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Cognitive Behavioural Therapy (CBT) or Psychoanalytical/Psychodynamic Therapy?

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
How do I know if my therapist is right for me?

This is a difficult question, but an important one nonetheless. For those who have the good fortune of finding a suitable therapist first time, this question may not even arise. For others however, it can be quite a different story. The search for the ‘right’ therapist is not unlike searching for the ‘right’ accountant, doctor, builder or hairdresser. Whether it be entrusting our finances, our health, our home or our hair to another person, few people would settle for just anyone.

We rarely seek anything unless we perceive or feel an immediate need for it. How many people do you know who can say that they have found a therapist but not yet engaged their services? Most people wait until they are suffering intense emotional pain or in the midst of a crisis – and need help right away. Such a time is probably not the best time to choose a therapist.

Desperate, we might make an appointment with the nearest and first available therapist. At the initial meeting we discover that the therapist operates on a wavelength that is not compatible with our own. We sink into despair and disappointment. Unaware of alternatives, some of us opt to persevere – albeit half heartedly. Or we might become disillusioned and give up on the idea of therapy altogether. A bad result all around.

What different types of therapists or counsellors are there?

There are several different types of counsellors and therapists who will be able to help with your self-development. The major differences relate to their training or membership of their professional body.


Are medically trained doctors who specialise in mental health. Whilst they are qualified to prescribe various medications, they’re also highly trained to deliver different type of therapy. In order to see a psychiatrist, you will need a referral from a GP. You can request your GP to refer you to a particular psychiatrist if you wish.


Have a rigorous background in the scientific study of human behaviour and their training reflects a strong emphasis on validity of measures and reliable evidence of effective interventions. Psychologists typically undertake formal tertiary study plus a prescribed number of years of work under professional supervision from another registered psychologist in order to qualify. Clinical and counselling psychologists usually provide psychological treatment from various orientations such as cognitive behavioural (CBT), and Gestalt, humanistic and client centred and psychodynamic approaches. These and other theoretical stances really reflect a different way of understanding and describing clients’ issues.


Have very varied training, from a Masters in counselling to a few weeks by correspondence, and at present in Australia any one can call themselves a counsellor or a psychotherapist. PACFA has been set up to protect the public with regard to the standards and ethical training that should accompany these professions.


Attempt to help the client to positively reorganise negative experiences of themselves or others. In essence psychotherapy is an attempt to heal the “self” when the client is not functioning as well as they would like. A developmental perspective usually informs psychotherapy. Psychotherapists usually have an approved tertiary degree, experience in the helping professions and personal suitability to become psychotherapists. Many psychologists and psychiatrists choose to practice psychotherapy and undertake training in this area. Psychotherapists, to register as clinical members of an accredited *organisation must be engaged in a minimum of several hours a week conducting psychotherapy and undertake regular professional development in terms of reading, lectures, conferences and seminars. PACFA (Psychotherapists and Counsellors Federation of Australia) is the organisation to which counsellors and psychotherapists who meet these standards may belong either as individuals, or as part of accredited organisations.

Psychotherapists are trained in a number of psychodynamic theories, and there is quite passionate argument about which theory is the most correct! Psychotherapists consider that “empathic fit” or the relationship between themselves and their client to be the most important determining factor influencing the effectiveness of the therapy.

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