Psychotherapies

Psychotherapy (sometimes called “talk therapy”) is a term for a variety of treatment techniques that aim to help a person identify and change troubling emotions, thoughts, and behavior. Most psychotherapy takes place with a licensed, trained mental health professional and a patient meeting one-on-one or with other patients in a group setting.

You might seek out psychotherapy for different reasons including:

• You might be dealing with severe or long-term stress from a job or family situation, the loss of a loved one, or relationship or family issues.
• You might have symptoms with no physical explanation: changes in sleep or appetite, low energy, a lack of interest or pleasure in activities that you once enjoyed, persistent irritability, worry, or a sense of discouragement or hopelessness that won’t go away.
• A health care provider may suspect or have diagnosed depression, anxiety, bipolar disorder, post-traumatic stress disorder, or other conditions or symptoms that may be interfering with your life, and recommended psychotherapy as a first treatment or to go along with medication.
• You may be seeking treatment for a family member or child who has been diagnosed with a condition affecting mental health and for whom a health care provider has recommended treatment.

An exam by a health care provider can ensure there is nothing in your or your loved one’s overall health that would explain symptoms. This step is important because sometimes symptoms like a change in mood or trouble concentrating can be due to medical conditions.

Psychotherapies and Other Treatment Options

Psychotherapy can be an alternative to medication or can be used with other treatment options, such as medications. Choosing the right treatment plan should be based on a person's individual needs and medical situation and under a mental health professional’s care.

Even when medications relieve symptoms, psychotherapy and other interventions can help a person address specific issues. These might include self-defeating ways of thinking, fears, problems interacting with other people, or dealing with situations at home, school, or work.

Elements of Psychotherapy

A variety of different types of psychotherapies and interventions have been shown to be effective for specific disorders. For example, the treatment approach for someone who has obsessive-compulsive disorder is different for someone who has bipolar disorder. Therapists may use one primary approach or incorporate other elements depending on their training, the condition being treated, and the needs of the person receiving treatment.

Elements of psychotherapies may include:

• Helping a person become aware of ways of thinking that may be automatic but are inaccurate and harmful (for example, someone who has a low opinion of their abilities). The therapist helps the person find ways to question these thoughts, understand how they affect emotions and behavior, and change self-defeating patterns. This approach is central to a type of psychotherapy called cognitive behavioral therapy (CBT).
• Identifying ways to cope with stress and developing specific problem-solving strategies.
• Examining a person’s interactions with others and offering guidance with social and communication skills.
• Mindfulness and relaxation techniques, such as meditation and breathing exercises.
• Exposure therapy for people with anxiety disorders. In exposure therapy, a type of CBT, a person spends brief periods in a supportive environment, learning to tolerate the distress caused by certain items, ideas, or imagined scenes cause. Over time, the fear associated with these things may dissipate.
• Tracking emotions and behaviors to raise awareness and the impact of each on the other.
• Supportive counseling to help a person explore troubling issues and provide emotional support.
• Creating a safety plan to help someone who has thoughts of self-harm or suicide recognize warning signs and use coping strategies such as contacting friends, family, or emergency personnel.

Note that there are many different types of psychotherapy. Other therapies are often variations on an established approach, such as CBT. There is no formal approval process for psychotherapies like there is for the use of medications from the Food and Drug Administration.

However, for many therapies, research involving large numbers of patients has provided evidence that treatment is effective for specific disorders. These "evidence-based therapies" have been shown in research to reduce symptoms of depression, anxiety, and other disorders. NIMH's health topic pages about specific disorders list some of the evidence-based therapies for those disorders.