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The main kinds of therapy
What each method actually does in the room, what it is usually offered for, and roughly how long a course runs.
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Method matters less than people think, and more than nothing
Comparisons between well-delivered therapies for the same problem tend to find smaller differences than the marketing implies; the therapist’s competence and the working relationship carry a great deal of the effect. But the differences are not zero, and for several specific problems the guidelines across this region point clearly at particular approaches — exposure-based work for anxiety disorders and obsessive-compulsive disorder, trauma-focused work for post-traumatic stress, family-based work for eating disorders in young people. So the sensible position is neither brand loyalty nor indifference: match the method to the problem where the evidence is clear, and otherwise care more about the person delivering it.
Cognitive-behavioural therapy
The default offer across the region, structured and time-limited, typically eight to twenty sessions with homework between them. It works on the loop between thoughts, feelings and behaviour, and its strongest component in the anxiety disorders is behavioural rather than cognitive: doing the thing that is avoided, deliberately and repeatedly, in a planned way. It suits people who like structure and measurable goals. It suits less well someone whose difficulty is diffuse, relational and long-standing, and it is not a good fit for a person who finds homework between sessions impossible — which is worth saying out loud at the start rather than dropping out over.
Psychodynamic and psychoanalytic therapy
Longer, less structured, and concerned with patterns rather than episodes: recurring difficulties in relationships, feelings that do not fit the present situation, and what happens between you and the therapist as a live sample of both. Courses run from several months to several years. It suits long-standing relational and personality-level difficulty, and people who want to understand rather than to fix. It is the slowest of the mainstream options and the one where the length of the commitment should be discussed explicitly at the beginning, not discovered.
The third-wave family
Acceptance and commitment therapy, mindfulness-based cognitive therapy, dialectical behaviour therapy and compassion-focused therapy grew out of the cognitive-behavioural tradition and share a shift of target: less argument with the content of thoughts, more change in the relationship to them. Dialectical behaviour therapy is the specific one to know — a structured programme combining individual sessions with a skills group, developed for chronic self-harm and emotional instability, and one of the few therapies with a strong evidence base for exactly that. Acceptance and commitment therapy is widely used for chronic pain and long-term conditions as well as mood problems.
Trauma-focused work
Post-traumatic stress has its own treatments and they are not general talking therapy: trauma-focused cognitive-behavioural therapy and eye-movement desensitisation and reprocessing are the two most commonly named in guidelines across this region. Both involve processing the memory in a controlled way, both are demanding, and both need a therapist trained specifically in them. Repeatedly narrating a trauma without a structured protocol is not the same thing and can make matters worse. If trauma is the problem, the specific training is one of the few cases where the method genuinely should decide the choice of therapist.
Family, couples and group work
Systemic and family therapy treats the pattern between people rather than the person, which is why it is standard for eating disorders in adolescents and for a great deal of child and adolescent work — the family is part of the treatment rather than an audience for it. Couples therapy has its own established methods and is the right frame when the relationship is the problem rather than a symptom of one. Group therapy is consistently under-taken and consistently effective, particularly for social anxiety, bereavement and anything where isolation compounds the problem, and it is far cheaper per session than individual work.
| Approach | Commonly offered for | Typical length |
|---|---|---|
| Cognitive-behavioural therapy | Anxiety disorders, depression, panic, obsessive-compulsive disorder, insomnia | About 8–20 sessions, structured, homework between |
| Behavioural activation | Depression, especially with withdrawal and inactivity | Short, often 8–12 sessions |
| Psychodynamic psychotherapy | Long-standing relational patterns, recurrent depression, personality-level difficulty | Months to years |
| Acceptance and commitment therapy | Chronic pain, long-term conditions, anxiety, avoidance | Usually short to medium |
| Dialectical behaviour therapy | Chronic self-harm and emotional instability | A structured programme, typically about a year |
| Trauma-focused CBT or EMDR | Post-traumatic stress disorder | Often 8–16 sessions with a trained therapist |
| Interpersonal therapy | Depression linked to loss, role change or conflict | Around 12–16 sessions |
| Systemic and family therapy | Child and adolescent problems, eating disorders in young people, family conflict | Varies; sessions often spaced further apart |
| Group therapy | Social anxiety, bereavement, isolation, shared conditions | Fixed-length courses or open groups |
Источники:Mielenterveystalo — treatment methods · 1177 — psychological treatment methods · Helsenorge — mental-health treatment· Изменяются правила, права и номера телефонов доверия: проверьте собственную страницу оператора, прежде чем полагаться на нее. Проверено2026-09-08.
Частые вопросы
Which therapy is best?
For most problems, differences between well-delivered therapies are smaller than the competence of the therapist and the quality of the relationship. For a few — anxiety disorders, obsessive-compulsive disorder, post-traumatic stress, eating disorders in young people — guidelines point clearly at particular approaches, and there the method should decide.
How many sessions will I need?
Structured cognitive-behavioural work usually runs eight to twenty sessions, trauma-focused work often eight to sixteen, interpersonal therapy about twelve to sixteen, and psychodynamic work months to years. Agree a review point at the start rather than an open-ended commitment.
What is EMDR?
Eye-movement desensitisation and reprocessing, a structured trauma treatment named in guidelines across this region alongside trauma-focused cognitive-behavioural therapy. It requires specific training, and trauma is one of the cases where the therapist’s particular training should decide your choice.
Is group therapy a cheaper substitute for individual therapy?
It is cheaper, but not a substitute — it does different work. For social anxiety, bereavement and isolation the group is doing something individual therapy structurally cannot, and it is one of the most under-taken effective options in the region.
What therapy is actually like
What happens in a first session
The hour, minute by minute: what they ask, what they write down, what you can ask back, and what to prepare beforehand.
How long therapy takes to work
When to expect the first change, what a fair review point looks like, and what to do when nothing is moving.
Confidentiality, records and what gets written down
Who can see your notes, the four situations where confidentiality has limits, and what a mental-health record does and does not affect.
Changing therapist, and ending well
How to tell a bad fit from a hard patch, how to raise it, and how to switch inside a funded system without losing your place.
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