CBT vs Humanistic Therapy: Understanding the Difference

When you're looking for therapy, you'll quickly encounter an alphabet soup of approaches: CBT, DBT, ACT, EMDR, and countless others. Two of the most common—and in many ways most contrasting—are CBT (Cognitive Behavioural Therapy) and humanistic therapy.

If you've engaged with NHS mental health services, you've almost certainly been offered CBT. It's the default approach across much of the UK's public healthcare system, backed by extensive research funding and NICE (National Institute for Health and Care Excellence) guidelines.

Humanistic therapy, whilst equally evidence-based and widely practised, often flies below the radar. It's more common in private practice, counselling services, and university counselling centres. Many people discover it only after trying CBT and sensing something was missing—or finding it through personal recommendation.

So what actually differentiates these approaches? Which suits which kinds of people and problems? And can you benefit from both? This guide breaks down the practical, philosophical, and experiential differences to help you make an informed choice.

Table of Contents

• The Fundamental Difference in Philosophy
• How Sessions Feel Different
• Structure and Techniques
• The Therapist's Role
• What Each Approach Works Best For
• Time Frame and Commitment
• Evidence Base and Effectiveness
• Cost and Availability
• Can You Combine Both Approaches?
• Frequently Asked Questions

The Fundamental Difference in Philosophy

Before diving into practical differences, it's worth understanding the fundamentally different views of human nature underlying each approach.

CBT: Thoughts Create Feelings

CBT emerged from cognitive psychology and behavioural science in the 1960s and 70s. Its central premise is that psychological distress arises largely from unhelpful thinking patterns and behaviours. Change how you think and act, and your feelings will follow.

CBT sees humans as essentially learning machines. We develop patterns—some helpful, some problematic—through experience and conditioning. The therapist's expertise lies in understanding these patterns and teaching more adaptive alternatives.

The focus is pragmatic and present-oriented: what's maintaining the problem right now, and what skills can reduce symptoms? There's less emphasis on exploring why you think or behave in particular ways, and more on changing what you do moving forward.

Humanistic: Growth is Natural When Obstacles Are Removed

Humanistic therapy emerged as a "third force" in psychology, explicitly rejecting both psychoanalysis and behaviorism. Its founders—Carl Rogers, Fritz Perls, Abraham Maslow—proposed that humans have an innate drive toward growth, health, and self-actualisation.

From this perspective, psychological distress arises when this natural growth gets blocked—by difficult circumstances, damaging relationships, trauma, or the internalisation of harsh judgements and impossible standards.

The therapist's role isn't to fix, teach, or guide you toward predetermined outcomes. It's to create conditions where your natural capacity for self-understanding and growth can emerge: safety, acceptance, empathy, and authenticity.

Where CBT asks "what skills do you need to learn?", humanistic therapy asks "what's blocking your natural capacity for wellbeing?"

The Map vs the Territory

Here's a useful metaphor: imagine you're lost in a city.

A CBT therapist hands you a map, shows you how to read it, and teaches you navigation skills. They might walk with you at first, but the goal is for you to learn to navigate independently using the tools they've provided.

A humanistic therapist walks beside you without a predetermined destination. They trust that as you explore together—noticing what draws you, what frightens you, what feels right—you'll eventually find your way. The journey itself reveals what you need to discover.

Neither approach is inherently superior. They suit different personalities, problems, and moments in life.

How Sessions Feel Different

The philosophical differences translate into distinctly different therapeutic experiences.

CBT Sessions

CBT sessions typically follow a structured format:

1. Check-in and agenda-setting (5-10 mins): You briefly update your therapist on the week and collaboratively decide what to focus on today.

2. Review homework (10-15 mins): If you were practicing a technique or completing thought records, you discuss what happened and what you learned.

3. Work on today's focus (20-25 mins): Your therapist might teach a new skill, help you examine a particular thought pattern, or plan a behavioral experiment.

4. Agree homework (5 mins): You decide what to practice before next session.

5. Summarize and feedback (5 mins): Your therapist summarizes key points and asks what was helpful or unclear.

There's an educational quality to CBT. Your therapist explains concepts (cognitive distortions, behavioural activation, exposure hierarchies), provides handouts, and explicitly teaches you techniques. You're expected to practice between sessions—CBT is sometimes called "homework therapy."

The therapist guides the process more actively. While collaborative, there's an implied expertise: they know approaches that work for your kind of difficulty, and they're teaching you to apply them.

Humanistic Therapy Sessions

Humanistic sessions are more fluid and client-led:

1. Open beginning: Your therapist might simply ask "How are you?" or "What would be helpful to talk about today?" There's no predetermined agenda.

2. Following your thread: You talk about whatever feels most pressing—something that happened, a feeling you're sitting with, a pattern you've noticed, or just whatever emerges in the moment.

3. Therapist presence and reflection: Your therapist listens deeply, offering reflections that capture what you're expressing. They might notice themes, gently point out contradictions, or share their genuine response to what you're exploring.

4. Natural ending: Sessions end organically rather than with homework or action plans.

The quality is more exploratory and relational. There's minimal teaching or technique-application. Your therapist isn't steering toward predetermined outcomes but trusting that what needs to emerge will emerge through the process of being deeply listened to and accepted.

The pace can be slower. You might spend an entire session sitting with a particular feeling or circling around something difficult to articulate. This isn't inefficiency—it's making space for deeper processing that can't be rushed.

Structure and Techniques

CBT: Specific Techniques for Specific Problems

CBT has developed protocols for particular difficulties. If you're struggling with panic attacks, there's a fairly standardised sequence: psychoeducation about anxiety, breathing retraining, cognitive restructuring of catastrophic thoughts, and gradual exposure to feared sensations.

Common CBT techniques include:

• Thought records: Identifying negative automatic thoughts, examining evidence, developing balanced alternatives
• Behavioural activation: Scheduling pleasant or meaningful activities to counter depression
• Exposure hierarchies: Gradually facing feared situations to reduce avoidance
• Behavioural experiments: Testing out predictions to see if feared outcomes actually occur
• Problem-solving training: Systematic approaches to practical difficulties
• Relaxation and mindfulness: Techniques for managing physical anxiety

The strength of this structure is clarity and efficiency. You know what you're working on and why. Progress is measurable: fewer panic attacks, higher mood scores, less avoidance.

The potential limitation is that complex human struggles don't always fit neat protocols. Your depression might not respond to behavioral activation if the underlying issue is existential meaninglessness or ungrieved loss.

Humanistic: The Relationship IS the Technique

Humanistic approaches don't rely on specific techniques in the same way. The therapeutic relationship itself—characterized by unconditional positive regard, empathic understanding, and congruence—is understood as the primary healing agent.

That said, different humanistic modalities do involve particular practices:

Person-Centred Therapy: The core "technique" is empathic reflection—mirroring back your experience to help you hear yourself more clearly. The therapist rarely offers interpretations or advice, trusting your own self-understanding to deepen through the process.

Gestalt Therapy: Uses creative experiments—empty chair dialogues, role-playing different parts of yourself, paying attention to body sensations—to bring unconscious material into awareness and integrate disowned aspects.

Transactional Analysis: Employs frameworks like ego states (Parent, Adult, Child) and life scripts to help you understand relational patterns. TA therapists might give explicit "permissions" to counter early prohibitions ("You're allowed to make mistakes," "Your needs matter").

The strength of humanistic approaches is depth and authenticity. You're not learning techniques to apply; you're becoming more fully yourself. Change happens at a fundamental level of identity and self-relationship, not just symptom management.

The potential limitation is that progress can feel less tangible, particularly in the early stages. You might not have homework or measurable goals, which some people find frustrating.

The Therapist's Role

The therapist's role differs substantially between approaches.

CBT Therapist: Guide and Teacher

In CBT, your therapist is an active expert. They diagnose patterns, educate you about psychological processes, and teach you skills. The relationship is collaborative—you work together toward goals you've agreed—but there's an asymmetry of expertise. Your therapist knows what works for your kind of problem.

This can feel reassuring, particularly if you're confused about what's happening to you or desperate for practical help. There's comfort in having someone knowledgeable taking an active role in moving you toward wellbeing.

Humanistic Therapist: Companion and Witness

In humanistic therapy, your therapist is a companion on your journey of self-discovery. They're not claiming to know better than you what you need or where you're headed. Their expertise lies in creating a particular quality of presence and relationship, not in possessing superior knowledge about your life.

This can feel liberating—particularly if you've had experiences of being told what to do or not being trusted to know your own mind. But it can also feel frustrating if you're hoping for direction or answers.

Genuineness and Self-Disclosure

Humanistic therapists typically share more of their genuine responses than CBT practitioners, who maintain stricter professional boundaries. A humanistic therapist might say "I notice I feel moved as you talk about this" or acknowledge their own uncertainty, creating a more mutual, human encounter.

CBT therapists generally maintain clearer boundaries, rarely sharing personal reactions or experiences. The focus stays on you and your patterns, with the therapist as professional facilitator rather than fellow human.

Neither style is better—they suit different preferences and needs.

What Each Approach Works Best For

CBT Tends to Suit:

Specific, well-defined problems: Panic attacks, specific phobias, OCD, social anxiety, insomnia—difficulties where symptoms are clear and treatable through established protocols.

Preference for structure: If you like having a clear plan, measurable goals, and concrete techniques to practice, CBT's structure often feels reassuring.

Solution-focused mindset: If you want to solve the problem and move on rather than explore underlying meanings, CBT's pragmatic approach fits well.

Limited time or budget: CBT is typically shorter-term (6-20 sessions), making it more affordable and practical if resources are constrained.

Need for rapid symptom relief: When you're in crisis or symptoms are severely impacting functioning, CBT's active, skills-based approach can provide quicker relief than more exploratory work.

Humanistic Therapy Tends to Suit:

Complex or diffuse difficulties: When you can't quite name what's wrong—general unhappiness, feeling stuck, relationship patterns, identity questions—humanistic therapy's exploratory nature allows you to discover what needs attention.

Desire for self-understanding: If you want to understand yourself more deeply, not just reduce symptoms, humanistic approaches offer that exploratory space.

Relational wounds: If your difficulties stem from damaging relationships or attachment wounds, the therapeutic relationship itself becomes a healing corrective experience.

Preference for autonomy: If being told what to do triggers resistance—even if the advice is good—humanistic therapy's non-directive nature respects your agency.

Previous unsatisfactory therapy: Many people find their way to humanistic approaches after CBT or other directive therapies felt constraining or superficial.

Long-term personal development: If you're seeking ongoing personal growth rather than crisis intervention, humanistic therapy accommodates long-term, open-ended work.

Neither Approach Has a Monopoly

That said, there's considerable evidence that both approaches effectively treat anxiety, depression, trauma, and relationship difficulties. Personal fit—whether you connect with your therapist and resonate with the approach—often matters more than which specific modality you choose.

Time Frame and Commitment

CBT: Time-Limited

CBT is typically offered as a short-term intervention: 6-12 sessions for milder difficulties, up to 20 sessions for more complex issues. This time-limited nature is partly philosophical (efficient, focused treatment) and partly practical (more affordable, fits NHS structures).

You'll usually have weekly sessions, with the expectation of practicing techniques between meetings. There's a planned ending from the start, with later sessions focused on consolidating skills and preventing relapse.

Humanistic: Open-Ended

Humanistic therapy is typically open-ended. You might work together for a few months or several years, depending on what you're exploring. There's no predetermined end point—therapy continues until it feels complete.

Many people start with weekly sessions and gradually space them out (fortnightly, then monthly) as they need less intensive support. Endings are collaboratively decided rather than predetermined.

This open-ended nature allows deeper work but requires greater financial and time commitment.

Evidence Base and Effectiveness

A common misconception is that CBT is "evidence-based" whilst humanistic approaches aren't. This isn't accurate—both have substantial research support, though the evidence looks somewhat different.

CBT's Evidence Base

CBT has been extensively researched through randomised controlled trials (RCTs)—studies comparing CBT to waitlist controls, placebo conditions, or other treatments. This research shows CBT effectively treats anxiety disorders, depression, OCD, PTSD, eating disorders, and insomnia, among other conditions.

CBT's evidence base is partly a function of fit: its structured, manual-based nature makes it easy to research using RCT methodology. Protocols can be standardised, outcomes are measurable, and time-frames are predictable.

Humanistic Therapy's Evidence Base

Humanistic approaches also have extensive evidence of effectiveness, though the research uses different methodologies more suited to relational, process-oriented work.

Meta-analyses (studies combining results from multiple trials) consistently show person-centred, gestalt, and other humanistic therapies are as effective as CBT for depression, anxiety, trauma, and relationship difficulties, with benefits maintained or increasing over time.

Some research suggests humanistic approaches may be particularly effective for complex, long-standing difficulties where standardised protocols are less applicable.

The Dodo Bird Verdict

Much psychotherapy research points to what's called the "Dodo Bird Verdict" (from Alice in Wonderland: "Everybody has won, and all must have prizes"). Different genuine therapy approaches seem roughly equally effective, with relationship quality and therapist skill mattering more than specific modality.

Choose based on personal fit rather than assuming one approach is scientifically superior.

Cost and Availability

NHS Availability

CBT: Widely available through NHS Talking Therapies (formerly IAPT). You can self-refer and usually receive treatment within weeks to months, though this varies by region. Treatment is time-limited (typically 6-12 sessions) and follows standardised protocols.

Humanistic therapy: Less commonly available through NHS, though some services do offer person-centred counselling or integrative approaches. University counselling services and some employee assistance programmes offer humanistic therapy.

Private Practice

CBT: Private CBT in London typically costs £60-£150 per session, similar to other modalities. The shorter-term nature means total cost is usually lower (£360-£3,000 for a full course).

Humanistic therapy: Similar per-session costs (£60-£150), but open-ended nature means higher total cost if you work long-term. Many people manage this through block bookings at discounted rates or less frequent sessions.

Practical Considerations

If budget is very limited, NHS CBT may be your most accessible option. However, investing in private humanistic therapy—even at a reduced frequency—might be worthwhile if CBT hasn't worked or doesn't fit your needs.

Some therapists offer block booking discounts (for example, 5 sessions for £375 instead of £400, or 10 for £750 instead of £800) or reduced rates for students and trainees, making longer-term work more affordable.

Can You Combine Both Approaches?

Absolutely. In fact, many therapists work integratively, drawing on both CBT and humanistic principles.

Integrative and Pluralistic Approaches

Integrative therapists are trained in multiple modalities and adapt their approach based on what each client needs. For example, they might provide a humanistic relational foundation—offering unconditional positive regard and empathic exploration—whilst occasionally using CBT techniques when specific skills would help.

You might spend most sessions exploring your experience in an open, person-centred way, but when you're struggling with panic attacks, your therapist might teach you breathing techniques or cognitive restructuring. Or you might primarily work with CBT protocols but have a therapist who's also warmly relational rather than purely technical.

Sequential Approaches

Some people benefit from CBT first for symptom stabilisation, then humanistic therapy for deeper exploration. Or vice versa: humanistic work to build self-acceptance and insight, then targeted CBT for specific residual symptoms.

Asking About Integration

If you're drawn to aspects of both approaches, ask potential therapists: "Do you work integratively?" or "Would you be comfortable using CBT techniques within a humanistic framework?" Many will say yes.

Frequently Asked Questions

Is CBT better than humanistic therapy for depression and anxiety?

Research shows both approaches effectively treat depression and anxiety. CBT may work faster for some people, particularly for specific anxiety disorders like panic or social anxiety. Humanistic therapy may be more effective for complex presentations or when relational issues underlie symptoms. Individual fit matters more than approach.

Why does the NHS mainly offer CBT?

This is partly evidence-based (CBT has been extensively researched using RCT methodology) and partly practical (CBT's structured, time-limited nature fits resource-constrained healthcare systems). It's not that humanistic approaches are less effective, but they're harder to standardise and deliver at scale.

Can humanistic therapy help with specific problems like OCD or phobias?

Yes, though the approach differs. Rather than following exposure protocols, humanistic therapy explores what the symptom is communicating and addresses underlying patterns. For some people this works well; others benefit from combining humanistic exploration with targeted CBT techniques for specific symptoms.

Is CBT too superficial?

Not necessarily. While CBT focuses on present symptoms rather than historical exploration, "superficial" isn't fair. Changing thought and behaviour patterns can create profound shifts. That said, some people do find CBT insufficient for complex or deep-seated difficulties, which is when humanistic approaches may offer more.

Do I have to do homework in humanistic therapy?

No. Humanistic therapy doesn't typically involve homework. Change happens through the therapeutic relationship and your own reflection, not through structured tasks. This suits some people; others miss the concrete focus that homework provides.

How do I know which approach to choose?

Consider: Do you want structure or exploration? Tools to practice or space to discover? Time-limited or open-ended? Direction or autonomy? There's no wrong answer. Many people find their way through trial and error—an initial consultation with a therapist will help you gauge fit.

Can my CBT therapist also work humanistically?

Some can; many CBT-specialist therapists are trained primarily in cognitive and behavioural approaches and may not be comfortable working non-directively. However, many integrative therapists can offer both. Ask directly: "Are you comfortable working in a less structured, more client-led way if that's what I need?"

Will humanistic therapy take years?

Not necessarily. Some people work humanistically for a few months; others stay longer. Unlike psychoanalysis (which traditionally involves years of multiple-times-weekly sessions), humanistic therapy is flexible. You might work intensively for 6 months, then check in occasionally, or maintain ongoing work. It's collaborative rather than prescribed.

Finding Your Fit

CBT and humanistic therapy represent genuinely different ways of understanding and working with psychological distress. Neither is universally superior—they suit different people, problems, and moments in life.

CBT offers structure, specific techniques, and efficient symptom relief. It's practical, evidence-based, and widely accessible. If you want to learn skills, solve a specific problem, and move on relatively quickly, it's an excellent choice.

Humanistic therapy offers depth, relational healing, and space for self-discovery. It's exploratory, person-centred, and addresses the whole person rather than isolated symptoms. If you want to understand yourself more deeply, heal relational wounds, or work on complex difficulties that don't fit diagnostic boxes, it may be a better fit.

Many people benefit from elements of both, whether simultaneously through integrative therapy or sequentially at different stages of their journey.

The best approach is the one that resonates with you, delivered by a therapist you trust. Most therapists offer initial consultations where you can discuss their approach and assess fit. Trust that your sense of whether it feels right is valuable data.

For humanistic, integrative therapy in London—drawing on person-centred, Gestalt, and Transactional Analysis approaches, with CBT techniques incorporated when helpful—contact Kicks Therapy for an initial consultation. We offer both in-person sessions in Fulham/SW6 and video counselling, tailored to your unique needs and preferences.

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About the Author: This article was written by the Kicks Therapy Content Team, with input from BACP-registered therapists trained in both CBT and humanistic approaches.

Further Reading:

• What is Person-Centred Therapy?
• Understanding Humanistic Therapy
• What is Transactional Analysis?
• How to Find the Right Therapist in London

Expert Sources:

• National Institute for Health and Care Excellence (NICE). (2022). Depression and anxiety: Treatment guidelines. https://www.nice.org.uk/
• Elliott, R., et al. (2013). Person-centered/experiential therapies are highly effective. Psychotherapy, 50(3), 449-453.
• Cooper, M. (2008). Essential Research Findings in Counselling and Psychotherapy. London: Sage.
• British Association for Counselling and Psychotherapy (BACP). (2024). Therapeutic approaches. https://www.bacp.co.uk/