Mental Illness Treatment

Psychotherapy Alphabet Soup: CBT, DBT, ACT, and More

Psychotherapy alphabet soup: CBT, DBT, ACT, and more

Some studies have shown that the quality of the therapeutic relationship between client and therapist is a stronger predictor of therapeutic outcomes than the type of therapy used. However, it seems logical that the type of therapy should at least to some extent match up with how you tend to conceptualize the problems you’re experiencing. Here is a brief run-down of some different psychotherapy approaches. This is by no means an exhaustive list, and it doesn’t include things like humanistic approaches or those therapies that do a deep dive into past issues and attachment. has a much more extensive list.

ACT: Acceptance and Commitment Therapy

ACT takes the perspective that resistance to thoughts and feelings is the main cause of distress. It addresses areas such as present moment awareness, acceptance, separating the self from thoughts, and taking committed action consistent with identified values. There are a lot of helpful metaphors used to help withconceptualizing various ACT concepts.

I’ve reviewed Steven Hayes’s book Get Out Of Your Mind and Into Your Life, which is an excellent way to get familiar with ACT. The MH@H Download Center also has a mini-ebook/workbook on the essentials of ACT.

CBT: Cognitive Behavioural Therapy

CBT is perhaps one of the best known counselling approaches. It considers the relationships between thoughts, feelings, and behaviours, and how each of those elements can be changed. Evidence for and against thoughts is examined with the goal of identifying problematic thinking patterns that cause distress and replacing them with more realistic thoughts. As well, new behaviours are practiced to reduce distress and promote more realistic thinking.

Some other important concepts in CBT include:

The MH@H Download Center has a mini-ebook on the essentials of CBT.has a mini-ebook on the essentials of CBT.

There are a number of different forms of therapy that are based on CBT. Here are just a few examples.

CPT: Cognitive Processing Therapy

This is a form of CBT for PTSD, and aims to change cognitions about the trauma that are keeping the person stuck and preventing them from fully processing the trauma. The post Creating a Trauma Account talks about how I borrowed a tool from CPT.

ERP: Exposure and Response Prevention

ERP is used in the treatment of OCD, and involves exposure without resorting to the use of compulsions.

PE: Prolonged Exposure

This is a form of CBT that aims to decrease fear and trauma responses by exposing the person in a controlled way. This can be either in vivo (in person) or imaginal (the client is asked to vividly imagine a particular situation), or a combination of both.  It progresses based on an identified hierarchy of feared stimuli.

TF-CBT: Trauma-Focused CBT

Like CPT, this is a form of CBT for trauma, but it is geared toward children and adolescents.

CFT: Compassion-Focused Therapy

CFT is influenced by CBT, and focuses on compassion towards both others and the self. It can be useful for people struggling with emotions like shame and self-criticism.

CFT describes three systems within the brain: the threat system, the drive system, and the caregiving system. The therapy aims to strengthen the care-giving system while toning down the threat system.

There’s more information about CFT on the Compassionate Mind Foundation.

DBT: Dialectical Behaviour Therapy

DBT was developed by Dr. Marsha Linehan to address some of the shortcomings of CBT for treating borderline personality disorder (BPD). The dialectic refers to the idea that the way the individual is doing things now is valid and they are doing the best they can, but they would still benefit from change. DBT is very skill-based, with modules covering areas of mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness.

Wise mind is a really useful DBT concept that involves the overlap of rational mind and emotion mind. There’s nothing wrong with rational mind or emotion mind, but we make our best decisions when we have both engaged.

Some of the foundational assumptions on which DBT is built are quite profound, regardless of whether or not you choose to do DBT; I talk more about these in the post Wise Words from DBT Creator Marsha Linehan.

An excellent DBT resource is the Dialectical Behavior Therapy Skills Workbook. The MH@H Download Center also has a mini-ebook on how DBT skills can be useful for people with mood disorders.

EFT: Emotionally Focused Therapy

This type of psychotherapy considers emotions to be reflective of underlying needs, and classifies emotions as adaptive, maladaptive, reactive, and instrumental. Therapeutic tasks are identified based on the client’s particular emotional experiences.

The International Center for Excellence in EFT has more information about the therapy.

Note: This isn’t the same thing as Emotional Freedom Techniques, also known as EFT or tapping.

EMDR: Eye Movement Desensitization and Reprocessing

EMDR is a type of trauma therapy. The client uses horizontal eye movements to track the therapists’ fingers, and while this is being done the client focuses on an identified distressing image and the bodily sensations associated with that distress. A Subjective Units of Distress (SUDS) scale is used to track progress, and as the SUDS score drops the therapist and client work on installing a new positive cognition.

EMDR is based on the idea that trauma memories are stored in an unintegrated manner in the brain, with a strong sensory element that’s disconnected from a narrative element. The goal of therapy is to process these memories so they can be stored in an integrated form like other memories.

The American Psychological Association goes into more detail in this article as part of their PTSD treatment guidelines. Counsellor Johnzelle Anderson has also done a guest post on EMDR for Mental Health @ Home.

IPT: InterPersonal Therapy

IPT is a short-term, structured approach that focuses on addressing interpersonal problems that contribute to problems with mental health, as well as building interpersonal communication skills. Research has supported its effectiveness in the treatment of depression.

The IPT Institute site goes into some of the details of IPT.

MBCT: Mindfulness-Based Cognitive Therapy

This type of psychotherapy is focused on the use of mindfulness to address cognitive distress. It covers things like acting on autopilot, being mindful of the breath, allowing and letting be, engaging in self-care, and recognizing that thoughts aren’t facts. has more information about this form of therapy.

SFBT: Solution-Focused Brief Therapy

SFBT works on identifying and developing the skills to create changes and achieve goals. The therapist asks particular types of questions to guide the client toward envisioning their future and identifying strengths and coping skills.

The Institute for Solution-Focused Therapy has more information.

What types of psychotherapy have you tried?  What was your experience like?

The Mental Health @ Home Blog Index has info on other therapy-related posts on MH@H.

33 thoughts on “Psychotherapy Alphabet Soup: CBT, DBT, ACT, and More”

  1. This is a great list, I’m confident it will be helpful to those who are looking in to different types of psychotherapy. Thank you! I have done CBT and DBT as well as typical talk therapy. Talk therapy is validating but CBT and DBT offer me the most practical steps for managing my illnesses. I am finding as time goes on I am realizing the impact of my CBT, at first I wasn’t confident I had really learned anything. DBT has been fantastic particularly for distress tolerance skills.

  2. I’ve been reading a lot on various kinds on therapy lately, but still some of those you mentioned were new to me. I’d been doing CBT for a long long time, with varying results, but I found it hugely helpful in the past when I was dealing with a lot of intense emotions and issues and learned a lot of useful coping techniques to regulate feelings or manage them better. I also had a great therapist with whom I was working for years, and apart from CBT, she was also mixing it with some other approaches/techniques, and she was a Christian therapist which I liked, being myself a practicing Christian. Though a few months ago, as you know, I had to change therapists and since then I wasn’t feeling like I was doing much progress, so now I”m starting psychodynamic therapy, with the therapist who is also integrating some other approaches a bit and so far it seems to be OK, although I’ve had just one session. I was a bit scared and thought it might turn out not too good for me as I’ve heard really various things about PD but since my issues are to do with the past that seemed to have the most sense, to choose psychodynamic therapy. If that won’t work though, I may try something humanistic, I know humanistic therapies aren’t to do with the past but as much as I kow about them something kinda speaks to me in them, or just look for another CBT therapist.

    1. I think it’s a good sign when a therapist can be flexible and integrate multiple different approaches to try to find a best fit for the client.

  3. I think there’s certainly an element of interpersonal relationships influencing the efficacy of therapy, it would be very difficult to engage fully with a therapist that you dislike.

    I have had CBT – excellent principles but really hard to put into use at the time when distress is greatest. For me, it was useful to look back at the negative distortions I was using and challenge these with fact, but only after the distress had diminished.
    BA (Behavioural Activation) – a subset of CBT, this looks at changing behaviour rather than challenging thoughts and personally I found it easier to use at the time of distress and was at least partially effective.
    EMDR – my therapist used hand tapping rather than eye movement. EMDR is a very tough therapy, it releases trauma memories, and you experience intense emotions and physical reactions as though you are back in the actual trauma. But it works, it’s incredibly hard to go through but for me it feels like magic has been worked on me! Since I finished EMDR, I have continued to benefit from it… like the process instilled little seeds of truth inside me and these have taken time to grow and heal. (stopping writing now before I sound completely away with the fairies!) 😀

  4. I have never used any of these therapies to be honest. I have peaked at DBT and CBT and read A LOT about everything. I think the therapy I used was learning to live and cope the best way for me. Centering yourself around positive people and settings, learning to live in the moment and forgiving myself were key elements for me. The best therapy was God’s love. God saved my life. Much love and hugs, Sue

  5. This is a great synopsis of the various approaches to therapy. I use CBT and DBT in my work with clients. When I went to therapy, I liked the CBT approach best.

  6. EMDR, all the way, I highly recommend. The bilateral sensory stimulation with reprocessing is magic.

    I had no idea there were so many different types of therapy! I would’ve said, “Behavioral, cognitive, uh… Freudian, maybe?” This has been a very informative post!!

    I definitely have done years of self-therapy–reading advice columns got me somewhere, hence my fascination with them. When I started reading Carolyn Hax, she was the first non-Ann-Landers columnist I encountered. This was back in 2004, 2005. I spent hours reading her archives, and it opened my mind to so much I’d never encountered nor thought of. Prior to that point (and this will sound super stupid), I thought most people grew up, became adults, and magically had all the answers. Reading Carolyn Hax made me see how naive I’d been. (And I was 27 years old in 2004, so I have no idea how to account for my adulthood belief.)

    I’ve done the EFT tapping and it got me nowhere. I didn’t notice a single improvement. And I read one of its books: EFT For Weightloss. It didn’t help at all, and here’s why: the book was filled with stories of people who had individual cravings: raisins, chocolate, etc. (Yeah, ya gotta watch out for those unhealthy raisins! I’m not making this up.) With me, I’m an equal opportunity junk-food fiend, and the book didn’t address what to do if you’ll eat a million different types of junk food. But EFT didn’t help anyways.

  7. Wow, there are several on here that I had never even heard of. The few that I have experienced over time is the ACT, CPT, CBT, MBCT, and EFT. My therapist and I still go over certain areas more so than others over the course of 2&1/2 years.
    A very informative post. Thank you!

    1. I find that with the passage of time and new learning/experiences I’m able to go back and look at things again and get even more out of them than I did originally.

      1. Oh, I know that that is the case with me. When I first went through CBT, I was still in a very scary, unfamiliar territory of being homeless. I was paying more attention to survival skills than anything else.
        When that situation was over with, I revisited that and moved forward from there. It made much more sense to me the second time around. 🙂

  8. This is such an informative post (and I love the title). I have tried EMDR and it was amazing, I was skeptical but it worked really well! I however am a Humanistic Therapist and from my side it seems to be really effective 🙂

  9. Great list! I love psychotherapy alphabet soup – must be the wannabe psychologist in me! ACT is something I’d like to write more about on my blog at some point soon as it’s used quite heavily in my pain management sessions and can be quite a powerful framework. x

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