PLEASE READ THIS FIRST. If you are in immediate danger or thinking about harming yourself, please get help now. Visit a nearby emergency service, hospital, or mental health clinic immediately. If you are in crisis, consider these helplines and suicide hotlines worldwide.
Show Crisis Numbers
- Australia: Lifeline 13 11 14 | Text 0477 13 11 14
- Canada: 988 Suicide Crisis Helpline | Text HOME to 741741
- France: SOS Amitié 09 72 39 40 50 | Suicide Écoute 01 45 39 40 00
- Germany: Telefonseelsorge 0800 111 0 111
- India: AASRA 91-22-27546669 | Sneha Foundation 044-24640050
- Ireland: Samaritans 116 123 | Pieta House 1800 247 247
- New Zealand: Lifeline 0800 543 354 | Depression Helpline 0800 111 757
- South Africa: LifeLine 0861 322 322 | SADAG 0800 567 567
- United Kingdom: 111 (Option 2) | Samaritans 116 123 | Text SHOUT to 85258
- United States: 988 Suicide & Crisis Lifeline | Text HOME to 741741
Which Type of Therapy is Best?
"Which type of therapy is best?" This is often the first question people ask. With so many acronyms like CBT, DBT, and EMDR, the options are quite bewildering.
The reality is that there is no single "best" type of therapy.
Research consistently shows that the most important factor in a successful outcome is the relationship you have with your therapist 1. However, for certain issues, specific therapy types have stronger evidence supporting them than others.
Objective: To shift the focus from asking "Which therapy is best?" to "Which therapy is the best fit for my personality, my goals, and my current challenges?"
Does Therapy Actually Work? Yes.
Before exploring the types, it is worth confirming: Is this process worth it? The evidence is clear:
- A landmark meta-analysis found that the average therapy client is better off than 75% of untreated individuals 4.
- A massive 2023 analysis of over 52,000 patients confirmed Cognitive Behavioural Therapy (CBT) is highly effective for depression 5.
- Modern research shows benefits go beyond symptom reduction. Clients report deeper self-understanding and improved emotional regulation 3.
The Four Main Categories of Therapy
Most therapists work within one of four primary frameworks. Understanding these categories helps simplify the options.
| Category | Core Concept | The Experience | Primary Focus |
|---|---|---|---|
| 1. Cognitive & Behavioural | Our thoughts influence our feelings. Changing patterns of thinking and behaving changes emotional states. | Structured, educational, and collaborative. Sessions often involve learning skills and completing tasks between appointments. | Symptom reduction: Anxiety, Depression, OCD, Phobias. |
| 2. Psychodynamic & Depth | Present difficulties are shaped by past experiences and unconscious processes. | Exploratory and reflective. The therapist speaks less, encouraging the client to associate freely and find patterns. | Relationship patterns, complex trauma, personality structure. |
| 3. Humanistic | Individuals have an innate capacity for growth when provided with empathy and acceptance. | Warm, non-directive, and supportive. A space to explore feelings without an agenda. | Self-esteem, grief, life transitions, personal growth. |
| 4. Systemic & Somatic | Psychological issues exist within a system (family/relationships) or the physical body. | Focuses on interaction cycles between people or physical sensations within the body. | Family conflict, PTSD, nervous system regulation. |
Guide to Common Therapy Types
There are many specific modalities within these categories. Use this guide to identify approaches that align with your needs.
Cognitive & Behavioural Therapies (Skills-Based)
- Cognitive Behavioural Therapy (CBT): A structured approach that challenges negative thought patterns. It is widely recognised as the first-line treatment for depression and anxiety disorders 5 6.
- Dialectical Behaviour Therapy (DBT): A specialised form of CBT that emphasises emotional regulation, distress tolerance, and mindfulness. It is particularly effective for Borderline Personality Disorder and self-harm 1.
- Acceptance and Commitment Therapy (ACT): Focuses on accepting difficult thoughts and feelings rather than fighting them, while committing to actions aligned with personal values.
- Exposure Therapy: A behavioural technique involving gradual exposure to feared situations to reduce the anxiety response. It is the primary treatment for phobias and OCD.
Psychodynamic & Insight Therapies (Depth-Based)
- Psychodynamic Therapy: Focuses on identifying recurring themes and patterns in your life, often stemming from early relationships. It aims for deep-seated change and self-understanding.
- Internal Family Systems (IFS): Views the mind as composed of various "parts" (e.g., protective parts, wounded parts). Therapy involves engaging with these parts to achieve internal harmony.
- Mentalisation-Based Therapy (MBT): Designed to improve the ability to understand one's own mental states and those of others. It is frequently used for personality disorders and relational difficulties.
Somatic & Trauma Therapies (Body-Based)
- Eye Movement Desensitisation and Reprocessing (EMDR): A structured therapy that facilitates the processing of traumatic memories using bilateral stimulation (eye movements). It is highly effective for PTSD 3.
- Somatic Experiencing (SE): A body-oriented approach that assesses where a person is "stuck" in the fight, flight, or freeze response and aims to resolve these physiological states.
Relational Therapies (Couples & Families)
- Emotionally Focused Therapy (EFT): Focuses on adult attachment and bonding. It helps couples identify negative interaction cycles and create a more secure emotional connection.
- Family Systems Therapy: Treats the family as a unit. It addresses problems by changing the communication patterns and dynamics of the family system rather than focusing solely on one individual.
Matching Your Needs: Comparing the Approaches
Most mental health conditions can be treated by several different types of therapy. The choice often depends on the mechanism of change you prefer. Do you wish to learn tools to manage symptoms (Skills), or do you wish to understand the root causes (Depth)?
| If you struggle with... | The "Skills" Option (e.g., CBT, DBT) |
The "Depth" Option (e.g., Psychodynamic) |
Decision Factor |
|---|---|---|---|
| Anxiety & Panic View your local Anxiety Therapists listed nearest first. |
CBT / Exposure: Focuses on challenging anxious thoughts and "un-learning" fear responses via behavioural exercises. | Psychodynamic: Focuses on understanding the unconscious conflicts or past experiences fueling the anxiety. | Choose Skills for immediate symptom relief. Choose Depth to understand the underlying "why." |
| Depression View your local Depression Therapists listed nearest first. |
CBT / ACT: Focuses on behavioural activation and reframing negative thought patterns to lift mood. | Psychodynamic / Humanistic: Views depression as a signal of unmet needs. Focuses on mourning, meaning, and self-acceptance. | Choose Skills to break the cycle of lethargy. Choose Depth to explore the meaning of the sadness 2. |
| Personality / Identity View your local Affordable Therapists and Psychologists listed nearest first. |
DBT: Teaches concrete skills for distress tolerance, emotional regulation, and interpersonal effectiveness. | TFP / MBT: Uses the therapeutic relationship to integrate different parts of the self and understand others. | DBT is recommended for safety and stabilisation first 1. Depth supports long-term structural change. |
| Trauma (PTSD) View your local Trauma Therapists listed nearest first. |
Trauma-Focused CBT / EMDR: Uses structured protocols to process specific memories and reduce their emotional charge. | Psychodynamic / Somatic: Focuses on how trauma has shaped one's life narrative or how it is held physically in the body. | EMDR is widely chosen for specific events 3. Depth/Somatic is often preferred for complex, developmental trauma. |
Benefits and Challenges: What to Expect
The Benefits
Therapy offers a confidential, non-judgmental environment to process experiences. Beyond symptom relief, it fosters self-esteem, improved relationships, and a deeper sense of personal agency. For severe psychiatric conditions, it provides essential tools for management and stability.
The Challenges
It is important to be realistic: therapy requires a significant investment of time, resources, and emotional energy. Confronting painful memories or changing long-standing habits can be exhausting, particularly in the early stages. Progress is rarely linear; it often involves periods of difficulty before a breakthrough. However, the clinical consensus is that for those who commit to the process, the long-term outcomes are transformative.
How to Choose the Right Approach
When speaking with potential therapists, you can assess their modality by asking about their focus:
- Past vs. Present: "Do you focus more on my history and childhood (Psychodynamic), or on my current thoughts and behaviours (CBT/Solution-Focused)?"
- Structure vs. Flow: "Will you provide an agenda and homework (CBT/DBT), or will I lead the session based on what is on my mind (Humanistic)?"
- Insight vs. Skills: "Is the goal to understand why I feel this way (Depth), or to learn tools to manage how I feel (Skills)?"
Note: Therapy is a personalised process. If you begin with a structured approach and feel restricted, it is appropriate to switch to a depth approach. If you begin with open exploration and feel directionless, a structured approach may be more suitable.
Frequently Asked Questions
How do I know if I should seek therapy?
Consider therapy if you are experiencing distress that disrupts your daily life, sleep, or relationships, or if you simply wish to gain greater self-understanding. You do not need to be in a crisis to benefit.
How long does therapy usually last?
Duration varies significantly by modality and need. Brief therapies (like SFBT or CBT) may last 6–20 sessions. Depth therapies (like Psychodynamic analysis) are often open-ended and may continue for months or years.
“Choosing the right therapy is like selecting the right pair of shoes. It must fit well, be comfortable, and support you on your journey.” — Irvin D. Yalom, M.D.
References
[1] Hernandez-Bustamante, M., et al. (2024). Efficacy of Dialectical Behaviour Therapy in the Treatment of Borderline Personality Disorder. Iranian Journal of Psychiatry. View Source
[2] Fonagy, P. (2015). The effectiveness of psychodynamic psychotherapies: An update. World Psychiatry. View Source
[3] Rasines-Laudes, P., & Serrano-Pintado, I. (2023). Efficacy of EMDR in Post-Traumatic Stress Disorder. Psicothema. View Source
[4] Smith, M. L., & Glass, G. V. (1977). Meta-analysis of psychotherapy outcome studies. American Psychologist.
[5] Cuijpers, P., et al. (2023). Cognitive behaviour therapy vs. control conditions for depression: a comprehensive meta-analysis. World Psychiatry. View Source
[6] Hofmann, S. G., et al. (2012). The Efficacy of Cognitive Behavioural Therapy: A Review of Meta-analyses. Cognitive Therapy and Research. View Source
TherapyRoute is not for emergencies and does not provide medical advice. All of our content is informational and cannot replace professional healthcare. In an emergency, contact a local emergency service. For immediate support, consider a local helpline.