# Types of psychological therapy: what they are and how to choose > CBT, EMDR, ACT, systemic, humanistic. Anyone looking for help for the first time runs into a catalogue of acronyms and no clue which one applies to them. Here is the map. *https://mypsicotest.com/en/blog/types-of-psychological-therapy/ · Published: 2026-09-16 · 10 min read · MyPsicoTest team* Someone finally decides to ask for help, types "psychologist" into a search box and runs into a catalogue of acronyms: CBT, EMDR, ACT, DBT, systemic therapy, integrative, humanistic. No page explains which one applies to them, and the decision ends up being made on proximity or price. The World Health Organization estimates that [more than a billion people](https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response) live with a mental health condition, and a sizeable share of those who do take the step get stuck right here. This guide maps out the **types of psychological therapy** that exist, explains how they actually differ and gives you criteria for choosing. ## What psychotherapy is, and what separates one therapy from another Psychotherapy is a treatment, not a friendly chat. It involves an initial assessment, agreed goals, a method and a way of checking whether the thing is working. What every school shares is the frame: a confidential space, a professional relationship and the aim of reducing distress and restoring functioning. What changes between them is one single thing, though it has plenty of consequences: **what each approach believes is keeping the problem going**. Where it intervenes follows from that. A concrete example. Someone has not slept properly for months because the moment the light goes off they start running through everything that could go wrong tomorrow. Cognitive behavioural therapy will look at the thoughts that trigger the arousal and the habits that sustain it, and work on both. Psychodynamic therapy will ask where that need to anticipate everything comes from and what holds it in place. Systemic therapy will want to know what function the insomnia serves at home, who gets up with whom and what would happen if it disappeared. Three different readings of the same insomnia, three ways in. None of them is nonsense. Some have far more research behind them than others, and that does matter. ## The main types of psychological therapy To get a sense of how many coexist, it helps to look at what a large public system offers. The [UK's National Health Service](https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/types-of-talking-therapies/) funds, depending on the case, guided self-help, cognitive behavioural therapy, counselling, interpersonal therapy, dynamic interpersonal therapy, couples therapy, EMDR, mindfulness-based cognitive therapy and dialectical behaviour therapy. Nine modalities, and that catalogue is only one public service's. ### Cognitive behavioural therapy The most studied of the lot and the one that appears first in almost every clinical guideline. It starts from the idea that thoughts, emotions and behaviour feed each other, and that the problem is kept alive by that loop rather than by whatever started it. The work happens in the present, with structure, measurable goals and tasks between sessions. Inside it there are very different protocols: exposure with response prevention for OCD, behavioural activation for depression, graded exposure for phobias. If you want the detail of how it works session by session, we cover it in our guide to [Cognitive behavioural therapy: what it is, how it works and what it treats](https://mypsicotest.com/en/blog/cognitive-behavioural-therapy/). ### Third-wave therapies: ACT and mindfulness The twist here is interesting. Instead of arguing with the thought ("what evidence do I have that I'll fail?"), the work is on the relationship you have with it. **Acceptance and commitment therapy** (ACT) trains you to stop wrestling with whatever shows up in your head and to point your behaviour at what matters to you, even with the anxiety still there. Mindfulness-based cognitive therapy was built for one specific purpose: preventing relapse in people with repeated episodes of depression. They are most useful when the problem is chronic, or when the attempt to control the symptoms has become part of the problem. Persistent pain is the classic example. ### EMDR and trauma-focused therapies When what sustains the distress is a memory that is still live, the approach changes. **EMDR** and trauma-focused CBT are the two treatments with the strongest backing in post-traumatic stress. They work directly on the memory rather than on the symptoms it produces. We go into it in depth in our article on [EMDR therapy: what it is, how it works and how it treats trauma](https://mypsicotest.com/en/blog/emdr-therapy-for-trauma/). ### Psychodynamic therapy An heir to psychoanalysis, but very different in format: today it is mostly practised in brief, focused versions of roughly fifteen to thirty sessions, face to face and with an agreed theme. What interests it is the pattern that repeats — the same kind of relationship, the same ending, over and over — and which old need holds it in place. ### Humanistic therapies Person-centred therapy, Gestalt, emotion-focused therapy. They share the idea that the therapeutic relationship is not the wrapping around the treatment but the treatment itself. They work with what happens in the session, with immediate experience and with emotions left half-processed. ### Systemic and family therapy It looks at the symptom inside the web of relationships around it. It asks less "what is wrong with you" than "what is going on between you for this to be showing up now". It is the usual frame in family and couples therapy, and it is also used with children and adolescents, where the family is an unavoidable part of the treatment. ![Group therapy session with a psychologist and four participants sitting in a circle in a bright consulting room](https://mypsicotest.com/assets/img/blog-terapia-de-grupo-psicologica-1200.webp) ## One to one, in a group, as a couple or as a family The approach is one decision; the format is a separate one. And sometimes it weighs more. **Individual therapy** is the most common and the one that allows you to go deepest into a personal history. **Group therapy** has an advantage individual work cannot replicate: seeing at first hand that what happens to you happens to other people too. It works particularly well in social anxiety, eating disorders and grief, and it is usually cheaper. **Couples and family therapy** works on the bond rather than on the people separately, and it is what you want when the problem lives in the relationship. ### In person or online The online format stopped being a substitute a long time ago. In anxiety and depression, trials comparing video calls with in-person sessions find equivalent outcomes when the treatment is the same and the professional is properly accredited. It has limits: it is not the first option in acute crises, suicide risk or severe presentations that need coordination with other services. If you are weighing that route, our guide [Online psychologist: how to choose well and what to expect from video-call therapy](https://mypsicotest.com/en/blog/online-psychologist-how-to-choose/) lists the checks worth making before the first session. ## Is one type of therapy better than the rest? It depends on the problem, and the honest answer has two halves. For some presentations there is a fairly clear preferred indication. In OCD, exposure with response prevention; in specific phobias, exposure; in post-traumatic stress, EMDR or trauma-focused CBT. Choosing badly there is not a neutral matter. For others, several options work in much the same way. The adult depression guideline from the [UK institute NICE](https://www.nice.org.uk/guidance/ng222) recommends close to ten first-line alternatives, among them individual CBT, behavioural activation, interpersonal therapy, counselling and short-term psychodynamic psychotherapy. They are not ranked by effectiveness, because the data does not allow ranking them. That parity between evidence-backed approaches has a name in the literature: the **Dodo bird verdict**, after the line in *Alice in Wonderland* according to which everybody has won and all must have prizes. The most widely accepted explanation is that a good part of the effect comes not from the technique but from **common factors**: the alliance between client and therapist, the expectation of improvement, having a framework that explains what is going on, and a professional who believes in what they are doing. Of all of them, the quality of the alliance is the best predictor of outcome. It is worth not drawing the wrong conclusion from this. That several evidence-backed therapies work similarly does not mean anything goes: there are approaches with no evidence behind them at all, and some that are straightforwardly pseudoscientific. ## How to choose the type of therapy that suits you Four criteria, in this order. **Start with the problem, not the school.** If you are clear about what is happening to you, look up what is indicated for it and filter afterwards. The useful question to put to a professional is not "which school do you follow?" but "how do you work with a case like mine?". **Check the credentials before the approach.** In Spain, psychological treatment can be provided by a *psicólogo general sanitario* or a specialist in clinical psychology, always with a verifiable registration number. "Psychotherapist" and "coach", on their own, are not regulated titles. **Ask three things in the first session**: how they are going to work, how many sessions they estimate before you start seeing movement, and how the two of you will know whether it is working. A vague answer to the third question tells you something. **Fit counts.** If after six or eight sessions you notice no change and you do not feel understood, say so out loud inside the session. A good professional welcomes that, revises the plan and, if need be, refers you on. Changing therapist is not starting from zero. Some clinicians work with an **integrative approach**: combining tools from several schools according to what each person needs at each point, rather than applying a single manual. That is a reasonable option as long as there is specific training behind each of those tools and not an improvised mix. ## Before choosing, put a name to what is happening Arriving at the first session knowing what is going on shortens the road considerably. You do not need a diagnosis — that is the professional's job — but you do need to have sorted out which symptoms you have, since when, and how much they limit you. Screening questionnaires are there for exactly that. If what dominates is constant worry and arousal, start with the [Anxiety Test](https://mypsicotest.com/en/anxiety-test/). If it is apathy and lack of drive, the [Depression Test](https://mypsicotest.com/en/depression-test/). If it all started with a specific overload that has not eased off, the [Stress Test](https://mypsicotest.com/en/stress-test/). They are in the [psychological tests](https://mypsicotest.com/en/psychological-tests/) catalogue, free and anonymous, and the result is calculated on your own device. What you get is not a label but a starting point, and a score you can compare against in a few months' time. Our guide on the [Mental health test: what it measures, which ones exist and how to read your result](https://mypsicotest.com/en/blog/mental-health-test/) explains how to read those scores without over-interpreting them, and [When to see a psychologist: signs, common doubts and what happens in the first session](https://mypsicotest.com/en/blog/when-to-see-a-psychologist/) covers what actually happens in that first appointment. ## How many sessions it takes and when you notice it The numbers vary with the approach and the problem, but there are reasonable orders of magnitude. A cognitive behavioural treatment for anxiety or depression usually runs between twelve and twenty sessions. Brief psychodynamic work, between sixteen and thirty. EMDR depends a great deal on whether the trauma was a single event or built up over years. The usual frequency is weekly at the start, spacing out as things improve. The first signs show up sooner than people expect, but they are not the ones people expect: symptoms rarely disappear by session four or five. What tends to change first is something else — understanding why what happens happens, reacting differently once where you always reacted the same way, sleeping half an hour longer — and that is exactly what to watch to know whether you are on track. ## Frequently asked questions ### What is the best type of psychological therapy? There is no single best one for everything. For OCD, phobias or post-traumatic stress there are clearly indicated treatments; for depression or generalised anxiety, several evidence-backed options work similarly. The choice is made on the specific problem and the professional's training, not on the school in the abstract. ### What is the difference between a psychologist, a psychotherapist and a psychoanalyst? Psychologist is a university degree, and treating people also requires health accreditation: *psicólogo general sanitario* or specialist in clinical psychology. "Psychotherapist" is not a regulated title in Spain on its own, so it may sit on top of solid training or mean nothing at all. Psychoanalyst denotes specific training within one particular school. What is always worth checking is the registration number. ### Can I switch to a different type of therapy if it is not working? Yes, and it happens more often than you would think. The sensible move is to raise it with your therapist first: sometimes what is failing is not the approach but the focus, and revising the goals is enough. If there is still no movement after several sessions, asking for a change of approach or of professional is a normal clinical decision, not a failure. ### Does online therapy work as well as in-person therapy? For the most common problems — anxiety, depression, stress — studies comparing the two find equivalent outcomes. It is not the right option in acute crises, suicide risk or severe presentations that need coordination with other services. What makes the difference is not the screen but whether the treatment is the right one and the professional is accredited. ### How long does therapy take to show results? The first changes usually appear between the fourth and sixth session, though not as symptoms disappearing: you notice it sooner in how you react to them. If nothing at all has shifted after eight or ten sessions, it is time to review the plan with your professional. ### Do I need a diagnosis before starting therapy? No. You can go to therapy for distress that fits no label, for a difficult decision or for a bereavement. A diagnosis, where one applies, comes out of the initial assessment; it is not an entry requirement. The only thing worth bringing is a clear idea of what is happening to you and since when.