Types of talking therapy: CBT, person-centred, psychodynamic and more

The main types of talking therapy in the UK include cognitive behavioural therapy (CBT), counselling, person-centred therapy, psychodynamic therapy, integrative therapy, interpersonal therapy and couples therapy. They differ in how structured they are and in whether they focus mainly on the present or also explore the past. The BACP notes that your relationship with your therapist is generally more important than the approach they use, so the right choice often depends on what you need and who you feel comfortable with.

Key points

• CBT is structured and focuses on current thoughts, feelings and behaviour, often with practice between sessions.
• Person-centred and other humanistic therapies focus on offering acceptance and understanding, with you leading the conversation.
• Psychodynamic therapy explores how past experiences and less conscious feelings shape the present.
• Integrative therapy combines elements of several approaches to suit the individual.
• In England, NHS Talking Therapies offers a range of therapies for anxiety and depression, and you can refer yourself.

What is cognitive behavioural therapy (CBT)?

CBT looks at the links between your thoughts, feelings and behaviour. The NHS describes it as a therapy in which a therapist helps you change how you think and act, and you practise what you learn between sessions. The BACP describes it as a short-term model, usually over weeks or a few months rather than years, focused on current problems and practical solutions.

According to the BACP, NICE recommends CBT for difficulties including anxiety, depression, panic attacks and OCD. There are many types of CBT, adapted for different problems. The NHS says people usually have between 5 and 15 sessions, depending on what they are having it for.

CBT may suit you if you like structure, want practical tools and are willing to try things between sessions.

What is counselling?

“Counselling” is sometimes used as a general word for talking therapy, and sometimes for a specific approach. The NHS describes counselling as talking with a therapist about your thoughts, feelings and experiences, while the therapist listens and helps you find your own solutions. On the NHS, counselling for depression is one of the therapies offered.

What is person-centred therapy?

Person-centred therapy was developed by the psychologist Carl Rogers in the 1940s and is one of the humanistic approaches. The BACP explains that the therapist does not direct the session or act as the expert on your life. Instead, they aim to offer acceptance without conditions, honesty and empathy, so you can explore your own feelings and find your own way forward.

Other humanistic approaches listed by the BACP include Gestalt, existential, solution-focused and transactional analysis. What they share is a view of the person as a whole and a focus on growth and self-understanding.

Person-centred therapy may suit you if you mainly want a safe, non-judgemental space to talk and make sense of things.

What is psychodynamic therapy?

Psychodynamic therapy grew out of psychoanalysis. The BACP describes it as looking at how past experiences, including childhood relationships, and feelings or impulses you may not be fully aware of, shape how you feel and act now. The relationship with the therapist is central, and patterns from other relationships can show up in it and be explored together.

The UK Council for Psychotherapy (UKCP) describes psychodynamic therapy as less intensive and briefer than psychoanalysis, which the BACP describes as lengthy and intensive. Some psychodynamic work is open-ended, while short-term psychodynamic psychotherapy is one of the options NICE lists for depression.

Psychodynamic therapy may suit you if you want to understand why you keep ending up in similar situations, or how your past connects to your present.

What is integrative therapy?

Integrative therapy draws on more than one approach and shapes it around the individual. The BACP says an integrative therapist may combine person-centred, psychodynamic and CBT elements, as well as others. The BACP says it can help with a range of short- and long-term issues.

What other talking therapies are there?

• Guided self-help. The NHS describes working through a workbook or online course, based on CBT principles, with support from a therapist. It is often offered first.
• Interpersonal therapy (IPT). Focuses on problems in your relationships and ways of dealing with them, according to the NHS.
• Dynamic interpersonal therapy. The NHS describes this as helping you see how childhood experiences affect your current relationships.
• Mindfulness-based cognitive therapy (MBCT). Uses mindfulness practices such as meditation and breathing to help you notice thoughts and feelings as they happen.
• Behavioural activation. Listed by NICE as an option for depression, it looks at the link between what you do and your mood, and helps you plan practical changes that reduce avoidance.
• Dialectical behaviour therapy (DBT). The NHS mentions this for specific conditions, such as personality disorders.
• Couples therapy. You and your partner work with a therapist on problems in your relationship. You can read more about couples counselling.
• Systemic and family therapy. The BACP describes this as looking at patterns within a family or relationship system, rather than at one person alone.

What does the NHS offer?

In England, NHS Talking Therapies offers free therapy for anxiety and depression. You can refer yourself if you are registered with a GP and aged 18 or over (16 or over in some areas), and you do not need a diagnosis. The NHS lists guided self-help, CBT, counselling, interpersonal therapy, dynamic interpersonal therapy, couples therapy and mindfulness-based cognitive therapy among the options.

The NHS says the type of therapy you are offered depends on what you need it for and what is available in your area. Sessions may be in person, by phone or video, or as an online course, and may be one-to-one or in a group. For some conditions, such as eating disorders, bipolar disorder or psychosis, you would usually need a referral from your GP.

For depression, NICE lists a range of options, including guided self-help, group or individual CBT, behavioural activation, interpersonal therapy, counselling and short-term psychodynamic psychotherapy, and says the choice should be a shared decision that takes account of the person’s needs and preferences. If you have questions about medication, your GP is the right person to talk to.

How do I choose the right type of therapy?

There is no single best therapy for everyone. Some questions that may help:

• Do I want structure and practical tools, or more open space to talk?
• Am I mainly focused on what is happening now, or do I also want to understand the past?
• Is there a specific treatment recommended for my difficulty, for example for OCD?
• Would I prefer to meet online, in person, or have the choice of both?
• Do I feel comfortable with this particular therapist?

Whichever type you choose, check that the therapist is registered with a professional body accredited by the Professional Standards Authority, such as the BACP or UKCP. My guide on how to check a therapist is BACP registered explains how.

How I work

I am an integrative psychotherapist registered with the BACP, drawing on person-centred, psychodynamic and CBT-informed ideas at a trauma-informed pace. I work with adults individually and as couples, online and in person in Farringdon, Central London, in English or Turkish. People often come to me with anxiety or depression, and sometimes simply wanting to understand themselves better.

If you are in crisis, call 999, go to A&E, call NHS 111, or contact Samaritans on 116 123 (free, 24/7).

If you are unsure which kind of therapy might suit you, you are welcome to get in touch to arrange an initial consultation. We can talk about what you are looking for, and if another approach or service would suit you better, I will say so.