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What is Psychotherapy?

By Olivia Guy-Evans, published March 30, 2022

by Saul Mcleod, PhD

Psychotherapy concept illustration

What is psychotherapy?

Psychotherapy is the general term to describe the process of treating psychological disorder and mental distress through verbal and psychological techniques.

Psychotherapy is also commonly known as talk therapy, counselling, psychosocial therapy, or simply, therapy. There are many types of psychotherapy, each with their own approach and grounded in different psychological theories.

The right type of psychotherapy for someone will depend on the individual and their situation.

Although they differ in practice, almost all types of psychotherapy involve developing a therapeutic relationship, communicating, and working to overcome problematic thoughts or behaviours. 

Trained professionals who can offer psychotherapy include clinical psychologists, psychotherapists, psychiatrists, counsellors, social workers, and mental health counsellors.

The trained therapist helps the client to tackle specific or general problems such as a particular mental health disorder or a source of life stress.

Psychotherapy is a collaborative treatment based on the relationship between the individual and a therapist, grounded in dialogue, and providing a supportive environment which allows the person to talk opening with someone who is non-judgemental. 

Psychotherapy gives the opportunity to learn about one’s moods, feelings, thoughts, and behaviours. Individuals can learn skills to help take control of their life and respond to challenging situations with healthy coping strategies.

Through therapy, people can learn to live happier, healthier, and more productive lives, understand more about their condition, and be equipped to face new challenges in the present and the future.

To see positive results, a person will usually need to understand the need for change, be willing to follow the treatment plan as advised, and find a suitable therapist they can trust. 

Who can benefit?

Psychotherapy comes in many forms, but all are designed to help people to overcome challenges, develop coping strategies, and lead happier, healthier lives.

If someone has been diagnosed with a mental health condition, their medical specialist may recommend psychotherapy in conjunction with medicative treatment.

Medication is often prescribed to lessen the symptoms of a mental health condition, while therapy can help to work through unhelpful or unwanted thoughts and behaviours. 

Below is a list of mental health conditions that may require psychotherapeutic treatment:

  • Anxiety disorders such as obsessive-compulsive disorder (OCD), phobias, panic disorder, posttraumatic stress disorder (PTSD), social anxiety disorder, or generalized anxiety disorder (GAD). 

  • Mood disorders such as depression or bipolar disorder.

  • Eating disorders such as anorexia or bulimia. 

  • Addictions such as substance-use disorder or compulsive gambling.

  • Personality disorders such as borderline personality disorder or dependant personality disorder.

  • Schizophrenia or other disorders that cause detachment from reality (psychotic disorders).

Although psychotherapy is often thought as being used to treat these conditions, people do not need to have a diagnosable mental health condition to consider therapy. Therapy can be useful for a number of life stresses and conflicts. It can help with:

  • Relieving stress or anxiety caused by work or any other situation.

  • Resolving conflicts with a partner, family member, or friend.

  • To cope with major life changes such as divorce, death of a loved one, or loss of a job. 

  • Recovering from physical or sexual abuse or being a witness to violence.

  • Learning to manage unhealthy reactions such as aggressive behaviours.

  • Coping with an ongoing or serious physical health condition such as cancer or chronic pain.

  • Getting better sleep e.g., insomnia.

  • Increasing low self-esteem.

  • Increasing low quality of life in any other way.

Below are some signs which may indicate that you could benefit from psychotherapy:

  • You feel an overwhelming, prolonged sense of helplessness and sadness.

  • You find it difficult to concentrate on working assignments or to carry out other everyday activities – the issues are interfering with daily life and functioning.

  • Your problems do not seem to get any better despite efforts and help from family and friends.

  • You worry excessively about many things, expect the worst, or are constantly on edge. 

  • Your unhelpful coping strategies, such as drinking alcohol, using drugs, or being aggressive, are harming yourself or others.

  • Your family or friends have expressed their concerns about you.

  • You have difficulty facing everyday challenges.

  • You feel that your situation will never improve. 

Some people attend psychotherapy after a doctor recommends it, but many seek help independently.

If you find yourself worrying about your mental well-being and think you may need psychotherapy, it is probably best to seek advice from a medical professional. 

Types of psychotherapy

Psychotherapy can take different formats depending on the needs of the individual and the style of the therapist.

Individual therapy

This is the most popular form of psychotherapy, involving working one-on-one with the therapist in a safe, caring, and confidential environment.

Individual therapy allows the therapist and client to focus on each other, build a strong rapport, and work together to solve the client’s issues.

This type of psychotherapy encourages in-depth discussions and full attention being given to the client.

Individual therapy may be best for people who do not like group environments and feel they can be more open and honest one-on-one. 

Couples therapy

Couples therapy involves working with the therapist as a couple to improve how the couple function in a relationship.

With the therapist, couples can explore issues in their relationship, work on their communication, improve interactions, and resolve conflict.

While many people may seek couples therapy to address problems, it can be helpful at any stage of a relationship. People in happy, healthy relationships can still benefit from therapy that strengthens their communication and connection.

People may also seek to when they have unresolvable disagreements, trouble expressing feelings, or want a stronger relationship.

Family therapy

Family therapy centres on improving the dynamic within families and can include multiple individuals within a family unit.

The therapist may provide premarital counselling, child counselling, and separation and divorce counselling.

Family therapy can help clients develop new interpersonal communication skills, help members of a family understand each other better, change negative behaviours, resolve conflicts, and create a better functioning home environment.

Family therapy can help with anger, anxiety, self-esteem problems, and grief.

Group therapy

Group therapy involves a small group of individuals who usually share a common goal. This allows members of the group to offer and receive support from others, as well as practise new skills and behaviours within a supportive group.

The group would usually meet for one to two hours a 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.

Although participating in a group may seem intimidating, it can help people realise that they are not alone with their problems.

Group therapy can also help people to develop communication skills, learn to express their issues, and accept criticism from others. 


Behaviour therapy

Behaviour therapy is an umbrella term for many techniques which are based on behaviourists theories such as classical conditioning, operant conditioning, and social learning theory.

This type of therapy seeks to identify and help change potentially self-destructive or unhealthy behaviours, changing them to more helpful or positive ones.

Behaviour therapy functions on the idea that all behaviours are learned, and thus unhealthy behaviours can be changed. 

Exposure therapy is a type of behaviour therapy which is used to help people overcome their fears of situations or objects. This therapy incorporates techniques that expose people to the source of their fears while practicing relaxation strategies. 

Another type of behaviour therapy, called systematic desensitization involves learning ways to relax (e.g., through visualization or progressive muscle relaxation), then making a list of fears, ranking them based on intensity.

After this, the therapist encourages the individual to start exposing themselves to these fears in stages so that they get increasingly more comfortable dealing with them.

The people who commonly seek behaviour therapy are those wanting to treat depression, anxiety, panic disorder, and anger issues.

Cognitive behavioural therapy (CBT)

CBT is a very popular type of therapy known for producing effective results in few required sessions.

CBT helps people to identify their unhelpful thinking patterns and behaviours with the therapist, then working together to challenge and restructure these into more healthy and positive thoughts and behaviours.

In CBT, individuals can set goals that they want to work on, problem-solve, and practice new skills with the therapist. 

Rational emotive behaviour therapy (REBT) is a type of CBT which focuses on identifying negative or destructive thoughts and feelings. The individual can then actively challenge those thoughts and replace them with more rational, realistic ones. 

Another type of CBT is mindfulness-based cognitive therapy which combined CBT with meditation. This type of therapy helps cultivate a non-judgemental, present-orientated attitude which is referred to as mindfulness. 

People commonly seek CBT for help treat anxiety disorders and depression, but it can be helpful for other mental disorders or any mental distress. 

Dialectical behaviour therapy (DBT)

DBT is a type of CBT which was originally intended to treat borderline personality disorder but has since been adapted to treat other conditions.

This therapy is used to help people who have difficulty with emotional regulation or are exhibiting self-destructive behaviours such as eating disorders or substance-use disorders.

DBT helps to address thoughts and behaviours while incorporating strategies such as emotional regulation and mindfulness. 

The goal of DBT is to teach people how to develop healthy ways to cope with stress, regulate their emotions, and improve relationships with others.

DBT teaches core mindfulness, distress tolerance, and interpersonal effectiveness. This therapy can help people who may lack useful coping skills and find that they move from one crisis to another. 

Humanistic therapy

This approach to therapy emphasizes the importance of being your true self in order to lead the most fulfilling life. Humanistic therapy is based on the principle that everyone has their own unique way of looking at the world, and this view can impact choices and actions.

The core belief is that people are good at heart and can make the right choices for themselves. Likewise, the belief is that if people do not hold themselves in a high regard, its harder to develop their full potential. 

The humanist psychologist Carl Rogers developed an approach known as client-centred therapy, which is the main type of humanistic therapy.

This is based on the ideas that absorbing criticism or disapproval from others can distort the way someone sees themselves, blocking personal growth which can lead to mental distress.

This therapy involves the therapist unconditionally accepting the client, even if they disagree, which helps to avoid the client holding back out of fear of disapproval.

The client is encouraged to guide the direction of the therapy while the therapist listens without judgement.

This approach focuses on helping people maximise their potential and stresses the importance of self-exploration, free will, and self-actualization. 

Psychodynamic therapy

Based on Sigmund Freud’s theory of psychoanalysis, this approach explores how the unconscious mind influences thoughts, feelings, and behaviours.

Psychoanalytic therapy examines how a person’s experiences, often, from childhood, may be contributing to their current experiences and actions.

Freud believed that there were unconscious influences which can lead to psychological distress and disturbances and therapy can help to uncover these unconscious thoughts, desires, and memories to heal.

Some techniques of psychoanalysts include:

Dream interpretation – believed to be the most important technique according to Freud, this provides insight into the workings of the unconscious mind. 

Free association – this is an exercise during which the psychoanalyst encourages individuals to freely share their thoughts. This can lead to the emergence of unexpected connections and memories.

Transference – this occurs when the client projects their feelings about another person onto the psychoanalyst. The client can then communicate with the psychoanalyst as if they were that other person.

Psychoanalytic approaches to emotional distress have advanced a great deal since Freud’s time, but still uses the main techniques. Psychoanalysis focuses on emotions, explores avoidance, identifies recurring themes, and explores interpersonal relationships.

It is also more free flowing compared to other therapies which can be more structured.  

How effective is psychotherapy?

Each person’s experience with psychotherapy will be different and the time it takes to see an improvement will vary.

Some people will notice a difference after around 6-12 sessions, while others may require ongoing treatment for longer, sometimes for years.

The effectiveness of psychotherapy can depend on some of the following factors:

  • The reason for seeking therapy, such as the mental health conditions or emotional distress being experienced. 

  • The skill of the therapist.

  • The relationships between the therapist and the individual. 

  • Any support the person may have outside the therapy sessions. 

  • The person’s willingness to help themselves – they have to take accountability and not expect the therapist to fix everything for them.

Psychotherapy has shown to be very helpful for a variety of different issues. Some of the notable benefits include:

  • Improved communication skills.

  • Healthier thinking patterns and a greater awareness of negative thoughts.

  • Improved ability to make healthier choices.

  • Greater insights into one’s own life.

  • Improved coping strategies to manage distress.

  • Stronger family bonds.

  • Providing someone to explore their problems within a confidential environment. 

  • Enabling people to see things from a different perspective.

  • Helping people to move towards a solution.

  • Learning more about one’s goals and values.

  • Developing skills for facing challenges in the present and in the future.

  • Being able to overcome specific problems such as phobias. 

Psychotherapy has been found to be effective at helping individuals with a variety of mental health conditions, specifically those who have depression (Munder et al., 2018).

Therapists can help depressed individual build new ways of thinking and reacting, attempting to examine the causes and potential solutions to their concerns.

Psychotherapy has also shown to be helpful for those with anxiety disorders, such as generalized anxiety and social anxiety, helping these individuals become less avoidant, understand their emotions, and make progress towards their goals. 

Research shows that most people who receive psychotherapy experience symptom relief and are better able to function in their lives. According to the American Psychological Association, about 75% of people who have psychotherapy show to benefit from it.

Numerous studies have identified brain changes in people with mental health disorders (including depression, panic disorder, PTSD, among others) as a result of undergoing psychotherapy.

In most cases, the brain changes were similar to changes that are observed in those that take medication for their condition (Karlsson, 2011). 

Specifically for CBT, meta-analyses have found that this therapy to be strongly effective, especially in improving the symptoms in people with anxiety-related disorders, including OCD and PTSD, as well as in anger problems, drug abuse, and general stress (Hofmann et al., 2012; NIDA, 2018).

CBT has also been used in children and adolescents, findings suggesting that this therapy can be effective in treating symptoms of depression and anxiety in these age groups (Oud et al., 2019). 

A review of 86 studies investigating humanistic therapies found that this approach was effective at helping people make lasting changes over time, with people in this therapy showing more change than people who were not in therapy (Elliott, 2002).

A 2016 review of existing research suggested that client-centred approaches to therapy, as seen in humanistic therapy, can be helpful for trauma, relationship difficulties, psychosis, and coping with chronic health issues (Elliott, 2016). 

Regarding psychoanalytic therapies, a review of the effectiveness of long-term psychoanalytic therapy found moderate to large success rates for reducing symptoms of a variety of psychopathologies (De Maat et al., 2009).

A 2021 review of studies found that short-term psychoanalytic therapy led to lasting improvements in somatic symptoms, depressive symptoms, and anxiety symptoms (Abbass et al., 2021). 

Overall, psychotherapies have a vast amount of support for their effectiveness. It is thought that people in all types of psychotherapy show some significant amount of positive change.

This suggests that it is more about finding a type of therapy which a person will enjoy and commit to, which is suited to their specific problem. 

How to get the most out of psychotherapy

To obtain all the benefits of psychotherapy, a person will need to:

Find the right therapist – its important to ensure you feel comfortable with your therapist. If you feel as if you are not ‘clicking’ with your current therapist or you would like to try someone else’s approach, there is no shame in finding someone new. 

Approach therapy as a partnership – the therapist is there to work with you, and it is helpful to build a strong interpersonal relationship for effective treatment.

Therapy is also more effective when you are an active participant and share in decision-making. Ensure that both yourself and your therapist agree in the way that problems are solved and decisions that are made. Together you can set goals and assess progress over time. 

Be honest – the effectiveness of psychotherapy often depends on your ability to be open and honest with the therapist. You should be willing to share thoughts, feelings, and consider new insights, ideas, and ways of doing things.

Being closed up and unwilling to change your thoughts may be an indication that you are not ready for therapy. However, it is fine to have boundaries with the therapist.

If there are certain topics that you do not want to discuss as they are painful or embarrassing, then let the therapist know so they know not to bring them up during sessions. 

Attend all appointments – whilst it can be tempting to skip sessions if you are feeling down or lack motivation, feeling this way may indicate that you need the session that day more than usual.

A high proportion of people quit therapy before the sessions are over as it may get too hard for them, or they cannot commit to the sessions. Skipping or quitting therapy can disrupt the progress that has already been made.

Try to stick to the recommended treatment plan, and if something is not working for you, such as the times of the sessions, discuss this with the therapist who may be able to come up with a solution.

It’s also useful to come to the therapy sessions with some ideas on what you want to discuss, so there is a reason in mind for attending the session that day. 

Don’t expect instant results – the number of sessions needed to see noticeable results can differ depending on the severity of your symptoms.

Working on emotional issues can be painful and require a lot of patience and hard work. For some people, they may feel somewhat better after one session, but others may require 6-12 sessions, whilst others may take longer.

The therapist will usually discuss your goals and progress at regular intervals throughout therapy and assess whether you will require more sessions. 

Complete assignments between sessions – depending on the type of therapy, such as with CBT, you may be asked to complete some homework between sessions. This may involve using a journal or completing worksheets.

It may feel like a lot of effort, and you may feel unmotivated to do so, but try to follow through on these tasks set by the therapist.

If you find these assignments hard to complete or to fit into your schedule, discuss this with the therapist as they may decide to make some adjustments or try a different approach with you. 

How to get started

As therapy can be effective for a range of issues, you do not necessarily have to have a mental health disorder or have to wait until life becomes so overwhelming to seek help. The sooner you reach out, the sooner you can get help. 

It may be useful to consider the following steps when looking to get started on psychotherapy:

Consult with your primary physician – they might want to rule out any physical conditions in the first instance. If no conditions are found, the doctor may then refer you to a mental health professional who is qualified to diagnose and treat mental illnesses. 

Look for a qualified individual to provide psychotherapy – people who provide therapy can hold a number of different titles or degrees. 

Choose the right therapist – consider whether you feel comfortable divulging personal information to the therapist.

Don’t be afraid to seek a different therapist if you one you have does not quite suit your needs. When choosing a therapist, consider thinking about what your deal breakers are, qualities that are important, and any other characteristics you value. 

Consider whether you need medication - if your treatment would require medication and psychotherapy, a psychiatrist may be beneficial for you.

If you would benefit from some form of therapy without medication, you might be referred to a clinical psychologist or counsellor. 

Be prepared to fill out paperwork-when things get started, the therapist will likely collect health history as well as personal contact information. They may also need some consent forms signed by you.

When you are ready to select a therapist, think about the following:

  • What type of therapy you want - do you want to do individual therapy, group therapy, or another type?

  • What are your main goals for therapy?

  • Whether you can commit the time each week – what days and times are most convenient for you?

Below are some things you may want to ask the therapist:

  • What are your areas of expertise?

  • Whether they work with your demographic.

  • Whether they have experience helping people with symptoms like yours

  • What their approach to treatment is and whether this has proved effective in the past. 

  • What they expect from you during therapy. 

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About the Author

Olivia Guy-Evans obtained her undergraduate degree in Educational Psychology at Edge Hill University in 2015. She then received her master’s degree in Psychology of Education from the University of Bristol in 2019. Olivia has been working as a support worker for adults with learning disabilities in Bristol for the last four years.

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