What’s the Difference Between Psychotherapy and CBT?

Not sure which type of therapy is right for you? Read on to learn about the differences between psychotherapy and cognitive-behavioral therapy.

When it comes to mental health treatment, two of the most commonly used approaches are psychotherapy and cognitive-behavioral therapy (CBT), both offering significant benefits depending on the needs of a specific person. However, they differ in their methodologies, duration, and underlying theories that support their principles and practices. Understanding the distinctions between the two can help determine which approach might work best for someone’s unique needs. Here are the main differences between psychotherapy and CBT and the different types of treatment that fall under each category.

What is psychotherapy?

Psychotherapy, also known as talk therapy, is a broad category of therapeutic approaches designed to help people address emotional difficulties, mental health disorders, and behavioral issues. Traditional psychotherapy typically involves one-on-one sessions with a mental health professional. Examples of psychotherapy include: 

• Psychodynamic therapy, which focuses on uncovering unconscious thoughts, past experiences, and repressed conflicts to better understand and resolve current emotional struggles.
• Humanistic therapy that emphasizes self-acceptance, personal growth, and authenticity through an empathetic and accepting therapeutic relationship.
• Interpersonal therapy (IPT), which is an approach that aims to improve communication, resolve conflicts, and strengthen social support to address mental health challenges.
• Family therapy, where amilies to improve communication, resolve conflicts, and foster healthier relationships within the family unit.

What is cognitive-behavioral therapy (CBT)?

CBT is a short-term, structured, and goal-oriented form of psychotherapy that focuses on the relationship between thoughts, feelings, and behaviors. Its goal is to help people identify and change negative thought patterns and behaviors that contribute to emotional distress. Four core components of CBT include:

• Cognitive restructuring, which involves replacing negative thoughts with realistic, balanced ones to promote healthier ways of thinking and reduce emotional distress.
• Behavioral activation, which encourages people to engage in meaningful activities to counteract withdrawal and improve mood and energy levels.
• Exposure therapy, which gradually confronts fears in a safe environment to reduce anxiety and avoidant behaviors over time.
• Problem-solving to break challenges into manageable steps, encouraging practical solutions and fostering emotional resilience.

Key differences in psychotherapy vs CBT 

While the main goal of both psychotherapy and CBT is to help people improve their mental health, they differ in several key aspects:

1. Focus and approach

Psychotherapy puts a strong emphasis on exploring the underlying causes of a person’s mental health issues in many different ways. This often involves delving into past experiences, unconscious thoughts, and unresolved emotional conflicts. By uncovering the root causes of psychological distress, psychotherapy helps individuals understand how their behaviors, thought patterns, and emotional responses are shaped by these deeper layers. The goal is to bring these unconscious elements to light, enabling people to process past trauma and develop healthier coping mechanisms. 

In contrast, CBT focuses on the present moment, addressing how thoughts, emotions, and behaviors are interrelated. Rather than exploring past experiences, CBT emphasizes identifying and changing negative thinking patterns and behaviors that contribute to emotional distress. This goal-oriented approach aims to create immediate, positive changes by helping individuals develop practical strategies for managing their mental health.

2. Duration of treatment

Psychotherapy is typically a longer-term approach, with treatment often lasting months or even years. This extended duration is especially common when the therapy is addressing deep-rooted emotional issues, complex trauma, or significant mental health disorders. The pace of psychotherapy is more flexible and aims to support long-term healing, personal growth, and the resolution of long-standing problems. Since the focus is often on uncovering unconscious influences and working through them, the process may take a considerable amount of time. 

On the other hand, CBT is usually much shorter in duration, typically lasting between 12 and 20 sessions. This is because CBT is a more focused and structured form of therapy that aims to provide clients with specific tools and strategies to manage their mental health challenges. The short-term nature of CBT is aligned with its goal of providing practical, actionable techniques to create quicker and more noticeable improvements in a person’s well-being.

3. Role of the therapist 

In psychotherapy, particularly psychodynamic therapy, the therapist tends to play a more active and interpretive role. The therapist helps clients uncover unconscious thoughts, emotions, and behaviors that may be contributing to their distress. They may analyze patterns in the client’s behavior and relationships, providing insight that helps clients understand how their past experiences affect their present challenges. This dynamic often involves a more directive approach, with the therapist offering feedback and interpretations to facilitate deeper emotional processing. 

In contrast, the role of a CBT therapist is more collaborative. The therapist works alongside the client to identify negative thought patterns and jointly develop strategies to change them. The therapist also plays an educational role, teaching clients cognitive and behavioral techniques they can apply in everyday life. This collaboration empowers clients to take an active role in their healing process.

4. Treatment goals

The main goal of psychotherapy is to help people gain insight into their emotions, thoughts, and past experiences in order to understand their behaviors and improve their emotional well-being. This approach is particularly helpful for individuals dealing with deep emotional issues, such as trauma, personality disorders, or complex mental health disorders. By exploring these underlying issues, psychotherapy fosters long-term healing and personal growth. 

In contrast, the goal of CBT is to provide clients with practical tools to address current challenges, manage symptoms, and change negative thought patterns. CBT is especially effective for individuals dealing with anxiety, depression, obsessive-compulsive disorder (OCD), and other mental health conditions where altering specific thought patterns can lead to significant improvements. The focus is more on symptom management and creating lasting changes in a shorter time frame.

How to choose between psychotherapy and CBT 

Choosing between psychotherapy and CBT depends on several factors, including the nature of the mental health condition, personal preferences, and treatment goals. Here are some important things to consider when making the choice. 

Someone should consider psychotherapy if:

1. They want to explore past experiences, unconscious processes, and unresolved conflicts that may be affecting their mental health. By examining these deep layers in a psychotherapy session, people can gain a better understanding of how past events, early relationships, and hidden emotions are influencing their current thoughts, behaviors, and reactions. 

2. They are dealing with deep-rooted issues, such as trauma, complex relationships, or personality disorders, that require in-depth exploration. Addressing these past experiences in a psychotherapy-based therapy session requires careful examination, as it involves bringing these underlying causes to the surface and understanding how they shape current emotions.

3. They prefer a longer-term, introspective approach to therapy, where the process unfolds over an extended period of time. Psychotherapy often requires months or even years of consistent sessions, allowing for a full understanding of past experiences. People who are looking for a type of therapy that provides ample time for reflection, gradual healing, and long-term personal growth are best suited for the space and duration to work at their own pace that psychotherapy offers. 

Someone should consider CBT if:

1. They are looking for a practical, structured approach to dealing with current mental health concerns like anxiety, depression, or stress. CBT offers a goal-oriented, time-limited approach that focuses on addressing specific thoughts, behaviors, and symptoms in the here and now. It’s a type of therapy that provides clear tools and strategies to manage challenges effectively, helping to develop practical skills for coping with everyday stressors. 

2. They want to develop specific coping strategies and learn how to manage negative thoughts and behaviors. Through structured exercises, CBT will help people learn how to challenge these unhelpful thoughts and replace them with healthier ones while building skills to cope with different emotions and situations more effectively. This approach helps people gain confidence in their ability to manage their mental health on their own. 

3. They have specific mental health concerns, such as phobias, panic attacks, or OCD, that can benefit from targeted interventions like exposure therapy. In CBT, exposure therapy gradually helps people face feared situations or thoughts in a controlled way, reducing anxiety over time. For those with these mental health concerns, this involves confronting triggers while learning to manage anxiety without resorting to avoidance or compulsive behaviors.

How Charlie Health can help

If you or a loved one are struggling with a mental health disorder, Charlie Health is here to help. Charlie Health’s virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for dealing with serious mental health conditions. Our expert clinicians incorporate evidence-based therapies into individual counseling, family therapy, and group sessions. With treatment, managing your mental health is possible. Fill out the form below or give us a call to start healing today.