According to the Psychotherapy and Counselling Federation of Australia "Psychotherapy is a holistic engagement that focuses on the mental, emotional, relational or spiritual health of a human being. It is useful when psychological, developmental, relationship and wellbeing issues arise in life". People have been engaged in some kind of "talking-cure" or "wise-counsel" for millennia. However, it wasn't until the mid 19th century that the English psychiatrist Walter Cooper Dendy coined the term psychotherapy. At the turn of the 20th century Sigmund Freud famously developed a theory to understand the mind, unconscious processes and a framework for what became the practice of psychoanalysis. Freud's ideas have been endlessly explored and adapted and have given rise to a range of practices which may be broadly called psychodynamic and particularly emphasis and seek to explore how thoughts, feelings and behaviour link to early experiences. Freud considered that therapists needed training, personal therapy and supervision of their practice (and these remain the foundations for becoming a therapist).

Over the 20th century and to this day there has been a proliferation of different 'schools' of non-medical therapies. To date there are at least 400 schools of psychotherapy all with somewhat differing views about the way emotional problems should be thought about and addressed. One of the most influential was Carl Rogers who developed what has become known as the "person-centred" approach to psychotherapy. Carl Roger's proposed that if a therapist demonstrated unconditional positive regard, warmth and congruence then this in itself was sufficient to bring about healing and change. Subsequent research has consistently demonstrated that the quality of the relationship between therapist and client is the most predictive of positive change even more than technique used.

A great expansion and investment in research on psychotherapeutic approaches focusing on particular problems or symptoms has taken place so that we now consider some types of talking therapy or approaches more or less "evidence based". Organisations such as beyond blue regularly review the evidence for particular kinds of therapies for high prevalence problems such as depression. Frequently, brief and educative interventions such as cognitive behavioural therapy (and variants) come out on top, in part because there has been a considerable effort to standardise, manualise and subject these "interventions" to trial by institutes of research and academic departments. Cognitive behavioural therapy (CBT) was developed by Aaron Beck and a variation on the same theme (called Rational Emotive Behaviour Therapy or REBT) by Albert Ellis. Richard Lakeman developed an e-book / e-therapy programme based on REBT in 1998 (click here to visit). CBT or some variation is probably the most dominant form of therapy readily available in Australia. CBT has a pedigree stretching back to stoic philosophy. Epictetus (a first century Stoic philosopher) sums up a key underpinning premise of CBT -“Man is disturbed not by things, but by the views he takes of them.” The point of CBT is therefore to help on examine and shift irrational or self-defeating beliefs about the world and thereby reduce suffering, negative emotions or compulsive behaviour. This is not to dismiss the unconscious (REBT and CBT both have views on how we come to develop underlying rules, or schemata from early experiences). CBT however provides some relatively efficient ways to alleviate certain kinds of distressing symptoms.

There is no consensus on the differences between counseling and psychotherapy. Counseling perhaps more properly describes helping with specific problems (e.g. relationship counseling) or with making important life decisions (e.g. guidance counseling or pregnancy counseling).

Are all psychotherapies equal and what kind of psychotherapy might be useful?

This really depends on what one is looking for from psychotherapy and what the problem is that one hopes to solve. There does appear to be some convincing evidence that some psychotherapeautic approaches are better for dealing with acute trauma (e.g. Exposure or Eye movement desensitization and reprocessing or EMDR). In relation to high prevalence problems such as depression and anxiety then CBT and interpersonal therapy have the hits on the board in terms of symptom reduction. However, it is worth noting that the research to support these claims arises from a biomedical paradigm where syndromes such as 'depression' are treated as entities in themselves. Depression can arise for lots of different reasons and a skilled and highly trained therapist can help explore the reasons and choose the best therapeutic approach. With complex problems it is advisable to consult with a therapist who has training in more than one modality. As Abraham Maslow famously observed "if all you have is a hammer, everything looks like a nail". A well trained therapist ought to have a tool box of evidence based therapies at their disposal and make a careful selection after considering the problem.

Many people seek some kind of psychological or emotional support or are recommended therapy when they confront a crisis. A skilled therapist can help people through a crisis period by facilitating access to the right kind of support, helping the person mobilise effective coping strategies, and helping the person to problem solve and maintain a reasonable perspective on events. Sometimes just getting through a difficult time is all the person wants and needs. Psychotherapy is the next step after a crisis towards recovery.

Choosing a therapy that resonates with your needs, values, and goals is a vital step toward personal growth and healing. With many different approaches available, each therapy type offers unique insights and techniques that cater to various aspects of human experience—whether that’s managing symptoms, fostering deeper self-understanding, or enhancing relationships. On this page, we’ll guide you through an overview of popular psychotherapies, from Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) to humanistic, psychodynamic, and integrated approaches. Understanding how each therapy formulates problems, sets goals, and frames the therapist-client relationship can help you make an informed choice and feel confident in your path forward.

Psychodynamic Therapy

Problem Formulation: Psychodynamic therapy views problems as originating from unconscious conflicts, unresolved childhood experiences, and the influence of past relationships on current behavior. Symptoms are often seen as manifestations of deeper, unrecognized emotional issues and internal conflicts.

Goals of Therapy: The goal is to achieve insight into unconscious processes, work through unresolved emotional conflicts, and understand the influence of past experiences on present behaviors and relationships. By bringing these insights to the surface, clients can achieve greater emotional freedom and healthier functioning.

Client’s Work: Clients engage in free association, exploring dreams, and examining recurring patterns in relationships and behaviors. This process involves self-reflection and becoming more aware of defenses, transference, and unconscious motivations.

Therapist’s Stance: The therapist takes a neutral, non-directive stance, often adopting a more reserved approach to allow clients to explore freely. They serve as an interpreter, helping clients uncover hidden meanings and unconscious motivations, often through analysis of the therapeutic relationship itself (transference and countertransference).

Humanistic Therapy

Problem Formulation: Humanistic therapy views psychological issues as stemming from a lack of self-acceptance, authenticity, or disconnection from one’s true self. Problems arise when individuals are unable to reach their full potential or when they adopt external values and expectations that don’t align with their own sense of self.

Goals of Therapy: The primary goal is self-actualization—helping clients become more authentic, self-aware, and accepting of themselves. This approach focuses on personal growth, self-acceptance, and fulfilling one’s innate potential.

Client’s Work: Clients are encouraged to explore their thoughts, feelings, and values openly, often through self-reflection and exploration of their own experiences. The work emphasizes increasing self-compassion and self-acceptance.

Therapist’s Stance: The therapist adopts a non-directive, empathic, and non-judgmental stance. They provide unconditional positive regard, empathic understanding, and authenticity (congruence) to create a safe and supportive therapeutic environment. This relationship is viewed as the primary healing force in therapy, fostering self-acceptance and growth.

Cognitive Behavioral Therapy (CBT)

Problem Formulation: CBT views psychological issues as stemming from unhelpful or distorted thinking patterns, maladaptive behaviors, and dysfunctional beliefs. These cognitive distortions impact emotions and actions, reinforcing the problem.

Goals of Therapy: The primary goal is to help clients identify and change negative thought patterns and behaviors, leading to healthier emotional responses and behaviors.

Client’s Work: The client actively engages in identifying and challenging cognitive distortions, completing homework (e.g., thought records, behavior experiments), and practicing new skills.

Therapist’s Stance: The therapist takes an active, structured, and directive role, working collaboratively with the client as a “coach” to guide the cognitive restructuring process.

Dialectical Behavior Therapy (DBT)

Problem Formulation: DBT understands problems as arising from emotional dysregulation, often due to a combination of biological sensitivity and an invalidating environment. It addresses behaviors like self-harm, suicidal ideation, and extreme emotional reactivity.

Goals of Therapy: Goals are to develop mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness, with an overarching aim of achieving a balanced life.

Client’s Work: The client learns and practices specific skills, often through skills training groups, and applies these skills in real-life situations to manage emotional distress.

Therapist’s Stance: The therapist maintains a validating and accepting stance while challenging the client toward change, balancing acceptance and change principles. Therapists use a team approach, often receiving support from peers due to the emotionally intensive nature of DBT.

Acceptance and Commitment Therapy (ACT)

Problem Formulation: ACT conceptualizes problems as the result of experiential avoidance, cognitive fusion, and lack of values-based action. Suffering arises from efforts to avoid difficult emotions, thoughts, and sensations rather than accepting them.

Goals of Therapy: The main goal is to increase psychological flexibility, enabling clients to live in alignment with their values even in the presence of painful experiences.

Client’s Work: Clients practice mindfulness, cognitive defusion, acceptance, and committed action towards values-driven goals. Exercises often include metaphors and experiential activities to shift the relationship with thoughts and emotions.

Therapist’s Stance: The therapist acts as a guide, helping the client discover values, cultivate mindfulness, and practice acceptance. The stance is compassionate and collaborative, with an emphasis on the present moment.

Existential Psychotherapy

Problem Formulation: Existential therapy sees problems as stemming from inherent human struggles such as fear of death, isolation, freedom, and the search for meaning. Anxiety, meaninglessness, and inner conflict are central issues.

Goals of Therapy: The primary goal is to help clients confront and understand existential anxieties, find personal meaning, and live authentically with greater self-awareness and acceptance of life’s uncertainties.

Client’s Work: Clients engage in self-reflection, explore life’s “big questions,” and work toward finding or creating personal meaning and purpose in their lives.

Therapist’s Stance: The therapist adopts a deeply respectful, authentic, and empathic stance, acting as a fellow traveler who helps the client explore life’s fundamental issues, with a focus on depth and understanding rather than symptom reduction.

Eye Movement Desensitization and Reprocessing (EMDR)

Problem Formulation: EMDR conceptualizes psychological distress as resulting from unprocessed traumatic memories that are stored dysfunctionally in the brain. These unprocessed memories contain emotions, beliefs, and physical sensations linked to past experiences, which are re-triggered in the present, leading to symptoms of PTSD, anxiety, or other psychological issues.

Goals of Therapy: The goal of EMDR is to help clients reprocess traumatic memories, reducing their emotional charge and integrating them into adaptive memory networks. This process aims to decrease distress associated with past trauma and alleviate trauma-related symptoms.

Client’s Work: Clients focus on specific traumatic memories, including the associated images, emotions, and bodily sensations, while following bilateral stimulation (typically side-to-side eye movements). Over time, clients are guided to reprocess the memory, often finding that it loses its emotional intensity and is reframed in a more adaptive way.

Therapist’s Stance: The therapist takes an active, structured role, following a standardized eight-phase protocol. They provide a safe and supportive presence, guiding the client through the reprocessing phases and helping them manage any distressing emotions that arise during the sessions. EMDR therapists are trained to ensure the process remains grounded and contained, helping clients move through intense memories safely.

Systemic Family Therapy

Problem Formulation: Systemic therapy views problems as relational and interconnected, arising from patterns of interaction within the family or social system rather than residing within an individual.

Goals of Therapy: The goals focus on changing patterns of communication and interaction within the family or system to create healthier and more adaptive dynamics.

Client’s Work: Family members work on developing new communication styles, understanding their roles, and interacting in ways that promote healthier relationships.

Therapist’s Stance: The therapist takes a neutral, non-blaming stance, working as an observer and facilitator to understand patterns within the system and help the family recognize and alter dysfunctional dynamics.

Solution-Focused Therapy

Problem Formulation: Solution-focused therapy avoids in-depth problem analysis, instead focusing on solutions and the client’s strengths. It views problems as temporary and solvable with a focus on what works well.

Goals of Therapy: The goal is to quickly identify solutions, emphasize existing strengths, and build upon past successes to solve present issues and achieve desired outcomes.

Client’s Work: Clients identify their goals and collaborate on finding practical, small steps toward those goals, often using techniques like the Miracle Question and scaling.

Therapist’s Stance: The therapist adopts a collaborative, future-focused stance, working as an encourager who helps the client identify strengths and amplify what is already working in their lives. The therapist avoids delving into deep-rooted issues, instead focusing on immediate change.

Couples Therapy

Problem Formulation: Couples therapy views issues as stemming from dysfunctional communication patterns, unmet needs, attachment insecurities, and relational dynamics rather than as isolated individual issues. Problems may arise from conflicting expectations, poor conflict management, or past hurts within the relationship.

Goals of Therapy: The primary goal is to improve communication, rebuild trust, enhance intimacy, and address relational issues. Specific goals depend on the couple’s unique concerns, whether those are conflict resolution, increasing emotional closeness, or co-parenting effectively.

Client’s Work: Each partner works on self-awareness, active listening, expressing needs more constructively, and taking responsibility for their part in relational dynamics. Partners may also work on increasing empathy and fostering emotional responsiveness.

Therapist’s Stance: The therapist serves as a neutral mediator and facilitator, helping each partner to feel heard, understand each other’s perspectives, and learn effective communication strategies. Techniques and approaches vary widely, from emotionally-focused therapy (EFT) to Gottman Method and Imago Therapy, with therapists adapting to the needs of the couple.

Integrated (or Integrative) Psychotherapy

Problem Formulation: Integrated psychotherapy is flexible, drawing from multiple therapeutic approaches to address psychological issues based on the specific needs and context of the client. Problems are viewed in a holistic way, acknowledging that they may stem from various sources, including cognitive patterns, emotional experiences, relational dynamics, or past trauma.

Goals of Therapy: The goals are tailored to each client, aiming for symptom relief, improved functioning, and overall well-being. Integrated therapists work with clients to establish individualized goals, which may involve cognitive, emotional, relational, or behavioral changes.

Client’s Work: Clients work on self-exploration, behavioral changes, emotional regulation, or other tasks depending on their unique needs. The work may include techniques from CBT, psychodynamic therapy, mindfulness, and other approaches, with interventions designed to fit each client’s preferences and goals.

Therapist’s Stance: The therapist takes a flexible, collaborative, and client-centered stance, adapting their approach to best suit the client’s issues, personality, and therapeutic goals. They may draw on a range of therapeutic techniques, integrating them in a cohesive way to provide a more personalized and holistic treatment.