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Talk Therapy

Understanding the Process of Therapy


Updated February 07, 2009

Talk therapy, also known as psychotherapy, is based on the core idea that talking about the things that are bothering you can help clarify them and put them in perspective. Some talk therapists follow a specific school of thought, such as cognitive theory or behaviorism. Others use a more eclectic approach, drawing techniques and principles from several different theories.

Talk Therapy vs. Medication Therapy

There is an age-old debate in the mental health community regarding the usefulness of talk therapy as opposed to medication therapy. According to the medical model, mental disorders are the result of physiological causes and should be treated by medication, surgery or other medical processes.

Proponents of talk therapy believe that mental disorders are largely based on reactions to one’s environment. Therefore, they can be treated through discussion, resolution of conflict, behavioral changes and changes in thinking.

Today, most members of the mental health community feel that the truth lies somewhere in the middle. Some conditions may be caused by physiological changes, while others are the result of conflict and unhealthy reactions. Most issues are based on a combination of factors. Therefore, many therapists choose to use both medical and talk therapy solutions depending on the situation.

Goals of Therapy

The ultimate goal of any type of therapy is to help the client deal more successfully with a disorder or a situation. The specific treatment goals depend on the individual client, the therapist’s theories and the situation at hand. The goal may be concrete, such as quitting smoking, or more abstract, such as anger management.

When talk therapy is used for phobia treatment, there are generally two goals. One is to help the client overcome the fear. The second goal is to help the client learn to manage any remaining fear, so that he or she is able to live a normal, functional life.

Some forms of talk therapy have a third goal. In psychoanalysis and related therapies, the goal is to discover and resolve the underlying conflict that caused the phobia or other disorder. In interpersonal therapies, the goal is to resolve problems in interpersonal relationships that have resulted from or contributed to the phobia or other disorder.

Progression of Talk Therapy

Talk therapy begins with an initial appointment, often referred to as an intake interview. During this appointment, the client will describe what brings him or her to therapy. This is known as the presenting problem.

The therapist will then ask questions to help clarify the nature of the problem, its duration and its severity. He will also try to determine the client’s goals for therapy. By the end of the first session, the therapist will have the beginnings of a treatment plan, although many therapists will wait until the second session to provide a more formalized plan to the client. Some therapists choose to maintain the treatment plan as a reference document for themselves, but do not present it to the client unless requested.

Despite the treatment plan, the client should always remain in control of the progression of his therapy. The issue may require more or fewer sessions than originally planned. Family members or friends may be invited to join in certain sessions. Auxiliary resources, such as support groups, may be recommended.

Group Talk Therapy

Although talk therapy is most commonly performed one on one, group talk therapy can also be effective. In traditional group therapy, the existence of the group plays a key role. Known as a therapeutic milieu, an environment is created within the group that provides structure, support and a feeling of safety. Within a safe and trusting environment, group members often feel more free to express feelings, confront their own negative personality traits and experiment with behavioral changes.

Of course, it takes time and effort to build a sense of community. The popularity of brief therapy has led to a different style of group therapy –- the seminar. Time-limited to a single evening or perhaps a weekend, seminars could be seen as group-style individual therapy. These short group sessions use individual cognitive-behavioral therapy methods that are presented to several people at once. The group setting is largely irrelevant, beyond the confidence that may develop from seeing others successfully battle their own issues.

Talk therapy is one of the most common treatment options for phobias, although the specifics will vary according to the client’s needs and the therapist’s school of thought. If you believe that you may have a phobia, be sure to read Finding a Therapist, which will help you locate a therapist whose goals and beliefs fit your own. A good match is necessary for treatment to be most effective.


Jensen, Jay, Bergin, Allen and Greaves, David. “The meaning of eclecticism: New survey and analysis of components.” Professional Psychology: Research and Practice. April 1990. Vol 21(2). Pp. 124-130. October 28, 2008.

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