Therapy Types Explained
A comprehensive guide to understanding different therapy approaches and finding the right modality for your mental health journey.
There are dozens of different therapy approaches, each with its own theory, techniques, and strengths. This guide explains the most common and evidence-based therapy types to help you understand what to expect and which approach might be right for you.
Understanding Therapy Approaches
Same Goal, Different Paths
All therapy approaches aim to reduce suffering and improve well-being, but they take different routes to get there. Some focus on thoughts, others on emotions, behaviors, or relationships.
Evidence-Based Matters
"Evidence-based" means the approach has been rigorously tested in research studies and shown to be effective for specific conditions. The therapies in this guide all have strong research support.
Therapists Often Integrate
Many therapists use an "integrative" or "eclectic" approach, drawing techniques from multiple modalities based on what works best for each client's unique needs.
Cognitive Behavioral Therapy (CBT)
Most researched and widely practiced therapy approach
What It Is:
CBT is a structured, short-term, goal-oriented therapy that focuses on the connection between thoughts, feelings, and behaviors. The core idea: It's not events themselves that upset us, but the meaning we give them.
The CBT Triangle:
Change one, and you can change them all
How It Works:
- • Identify automatic thoughts: Notice negative or unhelpful thinking patterns
- • Examine the evidence: Test whether thoughts are accurate or distorted
- • Challenge cognitive distortions: Replace unhelpful thoughts with balanced ones
- • Behavioral experiments: Test new behaviors to see if fears are accurate
- • Homework assignments: Practice skills between sessions
Best For:
- Depression
- Anxiety disorders (GAD, panic, social anxiety)
- OCD
- PTSD
- Eating disorders
- Insomnia (CBT-I)
What to Expect:
- • Structure: Agenda-driven sessions with specific goals
- • Active participation: You'll do exercises in and out of sessions
- • Skills-based: Learn concrete techniques you can use independently
- • Present-focused: Emphasizes current problems, not childhood history
Duration:
Typically 12-20 sessions (3-6 months)
Short-term and goal-oriented. Some conditions may require longer treatment.
Dialectical Behavior Therapy (DBT)
Balancing acceptance and change
What It Is:
DBT is a modified form of CBT developed by Marsha Linehan specifically for borderline personality disorder (BPD). It combines cognitive-behavioral techniques with mindfulness, acceptance, and distress tolerance skills. The word "dialectical" refers to balancing opposites—particularly acceptance ("I'm doing the best I can") and change ("I need to do better").
The Four Skill Modules:
1. Mindfulness
Being present in the moment without judgment
2. Distress Tolerance
Surviving crises without making things worse
3. Emotion Regulation
Understanding and managing intense emotions
4. Interpersonal Effectiveness
Asking for what you need while maintaining relationships
Best For:
- Borderline personality disorder (BPD)
- Emotion dysregulation
- Self-harm and suicidal ideation
- Complex PTSD
- Eating disorders (especially binge eating)
- Substance use disorders
What to Expect:
- • Individual therapy: Weekly one-on-one sessions
- • Skills group: Weekly group class teaching the 4 modules
- • Phone coaching: Brief calls to therapist for crisis support
- • Diary cards: Daily tracking of emotions, urges, and skill use
Duration:
Typically 6-12 months (or longer)
Full DBT program is intensive and time-limited, though some continue longer.
Psychodynamic Therapy
Exploring unconscious patterns and past experiences
What It Is:
Psychodynamic therapy is based on the idea that our current struggles are rooted in unconscious patterns formed in childhood. By bringing these patterns to awareness and understanding their origins, we can make different choices. It's less structured than CBT and emphasizes the therapeutic relationship itself as a tool for healing.
Key Concepts:
- • Unconscious mind: Much of our behavior is driven by thoughts/feelings outside awareness
- • Defense mechanisms: Ways we protect ourselves from painful emotions (denial, repression, projection)
- • Transference: Patterns from past relationships show up with therapist
- • Early experiences: Childhood relationships shape adult patterns
Best For:
- Recurring relationship problems
- Chronic depression
- Personality concerns
- Self-exploration and personal growth
- Unresolved grief or trauma
What to Expect:
- • Open-ended: Less structured; you guide what to discuss
- • Exploration: Therapist asks questions to deepen understanding
- • Interpretation: Therapist may offer insights about patterns
- • Past and present: Connect childhood experiences to current struggles
Duration:
Typically 6 months to several years
Often longer-term. Short-term psychodynamic therapy (STPP) is also available (12-20 sessions).
Humanistic / Person-Centered Therapy
Trusting your inner capacity for growth
What It Is:
Developed by Carl Rogers, person-centered therapy is based on the belief that humans have an innate drive toward growth and self-actualization. The therapist's role is not to direct or interpret, but to provide a warm, genuine, non-judgmental space where you can explore your feelings and find your own answers.
Core Conditions (Rogers):
Unconditional Positive Regard
Complete acceptance without judgment
Empathic Understanding
Deeply understanding your experience
Congruence (Genuineness)
Therapist is authentic and real, not distant expert
Best For:
- Self-esteem issues
- Relationship difficulties
- Life transitions and identity exploration
- Grief and loss
- Personal growth and self-discovery
What to Expect:
- • Client-led: You choose what to talk about each session
- • Reflective listening: Therapist mirrors back what you share
- • Non-directive: No homework, techniques, or advice-giving
- • Focus on feelings: Emphasis on emotional experience in the moment
Duration:
Varies widely (weeks to years)
Can be short-term or long-term depending on goals and needs.
Acceptance and Commitment Therapy (ACT)
Living a valued life despite difficult thoughts and feelings
What It Is:
ACT (said as one word, "act") is a mindfulness-based therapy that teaches psychological flexibility: the ability to stay present, accept painful thoughts/feelings without struggling against them, and take action guided by your values. Rather than trying to eliminate negative thoughts, ACT focuses on changing your relationship with them.
The Six Core Processes:
- 1. Acceptance: Making room for painful feelings rather than fighting them
- 2. Cognitive defusion: Noticing thoughts without believing or obeying them
- 3. Present moment: Being here now, not lost in past/future
- 4. Self-as-context: "Observer self" separate from thoughts/feelings
- 5. Values: Clarifying what matters most to you
- 6. Committed action: Taking steps aligned with your values
Best For:
- Chronic pain and illness
- Anxiety disorders
- Depression
- OCD
- Substance use
- Work stress and burnout
What to Expect:
- • Experiential exercises: Mindfulness practices and metaphors
- • Values work: Identifying what you want your life to stand for
- • Behavioral goals: Concrete actions aligned with values
- • Acceptance paradox: Welcoming discomfort to reduce its power
Duration:
Typically 8-16 sessions
Short to moderate duration, though some continue longer.
Eye Movement Desensitization and Reprocessing (EMDR)
Trauma-focused therapy using bilateral stimulation
What It Is:
EMDR is a specialized therapy for trauma and PTSD. Developed by Francine Shapiro, it helps the brain process traumatic memories that have become "stuck." While recalling distressing memories, you engage in bilateral stimulation (typically following the therapist's fingers with your eyes, or listening to alternating tones). This helps the brain reprocess memories so they become less disturbing.
The Eight Phases:
- 1. History taking: Identify target memories
- 2. Preparation: Build coping skills for distress
- 3. Assessment: Identify components of target memory
- 4. Desensitization: Process memory with eye movements
- 5. Installation: Strengthen positive belief
- 6. Body scan: Release residual physical tension
- 7. Closure: Return to calm state
- 8. Reevaluation: Check progress
Best For:
- PTSD and complex PTSD
- Single-event trauma (assault, accident, disaster)
- Childhood trauma and abuse
- Phobias
- Panic disorder
What to Expect:
- • Bilateral stimulation: Eye movements, tapping, or audio tones
- • Memory recall: Briefly bring traumatic memory to mind
- • Can be intense: May feel worse initially as memories surface
- • No detailed storytelling required: Don't have to describe trauma in detail
Duration:
Varies: 3-12+ sessions per trauma
Single traumas may resolve quickly; complex trauma takes longer.
Other Evidence-Based Approaches
Interpersonal Therapy (IPT)
Short-term therapy focusing on improving relationships and social functioning. Addresses four problem areas: grief, role transitions, role disputes, and interpersonal deficits.
Best for:
- • Depression
- • Eating disorders (especially bulimia)
- • Relationship problems
Duration: 12-16 sessions
Solution-Focused Brief Therapy (SFBT)
Future-oriented therapy that focuses on solutions rather than problems. Uses questions like "What would be different if your problem was solved?" and "When have things been better?"
Best for:
- • Specific, well-defined goals
- • Relationship issues
- • Work/school problems
Duration: 5-8 sessions (very brief)
Family Systems Therapy
Views problems as arising from dysfunctional family patterns rather than individual pathology. Family members attend sessions together to identify and change unhealthy dynamics.
Best for:
- • Family conflict
- • Childhood behavioral problems
- • Substance use (family involvement)
- • Eating disorders in adolescents
Duration: 12-20 sessions
Motivational Interviewing (MI)
Collaborative, client-centered approach designed to strengthen personal motivation for change. Particularly effective when ambivalence about change is the central issue.
Best for:
- • Substance use disorders
- • Health behavior change (diet, exercise)
- • Medication adherence
- • Any ambivalence about change
Duration: 1-4 sessions (brief intervention) or ongoing
How to Choose the Right Therapy Approach
Consider Your Needs:
- Specific diagnosis? Some therapies are gold-standard for specific conditions (e.g., CBT for panic disorder, DBT for BPD, EMDR for PTSD).
- Concrete skills vs. self-exploration? Want structured techniques (CBT, DBT) or deeper exploration (psychodynamic, person-centered)?
- Past or present focused? Some emphasize current problems (CBT, ACT), others explore childhood roots (psychodynamic).
- Timeline? Need quick relief (SFBT, CBT) or willing to invest in longer-term work (psychodynamic)?
The Therapist Matters More:
Research consistently shows that the therapeutic relationship is one of the strongest predictors of successful outcomes—often more important than the specific therapy approach.
- A good fit with your therapist matters tremendously
- Many effective therapists use integrative approaches
- It's okay to try a few therapists to find the right match
- Trust your gut—therapy requires vulnerability and trust
Questions to Ask Potential Therapists:
- • "What therapy approach do you primarily use?"
- • "Do you have experience treating [your specific concern]?"
- • "What does a typical session with you look like?"
- • "How do you measure progress?"
- • "How long do you expect treatment to last?"
- • "Are you trained in [specific modality] if applicable?"
Quick Reference: Therapy Types at a Glance
| Therapy Type | Primary Focus | Best For | Typical Duration |
|---|---|---|---|
| CBT | Thoughts, behaviors, present problems | Depression, anxiety, OCD, PTSD | 12-20 sessions |
| DBT | Emotion regulation, distress tolerance | BPD, self-harm, emotion dysregulation | 6-12 months |
| Psychodynamic | Unconscious patterns, past experiences | Relationship issues, chronic depression | 6 months - years |
| Person-Centered | Self-acceptance, personal growth | Self-esteem, identity, grief | Varies widely |
| ACT | Acceptance, values, committed action | Chronic pain, anxiety, OCD | 8-16 sessions |
| EMDR | Trauma memory processing | PTSD, trauma, phobias | 3-12+ sessions |
| IPT | Relationships, social functioning | Depression, eating disorders | 12-16 sessions |
| SFBT | Solutions, future goals | Specific problems, goal-oriented work | 5-8 sessions |
If You're in Crisis
If you're experiencing a mental health emergency, please reach out for immediate support:
National Suicide Prevention Lifeline
988
24/7 crisis support via call or text
Crisis Text Line
Text HOME to 741741
24/7 crisis support via text
If you're in immediate danger, call 911 or go to your nearest emergency room.