When you’re searching for a therapist, it’s important to make sure you choose a licensed mental health professional who’s qualified to address your specific issue. But there are often multiple ways to treat a condition, so it’s worth considering the type of therapy you want.
In many cases, you’ll find that different types of therapists offer the same type of therapy. Also, not every therapist sticks to just one type of therapy. Abby Gagerman, a therapist and licensed clinical social worker in Chicago, says many mental health clinicians use an “eclectic” approach, where they blend ideas and practices from various therapeutic methods.
Here’s a breakdown of seven common types of psychotherapy.
Cognitive behavioral therapy (CBT)
In a nutshell: Cognitive behavioral therapy is based on the idea that many psychological issues stem from distorted ways of thinking and/or behaving. “We often use CBT to change a person’s thoughts in order to alter their behavior, or vice versa,” says Grace Dowd, a licensed clinical social worker and therapist in Austin, Texas.
What it treats: Therapists often use CBT to treat depression, anxiety disorders, alcohol and drug use problems, marital problems and eating disorders, according to the American Psychological Association. Customized versions of CBT (subtypes) have been developed for a handful of conditions, including insomnia (CBT-I) and seasonal affective disorder (CBT-SAD).
How it works: Your therapist helps you identify harmful or incorrect beliefs and/or behaviors, as well as develop strategies to cope with psychological symptoms and reform bad habits. You’ll practice these strategies with your therapist so you can use them on your own.
Let’s say you dread going to work every day. During a CBT session, your therapist will help you pinpoint the warped beliefs holding you back — such as being convinced that everyone at work hates you, or that you’re not smart or qualified enough to do your job. Then, you’ll work to realign those beliefs with reality.
Since CBT aims to produce long-lasting changes in beliefs and behavior, Dowd says it’s common to leave sessions with homework. You can stay in treatment for as long as you need support, but CBT is intended to be finite.
Whom to see: While most therapists practice CBT, Dowd says, some, such as psychologists, are more likely to rely on it as their primary treatment method. Want to make sure a therapist offers CBT before booking with them? If they have an online profile (and most do), it should list the therapeutic approaches they use.
Most types of psychotherapy, including CBT, are covered by insurance — as long as you see a therapist who takes your insurance, or you have a plan with out-of-network coverage. If you plan to pay for therapy using insurance, a therapist should let you know right away if a certain modality (meaning a type of therapy) isn’t covered. Also, if your treatment plan includes multiple modalities, your therapist should give you a heads up if any session or service won’t be covered the same way others are.
If you’re wondering what’s covered and what’s not, talk to your therapist and/or your insurance plan so you don’t encounter any surprises. (Here’s a guide to paying for therapy.)
Dialectical behavioral therapy (DBT)
In a nutshell: DBT focuses on teaching patients coping skills to manage painful emotions and relationship conflict. It’s rooted in the idea that two opposing things can be true at the same time, Dowd says. You can love your partner and also feel anger or resentment toward them; you can be independent and still need a support system.
What it treats: DBT was originally developed to treat borderline personality disorder, for which it’s the first-line treatment. It’s now also used for depression, eating disorders, bipolar disorder, PTSD, suicide and substance abuse. Radically Open DBT, a sub-type of DBT that focuses on psychological flexibility, is designed to treat conditions characterized by excessive self-control, such as obsessive compulsive disorder and anorexia.
In addition, Dowd says, therapists may also use DBT with sensitive patients who need change-oriented therapy but don’t respond well to CBT. “DBT is basically CBT with mindfulness, acceptance and validation woven in,” she says. “It’s almost like people can face change a lot easier with a spoon full of sugar.”
How it works: DBT primarily focuses on fixing problems, not figuring them out. “Usually,” Dowd says, “it’s ‘this issue is coming up, and this is how you can manage it in the here and now.’”
In sessions, you’ll learn how to use mindfulness-based coping skills to stay present in the moment instead of escaping your emotional pain. Through DBT, people who tend toward black-and-white thinking can learn to accept things they don’t like in their lives while also working to change them.
Treatment duration varies. Usually, patients and therapists work together to come up with a plan that fits their schedule and needs. A common approach, Dowd says, involves attending both group and individual therapy for a predetermined amount of time (usually months), before transitioning to one-on-one sessions only.
Whom to see: While any therapist can practice DBT, Dowd suggests choosing someone who specializes in it. Look for a term like “DBT certified” or “DBT trained” in a therapist’s profile.
If you plan to attend multiple therapy sessions per week, which might be the case if you’re doing group and individual therapy at the same time, it’s worth contacting your insurance plan to find out exactly what they’ll cover.
In a nutshell: Psychodynamic therapists believe negative feelings and behaviors are often rooted in repressed emotions related to childhood experiences. With its Freudian roots, psychodynamic therapy hews closest to the traditional stereotype of talk therapy.
What it treats: It’s often used to treat depression, but it can also help people with conditions including addiction, social anxiety disorder and eating disorders.
How it works: During sessions, your therapist will ask you to talk about whatever’s on your mind, and they’ll analyze what you say. Essentially, they’re looking for recurring patterns in your unconscious emotions and thoughts. Once your therapist helps you get to the root cause of those patterns, you’ll work together to adopt healthier beliefs and behavior patterns.
For example, maybe you’re a generally moody person and you’ve noticed that your highs and lows are interfering with your relationships. The first part of addressing your mood swings is figuring out why they happen. Gagerman says it’s different from CBT (and DBT) because it focuses on your unconscious mind more than your conscious one.
Whom to see: As with any other other modality, look for a licensed mental health professional. Gagerman says psychodynamic therapists often have advanced training in psychoanalysis or psychodynamic therapy, but there’s no specific certification required to treat you.
In a nutshell: Somatic (or body-focused) therapy is a form of psychotherapy that helps people process past traumatic events underlying current mental health challenges.
What it treats: Somatic therapy is especially beneficial for those with post-traumatic stress disorder (PTSD), or trauma-related anxiety or depression, says Sara Mindel, a licensed independent clinical social worker based in Washington, DC, who focuses on somatic approaches. But there’s no hard-and-fast rule to determine what counts as trauma and what doesn’t. Somatic therapy might help anyone who needs to work through difficult memories.
How it works: In general, somatic therapy focuses more on bodily sensations related to traumatic memories than thought processes and behaviors. “CBT is really about how the brain moves us through the world, whereas somatic therapy is about how the body moves us through the world,” Mindel says.
There are several subtypes of somatic therapy, including eye movement desensitization and reprocessing (EMDR), hypnosis, neurofeedback, sensorimotor psychotherapy and somatic experiencing. Each subtype has its own treatment method. For example, you’d typically do EMDR to work through an individual memory, while somatic experiencing and sensorimotor psychotherapy are broader, mindfulness-based approaches to resolving trauma.
Somatic therapy does involve talking, but it’s not the linchpin of treatment. For example, if you’re discussing a memory of a car accident and you feel panicky, your therapist might ask you to notice and describe how panic feels in your body, and then use a mindfulness exercise to ground yourself in your current environment (the therapist’s office). Your therapist might also have you do physical exercises in the office, such as squeezing a pillow or pushing against a wall, to help you work through bodily sensations that bring on anxiety.
If traumatic memories are interfering with daily functioning, you might do somatic therapy on an ongoing basis. You can also do a shorter course of treatment for an acute problem — for example, if you want to deal with disturbing flashbacks of a car accident before going on a road trip.
Whom to see: Many insurance plans networks cover somatic therapy, Mindel says. When you’re searching for a clinician, look for phrases like “somatic” or “trauma-informed.” Some somatic approaches require specialized training. The EMDR International Association, sensorimotor psychotherapy and somatic experiencing websites all list certified practitioners.
Non-psychotherapists, such as masseuses and life coaches, can be trained in and practice somatic therapies. Look for a credentialed mental health professional, such as a licensed mental health counselor or a social worker. Psychologists might also practice somatic methods, but Dowd says it’s more common for them to focus on thought-centered therapies.
Acceptance and commitment therapy (ACT)
In a nutshell: ACT is a thought- and behavior-based form of therapy that helps you manage difficult feelings. It’s based on the theory that mental illness can become more severe if you try to control how you feel. The goal of therapy is to accept that anxiety (or fear) is part of your life, and then commit to coping with it.
What it treats: Learning how to accept emotions is the crux of the approach, which makes it especially valuable for those with long-term anxiety disorders, such as generalized anxiety disorder, says Gagerman. ACT can also help people who have disabilities or chronic disease manage ongoing anxiety and stress.
How it works: During sessions, Gagerman says, patients learn how to live with their emotional struggles as well as improve them through behavioral change. For example, let’s say you want to get married but have anxiety around commitment. Through ACT, you’d learn how to accept that anxiety in order to move forward with your life plans.
“I tell my ACT clients to put their arm around their anxiety and walk with it into the situation that makes them anxious,” Gagerman says. “It’s about accepting that anxiety is alway there, and then finding ways to work through it.”
Usually, Gagerman says, you do ACT on an ongoing basis, for as long as the anxiety you’re working through persists. “It’s not eight sessions and you’re done; it’s more about providing a client with a bunch of tools and a new way of thinking,” she says.
Whom to see: There’s no specific training required for ACT; you can see any therapist who says they practice it.
In a nutshell: Narrative therapy helps your reconstruct your personal narrative in order to adopt a more positive outlook.
“[It] changes the way you think about yourself by cleaning off the window you look at life through,” says Gagerman.
What it treats: Narrative therapy is especially helpful for couples working through conflicts, and for individuals with depression or generalized anxiety disorder.
How it works: During sessions, your therapist helps you reframe negative life experiences to highlight the skills you’ve gained from confronting challenges. For example, maybe you’ve had to make ends meet since losing your job. Narrative therapy would help you see yourself as a survivor instead of a victim, and focus on the resilience you displayed in the face of hardship, instead of the resulting adversity.
Whom to see: There’s no specific training or degree required to practice narrative therapy, and according to Gagerman, any type of credentialed mental health clinician can offer it.
In a nutshell: Exposure therapy helps people overcome fears that get in the way of everyday life. It’s thought to work by weakening associations between feared activities and bad outcomes, thereby showing patients they’re capable of facing their fears and dealing with the resulting emotions.
What it treats: Exposure therapy is useful for panic disorder, phobias, obsessive compulsive disorder, PTSD and social anxiety disorder.
How it works: There are different approaches to exposure therapy, but the gist is always the same: You gradually confront things that scare you in a safe setting. Usually, during sessions, patients share their fears and work with their therapists to develop effective coping mechanisms. Gagerman says homework is common.
Therapists often start exposure therapy by having patients make a list of their specific fears in order of least to most terrifying, Gagerman says. For example, if you have agoraphobia, you’d flesh out your general fear of leaving home by writing down each thing you’re afraid to do in the outside world. Then, your therapist would encourage you to start tackling your list — opening the front door one week, walking to the mailbox the next week, etc.
Whom to see: Sometimes, Gagerman says, exposure therapy works better in non-clinical settings. But there’s a chance treatment won’t be covered if your therapist uses a non-traditional approach, such as accompanying you to a place where you often have panic attacks, versus sitting in an office talking about panic-inducing scenarios. Insurance plans often only reimburse for services that correspond to treatment codes. In that case, you’d need to pay out-of-pocket. If you can’t afford your therapist’s rates, ask about a sliding scale.