What Kind of Therapy Do I Need?
Whether you are new to therapy or a seasoned client, it is normal to question what kind of therapy will bring about the change you desire. With so many types of therapy available, it is worth stepping back and asking what to pursue at this time.
As with many questions in the counseling world, the answer to this one is certainly, “it depends.” We want to help you consider this question thoughtfully as you seek care.
In this post, you’ll find guidance to help answer:
Do I need individual counseling or couples counseling? Or something else?
Which form of therapy makes sense for me? (Talk Therapy, EMDR, CBT)
What should I consider when exploring therapy?
Individual, Couples Counseling, Family or Group Therapy
A helpful starting point is to clarify whether you need individual counseling or would be better served by couples counseling, family therapy or group therapy. In many cases, you may need a combination - either simultaneously or in succession.
People most commonly enter individual counseling over other forms of therapy as it is suitable for a wide range of problems. Most people come to a point where the ways they have navigated life are no longer effective. Whether your interest in therapy is prompted by an event, a persistent struggle or general uncertainty, working one-on-one with a therapist allows you to process, orient and pursue growth with the support of another person who can accompany you and bear the weight with you.
Examples of problems that are commonly addressed in individual counseling include:
Anxiety or chronic stress
Depression or feeling persistently low
Generally feeling lost, stuck, dissatisfied or uncertain
Grief and Loss
Life Transitions
Personal Crisis
Relationship Issues
Self-Esteem and Identity Issues
Trauma
Unwanted behavior, such as patterns, habits or addictions
Individual vs. Couples Counseling
Relationship issues can be the source of immense distress in people’s lives and bring many people into therapy. If the issue you’re facing is specific to one relationship, then the nature of the relationship will determine whether individual therapy or marriage counseling is your best option. If you are seeking counseling to navigate a relationship with someone with whom you would not enter therapy, such as a co-worker or an estranged relative, then individual therapy will be most suitable.
If the primary driver for counseling is related to your marriage (e.g. communication with your spouse, conflict resolution, intimacy and connection, affair recovery), then couples counseling will typically be the most helpful setting to work on the relationship. With both partners in the room, you can engage the relational dynamic and the patterns that keep discord and disconnection in motion.
Attachment issues arise in intimate relationships, and it is common for attachment injuries to show up in marriage. If you have experienced an attachment injury in childhood, which can stem from a variety of interactions and events, you may experience a similar hurt showing up in your marriage. While attachment injuries can be worked on in both individual and couples counseling, marriage counseling can be a healing path forward if the injury has occurred in your marriage.
Frequently one partner in the marriage is reluctant or unwilling to move forward with couples therapy. If your spouse is not ready for therapy, then individual counseling is a great avenue to work on what is impacting you in the relationship and how you are responding.
In this case, think of individual counseling as a stepping stone to inviting your partner to enter couples counseling with you. Individual therapy can help you gain clarity around your desires in and for the relationship. By working with a therapist, you can examine how you are expressing that desire and may discover more helpful ways to communicate your relational hopes to your partner.
Family Therapy
When significant events or an unexpected crisis occur, they can take a serious toll on an entire family and greatly disrupt the functioning of it. Family therapy is worth pursuing when something arises or occurs that affects your whole family.
Problems that may signal the need for family therapy, include:
Death, illness or a major loss in the family
Trauma in the family
A significant disclosure
Substance use concerns
Relocation or another major change
Blended families
Caregiving stress
Conflict that involves multiple family members
Sometimes it can be difficult to discern whether couples counseling or family therapy is more appropriate. For example, you and your spouse may have ongoing conflict with one or more of your children. This could be symptomatic of something happening in the marriage, in which case couples counseling may be more effective or a needed complement to family therapy. If you are unsure, reach out to a therapist to consult around your needs.
Group Therapy
Group therapy can be one of the most life-changing experiences. It can be a great supplement to individual therapy or helpful as a standalone process. Isolation and shame often keep people stuck, making connection and compassionate support paramount for healing and wholeness. The power of having a group hold and respond to your pain can liberate you from a variety of struggles.
While group therapy can be immensely helpful for a variety of life’s challenges, not everyone is ready to engage in group therapy. Often the impact of an event such as a trauma, abuse or betrayal is too recent or unprocessed to share space with others. It is wise to work through trauma or abuse in individual therapy before engaging in group therapy. That said, group therapy can be a powerful intervention at a later stage of recovery or healing.
If you are apprehensive about group therapy, individual counseling can be a great place to prepare for it. If you are overcome by your own emotions or terrified of vulnerability, then try working with an individual counselor first to be able to participate in such a way that you can both offer and receive support in a group setting.
Group therapy is highly effective for:
Walking through the death of a loved one
Recovering from substance use
Gaining awareness of your interpersonal patterns
Overcoming social anxiety
Developing relational skills
Gaining support from others with similar experiences
The Relationship Matters Most: The Importance of The Therapist Over Modality
If you venture to explore the types of therapy available to you, you may quickly find yourself lost in the sea of letters that pervade the landscape. EMDR, CBT, EFT, ACT, IFS, and dozens of other modalities can be presented as the answer to what you experience, making it challenging to choose from the many options.
Here is an important consideration that alleviates the need to become versed in the various approaches to therapy. Research shows that the quality of the relationship between the counselor and the client is the most important factor in determining the outcome of therapy.
In other words, it matters far less what modality the therapist uses and far more the connection you have with the therapist you work with. The relationship between you and the counselor serves as the vehicle of change. Without a strong rapport with your therapist, it can be difficult to go to the places that can lead you forward.
While this doesn’t mean that the modality is unimportant, it is a good reason to make it a priority to find a therapist with whom you can develop a strong rapport for your work together.
The Type of Therapy That You Need
Each type of therapy approaches problems differently and as you start to explore options, you can feel like you need to be a therapist to know what type of therapy you need. Many modalities share a similar framework while employing different terms (e.g. parts vs. protective strategies). Others prioritize a different aspect of personhood, such as cognitions, emotions, or your physiological / somatic experience.
Talk Therapy with an Integrated Approach
If the struggle bringing you to therapy is of a relational nature, you’re wondering how to proceed in life or you aren’t sure of the origin, then talk therapy is a good starting place. You’ll gain insight and self-awareness as you uncover the root of what is happening and how you want to respond. If you are experiencing grief or suspect that there is unprocessed pain at play, talk therapy will provide a relational context to work through emotional pain that may be keeping you stuck.
Because you are designed as a whole person with interconnected thoughts, feelings, behaviors, longings and a physiology, and because you function in relationship with others, in a specific context, and with a history made up of countless experiences, consider finding a therapist who will take all of this into account. An integrative approach that can flexibly and skillfully work with the multifaceted dimensions of your life can be really helpful as you move toward healing and growth.
Cognitive Behavioral Therapy
One of the most widely known and accessible forms of therapy is Cognitive Behavioral Therapy (CBT). This highly structured approach to therapy focuses on changing your thoughts in order to change your behaviors. CBT takes a present-focused approach to managing symptoms and provides practical tools within a time-limited manner.
CBT, in its purest form, will not explore the experiences or drivers that may be exacerbating what you currently face. If you have tried CBT and your problem persists, consider taking a wider lens through talk therapy.
Your past shows up in the present, and what you desire for your future impacts how you engage the present. If you are curious about how past experiences, including the family you grew up in, have shaped you and how you engage in the world, then talk therapy will provide the space for such work.
EMDR
Resolving the insidious effects of trauma can be a long, slow work. If you experience lingering effects from trauma and have not found resolution through talk therapy, EMDR or Eye Movement Desensitization and Reprocessing is a trauma-specific therapy that takes a mind-body approach to help you work more directly with stored memories of trauma.
EMDR can serve as a standalone intervention or be an effective complement to talk therapy. Consider EMDR if you are encountering flashbacks, nightmares or other symptoms of trauma and are desperate for relief to continue your daily functioning. If it is highly distressing to think about seeking help for a specific traumatic event, then EMDR may help you experience healing from trauma without talking about it.
It is important to mention that while EMDR is a powerful tool to release you from the grip of trauma, it is not suitable for every client. A therapist trained in EMDR can help you determine whether to pursue EMDR therapy for your healing.
Other Things to Consider When Exploring Therapy:
There is no form of therapy that mitigates the need for courage and vulnerability. As you find the courage, know that therapy can be a highly rewarding experience that yields much goodness for you and those you love.
While we know it can be agonizing to desperately long for change in a relationship or for a loved one, it is generally ineffective to pressure someone into therapy. If this is you, pursue individual counseling for your own support to help you navigate the situation.
If you have tried therapy before and found it less helpful than you had hoped, it takes resilience to give it another try. Consider whether your experience had to do with the connection you felt with the therapist, their approach to therapy, where you were at the time, or some combination. This can help you determine your next step and whether to reach out to a different therapist, pursue a different type of therapy (such as talk therapy vs. EMDR), and/or commit yourself to engaging differently with therapy.
We understand that finding a therapist can be a difficult process. Check out our post on how to choose a therapist.
If you are considering counseling at this time, you do not have to navigate the question of what you need on your own. Reach out to one of our therapists today for a consultation.