5 Types of Talk Therapy

By Rosemary Black

Reviewed by QualityHealth's Medical Advisory Board

Considering therapy, but not sure what kind of therapist you should make an appointment with? Read on for brief overviews of five different types of talk therapy, plus tips on how to find a therapist that meets your needs.

Psychoanalysis

Created by Sigmund Freud, this is the original “talk therapy,” explains Simon Rego, PsyD, director of psychology training at Montefiore Medical Center in New York City. Based on the theory that people are moved to act by impulses that originate in their subconscious, the patient is invited to talk to the therapist about whatever comes to mind. Through listening to the patient, the therapist can help identify the recurring themes in the patient's life that may be the source of negative feelings, and then help the patient work through these feelings. Psychoanalysis was quite popular in the early 1900s, and is still practiced today. “This form of therapy is really what launched the era of discussions between therapist and patient to create opportunities for change in people’s mental health."

Psychodynamic Psychotherapy

“In psychodynamic therapy, the therapist is more actively involved than with psychoanalysis,” Rego explains. "It’s similar in terms of approach, but in psychodynamic psychotherapy, the treatment is typically briefer than psychoanalysis."

Psychodynamic therapy can be especially beneficial to individuals with relationship problems or deep psychological wounds from their past, says Ryan Howes, PhD, ABPP, a psychotherapist, writer, and adjunct professor based in Pasadena, California. “It takes a root-of-the-problem, focused approach that looks at personal factors and the therapeutic relationship as a source of healing. It’s less structured than psychoanalysis.”

Cognitive Behavioral Therapy (CBT)

This is the most popular form of talk therapy today. “It fits into the highly structured, symptom-reducing, one-size-fits-all approach that focuses on thoughts and behaviors,” Howes explains.

Cognitive behavioral therapists aim to provide quick relief from symptoms in a relatively short period of time. “The patient complains of distress and the therapist consults a manual for a step-by-step approach to reduce symptoms. You may be told to take deep breaths and challenge negative thinking if you are anxious. Feeling depressed? The advice may be to exercise, socialize, and confront depressing thoughts."

It also tends to work well for individuals who are complaining of intrusive thoughts or excessive worry. Mood disorders, eating disorders, sleep disorders, and personality disorders can be alleviated by CBT, according to the National Alliance on Mental Illness.

Dialectical Behavioral Therapy (DBT)

Dialectical Behavioral Therapy (DBT) integrates change-based techniques and acceptance-based techniques in order to help patients focus on changing their behavior while at the same accepting what is in front of them, Rego says. “What makes it different from other forms of therapy is that it was the first psychotherapy to incorporate mindfulness as a core component. The mindfulness skills taught in DBT are a behavioral translation of Zen practice.” DBT is about being fully aware and present in the moment without necessarily always trying to change your behavior.

“It can show people how to regulate their emotions," explains Matthew Lorber, Director of the Child and Adolescent Psychiatry Department at New York's Lenox Hill Hospital. This therapy is often used in combination with group and individual therapy, with the therapist helping clients review the skills they learned in groups.

Acceptance and Commitment Therapy (ACT)

With roots in the behavioral school of therapy, this style of treatment includes acceptance and mindfulness-based interventions. “ACT helps patients accept whatever is distressing to them,” Rego explains. “At the same time, they learn to clarify whatever they value in life and to develop the skills necessary to help them line up their behaviors with these values in order to lead a more meaningful life.”

With ACT, clients may have “homework” such as mindfulness exercises. Presented in one-on-one sessions or in groups, ACT often is used to treat individuals with mental health issues like depression, as well as those who are coping with chronic illness or workplace stress. It’s been used to treat phobias and depression, for smoking cessation, and for managing chronic pain.

Choosing a Therapist

Not sure which type of therapy is for you? Howes advises compiling a short list of potential therapists and taking each for a test drive. “Many therapists offer free initial sessions or a free consultation over the phone."

Tell the therapist what you’re dealing with and ask how they might go about treating it. Ask them what kind of experience they have treating similar problems, and what an expected outcome could be. “This information should tell you quite a bit about how they approach problems and people,” Howes says. “Listen for not only what they say, but how you feel talking with them. If you feel comfortable, listened to, and not judged, this is just as important as the content of their answers.”

Ryan Howes, PhD, ABPP, reviewed this article.