People say “therapy” as though it were one thing. It is not. Different approaches ask different things of you, work over different timescales, and start from different ideas about where difficulty comes from. Knowing roughly what is on offer makes it easier to ask for something, and easier to tell a therapist when what you are getting is not what you need.
Nothing below is a recommendation for any particular person. Which approach suits someone depends on their situation, and that is a conversation to have with a clinician.
Cognitive behavioral therapy (CBT)
CBT is structured and goal-oriented. You and the therapist look closely at your thoughts and emotions, work out how those thoughts are shaping what you do, and then practice different thinking patterns and habits.
Its defining idea is that how you interpret a situation drives how you feel about it, so an interpretation is something you can examine rather than something you have to accept. It attends mostly to the present rather than the past.
One practical piece of it that transfers to anything: goals work better when they are specific, measurable, achievable, realistic and time-limited, rather than large and vague.
Dialectical behavior therapy (DBT)
DBT was developed in the 1970s by the American psychologist Marsha Linehan. It is built on CBT but adapted for people who feel emotions very intensely, and it is a common treatment for borderline personality disorder, though therapists use it for other conditions as well.
“Dialectical” points at the balance the therapy is trying to strike: accepting who you are and what you are facing, while also working to change what is not working. Two things that look opposed, held at once.
DBT usually involves both individual sessions and skills training in a group, and teaches four sets of skills:
- Mindfulness — being fully aware of and focused on the present, rather than the past or the future.
- Distress tolerance — getting through a difficult moment without doing something harmful.
- Interpersonal effectiveness — asking for things, saying no, and keeping relationships and self-respect intact while you do.
- Emotion regulation — understanding your emotions and becoming less vulnerable to being overwhelmed by them.
Psychodynamic therapy
Psychodynamic therapy starts from the idea that how you feel and behave now is shaped by earlier experience, and by repeating patterns of thought and feeling that you are not fully aware of. You work with a therapist to notice those patterns and change them.
Sessions are open-ended rather than structured around a task, and it tends to be a longer piece of work than CBT. Psychoanalysis, which it grew out of, is a more intensive version of the same tradition, going back to Freud.
Humanistic and person-centered therapy
Humanistic approaches start from your own account of your experience, rather than from a theory about what is wrong. The therapist's job is to offer conditions in which you can work it out, not to interpret you.
Carl Rogers, who shaped this tradition, argued that people grow when they are met with unconditional positive regard — acceptance that does not depend on what they say or do. Alongside it sit empathic understanding and genuineness from the therapist. Unlike psychoanalysis or behaviourism, this tradition emphasizes free will and the capacity to make your own choices.
Interpersonal therapy (IPT)
A short-term therapy focused on relationships: unresolved grief, changes in social or work roles, conflicts with other people. It works on expressing emotions and communicating in ways that get you somewhere.
Therapies used alongside talk therapy
Some therapies are used in combination with the approaches above rather than instead of them — creative arts therapy (art, dance, music, poetry), animal-assisted therapy, and play therapy for younger children.
What about complementary approaches?
The version of this page we published listed fifteen complementary approaches — meditation, yoga, music, massage, acupuncture, aromatherapy, reiki, chiropractic, supplements and others — and then said that combining them with therapy “tends to be effective”. We had nothing to support that, and it is not what the evidence shows.
The National Center for Complementary and Integrative Health, the NIH center whose job is exactly this question, is careful in a way that is worth copying. On anxiety, it reports that mindfulness-based practices may be as effective as established treatments but that more research is needed; that some studies of yoga are helpful for anxiety symptoms without it being clear whether it helps anxiety disorders; that evidence for hypnosis is not conclusive; and that acupuncture, tai chi and qigong need larger, higher-quality studies before anything definite can be said.
None of that means these things are worthless. Several of them are pleasant, safe and worth doing for their own sake, and mindfulness in particular is a component of DBT. It means something narrower and more useful: they are not a substitute for treatment, and anyone telling you they are effective is going further than the research does.
Finding a therapist
Different combinations work for different people, and it often takes some trial and error. Psychology Today keeps a searchable directory of therapists that you can filter by location, insurance and approach.
Sources
- Cleveland Clinic — Psychotherapy (CBT, DBT, interpersonal and psychodynamic therapy, and the therapies used alongside them — checked September 2026)
- Cleveland Clinic — Dialectical behavior therapy (DBT) (Linehan, the 1970s, the four skills, and the acceptance-and-change balance — checked September 2026)
- NAMI — Psychotherapy (psychodynamic and interpersonal therapy — checked September 2026)
- Jain A, Mitra P — Personality theories, StatPearls, National Library of Medicine (Carl Rogers, person-centered theory and unconditional positive regard — checked September 2026)
- National Center for Complementary and Integrative Health — Anxiety and complementary health approaches (what the evidence does and does not show — checked September 2026)
- Psychology Today — Find a therapist (the directory; the original page linked the site's home page rather than the directory)