If you’ve been thinking about starting therapy, you may not know all your options — or you may feel confused by them. Choosing a therapist, and figuring out which type of therapy actually fits your situation, can start to feel like a chore. For a lot of people, that confusion is exactly the reason therapy keeps getting postponed, even though it’s something that can dramatically improve your life.

Therapists and counselors have extensive training in mental health techniques and mental health issues, and they work collaboratively with clients to decide which interventions to use based on shared goals. There are several types of mental health providers and several families of therapy, and knowing the differences can help you figure out which one best fits your particular needs. Here’s a breakdown.

Not all mental health providers are the same, and the differences affect cost and access

If you’re looking for the right kind of provider, it helps to know what’s actually available and how these roles differ. In most states, the most common types of mental health providers are licensed mental health counselors (LMHCs), licensed clinical social workers (LCSWs or LMSWs), psychologists, and psychiatrists.¹ Training and licensing requirements vary by state, but the basic distinctions below hold up almost everywhere.

Mental health counselors and social workers typically hold a master’s degree. There’s some difference in training focus between the two, but far more overlap than most people expect, and both are common in community mental health settings.

Psychologists hold a doctorate — a PhD or PsyD. Their training is more extensive, but they’re also typically more expensive and less likely to accept insurance directly, though many work on a sliding scale based on income. Psychologists tend to be harder to find outside of larger population centers; counselors and social workers are more likely to staff the community clinics that accept a wider range of insurance, including Medicaid.

Psychiatrists are medical doctors who specialize in psychiatry. Alongside psychotherapy, they can prescribe and manage medication as part of a course of treatment.¹

Once you’ve picked a provider, the next decision is which therapeutic approach fits

There are a great many different approaches to therapy, and they vary widely in method — some are proven especially effective for specific issues.² The first decision is usually the format: individual counseling, couples counseling, group therapy, child or adolescent therapy, or marriage and family therapy. From there, you can think about which method, or combination of methods, suits you best. Once you begin, your therapist may recommend a different approach depending on your diagnosis — but the options below are a good starting point.

Cognitive Behavioral Therapy (CBT): a short-term, skills-based approach for a wide range of issues

CBT is one of the most widely used forms of therapy.³ It’s typically structured, with each session building a specific skill over the course of treatment, and it teaches clients to notice and interrupt unhelpful thought patterns in order to change behavior. CBT is very present-focused, and while it’s often used for depression and anxiety, it’s been shown effective across a wide range of mental health issues.

One of CBT’s main advantages is that it’s usually time-limited rather than open-ended — typical courses run six to twelve weeks — which makes it a practical choice if your insurance only covers a set number of sessions. There are also adapted versions for specific issues, including trauma-focused CBT and mindfulness-based CBT.

Dialectical Behavior Therapy (DBT): built for intense, all-or-nothing patterns of thought and emotion

DBT has grown steadily in use since its development in the late 1980s.⁴ It was originally designed to treat borderline personality disorder — a pervasive pattern of thoughts, emotions, and relationship patterns that touches nearly every part of a person’s life. DBT has a strong mindfulness component and is built to help people who tend to think in strict black-and-white terms, with the goal of learning to tolerate the mixed, imperfect reality of both other people and themselves.

DBT is especially well-supported for borderline personality disorder, a history of trauma, and bipolar disorder, and it’s sometimes used in treating eating disorders as well.

EMDR: using guided eye movements to help the brain reprocess a stuck memory

Eye Movement Desensitization and Reprocessing (EMDR) is a structured therapy built specifically around traumatic and other distressing memories.⁶ While a client briefly focuses on a difficult memory, the therapist guides a specific pattern of eye movements (or another form of bilateral stimulation, like tapping). The idea is that this helps the brain “reprocess” the memory so it’s no longer as emotionally intense or intrusive — without requiring the client to describe the event in detail or complete homework between sessions, which sets it apart from CBT.

EMDR has a strong evidence base specifically for PTSD and other trauma-related conditions, and it’s often used alongside, or as an alternative to, trauma-focused CBT.

Psychodynamic Psychotherapy: a longer, deeper look at where your patterns came from

Psychodynamic therapy takes a very different approach from CBT or DBT. It examines early-life experiences and how the behavioral, thought, and relationship patterns learned then continue to shape adult life, building insight into why we act the way we do. That insight is the mechanism of change: understanding the pattern is what makes it possible to shift it. It tends to be more time-intensive than CBT, but research has found it produces durable gains that continue to grow even after treatment ends.⁵

Integrative Therapy: combining approaches to fit the person, not the method

Integrative (sometimes called eclectic) therapy combines elements of multiple approaches, chosen for what will work best for a particular person and problem rather than sticking to a single method throughout.² It’s well suited to a tailored approach built around an individual’s specific needs and goals. Other approaches worth knowing about include humanistic therapy, solution-focused therapy, and interpersonal therapy.

Intensive Trauma-Focused Therapy (ITFT): a compressed, retreat-style format for more entrenched trauma

Most of the approaches above are delivered in the familiar weekly-session format. Intensive Trauma-Focused Therapy takes an established trauma treatment and compresses it into a short, concentrated block of time — sometimes a few consecutive days — instead of stretching it across months of once-a-week visits.⁷ Research on this intensive format has found it can be as effective as the same treatment delivered in conventional weekly sessions, while producing faster results with less dropout.

It’s a less widely available option than CBT or EMDR, and it’s not the right fit for everyone, but it’s worth knowing about if weekly therapy hasn’t been enough on its own. It’s also the treatment model behind the trauma-focused program Stop Abuse Campaign helped develop with the Trauma Institute for justice-involved adults in Monroe County.

Taking the first step matters more than getting it perfect

Starting therapy is one of the most important things you can do for your health and your life overall. If you need help finding and choosing the right therapist, our companion post on how to choose a therapist walks through what to ask before your first session. And if you’re not sure where you stand, taking the ACE test is a good place to start understanding what you may be carrying and why the right kind of support matters.

Knowing your options is the first step toward finding the right course of action for your specific situation. We hope this has helped.