Which “Talk” Will Help You the Most? A Helpful Guide to Choosing the Right Therapy

Therapy 101: The Short, Simple Version

The Main Types of Therapy Families and Who They Help the Most

1) Cognitive-Behavioral Therapy (CBT)

• The main idea: Our thoughts affect how we feel and act, and we can change those patterns.
• Variants: ACT (Acceptance and Commitment Therapy), DBT (Dialectical Behavior Therapy), and exposure therapy are some of the offshoots you’ll hear about.
• Best for: Anxiety disorders, depression, PTSD, OCD, phobias, and a lot of other short- to medium-term problems where learning new skills is important.

2) Psychodynamic and Interpersonal Therapies

• The main idea: Relationships from the past and unconscious patterns affect how things are now. Therapy examines these patterns to facilitate enduring transformation.
• Note: Mentalization-based treatment is a specific psychodynamic method used to treat borderline personality disorder.
• Best for: Problems with relationships that have been going on for a long time, personality patterns that don’t change, and life cycles that feel “stuck.”

3) Humanistic Approaches

• Includes: Gestalt, existential therapy, client-centered therapy, and experiential work.
• The main idea: Everyone has the ability to grow. Therapy focuses on being real, finding meaning, and living in the present.
• Best for: Problems with self-esteem, questions about identity, changes in life, and existential distress.

4) Therapy That Helps

• Main idea: Less focus on insight and more on practical help, validation, and coping strategies.
• Best for: Short-term stress, adjusting to a medical illness, or someone who needs help getting stable before doing more work.

5) Models That Are Holistic or Integrative

• The main idea: Mix and match. CBT, mindfulness, creative arts, and animal-assisted work, depending on what you need.
• Best for: Kids, people who like to use different methods, people whose mental health is closely tied to their lifestyle, body-centered issues, or when you want a plan that uses more than one method.

Who Should Think About Getting Therapy? (Quick Self-Check)

• A low mood that lasts for two weeks or more
• Big changes in sleep or appetite
• Trouble getting things done at work or school
• Trauma symptoms or flashbacks
• Ongoing problems in relationships or with parenting
• Burnout, grief, and tiredness from taking care of someone

How to Find the Right Therapist: A Step-by-Step Guide

1. Money and access: Look into insurance, sliding-scale clinics, employee assistance programs (EAPs), or community clinics. University clinics and Open Path are both good options that don’t cost much.
2. Credentials:
   • MD/DO (can prescribe drugs and give therapy)
   • PhD/PsyD (testing and deep therapy)
   • LCSW/LMFT/LPCC (licensed talk therapists). Know what each person does.
3. Match modality:
   • Want to change based on skills? Find CBT.
   • Want to work on your relationships deeply? Think about psychodynamic.
   • Problems with controlling your emotions? DBT works.
4. Cultural fit: Language, religion, gender identity, and cultural competence are all important. If this matters to you, ask directly.
5. Call to consult: Use a free 10–15 minute call to check out the style. Find out how they plan to help you, what homework they expect you to do, what to do in case of an emergency, and how they track your progress.

Cheaper Hacks (So Therapy Is Possible)

• University training clinics (with supervision from experienced faculty)
• Community mental health centers
• Private therapists who charge on a sliding scale (many do)
• Nonprofits like Open Path Collective
• Group therapy (which is often cheaper and works well for social problems)
• Telehealth platforms that offer financial aid or prices based on income

What a Normal Therapy Session Looks Like

• Intake (1–2 sessions): History, goals, and screening.
• Goal setting: Short- and long-term goals.
• Active work: Sessions and homework (often).
• Periodic review: Check in on your progress every few weeks.
• Termination/relapse plan: How you’ll keep your gains and what to do if your symptoms come back.

How to Do the Work So That It Really Helps

• Be honest: I’m serious. Say something if something in therapy doesn’t feel right.
• Do the work: Even small things you do between sessions add up.
• Bring some examples: Talk about things that really happen, not just ideas.
• If asked, keep track: Of your mood or behavior. Short logs help therapists make treatment more effective.
• Re-evaluate if needed: If you don’t see any progress after 6 to 8 sessions, it’s time to think about it again. Sometimes a different therapist or way of doing things is what you need.

Signs That You Might Need to Make a Change or Get More Help

• No improvement in symptoms after 6–8 sessions of a reasonable therapy
• Weak therapeutic alliance (you don’t feel understood or safe)
• Therapist avoids working with your medical providers when needed
• Symptoms getting worse, suicidal thoughts, or severe functional impairment—seek urgent care or a higher level of support right away

Short FAQs That Are Useful

• Q: “Do I need a recommendation?”​
  A:​ Not very often. But make sure to check with your insurance company and any preauthorization that is needed.
• Q: “What if I can’t pay for it?”​
  A:​ Look at the cheap hacks above. Also, talk to therapists about sliding scales and free services.
• Q: “When will I feel better?”​
  A:​ It depends. Some problems get better right away, while others take months or longer. The most important thing is to find the right therapy for the problem and stick with it for a while.

Three Sentences to Take Home

1. The kind of therapy is important. CBT is good for anxiety, DBT is good for controlling emotions, and psychodynamic approaches are good for deep, recurring relationship patterns.
2. Credentials and chemistry equal success; use short consultations to find both.
3. Therapy is work; you have to show up, speak up, do the homework, and give it a fair shot before deciding it’s not for you.