There are thousands of reasons people seek therapy. Some need help managing mental health disorders like depression, while others seek advice about how to improve their relationships with others. Regardless of the reason, the goal is to heal mentally and emotionally — but to do that, you need to know which type of therapy will be the most effective.
“Psychotherapy” is an umbrella term for a range of treatments designed to help people understand their emotions and behaviors. One of the goals of psychotherapy is to help a person see their problems in a different light, which then makes room to create novel solutions. It also allows the person seeking treatment to accept themselves, and their goals and values, better.
People turn to psychotherapy to deal with and learn ways to cope with various issues affecting their relationships with others and themselves, such as infidelity, a phobia or an eating disorder. When coupled with medication, it’s also beneficial to help treat mental illnesses like depression and schizophrenia.
Contrary to popular belief, therapy doesn’t consist of a doctor magically solving your life’s problems with conversation. While talking is a big part of psychotherapy, both the clients and therapists must actively engage in the process — both during sessions and, in the case of the clients, in between sessions as well.
The short answer is: anyone. The long answer is: It depends on what type of psychotherapist you want to be. Like “psychotherapy,” the word “psychotherapist” is a catch-all term referring to anyone who has completed specialized training to treat people with emotional issues.
The answer to the question, “What, exactly, does a psychotherapist do?” doesn’t have a universal answer, since psychotherapy refers to several types of therapists, all of which have various specialties. Clinical psychologists, social workers, psychiatrists and psychoanalysts are all psychotherapists, and each profession requires different education and training. Each kind also varies in its limitations — for example, not all psychotherapists have the qualifications to prescribe medication.
Psychotherapists generally work with clients rather than focusing solely on research — though some can dabble in both simultaneously — and they can work with clients one on one, as couples or even in groups.
To become a clinical psychologist, you need a Ph.D. or a Psy.D. in psychology. No matter where you establish your practice, you will need to receive licensure from a licensing board or a college. The American Board of Professional Psychology lists eight foundational and eight functional competency requirements for clinical psychologists, including the following:
Clinical psychologists have the option to work directly with clients in clinics or schools, or as a researcher in labs or academia. They can diagnose disorders via conversations, tests and observation before working with the client to establish an agreeable course of action. Once the client puts this into practice, the clinical psychologist monitors their progress and makes adjustments as needed. They may also conduct research and write articles for publication in industry journals, as well as teach courses.
Social workers go through similar education as clinical psychologists, though social workers generally do not require more than a bachelor’s of social work (BSW) for entry-level positions. Those who want to practice clinical social work may wish to complete further education, like a master’s degree in social work (MSW). While a BSW is beneficial, it’s not a requirement to obtain an MSW. That means you can have a B.A. or B.S. degree in a different subject and still apply for an MSW. However, it’s helpful to have earned a degree in a related specialty, like psychology or sociology.
Before a social worker can practice psychotherapy, they need to obtain licensure or certification in the state where they wish to work. Each state has different requirements when it comes to these certifications, which can include supervised experience, as well as a social work exam. Once they have completed these prerequisites, social workers will become one of the following:
Unlike clinical psychologists, social workers do not diagnose conditions or provide psychological testing, but they do tend to specialize in an area, such as:
Social workers tend to focus more on a client’s environment and its influence on them. Depending on their specialty, they may work predominantly from an office or go out to see clients in their homes.
Of the different types of psychotherapists, psychiatrists are the only ones who have earned a medical degree, making them the only ones who can legally prescribe psychiatric medication to clients. Psychiatrists must complete medical school, as well as a psychiatric residency, before applying to get their medical license and board certification. After that, they are responsible for keeping up to date on any licensing and continuing education needed to keep their medical license in good standing.
While an undergraduate degree can be in any subject, many people who plan to attend medical school tend to have a pre-med or biochemistry major — or something else in a similar specialty — instead of psychology. To become a psychiatrist, medical training and experience are mandatory.
Psychiatrists consult with clients on a mental and physical level, and they can see clients solely to prescribe drugs such as antidepressants or to provide talk therapy in addition to medication.
While the stereotypical ideas of a Freudian psychoanalyst aren’t as accurate in this day and age, psychoanalysis is still a form of psychotherapy that focuses on the client’s unconscious. Psychoanalysts work with clients to get to the root of their conditions or problems and the motivation and defense mechanisms that seem to come naturally, causing them to consistently repeat harmful behaviors.
To become a psychoanalyst, you must do one of the following:
In addition to that, you also need a few years of experience as a therapist before you can qualify to train to become a psychoanalyst, and the facility in which you choose to train must have earned approval from the American Psychoanalytic Association.
These terms are often interchangeable, and while it’s correct to refer to a psychoanalyst or a social worker as a psychotherapist, the description cannot apply to a counselor.
Many psychotherapists do provide counseling as part of their treatment, but they have acquired several more years of training and certification and are, therefore, able to offer therapeutic services beyond talk therapy. Counselors may be just as efficient in giving advice, but they can’t provide the extent of treatment psychotherapists are.
So, while some psychotherapists can also offer counseling, counselors cannot provide psychotherapy.
What is psychotherapy counseling? Psychotherapy can treat several conditions and illnesses. It targets the individual and their relationship to others, helping clients cope with severe or debilitating emotions such as sadness, or feeling like there’s no way to improve their situation. Harmful habits, such as indulging too much in drugs or alcohol, can end up alienating people from their loved ones, and psychotherapy is often part of the road to recovery.
Depending on the reason you’re in therapy, the format will differ. A one-on-one session with the client on a couch is the most common mental image that comes to mind, but psychotherapy can be much more than that. So, how does psychotherapy work? Well, there are several types of psychotherapy, and each works uniquely.
Both family and group therapy are similar because they are not one on one. A group therapy session can have anywhere from six to 12 people, while a family therapy session can include any or all members of a family in conflict.
Both types of therapies bring together a group of people who are facing similar problems. In the family setting, it’s often an issue that’s negatively affecting one or more members of a family, and the psychotherapist works with them as a unit to improve communication, work on problem-solving as a group and identify harmful patterns to successfully break them.
Similarly, a group therapy session allows each client to comfortably express their thoughts and feelings in a safe environment with like-minded people. It’s also an opportunity to observe how others with similar issues deal with them and even get feedback from other members of the group.
Both types of therapy help clients see that they are not alone.
As its name suggests, behavioral therapy focuses on how the client’s behavioral patterns affect their emotions. It encourages clients to understand how their behavior impacts their feelings and work to find solutions to change how they act, and, thus, the way they feel. The goal of behavioral therapy is to replace negative habits with positive ones.
Generally, a behavioral therapist will ask clients to talk about their habits and experiences, and how those made them feel. With that knowledge, the therapist and client will work together to develop new or altered habits that will bring about positive feelings and outcomes and encourage more of that behavior. The therapist assesses the client’s behavior and uses their professional training to suggest actionable next steps, with regular interactions to examine whether the chain of action is leading to more positivity.
The foundation of cognitive therapy is the belief that how a person thinks can impact how they act. For example, someone living with depression may constantly think they are not good enough or are at fault for everything. A cognitive change — like thinking they are good enough — can positively impact their overall mood. But changing the way you think, especially when mental illness has you believing awful things about yourself, isn’t easy.
A psychotherapist providing cognitive therapy will examine how a client currently thinks and work with them to find ways to change it. Often, they do so by encouraging the client to confront negative thoughts and actively try to examine their circumstances from a positive angle. This type of therapy is especially useful for people who live with post-traumatic stress disorder.
Cognitive behavioral therapy is a combination of the therapies listed above, tackling both a client’s thinking and behavioral patterns.
Communication is essential, but not everyone has developed the skills to communicate effectively. Inevitably, this leads to many problems, especially with interpersonal relationships, which can end up affecting mental health. Interpersonal therapy aims to identify these feelings first, then locate their sources to come up with solutions to express these emotions healthily and constructively.
People who find they have a lot of fraught interpersonal relationships or those who find themselves sacrificing their well-being for the sake of pleasing others are likely to get the most benefit from interpersonal therapy. It allows them to learn how to change how they react in relationships.
The types of psychotherapists vary as much as the types of therapy they practice. Which one you choose is dependent on which issues and conditions you’re seeking to resolve. Of the people who opt for psychotherapy, about 75% find it beneficial. Regardless of the psychotherapy techniques used, there are undeniable benefits to treatment.
It’s one thing to understand what psychotherapy counseling is, but choosing whether it’s for you is another altogether. Deciding you need psychotherapy may not be easy to admit — and you may not even know how to tell if you need it. Perhaps you think medication alone will do the trick, or that your issues aren’t severe enough to warrant professional help. For psychotherapy to be effective, you have to actively engage in therapy sessions and work to change how you think and act.
Several signs indicate you may want to consider psychotherapy, such as:
Evidence-based and cutting-edge treatments are the foundation of Principium Psychiatry in midtown Manhattan. With specialty psychiatrists, we offer innovative approaches to psychiatric care, allowing us to help people from a range of backgrounds. Our priority is to provide expert psychiatric care.
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