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Section 27
Bibliography & Selected Readings

Answer Booklet | Table of Contents | Printable Page

Psychodynamic Psychotherapy vs CBT

If you’ve been following my blog then you should have a working understanding of what CBT is. (If not, check out this article before reading further.) I introduced you to CBT and discussed how it can help your clients better their lives and achieve their personal goals, but how does it stack up against other therapy techniques? Today I’m going to compare psychodynamic psychotherapy, which is based on psychoanalytic theory, and CBT, which is based on the cognitive and behavioral fields.

Psychodynamic Psychotherapy
We’re going to start by examining each form of therapy individually before comparing the two
As you know, Psychodynamic  psychotherapy, like CBT, has been proven to work through research. It makes use of the psychoanalytical theory of Sigmund Freud and uses free association and the understanding of transference and counter-transference to help clients recognize why they’re having psychological issues and lead them down a cathartic path where they can then improve their status after realizing the root of their problem.

This therapy method tends to work well because it focuses on getting to root of the client’s problems and allows for a free range of corrections that account for the various idiosyncrasies you may notice during your sessions.

The challenge with psychodynamic  psychotherapy – especially in today’s fast-paced society – is that it takes quite a while and is rather costly in order to be truly effective. Getting sensitive, helpful information from clients by getting them to talk about their childhood can be like pulling teeth. It’s also hard to test the therapy empirically since results are intrinsic to each particular individual, which makes its effectiveness a hotly debated topic.

CBT (Cognitive Behavioral Therapy)
CBT is seemingly the opposite of psychodynamic  psychotherapy.  It is goal-oriented, has a set time frame, and tends to be more structured – all pros in its corner. It also has a bit more scientific support and is much more cost effective than the former therapy type, which are big pluses in today’s economy.
CBT isn’t all roses and unicorns though. It can miss issues that are brought to light in more in-depth therapies like psychotherapy, which can greatly limited the overall effectiveness of CBT if those issues are left unaddressed. It tends not to be as effective for people with complex mental disorders or learning disabilities – limiting the population range CBT can benefit and causing you to have to turn away more clients if you choose to use only CBT.

The Final Comparison
CBT simply works better in today’s insurance reimbursement driven world. People are more skeptical of the psychodynamic approach than ever before and many simply aren’t willing to spend the money required to see real results from psychodynamic psychotherapy. You may it best to start with CBT, especially if there’s a specific issue the client wants addressed, and then ease into psychodynamic psychotherapy once the client has become acclimated with you and a working relationship and trust has been established.

An Example of  CBT used with Anxiety

CBT works by helping your client change the way he or she looks at life and their surroundings in order to help them achieve the goals they set.

CBT makes use of two schools of psychological thought: cognitive and behavioral psychology. As you know, cognitive psychology focuses on the study of mental processes such as thought, attention and memory. Behavioral psychology focuses on understanding how people interact within their environment. The two are used together within CBT to help clients with psychological disorders change both the way they think and the way they behave.

CBT is typically used to treat anxiety disorders in adults.  It can use proven techniques of desensitization to gradually introduce people to their fearful stimuli and teach them why they don’t need to afraid, or at least as afraid, of the subject of their phobias.

For instance, let’s say your client has arachnophobia, a fear of spiders.  As you may know, the theories behind CBT contend that you’ve been taught to be afraid of spiders (not in the literal sense but that could be the case too) and that slow exposure to your fear will help undo the fearful response.

Depending on just how afraid of spiders you are, you’d start at the lowest comfort level of CBT you can. In the above example, and perhaps you have tried this intervention, the client  would need to be introduced simply to the idea of spiders – being able to talk about them – before they could move on to seeing images, live specimens and possibly even letting one crawl along their arm!

As you know, CBT has been used effectively to treat a wide variety of disorders, such as schizophrenia, major depressive disorder, psychosis, and bipolar disorder.

Do you agree that CBT works by helping your client change the way he or she looks at life and their surroundings in order to help them achieve the goals they set?

If you would like additional information on this topic,
below are OPTIONAL books to consider buying for your personal library...

- Andrea, Helene;Ute Bültmann; Ludovic G. P. M. Van Amelsvoort; Ymert Kant, The incidence of anxiety and depression among employees—the role of psychosocial work characteristic, Depression & Aniety, Nov2009, Vol. 26, Issue 11, p 1040

- Bourgault-Fagnou, Michelle D. & Heather D. Hadjistavropoulos, Understanding health anxiety among community dwelling seniors with varying degrees of frailty, Aging & Mental Health, March2009, Vol 13, Issue 2, p 226

- Harvard Mental Health Letter, Jan2003.

- Harvard Mental Health Letter, Jan2007.

- Kennedy, Barbara L., Schwab, John J., Southern Medical Journal, Dec2002.

- Knapen J, Disability And Rehabilitation, 2003.

- Lesure-Lester, G. Evelyn, College Student Journal, Jun2001.

- Lundkvist-Houndoumadi, Irene; Thastum, Mikael. A "Cool Kids" Cognitive-Behavioral Therapy Group for Youth with Anxiety Disorders: Part 1, The Case of Erik. PCSP: Pragmatic Case Studies in Psychotherapy. 2013, Vol. 9 Issue 2, p122-178. 57p.

-Manassis, Katharina, Canadian Journal of Psychiatry, Oct2000

- Mogoase, Cristina; Podina, Ioana R.; Sucala, Mădălina; Dobrean, Anca. Evaluating the Unique Contribution of Irrational Beliefs and Negative Bias Interpretations in Predicting Child Anxiety. Implications for Cognitive Bias Modifications Interventions. Journal of Cognitive & Behavioral Psychotherapies. Nov2013, Vol. 13 Issue 2a, p465-475. 11p.

- Nakamura, Brad J.; Sarah L. Pestle; Bruce F. Chorpita, Differential Sequencing of Cognitive-Behavioral Techniques for Reducing Child and Adolescent Anxiety, Journal of Cognitive Psychotherapy, Vol. 23, Issue 2, p 114

- Owens, K. M. B., Hadjistavropoulos, T., Asmundson, G. J. G., Aging & Mental Health, Nov2000.

- Pereira, Ana; Barros, Luisa; Mendonça, Denisa; Muris, Peter. The Relationships Among Parental Anxiety, Parenting, and Children's Anxiety: The Mediating Effects of Children's Cognitive Vulnerabilities. Journal of Child & Family Studies. Feb2014, Vol. 23 Issue 2, p399-409. 11p. 1 Diagram, 3 Charts. DOI: 10.1007/s10826-013-9767-5

- Peter, Helmut, Hand, Iver, Hohagen, Fritz, Koenig, Anne, Mindermann, Olaf, Oeder, Frank, Wittich, Markus, Canadian Journal of Psychiatry, Aug2002.

- Santucci, Lauren; Ehrenreich-May, Jill. A Randomized Controlled Trial of the Child Anxiety Multi-Day Program (CAMP) for Separation Anxiety Disorder. Child Psychiatry & Human Development. Jun2013, Vol. 44 Issue 3, p439-451. 13p. DOI: 10.1007/s10578-012-0338-6.

- Schaffer, Ayal, Levitt, Anthony J, Bagby, R Michael, Kennedy, Sidney H, Levitan, Robert D, Joffe, Russell T, Canadian Journal of Psychiatry, 07067437, Nov2000.

- Scott EL, Depression And Anxiety, 2002.
- Singareddy R, Moin, Ali, Spurlock, Lisa, Merritt-Davis, Orlena, Uhde, Thomas W. Depression And Anxiety, 2003.

- Stallard, Paul; Taylor, Gordon; Anderson, Rob; Daniels, Harry; Simpson, Neil; Phillips, Rhiannon; Skryabina, Elena. The prevention of anxiety in children through school-based interventions: study protocol for a 24-month follow-up of the PACES project. Trials. 2014, Vol. 15 Issue 1, p1-6. 6p. DOI: 10.1186/1745-6215-15-77.

- Steinan, Mette Kvisten; Krane-Gartiser, Karoline; Langsrud, Knut; Sand, Trond; Kallestad, Håvard; Morken, Gunnar. Cognitive behavioral therapy for insomnia in euthymic bipolar disorder: study protocol for a randomized controlled trial. Trials. 2014, Vol. 15 Issue 1, p1-15. 15p. 1 Diagram, 1 Chart. DOI: 10.1186/1745-6215-15-24.

- Stikkelbroek, Yvonne; Bodden, Denise H. M.; Deković, Maja; van Baar, Anneloes L. Effectiveness and cost effectiveness of cognitive behavioral therapy (CBT) in clinically depressed adolescents: individual CBT versus treatment as usual (TAU). BMC Psychiatry. 2013, Vol. 13 Issue 1, p1-20. 20p. 2 Diagrams, 1 Chart. DOI: 10.1186/1471-244X-13-314

- VanBuskirk, Katherine; Roesch, Scott; Afari, Niloofar; Wetherell, Julie Loebach. Physical Activity of Patients With Chronic Pain Receiving Acceptance and Commitment Therapy or Cognitive Behavioural Therapy. Behaviour Change. Jun2014, Vol. 31 Issue 2, p131-143. 13p. DOI: 10.1017/bec.2014.6.

- Wigham, Sarah; McConachie, Helen. Systematic Review of the Properties of Tools Used to Measure Outcomes in Anxiety Intervention Studies for Children with Autism Spectrum Disorders. PLoS ONE. Jan2014, Vol. 9 Issue 1, p1-17. 17p. DOI: 10.1371/journal.pone.0085268.

- Yongmei Hou; Peicheng Hu; Yongmei Zhang; Qiaoyun Lu; Dandan Wang; Ling Yin; Yaoqi Chen; Xiaobo Zou. Cognitive behavioral therapy in combination with systemic family therapy improves mild to moderate postpartum depression. Revista Brasileira de Psiquiatria. Jan-Mar2014, Vol. 36 Issue 1, p47-52. 6p. DOI: 10.1590/1516-4446-2013-1170.

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The article above contains foundational information. Articles below contain optional updates.
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