“I am not feeling well for quite a while now and my partner says I should get therapy. But I doubt about that because I am not sure if it works. Can therapy really help me?”
The short answer
The simple answer is yes, therapy works. However, that does not mean that everyone will be completely recovered after receiving therapy.
Many therapies, many conditions
There are many types of therapy that are indeed effective. Effective therapies exist for depression, generalized anxiety disorder, panic disorder, social anxiety disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), insomnia, health anxiety and many other mental health conditions. For each of these problems, different types of therapy have been developed and tested.
Cognitive behavior therapy is perhaps the best known type of therapy, but there are many other types of therapy, including for example psychodynamic therapies, exposure-based therapy, acceptance and commitment therapy and many more. It has been estimated that there are a few hundred different types of therapy.
Some of these therapies have been examined in well-designed scientific studies. In such studies, also called randomized controlled trials, people who received these therapies were compared to people who did not get these therapies. That is why we know that they are more effective than not getting therapy. Not all therapies have been tested well and for many therapies it is not known whether they work or not.
If you want to know if a specific type of therapy is effective in the treatment of mental health problems, you can go to the website of the Metapsy project. There you can find a summary of the effects of the best examined types of therapy for eight mental health conditions: metapsy.org/database/explore. This website gives information about the chance of getting better when you get a specific type of therapy and how trustworthy these outcomes are.
Format matters less than you might think
Therapies are traditionally provided individually, meaning that the patient has individual sessions with a therapist. But therapies can also be provided in groups, by telephone or digitally through the internet. There is no evidence that one of these treatment formats is more effective than others. Sessions can vary considerably between therapies and conditions, but often a therapy is between 6 and 24 sessions.
How often does it actually work?
Many people get better when they receive therapy, but certainly not everyone. On average the chance of improving (defined as a 50% symptom reduction) is for example:
- 42% for depression
- between 30 and 40% for anxiety disorders, PTSD and OCD
- 25% for borderline personality disorder
That means that many people have not recovered or substantially improved through therapy. When you are receiving treatment and do not get better, your therapist will probably discuss with you to extend the therapy, to start another type of therapy, or for example combine the therapy with medication. In the end most people who receive mental health treatment do get better, but often not after the first treatment.
So yes, therapy certainly works, but not right away for everyone.
Pim Cuijpers is professor emeritus of clinical psychology and scientific director of Metapsy. He has been involved in more than 1,100 scientific studies, mostly on psychological treatments of mental health problems. This is one of a series of evidence summaries in which Prof. Cuijpers tries to answer questions from patients and clinicians, based on what is known in science about treatments. The knowledge is mostly drawn from collective work of the Metapsy collaboration of at least 15 years. Do you have other questions you would like Prof. Cuijpers to discuss? Feel free to contact us.
Literature
- Cuijpers P, Miguel C, Ciharova M, Harrer M, Basic D, Cristea IA, et al. (2024). Absolute and relative outcomes of psychotherapies for eight mental disorders: a systematic review and meta-analysis. World Psychiatry, 23, 267–275.