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What is Psychotherapy?

By: Dr. Jeremy Fink, LCSW, Psy.D.  |  May, 17th, 2017

You have heard of psychotherapy before. You know what it is, and it is likely that you or someone you know has attended a psychotherapy session. You may have taken a psychology 101 class in college, seen a television show about psychotherapy, or read about it in a magazine. You also may be searching the web and getting referrals from friends, searching for a psychotherapist who can help you or a family member with their problems.

Despite what you know about psychotherapy, if I were to ask 100 other people the question, what is psychotherapy, I would get many different answers. Since the time of Freud, the theories and practice of psychotherapy has evolved, as too have those who practice it. Gone are the times when only neurologists sat behind you on a couch. Marriage and family therapists, social workers, psychologists, counselors, pastoral counselors, life coaches, and a host of many others are practitioners of therapeutic mental health services, with educational background that vary from no education to professional schools to research universities.

The many treatment modalities too seem to increase in number every year. There is traditional psychoanalysis and psychodynamic psychotherapy and then there is cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), eye movement desensitization reprocessing (EMDR), emotionally focused therapy (EFT), acceptance and commitment therapy (ACT), the list on acronyms goes on and on.

So which is best?

The answer is that there is no best. One is just as likely to benefit from pastoral counseling or life coaching as another person’s DBT treatment with a psychologist or long-term psychoanalysis benefits them. There has been a big push over the past decade toward something called empirically based treatment, which tries to use research to determine the best treatment method for a person. However, this is a red herring. Human relationships are impossible to quantify or even qualify, there are too many moving parts, and it is the therapeutic relationship that has been found to be most beneficial to the consumer. Oftentimes the en vogue treatment has more to do with what insurance companies want to pay for and less to do with what is beneficial for a person. In truth, one treatment methodology is as good as another if it is agreed upon by therapist and client. And, level of education doesn't’t necessarily indicate a successful therapy either. I went to school for over a decade, but it was the training and level of experience that benefited me most. What research has shown is that all forms of psychotherapy are as effective as one another, and level of education is not correlated to a successful outcome.

So what is psychotherapy? Is it talking on a couch in an office about your mother or father or sister? Is it following a light bar from left to right with your eyes? Is it meditation, body scans, grounding techniques? Is it children playing or drawing or using puppets? Is it tracking your thoughts and trying to replace the negative ones with positive?

It very well may include some or all of these things.