Types of Therapy: The Main Approaches and How to Choose
There are hundreds of named therapies and most of them belong to a handful of families. This guide groups the approaches we cover, says in one line what each one does, and sets out what the research says about choosing between them.
Reviewed byMichael Callans, MSWHow to use this guide
The cards below are grouped by family in the order of the seven families listed next. Each card opens a page that explains the approach, what a session looks like, who it suits, what the research says and where its limits are. If you already know your problem, the anxiety, trauma, grief and recovery collections sort the tools by what they are for rather than by school. If you are deciding whether to see someone at all, the Do I Need Therapy self-reflection exercise is the place to start.
The seven families at a glance
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About this tool
Types of therapy is the question people search when they have decided to get help and found that the help comes in dozens of named forms. Cognitive behavioral therapy, psychodynamic therapy, EMDR, acceptance and commitment therapy, internal family systems, somatic experiencing: each has its own vocabulary, its own training route and its own claims. The names matter less than they look. Nearly all of them belong to one of seven families, and inside a family the approaches share a theory of what goes wrong and a way of working on it. This page is organized by those families, with a card for every approach we have written up, and it ends with how to choose, because the choice depends less on the label than most guides suggest.
The cognitive and behavioral family starts from the idea that thoughts, feelings and behavior shape one another and that changing the thinking or the behavior changes the feeling. Cognitive behavioral therapy is its center, with structured sessions, homework and a focus on the present problem. Its branches include rational emotive behavior therapy, exposure-based treatments for anxiety and OCD, behavioral activation for depression, and the transdiagnostic Unified Protocol, which treats anxiety and depression with one set of skills. The third-wave members, acceptance and commitment therapy and dialectical behavior therapy, add acceptance, mindfulness and values to the change-focused core. Cognitive remediation therapy sits here too, as training for attention, memory and planning rather than for mood.
The psychodynamic family starts from the idea that much of what drives us is out of awareness and was learned early, in relationships. The therapist follows emotion rather than an agenda, points out avoidance as it happens, and works with the way old patterns show up in the room, which is what transference and countertransference describe. Modern forms are shorter and more active than the analysis of the early twentieth century: Adlerian therapy works toward the goals a person has never put into words, and mentalization-based therapy trains one capacity, holding in mind that behavior comes from mental states. Internal family systems is often grouped here for its interest in inner parts, although it has its own model.
The humanistic and experiential family starts from the idea that people have a tendency toward growth that therapy can get out of the way of, and that the relationship itself is the treatment. Carl Rogers's client-centered therapy is the root, with empathy, congruence and unconditional positive regard as the therapist's offer. Gestalt therapy adds experiments that bring a problem into the present moment; existential therapy treats distress as a response to the facts of being alive; emotion-focused therapy works with emotion as the agent of change; compassion-focused therapy addresses shame by strengthening the soothing system. Transpersonal therapy extends the family to spiritual and peak experience.
The trauma-focused and body-based approaches are a family by problem rather than by theory. Trauma-focused cognitive behavioral therapy, cognitive processing therapy and prolonged exposure carry the strongest recommendations in the American Psychological Association's guideline for post-traumatic stress, and EMDR a conditional one. Brainspotting, somatic experiencing and the Feldenkrais Method work through the body and attention rather than mainly through talk, with smaller evidence bases that their own pages set out honestly. The best of these pages say the same thing: a body-based practice is a settling skill alongside treatment, not a replacement for it.
The interpersonal, systemic and goal-focused approaches work on what is around the person rather than on the person alone. Interpersonal therapy treats depression through the relationships around an episode. Reality therapy, solution-focused therapy and motivational interviewing are short, present-focused and practical, built on what the person wants and what is already working. Narrative therapy re-authors the story a problem tells about someone. Life review therapy walks a life in order, stage by stage, and is one of the better-evidenced treatments for depression in later life; it sits with narrative therapy here because both work on the account a person gives of their own life rather than on symptoms, in short structured courses.
The two remaining families are grouped by how the work is carried rather than by a theory of what goes wrong. Mindfulness-based stress reduction is the eight-week course that most mindfulness-based therapies descend from, and the creative therapies, psychodrama, drama therapy, sandtray, bricks, art, music and structured writing, give the work a medium other than conversation.
What does the evidence say about choosing between them? Two findings sit side by side. The first is that for the most common problems, the differences between bona fide therapies are small. A 2021 network meta-analysis of 331 randomized trials with 34,285 patients found that every main psychotherapy for depression beat usual care and waiting lists, and that the therapies did not differ significantly from one another, with the single exception of non-directive supportive counseling, which did worse than the rest. The second finding is that for some specific problems there are specific winners: exposure and response prevention for OCD, the trauma-focused treatments named above for post-traumatic stress, exposure for phobias and panic. So the honest answer is that the type matters a great deal for a few conditions and much less for most.
What predicts a good outcome across every type is the relationship. A meta-analysis of the alliance in adult psychotherapy, covering more than 30,000 patients, found a correlation of about .28 between the quality of the working alliance and the outcome, consistent across approaches and countries. Preference matters as well: a meta-analysis of 53 studies with more than 16,000 clients found that people whose preferences about treatment were accommodated were less likely to drop out and did somewhat better. Neither finding means the method is irrelevant. They mean that a competent therapist you can work with, using an approach that fits your problem and that you understand, beats the best-named approach delivered badly or to someone who does not want it.
How to choose, then, in five questions. First, what is the problem, in plain words, and does it have a treatment with specific evidence behind it; if it does, start there. Second, which family's way of working makes sense to you, because you will do the homework of the one you believe in. Third, what format can you sustain, weekly for months or a short structured course. Fourth, is the therapist trained in the approach they offer, which you may ask directly. Fifth, after three or four sessions, do you feel understood and is something changing; if not, say so, because the alliance can be repaired and, if it cannot, changing therapist is a normal move rather than a failure.
References
- Wampold BE, Imel ZE. The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work. 2nd ed. New York: Routledge; 2015. Open Library record: https://openlibrary.org/works/OL8345241W
- Cuijpers P, Quero S, Noma H, et al. Psychotherapies for depression: a network meta-analysis covering efficacy, acceptability and long-term outcomes of all main treatment types. World Psychiatry. 2021;20(2):283-293. https://doi.org/10.1002/wps.20860
- Flückiger C, Del Re AC, Wampold BE, Horvath AO. The alliance in adult psychotherapy: a meta-analytic synthesis. Psychotherapy. 2018;55(4):316-340. https://doi.org/10.1037/pst0000172
- Swift JK, Callahan JL, Cooper M, Parkin SR. The impact of accommodating client preference in psychotherapy: a meta-analysis. Journal of Clinical Psychology. 2018;74(11):1924-1937. https://doi.org/10.1002/jclp.22680
- Öst LG, Havnen A, Hansen B, Kvale G. Cognitive behavioral treatments of obsessive-compulsive disorder: a systematic review and meta-analysis of studies published 1993-2014. Clinical Psychology Review. 2015;40:156-169. https://doi.org/10.1016/j.cpr.2015.06.003
- American Psychological Association. Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults. 2025. https://www.apa.org/ptsd-guideline
Cite this source
Psychology.com. (2026, November 6). Types of Therapy. Psychology.com. https://psychology.com/tools/types-of-therapy
Types of Therapy FAQ
What are the main types of therapy?
Most named therapies belong to one of seven families: cognitive and behavioral (CBT, DBT, ACT, exposure, the Unified Protocol), psychodynamic (psychodynamic and psychoanalytic therapy, Adlerian therapy, mentalization-based therapy), humanistic and experiential (client-centered, gestalt, existential, emotion-focused, compassion-focused), trauma-focused and body-based (trauma-focused CBT, cognitive processing therapy, prolonged exposure, EMDR, somatic experiencing, brainspotting), interpersonal and systemic (interpersonal therapy, family and couples therapy, solution-focused and narrative therapy, motivational interviewing), mindfulness-based (MBSR, MBCT) and the creative therapies (art, music, drama, psychodrama, sandtray, writing).
Which type of therapy is the most effective?
For most common problems, none by a wide margin. The largest network meta-analysis of therapies for depression, 331 trials and 34,285 patients, found every main approach beat usual care and the approaches did not differ significantly from one another, apart from non-directive supportive counseling, which did worse. For some specific problems there are specific winners: exposure and response prevention for OCD, and trauma-focused CBT, cognitive processing therapy and prolonged exposure for post-traumatic stress.
Does it matter which type of therapy I choose?
It matters most when your problem has a treatment with specific evidence behind it, as OCD, post-traumatic stress and phobias do. Outside those cases the relationship with the therapist predicts the outcome more reliably than the label: across more than 30,000 patients, the quality of the working alliance correlated with outcome at about .28 regardless of approach. Choose an approach that makes sense to you and a therapist you can work with.
How do I know which therapy is right for me?
Name the problem in plain words and check whether it has a specifically supported treatment. Then pick the family whose way of working you believe in, because you will do the homework of that one. Check that you can sustain the format, and that the therapist is trained in what they offer. After three or four sessions, judge whether you feel understood and whether something is changing, and say so if not.
Can different types of therapy be combined?
Yes, and most working therapists do combine them. Integrative practice draws techniques from several families around one formulation of the problem, and some approaches are combinations by design: DBT pairs behavioral change with acceptance, and the Unified Protocol pulls the shared ingredients of several CBT manuals into one course. What matters is that the combination has a rationale you understand, not that it carries one name.
Is talking therapy the same as counseling?
The words overlap and are used differently by country and profession. Counseling often means shorter, more present-focused work on a defined difficulty; psychotherapy often means longer work on patterns. In practice the approaches on this page are offered under both names, and the training and licensing of the person matter more than the word on the door.