Psychotherapy

Medically Reviewed by Jabeen Begum, MD on April 08, 2024
Written by Tammy Worth
10 min read

Psychotherapy, also called talk therapy, is a type of mental health treatment.

It’s often used either alone or with medications to treat mental health conditions. During a psychotherapy session, you talk to a doctor or a licensed mental health care professional to identify and change troubling thoughts. Psychotherapy can help you deal with mental health conditions such as depression, anxiety and stress, or deal with life events such as trauma or the death of a loved one.

​​Psychotherapy vs. counseling

These two terms are often used interchangeably, but they do mean two different things. They are both mental health therapy, but the length of time and purpose of care are different.

Counseling tends to be short-term and usually focuses on creating solutions for a specific issue, for example, substance misuse. Psychotherapy is more likely to be a long-term treatment and can focus on multiple issues or more complex mental health conditions.

Psychotherapy can treat a wide range of issues, including several mental health conditions and stressors or conflicts in your daily life.

Mental health conditions that psychotherapy can treat include:

  • Depression
  • Bipolar disorder
  • Anxiety disorders such as social anxiety and phobias
  • Eating disorders including anorexia and bulimia
  • Posttraumatic stress disorder (PTSD)
  • Schizophrenia
  • Alcohol and substance abuse
  • Personality disorders such as obsessive-compulsive disorder (OCD) and borderline personality disorder
  • Adjustment disorders

You may not have a mental illness, but psychotherapy may help you deal with daily issues or stressful situations. It may be able to help you through things such as:

  • A medical condition such as cancer, autoimmune conditions, or chronic pain
  • Trauma, whether it's physical or emotional
  • Stress
  • Death of a friend or family member
  • Quitting smoking
  • Divorce or issues with a family member
  • Job challenges
  • Sexual issues
  • Emotional problems such as rage or unusually aggressive behaviors

Psychotherapy can be helpful for a range of issues. It has been shown to help relieve at least some symptoms for about three-quarters of people who take part in it. It has been shown to help people:

  • Identify behaviors, emotions, and ideas and learn how to modify them
  • Understand and identify their life problems or events -- such as a major illness, death in the family, loss of a job, or divorce -- and help them recognize which aspects of those problems they may be able to solve or improve
  • Regain a sense of control and pleasure in life
  • Learn healthy coping techniques and problem-solving skills
  • Learn to recognize if they are at risk for self-harm and learning tools to manage those feelings
  • Recover from abuse

Psychotherapy may also help you with daily functioning, including things such as:

  • Improving relationships at work and home
  • Having fewer sick days
  • Improving symptoms and having less disability with a chronic medical condition
  • Increasing life satisfaction
  • Actively participating in medical decision-making when you have health issues

Therapy can be given in a variety of formats, including:

Individual. This involves only you and your therapist.

Group. You and others get therapy together. Everyone shares their experiences and learns that others feel the same way and have had similar experiences.

Marital/couples. This helps you and your spouse or partner understand what changes in communication and behaviors can help and what you can do together. This can also help a couple that's struggling with their relationship.

Family. Because family is a key part of the team that helps you get better, it is sometimes helpful for your family members to understand what you are going through, how they can manage their feelings, and what they can do to help. This can also help resolve issues, improve communication, and reduce conflict between family members.

There are several approaches that mental health professionals can take to provide therapy. After talking with you about your disorder, your therapist will decide which approach to use. Different approaches include:

Psychodynamic therapy

It is based on the assumption that your emotional problems are a result of unresolved (generally unconscious) conflicts, often stemming from childhood. The goal of this type of therapy is to help you understand your beliefs and feelings so you can change unhealthy patterns. Psychodynamic therapy is done for several months, although it can last longer, even years.

Interpersonal therapy

This therapy focuses on your behaviors and interactions with your family and friends. The goal of this therapy is to improve your communication skills and increase your self-esteem during a short period. It usually lasts 3-4 months and works well for depression caused by mourning, relationship conflicts, major life events, and social isolation.

Cognitive-behavioral therapy (CBT)

CBT helps you identify and change wrong perceptions you may have of yourself and the world around you. The therapist directs your attention to your unhealthy assumptions and helps you learn new ways of thinking and more effective coping skills. CBT can be used to treat things such as depression, anxiety, and trauma. It is also one of the most common treatments for eating disorders, where it helps you focus less on body shape and reduces the need to use extreme measures to control your weight.

CBT may be an option for you if you:

  • Think and behave in ways that trigger and worsen your mental illness
  • Have depression or anxiety disorders (depending on the severity, CBT may be used along with antidepressant medication)
  • Do not want to, or are unable to, take antidepressant medication
  • Have a mental health condition that causes suffering, disability, or interpersonal problems

Acceptance and commitment therapy (ACT)

ACT teaches you how to understand what you are feeling at any moment and manage your behavior based on your values. Unlike CBT, where you learn to change unhealthy thought patterns, ACT helps you understand and accept your feelings, and then commit to a positive behavioral change. Instead of suppressing or ignoring unpleasant experiences, the goal is to become more "psychologically flexible," so you can adapt to these situations. ACT can be used to treat things such as grief, illness, and anxiety.

Dialectical behavior therapy (DBT)

DBT is a type of cognitive behavioral therapy used for high-risk, tough-to-treat patients. The term "dialectical" comes from the idea that bringing together two opposites in therapy -- acceptance and change -- brings better results than using either one alone. DBT helps you change unhealthy behaviors such as lying and self-injury through keeping daily diaries, individual and group therapy, and phone coaching.

DBT was initially designed to treat people with suicidal behavior and borderline personality disorder. But it has been adapted for other issues including eating disorders and PTSD.

Comprehensive DBT focuses on four ways to enhance life skills:

  • Distress tolerance: Feeling intense emotions such as anger without reacting impulsively or resorting to self-injury or substance use to dampen distress
  • Emotion regulation: Recognizing, labeling, and adjusting emotions
  • Mindfulness: Becoming more aware of yourself and others and attentive to the present moment
  • Interpersonal effectiveness: Navigating conflict and interacting assertively

Supportive therapy

Your therapist coaches you on ways to use your emotional resources to deal with mental health conditions. This approach helps boost your self-esteem, ease your anxiety, and improve your social skills and coping skills.

Humanistic therapy

This therapy does not focus on your symptoms or problems. Instead, it's based on the idea that self-discovery will help you reach your full potential, break old patterns, and improve your relationship with the world around you. It can be short- or long-term, depending on your needs. Humanistic therapy can be used to treat several mental health conditions including anxiety, depression, and OCD.

Sensorimotor therapy

This type of therapy is used mainly if you have attachment issues or trauma. Sensorimotor therapy uses the connection between your physical responses to emotional issues to help change unhealthy psychological patterns and beliefs.

Child-parent psychotherapy

This type of therapy is used for children from birth to age 6 who have trauma or a diagnosed mental health condition. A parent or caregiver is always involved in the sessions. Child-parent psychotherapy is based on the idea that, if the bond between the child and adult is strengthened, it will improve the child's mental health, behavior, and social functioning. 

Alternative and complementary forms of therapy can be used by themselves or in combination with regular psychotherapy.

Animal-assisted therapy. Dogs, horses, and other animals may help ease anxiety and depression, bringing comfort.

Art and music therapy. This can allow you to express and process your grief and other feelings.

Effective therapy depends on your active participation. It requires time, effort, and regularity. Keep these tips in mind as you start your treatment:

Attend all of your scheduled appointments.

Work with your therapist to set goals at the start. Review them from time to time.

Identify sources of stress and try keeping a journal. Note down stressful as well as positive events.

Reset priorities by focusing more on positive, effective behavior.

Make time for recreational and pleasurable activities.

Communicate by explaining and asserting your needs to someone you trust. Or write in a journal to express your feelings.

Focus on positive outcomes and finding methods for reducing and managing stress.

Be open and honest, as success depends on your willingness to share your thoughts, feelings, and experiences and to consider new insights, ideas, and ways of doing things. If you're not willing to talk about certain issues because of painful emotions, embarrassment, or fears about your therapist's reaction, let your therapist know.

Stick to your treatment plan even if you feel down or lack motivation. It may be tempting to skip psychotherapy sessions, but doing so can disrupt your progress. Try to attend all sessions and think about what you want to discuss.

Don't expect instant results, as working on emotional issues can be painful and may require hard work. You may need several sessions before you begin to see improvement.

Do your homework between sessions, asit can help you apply what you've learned in therapy to your life. If your therapist asks you to write your thoughts in a journal or do other activities outside of your therapy sessions, follow through.

It’s important that you like and feel comfortable with your therapist. You can find a psychotherapist by asking your family and friends for referrals and checking with your health insurer to see who is covered under your plan. Also, you can visit the website of an organization such as the American Psychological Association or your state's behavioral health association. Consider interviewing the provider by phone, video, or in person until you find a good match. You may want to set up initial appointments with a couple of therapists to find one that you prefer. 

Before you pick a therapist, you may want to ask:

  • How much they charge
  • If they use evidence-based treatment
  • If they accept insurance
  • What their appointment hours are
  • How many years of experience they have
  • About their areas of expertise to ensure they deal with the kind of issues you are having
  • About their treatment approach
  • Whether or not they offer telehealth (virtual appointments)
  • How long they think the therapy might last
  • If they are available for emergency visits

If you are looking for a therapist with a focus on diversity, there are several ways to make sure they will be able to understand your unique needs. When you talk with them before your first visit, you can ask questions such as:

  • What is their experience dealing with people of your ethnic background, sexual orientation, or race?
  • Have they received any training on how to incorporate equity into their practice?
  • How much experience do they have working with patients from diverse backgrounds?
  • Can they offer an example of how they have treated a patient with a background similar to yours?

Most therapy sessions are 45-60 minutes of guided conversation. Your therapist may ask many questions, especially in the beginning. They may also ask you to fill out forms on your first visit to get an idea of what you are feeling and what you want out of the sessions. They may want to know about your history, experiences, feelings, and worries.

It’s best that you both agree on your treatment goals. Your therapist may want to schedule more sessions. Some therapists can prescribe medication if necessary.

During therapy, you may find yourself crying, becoming exhausted, or having an outburst. This is normal because you are likely working through uncomfortable emotions. Your therapist isn't there to judge your behavior, so you should feel free to open up and they can help you through these feelings.

Your therapy is also confidential with very few exceptions. They can't repeat what you have told them unless they think there is an immediate threat to your or others' safety. You can talk to your therapist and they can answer any concerns you have about confidentiality.

Your therapist might give you homework. This can include things such as journaling, having a new experience, or creating a plan to manage one of your symptoms. If the therapist asks you to do something you don't feel comfortable with, let them know. Homework can be a good way to put into practice what you are learning during your sessions.

 

The amount of time you spend in therapy will depend on several factors. Research shows that as few as 12 weekly sessions may help ease many symptoms. It's common to expect about 6 months to have full relief of symptoms and to learn skills to help you deal with issues moving forward. If you have more complex issues, it can take a year or longer to see improvement. And, like some people, you may go to therapy off and on throughout your life for mental health maintenance.

How long you will need therapy depends on things such as:

  • The kind of therapy your psychotherapist provides
  • How severe your symptoms are
  • The length of time you've had the symptoms
  • Your dedication to therapy
  • Your insurance coverage and cost limitations

Psychotherapy, or talk therapy, can be used to treat many emotional and mental health conditions. If you need a referral, talk to friends and family, or look to state or national associations for licensed therapists in your area. You can expect to have some relief of your symptoms in about 6 months, but psychotherapy can be shorter or longer, depending upon many factors.

What is the difference between a psychotherapist and a psychologist?

Psychotherapist is an umbrella term for professionals who perform talk therapy and can include psychologists, social workers, and family therapists. A psychologist is a therapist who has at least a master's degree in psychology (but usually a doctoral degree). Psychologists typically don't prescribe medication (a psychiatrist can) but do have a license to prescribe in some states.