Psychotherapy is treatment involving psychological techniques; it consists of interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth. The major psychotherapies derive from psychology’s psychodynamic, humanistic, behavioral, and cognitive perspectives. Biomedical therapy treats psychological disorders with medications or procedures that act directly on a patient’s physiology. An eclectic approach combines techniques from various forms of therapy.

Through psychoanalysis, Sigmund Freud tried to give people self-insight and relief from their disorders by bringing anxiety-laden feelings and thoughts into conscious awareness. Psychoanalytic techniques included using free association and interpretation of instances of resistance and transference. Psychodynamic therapy has been influenced by traditional psychoanalysis but differs from it in many ways, including the lack of belief in id, ego, and superego. This contemporary therapy is briefer, less expensive, and more focused on helping the client find relief from current symptoms. Psychodynamic therapists help clients understand how past relationships create themes that may be acted out in present relationships. Interpersonal therapy is a brief 12- to 16-session form of psychodynamic therapy that has been effective in treating depression.

Both psychoanalytic and humanistic therapists are insight therapies—they attempt to improve functioning by increasing clients’ awareness of motives and defenses. Humanistic therapy’s goals have included helping clients grow in self-awareness and self-acceptance; promoting personal growth rather than curing illness; helping clients take responsibility for their own growth; focusing on conscious thoughts rather than unconscious motivations; and seeing the present and future as more important than the past.
     Carl Rogers’ client-centered therapy proposed that therapists’ most important contributions are to function as a psychological mirror through active listening and to provide a growth-fostering environment of unconditional positive regard, characterized by genuineness, acceptance, and empathy.

Behavior therapies are not insight therapies. Their goal is to apply learning principles to modify problem behaviors.
     Classical conditioning techniques, including exposure therapies (such as systematic desensitization or virtual reality exposure therapy) and aversive conditioning, attempt to change behaviors through counterconditioning—evoking new responses to old stimuli that trigger unwanted behaviors.

Operant conditioning operates under the premise that voluntary behaviors are strongly influenced by their consequences. Therapy based on operant conditioning principles uses behavior modification techniques to change unwanted behaviors through positively reinforcing desired behaviors and ignoring or punishing undesirable behaviors.
     Critics maintain that (1) techniques such as those used in token economies may produce behavior changes that disappear when rewards end, and (2) deciding which behaviors should change is authoritarian and unethical. Proponents argue that treatment with positive rewards is more humane than punishing people or institutionalizing them for undesired behaviors.

The cognitive therapies, such as Aaron Beck’s cognitive therapy for depression, assume that our thinking influences our feelings, and that the therapist’s role is to change clients’ self-defeating thinking by training them to view themselves in more positive ways. The widely researched and practiced cognitive-behavioral therapy (CBT) combines cognitive therapy and behavior therapy by helping clients regularly act out their new ways of thinking and talking in their everyday life.

Group therapy sessions can help more people and costs less per person than individual therapy would. Clients may benefit from exploring feelings and developing social skills in a group situation, from learning that others have similar problems, and from getting feedback on new ways of behaving. Family therapy views a family as an interactive system and attempts to help members discover the roles they play and to learn to communicate more openly and directly.