Therapy: Definition, Types, & Tips

By Charlie Huntington, M. A., Ph. D. Candidate
​Reviewed by Tchiki Davis, M.A., Ph.D.
Therapy improves our lives by changing how we think, feel, and act, and as many as 20% of adults see a therapist each year. Let’s learn more about the common and essential experience of therapy.
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Okay, it’s confession time: I am one of those therapists who originally did not think he needed therapy himself. You might be surprised how many therapists have trouble acknowledging their own need for help. There is something very satisfying in helping other people but also something very vulnerable in being helped. And yet, at this moment, Americans – especially teenagers – are facing more mental health issues and need therapy more than ever (Centers for Disease Control and Prevention, 2023). 
As many as 20% of adults seek out therapy in a given year (Terlizzi & Zablotsky, 2020), and I would bet that this number will keep going up. Modern life is constantly changing and challenging us in new ways, so let’s talk about the basics of therapy, such as what it is and what happens in a session.
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What Is Therapy? (A Definition)

In this article, I am going to be discussing a particular form of therapy: psychotherapy (which I may just call therapy at other points in this article). While all therapies seek to improve health or heal wounds, psychotherapy focuses on changing the thoughts, feelings, and behaviors of a certain person (or couple, or family, or group of people) to help them function better and adjust to life more effectively (Lambert et al., 1994).
 
All states in the U.S. regulate the delivery of psychotherapy, allowing only people with specialized training to acquire a license to practice psychotherapy and to be reimbursed by insurance companies for providing psychotherapy. (In some states, people can offer psychotherapy without a license, but they typically have to state very clearly that they are not licensed, and they cannot be reimbursed by insurance companies.) 

Although the exact titles may differ from one state to another, people trained as psychologists, psychiatrists, social workers, and professional counselors can provide therapy to people of any age. They may deliver therapy to people individually, in couples, as a family, or as a group of otherwise unrelated individuals (Lambert et al., 1994), such as at a rehabilitation center for substance users.​

Benefits of Therapy

While most people I know who have gone to therapy have stories of frustrating, ineffective therapists, most of them also have stories of highly beneficial experiences in therapy, too. My own experiences follow the same pattern, and in that regard, all the anecdotes I have heard reflect the broader data: if we stick with therapy, it usually helps! Across many mental health disorders, people benefit from as few as five to twenty sessions of therapy – they often no longer need therapy at this point (Lambert et al., 1994). For others, more sessions – perhaps a year of therapy or more – may be needed. Research studies with longitudinal designs – meaning that the people receiving therapy in the study were interviewed after finishing therapy – show that people often continue to experience the positive benefits of therapy for years after therapy is over (Lambert et al., 1994).

What Is Online Therapy?

Online therapy, also known as teletherapy, has become much more common since the onset of the COVID-19 pandemic (Lin et al., 2022). In this format, people meet with their therapist through a video conferencing software such as Zoom, or (less often) simply by talking over the phone. There are many benefits to making therapy available online: primarily, it is more convenient for many people, and may help some people who would have a hard time opening up in person to start to be more vulnerable. Research tells us that online therapy is generally as effective as in-person therapy for most mental health challenges, although people may be more likely to stop attending online versus in-person therapy (Lin et al., 2022).
 
From my experience on both sides of the teletherapy equation, I believe it is pretty effective, too. I have been able to meet with my own therapist, who lives several hours away from me, from several different states, and I can just as easily see him from my office at work or my bedroom. I have also worked with clients who would have had great difficulty attending therapy in person because they could not find childcare, or because their anxiety made leaving the house difficult for them. I think online therapy reflects the state of modern life, too: we are simply getting used to doing everything online, even if that includes spilling our hearts to people we may have never met in person.​

What Is Couples Therapy?

Couples therapy is psychotherapy delivered to romantic partners who meet with the therapist at the same time (and hopefully in the same place). Where individual therapy aims to help the client manage their own mental health better, in couples therapy, both partners are “the client,” but the well-being of the relationship is the focus (Snyder et al., 2006).
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As a couple therapist, I can tell you that this is sometimes confusing to manage. It is hard to watch two people who seem ill-suited to each other struggle to make their relationship work, and sometimes I wonder if the effort is worth it. But I have also helped couples resolve longstanding conflicts and rekindle intimacy – the process can be beautiful. And the process works: there is lots of research that demonstrates that many (although not all) couples in distress benefit from couples therapy (Snyder et al., 2006). Interestingly, many couples also meet therapists to get help with a mental health challenge that primarily affects one partner, such as an eating disorder or depression (Snyder et al., 2006).​

Therapy Types​

There are lots of ways to categorize the different types of psychotherapy. Here, I will describe four main categories that I find useful (Kazdin, 2000):
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  • Psychoanalytic and psychodynamic therapies. These approaches focus on bringing to conscious awareness the thoughts and emotions we may not be aware of so that we can more effectively live our lives. Psychodynamic therapy, in particular, focuses on the relationship between therapist and client as it unfolds, observing how the client brings aspects of their life into the therapeutic relationship.  
  • Behavior therapy. Behavior therapy looks at how we get negatively and positively reinforced for our behaviors, and how this teaches us how to live our lives over time. Over time, behavior therapy began to consider how thoughts and behaviors are related to each other, too.
  • Cognitive therapy. Cognitive therapy focuses mostly on cognitions, or thoughts. It began from the belief that just focusing on changing ineffective thinking patterns could resolve our psychological issues. Over time, cognitive therapists recognized that addressing thoughts alone might not be as effective as considering both feelings and behaviors, which is how cognitive therapy and behavior therapy came to merge into cognitive-behavioral therapy.
  • Humanistic therapy. This kind of therapy is sometimes called “client-centered” therapy. It embraces the humanity of clients, assumes that they have the knowledge they need to get better (since they are in their own heads, and the therapist isn’t) and tries to use consistent positive attention and care to help clients recognize their inner potential.

Many therapists use some combination of these approaches – in fact, few therapists operate strictly from just one school of thought (Kazdin, 2000). Personally, I think this reflects the fact that we vary so much from one person to another that no single approach will work for everybody.

What Is A Therapy Session Like?

If you have never been to therapy, you may wonder what it looks like. What actually happens in therapy? Most therapists spend the first session or two building a positive connection with the client and collecting background information to help them understand what is happening in the client’s life and how they might help. We call this process ‘case conceptualization’.

Once the therapist and the client have this shared foundation of knowledge about the client’s life, and have agreed on goals for therapy, they do the work of looking at and changing the client’s thoughts, feelings, and behaviors. This can look many, many different ways, but there are several aspects of therapy that seem to be common to most approaches and to be helpful in most contexts. A massive study of many, many therapeutic relationships discovered that core elements of effective therapy include, but aren’t limited to, the following (Russell et al., 2007):
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  • Exploring and processing client emotions. A client might arrive at therapy in a negative mood, and the therapist would help them figure out where the emotions came from and how they can resolve their emotions.
  • Talking about relationships. For example, the therapist might ask whether the client’s perfectionism might be related to messages they got from caregivers when they were a child.
  • Mutually investigating patterns in the client’s life. For example, a therapist might observe and share with the client that the client is rejecting positive feedback, just the way they discount praise from their supervisor at work and their spouse at home.
  • Providing support and validation. Many people find that sharing things they are ashamed of and then being accepted as they are are powerfully therapeutic experiences.

Therapy vs Psychiatry

Psychiatrists are different from other psychotherapy providers in that they can also provide what is called psychopharmacology, or the treatment of mental health challenges using psychiatric medication. In other words, they are the only therapists that can prescribe medications such as antidepressants. It is clear that psychiatric medication and psychotherapy can both help with mental health challenges, although some disorders respond more to medication and others respond more to psychotherapy (Cuijpers et al., 2013).

Therapy vs Counseling

You might hear people use therapy and counseling interchangeably, but they are not quite the same. People who practice psychotherapy work on healing mental health disorders, while people who practice counseling provide a broader range of psychological support and do not focus as much on mental health disorders (Czabala, 2016). For example, a therapist might help a client work on their depressive symptoms, while a counselor might help that same client work through losing their job and figuring out their career aspirations.

Dog Therapy, Cat Therapy, & Horse Therapy

Therapy with animals has long existed and is becoming more prevalent (Bachi & Parish-Plass, 2017). Especially with children and people who have trouble opening up to others, therapeutic interactions with animals offer a more comfortable space to begin to connect and be vulnerable.

Quotes on Therapy

  • “Whenever two people meet, there are really six people present. There is each man as he sees himself, each man as the other person sees him, and each man as he really is.” – William James
  • “In my early professional years I was asking the question: How can I treat, or cure, or change this person? Now I would phrase the question in this way: How can I provide a relationship which this person may use for his own personal growth?” – Carl Rogers 
  • “I would say that I began with a very edgy, very driven personality and after a sufficient amount of therapy over many, many years, I managed to become rather relaxed and happy.” – John Cleese
  • “We may define therapy as a search for value.” – Abraham Maslow
  • “The one thing I really learned, and learned well, in group therapy was that you don’t die if someone doesn’t like you.” – Rita Moreno
  • “Our wounds are often the openings into the best and most beautiful part of us.” ― David Richo
  • “Money doesn’t buy happiness, but it does pay for therapy.” – Travis Kalanick

Articles Related to Therapy​

​Want to learn more? Check out these articles:

Books Related to Therapy

If you’d like to keep learning more, here are a few books that you might be interested in.

Final Thoughts on Therapy

I want to end with my tips for getting started with therapy. First, remember that it is normal to be nervous about the process and to hesitate to open up. We spend so much time hiding ourselves from others that doing the opposite has gotten hard. Second, do not settle for a therapist with whom you feel uncomfortable. You are worthy of being listened to by somebody you feel safe with and seen by. Third, please give your therapist feedback. We therapists need feedback to get better at what we do. And if your therapist cannot handle your feedback, they may not be the best person to help you. Finally, if you are not sure whether therapy is right for you, I encourage you to try it at least once. It is a private space just for you, safe for whatever you want to share. That is a rare gift in our lives today.

​For more general information about therapy, I recommend watching the following video:​

Video: Psychotherapy

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