How psychotherapy works 

One of the key objectives of psychotherapy is to help you gain a better understanding of the issues that are troubling you.

It can help you work out new ways of approaching situations that you find difficult, as well as suggesting new methods to help you cope.

Developing a trusting relationship with your psychotherapist is very important and will help you be able to talk about long-standing problems. However, this can take time.

Depending on the type of psychotherapy you have and the reason you're having it, your treatment may need to last several months or, in some cases, years.

Types of psychotherapy

There are many different types of psychotherapy. The type used will depend on your personal needs and which method your psychotherapist thinks will be most helpful for resolving your issues.

Some of the main types of psychotherapy are outlined below.

Psychodynamic (psychoanalytic) psychotherapy

Psychoanalysis is based on the modern developments of the theories of Sigmund Freud. Freud believed that bad thoughts and experiences from childhood are repressed but continue to influence your feelings as an adult.

In psychoanalysis, you talk about your personal relationships and the thoughts you have about other people. You're encouraged to discuss the past as well as the present.

This allows the therapist to identify links between past events and how you think and act now. This form of psychotherapy is usually quite intensive and requires long-term commitment.

Psychodynamic therapy is a less intensive form of psychoanalysis that uses similar techniques, but aims to find quicker solutions to more immediate problems.

Art, music and movement therapies often use the psychodynamic model of working, but encourage alternative forms of self-expression and communication as well as talking. Even young children can take part – this is known as play therapy. Musical or technical skills are not needed for this type of therapy to be successful.

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) is a treatment based on a combination of cognitive therapy and behavioural psychotherapy.

Cognitive therapy explores ways your thoughts and beliefs may be causing emotional problems. Your therapist will discuss these issues with you so you can try to develop more helpful ways of thinking to allow you to overcome your problems.

Behavioural psychotherapy involves finding ways to help you change the way you act. It's often used to overcome a specific fear or phobia by encouraging you to gradually face these fears and help you relax and feel comfortable as you do it.

During CBT, you and your therapist agree on tasks for you to do in between sessions. This will help you deal with problems yourself so you no longer need therapy.

CBT is usually aimed at a specific problem and the courses are often brief, typically involving 6 to 20 sessions.

Cognitive analytical therapy

During early sessions of cognitive analytical therapy (CAT), you'll discuss events and experiences from your past to help you understand why you feel, think and behave the way you do now.

After the first few sessions, your therapist will write down what you've discussed on paper, and will work with you to map out problem patterns that have emerged to help you understand how these problems occurred.

Your therapist will use this to help you figure out ways of changing these problem patterns. They may suggest using diaries and progress charts to help you develop skills you can use to continue improving after the therapy sessions have finished.

Like CBT, a course of CAT is often brief. It may involve about 16 sessions.

Humanistic therapies

Humanistic therapies encourage you to explore how you think about yourself and recognise your strengths. The aim is to help you think about yourself more positively and improve your self-awareness.

There are a several types of humanistic therapies, which are described below.

  • person-centred counselling – aims to create a non-judgmental environment where you can feel comfortable talking about yourself and are able to see that you have the ability to change. Your therapist will try to look at your experiences from your point of view.
  • Gestalt therapy – takes a holistic approach, focusing on your experiences, thoughts, feelings and actions to help improve your self-awareness. This type of therapy often involves activities such as writing or role-playing.
  • transactional analysis – aims to explore how the problems in your life may have been shaped by decisions and teachings from childhood. You'll work with your therapist to help you find ways to break away from these unconscious repetitive patterns of thinking and behaving.
  • transpersonal psychology – encourages you to explore who you really are as a person. It often involves using techniques such as meditation and visualisation.
  • existential therapy – aims to help increase your self-awareness and make sense of your existence. Existential therapy is not too concerned with your past, but instead focuses on the choices to be made in the present and future.

The Counselling Directory website has more information about the different types of humanistic therapies.

Interpersonal psychotherapy

Interpersonal psychotherapy (IPT) has been shown to be particularly effective in treating depression.

Your therapist will be interested in the link between your relationships with others and your emotional problems. They will help you develop new approaches to dealing with interpersonal difficulties to help improve your mental health.

IPT usually involves about 12 to 16 sessions.

Family and couple (systemic) therapy

Family therapy focuses on family relationships, such as marriage, and encourages everyone within the family or relationship to work together to fix problems.

The therapist encourages group discussions or exercises that involve everyone, and promotes a healthy family unit as a way of improving mental health.

In some cases, there may be more than one therapist involved to make sure everyone involved in the therapy has their say.

Page last reviewed: 14/04/2015

Next review due: 14/04/2017