October 29, 2021 — 15:21 PM
Therapy is a transformative journey where you can dive into your interior world and gently unpack your story. Making the decision to engage in a deeper relationship with yourself is a positive step forward to manage your well-being and mental health effectively. Before you decide on a therapist, it could be useful first to understand some of the different types of therapies out there to choose the right one for you.
Read on for a list of common therapeutic approaches, how they work, and how to choose the modality that will best ensure you’ll feel meaningfully seen and heard.
“Psychodynamic therapy is rooted in traditional psychoanalysis, and it tends to focus on the roots of emotional suffering that is usually found in the formation years and our early experiences with our caregivers,” licensed psychologist Lydiana Garcia, Ph.D., tells mbg.
Psychodynamic therapy works by talking in-depth about the external things that make up your life: your day, dreams, childhood, and how your past may be influencing your current behaviors. By gaining a greater understanding of your unconscious motivations and the true reasons behind your actions, you can choose how you want to react healthier.
“It strives to help clients increase self-reflection and self-examination and thus improve their ability to relate to others, make choices and create a life they would like to live,” Garcia defines.
The evidence-based talk therapy would be well suited to you if you’re looking to surface repressed emotions and if you feel chronically sad and lost in life. By free-associating your thoughts out loud, your therapist can help you become aware of your patterns. The therapy can help those with depression, anxiety, mental disorders, and stress ailments. Treatment can either be short term and last under a year or be something more long term, which could be longer than a year.
2. Cognitive-behavioral therapy
Cognitive-behavioral therapy (CBT) is a type of talk therapy that aims to challenge cognitive distortions present in your thinking and find better ways to cope and manage your stress through problem-solving. It’s predicated on the idea that your thoughts create your reality, so you can shift them to feel better.
“[CBT] tends to focus on changing behaviors, usually maladaptive behaviors. Some of their techniques include identifying the factors that contribute to the maladaptive behaviors to remove them, and ‘learning’ new ones,” Garcia says. It aims to modify maladaptive behaviors such as passive-aggressiveness, withdrawal, avoidance, daydreaming, etc., by replacing them with healthier and constructive ways of coping.
CBT is a time-based intervention and can last between 12 and 20 sessions for those with depression, anxiety, somatic issues, eating disorders, substance abuse problems, relationship issues, and severe mental illnesses. A CBT therapist will teach you constructive strategies to break you out of your negative thought patterns and thus deal with your problems productively. The behavioral therapy emphasizes the use of a host of techniques to be assertive, positively manage stress, and build confidence and resilience.
“Humanistic therapy is a psychological perspective that focuses on the whole individual, including their sense of purpose/potential and well-being. It takes into consideration what happened in someone’s life but also focuses on the potential of changing it,” Garcia says.
Humanistic therapy parallels the gestalt, present-oriented approach. The talk therapy doesn’t focus as much on past events as it does on your active participation with the current moment. Your therapist helps you empathetically validate your perspective while also offering you a safe space to reconnect to your true identity.
If you believe your lack of self-acceptance is blocking you from having the life you want, humanistic therapy may be for you. It’s a positive form of therapy that seeks to support and draw out your unique, individual nature. The humanistic approach aims to nurture you toward self-actualization with the belief that you have all of the innate wisdom you need.
This approach helps those seeking treatment for addictions, personality disorders, self-esteem, anxiety, depression, relationship issues, worthlessness, and schizophrenia. You can set your own goals and decide whether short-term or long-term therapy is right for you.
4. Dialectical behavioral therapy
“Dialectic [behavioral] therapy (DBT) is rooted in cognitive-behavioral therapy and integrates mindfulness, communication, and interpersonal skills; distress tolerance; and regulating emotions,” Garcia defines. The core concept of dialectical thinking is being comfortable with the notion that two simultaneous opposing ideas can co-exist and be truthful at the same time, thus validating the contrasting emotional thoughts.
DBT is a form of psychosocial therapy that isn’t so much about talking as it is about “doing.” Your therapist helps you learn how to feel OK around uncomfortable thoughts so you don’t have to resort to destructive behavior, increasing your overall emotional competency and flexibility. On top of attending sessions, you’ll be implementing your lessons in real life through role-play and homework assignments to cultivate skills such as mindfulness and self-soothing.
DBT is often very effective if you’re suffering from suicidal thoughts, borderline personality disorder (BPD), or self-harm issues, but it can also be useful for those with less severe cases. If your emotions feel intensely outsized and hard to get under control, dialectical therapy can be very balancing. It centers you in the here and now by leaning on mindfulness, emotional regulation, interpersonal effectiveness, acceptance of what is, and increasing your comfort to distress. Completing treatment is broken down into modules and can take anywhere between six months and over a year.
“Exposure therapy is a type of treatment that is rooted in behavioral therapy to help people confront their fears and decrease post-traumatic symptoms,” Gray says. This type of therapy is about facing your fears and has roots in cognitive-behavioral therapy.
If you’re scared or anxious about something, it’s likely you may avoid whatever might be inspiring your agitation. Through therapy, your therapist will create a safe environment to expose you to the very things that you’re trying to get away from, which disrupts your avoidance patterns as the new learned behaviors move you toward lessened fear.
By repeated exposure, it helps reduce phobias and your circumscribed behaviors. It can be paced through hierarchical exposure from least difficult to the most difficult fears or systematic desensitization, which combines relaxation techniques to the situation to associate calmness to the trigger.
Exposure therapy works to relieve conditions including obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), anxiety, panic, social anxiety, and phobic disorders. Undergoing a full course of exposure therapy can be fairly quick. Depending on the depth of your fears and how you respond to the program, it can take anywhere between a few weeks and more than 20 sessions.
“[Interpersonal therapy] is a type of therapy that has been shown to be effective for treating mood disorders. It focuses on becoming aware and changing interpersonal dynamics/skills that are contributing to the mood disorder,” Garcia says.
Interpersonal therapy is an attachment-focused and person-based form of psychotherapy. Your therapist works as a nonjudgmental guide to help you improve your relational problems so you can better manage your social functioning and interpersonal relationships. It can take place one-to-one or in a group setting.
Interpersonal therapy is time-limited (up to 12 to 16 sessions) and is empirically validated to treat a variety of psychiatric disorders and other areas such as life changes, substance abuse, anxiety, postpartum depression, eating disorders, depression, grief, and difficulty starting and sustaining relationships.
7. Mentalization-based therapy
Mentalizing literally means to be aware of your own mind and other people’s minds. In a study published in Psychoanalytic Inquiry, researchers note that mentalization-based therapy (MBT) is the process in which “we make sense of each other and ourselves, implicitly and explicitly, in terms of subjective states and mental processes.” As you move in the world, it’s natural to focus on yourself, but it can negatively affect one’s life if you’re unable to identify your internal dialogue or how other people are thinking and feeling in relation to you.
Your therapist will work with you to acknowledge your emotions to decrease impulsivity and instability in yourself and, subsequently, your relationships. Learning self-regulation and healthy emotional expression are key tenets in the framework. Your therapist functions as a secure therapeutic attachment as you gain more insight into your mental processes and explore your interpretations of behaviors around you.
MBT was initially developed for borderline and antisocial personality disorders but can also treat substance abuse, eating disorders, and depression. Some research (such as this paper published in World Psychiatry) notes its effectiveness for people with early abandonment issues or who didn’t grow up in a securely attached household. The treatment program varies depending on your symptoms, but it usually ranges for up to 18 months.
8. Mindfulness-based therapy
Mindfulness-based therapy (MBCT) intertwines cognitive-behavioral techniques together with mindfulness and breathwork to bring awareness to your present moment. The intervention focuses on observing distressing emotions nonjudgmentally and separating your sense of self from negative messages to stave off depression.
Research published in Mindfulness notes MBCT is generally in a group setting, but it’s also possible to do it individually with a therapist. Your therapist will help you sit through the overwhelming, charged emotions you may feel as you develop positive thought patterns. Along with weekly sessions, there will be homework and meditation exercises to incorporate your new coping skills into your daily life.
The study above shows MBCT may be highly effective for treating chronic unhappiness, depression, stress, anxiety, physical pain, and mood disorders. Instead of eliminating sources of pain, this approach teaches you to find relief by recognizing you can feel difficult emotions but it doesn’t have to define you. The program is typically known to last for eight weeks.
“Somatic psychotherapy is a type of body-centered therapy that works great for treating trauma and similar issues. There are many different models and styles, but in general, they focus on helping people become aware of the interconnection of their body-mind-brain behavior,” Garcia says.
This type of alternative therapy works off the notion that talk therapy can only address a part of previous traumas. Somatic psychotherapy seeks to also look at your physical body and how it can hold on to stress. Therefore, the emphasis is on moving through pent-up feelings and blending together different holistic approaches to fit your specific needs. Your therapist will bring up past traumatic experiences and help you notice and feel the physical responses as you go through the uneasiness. Somatic psychotherapy teaches you concepts such as self-regulation, grounding, boundary development, and movement.
This modality can address a wide range of psychological and physical mental health issues like stress, depression, anxiety, chronic pain, addiction, trauma, abuse, dysfunctional relationships, and sexual function. It helps you bridge your mind and body for proper integration and may incorporate physical therapies like dance, yoga, meditation, and breathwork to help clear your mind and heal. The length of treatment varies from person to person.
10. Marriage and family therapy
“Typically, couples’ therapy involves talking through relationship challenges as a couple with a neutral party (your therapist) who is trained to help you get to the bottom of the issue,” marriage therapist Linda Carroll, LMFT, previously told mbg.
Your therapist will be there as an unbiased mediator to observe your dynamic and hear out your ongoing fights and present pain points. During the process, it’s paramount that both people can be vulnerable and commit to being fully seen, no matter how uncomfortable or ugly it may seem.
As your therapist hears both of your perspectives out, they will point out any limiting beliefs and encourage active listening to push your relationship toward its fullest potential. Outside of ongoing therapy, your therapist may assign you homework in between sessions.
It’s helpful for all couples during any stage. There’s value in seeing couples’ therapy as relationship maintenance to learn how to improve communication, navigate life changes, and see each other more clearly. Carroll notes most people go to couples’ therapy when the relationship is on life support and they’re looking for repair, but “a healthy relationship is a skill set. Most of us don’t learn these skills growing up, so we just expect love to carry us through. But it isn’t enough. That said, love combined with skills usually is enough.” The length of couples’ therapy ranges but can typically take a few months or years to work through issues.
“Group therapy is therapy delivered in a small-group setting. Group therapy is incredibly helpful to connect you with others who are experiencing similar challenges. It can be done on its own or also in combination with individual therapy,” says licensed psychologist Lisette Sanchez, Ph.D.
“There are different types of therapy groups. Most groups require a prior meeting with the therapist(s) facilitating the group. Groups may have a set duration, four to 12 weeks, or may have ongoing availability,” Sanchez further explains. A therapist will lead discussions as the group chimes in with perspective and experiences. Engaging in group therapy can be incredibly cathartic as you share your personal stories and develop new skills to relate to others.
Group therapy treats many mental illnesses and has a lot of efficacy around family problems, attention deficit hyperactivity disorder (ADHD), depression, anxiety, panic disorders, eating disorders, phobias, post-traumatic stress disorders (PTSD), and substance abuse. It can be affirming to be around people who are going through similar afflictions, so you don’t feel alone. If you’re looking for interpersonal support, a sense of belonging, and a sounding board to better understand yourself, group therapy may be for you.
12. Eye movement desensitization and reprocessing therapy
Research suggests that eye movement desensitization and reprocessing psychotherapy (EMDR) is an empirically validated treatment for trauma in processing negative life experiences. It facilitates the processing of unprocessed and otherwise inaccessible memories. (You can read more about EMDR here.)
EMDR works in phases and specifically looks at childhood events rather than present stressors. Your clinician will develop a treatment plan by learning about your history and the level of your emotional distress. Then they will teach you stress reduction techniques so you can feel equipped down the road to sit with disturbing images related to your memories and undergo bilateral stimulation, which can be eye movements or taps. It works by feeling those tough emotions and installing positive beliefs over negative beliefs.
Clinical applications show it may help with psychological problems such as stress-induced physical disorders, post-traumatic stress disorder (PTSD), complex post-traumatic stress disorder (CPTSD), complicated grief, dissociation, substance abuse, eating disorders, panic, and anxiety. EMDR is a time-based intervention and depending on the traumatic memories you’re looking to address, it can take between three and 12 sessions or more.
13. Internal family system
A 2011 case study defines internal family system (IFS) as a form of therapy that works to regulate shame and facilitate a whole relationship with yourself through internal compassion. Research published in the Encyclopedia of Couple and Family Therapy posits that the natural state of the mind contains multiple, subpersonalities that “contain valuable qualities and abilities but are forced from their naturally vulnerable states by traumas or attachment injuries. Some are forced into protective roles, and others are locked away inside the mind such that people no longer have access to them.” The goal is to become comfortable with those inner parts and integrate them.
Your therapist will help you understand your subpersonalities and assist you in creating a cohesive relationship with those autonomous parts to move toward a cohesive, unchanging core self. One study from the Journal of Clinical Psychology notes that while psychotherapy is usually about changing unwanted behaviors, emotions, or thoughts, IFS instead fosters radical acceptance of all parts, no matter how destructive or shameful.
It can treat a variety of conditions including depression, anxiety, phobias, panic, post-trauma stress disorder (PTSD), substance abuse, eating disorders, and physical health conditions. The length varies depending on your specific concerns and your acclimation to the model.
The Mayo Clinic defines family therapy as a type of psychotherapy that addresses underlying issues that affect the psychological health of the family. It helps improve communication by understanding dynamic relationships within the family system and tackle conflicts in a manageable way.
Your therapist will teach you tools to resolve problems effectively while identifying issues with family roles and behavior patterns that may contribute to those issues. It can corral the entire family together to support each other beneficially.
It’s useful in bringing several members of the family together to explore thoughts, emotions, and conflict in a safe setting. Family therapy is often short-term and can generally take 12 sessions. It depends on your therapist’s recommendations and your family situation. Some common problem areas are communication, economic hardship, anger, addiction, depression, medical issues, and tragedy.
Art therapy uses the creative process of art-making as an avenue for self-expression to examine your emotions and inner experiences. Through the process, it aims to enhance mental well-being and gain greater insight into who you are as an individual.
By using creative expression, your therapist will help encourage exploration into your creative sides and often interpret the creative results. There are many artistic mediums you can use in art therapy such as coloring, drawing, painting, photography, doodling, collaging, sculpting, music, dance, pottery, and more.
Research published in the journal Procedia notes people living with mental illnesses often use art and drawings as a way to visually communicate and unload their emotions. If it’s hard for you to name and verbally express your feelings, art therapy can help you meaningfully engage your mind, understand yourself better, and share thoughts—to help resolve ongoing conflicts in your life. Art therapy has been used to treat anxiety, learning disabilities, depression, emotional difficulties, stress, brain injuries, psychological symptoms, psychosocial issues, stress, substance abuse, and more.
How do you know which therapy is right for you?
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“The right therapy for you will be a combination of what you are wanting to work on, what the therapist specializes in, and the relationship you develop with your therapist. My biggest recommendation is that after you find several therapists that meet your criteria, schedule a consultation or a couple of sessions to get to know them and see if you feel the connection,” Garcia says. She also notes that developing a safe relationship with your therapist is the most important thing to keep in mind on your search. “If you cannot connect with a therapist, they can have the best skills, but the therapy may not be that helpful.”
“There are many therapeutic modalities. There are many benefits to each, and it is about finding the right fit. Overall, the biggest predictor of success in therapy is the client-therapist relationship,” Sanchez affirms. It is best to find someone who you feel comfortable with and who you feel connected to.”
What’s more, depending on your unique identity and the nuances of your background, it can be imperative to talk to prospective therapists about how they handle cultural sensitivities like sexuality, race, gender, religion, privilege, and how that may intersect with your personal belief and value systems. Garcia points out: “For communities that have been marginalized, it is important to look for therapists that are for liberation and that are not upholding supremacy standards.”
There are so many different therapeutic approaches to choose from, including these 15 popular modalities. However, the most important thing is finding the method that works best for you. “Sometimes, it takes time to explore and learn about what you might like. If it is not working for you, I recommend you have a conversation with your therapist. Explain the concerns you have, they may be able to offer additional guidance,” Sanchez says.
If one therapeutic approach doesn’t work for you, take it as an invitation to try another type to see if that resonates. It’s crucial you feel OK expressing yourself freely and honestly. Once you find the right therapist to manage your anxieties and challenge your emotional issues with, commit to then seeing the process through.