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Transforming the understanding
and treatment of mental illnesses.

Psychotherapies

Overview

Psychotherapy (sometimes called “talk therapy”) is a term for a variety of treatment techniques that aim to help a person identify and change troubling emotions, thoughts, and behavior. Most psychotherapy takes place with a licensed, trained mental health professional and a patient meeting one-on-one or with other patients in a group setting.

You might seek out psychotherapy for different reasons including:

  • You might be dealing with severe or long-term stress from a job or family situation, the loss of a loved one, or relationship or family issues.
  • You might have symptoms with no physical explanation: changes in sleep or appetite, low energy, a lack of interest or pleasure in activities that you once enjoyed, persistent irritability, worry, or a sense of discouragement or hopelessness that won’t go away.
  • A health care provider may suspect or have diagnosed depression, anxiety, bipolar disorder, post-traumatic stress disorder, or other conditions or symptoms that may be interfering with your life, and recommended psychotherapy as a first treatment or to go along with medication.
  • You may be seeking treatment for a family member or child who has been diagnosed with a condition affecting mental health and for whom a health care provider has recommended treatment.

An exam by a health care provider can ensure there is nothing in your or your loved one’s overall health that would explain symptoms. This step is important because sometimes symptoms like a change in mood or trouble concentrating can be due to medical conditions.

Psychotherapies and Other Treatment Options

Psychotherapy can be an alternative to medication or can be used with other treatment options, such as medications. Choosing the right treatment plan should be based on a person's individual needs and medical situation and under a mental health professional’s care.

Even when medications relieve symptoms, psychotherapy and other interventions can help a person address specific issues. These might include self-defeating ways of thinking, fears, problems interacting with other people, or dealing with situations at home, school, or work.

Elements of Psychotherapy

A variety of different types of psychotherapies and interventions have been shown to be effective for specific disorders. For example, the treatment approach for someone who has obsessive-compulsive disorder is different for someone who has bipolar disorder. Therapists may use one primary approach or incorporate other elements depending on their training, the condition being treated, and the needs of the person receiving treatment.

Elements of psychotherapies may include:

  • Helping a person become aware of ways of thinking that may be automatic but are inaccurate and harmful (for example, someone who has a low opinion of their abilities). The therapist helps the person find ways to question these thoughts, understand how they affect emotions and behavior, and change self-defeating patterns. This approach is central to a type of psychotherapy called cognitive behavioral therapy (CBT).
  • Identifying ways to cope with stress and developing specific problem-solving strategies.
  • Examining a person’s interactions with others and offering guidance with social and communication skills.
  • Mindfulness and relaxation techniques, such as meditation and breathing exercises.
  • Exposure therapy for people with anxiety disorders. In exposure therapy, a type of CBT, a person spends brief periods in a supportive environment, learning to tolerate the distress caused by certain items, ideas, or imagined scenes cause. Over time, the fear associated with these things may dissipate.
  • Tracking emotions and behaviors to raise awareness and the impact of each on the other.
  • Supportive counseling to help a person explore troubling issues and provide emotional support.
  • Creating a safety plan to help someone who has thoughts of self-harm or suicide recognize warning signs and use coping strategies such as contacting friends, family, or emergency personnel.

Note that there are many different types of psychotherapy. Other therapies are often variations on an established approach, such as CBT. There is no formal approval process for psychotherapies like there is for the use of medications from the Food and Drug Administration.

However, for many therapies, research involving large numbers of patients has provided evidence that treatment is effective for specific disorders. These "evidence-based therapies" have been shown in research to reduce symptoms of depression, anxiety, and other disorders. NIMH's health topic pages about specific disorders list some of the evidence-based therapies for those disorders. 

What to Consider When Looking for a Therapist

Therapists have different professional backgrounds and specialties. See below for information that can help you find out about the different credentials of therapists and resources for locating therapists.

The approach a therapist uses depends on the condition being treated and the training and experience of the therapist. Also, therapists may combine and adapt elements of different approaches.

Once you’ve identified one or more possible therapists, a preliminary conversation with a therapist can help you understand how treatment will proceed and whether you feel comfortable with the therapist. Rapport and trust are important. Discussions in therapy are deeply personal, and it’s important that you feel comfortable with the therapist and have confidence in their expertise. These preliminary conversations may happen in person, by phone, or virtually. Consider trying to get answers to the following questions:

  • What are the credentials and experience of the therapist? Do they have a specialty?
  • What approach will the therapist take 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 in diagnosing and treating the age group (for example, a child) and the specific condition for which treatment is being sought? If a child is the patient, how will parents be involved in treatment?
  • What are the goals of therapy? Does the therapist recommend a specific timeframe or number of sessions? How will progress be assessed, and what happens if you (or the therapist) feel you aren't starting to feel better?
  • Are medications an option? Is this therapist able to prescribe medications?
  • Are the meetings confidential? How is confidentiality assured? Are there limits to confidentiality?

Finding a Therapist

Many different types of professionals offer psychotherapy. Examples include psychiatrists, psychologists, social workers, counselors, and psychiatric nurses. Information on the credentials of providers is available from the National Alliance on Mental Illness. In addition, you can find resources to help find a therapist on the NIMH's Help for Mental Illnesses webpage.

Your health insurance provider may have a list of mental health professionals who participate in your plan. Other resources on the Help for Mental Illnesses webpage can help you look for reduced-cost health services. When talking with a prospective therapist, ask about treatment fees, whether the therapist participates in insurance plans, and whether there is a sliding scale for fees according to income.

The following professional organizations have directories or locators on their websites for mental health care professionals:

National advocacy organizations have information on finding a mental health professional, and some have practitioner locators on their websites. Examples include:

Note: NIMH does not evaluate the professional qualifications and competence of individual practitioners listed on these websites. These resources are provided for informational purposes only. These are not comprehensive lists and do not constitute an endorsement by NIMH, the National Institutes of Health, the U.S. Department of Health and Human Services, or the U.S. government.

University or medical school-affiliated programs may offer treatment options, including training clinics. Search on the website of local university health centers for their psychiatry or psychology departments. You can also go to your state or county government website and search for the health department for information on mental health-related programs within your state.

The goal of therapy is to gain relief from symptoms, maintain and/or improve daily functioning, and improve quality of life. If you have been in therapy for what feels like a reasonable amount of time and feel you are not getting better, talk to your therapist or look into other mental health professionals or approaches.

Digital Health Options

The telephone, internet, and mobile devices have created new opportunities to provide more readily available and accessible interventions, including in areas where mental health professionals may not be physically available. Some of these approaches involve a therapist providing help at a distance. Still, others—such as web-based programs and mobile apps—are designed to provide immediate information and feedback in the absence of a therapist. For an overview, see NIMH's Technology and the Future of Mental Health Treatment webpage.

Learn More

Free Fact Sheets

Federal Resources

Health Hotlines

  • 988 Suicide & Crisis Lifeline: The Lifeline provides 24-hour, confidential support to anyone in suicidal crisis or emotional distress. Call or text 988 to connect with a trained crisis counselor. Support is also available via live chat. Para ayuda en español, llame al 988.
  • Disaster Distress Hotline: People affected by any disaster or tragedy can call this helpline, sponsored by SAMHSA, to receive immediate counseling. Call or text 1-800-985-5990 to connect with a trained professional from the closest crisis counseling center within the network.
  • Veterans Crisis Line: This helpline is a free, confidential resource for Veterans of all ages and circumstances. Call 1-800-273-8255, press "1"; text 838255; or chat online to connect with 24/7 support.
  • Crisis Text Line: Text HELLO to 741741 for free and confidential support 24 hours a day throughout the U.S.
  • More NIH Information Lines

Last Reviewed: June 2021

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