What is the meaning of psychotherapy

What is Psychotherapy?

Learn about psychotherapy.

Psychotherapy, or talk therapy, is a way to help people with a broad variety of mental illnesses and emotional difficulties. Psychotherapy can help eliminate or control troubling symptoms so a person can function better and can increase well-being and healing.

Problems helped by psychotherapy include difficulties in coping with daily life; the impact of trauma, medical illness or loss, like the death of a loved one; and specific mental disorders, like depression or anxiety. There are several different types of psychotherapy and some types may work better with certain problems or issues. Psychotherapy may be used in combination with medication or other therapies.

Therapy Sessions

Therapy may be conducted in an individual, family, couple, or group setting, and can help both children and adults. Sessions are typically held once a week for about 30 to 50. Both patient and therapist need to be actively involved in psychotherapy. The trust and relationship between a person and his/her therapist is essential to working together effectively and benefiting from psychotherapy.

Psychotherapy can be short-term (a few sessions), dealing with immediate issues, or long-term (months or years), dealing with longstanding and complex issues. The goals of treatment and arrangements for how often and how long to meet are planned jointly by the patient and therapist.

Confidentiality is a basic requirement of psychotherapy. Also, although patients share personal feelings and thoughts, intimate physical contact with a therapist is never appropriate, acceptable, or useful.

Psychotherapy and Medication

Psychotherapy is often used in combination with medication to treat mental health conditions. In some circumstances medication may be clearly useful and in others psychotherapy may be the best option. For many people combined medication and psychotherapy treatment is better than either alone. Healthy lifestyle improvements, such as good nutrition, regular exercise and adequate sleep, can be important in supporting recovery and overall wellness.

Does Psychotherapy Work?

Research shows that most people who receive psychotherapy experience symptom relief and are better able to function in their lives. About 75 percent of people who enter psychotherapy show some benefit from it.1 Psychotherapy has been shown to improve emotions and behaviors and to be linked with positive changes in the brain and body. The benefits also include fewer sick days, less disability, fewer medical problems, and increased work satisfaction.

With the use of brain imaging techniques researchers have been able to see changes in the brain after a person has undergone psychotherapy. Numerous studies have identified brain changes in people with mental illness (including depression, panic disorder, PTSD and other conditions) as a result of undergoing psychotherapy. In most cases the brain changes resulting from psychotherapy were similar to changes resulting from medication.2

To help get the most out of psychotherapy, approach the therapy as a collaborative effort, be open and honest, and follow your agreed upon plan for treatment. Follow through with any assignments between sessions, such as writing in a journal or practicing what you’ve talked about.

Types of Psychotherapy

Psychiatrists and other mental health professionals use several types of therapy. The choice of therapy type depends on the patient’s particular illness and circumstances and his/her preference. Therapists may combine elements from different approaches to best meet the needs of the person receiving treatment.

• Cognitive behavioral therapy (CBT) helps people identify and change thinking and behavior patterns that are harmful or ineffective, replacing them with more accurate thoughts and functional behaviors. It can help a person focus on current problems and how to solve them. It often involves practicing new skills in the “real world.” CBT can be helpful in treating a variety of disorders, including depression, anxiety, trauma related disorders, and eating disorders. For example, CBT can help a person with depression recognize and change negative thought patterns or behaviors that are contributing to the depression.
• Interpersonal therapy (IPT) is a short-term form of treatment. It helps patients understand underlying interpersonal issues that are troublesome, like unresolved grief, changes in social or work roles, conflicts with significant others, and problems relating to others. It can help people learn healthy ways to express emotions and ways to improve communication and how they relate to others. It is most often used to treat depression.
• Dialectical behavior therapy is a specific type of CBT that helps regulate emotions. It is often used to treat people with chronic suicidal thoughts and people with borderline personality disorder, eating disorders and PTSD. It teaches new skills to help people take personal responsibility to change unhealthy or disruptive behavior. It involves both individual and group therapy.
• Psychodynamic therapy is based on the idea that behavior and mental well-being are influenced by childhood experiences and inappropriate repetitive thoughts or feelings that are unconscious (outside of the person’s awareness). A person works with the therapist to improve self-awareness and to change old patterns so he/she can more fully take charge of his/her life.
• Psychoanalysis is a more intensive form of psychodynamic therapy. Sessions are typically conducted three or more times a week.
• Supportive therapy uses guidance and encouragement to help patients develop their own resources. It helps build self-esteem, reduce anxiety, strengthen coping mechanisms, and improve social and community functioning. Supportive psychotherapy helps patients deal with issues related to their mental health conditions which in turn affect the rest of their lives.

Additional therapies sometimes used in combination with psychotherapy include:

• Animal-assisted therapy – working with dogs, horses or other animals to bring comfort, help with communication and help cope with trauma
• Creative arts therapy – use of art, dance, drama, music and poetry therapies
• Play therapy – to help children identify and talk about their emotions and feelings

Finding and Choosing a Psychotherapist

Psychotherapy can be provided by a number of different types of professionals including psychiatrists, psychologists, licensed social workers, licensed professional counselors, licensed marriage and family therapists, psychiatric nurses, and others with specialized training in psychotherapy. Psychiatrists are also trained in medicine and are able to prescribe medications.

Finding a psychiatrist or other therapist with whom an individual can work well is important. Sources of referrals include primary care physicians, local psychiatric societies, medical schools, community health centers, workplace Employee Assistance Programs (EAP), and online resources (see links to online locators below).

Federal law requires that in most cases mental health services, including psychotherapy, be covered by health insurance similar to other medical care costs. (Read more about insurance coverage of mental health care)

Online Locators for Psychotherapy/Counseling:

References

1. American Psychological Association. Understanding psychotherapy and how it works. 2016.
2. Karlsson, H. How Psychotherapy changes the Brain. Psychiatric Times. 2011.
3. Wiswede D, et al. 2014. Tracking Functional Brain Changes in Patients with Depression under Psychodynamic Psychotherapy Using Individualized Stimuli. PLoS ONE. 2014.http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0109037

Physician Review

Ranna Parekh, M.D., M.P.H.

Lior Givon, M.D., Ph.D.

January 2019

What Is Psychotherapy?

Psychology, also known as talk therapy, refers to techniques that help people change behaviors, thoughts, and emotions that cause problems or distress. It is an umbrella term that describes treating psychological disorders and mental distress through verbal and psychological techniques.

During this process, a trained psychotherapist helps the client tackle specific or general problems, such as mental illness or a source of life stress. Depending on the approach used by the therapist, a wide range of techniques and strategies can be used. Almost all types of psychotherapy involve developing a therapeutic relationship, communicating and creating a dialogue, and working to overcome problematic thoughts or behaviors.

Psychotherapy is increasingly viewed as a distinct profession in its own right, but many different types of professionals offer it, including clinical psychologists, psychiatrists, counselors, marriage and family therapists, social workers, mental health counselors, and psychiatric nurses.

This article discusses the different types of psychotherapy that are available and the potential benefits of psychotherapy. It also covers the different conditions it can treat and its effectiveness for a variety of disorders.

Types of Psychotherapy

Psychotherapy can take different formats depending on the style of the therapist and the needs of the patient. A few formats that you might encounter include:

• Individual therapy, which involves working one-on-one with a psychotherapist.
• Couples therapy, which involves working with a therapist as a couple to improve how you function in your relationship.
• Family therapy, which centers on improving the dynamic within families and can include multiple individuals within a family unit.
• Group therapy, which involves a small group of individuals who share a common goal. (This approach allows members of the group to offer and receive support from others, as well as practice new behaviors within a supportive and receptive group.)

The Best Online Therapy Programs

We’ve tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain.

Techniques

When people hear the word “psychotherapy,” many imagine the stereotypical image of a patient lying on a couch talking while a therapist sits in a nearby chair jotting down thoughts on a yellow notepad. The reality is that there are a variety of techniques and practices used in psychotherapy.

The exact method used in each situation can vary based upon a variety of factors, including the training and background of the therapist, the preferences of the client, and the exact nature of the client’s current problem. Here is a brief overview of the main types of therapy.

Behavioral Therapy

When behaviorism became a more prominent school of thought during the early part of the twentieth century, conditioning techniques began to play an important role in psychotherapy.

While behaviorism may not be as dominant as it once was, many of its methods are still very popular today. Behavioral therapy often uses classical conditioning, operant conditioning, and social learning to help clients alter problematic behaviors.

Cognitive Behavioral Therapy

The approach known as cognitive behavioral therapy (CBT) is a psychotherapeutic treatment that helps patients understand the thoughts and feelings that influence behaviors. CBT is used to treat a range of conditions including phobias, addiction, depression, and anxiety.

CBT involves cognitive and behavioral techniques to change negative thoughts and maladaptive behaviors. The approach helps people to change underlying thoughts that contribute to distress and modify problematic behaviors that result from these thoughts.

Cognitive Therapy

The cognitive revolution of the 1960s also had a major impact on the practice of psychotherapy, as psychologists began to increasingly focus on how human thought processes influence behavior and functioning.

For example, if you tend to see the negative aspects of every situation, you will probably have a more pessimistic outlook and a gloomier overall mood.

The goal of cognitive therapy is to identify the cognitive distortions that lead to this type of thinking and replace them with more realistic and positive ones. By doing so, people are able to improve their moods and overall well-being.

Cognitive therapy is centered on the idea that our thoughts have a powerful influence on our mental well-being.

Humanistic Therapy

Starting in the 1950s, the school of thought known as humanistic psychology began to have an influence on psychotherapy. The humanist psychologist Carl Rogers developed an approach known as client-centered therapy, which focused on the therapist showing unconditional positive regard to the client.

Today, aspects of this approach remain widely used. The humanistic approach to psychotherapy focuses on helping people maximize their potential and stresses the importance of self-exploration, free will, and self-actualization.

Psychoanalytic Therapy

While psychotherapy was practiced in various forms as far back as the time of the ancient Greeks, it received its formal start when Sigmund Freud began using talk therapy to work with patients. Techniques commonly used by Freud included the analysis of transference, dream interpretation, and free association.

This psychoanalytic approach involves delving into a person’s thoughts and past experiences to seek out unconscious thoughts, feelings, and memories that may influence behavior.

Recap

There are many different types of psychotherapy available. The kind that is most appropriate for you depends on a variety of factors including your preferences, your condition, and the severity of your symptoms.

What Psychotherapy Can Help With

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

If you are experiencing symptoms of a psychological or psychiatric disorder, you might benefit from an evaluation by a trained and experienced psychotherapist who is qualified to assess, diagnose, and treat mental health conditions.

Psychotherapy is used to treat a wide range of mental health conditions, including:

In addition, psychotherapy has been found to help people cope with the following:

• Chronic pain or serious illnesses
• Divorce and break-ups
• Grief or loss
• Insomnia
• Low self-esteem
• Relationship problems
• Stress

How to Get the Most Out of Psychotherapy

The efficacy of therapy can vary depending on a wide range of factors. The nature and severity of your problem will play a role, but there are also things you can do to get the most out of your sessions, including:

• Being honest with your therapist: Don’t try to hide problems or feelings. Your goal is to show up as your true self without trying to hide aspects of your personality that you might be afraid to reveal.
• Feeling your feelings: Don’t try to hide negative or distressing emotions such as grief, anger, fear, or jealousy. Talking about these feelings within the context of therapy can help you understand them better.
• Being open to the process: Work on forming an open and genuine therapeutic alliance with your therapist. Some research suggests that therapy is most effective when you feel a connection with the mental health professional treating you.
• Attending your sessions: Life gets busy, but try to stick to your treatment plan and scheduled appointments as best you can. 
• Doing the work: If your therapist assigns homework to work on outside of your sessions, make an effort to finish it before the next session.

Benefits

Psychotherapy is often more affordable than other types of therapy and a viable option for those who don’t require psychotropic medication.

You can reap the possible benefits of psychotherapy even if you just feel that there is something “off” in your life that might be improved by consulting with a mental health professional.

Notable benefits of psychotherapy include:

• Improved communication skills
• Healthier thinking patterns and greater awareness of negative thoughts
• Greater insights about your life
• Ability to make healthier choices
• Better coping strategies to manage distress
• Stronger family bonds

Effectiveness

One of the major criticisms leveled against psychotherapy calls into question its effectiveness. In one early and frequently cited study, a psychologist named Hans Eysenck found that two-thirds of participants either improved or recovered on their own within two years, regardless of whether they had received psychotherapy.

However, in numerous subsequent studies, researchers found that psychotherapy can enhance the well-being of clients.

Verywell Mind’s Cost of Therapy Survey found that 8 in 10 Americans in therapy believe it to be a good investment despite the high costs. Additionally:

• 91% are satisfied with the quality of therapy they receive
• 84% are satisfied with their progress toward personal mental health goals
• 78% believe therapy plays a big part in meeting those goals

In his book “The Great Psychotherapy Debate,” statistician and psychologist Bruce Wampold reported that factors such as the therapist’s personality as well as their belief in the effectiveness of the treatment played a role in the outcome of psychotherapy.

Surprisingly, Wampold suggested that the type of therapy and the theoretical basis of the treatment do not have an effect on the outcome. The disagreement has motivated researchers to continue to examine and study the effectiveness of psychotherapy.

More recent research has shown that psychotherapy is an effective form of treatment for some anxiety disorders, mood disorders, and eating disorders as well as grief and trauma.

Recap

Mental health conditions can create distress and make it difficult to function, but psychotherapy can help improve well-being and reduce the negative impact of many symptoms. 

Things to Consider

There are a number of issues or concerns for both therapists and clients. When providing services to clients, psychotherapists need to consider issues such as informed consent, patient confidentiality, and duty to warn.

Informed consent involves notifying a client of all of the potential risks and benefits associated with treatment. This includes explaining the exact nature of the treatment, any possible risks, costs, and the available alternatives. Duty to warn gives counselors and therapists the right to breach confidentiality if a client poses a risk to another person.

Because clients frequently discuss issues that are highly personal and sensitive in nature, psychotherapists also have a legal obligation to protect a patient’s right to confidentiality. However, one instance where psychotherapists have a right to breach patient confidentiality is if clients pose an imminent threat to either themselves or others.

How to Know If You Need Psychotherapy

You might realize that psychotherapy can help with life’s problems, but it can still be difficult to seek help or to even recognize when it is time to talk to a professional.

Some key signs that it might be time to see a psychotherapist are when:

• The issue is causing significant distress or disruption in your life. If you feel that the problem you are facing interrupts a number of important areas of your life, including school, work, and relationships, it may be time to try psychotherapy.
• You are relying on unhealthy or dangerous coping mechanisms. If you find yourself dealing with your problem in unhealthy ways such as by smoking, drinking, overeating, or taking out your frustrations on others, seeking assistance can help you find healthier and more beneficial coping strategies.
• Friends and family are concerned about your well-being. If it has reached a point where other people are worried about your emotional health, it may be time to see if psychotherapy can improve your psychological state.
• Nothing you have tried so far has helped. You’ve read self-help books, explored some techniques you read about online, or even tried just ignoring the problem, yet things just seem to be staying the same or even getting worse.

A common misunderstanding about therapy among patients is that you’ll immediately start to feel better, however, the reality is that it is an individual process that takes time depending on the type of psychotherapy you need as well as the severity of your symptoms.

How to Get Started

Psychotherapy can be an effective treatment choice for a range of psychological issues. You don’t have to wait until your life becomes so overwhelming that you can’t cope to ask for help. The sooner you reach out, the sooner you can get the help you need to live a healthier, happier life.

If you feel that you or someone you love might benefit from this form of therapy, consider the following steps:

• Consult with your primary physician. Your doctor might begin by ruling out any physical diseases that could cause or contribute to your symptoms. If no specific physical cause is found, your doctor can refer you to a mental health professional who is qualified to diagnose and treat mental illness.
• Look for a qualified individual. People who provide psychotherapy can hold a number of different titles or degrees. Titles such as “psychologist” or “psychiatrist” are protected and carry specific educational and licensing requirements. Some of the individuals who are qualified to offer psychotherapy include psychiatrists, psychologists, licensed counselors, licensed social workers, and advanced psychiatric nurses.
• Choose the right therapist. When selecting a therapist, consider whether you feel comfortable divulging personal information to the therapist. You should also assess the therapist’s qualifications, including the type of degree they hold and years of experience. Referrals from friends and family members can sometimes be a good route to connecting with a therapist who can help you.
• Consider whether you need medication. Your symptoms should play a role in the treatment and therapist you choose. For example, if the best treatment for you would require prescription medications and psychotherapy, seeing a psychiatrist may be beneficial. If you would most benefit from some form of talk therapy without the addition of prescription drugs, you might be referred to a clinical psychologist or counselor.
• Be prepared to fill out paperwork. When getting started with therapy, your therapist will likely collect your health history as well as personal contact information. You will also likely need to sign some consent forms.
• Don’t be afraid to try different therapists. Psychotherapy is both an art and a science. If your sessions don’t feel helpful or you just don’t seem to “click” with your current therapist, it’s OK to try therapy with someone else. Keep looking until you find a professional that you feel comfortable with.

As you evaluate a potential psychotherapist, consider the following questions:

• Does the therapist seem professional and qualified?
• Do you feel comfortable sharing your feelings and experiences?
• Do you like the therapist’s conversational style?
• Are you satisfied with the extent of your interaction with the therapist?
• Do they seem to understand what you are feeling?
• What is their approach to treatment?
• What type of goals do they have for your treatment?

A Word From Verywell

Psychotherapy can be helpful for people who are experiencing a mental health problem, but it can also be beneficial for people interested in learning new coping strategies or better understanding their own thoughts and experiences.

If you are interested in trying psychotherapy, you might start by talking to your primary care physician about your options. Referrals from friends, referral services, and online therapist directories can also be a great way to find a therapist.