Introduction
“I don’t need therapy.” How many times have you said — or thought — that?
The stigma is still very much alive. But the truth is: psychotherapy is one of the most studied and effective health interventions in the history of medicine. A 2014 meta-analysis published in the Psychological Bulletin reviewed 365 studies and concluded that the benefits of psychotherapy are large and enduring — comparable to medication for a range of conditions.
Brazil’s Federal Psychology Council estimates that 40 million people could benefit from psychotherapy, yet only 2 million actively attend sessions.
This guide will help you understand what psychotherapy is, the main types available, how to choose a therapist, and what to expect.
1. What Is Psychotherapy
Psychotherapy is a structured process of psychological treatment delivered by a qualified professional (a psychologist or psychiatrist, depending on the approach), with the aim of:
- Reducing emotional distress
- Modifying thought patterns and behaviour
- Promoting self-awareness
- Developing emotional regulation skills
- Improving quality of life and relationships
1.1. The difference between psychotherapy and counselling
| Counselling | Psychotherapy |
|---|---|
| Focus on current problems | Focus on patterns + current problems |
| Short-term (weeks) | Medium to long-term (months to years) |
| Surface-level | In-depth |
| Practical guidance | Personal transformation |
2. The Main Types of Psychotherapy
2.1. CBT (Cognitive Behavioural Therapy)
Foundation: the relationship between thoughts, emotions, and behaviour.
Most effective for:
- Anxiety
- Depression
- Phobias
- OCD
- Insomnia
Typical duration: 12-20 sessions.
Evidence level: A (highest).
2.2. Psychoanalysis
Foundation: the unconscious, childhood conflicts, transference.
Most effective for:
- Identity issues
- Repetitive relationship patterns
- Deep trauma
Typical duration: years.
Evidence level: C (lower, due to methodological challenges).
2.3. Schema Therapy
Foundation: early maladaptive emotional schemas.
Most effective for:
- Personality disorders
- Chronic patterns
- Complex trauma
Typical duration: 1-3 years.
2.4. Gestalt Therapy
Foundation: here and now, awareness, wholeness.
Most effective for:
- Self-awareness
- Existential concerns
- Emotional blocks
2.5. ACT (Acceptance and Commitment Therapy)
Foundation: mindfulness, values, committed action.
Most effective for:
- Chronic anxiety
- Depression
- Chronic pain
- Avoidance behaviours
2.6. Systemic Therapy
Foundation: the family as a system.
Most effective for:
- Family conflict
- Couples
- Parenting issues
2.7. Clinical Hypnotherapy
Foundation: the use of hypnosis to access unconscious processes.
Clinical hypnosis is recognised by Brazil’s Federal Psychology Council (CFP Res. 013/2000) as a complementary technique within psychological practice.
Most effective for:
- Phobias
- Anxiety
- Trauma
- Habit change
- Chronic pain
3. Proven Benefits of Psychotherapy
3.1. Emotional benefits
- Reduced anxiety and depression
- Greater emotional regulation
- Improved self-esteem
- A stronger sense of purpose
3.2. Cognitive benefits
- Restructuring limiting beliefs
- Greater mental clarity
- Improved decision-making capacity
3.3. Behavioural benefits
- Healthier habits
- More fulfilling relationships
- Better professional performance
3.4. Physical benefits
- Reduction of psychosomatic symptoms
- Improved sleep
- Strengthened immune function
3.5. Social benefits
- Communication skills
- Greater empathy
- Stronger support networks
4. How a Psychotherapy Session Works
4.1. First session (assessment session)
- Listening to the main concern
- Life history
- Therapeutic goals
- Agreeing on the method
4.2. Subsequent sessions
- Exploring themes
- Practical exercises
- Homework
- Feedback
4.3. Frequency and duration
- Frequency: weekly (typical)
- Duration: 50 minutes per session
- Total: ranges from 8 sessions to several years
5. How to Choose the Right Psychotherapist
5.1. Technical criteria
- Valid registration with the relevant psychology board — mandatory
- Appropriate training — psychology degree plus specialisation
- Approach suited to your situation — check this carefully
- Experience with your issue — ask directly
5.2. Personal criteria (just as important)
- Therapeutic alliance — the relationship with your therapist is the strongest predictor of success
- Do you feel safe?
- Do you feel heard?
- Does the therapist feel genuine to you?
5.3. When to change therapist
Consider changing if:
- After 4-6 sessions you feel no improvement or sense of connection
- The therapist judges you or imposes their values
- There are ethical breaches (crossed boundaries)
- You consistently feel worse after sessions
6. Online Therapy vs In-Person Therapy
6.1. Advantages of online therapy
- Geographic accessibility
- Comfort of being at home
- Flexible scheduling
- Generally lower cost
- Protected confidentiality
6.2. When to prefer in-person
- Acute crises
- Severe trauma
- Cases requiring physical presence
- Personal preference
6.3. Comparative effectiveness
Studies show that online therapy is as effective as in-person therapy for the majority of cases, except in very severe conditions.
7. Cost and How to Access Support
7.1. Session fees
| Format | Fee | Duration |
|---|---|---|
| Initial consultation | Free | 30 min |
| Individual session | £95 | 50-60 min |
| 3-session package | £250 (saving £35) | - |
| 6-session package | £480 (saving £90) | - |
Payment by bank transfer, credit card, or cash. Please check whether your health insurance provides cover.
7.2. Where to access free support
- Your GP or community mental health services
- University training clinics
- Samaritans (116 123) — emotional support
- Social projects run by charities and community organisations
8. Myths About Psychotherapy
| Myth | Reality |
|---|---|
| ”It’s only for people with serious problems” | Anyone can benefit |
| ”I’ll become dependent on my therapist” | The goal is autonomy |
| ”It’s a waste of time” | Robust evidence of effectiveness |
| ”Psychologists can’t prescribe medication” | True, but they can refer to a psychiatrist |
| ”I know what’s wrong with me” | Diagnosis requires a professional |
9. Hypnotherapy vs Psychotherapy
Hypnotherapy does not replace psychotherapy for every situation, but it can be a powerful complement:
| Aspect | Psychotherapy | Hypnotherapy |
|---|---|---|
| Focus | Conscious + unconscious | Primarily unconscious |
| Time to results | Months | Weeks |
| Depth | Medium to high | High |
| Specific cases | Most conditions | Phobias, habits, trauma |
10. FAQ
How do I know if I need therapy?
If something has been bothering you for more than 2 weeks and is affecting your daily life, consider seeking help.
How long does treatment last?
It varies: from 3 months to 2 years or more, depending on the issue.
Does online therapy work?
Yes, with comparable effectiveness to in-person therapy.
Can I do therapy and take medication?
Yes. In many cases it is the ideal combination.
How do I know if a therapist is good?
Look for: therapeutic alliance, ethical practice, verified professional registration, and an approach suited to your needs.
Conclusion
Psychotherapy is one of the most powerful tools available for psychological wellbeing. Seeking it is not a sign of weakness — it is an investment in yourself.
If you are considering it, take that first step: book an initial consultation with at least two different professionals. Compare. Listen to how you feel. Then choose.
Your mental health deserves it.
