Psychotherapy

Psychotherapy is a general term that refers to meeting with a licensed mental health professional to discuss thoughts, feelings, and life problems. Also called talk therapy, psychotherapy is one of the primary treatments for mental health disorders ^[1].

What is psychotherapy?

Psychotherapy, or talk therapy, is the primary treatment for mental health disorders. It usually involves meeting one-on-one with a mental health professional to discuss thoughts, feelings, and problematic behaviors. However, some treatment providers offer group psychotherapy as well ^[1].

The goal of psychotherapy is for a person to find relief from their symptoms. For example, if someone is experiencing significant distress within relationships, the goal of psychotherapy would be to reduce this distress. Similarly, if someone struggles with depression, the goal of psychotherapy would be to develop coping skills and reduce the negative impact of depression in daily life ^[1].

There are several specific types of psychotherapy, but what they all have in common is they involve sitting down with a mental health professional to set goals related to improving mental health or psychosocial functioning. The process of psychotherapy usually begins with a referral, perhaps from a doctor who is concerned a patient has a condition like anxiety or depression. Alternatively, someone who is struggling with their mental health may reach out to a therapist seeking support ^[1].

Psychotherapy is a common form of treatment for mental and emotional health problems. However, it is not the only form of treatment. Medication is another common treatment for mental health disorders. Sometimes, people find they get the best relief from taking medications and also participating in psychotherapy ^[1].

Types of Psychotherapy

Psychotherapy is a general term referring to talk therapy, but there are multiple different kinds of psychotherapy. Some of the most common types of psychotherapy are detailed below. Keep in mind that these are not the only forms of psychological counseling, but they are some of the most common modalities.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) is a popular modality, used to treat a variety of mental and emotional health problems. CBT focuses on changing distorted or negative patterns of thinking, in order to improve emotions and behaviors ^[2]. For example, a person who lives with symptoms of anxiety may be able to change distorted thoughts, such as the belief that the world is dangerous, by undergoing CBT.

Dialectical Behavior Therapy

Like CBT, dialectical behavior therapy (DBT) promotes behavioral change, but it emphasizes a balance of acceptance and change. DBT therapists communicate radical acceptance of clients, and they help clients to accept their own negative thoughts and emotions. However, the aim of DBT is to change unhelpful behaviors and instead learn healthy stress management and emotion regulation skills ^[2][3].

Psychodynamic Therapy

Psychodynamic therapy is an insight-oriented therapy that helps clients to identify how unconscious motivations and desires are shaping their current behavior. Psychodynamic therapists use strategies like dream analysis and free association to identify subconscious thoughts. Free association involves speaking about whatever comes to mind, which can bring unconscious thoughts to light ^[4].

Interpersonal Therapy

As its name might suggest, interpersonal psychotherapy operates under the assumption that interpersonal or social problems lead to psychiatric distress. In line with this assumption, interpersonal therapy seeks to improve social functioning in order to alleviate symptoms of conditions like depression. It focuses on four key areas of social functioning: grief, role transitions, disputes, and distress ^[5].

Humanistic Therapy

Humanistic therapy plays a major role within the history of psychotherapy. This therapeutic practice focuses on basic principles, such as the belief that connection and support from a therapist play a foundational role in healing. Humanistic therapy models also assume that expressing emotions can pave the way for change ^[6]. Humanistic therapists believe that people have the capacity to make the best choices for themselves, and providing a safe therapeutic setting is the impetus that allows people to make positive changes in their lives ^[7].

How does psychotherapy work?

The specific activities of psychotherapy can vary based on the treatment modality. For instance, psychodynamic therapy may look different from humanistic therapy. However, there is a general process that psychotherapy tends to follow. First, your therapist will conduct an assessment with you to determine what has brought you to therapy, and what you’d like to get out of your time together. As the therapist assesses your needs, he or she will take the time to build a trusting therapeutic relationship with you, so that you feel comfortable sharing with him or her during sessions ^[8].

Once you’ve built a therapeutic relationship, your therapist will work with you to decide the goals of treatment. Your relationship will be collaborative, with you and your therapist working together as partners to establish goals. You and your therapist will come to an agreement about the length of therapy; some people may find that symptoms improve with short-term treatment, lasting just a few months, whereas other people may decide in collaboration with their therapist that treatment should be longer-lasting ^[8].

Depending on your needs, therapy can be individual, involving one-on-one meetings with you and your therapist, or you may participate in sessions with other people. Some therapists may meet with families, or they might conduct therapy in a group setting. In many cases, therapy tends to occur once weekly for about 45 to 50 minutes at a time ^[8].

What conditions can psychotherapy treat?

Psychological therapy can treat a range of different problems. Some people may participate in therapy to treat a specific mental health condition, like depression, whereas others may seek therapy to help them cope with life stressors. Some examples of conditions therapy can treat include ^[8]:

• Depression
• Anxiety
• Trauma-related disorders
• Grief arising from the loss of a loved one
• Substance use disorders
• Personality disorders
• Life stressors, like the loss of a job
• Eating disorders
• Relationship problems

The list above is not exhaustive, but it provides a general overview of the uses of psychological counseling.

What to expect in psychotherapy

The specifics of psychotherapy can vary, based on the modality used and a client’s unique needs. However, psychotherapy tends to unfold in several stages. Understanding these stages is helpful, so you know what to expect.

First, psychotherapy will begin with the development of a strong therapeutic alliance. This alliance is the foundation for the working relationship between client and therapist. When you attend your initial psychotherapy session, your therapist will work with you to establish a strong alliance, based on collaboration and trust ^[9][10]. During this stage, they will explain to you the process of therapy, including the fact that what is shared in therapy remains confidential, except in special circumstances, such as when one’s safety is in danger ^[8].

After establishing a therapeutic alliance, you and your therapist will work together to assess the problem that has brought you to therapy. Then, you will move toward setting goals together, while maintaining a strong working relationship with your therapist. Next, you’ll select specific interventions you’ll use during sessions to work toward your treatment goals. As you progress through psychological therapy, you and your therapist will evaluate your progress and modify goals and interventions as needed ^[10].

The therapeutic work noted above will be carried out during regular sessions. After you’ve established your treatment goals, you will collaborate with your therapist during sessions to work toward your goals and discuss your progress. For many people, sessions occur once weekly for 45-50 minutes. These sessions can last weeks, months, or even years, depending on your specific needs ^[8].

How effective is psychotherapy?

Now that you’ve learned about the therapeutic process, you’re probably wondering, “Does psychotherapy work?” Fortunately, researchers have conducted several studies related to the benefits of psychotherapy to answer this question. While the effectiveness of therapy can vary, based on the specific intervention used and the problem that has led someone to seek treatment, the findings of research provide general information about the effectiveness of therapy.

In general, research suggests that psychotherapy is beneficial, as it produces positive changes in people’s lives. Research has also found that the therapeutic alliance between client and therapist is associated with positive change, and it is one of the most important factors in facilitating change ^[9]. So, it is not necessarily the specific therapy method that benefits clients, but rather the working relationship they have with their therapist that predicts positive change. It’s also important to understand that there is a biological basis of psychotherapy, meaning that the learning that occurs in therapy can change brain connections, which in turn changes behavior ^[11].

While the relationship between therapist and client is paramount, researchers have also studied the effects of specific treatment modalities. For example, researchers have found that both cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) are beneficial for treating depression and anxiety; however, DBT seems to be more beneficial than CBT for improving executive functioning skills like planning and organization ^[2].

Psychologists have also conducted studies to evaluate the benefits of psychodynamic therapy, and results have been promising. A review of the research with this modality has found that it is equally effective when compared to other established treatments, including CBT. It may be slightly superior to other modalities for improving overall psychosocial functioning ^[12].

Finally, psychology experts have researched the benefits of interpersonal psychotherapy, also arriving at promising findings. While results can vary based on the individual client, interpersonal psychotherapy has been found to be equally effective to CBT for treating depression ^[13].

Based on the body of research with psychological therapy, there is evidence that it’s effective. That being said, psychotherapy isn’t perfect, and not everyone experiences lasting benefits ^[12]. Sometimes, people may need additional treatments, such as medication, to find lasting relief from mental health symptoms ^[1].

Is psychotherapy right for you?

Deciding if therapy is for you is a significant life choice. If you have been struggling with a mental health problem like depression, or you are having a difficult time dealing with stress, therapy may be a good fit. A therapist can help you develop coping skills, learn healthy ways to communicate, and better understand the connection between emotions and behaviors. Therapy sessions are also safe settings for overcoming the symptoms of specific conditions like anxiety ^[1]. If you’re having a difficult time with emotions or behaviors, therapy can help.

How to Choose the Right Psychotherapist

When you’re ready to seek psychological therapy, it’s important to choose a professional who is a good fit. First, this person should be licensed to practice therapy. This means they’ll be licensed as a psychologist, professional counselor, psychiatric nurse, or clinical social worker. You can find such a person by contacting a local mental health center or private practice therapy clinic ^[1].

Finally, it’s essential to select a therapist who makes you feel comfortable. Since the therapeutic relationship is the most critical component of treatment, you should feel that you can trust your therapist. Before committing to therapy, make a few phone calls to connect with available therapists. Have a discussion with them about their usual methods and approach to treatment. If you feel you have a connection with a particular professional, and you can easily build rapport with them, it’s likely a good fit ^[1].