If you’ve ever typed “types of therapy” into a search tool and felt more confused after reading the results, you’re not alone. Terms like cognitive behavioral therapy, dialectical behavior therapy, and EMDR can sound clinical and intimidating, but this guide helps you understand these approaches with definitions written for real people like you.

Whether you’re considering therapy for the first time, exploring options for a loved one, or simply trying to ask better questions when working with a therapist, we can help you through it all.

Why Knowing Your Therapy Options Matters

The beauty of therapy is that there is no one approach: it looks different for everyone, depending on their needs. The right treatment for someone navigating grief may look very different from what works for someone managing borderline personality disorder or processing childhood trauma. You may have heard of cognitive-behavioral therapy (CBT), which is very effective for many people, but it’s just one of many therapy approaches that trained professionals can use.

Knowing what’s available and which modalities address different needs empowers you to have informed, meaningful conversations with potential therapists or current therapists. It also helps you trust the process once you begin the healing journey.

The Most Common Types of Therapy, Explained

How Do You Know Which Type of Therapy Is Right for You?

The truth is: You don’t always know in advance, and that’s okay. Most skilled therapists are trained in multiple modalities and will tailor their approach to your specific needs, history, and goals. The most skilled therapists have a diverse toolkit of methods they can draw from, adapting their approach to match each person’s unique needs, interests, and developmental stage.

That said, going in with some knowledge gives you the ability to ask meaningful questions. When looking for the right therapist, or during your next session, try asking your therapist these questions:

Asking these questions will help you find the right fit for your healing journey, and a good therapist will welcome them.

A Quick Reference: Therapy Types and What They Address

There are so many therapeutic approaches out there, and we’ve only covered a few. Still, here’s a breakdown of the theories we discussed and what they can help support:

Taking the Next Step

Understanding these approaches is the first step in building a better you. Finding the right therapist is a significant part of improving your mental health, but you don’t have to do it alone. GoodTherapy’s therapist directory allows you to filter by therapy type, specialization, location, and more, so you can find someone who truly fits your needs.

If you’re still exploring whether therapy is right for you, our blog on what to expect in your first therapy session can help you get started.

Remember, reaching out is not a sign that something is irreparably wrong with you. It’s a sign that you know your well-being is worth investing in.

For people struggling with trauma, anxiety, or depression, the journey to healing requires understanding which trauma therapy approaches actually work. Many begin with well-meaning but inadequate advice: “Just think positive thoughts,” “Try meditation,” or “Practice positive affirmations.” While these approaches have value in general wellness, they fall short when addressing the complex neurobiological impact of trauma.

If you’ve tried meditation, positive affirmations, Reiki, yoga, or other wellness practices but still feel stuck, drained, or triggered by past experiences, you’re not alone. Understanding why these methods fail and discovering evidence-based trauma therapy approaches that actually work can transform your healing journey.

The Science Behind Why Positive Affirmations Fail for Trauma

Research reveals a fundamental flaw in how positive affirmations are typically used for trauma recovery. Positive affirmations jump directly from negative feelings to positive ones without addressing the underlying trauma. For a positive affirmation to take hold, its negative counterpart must first be neutralized or desensitized.

This means whatever makes the feeling negative needs to lose its emotional power first. Only then, by adding a positive affirmation to a neutral state, can that positive feeling hold lasting power.

For example, if someone goes from “I am unsafe” to “I am safe,” the safety cannot truly take hold unless the unsafe feeling first loses its emotional charge. The person must no longer be bothered by the original trauma trigger.

The Neurobiological Reality of Trauma

As Bessel van der Kolk, MD, explains in The Body Keeps the Score, trauma’s impact exists in the survival part of the brain, which doesn’t return to baseline after the threat ends. Through brain imaging technology, we can visualize how traumatized individuals struggle to process ordinary, non-threatening information, making it difficult to fully engage in daily life.

Trauma affects the entire human organism; thinking, feeling, relationships, and bodily functions. Survivors often experience:

• Chronic feeling of being unsafe in their bodies
• Visceral warning signs and bodily sensations
• Frozen traumatic images, sounds, or smells in the brain
• Difficulty with emotional regulation
• Recurring patterns and triggers

Why Alternative Therapy Approaches Fall Short for Trauma Healing

Meditation and Mindfulness

While meditation can provide temporary relief and general wellness benefits, it doesn’t specifically resolve underlying trauma issues. Meditation helps manage symptoms but rarely addresses the root cause of traumatic stress stored in the body.

Reiki and Energy Work

Reiki can identify where negative emotions are felt in the body, such as the chest, neck, or legs. However, most energy healing modalities lack specialized tools to actually remove trauma and negative emotions stuck in the body.

Exercise and Yoga

Physical activity and yoga benefit both body and mind and can help clear mental fog. However, when someone has experienced traumatic events like car accidents, painful divorces, or other overwhelming experiences, the negative sensory memories can become frozen in the brain. No amount of yoga or exercise alone can unfreeze those traumatic imprints.

Evidence-Based Trauma Therapy Approaches That Actually Work

Trauma-Focused Therapy Approaches (TF-CBT)

Research demonstrates that TF-CBT effectively reduces symptoms of depression, anxiety, and PTSD. This approach combines:

• Psychoeducation about trauma’s effects
• Coping skills development
• Trauma narrative processing
• Cognitive restructuring of trauma-related beliefs
• Post-treatment planning and relapse prevention

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR helps process traumatic memories without requiring extensive verbal processing, making it particularly effective for those who find talk therapy challenging or re-traumatizing.

Emotion-Focused Therapy (EFT)

EFT helps clients build emotional regulation skills and learn healthy responses to difficult emotions. This approach is particularly effective for complex trauma survivors.

Body-Based Trauma Therapy Approaches

These therapies recognize that trauma lives in the body and focus on:

• Resensitizing the nervous system to safety
• Completing interrupted fight-or-flight responses
• Restoring a felt sense of control and empowerment
• Processing trauma through body awareness rather than just talk

Find Specialized Trauma Support

If you recognize yourself in this description, feeling stuck despite trying positive approaches, experiencing unexplained anxiety, or finding that the same patterns keep recurring, it may be time to seek specialized trauma support.

Ready to explore evidence-based trauma therapy approaches? Browse our comprehensive directory of trauma-informed therapists who specialize in approaches that actually resolve trauma at its root rather than just managing symptoms.

How Professional Trauma Therapy Approaches Differ from General Counseling

The Tracing Process

Effective trauma therapy approaches often involve tracing current difficulties back to their origins. On average, it takes less than a minute for trained trauma specialists to identify the connection between today’s struggles and past experiences. This linking process clarifies differences between past and present, helping clear current issues successfully.

Specialized Treatment Methods

Talk therapy alone often isn’t enough to heal trauma. Since trauma keeps people stuck in the past, talking about traumatic experiences can sometimes worsen distress. The good news is that specialized treatment methods can resolve trauma with little or no talking required.

Addressing the Unconscious

If you wonder why you feel anxious for no apparent reason at 2 a.m., rest assured there’s always an unconscious cause. Trauma therapy approaches help uncover and resolve these hidden triggers that keep you stuck in survival mode.

Understanding Different Trauma Therapy Approaches and Timelines

The length of trauma therapy approaches depends on several factors:

• How many issues you wish to resolve
• How deeply traumas are embedded in the unconscious
• Your personal healing capacity and resources
• The therapeutic approach used

It’s important to note that there are major traumas (like accidents) and smaller ones (like conflicts with loved ones). The process to resolve them is essentially the same, though the timeline may vary.

FAQ: Common Questions About Modern Trauma Therapy Approaches

Q: How do I know if I need specialized trauma therapy approaches versus regular counseling? A: If you experience recurring patterns, unexplained anxiety, emotional numbness, intrusive thoughts, or feel stuck despite trying positive approaches, trauma-informed therapy approaches may be more appropriate than general counseling.

Q: Will trauma therapy approaches make me feel worse initially? A: Quality trauma therapy approaches prioritize your safety and emotional capacity. While processing can bring up difficult feelings, skilled trauma therapists use techniques to prevent overwhelming or re-traumatizing clients.

Q: How long do trauma therapy approaches typically take? A: The timeline varies based on individual factors, but many people notice significant improvements within 3-6 months of consistent trauma-informed therapy. Complex trauma may require longer treatment.

Q: Can trauma therapy approaches work if I don’t remember my trauma clearly? A: Yes. Many effective trauma therapy approaches work with whatever memory or body sensations you have, regardless of detail or clarity. Your body holds the memory even when your mind doesn’t.

Q: Is it normal to feel resistant to trauma therapy approaches? A: Absolutely. Resistance often indicates your protective system is working. A skilled trauma therapist will work with your resistance compassionately and help you move at a pace that feels safe.

Building Trust and Connection in Healing

Above all, trust and connection between therapist and client are essential for trauma recovery. This therapeutic relationship becomes the foundation for healing because, ultimately, you’ll be working toward the same goals: your healing, growth, and freedom from trauma’s grip.

When choosing a trauma therapist, look for someone who:

• Specializes in trauma-informed approaches
• Creates a sense of safety and trust
• Respects your pace and autonomy
• Uses evidence-based methods
• Understands trauma’s impact on the nervous system

Moving Forward: Your Investment in Healing

Imagine for a moment that you could resolve your trauma symptoms and ease your physical stress responses in the most effective and efficient way possible. How would that change your life? What becomes possible when you’re no longer held hostage by past experiences?

Quality trauma therapy approaches aren’t just an expense, they’re an investment in reclaiming your life, relationships, and peace of mind.

Remember, healing is possible. With the right therapeutic approach and support, you can move from surviving to truly thriving.

Additional Resources

• Read More:
  • Understanding Different Trauma Therapy Approaches
  • Complex Trauma and Emotion-Focused Therapy
  • The Three Phases of Trauma Healing
• External Resources:
  • National Center for PTSD – Treatment Options
  • International Society for Traumatic Stress Studies

How Therapists Are Using EMDR in Telehealth Sessions

Eye Movement Desensitization and Reprocessing, commonly referred to by its initials EMDR, is well-known as a model of therapy. This type of therapy was created to treat individuals suffering from Post-Traumatic Stress Disorder (PTSD) and trauma-related mental illness. Since its invention, it has been proven to help with other disorders and mental illnesses as well such as anxiety, phobias, sleep irregularities, and chronic pain.

Due to the COVID-19 pandemic, mental health providers have had to adapt EMDR to a telehealth format. A treatment that is traditionally done in person, this modality has required providers to innovate ways to deliver this treatment to patients over video chat. What are therapists doing to effectively adapt EMDR online?

The Pandemic and Telehealth

The coronavirus pandemic prompted mental and behavioral health providers to transition their care delivery to be primarily online. Telehealth has broken down several of the existing barriers to mental health services like travel, transportation, and scheduling. More individuals than ever before have access to mental health care. While this tool has revolutionized the delivery of mental health services, it has posed some challenges as well. Not every kind of treatment is easy to deliver when the client and therapist are separated by a screen.

How EMDR Works

This type of therapy works by mimicking how your brain processes emotions through directed eye movements. It aims to enable someone to reprocess difficult experiences and emotions and transition them out of the fight-flight-freeze-fawn response.

How EMDR Is Being Adapted to Online Therapy

The pandemic has moved most mental health services online. This has prompted major challenges for providers who regularly utilize EMDR in therapy. Traditionally, EMDR in therapy is done in person through the utilization of bilateral stimulation tools. How are providers adapting this to a virtual therapy setting?

Screen Sharing

Some providers are utilizing screen sharing options to continue delivering EMDR therapy. This tool allows them to share with their client what they wish them to focus on. This enables the therapist to control the left to right visual stimulation.

Patient Instructions

Providers have also tried delivering EMDR in therapy by asking patients to try different methods of stimulation like tapping on their legs. This is more difficult because the provider does not have control over the speed, start, and stop of the process.

Issues Providers Might Run Into

The nature of EMDR is to help clients process trauma. It is best to do this in person so you have control over the client’s environment and safety. This kind of therapy can often trigger trauma responses and crisis-level reactions that a therapist would normally be present to help navigate. Online EMDR therapy removes these safety options.

Providers are also used to seeing the client’s entire body movements. This helps them read whether or not a client is becoming too overwhelmed. Online therapy makes this difficult as providers can only see the top half of their client’s body.

Providers are navigating these issues and complications to practicing EMDR virtually through the use of emergency contact information. If they believe their client is in danger or at risk, they can contact their designated emergency contact.

Therapists everywhere are doing an incredible job transitioning to online care during unprecedented times. To learn more about a therapist in your area, click here.

“Memory is not a recording of an ‘image’ or a ‘trace’ but part of the process of knowing and understanding.” —Rosenfield, 1992; p.18

There are polarizing beliefs when it comes to eye movement desensitization and reprocessing (EMDR) therapy. On one end, it is viewed as a+ cure-all treatment for mental health symptoms. On the other, critics see it as a treatment akin to modern-day snake oil.

The protocol for EMDR therapy is comprehensive and detailed. Put simply, the idea is to transform disturbing input—process and decondition it—into an adaptive resolution and a psychologically healthy integration. The model is past-focused, meaning one is going back in time to recall events as opposed to addressing current life stressors (not that the two are mutually exclusive). This includes redefining the event, finding meaning in it, and alleviating self-blame while integrating new skills (Shapiro, 2001). The modality focuses on the core cognitions or self-referential beliefs individuals associate with the disturbing events. These often fall into domains related to personal responsibility, safety, and power or control. “Trauma in each of these domains is reflected by the client’s distorted self-referencing beliefs linked to the effects of unresolved memories” (Nickerson, 2017).

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EMDR is an evidence-based therapy primarily used to treat posttraumatic stress (PTSD), but as it gains momentum in mental health circles, indications for its use are ever-expanding. The question for me is less about EMDR efficacy or benefit. The concern is the theory behind it and my general curiosity regarding its unique properties. There are aspects of the treatment that are altogether strange. Likewise, it contains components that are familiar to popular understanding of memory and a few things that tend to go overlooked or are forgotten.

Strange

EMDR was founded by Francine Shapiro in 1989. The legend is she was walking in a park and thinking about something distressing to her. She noticed that moving her eyes from tear duct and back to her periphery (i.e., side to side) lessened her distress. This was the early evolution of utilizing what is called bilateral stimulation. During the processing stage of EMDR therapy, the practitioner will use their fingers, tactile sensors, and/or auditory sounds that activate from left to right or vice versa. The theory is this process stimulates each hemisphere of the brain. The left hemisphere is primarily focused on language, linguistics, and narratives of our experience as opposed to the experiential aspect of the right hemisphere. In this manner, the person processing the traumatic memory integrates both the story and the felt experience. The bilateral stimulation is said to parallel how memory is consolidated during dream or REM (rapid eye movement) states when we sleep.

Fundamentally speaking, accelerated processing during EMDR splits the attention of the individual. During bilateral stimulation (i.e., finger movements, tones in the ear, or hand sensors), working memory is taxed because one must partially focus on the stimulation. This multitasking softens the emotional blow of recalling disturbing memories.

For those unfamiliar to the processing aspect of EMDR, practitioners are trained to sit close to the person in treatment. During this process, the therapist and person in therapy are cohabiting each other’s personal space, with one knee a couple of inches from the other’s. The direction is for the two people to be seated in an orientation “like two ships crossing in the night.” This unique approach to treatment creates an added level of intimacy and implicit vulnerability. It is strange and often overlooked when considering how the intervention benefits people in therapy. In a garden-variety individual therapy session, the two people are often sitting across the room from each other or at least several feet away.

Another oddity of EMDR is the historical context and initial hypothesis pertaining to trauma. In 1989, Shapiro questioned if trauma was essentially a disruption in the excitatory and inhibitory balance of the brain. This was two years after Prozac was introduced to the United States and a year before the Decade of the Brain. Mental health was beginning to be understood from a chemical or biological perspective. EMDR benefited from hitching the idiosyncratic trauma treatment to the biological wagon of mental health. EMDR’s individualized treatment would offer a correction to this brain imbalance akin to the overly simplistic solution for depression being a deficit of serotonin.

Familiar

Popular understanding of memory is that it is solely a brain function, with stored archives of our moments from the past organized in little synaptic shelves of neurons. This concept of memory as photographic snapshots stored in an album of existence is analogous to social and news media feeds displaying a history of ourselves across set positions on timelines. The click or swipe reveals the exact same image with no distortion. In Israel Rosenfield’s book The Strange, Familiar, and Forgotten: An Anatomy of Consciousness, he notes our false conception of memory based on Freudian ideas of the unconscious: “The problem is that we have tended to think of memories as unconscious items that one brings to consciousness, not as part of consciousness” (1992; p. 12). The false dichotomy of consciousness versus unconsciousness holds this misconception in place.

In Pixar’s animated film Inside Out, the main character’s memory process was portrayed in a similar manner. Her brain would produce marble-like spheres that rolled down a mechanical carousel to produce videos of previous experiences. The film portrays an exact reconstruction of past events as if these histories could be called upon via a brigade of emotional activity. This is not unlike the theory behind EMDR therapy. Disturbed memory channels in the limbic system are said to be clogging or inhibiting the individual from moving past the traumatic event. A subtle distinction is important to note: each time one thinks of a memory, they are essentially reconstructing or imagining what happened. This process creates tiny errors similar to the manner in which one copies a computer file. Over time, these little distortions add up and the factual elements of the memory are changed. The most salient and accurate memories are the ones we only rarely recall (like the original file before it is copied). The misconception of memory processes fits with Western culture’s ego-centric, fixed sense of self; “the conviction that memory is one thing is an illusion” (Eagleman, 2011; p.126).

The idea of having storage units or filing cabinets in the brain holding our past experiences aligns with current cultural frameworks (i.e., email, cloud technology, digital folders) and therapeutic modalities related to trauma and clogged memory channels (i.e., EMDR therapy). Rosenfield (1992) is explicit in drawing attention to this faulty neurology. When one remembers, they are referring to an event/object/person as they are represented based on one’s own subjective experience, “not mechanical reproduction” (p.42). Memory is less of a product of history or biological remnant, but a dynamic ability to integrate knowledge in a relational manner. The timestamp or notarizing of the event occurs within a conceptualization of who it is we think we are as a person.

Memory is rooted in our sense of time and part of the very structure of conscious knowledge. It is not an isolated phenomenon, but rather a manifestation of subjective states created by brain activities (Rosenfield, 1992). Therefore, failure of memory is not due to the loss of specific items “stored” somewhere in the brain, but rather a breakdown of the mechanisms of consciousness; “there are no memories without a sense of self.” As Rosenfield (1992) notes, “Without knowledge of one’s own being, one can have no recollections. How can I remember my parents, my house, if I am not sure I exist?” (p.41).

Forgotten

You need to remember EMDR therapy is an intervention that implies a Western understanding of the self or mind. It turns out the way highly educated, wealthy, democratic minds think is not representative of the entire globe. Most of us in the West do not think of ourselves as a body; we think we “have” a body. There is a notion we are the chariot drivers of our experience or, put another way, there is this little person inside our heads that has all types of likes and dislikes, proclivities, and things we retract from or avoid. This is an ego-centric perspective of the mind.

If you stop and pay attention to the present moment, one’s habitual patterns of cognition start to become clearer. The ego-dominating belief of our existence lying somewhere in the center of our skulls begins to be challenged. This is worth remembering.

By comparison, if you ask a Sri Lankan about themselves, they may describe their interpersonal relationships, family, and roles or responsibilities. This is a socio-centric version of the self with less of a demand on individuality. Watters (2010) articulates this distinction via several cultural specific examples in his book, Crazy Like Us: The Globalization of the American Psyche. He describes the 2004 Indian Ocean tsunami that killed around a quarter million people. Sri Lanka was one of the areas hit especially hard by this tragedy.

Western mental health practitioners rushed into these areas without knowledge of the culture. They did not know how to speak the language or have any awareness of local conceptualizations of trauma. This included benevolent EMDR therapists who assumed there would be an epidemic of PTSD. However, if you asked the Sri Lankans where their trauma resided, they generally did not point to their heads or speak of their minds being broken. For them, the damage was to the community and broken relationships. “Because Western conception of PTSD assumes the problem, the breakage, is primarily in the mind of the individual, it largely overlooks the most salient symptoms for a Sri Lankan, those that exist not in the psychological but in the social realm” (Watters, 2010; p.92).

The Westernized perspective is assumed to be a universal one. When one considers trauma, they must consider the time it happens and the cultural frame it occurs in. The consequence of an ignorant global construct for trauma is we remove the nuanced experience from other cultural narratives and beliefs that might give meaning to how the person suffers (Watters, 2010).

Self-Centered Awareness

David Foster Wallace (2005) hit on the margins of this notion—self-centered awareness—in his commencement address to Kenyon College titled This Is Water. He spoke about the choice of where we place our attention within conscious awareness (as opposed to relying on our “default setting” or autopilot) and how one can cultivate compassion within the banal aspects of daily life:

And the so-called real world will not discourage you from operating on your default settings, because the so-called real world of men and money and power hums merrily along in a pool of fear and anger and frustration and craving and worship of self. Our own present culture has harnessed these forces in ways that have yielded extraordinary wealth and comfort and personal freedom. The freedom to be lords of our tiny skull-sized kingdoms, alone at the center of all creation.

There is an ancient technology available to emancipate us from the constraints of these small, isolative worlds. To notice this ostensible imprisonment, all one need do is sit down in silence and observe where their mind goes. Who is producing this stimulation and is there a navigator of control? What happens when all you do is focus on the inhalation and exhalation of the breath?

Mindfulness and meditation practices will not cure individuals from the impacts of trauma or reoccurring disturbing memories. However, it is a prophylactic to inhibit self-centeredness or personalization of momentary experience (which tends to lead to the anxiety-provoking reoccurrences of mind).

When one has a thought, feeling, or sensation, it is often turned into a belief that becomes self-referential. A simple interaction with a partner or family member illuminates this silly human deficiency. If the person yawns during a conversation (the thought), this can lead to a belief (e.g., the person is bored) which is then internalized (i.e., “I am unlikable” or “unlovable.”). One falls down this self-deprecating rabbit hole all too quickly. The antidote is to just notice what is arising in terms of thoughts and beliefs before assuming a story about yourself.

If you stop and pay attention to the present moment, one’s habitual patterns of cognition start to become clearer. The ego-dominating belief of our existence lying somewhere in the center of our skulls begins to be challenged. This is worth remembering.

References:

1. Eagleman, D. (2011). Incognito: The secret lives of brains (1st American edition). New York: Pantheon Books.
2. Rosenfield, I. (1992). The strange, familiar, and forgotten: An anatomy of consciousness. New York: Knopf.
3. Shapiro, F. (2001). Eye movement desensitization and reprocessing: Basic principles, protocols, and procedures (2nd edition). New York: Guilford Press.
4. Wallace, D.F. (2005). This is water. Transcript retrieved from https://web.ics.purdue.edu/~drkelly/DFWKenyonAddress2005.pdf
5. Watters, E. (2010). Crazy like us: The globalization of the American psyche. New York: Free Press.