What is it?
Talking to friends and family is important for your well-being and a great way to get support. That being said, if you need more than what they’re equipped to help with, more time or a faster response than they can provide, or your relationship prevents them from being objective, it can be useful to seek professional help.
Therapists and psychiatrists are trained to deal with a range of situations and can reliably hold a safe space for working through things together.
Maybe you’ve heard of a friend seeing a therapist or even watched a TV character meet with one, but it might be unclear what therapy really means. In the broadest sense of the word, therapy is treatment provided by a trained mental health professional (broadly referred to as a “therapist”) aimed at helping you manage your emotions, thoughts, and behaviors or, more generally, improve your overall emotional well-being.
People often use the term “therapy” to refer to talk therapy, which involves discussion or skills-based sessions, but there are also types of therapy that go beyond talking.
People may engage in therapy for a variety of personal reasons, which might include dealing with difficult emotions, challenging experiences or symptoms of a mental health condition. But you don’t need a diagnosable condition or major life event to go to therapy. It’s normal to see a therapist just to have time and space to talk to someone or process what’s happening around you.
If you’re considering therapy, you aren’t alone. The number of Americans seeking therapy is almost twice as high as it was two decades ago.1 While pandemic stressors and a general decline in mental health are partly responsible for the high demand, so are positive factors like the availability of therapy through video visits and apps, as well as more openness to discussing mental health with each other. Chances are you know someone who has seen a therapist, even if they haven’t brought it up to you yet.
What types of therapy are there?
Knowing types of therapy and related approaches can help you understand your options and think more specifically about what could be a good fit for you. It can help to think about your personality type, what activities might be the most helpful for you (for example, talking versus doing “homework” like journaling between sessions) and what might be specifically good for what you’re dealing with.
Talk therapy (also known as psychotherapy) involves discussion and skills-based sessions that can be individual or group-based. Some common approaches include:
- Psychodynamic therapy: looking at your past to analyze how it has affected you, including in ways you might not recognize (unconscious behaviors or emotions). This therapy focuses a lot on the relationship with your therapist and can feel very open-ended.
- Cognitive and behavioral therapies: helping you address problematic thinking or behaviors in the moment and how they relate to each other. This therapy often includes skills learning and may include “homework” between sessions.
- Humanistic or client-centered therapy: focusing on you as an individual and your positive characteristics and potential for growth and change. This therapy allows you to arrive at insights about yourself through a largely self-guided process.
- Family, Group, or couples therapy: helping address relationship issues and interpersonal dynamics. This therapy often focuses on improving communication with others.
If talking feels too difficult or maybe not right for what you are going through, your therapist might incorporate (or you might seek out a therapist who specifically focuses on) types of therapy that go beyond discussion:
- Experiential therapy: taps into processes of the mind—particularly past emotional situations and relationships—through activities like role-playing, crafting, and other creative outlets such as pet therapy.
- Somatic therapy: focuses on the mind-body connection and how our emotions, especially if they are unresolved or traumatic, appear in physical sensations. Eye movement desensitization and reprocessing (EDMR) is one example.
Knowing yourself and what you like, you might feel pulled toward one (or more) approach. But if not, or if that list left you more confused, that’s okay, too—your therapist can help you find the right fit. It’s also common to combine therapy types and approaches based on your needs, so therapy looks a little different for everyone. If there is an approach you are interested in that your therapist doesn’t seem to have tried, bring it up and have a conversation with them.
While it’s common to combine therapy with medication, this is not required at all. Your therapist might suggest the idea of medication or other treatments if therapy does not seem to be enough or your symptoms are more severe or worsening. In this case, they can refer you to your primary care doctor or a psychiatrist (a medical doctor who specializes in mental health) who can further assess your situation and prescribe medication. In that instance, continuing therapy is key.
What are the reasons to see a therapist?
Choosing to go to therapy is a personal decision. Though many seek it out to help solve a problem or active challenge in their daily lives, there are a variety of reasons to try therapy, and all are valid. Here are some of the common ones:
- Managing difficult emotions and moods like burnout, grief, isolation, sadness, and worry, or just not feeling like yourself
- Coping with life challenges, including stressors like aging and health issues, relationship issues, substance use, workplace issues, and trauma
- Alleviating issue-related symptoms such as intrusive thoughts and symptoms (like sleep or concentration) related to mental health disorders like anxiety, depression, and PTSD
- Recognizing and changing undesirable thoughts or behaviors like low self-confidence, negative self-talk, fears, or unhealthy coping mechanisms
- Improving relationships by learning new ways of relating to and communicating with family, romantic partners, friends, or coworkers
- Developing self-awareness by exploring what’s important to you, your history, how you feel, and why you behave the way you do
If you don’t know exactly what you want to get out of therapy going into it, that’s OK, too. You can work with your therapist to gain clarity on issues that may be holding you back and define goals to work toward. Many people’s goals change over time, and sometimes the reason they think they want therapy is not the core reason after all.
How do I find a therapist?
Taking steps to focus your search can help you find promising matches. Learn more about finding the best mental health provider for you.
A variety of online directories exist to help folks find a therapist that meets their needs—in terms of budget, cultural sensitivity and style.
NAMI offers valuable information about mental health care for the various communities, including questions you can ask during your search.
NAMI also offers tips for finding culturally competent providers.
How effective is therapy?
Why therapy works
Research has shown that therapy is very effective. From a biological perspective, advances in neuroscience (studies of the brain and nervous system) have demonstrated that life experiences can change brain structure and function.
When someone participates in therapy, these structural changes show as positive. Using imaging technology, we also can see changes in areas of the brain affected by certain disorders.2 Imaging technology also shows that after someone goes to therapy for those disorders, there are improved connections in those same areas of the brain.
When therapy doesn’t work
In some cases, therapy may feel like it’s not working. You may feel like you are “just going and talking, and nothing changes.” Or, you might not like your therapist or something they said.
As long as the issue is not safety-related, let your therapist know—even if it feels uncomfortable. Therapists can often adjust the approach or recommend other therapists. You might be surprised just how helpful even having a conversation like that can be.
Keep in mind that effective therapy takes time and effort. How many sessions you need varies by person and what they’re facing, but it’s not something that can be solved overnight and without your own dedication and self-reflection.
Still, the potential payoff is worth it. Clinical trials show that people who participate in talk therapy have a higher chance of improving their mental health than those who don’t.3 Taking the step to start might be a hard one or even a bit scary, but it’s incredibly hopeful.
What should I expect?
It’s normal to feel nervous about starting therapy, but know that your therapist is there to support you and provide a caring, confidential and safe space.
The first session generally involves your therapist getting to know you, asking a lot of questions about your current experiences and symptoms, and setting expectations. After that, the frequency and length of sessions, as well as how long you attend therapy in general, will vary based on your goals and treatment needs or approach.
Talk therapy sessions are usually a little less than an hour long (typically 50 minutes) and once a week or every other week, but could get less frequent over time. In general, recognizing change within yourself—whether it’s a lessening of symptoms, developing new skills, or knowing yourself better—is a sign therapy is working.
There’s no standard answer for when you should stop going to therapy. You and your therapist might decide to end therapy after agreeing you’ve met your goals; however, many people decide to keep therapy as part of their ongoing routine, especially if they take medication for a mental health condition or have ongoing stressors at work or home.
Before you stop therapy altogether, make sure you:
- Know how to identify a relapse
- Can identify if your symptoms get worse
- Have the skills to support yourself alone if you experience a relapse or worsening of symptoms
You can always return to therapy, whether it’s for an issue or challenge, or something else. Getting help and understanding yourself is not a straight line.
Online interactive tool(s)Where to get help | Mental Health AmericaMental Health America offers a "Where to Get Help" interactive tool to recommend locating mental health support resources based on your needs.
How-to articleHow to Find a Culturally Competent Therapist | The Jed FoundationThis resource from the Jed Foundation breaks down step-by-step how to find a therapist who shares your background, has experience supporting people from your community, or is trained to be open to, respect, and take into account your identity and lived experience.
Online directoryFind a Therapist | Latinx TherapyLatinx Therapy offers a national U.S. directory for Latinx therapists.
Online directoryFind a Therapist | Therapy for Black MenAt TherapyforBlackMen.org, we want to break the stigma that asking for help is a sign of weakness. With a rapidly growing directory of 408 therapists and 40 coaches throughout the fifty states thus far, we are here to provide judgment-free, multiculturally-competent care to Black men.
Online directoryFind a Therapist | Therapy Aid CoalitionFind a therapist for health care professionals or first responders. Each participating therapist is offering four free or low-fee short-term therapy sessions.