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Therapy & Assessment

Treatment Approaches

A broad range of psychological approaches can be drawn upon according to the person, the problem, the clinical formulation and the goals of therapy.

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Choosing How to Work

Treatment is tailored to the person rather than selected from a menu

Over many years of clinical practice I have trained in, used and drawn upon a wide range of psychological treatment approaches. These approaches are not separate packages from which a client is expected to choose.

The more useful question is which ideas and methods are most appropriate for the person, the nature of the difficulty, the circumstances in which it has developed, and the goals we agree upon.

Some people benefit from quite structured cognitive and behavioural work. Others may require greater attention to emotion, relationships, trauma, physiological regulation, meaning, longstanding patterns or the broader context of their lives. In more complex presentations, treatment may draw upon several complementary approaches over time.

The list below reflects the breadth of approaches represented in my clinical background. It does not mean that every approach is suitable for every person or every problem.

Approaches Used in Practice

Explore the main treatment approaches

The accordions below group related approaches together so that you can explore them without having to navigate a large number of separate pages.

Cognitive Behaviour Therapy (CBT)

Cognitive Behaviour Therapy is a collaborative and usually structured approach that examines the interaction between thoughts, emotions, behaviour and the situations in which difficulties occur. Treatment may involve identifying unhelpful patterns of thinking, testing assumptions, modifying behaviour and developing more effective coping strategies.

CBT has been used extensively in the treatment of anxiety, depression, panic, phobias, obsessive-compulsive difficulties, trauma-related problems, anger, stress and a range of other psychological concerns.

Acceptance and Commitment Therapy (ACT)

ACT places particular emphasis on psychological flexibility: learning to respond differently to difficult thoughts and feelings while moving toward actions that are consistent with personally important values.

Mindfulness, acceptance and values-guided action are central elements of ACT. The aim is not necessarily to eliminate every unwanted internal experience, but to reduce the extent to which those experiences control behaviour and restrict life.

Schema Therapy

Schema Therapy extends cognitive and behavioural approaches by paying closer attention to longstanding patterns that may have developed earlier in life and continue to influence relationships, emotions and behaviour.

Treatment may involve identifying entrenched beliefs and coping patterns, understanding how they developed, and building healthier ways of thinking, feeling and responding.

Mindfulness-Based Therapy

Mindfulness-based approaches help people become more aware of thoughts, emotions and bodily experiences without automatically reacting to them. This can be useful where rumination, self-criticism, anxiety, stress-related arousal or recurrent mood difficulties are prominent.

Mindfulness may be incorporated within broader therapy rather than used as a stand-alone technique.

Emotionally Focused Therapy

Emotionally focused approaches work with emotional experience as an important source of information about needs, relationships and patterns of responding.

These approaches are particularly relevant where distress is closely connected with attachment, relationships, recurring interpersonal patterns or difficulty understanding and regulating emotion.

Positive Psychotherapy

Positive psychotherapy complements problem-focused treatment by also attending to strengths, meaning, engagement, relationships and the aspects of life that support psychological wellbeing.

This does not involve ignoring distress or simply encouraging positive thinking. Rather, it can help broaden therapy beyond symptom reduction toward the development of a more satisfying and meaningful life.

Eye Movement Desensitisation and Reprocessing (EMDR)

EMDR was developed for the treatment of distress associated with traumatic memories. It involves attending to emotionally disturbing material while also engaging in structured bilateral stimulation, commonly through guided eye movements.

Where clinically appropriate, EMDR can be considered as part of a broader trauma treatment plan following careful assessment.

Clinical Hypnosis

Clinical hypnosis involves the deliberate use of focused attention, imagery and therapeutic suggestion within a clinical context. It can be used to help some people develop greater control over attention, physiological arousal, pain, anxiety, habitual responses or other aspects of psychological functioning.

Hypnosis is not a loss of control or a passive state in which the therapist takes over. It is a collaborative procedure and, where used, forms part of a broader clinical treatment plan.

Psychodrama

Psychodrama is an experiential approach involving role play, enactment and other action methods to explore experiences, relationships and recurring patterns.

It can help make aspects of a person's experience more immediate and visible, allowing alternative responses, perspectives or roles to be explored rather than only discussed abstractly.

Narrative Therapy

Narrative Therapy pays attention to the stories people develop about themselves and their lives. Difficulties can become embedded in restrictive or self-defeating narratives that shape how past and present experiences are interpreted.

Therapy can help separate the person from the problem, identify abilities and exceptions that may have been overlooked, and develop alternative meanings that are more useful and empowering.

Couple Therapy

Couple therapy focuses on the relationship between partners rather than treating one person as the problem. The work may explore recurring communication patterns, conflict, intimacy, trust, emotional needs and the effects of external stress on the relationship.

FreoPsych also has a dedicated Couples Therapy page with more information.

Family & Marital Therapy

Family and marital approaches consider psychological difficulties within the network of relationships in which they occur. Patterns of communication, roles, expectations and responses between family members can all influence how difficulties develop and are maintained.

Dispute Mediation

Mediation-based methods can be useful where conflict has become entrenched and people need a structured process for clarifying concerns, identifying areas of agreement and developing workable ways forward.

Mediation is distinct from psychotherapy, although skills developed through psychological and relationship work can inform the management of interpersonal conflict.

Group Therapy

Group therapy provides opportunities to learn not only from the therapist but from the experiences, feedback and support of other participants. Depending on the group, the focus may be psychoeducation, skills, support, interpersonal learning or broader psychotherapy.

Group work has formed part of my psychological background, although current availability of group programs may vary.

Rehabilitation Counselling

Rehabilitation counselling is relevant where psychological adjustment, health, injury, work capacity and return to meaningful activity overlap.

This can be particularly important in occupational injury, chronic pain, illness and return-to-work contexts, where treatment needs to take account of both psychological wellbeing and functional recovery.

Biofeedback

Biofeedback uses monitoring technology to provide information about physiological processes such as heart rate, muscle tension, skin responses or other aspects of bodily arousal.

The purpose is to increase awareness of the relationship between physiological state, thoughts, emotions and behaviour, and where appropriate to help develop greater self-regulation.

EEG Neurofeedback / Neurotherapy

EEG neurofeedback is a specialised form of biofeedback that uses real-time information about electrical brain activity. Sensors placed on the scalp record EEG activity and feedback is provided through visual or auditory signals.

The evidence base varies according to the condition and the form of neurofeedback being considered. Suitability therefore needs to be assessed individually rather than assuming that neurofeedback is an appropriate treatment for every problem.

More information is available on the dedicated Biofeedback & Neurofeedback page.

Integrative Clinical Practice

The approach follows from the assessment

Having experience with a broad range of approaches makes it possible to think flexibly about treatment, but breadth is useful only when it is guided by careful clinical judgement.

The process therefore begins with understanding the difficulties, relevant history, current circumstances, strengths and goals. From there, we can decide which methods are likely to be most useful and whether one approach, a combination of approaches, or referral elsewhere is most appropriate.

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Taking the Next Step

You do not need to decide which treatment approach you need.

A first consultation is the appropriate place to begin clarifying the problem and considering which therapeutic approach may be most useful.

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