What is psychotherapy?

Psychotherapy (also called talk therapy) refers to a variety of treatments that aim to help a person identify and change distressing feelings, thoughts, and behaviors. In general, the goals of psychotherapy are to relieve symptoms, maintain or enhance daily functioning, and improve quality of life. You or someone you know may seek psychotherapy for a variety of reasons, including:

Dealing with severe or long-term stress from a job or family situation, the death of a loved one, or relationship or family problems
Having symptoms with no physical cause, such as changes in sleep or appetite, low energy, loss of interest or pleasure in activities you previously enjoyed, persistent irritability, excessive worry, or feelings of hopelessness or despair that do not go away
The healthcare provider suspects that you have or have been diagnosed with a mental disorder that is interfering with your life.
Helping a child or family member who has been diagnosed with a condition affecting their mental health
Getting checked out by a healthcare provider first can help rule out a physical health problem. This step is important because sometimes symptoms such as mood swings or trouble concentrating are caused by a medical condition.

Psychotherapy and other treatment options

Psychotherapy can be used as an alternative to, or in conjunction with, medication and other treatment options. Choosing the right treatment plan is based on a person's individual needs and medical condition and should be done under the guidance of a mental health professional.

Even when medication relieves symptoms, psychotherapy can help address specific issues. These may include self-defeating thinking patterns; irrational fears; problems interacting with other people; or difficulty coping with situations at home, school, or work.

What are the elements of psychotherapy?

Several types of psychotherapy have been proven effective in treating mental health disorders. Often, the type of treatment is tailored to the specific disorder. For example, the treatment approach for a person with obsessive-compulsive disorder is different from the approach for a person with bipolar disorder. Therapists may use one primary approach or incorporate elements from multiple approaches, depending on their training, the disorder being treated, and the needs of the person receiving treatment.

The elements of psychotherapy may include the following:

Help a person become aware of automatic thinking patterns that are inaccurate or harmful (for example, having a low opinion of their abilities) and then question those thoughts, understand how the thoughts affect their feelings and behavior, and change self-defeating behavior patterns. This approach is known as cognitive behavioral therapy (CBT).

Identify ways to cope with stress and develop problem-solving strategies.

Examine interactions with others and teach social and communication skills.

Apply mindfulness and relaxation techniques, such as meditation and breathing exercises.

Use exposure therapy (a type of CBT) for anxiety disorders, in which the person spends brief periods in a supportive environment to learn to tolerate the distress caused by certain objects, thoughts, or imagined scenes. This continues until, over time, the fear associated with those things diminishes. Track feelings and behaviors to increase awareness of their impact on each other. Use supportive counseling to explore troubling issues and get emotional support. Create a safety plan to help deal with thoughts of self-harm or suicide, recognize warning signs, and use coping strategies, such as contacting friends, family, or emergency personnel. There are many types of psychotherapy. Treatments are often variations of an established approach, such as CBT.

What should I look for in a therapist?

Therapists have different professional backgrounds and specialties. The approach a therapist uses depends on their training and experience and the disorder being treated. This section and the next one provide information that can help you find therapists' credentials and resources for finding a therapist.

Once you have identified one or more potential therapists, an initial conversation can help you understand how treatment will proceed and whether you feel comfortable with the therapist. Rapport and trust are essential. Discussions in therapy are very personal, and it is important that you feel comfortable with the therapist and trust their expertise. These initial conversations can take place in person, over the phone, or virtually.

Consider asking the following questions:

What are the therapist's credentials and experience? Does the therapist have any specialties?

What approach will the therapist use to help you? Do they practice a particular type of therapy? What is the rationale for the therapy and its evidence base?

Does the therapist have experience diagnosing and treating the age group (for example, a child) and the specific condition? If the patient is a child, how will parents or caregivers be involved in treatment?

What are the goals of therapy? 

Does the therapist recommend a specific time frame or number of sessions? How will progress be assessed? What happens if you (or the therapist) feel you are not improving?

Are medications an option? 

Can this therapist prescribe medications?

Are meetings confidential? How is confidentiality ensured? 

Are there any limits to confidentiality?

If you have been in therapy for a reasonable amount of time and are not getting better, talk to your therapist. You may want to explore other mental health professionals or approaches.