Types of Therapy: Different Types of Approaches and How They Work
Therapy is a journey toward self-discovery, healing, and growth, and it is as unique as the individuals who seek it. With so many approaches available, finding the right fit can feel overwhelming. Each type of therapy offers distinct tools and perspectives to address emotional, relational, and mental health challenges, helping clients navigate life's complexities with greater clarity and resilience. In this article, I will explore some of the most common therapy modalities, how they work, and what makes them effective. Whether you are new to therapy or looking to deepen your understanding, this guide will help you better appreciate the transformative power of therapeutic approaches.
Common Therapy Modalities
When it comes to therapy, various modalities are used to address a range of needs, particularly for couples and individuals navigating emotional and relational challenges. Below is an expert breakdown of approaches commonly utilized to support clients effectively:
Gottman Method
The Gottman Method plays a central role in managing conflict between couples. Focusing on evidence-based strategies helps couples address and resolve conflicts constructively, paving the way for healthier communication and stronger relationships.
The Gottman Method focuses on constructing what is called the "Sound Relationship House," a framework designed to foster healthy, sustainable relationships. This concept emphasizes several key components, such as improving communication skills, strengthening emotional connections, and identifying the elements that make relationships thrive over the long term.
A central principle of the Gottman Method is recognizing that relationships naturally involve conflict. Conflict often carries a negative connotation, but it is an inevitable outcome of bringing together two unique individuals with different perspectives and experiences. Rather than avoiding conflict or treating it as a problem, the Gottman Method reframes it as an opportunity for growth. It focuses on how couples manage and navigate conflict, understanding that the way disputes are handled is where issues may arise.
The Sound Relationship House begins with two foundational pillars: trust and commitment. From there, couples build upward, starting with core elements like creating "love maps" — a deep understanding of each partner's inner world. By addressing foundational pieces first, couples can strengthen their relationship to support progress to more advanced levels of connection and conflict management, all without the risk of the "house" falling apart.
Family Systems
A core element of my overarching approach is family systems theory, which conceptualizes issues within the broader context of relationships and systems rather than isolating the individual. By examining how family dynamics and interactions influence behavior and emotions, this modality creates a more comprehensive understanding of challenges and opportunities for growth.
Family systems theory provides a way to understand individual challenges within the broader context of relationships. Humans are inherently social creatures, constantly influencing and being influenced by those around them. This theory frames individual problems as interconnected with the dynamics of their relationships, offering a holistic perspective on behavior, emotions, and development.
A helpful analogy for family systems theory is to think of a set of gears in an engine. When one gear turns, it impacts the movement and function of the other gears. Similarly, individuals and their relationships operate as interconnected parts of a larger system. How one behaves or feels can influence others and vice versa.
Using this approach, I examine patterns of interaction and the roles individuals assume within their relationships—whether between a parent and child, spouses, coworkers, or other connections. These roles shape how individuals define themselves and interact with others, affecting the overall "engine" of the system.
Family systems theory also highlights how changes made at the individual level often meet resistance if the surrounding system is not considered. For example, even if someone starts adopting healthier behaviors, their success depends on how those changes fit and thrive within their relational environment. Addressing the system as a whole, rather than focusing solely on the individual, can lead to more sustainable and effective solutions.
Cognitive Behavioral Therapy
CBT is another foundational modality I use to help clients challenge cognitive distortions and adopt healthier behaviors. By addressing thought patterns and their impact on actions, CBT supports clients in aligning their behaviors with their goals.
Dialectical Behavioral Therapy
For clients struggling with intense emotions or needing skill-building support, DBT offers tools to manage and process strong feelings. This approach focuses on mindfulness, distress tolerance, and emotional regulation to help clients achieve balance and stability.
Dialectical Behavioral Therapy (DBT) builds on the principles of Cognitive Behavioral Therapy (CBT), incorporating additional components like mindfulness and acceptance strategies. The core of DBT is finding balance—accepting what cannot be changed while actively working on what can. This approach focuses on developing new skills or strengthening existing ones to help individuals achieve meaningful change.
DBT centers on four main skill areas: mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. These skills are designed to help individuals navigate situations involving intense emotions or significant distress. Unlike CBT, which heavily relies on executive functioning and prefrontal cortex engagement, DBT is especially effective when those cognitive functions become impaired during heightened emotional states.
DBT helps individuals regain emotional stability and return to a calmer state by emphasizing these four skill areas. Once there, they can re-engage their problem-solving and executive functioning abilities, enabling them to tackle challenges more clearly and effectively.
Emotional Focused Therapy
When couples seek to rebuild intimacy or address non-conflict-related challenges, I incorporate emotionally focused therapy, which is grounded in attachment theory. This method explores how insecurities and relational dynamics affect the relationship while emphasizing the strengths that foster deeper connection and trust.
Attachment theory, which forms the foundation of Emotionally Focused Therapy (EFT), emphasizes strengthening emotional bonds and fostering secure attachment styles within relationships. According to this theory, secure attachments are among the most effective ways to help couples build strong, lasting connections.
Applying attachment theory involves examining how individuals relate to others, including patterns of interaction. For instance, does someone tend to be trusting and forgiving, or are they more untrusting and prone to blame others for their distress? The goal is to identify and restructure these patterns to encourage connection, empathy, vulnerability, and emotional responsiveness.
Secure attachments tap into the deeply social nature of the human brain, significantly improving emotional regulation. When individuals feel securely attached, they can regain access to their executive functioning skills, enabling them to solve problems more effectively and function at their best.
Attachment theory also draws from systemic approaches, like family systems theory, by considering the individual's environment—specifically their social interactions. By fostering secure attachments, individuals can create an environment that supports growth, allowing them to thrive and bring out their best selves.
Solution Focused Therapy
Solution-focused therapy offers a direct and efficient way to tackle specific issues. This approach emphasizes identifying goals and actionable steps, helping clients make meaningful progress in a shorter timeframe.
Solution-focused therapy is a goal-oriented, strength-based approach that prioritizes finding practical solutions to immediate challenges. This modality holds a special place in my heart, as some of my earliest instructors, like Dr. Tony Zimmerman from Colorado State University, strongly advocated for it. Dr. Zimmerman, who also trains supervisors for marriage and family therapists, deeply valued this approach, and over time, it became one of my favorites as well.
What sets solution-focused therapy apart is its focus on the here and now, making it especially effective in situations where immediate action is necessary. While exploring root causes and addressing deeper issues is essential, there are moments when stability needs to be established first. Solution-focused therapy provides a way to quickly create stability, enabling clients to move forward and regain control.
One of the key strengths of this approach is its ability to foster a sense of progress and achievement early in the therapeutic process. It operates on the belief that clients already possess the resources, skills, and abilities needed to create positive change. By identifying and leveraging these existing strengths, solution-focused therapy helps clients address immediate challenges while laying the groundwork for deeper exploration and long-term growth.
Common Therapy Formats
When considering the formats of therapy I offer, it is essential to reflect on what therapy truly is: intentional time set aside to process emotions, explore experiences, and implement meaningful changes. The format of therapy plays a significant role in shaping this process, whether it involves individual, couple, or family sessions.
One key consideration is the number of people in the room. Individual therapy provides the opportunity to focus intensely on personal growth and self-understanding. Couples therapy emphasizes strengthening relationships and addressing dynamics between partners. In contrast, family therapy explores the broader system and interactions within the family unit, offering a balance of depth and breadth depending on who is present.
Another distinction is between in-person and telehealth sessions. Currently, I provide telehealth services to clients in Colorado and Utah and in-person therapy for those who visit our office in Orem. Each format has unique advantages. Telehealth sessions allow for the integration of digital tools, such as shared drawings or psychoeducational video clips, to enrich the therapeutic process. In-person therapy, on the other hand, offers an experiential dimension, engaging the five senses to deepen emotional processing. For example, tactile experiences or certain scents can evoke emotions that aid in healing, and activities like mindfulness exercises, progressive muscle relaxation, or sand tray therapy become more immersive in a physical space.
Both formats lend themselves to creative approaches, such as therapeutic games that recreate challenging scenarios in a safe and supportive environment. Additionally, clients may benefit from moments of intentional silence, during which they can journal or reflect without the distractions or privacy concerns they might face at home.
Ultimately, these flexible formats tailor therapy to each client's unique needs, creating a supportive environment that fosters growth, healing, and meaningful change.
Specialized Therapies for Specific Needs
Determining the most effective modalities and formats for each client begins with recognizing the limits of my own skills as a therapist. Different therapeutic modalities are designed to address specific types of challenges, and choosing the right one is crucial. For instance, while solution-focused therapy is excellent for addressing immediate problems, it is not ideal for deep trauma work, which is better suited to approaches like EMDR (Eye Movement Desensitization and Reprocessing), a modality specifically developed to treat trauma.
Understanding my strengths as a therapist is just as important as understanding the tools themselves. Even if a particular method is proven effective, I need to ensure that I can apply it confidently and competently to help clients achieve their goals. This brings me to the most critical factor: understanding the client's goals. Why are they seeking therapy? What changes are they looking to make? Are there specific symptoms they want to manage or particular areas of their life they want to enhance?
Sometimes, clients come to therapy without clear goals, feeling overwhelmed and unsure of their needs. In such cases, their initial goal may be to gain clarity. This involves helping them unpack their emotions, develop coping strategies, and regain access to their executive functioning skills. Once they have a better mental state, we can work together to define and refine their focus.
A critical step in this process is ensuring the client understands and agrees with the goals we establish. For example, I might restate what I have heard, and if the client responds with something like, "Yes, that is exactly what I want and how I want to approach it," we know we are aligned and ready to move forward.
From there, I assess which aspects of their goals align with my expertise and where I can confidently make a meaningful impact. At the same time, I reflect on any areas that might fall outside my comfort zone or skill set. If the client feels comfortable continuing, we can focus on areas where I am confident and see if addressing those helps resolve other issues as part of the process.
However, it is vital to be transparent if we reach a point where I have helped the client as much as I can. I provide resources or referrals to other professionals who are better suited to guide them further, ensuring they continue to receive the best possible support for their needs.
Choosing the Right Therapy
If you have never gone to therapy before, my advice is simple: start as soon as you find someone you feel comfortable with—someone you can talk to openly. That initial connection is key. For first-time therapy clients, it is common to feel unsure about what you are looking for or what to expect. You might have much to unpack, and articulating your goals can initially feel overwhelming.
I have worked with clients who came into therapy thinking they had one specific goal, only to discover, after a few sessions, that their concerns went deeper or lay in an entirely different area. For example, some clients come in unaware of underlying issues like ADHD. As we talk, I might notice telltale signs and gently ask, "Has anyone ever mentioned this to you? Could this be contributing to the struggles you are describing?" Often, that insight opens a new path for them to explore. So, if it is your first time, focus on finding a therapist you can connect with and start there—you will figure out the rest as you go.
For those who are more seasoned in therapy, it is natural to focus on finding therapists within your insurance network, especially given today's economic challenges. However, that can sometimes limit your options. You might see a therapist outside your network who specializes in your specific concerns and is a great fit. It is a personal decision that depends on your financial situation, but it is worth considering if your insurance does not cover the right therapist for you.
Whether new to therapy or experienced, finding the right therapist often comes down to the "goodness of fit." Do you feel comfortable opening up to this person? Do they have the expertise or specialization that matches your needs? Certifications, client reviews, and professional directories like Psychology Today can be valuable tools in your search. Many therapists list their areas of expertise, accreditations, and client feedback on their websites or profiles, giving you helpful insights into what they offer.
Ultimately, the right therapist is someone who feels like a partner in your journey—someone you can trust to help you navigate your challenges.
Conclusion
One of the most compelling aspects of therapy is simply creating the space to process your thoughts, emotions, and challenges intentionally. Taking the time to slow down, reflect, and develop a game plan is often half the battle—and half the reason therapy produces the results people are looking for.
It is not always about the specific modality being used. Sometimes, real progress comes from being intentional— choosing not to let life slip into chaos but instead committing to examining it thoughtfully. Therapy provides a structured environment to do this, helping you gain clarity and chart a purposeful path forward.
Author Bio
Joshua Powner has been practicing therapy since 2018, bringing over half a decade of experience to his work. He earned his master's degree in marriage and family therapy from Colorado State University. He has completed extensive training in therapeutic approaches, including cognitive behavioral therapy, dialectical behavioral therapy, and the Gottman Method—an evidence-based approach particularly effective for couples counseling.
In addition to his therapy practice, Powner served as a clinical team lead at Telos, where he provided high-quality treatment and counseling, managed comprehensive treatment plans, and collaborated with psychiatrists to ensure effective medication management. These plans often integrate life coaching, academic support, and other tailored interventions to support clients holistically.
Powner's expertise includes a focus on processing approaches and a specialization in working with couples and families, particularly those navigating challenges such as ADHD or high-functioning autism. Since 2023, he has successfully operated his practice, building on prior experience gained through collaborations with program directors, leaders within the American Association for Marriage and Family Therapy, and other professionals in the field.
His professional development has been profoundly influenced by the mentorship of Dr. Tony Zimmerman, whose expertise in marriage and family therapy shaped Powner's approach and guided his pursuit of national-level training to become a supervisor. With a deep passion for helping individuals, couples, and families navigate their unique challenges, Powner remains committed to advancing his expertise and providing compassionate, effective care to his clients.
