Psychotherapy: What It Is & When to Seek Help

Whether you're dealing with anxiety, depression, or simply navigating life’s challenges, psychotherapy provides a structured approach to understanding yourself better and developing coping strategies. In this article, we’ll explore what psychotherapy is, its various types, and how it can help people from all walks of life manage their mental health and achieve greater well-being.

What is Psychotherapy?

Psychotherapy is an evidence-based mental health treatment that involves talking with mental health professionals. It is also called talk therapy, psychosocial therapy, counseling, or therapy.

The goal of psychotherapy is to help you understand your thoughts, feelings, and behaviors, learn healthy coping skills, and take control of your emotions in challenging situations.

Psychotherapy and other mental health services are provided by psychologists, psychiatrists, licensed social workers, psychiatric nurses, marriage and family therapists, and other mental health professionals.

Psychotherapy sessions can be provided in various settings, including individual therapy (one-on-one sessions), a group setting, family therapy, in-person visits, and telemental health services (online therapy or web-based services).

Psychotherapy vs. Counseling

The terms psychotherapy and counseling are often used interchangeably. However, some experts make a small distinction between them. Psychotherapy refers to a longer-term, more intensive form of therapy that helps a therapist gain insight into a person’s mental illness and treat mental health conditions. Counseling is a brief treatment that targets a specific symptom or helps to resolve a current issue.

Psychotherapy vs. Therapy

Again, therapy and psychotherapy are often used interchangeably. However, therapy is a broader term that includes treatments for both physical and mental health issues. Psychotherapy focuses on the mind and is used to treat a medical condition affecting the mind. Therefore, psychotherapy is a type of therapy.

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Types of Psychotherapy

Some of the most common psychotherapy techniques are briefly described below.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) is a structured, evidence-based form of psychotherapy that helps you identify negative thought patterns, painful emotions, and unhealthy behaviors and replace them with healthier ones. CBT helps you understand how your thoughts and feelings affect your behaviors. It also helps you learn coping skills and respond to challenging situations more effectively.

Dialectical Behavior Therapy (DBT)

Dialectical behavior therapy (DBT) is a type of CBT that is especially useful for people who experience intense emotions, for example, those with a mental illness called borderline personality disorder (BPD). Dialectical means opposing ideas. This type of psychotherapy helps you understand your reality and strike a balance between accepting who you are and your challenges. The goal of DBT is to help you learn skills to regulate your emotions.

Psychodynamic Therapy

Psychodynamic psychotherapy focuses on uncovering unconscious thoughts that affect your current behaviors. The goal of psychodynamic therapy is to improve self-awareness and help you better understand how your past influences your present behavior. This approach enables you to examine unresolved conflicts, such as past dysfunctional relationships, which can lead to unhealthy present behaviors, such as substance abuse.

Family Therapy and Interpersonal Psychotherapy

Interpersonal therapy is a type of psychotherapy that explores how your emotions affect your relationships and vice versa. The goal is to improve your relationships with others by helping you understand emotional distress and how it affects how you relate to others. You also learn communication skills to reduce discord. Family therapists work with couples and families to address emotional and behavioral issues.

Note: Your therapist may recommend a different psychotherapy treatment approach, such as supportive psychotherapy, animal-assisted therapy, humanistic therapy, commitment therapy, or others. Clinical trials have shown different types of psychotherapy are effective for different mental health conditions. The behavioral techniques that will be most beneficial depend on the specific issues of the person receiving treatment. Psychotherapy is often combined with medication, such as antidepressants, depending on the individual's condition and treatment needs.

What is a Psychotherapist?

Qualifications and Training

A psychotherapist is a trained professional who offers various forms of psychotherapy, such as cognitive behavior therapy, to help people with mental health concerns. Psychotherapists complete an undergraduate degree in any discipline, followed by a graduate program in psychology. They gain expertise through coursework that includes a combination of theory and practical hands-on experience. Some psychotherapist programs require students to do research as part of their training.

Is A Psychotherapist A “Real Doctor”?

No, a psychotherapist is not usually a medical doctor, though some may be. Psychotherapists are trained to help people with emotional issues, and they often use talk therapy. However, they have not completed medical school and cannot prescribe medications to manage mental health conditions.

Psychotherapist vs. Clinical Psychologist vs. Psychiatrist

As mentioned above, a psychotherapist can graduate in any discipline and do a post-graduate (master’s level) program in psychology. It is therefore a more flexible educational program compared to clinical psychology courses.

A clinical psychologist requires an undergraduate degree in psychology, followed by a graduate degree (master’s degree, doctorate, or both) in clinical psychology. Therefore, clinical psychologists have more specialized education and training compared to psychotherapists.

A psychiatrist must complete medical school, and upon graduating from medical school, complete a 4-year residency program in psychiatry where they learn how to take care of patients with mental health conditions. Upon completing psychiatry residency, a psychiatrist can apply for board certification by the American Board of Psychiatry and Neurology. According to the American Psychiatric Association, many psychiatrists continue their training to specialize, for example, in child and adolescent psychiatry or forensic (legal) psychiatry. Psychiatrists can prescribe medications to manage mental health conditions.

Do Psychotherapists Prescribe Medication?

No, psychotherapists generally cannot prescribe medication. Only psychiatrists, who are medical doctors with specialized training in mental health, are authorized to prescribe medication as part of a patient’s treatment plan. In some states, psychiatric nurse practitioners and physician assistants can prescribe medications to manage psychiatric medical conditions, but their scope of practice varies from state to state.

How Do I Know If I Need Therapy?

Recognizing Mental Health Symptoms

People with mental health conditions can have a wide range of symptoms. The following list of emotional and behavioral patterns should not be used to diagnose mental health conditions. Rather, it is meant to help you gain awareness and know when to seek professional help. You may need therapy if you:

Feel constantly anxious or worried to the point that it interferes with your ability to function in daily life.
Feel depressed or unhappy all or most of the time.
Have feelings of guilt, worthlessness, hopelessness, or helplessness.
Lack motivation or energy.
Are tearful all the time.
Feel overly happy, excited, or spend excessive amounts of money you can’t afford.
Have emotional outbursts (sudden or dramatic changes in mood), including anger, violence, or extreme distress.
Experience changes in sleep patterns, such as insomnia (an inability to fall asleep or stay asleep), hypersomnia (sleeping too much), or staying up all night and sleeping during the daytime.
Have increased or decreased appetite and weight gain or weight loss.
Have withdrawn from friends, family, and social activities.
Experience a lack of interest in previously enjoyed hobbies.
Neglect school or work responsibilities or experience a fall in performance.
Engage in substance abuse (use of substances such as alcohol or drugs) to cope with emotional problems.
Engage in high-risk behavior, such as substance use, drunk driving, or unprotected sex.
Have bizarre or strange thoughts, such as “I have a special power” or “Someone is controlling my thoughts and actions” or “People are out to get me.”
See or hear things that aren’t there (visual and auditory hallucinations).
Have suicidal ideation (thoughts or behavior of self-harm).
Have homicidal ideation (thoughts of hurting others).

Identifying the Need for Therapy

A person might start out by showing subtle changes in their emotions, thinking, and behavior. Ongoing or significant changes in emotional health could be a sign of a mental health condition. If something doesn't feel “quite right,” it's important to have a conversation with a loved one about getting help. Your primary care physician can be the first point of contact. They can refer you to a psychiatrist or psychologist for behavioral therapy and/or medications if needed.

Common Mental Health Conditions Treated

Some of the mental health conditions that can benefit from psychotherapy include:

Anxiety disorders, such as generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder (OCD), specific phobias, panic disorder, and post-traumatic stress disorder (PTSD).
Mood disorders, such as major depressive disorder and bipolar disorder.
Eating disorders, such as anorexia, bulimia, or binge eating disorder.
Addictions, such as drug abuse, alcohol use disorder, or gambling.
Schizophrenia and other psychotic disorders that cause a person to become detached from reality.
Personality disorders, such as borderline personality disorder, narcissistic personality disorder, or dependent personality disorder.

The Psychotherapy Process

What to Expect During Therapy Sessions

Before starting therapy, you may be asked to fill out forms with questions about your mental and emotional health. The answers you provide can help your clinical psychologist or psychiatrist in diagnosing mental health conditions. There are specific questionnaires such as PHQ-9 for depression, and GAD-7 for anxiety, amongst other mental health conditions.

During the first psychotherapy session, mental health professionals usually gather information about the patient to understand their needs. This may be accomplished in one session, or it can take multiple sessions.

The initial therapy sessions are also an opportunity for you to see whether you can build a rapport with the psychotherapist and whether their approach will work for you. It is important to note that finding the most compatible psychotherapist for you is of utmost importance. Everyone and their needs are different, and sometimes you will have to meet with a few psychotherapists before finding out who is the best fit for you. Do not hesitate to ask questions about:

What type of psychotherapy they use
Their experience in treating mental health conditions
The goals of the treatment plan they are developing for you
The length of each session
How many sessions you will need
Payment terms
What happens if you need to skip psychotherapy sessions

After the initial session, you will begin meeting with your psychotherapist regularly, either in the office, medical clinic, or via video call. Each session usually lasts 45 to 55 minutes. You will work with your therapist to identify and change unhealthy behaviors and practice new skills and coping strategies.

Goals and Outcomes of Psychotherapy

Psychotherapy can help to:

Relieve anxiety or stress in challenging situations.
Reduce sadness and depressed mood.
Recognize and change unhealthy emotions and reactions, such as anger, aggression, violence, or road rage.
Resolve conflicts with loved ones.
Stop or reduce substance abuse, such as excessive drinking or use of illegal drugs.
Cope with major life events, such as the loss of a job, divorce, or the death of a loved one.
Overcome physical or sexual abuse or other traumatic events.
Accept serious health diagnoses such as cancer or chronic health conditions such as diabetes or long-lasting pain.
Cope with physical symptoms such as sleep disturbances.

Finding the Right Psychotherapist

Here are some tips on finding a good therapist:

Define your goals. Ask yourself what you want to accomplish from psychotherapy. This will help you communicate your goals to your therapist. Studies have found that when clients and therapists work towards the same goals, the outcomes are better.
Ask for references. A trusted family member or friend can guide you towards psychotherapists in your local area. However, keep in mind that everyone’s needs are different, and what worked for someone you know might not work for you.
Explore resources in your community. For example, students might have access to a university counseling center, employees to a workplace emotional wellness program, or they may be able to access talk therapy through a faith-based organization.
Find out how you will pay for mental health services. Call your insurance provider to find in-network psychotherapists.

As mentioned previously, it is of utmost importance to find the right therapist for you. It might take many sessions with many different therapists to build rapport with a therapist and find the right fit. Focus on your needs and your goals, and try to find a therapist who fits well with your desires.

Online vs. In-Person Therapy

The American Psychological Association (APA) says that web-based or online talk therapy has various benefits, including convenience, cost, and higher levels of comfort for some people.

However, not all mental health conditions can benefit from online therapy. It’s also important to make sure the therapist you choose is licensed and the app providing web-based therapy for mental well being assures patient confidentiality.

Also, you should check with your health insurance if they will pay for online therapy. Some insurance plans pay for mental health services provided in person by a licensed psychotherapist but not for web-based talk therapy.

How to Access Affordable Therapy Options

Here are some ways to access affordable therapy options:

In a crisis situation, call or text the 988 Suicide and Crisis Lifeline at 988 or use the chat feature at 988Lifeline.org.

Use online search tools from organizations such as:

Look for psychotherapists that specialize in specific disorders, such as:

Frequently Asked Questions

Can I Talk To A Therapist For Free?

You can talk to a therapist for free in some situations, for example, through crisis hotlines. Some non-profit organizations and government programs also offer limited free sessions with licensed therapists. If you are a university student, your institution might have partnerships with certain therapy services and provide you with free or heavily discounted therapy sessions. However, availability is usually limited, and you can only get a certain number of free sessions. Depending on your mental health needs, you will likely need to pay for ongoing sessions with a professional therapist.

What Do You Do During Psychotherapy?

Once you feel comfortable with your psychotherapist, you will likely meet with them anywhere from a couple of times a week to every other week. Each session usually lasts 45 to 55 minutes. The sessions can be held in the psychotherapist’s office, a medical clinic, or through a video call.

During psychotherapy sessions, you will talk with your therapist about your thoughts and feelings and work together to identify and change unhealthy behaviors. You may also practice new skills and coping strategies.

What Are The 4 Stages of Psychotherapy?

The four main stages of psychotherapy are:

Building a relationship and establishing a connection with the psychotherapist.
Identifying issues and problems in the client’s history or diagnosing a mental illness.
Working through issues by applying psychotherapy approaches, either through individual or group therapy.
Termination or ending a therapeutic relationship.