Psychotherapy: everything you need to know

There’s always a lot going on in the world. Add in those common personal problems that everyone faces from time to time, and it’s easy to see how you could start to feel stressed out and overwhelmed. In some cases, those feelings can build into a more serious mental health condition, such as depression or anxiety. 

Whether or not you have a diagnosable mental health condition, sometimes it helps to have an objective person to talk to about what’s going on and how you’re feeling. One way to find someone to listen and help you sort out your thoughts and feelings is by trying out psychotherapy.

Here’s everything you need to know about psychotherapy, some common types, and what conditions it can help treat.

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Psychotherapy is an umbrella term for a type of treatment. You meet with a mental health clinician to identify and change bothersome or harmful thoughts, feelings, or behaviors. You might also hear it called talk therapy, behavioral therapy, or even just therapy (U.S. Department of Health and Human Services, 2016).

There are many different forms of psychotherapy. In the 1990s, there was a push to begin using evidence-based practices in medicine, which also extended to mental health therapies. Your therapist can help you choose the therapy style that will work best for you based on scientific research, your characteristics, and your personal preferences (Cook, 2017).

No matter what type of therapy you choose to engage in, the results you get will be affected by (Cook, 2017):

• Your history and life stage

• Your current personal problems

• Your strengths

• Your personality

• How ready you are to change or engage in psychotherapy

• How much social support you have

• Your family background, cultural factors, and environment

Psychotherapy works differently depending on which type you choose. No matter what approach you take, though, the most important part is building a solid and healthy rapport with your therapist. That rapport is essential for creating a therapeutic relationship or therapeutic alliance (U.S. Department of Health and Human Services, 2016).

This therapeutic alliance allows the therapist and the client to build trust and work together to create changes in the client’s life. Psychotherapists can encourage a therapeutic relationship by (Cook, 2017):

• Using empathy

• Asking for feedback

• Being clear about the goals of therapy

• Treating the person in therapy with positive regard

• Encouraging collaboration 

An American Psychological Association task force concluded that: “The therapy relationship accounts for why clients improve (or fail to improve) at least as much as the particular treatment method” (Norcross, 2014).

It’s estimated that there are over 50 different types of psychotherapy—that’s a lot to choose from! The approach that a mental health professional will decide to use depends on their training and experience, but also the symptoms you want to improve. Often, your therapist will combine elements of several different approaches to create a unique treatment plan for your needs (U.S. Department of Health and Human Services, 2016).

Don’t worry. We won’t go through all 50 types of psychotherapy, but here are a few of the most common types you might encounter.

Interpersonal therapy

Interpersonal therapy is a type of short-term psychotherapy (usually 12 to 16 weeks). During this time, the therapist helps you identify a target mental health issue to work on and how it’s impacting your interpersonal interactions. The therapist then uses specific strategies to focus on the identified problem areas (Markowitz, 2004).

Research shows interpersonal therapy is effective for treating (Markowitz, 2004):

• Major depression

• Social phobia

• Post-traumatic stress disorder (PTSD)

• Anxiety

• Eating disorders

This type of therapy does not seem to be helpful for substance abuse disorders. Further studies are underway to determine how beneficial it can be for other conditions such as borderline personality disorder, primary insomnia, and body dysmorphic disorder (Markowitz, 2004).

Cognitive-behavioral therapy (CBT)

CBT is a form of psychotherapy based on identifying the relationships between a person’s thoughts, feelings, and behaviors. The therapist helps you identify automatic thoughts, cognitive distortions (inaccurate and often harmful ways of thinking), and underlying beliefs about a situation. You will then work together to replace the thoughts and ideas that aren’t serving you with more helpful ones (Chand, 2021). 

Cognitive-behavioral therapy has been researched extensively and shown to be an effective component of treatment for (Chand, 2021):

• Depression

• Anxiety disorders

• Eating disorders

• Substance abuse

• Personality disorders

• Bipolar disorder

• Schizophrenia

It can also help treat non-psychiatric disorders, such as irritable bowel syndrome, chronic fatigue syndrome, insomnia, migraines, and chronic pain conditions (Chand, 2021).

Dialectical-behavioral therapy (DBT)

DBT was initially developed to be a comprehensive, evidence-based treatment for borderline personality disorder. It shares many similarities with cognitive-behavioral therapy. DBT focuses on interventions that help you to accept yourself, your emotions, thoughts, the world, and others as they are (Chapman, 2006).

A DBT treatment program is more time-intensive than some other forms of psychotherapy. It typically consists of weekly individual therapy sessions, a weekly group skills training session, and a therapist consultation team meeting  (Chapman, 2006).

Dialectical behavioral therapy has been well-studied and found effective for treating (Chapman, 2006):

• Borderline personality disorder

• Self-harm behaviors in women

• Substance use disorder

• Binge-eating disorder

• Depression in elderly people

Eye movement desensitization and reprocessing (EMDR) 

EMDR is an innovative and evidence-based treatment that is effective for PTSD. It involves combining some other therapy styles with back and forth eye movements to desensitize traumatic memories and reduce anxiety levels in participants (Landin-Romero, 2018).

Despite its successful outcomes in clinical trials, EMDR remains slightly controversial since researchers don't fully understand precisely how it works (Landin-Romero, 2018).

Besides PTSD, EMDR has been studied and found to possibly help in treating other mental disorders such as (Landin-Romero, 2018):

• Bipolar disorder

• Psychosis 

• Unipolar depression 

• Dental phobia 

• Obsessive-compulsive disorder

• Panic disorder 

• Alcohol dependency

• Pain management 

There are a wide variety of conditions and symptoms that psychotherapy can help you with. Most healthcare providers recommend talk therapy along with medication as the first-line treatment for mental health conditions such as (U.S. Department of Health and Human Services, 2016):

• Depression

• Bipolar disorder

• Anxiety

• PTSD

You don’t have to have a mental illness to benefit from talking with a therapist, though. Psychotherapy can help you manage the thoughts and emotions associated with a range of situations that could be causing you stress. These might include (U.S. Department of Health and Human Services, 2016):

• Job stress

• Family stress

• Loss of a loved one

• Relationship issues

• Self-defeating behaviors

• Low self-esteem

• Interpersonal conflicts

• Coping with medical illnesses

If you think psychotherapy might be helpful for you, reach out to your healthcare provider. They can refer you to local psychotherapists or other mental health counselors. You may also want to contact your health insurance company to see who is covered by your plan. 

You can also contact the Substance Abuse and Mental Health Services Administration’s national helpline. This helpline is a free and confidential treatment referral and information service for anyone facing mental health or substance use issues. The helpline is available in both English and Spanish and is available 24/7, 365 days a year.

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Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Current version

June 24, 2021

Written by

Ellyn Vohnoutka, BSN, RN

Fact checked by

Steve Silvestro, MD

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About the medical reviewer

Steve Silvestro, MD, Ro

Dr. Steve Silvestro is a board-certified pediatrician and Associate Director, Clinical Content & Education at Ro.