What psychotherapeutic approach is the most effective?

Learning Objectives

• Compare and evaluate various forms of psychotherapy

How can we assess the effectiveness of psychotherapy? Is one technique more effective than another? For anyone considering therapy, these are important questions. According to the American Psychological Association, three factors work together to produce successful treatment. The first is the use of evidence-based treatment that is deemed appropriate for your particular issue. The second important factor is the clinical expertise of the psychologist or therapist. The third factor is your own characteristics, values, preferences, and culture. Many people begin psychotherapy feeling like their problem will never be resolved; however, psychotherapy helps people see that they can do things to make their situation better. Psychotherapy can help reduce a person’s anxiety, depression, and maladaptive behaviors. Through psychotherapy, individuals can learn to engage in healthy behaviors designed to help them better express emotions, improve relationships, think more positively, and perform more effectively at work or school. In discussing therapeutic orientations, it is important to note that many clinicians incorporate techniques from multiple approaches, a practice known as integrative or eclectic psychotherapy.

Figure 1. Therapy comes in many different forms and settings, but one critical factor in its success is the relationship between the therapist and client.

Consider the following advantages and disadvantages of some of the major forms of psychotherapy:

• Psychoanalysis: Psychoanalysis was once the only type of psychotherapy available, but presently the number of therapists practicing this approach is decreasing around the world. Psychoanalysis is not appropriate for some types of patients, including those with severe psychopathology or mental retardation. Further, psychoanalysis is often expensive because treatment usually lasts many years. Still, some patients and therapists find the prolonged and detailed analysis very rewarding.
• Cognitive-Behavioral Therapy: CBT interventions tend to be relatively brief, making them cost-effective for the average consumer. In addition, CBT is an intuitive treatment that makes logical sense to patients. It can also be adapted to suit the needs of many different populations. One disadvantage, however, is that CBT does involve significant effort on the patient’s part, because the patient is an active participant in treatment. Therapists often assign “homework” (e.g., worksheets for recording one’s thoughts and behaviors) between sessions to maintain the cognitive and behavioral habits the patient is working on. The greatest strength of CBT is the abundance of empirical support for its effectiveness.
• Humanistic Therapy: One key advantage of person-centered therapy is that it is highly acceptable to patients. In other words, people tend to find the supportive, flexible environment of this approach very rewarding. Furthermore, some of the themes of PCT translate well to other therapeutic approaches. For example, most therapists of any orientation find that clients respond well to being treated with nonjudgmental empathy.

Many studies have explored the effectiveness of psychotherapy. For example, one large-scale study that examined 16 meta-analyses of CBT reported that it was equally effective or more effective than other therapies in treating PTSD, generalized anxiety disorder, depression, and social anxiety disorder (Butlera, Chapmanb, Formanc, & Becka, 2006). Another study found that CBT was as effective at treating depression (43% success rate) as prescription medication (50% success rate) compared to the placebo rate of 25% (DeRubeis et al., 2005). Another meta-analysis found that psychodynamic therapy was also as effective at treating these types of psychological issues as CBT (Shedler, 2010). However, no studies have found one psychotherapeutic approach more effective than another (Abbass, Kisely, & Kroenke, 2006; Chorpita et al., 2011), nor have they shown any relationship between a client’s treatment outcome and the level of the clinician’s training or experience (Wampold, 2007). Regardless of which type of psychotherapy an individual chooses, one critical factor that determines the success of treatment is the person’s relationship with the psychologist or therapist.

Review each of the types of psychotherapy you’ve learned about in this lesson in the following CrashCourse video.

You can view the transcript for “Getting Help – Psychotherapy: Crash Course Psychology #35” here (opens in new window).

eclectic psychotherapy: also called integrative psychotherapy, this term refers to approaches combining multiple orientations (e.g., CBT with psychoanalytic elements).

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Updated 3/7/2022

There are many different types of therapy that might be right for you. To make the choice manageable, we broke them down into the factors that make a “type” of psychotherapy (you can use the handy links below to jump around the guide):

• In-Person or Online Therapy
• The Most Common Types of Therapy
• Less Common Types of Therapy
• Integrated or Singular Therapeutic Approach (Using Multiple Therapeutic Approaches or Not)
• Types of Therapy for Groups (Couples, Families, or Group Therapy)
• Short-Term or Long-Term Therapy Options
• Therapy for People of a Certain Sexual Orientation, Race, Income Level, Gender, Religion, Political Ideology and More
• Therapy for Certain Life Events, Medical Issues and Situations (Childbirth, Divorce, Death, Impotence, Infertility, etc.)
• Therapy for Certain Mental Health Issues and Illnesses

Whether you are an aspiring therapist planning your career path or a potential client looking for the type of therapy that best fits your preferences, considering all of these factors is crucial. “Type of therapy” typically refers to a therapeutic approach, but this factor is not more important than others. Many clients and therapists value the other factors far more than the particular therapeutic approach. By the end of this article, you’ll be able to find the right kind of therapy session for your mental health condition.

In-Person or Online Therapy

Regardless of therapeutic approach, online therapy offers results that are in line with in-person therapy. Even less traditional methods of therapy, such as dance therapy and art therapy, can now be realistically administered online with new video technology platforms.

With the exception of severe mental illnesses that require intensive in-person treatment, the choice between online therapy and in-person therapy is a matter of preference.

The Most Common Types of Therapy

There are more than fifty types of therapeutic approaches. Yet, only a few of them are common. Here are the types you are most likely to encounter. These approaches apply regardless of the other type factors we will explore later in the guide.

Note: Remember, most therapists blend therapeutic approaches and customize an integrated counselling approach for each client.

Client-Centered Therapy (Person-Centered Therapy, PCT, CCT or Rogerian Therapy)

Client-centered humanistic therapy focuses as much on the client as possible. The therapist provides little authority or direction. Instead he or she offers subtle guidance on an individual’s life or mental health illness and encourages the client to take control of their future.

CCT therapists demonstrate more overt care for their client than more analytical therapists. They put more time and effort into empathizing with clients.

Cognitive Behavioral Therapy (CBT) 

Cognitive Behavioral Therapy, or also known as CBT treats dysfunctional thinking that leads to maladaptive behaviors, mental illness, and negative emotion. It focuses on thoughts and behaviors. This type of therapy is often used to treat individuals with Bipolar Disorder, Borderline Personality Disorder, Anxiety Disorder, and much more. 

Existential Therapy (part of the Humanistic-existential Approach)

Humanistic therapy as a whole focuses on one’s personal life experience to help guide individuals in reaching their full potential. Existential therapy is part of the Humanistic-existential Approach which helps clients manage aspects of the human condition,  including all the givens of human existence: isolation, meaninglessness, mortality, and freedom. 

Gestalt Therapy (part of the humanistic category)

Gestalt therapy emphasizes personal responsibility and helps clients focus on the present. It also stresses the development of the therapist-client relationship, the social context of the client’s life, awareness, attitudes and direct feelings and perceptions rather than interpretations.

Psychoanalytic or Psychodynamic Therapy

The psychodynamic therapy approach explores unconscious feelings or thoughts and the impact of the past on the present. It is the oldest type of psychotherapy and closest to what Freud created.

Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy uses a problem solving and acceptance-based framework — among other strategies — usually to treat severe and chronic mental health conditions, including: borderline personality disorder, suicidal ideation, self-harming, eating disorders and PTSD.

Less Common Types of Therapy

There are so many types of psychotherapy. To stop the information from overwhelming you, think about what you most want from psychotherapy then scroll through and see which keywords align with what you were thinking.

Note: To make the list manageable, this guide mostly focuses on talk therapy for adults and excludes forms of psychotherapy that are controversial or do not have sufficient evidence to back their effectiveness.

Accelerated Experiential Dynamic Therapy (AEDP)

AEDP explores difficult emotional and relational experiences to develop coping tools that allow better functioning.

Acceptance and Commitment Therapy (ACT)

ACT helps clients develop mindfulness skills with the goal of consistent values and psychological flexibility.

Adlerian Psychotherapy

This approach improves the ability to adapt to feelings of inadequacy and inferiority relative to others.

Anger Management

This approach teaches clients to identify stressors, remain calm and handle tense situations in a positive and constructive manner.

Bibliotherapy

This approach uses literature to improve mental health and explore psychological issues.

Coherence Therapy (Depth-Oriented Brief Therapy)

Coherence therapy helps clients empathetically and quickly delve into deeply held emotional beliefs.

Collaborative Therapy

In collaborative therapy both the therapist and client use knowledge and experience to make progress.

Compassion-Focused Therapy

This approach encourages people to be compassionate toward themselves and others.

Conflict-Resolution Therapy

This approach teaches clients how to resolve conflicts with great results and minimal stress.

Contemplative Psychotherapy

This approach integrates Buddhist teachings and Western psychotherapy to focus on self-awareness, improve overall health and use wisdom to heal.

Core Process Psychotherapy (CPP)

CPP is a mindfulness-based approach that emphasizes awareness of body and mind for self-exploration and healing.

Ego State Therapy

Based on psychodynamic therapy, ego state therapy operates under the principle that a person’s psyche is composed of identities and roles he or she takes on. It addresses these identities and the mental health issues they might be connected to.

Emotion-Focused Therapy (EFT)

Emotion-Foucsed Therapy (EFT) uses emotions as a source of healing and insight. It is especially effective for moderate depression, issues of childhood abuse and couples in the middle of a conflict.

Holistic Psychotherapy

Holistic psychotherapy integrates other therapeutic approaches and focuses on the relationship between mind, body and spirit.

Intensive Short-Term Dynamic Psychotherapy (ISTDP)

ISTDP helps clients permanently change character flaws in a short period of time by releasing emotional inhibitions and discussing the source of character issues.

Interpersonal Psychotherapy (IPT)

IPT focuses on interpersonal issues such as relationships and major life events. Its goal is to improve mood and interpersonal issues within 6-20 weeks.

Journey Therapy

In journey therapy, the therapist guides the client on a mental and emotional journey to uncover repressed memories that have created issues in the present.

Jungian Psychotherapy

Jungian psychotherapy focuses on the balance of consciousness and unconsciousness. Clients can become more whole and well-adjusted by achieving this balance and exploring both sides.

Logotherapy

Logotherapy focuses on the pursuit of meaning and purpose in one’s life.

Mindfulness-Based Cognitive Therapy

This therapy combines the best of CBT with mindfulness strategies that help clients assess thoughts in the present.

Motivation Enhancement Therapy (MET)

MET focuses on improving motivations to make positive changes and eliminate maladaptive patterns.

Narrative Therapy

Narrative therapy helps clients interpret their experiences as stories that give meaning to their lives and guide them. It encourages people to identify their skills, values, and knowledge so they can use them to live well.

Positive Psychotherapy

This approach helps clients view their illness or issues in a positive way. It focuses on the abilities of the client, inner balance, storytelling and hope.

Rational Emotive Behavior Therapy (REBT)

REBT helps clients develop rational thinking to facilitate healthy emotional behavior and expression. It is similar to CBT.

Reality Therapy

Reality therapy focuses on present issues and encourages clients to change behavior that might be preventing them from addressing those issues. It operates under the principle that people experience distress when they are not meeting five basic needs: power, love/belonging, freedom, fun and survival.

Redecision Therapy

Redecision therapy helps clients examine messages from caretakers and adults in their childhood, as well as any negative decisions.

Regression Therapy

Regression therapy addresses three layers of consciousness and helps clients align them.

Relational Psychotherapy

Relational psychotherapy helps clients become cognitively and emotionally healthy by forming and maintaining fulfilling relationships.

Schema Therapy

Schema therapy helps clients identify the cognitive and behavior patterns that are causing or maintaining their mental health issues. It is especially effective in treating borderline personality disorder.

Solution-Focused Brief Therapy (SFBT)

SFBT focuses on goals for the present and future rather than addressing the past or symptoms.

Symbolic Modeling

This therapeutic approach uses symbols, progressive questioning, metaphors and modeling to enact positive change.

Integrated or Singular Therapeutic Approach

Most psychotherapists use an integrated approach that combines various aspects of the aforementioned therapeutic approaches. They then customize the approach based on the client’s needs and preferences.

An integrated approach is usually as effective as a singular therapeutic approach. There are, however, circumstances where clients might prefer or benefit more from a singular approach.

It usually depends on whether the client is coming to therapy for a specific issue. If a client has borderline personality disorder, a singular DBT approach might work better than an integrated approach. For general mental health issues or depression and anxiety, an integrated approach could be more effective.

Clients who like a more rigid structure of treatment should choose a singular approach. On the other hand, an integrated approach is better for clients who see therapy as a place to explore issues without limit.

Types of Therapy for Groups (Couples, Families or Group Therapy)

Therapists can apply aspects of the aforementioned therapeutic approaches to individuals, couples, and groups.

While couples therapy applies to two or more people working on the health of their relationship, clients can use individual or group therapy to work on their self–identified personal challenges. Individual therapy provides singular attention and yields results that apply to that individual. Group therapy may take more time but can also be a more affordable option. People also might like the opportunity to connect with others who have similar issues or experiences.

Couples Therapy

• Collaborative Couple Therapy [CCT]: couples learn to help each other with problems rather than opposing each other
• Developmental Model of Couples Therapy: focusing on partners’ development individually and as a couple
• Gottman Method Couples Therapy: a structured and goal-oriented form of therapy that focuses on understanding, empathy, connectedness, disarming verbal conflicts and fostering interpersonal growth
• Imago Relationship Therapy: using spiritual, behavioral and Western psychological methodologies to help couples relate to each other in healthy ways, resolve conflicts and explore childhood factors that might have lead to current issues
• Relational Life Therapy: helping partners resolve conflicts, develop personal accountability, improve communication and foster intimacy
• Relationship Enhancement Therapy: teaching couples and families to better communicate feelings and develop coping strategies

Family Therapy

• Family Attachment Narrative Therapy: family therapy for behaviorally disturbed children, often children who suffered from abuse and attachment issues in the past
• Family Systems Therapy: uses systems theory as a foundation to explore how behaviors influence the functioning of a family unit and vice versa, usually tackles family conflicts
• Filial Therapy: teaching parents play therapy techniques so they can use the techniques with their children
• Internal Family Systems: fully understanding individuals by analyzing them in the context of a family; using this analysis to address issues and assess various parts of “sub-personalities” of a person
• Parent-Child Interaction Therapy [PCIT]: teaching parents how to improve their relationships with their children by better interacting with them, often with the goal of reducing negative behaviors and strengthening bonds
• Parent Work: helping parents improve their parenting by analyzing the relationship between parent and child, exploring themes and developing a positive parenting narrative
• Satir Transformational Systemic Therapy: improving relationships and communication within a family by addressing actions, emotions and perceptions in the context of a family dynamic

Group Therapy

In group therapy there are types of groups and therapeutic approaches for groups. Although most of them deal with some form of substance abuse, the issues can range from trauma and grief to abuse and addiction.

Here are the most common types and approaches:

• Cognitive-Behavioral/Problem Solving Groups: using the CBT approach to interpret addiction and dependency as learned behaviors clients can modify
• Interpersonal Process Group Psychotherapy: healing by changing maladaptive internal and interpersonal psychological dynamics
• Modified Dynamic Group Therapy [MDGT]: using an interpersonal approach to address the self-regulatory ego deficits of abusers and addicts
• Psychoeducational Groups: educating clients about substance abuse, related behaviors and consequences
• Skills Development Groups: teaching people the skills they need to abstain from abusing drugs
• Support Groups: strengthening interpersonal skills and working with other clients to maintain abstinence and improve self-esteem, confidence, etc.

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Short-Term or Long-Term Therapy Options

When clients begin therapy, they can request short-term therapy and work with the therapist to set a timeframe. They can also seek a therapist who practices a form of brief therapy. If the therapist practices a form of brief therapy, he or she will suggest or prescribe a timeframe.

The duration of mental health treatment depends on the therapeutic approach, the severity of issues and both the client and therapist’s preferences. 12 weeks is the typical  time it takes to see results and 10-20 weeks is the typical range for brief therapy. Therapy can be shorter or much longer than that, though.

Some clients — regardless of choosing short or long-term psychotherapy — leave therapy when they have dealt with the most acute symptoms of their condition or resolved the issue they sought treatment for. Others stay because they see therapy as a long-term journey to improve their mental health and become a better version of themselves. These people work with therapists for years, sometimes decades.

Most therapeutic approaches can be short or long-term depending on the client’s preferences, but there are a few that are only short-term. Here is a quick list of them:

Types of Psychotherapies That Are Only Short-Term

Long-Term Therapy

Most therapeutic approaches, especially when applied as an eclectic intervention can be long term. A client may decide to extend therapy, due to evolving goals or for mental health maintenance.

Therapy for People of a Certain Sexual Orientation, Race, Income Level, Gender, Religion, Political Ideology and More

To address the needs of minorities and people who want therapy that focuses on a specific part of their identity, therapists created psychotherapies for clients of certain groups. Here are some examples:

Affirmative Psychotherapy (for LGBTQIA+ community members)

Because of a history of mental health professionals pathologizing non-heterosexual orientations and trying to change them, psychotherapists created affirmative psychotherapy that focuses on authenticity and accepting sexual orientation.

Gender Aware Therapy (GAT)

GAT encourages male and female clients to explore gender-related experiences. It incorporates feminist therapy and is a great option for men and women who feel they need to address issues related to their gender.

Feminist Therapy

Feminist therapy acknowledges that women may experience mental health issues as a result of psychological oppression that targets them because of their gender.

Multicultural Counseling

Multicultural counseling incorporates an understanding, sensitivity and appreciation of the history, values and experiences of minority groups. It recognizes differences between the counselor and client.

Religious Therapy

There are therapists who specialize in working with clients of all religious backgrounds. Nonetheless, not all religious therapies have standardized names. Here are a few that have commonly-used terms to describe them:

• Biblical Counseling, Christian Counseling, Pastoral Counseling, etc. (forms of therapy that combine psychotherapeutic practices and Christian philosophy)
• Quranic Psychotherapy (therapy for Muslims or therapy that incorporates the teaching of the Quran)

Therapy for Certain Life Events, Medical Issues and Situations (Childbirth, Divorce, Death, Impotence, Infertility, etc.)

Sometimes therapy is simply a way to cope with a rough period of life or a medical issue with mental health consequences or roots. Here are some types of therapy that address these issues (remember that many therapeutic approaches can address these issues):

• Addiction Counseling (helping clients beat their addictions and address the related psychological factors; the addiction can be for anything, including drugs, sex, pornography etc.)
• Divorce Counseling (for couples who want to maintain good relationships and mental health despite going through a divorce)
• Erectile Dysfunction Sex Therapy (addressing the mental issues that might be contributing to erectile dysfunction)
• Grief Counseling (coping with the death of a loved one)
• Postpartum Counseling (coping with life changes and emotional adjustment after having a child or postpartum depression)
• Sex Therapy (treating sexual dysfunction when there is no medical reason for the dysfunction)
• Therapy for Infertility (coping with the emotional pain of being unable to conceive a child or maintain successful  pregnancy to term.)
• Therapy for Infidelity (coping with the aftermath of an affair and deciding whether to end or heal the relationship)
• Therapy for Miscarriages (coping with the emotional pain and trauma of a miscarriage)
• Therapy for Pregnancy (coping with body and life changes during pregnancy)

Therapy for Certain Mental Health Issues and Illnesses

The vast majority of therapeutic approaches do not apply to only one mental health issue or illness. Psychotherapists can use an approach to treat depression, for example, but there is no “Depression Therapy.” Nonetheless, some types of psychotherapy are especially effective for certain issues and illnesses.

Below is a short list of therapeutic approaches and types that are especially effective for treating certain mental health conditions (listed in the parentheticals):

• Behavioral Types of Therapy (Attention Deficit Hyperactivity Disorder [ADHD])
• Dialectical Behavior Therapy (borderline personality disorder [BPD], eating disorders, PTSD, self-harming or suicidal behavior)
• Exposure Response Prevention Therapy (obsessive compulsive disorder [OCD])
• Group Therapy (Addiction)
• Schema Therapy (borderline personality disorder)

Most types of therapy can address the following issues and illnesses:

• Anxiety
• Bipolar Disorder
• Depression
• Relationships
• Social Anxiety Disorder
• Trauma

Which Therapy Combination is  Best for You?

If you are an aspiring therapist or a potential client seeking a type of psychotherapy, use the factors in this guide to decide exactly what you want. Think about which factor you value most. Is it the therapeutic approach? Is it the issues you might tackle?

Here are some examples of combinations you could consider:

• Long-term online therapy that uses an integrated approach and focuses on depression
• Short-term couples therapy that uses the Gottman Method
• Multicultural counseling that sometimes uses an existential approach

Once you figure out which type is best for you, it will be easier to structure your career or find a therapist who can help you rapidly improve your mental health and be happier.

Note: By using Talkspace’s matching system or chatting with our matching specialists, you can quickly and easily find a therapist who specializes in many of the types of therapy in this guide.

Talkspace articles are written by experienced mental health-wellness contributors; they are grounded in scientific research and evidence-based practices. Articles are extensively reviewed by our team of clinical experts (therapists and psychiatrists of various specialties) to ensure content is accurate and on par with current industry standards.

Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.

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