What is Psychotherapy? How Does Psychotherapy Work?

What is psychotherapy? How can it help me?

Psychotherapy is an interpersonal, relational intervention used by trained psychotherapists to aid clients in problems of living. This usually includes increasing individual sense of well-being and reducing subjective discomforting experience. Psychotherapists employ a range of techniques based on experiential relationship building, dialogue, communication and behavior change and that are designed to improve the mental health of a client or patient, or to improve group relationships (such as in a family). Psychotherapy may be performed by practitioners with a number of different qualifications, including psychologists, marriage and family therapists, licensed clinical social workers, counselors, psychiatric nurses, and psychiatrists.

Millions of Americans have found relief from depression and other emotional difficulties through psychotherapy. Even so, some people find it hard to get started or stay in psychotherapy. This brief question-and-answer guide provides some basic information to help individuals take advantage of outpatient (non-hospital) psychotherapy.

Why do people consider using psychotherapy?

Psychotherapy is a partnership between an individual and a licensed professional trained to help people understand their feelings and assist them with changing their behavior. According to the National Institute of Mental Health, one-third of adults in the United States experience an emotional or substance abuse problem. Nearly 25 percent of the adult population suffers at some point from depression or anxiety.

People often consider psychotherapy, also known simply as therapy, under the following circumstances:

  • They feel an overwhelming and prolonged sense of sadness and helplessness, and they lack hope in their lives.
  • Their emotional difficulties make it hard for them to function from day to day. For example, they are unable to concentrate on assignments and their job performance suffers as a result.
  • Their actions are harmful to themselves or to others. For instance, they drink too much alcohol and become overly aggressive.
  • They are troubled by emotional difficulties facing family members or close friends.

What does research show about the effectiveness of psychotherapy?

Research suggests that therapy effectively decreases patients' depression and anxiety and related symptoms- such as pain, fatigue and nausea. Psychotherapy has also been found to increase survival time for heart surgery and cancer patients, and it can have a positive effect on the body's immune system. Research increasingly supports the idea that emotional and physical health are very closely linked and that therapy can improve a person's overall health status.

There is convincing evidence that most people who have at least several sessions of psychotherapy are far better off than untreated individuals with emotional difficulties. One major study showed that 50 percent of patients noticeably improved after eight sessions while 75 percent of individuals in therapy improved by the end of six months. Psychotherapy with children is similar in effectiveness to psychotherapy with adults.

If I begin psychotherapy, how should I try to gain the most from it?

There are many approaches to outpatient psychotherapy and various formats in which it may occur, including individual, group and family psychotherapy. Despite the variations, all psychotherapy is a two-way process that works especially well when patients and their therapists communicate openly. Research has shown that the outcome of psychotherapy is improved when the therapist and patient agree early about what the major problems are and how psychotherapy can help.

You and your therapist both have responsibilities in establishing and maintaining a good working relationship. Be clear with your therapist about your expectations and share any concerns that may arise. Psychotherapy works best when you attend all scheduled sessions and give some forethought to what you want to discuss during each one.

How can I evaluate whether therapy is working well?

As you begin psychotherapy, you should establish clear goals with your therapist. Perhaps you want to overcome feelings of hopelessness associated with depression. Or maybe you would like to control a fear that disrupts your daily life. Keep in mind that certain tasks require more time to accomplish than others. You may need to adjust some of your goals depending on how long you plan to be in psychotherapy.

After a few sessions, it's a good sign if you feel the experience is truly a joint effort and that you and the therapist enjoy a good rapport. On the other hand, you should be open with your therapist if you find yourself feeling "stuck" or lacking direction once you've been in psychotherapy awhile.

There may be times when a therapist appears cold and uninterested or doesn't seem to regard you positively. Tell your therapist if this is the situation, or if you question other aspects of his or her approach. If you find yourself thinking about discontinuing psychotherapy, talk with your therapist. It might be helpful to consult another professional, provided you let your therapist know you are seeking a second opinion.

Patients often feel a wide range of emotions during psychotherapy. Some qualms about psychotherapy that people may have result from the difficulty of discussing painful and troubling experiences. When this happens, it can actually be a positive sign indicating that you are starting to explore your thoughts and behaviors.

You should spend time with your therapist periodically reviewing your progress (or your concern that you are not making sufficient headway). Although there are other considerations affecting the duration of psychotherapy, success in reaching your primary goals should be a major factor in deciding when your psychotherapy should end.

Psychotherapy isn't easy, but patients who are willing to work in close partnership with their therapists often find relief from their emotional distress and begin to lead more productive and fulfilling lives.