Our psychologists use a number of different therapeutic approaches, depending on their particular practice background, the issue and the client. At times they might use a combination of techniques.
All of the therapies used in Psychology Melbourne’s practice have a sound theoretical basis and are supported by the evidence of research comparing different treatments and systematic reviews.
It is important to note, however, that while formal theories about the contribution of specific techniques to successful outcomes in therapy tend to dominate professional discussions in counselling and psychotherapy, decades of research since the mid-1930s has shown repeatedly that these techniques are less important than such common factors as the therapeutic relationship between client and therapist, and the "client's theory of change" - the perception that the client has about his or her problems and the possible resolution.
A recent meta-analysis of research attitudes show these factors to be responsible for as much as 87 per cent of outcome variance. This practice is very much committed to the importance of working closely with the client experience and to the strength of the therapeutic alliance.
Within that framework, we do employ a number of different therapies which have been acknowledged as being particularly effective in particular areas, including the following:
Cognitive Behavioural Therapy
Cognitive Behavioural Therapy (or CBT) aims to identify negative emotions, behaviours and thoughts (cognitions) and ways of replacing them with more effective ones. It has been shown to be effective in more than 400 outcome studies in the treatment of depression, general anxiety disorders, panic, anger, eating disorders, Obsessive Compulsive Disorder (OCD) and marital distress. It has also been shown to be effective in the treatment of a number of medical conditions, including chronic pain and hypertension.
The therapist and client work together as a team to identify and solve problems, and therapists help clients to change their thinking and behaviour and thus overcome their difficulties.
At Psychology Melbourne, we use CBT in individual therapy as well as group settings. It plays a major part in our weight-management program.
Psychodynamic Therapy helps clients uncover the cause of their feelings and behaviour, revealing deeper and often unconscious motivations, where CBT, for instance, is more focused on alleviating symptoms as quickly as possible - showing the client how to replace dysfunctional thought patterns, perceptions and behaviour with more realistic or helpful ones.
Successful treatment should not only relieve symptoms, it should also result in heightened enjoyment of life, including the ability to have more fulfilling relationships, greater self-esteem and richer experiences in careers and daily life and the ability to respond in a more satisfying way to life's challenges and opportunities.
While Psychodynamic Therapy can be brief, it is often longer-term and less structured than CBT.
Dialectical Behaviour Therapy
Developed through the work of Dr Marsha M. Linehan at the University of Washington, Dialectical Behaviour Therapy (DBT) has had particular success as a treatment for suicidal behaviour, self-injuring behaviour, eating disorders, depression in the elderly, bipolar adolescents and borderline personality disorder.
DBT works fundamentally on validation and acceptance, problem-solving and change. The treatment program developed by Dr Linehan embraces learning theory, social psychology and dialectical philosopy. It has been proved effective in helping people to make changes in their behaviour and environment. It has also helped people reach an understanding of themselves which Linehan calls "radical acceptance".
Many of the skills and treatment strategies have been influenced by Buddhist principles and mindfulness meditation practices.
Mindfulness is a mental state, characterised by concentrated awareness of one's thoughts, actions or motivations.
Mindfulness is an activity that can be done at any time; it does not require sitting, or even focusing on the breath, but rather is done by bringing the mind to focus on what is happening in the present moment, while simply noticing the mind's usual "commentary".
One learns to become aware of this monologue, e.g. "I wish washing dishes wasn't so boring", etc. Once we have noticed the mind's “talk”, we can stop identifying with it. We can see (for example) that washing dishes does not have to be regarded as "boring” and can perhaps even be enjoyed. Any activity done mindfully is a form of meditation, and mindfulness is possible practically all the time.
Psychology Melbourne offers Mindfulness classes which teach people how to develop mindful awareness on a daily basis. Only five minutes, twice a day are initially required. This approach is particularly helpful when it is difficult to establish a regular meditation practice.
Although mindfulness has its origins in Buddhism, it is attracting increasing interest in Western psychology and psychiatry. Clinical research indicates its effectiveness in managing stress, anxiety and panic. It has also achieved positive results in the treatment of chronic pain, depression, obsessive thinking and other medical and mental health conditions.
Schemas are simply any negative lenses through which we view the world. They are very stable, and are difficult to change. They develop during childhood and they stick with the person throughout adulthood. They are beliefs that the person doesn’t challenge, but has accepted to be a part of who they are, even if they don’t realise it consciously. If a schema develops, for example, regarding a child who is told that they will never be successful, then the schema will still be present in adulthood, and the person will see themselves as someone who never succeeds.
There are many different schemas that a person can develop during childhood, and some of them include:
- Wanting approval from others, and not being able to develop your own sense of self
- Believing that you are entitled to anything you want, without taking into consideration other people
- The inability to work and function independently, after not being given the opportunity to become independent from caregivers
- The belief that you will never succeed in anything you do, and that you are destined to be a failure
It is rare for a schema to go away without getting help from a professional, such as a psychologist. The schema sits in the sub-conscious part of the mind, and is very stubborn, working to perpetuate itself.
Acceptance and Commitment Therapy
Acceptance and Commitment Therapy (ACT) is a mindfulness-based therapy, and is characterised by focusing not on changing or getting rid of undesirable thoughts, but on accepting that unpleasant thoughts are part of who we are, and letting our thoughts come and go as they please. In this way, psychological symptoms are alleviated as a by-product, because the client learns to detach themselves from their thoughts, and not hold on to them as they may have done in the past.
ACT is based on mindfulness, which you can read about above, and is generally about being in the here-and-now, and not getting caught up in the past or the future. However, it differs from other mindfulness-based therapies in that the goal of ACT is not reduction of symptoms. One of the core ideas in ACT is to remove need to control emotions and thoughts, and move past them instead.
The ‘commitment’ segment of ACT is based around the longer-term focus of ACT, which is to live a fulfilled and valuable life, through commitment to goals and action. This is why ‘ACT’ is such a good acronym for this type of therapy.
Interpersonal Therapy, or Interpersonal Psychotherapy (IPT), is a relatively new approach, developed in the 1970s and becoming more widely known in the late 1990s. It is now included in the Better Access to Mental Health scheme which makes it eligible for Medicare rebates. To some extent, that has enhanced its popularity in Australia.
IPT is suitable for clients with interpersonal issues that can be explored in a narrative format. At the beginning of treatment, the psychologist will determine whether IPT is suitable for the client by viewing how the client describes their issues, and considering why the client is having interpersonal problems. An interpersonal inventory will be created, to explore and clarify all relationships important to the client; the history of those relationships, and the type of communication and attachment style involved, among other factors. This information is then used to move forward with IPT interventions.
Based on the work of Martin Seligman, then president of the American Psychological Association, and Mihaly Csikszentmihalyi’s Flow (The Psychology of Optimal Experience), and acknowledging a debt to the pioneers of humanistic psychology, Positive Psychology is aimed at complementing traditional psychology by focusing on research into the elements of a satisfying life. Rather than looking at what is clinically “wrong”, it concentrates instead on the strengths and virtues that allow people to thrive. It is sometimes referred to as “the science of happiness”.
It teaches clients practical strategies to increase psychological well-being.
Family Systems Therapy
We can view families as a type of system, because there are different “elements” of a family system (i.e., family members) with distinct behavioural patterns, roles and boundaries.
Family systems therapy proposes that an individual’s experiences within the family while growing up influence the way he or she functions in other relationships throughout life. By uncovering the dynamics within the family of origin, clients can resolve problem and develop different ways of relating.
Family systems therapy can be useful in helping to resolve relationship disputes, childhood and parenting issues, separation or divorce situations, and communication difficulties in families.