Types of psychotherapy: 7 approaches compared, from CBT and ACT to MI
CareOps editorial team · · 6 min read
Mental wellness information and service guidance published by CareOps.
Translated from our Korean guide. Korean public services, insurance, and helpline numbers refer to South Korea. For urgent help elsewhere, contact local emergency services or a crisis line in your country.
When you look into counseling, unfamiliar abbreviations like CBT, ACT, and MI pile up. Whatever the name, they all help through conversation; the difference is what they work on first. Here are seven of them side by side.
At a glance
- Psychotherapy works with thoughts, feelings, and actions through conversation and practice. Each type works on something different first: thoughts, actions, ambivalence, problems, sleep, or how you treat yourself.
- The seven covered here (CBT, ACT, behavioral activation, motivational interviewing, problem-solving therapy, CBT-I, and compassion-focused therapy) have all been studied in randomized controlled trials or meta-analyses.
- No single one is always best; the right fit depends on the concern. In real counseling, several methods are often combined.
What is psychotherapy?
Psychotherapy works on difficulties with thoughts, feelings, and actions through conversation with a trained professional and practice between sessions. Where medication acts on the body, psychotherapy works by changing how you see situations and how you respond to them. Diagnosis and medication are decided in psychiatric care, and psychotherapy can go alongside it.
How do the 7 types of psychotherapy differ?
| Therapy | What it works on first | Worth looking into when |
|---|---|---|
| Cognitive behavioral therapy (CBT) | The loop of situation, thought, feeling, and action | Thoughts pull your mood down, as in depression or anxiety |
| Acceptance and commitment therapy (ACT) | Moving toward what matters without fighting thoughts | The harder you try to stop worrying, the more stuck you get |
| Behavioral activation (BA) | Moving a little before the mood comes | You feel too drained to do anything |
| Motivational interviewing (MI) | The two sides of being unsure about change | You know you should change but keep putting it off |
| Problem-solving therapy (PST) | Narrowing a problem, choosing a solution, and trying it | Tasks and problems are tangled and you feel stuck |
| CBT for insomnia (CBT-I) | Habits and thoughts that get in the way of sleep | You have trouble falling asleep or wake often |
| Compassion-focused therapy (CFT) | Harsh self-criticism | You come down hard on yourself after every mistake |
How strong is the research behind each one?
- CBT: the most studied psychotherapy across depression, anxiety disorders, panic, OCD, and insomnia. More: What is cognitive behavioral therapy?
- ACT: a review pooling 20 meta-analyses (12,477 participants) found it effective for anxiety, depression, substance use, and pain. More: What is acceptance and commitment therapy (ACT)?
- Behavioral activation: a meta-analysis of 26 randomized controlled trials on depression (1,524 people) found it effective, and a large comparison trial found it no worse than CBT. More: Overcoming low energy with behavioral activation
- Motivational interviewing: a meta-analysis of 119 studies found small but durable effects on behavior change such as drinking, smoking, and exercise. More: What is motivational interviewing (MI)?
- Problem-solving therapy: a meta-analysis of 30 randomized controlled trials on depression (3,530 people) found effects that were small but comparable to other psychotherapies.
- CBT for insomnia: the American College of Physicians recommends it as the first treatment for chronic insomnia in adults. More: What is CBT for insomnia (CBT-I)?
- Compassion-focused therapy: it treats shame and self-criticism as problems that cut across many difficulties and works by building compassion toward yourself. People with more self-compassion have also been found to tend toward lower depression, anxiety, and stress. More: Why self-compassion comes before self-esteem
How do I choose the right psychotherapy for me?
No single therapy is always the best. Starting from what's hardest right now makes it easier to choose.
- If thoughts pull your mood down: CBT, or ACT if you'd rather step back from thoughts
- If you don't feel like doing anything and your body feels heavy: behavioral activation
- If you keep going back and forth on a change: motivational interviewing
- If practical problems have piled up: problem-solving therapy
- If sleep is the biggest problem: CBT for insomnia
- If you push yourself too hard: compassion-focused therapy
In real counseling, several methods are often used together for one person. When you look for counseling, ask which methods they use and roughly how many sessions it takes. Costs are covered in How much does counseling cost?.
See a professional first if
If things are so hard that keeping up daily life is difficult, or you feel like hurting yourself, reach out directly to a psychiatrist or a counseling center. Diagnosis and medication are decided in clinical care, and you can keep up practices like these while you are in treatment or counseling.
Can an app use psychotherapy techniques?
CareOps Maeumi is an AI counseling app. Its conversations draw on the seven approaches above, and it chooses an approach that fits you from what you share in the self-check and first session, then continues it from session to session. How it differs from general-purpose AI is covered in AI counseling apps vs. ChatGPT.
Frequently asked questions
- Are psychotherapy and counseling the same thing?
- They overlap a lot. Counseling is often a broad word for talking through and sorting out concerns, while psychotherapy is more often used for treatments with set methods and goals, such as CBT. In practice, counseling uses many psychotherapy methods too.
- Which is better, CBT or ACT?
- Studies comparing the two directly found no clear difference in effect. If checking whether a thought fits the facts feels natural, CBT may suit you; if stepping back from thoughts rather than arguing with them feels better, ACT may suit you.
- How many sessions of psychotherapy do I need?
- It depends on the method and the concern. CBT usually runs about 5 to 15 sessions, and some methods, such as motivational interviewing, have shown effects even in brief encounters. Ask at the first meeting roughly how many sessions to expect.
- Can I have medication and psychotherapy at the same time?
- Yes. Diagnosis and medication are decided in psychiatric care, and psychotherapy can go alongside it. Talk with your doctor about which combination fits you.
Sources
- Hofmann et al. (2012), The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses, Cognitive Therapy and Research
- A-Tjak et al. (2015), A Meta-Analysis of the Efficacy of Acceptance and Commitment Therapy for Clinically Relevant Mental and Physical Health Problems, Psychotherapy and Psychosomatics 84(1), 30–36
- Gloster et al. (2020), The empirical status of acceptance and commitment therapy: A review of meta-analyses, Journal of Contextual Behavioral Science 18, 181–192
- Ekers et al. (2014), Behavioural Activation for Depression; An Update of Meta-Analysis of Effectiveness and Sub Group Analysis, PLoS ONE
- Richards et al. (2016), Cost and Outcome of Behavioural Activation versus Cognitive Behavioural Therapy for Depression (COBRA), The Lancet
- Lundahl et al. (2010), A Meta-Analysis of Motivational Interviewing: Twenty-Five Years of Empirical Studies, Research on Social Work Practice 20(2), 137–160
- Rubak et al. (2005), Motivational interviewing: a systematic review and meta-analysis, British Journal of General Practice 55(513), 305–312
- Cuijpers et al. (2018), Problem-solving therapy for adult depression: An updated meta-analysis, European Psychiatry 48, 27–37
- Qaseem et al. (2016), Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians, Annals of Internal Medicine 165(2), 125–133
- Gilbert (2009), Introducing compassion-focused therapy, Advances in Psychiatric Treatment 15(3), 199–208
- MacBeth & Gumley (2012), Exploring compassion: A meta-analysis of the association between self-compassion and psychopathology, Clinical Psychology Review
This article shares general mental wellness information. For urgent help, contact local emergency services or a crisis line in your country. In South Korea, the suicide prevention helpline is 109 (24 hours), and the mental health crisis line is 1577-0199.