payment page
There are many different types of treatment for psychological disorders, all of which fit into three broad types: insight therapies, behavior therapies, and biomedical therapies.
Insight therapies involve complex conversations between therapists and clients. The aim is to help clients understand the nature of their problems and the meaning of their behaviors, thoughts, and feelings. Insight therapists may use a variety of approaches, including psychodynamic, cognitive, or humanistic.
Behavior therapies also involve conversations between therapists and clients but attempt to directly influence maladaptive behaviors. Behavior therapies are based on learning principles.
Biomedical therapies involve efforts to directly alter biological functioning through medication, electric shock, or surgery.
Psychotherapy
Psychotherapy is the treatment of psychological problems through confidential verbal communications with a mental health professional. All psychotherapies offer hope that a problem will improve, present new perspectives on the problem, and encourage an empathic relationship with a therapist. The approach a psychotherapist uses depends on his or her theoretical orientation. Types of approaches include psychodynamic, cognitive, humanistic, and behavioral.
Types of Mental Health Professionals
Clinical and counseling psychologists have a doctoral degree as well as specialized training for diagnosing and treating psychological disorders and problems of daily living.
Psychiatrists are physicians. They have a medical degree and specialize in diagnosing and treating psychological disorders. Psychiatrists tend to focus on biomedical therapies, although they sometimes also provide psychotherapy.
Psychiatric social workers and psychiatric nurses also provide psychotherapy, often in institutional settings such as hospitals and social service organizations. They sometimes practice independently as well.
Counselors who provide psychotherapy services usually work in schools, colleges, and social service organizations.
Research on the Treatment of Psychological Disorders
Research into the treatment of psychological disorders consistently demonstrates the effectiveness of psychotherapy, particularly when interventions are tailored to the individual’s needs and grounded in scientific evidence. Meta-analytic studies, which combine data from multiple research studies, conclude that psychotherapy is generally effective in improving mental health outcomes. Clients undergoing therapy often show significant improvements compared to untreated individuals.
A key factor in the success of psychotherapy is the use of evidence-based interventions. These are treatment methods grounded in empirical research and proven to be effective for specific disorders. For example, cognitive behavioral therapy (CBT) is widely used for diagnoses such as anxiety, depression, and obsessive-compulsive disorder, while trauma-focused therapies such as exposure therapy are recommended for post-traumatic stress disorder (PTSD) and phobias.
To further enhance the effectiveness of therapy, therapists are encouraged to practice cultural humility. This involves acknowledging and respecting the client’s cultural background, values, and beliefs and being open to learning from the client’s perspective. Cultural humility helps build rapport and ensures that the therapy process is inclusive and responsive to the client’s unique context.
Another key focus in psychotherapy research is the importance of the therapeutic alliance – the collaborative relationship between the therapist and client. Studies show that a strong therapeutic alliance, characterized by trust, mutual respect, and shared goals, is one of the most significant predictors of successful treatment outcomes.
Trends in treatment also highlight the role of technology, with the rise of teletherapy and digital mental health tools expanding access to care. Online platforms and apps for therapy, self-monitoring, and skill-building are becoming increasingly common, especially in response to barriers such as geographic location or stigma associated with seeking help in person.
Treatment Trends
Two current trends that affect the treatment of psychological disorders are managed care and deinstitutionalization.
Managed care is an arrangement in which an organization, such as a health maintenance organization (HMO), acts as an intermediary between a person seeking health care and a treatment provider. People buy insurance plans from HMOs and then pay only a small copayment each time they get healthcare services. Prior to managed care, health care was done through fee-for-service arrangements. In fee-for-service arrangements, people pay for any health care services they believe they need. They may then be reimbursed by insurance companies or government health care programs, such as Medicaid and Medicare.
The advantages of managed care are that consumers pay lower fees to providers and that money is not usually spent on medically unnecessary services.
Criticisms of Managed Care: Managed care systems have many critics who argue that HMOs compromise the quality of health care in the following ways:
- Consumers are often denied treatment they need, or the length of treatment is inappropriately limited.
- Managed care creates barriers to accessing health care services by requiring people to get referrals through their primary care providers or by authorizing only a small number of therapy sessions at a time.
- Because of cost issues, the professionals who provide treatment are often less well-trained to treat severe disorders. For example, they may be counselors with master’s degrees rather than doctoral-level psychologists or psychiatrists.
- Physicians might be required to prescribe older, less effective drugs rather than new drugs to keep costs down.
- Clients’ confidentiality may be threatened because HMOs require therapists to disclose details about the clients’ problems in order to have treatment authorized.
The Community Mental Health Movement
In the past, people with psychological disorders typically received inpatient treatment at mental hospitals, or medical institutions that specialize in providing such treatment. In the 1950s, however, it began to be clear that mental hospitals often made psychological problems worse instead of better. Mental hospitals were very crowded and had few properly-trained professionals, and they were often in less-populated areas, giving patients little access to their friends and families for support.
In the 1950s, the community mental health movement started. This movement advocated treating people with psychological problems in their own communities, providing treatment through outpatient clinics, and preventing psychological disorders before they arose.
Because of the community mental health movement, deinstitutionalization became popular.
Deinstitutionalization refers to providing treatment through community-based outpatient clinics rather than inpatient hospitals. Although people are still hospitalized for serious psychological problems, inpatient stays are usually relatively short and occur in psychiatric wings of general hospitals, rather than in mental hospitals far away from people’s communities.
Advantages of deinstitutionalization: Treatment at outpatient clinics is less costly than inpatient care and often just as effective. Also, people often prefer the freedom of community-based treatment to inpatient hospitals.
Disadvantages of deinstitutionalization: It has contributed to homelessness, since some people released from inpatient facilities have nowhere to go. Also, it has led to what is referred to as a “revolving door” population of chronically mentally ill people who are periodically hospitalized, released, and re-hospitalized.
Ethical Principles
Psychologists working in clinical or therapeutic settings must follow strict ethical principles established by the American Psychological Association (APA). These principles guide professional conduct, ensuring that psychologists act in ways that promote the well-being, dignity, and rights of their clients. The key principles include nonmaleficence, fidelity, integrity, and respect for people’s rights and dignity.
Nonmaleficence: Psychologists are required to avoid causing harm to their clients. This principle emphasizes the importance of minimizing physical, emotional, and psychological harm during therapy or intervention. For example, psychologists must carefully consider the potential negative consequences of their methods and ensure that the benefits outweigh any risks.
Fidelity: This principle focuses on trustworthiness and responsibility. Psychologists must establish and maintain a trusting relationship with their clients by being honest, dependable, and committed to confidentiality (within legal and ethical limits). Fidelity also involves following through on professional commitments and acting in the best interest of the client.
Integrity: Psychologists must uphold high standards of honesty and accuracy in their professional work. This includes being truthful about their qualifications, avoiding deceptive practices, and ensuring that the information they provide to clients is reliable and evidence-based. Integrity helps maintain the credibility of the profession and the therapeutic process.
Respect for People’s Rights and Dignity: Psychologists must honor and protect the inherent worth, autonomy, and rights of every individual. This includes respecting clients’ privacy, cultural backgrounds, personal values, and beliefs. Psychologists must also obtain informed consent before beginning treatment and ensure that clients fully understand their rights and the nature of the therapeutic process.
These ethical principles form the foundation of effective and compassionate clinical practice. They not only protect clients, but also ensure that psychologists act with professionalism and accountability.
Psychodynamic Therapies
Psychodynamic therapy focuses on uncovering unconscious thoughts, feelings, and conflicts that influence behavior. Rooted in the work of Sigmund Freud, this approach aims to bring unconscious mental content to conscious awareness, allowing clients to gain insight into their past experiences and unresolved issues. Some techniques commonly used in psychoanalysis include free association, dream analysis, and interpretation.
Free Association: Psychoanalysts encourage clients to say anything that comes to mind. Clients are expected to put all thoughts into words, even if those thoughts are incoherent, inappropriate, rude, or seemingly irrelevant. Free associations reveal the client’s unconscious to the psychoanalyst.
Dream Analysis: Dreams also reveal the subconscious. In psychodynamic therapy, clients are asked to recall and describe their dreams. The therapist works with the client to analyze the content of the dream, distinguishing between the manifest content (the literal events of the dream) and the latent content (the symbolic, hidden meanings). For example, a dream about being trapped might reflect feelings of being stuck in a relationship or career. By interpreting dreams, therapists help clients uncover unconscious conflicts or desires that may be influencing their emotions and behavior.
Interpretation: A key technique in psychoanalysis, interpretation refers to the psychoanalyst’s efforts to uncover the hidden meanings in the client’s free associations, dreams, feelings, memories, and behavior. Psychoanalysts are trained to make interpretations carefully and only when a client is ready to accept them. Ideally, such interpretations increase the client’s insight.
Psychodynamic techniques are particularly useful for exploring deep-seated emotional issues and gaining insight into the connections between past experiences and present behavior.
Cognitive Therapies
Cognitive therapies aim to identify and change maladaptive thinking patterns that can result in negative emotions and dysfunctional behavior. Psychologist Aaron Beck first developed cognitive therapy to treat depression, although cognitive therapies are now used to treat a wide range of disorders. Beck’s cognitive therapy helps clients test whether their beliefs are realistic. Cognitive therapists such as Beck believe that depression arises from errors in thinking. According to this theory, depressed people tend to do any of the following:
- Blame themselves for negative events (They underestimate situational causes.)
- Pay more attention to negative events than positive ones
- Are pessimistic
- Make inappropriately global generalizations from negative events
Cognitive therapy employs techniques such as cognitive restructuring and fear hierarchies to help individuals replace unhelpful thoughts with more balanced and constructive ones. Additionally, the cognitive triad provides a framework for understanding the core areas where negative thinking often occurs.
Cognitive Restructuring
Cognitive restructuring is a technique used to challenge and change distorted or irrational thoughts. Clients learn to identify automatic negative thoughts that arise in response to specific situations, such as “I’m a failure” or “No one likes me.” Through work with a therapist, these thoughts are evaluated for accuracy and replaced with more rational alternatives. For example, individuals who believe they will fail an exam might reframe their thought to, “I can prepare thoroughly and improve my chances of doing well.” This process helps clients develop a healthier and more adaptive perspective, reducing emotional distress and improving behavior.
Fear Hierarchies
Though often associated with exposure therapy, fear hierarchies can be incorporated into cognitive therapy to address specific anxieties or phobias. Individuals create a graded list of feared situations, starting with those that cause mild anxiety and progressing to more distressing scenarios. For example, someone with a fear of public speaking might begin by imagining speaking in front of a small group and work toward giving a presentation to a large audience. By gradually confronting these fears, individuals learn to challenge irrational beliefs and gain confidence in their ability to cope.
The Cognitive Triad
The cognitive triad is a central concept in cognitive therapy, particularly for treating depression. It identifies three core areas of negative thinking that often reinforce one another:
Negative thoughts about oneself: Viewing oneself as inadequate or unworthy (e.g., “I’m not good enough”).
Negative thoughts about the world: Believing the world is unfair or overly challenging (e.g., “Nothing ever works out for me”).
Negative thoughts about the future: Expecting failure or disappointment in the future (e.g., “Things will never get better”).
Therapists work with clients to identify patterns in the cognitive triad and challenge these distorted beliefs, encouraging clients to adopt a more optimistic and realistic outlook.
Applied Behavior Analysis and Conditioning-Based Therapies
Applied behavior analysis (ABA) involves the systematic application of conditioning principles to modify behavior and improve outcomes in individuals with mental disorders or developmental disabilities. By targeting specific behaviors, ABA helps individuals learn adaptive skills or reduce maladaptive behaviors. Several therapeutic approaches, including exposure therapies, aversion therapies, token economies, and biofeedback, use these principles to address a wide range of psychological and physiological obstacles.
Exposure therapies, such as systematic desensitization, use classical conditioning to help individuals reduce anxiety responses to specific stimuli. In systematic desensitization, a person is gradually exposed to a feared object or situation while practicing relaxation techniques, breaking the association between the stimulus and the anxiety response. For example, someone with a phobia of spiders might start by imagining a spider and eventually progress to being in the same room as one while maintaining a calm state.
Aversion therapies use classical conditioning to discourage harmful behaviors by associating them with an unpleasant stimulus. For instance, individuals with substance use disorders may be given a medication that induces nausea when combined with alcohol, creating a negative association with drinking. Many doctors and psychologists criticize aversion therapy as both inhumane and ineffective. Therapists have sometimes used aversion therapy for controversial ends. For example, in the past, therapists used aversion therapy to “treat” homosexuality. While controversial, aversion therapy is used selectively and can be effective in addressing certain maladaptive behaviors.
Token economies use operant conditioning to reinforce desired behaviors by providing tokens or points that can be exchanged for rewards. This technique is often used in settings such as schools, hospitals, or group homes to encourage adaptive behaviors. For example, children with developmental disabilities might earn tokens for completing tasks, following instructions, or displaying prosocial behavior, which they can later trade for privileges or tangible rewards.
Biofeedback uses conditioning principles to help individuals regulate their physiological responses, such as heart rate, muscle tension, or breathing, which are often influenced by the sympathetic and parasympathetic nervous systems. Individuals are connected to devices that provide real-time feedback about their physiological states, enabling them to practice controlling these responses. For example, someone experiencing anxiety might learn to lower their heart rate or practice deep breathing to reduce symptoms. Over time, these self-regulation techniques help individuals manage the physiological symptoms of anxiety or depression more effectively.
Cognitive Behavioral Therapies
Cognitive behavioral therapies (CBT) are a group of evidence-based treatments that integrate techniques from both cognitive and behavioral perspectives to address mental and behavioral disorders. These therapies focus on identifying and modifying maladaptive thought patterns (cognitive processes) while simultaneously encouraging behavioral changes that promote healthier coping strategies and improved functioning. Two key approaches of CBT are dialectical behavior therapy (DBT) and rational emotive behavior therapy (REBT).
Originally developed to treat borderline personality disorder (BPD), dialectical behavior therapy (DBT) is now used for a variety of mental health conditions, including emotion regulation issues, self-harm, and eating disorders. DBT incorporates elements of CBT while emphasizing mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness. Key components of DBT include:
Mindfulness practices to help individuals remain present and nonjudgmental about their experiences.
Distress tolerance skills to manage acute emotional crises without resorting to harmful behaviors.
Emotion regulation techniques to reduce the intensity of overwhelming emotions.
Interpersonal effectiveness skills to improve communication and relationships.
Dialectical behavior therapy (DBT) is based on the principle of dialectics, which balances acceptance of the individual’s current situation with efforts to change problematic behaviors and thought patterns.
Developed by Albert Ellis, rational emotive behavior therapy (REBT) focuses on identifying and disputing irrational beliefs that lead to emotional distress and maladaptive behaviors. According to Ellis, these irrational beliefs are often rooted in absolute thinking such as “I must always succeed” or “Others must always treat me fairly.” Key steps in REBT include:
- Identifying irrational beliefs that underlie negative emotions or behaviors.
- Challenging these beliefs through disputation and logical reasoning.
- Replacing irrational beliefs with rational alternatives that lead to healthier emotional and behavioral responses.
For example, someone experiencing anxiety about public speaking might replace the belief, “I must be perfect, or everyone will judge me,” with “It’s okay to make mistakes, and people are generally understanding.”
CBT techniques, including DBT and REBT, are widely used to treat disorders such as depression, anxiety, post-traumatic stress disorder (PTSD), eating disorders, and personality disorders. These therapies are highly structured, goal-oriented, and typically short-term, making them accessible and effective for a wide range of individuals. By addressing both thought patterns and behaviors, cognitive behavioral therapies provide clients with practical tools to manage their symptoms and improve their quality of life.
Humanistic Therapy
Humanistic therapies are derived from the school of humanistic psychology. Humanistic therapists try to help people accept themselves and free themselves from unnecessary limitations. The influence of humanistic therapies led to the use of the term clients, rather than patients, in referring to people who seek therapy. Humanistic therapists tend to focus on the present situation of clients rather than their past. The best-known humanistic therapy is client-centered therapy.
Client-centered therapy, or person-centered therapy, was developed by the psychologist Carl Rogers. It aims to help clients enhance self-acceptance and personal growth by providing a supportive emotional environment. This type of therapy is nondirective, which means that the therapist does not direct the course and pace of therapy. Client-centered therapists believe that people’s problems come from incongruence, or a disparity between their self-concept and reality. Incongruence arises because people are too dependent on others for approval and acceptance. When people have incongruence, they feel anxious. They subsequently try to maintain their self-concept by denying or distorting reality.
In client-centered therapy, people learn to adopt a more realistic self-concept by accepting who they are and thus becoming less reliant on the acceptance of others. To do this, therapists must be genuine, empathic, and provide unconditional positive regard, which is nonjudgmental acceptance of the client, allowing the client to explore his or her true self without fear of rejection or criticism. Client-centered therapists use active listening to show empathy by accurately mirroring, or reflecting, the thoughts and feelings of the client. They help the client to clarify these thoughts and feelings by echoing and restating what the client has said.
Group Therapy versus Individual Therapy
Group therapy and individual therapy are two distinct approaches, or formats, to therapy, each with unique benefits and applications. While both aim to improve mental health and functioning, their structure and dynamics differ significantly.
In group therapy, a therapist meets with several people at once. Psychotherapy groups usually have between four and fifteen people. The format encourages interaction among group members and uses shared experiences to promote healing and growth. Key characteristics of group therapy include:
Peer Support: Individuals benefit from hearing others’ stories, realizing they are not alone in their struggles. This shared understanding can reduce feelings of isolation and foster a sense of community.
Interpersonal Feedback: Group members provide and receive constructive feedback, which can help individuals gain new perspectives and develop healthier ways of relating to others.
Skill Practice: Group therapy often focuses on building social skills, such as assertiveness or conflict resolution, in a supportive and structured setting.
Cost-Effectiveness: Group therapy is generally more affordable than individual therapy, making it accessible to more people.
Self-help groups, such as Alcoholics Anonymous, resemble therapy groups except that they do not have a therapist. These groups allow people to feel less alone in dealing with their problems. Self-help group participants both give and receive help and can usually attend the group free of charge. Self-help groups are used very widely.
Groups may be homogeneous or heterogeneous. In homogeneous groups, all members share one or more key characteristic. For example, a group may be composed of people who are all suffering from depression or people who are between the ages of 20 and 30. Many groups are heterogeneous and contain people who differ in age, type of problem, gender, and so on.
The therapist usually screens people to determine whether they would be suitable for a group, excluding people who are likely to be highly disruptive. In the group, the therapist’s role is to promote a supportive environment, set goals, and protect the clients from harm.
Group members discuss their problems and experiences with one another and consider different ways of coping. They provide each other with acceptance, support, and honest feedback. A therapy group is a place where people can practice coping strategies and ways of relating to others. Therapy groups also help people to realize they are not alone in their suffering.
Common applications of group therapy include treating substance use disorders, social anxiety, and trauma-related conditions. Specific types of group therapy include support groups designed to provide emotional support and community, and psychoeducational groups, designed to provide education and skill building.
Privacy and Confidentiality: Individuals may feel more comfortable discussing sensitive topics in a private setting without the presence of others.
Individualized Attention: The therapist can tailor techniques and interventions specifically to the individual’s unique needs, history, and goals.
Deeper Exploration: Individual therapy allows for more in-depth exploration of personal issues, including childhood experiences, unresolved trauma, and complex emotional struggles.
Individual therapy is often preferred for individuals with conditions that require intensive or highly-specialized treatment, such as severe depression, post-traumatic stress disorder (PTSD), or personality disorders.
Hypnosis
Hypnosis is a therapeutic technique that induces a heightened state of focus and suggestibility. It is often used to help individuals manage psychological or physiological challenges. While hypnosis has shown effectiveness in specific areas, such as pain management and reducing anxiety, research does not support its use for memory retrieval or age regression.
Research indicates that hypnosis can be a useful tool for alleviating chronic pain and managing acute pain in medical procedures, such as surgeries or dental treatments. It works by helping individuals enter a deeply-relaxed state, reducing their perception of pain and improving their ability to cope with discomfort. Hypnosis is also effective in treating anxiety disorders, including phobias, generalized anxiety, and performance-related stress, as it promotes relaxation and helps reframe anxious thought patterns.
While hypnosis can influence perception and behavior, it is not reliable for certain controversial applications:
Memory Retrieval: Research shows that hypnosis does not reliably enhance memory accuracy. In fact, it may increase false memories or distortions, as individuals under hypnosis are highly suggestible and may incorporate leading questions or external cues into their recollections.
Age Regression: Claims that hypnosis can help individuals mentally “regress” to earlier stages of life (e.g., childhood or even past lives) lack scientific support. These experiences are considered imaginative constructs rather than actual re-experiencing of past events.
