Ask a Psychologist: Do I need “talk therapy” or skills coaching?

When someone is interested in therapy, one of the common questions we receive is whether they would benefit from “talk therapy” or therapy that focuses on skills development and training.  To start, there are often misunderstanding about what talk therapy is. “Talk therapy” doesn’t just mean non-directed or non-targeted conversations. Talking and expressing our emotions and thoughts is one of the fundamental elements of effective therapy. In general, all psychological therapy is “talk therapy”, as we use talking and words to convey ideas, express ourselves, make sense of our (emotional) experience etc. We also learn about our internal world and develop insight into how and why we respond the way that we do. Talking and expressing ourselves also helps us to communicate, and thus facilitate feedback from the psychologist in relation to our experience. It also helps to model healthy interpersonal relationships. 

Through communication and talking, we also gradually identify unhelpful patterns of emotional and behavioural responses, and interpersonal relationships. Some people may find that their emotions are very intense and challenging to manage, while others may find establishing healthy friendship difficult and falling into a self-sacrificing mode regularly. Often, our unhelpful patterns intertwine and perpetual each other. Identifying these patterns and styles are crucial, as it helps us to discuss what helpful and healthy patterns look like, and identifying ways to achieve them. It is natural that some people find this straightforward, while others may need to obtain some new skills for change to occur. 

This is when skills training comes into practice. Skills training may seem didactic initially, with skills targeting specific problems. However, as our emotions are usually one of the barriers of skill acquisition and application, we may spend quite some time tackling this barrier and work on emotional regulation and managing our thoughts, for change to happen. The skills may seem simplistic, although application can be challenging. The followings are examples of therapeutic frameworks where we draw psychological skills from:

• Cognitive Behavioural Therapy (CBT)

  CBT focuses on changing our emotions, thoughts and behaviours. We first work on identifying our problematic or unhelpful thinking or behaviours. By challenging and changing these, we aim to change our emotions.

• Acceptance and Commitment Therapy (ACT)

  ACT works on both accepting and distancing from our experience (emotions and thoughts), in order to act on our values and goals that are meaningful to us. Its initial goal is not to change these experiences or primary symptoms. Rather, to develop skills to make room for and manage them, so that they are no longer a barrier for us to act effectively or in accordance with our values. 

• Dialectical Behaviour Therapy (DBT)

  There are multiple skills modules in DBT, namely Mindfulness, Interpersonal Effectiveness, Distress Tolerance and Emotional Regulation. All these modules contain relevant and helpful skills accordingly. As there are many skills available in DBT, your psychologist would usually select the most relevant and applicable skills for you, depending on your needs. 

• Solution-focused therapy (SFT)

  As the name suggests, SFT is a short-term therapy that focuses on identifying the problems and thus the solutions to the same. It is targeted and usually applicable to the presenting problems.

• Mindfulness    

  Mindfulness is central to many psychological skills, including those above. Mindfulness is about being able to observe and notice our present moment. It helps us to make room for and sit with our internal and external experience, without judgement and urge to eliminate the same. 

Overall, talk therapy and skills coaching come hand in hand, and realistically interrelated. It is believed that therapy is most effective when we keep both in mind with openness and willingness.

If you want to learn a bit more about what may be suitable for you, and what the first step looks like, feel free to contact our Client Support Team to discuss further.