Two of the most popular forms of therapy and while both aim to reduce symptoms and distress, perhaps the most central difference between CBT and psychodynamic therapy is that psychodynamic therapy tries to get at why you feel or behave the way you do (i.e., uncover deeper and often unconscious motivations for feelings and behaviour) whereas CBT does not. CBT simply attempts to alleviate suffering as quickly as possible by training your mind to replace dysfunctional thought patterns, perceptions, and behaviour (without asking more about them) with more realistic or helpful ones in order to alter behaviour and emotions.

Advocates of psychodynamic therapy argue that for many issues, a deeper treatment is required to produce lasting change. Advocates of CBT argue that their briefer methods are just as effective. And while a subject of controversy, the research data generally support both approaches.

Features of CBT:

  • It is relatively brief and time-limited (twelve weeks to six months).
  • It is highly instructional in nature and homework is a central element.
  • It is highly structured and directed with the therapist setting the agenda for each session (based on mutually set goals).
  • It focuses on the here-and-now only and not a person’s history.
  • The relationship with the therapist is not a focus of the treatment.

Features of Psychodynamic Therapy:

  • While it can be brief, it is often longer term (six months or longer).
  • It is less structured, typically without homework assignments.
  • The client, not the therapist sets the agenda for the session by talking about whatever is on their mind.
  • It focuses on the here-and-now as well as on personal history.
  • The relationship with the therapist is included as a focus of therapy.

Clinical research generally supports the efficacy of both CBT and psychodynamic therapy. Deciding which one is better for you depends to varying extents on:

  • Which approach appeals to you
  • Finding a “good fit” with a competent therapist (of either orientation)
  • Your reasons for seeking therapy, your level of commitment, and your financial resources

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