What is Therapy?
Therapy (or psychotherapy) is a collaborative process between you and a trained mental health professional. Through conversation and specific techniques, therapy helps you understand your thoughts, feelings, and behaviors, and develop healthier ways of coping with life's challenges.
Unlike advice from friends or self-help books, therapy provides:
- Professional expertise: Therapists are trained to recognize patterns, understand psychological dynamics, and apply evidence-based techniques.
- Confidential space: A non-judgmental environment where you can be completely honest without social consequences.
- Objective perspective: Someone outside your life who can see patterns you might miss.
- Structured approach: Goals, progress tracking, and accountability.
Therapy isn't about being "broken." It's about having support and tools to navigate life's complexity. Many people without diagnosable conditions benefit enormously from therapy.
Types of Therapy
There are many therapeutic approaches, each with different philosophies and techniques. Here are the most common:
Cognitive Behavioral Therapy (CBT)
The most researched and widely used approach. CBT focuses on the connection between thoughts, feelings, and behaviors. It's practical, skill-based, and typically shorter-term (12-20 sessions for many issues).
Best for: Anxiety, depression, phobias, OCD, insomnia, and specific behavioral changes.
Dialectical Behavior Therapy (DBT)
Originally developed for borderline personality disorder, DBT teaches skills in four areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. More structured than traditional therapy.
Best for: Emotion dysregulation, self-harm, suicidal ideation, BPD, and intense emotional experiences.
Psychodynamic Therapy
Explores how unconscious processes and past experiences (especially childhood) shape current behavior. Less structured, more exploratory. Often longer-term.
Best for: Deep-seated patterns, relationship issues, self-understanding, and those who want to explore "why" not just "how."
Acceptance and Commitment Therapy (ACT)
Combines mindfulness with behavioral change strategies. Focuses on accepting difficult thoughts and feelings while committing to actions aligned with your values.
Best for: Anxiety, chronic pain, depression, and anyone struggling with experiential avoidance.
EMDR (Eye Movement Desensitization and Reprocessing)
Uses bilateral stimulation (often eye movements) while processing traumatic memories. Helps the brain reprocess trauma so it no longer triggers the same distress.
Best for: PTSD, trauma, and disturbing memories that feel "stuck."
Humanistic/Person-Centered Therapy
Emphasizes the therapeutic relationship and unconditional positive regard. The therapist creates a supportive environment where you can explore and grow at your own pace.
Best for: Self-esteem issues, personal growth, and those who need a supportive, non-directive approach.
Which Type is Right for You?
The "best" therapy depends on your specific issues, personality, and preferences. CBT is a good starting point for most people due to its strong evidence base. But the therapeutic relationship matters more than the specific approach. A good fit with your therapist predicts outcomes better than the technique used.
Finding a Therapist
Finding the right therapist can feel overwhelming. Here's a practical approach:
Step 1: Determine Your Needs
Before searching, consider:
- What issues do you want to address?
- Do you have preferences about the therapist (gender, age, background)?
- In-person or telehealth?
- What's your budget and insurance situation?
- What times are you available?
Step 2: Search for Options
Psychology Today Directory
Most comprehensive database. Filter by location, insurance, specialty, and more.
Insurance Provider
Check your insurance's list of in-network providers for lower out-of-pocket costs.
Referrals
Ask your doctor, friends, or family (if comfortable). Personal recommendations can be valuable.
Employer EAP
Many employers offer Employee Assistance Programs with free confidential counseling sessions.
Step 3: Initial Contact
Many therapists offer free 15-minute consultations. Use this to:
- Briefly describe what you're looking for
- Ask about their approach and experience with your issues
- Confirm logistics (fees, scheduling, cancellation policy)
- Get a sense of how you feel talking to them
Step 4: Evaluate Fit
After 2-3 sessions, check in with yourself:
- Do you feel heard and understood?
- Do you feel safe being honest?
- Does their style work for you?
- Are you making any progress (even small)?
It's okay to try a different therapist if the fit isn't right. This is normal and expected.
Your First Session
The first session is different from ongoing sessions. Here's what typically happens:
Paperwork
Consent forms, privacy notices, and intake questionnaires. Often completed before the session.
History Gathering
Questions about your background, family, medical history, and what brought you to therapy.
Current Concerns
Discussing what's happening now and what you hope to get from therapy.
Treatment Planning
Initial thoughts on approach, frequency of sessions, and goals.
It's Okay to Be Nervous
Almost everyone feels anxious before their first session. You're about to share vulnerable things with a stranger. Therapists expect this and are trained to help you feel comfortable. You don't have to share everything in the first session.
Getting the Most from Therapy
Therapy works best when you're an active participant, not a passive recipient.
Be Honest
Therapy only works with what you bring in. If you're editing yourself, hiding things, or presenting a polished version, you're limiting what can be accomplished. Your therapist has heard it all before.
Do the Work Between Sessions
Therapy is one hour per week. Your life is the other 167 hours. When your therapist suggests exercises, reflections, or new approaches, actually try them. This is where change happens.
Give Feedback
Tell your therapist what's working and what isn't. If something feels off, say so. If you want to try something different, ask. Therapy should be collaborative.
Be Patient
Deep patterns don't shift in a few weeks. Therapy often involves discomfort as you examine difficult things. Trust the process while also holding your therapist accountable for progress.
Show Up Consistently
Therapy works through accumulation. Sporadic attendance produces sporadic results. Commit to a consistent schedule, especially at the beginning.
When Therapy Isn't Working
Sometimes therapy doesn't feel helpful. Here's how to diagnose and address the problem:
Is it the Therapist?
Not every therapist is right for every person. Signs of poor fit: feeling consistently misunderstood, dreading sessions, feeling judged, or sensing that their approach doesn't match your needs.
Solution: Try a different therapist. This is normal and expected.
Is it the Approach?
Maybe CBT feels too structured, or psychodynamic feels too abstract. Different approaches suit different people.
Solution: Discuss alternative approaches with your therapist, or seek someone with a different orientation.
Is it You?
This isn't blame. Sometimes we're not ready for change, we're holding back, or we're not doing the work between sessions.
Solution: Honest self-reflection. Are you fully engaging? What might you be avoiding?
Is it Timing?
Change takes time. Expecting transformation after a few sessions is unrealistic for most issues.
Solution: Give it at least 8-12 sessions (unless there are clear red flags) before evaluating.
AI Tools as a Complement to Therapy
AI mental health tools aren't replacements for therapy, but they can complement it in specific ways:
Between Sessions
Process events and insights that come up during the week. Practice skills you're learning in therapy.
Session Preparation
Work through what you want to bring to your next session. Clarify thoughts before articulating them.
Crisis Hours
At 2am when your therapist isn't available, AI can help you process and stabilize (not for true emergencies).
Waitlist Support
While waiting for therapy to start, AI tools can provide some support and skill-building.
Frequently Asked Questions
How do I know if I need therapy?
Consider therapy if you're struggling with persistent emotional difficulties, relationship problems, life transitions, or if everyday functioning feels harder than it should. You don't need to be in crisis to benefit from therapy. Many people use it for personal growth, self-understanding, and developing coping skills.
How long does therapy take?
It varies widely. Some focused approaches (like brief CBT for a specific phobia) might take 8-12 sessions. More complex issues or deeper exploration often take months to years. Many people find 3-6 months helpful for meaningful change, with some continuing longer for ongoing support and growth.
What's the difference between a therapist, psychologist, and psychiatrist?
Therapist is a general term for mental health professionals who provide talk therapy. Psychologists have doctoral degrees (PhD or PsyD) and specialize in psychological testing and therapy. Psychiatrists are medical doctors (MD) who can prescribe medication; some also provide therapy. Licensed clinical social workers (LCSWs) and licensed counselors also provide therapy.
Is everything I say in therapy confidential?
Generally yes, with important exceptions. Therapists are legally required to break confidentiality if there's imminent risk of harm to yourself or others, suspected child or elder abuse, or court orders. They should explain these limits at the start of treatment. Day-to-day content of sessions is protected.
Additional Resources
Continue learning with these related articles:
Support Between Sessions
ILTY is an AI companion designed to complement therapy, not replace it. Process between sessions, prepare for difficult conversations, and practice the skills you're building. Available 24/7.
No credit card required. Free during beta.