What Is Therapy?

Most people, regardless of their specific challenges, can benefit from having an impartial observer listen and offer guidance. Because of therapy’s cost and time investment, however—as well as lingering stigma surrounding mental health—the decision to begin therapy isn’t always an easy one.

To determine whether therapy is the right choice for a particular individual, they should consider whether they feel sad, anxious, overwhelmed, or irritable more often than not; if yes, therapy would likely offer emotional support and help them develop the tools to manage their mental health. But strong negative emotions aren’t the only reason someone should seek therapy. If they are struggling with relationship challenges, feel stuck in their career, find themselves turning to drugs, alcohol, or food to cope with unpleasant events, or feel disconnected from the people around them, they may find therapy to be immensely helpful.

For more on the choice to start seeing a therapist, visit The Decision to Begin Therapy.

There are countless compassionate and effective therapists in the world—but not every single therapist is the best person to help every individual seeking treatment. Though it can be frustrating for patients and professionals alike, finding the right therapist is usually a process of trial and error.

While the prospect of searching for a therapist can indeed be daunting, several online tools can make the process significantly easier. Using online directories (such as the Psychology Today Therapy Directory), search engines, or their insurance company’s online list of covered providers, prospective clients can locate therapists (either in their area or who are licensed to provide online therapy) who take their insurance and who strike them as a potential good fit based on modality, gender, or the most common issues treated. From there, clients should contact a few potential candidates and take steps toward setting up their first appointment.

For more on locating and choosing the best therapist, visit How to Find a Therapist.

Watching a loved one struggle with mental health challenges can be painful and trigger feelings of helplessness. But while the choice to pursue therapy will be, in a large number of cases, solely up to the individual, it is possible for concerned others to offer emotional support as well as concrete assistance. This can mean connecting them with educational resources about therapy, helping them identify potential clinicians in their area, setting up appointments, or providing transportation to their first session.

For more on facilitating the process for a loved one, visit Finding Help for Others.

Many types of therapy have been shown to be effective at treating common mental health challenges, and determining which approach is “best” for a particular person often comes down to their particular concerns, the alliance they’re able to form with their therapist, and their personal preferences. Clients who are coming to therapy with specific mental health concerns—such as obsessive compulsive disorder or post-traumatic stress—may benefit most from a clinician who specializes in the area or who employs a type of therapy specifically designed to treat it.

Those seeking help with relationship or family problems may benefit from marriage and family therapy, couples therapy or couples counseling.

Those seeking a potentially more affordable type of therapy, or for whom it could be beneficial to attend therapy with others who have similar experiences, may wish to consider group counseling or group therapy.

To learn more about different types of therapy, visit Therapy Types and Modalities.

The cost of therapy, and whether it can fit into a client’s budget, will likely depend on a few factors, including the individual’s insurance coverage, their location, and their income. While some therapists charge a set fee per session, others offer a sliding scale based on clients’ income. In many locations, low- or no-cost therapy is available for low-income clients, often through universities or other therapist training programs. Prospective clients should verify their insurance coverage, along with the therapist’s fee structure, before setting up an appointment.

To learn more about the finances of therapy, visit Cost and Insurance Coverage.

The first session of therapy can be anxiety-provoking, and it’s normal to feel nervous or unsure of what to expect. Luckily, most patients will find that the first session of therapy follows a predictable format. Most therapists spend the first session asking general questions to get a sense of the client’s background, their past experience with therapy, and what issues they’re hoping to address. Clients may wonder what they can and should bring to the table in terms of discussion, and the fact is that few, if any, topics are off limits. They will also likely discuss their own modality or style and offer an outline of what the client can expect. If a client has questions about privacy and confidentiality, those concerns should be raised and addressed. Logistical details, such as verifying insurance coverage and setting up a payment schedule, may happen in the first session as well.

To learn more about what to expect when starting therapy, visit Your First Therapy Session.

Medication is often used in conjunction with psychotherapy—particularly for cases of severe depression, anxiety, or bipolar disorder—but it’s not a given for every client. If a therapist thinks a particular client could benefit from medication, he or she will discuss it with the client before referring him or her to a prescribing professional such as a psychiatrist or nurse practitioner. While the client will likely need to attend periodic meetings with the prescribing professional to discuss any side effects and dosage adjustments, they will also continue to see the therapist to build coping skills and strategies to further support their mental health.

For more about the use of medication, visit Medication and Therapy.

Even the best therapists aren’t perfect, and it’s possible for effective, ethical therapists to make mistakes or inadvertently upset a client. But there are some therapists, unfortunately, who are not suited to the profession. Common warning signs of an ineffective therapist include talking too much—to the point where the client feels unable to talk about their own concerns—or sharing inappropriate details about their own personal life. Therapists who are judgmental or condescending to the client are also likely not good fits, as are therapists who frequently appear bored or distracted.

Unethical therapists are much rarer than unqualified or ineffective ones, but they certainly exist. An unethical clinician may make sexual or romantic overtures toward a client, threaten or blackmail them, or breach confidentiality agreements without just cause. Clients should report such therapists to their licensing board and end therapy as soon as possible.

For more on therapeutic boundaries, visit Boundaries and Red Flags in Therapy.

Therapy typically ends when the client feels they have achieved their goals or when they feel they are no longer making progress; in some cases, logistical issues, such as changing insurance coverage, necessitate the end of therapy. Alternatively, it is possible for a therapist to determine that they are not the best practitioner to aid a particular client. When this occurs, the therapist will typically refer the client to another provider, where they can continue work if they so choose.

For more on what to expect when terminating therapy, see Ending Therapy.