How do therapeutic modalities fit into my search for a counselor?

Jonathan: Do therapy approaches like CBT, EFT, EMDR, there's an alphabet soup here, but do particular therapy approaches matter? There are so many out there, so many different acronyms. Let me name even the ones I just mentioned. CBT stands for cognitive behavioral therapy. EFT stands for emotionally focused therapy. And EMDR stands for eye movement desensitization and reprocessing. Does a particular approach matter? And what are people wondering when they call our office?

Martha: Yeah, so whenever someone contacts us and they use particular approaches, like they say, “I want to have CBT therapy,” or “Do you have EMDR?”, I usually want to know what they know about that. Have they been in counseling before, and this has been effective for them? Oftentimes a doctor will recommend CBT: “You have anxiety. Go get CBT from a therapist.” Oftentimes when people have been in counseling before and it hasn't worked out for them, they know what they don't want. And so they might be asking, like, “I know I want therapy, but I don't want this, this, this.”

Jonathan: It's a lot of life, a lot of how we learn.

Martha: And those are important things to understand. So usually when people want to know what are the therapeutic modalities that these counselors are using, it's great to look at their individual pages. They can hear more about how our counselors work. Again, telling them the distinction between a certification and training: yes, they have training in this that you're looking for. Some people have heard and read a lot more lately about EMDR. We don't have anyone on staff trained in that, but we do have someone that's trained in ART. And so we can offer and give them a little more information about how those are similar, and they can work with similar circumstances, and offer that as an option to them. So, I do think it matters.

Jonathan: Yeah, for sure.

Martha: The modality, through the intake process, we just want to understand: why do you really want this particular type of therapy?

Jonathan: Yeah, so much of it, I think, comes back to really trying to listen and understand a particular client's question or their concerns. What have they heard? There's a variety of therapy models, and then there's a variety of problems that people experience, and it's not always a one-to-one correlation. CBT can be effective with a variety of things. Anxiety might be helped by a few different approaches. Ultimately, we want to follow the evidence and research, but it's so good to understand what people are expecting as they come to us.

Martha: Yes, and a lot of people, and I think a lot of physicians, hear a lot about CBT, and it's wonderful, and a lot of skills, it helps a lot of people. There are additional approaches that also are effective, that maybe just might not be as well known.

Jonathan: Right, so certain other professions might be exposed to certain kinds of counseling versus others. Cognitive behavioral therapy is really working kind of top-down: how do we challenge our thinking? How do we ask ourselves, is that really true in this scenario? Or what can we do differently with our actions? Do you want to take a swing at how you would explain what more of an emotion-focused approach would be?

Martha: Yeah, so with our couples clients, there are four of us that work with couples in the practice, and all of us do use EFT, emotionally focused therapy, in couples. And again, there's just varying degrees of training in that, and that one takes a long time. But that's more like really understanding your emotional experience, the meaning you're attaching to that experience, then how you're responding. And so that can be both in couples and individual therapy as well. And there are people who resonate more with that emotional approach than the cognitive approach, and vice versa. There are a lot of people who are like, it's up here, and that's what I want to talk about, and look at it that way.

Jonathan: Yeah, and again, both can be effective depending on what we're doing. But regardless, if you're expecting me to ask you about your thoughts, or let's take time to plan for some homework and some actions, and I'm expecting that we use our time to slow down and explore what might be happening on the inside, in your body or in your emotions, and just making space for that, we can just be frustrated if we have different expectations.

Martha: Yeah, and I think it's great in those initial sessions, and we do encourage clients to ask the therapist, like, “I've kind of shared where I'm coming from. What's your plan with me?” We always ask people in the initial session: have you had therapy before? What's worked? Those questions are important for us to know: this person really resonates with this approach. Doesn't mean they couldn't benefit from some things in different approaches. But we use all of that information to really understand what works for the client.

Jonathan: I think a maturing therapist really should be able to express and explain clearly to a client: this is the plan I'm using, and this is the plan I would recommend. And then have a conversation: does that feel right to the client? Do they have any questions? Hopefully people listening get the vibe that if you're not sure, you can totally ask.

Martha: Yes, we want you to ask. If you don't understand, or you're like, “I don't think that'll work for me,” we want to hear that.