What is therapy?

Therapy, or psychotherapy, is defined as a technique to improve the symptoms of a mental health disorder, help patients enjoy greater social and interpersonal functioning, and achieve an increased sense of mental and emotional well-being.

The types of therapy include individual therapy, group therapy, behavioral therapy, holistic therapy, detox therapy, medication-assisted treatment, experiential therapy, eye movement desensitization and reprocessing (EMDR) therapy, educational programs, Minnesota Model, 12-step programs, NAD therapy, aftercare, and peer support programs.

The benefits of therapy are increased self-awareness and self-esteem, a larger repertoire of healthy coping mechanisms and behavioral responses, increased problem-solving skills, improved interpersonal relationships, increased physical health, and greater life and work satisfaction.

The purpose of therapy is to eliminate and/or reduce symptoms of mental health disorders in patients, identify and replace maladaptive thinking and behavioral patterns with positive ones, teach essential life skills that contribute to improved relationships and social functioning, and enable patients to become their best selves.

The process of therapy comprises these stages: bonding with the patient; making a diagnosis and identifying the recurrent patterns in their lives; conditioning them to make positive changes; forming a therapeutic alliance; delivering treatment and monitoring progress; reinforcing desirable changes; and sustaining the positive shifts.

Therapy is delivered by a trained and licensed therapist, also known as a psychotherapist, counselor, or psychologist. Besides these professionals, licensed social workers, licensed professional counselors, psychiatric nurses, licensed marriage and family therapists, psychiatrists, and other professionals trained in mental health care and licensed to practice also provide psychotherapy.

A therapy session is a dialogue-based meeting between the therapist and one or more patients. Regardless of the type, all psychotherapy sessions aim to create a supportive and collaborative environment where patients are encouraged to share their struggles and lived experiences as they work with the therapist to reach agreed-upon treatment goals.

What is the definition of therapy?

Therapy is defined as the remediation or the process of improving the symptoms of a physical, behavioral, or mental disease, according to the APA Dictionary of Psychology by the American Psychological Association(APA), which was updated in April 2018. In a mental healthcare setting, therapy refers to psychotherapy or talk therapy that comprises different treatment modalities that strive to help patients identify and alter maladaptive thoughts, emotions, and behavioral responses, according to this February 2024 article titled “Psychotherapies” by the National Institute of Mental Health.

Does therapy work?

Yes, therapy works and is beneficial for treating several types of mental and behavioral health issues in diverse population groups. According to this 2012 press release by the American Psychological Association (APA), titled “Research Shows Psychotherapy Is Effective But Underutilized,” psychotherapy generally produces more positive effects than many medical therapies at a lesser cost and without the harmful side effects that several pharmacological treatments entail. The results of psychotherapy tend to sustain longer than those produced by psychopharmacological treatment.

In fact, according to this 2011 article by Hasse Karlsson titled “How Psychotherapy Changes the Brain” published in UBM Medica’s Psychiatric Times, psychotherapy techniques like cognitive-behavioral therapy (CBT), psychodynamic psychotherapy, dialectical behavior therapy (DBT), and interpersonal psychotherapy (IPT) alter brain functionality in people with major depressive disorder, certain phobias, anxiety disorder, panic disorder, obsessive-compulsive disorder, borderline personality disorder, and post-traumatic stress disorder.

Psychotherapy not only improves the symptoms of mental health disorders but also enhances the quality of life of the patient by reducing disability, morbidity, and mortality; improving their day-to-day functionality and independence; and decreasing the instances of psychiatric hospitalization (APA, 2012).

Who created therapy?

Psychotherapy, the way it is practiced today, was created by Sigmund Freud in the 1800s. He is also credited with taking the practice mainstream. Freud was an Austrian neurologist and the founder of psychoanalysis, according to Britannica’s entry titled “Sigmund Freud” last updated in June 2024.

While working with neurotic patients, he realized that repressing painful thoughts and memories and keeping them buried in the unconscious mind triggers a variety of mental illnesses. He developed techniques that involved listening to a patient describing their thoughts and emotions and interpreting the narratives to unearth deep-seated traumas. His work with Otto Rank, Alfred Adler, Carl Jung, Karl Abraham, and Snador Ferenczi led to the development of psychoanalysis and psychodynamic therapy. Freud’s work laid the foundation for understanding and treating psychiatric disorders.

What are the types of therapy?

The types of therapy are listed below.

• Individual therapy: Individual therapy is providing one-on-one mental health treatment. It is tailored to suit the unique needs of the patient. It allows for a strong therapeutic alliance to form between the patient and the therapist and an intensive and comprehensive level of analysis to take place. Additionally, individual therapy is completely confidential and is convenient for busy individuals who desire quick appointments and flexible scheduling.
• Group therapy: Group therapy involves one or more therapists simultaneously addressing the issues of several people. Groups typically consist of 5-15 patients. According to this 2019 article titled “Psychotherapy: Understanding group therapy” published by the American Psychological Association, groups are designed to address a specific psychiatric diagnosis, such as depression, chronic pain, social anxiety disorder, or substance abuse, or focus on general themes like improving social and communication skills, helping individuals manage issues like low self-esteem, loneliness, or shyness, or emotionally supporting an individual through a difficult life event, such as the loss of a loved one. Cognitive behavioral groups, interpersonal groups, skills development groups, support groups, psychodynamic groups, and psychoeducational groups are models of group therapies. According to this 2023 article by Stephanie Pappas titled “Group therapy is as effective as individual therapy, and more efficient. Here’s how to do it successfully” published in Monitor on Psychology, a magazine by the APA, group therapy is equally effective as individual therapy and much more cost- and personnel-efficient. Group therapy is one of the most common types of therapy and is provided at hospitals, mental health clinics, private practices, and community centers.
• Family therapy: Family therapy is a form of group psychotherapy that addresses issues that are adversely affecting a family’s mental health and functionality. The goals of family therapy are to improve and/or strengthen communication and relationships between family members and manage conflicts to create a loving and supportive home environment. Family therapy helps members of a family unit navigate challenging situations like adjusting to change, such as moving, incarceration, unemployment, or a chronic or acute medical condition; coping with death and grief; confronting aging issues; and supporting a member experiencing and/or undergoing treatment for a mental or behavioral health condition. Functional family therapy, strategic family therapy, structural family therapy, and systemic family therapy are some forms of family therapy.
• Behavioral therapy: Behavioral therapy is a form of highly focused, present-oriented, action-based therapy that aims to alter maladaptive behavioral responses in patients by reinforcing positive behaviors and eliminating negative or unwanted ones. There are several types of behavioral therapies, namely, applied behavior analysis, cognitive-behavioral therapy (CBT), cognitive behavioral play therapy, exposure therapy, dialectical behavior therapy (DBT), social learning theory, and rational emotive behavior therapy. These methods are based on the principles of classical conditioning and operant conditioning. Behavioral therapy has been shown to be most effective when delivered as part of a comprehensive treatment plan. CBT is effective for treating a variety of psychiatric disorders, such as anxiety, depression, substance abuse, eating disorders, and personality disorders in diverse populations. It is provided as adjunctive treatment to medication to treat severe mental ailments like schizophrenia and bipolar disorder. DBT is a structured treatment program based on the principles of CBT that was originally developed to treat patients with borderline personality disorder (BPD) with a high risk of committing suicide. It has now been found to be effective in addressing the symptoms of substance use disorder, post-traumatic stress disorder, mood disorder, and eating disorder.
• Holistic therapy: Holistic therapy or holistic psychotherapy is an integrative form of therapy that, instead of trying to resolve a specific problem, addresses the physical, mental, emotional, and spiritual aspects of the human condition that contribute to a person’s overall well-being. For instance, in supportive therapy, which is a model of holistic therapy, the therapist guides and encourages the patient to discover their strengths and tap into their inner resources to overcome the challenges in their lives. It aims to enhance a patient’s self-esteem, build resilience, reduce anxiety, bolster coping mechanisms, and improve social functioning. Holistic therapies incorporate aspects of conventional talk therapy and non-traditional approaches like meditation, hypnosis, breathwork, guided imagery, mindfulness, reiki, and biofeedback. They also draw on the techniques used in CBT, person-centered therapy, and psychoanalysis.
• Detox therapy: Detoxification or detox refers to a process of cleansing or purification. In the context of therapy, it refers to the process of safely discontinuing a substance of dependence or misuse or an undesirable and/or harmful behavior. Medical detox is the process of physically eliminating drugs and alcohol from the body in a way that helps ease the effects of withdrawal and conditions the patient for subsequent recovery. On the other hand, according to this guide prepared for clinicians by the Substance Abuse and Mental Health Services Administration (SAMHSA) titled “Detoxification and Substance Abuse Treatment” printed in 2006, the social model of detoxification aims to provide a safe, non-hospital, and supportive environment to help patients navigate withdrawal. The American Society of Addiction Medicine (ASAM) labels non-medical or social detox as Clinically Managed Residential Detoxification where the emphasis is on peer and social support.
• Medication-assisted treatment (MAT): MAT is a “whole-patient” approach to treating addiction to opioids or prescription painkillers through the use of medicines alongside psychosocial support and behavioral therapy, according to this release by the Illinois Department of Public Health titled “Medication-Assisted Treatment FAQ.” The FDA has approved the use of these three medicines to treat opioid use disorder: methadone, buprenorphine, and extended-release naltrexone. These medications work by regulating brain chemistry, blocking effects like euphoria that are desired by addicts, and reducing physical cravings without producing the negative effects of opioids. Antabuse (generic name: disulfiram) is used for treating alcoholism, and it deters drinking by triggering unpleasant side effects when alcohol is consumed.
• Experiential therapy: In experiential therapy, patients immerse themselves in an experience through activities like caring for an animal, role-playing or acting, and engaging in guided imagery, and using various props, music, and arts and crafts. Through these activities, patients relive experiences from the past, process difficult emotions like anger and shame related to these experiences, and identify the feelings associated with responsibility, self-esteem, success, and failure. The emphasis of experiential therapy is on physical action, which allows individuals to access psychological states that they wouldn’t have known otherwise and thereby, conditions them to think in novel ways.
• EMDR therapy: Eye movement desensitization and reprocessing (EMDR) therapy is a type of interactive therapy designed to relieve mental distress and treat post-traumatic stress disorder (PTSD). According to a publication by the American Psychological Association (APA) titled “Eye Movement Desensitization and Reprocessing (EMDR) Therapy” and last updated in July 2017, EMDR focuses on changing the way a specific traumatic and unprocessed memory is stored in the brain instead of changing the thoughts, emotions, and responses rooted in traumatic events from the past. The EMDR therapist aims to reduce the vividness and strong emotions associated with the traumatic memory by having the patient focus briefly on the memory and then shifting their focus away from the memory through bilateral (left-right or side-to-side) stimulation using, for example, eye movements.
• Educational programs: Information is a catalyst for transformation and addiction recovery relies heavily on knowledge to bring about and sustain positive change in individuals in recovery. Relapse prevention programs focus on identifying triggers that have the potential to give rise to thoughts of using substances, and developing and implementing strategies that help individuals in recovery learn healthy coping skills to manage these triggers without resorting to drugs and/or alcohol. Life skills training focuses on six aspects of mental well-being: independence, mastery of situations, healthy and positive interpersonal relationships, personal growth, self-acceptance, and finding meaning in life. It has been shown to promote psychological well-being in a population of individuals abusing drugs in various addiction treatment centers, according to this 2023 article by Baha Amini and Karim Afsharineya published in the Shenakht Journal of Psychology and Psychiatry, titled “The effectiveness of life skills training on the psychological well-being of people with drug abuse.”
• Minnesota Model: The Minnesota Model is an abstinence-based, multi-professional approach to treating addiction and is founded on the tenets of Alcoholics Anonymous (AA), according to this 1988 article by Christopher C. H. Cook published in the British Journal of Addiction and titled “The Minnesota Model in the Management of Drug and Alcohol Dependency: miracle, method or myth? Part I. The Philosophy and the Programme.” It regards alcoholism as a primary, chronic, progressive health condition that requires persistent care and remaining connected to an ongoing program of recovery. There is a focus on personalized care and providing and receiving peer support. Patients undergoing this therapy are encouraged to join self-help organizations like Narcotics Anonymous (NA) and AA. Although the model was created in the 1950s, it remains relevant and is widely practiced.
• 12-step programs: The 12-step program was conceptualized by AA and is based on the premise that providing and receiving peer support and being part of a supportive and sober community help individuals in recovery achieve and sustain sobriety. The 12 steps that form the cornerstone of this therapy are directions to help patients on their journey to sustained sobriety and living a substance-free life. The 12 steps are used in recovery programs to treat a variety of addictions.
• NAD therapy: NAD therapy is the administration of synthetic nicotinamide adenine dinucleotide (NAD) to replenish depleted stores in the body. NAD occurs naturally in the body, but its levels decrease with age, chronic inflammation, and substance abuse. NAD therapy supports addiction treatment by optimizing detoxification, decreasing the severity of withdrawal symptoms, reducing cravings, enhancing mood, and boosting the stamina of the individual in recovery to help them heal faster. However, research on the efficacy of NAD therapy is still ongoing, and more large-scale clinical studies are needed before NAD therapy is accepted as a standard treatment for addiction.
• Aftercare: Aftercare refers to ongoing treatment after an individual has achieved initial sobriety. It aims to promote sustained abstinence by supporting a patient through early recovery, preventing relapse by teaching healthy ways to cope with stress and manage triggers, and helping them as they work toward realizing their life’s goals. Typical aftercare programs include attending outpatient counseling sessions and taking part in support groups. Outpatient counseling works best for people with professional or childcare responsibilities, or those who have access to resources to support recovery without the need for intensive inpatient programs. Support groups keep individuals connected to a supportive community where the members act as cheerleaders, educators, inspirations, and guides.
• Peer support programs: Peer support programs include recovery support services provided by peer recovery coaches and sober companionship. Recovery coaching is provided in a non-clinical setting by an individual with lived experience of addiction and recovery. Coaching involves educating and supervising the patient as they initiate and maintain recovery and attempt to rebuild and enhance the quality of their interpersonal relationships that are so instrumental in sustaining sobriety. According to this release by the SAMHSA titled “Peers Supporting Recovery from Substance Use Disorders,” recovery coaching has been shown to reduce substance use, increase treatment retention, decrease emergency service utilization, reduce re-hospitalization rates, lessen relapse rates, and reduce criminal justice involvement. A sober companion, too, has lived experience of addiction and recovery. They help an individual in recovery stay sober and support them as the latter adjusts to life outside rehab and learns to go through the grinds and stresses of daily life without resorting to substance use. A sober companion helps prevent relapses by helping the patient identify triggers and adopt healthy coping strategies.

What are the benefits of therapy?

The benefits of therapy are listed below.

• Enhanced self-awareness: Increased self-awareness allows patients to identify maladaptive thoughts and behavioral patterns, and obtain a greater understanding of their values, beliefs, and needs. Increased self-awareness helps individuals regulate their emotions, act based on their authentic selves, live intentionally, and feel empowered in their life’s journey.
• Healthy behavioral responses and thinking patterns: Identifying automatic negative behavioral responses is the first step to changing them. Replacing negative behaviors and thoughts with positive ones helps individuals navigate life’s stresses without feeling anxious, stressed, and needing to seek solace in addictive substances or behaviors.
• Healthy coping mechanisms and problem-solving skills: The healthy coping strategies and problem-solving skills learned in a therapy setting help patients manage their day-to-day challenges in a way that feels relaxing and empowering. There is less stress and anxiety and more positivity and optimism.
• Improved interpersonal relationships: Interacting with the therapist and/or other group members improves communication skills and gives an individual the confidence to speak up for themselves, express their needs, and enforce boundaries without disrespecting others. Mindful and effective communication improves relationships by lessening conflicts and enhancing the feeling of being connected.
• Increased self-esteem: Navigating life’s stresses without resorting to harmful and self-destructive coping strategies, building and sustaining meaningful and positive relationships, and knowing that they are in control of their lives feel empowering and boost self-esteem in patients.
• Improved physical health: Improving mental health improves overall physical health. For instance, a positive mental outlook lowers the risk of cardiovascular diseases. Psychiatric conditions like depression, anxiety, chronic stress, and anger adversely impact physical health by triggering inflammation, digestive issues, irregular heartbeat, increased blood pressure, and reduced flow of blood to the heart.
• Increased productivity at the workplace: Improved mental and physical health translates into fewer sick days and greater focus at work.
• Increased quality of life: Improved interpersonal relationships, greater work satisfaction, better physical and mental health, and greater problem-solving skills increase the quality of life.

What is the purpose of therapy?

The purpose of therapy is to help patients transform through cognitive reframing the meaning of their circumstances, experiences, and symptoms. They thus feel a sense of well-being and are able to adapt to life’s changes and challenges and function to the best of their abilities, according to this 2019 article by Locher et al., published in the journal Frontiers in Psychology, titled “Psychotherapy: A World of Meanings.” By enabling patients to explore their emotions and behavioral responses, life circumstances, and values; gain greater self-knowledge; and examine their relationship patterns and communication styles, psychotherapy helps them enhance their quality of life.

A few overarching goals of therapy in a mental healthcare setting are reducing the severity of or removing the symptoms of mental ailments, guiding the patient toward self-actualization, restoring them to their earlier level of functionality and independence, and helping them find and/or rediscover their purpose in life.

What is the process of therapy?

The process of therapy consists of seven stages. First, the therapist pairs or bonds with the patient by displaying empathy, unconditional positive regard, validation, authenticity, and congruence. An environment of mutual trust and respect makes the patient feel heard and encourages them to engage and be candid with the therapist. In the next stage, the therapist identifies the patient’s mental health problems and the recurrent patterns in their lives. The aim is to identify both positive and maladaptive patterns. The former helps to build on the patient’s strengths, while the latter tends to be at the root of their psychiatric problems. Next, the patient is primed for positive change. For this shift in mindset to happen, the therapist must provide a coherent explanation of the patient’s mental health issues along with the rationale for treatment. This phase is critical for the formation of a therapeutic alliance, which is the fourth stage.

According to this 2011 article by Rita B. Ardito and Daniela Rabellino, titled “Therapeutic Alliance and Outcome of Psychotherapy: Historical Excursus, Measurements, and Prospects for Research,” published in the journal Frontiers in Psychology, therapeutic alliance is a collaborative relationship between the therapist and the patient where they mutually agree on the goals of the treatment and the tasks required to achieve these goals. However, the success of this collaboration depends significantly on the strength of the bond formed between the therapist and the client. A strong bond grounded in reciprocal positive feelings is healing in and of itself and encourages the patient to adhere to therapy and believe in its favorable outcome.

The fifth stage of psychotherapy entails engaging in the treatment. Whatever the modality of therapy, it must target a shift in the maladaptive behavioral and/or thinking patterns of the patient. The therapist should monitor the progress of the patient and adjust the interventional techniques depending on the patient’s level of receptivity and response, and evolving therapy goals. The penultimate stage of psychotherapy is acknowledging, supporting, and reinforcing positive pattern shifts in the patient.

Sustaining positive change requires that the patient realizes that their psychiatric issues are the result of their situation and hence, are transient. They must believe themselves to be autonomous agents and that the changes they have brought about in themselves are positive and permanent. In the last stage, the therapist helps patients sustain positive change by fostering resilience and teaching them techniques to prevent relapse.

What is a therapist?

A therapist is a trained and licensed professional who specializes in helping their patients improve their emotional and cognitive abilities, reduce and/or cope with their symptoms of a mental health disease, and learn to cope healthily with life’s stressors.

The term “therapist” is a broad designation that applies to psychologists, psychiatrists, psychotherapists, counselors, licensed professional counselors, licensed social workers, psychiatric nurses, licensed marriage and family therapists, and other professionals with mental health care training with a license to practice and provide therapeutic services.

Psychotherapists possess at least a master’s degree, have undergone a supervised internship period, and passed the licensure examination in the state where they want to practice. There are professionals who hold a doctoral degree. Psychotherapists also specialize in a specific field of expertise, such as substance abuse, behavioral disorders, community mental health, and grief and loss. Psychiatrists–medical doctors specializing in mental health and licensed to prescribe medicines–also provide psychotherapy.

What does a therapist do?

A therapist diagnoses psychiatric conditions and helps the patient reduce or manage the symptoms of their disorder. They create a safe, non-judgmental, and supportive environment and display empathy, unconditional positive regard, and understanding to encourage patients to share their struggles and explore their inner worlds.

A therapist helps patients unearth deep-seated traumas and repressed emotions and become aware of the maladaptive thoughts and behavioral patterns that are contributing to their present problems. They use evidence-based methods to help patients improve their mental health and well-being by teaching them healthy and productive habits that enhance their mental and physical health, improving their interpersonal and communication skills, and teaching them healthy coping strategies to navigate life’s stressors.

What is a therapy session?

A therapy session is a meeting between a therapist and a patient or a group of patients to collaborate and work toward achieving agreed-upon treatment goals.

According to an article titled “Understanding psychotherapy and how it works” published by the American Psychological Association and updated in December 2023, this collaboration is based on a relationship between the therapist and the patient and is grounded in dialogue. These conversations are confidential except in cases where the therapist is required by law to report concerns to authorities, for instance, when a patient is suicidal or is deemed to be harmful to others. In certain types of psychotherapies, interactions between the members of a group of patients are also encouraged and patients are asked to take part in group discussions.

Although conversation is an integral component of psychotherapy, therapists often ask patients to complete activities to practice what they have learned. It takes place at the therapist’s office or virtually through a video meeting. Psychotherapy sessions are also conducted for patients admitted to a hospital.

How is therapy used in addiction treatment?

Therapy is used in addiction treatment to address the underlying social, environmental, and psychological causes of a patient’s addictive behaviors that medication usually cannot address, according to this 2022 StatPearls [Internet] release by Han Yue and Eduardo Pena, titled “Addiction Psychotherapeutic Care.” Psychotherapy helps patients in recovery identify the causes behind their addictive behaviors, modify their behavior or thought patterns to perceive significant events and issues from a new and more positive perspective and learn healthy coping strategies to deal with life’s stressors and prevent relapse.

Motivational interviewing, cognitive-behavioral therapy, supportive psychotherapy, contingency management, and psychodynamic psychotherapy are the common psychotherapeutic interventions currently in practice to treat addiction. Psychotherapy is also provided alongside pharmacological interventions to treat addiction. Psychotherapy is used to treat different types of addiction, such as addiction to substances and behavioral addiction.

What is it like to be in therapy?

Being in therapy is like being in a safe, supportive, and non-judgmental environment where one is free to share their deepest thoughts and fears, repressed traumas, and most pressing mental struggles.

According to this 2019 article by Locher et al., published in the journal Frontiers in Psychology, titled “Psychotherapy: A World of Meanings,” a patient in therapy feels heard and receives a satisfactory and rational explanation for their mental health challenges. They perceive care, concern, empathy, and unconditional positive regard from the therapist, which, in turn, helps enhance self-esteem.

Certain forms of psychotherapy focus on reframing a patient’s internal narratives and imparting new meaning to their experiences, the words they use, and the beliefs they harbor to help them make sense of their experiences and start believing that they have the ability to control their lives. Being in therapy thus helps patients feel an enhanced sense of self-mastery.

How long does therapy take to work?

The duration of therapy depends on the nature of the mental health issue being treated, the duration and severity of the symptoms, the therapeutic approach employed, how quickly the patient progresses toward specific treatment goals, the level of functionality of the patient, the family and social support they have, and the financial limitations they face.

For instance, treating a severe psychiatric disorder takes more time than addressing a short-term mental health issue. Authors Nordmo et al., in a 2020 PsyArXiv preprint of their publication titled “Problem severity, treatment duration, and the outcome of psychotherapy: The benefits keep growing with time spent in treatment for longer than previously known” mention that the extent of improvement in a mental health condition is linearly associated with the duration of psychotherapy and contingent upon the severity of symptoms manifested at the time of initiation of therapy.

According to Rosa Maria De Geest and Reitske Meganck in their 2019 article titled “How Do Time Limits Affect Our Psychotherapies? A Literature Review” published in the journal Psychologica Belgica, therapists tend to prefer unlimited treatment over time-restricted therapies for complex diagnoses like neurotic depression, personality disorders, and psychosis. Therapists consider time-limited therapies to be more beneficial as a crisis intervention measure to address a situational adjustment disorder.

What are the differences between self-help, counseling, therapy, and psychiatry?

The differences between self-help, counseling, therapy, and psychiatry are based on the goals of treatment, their duration, the mechanism and/or agent of delivery, treatment strategies, and the problems addressed during therapy.

The differences are described in the table below.