Types of therapy: CBT, ACT, DBT and IFS

Whether you’re already in therapy or just thinking about it, you may be interested to learn about some of the different types of therapy available. This can help you when talking with a therapist about what options are available and which ones might work for you.

While there are lots of different types of therapy, we will explore:

• Cognitive Behaviour Therapy (CBT)

• Acceptance and Commitment Therapy (ACT)

• Dialectical Behaviour Therapy (DBT)

• Internal Family Systems (IFS)

• What if I'm not ready for therapy?

These four types of therapy are all evidence-based and are commonly used by mental health professionals. Many therapists may combine exercises or practices from different therapies to suit your particular situation.

Cognitive Behaviour Therapy (CBT): What is it and how might it help me?

CBT is a form of talk-therapy that is effective in treating lots of mental health conditions, including anxiety disorders, depression, substance use and relationship difficulties. When we think in a certain way, it influences how we feel, which then affects how we act or behave. With CBT, you work with your therapist to identify any unhelpful or unrealistic thought patterns you have, and then challenge them with more helpful and realistic ways of thinking.

Changing our patterns of behaviour may look like facing our fears or things we’ve been avoiding, or role playing ‘what if’ scenarios with your therapist and seeing how likely they are to happen. It’s about being aware of an unhelpful thought, and then challenging it with some evidence from the reality around you. For example, you can counter the thought ‘Nobody likes me’ by focusing on the people in your life who you know do like you, such as your friends and family members, and by considering the fact that not everyone knows you well enough to have a strong or realistic opinion of you.

CBT will usually also involve your therapist giving you tasks and exercises to do in between sessions, such as writing down your thoughts in order to become more aware of your patterns of thought and better able, with practice, to challenge unhelpful ones and prove them wrong.

CBT can be helpful for both short- and long-term therapy. It will be up to you and your therapist to determine how many sessions you may need, which will depend on the issue(s) you are working on.

Acceptance and Commitment Therapy (ACT): What is it and how might it help me?

ACT is a talk-based therapy that aims to help people accept what kinds of things are out of their control. Once they’ve done that, ACT is all about committing to actions that will help them to move in a positive direction. ACT is about working towards a meaningful and values-driven life.

ACT includes techniques such as mindfulness-based practices (leaning into the present moment, and paying attention to what is happening in that moment, without making judgements) and working out what your core values are (what is truly important and meaningful to you) so that you spend more time living in line with these values.

Sometimes using logic to solve our problems just doesn’t work. ACT is about knowing that life will be messy at times, and that we will sometimes be faced with painful situations that result in painful emotions. However, we can make room for these feelings, emotions and sensations, and practise moving forward with our life at the same time.

ACT has been shown to be helpful for a wide variety of mental health conditions, as well as for practising accepting life’s circumstances in general. It has been proven to be effective for anxiety disorders, depression, substance use, psychosis, chronic pain and relationship difficulties. ACT can be useful in both short and long-term therapy.

Dialectical Behaviour Therapy (DBT): What is it and how might it help me?

DBT is a talk-based therapy that offers many exercises that attempt to work towards reducing harm, distress and strong emotional reactions. It also aims to improve our relationships with others and ourselves through changing some unhelpful behaviour patterns.

DBT is practised within a group or one-on-one with a DBT therapist. The therapist may introduce items to the weekly sessions that help you to use your senses (sight, touch, taste, smell, hearing) to practise mindfulness. You might also discuss strategies to use to soothe yourself whenever you feel strong emotions. DBT focuses on learning how to manage intense emotions in the moment, instead of trying to change them.

DBT works well with a wide variety of issues and is known to be especially helpful for those who have suicidal ideation, self-harm tendencies or Borderline Personality Disorder.

In a DBT therapy session, you learn practical skills such as mindfulness-based activities. You then practise these skills in between sessions and later share what happened.

Internal Family Systems (IFS): What is it and how might it help me?

IFS is a traditional talk-therapy done one-on-one with a therapist. Although it has ‘family’ in the name, a core principle of the therapy is that we are all individuals made up of different ‘parts’, and that in order to heal, we need to build healthy relationships with all of those ‘parts’ of us. For example, if you have a part of you that is shy and you dislike that side of you, how can you build a healthier story about it in order to be accepting of your overall self?

IFS is also based on the principle that there is no ‘bad’ part of you; all of these parts make up your internal family system and your inner world. The more comfortable we become with our internal systems, the healthier our external systems become – like the relationships you have with people and other parts of your life. IFS can be used on its own or alongside other models of therapy.

IFS is used to treat a wide variety of mental health conditions, such as anxiety disorders, depression, disordered eating, substance use and personality disorders. It is also used for trauma, and emotional/sexual or physical abuse. It’s best used for longer-term therapy.

All of these therapies can help with self-awareness, allow for healing, and can bring positive change to your mental wellbeing. If you are interested in any of these therapies and would like to try them out, talk to your therapist about them and find out if they practise them. Your therapist should let you know which model they think will work best with your issues.

What if I'm not ready for therapy?

If you feel like you want some professional support, but you're not quite ready for therapy, you could try talking to a peer worker. Peer workers have their own experience of tough times and mental health challenges, and recovery. They are trained mental health professionals whose experiences help them to form a strong connection with those going through similar mental health challenges. They can listen to what’s going on with you and help you feel more empowered to figure out what to do next.

What peer workers do is known as ‘peer support’, which recognises that we all learn and grow from each other, and that support can be found in many places outside of a clinical setting.

Do you want to chat with a peer worker? Book a free, text-based session with ReachOut PeerChat here.

Written by Rashida Dungarwalla, Psychologist.