Psychotherapy

What is psychotherapy?

Psychotherapy, also called talk therapy, is a term for a variety of treatment techniques that aim to help a person identify and change unhealthy emotions, thoughts and behaviors. These thoughts and emotions can be related to situations, such as:

• Relationship issues.
• Grief.
• Adjusting to a new life situation or medical condition.
• Stress and coping difficulties.

They can also be related to diagnosed mental health and behavioral conditions.

Psychotherapy takes place with a trained, licensed mental health professional, such as a psychologist or psychiatrist. It can provide support, education and guidance to you and/or your family to help you function better and increase your well-being.

Psychotherapy may be used in combination with medication or other therapies or as a standalone treatment.

What’s the difference among psychotherapy, counseling and therapy?

Many people use the words “psychotherapy,” “counseling” and “therapy” to convey the same thing: talk therapy with a mental health professional to help resolve issues or treat mental health conditions.

Although people often use “therapy” as a shortened version of “psychotherapy” (which is a correct substitution), it should be noted that psychotherapy specifically deals with mental, emotional and behavioral issues. There are several other types of therapy for various health conditions, such as speech therapy, physical therapy, hydrotherapy, radiation therapy and many more.

Counseling is typically a brief treatment that targets a specific symptom or situation, such as marital or family issues, while psychotherapy is usually a longer-term treatment that attempts to gain more insight into someone’s issues or help with a mental health condition. It’s OK to use the terms interchangeably.

What are the types of psychotherapy?

Mental health professionals use several types of psychotherapy, and many professionals specialize in certain types. The choice of therapy type depends on your particular condition and/or circumstances. Therapists may combine elements from different therapeutic approaches to best meet your needs.

Some of the more common types of psychotherapy include:

• Cognitive behavioral therapy (CBT): This is a structured, goal-oriented type of psychotherapy. Mental health professionals use it to treat or manage mental health conditions and emotional concerns. Your therapist or psychologist helps you take a close look at your thoughts and emotions. You’ll come to understand how your thoughts affect your actions. Through CBT, you can unlearn negative thoughts and behaviors and learn to adopt healthier thinking patterns and habits.
• Dialectical behavior therapy (DBT): DBT is a type of talk therapy that’s based on cognitive behavioral therapy, but it’s specially adapted for people who experience emotions very intensely. The main goal of therapists who use DBT is to strike a balance between validation (acceptance) of who you are and your challenges and the benefits of change. Your therapist will help you learn new skills to improve emotion regulation. It involves both individual and group therapy.
• Interpersonal therapy (IPT): This is a short-term form of therapy. It helps you understand underlying interpersonal issues that are troublesome, like unresolved grief, changes in social or work roles, conflicts with others and issues relating to others. It can help you learn healthy ways to express emotions and ways to improve communication.
• Psychodynamic therapy: This type of therapy is based on the idea that behavior and mental well-being are influenced by childhood experiences and problematic repetitive thoughts or feelings that are outside of your awareness (they’re unconscious). You’ll work with a therapist to improve your self-awareness and change old patterns so you can more fully take charge of your life.

Additional therapies that mental health professionals sometimes use in combination with psychotherapy include:

• Animal-assisted therapy: This involves working with dogs, horses or other animals to bring comfort, help with communication and help cope with trauma.
• Creative arts therapy: This involves the use of art, dance, music and poetry to aid with talk therapy and communication.
• Play therapy: This therapy specifically helps children identify and talk about their emotions and feelings through play.

There are also different types of therapy depending on who’s taking part in the session. These include:

• Individual therapy: This therapy involves only you and the mental health professional.
• Group therapy: This therapy happens when two or more people participate in therapy with a mental health professional at the same time. In group therapy, you’re able to share experiences and learn from others about their similar experiences.
• Marriage counseling/couples therapy: This therapy involves you and your spouse or romantic partner. Licensed Marriage and Family Therapists (LMFT) are specifically trained to help couples determine their problems and work on solutions. Issues may be related to communication, raising children, finances, understanding your or your partner’s mental health condition and more.
• Family therapy: This therapy involves you and your family members — either all of them or some of them. It can help family members improve communication and resolve conflicts, which can range from sibling jealousy to issues with coping with the death of a family member.

Who needs psychotherapy?

Psychotherapy can benefit anyone who’s struggling with life’s challenges, excessive stress, adjusting to a new life situation or medical condition and/or who has a mental health or behavioral condition. This includes children, adolescents and adults.

Psychotherapy sessions can last a few weeks or months for short-term issues or could last for several months or years for more complex situations or chronic conditions.

Some (but not the only) signs that you or your child may benefit from talk therapy include:

• You feel a negative mood most days.
• You have lost interest in things that you once enjoyed.
• You feel overwhelmed by life, and it’s impacting your mood and daily functioning.
• You feel like you can’t control your emotions.
• You have anxious, intrusive or racing thoughts.
• Your eating and/or sleeping habits have changed.
• Certain habits are becoming problematic, such as excessive drinking, drug use, gambling or other risky behaviors.
• You’ve experienced trauma, such as a car accident, the death of a loved one or physical or sexual assault.
• You have persistently low self-esteem and self-confidence.
• You’re experiencing persistent issues with relationships, whether it’s with a romantic partner, family member or co-worker.
• You’re having a hard time dealing with stress related to work, family or school.
• You’ve been withdrawing from social relationships and/or social activities.

If you’re unsure if psychotherapy could help you or not, reach out to your primary healthcare provider. They can provide guidance.

What conditions or issues does psychotherapy help manage?

Issues that psychotherapy can help with include (but aren’t limited to):

• Difficulties in coping with daily life or medical conditions.
• Stress.
• Anger.
• Trauma (physical or emotional).
• Difficulties with losing weight or quitting smoking.
• Coping with acute or chronic illness, such as multiple sclerosis, cancer, stroke, chronic pain or an autoimmune disease.
• The death of a loved one and grief.
• Divorce or relationship issues.
• Job or family issues.
• Specific mental health conditions, such as depression, anxiety, bipolar disorder, post-traumatic stress disorder (PTSD), eating disorders, personality disorders and more.
• Behavioral conditions, such as attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder and more.

There are several different types of psychotherapy and some types may work better with certain problems or issues. You may participate in psychotherapy in combination with taking certain medications or other therapies to manage your condition.

How do I find a therapist?

A therapist can be a psychologist, psychiatrist (a medical doctor who can prescribe medications), psychiatric nurse, social worker or family therapist.

Finding the right therapist is often a time-consuming task. Try not to become discouraged. Talk to people you trust to give you a referral for a therapist, whether it’s your primary healthcare provider or a friend or family member.

You can also search for therapists online through local and state psychological associations.

Be sure that any therapist you’re interested in seeing is a state-certified and licensed mental health professional and that they treat your area of concern (for example, grief, depression, family therapy, etc.).

Most therapists’ websites list the conditions they treat. If you have questions, call or email the therapist’s office before you choose.

It may be helpful to ask a potential therapist the following questions:

• What’s the nature of your training in psychotherapy?
• How long have you been providing therapy?
• What type of therapy do you recommend for me?
• What’s your policy on phone calls and emails during the week?
• How much time will you initially ask me to commit to for the entire therapy process?

How does psychotherapy work?

Psychotherapy is an evidence-based treatment that’s grounded in theory and skill-based dialogue (conversations). It provides a supportive, non-judgmental and safe environment that allows you to talk openly with a mental health professional who’s objective and specially trained to help you with the issues you’re having.

During sessions, you and your mental health professional will work together to identify and change thoughts and behaviors that are preventing you from living your best life. The frequency between sessions will vary, depending on the condition that you’re being treated for, your lifestyle and your therapist’s practice.

As conversation is the main part of psychotherapy, you need to be actively involved in the therapy. The trust and relationship between you and your therapist are essential to working together effectively and benefiting from the therapy.

Mental health professionals prioritize confidentiality and maintaining your privacy. In fact, it’s a part of their professional code of ethics. Mental health professionals who violate patient confidentiality risk losing their ability to practice therapy in the future.

However, if you reveal that you plan to hurt yourself or others, your mental health professional is duty-bound to report that to authorities for your protection and/or the safety of others. They must also report abuse, exploitation or neglect of children, the elderly or people with disabilities.

You can always give your mental health professional written permission to share all or part of your discussions with your primary healthcare provider, family members, teachers or anyone else if you want.

What are the benefits of psychotherapy?

Research shows that about 75% of people who participate in psychotherapy experience some type of benefit and can function better day to day.

Studies also show that psychotherapy improves emotions and behaviors and is linked to positive changes in your brain and body. Other benefits may include:

• Fewer sick days.
• Less disability.
• Active participation in medical decision-making.
• Fewer medical issues.
• Increased work and life satisfaction.

However, talk therapy isn’t for everyone. Therapy is more likely to work if you:

• Are open and honest with your therapist.
• Are committed to making positive changes.
• Follow your agreed-upon treatment plan.
• Are ready to fully commit to therapy and do homework assignments (if applicable).

How long will I need psychotherapy?

How long you’ll need psychotherapy depends on several factors, including your specific reason for participating in therapy, what your goals are and if you’re actively trying to work on the issues you’re having.

Psychotherapy can be short-term (a few sessions), dealing with immediate issues, or long-term (months or years), dealing with mental health conditions and/or complex issues. Together, you and your therapist will determine the goals of treatment and arrangements for how often and how long you’ll meet.

In one classic study, half of the people who participated in psychotherapy improved after eight sessions, and 75% improved after six months.

You may consider being “done” with therapy when you, with the help of your therapist, have solved the problem that brought you in and you’ve learned new skills so you can better cope with whatever challenges come up in the future.

Many people participate in psychotherapy multiple times throughout their life — whether for the same issue or several different issues.

When should I see my healthcare provider or mental health professional while doing psychotherapy?

It’s important to go to all of your scheduled therapy sessions or to reschedule any sessions you have to miss.

If you’ve been participating in psychotherapy for a while and it’s not helping your symptoms, talk to your healthcare provider about the possibility of taking medication to treat your symptoms.

If you’re experiencing a crisis, such as feeling suicidal, you should go to your local emergency room, call 911 or call the Suicide and Crisis Lifeline at 988. Someone will be available to talk with you 24 hours a day, seven days a week.

What is psychoanalysis?

Psychoanalysis is a specialty in psychology that’s a more intensive form of psychodynamic therapy. It involves a set of psychological theories and therapeutic methods that originate from the work of Sigmund Freud.

The primary assumption of psychoanalysis is the belief that all people have unconscious thoughts, feelings, desires and memories. It aims to release repressed emotions and experiences (making the unconscious conscious).

A note from Cleveland Clinic

While it can be overwhelming to acknowledge and seek help for a mental health condition or emotional difficulties in your life, it’s important that you do. Psychotherapy can help you better understand and work through the roadblocks that are preventing you from living a full and healthy life. Mental health professionals are experts in their field and have up-to-date knowledge on research and therapy strategies that can help you. Your mental health professional will work with you to determine a treatment plan that works best for you.