Understanding the Types of Talking Therapy

When it comes to addressing mental health concerns, deciding which therapy may be right for you can be confusing. Some of the popular options with a strong evidence base include Cognitive Behavioural Therapy (CBT), Counselling, and Psychotherapy. Whilst it’s great to have options, how are you supposed to know which one will best suit your unique needs? 

It can be useful to explore the strengths and areas of application for each model. Take a look at the table below to explore which may be the appropriate method for you. 

Key Distinctions

	Duration	Focus	Approach	Applicability
CBT	Short-term, 6-20 sessions	Change unhelpful thoughts and behaviours	Structured, evidence-based4	Targeted, known issues
Counselling	Mid-long term, flexible	Self-discovery	Empathetic, open conversations	Open, supportive dialogue
Psychotherapy	Long term, open-ended	Trauma, deep-rooted psychological patterns	Utilises diverse therapy models	Complex, long standing concerns

Cognitive Behavioural Therapy (CBT)

Cognitive Behavioural Therapy, also known as CBT is a “strategic problem-solving” technique. It’s a dynamic form of talking therapy that focuses on your current thoughts and feelings, and how they impact your current actions and emotions, rather than looking at your past¹. The focus of CBT is to develop practical solutions which cause a positive shift in thoughts and beliefs in your life². 

Treatment, over the course of 6-20 sessions depending on the severity of the individual's concerns², may include:

• Determining your negative thought patterns or unsupportive behaviours.
• Brainstorming practical solutions for personal challenges with your clinician. 
• Homework to practise new techniques to question your beliefs and challenge your behaviours¹.

The benefits of CBT include:

• Its structured approach means it's easy to follow. 
• Focusing on the here-and-now means you don’t have to dig up difficult memories². 
• The structure makes it perfect for things like group therapy, self-help books and online resources².
• There is strong evidence to support its outcomes for mental health concerns such as anxiety, depression, phobias and OCD¹. 
• The independent aspect of treatment due to homework outside of the therapy room can bring a sense of achievement to an individual and encourage future change.

The drawbacks of CBT include:

• For those with chronic mental health conditions, it may not dig deep enough or explore wider issues that are contributing to difficult emotions². 
• The structured, weekly meetings may be a challenging commitment².
• The structure of the model may be too intense and individuals may require a more flexible approach².

Counselling

Counselling offers a space for open dialogue and meaningful conversation. Your clinician will listen, ask questions, provoke reflection and help you to explore thoughts and feelings as long as you require. 

The benefits of counselling include:

• The flexible approach to counselling means you can come and go with sessions as and when you need it. 
• Counselling offers  a space to let go of what you're thinking and provides you with a space to analyse your thoughts and get things off your chest. 
• Counselling offers a versatile therapeutic option with limitless possibilities of topics you can address. 

The drawbacks of counselling include:

• If you are unsure what issues you are having, the lack of structure may make it difficult to identify them in a timely manner. 

Psychotherapy

Psychotherapy explores previous traumatic events that have (possibly subconsciously) left you feeling unsafe, helpless or vulnerable. The duration of psychotherapy depends on the severity of the impact of trauma experienced by a patient (note: the severity of trauma will be relative to the individual) and how long this requires to untangle.

Treatment, with a duration defined by the severity of the impact of trauma experienced by a patient (note: the severity of trauma will be relative to the individual) and how long this requires to untangle may include:

• A compassionate space to listen and understand your concerns, allowing you to express and process your emotions to gain deeper insight into your issues. 
• Teach you coping mechanisms such as enhancing or changing your current thought patterns and behaviours.
• Develop improved communication skills and tolerance for differences in yourself and others³.

The benefits of psychotherapy:

• The goals of psychotherapy are determined by the client and therapist, so you can flexibly work on your personal concerns. 
• Provides exploration of deeper rooted issues from the past and the impact they are having on the present moment. 
• Provides space to put previous experiences in the past and develop coping mechanisms to cope with future challenging situations. 

The drawbacks of psychotherapy may include:

• It is a long-term therapy approach and may require extensive time, commitment and energy to resolve past traumas. 
• Due to the nature of psychotherapy exploring past events, clients may find this distressing at the beginning of the process^5.

In summary, CBT is well-suited for addressing specific mental health conditions and behaviours with its structured and evidence-based approach. In contrast, psychotherapy and counselling may be more suitable for longer-term support for individuals wanting to look at deeper rooted issues from the past. The choice between these approaches depends on an individual's specific needs, personal preferences, and treatment goals.

To find out more about the CBT programme offered by eMed, check out our CBT service here.

Alternatively, if you feel you require an alternative form of treatment you can book an appointment with an eMed Mental Health Practitioner here to explore further options.

References

• Royal College of Psychiatry, Cognitive behavioural therapy (CBT), 2022, Available from: https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/cognitive-behavioural-therapy-(cbt) 
• NHS, Overview - Cognitive behavioural therapy (CBT), 2022, Available from: https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/overview/ 
• UK Counsel for Psychotherapy, What is psychotherapy?, 2023, Available from: https://www.psychotherapy.org.uk/seeking-therapy/what-is-psychotherapy/ 
• Hofmann SG et al., 2012, The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses, Cognitive Therapy and Research, 36(5):427-440. doi: 10.1007/s10608-012-9476-1 
• Strauss B, Gawlytta R, Schleu A, Frenzl D. Negative effects of psychotherapy: estimating the prevalence in a random national sample. BJPsych Open. 2021;7(6):e186. doi:10.1192/bjo.2021.1025