Overview of Psychotherapy

What is psychotherapy?

Psychotherapy is a term used to describe a broad range of non-pharmacological mental health treatments. In nearly all cases, psychotherapy involves meeting with a trained professional to explore and work through problems.

Why do people choose psychotherapy?

People enter psychotherapy with a variety of different goals. Here are some common reasons that people use psychotherapy:

To learn how to cope better with challenges and problems
To reflect on experiences and feelings with a supportive listener
To get a different perspective on problems from someone who has experience and training in helping others
To learn to recognize, develop, and use personal strengths
To have a safe and supportive place to talk about problems and experiences
For help making difficult decisions or getting through difficult times
For help in finding direction and setting future goals
To improve relationships with others
For help coping with a chronic medical or mental health problem or with the side-effects of medication

How do the various types of psychotherapy differ from each other?

Psychotherapies can take many different forms and can involve very different activities. Here are some ways that psychotherapies differ from each other:

Format

Individual Psychotherapy. In individual psychotherapy, clients have one-on-one sessions with their therapist.
Group Psychotherapy. Sometimes mental health problems are better treated in a group setting where several clients with similar issues meet with a therapist (or sometimes more than one therapist). Groups can be non-threatening, supportive places to work on interpersonal difficulties and receive feedback from peers. Groups can also be helpful forums to learn how others have dealt with similar difficulties and have learned to cope with them.
Family Psychotherapy. Family therapists help families, couples, and sometimes other groups of individuals who live or work closely together to work through difficult problems and identify both healthy and unhealthy patterns of interaction. All members of the group or family are considered clients and the therapist(s) is bound to act on behalf of all members.

Approach

There are many different approaches to psychotherapy that reflect different theories of how problems develop and how to best help others to manage them. A detailed description of the different approaches to therapy could fill several textbooks, so only a brief introduction to three broad categories or styles of therapy is provided here. These categories are broad and may overlap, but should provide a sense of how therapies differ in their focus. For more detailed information, see the National Institute of Mental Health’s description of psychotherapies.

Skill-Focused Psychotherapies.

The focus of these approaches is on helping a person learn skills and coping strategies. Examples include how to communicate with others more effectively or how to engage in activities that will help a person’s mood.
These approaches tend to be present-focused; that is, they emphasize the importance of analyzing and adapting a person’s current behavior and circumstances.
These approaches tend to be directive; that is, the therapist will often recommend specific strategies (often in the form of homework assignments) or changes for the patient to make.
Cognitive-Behavioral Therapies (CBT) and Dialectical Behavior Therapy (DBT) are examples of skill-based psychotherapies.

Insight-Focused Psychotherapies.

The goal of these approaches is generally to help individuals gain better self-understanding by exploring their experiences, emotions, and relationships.
The understanding of past experiences and how they relate to current emotions and behavior is considered crucial.
These approaches are often (but not always) less directive than skill-focused psychotherapies; that is, the therapist is less likely to recommend specific changes or strategies to the client.
These approaches tend to take longer (i.e., require more sessions) than skill-based therapies.
Brief Psychodynamic Therapy and Psychoanalytic Therapy are examples of insight-focused psychotherapy.

Relationship-Focused Psychotherapies.

These approaches also involve relationship skills.
These approaches focus on how relationships impact mental health and functioning.
Often the goal of these approaches is to help clients better understand how their behavior influences relationships by analyzing positive and negative patterns and developing alternative strategies.
These approaches can be directive or non-directive depending on the therapist and his/her training and outlook.
Interpersonal Therapy is an example of a relationship-focused psychotherapy

Often, therapies don’t fall cleanly into any one of the above three categories. You should feel comfortable talking to your therapist about his/her approach to therapy.

Therapist / Client Relationship

Therapy, no matter what the approach or format, is not a “one-size-fits-all” endeavor. No two therapists, even those who have similar training and experiences, take exactly the same approach to therapy. Additionally, every person who seeks out therapy brings different experiences that affect the course and content of the treatment. Your unique relationship with your therapist will have a major impact on your therapeutic experience. We provide more information about the important relationship between patient and client later in this section.

What do the various types of psychotherapy have in common?

There are several qualities that are crucial components of any psychotherapy regardless of the approach. These qualities are often called “common factors” since they are considered important in each approach to psychotherapy. The following are key factors in any form of psychotherapy:

A Warm and Trusting Therapist-Client Relationship. All psychotherapeutic approaches consider the relationship between the client and therapist to be an important part of the therapy. Good therapists do their best to understand and show a genuine interest in their clients’ feelings and experiences.
Belief in Change. Psychotherapies are based on the idea that a helpful change in the client’s situation is possible. Sometimes the underlying problem won’t change—psychotherapy won’t change the fact that a client has Bipolar Disorder, for instance—but the change is often in the way the client copes with the problem or in the client’s outlook.
Support. All therapies, regardless of their format or approach, are supposed to be supportive. Simply having a supporter can be a powerful tool, and clients should expect therapists to support their desire to make positive changes. Therapists differ greatly in how they provide this support, but it should be clear to clients that the therapist is an advocate for their well-being. This does not mean, however, that your therapist will condone any and all of your actions or behaviors. For example, you should not expect a therapist to support your decision to cope with problems by excessive drinking or drug use.

How can psychotherapy be helpful?

As a Stand-Alone Treatment

Psychotherapy is used by many people with mental health disorders as their primary treatment.
- Research suggests that psychotherapy is an effective treatment for many people with mental health disorders. The Society of Clinical Psychology website provides detailed information about available research evidence for psychotherapies.
There are some mental health problems (like schizophrenia and bipolar disorder) for which medication is almost always necessary or recommended; psychotherapy alone is generally not recommended for these disorders.

In Combination with Medication

Psychotherapy and psychiatric medication are commonly used in combination to treat mental health problems, and there is some research evidence suggesting that a combination treatment is preferable for some people.
Psychotherapy as an additional treatment to medications can address certain issues or symptoms that medication alone cannot.
Here are some common reasons that people who use psychiatric medication as their primary treatment choose to also attend psychotherapy:
- They have a mental health issue for which research has found that a combination of psychotherapy and medication is most useful (e.g., recurrent depression or bipolar disorder).
- They want to learn skills that they can use in their everyday life that can help relieve mental health symptoms, or that can help them function despite having mental health problems.
- They want a supportive environment to talk through problems and to cope with the idea of having a mental health disorder.
- They need support to stay on a difficult medication regimen.

Next > Making the Most of Psychotherapy Patience