What are the basic approaches to psychotherapy?

David Tolin
The psychotherapy with the strongest evidentiary basis is called cognitive-behavioral therapy (CBT).  The basic premise of CBT is that emotional problems stem from faulty or irrational beliefs or thought patterns, as well as maladaptive or unhealthy patterns of behavior.  CBT therefore focuses on teaching clients to become aware of (and then change) the way they think in critical situations, and to practice new ways of responding to uncomfortable situations.

CBT is different from other kinds of psychotherapy or "talk therapy." Whereas some forms of therapy focus on helping the person to discover why they feel bad, CBT emphasizes teaching the person how to feel better. Whereas traditional psychotherapy often takes place over several years, CBT is designed to be a relatively brief treatment with distinct, tangible goals. The advantages of CBT are a lack of unwanted side effects and long-lasting beneficial effects that continue even after the person leaves treatment. The disadvantages are that the effects of CBT may take a longer period of time to develop, although sometimes effects can be seen after just a few visits, and that CBT involves more time and effort on the part of the person with the disorder.

A wealth of well-conducted studies show that CBT is effective for a range of psychiatric disorders, including anxiety disorders, depression, personality disorders, and substance use disorders.  In many cases, CBT has been shown to be as effective as, or more effective than, psychiatric medications.

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