You may have a specific vision in mind when you think of therapy, a balding man with round spectacles holding a cigar as he sits attentively beside a leather couch. Or perhaps you’re more informed by pop cultural psychologists and psychiatrists, Frasier Crane or Dr. Melfi of Soprano’s fame.
But, whatever you imagine, it’s important to remember that therapy isn’t just for those with serious mental illness. It’s also for anyone interested in feeling healthier and happier. It can help you alleviate emotional distress, improve your relationships, and reach your goals — therapy provides a licensed professional who is trained to listen empathetically and help you work through specific challenges.
If you’d like to learn more about therapy and counseling, you’ll find everything you need to know below. However, if you know you’re interested in finding a therapist, you can talk with a licensed professional right now about your challenges and the ways that counseling can help.
To further understand therapy and what it involves, it will be beneficial to explore the following:
- Defining Therapy
- Common Types of Therapy
- Benefits of Therapy
- Finding the Right Therapist
- What Does a Therapist Do?
- How Much Does Therapy Cost?
- How Much Does Online Therapy Cost?
- Cost-Saving Options
- How Long Does Therapy Take?
- How to Know if Therapy is Working
- How Do Therapists Define Therapy?
- The History of Therapy
- The Future of Therapy
Therapy (or psychotherapy, sometimes called talk therapy) is the process of working with a licensed therapist or counselor to develop positive thinking and coping skills to treat specific mental health conditions like depression or anxiety, trauma, or simply the daily human challenges we all face.
Therapy can be administered by an assortment of licensed professionals including psychologists, social workers, psychiatrists, and counselors. These professionals have completed rigorous training in the form of at least a master’s degree in their respective course of study as well as at least 3,000 supervised clinical hours.
Most forms of widely practiced counseling has been researched extensively and found to be extremely effective in dealing with a range of issues — from the everyday stresses of modern life to issues like past abuse in childhood.
There are also different ways to connect with a therapist — online or in-person — and modes of doing so — whether by text message, phone, or live video — to meet client needs and lifestyle. The best therapy for you will be that which most closely aligns with your reasons for considering counseling.
In order to answer the question “What is therapy?,” however, we must go far beyond basic definitions.
All forms of psychotherapy exist to improve clients’ mental health, but there are styles of therapy specific to issues clients face, as well as different therapeutic approaches, represented by different schools of thought around treating mental health and the nature of the mind. Some schools hew more closely to the older styles of counseling developed by early psychoanalysts like Sigmund Freud, while others are more contemporary and reflect newer research by theorists.
A few of the most popular popular types of therapy include:
Challenges negative client-thought patterns about themself and the world to alter unwanted behaviors or treat disorders such as depression. CBT provides relatively short-term treatment for a range of conditions, phobias, disorders and is backed by a great deal of research on its effectiveness.
Focuses on the client, who helps determine the course of the session; the therapist offers a high-degree of empathy, helps build self-esteem and problem-solving abilities, but does not overtly guide the session.
Stresses acceptance and change while teaching behavioral skills (mindfulness, distress tolerance, interpersonal effectiveness, emotion regulation) that help clients enhance motivation. DBT is often used to treat more severe mental health issues including PTSD, borderline personality disorder, self-harming, and eating disorders.
Derived from existential philosophy, this modality emphasizes self-actualization in the face of the realities of the human experience, including our isolation from one another and mortality. Existential therapy helps clients face these difficult and overwhelming truths.
Stresses the client-therapist relationship and their therapeutic alliance to highlight personal responsibility and a focus on the present. Often gestalt therapy invokes role playing to resolve conflicts from the client’s past.
Explores a client’s unconscious feelings/thoughts and how the present is impacted by the past. Psychodynamic therapy is the oldest form of psychotherapy and is, in fact, an outgrowth of psychoanalytic therapy developed by Freud where clients are encouraged to speak extemporaneously on whatever comes to mind, whether it be fears, dreams, or desires.
Therapy can benefit everyone, but it isn’t solely beneficial after a traumatic experience, abuse, anxiety, or a major life change —it can help you through everyday life, too! Many highly successful people use therapy to be more productive in goal setting and self-acceptance.
Ways therapy can help
Nearly all aspects of your life can be impacted and improved with psychotherapy. Your therapist may provide new techniques for problem solving, help you challenge irrational habits and incorrect assumptions, help you reframe long-held views, or or assign you homework to help you grow and change. A therapist can also help you overcome mental health conditions like depression, anxiety, body image issues, and even addiction.
Primarily a therapist will help you to:
- Understand your feelings
Learn what emotions are common for your condition or circumstances.
- Get immediate support
While deep-seated issues can be addressed down the line, counseling can benefit you in situations where you need help urgently.
- Plan your future
Therapists can help you create a game plan and set goals for your future in a safe environment and keep you accountable.
- Relieve the pressure with a therapeutic relationship
Often, simply getting things off your chest in a safe space can be healing. If serious problems arise again, your on-going therapeutic relationship will keep you strong.
The most important thing is that your therapist is always there for you. They’re an impartial ally who will support you without judgment. While your friends might not text you back, your therapist is always willing to listen.
A therapist, or psychotherapist, is a licensed mental health professional who helps clients improve the lives of their clients, helping them develop better cognitive and emotional skills, reduce the symptoms of mental illness and cope with various day-to-day challenges. Therapists primarily help clients, whether via in-person or online therapy, improve their mental health. Some therapists work in a research capacity or in an academic setting.
Therapists work in a range of modes and capacities. They help their clients cope with whatever they’re struggling with and assist in modifying behaviors that may be unhealthy, maladaptive, or harmful. Therapists also teach better coping skills.
Whatever type of counseling you engage in you can be sure that your therapist will:
- Listen with empathy and understanding
- Analyze past and present events to help clients better understand their behaviors
- Comfort clients when they undergo misfortune
- Provide a third-party unbiased opinion
- Teach emotional, cognitive, and communication skills
- Guide clients through stressors and anxieties
- Provide non-directive advice
- Help provide assessment and diagnosis of mental health conditions
Therapists themselves do not prescribe medication, but they refer clients to psychiatrists, mental health facilities, or other medical professionals as needed.
As a prospective client, it’s great for you to share what your preferences are and what you’re looking to get out of therapy. In fact, it’s critical to your success in therapy! The intake process — where you answer some questions about what’s brought you to counseling or what challenges you’re dealing with — is a great opportunity for clients to be up front about what they need from a therapist.
What to look for in a therapist
While by definition therapists are unbiased advocates, forming a real and trusting bond with your therapist is the most important element of selecting the right fit. Here are some aspects to consider when deciding on a therapist:
Do you prefer a therapist who is younger or older than you? Someone who has the experience of many years as a therapist or someone younger who can perhaps relate to your lifestyle in a more authentic way.
Would you prefer having a therapist of the same ethnicity, who makes you feel more comfortable and understood — having a shared understanding and not having to explain your experience of the world, including microaggressions and more direct racism, prejudice, and oppression?
Do you prefer a therapist of the same gender or sexuality, who can better relate to your experience in relationships, career, and your experience with your family?
Would you prefer a therapist who has expertise in a specific area or specializes in specific challenges like trauma or eating disorders? Or would you prefer a generalist who deals with all kinds of issues?
Do you prefer a therapist who shares your religious beliefs or is a shared faith less important for the issues you’re working on.
On a platform like Talkspace, you can find a therapist that fits your precise needs. And if you don’t connect with your therapist, it’s easy to switch to another with no-hassle, and at no additional cost. Finding the right therapist is essential and, with Talkspace, you don’t have to spend time searching, making appointments, and auditioning therapists — the perfect fit is just a click away.
As you can imagine, because counseling can be so impactful and therapists can do so much to improve the specific challenges clients struggle with, the service is not without costs. Therapists are highly trained professionals — licensed in the state they practice in, each with a master’s degree and an additional 3,000 hours of supervised work. They deserved to justly compensated! Talkspace also requires six-weeks of training and onboarding for the platform.
The relatively high costs of therapy and healthcare more generally do make it prohibitively expensive for many. That’s why, at Talkspace, we aim to make counseling more accessible by keeping costs low — we believe in therapy for all. Often costs vary by region, but in-person therapy costs on average $75-150 per hour (in places like New York it is generally between $200-300 per hour) and the majority of therapists do not take health insurance.
Online therapy, however, is a most cost effective and affordable option for those who need access to care, but don’t have the means to access brick-and-mortar counseling.
Online therapy has been proven to have the same efficacy as in-office therapy and is typically much more affordable (often less than half the cost of traditional therapy). This is mostly due to the fact that online counseling requires less overhead than therapists who work in an office.
You can use an online therapy network, like Talkspace, to find a therapist or check if a therapist you know will provide online service.
Therapy can be lifesaving for those who struggle with mental health challenges — everyone should have access to it. But for those whom counseling proves too cost prohibitive, there are a few options that can help defray the expense.
Below are some affordable examples of ways to find the mental healthcare you need:
- Ask the Therapist for a Discount or Seek Therapists With Sliding Scales
Most therapists are not in it for the money. Though therapists need to be able to make a living, if you tell them you can only afford a discounted rate, they may oblige. There are also therapists who use sliding scales for all payments. Before sessions begin, check for this information on their website, therapy network, or profile.
- Schools or universities
If you’re a student and want free or discounted therapy, ask your student health center for more information. Student health centers can often provide low-cost or free mental health services on a short-term basis (a semester or quarter) — a good temporary solution until you find a long-term therapist you can afford.
- Therapy practices
Therapy practices — sometimes called agencies or firms — are often more affordable because more than one person is chipping in for the cost of rent and other overhead. These practices often have interns — those who are working on their supervised clinical hours — who charge less. If you prefer in-office counseling, practices are often a more affordable option.
- Not using insurance
Many assume that using insurance for therapy will lower the overall cost. However, circumventing insurance providers is sometimes the cheaper option. Many therapists choose not to accept insurance coverage because payments are often lower and there is a great deal of paperwork for reimbursements.
- Federally-funded health centers
Federally qualified health centers (FQHCs) usually have mental health resources and the law requires they offer a sliding payment scale. You can search for one in your area.
While therapy can be expensive, it’s important to remember that your mental health touches every aspect of your life — your relationships, career, and happiness. Gambling with your mental health is not something that will pay off long-term. It’s important to prioritize your well-being!
The length of the therapeutic process is dependent upon your individual needs, goals, and challenges. The number of recommended sessions varies by condition and treatment type, which is something you can discuss in an initial consultation with a therapist. Many clients with depression and anxiety report feeling better after three months.
Those who are treated via Cognitive Behavioral Therapy report feeling better around 10-20 sessions, Talkspace therapist Cynthia Catchings explains. She’s had “many successful stories with clients who had situational issues that only needed brief therapy services” in order to start feelings better. She adds, “it is important to mention that therapy is not only a way to solve a problem, but also a way of living. In the same way that we go to the gym and exercise or tone our body, therapy is like exercise for our mind, heart, and soul.”
Whatever your therapeutic process may look like, remember to trust your gut and express any concerns to your therapist. Honesty and transparency will ensure you’re on the right path to feeling better as soon as possible.
While everyone’s therapeutic process is different, there are some common signs you’re making progress in therapy.
If you sought counseling for a mental health condition, symptom improvement is a main indicator that therapy is working for you. Other indicators of improvement include progress toward long-term goals — you’ve moved past venting and have started working toward change — or recognizing the development of new skills, coping mechanisms, or better habits and ways of thinking.
And remember, if you’re concerned about the progress you’re making in counseling, express these worries to your therapist.
And, while we’ve established a common psychotherapy definition, every therapist does define therapy in slightly different ways. By looking at the aspects they stress, you can see a more detailed picture of counseling and whether the therapist’s approach aligns with your goals.
Here are some therapy definitions we gathered by surveying Talkspace therapists and reaching outside our network:
A commitment to yourself and to opening yourself up to someone else; being willing to trust someone enough to let them into your life and learn from each other.Alaina Brubaker, Talkspace Therapist
A way of changing your perspective on how to handle a situation.Noor Pinna, Talkspace Therapist
A communication process of increasing clarification and understanding pertinent to specific experiences related to such terms as discomfort, dissatisfaction, disappointment, discontent, disenchantment, and other dispositions that are perceived as problematic.Ken Fields, Talkspace Therapist
A dynamic process that occurs in a safe and contained relational frame wherein destructive patterns of being are identified and replaced with healthy and productive ones.Paul Hokemeyer, Marriage and Family Therapist
Empathy, a nonjudgmental attitude and the creation of a safe space in which nothing the client wants to explore is off-limits and everything is on the metaphorical table.Kristen Martinez, LGBT Therapist
Learning how to overcome your personal or relational struggles by developing long-term tools.Jennine Estes, Marriage and Family Therapist
The art and science of engineering self-improvement and growth in clients via a strong therapeutic relationship and evidenced-based therapies.Michael Zito, Therapist, Ph.D.
Helping clients break free of old ideas, patterns and wounds that are restricting their happiness and contentment; coaching them through life passages, teaching skills and techniques for self-awareness, relationships and success.Tina B. Tessina, Therapist, Ph.D.
To fully understand psychotherapy and counseling, it can be helpful to explore its past, present, and possible future. This timeline will give you a richer understanding of what counseling is and how it evolved.
Before Freud and other early psychologists such as Wilhelm Wundt, philosophy was the closest relative to therapy. It was the only field that explored human behavior and mental health.
“Psychology is an offshoot of philosophy,” psychologist Bart Rossi told Talkspace.
Rossi cited schools of philosophy such as rationalism and empiricism. He also said philosophers including Immanuel Kant contributed to the development of therapy.
One of the best examples of philosophy informing psychotherapy is existential therapy, which is derived from existential philosophy. Existential psychotherapist Irvin Yalom, who shaped the field of modern existential therapy, said existential philosophers such as Nietzsche inspired his work.
Therapy during Freud’s time and the 20th century
Because Freud was a psychiatrist, and invented psychoanalysis, early psychotherapy was mostly about reducing symptoms. It followed a medical model rather than the wellness/medical model we more frequently see today. Therapy was for “patients” with diagnosable mental illnesses, not clients who see a therapist for all kinds of reasons.
“I think in the past, therapy was centered around ‘fixing’ what was ‘wrong’ with people,” said therapist Kristen Martinez. “[The medical establishment] thought they were the healthy ones, and psychotherapy focused on getting ‘unhealthy’ people to be healthy like them.”
Progress of therapy
Modern psychotherapy tends to balance the wellness and medical model. Therapists want to reduce symptoms in people dealing with mental illness, but they’re squarely centered on the needs and direction of the client.
Cognitive Behavioral Therapy (CBT) changed the definition of counseling, according to Rossi. It is now more behavior-focused and psychodynamic approaches have become less common.
The advent of online therapy has also appended what therapy is and how it is delivered. Although prior definitions of therapy did not explicitly describe it as occurring solely in-person, therapy required in-office visits because distance counseling was not easily facilitated before the development of the internet.
Earlier therapy definitions also implied counseling could only take place only via “sessions,” where the therapist and client scheduled a meeting or phone call at a specific time. Because of technology and approaches such as the text therapy Talkspace offers, counseling no longer requires set sessions.
While psychotherapy isn’t going anywhere there are some trends that will expand the definition of what is possible in therapy.
Here are some trends that might contribute to the evolution of psychotherapy and counseling in the future:
- Additional technological advances in online counseling
- Virtual reality
- Integration of medical care
- More focus on the therapeutic relationship
- Increased cultural consideration
- New CBT approaches
Now that we’ve discussed what therapy is and is not and have established a common definition for psychotherapy, take a moment to think about what it might be able to do for you.