What Is Psychotherapy & How Does it Work?

Katelyn Hagerty FNP

Reviewed by Katelyn Hagerty, FNP

Written by Our Editorial Team

Published 03/27/2021

Updated 03/28/2021

Psychotherapy, also known as talk therapy, adopts the basic concept of solving problems by talking through them, modifies this idea, and then uses the approach to find solutions to emotional and mental difficulties.

All over the world, people are affected by a wide range of mental and psychological issues. In the United States alone, tens of millions of people live with a mental health condition, with only around half of them receiving treatment. 

Psychotherapy can serve as an effective way to manage these mental and behavioral conditions, especially without the sometimes negative outcomes when medication is used to handling these challenges.

But how effective is this treatment? We'll be answering this question after taking a look at what psychotherapy entails and the different techniques that come under this treatment method.

What Is Psychotherapy?

Psychotherapy is one of the main approaches for dealing with psychological, mental, or emotional challenges. It can help to find relief from emotionally, and sometimes physically disruptive traits such as anxiety, fear, or depression.

This treatment requires the collaborative effort of an individual and a mental health professional to talk through, identify and change troubling thoughts, emotions, or behaviors that can affect the well-being.

In mild cases such as anxiety, psychotherapy alone may be effective at managing such conditions. However, more severe cases like schizophrenia, multiple personality disorder, etc will require additional drug therapy for proper treatment.

Psychotherapy may be provided by physicians, professional counselors, nurses, social workers and graduate students.

However, while psychotherapy is currently a mainstay for dealing with life issues such as disappointment, negative thoughts, heartbreak, grief, sleep difficulties, career dissatisfaction etc — other treatments precede and may serve as alternative options to this treatment. One of these measures is psychoanalysis.

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Psychoanalysis vs. Psychotherapy

Fundamentally, psychoanalysis and psychotherapy share similar end goals: the resolution of emotional difficulties that interfere with daily life.

However, while psychotherapy examines personal actions, as well as interactions with others for a better grasp of neurotic, anxious, or depressive disorders — psychoanalysis digs deep into the subconscious to understand how involuntary thoughts and actions affect our mental wellbeing.

Psychoanalysis entails an intensive, long-term form of psychotherapy, with treatment likely to take place several times a week, usually for a number of years.

Developed by Sigmund Freud using case studies carried out on one or more people, its premise lies in the belief that mental disorders are caused by repressing painful and unpleasant feelings. 

This repression can occur during the process of sexual and other development. It is believed to encourage mental blockages which may cause psychological distress.

Psychoanalysis is designed to remove neurotic blockages that occur during a person's development.

This was originally achieved by examining dreams and engaging in free association — a process where a patient is encouraged to say the first thing that comes to mind when asked questions. This is believed to expose unconscious conflicts. 

In comparison, psychotherapy requires fewer sessions to record improvements, with patients showing improvements as early as eight sessions into treatment

Although it has shifted into more scientifically-grounded evidence, psychoanalysis initially employed hard-to-measure units like dreams, sexual development, the unconscious mind, and limited case studies to manage mental health conditions.

Psychotherapy makes use of scientific, evidence-based techniques to properly measure treatment progress, as well as to restrict the amount of time and expenses made on treatment.

Psychotherapy Techniques

With cases of mental health conditions growing worldwide, coupled with the fact that psychiatric disorders are known to accompany medical illnesses —  the proper management of mental health conditions is very important for improving wellbeing.

Psychotherapy approaches that are rooted in extensive scientific research, otherwise known as evidence-based psychotherapies, are highly recommended for managing different forms of mental disorders. These techniques include:

Behavior therapy

This form of therapy helps to identify and modify lifestyles that hold potentially harmful and unhealthy outcomes.

Engaging in substance abuse or living with conditions such obesity, hypertension, or diabetes may require lifestyle changes to avoid fatal consequences.

Behavior therapy helps to provide non-judgmental support to encourage healthy changes in habits. A popular variation of this therapy — cognitive behavioral therapy (CBT) is popularly used for managing conditions like depression, anxiety, alcohol and drug use, marital problems, eating disorders etc. It does this by changing and improving negative thought and behavioral patterns.

Cognitive therapy

This technique of psychotherapy focuses on how thinking can affect the way we feel emotionally. It supposes that negative emotions and harmful behaviors are a product of dysfunctional thoughts and ways of reasoning.

Cognitive therapy aims to change these patterns of reasoning by encouraging the ability to cope with difficult situations. This treatment provides guidance through emotional distress.

Humanistic therapy

Humanistic therapy is rooted in the belief that humans are capable of self-actualization, it is less concerned with curing disorders or illnesses.

This form of therapy encourages clients to make well-founded choices with the hope of achieving their full potential.

Integrative/holistic therapy

This form of treatment brings different complementary methods of therapy together for the coordinated management of mental health issues. Rather than focus on a particular condition, an integrative approach focuses on treating the patient as a whole to improve wellbeing.

Under these techniques, different types of therapy exist such as mindfulness, supportive therapy, dialectical behavior therapy, psychodynamic therapy, marriage counseling etc.

Benefits of Psychotherapy

With techniques tailored to improve individual aspects of life, psychotherapy holds many benefits that can lead to lasting improvements in mental health and well being.

These benefits include:

Helping to identify negative and harmful ways of thinking

This approach is popularly observed in CBT, where a therapist assists a client to piece apart, and question thoughts of low self-esteem, self doubt or self worth. This activity helps to point out the ways negative forms of reasoning can affect outlook and behaviors. Through therapy,  the methods to overcome these patterns may be identified.

Therapy provides methods to cope with stress

Mindfulness — a deepened awareness of our thoughts, feelings and surroundings,  together with CBT, are popular psychotherapy techniques used for managing stress and anxiety related symptoms.

With CBT based on the premise of changing thoughts that can cause negative feelings and stress in an individual, the strategies used to make the gradual switch from cynicism to a more optimistic way of life can assist in the better management of stress.

Psychotherapy can improve interpersonal relationships

Other forms of therapy like marriage counseling, family therapy, and other forms of therapy can help to evaluate  interactions between spouses, partners, family, friends and others. Following evaluation, methods of improving communication between these personalities can be recommended in therapy.

Therapy improves anxiety and other mental health disorders

Anxiety disorders are common mental health challenges with about 18.1 percent of American adults living with one or the other. 

Most of these disorders are treatable, with psychotherapy techniques like exposure therapy which helps people face their fears, CBT, dialectical behavioural therapy etc.

Likewise, conditions like depression and personality disorders can be treated with therapy.

Psychotherapy provides emotional support

In dealing with a mental health condition, therapy can help with tracking emotions and their impact on welfare. Therapy can teach resilience in the face of current mental health challenges, as well as future obstacles.

Does Psychotherapy Work?

Does therapy work for everyone? Mental health conditions like depression, anxiety and personality disorders can produce symptoms that make normal, everyday functioning difficult in patients. To help manage these conditions, pharmaceutical interventions are usually used, however, there is a chance that psychotherapy may be just as effective, if not more effective at managing these conditions.

In a 16-week study comparing the effects of antidepressants and cognitive therapy on 240 patients with moderate to severe depression, subjects were to receive 50mg of antidepressants daily, while others received individual therapy. Others were treated using a placebo pill.

At eight weeks, response rate to medications was at 50 percent, therapy was at 43 percent, while placebo response came in at 25 percent.

By the 16th week, patient response had evened out in both treatment methods to 58 percent.

Using medication, 46 percent of patients went into remission, while the number came in at 40 percent for therapy.

In the continuation phase of this study, patients who responded to therapy were permitted three sessions of therapy, at one session per month in the first year of the follow up period. Patients who responded to medication were assigned to either continue treatment or change to a placebo.

Seventy-six percent of patients who were taken off antidepressant medication relapsed, compared with 31 percent of patients who were only treated with therapy.

Patients who continued medication had a relapse rate of 47 percent which also came in higher than therapy's 31 percent.

When this continuation phase had ended, patients who did not relapse while on medication were withdrawn from antidepressants, 54 percent of these patients experienced a recurrence of a depressive episode, compared with only 17 percent of patients who were treated with only cognitive therapy.

This outcome suggests that therapy has more long lasting effects for the treatment of depressive disorders.

Beyond studies, therapy also gets the popular vote from patients treated with this method, as shown in a small study of 10 people who reported a reduction in symptoms of anxiety, compulsive rituals and mood disorders following extended therapy. 

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Ending The Session

Psychotherapy offers a chance to talk through and overcome emotional, mental, or behavioral challenges.

Through regular communication with a qualified therapist, techniques such as cognitive therapy, behavioral therapy, psychoanalysis and integrative therapy help with the management of disorders like depression, anxiety disorders and other mental health challenges.

The benefits of this treatment method may be on par with, or even outweigh medication when it comes to managing these conditions. 

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Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Katelyn Hagerty, FNP

Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.

She received her undergraduate degree in nursing from the University of Delaware and her master's degree from Thomas Jefferson University. You can find Katelyn on Doximity for more information.

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