Types of Therapy
There is no single right way to do therapy. Different approaches work best for different problems, different people, and different goals. Understanding the main types helps you have a more informed conversation with a potential therapist and set realistic expectations for what treatment will involve. This guide covers the most widely used and best-researched therapy types in plain language.
What You Should Know
- "Evidence-based" means the approach has been tested in controlled studies and shown to produce measurable benefit for specific conditions. Not all therapies carry the same level of evidence.
- Most therapists are trained in multiple approaches and adapt their method to the individual. Being committed to a single label is less important than finding someone whose training matches your concern.
- The therapeutic relationship consistently outperforms any specific technique as a predictor of outcome. Fit with your therapist matters as much as the modality.
- Therapy type is not the same as therapist type. A psychologist, licensed clinical social worker (LCSW), licensed professional counselor (LPC), and marriage and family therapist (MFT) can all be trained in CBT, DBT, or other approaches.
Cognitive Behavioral Therapy (CBT)
CBT is the most extensively researched form of psychotherapy in the world. It is built on the principle that thoughts, emotions, and behaviors are interconnected. Changing the way you think about a situation changes how you feel about it and what you do. CBT is structured, goal-directed, and typically time-limited, running 12 to 20 sessions.
Sessions involve identifying distorted or unhelpful thought patterns (such as catastrophizing or black-and-white thinking), challenging those patterns with evidence, and practicing different responses. Most CBT involves homework between sessions: keeping thought records, practicing new behaviors, or conducting gradual exposure to feared situations.
CBT has strong evidence for depression, anxiety disorders (including panic disorder, social anxiety, and generalized anxiety), OCD, PTSD, insomnia, eating disorders, and substance use disorders.
Dialectical Behavior Therapy (DBT)
DBT was developed by psychologist Marsha Linehan in the 1980s originally for people with borderline personality disorder and chronic suicidal behavior. It is now used broadly for anyone with significant emotional dysregulation. The word "dialectical" refers to the central tension DBT holds: accepting yourself as you are right now, while also working hard to change.
Comprehensive DBT involves four skill modules: mindfulness (being present with your experience without judgment), distress tolerance (surviving a crisis without making things worse), emotion regulation (understanding and managing intense emotions), and interpersonal effectiveness (communicating clearly and maintaining relationships under stress). Full DBT typically combines individual therapy with a weekly skills training group.
DBT has strong evidence for borderline personality disorder, self-harm and suicidal behavior, eating disorders (particularly binge eating and bulimia), and substance use. Individual DBT skills are widely used in other treatment contexts.
Eye Movement Desensitization and Reprocessing (EMDR)
EMDR is a trauma-focused therapy endorsed by the World Health Organization, the American Psychological Association, and the Department of Veterans Affairs for PTSD. It is based on the observation that traumatic memories are stored differently in the brain and remain emotionally raw because they were not fully processed at the time of the event.
In EMDR sessions, you bring a traumatic memory to mind while simultaneously engaging in bilateral stimulation, typically following the therapist's fingers with your eyes side to side, or receiving alternating taps. This bilateral stimulation is thought to engage the brain's natural processing mechanisms, allowing the memory to be integrated and lose its emotional charge over time.
EMDR does not require you to describe trauma in detail, which some people find preferable. It is effective for PTSD and single-incident trauma and is being studied for other presentations including anxiety and depression. Standard treatment for a single traumatic event often requires 8 to 12 sessions.
Acceptance and Commitment Therapy (ACT)
ACT, pronounced as the word "act," is a newer cognitive behavioral approach that takes a different stance than traditional CBT. Rather than trying to change or eliminate negative thoughts, ACT focuses on accepting them as mental events without letting them dictate behavior. The goal is psychological flexibility: the ability to be fully present, open to difficult experiences, and committed to meaningful action aligned with your values.
ACT uses mindfulness exercises, metaphors, and values clarification work. A central concept is defusion: learning to observe thoughts from a slight distance rather than being fused with them. Instead of "I am worthless," the ACT reframe might be "I am having the thought that I am worthless," which changes your relationship with the thought without requiring you to argue against it.
ACT has solid evidence for depression, anxiety, chronic pain, OCD, and work-related stress. It is particularly useful for people who have found challenging thoughts in traditional CBT to be unhelpful or exhausting.
Psychodynamic Therapy
Psychodynamic therapy is rooted in the idea that current difficulties are often shaped by unconscious patterns, early experiences, and relationship dynamics. Rather than targeting specific symptoms with structured techniques, it focuses on insight: understanding why you feel and act the way you do at a deeper level. Sessions are less structured than CBT and tend to follow what the client brings.
Key concepts include exploring recurring relational patterns, understanding how the past shows up in the present, and making use of the therapeutic relationship itself as a window into those patterns. When you find yourself feeling something toward your therapist, whether admiration, frustration, or dependence, psychodynamic therapists treat that as meaningful information about your relational world outside of therapy.
Psychodynamic therapy is open-ended and tends to run longer than CBT, often one to three years. It is well-suited for people with longstanding relationship difficulties, personality-related concerns, depression with significant interpersonal dimensions, or those who want deeper self-understanding rather than symptom reduction alone. A growing body of research, including meta-analyses, supports its effectiveness for depression, anxiety, and personality disorders.
Other Approaches Worth Knowing
Interpersonal Therapy (IPT)
A time-limited, structured therapy focused on improving the quality of relationships and addressing interpersonal stressors, such as grief, role transitions, and relationship conflicts, that are maintaining depression. IPT has strong evidence for major depressive disorder and postpartum depression.
Mindfulness-Based Cognitive Therapy (MBCT)
Developed to prevent relapse in people with recurrent depression. It combines CBT techniques with mindfulness meditation practices. Research shows it reduces relapse risk by approximately 50% in people with three or more prior depressive episodes. It is specifically recommended for people in remission who want to prevent future episodes.
Cognitive Processing Therapy (CPT)
A structured, 12-session CBT-based protocol developed specifically for PTSD. It focuses on identifying and challenging "stuck points," beliefs about the trauma and its meaning that maintain PTSD symptoms. CPT is a first-line treatment for PTSD endorsed by the VA and APA.
Motivational Interviewing (MI)
A collaborative, goal-oriented conversation style designed to build motivation and commitment to change. It is not a standalone therapy for most conditions but is widely used as an early-stage intervention, particularly in substance use treatment and when someone is ambivalent about changing a behavior.
How to Choose the Right Approach
"No single psychotherapy is superior for all conditions or all people. Matching therapy type to the specific concern and individual preference improves outcomes." — American Psychological Association
Use these guidelines as a starting point. Your therapist can refine the direction once they know more about you.
| Your primary concern | Approaches with strong evidence |
|---|---|
| Depression | CBT, IPT, Psychodynamic, MBCT (for relapse prevention) |
| Anxiety disorders | CBT (including exposure), ACT |
| PTSD and trauma | EMDR, CPT, Trauma-Focused CBT |
| Emotional dysregulation / BPD | DBT |
| OCD | CBT with exposure and response prevention (ERP) |
| Relationship patterns, self-understanding | Psychodynamic, IPT |
| Substance use | CBT, DBT, Motivational Interviewing |
Common Questions About Therapy Types
Answers to the questions people most often ask when comparing therapy approaches.
Which therapy is best for anxiety?
Cognitive Behavioral Therapy (CBT) has the strongest evidence base for anxiety disorders. Exposure therapy, which is a component of CBT, is particularly effective for phobias, social anxiety, and OCD. Acceptance and Commitment Therapy (ACT) is also well-supported. The right choice depends on the specific anxiety presentation and your preferences.
Which therapy is best for trauma?
EMDR and Trauma-Focused CBT (TF-CBT) are the two most evidence-supported approaches for PTSD and trauma. Both are endorsed by the American Psychological Association and the Department of Veterans Affairs. CPT (Cognitive Processing Therapy) is another first-line option for PTSD.
Is DBT only for borderline personality disorder?
DBT was originally developed for borderline personality disorder, but its skills are now applied broadly. DBT is used effectively for eating disorders, substance use, suicidal behavior, self-harm, and emotional dysregulation in other contexts. Many people without a BPD diagnosis benefit from DBT skills training.
How long does each type of therapy take?
Structured therapies like CBT and DBT are typically time-limited, ranging from 12 to 24 sessions. EMDR can produce gains in fewer sessions for some people (8 to 12 for single-incident trauma). Psychodynamic and psychoanalytic therapies are open-ended and may continue for one to three years or longer. Your therapist should be transparent about the expected duration of any approach they recommend.
Can I do more than one type of therapy at a time?
Most therapists use an integrative approach, drawing from multiple modalities based on your needs. Formal concurrent enrollment in two different structured therapy programs (such as CBT and DBT simultaneously) is less common and may be unnecessary for most people. Discuss this with your therapist if you are curious about combining approaches.
What is the difference between a psychologist and a psychiatrist?
A psychologist typically holds a doctoral degree (PhD or PsyD) in psychology and specializes in assessment and talk therapy. A psychiatrist holds a medical degree (MD or DO) and can prescribe medication. Psychiatrists focus more on medication management. Some people see both: a psychiatrist for medication and a psychologist or therapist for talk therapy.
Sources
- American Psychological Association (APA) — Cognitive Behavioral Therapy
- National Institute of Mental Health (NIMH) — Psychotherapies
- EMDR International Association — What Is EMDR?
- Mayo Clinic — Cognitive Behavioral Therapy
- American Psychiatric Association — Psychotherapy
- U.S. Department of Veterans Affairs — PTSD Treatment
- World Health Organization (WHO) — Mental Health Guidelines
Choosing therapy support
These guides help connect therapy approaches with access, cost, and fit.