If you are seeking therapy for anxiety, you will likely come across a variety of counselling options, most falling under the umbrella category of psychotherapy. Which type of therapy you choose will depend upon your unique situation and needs.

What is psychotherapy?
Psychotherapy, or talk therapy, is a form of counselling in which you speak to a mental health care professional to discover more about your condition and your thoughts, feelings, and behaviours. Through the different kinds of psychotherapy, you can learn strategies for dealing with stress, anxiety, and the unhealthy, unproductive thoughts and behaviours that affect your quality of life. The goal of any type of psychotherapy is the control or elimination of symptoms and an improved sense of well-being.

Why is psychotherapy recommended for anxiety?
People with anxiety disorders often benefit from the life skills and coping strategies that can be learned in collaboration with a therapist. While you may also be prescribed medication to reduce your anxiety symptoms, psychotherapy provides useful insight that you can carry over into all areas of your life - even after you have stopped taking medication.

What are the different types of psychotherapy?
Cognitive-behavioural therapy (CBT) is considered the most effective and established psychotherapy for treating anxiety disorders. A therapist using CBT methods will talk with you to help you to recognize, understand, and actively replace negative, unproductive patterns of thought and behaviour with healthier, more balanced patterns. You will be expected to complete "homework" as a way to practice the skills and strategies learned while in session. CBT produces lasting results, even though therapy often lasts only 10 to 20 sessions of 45 minutes to one hour each.

Acceptance and commitment therapy (ACT) has many similarities to CBT and emphasizes acceptance and commitment to change.

Exposure therapy is a type of behavioural therapy used to treat all anxiety disorders. The "exposure" portion of therapy involves a patient facing up to the thing they fear or dread - but in a gradual and controlled way so the patient's fear response lessens with repeated exposures. During exposures, patients are encouraged to resist using any "safety behaviours" (e.g. distraction). In the case of obsessive-compulsive disorder, the person exposes themself to the feared situation or thought without resorting to ritualistic behaviours. This is referred to as "exposure and response prevention."

Psychodynamic psychotherapy and psychoanalysis are modes of psychotherapy focused on increasing a patient's awareness of memories and unconscious thoughts and behaviours. Psychoanalysis is often more intensive with more frequent sessions.

If anxiety is rooted in relationships, you might consider interpersonal therapy, family therapy, or couples' therapy. Art therapy and play therapy are used to harness the power of play and creative expression as means of communicating complex emotions and anxieties.

What should I expect from a session of therapy?
Your first session with a therapist will mostly be an information-gathering session. You will be asking questions and listening closely to decide whether or not this therapist is the right one for you. Your therapist will also ask you questions and have you fill out forms detailing your medical and mental health history.

Your therapist may practice out of a medical office or in a hospital, a suite in an office building, or even a home-based setting. You will most likely sit face-to-face with your therapist for the 45- to 60-minute session. In some instances, a therapist may suggest that you meet in a group therapy session along with a small group of others going through similar issues.

Do not be surprised if you feel uncomfortable at first with the notion of talking about yourself in such an intimate way. It can get emotionally charged, so do not hesitate to cry or to express feelings of upset or anger. Your therapist is there to help you understand these sorts of emotions and to give you ways of coping with them.

Take comfort in the fact that what you share with your therapist is considered confidential. Only in few instances would a therapist have to break confidentiality: if you threaten to harm yourself or commit suicide, if you threaten to harm or take the life of someone else, if you tell the therapist about a child or vulnerable adult who is being abused or at risk of being abused, or if your records are subpoenaed by a judge. In no instance is it appropriate to share intimate physical contact with a therapist.

Does psychotherapy work?
In general, people who undergo psychotherapy get relief from their symptoms, as well as improved functioning and quality of life. Other benefits include fewer sick days and medical problems.

To get the most out of psychotherapy, you must be honest, open, adherent to the agreed-upon treatment plan, and outspoken when something is not working or does not feel right. Consider therapy a collaboration or an alliance between yourself and your therapist.

Is psychotherapy only for people with mental health disorders?
The presence of "psycho" in the word "psychotherapy" may turn some people off of it. But psychotherapy is not only for the mentally ill or the terribly troubled. Psychotherapy is sought out by people needing help dealing with anxiety symptoms and any number of other emotional and mental health concerns - stress, sleeping problems, resolving conflicts, sex and relationship difficulties, adjusting to major life changes, or recovering from abuse or trauma.

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What should I look for when choosing a therapist?