Traditions and approaches in psychotherapy and counselling

Trainings, registers and referral directories all sort practitioners by tradition, and the names carry assumptions that are rarely spelled out. What follows is descriptive: what each approach holds, the lineage it belongs to, and what a session in it tends to look like. It is not a comparison, and nothing here says which approach suits which person, which is a clinical judgement made with a client rather than from a list.

Psychoanalytic and psychodynamic

The oldest lineage in the field, built on the premise that a good deal of mental life is outside awareness and shows itself in the relationship with the therapist rather than only in what is reported.

• Psychoanalysis

  The tradition that begins with Freud in Vienna in the 1890s and continues through the Kleinian, Independent and contemporary Freudian groups. Practised at high frequency, typically three to five sessions a week, often with the patient on the couch, and the analyst working with free association, dreams and transference. Training requires the trainee's own analysis at that same frequency, which is why it remains a long and expensive route.

• Psychoanalytic and psychodynamic psychotherapy

  The same body of thinking applied at once or twice weekly, face to face rather than on the couch, and usually with more attention to a focus agreed at the start. It is the form most often found in NHS psychological therapy services and in private practice, and it covers a wide span, from open-ended work to time-limited dynamic therapy of sixteen to twenty-four sessions.

• Analytical psychology, Jungian analysis

  The line that follows Jung rather than Freud, working with image, myth, dream series and the idea of individuation as a lifelong process. Practised at one to three sessions a week. In Britain it is trained through the Society of Analytical Psychology and related bodies, and registered with the British Psychoanalytic Council alongside the Freudian and Kleinian groups.

• Lacanian psychoanalysis

  A distinct international current, strongest in France, Spain, Argentina and Brazil, which reads Freud through structural linguistics and treats the unconscious as structured like a language. Notable in practice for the variable-length session and for a training model built on the analysand's own testimony rather than on hours accumulated.

Humanistic and person-centred

Approaches that came out of the 1940s to 1960s reaction against both analysis and behaviourism, taking the person's own experience and capacity for growth as the starting point.

• Person-centred therapy

  Carl Rogers's approach, built on the therapist offering empathy, congruence and unconditional positive regard, and on the belief that the client rather than the therapist directs the work. Practised weekly, without formal assessment instruments or homework, and it underpins a large share of counselling training in the UK.

• Gestalt therapy

  Developed by Fritz and Laura Perls and Paul Goodman in the 1950s. Attends to what is happening in the present moment, in the body and in the contact between client and therapist, and uses experiment, for example two-chair work, rather than interpretation. Trainings are typically four years and heavy on personal process work.

• Existential therapy

  Draws on phenomenology and existential philosophy, Heidegger, Sartre, Buber, and takes up the givens of living: mortality, freedom, isolation and meaning. There is no technique set as such; the work is a disciplined description of how a person is making sense of their situation. Strong in London, where it has its own training institutions and journal.

• Transactional analysis

  Eric Berne's model of ego states, parent, adult and child, and of the repeated patterns that run between people. Uses an explicit contract with the client and a shared vocabulary, which makes it common in organisational and educational settings as well as in clinical practice.

Cognitive and behavioural

A lineage that begins with learning theory and moves through Beck and Ellis to the newer contextual therapies, working with what a person does and how they relate to their own thinking.

• Cognitive behavioural therapy

  Structured, time-limited and problem-focused, usually twelve to twenty sessions with an agenda, measures taken each session and agreed tasks between sessions. Formulation is disorder-specific rather than general, so panic, social anxiety and obsessive compulsive disorder each have their own protocol. It is the modality most used in UK talking therapies services.

• Third wave, ACT, DBT, CFT and mindfulness-based approaches

  Later developments that shift the target from the content of thought to a person's relationship with it. Acceptance and commitment therapy works with values and psychological flexibility, dialectical behaviour therapy pairs individual sessions with a skills group and was developed for chronic suicidality, compassion focused therapy addresses shame and self-criticism. All keep the structure of the cognitive tradition.

Systemic, integrative and body-oriented

Approaches organised around the relationships a person lives in, around the deliberate combination of models, or around the body as the place where experience is held.

• Systemic and family therapy

  Treats the family or couple as the unit of the work rather than the individual, and looks at patterns of interaction, beliefs held in common and the wider context of culture and institutions. Often practised with a team behind a screen or in the room, and with reflecting conversations that the family listens in on.

• Integrative and pluralistic practice

  Trainings that combine models deliberately rather than by improvisation, most often relational, humanistic and cognitive elements held inside one coherent frame. Pluralistic practice, associated with Mick Cooper and John McLeod, goes further and makes the choice of method an explicit and repeated conversation with the client.

• Body psychotherapy and trauma-focused work

  Traditions descending from Reich, and newer trauma-oriented approaches such as sensorimotor psychotherapy and EMDR, which work with posture, breath, arousal and memory rather than with narrative alone. Practised inside a careful frame around consent and touch, and increasingly cross-referenced with the wider trauma literature.

• Arts therapies

  Art, music, drama and dance movement therapy, in which the medium itself carries the work. In the UK these are the only titles in this list held by a statutory regulator: art therapist, music therapist and dramatherapist are protected by the Health and Care Professions Council and require an approved postgraduate qualification.

Last checked 18 August 2026. External links are provided for reference; Vestibola is not affiliated with these organisations. If an entry is out of date or wrong, write to hello@vestibola.com and it will be corrected.