One size doesn’t fit all.
Decided it’s time to give therapy a try? No matter what type of treatment you seek,
certain therapy practices are standard. In many modalities of psychotherapy, you can expect to sit across from a therapist, who will ask direct questions to get to the root of what’s bothering
you. Rather than having you attempt to figure out solutions on your own while you share your problems (though that does occasionally happen), your therapist may make specific suggestions on how you can think and behave in ways that make you feel happier and more in control. “There’s a real emphasis on collaboration between the patient and the therapist,” says Stanley Berman, Ph.D., a clinical psychologist and the vice president for academic affairs
at William James College, in Newton, Massachusetts.
That said, the specific therapist you choose can make a difference in your experience. “A good fit between therapist and patient is a strong predictor of success,” says Andrew Gerber, a psychiatrist, a psychoanalyst, and the medical director and CEO of the Austen Riggs Center, in Stockbridge, Massachusetts, who studies treatment efficacy. You should feel comfortable with your therapist, but you don’t need to be his best friend, says Gerber. As a rule of thumb, always ask a potential therapist if he has experience treating your specific problem before you book your first session. Nothing beats a personal referral, but because many people don’t talk about being in therapy, referrals can be hard to get from friends and colleagues. Ask your doctor for a recommendation, or contact your health-insurance company for a list of mental-health providers in your network. And be ready to make a few calls before finding a match.
To further increase your odds of getting good therapy, start with a method that’s proven to treat the issue that you’re contending with.
To deal with negative thoughts or to break a habit, consider Cognitive Behavioral Therapy (CBT).
CBT centers on changing attitudes and behavior by focusing on false thoughts and the beliefs behind them. Research shows that it’s effective for most mental-health concerns, including depression and anxiety.
Seek the help of: A psychologist (Ph.D. or Psy.D.), a licensed clinical social worker (M.S.W.), or a licensed professional counselor (M.A., M.S., or Ph.D.) trained in CBT.
For persistent anxiety, consider Acceptance and Commitment Therapy (ACT).
ACT is a form of CBT that teaches you how to live
with anxiety without letting it limit or control you. “Instead of trying to change the content of your thoughts, you accept that they exist, but you don’t let them define you or your behavior,” says Joanna Arch, Ph.D., a clinical psychologist and an assistant professor of psychology at the University of Colorado, in Boulder. Arch’s research has shown that ACT is as effective as (and, in
one study, more effective than) traditional CBT in treating anxiety.
Seek the help of: A psychologist, a licensed clinical social worker, or a licensed professional counselor trained in ACT.
If you want to go deeper,
People who have been in therapy
for at least a year and who want to better understand the forces behind their behavior might want to try psychoanalysis. It’s best for phobias, obsessions, compulsions, or continual negative thoughts, as well as troubled relationships with people (rather than day-to-day problems
or very specific goals). Whereas most other forms of therapy involve meeting once a week or every two weeks, psychoanalysis often requires three to five weekly visits.
Seek the help of: A psychoanalyst—who could be a psychiatrist (M.D.), a psychologist, a licensed clinical social worker, or a licensed professional counselor with training in psychoanalytic theory and technique.
For relationship problems that keep repeating, consider Psychodynamic Therapy.
Your therapist will work with you to examine how past events and relationships have contributed to your current difficulties and help you understand how subconscious factors affect the way you interact with others.
Seek the help of: A psychologist, a licensed clinical social worker, or a licensed professional counselor with experience in psychodynamic therapy.
For severe problems, like addiction or
suicidal thoughts, consider Dialectical Behavioral Therapy (DBT).
DBT combines individual therapy with a weekly group session focused on mindfulness, emotion regulation,
and other skills. For example, if a family rift is
triggering you to binge-drink, your therapist may use CBT and recommend group therapy as well.
Seek the help of: A psychologist, a licensed clinical social worker, and/or a licensed professional counselor. (You may work with more than one professional.)
For a serious disorder, such as clinical depression or bipolar disorder, consider therapy in addition to medication.
wealth of research shows that combining CBT with psychotropic medication prescribed by a medical doctor, such as an antidepressant, is often highly effective for significant mental-health problems. “Psychotherapy gives you tools to deal with issues and to understand how your relationships, history, and environment inform the struggles you’re having,” says Berman. “Meanwhile, medication helps you feel better, which gives you the motivation and energy to be active in your therapy.”
Seek the help of: Ideally, a psychiatrist (a medical doctor with mental-health training). However, your primary-care doctor can also prescribe psychotropic medications. And, for psychotherapy, a psychologist, a licensed clinical social worker, or a licensed professional counselor.