Types of Therapy Explained: CBT, DBT, EMDR and More

The main types of therapy differ in what they focus on and what a session actually looks like. Cognitive behavioral therapy (CBT) works on thinking and behavior patterns; dialectical behavior therapy (DBT) teaches specific skills; EMDR uses guided bilateral stimulation, such as side-to-side eye movements, while a person recalls distressing memories; psychodynamic therapy looks at how past experience shapes present behavior; interpersonal therapy focuses on relationships and role changes; and acceptance and commitment therapy (ACT) builds flexibility around thoughts and feelings. None of these is a brand-name product with a formal approval process like a medication has, and no single approach is the right fit for everyone. What also matters is that the approach makes sense to you and that you feel comfortable with the therapist.

The main approaches at a glance

Many kinds of professionals offer psychotherapy, including psychiatrists, psychologists, clinical social workers, counselors, marriage and family therapists and psychiatric nurses. The approach is the method; the license is the professional’s training and legal scope. Both matter when you are choosing.

CBT: noticing the pattern and trying something different

Cognitive behavioral therapy helps people identify and change thinking and behavior patterns that are unhealthy or ineffective. A session is usually structured: you bring a situation from the week, look at what went through your mind, and consider how that thought shaped what you did. Exposure therapy is a type of CBT used for anxiety disorders, and it involves approaching feared situations in a planned way rather than avoiding them. CBT is often described as practical and time-limited, though how long it lasts depends on the person and the goals.

DBT: skills, coaching and a team behind the therapist

Dialectical behavior therapy was developed by Marsha Linehan, originally for suicidal behaviors and for people with borderline personality disorder. Standard outpatient DBT has four modes: individual therapy, skills training (often in a group), phone coaching in the moment, and a consultation team for the therapists. It teaches four skill sets: mindfulness, distress tolerance, interpersonal effectiveness and emotion regulation. A DBT skills group is a class-like setting where people practice those skills; it is not the same as a process group where members talk about whatever comes up.

EMDR: eight phases and guided eye movements

EMDR stands for eye movement desensitization and reprocessing. It is delivered in eight phases and uses guided bilateral stimulation, such as side-to-side eye movements, while a person recalls distressing memories. A session may involve brief sets of eye movements with pauses to check in on what came up. The American Psychological Association’s PTSD guideline for adults conditionally recommends EMDR, and the VA’s National Center for PTSD names it among the talk therapies that work best for PTSD, alongside cognitive processing therapy and prolonged exposure.

Psychodynamic therapy: past experience and repeating patterns

Psychodynamic therapy is based on the idea that behavior and mental well-being are rooted in childhood and past experiences. Sessions tend to be less structured than CBT: you talk, and the therapist listens for themes, repeated patterns and feelings that may connect to earlier relationships. It is often open-ended rather than a fixed number of sessions.

Interpersonal therapy: a short-term focus on relationships

Interpersonal therapy (IPT) is a short-term treatment focused on issues such as unresolved grief, changes in social or work roles, conflicts with significant others and problems relating to others. A session centers on one of those areas and on what happened in the past week. IPT is one of the approaches NIMH names as evidence-based for depression, along with CBT.

ACT: acceptance, values and committed action

Acceptance and commitment therapy encourages nonjudgmental acceptance of thoughts and feelings and uses mindfulness and goal setting, together with commitment to actions in line with a person’s values, to build psychological flexibility. Rather than trying to argue a thought away, ACT asks what you would do if the thought were simply there.

Formats: individual, couple, family and group

Therapy can be individual, couple, family or group, for children and adults. The format is separate from the approach: a CBT therapist may see people individually or in a group, and a DBT program usually combines individual sessions with a skills group. Therapy for family members and caregivers is often helpful, and it can be part of the picture even when the person in treatment is someone else.

No FDA-style approval, and why that matters

There is no formal approval process for psychotherapies like the FDA’s for medications. That means you will not find a government stamp on a therapy’s label. Instead, professional bodies publish guidelines, training programs set their own requirements, and individual therapists describe their approach and its rationale. The American Psychological Association’s PTSD guideline, for example, strongly recommends CBT, cognitive processing therapy, cognitive therapy and prolonged exposure for adults, and conditionally recommends brief eclectic psychotherapy, EMDR and narrative exposure therapy. Those are recommendations, not approvals, and they are specific to PTSD.

The relationship matters, not only the label

Rapport and trust are essential, and a person should feel comfortable with the therapist. A method that sounds right on paper can be hard to use with someone you do not feel at ease with. Psychologists are required to inform clients as early as feasible about the nature and expected course of therapy, fees, involvement of third parties and the limits of confidentiality, and to discuss confidentiality at the outset. You can ask any therapist to explain those things in plain words.

How to ask a therapist about their approach

When you contact a therapist, you can ask which approach they use, why they use it for a concern like yours, and what a typical session looks like. NIMH suggests asking about the therapist’s credentials, experience and any specialty; the approach and its rationale and evidence base; the goals of therapy; whether a time frame or number of sessions is recommended; how progress will be assessed; whether medication is an option and whether this therapist can prescribe; whether meetings are confidential and what the limits of confidentiality are; and fees, whether insurance is accepted and whether there is a sliding scale. A prescriber (a psychiatrist, a psychiatric nurse practitioner or another doctor) can talk about whether medication is an option. A fuller list is in the questions worth asking first.

Goals of treatment, and how long and how often to meet, are discussed by the patient and therapist together. Sessions are typically held once every 1-2 weeks for about 30 to 50 minutes. Psychotherapy can be used instead of or alongside medication and other treatment, and choosing a treatment plan should happen with a mental health professional.

What goes wrong

Picking a label instead of a person

It is easy to decide that CBT is “the one” or that DBT sounds too intense, and then treat the search as finished. The label tells you little about whether you will feel comfortable with the therapist, whether they have experience with your situation, or whether their training is current. A therapist who lists an approach may use it flexibly, and two therapists who both say “CBT” may run sessions quite differently. Ask what a session looks like, not just what the method is called.

Assuming one approach fits everyone

There is no single approach that suits every person or every concern. A short-term, structured therapy may fit a specific goal; an open-ended approach may fit someone who wants to understand long-standing patterns. The same person may do better with one format at one point and another later. If therapy has gone on for what feels like a reasonable time without improvement, talk to the therapist; it may make sense to explore other professionals or approaches.

Expecting a method to do the work by itself

A therapy is something you do with a therapist, not something done to you. The between-session practice in CBT or DBT, the memories recalled in EMDR, and the reflections in psychodynamic work all ask something of you. That is also why the fit matters: it is easier to keep up the work with someone you trust.

Overlooking the license behind the approach

Coaching is not a licensed mental health profession, and a person can ask any provider which state license they hold. Titles differ by state, and requirements for supervised hours vary. Licenses can be checked on the state licensing board’s website; each state has its own boards for psychologists, social workers, counselors and marriage and family therapists, sometimes combined. If a provider cannot say which license they hold, that is worth noticing.

Forgetting the limits of confidentiality

Confidentiality has limits. A psychologist may disclose without consent only where the law requires it or permits it for a valid purpose, such as protecting the client or others from harm; social workers may disclose to prevent serious, foreseeable and imminent harm, and then only the minimum necessary. Mental health professionals are mandated reporters of child abuse and neglect in many states, and rules vary by state. Ask about this at the start rather than learning about it later.

If you are in crisis, in the US you can call or text 988 (the 988 Suicide & Crisis Lifeline), or call 911 in an emergency.