What kind of therapy is best for anxiety and depression

Deborah C. Escalante

man listening to his therapistJust as no two people are affected the exact same way by depression and anxiety, there is no “one size fits all” treatment. What works for one person might not work for another.

The best way to treat depression or anxiety is to become as informed as possible about the treatment options, and then tailor them to meet your needs.  In many cases, it is helpful to work with a professional to determine the best fit.

Types of therapy

Therapy may help you develop an awareness of what you feel, why you feel that way, what your triggers are, and how you might change your reaction to them. Some types of therapy teach practical techniques to reframe negative thinking and change behaviors.

There are many types of therapy available. Three of the more traditional methods used in depression include cognitive behavioral therapy, interpersonal therapy, and psychodynamic therapy. Often, a blended approach is used.

Therapy is a form of treatment that aims to help resolve mental or emotional issues. There are many types of therapy available.

A therapy support group is one of the types of therapy

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Psychotherapy, or talk therapy, involves a person speaking with a trained therapist who can help them understand certain feelings and behaviors.

Therapy can help people deal with these issues by teaching coping skills or by working to eliminate them.

This article will provide an overview of the different types of therapy available.

1. Cognitive-behavioral therapy

A therapist uses cognitive-behavioral therapy (CBT) to explore the relationship between a person’s behavior and thoughts, feelings, or both.

A CBT therapist will work with an individual to uncover unhealthful thought patterns. The therapist will discuss with the person how these patterns might or do cause self-destructive behaviors and beliefs.

Together, the therapist and their client can work on developing constructive ways of thinking. These changes can offer a healthier, more positive outlook and help a person change their behaviors and beliefs.

The National Alliance on Mental Health (NAMI) indicate that CBT is an effective treatment for a variety of disorders, including:

  • anxiety disorders
  • depression
  • bipolar disorder
  • eating disorders
  • schizophrenia
  • trauma-related disorders

3. Eye movement desensitization and reprocessing therapy

Eye movement desensitization and reprocessing therapy (EMDR) is a technique that therapists primarily use to treat people with PTSD.

EMDR involves a person recalling a traumatic event while performing specific eye movements.

EMDR aims to replace adverse reactions to painful memories with less charged or positive responses.

The benefits of EMDR remain controversial, and a 2016 review of studies was unable to identify what part of the treatment is beneficial. One conclusion was that the benefits derive from a person’s exposure to the trauma rather than the eye movement.

4. Exposure therapy

Exposure therapy is a form of CBT. An article in Behavior Research and Therapy notes that therapists have successfully used exposure therapy to treat people with fear and anxiety disorders.

Therapists may use exposure therapy to help treat:

  • obsessive-compulsive disorder (OCD)
  • PTSD
  • phobias

A person undergoing exposure therapy will work with their therapist to figure out what triggers their anxiety. The person will learn methods to avoid ritualistic behaviors or anxiety after exposure to these triggers.

The therapist will then expose the person to their triggers in a controlled environment to put these methods into practice.

5. Interpersonal therapy

Interpersonal therapy aims to help a person work on their relationships with others. According to NAMI, therapists often use interpersonal therapy to treat depression.

During interpersonal therapy, the therapist evaluates a person’s social interactions and helps them to notice negative patterns. The therapist can then help the person learn ways to understand and interact positively with others.

6. Mentalization-based therapy

According to Psychology and Psychotherapy, mentalization-based therapy (MBT) is an effective treatment to treat BPD.

MBT involves a technique called mentalizing. This therapy helps people with BPD to notice and understand their thoughts and feelings and those of others.

Its primary aim is to give a person with BPD a sense of self and help them connect to other people.

7. Psychodynamic therapy

Psychodynamic therapy aims to help a person combat negative patterns of behavior that derive from past experiences.

This form of therapy involves a person speaking freely in response to a therapist’s questions, which allows a therapist to identify patterns of behavior and thought.

Once a person understands how experiences have created unhelpful behaviors and feelings, they can learn to overcome them.

One 2018 article indicates that psychodynamic therapy is successful in treating depressive disorders, BPD, and anxiety. However, therapists employ this technique to treat a wide range of mental health issues and personality disorders

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Psychoanalysis is a more intense type of psychodynamic therapy. According to the American Psychiatric Association, therapy sessions generally take place three or more times a week.

8. Animal-assisted therapy

Animal-assisted therapy involves a person spending time with a trained therapy pet. A therapy pet can help reduce a person’s anxiety, as well as help those with PTSD.

Some hospitals, nursing homes, and other medical facilities use therapy pets to provide support or comfort.

NAMI indicate that therapy dogs are particularly helpful to patients with cancer, heart disease, or mental health disorders.

An article in Frontiers in Psychology, researchers recommend using animal-assisted therapy, alongside music therapy, an enriched environment, and other supportive therapies, to minimize stress and trauma for hospitalized people who may require compulsory admission or seclusion.

9. Emotion-focused therapy

Emotion-focused therapy (EFT) focuses on building awareness of emotions and regulating and resolving them. EFT encourages people to work on their emotions rather than suppressing them.

According to a 2018 article, EFT can treat:

  • depression
  • trauma
  • social anxiety
  • interpersonal problems
  • eating disorders
  • relationship issues

10. Family therapy

Family therapy involves working with a family unit to help an individual within the family resolve specific issues. Family therapists help a family understand and work through patterns of negative behavior that may cause underlying problems.

An article in the International Journal of Environmental Research and Public Health states that family therapy can help families with adolescents experiencing mental health issues.

This type of therapy can also help people with:

  • substance misuse disorders
  • eating disorders
  • behavioral problems
  • anxiety
  • OCD
  • medical issues

11. Group therapy

Group therapy allows people experiencing similar issues to join together as a group to resolve them. In group therapy, a therapist leads the discussion, and individuals can comment or contribute personal thoughts and experiences.

Group therapy helps a person see that they are not alone, and it offers people an opportunity to support each other.

However, a disadvantage of group therapy is that a person does not get the same amount of one-on-one attention as they would in a one-to-one therapy situation.

Group therapy is also less confidential, meaning some people may be reluctant to share their experiences.

According to the American Group Psychotherapy Association, group therapy can benefit people with:

  • interpersonal relationship issues
  • behavioral, learning, or family issues in children and adolescents
  • medical issues
  • aging issues
  • depression
  • anxiety
  • difficulty recovering from a loss
  • trauma
  • lifestyle issues
  • addiction
  • personality disorders

12. Mindfulness-based therapy

Mindfulness is the practice of becoming present in the moment. Mindfulness aims to encourage a person to observe and accept things as they are and without judgment.

A 2015 study found that mindfulness-based therapy helped relieve anxiety and depressions in people who had cancer. However, the researchers indicate that the benefits of the therapy may not be long-lasting.

Another study found that mindfulness-based interventions were beneficial to people with:

  • depression
  • schizophrenia
  • stress
  • anxiety
  • pain

Meditation can be a big part of practicing mindfulness.

13. Creative arts therapy

Creative art therapy aims to engage the mind through various methods of creativity. Creative art therapy allows people to express how they are feeling through different mediums, such as art, dance, music, or poetry.

According to the American Art Therapy Association, art therapists use these sessions to:

  • improve cognitive and motor function
  • improve self-esteem and self-awareness
  • encourage emotional strength
  • build social skills
  • resolve conflicts and distress

14. Play therapy

Specialists use play therapy to help children talk about their thoughts and feelings. Play therapists provide a child with a space where they feel safe and cared for.

Children in play therapy may show their feelings or experiences through how they play. This type of therapy allows a child to deal with behavioral problems, stress, or trauma in a safe environment.

A 2019 case study showed how play therapy could have a therapeutic effect on children.

Summary

There are many types of therapy available for a person who would like help working through certain issues.

Certain types of therapy may be more effective for some conditions as opposed to others.

It is important to remember that what works for one person may not work for another, so choosing the best form of therapy for an individual is a personal choice.

If a person is not sure about which type of therapy is best suited to them, they should speak to a doctor or healthcare provider.

There are many different types of therapy to treat depression and other mood disorders. Psychotherapy can be an effective form of treatment for depression because it can help you delve into possible underlying reasons for your depressive feelings and learn new skills to cope.

Finding out which type of psychotherapy is best for you will depend on a number of factors, including the severity of your symptoms, your own personal preferences, and your therapy goals. The therapeutic modalities described below have evidence supporting their benefits as treatments for depression.

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What Is Psychotherapy?

Psychotherapy:

Psychotherapy is the process of treating psychological disorders with verbal and psychological techniques.

Most types of psychotherapy foster a relationship between therapist and client to help individuals identify and overcome negative thoughts or behavioral patterns.

Psychotherapy is often called “talk therapy” because it involves an individual and a psychotherapist sitting in a room together talking. But it is so much more than that. Psychotherapists have formal training in a variety of techniques that they employ to help people recover from mental illness, resolve personal issues, and create positive changes in their lives.

What is the best approach?

Several studies suggest, however, that the combination of an antidepressant and psychotherapy is the best approach, because of the complex mix of causes of mood disorders like depression.

While psychotherapy is its own professional field, other professionals offer this modality as well, including psychiatrists and clinical psychologists, substance abuse counselors, mental health counselors, marriage and family therapists, social workers, and psychiatric nurses.

If you or a loved one are struggling with depression, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Psychotherapy for Depression

The right type of therapy for depression depends on a variety of factors, and there is no approach that is right for everyone. The type of treatment you choose may depend on various factors, including your preferences and the severity of your symptoms. Consider some of the following commonly used types of therapy for depression to better determine which one might be right for your needs.

Cognitive Therapy

At the heart of cognitive therapy is the idea that our thoughts can affect our emotions. For example, if we choose to look for the silver lining in every experience, we will be more likely to feel good, as opposed to if we only focus on the negative.

Negative thoughts can contribute to and exacerbate depression. Feeling good is hard when you’re stuck in a constant loop of negative thoughts. Cognitive therapy helps people learn to identify common patterns of negative thinking (known as cognitive distortions) and turn those negative thoughts into more positive ones, thus improving mood.

Cognitive therapy is usually short-term and goal-focused. Therapy sessions are structured with a specific plan for each session, and there is “homework” practice to do outside of therapy. Cognitive therapy usually lasts between six weeks to four months.

Behavioral Therapy

Whereas cognitive therapy is focused on the negative thoughts that contribute to depression, behavioral therapy is centered on changing behaviors that affect emotions. A central focus of behavioral treatment for depression is behavioral activation. This entails helping patients engage in activities that will enhance their feelings of well-being.

Cognitive-Behavioral Therapy 

Because cognitive therapy and behavioral therapy work well together to treat depression and anxiety disorders, the two are often combined in an approach called cognitive behavioral therapy (CBT). CBT focuses on addressing both the negative thought patterns and the behaviors that contribute to depression.

Your therapist may ask you to keep a journal to track the events of the week and any self-defeating and negative reactions to those events. Habitual negative responses to events (known as automatic negative reactions) are just one pattern of thinking you might address over the course of CBT. Other response patterns include all-or-nothing thinking and overgeneralization, two common cognitive distortions. 

Once you have learned how to recognize your response patterns, you will work with your therapist to learn new ways of thinking and responding. You might also practice positive self-talk.

Like cognitive therapy and behavioral therapy, CBT is usually brief and goal-oriented. It generally involves between five to 20 structured sessions centered on addressing specific concerns.

CBT sessions are often accompanied by “homework,” which may include keeping a journal, practicing relaxation activities, completing readings, and using worksheets focused on specific goals. Research suggests that CBT can be effective in the treatment of depression and may have lasting effects that prevent future relapses of depressive symptoms.

Dialectical Behavior Therapy

Dialectical behavior therapy is mostly based on CBT. The key difference is that it asks individuals with depression to acknowledge and accept their negative thoughts and behaviors. Through the practice of validation, individuals can come to terms with their negative emotions, learn to cope with stress and regulate their reactions to it, and even improve their relationships with others.

This type of psychotherapy also incorporates mindfulness practices from Buddhist traditions to inform crisis coaching, in which an individual can call the therapist to receive guidance on how to handle difficult situations. As the person continues to practice these new skills, they will eventually become better equipped to handle their challenging situations on their own.

The National Alliance on Mental Health states that DBT has been shown to be effective in the treatment of mental illnesses, including depression.

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Psychodynamic Therapy

Psychodynamic therapy, also known as psychoanalytic therapy, assumes that depression can occur because of unresolved—usually unconscious—conflicts, often originating from childhood. The goals of this type of therapy are for the patient to become more aware of their full range of emotions, including contradictory and troubling ones, and to help the patient more effectively bear these feelings and put them in a useful perspective.

Unlike some other treatment approaches for depression, psychodynamic therapy tends to be less focused and longer-term. This approach can be useful for finding connections in past experiences and seeing how those events might contribute to feelings of depression. This approach can also help build self-awareness and increase certain emotional capacities.

Interpersonal Therapy 

Interpersonal conflict and poor social support can also contribute to feelings of depression. Interpersonal therapy is a type of therapy that focuses on these issues by addressing past and present social roles and interpersonal interactions. During treatment, the therapist generally chooses one or two problem areas to focus on.

This type of therapy is usually brief and involves examining social relationships with important people in your life. This can include your relationships with your partner, friends, family, and co-workers.

The goal is to identify the role these relationships play in your life and find ways of resolving conflicts. 

Your therapist might ask you to roleplay different scenarios in order to practice and improve your communication. By doing this, the idea is that you will be able to implement these strategies in your relationships and build a stronger social support system.

Approaches to Psychotherapy

Psychotherapy can be delivered in a few different ways. In some cases, your treatment may incorporate two or more formats, such as meeting individually with your therapist followed by the occasional group session where you can practice new skills with others. Common approaches to psychotherapy include:

  • Individual therapy: This modality involves one-on-one work between patient and therapist. It allows the patient to have the full attention of the therapist but is limited in that it does not allow the therapist an opportunity to observe the patient within social or family relationships.
  • Family therapy: This approach is most useful when it is necessary to work on dynamics within the family group. Family therapy can be especially helpful for children and teens.
  • Group therapy: Group therapy generally involves anywhere from three to 15 people. It allows everyone to give and receive group support in coping with their particular issues and allows therapists to observe how participants interact in group settings. It may also be a less expensive alternative to individual therapy.
  • Couples therapy: This type of therapy is geared toward married couples and those in committed relationships who desire to improve their functioning as a couple.

Choosing a Technique and Therapist

Finding a psychologist or therapist can seem daunting since there are so many to choose from, and you might not know where to start.

  • Ask friends and family: Recommendations from others can often be a great way to find a good therapist.
  • Ask your doctor: Another place to start is by asking your doctor or another health care professional.
  • Conduct your own online research: The American Psychological Association (APA) recommends contacting your local or state psychological association.
  • Contact a local mental health center: You can also connect with a mental health center in your community.
  • Use an online directory: The APA has a helpful psychologist locator service to help you find a therapist in your area.

When deciding on a potential psychotherapist, you will want to find out what their credentials are and whether they are qualified to treat you for depression. Ask if they take your health insurance or if they’re able to work with you on a sliding scale. 

Once you determine that the therapist is adequately trained and licensed, you can read their bio on their website if they have one or send an email inquiry to find out where they received their education and how many years of experience they have. You’ll also want to know if they have any particular areas of expertise.

For example, one therapist may specialize in marriage or family counseling, while another may be an expert in substance abuse, but both may be skilled at treating depression. You might also be curious about their style of therapy and whether they’ve studied other modalities that inform their technique, such as mindfulness-based stress reduction.

Once You Find a Therapist

When you’re ready to try a session with a therapist, remember that it’s of the utmost importance that the two of you click and that you feel comfortable continuing your work together. Treatment is a collaborative two-way process of finding solutions to reinforce the constructive thoughts, behaviors, and emotions that will create positive change in your life.

A Word From Verywell

Psychotherapy should be a safe and supportive process, no matter which type of therapy you decide on. When working with a psychotherapist, you should always feel comfortable opening up and sharing your feelings and challenges with depression.

If you try a therapist and don’t feel connected or are concerned that their technique or approach isn’t the right fit for you, it may be a good idea to try a different therapist. It’s also OK to be upfront and honest with the therapist who didn’t work out, too. They might even have a better recommendation or referral for you.

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