization and Reprocessing
Additional Remarks
Hopefully you can appreciate that there are a lot of different approaches in psychotherapy and this is by no means an exhaustive list or review of the various modalities available. Other modalities not discussed in this article include Gestalt Therapy, Psychodrama, Bowen Family Therapy, and many, many more.
Key Takeaways
- Ultimately it is familiarity with a variety of approaches that will serve any individual best.
- There is no ‘best’ type of therapy
- The most important factor in therapy is the strength of the therapeutic alliance (the relationship between the therapist and patient) and there being a mutual understanding of the purpose of the treatment and the how the treatment will be conducted
Citations
Ardito RB, Rabellino D. Therapeutic alliance and outcome of psychotherapy: historical excursus, measurements, and prospects for research. Front Psychol. 2011 Oct 18;2:270. doi: 10.3389/fpsyg.2011.00270. PMID: 22028698; PMCID: PMC3198542.
