Therapy: Definition, Types, & Tips
Therapy improves our lives by changing how we think, feel, and act, and as many as 20% of adults see a therapist each year. Let’s learn more about the common and essential experience of therapy.
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Okay, it’s confession time: I am one of those therapists who originally did not think he needed therapy himself. You might be surprised how many therapists have trouble acknowledging their own need for help. There is something very satisfying in helping other people but also something very vulnerable in being helped. And yet, at this moment, Americans – especially teenagers – are facing more mental health issues and need therapy more than ever (Centers for Disease Control and Prevention, 2023). |
As many as 20% of adults seek out therapy in a given year (Terlizzi & Zablotsky, 2020), and I would bet that this number will keep going up. Modern life is constantly changing and challenging us in new ways, so let’s talk about the basics of therapy, such as what it is and what happens in a session.
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What Is Therapy? (A Definition)
All states in the U.S. regulate the delivery of psychotherapy, allowing only people with specialized training to acquire a license to practice psychotherapy and to be reimbursed by insurance companies for providing psychotherapy. (In some states, people can offer psychotherapy without a license, but they typically have to state very clearly that they are not licensed, and they cannot be reimbursed by insurance companies.)
Although the exact titles may differ from one state to another, people trained as psychologists, psychiatrists, social workers, and professional counselors can provide therapy to people of any age. They may deliver therapy to people individually, in couples, as a family, or as a group of otherwise unrelated individuals (Lambert et al., 1994), such as at a rehabilitation center for substance users.
Benefits of Therapy
What Is Online Therapy?
Online therapy, also known as teletherapy, has become much more common since the onset of the COVID-19 pandemic (Lin et al., 2022). In this format, people meet with their therapist through a video conferencing software such as Zoom, or (less often) simply by talking over the phone. There are many benefits to making therapy available online: primarily, it is more convenient for many people, and may help some people who would have a hard time opening up in person to start to be more vulnerable. Research tells us that online therapy is generally as effective as in-person therapy for most mental health challenges, although people may be more likely to stop attending online versus in-person therapy (Lin et al., 2022).
From my experience on both sides of the teletherapy equation, I believe it is pretty effective, too. I have been able to meet with my own therapist, who lives several hours away from me, from several different states, and I can just as easily see him from my office at work or my bedroom. I have also worked with clients who would have had great difficulty attending therapy in person because they could not find childcare, or because their anxiety made leaving the house difficult for them. I think online therapy reflects the state of modern life, too: we are simply getting used to doing everything online, even if that includes spilling our hearts to people we may have never met in person.
What Is Couples Therapy?
Couples therapy is psychotherapy delivered to romantic partners who meet with the therapist at the same time (and hopefully in the same place). Where individual therapy aims to help the client manage their own mental health better, in couples therapy, both partners are “the client,” but the well-being of the relationship is the focus (Snyder et al., 2006).
As a couple therapist, I can tell you that this is sometimes confusing to manage. It is hard to watch two people who seem ill-suited to each other struggle to make their relationship work, and sometimes I wonder if the effort is worth it. But I have also helped couples resolve longstanding conflicts and rekindle intimacy – the process can be beautiful. And the process works: there is lots of research that demonstrates that many (although not all) couples in distress benefit from couples therapy (Snyder et al., 2006). Interestingly, many couples also meet therapists to get help with a mental health challenge that primarily affects one partner, such as an eating disorder or depression (Snyder et al., 2006).
Therapy Types
- Psychoanalytic and psychodynamic therapies. These approaches focus on bringing to conscious awareness the thoughts and emotions we may not be aware of so that we can more effectively live our lives. Psychodynamic therapy, in particular, focuses on the relationship between therapist and client as it unfolds, observing how the client brings aspects of their life into the therapeutic relationship.
- Behavior therapy. Behavior therapy looks at how we get negatively and positively reinforced for our behaviors, and how this teaches us how to live our lives over time. Over time, behavior therapy began to consider how thoughts and behaviors are related to each other, too.
- Cognitive therapy. Cognitive therapy focuses mostly on cognitions, or thoughts. It began from the belief that just focusing on changing ineffective thinking patterns could resolve our psychological issues. Over time, cognitive therapists recognized that addressing thoughts alone might not be as effective as considering both feelings and behaviors, which is how cognitive therapy and behavior therapy came to merge into cognitive-behavioral therapy.
- Humanistic therapy. This kind of therapy is sometimes called “client-centered” therapy. It embraces the humanity of clients, assumes that they have the knowledge they need to get better (since they are in their own heads, and the therapist isn’t) and tries to use consistent positive attention and care to help clients recognize their inner potential.
Many therapists use some combination of these approaches – in fact, few therapists operate strictly from just one school of thought (Kazdin, 2000). Personally, I think this reflects the fact that we vary so much from one person to another that no single approach will work for everybody.
What Does A Therapy Session Like?
Once the therapist and the client have this shared foundation of knowledge about the client’s life, and have agreed on goals for therapy, they do the work of looking at and changing the client’s thoughts, feelings, and behaviors. This can look many, many different ways, but there are several aspects of therapy that seem to be common to most approaches and to be helpful in most contexts. A massive study of many, many therapeutic relationships discovered that core elements of effective therapy include, but aren’t limited to, the following (Russell et al., 2007):
- Exploring and processing client emotions. A client might arrive at therapy in a negative mood, and the therapist would help them figure out where the emotions came from and how they can resolve their emotions.
- Talking about relationships. For example, the therapist might ask whether the client’s perfectionism might be related to messages they got from caregivers when they were a child.
- Mutually investigating patterns in the client’s life. For example, a therapist might observe and share with the client that the client is rejecting positive feedback, just the way they discount praise from their supervisor at work and their spouse at home.
- Providing support and validation. Many people find that sharing things they are ashamed of and then being accepted as they are are powerfully therapeutic experiences.
Therapy vs Psychiatry
Psychiatrists are different from other psychotherapy providers in that they can also provide what is called psychopharmacology, or the treatment of mental health challenges using psychiatric medication. In other words, they are the only therapists that can prescribe medications such as antidepressants. It is clear that psychiatric medication and psychotherapy can both help with mental health challenges, although some disorders respond more to medication and others respond more to psychotherapy (Cuijpers et al., 2013).
Therapy vs Counseling
Dog Therapy, Cat Therapy, & Horse Therapy
Quotes on Therapy
- “Whenever two people meet, there are really six people present. There is each man as he sees himself, each man as the other person sees him, and each man as he really is.” – William James
- “In my early professional years I was asking the question: How can I treat, or cure, or change this person? Now I would phrase the question in this way: How can I provide a relationship which this person may use for his own personal growth?” – Carl Rogers
- “I would say that I began with a very edgy, very driven personality and after a sufficient amount of therapy over many, many years, I managed to become rather relaxed and happy.” – John Cleese
- “We may define therapy as a search for value.” – Abraham Maslow
- “The one thing I really learned, and learned well, in group therapy was that you don’t die if someone doesn’t like you.” – Rita Moreno
- “Our wounds are often the openings into the best and most beautiful part of us.” ― David Richo
- “Money doesn’t buy happiness, but it does pay for therapy.” – Travis Kalanick
Articles Related to Therapy
- Somatic Therapy: Definition, Examples, & Exercises
- Clinical Psychology: Definition, Programs, & Careers
- Mental Health: Definition, Awareness, & Resources
- Acceptance and Commitment Therapy: Definition & Exercises
- Family Therapy: Definition, Activities, & Techniques
- Gestalt: Psychology, Principles, & Therapy
- Psychologists: Definition, History, & Types
- Internal Family Systems (IFS): Therapy, Parts, & More
Books Related to Therapy
Final Thoughts on Therapy
For more general information about therapy, I recommend watching the following video:Video: Psychotherapy
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References
- Bachi, K., & Parish-Plass, N. (2017). Animal-assisted psychotherapy: A unique relational therapy for children and adolescents. Clinical Child Psychology and Psychiatry, 22(1), 3-8.
- Centers for Disease Control and Prevention (2023). Youth Risk Behavior Survey Data Summary & Trends Report: 2011-2021. Atlanta, GA.
- Cuijpers, P., Sijbrandij, M., Koole, S. L., Andersson, G., Beekman, A. T., & Reynolds III, C. F. (2013). The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: A meta-analysis of direct comparisons. World Psychiatry, 12(2), 137-148.
- Czabała, J. C. (2016). Psychological counseling versus psychotherapy. Roczniki Psychologiczne, 19(3), 535-548.
- Kazdin, A. E. (2000). Encyclopedia of psychology (Vol. 8). American Psychological Association (Ed.). Washington, DC: American Psychological Association.
- Lambert, M. J., Bergin, A. E., & Garfield, S. L. (1994). The effectiveness of psychotherapy. Encyclopedia of Psychotherapy, 1, 709-714.
- Lin, T., Heckman, T. G., & Anderson, T. (2022). The efficacy of synchronous teletherapy versus in-person therapy: A meta-analysis of randomized clinical trials. Clinical Psychology: Science and Practice, 29(2), 167.
- Russell, R. L., Jones, M. E., & Miller, S. A. (2007). Core process components in psychotherapy: A synthetic review of P-technique studies. Psychotherapy Research, 17(3), 271-288.
- Snyder, D. K., Castellani, A. M., & Whisman, M. A. (2006). Current status and future directions in couple therapy. Annual Review of Psychology, 57, 317-344.
- Terlizzi, E. P., & Zablotsky, B. (2020). Mental health treatment among adults: United States, 2019. NCHS Data Brief, no 380. Hyattsville, MD: National Center for Health Statistics. 2020.
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