Evidence-Based Therapeutic Approaches

There are many therapeutic approaches that are well-used by mental health practitioners.  These approaches assist individuals, couples, and families in their efforts to improve their well-being and live healthy, meaningful lives. Below are three commonly-used approaches which are evidence-based and rigorously tested through research, and shown to be effective. All of these therapies are accompanied by a framework that involves the therapist guiding the sessions in a compassionate, non-judgemental, and reflective stance.

It is important to note, that these approaches can be used within a wide range of settings: individual, couples, and family work. As well, these approaches can be utilized with clients who present various problems. A therapist may use one approach in her/his practice, or integrate a few approaches, depending on her/his skills and expertise, and the client’s focus area.

Emotion-Focused Therapy (EFT):

Emotion-focused therapy is a therapeutic approach that primarily focuses on the premise that emotions are vital to one’s identity. Moreover, in Emotion-Focused Therapy, emotions are a guide for individual choice and decision-making. This type of therapy presupposes that lacking emotional awareness or avoiding unpleasant emotions can cause harm to oneself and within our relationships.

Therapists qualified in EFT help people learn to become more aware of their emotions, subsequently using information provided by adaptive emotion. As well, people may become better able to cope with, and decrease maladaptive emotions. Unsuccessful attempts to control emotions may worsen many issues that people bring to therapy. For example, people who experience depression may spend large amounts of time avoiding situations that lower their mood. People who are experiencing anxiety might feel hindered by their attempts to reduce fear and worry.

Through the use of EFT, people may come to see their emotions as valuable sources of information instead of difficult or painful states. They may learn to experience rather than suppress these emotions, coping with instead of avoiding difficult or painful emotional states.

Cognitive Behaviour Therapy (CBT):

The premise of the cognitive model is that erroneous thinking influences an individual’s mood and behaviour. A CBT therapist helps individuals to evaluate their thinking in a more realistic and adaptive way, thereby the person experiences improvement in their emotional state and in their behaviour. For example, if an individual was depressed and bounced some cheques, they might automatically think “I can’t do anything right”. This thought might then lead to a certain reaction like sadness (emotion), and withdraw to bed (behaviour). Once examining the validity of this idea, the person may come to realize that in fact there are many things they do well. Creating a more balanced and realistic thought would probably make the person feel better, which in turn would lead to more functional behaviour.

For more lasting improvements in an individual’s mood and behaviour, cognitive therapists work at a deeper level of the person’s thought process: their basic beliefs about themselves, their world, and other people. For example, if you continuously underestimate your abilities, you may have an underlying belief of incompetence. Modifying this general belief can alter your perception of certain situations. You will no longer have as many thoughts that allude to “I can’t do anything right”, but rather a more balanced way of thinking.

Dialectical Behaviour Therapy (DBT):

Dialectical refers to the processes that bring opposite concepts together, such as change and acceptance. Thus, the DBT approach supports individuals to utilize both problem-solving and acceptance strategies.

The DBT approach is support-oriented, in that it helps a person identify their strengths and builds on them so that the person can feel better about him or herself and their life. It is also cognitive-based, which helps individuals identify thoughts, beliefs and assumptions that make life harder. It helps people to learn different ways of thinking that will make life more bearable.

There are four modules in DBT which teach the skills of Mindfulness, Interpersonal Effectiveness, Distress Tolerance, and Emotion Regulation.

Mindfulness: Observe, Describe, and Participate are the core mindfulness skills. These are practiced in a way that is non-judgmental, wise-minded, and effective.

Interpersonal Effectiveness: These skills include effective strategies for asking for what one needs, how to assertively say ‘no,’ and learning to cope with inevitable interpersonal conflict.

This module focuses on situations where the objective is to change something (e.g., requesting someone to do something). Or, to resist changes someone else is trying to make (e.g., saying no). The skills taught are intended to maximize the chances that a person’s goals in a specific situation will be met. While at the same time not damaging either the relationship or the person’s self-respect.

Distress Tolerance: They have to do with the ability to accept, in a non-evaluative and nonjudgmental fashion, both oneself and the current situation. Although the stance here is a nonjudgmental one, this does not mean that it is one of approval. Acceptance of reality is not approval of reality.

Distress tolerance behaviors are concerned with tolerating and surviving crises and with accepting life as it is in the moment. Four sets of crisis survival strategies are taught: distracting, self-soothing, improving the moment, and thinking of pros and cons. Acceptance skills include radical acceptance, turning the mind toward acceptance, and willingness versus willfulness.

Emotion Regulation: This skill includes, learning to properly identify and label emotions; identifying obstacles to changing emotions; reducing vulnerability to “emotion mind”; increasing positive emotional events; increasing mindfulness to current emotions; taking opposite action; applying distress tolerance techniques.

If you have questions about therapeutic approaches never hesitate to connect with the agency or your clinician.