Talk Therapy

Key takeaways

• Ways to find a therapist: your doctor, your insurance plan's directory, an employee assistance program, or FindTreatment.gov
• Well-studied for anxiety and depression: cognitive behavioral therapy (CBT)
• Most useful single change: Ask your doctor for a referral, or contact therapists in your insurance network directly.
• Commonest mistake: Assuming you cannot find therapy without a referral.
• See a doctor if any of the signs under "When to get help" below apply to you.

Why it matters

Psychotherapy is a core treatment for several common conditions, and there is more than one route to finding it.

The numbers, in one place

Published figures for Talk Therapy

Measure	Figure
Ways to find a therapist	your doctor, your insurance plan's directory, an employee assistance program, or FindTreatment.gov
Well-studied for anxiety and depression	cognitive behavioral therapy (CBT)
Typical course	a limited number of sessions, often weekly
Delivery	in person, by phone, by video, or digitally
SAMHSA National Helpline	1-800-662-4357, free, confidential, 24/7

What helps

• Ask your doctor for a referral, or contact therapists in your insurance network directly
• Do the between-session work, which is where most of the change happens
• Say early if the approach is not fitting; it can be changed
• Ask your insurer about copays and session limits before you start

What to avoid

• Assuming you cannot find therapy without a referral
• Stopping after one difficult session
• Treating therapy and medication as mutually exclusive

In depth

Talk therapy, or psychotherapy, is a structured way of working with a trained professional to understand and change patterns of thinking, feeling and behavior. It is different from an ordinary supportive conversation: sessions have a clear focus, the therapist uses techniques with an evidence base, and you usually agree on goals at the start. Therapy is a core treatment for many conditions, including depression, anxiety disorders, post-traumatic stress disorder, eating disorders and insomnia.

There are many types. Cognitive behavioral therapy looks at how thoughts, feelings and behaviors influence each other and teaches practical skills. Interpersonal therapy focuses on relationships and life changes. Dialectical behavior therapy helps with intense emotions and self-harm. Psychodynamic therapy explores how past experiences shape current patterns. Some approaches, such as exposure therapy or CBT for insomnia, target a specific problem. Different conditions respond best to different approaches.

In the US, therapy is provided by several kinds of licensed professionals, including psychologists, licensed clinical social workers, licensed professional counselors and marriage and family therapists, as well as psychiatrists, who are medical doctors. Insurance coverage, cost and waiting times vary widely. Knowing how to navigate the options, and what to expect once you start, makes it more likely you will find help that works and stick with it.

Signs and symptoms

• Low mood, worry or stress that has lasted for weeks and affects daily life
• Repeating patterns in relationships that you want to change
• Difficulty coping after a loss, trauma or major life change
• Sleep problems that have not improved with simple changes
• Using alcohol, food or other habits to manage difficult feelings
• A doctor recommending therapy as part of treatment

Causes and risk factors

• The match between the type of therapy and the problem being treated
• The working relationship with your therapist
• How regularly you attend and whether you practice between sessions
• Insurance coverage, cost and how easy it is to attend
• Whether other problems, such as substance use, are also addressed

How it is checked

The first session or two are usually an assessment. The therapist asks about your current difficulties, history, health, relationships and goals, and may use questionnaires to measure symptoms. This helps them understand what is going on, suggest an approach and agree on a plan with you. It is also your chance to ask questions and judge whether you feel comfortable working with them.

If you start with your primary care doctor, they can assess your symptoms, check for physical causes and refer you to a therapist or psychiatrist. Your insurance plan may require a referral or pre-authorization, so it is worth checking before you book. Many therapists also offer a brief phone call before the first session to discuss fit.

Related topics

• Psychological Therapies for Pain: What Published Guidance Supports (Chronic Pain)
• Physical Therapy: Sorting the Evidence From the Noise (Back and Posture)
• Physical Therapy Services: Sorting the Evidence From the Noise (Rehabilitation)
• What the Guidance Really Says About Insomnia (Sleep)

Where to go next

• Talk Therapy for Beginners: Where to Start
• Answers to the Common Questions on Talk Therapy
• Mental Health: The Complete Guide
• The Evidence on Screen Time and Mood, Without the Hype
• Supporting Someone Else: What the Evidence Actually Says

When to get help

See your doctor urgently if symptoms are severe or you have psychotic symptoms such as hearing voices. If you feel unable to keep yourself safe or have thoughts of harming yourself, call or text 988 at any hour. In immediate danger, call 911 or go to the nearest emergency room.

Where this comes from

• National Institute of Mental Health — Psychotherapies
• SAMHSA — National Helpline

How this page was put together

Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.

Medical disclaimer

This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.