How Psychotherapy Is Used to Treat Disorders

Female mental health professional talks with patient
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Psychotherapy is a general term that is used to describe the process of treating psychological disorders and mental distress through the use of verbal and psychological techniques. During this process, a trained psychotherapist helps the client tackle specific or general problems such as a particular mental illness or a source of life stress.

Depending on the approach used by the therapist, a wide range of techniques and strategies can be used. Almost all types of psychotherapy involve developing a therapeutic relationship, communicating and creating a dialogue, and working to overcome problematic thoughts or behaviors.

Psychotherapy is increasingly viewed as a distinct profession in its own right, but many different types of professionals offer it, including clinical psychologists, psychiatrists, counselors, marriage and family therapists, social workers, mental health counselors, and psychiatric nurses.

Types of Psychotherapy

When many people hear the word "psychotherapy," they immediately imagine a patient lying on a couch talking while a therapist sits in a nearby chair jotting down thoughts on a yellow notepad. The reality is that there are a variety of techniques and practices used in psychotherapy.

The exact method used in each situation can vary based upon a variety of factors, including the training and background of the therapist, the preferences of the client, and the exact nature of the client's current problem. Here is a brief overview of the main types of therapy.

Psychoanalytic Therapy

While psychotherapy was practiced in various forms as far back as the time of the ancient Greeks, it received its formal start when Sigmund Freud began using talk therapy to work with patients. Techniques commonly used by Freud included the analysis of transference, dream interpretation, and free association.

This psychoanalytic approach involves delving into a patient's thoughts and past experiences to seek out unconscious thoughts, feelings, and memories that may influence behavior.

Behavioral Therapy

When behaviorism became a more prominent school of thought during the early part of the twentieth-century, techniques such as different types of conditioning began to play an important role in psychotherapy.

While behaviorism may not be as dominant as it once was, many of its methods are still very popular today. Behavioral therapy often uses classical conditioning, operant conditioning, and social learning to help clients alter problematic behaviors.

Humanistic Therapy

Starting in the 1950s, the school of thought known as humanistic psychology began to have an influence on psychotherapy. The humanist psychologist Carl Rogers developed an approach known as client-centered therapy, which focused on the therapist showing unconditional positive regard to the client.

Today, aspects of this approach remain widely used. The humanistic approach to psychotherapy focuses on helping people maximize their potential and stresses the importance of self-exploration, free will, and self-actualization.

Cognitive Therapy

The cognitive revolution of the 1960s also had a major impact on the practice of psychotherapy, as psychologists began to increasingly focus on how human thought processes influence behavior and functioning.

Cognitive therapy is centered on the idea that our thoughts have a powerful influence on our mental well-being.

For example, if you tend to see the negative aspects of every situation, you will probably have a more pessimistic outlook and a gloomier overall mood.

The goal of cognitive therapy is to identify the cognitive distortions that lead to this type of thinking and replace such thoughts with more realistic and positive ones. By doing so, people are able to improve their moods and overall well-being.

Cognitive Behavioral Therapy

The approach known as cognitive behavioral therapy (CBT) is a psychotherapeutic treatment that helps patients understand the thoughts and feelings that influence behaviors. CBT is used to treat a range of conditions including phobias, addiction, depression, and anxiety.

CBT involves cognitive and behavioral techniques to change negative thoughts and maladaptive behaviors. The approach helps people to change underlying thoughts that contribute to distress and modify problematic behaviors that result from these thoughts.

Psychotherapy Formats

Psychotherapy can take different formats depending on the style of the therapist and the needs of the patient. A few formats that you might encounter include:

  • Individual therapy, which involves working one-on-one with a psychotherapist.
  • Couples therapy, which involves a therapist working with a couple to help improve how the two function in their relationship
  • Family therapy, which centers on improving the dynamic within families and can include multiple individuals within a family unit
  • Group therapy, which involves a small group of individuals who share a common goal (This approach allows members of the group to offer and receive support from others, as well as practice new behaviors within a supportive and receptive group.)

Before You Try Psychotherapy

There are a number of issues or concerns for both therapists and clients. When selecting a therapist, consider whether you feel comfortable divulging personal information to the therapist. You should also assess the therapist's qualifications, including the type of degree they hold and years of experience.

People who provide psychotherapy can hold a number of different titles or degrees. Titles such as "psychologist" or "psychiatrist" are protected and carry specific educational and licensing requirements.

Some of the individuals who are qualified to offer psychotherapy include psychiatrists, psychologists, counselors, licensed social workers, and advanced psychiatric nurses.

When providing services to clients, psychotherapists need to consider issues such as informed consent, patient confidentiality, and duty to warn. Informed consent involves notifying a client of all of the potential risks and benefits associated with treatment. This includes explaining the exact nature of the treatment, any possible risks, costs, and the available alternatives.

Because clients frequently discuss issues that are highly personal and sensitive in nature, psychotherapists also have a legal obligation to protect a patient's right to confidentiality. However, one instance where psychotherapists have a right to breach patient confidentiality is if clients pose an imminent threat to either themselves or others.

Duty to warn gives counselors and therapists the right to breach confidentiality if a client poses a risk to another person.

How Effective Is Psychotherapy?

One of the major criticisms leveled against psychotherapy calls into question its effectiveness. In one early and frequently cited study, a psychologist named Hans Eysenck found that two-thirds of participants either improved or recovered on their own within two years, regardless of whether they had received psychotherapy.

However, in numerous subsequent studies, researchers found that psychotherapy can enhance the well-being of clients.

In his book "The Great Psychotherapy Debate," statistician and psychologist Bruce Wampold reported that factors such as the therapist’s personality as well as their belief in the effectiveness of the treatment played a role in the outcome of psychotherapy.

Surprisingly, Wampold suggested that the type of therapy and the theoretical basis of the treatment do not have an effect on the outcome. The disagreement has motivated researchers to continue to examine and study the effectiveness of psychotherapy.

How to Know If You Need Psychotherapy

You might realize that psychotherapy can help with life's problems, but it can still be difficult to seek help or to even recognize when it is time to talk to a professional.

Some key signs that it might be time to see a psychotherapist include:

  • The issue is causing significant distress or disruption in your life. If you feel that the problem you are facing interrupts a number of important areas of your life including school, work, and relationships, it may be time to see if psychotherapy can help.
  • You are relying on unhealthy or dangerous coping mechanisms. If you find yourself dealing with your problem by smoking, drinking, overeating, or taking out your frustrations on others, seeking assistance can help you find healthier and more beneficial coping strategies.
  • Friends and family are concerned about your well-being. If it has reached a point where other people are worried about your emotional health, it may be time to see if psychotherapy can improve your psychological state.
  • Nothing you have tried so far has helped. You've read self-help books, explored some techniques you read about online, or even tried just ignoring the problem, yet things just seem to be staying the same or even getting worse.

You don't have to wait until your life becomes so overwhelming that you can't cope to ask for help. The sooner you reach out, the sooner you can get the help you need to live a healthier, happier life.

Choosing a Therapeutic Technique and Therapist

If you feel that you might benefit from psychotherapy, your first step is to discuss your concerns with your primary care physician. Your doctor might begin by ruling out any physical diseases that could cause or contribute to your symptoms.

If no specific physical cause is found, your doctor can refer you to a mental health professional who is qualified to diagnose and treat mental illness.

Your symptoms often play a role in the treatment and therapist you choose. For example, if the best treatment for you would require prescription medications and psychotherapy, seeing a psychiatrist may be beneficial.

A psychiatrist is a medical doctor who can prescribe medications and has specific training in the treatment of psychological and psychiatric conditions.

If you would most benefit from some form of talk therapy without the addition of prescription drugs, you might be referred to a clinical psychologist or counselor. Referrals from friends and family members can sometimes be a good route to connecting with a therapist who can help you.

Psychotherapy is both an art and a science. If your sessions don't feel helpful or you just don't seem to "click" with your current therapist, it's OK to try therapy with someone else. Keep looking until you find a professional that you feel comfortable with.

As you evaluate a potential psychotherapist, consider the following questions:

  • Does the therapist seem professional and qualified?
  • Do you feel comfortable sharing your feelings and experiences?
  • Do you like the therapist's conversational style?
  • Are you satisfied with the extent of your interaction with the therapist?
  • Do they seem to understand what you are feeling?

A Word From Verywell

Psychotherapy comes in many forms, but all are designed to help people overcome challenges, develop coping strategies, and lead happier and healthier lives.

If you are experiencing symptoms of a psychological or psychiatric disorder, you might benefit from an evaluation by a trained and experienced psychotherapist who is qualified to assess, diagnose, and treat mental health conditions.

You can reap the possible benefits of psychotherapy even if you just feel that there is something "off" in your life that might be improved by consulting with a mental health professional.

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Article Sources
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  1. Norcross JC, ed. Psychotherapy relationships that work: Evidence-based responsiveness. 2nd edition. Oxford University Press; 2011. doi:10.1093/acprof:oso/9780199737208.001.0001 

  2. Wampold BE. The good, the bad, and the ugly: A 50-year perspective on the outcome problem. Psychotherapy (Chic). 2013;50(1):16-24. doi:10.1037/a0030570

  3. American Psychiatric Association. What is Psychotherapy? Updated January 2019.

Additional Reading
  • Eysenck, HJ. The effects of psychotherapy: An evaluation. Journal of Consulting Psychology. 1957;16:319-324.

  • Smith, M.L. What Research Says About the Effectiveness of Psychotherapy. Psychiatric Services; 2006.

  • Henrik, R. (1980). The Psychotherapy Handbook. The A-Z handbook to more than 250 psychotherapies as used today. New American Library; 1980.
  • Wampold, B. E. The Great Psychotherapy Debate: Models, Methods, and Findings. Routledge; 2001.