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Psychotherapies

What is psychotherapy?

Psychotherapy (also called talk therapy) refers to a variety of treatments that aim to help a person identify and change troubling emotions, thoughts, and behaviors. Most psychotherapy takes place one-on-one with a licensed mental health professional or with other patients in a group setting.

Psychotherapy and medication are the most common forms of mental health treatment. NIMH has information on mental health medications.

In general, the goals of psychotherapy are to gain relief from symptoms, maintain or enhance daily functioning, and improve quality of life.

You or someone you know might seek out psychotherapy for many reasons, including:

  • Dealing with severe or long-term stress from a job or family situation, the loss of a loved one, or relationship or family problems
  • Having symptoms with no physical explanation, such as changes in sleep or appetite, low energy, lack of interest or pleasure in activities you once enjoyed, persistent irritability, excessive worry, or a sense of discouragement or hopelessness that won’t go away
  • A health care provider suspecting you have or diagnosing you with a mental disorder that is interfering with your life
  • Supporting a child or family member who has been diagnosed with a condition affecting their mental health

First being examined by a health care provider can help rule out a physical health issue. This step is important because sometimes symptoms, like a change in mood or trouble concentrating, are due to a medical condition.

Psychotherapy and other treatment options

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

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

What are the elements of psychotherapy?

A variety of psychotherapies have been shown to effectively treat mental health disorders. Often, the type of treatment is tailored to the specific disorder. For example, the treatment approach for someone who has obsessive-compulsive disorder is different than the approach for someone who has 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.

Elements of psychotherapy can include the following:

  • Help a person become aware of automatic ways of thinking 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 emotions 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 a person spends brief periods in a supportive environment learning to tolerate the distress caused by certain items, ideas, or imagined scenes. This is continued until, over time, the fear associated with those things goes down.
  • Track emotions and behaviors to raise awareness of their impact on each other.
  • Use supportive counseling to explore troubling issues and receive emotional support.
  • Create a safety plan to help 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. Therapies are often variations of an established approach, such as CBT. There is no formal approval process for psychotherapies like there is for medications by the U.S. Food and Drug Administration.

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

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 provide information that can help you find a therapist’s credentials and resources for locating therapists.

Once you have identified one or more possible therapists, a preliminary conversation can help you understand how treatment will proceed and if you feel comfortable with the therapist. Rapport and trust are essential. 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 asking the following questions:

  • What are the credentials and experience of the therapist? Does the therapist have a specialty?
  • 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 in 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 aren't starting to improve?
  • Are medications an option? Is this therapist able to prescribe medications?
  • Are meetings confidential? How is confidentiality assured? Are there limits to confidentiality?

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

How can I find a therapist?

Many types of professionals offer psychotherapy. Examples include psychiatrists, psychologists, social workers, counselors, and psychiatric nurses. Information on providers’ credentials is available from the National Alliance on Mental Illness  and the Substance Abuse and Mental Health Services Administration 

NIMH has information on ways to get help, find a health care provider, and access treatment, including reduced-cost health services. Your health insurance provider may also have a list of specific mental health professionals participating in your plan.

When talking with a prospective therapist, ask about treatment fees, whether the therapist accepts insurance, and whether there is a sliding scale for fees according to income.

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

National advocacy organizations provide information on finding mental health professionals, and some have locators for finding a therapist on their websites. Examples include:

Note: NIMH does not evaluate the professional qualifications and competencies of individual practitioners listed on these websites. These resources are provided for informational purposes only. They are not comprehensive lists, and an organization’s inclusion does 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.

Many universities or medical schools have affiliated programs that offer treatment options, including training clinics. You can find these programs by searching the website of local university health centers for their psychiatry or psychology departments. You can also go to the website for the health department in your state or county to look for mental health-related programs they might offer.

What are options for digital health care?

The telephone, the internet, and mobile devices have created new opportunities for readily available and accessible treatment, including in areas where mental health professionals may not be physically available. Some of these approaches involve a therapist providing help at a distance. Others, such as web-based programs and mobile apps, are designed to provide immediate information and feedback in the absence of a therapist. 

NIMH provides information on and examples of technology used for mental health treatment.

How can I learn more about mental health care?

Fact sheets

Federal resources

Health hotlines

  • 988 Suicide & Crisis Lifeline : This lifeline provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week, across the United States. Call or text 988 to connect with a trained crisis counselor. Support is also available via live chat at 988lifeline.org . Para ayuda en español, llame al 988.
  • Disaster Distress Helpline : 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.
  • SAMHSA’s National Helpline : This helpline provides free and confidential treatment referral to local facilities, support groups, and community-based organizations 24 hours a day, 7 days a week. Call 1-800-662-HELP (4357).
  • Veterans Crisis Line : This crisis line is a free, confidential resource for veterans of all ages and circumstances. Dial 988 and press 1, text 838255, or chat online  to connect with 24/7 support.
  • More NIH Health Information Lines 

Last Reviewed: February 2024

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