When you’re dealing with mental health challenges, knowing you want to find a therapist is an amazing step toward healing. But with many different types of therapy available, you might wonder: what kind of therapist do I need?
The truth is that different issues and mental health conditions benefit from specific forms of therapy. A therapy technique that works well for depression and anxiety can exacerbate eating disorders or obsessive-compulsive disorder (OCD), for example. To help you know the right path for you, we’re sharing some must-knows about therapy and different modalities you might want to look into.
What exactly is therapy?
Therapy is the process of meeting with a licensed professional to treat specific issues or resolve certain feelings, behaviors, or patterns that are negatively affecting you. Most therapy takes place one-on-one with a licensed mental health professional—whether in-person or virtually—but it can also take place in a group setting. Therapy can be useful if you have a specific mental health condition, like clinical depression, anxiety, OCD, post-traumatic stress disorder, social anxiety disorder, or a specific phobia (just to name a few). But it can also be something you turn to when you need extra support in challenging seasons of life, as therapists can be a great tool to help you build emotional resilience and develop better coping strategies.
What are some common types of therapy?
There are dozens of therapy types, and some are more effective for specific conditions than others. Here’s a list of the most broadly used methods, and how they’re applied:
- Cognitive Behavioral Therapy (CBT). This treatment involves methods to identify and change unhelpful thinking patterns or behaviors. Therapists trained in CBT help their patients face their fears by using mock scenarios or calming techniques to make real-life situations less threatening. CBT is commonly used for anxiety disorders, alcohol and drug use problems, eating disorders, and, in some cases, severe mental illness.
- Dialectical Behavior Therapy (DBT). DBT focuses on teaching people skills to manage intense emotions and cope with challenging relationships or situations. DBT encourages experiencing and accepting your thoughts and emotions—and developing healthy ways to cope with them— rather than try to change them. DBT can be effective at treating PTSD, mood disorders, substance-use disorders, and eating disorders. It can help people who have strong urges for self-harming behavior.
- Exposure and Response Prevention (ERP). ERP was developed specifically to treat OCD. It works by interrupting OCD’s cycle of obsessions (intrusive thoughts, images, sensations, feelings or urges) and compulsions (repetitive physical and/or mental behaviors in response to an obsession). In this treatment method, patients are encouraged to gradually expose themselves—with the aid of a trained ERP therapist—to what triggers their intrusive thoughts and learn response prevention techniques that allow them to resist compulsions. This evidence-based therapy is the gold standard and first-line treatment for managing OCD symptoms.
- Eye Movement Desensitization and Reprocessing Therapy (EMDR). EMDR was developed in the 1980s as a treatment for PTSD. The practice involves a therapist helping a patient to process traumatic memories while simultaneously activating both sides of the brain. For instance, patients might flit their eyes back and forth, following a therapist’s finger. The idea is to anchor the brain in the present moment, while weakening the effect of negative emotions.
- Mindfulness-Based Cognitive Therapy (MBCT). MBCT combines elements of cognitive therapy with mindfulness and meditation. It aims to teach people to consciously pay attention to their thoughts and feelings without judgment. The result is an increased awareness of their habitual thought patterns that make them more susceptible to symptoms of depression and anxiety. MBCT includes breathwork practices and present-moment awareness techniques like body scan exercises. While MBCT was originally formulated for depression, it’s also used for anxiety, addiction, and general emotional distress.
- Acceptance and Commitment Therapy (ACT). ACT is based on a fundamental understanding that emotions like grief and anxiety and inevitable facets of human life. ACT is far less evidence-based than ERP, but it has shown positive results when used alongside ERP in treating OCD. Rather than targeting specific compulsions via exposures, it teaches people to accept their thoughts and feelings while committing to living according to their values—i.e. prioritizing intimate relationships, meaningful work, and personal growth. Besides being potentially helpful for some people with OCD, ACT is commonly used in anxiety, depression, and stress regulation.
- Psychoanalysis. This is often known as “talk therapy” and is intended to help people to improve daily living by giving them a better understanding of their thoughts and feelings. Psychoanalytic therapists analyze how their patients’ experiences have shaped them—and how events from the past can unconsciously influence the present. It is used for a wide range of emotional challenges and life changes including stress, grief, relationship issues, anxiety, and depression.
- Psychodynamic Therapy. Psychodynamic therapy follows the same method as psychoanalysis, but usually takes place over a handful of more flexible sessions rather than over years of weekly meetings with the same therapist.
What is evidence-based therapy and why is it important?
In simple terms, evidence-based therapy means that research shows it produces results. It’s important to seek out evidence-based therapy when possible, because those methods have been backed by a body of research proven to be effective over a number of years, according to NOCD clinician Tracie Ibrahim, LMFT, CST. Evidence-based therapies include CBT, DBT, ERP, and ACT listed above.
7 times you might need a specialized therapist
In some cases, therapists are focused on a specific condition or issue— that’s their area of specialization. They may use a combination of different types of therapy in their practice based on their training and expertise.
“Just as you would see a medical specialist for physical ailments that require in-depth treatment, you should do the same for mental health conditions,” says Stacy Quick, LPC. Here are some examples of specialists you might seek help from:
- Marriage and family counselor. These are specialists who are trained to treat issues related to relationships, marriage, and broader family systems. They address communication issues, sex and intimacy problems, infidelity, behavioral issues in kids, and conflicts surrounding divorce. They often interact with all members of a family (or a couple) to enhance the overall well-being of everyone involved.
- Addiction therapist. If you struggle with addiction related to drugs or alcohol, addiction therapists have specialized training in dependency on those substances— and knowledge about how to cope with this reliance. They are experts on the intricacies of addiction and develop customized treatment plans based on your specific addiction.
- OCD therapist. OCD specialists are trained to address the obsessions and compulsive behaviors that come with OCD. OCD is complex, and it takes specialized training and expertise to diagnose and treat it. Unfortunately, many professionals will say that they treat OCD when they are not specialists— and this can lead to inadequate or even harmful care using modalities like general CBT or talk therapy (rather than the gold-standard treatment of ERP). As mentioned above, in ERP, patients track their obsessions and compulsions, then work with their therapist to slowly put themselves into situations that bring on their obsessions. This is done in order to develop new responses that don’t involve compulsions.
- Divorce therapist. These specialists help couples who are going through the divorce process move toward healthier relationships. They may counsel couples who are considering divorce but want to try and stay together, or individuals who are already divorced and need guidance and support in their next life phase.
- Eating disorder therapist. Eating disorder therapists have a specific niche because they help treat the underlying cause of the disorder while also helping to develop tailored treatment plans, often with the help of a nutritionist or dietician. They typically treat a range of disorders, including anorexia, bulimia, binge-eating disorder, while also addressing body dysmorphia.
- Trauma therapist. For people that have experienced a traumatic event, trauma therapists can help build coping mechanisms, identify triggers, and establish a sense of safety. Treatment can include some of the methods listed above such as EMDR,CBT, or prolonged exposure (PE).
- BFRB therapist. Body-Focused Repetitive Behaviors (BFRBs) are behaviors that include trichotillomania (hair pulling) and dermatillomania (skin picking), and tic disorder. BFRB therapists might use habit-reversal training (HRT) in their treatment. HRT helps teach patients how to become aware of their BFRB, manage their urges, and respond differently to their triggers.
What are the different types of mental health professionals?
- Psychologist. In general, psychologists use talk therapy to help people cope with mental health issues or other emotions. Psychologists can have a number of qualifications, including the ones listed below.
- Licensed Clinical Social Worker (LCSW). LCSWs are mental health professionals with a master’s degree in social work. They’re qualified to provide diagnoses and counseling services for mental, behavioral, and other emotional issues.
- Licensed Marriage and Family Therapist (LMFT). LMFTs typically hold master’s or doctorate degrees in marriage and family therapy or a related counseling field. They specialize in helping individuals, couples, groups, and families resolve individual or interpersonal conflicts.
- Licensed professional counselor (LPC). LPCs provide mental health services that focus on behavioral, emotional and mental issues in various healthcare settings: private practice, schools, hospitals and other environments. Professional counselor titles vary by state, meaning they may also be called a licensed clinical professional counselor (LCPC), licensed mental health counselor, or something similar.
- Psychiatrist. Psychiatrists are distinct from the professionals above because they can prescribe medications to treat mental, emotional, and behavioral disorders. Unlike LCSWs or LMFTs, psychiatrists attend medical school and receive additional training that includes the biological components of mental illnesses.
Different types of therapy formats to know about
While one-on-one therapy is often the most commonly advertised form of help, it isn’t the only therapy arrangement available to you.
- Individual therapy. This is one-one-one therapy with a mental health professional to address individual needs.
- Relationship therapy. In relationship therapy, two or more people in a romantic relationship see the same therapist, who helps them work through conflict.
- Family therapy. Family therapy can involve multiple combinations of family members including parents, spouses, or siblings, as well as grandparents or aunts and uncles.
- Group therapy. Group therapy is a form of psychotherapy in which one healthcare provider or more works with multiple patients in each session. Often, people go to group therapy to develop new interpersonal skills, change certain aspects of their behavior, cope with grief, or deal with something specific like an eating disorder or addiction.
Can virtual therapy replace in-person therapy?
Every individual has different needs when it comes to therapy, and the format in which they meet their therapist is no exception. But in many cases, virtual therapy—which can be conducted by video chat or by phone—has benefits for people who have trouble getting to offices, either because of logistical constraints or mental health challenges. It also makes treatment more accessible for people who might not have access to specialized therapists near their home.
“Now that virtual therapy is more readily available, it’s becoming clear that it’s not only helping make much-needed treatment more accessible, but also that it’s just as effective—and in my experience, sometimes more effective—than in-person treatment,” says NOCD Chief Clinical Officer Patrick McGrath, PhD, referring to the role of virtual therapy in treating OCD. “Being in a person’s environment, instead of having them come into mine, has allowed them to face so many more of their fears than they ever could in my office.”
How to find the right therapist for you
“I put low importance on the letters or degrees that a person has next to their name,” says Ibrahim. “It’s really about the skills of the human, not what classes they completed.” She added that the best way to find a therapist for your specific needs is to call and ask what they specialize in treating—and find out the treatment methods they use. “Avoid vague answers,” she says. “Ask for specifics—and if they dance around those answers, you know that is not who you want to go to.”
Once you’ve found a therapist that looks promising, give it a session or two to decide whether the person is the right fit for you. “If you got to a session and that first session is a no, don’t feel bad for never going back,” Ibrahim says. “Go somewhere else, you don’t have to feel guilty.”