Types of therapists

Originally Published: May 16, 2008
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Dear Alice,

I'm thinking about seeking therapy for my anxiety and I was wondering if you could talk about the different types of therapists out there. I know the difference between psychologists and psychiatrists is a psychologist didn't go through med-school and so can't perscribe drugs, but what about cognative-behavior therapists verses... well, whatever else is out there?

Thanks!
Thinkin' about Therapy

Dear Thinkin' about Therapy,

Good for you for considering seeking professional help in dealing with your anxiety. There are a lot of different options out there and you want to make sure you seek a treatment that will work for you.

You're right that psychologists have received graduate training in psychology, usually obtaining a Ph.D or Psy.D in clinical or counseling psychology. Psychiatrists first go through medical school and obtain an M.D., then complete an additional 4-year residency training in mental health. As medical doctors, they may prescribe medications to assist in treating patients.

Mental health professionals may practice a number of different kinds of therapy, such as cognitive therapy, and, for example, may call themselves cognitive behavioral therapists. Some of the more common types of therapy include:

  • Psychotherapy (a.k.a. talk therapy, counseling, or just therapy) is a general term referring to treating mental and emotional disorders by talking with a mental health professional.
  • Behavior therapy focuses on modifying and gaining control over unwanted behavior. A focus of behavior therapy is giving the individual control over his/her life.
  • Cognitive therapy focuses on changing unproductive or upsetting thoughts and feelings. The therapist helps the patient examine his/her thoughts and feelings in order to identify unrealistic and intrusive thoughts.
  • Cognitive-Behavioral therapy (CBT) is a combination of cognitive and behavior therapies.
  • Dialectical behavior therapy (DBT) is a type of CBT that teaches the patient skills to help tolerate stress, regulate emotions, and improve relationships.
  • Exposure therapy is a kind of behavior therapy where the patient is exposed to stimuli that s/he has identified as upsetting or disturbing. Exposure therapy may be used with mental health disorders such as obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).
  • Interpersonal therapy focuses on the patient's relationships with others with the goal of improving interpersonal skills.
  • Psychoanalysis, made famous by Freud, is a type of therapy where the patient examines past events, feelings and memories to understand how they shape her/his life today. Psychoanalysis is a long-term approach to therapy, usually lasting a few years.
  • Psychodynamic psychotherapy is like traditional psychotherapy, but focuses on becoming aware of unconscious thoughts and behaviors to help the patient understand his/her own motivation.

As you can see, there are a lot of options out there. Before you choose a therapist you may want to ask trusted friends and family for recommendations. If that doesn't work, check out How to find a therapist. Columbia students may go to Counseling and Psychological Services for short-term therapy available on campus and/or a referral for longer-term counseling or therapy (call x4-2878 for an appointment).

In addition to your search, you may want to call potential therapists to ask about therapy techniques. Some questions to consider include:

  • What kind of training does s/he have in treating anxiety disorders (or whatever concern you have)?
  • What is his/her approach to treatment?
  • Can s/he prescribe medication or refer to someone who can?
  • How long is the course of treatment? How long is each individual session?
  • Are family members asked to participate in therapy sessions?
  • What kind of insurance s/he accepts

Perhaps the most important question is one you have to ask yourself — do you feel comfortable talking to your therapist? Being able to be open and honest about your feelings is key in each of these types of therapy, so it's definitely worth spending the extra time to find someone who is a good fit (and has a comfortable couch. Just kidding!).

Good luck with your search, and in moving from "thinkin' about therapy" to doing something about it.
Alice