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This article is for those seeking therapy, perhaps parents looking for therapy for their children, as well as mental health clinicians seeking resources for clients.
Mental health therapy, or “talk therapy,” is a tool for addressing mental health diagnoses and other concerns. Sometimes clinicians find that needs aren't fully addressed in talk therapy. An individual may have sensory processing difficulties, deficits in social communication, or difficulty with activities of daily living (ADLs).
Alternatively, those seeking therapy for themselves or loved ones are often curious about the intervention or combination of interventions that might be most effective for their particular struggle.
We'll explore differences between various mental health interventions including mental health therapy, occupational therapy, applied behavioral analysis (ABA), and psychiatry. While the options for addressing mental health concerns extend beyond those outlined here, understanding a few basic modalities can help identify a helpful approach. These treatments can be used as standalone interventions or utilized together to provide multi-faceted care.
Talk Therapy
Talk therapy, also referred to as mental health counseling or simply "therapy", is the process of meeting for regularly scheduled sessions with a licensed or pre-licensed mental health professional, typically for 50-minutes, to address a variety of mental health concerns.
Talk therapy focuses on exploring and processing emotions, memories, and the impacts of past and present stressors and traumas. Relationships are also a common focus, with relationships meaning all those with a significant connection to the client- childhood, adulthood, living or deceased, and includes the relationship with oneself.
Talk therapy is used with individuals, couples, families and groups. Group therapy, also referred to as process groups, allows next level interaction in which individuals engage, connect, and process difficulties alongside and in response to each other.
Talk therapy is not exclusively for those with a diagnosed condition; many children, teens and adults from all backgrounds benefit from the experience of sitting with a trusted, qualified professional regardless of the reason.
Talk therapy can include skills work, for example stressor-specific coping skills, interpersonal skills, and emotion regulation techniques.
Occupational therapy
An occupational therapist (OT) might work within the mental health realm, or might work specifically with physical health. Occupational therapists work to ensure clients can meet daily needs and perform effectively in environments such as within school, work, leisure, and social settings. When an OT works with clients in a mental health context, clients often have mental health conditions causing functional impairment in these various environments, meaning they aren't able to operate within these settings to the extent that is ideal or that is preferable. At an OT clinic, individuals work with masters or doctorate-level occupational therapists as well as occupational therapy assistants.
In a mental health setting, the focus of OT may incorporate strengths-based approaches to decrease the extent of disruptions that symptoms create, and to improve quality of life and for the purpose of a greater sense of wellbeing. Activities of daily living (ADLs) are addressed that are present in a variety of mental health conditions, such as depression, ADHD, postpartum mood and anxiety disorders, and autism spectrum disorder.
An OT might also examine aspects of one's routine, assisting with building in supports for daily functioning and increased independence. An OT may be a good fit for someone struggling with emotion regulation or sensory processing by way of facilitating the development of coping skills for these specific difficulties.
Applied Behavioral Analysis
Applied behavioral analysis, or ABA therapy, was originally developed to treat children with autism. ABA is based on behaviorism, the branch of psychology that focuses on changing or reinforcing behavior with punishment or reward.
ABA does not utilize punishment to alter harmful behavior, rather it uses rewards to reinforce helpful behavior and discourage harmful behavior. Compared to occupational therapy and talk therapy, this type of therapy focuses less on emotions, emotion regulation and daily functioning, and more on systematic behavioral change.
In an ABA setting, individuals work with registered behavioral therapists (RBTs) who are closely supervised by board certified behavior analysts (BCBAs). Because the nature of ABA is systematic, interventions are standardized among practitioners.
While ABA is commonly utilized for autism spectrum disorder, it can be utilized for anyone who would benefit from decreasing harmful behaviors and identifying helpful behaviors. ABA uses evidenced-based methods to focus on increasing the use of less disruptive behaviors and optimizing functioning in a variety of settings, which might include learning social skills.
ABA often includes a parent coaching component to help enlist the family in reinforcing new behaviors in the home.
Psychiatry
One of the most commonly questions asked of mental health professionals goes something like this: "Is that the one that prescribes medication?"
Psychiatrists are the ones that prescribe medications, along with advanced practice nurse practitioners (APRNs), and a few others. A psychiatry appointment involves meeting with a professional who works to find a medication that may help decrease symptoms of mental health conditions. Myriad mental health conditions can be treated within the realm of psychiatry, and is commonly used an adjuctinve treatment to another approach or treatment modality, such as trauma-informed yoga, talk therapy, or a support group.
A psychiatrist holds an MD with a psychiatry residency and specialized training in the treatment and diagnosis of mental health conditions.
Primary care physicians (PCPs) can prescribe medications for mental health symptoms, however PCPs have varying levels of training and experience in mental health concerns. For some individuals, a primary care physician provides a wealth of support and reliable care for receiving medication. PCPs are often a resource for those struggling with depression and anxiety due to their familiarity with SSRIs (selective serotonin reuptake inhibitors), a common type of medication used to treat depressive disorders, which are also used commonly as treatments for anxiety.
References
American Occupational Therapy Association. (n.d.). Overview of occupational therapy in mental health. Retrieved from https://www.aota.org/-/media/corporate/federal/overview-of-ot-in-mental-health.pdf
Gasiewski, K., Weiss, M. J., Leaf, J. B., & Labowitz, J. (2021). Collaboration between Behavior Analysts and Occupational Therapists in Autism Service Provision: Bridging the Gap. Behavior analysis in practice, 14(4), 1209–1222. https://doi.org/10.1007/s40617-021-00619-y
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