Finding Your Fit - Choosing the Right Therapist and Approach

When new clients reach out, they're often unsure about what kind of therapy they need. That uncertainty makes sense. With so many options, it can feel confusing.

Part of my role as a psychologist is to offer guidance on these approaches when potential clients first make contact. I want people to have the information they need to make a thoughtful choice.

The therapy world can seem overwhelming. Each approach has its own language, philosophy, and methods. Understanding the basics helps people see their options more clearly. It also helps them recognise when something doesn't feel like a good fit.

Table of Contents | Jump Ahead

• Psychodynamic Therapy
• Cognitive-Behavioural Therapy (CBT)
• Humanistic and Person-Centred Approaches
• Specialised Approaches
• Integrative and Eclectic Approaches
• Choosing the Right Therapy
• References

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I've also noticed how much misinformation is out there. Sometimes, even other health professionals give well-meaning but misleading advice about what therapy is "best." The truth is simpler: what matters most is (1) having accurate information, and (2) being with a therapist who truly understands you.

Again and again, research and my own experience point to the same conclusion. It's not the approach that predicts success. It's the relationship.

This guide covers the most common, evidence-supported therapies. You'll learn what they focus on, how they work, and who they help most. It doesn't favour one approach. Instead, it gives you tools to choose based on your goals, style, and circumstances.

Remember: the right therapy is the one that feels supportive, effective, and aligned with your growth.

Psychodynamic Therapy

Core Idea

Psychodynamic therapy explores how unconscious thoughts and early experiences shape behaviour. It emphasises patterns in relationships and recurring emotional themes. Insight and self-understanding are central.

Techniques

• Free association: Speak freely to uncover hidden thoughts.
• Interpretation: Connect past experiences to current behaviours
• Dream and fantasy analysis: Explore unconscious content
• Transference and countertransference: Study feelings toward the therapist to reveal relational patterns.

Effectiveness

It is effective for depression, anxiety, personality issues, and relationship challenges. Benefits may grow even after therapy ends. Short-term psychodynamic therapy can also produce meaningful results.

Who Benefits

Ideal for people curious about themselves and their relationships. Helpful for those facing complex patterns, recurring difficulties, or looking for deep personal insight.

Cognitive-Behavioural Therapy (CBT)

Core Idea

CBT focuses on changing unhelpful thoughts and behaviours to improve mood and coping. It is practical and goal-driven.

Techniques

• Thought records: Track situations, thoughts, and reactions to find patterns.
• Behavioural experiments: Test beliefs in real-life situations.
• Exposure therapy: Face fears gradually to reduce anxiety.
• Activity scheduling: Increase meaningful, rewarding actions.
• Cognitive restructuring: Challenge negative thinking and adopt balanced perspectives.

Effectiveness

CBT works well for anxiety, depression, trauma, phobias, and more. Studies show 60 to 80 % success rates for anxiety disorders. For depression, outcomes often match or exceed medication, with skills that last beyond therapy.

Who Benefits

CBT suits people who like structured, practical approaches. It works best for those motivated to practice skills outside sessions. Time-limited therapy (12–20 sessions) makes it ideal for focused goals.

Humanistic and Person-Centred Approaches

Core Idea

Humanistic therapy emphasises growth, self-actualisation, and change. One such approach is person-centred therapy, pioneered by Carl Rogers, which focuses on acceptance and therapist authenticity. Clients are seen as the experts in their own lives.

Techniques

• Active listening and reflection: Clarify thoughts and feelings.
• Gestalt exercises: Explore present-moment experiences through techniques like the empty chair.
• Experiential methods: Engage with emotions creatively or physically.

Effectiveness

Humanistic therapy is effective for depression, anxiety, self-esteem, and relationship issues. While changes may be slower than in CBT, results often improve self-concept and life satisfaction over the long term.

Who Benefits

Works for those seeking personal growth, authenticity, and self-exploration. Helpful for navigating identity, life transitions, or relationship challenges.

Specialised Approaches

EMDR (Eye Movement Desensitisation and Reprocessing)

Used for trauma and PTSD. Involves recalling memories while using guided eye movements. Helps process and integrate difficult experiences. Often shows improvement in 6 to 12 sessions

DBT (Dialectical Behaviour Therapy)

Combines CBT with mindfulness and practical skills for managing distress, regulating emotions, and building healthy relationships. Effective for emotional ups and downs, self-harm behaviours, and borderline personality traits.

ACT (Acceptance and Commitment Therapy)

Focuses on psychological flexibility. Accept difficult emotions while acting in line with personal values. Supports anxiety, depression, chronic pain, and life challenges requiring value-driven action.

Integrative and Eclectic Approaches

Some therapists combine techniques from multiple therapies. This allows flexibility for complex needs. A therapist may mix CBT for symptoms with psychodynamic insights for relationships.

Benefits

Customisable and responsive to your unique situation.

Considerations

Therapists must be trained in multiple approaches. Without focus, therapy can feel scattered. Ask therapists to explain their rationale clearly.

Choosing the Right Therapy

Goals Matter

Are you seeking symptom relief, skill-building, or deeper self-understanding? Some therapies reduce symptoms quickly; others foster long-term insight.

Learning Style

Do you prefer structured guidance or exploration? Do you enjoy homework and exercises, or reflection at your own pace?

Practical Factors

Consider session length, frequency, cost, and accessibility. CBT is often short-term; psychodynamic therapy may last longer.

Therapeutic Relationship

Your bond with your therapist is crucial. Feeling understood, safe, and supported matters more than the approach itself.

Flexibility

It’s okay to adjust or try different approaches. Therapy is a collaborative journey. What works now may not fit later.

References

Abbass, A. A., Town, J. M., & Driessen, E. (2012). Intensive short-term dynamic psychotherapy: A systematic review and meta-analysis of outcome research. Harvard Review of Psychiatry, 20(2), 97–108.https://doi.org/10.3109/10673229.2012.677347

Beck, J. S. (2011). Cognitive behaviour therapy: Basics and beyond (2nd ed.). Guilford Press.

Bordin, E. S. (1979). The generalisability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 16(3), 252–260.https://doi.org/10.1037/h0085885

Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioural therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17–31.https://doi.org/10.1016/j.cpr.2005.07.003

Del Río Olvera, F. J., Rodríguez-Mora, Á., Senín-Calderón, C., & Rodríguez-Testal, J. F. (2022). The first session is the one that counts: An exploratory study of therapeutic alliance. Frontiers in Psychology, 13, 1016963.https://doi.org/10.3389/fpsyg.2022.1016963

Elliott, R., Watson, J. C., Goldman, R. N., & Greenberg, L. S. (2013). Learning emotion-focused therapy: The process-experiential approach to change (2nd ed.). American Psychological Association.https://doi.org/10.1037/0000458-001

Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316–340.https://doi.org/10.1037/pst0000172

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). Guilford Press.

Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioural therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427–440.https://doi.org/10.1007/s10608-012-9476-1

Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press.

McWilliams, N. (2011). Psychoanalytic diagnosis: Understanding personality structure in the clinical process (2nd ed.). Guilford Press.

Norcross, J. C., & Goldfried, M. R. (Eds.). (2019). Handbook of psychotherapy integration (3rd ed.). Oxford University Press.https://doi.org/10.1093/med-psych/9780190690465.001.0001

Perls, F. (1969). Gestalt therapy verbatim. Real People Press.

Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21(2), 95–103.https://doi.org/10.1037/h0045357

Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65(2), 98–109.https://doi.org/10.1037/a0018378

Shapiro, F. (2018). Eye movement desensitisation and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press.

Wampold, B. E., & Imel, Z. E. (2015). The great psychotherapy debate: The evidence for what makes psychotherapy work (2nd ed.). Routledge.https://doi.org/10.4324/9780203582015