Want to start therapy, but aren’t sure which type will be right for you? Here are four to consider

Quarter life, a series of The Conversation

Have you been feeling persistently sad for weeks or months? Perhaps you lack motivation, or feel irritable, or anxious, or constantly nervous. If symptoms like these are causing you concern and affecting your daily life, including work, social life, or both, you may want to consider therapy.

If you experience persistent mental health symptoms, you should consider speaking to your GP in the first instance. You will be able to discuss with them your specific symptoms and possible treatments, including therapy.

If you decide that psychological therapy is right for you, there are many different types available. It can be confusing deciding which would work best for you, especially if this is your first time seeking therapy.

So here are some of the different options to help you figure out what might be right for you.

The options covered in this article are some of those used to treat mild depression, as recommended by health authorities in the UK and generally available free of charge through the NHS or mental health charities. But if you have a preference or want to specify your therapist, you may need to go private.

Quarter life, a series of The Conversation

This article is part of Quarter Life, a series about the issues that affect those of us in our twenties and thirties. From the challenges of starting a career and taking care of our mental health, to the excitement of starting a family, adopting a pet, or just making friends as adults. Articles in this series explore questions and provide answers as we navigate this turbulent time in life.

You may be interested in:

Postnatal depression: what new dads need to know and how to get help

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1. Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is based on the theory that psychological problems result from unproductive ways of thinking and learned patterns of unhelpful behavior. An example is all-or-nothing thinking, where people believe that if one thing goes wrong during the day, the whole day is ruined, or if they answer a question wrong in a job interview, the whole interview was a waste of time.

During CBT, the therapist guides the client to learn ways to cope and change their thinking patterns. This form of therapy focuses on the person’s current problems and does not address larger issues such as family or underlying past issues.

CBT is highly structured, and the skills learned, such as problem solving and reframing unnecessary thoughts, are practical and can be incorporated into daily life. It also involves homework, such as goal-setting worksheets, that people must be willing to complete to get the most out of treatment.

CBT is most commonly used to treat anxiety and depression, but it can also help with other mental health issues and can even help people cope with certain physical health conditions.

This approach may be suitable for people who want a structured, guided method with a specific focus on unhelpful thoughts and behaviors.

2. Short-term psychodynamic psychotherapy

Short-term psychodynamic psychotherapy seeks to target troubling thoughts and feelings that may be interfering with relationships, communication, and daily life. A key goal is to change problematic relationship patterns.

It is based largely on the belief that psychological problems are rooted in the unconscious part of the mind. So short-term psychodynamic psychotherapy aims to help the client identify the root causes of any problematic thoughts and feelings, such as unresolved or repressed traumas, and work through them.

The therapist does this by building a trusting relationship with the client and exploring past and current events.

Similar to CBT, this approach teaches the client coping skills to help with future situations. But it is less structured than CBT and the client can direct what is being discussed.

This type of therapy may therefore be suitable for those who want a little more autonomy and want to focus on interpersonal difficulties, such as the loss or change in relationship dynamics, which may be associated with depression or anxiety.

A young woman looking at a smartphone.
It can be overwhelming deciding which type of therapy is best for you.

3. Behavioral activation

Behavioral activation focuses on the association between a person’s activities and their mood and involves helping the client use activities to influence their emotional state. For example, behavioral activation can be used for people with depression, who often lose interest in activities they previously enjoyed.

Similar to CBT, this form of therapy looks at behavior patterns and the therapist explores behavioral changes the client might be making in their daily life. Encourage clients to engage in activities they enjoy but are avoiding, and explore the thoughts and feelings that have led to this avoidance.

For example, the client might avoid exercise classes they loved because they feel low on energy and fear that other class members won’t talk to them.

Behavioral activation focuses on the client’s current situation and environment and does not explore past events. It doesn’t target unhelpful thoughts and beliefs, so it may not be suitable for people who want to address these aspects. It also requires motivation and discipline to be able to engage in relevant activities (such as exercising on Monday nights).

This approach may be more suitable for someone whose symptoms have led to social withdrawal and he is engaging in fewer activities that bring him happiness. It will also be better suited to someone who is action oriented (who wants to take practical action to address their problems).

4. Person-centered therapy

Person-centered therapy is based on the theory that people are inherently driven to reach their potential. The client is the expert on his life and therefore guides the direction of therapy. This approach creates a supportive, flexible and stimulating environment for self-exploration.

The therapist uses reflections and questions to help clients understand their thoughts, feelings, and actions. Person-centered therapy aims to improve self-esteem, self-efficacy (the belief in one’s ability to succeed), and the ability to cope with everyday situations.

Due to the lack of guidance from the therapist, person-centered therapy requires the client to be motivated and have the ability to self-reflect. It is less problem-focused and the therapist does not suggest coping strategies.

This approach may suit someone who wants the freedom to talk about the problems and issues they want to address in a supportive environment. It’s best for someone who wants less structure with no specific techniques and tasks to undertake.

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