Types of Therapy Compared: CBT, DBT, EMDR, ACT, and More
Updated 16 April 2026
Understanding therapy types helps you ask the right questions when choosing a provider. Here are the 6 major approaches, what they treat, their evidence base, and which providers typically offer them.
Quick Comparison
| Therapy | Best For | Duration | Evidence |
|---|---|---|---|
| CBT | Anxiety, depression, insomnia, phobias | 8-20 sessions | Very strong |
| DBT | BPD, self-harm, emotional dysregulation | 6-12 months | Strong |
| EMDR | PTSD, trauma, phobias | 8-12 sessions | Strong |
| ACT | Chronic pain, anxiety, values clarity | 8-16 sessions | Growing |
| Psychodynamic | Personality patterns, long-term issues | Months to years | Moderate |
| EFT / Gottman | Couples, attachment, communication | 8-20+ sessions | Strong |
CBT (Cognitive Behavioral Therapy)
The most widely available and researched therapy approach.
CONDITIONS TREATED
Depression, generalized anxiety, social anxiety, panic disorder, insomnia, phobias, OCD (with ERP), chronic pain
TYPICAL DURATION
8-20 sessions typical for a specific issue
HOW IT WORKS
Structured, goal-oriented. Identifies negative thought patterns and behavioral habits. Uses homework (thought logs, behavioral experiments). Measures progress with standardized questionnaires.
EVIDENCE BASE
Strongest evidence base of any therapy. Hundreds of RCTs. Recommended as first-line treatment by APA, NICE, and WHO for depression and anxiety disorders.
WHO PROVIDES IT
All provider types (LPC, LCSW, psychologist, LMFT). Most therapists have at least basic CBT training.
BEST FOR
People who want structured, practical, time-limited therapy with measurable goals. Works well for specific symptoms like panic attacks, insomnia, or negative thinking patterns.
DBT (Dialectical Behavior Therapy)
Specialized for emotional regulation and distress tolerance.
CONDITIONS TREATED
Borderline personality disorder, chronic suicidality, self-harm, eating disorders, substance abuse co-occurring with emotional dysregulation
TYPICAL DURATION
6-12 months minimum. Includes individual therapy (weekly) and group skills training (weekly, 2-2.5 hours)
HOW IT WORKS
Four modules: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Individual sessions plus group skills class. Therapist is available for between-session coaching calls.
EVIDENCE BASE
Strong evidence for BPD and chronic suicidality. Multiple RCTs showing reduced self-harm, hospitalization, and treatment dropout. Originally developed by Marsha Linehan at the University of Washington.
WHO PROVIDES IT
Requires specialized DBT training. Look for providers who completed Linehan Board certification or intensive DBT training (not just therapists who 'use DBT skills'). Most commonly offered by psychologists and LPCs with additional training.
BEST FOR
People with intense emotions, relationship instability, impulsive behavior, or chronic feelings of emptiness. Especially effective when previous therapy has not addressed emotional dysregulation.
EMDR (Eye Movement Desensitization and Reprocessing)
Trauma-focused therapy that processes disturbing memories through bilateral stimulation.
CONDITIONS TREATED
PTSD, complex trauma, phobias, performance anxiety, grief, disturbing memories from childhood abuse, accidents, or violence
TYPICAL DURATION
8-12 sessions for single-incident trauma. Longer for complex or developmental trauma (multiple traumatic experiences over time).
HOW IT WORKS
8-phase protocol. The core involves recalling the traumatic memory while following the therapist's finger movements (or tapping or auditory tones). This bilateral stimulation appears to help the brain reprocess the memory, reducing its emotional charge. Does not require detailed verbal retelling of trauma.
EVIDENCE BASE
Strong evidence from 30+ RCTs. Recommended by WHO, APA, VA/DoD, and NICE for PTSD treatment. Comparable effectiveness to trauma-focused CBT approaches.
WHO PROVIDES IT
Requires EMDRIA-certified training (not just a weekend workshop). Offered by psychologists, LPCs, and LCSWs with specific EMDR certification. Some forms work better in person than via telehealth.
BEST FOR
People with PTSD or trauma symptoms who want a treatment that does not require extensive verbal retelling of traumatic events. Particularly effective for single-incident trauma (accidents, assaults).
ACT (Acceptance and Commitment Therapy)
Values-based approach focused on psychological flexibility rather than symptom elimination.
CONDITIONS TREATED
Chronic pain, anxiety, depression, OCD, substance use disorders, work stress, adjusting to chronic illness
TYPICAL DURATION
8-16 sessions typical, though can be longer for chronic conditions.
HOW IT WORKS
Six core processes: cognitive defusion (distancing from thoughts), acceptance, present-moment awareness, self-as-context, values clarification, and committed action. Uses metaphors and experiential exercises rather than direct thought challenging.
EVIDENCE BASE
Growing evidence base with 200+ RCTs. Particularly strong for chronic pain, where it outperforms many traditional approaches. Recognized by APA Division 12 as having strong research support.
WHO PROVIDES IT
Available from all provider types. ACT training is increasingly common in graduate programs. Look for providers who list ACT specifically in their profile, not just 'integrative' approaches.
BEST FOR
People dealing with chronic conditions where symptom elimination is not realistic (chronic pain, chronic illness), or those who find CBT's direct thought-challenging approach too confrontational.
Psychodynamic Therapy
Insight-oriented approach exploring unconscious patterns and past experiences.
CONDITIONS TREATED
Personality disorders, recurring relationship patterns, chronic depression, identity issues, unresolved childhood experiences, existential concerns
TYPICAL DURATION
Months to years. Short-term psychodynamic therapy is 12-24 sessions. Long-term may continue for 1-3+ years with weekly or twice-weekly sessions.
HOW IT WORKS
Less structured than CBT. Explores past experiences, dreams, and the therapeutic relationship itself to identify unconscious patterns. The therapist helps you recognize how childhood experiences and defense mechanisms shape current behavior and relationships.
EVIDENCE BASE
Meta-analyses show effectiveness comparable to CBT for depression, with some evidence that gains continue to grow after treatment ends (the 'sleeper effect'). Less RCT evidence than CBT but strong clinical tradition spanning 100+ years.
WHO PROVIDES IT
Primarily psychologists and some LPCs/LCSWs with psychodynamic training. Psychoanalysts (completing additional 4-6 year training programs) provide the most intensive form.
BEST FOR
People who want to understand the deeper patterns driving their behavior, particularly recurring relationship difficulties or long-standing personality issues. Best when you have time and resources for longer-term treatment.
Couples/Family Therapy (EFT, Gottman Method)
Relationship-focused modalities addressing attachment and communication patterns.
CONDITIONS TREATED
Relationship distress, communication breakdown, infidelity recovery, pre-marital counseling, family conflict, co-parenting disputes, attachment injuries
TYPICAL DURATION
EFT: 8-20 sessions. Gottman Method: varies, often 12-20+ sessions. Family therapy: 8-16 sessions.
HOW IT WORKS
EFT (Emotionally Focused Therapy): Identifies negative interaction cycles and underlying attachment needs. Three stages: de-escalation, restructuring, and consolidation. Gottman Method: Based on 40+ years of couples research. Uses assessment (including questionnaires), identifies 'Four Horsemen' (criticism, contempt, defensiveness, stonewalling), and builds skills in friendship, conflict management, and shared meaning.
EVIDENCE BASE
EFT: Strong evidence with 70-75% of couples reporting significant improvement and 90% showing some improvement. Gottman Method: Backed by longitudinal research predicting relationship outcomes with 94% accuracy. Both recommended by APA.
WHO PROVIDES IT
LMFTs are the primary specialists. EFT-certified therapists have completed ICEEFT training. Gottman-trained therapists complete the Gottman Institute's certification levels. Some psychologists and LPCs also specialize in couples work.
BEST FOR
Couples experiencing communication problems, emotional disconnection, or conflict cycles. EFT is especially effective for attachment injuries (betrayal, infidelity). Gottman is strong for building practical communication and conflict skills.
Which Therapy for Which Condition?
| Condition | First Choice | Also Effective |
|---|---|---|
| Generalized anxiety | CBT | ACT, psychodynamic |
| Depression (mild-moderate) | CBT | ACT, psychodynamic, behavioral activation |
| PTSD (single incident) | EMDR or CPT | Prolonged exposure, CBT |
| Complex/developmental trauma | EMDR (phased) | CPT, psychodynamic |
| Borderline personality | DBT | Schema therapy, MBT |
| OCD | CBT with ERP | ACT |
| Eating disorders | CBT-E | DBT, family-based therapy |
| Relationship distress | EFT or Gottman | Psychodynamic couples therapy |
| Chronic pain | ACT | CBT, mindfulness-based |
| Insomnia | CBT-I | Stimulus control, relaxation |