Which therapy suits you?

What is it?

Cognitive behavioural therapy (CBT) is a scientifically grounded treatment based on the close connection between thinking, feeling and doing. Unhelpful thought patterns can lead to emotional problems and to behaviour that keeps the symptoms going. With anxiety you might think 'this will go wrong', with low mood 'I don't matter'. CBT helps you recognise and break these patterns: not through positive thinking, but by examining your thoughts and testing them against reality.

How does it work?

CBT combines two tracks. In the cognitive part you examine which thoughts feed your symptoms and challenge unrealistic or limiting beliefs. In the behavioural part you practise new behaviour through concrete assignments that fit your daily life. Step by step, both how you think and what you do begin to change. On average 8 to 20 sessions are needed.

What is it?

EMDR (Eye Movement Desensitization and Reprocessing) is a proven therapy for people who keep suffering from the effects of a distressing experience, such as an accident, sexual violence or an act of aggression. The Dutch EMDR Association regards it as the first-choice treatment for post-traumatic stress disorder. An unprocessed memory keeps intruding: in nightmares, heightened alertness, concentration problems, avoidance or feelings of guilt and shame. EMDR helps your brain to finally process that memory, so that it loses its emotional charge.

How does it work?

You bring the distressing memory back to mind while doing a distracting task at the same time: you follow the therapist's hand with your eyes, or you hear a sound alternating left and right through headphones, sometimes with light taps on your hands. This dual task loads your working memory, leaving little room for the memory itself. As a result it fades, becomes less vivid and loses its power: afterwards it feels like an ordinary, unpleasant memory rather than something happening right now. How many sessions you need depends on the number and complexity of the traumas and is hard to predict in advance; you discuss this together with your therapist.

What is it?

ACT (Acceptance and Commitment Therapy) is a third-generation behavioural therapy. The goal is not to eliminate symptoms, but to become psychologically flexible: to deal smoothly with what goes on inside you while investing in what truly matters to you. You do not have to fight thoughts and feelings; you learn to relate to them differently and give them room.

How does it work?

ACT builds six skills that together form psychological flexibility: acceptance, defusion (stepping back from your thoughts), contact with the here and now, the observing self, gaining clarity about your values, and committed action towards a meaningful life. You practise this through conversations and experiential exercises, even when it is difficult.

What is it?

Anxiety keeps itself going through avoidance: whatever you steer clear of stays frightening. Your brain never gets the chance to discover that the situation is safer than it feels. Exposure means facing what you fear: guided by your therapist, you approach the situations you avoid, step by step. You are not thrown in at the deep end; you practise at a pace that suits you. Exposure is a core component of cognitive behavioural therapy and, according to the Dutch mental healthcare guideline, the first choice for anxiety and obsessive-compulsive disorders.

How does it work?

Together with your therapist you map out which situations you avoid and build a practice ladder, from easy to difficult. You practise in real life (in vivo), in your imagination (imaginal) or with physical sensations, and you stay in the situation until you notice the anxiety is bearable and subsides. For obsessive-compulsive symptoms, response prevention is added: seeking out the situation without performing the compulsion. Every successful exercise is a new learning experience for your brain. The number of sessions depends on the symptoms and is decided together with your therapist.

What is it?

Some patterns run deep. You may have known for years that you put yourself last, set impossibly high standards or keep ending up in the same kind of relationships, yet you cannot seem to change it. Schema therapy targets those persistent patterns, called schemas: sensitive spots that developed early in life because basic needs such as safety, connection or appreciation were not sufficiently met. The therapy is mainly intended for personality disorders and for recurrent or long-standing depression, and is particularly suitable when shorter treatments have not helped enough.

How does it work?

Together with your therapist you explore which schemas and emotional states (modes) steer your life and where they come from. Schema therapy combines cognitive and behavioural techniques with experiential exercises, such as imagery work and the multiple-chair technique, which give old experiences a different emotional charge. The relationship with your therapist is also part of the treatment: within it you practise trust, setting boundaries and taking your own needs seriously. Schema therapy is a longer treatment: according to the Dutch Schema Therapy Association at least 25 sessions are needed, usually weekly and often spread over one to several years.

What is it?

When emotions flare up at lightning speed and are hard to regulate, daily life can become a struggle: intense mood swings, impulsive decisions, conflicts, or harming yourself to release tension. Dialectical behaviour therapy (DBT), developed by Marsha Linehan, was designed specifically for these problems. Its core is dialectical: you learn to accept yourself and your feelings as they are right now, while at the same time working on change. The two do not exclude each other; they actually need each other.

How does it work?

DBT combines individual therapy with skills training, usually in a group. You train four skills: mindfulness, regulating emotions, getting through a crisis without causing harm, and dealing effectively with others. Between sessions you can often consult your therapist by phone when things get tense, so that you practise your new skills exactly when they matter most. A DBT programme usually lasts six months to a year, sometimes longer. Research shows that self-harm and suicide attempts decrease and that fewer people drop out of treatment early.

What is it?

How things go in your relationships largely determines how you feel. IPT explores the connection between your symptoms and what is happening in your relationships. That may be: grief after loss, conflicts, changes in your life, or the feeling of not belonging anywhere. By understanding this, you improve your mood from within.

How does it work?

IPT has a fixed structure of 12 to 16 sessions. You map out which relational themes are linked to your symptoms. Then you practise communication, setting boundaries and navigating change, step by step.

What is it?

EFT relationship therapy (Emotionally Focused Therapy) is an effective form of couples therapy centred on the emotions and communication between you and your partner. It was developed by Dr Sue Johnson. Behind many conflicts lies an attachment need: 'am I important to you?', 'will you be there when I need you?'. When that need is not understood, negative patterns arise in which you drift further apart.

How does it work?

EFT focuses on recognising and breaking that negative pattern. Emotions are given room, because they show what is really going on; this rebuilds understanding and trust. According to the EFT Netherlands Foundation, EFT has been researched scientifically several times, with a strong positive effect on connection and little relapse. EFT is for couples, but also for families and individuals.

What is it?

A mental health problem never stands alone: your relationships, family and environment always play a role, both in how it arises and in how you recover. Systemic therapy, also known as couple and family therapy, therefore involves important loved ones in the treatment: your partner, family members or others close to you. Together they form the system you live in. The aim is not to point out who is to blame, but to understand how you respond to each other and how that can keep symptoms going.

How does it work?

In the sessions you usually sit with your partner or family members together with the therapist. You map out what the mutual patterns look like: who reacts to what, and what happens next? Everyone's perspective is given room. You then practise responding to each other differently, breaking patterns that have become stuck. According to the NVRG, recovery is faster when loved ones are involved in the treatment, both in the short and in the long term. The duration varies and is agreed together with the therapist.

What is it?

Most mental health symptoms are maintained by automatic thought patterns: thoughts you have without realising you are having them. MBCT combines mindfulness exercises with cognitive therapy to make you aware of those patterns. Not to push them away, but to see them without being swept along by them.

How does it work?

MBCT is a structured 8-week programme. You practise daily with meditations, body scans and cognitive exercises. Not to become 'zen', but to develop a different relationship with your thoughts. Proven effective for anxiety, depression and chronic stress.

What is it?

Sleep problems are rarely caused by simply being unable to sleep. They are maintained by what you do and think around sleeping. You worry, go to bed earlier, sleep during the day, and in doing so you train your brain to be alert precisely when you want to sleep. CBT-I breaks that cycle.

How does it work?

CBT-I consists of four components: sleep restriction (temporarily narrowing your sleep window), stimulus control (linking your bed to sleeping rather than worrying), sleep hygiene (concrete behavioural adjustments), and cognitive restructuring (dealing with worrying thoughts). On average 6 to 8 sessions are needed.

What is it?

Grief is a normal response to loss, but sometimes the process gets stuck. When intense grief symptoms persist for more than 12 months and seriously affect daily life, we speak of complicated grief. Grief therapy helps you find a place for the loss, so that alongside the sorrow you also make room for life.

How does it work?

Grief therapy works from the dual process model: you practise both allowing the pain of the loss and taking steps towards a new life. Complicated Grief Treatment combines elements of exposure, CBT and interpersonal therapy in a structured programme of about 16 sessions.