Learn about the different types of therapy

Psychotherapy, or talk therapy, has come a long way since the days of Sigmund Freud when people would lie on a couch while a psychologist analyzed their childhood and dreams. Today’s psychotherapy sessions, or behavioral health sessions, are evidence-based and focused on treating emotional and mental health issues.

Psychotherapy often is combined with medicine to help people feel and function better. It is important for you to clarify your goals for treatment by asking yourself this question: “What would be different if therapy was successful?”. Your therapist will work with you to help determine and achieve your wellness goals.

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Types of Therapy

Although the American Psychological Association and American Psychiatric Association each break down the types of therapies differently, in general, there are a few broad categories:

Cognitive-behavioral therapy (CBT)

CBT is a combination of cognitive therapy, which focuses on identifying and changing negative thoughts, and behavioral therapy, which focuses on identifying and changing negative behavior. CBT is effective for treating anxiety and depression, as well as trauma-related disorders and eating disorders. It works by teaching you to develop more constructive thought and behavior patterns to replace bad habits that magnify feelings of worthlessness and hopelessness. With a therapist’s guidance, you practice these new skills in a real-life setting. For example, a therapist might direct you to face something you fear, such as the dark, a little at a time to gradually overcome the phobia. The emphasis is on problem solving.

Dialectical behavior therapy (DBT)

As its name indicates, this therapy uses “dialectical” ideas, which are two opposite notions that can be true at the same time. DBT helps the person find ways to balance two seemingly opposite perspectives at once, avoiding a black or white style of thinking. Instead of an either/or approach, such as, “I love this” or “I hate this,” DBT encourages consideration that both emotions can coexist and contribute to a new truth. DBT focuses on mindfulness; tolerance of negative emotion rather than escape from it; emotion regulation to manage issues; and interpersonal effectiveness to communicate and maintain self-respect.

Interpersonal therapy (IPT)

Interpersonal therapy is a short-term form of treatment that teaches you how to cope with stressful relationships and situations. You might consider IPT if you have a conflict with your partner, face difficult changes at work, or struggle to relate to others. IPT targets the underlying issues that contribute to these problems and provides new, healthy ways to express emotions and communicate. IPT is among the most effective treatments for depression and anxiety disorders, two of the most common mental health conditions in the United States

Acceptance and commitment therapy (ACT)

ACT focuses on increased psychological flexibility using acceptance and mindfulness. It acknowledges that change can sometimes be counterproductive and offers alternatives to produce change, such as acceptance, mindfulness, values, committed action and cognitive defusion—which is the separation of an emotion-provoking stimulus from the unwanted emotional response. ACT can be used as a standard psychotherapy to treat a variety of problems and can also be used in short interventions in classroom settings, with couples, and during workplace trainings.

Exposure response prevention (ERP)

ERP therapy was developed specifically to treat obsessive compulsive disorder (OCD) when traditional psychotherapies are not effective. It is a type of cognitive therapy that helps individuals reduce or eliminate the obsessions and compulsions they experience. It works by developing a hierarchy of things that are troubling, addressing them, and then “exposing” you to them is a manner that desensitizes the response and decreases the behavior.

Supportive or humanistic therapy

In this type of treatment, the therapist doesn’t act as the authority on what’s causing negative feelings or behavior. Instead, the therapist offers guidance and support to help people comprehend their situations and make the changes they feel are appropriate. The therapist promotes self-sufficiency and resilience by helping people identify their own resources.

Psychoanalysis and psychodynamic therapy

Dream analysis might no longer be the main focus, but Freud is still credited with pioneering this approach to mental health issues. His theory and practice of psychoanalysis is based on the idea that negative behavior and mental wellness are influenced by childhood experiences and unconscious thoughts or feelings.

As Freud’s work has been modified and expanded, these treatments are often referred to now as psychodynamic therapy.

For both psychodynamic therapy and psychoanalysis, you work with a mental health professional to improve your awareness of negative experiences, feelings, and thoughts that may be contributing to your mental health issues. With this self-knowledge, you can escape harmful patterns and take charge of your mental well-being.

A Personalized Approach to Psychotherapy

Our lives are complex. The same goes for our mental health challenges. Often, people can benefit from more than one type of psychotherapy. At UPMC, one of our behavioral health counselors will work with you to choose the best therapy or therapies for your mental health diagnosis or situation.

You can receive psychotherapy from various mental health professionals, including a psychologist, psychiatrist, behavioral health counselor, or licensed social worker, as well as licensed marriage and family therapists, and psychiatric nurses. As medical doctors, psychiatrists can prescribe medicines if necessary.

You might only need psychotherapy in the short term, such as for processing the death of a loved one or your own acute illness. For those with a chronic mental health condition or other complex issues, psychotherapy can be part of long-term maintenance therapy. For some people, psychotherapy alone is enough to manage mental health challenges. Others may need a treatment plan that includes medicines or medical procedures, such as deep brain stimulation.

You can receive psychotherapy as an individual or as part of a family, a couple, or a group. Sessions are most often conducted on an outpatient basis, meaning you would visit a clinic or the therapist’s office. If you require more intensive care, such as when you’re thinking about self-harm, you  can receive psychotherapy in an inpatient facility. UPMC also offers telepsychiatry — therapy sessions conducted via video conferencing.

To learn more about psychotherapy and how it could help you, check out the counseling services at the Department of Family Medicine. To ask questions or to schedule an appointment at UPMC Western Psychiatric Hospital, call 1-877-624-4100.

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Editor's Note: This article was originally published on , and was last reviewed on .

About UPMC Western Behavioral Health

UPMC Western Psychiatric Hospital is the hub of UPMC Behavioral Health, a network of community-based programs providing specialized mental health and addiction care for children, adolescents, adults, and seniors. Our mission is to provide comprehensive, compassionate care to people of all ages with mental health conditions. UPMC Western Psychiatric Hospital is a nationally recognized leader in mental health clinical care, research, and education. It is one of the nation’s foremost university-based psychiatric care facilities through its integration with the Department of Psychiatry of the University of Pittsburgh School of Medicine. We are here to help at every stage of your care and recovery.