Psychotherapy Treatments

Image Credit: Anastasia Olympiou, MSc

Cognitive Behavioural Therapy (CBT)

Cognitive therapy, developed by Albert Ellis and Aaron T. Beck in the 1950s and 1960s, is the application of the cognitive model to a disorder with the use of different techniques to modify the dysfunctional beliefs (Beck, 1995; 2005; 2011; Leichsenring et al., 2006).

Cognitive-behavioral therapy (CBT) represents a unique category of psychological interventions based on scientific models of human behavior, cognition, and emotion (Dobson, 2010). It includes a wide range of treatment strategies that take the current knowledge about the etiology and maintenance of the different mental disorders into account (Beck, 1995; 2011). Patients and therapists work together to identify and understand problems in terms of the relationship between thoughts, feelings, and behavior. The focus lies in the here and now.

Individualized, usually time-limited therapy goals are formulated. CBT intends to directly target symptoms, reduce distress, re-evaluate thinking and promote helpful behavioral responses. The therapist supports the patient to tackle problems by harnessing his or her own resources. Specific psychological and practical skills are acquired (e.g., reflecting and re-evaluating the meaning attributed to a situation with subsequent behavior changes) and the therapist actively promotes change with an emphasis on putting what has been learned into practice between sessions (“homework”).

The patient learns to attribute improvement to his or her own efforts (self-efficacy). A trusting and safe therapeutic alliance is viewed as an essential ingredient, but not as the main vehicle of change. Patients learn to reward themselves systematically whenever they have been successful in showing new and adequate reactions to crucial situations.

The therapist assists the patient to become more aware of maladaptive automatic thoughts that spring to mind and evoke negative personal interpretations (e.g., “I’m in danger”). A style of trained questioning (called “Socratic dialogue” or “guided recovery”) gently probes for patient meanings and stimulates alternative viewpoints or ideas.

CBT-trained therapists work with individuals, families, and groups.

The duration of cognitive-behavioral therapy varies, although it typically is thought of as one of the briefer psychotherapeutic treatments. In routine clinical practice, duration varies depending on patient comorbidity, treatment goals, and the specific conditions of the health care system.

The findings of the national institute of mental health study on depression are consistent with this duration of CBT, indicating that 16 to 20 sessions of cognitive behavioral (and interpersonal therapy or pharmacotherapy of a comparable duration) are insufficient for most patients to achieve lasting remission (Shea et al., 1992).

Some of the methods and techniques used in CBT are: Systematic desensitization (counter-conditioning), Exposure/response prevention (ERP), Relaxation, Positive and negative reinforcement, Cognitive modification, Assertiveness training (social skills training), Stress management, Problem solving (Beck, 1995; 2011; Dobson, 2010; Masters et al., 1987)



Beck, A. T. (2005). The Current State of Cognitive Therapy: A 40-Year Retrospective. Archives of General Psychiatry62(9), 953–959.

Beck, J. S. (1995). Cognitive Therapy—Basics and Beyond. New York: Guilford Press.

Beck, J. S., & Beck, J. S. (2011). Cognitive behavior therapy. [electronic resource] : basics and beyond (2nd ed.). Guilford Press.

Dobson, K. S. (2010). Handbook of cognitive-behavioral therapies. [electronic resource] (3rd ed.). Guilford Press.

Leichsenring, F., Hiller, W., Weissberg, M., & Leibing, E. (2006). Cognitive-Behavioral Therapy and Psychodynamic Psychotherapy: Techniques, Efficacy, and Indications. American Journal of Psychotherapy (Association for the Advancement of Psychotherapy), 60(3), 233–259.

Masters, J. C., & Rimm, D. G. (Eds). (1987), Behavior Therapy. Techniques and empirical findings. Orlando, Florida: Harcourt Brace Jovanovich,

Shea, T., Elkin, I., Imber, S. D., Sotsky, S., M., Watkins, J. T., Collins, J. F., Pilkonis, P. A., Backham, E., Glass, D. R., Dolan, R.T., & Parloff, M.B. (1992). Course of Depressive Symptoms Over Follow-up: Findings From the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Archives of General Psychiatry49(10), 782–787.

Rational Emotive Behavioral Therapy (REBT)

Rational Emotive Behavior Therapy (REBT) was founded in 1955 by Albert Ellis, a U.S. clinical psychologist.

REBT theory holds that human beings are capable of thinking rationally and irrationally. The ease with which we transform our strong desires into rigid demands, for example, suggests that the tendency toward irrational thinking is biologically based, but can be buffered or encouraged by environmental contexts (Ellis, 1976).

Rationality is a concept that is applied to a person’s beliefs. Rational beliefs, which are deemed to be at the core of psychological health in REBT, are flexible, consistent with reality, logical, and self- and relationship enhancing. Irrational beliefs, which are deemed to be at the core of psychological disturbance, are rigid, inconsistent with reality, illogical, and self- and relationship-defeating.

REBT therapists consider that the core facilitative conditions of empathy, unconditional positive regard, and genuineness are often desirable, but neither necessary nor sufficient for constructive therapeutic change. For such change to take place, REBT therapists need to help their clients to do the following:

  • Realize that they largely create their own psychological problems and that while situations contribute to these problems, they are in general of lesser importance in the change process
  • Fully recognize that they are able to address and overcome these problems
  • Understand that their problems stem largely from irrational beliefs
  • Detect their irrational beliefs and discriminate between them and their rational beliefs
  • Question their irrational beliefs and their rational beliefs until they see clearly that their irrational beliefs are false, illogical, and unconstructive while their rational beliefs are true, sensible, and constructive



Dryden W. (2005) Rational Emotive Behavior Therapy. In: Freeman A., Felgoise S.H., Nezu C.M., Nezu A.M., Reinecke M.A. (eds) Encyclopedia of Cognitive Behavior Therapy. Springer, Boston, MA.

Ellis, A. (1962). Reason and emotion in psychotherapy. Secaucus, NJ: Lyle Stuart.

Ellis, A. (1976). The biological basis of human irrationality. Journal of Individual Psychology, 32, 145–168.

Ellis, A. (1994). Reason and emotion in psychotherapy. Revised and updated edition. New York: Birch Lane Press.

Psychodynamic Therapy

Psychodynamic psychotherapy serves as an umbrella concept for psychotherapeutic treatments that operate on an interpretive-supportive (or expressive-supportive) continuum (Leichsenring, et al., 2006).

The supportive-interpretive continuum of psychodynamic interventions enhances the patient’s insight about repetitive conflicts sustaining his or her problems (Luborsky, 1984; Gabbard, 2003). Supportive interventions aim to strengthen abilities that are temporarily inaccessible because of acute stress (e.g. traumatic events) or that have not been sufficiently developed (e.g. impulse control in borderline personality disorder).

In the interpretive-supportive continuum, interpretation marks the one pole, being the most insight-enhancing intervention (Gabbard, 2000) (e.g., “Maybe you do not only want to pass your examination, but you are also afraid of what happens when you are successful”). Advice, praise, and affirmation mark the least interpretive and most supportive pole. Other interventions on the supportive-expressive continuum (e.g., confrontation, clarification, empathic validation) lie between interpretation and advice, praise and affirmation.

The use of more supportive or more interpretive (insight-enhancing) interventions depends on the patient’s needs.

A broad spectrum of psychiatric problems and disorders, ranging from milder adjustment disorders or stress reactions to severe personality disorders, such as borderline personality disorder or psychotic conditions, can be treated with psychodynamic psychotherapy.

The emphasis psychodynamic psychotherapy places on the relational aspects of transference is a key technical difference between it and cognitive-behavioral therapies. Transference, defined as the repetition of past experiences in present interpersonal relations, consists of patterns of feelings and behavior that arise from early ontogenetical experiences and impinge on everyday reality and relationships (Gabbard, 2003; Gabbard, 2014; Luborsky, 1984). In psychodynamic psychotherapy, transference is regarded as a primary source of understanding and therapeutic change (Gabbard, 2003; Gabbard, 2014; Luborsky, 1984).

Psychodynamic psychotherapy can be carried either as a short-term or as a long-term treatment. Short-term treatment is time limited, usually 16 to 30 sessions with a range of 7 to 40 sessions (Messer, 2001). Duration of long-term treatment ranges from a few months to several years (Gabbard, 2014; Luborsky, 1984).

Some of the methods and techniques used in Psychodynamic Psychotherapy include: Interpretation, Confrontation, Clarification, Encouragement, Empathic validation, Advice and praise, Affirmation, Working Through, Abstinence, Neutrality, Transference, Regression, Resistance (Gabbard, 2014, p.89-114; Luborsky, 1984).



Gabbard, G. O., Westen, D., (2003). Rethinking therapeutic action. International Journal of Psychoanalysis, 84, 823-41

Gabbard, G. O. (2014). Psychodynamic psychiatry in clinical practice, 5th ed. American Psychiatric Publishing, Inc.

Leichsenring, F., Hiller, W., Weissberg, M., & Leibing, E. (2006). Cognitive-Behavioral Therapy and Psychodynamic Psychotherapy: Techniques, Efficacy, and Indications. American Journal of Psychotherapy (Association for the Advancement of Psychotherapy), 60(3), 233–259.

Luborsky, L. (1984). Principles of Psychoanalytic Psychotherapy : A Manual for Supportive-expressive Treatment. Perseus Books Group.

Messer, S. B., (2001). What makes brief psychodynamic therapy time efficient. Clinical Psychology: Science and Practice 8 (1), 5-22.

Person-Centered Therapy (PCT)

Client-centered therapy, also called the person-centered approach is a form of psychoterhapy developed by Carl R. Rogers (1946) who worked with individuals experiencing all types of personal disturbances or problems in living.

Rogerian psychologists aim to create a therapeutic environment for their clients to change that is conformable, non-judgmental, and empathetic. Individuals grow psychologically, become more self-aware, and change their behavior via self-direction (Moon & Rice, 2012).

The most common applied techniques are:

  • Genuineness and congruence
  • Unconditional positive regard
  • Empathetic understanding

Rogers deliberately used the term ‘client’ over ‘patient’ supporting that the term ‘patient’ implies that the individual is sick and seeks a cure from a therapist. With the term ‘client’, Rogers emphasized the importance of the individual in seeking assistance, controlling their destiny, and overcoming their difficulties. This self-direction plays a vital part in client-centered therapy (Moon & Rice, 2012).

The American Psychological Association (APA, 2020) definition to Rogerian therapy clearly states that:

‘According to Rogers, an orderly process of client self-discovery and actualization occurs in response to the therapist’s consistent empathic understanding of, acceptance of, and respect for the client’s frame.

The therapist sets the stage for personality growth by reflecting and clarifying the ideas of the client, who is able to see himself or herself more clearly and come into closer touch with his or her real self.

As therapy progresses, the client resolves conflicts, reorganizes values and approaches to life, and learns how to interpret his or her thoughts and feelings, consequently changing behavior that he or she considers problematic.

It was originally known as nondirective counseling or nondirective therapy, although this term is now used more broadly to denote any approach to psychotherapy in which the therapist establishes an encouraging atmosphere but avoids giving advice, offering interpretations, or engaging in other actions to actively direct the therapeutic process. Also called client-centered psychotherapyperson-centered therapyRogerian therapy.’

A world association, which can be contacted online, was founded in Lisbon in 1997 that reflects the growth and vitality of the approach entitled the World Association for Person-Centered and Experiential Psychotherapy and Counseling (WAPCEPC, 2021).



American Psychological Association (2020). APA Dictionary of Psychology.

Moon, K. A, Rice, B. (2012). The nondirective attitude in client-centered practice: A few questions. Person-Centered & Experiential Psychotherapies, 11(4). 289-303.

Rogers, C. R. (1946). Significant aspects of client-centered therapy. American Psychologist, 1(10), 415–422.

Witty M.C. (2007) Client-Centered Therapy. In: Kazantzis N., LĽAbate L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA.

World Association for Person Centered & Experiential Psychotherapy & Counseling (2021). Welcome to the website for the World Association for Person Centered & Experiential Psychotherapy & Counseling.

Life Coaching

The way we think profoundly influences the way we feel, so learning to think differently can enable us to feel and act differently (Neenan & Dryden, 2002). Derived from the methods of cognitive behavior therapy, Life Coaching aims to help people to tackle self-defeating thinking and replace it with a problem-solving outlook. Life Coaching helps people to:

  • Deal with troublesome emotions
  • Improve self-efficacy, self-acceptance, self-responsibility
  • Tolerate frustration
  • Develop realistic expectations
  • Overcome procrastination
  • Increase flexibility in thinking and action-taking
  • Become assertive
  • Set and reach their goals
  • Tackle poor time management
  • Take calculated risks
  • Persist at problem solving
  • Handle criticism constructively
  • Take risks and make better decisions



Neenan, M., & Dryden, W. (2002). Life coaching. [electronic resource]: a cognitive-behavioural approach. Brunner-Routledge.