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It can be challenging to cope with your difficulties by yourself. Perhaps you’ve dealt with depression, anxiety, or anger for a long time, or you have a sudden problem that you need help navigating. Whatever your current challenge may be, therapy with a skilled mental health professional can provide a fresh perspective for you.
The types of therapy available are as varied as the problems experienced by people looking for treatment. So how do you know what will work for you?
Let’s take a look at some of the most common types of therapy, what conditions they treat, and how to know what treatment style is right for you.
What is therapy?
Therapy is a catch-all term for any mental health treatment where you collaborate with a healthcare professional to identify and change thoughts, feelings, or behaviors that are negatively affecting your life. You might also hear it called psychotherapy, talk therapy, or behavioral therapy (U.S. Department of Health and Human Services, 2016).
There are over 50 different types of therapy recognized. The same evidence-based practices used in medicine are also used to evaluate mental health therapies (Cook, 2017).
A skilled therapist can help you choose the type of therapeutic intervention that will work best for you. They’ll make recommendations based on scientific evidence, the symptoms you want to change, and your personal preferences (Cook, 2017).
Therapy, along with medication, is the first-line treatment for most mental health conditions (like depression, anxiety, or bipolar disorder). Still, you don’t need to have a diagnosed mental illness to benefit from therapy. Therapy can help you manage the thoughts and emotions associated with a range of stressful situations. Some examples include (U.S. Department of Health and Human Services, 2016):
- Family or occupational stress
- Relationship conflicts
- Self-sabotaging behaviors
- Low self-esteem
- Coping with medical illnesses
Psychotherapy: everything you need to know
What are some common types of therapy?
Here are some of the most common types of therapy that you might encounter. Your therapist will choose a treatment approach based on their training, professional experience, and shared goals for treatment (U.S. Department of Health and Human Services, 2016).
Psychodynamic therapy comes from Sigmund Freud’s models of psychoanalysis. It aims to treat mental health disorders by analyzing and interpreting conscious and unconscious thoughts, childhood experiences, and the person’s resistance to therapy. It aims to assist the person in achieving a sense of authenticity and uniqueness (Ribeiro, 2018).
Therapy, in general, is known to be highly effective in treating depressive disorders. Psychodynamic therapy, in particular, has a great deal of evidence supporting its effectiveness in treating depression (Ribeiro, 2018).
There are, however, some conditions for which psychodynamic therapy isn’t as effective. An analysis of four randomized trials looking at the use of psychodynamic therapy for individuals currently hospitalized with schizophrenia found that those treated with psychodynamic therapy alone (versus medication alone) were significantly less likely to be able to be discharged. This strongly suggests that psychodynamic therapy may not be a good choice for those seriously ill with schizophrenia (Malmberg, 2001).
Psychodynamic therapy: could it work for you?
Cognitive-behavioral therapy (CBT)
Aaron Beck developed CBT in the 1960s. Since then, it has become the most extensively studied form of therapy. The CBT model is based on identifying and making changes to the automatic thoughts, cognitive distortions, and underlying beliefs affecting behavior (Chand, 2021).
Cognitive-behavioral therapy has been demonstrated by evidence-based research to be effective for (Chand, 2021):
- Depressive disorders
- Anxiety disorders
- Eating disorders
- Substance use disorders
- Personality disorders
- Attention deficit hyperactivity disorder (ADHD) in children
Cognitive-behavioral therapy has also been shown to be effective when combined with medication for serious mental illnesses such as bipolar disorder and schizophrenia (Chand, 2021).
Dialectical-behavior therapy (DBT)
Marsha Linehan developed DBT as a spin-off of cognitive-behavioral therapy, designed to treat borderline personality disorder. Similar to CBT, DBT involves analyzing the negative thoughts and feelings causing problem behaviors for a person. However, DBT involves a more comprehensive program to encourage acceptance, mindfulness, and coping skills development (Chapman, 2006).
A dialectical-behavior therapy treatment program is more intensive than some other forms of therapy. It typically consists of weekly individual therapy sessions, a weekly group therapy session, and a therapist consultation team meeting (Chapman, 2006).
In addition to borderline personality disorder, DBT has also been studied as an effective treatment for (Chapman, 2006):
- Eating disorders
- Depressive disorders in elderly patients
- Substance use disorders
Dialectical behavioral therapy: is it effective?
Eye movement desensitization and reprocessing (EMDR)
EMDR is a novel form of psychotherapy developed by Francine Shapiro. Studies show it’s similarly effective to medication or other psychological interventions for individuals with post-traumatic stress disorder (PTSD) (Landin-Romero, 2018).
Researchers have yet to uncover precisely why EMDR works. Treatment involves using back and forth eye movements (or sometimes using hand tapping or auditory tones) to desensitize traumatic memories and reduce anxiety levels in participants. This treatment is usually done in conjunction with some self-awareness and reframing tools used by other therapeutic styles (Landin-Romero, 2018).
While primarily used to treat PTSD, studies show EMDR is also an effective treatment for other conditions such as (Landin-Romero, 2018):
- Bipolar disorder
- Depressive disorders
- Dental phobia
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Alcohol use disorder
- Chronic pain
EMDR therapy for anxiety, grief, and PTSD
Exposure therapy is a type of therapy based on the work of Ivan Pavlov. It involves repeated confrontations with anxiety or fear-provoking situations to reduce the amount of discomfort that these situations create (Craske, 2014).
Exact strategies vary but can include gradual exposure, intense exposure, imaginary exposure, or real-life exposure to the feared object or situation. Throughout multiple therapy sessions, the person realizes that the anticipated negative effect from the fear will not occur. As a result, the fear becomes reduced or extinct (Craske, 2014).
Exposure therapy has shown effectiveness in treating several mental health conditions such as (Craske, 2014):
- Panic disorder
- Social anxiety disorder
- Post-traumatic stress disorder (PTSD)
- Obsessive-compulsive disorder (OCD)
- Specific phobias
Despite its effectiveness in the research, not everyone benefits from exposure therapy (Craske, 2014).
Existential therapy is a brief therapy that focuses on understanding human experience and emphasizes that the participant is a whole person, rather than defining them by their symptoms. It uses a variety of approaches, but the central themes are “responsibility” and “freedom” (Center for Substance Abuse Treatment, 1999).
Existential therapy emphasizes the following six core propositions (Center for Substance Abuse Treatment, 1999):
- All people have the capacity for self-awareness.
- As free beings, everyone must accept the responsibility that comes with freedom.
- Each person has a unique identity that can only be known through relationships with others.
- Each person must continually recreate himself. The meaning of life and existence is never fixed; rather, it constantly changes.
- Anxiety is part of the human condition.
- Death is a basic human condition that gives significance to life.
Existential therapy has been used for people dealing with anxiety disorders, substance abuse disorders, and terminal medical illnesses (Center for Substance Abuse Treatment, 1999).
How do I know what type of therapy is right for me?
With so many different types of therapy available, it can be challenging to predict which treatment will be most successful for each unique individual. Overall, it might be more important to find a therapist with whom you can have a good therapeutic relationship (Cook, 2017).
A good therapeutic relationship allows the therapist and the client to build trust, working together to create positive change in the client’s life. This relationship should be caring, positive, and have clear professional boundaries (Cook, 2017).
What is behavioral therapy and who is it for?
The American Psychological Association commissioned a task force which concluded: “The therapy relationship accounts for why clients improve (or fail to improve) at least as much as the particular treatment method” (Norcross, 2014).
Additionally, an experienced therapist will often combine elements of several different techniques to create a unique treatment plan to meet your needs (U.S. Department of Health and Human Services, 2016).
Resources for finding a therapist
If you think that therapy might be helpful for you, contact your healthcare provider. They can refer you to local mental health providers.
You can also contact the Substance Abuse and Mental Health Services Administration’s national helpline. The helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service for individuals and families facing mental health or substance use disorders. The helpline is available in both English and Spanish.
- Center for Substance Abuse Treatment. (1999). Brief interventions and brief therapies for substance abuse. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1999. (Treatment Improvement Protocol (TIP) Series, No. 34.) Chapter 6 –Brief Humanistic and Existential Therapies. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK64939/
- Chand SP, Kuckel DP, Huecker MR. (2021). Cognitive behavior therapy. [Updated 2021 Apr 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK470241/
- Chapman A. L. (2006). Dialectical behavior therapy: current indications and unique elements. Psychiatry (Edgmont (Pa.: Township)), 3(9), 62–68. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2963469/
- Cook, S. C., Schwartz, A. C., & Kaslow, N. J. (2017). Evidence-based psychotherapy: advantages and challenges. Neurotherapeutics: The Journal of the American Society for Experimental NeuroTherapeutics, 14(3), 537–545. doi: 10.1007/s13311-017-0549-4. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5509639/
- Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: an inhibitory learning approach. Behaviour Research and Therapy, 58, 10–23. doi: 10.1016/j.brat.2014.04.006. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4114726/
- Landin-Romero, R., Moreno-Alcazar, A., Pagani, M., & Amann, B. L. (2018). How does eye movement desensitization and reprocessing therapy work? A systematic review on suggested mechanisms of action. Frontiers in Psychology, 9, 1395. doi: 10.3389/fpsyg.2018.01395. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6106867/
- Malmberg, L., & Fenton, M. (2001). Individual psychodynamic psychotherapy and psychoanalysis for schizophrenia and severe mental illness. The Cochrane Database of Systematic Reviews, (3), CD001360. doi: 0.1002/14651858.CD001360. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171459/
- Norcross, J. C. (2014). Conclusions and recommendations of the Interdivisional (APA Divisions 12 & 29) Task Force on Evidence-Based Therapy Relationships. [Web article]. Retrieved from https://societyforpsychotherapy.org/evidence-based-therapy-relationships
- Ribeiro, ., Ribeiro, J. P., & von Doellinger, O. (2018). Depression and psychodynamic psychotherapy. Revista Brasileira de Psiquiatria (Sao Paulo, Brazil : 1999), 40(1), 105–109. doi: 10.1590/1516-4446-2016-2107. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6899418/
- U.S. Department of Health and Human Services. (2016). Psychotherapies. National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/topics/psychotherapies/
Dr. Steve Silvestro is a board-certified pediatrician and Senior Manager, Medical Content & Education at Ro.