There are multiple therapy types, which divide broadly into three categories: Psychodynamic, Humanistic, and Cognitive-Behavioral. Simplistically, they differ in that Psychodynamic focuses on the causes of a psychological difficulty; Humanistic on acceptance of it; and Behavioural on managing its symptoms. There’s also Integrative therapy, which means a combination of these specific to a particular therapist. In practice, you might not notice much difference between these types, but their underlying theories do differ.
I take an Integrative position. I consider all the leading therapy modalities to have enormous value, but that no single one of them captures the breadth of human experience or therapeutic potential. My primary approach is Psychodynamic, but I believe that the journey and ultimate goals of therapy are Humanistic.
It depends on wether you’re primarily interested in understanding the roots of your problem (Psychodynamic), finding the wisdom to live with it (Humanistic), training yourself to experience it differently (Cognitive-Behavioural), or a combination of these (Integrative). But more important than choosing a type of therapy, it turns out, is the quality of the relationship you have with the actual therapist.
You’ll spend a lot of time with your therapist, and you’ll need to feel comfortable opening up emotionally and sharing very personal things with them. This will depend on a deep sense of trust, companiability, and that they feel like a real person to you. The dynamic between you and them is in itself therapeutic and transformative – if you click on some crucial, basic level. If you don’t, you haven’t found the right therapist.
Honestly, I believe it is. The quality of your relationship with your therapist is so important, and it’s almost inevitably much more likely to develop if you both get to sit in the same room. Online therapy has obvious time and financial conveniences, but is less likely to be transformative. I generally only offer it as an occasional fallback, rather than as a primary way of working.
No, it doesn’t. That said, many people agree that weekly is a good rhythm. It maintains momentum, allows enough life to happen in between sessions, and is (hopefully) affordable. But some people prefer fortnightly or ad-hoc sessions for financial or scheduling reasons. And classical psychoanalysis is up to five times a week! So, there’s a lot of variance. I encourage weekly sessions, but we can discuss what’s right for you.
Yes and no. The structure is a 50-minute session; it starts and ends predictably; the therapist is fully present, ethical, and boundaried; they attend to you with committed interest, non-judgment, and without agenda. You just need to show up. Say what you need to say or feel what you need to feel. You can experiment with preparation and with no preparation. The therapist holds the frame, and you can be whoever you are within it. Everyone is different.
Only as long as it’s useful. That’s not quite as simple as it sounds, because it can take time to become felt as useful. But I encourage this to be discussed, and I am keen that you make a tangible sense of progress in it, and that it doesn’t drag on or become a dependency. And in all cases, it’s always completely your decision to start, pause, or end it.