Person walking on tree-lined path stretches arms and smilesCoherence therapy, an approach to mental health treatment based on depth psychology, recognizes that both the unconscious and conscious minds play a part in emotional and psychological health. This experiential treatment is grounded in principles of constructivism and neurobiology and offers an empathic, non-pathologizing approach that might be used to address any number of concerns.

People seeking help often find this brief therapy to be beneficial, as it may only takes a few sessions before they are able to reach the root of their belief system and uncover and explore the reasons underlying their symptoms and/or the challenges that have brought them to therapy.  

History and Development

After years of examining the complexities of therapeutic shifts in an attempt to understand why some people in treatment experienced lasting change and others did not, Bruce Ecker and Laurel Hulley, the co-developers of this approach, were able to identify a distinct sequence of experiences they believed were necessary before this type of profound shift—the kind of change where a potent emotional theme completely disappears—could take place in therapy. They discovered that certain patterns were typical in breakthrough experiences, regardless of a person's condition, and began working to establish a focused modality specifically designed to set these processes in motion.  

Recent advancements in neuroscience supporting the mind's ability to undo emotional memory patterns lend support to their findings: long-term neurobiological changes can result when a profound emotional shift occurs. The results of their analysis informed the development of coherence therapy (which was known as depth-oriented brief therapy until 2005, when the name was changed to better reflect the guiding principles of the therapeutic framework) and its application to various psychological conditions. 

How Does Coherence Therapy Work?

Practitioners of this approach utilize a group of techniques and strategies that allow them to help individuals in treatment dynamically alter beliefs relating to a particular symptom or issue. This method is believed to be effective at creating long-lasting transformation at the core of the problem, in a focused and expedited way. 

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When people first enter therapy, therapists begin working with them by encouraging them to use their own resources to seek out and dispel those emotional truths, typically formed in childhood, contributing to present-day symptoms. One part of the process is helping individuals identify which symptoms are necessary, or serve a critical function, and which ones are not necessary and may be unhelpful. Some of these symptoms may be the effect of another coherent response, as many symptoms are believed to be "created" by an individual’s unconscious for purposes of self-preservation or self-realization. This is in keeping with the theory of constructivism, which theorizes that behavior and experience are shaped in part by the self. Both types of symptoms, functionless and functional, are recognized as coherent relative to an individual's psychological structure. Proponents of this approach suggest these symptoms are "solving" the problem of a person's distress, or emotional truths, and when the truths are uncovered and the symptoms recognized as a form of protection, the symptoms will fade as healing begins occur.  

The therapist's empathic connection and attunement with the person in treatment is critical to the therapy's success. With the support of the therapist, people in treatment can often experience a profound shift in fewer sessions than they might through traditional psychotherapy, which may continue for months or even years before a similar breakthrough is achieved.  This approach is intended to help a person achieve results by examining their concerns, or symptoms, and the potential causes or roots of them. As such, it is not designed to treat any specific issue and can therefore be beneficial in the treatment of any number of mental health and emotional concerns. 

Depth therapies are considered by many to be the only way to achieve results swiftly in the field of mental health care. Most practitioners who strive to complete therapy rapidly avoid addressing a person's deeper, unconscious beliefs and perceived realities. Proponents of coherence therapy believe, however, it is through this precise technique that this modality is able to elicit such powerful and permanent results in so few sessions.

How Can Coherence Therapy Help? 

Coherence therapy can be used in treatment with individuals, couples, and families. It has been used as a complement to the Internal Family Systems model, and some therapists have found it particularly effective when used in therapy with adolescents and teenagers, as the approach emphasizes the importance of allowing changes to be made when the individual is ready to make them. 

This approach is intended to help a person achieve results by examining their concerns, or symptoms, and the potential causes or roots of them. As such, it is not designed to treat any specific issue and can therefore be beneficial in the treatment of any number of mental health and emotional concerns. The developers have compiled case studies discussing the approach's use in the treatment of depression, panic, anxiety. underachievement, and couples counseling, but it may also be quite effective in the treatment of many other presenting issues. 

Because individuals may see results after just a few sessions, this modality may be a good approach for individuals who do not wish to pursue a lengthy course of therapy. Research suggests many people can quickly achieve real and lasting change in belief perceptions and the implications these perceptions have on their emotional state.

Limitations of Coherence Therapy

Research supports many of the principles underlying coherence therapy, and the results of a randomized controlled trial were favorable—though due to the small size of the study, further studies may be indicated. There are few criticisms of coherence therapy as a tool for supporting change in people with a range of psychological concerns. However, the success of this form of therapy does rely heavily on the empathic attunement and skill of the therapist, and individuals considering this form of therapy are advised to carefully consider the therapist's level of training and experience in this approach. The approach is considered most effective when breakthroughs are further experienced as change in everyday life, and skilled therapists can help those they are treating to establish effective methods of doing so. 


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