Approaches To Psychotherapy

This is a list of the major types of psychotherapy. This is a non-exhaustive list, as these are the main approaches that tend to be used when dealing with most major disorders and concerns in therapy (anxiety, depression, panic disorder, post-traumatic stress disorder, etc). There are a lot of therapeutic techniques outside of this, but most build on the foundations of the same theories that these therapies are based on.

Psychodynamic therapy

When it was first developed by Freud as psychoanalysis, it put the therapist in a position of power. Originally, this type of therapy had less structure, where the therapist often said very little and encouraged the patient to say whatever came to mind. It also involved the exploration of dreams and other parts of the ‘unconscious’ mind. Modern psychodynamic therapy has a more equal relationship between the therapist and client. Using principles of original psychoanalysis, this form of therapy involves investigating unconscious thoughts and desires and working through the distortion between who we are and who we are ‘deep down.’ A typical session is done through talking about repeated patterns in thoughts and actions, and looking into the childhood and the past experiences of a client. The purpose of this is to help a client with self-awareness and push them to be an active participant in their life. This can still involve dream analysis depending on what the client and therapist desire.

This is used to treat depression, anxiety, eating disorders, somatic symptoms, and schizophrenia, among other conditions

Behavioral therapy

This therapy places an emphasis on behavior, especially repeated behavior, to help a client find the behaviors in their life that are not serving them and work to change them. This focus avoids the unconscious thoughts/desires that are common in psychodynamic therapy. This may look like exposure therapy or talk therapy; it is quite dependent on the behavior at hand, the disorder of the client, and the experience of the therapist.

Subtypes include systematic desensitization, aversion therapy, and flooding.

This is typically used to treat anxiety, phobias, substance use disorder, ADHD, OCD, oppositional and defiant disorders, and other behaviorally related issues.

Eye Movement Desensitization and Reprocessing (EMDR)

This therapy involves a client retelling traumatic or difficult events in their life while also focusing on an external stimulus (usually an object the therapist holds). The therapist will move the object for lateral eye movements. This may seem random, but oftentimes when people go through trauma, revisiting it is incredibly difficult, especially without regressing to the moment that the traumatic event occurred. By having the client focus on an external stimulus, this keeps the client mentally in the room while they are accessing memories of trauma in the brain. This can help the client talk more openly about their trauma and be able to process it without getting stuck in a fight-or-flight response that can re-traumatize the patient.

Typically used to treat PTSD patients

Cognitive behavioral therapy (CBT)

This is a very common form of therapy. For the average person, it tends to be successful in a shorter time frame than other approaches to therapy, which is often why it is covered in insurance and encouraged for clients. This is a great start if you have never tried therapy and would like a shorter treatment schedule. Typical cycles of CBT can be between 5-20 sessions. This is a type of talk therapy that focuses on thought patterns and actions that are taken through frameworks in the mind. In a typical session, you will talk with your therapist about difficult situations and how you think and feel about them, as well as the actions you take. The therapist will work to question unhelpful ways of thinking, help you notice and understand your emotions, and then work to change the action itself.

Typically used to treat: depression, anxiety, PTSD, eating disorders, bipolar disorder, personality disorders, but has also been shown to be effective for things like sleep problems, pain, substance abuse, IBS, and CFS

Dialectical behavioral therapy (DBT)

This is a subtype of CBT and is much more intensive. To do DBT as it is designed, it is a 6-month to a year commitment. This involves individual therapy sessions, group skills training, and phone coaching, which happen at least once a week if not multiple times a week. The skills that are taught are distress tolerance, interpersonal effectiveness, and emotional regulation. Dialectical means two opposing ideas; DBT is about finding a balance between acceptance and change. This helps people be able to accept their emotions (even extreme emotions) without judgment and work to make positive changes to make themselves feel better.

This treatment is typically used to treat severe depression, suicidal thoughts and behaviors, self-harm, and is the only empirically supported treatment for borderline personality disorder (BPD)

Acceptance and commitment therapy (ACT)

Also a subtype of CBT. ACT is about accepting that your thoughts and emotions are normal and appropriate for certain situations, and committing to making changes in your life. This looks like acknowledging your thoughts and emotions as a part of you without letting them consume you. This can mean instead of saying “I am anxious,” you can say “I feel anxious because of ___ and that’s okay, it is normal I feel that way because ___ is important to me, I can work to feel better by using a coping strategy like breathing.” The commitment piece is about making small, achievable goals that help boost self-esteem and help you meet an overall objective of emotional well-being.

This treatment can be used to treat a variety of people with a variety of conditions, including adolescents (as long as they can conceptualize thoughts and feelings)

There are many types of therapy outside psychotherapy, as well as more subtypes of psychotherapy. Most therapists use a combined method where they will use parts of different kinds of therapy to aid their clients. This might mean teaching a skill to a client that is based in DBT, doing a session with EMDR, or talking about thought patterns through a CBT lens. This combined methodology allows therapists to try to help their clients in a way that is tailored to the individual client. If you are particularly interested in a certain kind of therapy, you can look for a therapist who practices it, or bring it up with a therapist to see if they would be willing to utilize more strategies from that kind of therapy with you.

Therapy is difficult work. Finding a therapist who feels like they understand you and who practices therapy in a way that helps you can be difficult, on top of the emotional labor that goes into the sessions themselves. In the process of finding a therapist, be sure to take care of yourself, and if you don’t like a therapist you meet, you can find another. It can be discouraging after doing the work to find a therapist to realize that their techniques or personality don’t work for you, but try not to let yourself to discouraged. There are more therapists out there who may understand you better or have a different modality of therapy that works better for you.

Citations

Cleveland Clinic. (2024, September 30). Acceptance and commitment therapy (ACT). Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/acceptance-and-commitment-therapy-act-therapy

EMDR Institute. (2024, December 3). What is EMDR?. EMDR Institute - EYE MOVEMENT DESENSITIZATION AND REPROCESSING THERAPY. https://www.emdr.com/what-is-emdr/#layperson

Gatta, F. (2025, February 20). Psychodynamic therapy: What it is, how it works, and who it’s best for. helloalma.com. https://helloalma.com/blog/psychodynamic-therapy-what-it-is-how-it-works-and-who-its-best-for/

May, J. M., Richardi, T. M., & Barth, K. S. (2016). Dialectical behavior therapy as treatment for borderline personality disorder. The mental health clinician, 6(2), 62–67. https://doi.org/10.9740/mhc.2016.03.62

NHS. (2025, March 28). Cognitive behavioural therapy (CBT). NHS choices. https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/#:~:text=If%20you%20have%20CBT%20on,they%20will%20usually%20last%20longer.

Raypole, C. (2024, January 30). Types of therapy: Different types of approaches and how they work. Healthline. https://www.healthline.com/health/types-of-therapy#cbt-and-subtypes

Tahir, H., & Rafique, A. (2022, February 24). 7 popular types of psychotherapy for a variety of mental health issues. One Behavioral. https://onebehavioralhealth.com/7-popular-types-of-psychotherapy-for-a-variety-of-mental-health-issues/

Yale Medicine. (2024, October 25). Dialectical behavior therapy (DBT). Yale Medicine. https://www.yalemedicine.org/conditions/dialectical-behavior-therapy-dbt