Finding the Therapeutic Modality That is Right for You

Amy Black, PhD, CGP
Licensed Psychologist
Partner at The Evidence Based Practice of Nevada

You are thinking about starting therapy—but what kind? The number of options may be overwhelming, and it may be hard to know where to start. One of the many choices to make is which modality of therapy to pursue. Here’s a quick run-down of some of the pros and cons of three common treatment modalities. 

Individual Therapy

What it looks like: One-on-one, (typically) weekly 45-60 minute sessions. Sessions may be more or less frequent depending on various factors, such as your goals and the stage of treatment. In individual therapy, you are the only patient. Even if you invite a loved one to one of your sessions, you are still considered the patient and they are there to support you in your treatment. 

Advantages: 

·      Most widely available form of therapy!

·      Individual therapy is appropriate for a very wide range of therapy goals. 

·      The whole session focuses directly on you—your challenges, goals, and experiences, and your part in your relationships and interactions. 

·      Individual therapy can help you build specific skills to improve your life, examine behavior patterns, provide a space to unpack a difficult experience, and/or support exploration of your unique identity and values. 

·      Individual therapy is built entirely around your treatment plan, which is a collaborative effort between you and your therapist. The treatment plan can easily adjust in response to life circumstances, such as a new issue arising that you want to address.

·      Individual therapy is a good option for individuals wanting to do couples therapy but whose partners are unable or unwilling to participate in couple’s therapy. 

·      Evidence-based therapy is time limited and helps you reach your goals and get back to your life.

Disadvantages:

·      Although individual therapy may be a good fit for a very wide range of treatment goals, it is not always the best fit treatment approach in every case.

·      It can sometimes be hard to hear feedback or empathy from a therapist. You may wonder if your therapist is just being nice to you because they are paid to be (not true, I promise!) or wonder if the therapist really “gets it” since they’re a professional.

·      You may wonder if you’re normal even when your therapist reassures you that there are a lot of people out there who feel like you, because your experiences are the only ones in the room.

·      Although “real-time change” does happen in individual therapy, often the most significant changes take place outside sessions as you experiment with new skills and new ways of relating to others. Therefore, individual therapy is unlikely to be truly effective without outside-of-session effort.  

Couples Therapy

What it looks like: You and your partner attend all (or the majority of) sessions together. Typically, sessions are weekly and are 60-90 minutes long. Rather than you and/or your partner being the patient(s), your relationship is the patient. In other words, the focus of treatment is on your relationship rather than each of you individually.

Advantages:

·      The therapist’s task is to help you and your partner strengthen your relationship by identifying ineffective relationship patterns and coaching new ways of relating and interacting with each other. 

·      With both partners in the room, you can try out new skills and patterns in the session with your therapist in the room to coach you and provide feedback.

·      Because both partners are present, therapists may obtain a clearer view of what is not working in a relationship rather than relying on a single perspective in individual therapy.

·      Even partners who have been together for many years often express surprise as they hear or understand something about their partner or their relationship for the first time. 

·      Real time relationship change can occur in the session and be built upon outside of the session.

·      Working on your relationship with your partner supports individual growth.

·      Even if you are looking to end a relationship, therapy can help with setting up rules and boundaries for ending a relationship.

Disadvantages:

·      The therapist can’t force you or your partner to change. 

·      It is difficult to make progress in couples therapy if one or both partners are not committed or if partners have opposing goals for therapy.  

·      Because the focus is on the relationship, it is unlikely to be an optimal setting to work out your individual challenges, such as individual identity development, mental illness, trauma, or issues related to individual development.  These types of challenges often require individualized therapeutic attention.  

·      You and your partner may not be in agreement about whether the therapist is a good fit or when to terminate services.

Group Therapy

What it looks like: Weekly 90-120 minute sessions with 4-12 group members and 1-2 therapist group leaders. The focus is on building skills and/or exploring and processing lived experience. In group therapy, each member of the group is an individual patient (that is to say, the group leaders are attending to your individualized treatment plan and goals in the context of the group).  At the same time, the group leaders apply understanding of group dynamics to also view the group as a whole. Sound complicated? It is, and that’s why it’s important to look for a group with leaders who have specialized training in group therapy.

Advantages:

·      Group therapy is appropriate for a wide range of therapeutic goals. In fact, the research indicates that for some goals, such as addressing social anxiety, group psychotherapy is more effective than individual therapy. 

·      Group is an ideal place to learn new skills. Other group members can help you to troubleshoot skills application, and you benefit from hearing multiple perspectives. 

·      Having more people in the room than in individual therapy means more opportunities for social learning, normalization, and the development of interpersonal connections. Humans are fundamentally social, relational beings, so our struggles show up in, and are worsened by, our interpersonal worlds. At the same time, interpersonal connections have the power to provide deep healing, a fact of human nature that is maximized in group therapy.

·      Group therapy is a “social laboratory”—a small, safe group of people that you don’t need to worry about seeing later at home, work, school, a party, or Thanksgiving dinner. It is the perfect place to venture outside of your comfort zone, try new ways of being with other people, and receive valuable feedback that most of us aren’t in the habit of giving each other in our social circles. 

·      You hear from others who have experiences and identities in common with and different from yours, and gain insight into your own life as they share and make sense of their experiences. Even when the group is talking about someone else’s experience, healing comes from vicarious learning and the opportunity to offer curiosity, compassion, and support. 

·      Group therapy is typically the most cost-effective form of treatment—the most therapy time for the lowest price. 

Disadvantages:

·      Although the group leaders attend to your individual needs within the group, sometimes it can take time to learn all of the skills and some skills may be more applicable to your life than others.   

·      You may worry about getting enough “air time” in group or worry you are taking up too much space. (Don’t worry, this is a normal part of the process!)

·      Groups that are led or supervised by clinicians without specialized group training may be prone to being less effective or it may feel like you and other group members are taking turns receiving individual therapy with a small audience—this is not the goal of group therapy.

Final Thoughts

The goal of this post was to provide general Information about each of three common therapeutic treatment modalities. You may still have questions or be wondering how your particular goals fit into these treatment frameworks. To schedule an appointment with one of our licensed psychologists to discuss the most effective course of therapy for you, please call our Clinical Executive Director at 702-508-9181.