Psychotherapy includes a number of different types of therapy. Each one uses techniques intended to help you become more aware of your thoughts and feelings, and some focus on making changes in behavior. And each psychotherapy has a theory for how those changes take place.

Cognitive Behavior Therapy (CBT) helps people become aware of their feelings and thoughts in order to change their behaviors. Specifically, cognitive behavior therapists use techniques and give clients tools to decrease self-defeating behaviors like procrastination, social isolation, avoidance, smoking, overeating, alcohol abuse, passive-aggressive behaviors, aggressive behavior, substance abuse, reassurance seeking, and many other behaviors that get in the way of living a more satisfying, meaningful, and happy life. CBT therapists also help clients learn new adaptive behaviors or increase their frequency. Those behaviors may include effective communication, greater productivity, increased physical activity, relaxation exercises, reading social cues, assertively asking for what you want, dating skills, etc.

Cognitive Behavior Therapy (CBT) is really about setting goals and helping people to decrease unhelpful, self-sabotaging behaviors, while increasing effective skills so that individuals can reach their goals now, and have the skills to do that again and again on their own in the future. Of course, when people behave better and achieve their goals more frequently, they often times reduce the intensity and even the number of times they experience negative emotions like guilt, anxiety, embarrassment, and shame.

Goal setting and therefore the behaviors that help get you to those goals are set based on your values, morals, philosophies, religious beliefs, principles, or any other kind of guiding beliefs that are central to how you want to live your life. So CBT therapists will often help you explore and clarify those bigger principles too.

Psychotherapy at its best, reduces suffering as efficiently as possible, enhances existing strengths, and teaches you skills you don’t have yet that you need to build the life you want.

So the goal is really to help the client reduce suffering and increase vitality currently in psychotherapy in session with therapeutic techniques and with suggested exercises in between sessions. Work in between session is done to speed up the healing process and to cultivate self-confidence, real world practice, and greater independence. With enough practice clients learn how to use the skills to take care of themselves so they can leave therapy confident they can use the tools themselves as needed, while always knowing if additional support is needed they can return. But independence and autonomy are stressed. We don’t want therapy to decrease a client’s abilities or foster dependency.

Effective therapists function as both experts; conducting therapeutic techniques in session, educating clients about mental health issues and the scientific and research that supports the treatment of these issues, and as collaborative equal partners who recognize we are all in this together; empathizing and humanizing the experience of suffering and the path to healing and growth.

Psychotherapy and counseling are often used interchangeably. Historically counseling was often taught in departments of education and may have focused on working with students and/or dealing with career development. Many counseling programs focused on strengths and were client focused. But there has always been a great variety of approaches within counseling.

More important than whether someone says they are providing psychotherapy or counseling is the specific theoretical approach, technical skills, and styles they use. For instance a counselor and a psychotherapist may both practice the same kind of therapy, while two psychotherapists could have two very different theories for how therapy works, use different techniques, and differ greatly in their personal style.

So if you are considering seeing a professional counselor or psychotherapist, it is important to ask him or her to tell you what their theoretical approach is, what kinds of techniques they use, if those techniques are supported with scientific research, and what their style is like.

Professionals or staff in their office should be happy to answer those questions or point you to information on their website that address those questions.

Psychologists in New York State can be licensed professionals with doctoral degrees. This typically involves at least five years of graduate work, a clinical internship, passing of a licensure exam, and completing a number of supervised clinical hours. The requirements vary by state.

Anyone can call themselves a “therapist.” That doesn’t mean that someone referring to themselves as a therapist is not a licensed professional, it just doesn’t mean that they are. Licensing is done by the state, so different states license different kinds of professionals. If someone refers to him or herself as a therapist, it is a good idea to ask if he or she is licensed, and if so as what kind of a professional and what kind of training have they had.

This question differs depending on the person, symptoms, diagnosis, etc. The important thing if you are experiencing symptoms is to see a qualified professional who can accurately assess what you are experiencing and then recommend the appropriate kind of treatment.

As explained above, the word, “therapist” is a general term that could refer to anyone. Someone without any mental health education or training can call themselves a “therapist” in New York, but some very well trained social workers, psychologists, and other licensed professional therapists use the term as well.

In addition a psychiatrist, who is a medical doctor, can provide psychotherapy and/or prescribe medication to treat mental health disorders. So if it is determined you need medication, a psychiatrist or nurse practitioner (NP) is necessary in New York. If various kinds of therapy are required a psychiatrist if trained in effective therapy may be a good choice, or a psychologist, social worker, or mental health counselor could be effective as well.

Again, the important first step is to have a well qualified professional assess what you are experiencing to determine who will be best able to help you.

Fortunately, there are many mental health disorders that can be effectively treated. There is scientific evidence that Obsessive Compulsive Disorder (OCD), Depression (Major Depressive Disorder), phobias, Post-traumatic Stress Disorder (PTSD), Bulimia Nervosa, Binge Eating Disorder, and many other disorders can be effectively treated with certain kinds of therapy.

Unfortunately, there do remain some disorders that we have not yet demonstrated we can effectively treat and even for the disorders above, there are some people who do not improve as much as we would hope.

What is also critically important to know is that not all kinds of psychotherapy have been shown to effectively treat the disorders listed above or others. Some forms of psychotherapy have not been shown to help these or other disorders and there is evidence in some cases, particular kinds of therapy can even make problems worse. So it is incredibly important to find professionals who are able to provide scientifically supported treatments for the specific issues you are experiencing.

Individual therapy sessions typically run from 30-55 minutes. There are clients and kinds of therapy where 80-90 minute sessions are also conducted.

Group therapy sessions can run from 45 minutes to two hours depending on the kind of group and the number of group members.

The most common frequency is once a week .

But there are times when two or more times per week could be appropriate, especially if the issue is acute and serious, or if the goal is to provide therapy in a condensed format for a reason like someone is preparing to go away to college, etc.

There are also times, when going every other week or once a month could make sense. I often taper clients to this kind of schedule after symptoms have been significantly reduced and the client has learned the skills to cope better on his or her own.

Therapy certainly can be expensive, but it depends on where you seek a therapist and what is financially reasonable for you. There is very good therapy available on sliding scales at many universities, and at my group therapy practice, New York Behavioral Health.

There are also therapists that take insurance, where you may only be responsible for a co-payment and deductible.

You may also have out-of-network coverage with your insurance plan where you may be reimbursed for some portion of the payment to a psychotherapist who doesn’t take insurance.

Psychotherapy in NYC can range anywhere from $100 to $450 per session. You will want to call the psychotherapist and ask what their rate is.

Therapy is frequently covered by insurance. Depending on your insurance plan you may have to see an in-network provider or you may have out-of-network coverage where you could see someone who isn’t in-network, but your insurance company will pay for a portion of the cost. You can call your insurance company and ask them if you have out-of-network coverage for individual psychotherapy.

That way you can know in advance what you can expect to pay. The last thing you want is to find out after finding a great therapist is that you are stressed by the cost, that defeats the whole purpose.

At my practice, New York Behavioral Health, there are a number of therapists. I always let potential clients know that we want to be sure they are incredibly comfortable with the fit. So if they are not very satisfied after three or four sessions, I encourage them to call me directly and I will arrange for them to see someone else. Honestly this has only occurred a few times in the years I have been doing this, and in those cases it had to do with a client realizing they would be more comfortable with a therapist of a different age or sex.

Cognitive Behavior Therapy (CBT) is an active directive form of therapy. Expert CBT therapists perform a careful assessment of thoughts, feelings, behaviors, relationships, etc. Goals are established based on what is valuable to the client. Wherever negative symptoms exist, CBT therapy specifically assesses what is maintaining the symptom and intervenes to alleviate symptoms.
The general model proposes that we frequently behave in ways that are self-defeating when we are experiencing intense negative emotions. For example, we may greatly value a relationship. In fact because we value it so much, we become incredibly scared, hurt, and then angry when our partner says something that indicates his or her dissatisfaction with us. In a fit of anger we may say something in response that makes the situation worse. Over time, this pattern can put the relationship we value so much at risk.
CBT helps clients to become much better at recognizing situations and thinking patterns (distortions and faulty reasoning) that intensify negative emotions, putting people at greater risk of behaving against their own goals. With practice clients learn these and other skills to regulate their emotions and at times even more importantly change their behaviors. This enables clients to initiate and develop healthy relationships, be more productive at work, and enjoy recreational pursuits. The overall goal is to reduce distress and to enhance well being.