Different Types of Therapy Explained: Complete Guide to Counselling Modalities

Walking into therapy for the first time can feel like entering a foreign country. Everyone speaks a language you don't quite understand: CBT, person-centred, psychodynamic, integrative, EMDR...

What do these words actually mean? And more importantly, which one do you need?

The truth is, the therapeutic approach matters less than you might think—research consistently shows the therapeutic relationship is the strongest predictor of outcomes. But different approaches do suit different people and problems better.

This guide explains the main types of therapy available in the UK, what each involves, who they help most, and how to choose.

The Main Categories

Therapy approaches can be grouped into three broad categories:

1. Cognitive-Behavioural (thinking and doing): Focus on thoughts, beliefs, and behaviours

2. Humanistic-Existential (experiencing and being): Focus on personal growth, present experience, and authentic living

3. Psychodynamic-Analytic (understanding and insight): Focus on unconscious patterns, past experiences, and deep exploration

Within these categories sit specific modalities. Let's explore the most common.

Cognitive Behavioural Therapy (CBT)

What It Is

CBT is a structured, goal-oriented therapy that examines the relationship between thoughts, feelings, and behaviours.

Core premise: Your thoughts influence your feelings, which influence your behaviours. By changing unhelpful thought patterns, you can change how you feel and act.

How It Works

Typical session:

• Identify specific problems
• Examine thoughts about the problem
• Challenge unhelpful or distorted thinking
• Develop alternative, more balanced thoughts
• Practice new behaviours

Homework: CBT involves between-session tasks—thought records, behavioural experiments, exposure exercises.

Duration: Usually time-limited (8-20 sessions)

What Makes It Distinct

• Structured: Clear agenda each session
• Present-focused: Concentrates on current problems, not childhood
• Evidence-based: Strong research support for specific disorders
• Directive: Therapist actively teaches and guides
• Practical: Emphasises tools and techniques

Best For

Specific anxiety disorders:

• Panic disorder
• Social anxiety
• Health anxiety
• Specific phobias
• OCD

Depression: Particularly effective for moderate depression

Other conditions:

• Eating disorders (often CBT-E—Enhanced CBT)
• Insomnia (CBT-I)
• Chronic pain management
• PTSD (trauma-focused CBT)

Less Suitable For

• Deep exploratory work
• Personality difficulties
• Relational trauma
• People who want to understand "why," not just "how to cope"

Finding a CBT Therapist

Look for:

• Accredited CBT training (Diploma/MSc in CBT)
• BABCP registration (British Association for Behavioural and Cognitive Psychotherapies)
• IAPT experience (many NHS CBT therapists)

Person-Centred Therapy

What It Is

Developed by Carl Rogers, person-centred therapy trusts your innate capacity for growth and self-healing.

Core premise: You are the expert on yourself. Given the right conditions (acceptance, empathy, genuineness), you'll naturally move towards growth and healing.

How It Works

Therapeutic relationship is central: The therapist provides three "core conditions":

1. Unconditional positive regard: Acceptance without judgment
2. Empathy: Deep understanding of your experience
3. Congruence: Therapist is genuine, not hiding behind a professional mask

Non-directive: You lead. The therapist follows, reflecting back what they hear, helping you understand yourself more clearly.

No agenda: Sessions don't have predetermined goals or structure. You explore whatever feels important.

What Makes It Distinct

• Client-led: You choose what to talk about
• Relationship-focused: The relationship itself is healing
• Non-judgmental: Complete acceptance
• Exploratory: Process-oriented, not solution-focused
• Holistic: Sees you as whole person, not collection of symptoms

Best For

Relationship issues: Understanding patterns, improving intimacy, healing relational wounds

Low self-esteem: Experiencing unconditional acceptance helps you accept yourself

Identity and authenticity: Exploring who you are, what you want, living authentically

Personal growth: Not fixing problems, but becoming more fully yourself

When you need to be heard: If you've never experienced being truly listened to without judgment

Less Suitable For

• Specific symptom reduction (phobias, panic)
• People who want structure and direction
• Crisis requiring immediate intervention

Finding a Person-Centred Therapist

Look for:

• Training in person-centred or humanistic therapy
• BACP or UKCP registration
• Profile mentioning Rogers, core conditions, client-led

Psychodynamic Therapy

What It Is

Psychodynamic therapy explores how unconscious patterns, formed in early relationships, shape current life.

Core premise: Current difficulties often have roots in past experiences, particularly childhood. By understanding these connections and bringing unconscious patterns to awareness, you can change them.

How It Works

Exploration of past: Examining early relationships, attachment, formative experiences

Unconscious patterns: Noticing what you're not aware of—repetitive patterns, defences, projections

Transference: How you relate to your therapist often mirrors how you relate to others—examining this provides insight

Free association: Saying whatever comes to mind without censoring

Interpretation: Therapist offers insights about patterns and meanings

What Makes It Distinct

• Past-focused: Explores childhood and history
• Depth-oriented: Seeks underlying causes, not just symptoms
• Interpretive: Therapist offers insights
• Long-term: Usually open-ended
• Explorative: Less structured

Best For

Complex difficulties: Where problems don't have clear external cause

Relationship patterns: Repeating the same relationship dynamics

Personality difficulties: Deep-rooted ways of seeing self and others

When "why" matters: If you want to understand not just cope

Chronic low mood: Particularly when rooted in loss or unresolved grief

Less Suitable For

• Immediate symptom relief
• People who prefer present-focus
• Time-limited work
• Concrete, practical problems

Finding a Psychodynamic Therapist

Look for:

• Psychodynamic or psychoanalytic training
• UKCP or BPC (British Psychoanalytic Council) registration
• Long-term availability

EMDR (Eye Movement Desensitisation and Reprocessing)

What It Is

EMDR is a structured therapy specifically developed for trauma and PTSD.

Core premise: Traumatic memories get "stuck" and aren't processed properly. Bilateral stimulation (eye movements, tapping) helps the brain reprocess these memories, reducing their emotional charge.

How It Works

Eight-phase protocol:

1. History and treatment planning
2. Preparation and resourcing 3-7. Reprocessing traumatic memories using bilateral stimulation
3. Re-evaluation

Bilateral stimulation: Following therapist's finger with your eyes (or using taps/sounds) whilst holding trauma memory

Memory reprocessing: Over sessions, the memory becomes less distressing, more like a normal memory

What Makes It Distinct

• Trauma-specific: Developed for PTSD
• Structured: Clear protocol
• Body-based: Works with sensations and bilateral stimulation
• Less talking: Don't need to narrate trauma in detail
• Evidence-based: Strong research support

Best For

PTSD: Single-incident trauma (assault, accident, etc.)

Specific traumatic memories: Flashbacks, intrusive images

Phobias: Rooted in specific traumatic event

Less Suitable For

• Complex developmental trauma (needs modification)
• General anxiety or depression without specific trauma
• People who prefer talk-based therapy

Finding an EMDR Therapist

Look for:

• EMDR Association UK accreditation
• Completed EMDR training (not just introductory course)
• Experience with your type of trauma

Gestalt Therapy

What It Is

Gestalt therapy emphasises present-moment awareness, personal responsibility, and authentic contact.

Core premise: Healing happens through awareness and authentic relating in the here-and-now.

How It Works

Present-focus: "What are you experiencing right now?" rather than analysing past

Experiments: Creative exercises (empty chair, role-play, movement) to increase awareness

Awareness: Noticing body sensations, emotions, thoughts, behaviour

Contact: Authentic, direct relating with therapist

What Makes It Distinct

• Experiential: Focuses on experience, not explanation
• Present-focused: Here-and-now awareness
• Creative: Uses experiments and embodied work
• Responsibility: Emphasises ownership and choice

Best For

Feeling stuck or disconnected: Gestalt helps you reconnect with immediate experience

Emotional avoidance: Brings you into present-moment feelings

People who think too much: Bypasses overthinking through experiential work

Less Suitable For

• People who prefer purely talk-based therapy
• Those uncomfortable with creative exercises
• Crisis requiring immediate stabilisation

Finding a Gestalt Therapist

Look for:

• Gestalt training (Diploma/MSc)
• UKCP registration
• Profile mentioning experiments, here-and-now, awareness

Acceptance and Commitment Therapy (ACT)

What It Is

ACT combines mindfulness, acceptance, and behaviour change strategies.

Core premise: Trying to control or eliminate difficult thoughts and feelings often makes them worse. Instead, accept them and commit to actions aligned with your values.

How It Works

Six core processes:

1. Acceptance (of difficult feelings)
2. Cognitive defusion (not believing all your thoughts)
3. Present-moment awareness
4. Self-as-context (you're not your thoughts)
5. Values clarification
6. Committed action

Metaphors and exercises: Uses creative language and experiential exercises

What Makes It Distinct

• Acceptance-based: Not trying to eliminate symptoms
• Values-driven: Focus on living meaningfully
• Mindfulness-informed: Present-moment awareness
• Action-oriented: Behaviour change towards values

Best For

Chronic conditions: Where eliminating symptoms isn't realistic (chronic pain, tinnitus)

Anxiety: Particularly health anxiety, worry, rumination

Value-driven work: When you feel directionless

Finding an ACT Therapist

Look for:

• ACT training or certification
• BABCP or BACP registration
• Mindfulness background

Integrative Therapy

What It Is

Integrative therapists draw from multiple approaches, adapting to your needs.

Core premise: No single approach suits everyone. Effective therapy combines elements from different modalities.

How It Works

Example integration:

• Person-centred relationship (safety, acceptance)
• CBT techniques (for specific symptoms)
• Psychodynamic exploration (understanding patterns)
• Gestalt experiments (when stuck)

Therapist flexibly uses what's helpful.

What Makes It Distinct

• Flexible: Adapts to you
• Holistic: Addresses multiple levels (thoughts, feelings, patterns, relationship)
• Personalised: Not one-size-fits-all

Best For

Most people: Integrative is increasingly common and effective

Complex presentations: When you need different approaches for different issues

Finding an Integrative Therapist

Look for:

• Training in multiple modalities
• Profile explicitly stating "integrative"
• BACP or UKCP registration

How to Choose

Start With Your Issue

Specific anxiety/phobia: CBT or EMDR

Trauma: EMDR, trauma-focused CBT, or sensorimotor psychotherapy

Depression: CBT, person-centred, or psychodynamic

Relationship patterns: Person-centred, psychodynamic, or Gestalt

Personal growth: Person-centred or existential

Chronic pain/illness: ACT

Consider Your Preferences

Prefer structure: CBT, ACT

Prefer exploration: Person-centred, psychodynamic

Want to understand why: Psychodynamic

Want tools and strategies: CBT, ACT

Value relationship: Person-centred, Gestalt

Ask Potential Therapists

"What's your approach?" "How do you typically work with [your issue]?" "Are you flexible in your approach?"

Remember: Relationship Matters Most

The therapeutic relationship predicts outcomes more than modality. Choose a therapist you feel comfortable with, even if their approach isn't textbook-perfect for your issue.

Final Thoughts

You don't need to become an expert in therapy modalities before starting. Most people choose based on:

• Therapist they connect with
• Availability and cost
• Recommendation

If the approach doesn't suit you after 3-4 sessions, you can:

• Discuss with therapist
• Try different therapist/approach
• Give it a bit longer

Therapy is flexible. The right approach is the one that helps you.

If you're in London and unsure what type of therapy might suit you, I offer a free initial consultation. I work integratively, combining person-centred, Gestalt, and transactional analysis, tailoring my approach to what you need.

You can reach me at 07887 376 839 or via the contact form on this website.