Psychotherapy: What to expect and how it works (original) (raw)

Psychotherapy can help treat challenges and symptoms relating to mental health and emotions.

Also known as talk therapy, psychotherapy aims to help a person understand their feelings and equip them to face new challenges, both in the present and the future.

Psychotherapy is similar to counseling, and the two can overlap. However, the former tends to look more deeply, addressing the underlying causes of a person’s problems as well as how to solve them.

To see positive results, a person will usually need to understand the need for change and be willing to follow the treatment plan as the specialist advises. They will also need to find a suitable therapist they can trust.

Psychotherapy can help when depression, low self-esteem, addiction, bereavement, or other factors leave a person feeling overwhelmed. It can also help treat bipolar disorder, schizophrenia, and certain other mental health conditions.

In this article, learn more about what psychotherapy involves.

There are many approaches to psychotherapy.

Some forms last for only a few sessions, while others may continue for months or years, depending on the person’s needs. Individual sessions usually last for around 45–90 minutes and follow a structured process.

Sessions may be one-to-one, in pairs, or in groups. Techniques can include talking and other forms of communication, such as drama, story-telling, or music.

A psychotherapist may be:

Psychotherapy can help people in a range of situations. For example, it may benefit someone who:

Some people attend psychotherapy after a doctor recommends it, but many seek help independently.

There are several styles of and approaches to psychotherapy. The sections below will outline these in more detail.

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) helps a person understand and change how their thoughts and behaviors can affect the way they feel and act.

CBT can help people with many issues, including:

Interpersonal therapy

Under this approach, a person learns new ways to communicate or express their feelings. It can help with building and maintaining healthy relationships.

For example, if someone who responds to feeling neglected by getting angry, this may trigger a negative reaction in others. This can lead to depression and isolation.

The individual will learn to understand and modify their approach to interpersonal problems and acquire ways of managing them more constructively.

Psychodynamic therapy

Psychodynamic therapy addresses the ways in which past experiences, such as those during childhood, can impact a person’s current thoughts and behaviors. Often, the person is unaware that this influence is even present.

Identifying these influences can help people understand the source of feelings such as distress and anxiety. Once they identify these sources, the psychotherapist can help the person address them. This can help an individual feel more in control of their life.

It is similar to psychoanalysis but less intense.

Family therapy

Family therapy can provide a safe space for family members to:

This form of psychotherapy can be useful when problems stem from family relationships, or when a child or young person is facing difficulties.

In fact, one 2019 article suggests that family therapy may help adolescents with mental health problems. It may also improve family cohesion and enhance parenting skills.

Relationship therapy is another type of psychotherapy. It is very similar to family therapy, but a person may instead wish to present to therapy with their partner to address issues within a relationship.

Group therapy

Group therapy sessions usually involve one therapist and around 5–15 participants with similar concerns, such as:

The group will usually meet for 1 or 2 hours each week, and individuals may also attend one-on-one therapy.

People can benefit from interacting with the therapist but also by interacting with others who are experiencing similar challenges. Group members can also support each other.

Although participating in a group may seem intimidating, it can help people realize that they are not alone with their problem.

Online therapy

Many people are now opting for online therapy, otherwise known as telehealth. This can have many benefits, especially for someone who:

Tools include video meetings and messaging services.

Although online services have helped “normalize” psychotherapy, making it easier to integrate into daily life, a person should check carefully before choosing a provider.

For example, they should consider:

Other types

There are many other types of psychotherapy, including:

Each person’s experience of psychotherapy will be different, and the time it takes to see an improvement will also vary.

Some people will notice a difference after around six to 12 sessions, while others may need ongoing treatment for several years.

Psychotherapy can help a person by:

Participants can:

To benefit from the process, a person needs to:

Effectiveness can also depend on:

A trusting relationship between the individual and the therapist is also essential to the process.

Choosing a suitable therapist

People seek psychotherapy for a wide range of reasons, and each individual is different. Providers should have training in dealing with a wide range of situations, but some can meet more specific needs.

For example, a practitioner may specialize in counseling for survivors of sexual abuse.

A person who has experienced trauma due to race, sexual orientation, or human trafficking, for example, will need to find someone who understands where the person is starting from. They will also need appropriate training.

After identifying a therapist who seems suitable, the individual should ask plenty of questions before starting therapy to make sure that this is the person they want.

A doctor, online community, or local support group can often recommend a suitable therapist.

Psychotherapy can offer many benefits, but there are some cautions to be aware of before starting. The following sections will outline these in more detail.

Unexpected effects

During psychotherapy, some people may experience changes they had not expected or did not want.

Recalling past events can sometimes trigger unwanted emotions. Addressing and resolving these emotions is an integral part of therapy, but it can be challenging.

It is essential to find a trusted and qualified psychotherapist who is skilled at guiding people through these situations in a constructive way.

Unhelpful therapy

Most people feel better as a result of therapy, but it can take time to work — and sometimes, the approach the therapist takes is not suitable. In fact, according to some research, around 10% of people feel worse after starting therapy.

Some experts have expressed concerns about potentially harmful therapies. These could be techniques that leave a person feeling worse rather than better or approaches that may actually slow an individual’s progress.

Some approaches may not have enough research evidence to support their use. In some cases, the approach or “chemistry” between the individual and the therapist may not be suitable.

However, if the practitioner monitors the person’s progress regularly and asks for feedback, the risk of therapy not working or having a negative impact will be lower.

Using an interpreter

Not everyone can find a psychotherapist who speaks their primary language. This can pose a challenge for people who are already at a disadvantage in society.

One option is to find an interpreter, but it is essential to find someone who understands the complex issues that treatment is likely to involve.

Ideally, the person should also have the skills and training necessary for managing the specific dynamics the relationship will involve.

Cost in time and money

Psychotherapy can be expensive and time consuming. This is another reason that it is essential to find a qualified practitioner.

If a health professional considers treatment necessary, the Mental Health Parity Act requires that insurance companies pay for mental healthcare in a similar way to paying for physical medical care.

It is worth noting that the definitions of “reasonable and appropriate” or “medically necessary” may vary.

Psychotherapy can help people with various mental health needs, ranging from overcoming stress to living with bipolar disorder.

A doctor will often prescribe it alongside medication, though some people may only benefit from psychotherapy.

It is essential to find a professional. The person should be well-qualified and experienced, and they should inspire a person’s trust and confidence.

Family physicians can usually recommend a suitable psychotherapist, or a person can find a suitable practitioner through a register, such as the APA’s psychologist locator.