If you need help for depression, anxiety, relationship problems or other emotional difficulties, it can be hard to know which type of treatment might help. Two common options are traditional psychotherapy and Cognitive Behavioral Therapy (CBT). Knowing the difference between the two can help you make sure you are getting the right kind of care for your needs.
What Is Psychotherapy?
Traditional psychotherapy is used for a wide array of concerns. It can help you process or cope with stressful or sudden life events. It can also help you better understand yourself and your relationship patterns at a deep level. For example, you might learn about certain unconscious wishes or urges that drive a lot of what you do and how you see things.
Traditional psychotherapy also focuses on understanding how your early life experiences shaped who you are. It emphasizes understanding the impact of early relationships with key adult figures (like parents, guardians, or other significant individuals) on your development.
There are many different types of therapy that can fall under the “psychotherapy” umbrella term. These include psychodynamic therapy, humanistic therapy, supportive therapy, psychoanalytic therapy, and others.
Psychotherapy creates connections and fosters emotional insight
Cultivating greater insight into your symptoms, understanding patterns, and identifying common relationship dynamics are all key components of psychotherapy. You and your psychotherapist will work to make connections between past experiences and current situations. These insights can help you understand things differently and can help you make choices that better align with your values and goals.
What is Cognitive-Behavioral Therapy (CBT)?
CBT focuses on changing negative thinking patterns and unhelpful problem behaviors
CBT is a type of psychological treatment that aims to make changes to the things you do and the ways that you think. It is based on understanding how your thoughts, feelings, and behaviors are related to each other. Changing one of them (like negative thoughts) can influence another (like your behaviors) to be more healthy or useful. CBT focuses on measurable symptom improvement, and its focus is more practical and structured than that of traditional psychotherapy.
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CBT involves varied techniques
CBT therapists use different techniques to help address your symptoms. These techniques can help you develop a greater understanding of your thoughts, how you interpret them, and the beliefs that underlie them. One example is cognitive restructuring, which teaches you ways to change unhelpful, negative thoughts (sometimes called cognitive distortions) to be more balanced.
CBT therapists also teach you skills to change behaviors that positively impact your thoughts and emotions. One example is behavioral activation, which works to encourage you to take new or different actions to improve your mood. Another example is exposure, which gradually and intentionally reduces your avoidance of certain experiences or objects to reduce worry or fear.
CBT therapists use many other techniques too. The skills they teach you will help you to form new habits that will reduce your symptoms.
What Is the Structure of the Sessions?
Psychotherapy: typically longer-term and more open-ended
Psychotherapy sessions are less structured than CBT sessions. In psychotherapy sessions you as the patient have more control over what you talk about in each session. This means that the content of sessions can change as your needs or interests shift. For example, you might start psychotherapy wanting to talk about stressors in your relationship. Then, as you progress, you may want to delve more deeply into important moments from your childhood.
Psychotherapy is often a longer-term treatment than CBT since it is not usually tied to a symptom reduction goal. Many people engage in psychotherapy for years.
CBT: Structured and time-limited
CBT sessions are more structured than traditional psychotherapy sessions. They usually start with you and your therapist setting an agenda for that day’s session. Then you might review your efforts to practice what you learned in the prior session, then discuss new concepts and skills that are relevant to your situation. Lastly, the therapist would assign new homework for you to practice between sessions that will help your symptoms decrease over time.
CBT is a structured and goal-focused treatment, making it more time-limited than traditional psychotherapy. You and your CBT therapist determine goals for treatment based upon your symptoms and their severity. Your therapist may suggest an approximate number of sessions or amount of time that seems appropriate to work towards your goals together.
Throughout your treatment you would discuss your progress with the therapist and adjust your treatment plan accordingly. As your symptoms improve, you may meet with your CBT therapist less frequently as you near the end of your work together.
Which Mental Disorders Are They Effective for?
CBT: effective for a range of conditions
CBT was originally developed to treat depression in the 1960s and 1970s. CBT remains the gold-standard treatment for people with depression. It is also a primary treatment for anxiety and related disorders, including:
- Generalized anxiety disorder
- Social anxiety disorder
- Panic disorder
- Health anxiety
- Attention-deficit hyperactivity disorder (ADHD)
- Emotion dysregulation
- Phobias
It is also appropriate for a wide range of ages, from children to older adults. In addition to the above-listed anxiety and depressive disorders, CBT is effective at treating the following disorders:
- Addictions (like gambling)
- Obsessive compulsive disorder
- Post-traumatic stress disorder
- Psychotic disorders, like schizophrenia (often paired with medications)
- Bipolar disorder (often paired with medications)
- Body dysmorphic disorder (BDD)
- Eating disorders
- Hair pulling (trichotillomania) and skin picking (dermatillomania)
- Insomnia
- Chronic pain
- Irritable bowel syndrome (IBS)
Psychotherapy: effective for various life concerns
You can use psychotherapy to help with a variety of challenges. For example, it can help you manage challenging relationships, work stress, and other emotional issues. It can help you develop useful insights and feel supported around challenges in your life. It can improve your understanding of things that are confusing and help you cope.
There is some research evidence that traditional psychotherapy can be helpful for depression, anxiety, trauma symptoms, panic attacks, and chronic relationship problems. However, studies have usually found that for many specific disorders, CBT is more effective in helping people achieve symptom reduction.
Your choice may depend on what your goals are. If your goals are to explore and gain insight around a problem (rather than symptom reduction), traditional psychotherapy may be better suited for your needs.
Factors to Consider When Choosing Between Psychotherapy and CBT
What are your goals?
Reflect on what you are hoping to get out of therapy. Do you want to learn more about yourself, process past negative events, or talk through stressful life experiences? Psychotherapy may be a good fit. Are you experiencing significant worry, panic attacks, problematic substance use, ADHD, trouble sleeping, or feeling depressed? CBT might help provide relief.
Personal preferences
Sometimes, choosing therapy comes down to your personal preference. Some people want structured treatment that includes homework practice, like CBT. Other people might want to have flexibility about what they discuss with their therapist each week, like psychotherapy.
There are some factors important to your choice of therapy regardless of what type you choose. One of the most important factors in treatment is trusting your therapist. Trusting your therapist means that you feel aligned on your goals, you find them empathetic, and feel like they understand who you are in the context of your culture and background.
Severity of symptoms
Another important factor is how impairing your symptoms are. If your symptoms are making it hard for you to get out of bed, to go to work, or to be around loved ones, you might need a structured treatment that targets specific symptoms, like CBT. If your symptoms aren’t making daily life difficult, and you are more interested in learning more about yourself at a deeper level, psychotherapy might be right for you.
Cost
There are many factors that impact the cost of psychotherapy and CBT.
- The treatment setting can impact cost for any type of mental health treatment. Cost can vary between hospitals, community settings, and private practices.
- In the United States, the treatment setting also impacts whether your sessions are covered by your insurance. Some settings may take your insurance, whereas others are out-of-network. (If your therapist is out-of-network, it means that you pay them for each session. Afterward, you can submit a claim to your insurer for reimbursement if your insurance plan includes coverage for out-of-network care). However, whether (and how much) you get reimbursed depends on your insurance coverage.
- The cost of therapy may also vary based on where you live (i.e., a large city versus smaller suburban community).
- The therapist’s education level can also impact cost (i.e., a master’s level clinician may charge less per session versus a doctoral-level psychologist or psychiatrist, who will have a higher session rate).
- Depending on how long you want to be in treatment, the long-term cost of therapy can vary. Shorter-term treatment may be more affordable than longer treatment depending on the treatment setting.
All of these are important factors to think about as you choose between psychotherapy vs. cognitive-behavioral therapy.
If you think cognitive-behavioral therapy could be a good fit for you, please contact us today.
