What Are The 4 Main Approaches to Clinical Psychology?

As a young social science, psychology has changed drastically from its origins as a practical application of philosophical speculation. This vast field now embraces a spectrum of theories from the 19th and 20th centuries. Classical concepts such as structuralism – how the mind works in a step-by-step way and functionalism – how the mind adapts to external stimuli shape modern clinical methods like behaviorism and psychoanalysis. Despite the differences in approaches, such as the cognitive-behavioral focus on conscious thought processes versus the psychodynamic focus on unconscious processes, modern psychological approaches share a core goal: exploring ideas for scientific insights into the mind and behavior. Whether you’re about to start your psychology education or developing specialized skills with a Masters of Mental Health online, understanding these distinctions proves incredibly valuable when practicing as a Clinical Psychologist. 

1. Psychodynamic

Let us delve into the unconscious. This approach examines conscious and unconscious processes and how they present in current behavior. It stems from psychoanalytic theory, which includes Freudian psychoanalysis, self-psychology, and ego psychology.

Modern therapists draw upon Freud’s ideas regarding the psyche as dynamic or something that can change. They believe the conscious mind does not always control how we think and behave and aim to address the foundation upon which clients build mental processes. 

The key techniques of Psychodynamic therapy include: 

Free association 

You may have played word games with family and friends or seen this classic technique in the movies; however, it is an invaluable tool. Free association gives an insight into the unconscious by asking patients to verbalize anything that comes to mind. Exposing the inner workings of a patient’s mind in this manner gives the therapist insight into underlying issues. 

Transference/countertransference

This fascinating process could be a degree in itself. It refers to the unconscious redirection of an individual’s feelings and desires onto the therapist or counselor and vice versa. In a psychodynamic setting, this technique can create a bond between client and therapist, allowing for deeper, more genuine conversations. 

Catharsis 

Releasing pent-up tension and repressed emotions through conversation in a therapeutic environment. This fosters a sense of relief and allows the client to begin processing complex emotions.  

Content vs process 

This technique narrows down conversations; content refers to the stories a client shares, and the process is how the therapist addresses and accesses stories that are relevant to the session’s goal.

Clarification and interpretation 

A tool to make sure the therapist asks questions to seek a clear understanding, gathering all the data before assigning meaning through their own interpretation. 

1. Cognitive Behavioral Therapy

Cognitive Behavioral Therapy, or CBT, is a form of psychotherapy that believes psychological problems to be routed, in part to faulty and unhelpful cognitive processes alongside learned patterns of unhelpful behavior. The solution – interventions aimed at changing cognitive patterns by recognizing the harmful ways in which we think, better understanding why people act the way they do, and building a ‘toolbox’ of techniques to cope with challenging situations. These techniques include exposure therapy – where a patient is gradually exposed to their specific phobias until they overcome them, controlled breathing exercises to promote relaxation, journaling, and behavior activation – scheduling pleasant activities to look forward to. 

In recent years, CBT has become the gold standard among American psychologists, with surveys showing it to be the fastest-growing approach to treatment for mental health issues. This rise in popularity is attributed to the empirical base upon which the various tools sit. There have now been over 325 clinical trials for CBT methods spread across large populations. 

The relative ease at which therapists, counselors, and psychologists can apply at least some aspects of this approach makes it ideal to teach, and the high efficacy rate makes it an effective tool in combating issues ranging from depression and anxiety to bipolar and Obsessive-compulsive disorder. 

2. Humanistic 

This school of psychology presumes the inherent dignity and worth of humans above all else, pursuing perspectives that seek to uphold human values and resist the reduction of human beings to the sum total of their parts, behavior, and environment. The approach has been described as a reaction to the pessimistic view of psychoanalysis with its tendency to focus on the disturbed aspects of the psyche.

Working from baseline positive assumptions on personality, Carl Roger’s theory of personality saw personalities as an overlap between the real self. In other words, how someone is today versus the ideal self or whom one wants to become. The real struggle toward self-actualization lies partly in attaining the ideal overlap between the two selves. Rogers called this overlap congruence. 

 Getting the right measure of who you are and who you want to become is no easy job, especially when these two versions of self are battling it out. This internal fight is driven by esteem and self-image.

Another key player in the humanist story is Abraham Maslow, famous for the hierarchy of needs, as pictured below. Maslow believed action to be driven by the innate desire to meet certain needs, and, as these needs are met, one may move on to meeting the following need.

Perhaps humanism’s greatest benefit lies in using active listening to build genuine relationships with clients, putting themselves in their shoes to create an empathetic connection between both parties. Developing this level of understanding is incredibly beneficial for building trusting relationships and finding effective and long-lasting solutions for patients. 

3. Family Systems

The family systems theory was developed by Murray Bowen, an influential American psychiatrist, to address familial issues by examining complex relationships and intergenerational behavior patterns.

 Viewing the family as an emotional unit, practitioners focus on individual needs within the family context. During therapy, families engage with a therapist to observe dynamics, hierarchy, and communication. This holistic approach proves beneficial for diverse issues, including marital problems, substance abuse, and pathological behavior.

 Bowen categorizes eight key areas for observation:

1. Differentiation of self 

The core concept of Bowen’s theory is that a differentiated self is someone who is connected to others but does not allow the anxiety of others to influence their function in the unit.

2. Triangles 

When two people form a relationship, they often require a third ( if available) to stabilize them; this third element is not limited to people; it could be a movie between partners.

3. Nuclear family emotional system

This aspect sees marriage as the glue to hold family units together, with the highest level of emotional transference occurring inside the nuclear family. 

4. Multigenerational transmission process

The idea is that general levels of differentiation transmit from one generation to the next. Parents who achieve a high level of self-differentiation pass it on to their kids.  

5. Sibling position 

Takes into account the different roles siblings play; older brothers function as leaders in a distinct way to oldest sisters, younger children are better paired with older children in marriage, and younger children are more social. 

6. Emotional cutoff

Observing the effects of emancipated children, runaway teens, or others who have severed relations with parents or have limited interactions. These relationships or lack thereof still have a large emotional effect on both parties. 

7. Emotional process in society 

As with other tenets of Bowenian theory, this applies to non-family groups, such as work, school, and other social organizations. Bowen considered there to be periods of societal regression driven by a rise in anxiety. One such period was the post-war era in which he lived. During the 1950s and 60s, the observable symptoms of societal regression were a higher crime rate, increased divorce, and a rise in drug abuse. Rather worryingly, Bowen predicted society would regress for around 20 years or until the pain became too much for humankind. Eventually, a large-scale modification of behavior will happen to end this period of societal regression. 

8. Family projection process

The way parents transmit their emotions to their children. This dynamic influences the child’s behavior and emotions. Therapists work to disrupt this cycle, fostering self-awareness and healthier family dynamics.

Closing Thoughts

The ways we approach mental health matters, and with such a variety of methods, we can all learn something new. Whether you are looking to become a counselor and the concepts of humanistic self-actualization fascinate you or for those simply looking to improve family dynamics through better differentiation of self. Each approach enriches our understanding of the mind, adding questions to the infinite list of dilemmas psychology reveals.