Why this matters
When you are looking for a therapist, you will often see a list of acronyms. CBT. ACT. DBT. EMDR. Somatic. Schema. Most people do not know what these mean, which makes it hard to ask for what you need or evaluate whether a therapist's approach suits your situation.
This is a plain-English breakdown of the most common approaches and who they tend to work best for.
CBT — Cognitive Behavioural Therapy
What it is: CBT works with the relationship between thoughts, feelings, and behaviour. The core idea is that how we interpret events shapes how we feel, and that some patterns of thinking cause unnecessary suffering.
What happens in sessions: You identify unhelpful thought patterns (catastrophising, black-and-white thinking, mind-reading), examine the evidence for and against them, and practise more balanced ways of thinking. Often includes homework between sessions.
Good for: Anxiety, depression, phobias, OCD, health anxiety, social anxiety, perfectionism.
Time frame: Typically structured, 8–20 sessions. One of the most researched therapy approaches in the world.
ACT — Acceptance and Commitment Therapy
What it is: Where CBT tries to change unhelpful thoughts, ACT teaches you to change your relationship to them. The goal is not to eliminate difficult thoughts and feelings but to stop letting them run your life.
What happens in sessions: Mindfulness exercises, values clarification, and practical work on committed action — doing what matters to you even when difficult feelings are present.
Good for: Anxiety, burnout, chronic pain, depression, life transitions, situations where the problem cannot be eliminated but must be lived with.
Time frame: Variable. Can be brief (6–12 sessions) or longer depending on complexity.
DBT — Dialectical Behaviour Therapy
What it is: Originally developed for borderline personality disorder, DBT is now used more broadly for emotional dysregulation — intense, hard-to-manage emotions and the behaviours that follow them.
What happens in sessions: Skills training in four areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Often includes both individual therapy and group skills training.
Good for: Emotional dysregulation, self-harm, BPD, eating disorders, intense relationship difficulties, trauma with strong emotional components.
Time frame: Usually 6 months to a year for full DBT. Skills components can be taught in shorter formats.
EMDR — Eye Movement Desensitisation and Reprocessing
What it is: A trauma-focused therapy that uses bilateral stimulation (typically eye movements, sometimes taps or tones) while you hold a traumatic memory in mind. The mechanism is debated but the evidence for trauma treatment is strong.
What happens in sessions: After a preparation phase, you focus on a specific traumatic memory while following the therapist's hand movements or another bilateral stimulus. Sessions are intense and often emotionally activating.
Good for: PTSD, single-incident trauma (accidents, assaults), complex trauma, phobias.
Time frame: Preparation takes a few sessions. Active processing varies by complexity of trauma. Often 8–20+ sessions.
Somatic Therapy
What it is: Somatic approaches focus on the body rather than primarily the mind. The premise is that trauma and stress are stored in the body and that resolution requires physical, not just cognitive, work.
What happens in sessions: Attention to physical sensations, breath, posture, and movement. The therapist helps you notice and work with body signals that carry emotional information. Methods include Somatic Experiencing, Sensorimotor Psychotherapy, and others.
Good for: Trauma where talk therapy feels inadequate, chronic stress, dissociation, anxiety with strong physical symptoms, people who "talk about" problems without feeling better.
Time frame: Varies significantly. Can be long-term work.
Person-Centred Therapy
What it is: The therapist provides unconditional positive regard, empathy, and authenticity. The relationship itself is the therapeutic mechanism.
What happens in sessions: Led entirely by you. The therapist reflects, questions, and holds space. No structured techniques or homework.
Good for: Grief, self-worth, relationship difficulties, life transitions, situations where being genuinely heard is the primary need.
Time frame: Open-ended.
How to choose
You do not need to know in advance which approach you want. A good therapist will:
- Assess your situation and recommend an approach
- Explain why they think that approach suits you specifically
- Adapt as needed
The most important factor in therapy outcomes is not the modality — it is the quality of the relationship with your therapist. An excellent person-centred therapist will often produce better outcomes than a mediocre CBT therapist, even if CBT is technically "the right" approach for your presentation.
Ask any prospective therapist: "What approach do you use and why do you think it would suit what I've described?" Their answer — and how clearly they give it — will tell you a lot.
Before your first session
The free Clarity Check gives you PHQ-9, GAD-7, and WHO-5 scores in 10 minutes. Sharing them with your therapist means your first session can skip the ground-laying and go straight to what matters.