Understanding the different types of therapy
When you start thinking about therapy, it can be overwhelming trying to figure out what all the options are. There’s cognitive behavioural therapy, schema therapy, ACT, EMDR, narrative therapy…
The truth is, there’s no single “best” type of therapy. Different approaches suit different people, personalities, and problems. What matters most is that the therapy helps you make sense of what’s happening, builds insight, and supports change in a way that feels meaningful and sustainable.
Here’s a breakdown of some of the more common approaches you might come across, and what they actually involve.
Cognitive behavioural therapy
Cognitive behavioural therapy (CBT) is one of the most widely known and researched forms of therapy. At its core, CBT is about recognising the link between your thoughts, feelings, and behaviours. The idea is that our thoughts shape how we feel and act, and that by identifying and adjusting unhelpful thought patterns we can change how we experience situations and respond to them.
A typical CBT session involves exploring specific situations that trigger distress or anxiety, examining the automatic thoughts that arise, and gently testing whether those thoughts are accurate or helpful. You’ll often learn practical strategies for managing anxiety, low mood, or stress, for example, scheduling pleasant activities, challenging negative thinking, or learning relaxation skills.
Because CBT is a broad approach, it has several specialised branches designed to target specific issues:
CBT-I (Cognitive Behavioural Therapy for Insomnia): Focuses on improving sleep by addressing the habits, thoughts, and behaviours that keep people awake. This might include things like sleep restriction, relaxation training, and learning to challenge unhelpful thoughts about sleep (“I’ll never fall asleep” or “If I don’t get eight hours, I’ll be useless tomorrow”).
CBT for panic disorder or phobias: Helps people gradually face feared situations while learning how to reduce physical and emotional anxiety responses.
CBT for depression: Emphasises understanding and shifting patterns of thinking and behaviour that maintain low mood, such as avoidance, rumination, or self-criticism.
CBT tends to be structured, short-term, and focused on practical skills. It’s especially helpful if you like clear goals and want strategies you can apply in everyday life.
Acceptance and commitment therapy
Acceptance and commitment therapy (often just called ACT) is a more recent form of behavioural therapy that takes a slightly different path. Rather than trying to change difficult thoughts or feelings directly, ACT focuses on changing your relationship with them.
The idea is that struggling to eliminate uncomfortable feelings like anxiety, sadness and fear often makes them stronger. ACT teaches skills to notice and accept these experiences without being controlled by them. Through mindfulness and values-based work, the focus shifts from “How can I get rid of this feeling?” to “How can I live the life I want, even when difficult feelings show up?”
ACT can be especially helpful if you feel stuck in cycles of avoidance, such as putting life on hold until you “feel better.” Instead, ACT encourages movement towards what really matters: your relationships, values, and sense of purpose.
Eye movement desensitisation and reprocessing
EMDR was originally developed for people experiencing post-traumatic stress disorder (PTSD), but it’s now used to help with a range of distressing memories or events.
The approach might sound unusual: during EMDR, I’ll guide you to recall parts of a traumatic or upsetting memory while you follow my finger from side to side with your eyes.
This process helps the brain reprocess the memory, so it becomes less emotionally intense and more integrated with other life experiences. It’s not hypnosis, and you don’t lose control, you remain aware and present throughout.
People often find that after EMDR, the memory still exists but feels more distant and less distressing. It’s a highly evidence-based treatment for trauma and can be amazing for those who’ve experienced painful or overwhelming events.
Clients are often sceptical about this treatment, but it’s surprisingly effective.
Schema therapy
Schema therapy blends ideas from CBT, attachment theory, and psychodynamic therapy. It’s particularly helpful for people who notice long-standing emotional patterns that seem to repeat in relationships, work, or self-image — such as feeling unworthy, abandoned, or constantly on guard.
“Schemas” are deep-seated beliefs or emotional templates formed early in life, often in response to unmet needs or difficult experiences. For example, someone with an “abandonment schema” might expect others to leave them, even in safe relationships. Over time, these schemas shape how we interpret and respond to the world.
In schema therapy, you work to understand these patterns with compassion, identify where they come from, and gradually develop healthier ways of thinking, feeling, and relating.
Narrative therapy
Narrative therapy starts from the idea that we all make sense of our lives through stories — the stories we tell about ourselves, and the stories others tell about us. Sometimes, those stories become narrow or self-critical: “I’m the anxious one,” or “I always mess things up.”
In narrative therapy, the goal is to help you step back and see that you are not the problem, the problem is the problem. You’ll explore alternative stories that highlight your strengths, values, and intentions. It’s about rediscovering the control of your own life.
This approach is often creative and collaborative. It can involve exploring language, metaphors, or even writing your story in a new way. It’s particularly empowering for people who want to reconnect with their sense of agency and identity.
Finding the right fit
Choosing a therapy type can feel overwhelming, but remember: you don’t have to have it all figured out at the start. A good therapist will help guide you, explain their approach, and adapt techniques to suit your needs.
The most important ingredient across all therapies is the relationship, feeling understood, respected, and supported. From there, the specific model is simply the framework that helps change unfold.
At Deep Well Psychology, I draw from several of these approaches, depending on what’s most helpful for each person. Therapy isn’t one-size-fits-all, it’s about finding what resonates and helps you move toward a fuller, more connected life.