Therapy is therapy to many people. Understanding the different styles, what is available and what is appropriate for the patient can be a minefield. The NHS in the UK currently offers Seven types of talking therapy, Cognitive Behaviour therapy (CBT), Counselling, Behavioural activation, Interpersonal Therapy, Eye movement desensitisation and reprocessing, Mindfulness-based cognitive therapy and Psychodynamic psychotherapy (PP). All of which, in one way or another deal with depression, anxiety, panic disorders, phobias, obsessive compulsive disorder, post-traumatic stress disorder and bulimia etc. The lottery of different types of therapy for different problems, can be a difficult call for a GP, waiting times for referrals are currently running at 18 weeks and this is just to ascertain which of the seven is the best road to take, subject of course, to what specialists are available in the particular areas of the UK. Not great if your need is far greater than the waiting list.
We will compare below a selection of different therapy types, that deal with similar problems. These will be compared directly to the Solutions Focused Hypnotherapy (SFH) model and we will show how research has developed SFH it in the way it has.
Cognitive Behaviour therapy (CBT)
The aim of CBT is to explore change and how you think about your life.
Goals are set
Tasks are often used
Up to 20 sessions are often needed, sometimes longer.
Its highly structured to give consistency
Problems are broken down into parts and analysed.
It’s based on a theory, that thoughts, feelings, physical sensations and actions are all linked and that negative thoughts and feelings affect your mental wellbeing.
It’s recognised as a pragmatic therapy and doesn’t dwell on past problems, it’s very much in the now.
A very common therapy that is prescribed for most problems and extremely effective and is used to compliment medications also. It can be successful in a short period, but can take up a lot of the client’s time with extra work that could be asked for between sessions. It is focused solely on the client, rather than dealing with the wider issues going on in their lives.
Counselling
Counselling is a talking therapy
Problems are discussed in confidence with a counsellor
The expertise of the counsellor is vital to find solutions to offer to the clients.
Mainly used for depression, bereavement, anger, sexual orientation and to find reasons for the client’s unrest. It can be a long therapy. The client may have to discuss issues that they would rather forget and the past can be trawled over to find rational to why they are feeling that they are. But good for those that want to discuss and vent and to find those reasons.
Psychodynamic psychotherapy (PP)
This therapy looks at how childhood experiences and thoughts that the client is unaware of, effect feelings, relationships and behaviour.
The subconscious mind is assessed to provide reasoning for past problems that effect today.
Psychodynamic therapy focuses on the psychological roots of emotional suffering. Its hallmarks are self-reflection and self-examination, and the use of the relationship between therapist and patient as a window into problematic relationship patterns in the patient's life.
Hypnotherapy
Utilises guided relaxation to achieve a state of focused attention which enables the mind to find solutions
Used to treat conditions, such as anxiety, phobia, addictions, change habits, ease pain and increase confidence, to name a few.
Results are long lasting and success is usually in a short space of time.
Not currently prescribed on the NHS, but recognised by the British Medical Association as a valid medical treatment in 1955
Solution Focused Brief Therapy (SFBT)
Not currently prescribe on the NHS
Is future orientated to find solutions to problems
Is positive and builds on the strengths of the clients, with the understanding that they know what they need to do to move forward
Clients describe what they want, rather than what they do not want
The use of Scales is incorporated to monitor progress
It is goal directed
It finds exceptions to problems, investigating to find when the problem isn’t there
Does not rely on knowing what the problem is to be able to deal with it
Is structured and every problem, has the same process
Is a short therapy, 3-6 appointments us usually enough.
This method of therapy was devised to be brief and to allow clients to achieve their goals by positively questioning and encouraging success at every stage of the process. It relies on a team of people to watch the session with clients and is labour intensive, but has fast results.
What we have here is a SMALL selection of therapies available today and some of the similarities and differences, but not all. Before we compare this with the SFH model, let’s consider this - Knowledge is everything! having an understanding of how something works allows us to know when something isn’t working properly. Most appliances in the home come with operating instructions, so why don’t Humans?
Milton Erickson believed that everyone had sufficient wisdom and resourcefulness to be able to cope with life effectively, the subconscious part of the brain knew all the answers.
The cerebral cortex is a vast intellectual library, that is there for us all to access to find solutions. So how has Neuroscience influenced therapy? Well, there are too many contributors to mention, but let’s
consider a few, that have shaped the way that we work.
Jonathan Cohen, pioneered neuro-economics, he believed the forces that drive both rational and irrational forces are often at conflict with each other. He carried out a series of brain scans and identified that the more powerful the low roads activity (Amygdala), the less rational the reaction, the more active the high roads activity (prefrontal cortex) the more balanced the outcome. The low road was considered therefore a direct pathway designed to protect us without conscious thought.
Richard Davidson, proved that a positive state of mind can be trained, he carried out brain scans on monks who were thinking positively, then negatively and it showed that different parts of our minds are responsible for different feelings, so we can identify what part of the brain we are using and encourage positive thoughts.
John Ratey in his book, A users guide to the brain, saw the brain as an office, the Pre-frontal cortex was The Boss, who led the operation, the Amygdala was the Safety officer, always on the look out for danger and the Anterior cingulate was the Secretary, who let the boss know of any information he needed to know. In times of danger, the safety officer would take over instantly and the boss would be informed of his actions by the secretary, he could then make a rational decision about the situation, a great elaboration of Cohens discoveries. Ratey also proved we can alter the chemical balance in our brains in many ways to ensure we are “keeping the brain in balance to change your life”
Paul Elman discovered the Smile Advantage and discovered the brain is primed for positive feelings.
Marcus Raichle discovered that the brain showed large amounts of activity whilst resting or daydreaming and noticed that this activity stopped when the subject was given a task to complete. Asking the question, what was it doing during rest? the solution was reinforced by his colleague Gordon Shulman who saw on a sample of 134 brain scans that regardless of the task, areas of the brain that were active during rest, dimmed as soon as the subject was concentrating. They had discovered that the brain resorts to a default mode when unoccupied, which could be described as a trance like state and speculated that this may provide us with an inner rehearsal, considering future choices and outcomes.
Donald Hebb proved that neural networks were strengthened with repeated patterns of behaviour, by using rats to perform repeated tasks. Repetition strengthened areas in the brain, showing we can exercise our brains to and encourage growth.
Returning to the statement “knowledge is everything” why do most forms of therapy omit teaching the client how the mind works? We have years of scientific evidence to prove what is happening in our minds, surely an understanding of this is essential for our clients to be able to understand why they feel as they do.
Let’s finally look at Solution Focused Hypnotherapy and identify the similarities to other forms of Psychotherapy and the beneficial science-based additions that allow us to give a comprehensive service to our clients.
Solution Focused Hypnotherapy
A comprehensive presentation of the workings of the brain and mind is given to allow clients to see and understand how and why they are feeling like they do. Utilising research and scientific evidence from a multitude of professional bodies and researchers.
It is a talking Therapy (Counselling) (CBT) (SFBT) (PP) (Erickson)
Is future orientated, enabling the client to find solutions to problems (CBT) (SFBT)
It promotes positive change (CBT) (SFBT)
Its highly structured to give consistency (CBT) (SFBT)
It’s recognised as a pragmatic therapy and doesn’t dwell on past problems, it’s very much in the now. (CBT) (SFBT)
Is positive and builds on the strengths of the clients, with the understanding that they know what they need to do to move forward (CBT) (SFBT)
Clients describe what they want, rather than what they do not want (SFBT)
The use of Scales is incorporated to monitor progress (SFPT)
It is goal directed (CBT) (SFBT)
It finds exceptions to problems, investigating to find when the problem isn’t there (SFBT)
Does not rely on knowing what the problem is to be able to deal with it (SFBT)
Is structured and every problem, has the same process (SFBT)
Utilises guided relaxation to achieve a state of focused attention which enables the mind to find solutions (HYPNOTHERAPY) (Erickson)
Results are long lasting and success is usually in a short space of time (HYPNOTHERAPY)
Utilises repetition to build neural pathways in the brain (HEBB)
Puts the brain into a resting or trance state to activate the default mode and Inner rehearsal (Raichle/Shulman) (hypnotherapy) (Erickson)
As we can see, SFH is a combination of the best elements of many differing styles of therapy and its practice incorporates influences from esteemed therapists, scientists, researchers and the great Milton Erickson. Its solution focused approach allows clients to understand why they feel like they do and focusses on small positive changes to improve their mental health and wellbeing, allowing the mind to access its vast intellectual database to find solutions. Such a collaboration of different therapies ensure that clients are given the best possible chance of living the lives that want to live, giving them the knowledge to make a change, because as we know, Knowledge is everything
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