by Scott Haltzman, M.D.

Q. I’ve heard there are different types of therapy. What are they, and how should I choose one?

A. Here are some of today’s most widely practiced forms of psychotherapy.

Psychoanalysis
When you see a cartoon of a patient lying on a couch talking about whatever, you’re seeing an example of psychoanalysis. It proposes that a person’s unconscious problems, often rooted in childhood, cause emotional symptoms. (“I’ve been afraid to succeed at work because I thought I’d be punished by my boss, who reminds me of my father.”)

Most likely to help: People who have deeply engrained personality problems or repetitive relationship difficulties, or who can’t seem to achieve their potential.

Pros of psychoanalysis: Highly trained therapist. Very thorough.

Cons of psychoanalysis: Often takes years. Involves several weekly visits. Insurance may not cover it.

Insight-Oriented Therapy
Understanding the unconscious reasons you do things is the most important step toward undoing them, says this therapy. (“I get into fights with my wife because of my insecurity about how well I can provide for her.”)

Most likely to help: People with problems interacting or with inner turmoil that leads to depression, anxiety or some phobias.

Pros of insight-oriented therapy: Less expensive. More give-and-take in the early stages. Highly individualized.

Cons of insight-oriented therapy: Requires regular visits for several months. You must be willing to get in touch with your inner thoughts to make the most of it.

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Cognitive and Behavioral Therapy
These are different forms of therapy that frequently go together.

Cognitive therapy suggests that the way you think affects how you feel. If you think, “My work is a drag,” you’ll lose energy and be more likely to find things not to like, and, lo and behold, work will be a drag!

Treatment involves examining the validity of the thoughts. (You make good money; it’s a chance to meet new people; it could provide future opportunities.)

The counselor may add behavior therapy such as deep breathing; an exercise program; or declaring to your co-workers, “I love my job!”

Most likely to help: People who have phobias or anxiety disorders, or depression based on faulty perceptions.

Pros of cognitive and behavioral therapy: Highly trained therapists. Relatively quick, targeted treatment. Well-researched. Sometimes exceeds what medications can do (for instance, in helping people sleep).

Cons of cognitive and behavioral therapy: May seem cookie-cutter. Less of an opportunity to talk openly about whatever comes to mind.

Eclectic Therapy
Most therapists combine features. An eclectic therapist may help you understand how your childhood experiences colored your views but also recommend workbooks or teach you meditation.

Most likely to help: Any degree of emotional distress, especially as an add-on to medication for more severe mental problems.

Pros of eclectic therapy: Highly individualized. Good balance of listening and advice giving. May require fewer visits than some other therapies.

Cons of eclectic therapy: Therapy type and therapist training are very variable. Sometimes only partial use of specific models give you only partial results!

Board-certified psychiatrist SCOTT HALTZMAN, M.D., is the founder of 365Reasons.com ("365 reasons why marriage rocks!") and medical director of author of NRI Community Services, a behavioral-health provider in Woonsocket, RI. Dr. Haltzman's latest book is The Secrets of Happy Families. He practices eclectic therapy.

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Last updated and/or approved: December 2011. Original article appeared in November/December 2007 former print magazine. This general health-care information is not meant as individual advice. Please see our disclaimer.

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