Therapy methods

Even though it is theoretically possible to treat everything with each of the four (German) guideline procedures, there are still people who cope better with certain procedures than others due to personal preferences. Those who want to find out more about the core elements of the four guideline procedures can find a brief comparison and summary below.

Cognitive behavioral therapy

Behavioural therapy (CBT) is now the most commonly practised method – at least in Germany – as it is best operationalized and can therefore be better researched in randomized controlled trials. Although it also incorporates the patient’s biography, it usually focuses on everyday life and possible behavioral changes. VT assumes that psychological complaints are the result of conscious and unconscious learning processes. These learning processes need to be identified and, if necessary, changed (“relearned”). Behavioral and functional analyses are carried out, conditioned reactions and cognitive errors are identified and systematically questioned. The therapies tend to be somewhat shorter, manualized procedures and concrete exercises (e.g. in the form of homework, exposure, …) are used more frequently than in other methods and the therapist takes on an active, often guiding role. This method could possibly be more successful for you if you are interested in the quickest possible behavioral changes, concrete exercises or improvement in limited areas of your life (e.g. in the case of a specific phobia).

Depth psychology-based psychotherapy

In depth psychology-based therapy (DPT), symptoms of illness are seen as a consequence (and possibly also as an unconscious attempt at a solution) of current inner and outer conflicts or unresolved relationship experiences from earlier phases of life. The biography is thus incorporated somewhat more into the therapy; the experience and behavior from the present is made understandable through references to the past. The therapies tend to be somewhat longer, the therapeutic relationship is given a greater role, concrete exercises are less often part of the therapy and the therapist does not take such an active role. The aim of the treatment is to recognize the underlying unconscious motives and conflicts of the current symptoms and to deal with them. This method may be more suitable for you if you are interested in taking a deeper, longer and more detailed look at yourself and your past, if you are open to the idea of symptoms as unconscious and dysfunctional attempts to resolve inner conflicts, or even if you feel that you are less able to cope with specific exercises.

Psychoanalysis

Psychoanalysis, or Analytical psychotherapy in its pure form (further developments such as psychoanalytic interactional therapy are excluded here) is now used somewhat less frequently. It is the oldest type of psychotherapy, lasts longer than the other forms of therapy, usually involves a higher frequency of sessions (usually 2-3x/week) for a period of at least 2-3 years and is sometimes also carried out lying down. The therapist plays a more reserved role, asks fewer questions, endures longer periods of silence and thus gives you the opportunity to delve deep into your own emotions and thoughts. Analytical psychotherapy also assumes that symptoms of illness are caused and maintained by conflictual unconscious processing of previous relationship experiences. However, the therapeutic relationship plays an even greater role than in TP. Feelings and actions that may initially seem incomprehensible in the present are made more understandable and thus changeable in the therapeutic relationship work. This method may be more suitable for you if you want a fundamental change in many areas of your life, if you have time, patience and psychological resources, if you can reflect well on your own and are ready for a deeper, long-term therapeutic relationship.

Systemic therapy

Systemic therapy (ST) involves “the system”, i.e. the family and work/school environment, more in the therapy. Therapies can take place with several people (unfortunately, family or couples therapy is not funded by the German health insurance companies) or in an individual setting. ST is based on the assumption that there is no “one sick person”, but that the person with the diagnosis is only a “symptom carrier” who embodies an imbalance in the system. The aim is to confuse and shake up the deadlocked system through targeted interventions. Vicious circles are broken, for example, by asking provocative questions, promoting changes of perspective and an understanding of transgenerational delegation of expectations/tasks. The aim of the therapy is to enable the system to reorganize itself on its own and, if necessary, better.