The choice of therapy depends upon various other factors, such as the client’s specific symptoms, personality traits, coexisting diagnoses, family dynamics, a preferred way of interacting with the therapist, and treatment goals.
Depression
Several types of counseling are useful at treating depression, such as Behavioral Therapy, Cognitive-Behavioral Therapy, Interpersonal Therapy, and Mindfulness-Based Cognitive Therapy (Jorm, Allen, Morgan, & Purcell, 2013).
Behavioural Therapy for depression is a good fit for someone who needs help getting involved in activities and behaviours that are inconsistent with a depressed mood. The individual’s cognitions would not be the target of a behavioural intervention; rather, the client would be behaving their way out of depression.
On the other hand, a CBT approach would contain behavioral elements in addition to a focus on faulty beliefs and thought patterns contributing to depression. CBT is the most researched type of treatment for depression, with many studies supporting its efficacy (Jorm et al., 2013).
Mindfulness-Based CBT combines CBT with the element of present-moment awareness of how ruminative or wandering thoughts relate to depressed thinking (Jorm et al., 2013). Interpersonal Counseling involves working with the client to identify aspects of interpersonal relationships that contribute to depressive symptoms.
Overall, there are several effective approaches for treating depression, elements of which may be combined or modified to meet the client’s unique needs.
Anxiety
Anxiety treatment may also involve any of the above approaches; however, CBT is the most widely used approach for treating anxious symptomatology. CBT counselors working with anxious clients will tailor therapy to the individual needs of the client and make modifications based on their progress (Hazlett-Stevens & Craske, 2004).
CBT occurs in a variety of forms and may include different components.
Exposure Therapy is a type of CBT that is commonly used to treat anxiety disorders. This technique involves exposing the client to their feared object or situation. Such exposure is typically gradual, with the exposure beginning with less threatening stimuli and gradually working its way toward increasingly feared stimuli.
When systematic desensitization is used, gradual exposure also involves relaxation techniques as a way of pairing the feared stimulus with a state that is not compatible with anxiety.
Flooding exposure involves having a client confront their fears all at once (not gradually), based on the idea that without engaging in avoidance, the patient’s fear will be extinguished (Abramowitz, Deacon, & Whiteside, 2019).
Exposure Therapy also may include in vivo exposure (exposure to an actual feared object), simulated exposure (exposure to a proxy of a feared object), or virtual reality exposure (exposure to a highly realistic virtual space).
CBT comes in many forms, and it is generally regarded as a highly effective approach for treating anxiety (Butler, Chapman, Forman, & Beck, 2006; Deacon & Abramowitz, 2004).
H.S. Lonczak, Ph.D.