What is psychotherapy?
Psychotherapy is a type of therapy used to treat emotional problems and mental health conditions.
It involves talking to a trained therapist, either one-to-one, in a group or with your wife, husband or partner. It allows you to look deeper into your problems and worries and deal with troublesome habits and a wide range of mental disorders, such as depression and schizophrenia.
Psychotherapy usually involves talking but sometimes other methods may be used – for example, art, music, drama and movement.
Psychotherapy can help you to discuss feelings you have about yourself and other people, particularly family and those close to you. In some cases, couples or families are offered joint therapy sessions together.
A therapist will treat sessions as confidential. This means you can trust them with information that may be personal or embarrassing.
Read more about how psychotherapy works.
Psychotherapists are mental health professionals who are trained to listen to a person's problems to try to find out what's causing them and help find a solution.
As well as listening and discussing important issues with you, a psychotherapist can suggest strategies for resolving problems and, if necessary, help you change your attitudes and behaviour.
Some therapists teach specific skills to help you tolerate painful emotions, manage relationships more effectively or improve behaviour. You may also be encouraged to develop your own solutions. In group therapy, the members support each other with advice and encouragement.
What is psychotherapy used to treat?
Psychotherapy can be used to treat a wide range of mental health conditions, including:
- anxiety disorders
- borderline personality disorder (BPD)
- obsessive-compulsive disorder (OCD)
- post-traumatic stress disorder (PTSD)
- long-term illnesses
- eating disorders, such as anorexia nervosa, bulimia and binge eating
- drugs misuse
Types of psychotherapy
There are several different types of psychotherapy that have been proven to be effective and are offered on the NHS. These are described below.
- psychodynamic (psychoanalytic) psychotherapy – a psychoanalytic therapist will encourage you to say whatever is going through your mind. This will help you to become aware of hidden meanings or patterns in what you do or say that may be contributing to your problems
- cognitive behavioural therapy (CBT) – a form of psychotherapy that examines how beliefs and thoughts are linked to behaviour and feelings. It teaches skills that retrain your behaviour and style of thinking to help you deal with stressful situations
- cognitive analytical therapy (CAT) – uses methods from both psychodynamic psychotherapy and CBT to work out how your behaviour causes problems and how to improve it through self-help and experimentation
- interpersonal psychotherapy (IPT) – looks at the way an illness can be triggered by events involving relationships with others, such as bereavements, disputes or relocation. It helps you cope with the feelings involved as well as working out coping strategies
- humanistic therapies – encourage you to think about yourself more positively and aim to improve your self-awareness; there's not as much evidence to support humanistic therapies compared with other types of psychotherapy
- family and marital (systemic) therapy – therapy with other members of your family that aims to help you work out problems together
If you have psychotherapy, you will meet your therapist regularly, usually once a week. However, in some cases, more frequent sessions may be needed.
A short-term course of psychotherapy may involve anything between 6 and 20 sessions, with individual sessions lasting about 50-60 minutes. Group sessions are often longer.
Read more about how psychotherapy works.
How can I get psychotherapy?
If you're interested in psychotherapy, the best place to start is with your doctor.
Finding psychotherapy services
When looking for a psychotherapist, make sure they're fully qualified and if appropriate, they have experience in treating your specific condition.
Seeing a psychotherapist
However, there are often long waiting lists to see psychotherapists, so you may want to consider seeing a private therapist.
Mental health specialists, including psychotherapists, already work in some doctor surgeries. If there's not one available in your surgery, your doctor may be able to refer you to a:
- a mental health team which decides what treatment is needed and refers you to a specific member of the team or to a specialist psychotherapy service
- specialist psychotherapy service – which carries out an assessment to determine appropriate treatment and refer you to one of its teams of psychotherapists
- consultant psychiatrist in psychotherapy – who is trained and experienced in a wide variety of methods and can work out which treatments are needed
If you're already seeing a psychiatrist or a local mental health team, they may be able to help you get psychological therapy as part of your treatment.
You can also arrange to see a psychotherapist or psychoanalyst privately.
However, as psychotherapy is an unregulated profession, so when choosing a private therapist make sure they're experienced in the type of treatment they're offering and have been trained through a recognised professional organisation.
Your doctor may also be able to recommend a qualified psychotherapist. It's important to be aware that different therapies may be recommended for different disorders.
If you have a problem, such as mild anxiety or depression, which you feel you may be able to improve without professional treatment, there are many self-help books and programs available. These are mainly based on cognitive behavioural therapy (CBT). The websites of charities involved in your condition can also be useful resources.
What is psychotherapy used for?
One of the key objectives of psychotherapy is to help you gain a better understanding of the issues that are troubling you.
It can help you work out new ways of approaching situations that you find difficult, as well as suggesting new methods to help you cope.
Developing a trusting relationship with your psychotherapist is very important, and will help you to talk about long-standing problems. However, developing trust can take time. Depending on the disorder and the style of psychotherapy, some treatment courses may need to last for several months or, in some cases, years.
Types of psychotherapy
There are many different types of psychotherapy. The type used will depend on your personal needs and which method your psychotherapist thinks will be most helpful for resolving your issues.
The different types of psychotherapy are discussed in more detail below.
Psychodynamic (psychoanalytic) psychotherapy
Psychoanalysis is based on the modern developments of the theories of Sigmund Freud. Freud believed that bad thoughts and experiences from childhood are repressed but continue to influence your feelings as an adult.
In psychoanalysis, a long time is spent talking about your personal relationships and the thoughts you have about other people. You're encouraged to discuss the past as well as the present. This allows the analyst to identify links between past events and how you think and act now.
Psychodynamic therapy is a less intensive form of psychoanalysis. It relies more on the way the relationship develops between you and your therapist than other types of therapy do. Your therapist may encourage you to talk about your childhood experiences with your parents and others to help reveal your unconscious thoughts.
Art, music and movement therapies often use the psychodynamic model of working but encourage alternative forms of self-expression and communication as well as talking. Even young children can take part and this is known as ‘play therapy’. Musical or technical skills are not needed for this type of therapy to be successful.
Cognitive behavioural therapy (CBT)
Behavioural psychotherapy and cognitive therapy are combined in cognitive behavioural therapy (CBT).
Cognitive therapy focuses on ways in which your thoughts and beliefs may be causing emotional problems. Your therapist will discuss these issues with you so that you can try to develop more helpful ways of thinking and are able to overcome the problems.
Behavioural psychotherapy can be used to help you gain a healthy, structured life. It's also often used to overcome a specific fear or phobia by helping you change the way you act. Your therapist may encourage you to gradually face these fears and help you to relax and feel comfortable as you do it.
During CBT, you and your therapist agree on tasks for you to do in between sessions. This will help you deal with problems yourself so that you no longer need therapy.
CBT is usually aimed at a specific problem and the sessions are often brief. A course usually consists of 6 to 20 sessions.
Cognitive analytical therapy (CAT)
During early sessions of cognitive analytical therapy (CAT), the therapist will discuss your life story, mapping out with diagrams potential problems that have occurred. You may also exchange letters with the therapist to help you both understand what's causing the problem.
A CAT therapist uses diaries and progress charts. These help you to develop skills that can be used to help you continue improving after the therapy sessions have finished.
Like CBT, CAT is often brief and may consist of about 16 sessions.
Humanistic therapies encourage you to explore how you think about yourself and to recognise your strengths. The aim is to help you think about yourself more positively and to improve your self-awareness.
There are several types of humanistic therapies, which are described below.
- person-centred counselling – aims to create a non-judgmental environment where you can feel comfortable talking about yourself and are able to accept who you are. Your counsellor will try to look at your experiences from your point of view
- gestalt therapy – takes a holistic approach, focusing on your past experiences including your thoughts, feelings and actions to help improve your self-awareness. This type of therapy often involves activities such as writing or role-playing
- transactional analysis – aims to identify communication problems and change unhelpful patterns of behaviour. You'll analyse the decisions you've made so you understand the effect they've had on your life. This type of therapy also helps you to trust your decisions and improve the way you feel about yourself
- transpersonal psychology – encourages you to explore who you really are as a person. It involves using techniques such as meditation and visualisation
- existential therapy – is based on the theories of philosophers, such as Soren Kierkegaard and Friedrich Nietzsche, to help increase your self-awareness and broaden your views of the world. Existential therapy is not concerned with your past, but instead focuses on the choices to be made in the present and future
It's important to be aware that there's not as much evidence to support humanistic therapies compared with other types of psychotherapy.
Interpersonal psychotherapy (IPT)
Interpersonal psychotherapy (IPT) has been shown to be particularly effective in treating depression. Your therapist will be interested in how your relationships with others can be managed as healthily as possible to help with recovery and staying healthy.
Your therapist will help you develop a new approach to dealing with any recent interpersonal difficulties.
IPT consists of about 12 to 16 sessions.
Family and marital (systemic) therapy
Family therapy focuses on family relationships, such as marriage, and encourages everyone within the family or relationship to work together to fix problems rather than blaming each other.
There's often more than one therapist involved to make sure everyone in the group has their say.
The therapist encourages group discussions or exercises that involve everyone, and promotes a healthy family unit as a way of improving mental health.