How to Decide Between Different Types of Therapy
Explore common therapy types like CBT, DBT, and EMDR to find the best fit for your mental health needs and goals.
Choosing the right type of therapy can feel overwhelming with so many options available. This guide breaks down the most common therapies, their approaches, and key factors to help you decide which one suits your needs best. Therapy, also known as psychotherapy or talking therapy, involves working with a trained professional to address mental health concerns, emotional challenges, or life stressors.
What are the common types of therapy?
There is no single therapy that works for everyone. The best choice depends on your specific issues, preferences, and goals. Common types include person-centred therapy, cognitive behavioural therapy (CBT), dialectic behaviour therapy (DBT), psychodynamic therapy, eye movement desensitisation and reprocessing (EMDR), integrative therapy, and Gestalt therapy. Each focuses on different aspects of mental health, from changing thought patterns to processing trauma.
Research shows that matching therapy to patient needs improves outcomes. For instance, systematic treatment selection (STS) emphasizes tailoring interventions to individual proclivities to avoid resistance and enhance effectiveness. Studies also confirm that various psychotherapies outperform waitlist controls, with moderate to large effects across interventions.
Person-centred therapy
Person-centred therapy, developed by Carl Rogers, is a humanistic approach that emphasizes empathy, unconditional positive regard, and congruence. The therapist creates a supportive environment where you explore your feelings and experiences at your own pace without judgment or direction.
This therapy suits those seeking a non-directive space to gain self-understanding. It’s particularly helpful for low self-esteem, depression, anxiety, or relationship issues. Sessions focus on your present experiences rather than past events, fostering personal growth and self-acceptance.
Key benefits:
- Builds self-confidence and emotional resilience.
- Ideal for those who prefer a collaborative, client-led process.
- Evidence supports its efficacy in improving well-being and relational functioning.
Cognitive behavioural therapy
**Cognitive behavioural therapy (CBT)** is one of the most widely available therapies, often offered through the NHS. It targets the connection between thoughts, feelings, and behaviours, helping you identify and challenge negative patterns to develop healthier responses.
Rather than dwelling on past causes, CBT focuses on current problems and practical solutions. For example, if a situation triggers anxiety, you’ll examine your thoughts about it, how they make you feel, and alternative behaviours to try. Typical sessions last 6-20 weeks, making it a structured, goal-oriented option.
CBT is effective for anxiety disorders, depression, bipolar disorder, borderline personality disorder, and more. The National Alliance on Mental Illness (NAMI) highlights its success in treating a variety of conditions by promoting constructive thinking.
| Condition | CBT Effectiveness |
|---|---|
| Anxiety | High; reduces dysfunctional thinking. |
| Depression | Strong evidence for symptom relief. |
| PTSD | Useful in trauma-focused variants. |
Dialectic behaviour therapy
**Dialectic behaviour therapy (DBT)** builds on CBT principles but places greater emphasis on mindfulness, emotional regulation, and acceptance. It teaches skills to tolerate distress, improve relationships, and balance acceptance with change.
Originally developed for borderline personality disorder (BPD), DBT helps individuals accept uncomfortable thoughts and feelings while learning to regulate emotions. Unlike standard CBT, which challenges thoughts directly, DBT validates emotions first. It’s delivered in individual sessions, group skills training, phone coaching, and therapist consultation teams.
DBT shows significant, long-lasting effects for BPD, eating disorders, PTSD, self-harm, and suicidal behaviours. Therapists use it for those struggling with intense emotions or interpersonal conflicts.
Psychodynamic therapy
Psychodynamic therapy explores unconscious patterns from past experiences, particularly childhood, that influence current behaviour and emotions. It aims to bring these to conscious awareness for resolution.
Unlike CBT’s focus on the present, psychodynamic approaches delve into relational dynamics and defence mechanisms. Sessions encourage free association, dream analysis, and transference exploration. It’s often longer-term but can be effective for depression, anxiety, and personality disorders.
Research distinguishes psychodynamic therapy by its emphasis on in-depth emotional processing, with profiles showing consistent differences from other modalities like cognitive or experiential therapies.
Eye movement desensitisation and reprocessing (EMDR)
**Eye movement desensitisation and reprocessing (EMDR)** is a trauma-focused therapy developed by Francine Shapiro in the 1980s for PTSD. It involves recalling traumatic memories while following guided eye movements, mimicking REM sleep to reprocess and desensitize the trauma.
Clients relive experiences in controlled doses, forming new associations. EMDR is typically shorter-term (8-12 sessions) and doesn’t require detailed verbal recounting. It’s NICE-recommended for PTSD and effective for phobias, anxiety, and grief.
Prolonged exposure variants help adolescents with PTSD, especially over age 14.
Integrative therapy
**Integrative therapy** combines elements from multiple approaches, tailored to the client’s unique needs. It views the person holistically—mentally, physically, and emotionally—adapting techniques like CBT skills with psychodynamic insights.
This flexible method suits complex issues where no single therapy fits. Therapists might use mindfulness from DBT alongside behavioural strategies. The Systemic Treatment Selection (STS) model supports this by allowing creative adaptation to enhance patient-therapist fit.
- Pros: Personalized and comprehensive.
- Cons: Depends on therapist expertise.
Gestalt therapy
**Gestalt therapy**, originating in Germany, is humanistic and holistic, focusing on the ‘whole’ person in the present moment. It emphasizes awareness of thoughts, feelings, and behaviours as they occur.
Techniques include empty chair dialogues and body awareness to resolve unfinished business and improve self-awareness. It’s ideal for those feeling stuck, with issues in relationships or self-perception, rather than deep past excavation.
How do I choose the right therapy for me?
Consider your goals, problem type, and preferences. Ask:
- What issue am I addressing? Trauma? CBT/EMDR. Emotions/relationships? DBT/Person-centred.
- Short or long-term? CBT/EMDR for quick results; psychodynamic for depth.
- Directive or exploratory? Structured (CBT) vs. open (person-centred).
- Individual, group, or online? Many offer flexibility.
Speak to your GP for NHS referrals or search accredited therapists via BACP/UKCP. Trial sessions help assess fit. Evidence supports patient-therapist matching for better outcomes.
Factors to consider
Beyond type, evaluate therapist qualifications, cost, availability, and modality (in-person/online). For specific groups, seek culturally sensitive options. Research comparative efficacy: all major therapies work, but personalization matters.
| Therapy | Best For | Duration | Approach |
|---|---|---|---|
| CBT | Anxiety, Depression | Short-term | Thoughts/Behaviours |
| DBT | BPD, Emotion Regulation | Medium | Mindfulness/Acceptance |
| EMDR | PTSD/Trauma | Short-term | Memory Reprocessing |
| Psychodynamic | Personality Issues | Long-term | Unconscious Patterns |
Frequently Asked Questions (FAQs)
What is the most effective type of therapy?
No single type is universally best; efficacy depends on fit. CBT and psychotherapies show strong results across studies.
How long does therapy take?
Varies: 6-20 sessions for CBT/IPT; longer for psychodynamic. Short-term options like coherence therapy are 10-20 sessions.
Is online therapy as good as in-person?
Yes, for many conditions, with equivalent outcomes in CBT and others.
Can I switch therapies?
Absolutely; integrative approaches or therapist changes support this.
Does therapy work for everyone?
Most benefit, especially with good alliance. About 75% improve per meta-analyses.
References
- Different Types of Therapy [Psychotherapy]: Which is Best For You? — Talkspace. 2023. https://www.talkspace.com/blog/different-types-therapy-psychotherapy-best/
- Selecting the most appropriate treatment for each patient — PMC – NIH. 2018-11-14. https://pmc.ncbi.nlm.nih.gov/articles/PMC6225028/
- How to decide between different types of therapy — Patient.info. 2023. https://patient.info/features/treatment-medication/how-to-decide-between-different-types-of-therapy
- A guide to different types of therapy — Medical News Today. 2023. https://www.medicalnewstoday.com/articles/types-of-therapy
- Comparative Efficacy of Seven Psychotherapeutic Interventions — PLOS Medicine. 2012-10-30. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001454
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