What is psychotherapy?
Psychotherapy can help treat challenges and symptoms relating to mental health and emotions.
Also known as talk therapy, psychotherapy aims to help a person understand their feelings and equip them to face new challenges, both in the present and the future.
Psychotherapy is similar to counseling, and the two can overlap. However, the former tends to look more deeply, addressing the underlying causes of a person’s problems as well as how to solve them.
To see positive results, a person will usually need to understand the need for change and be willing to follow the treatment plan as the specialist advises. They will also need to find a suitable therapist they can trust.
Psychotherapy can help when depression, low self-esteem, addiction, bereavement, or other factors leave a person feeling overwhelmed. It can also help treat bipolar disorder, schizophrenia, and certain other mental health conditions.
People often, but not always, use both psychotherapy and medication.
In this article, learn more about what psychotherapy involves.
What to expect
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There are many approaches to psychotherapy.
Some forms last for only a few sessions, while others may continue for months or years, depending on the person’s needs. Individual sessions usually last for around 45–90 minutes and follow a structured process.
Sessions may be one-to-one, in pairs, or in groups. Techniques can include talking and other forms of communication, such as drama, story-telling, or music.
A psychotherapist may be:
a marriage and family therapist
a licensed clinical social worker
a licensed clinical professional counselor
a mental health counselor
a psychiatric nurse practitioner
Who can benefit?
Psychotherapy can help people in a range of situations. For example, it may benefit someone who:
has overwhelming feelings of sadness or helplessness
feels anxious most of the time
has difficulty facing everyday challenges or focusing on work or studies
is using drugs or alcohol in a way that is not healthful
is at risk of harming themselves or others
feels that their situation will never improve, despite receiving help from friends and family
has experienced an abusive situation
has a mental health condition, such as schizophrenia, that affects their daily life
Some people attend psychotherapy after a doctor recommends it, but many seek help independently.
Traditional therapy – done online
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There are several styles of and approaches to psychotherapy. The sections below will outline these in more detail.
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) helps a person understand and change how their thoughts and behaviors can affect the way they feel and act.
CBT can help people with many issues, including:
post-traumatic stress disorder
Under this approach, a person learns new ways to communicate or express their feelings. It can help with building and maintaining healthy relationships.
For example, if someone who responds to feeling neglected by getting angry, this may trigger a negative reaction in others. This can lead to depression and isolation.
The individual will learn to understand and modify their approach to interpersonal problems and acquire ways of managing them more constructively.
Psychodynamic therapy addresses the ways in which past experiences, such as those during childhood, can impact a person’s current thoughts and behaviors. Often, the person is unaware that this influence is even present.
Identifying these influences can help people understand the source of feelings such as distress and anxiety. Once they identify these sources, the psychotherapist can help the person address them. This can help an individual feel more in control of their life.
It is similar to psychoanalysis but less intense.
Family therapy can provide a safe space for family members to:
express their views
explore difficult feelings
understand each other
build on existing strengths
find solutions to problems
This form of psychotherapy can be useful when problems stem from family relationships, or when a child or young person is facing difficulties.
In fact, one 2019 articleTrusted Source suggests that family therapy may help adolescents with mental health problems. It may also improve family cohesion and enhance parenting skills.
Relationship therapy is another type of psychotherapy. It is very similar to family therapy, but a person may instead wish to present to therapy with their partner to address issues within a relationship.
Group therapy sessions usually involve one therapist and around 5–15 participants with similar concerns, such as:
The group will usually meet for 1 or 2 hours each week, and individuals may also attend one-on-one therapy.
People can benefit from interacting with the therapist but also by interacting with others who are experiencing similar challenges. Group members can also support each other.
Although participating in a group may seem intimidating, it can help people realize that they are not alone with their problem.
Many people are now opting for online therapy, otherwise known as telehealth. This can have many benefits, especially for someone who:
has mobility problems
cannot find a suitable specialist in their area
has difficulty fitting therapy into their schedule
does not feel comfortable with face-to-face communication
Tools include video meetings and messaging services.
Although online services have helped “normalize” psychotherapy, making it easier to integrate into daily life, a person should check carefully before choosing a provider.
For example, they should consider:
the qualifications and experience of the therapist
the online and other security measures the provider has in place
using a company that psychologists run and that has links with professional associations
There are many other types of psychotherapy, including:
creative arts therapy
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Each person’s experience of psychotherapy will be different, and the time it takes to see an improvement will also vary.
Some people will notice a difference after around six to 12 sessions, while others may need ongoing treatment for several years.
Psychotherapy can help a person by:
giving them someone to explore their problem with confidentially
enabling them to see things in a new way
helping them move toward a solution
learn more about themselves and their goals and values
identify causes of tension in relationships
develop skills for facing challenges
overcome specific problems, such as a phobia
To benefit from the process, a person needs to:
have a desire to participate
engage actively in treatment
attend appointments and complete any assignments between sessions
be honest when describing symptoms and situations
Effectiveness can also depend on:
the reason for seeking therapy
the skill of the practitioner
the relationship between the therapist and the individual
any support the person may have outside the therapy sessions
A trusting relationship between the individual and the therapist is also essential to the process.
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A good therapist
According to the American Psychological Association (APA), the qualities of a good therapist include such factors as:
having a developed set of interpersonal skills
taking time to build trust with the individual
having a treatment plan in place and keeping it flexible
monitoring the person’s progress
offering hope and realistic optimism
relying on research evidence
Choosing a suitable therapist
People seek psychotherapy for a wide range of reasons, and each individual is different. Providers should have training in dealing with a wide range of situations, but some can meet more specific needs.
For example, a practitioner may specialize in counseling for survivors of sexual abuse.
A person who has experienced trauma due to raceTrusted Source, sexual orientation, or human trafficking, for example, will need to find someone who understands where the person is starting from. They will also need appropriate training.
After identifying a therapist who seems suitable, the individual should ask plenty of questions before starting therapy to make sure that this is the person they want.
A doctor, online community, or local support group can often recommend a suitable therapist.
Learn about how mental health issues can affect Black communities and what to do here.
Risks and cautions
Psychotherapy can offer many benefits, but there are some cautions to be aware of before starting. The following sections will outline these in more detail.
During psychotherapy, some people may experience changes they had not expected or did not want.
Recalling past events can sometimes trigger unwanted emotions. Addressing and resolving these emotions is an integral part of therapy, but it can be challenging.
It is essential to find a trusted and qualified psychotherapist who is skilled at guiding people through these situations in a constructive way.
Most people feel better as a result of therapy, but it can take time to work — and sometimes, the approach the therapist takes is not suitable. In fact, according to some research, around 10% of people feel worse after starting therapy.
Some experts have expressed concerns about potentially harmful therapies. These could be techniques that leave a person feeling worse rather than better or approaches that may actually slow an individual’s progress.
Some approaches may not have enough research evidence to support their use. In some cases, the approach or “chemistry” between the individual and the therapist may not be suitable.
However, if the practitioner monitors the person’s progress regularly and asks for feedback, the risk of therapy not working or having a negative impact will be lower.
Using an interpreter
Not everyone can find a psychotherapist who speaks their primary language. This can pose a challenge for people who are already at a disadvantage in society.
One option is to find an interpreter, but it is essential to find someone who understands the complex issues that treatment is likely to involve.
Ideally, the person should also have the skills and training necessary for managing the specific dynamics the relationship will involve.
Cost in time and money
Psychotherapy can be expensive and time consuming. This is another reason that it is essential to find a qualified practitioner.
If a health professional considers treatment necessary, the Mental Health Parity Act requires that insurance companies pay for mental healthcare in a similar way to paying for physical medical care.
It is worth noting that the definitions of “reasonable and appropriate” or “medically necessary” may vary.
Psychotherapy can help people with various mental health needs, ranging from overcoming stress to living with bipolar disorder.
A doctor will often prescribe it alongside medication, though some people may only benefit from psychotherapy.
It is essential to find a professional. The person should be well-qualified and experienced, and they should inspire a person’s trust and confidence.
Family physicians can usually recommend a suitable psychotherapist, or a person can find a suitable practitioner through a register, such as the APA’s psychologist locator.