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Treatment terms

Psychotherapy

Shariq Refai, MD, MBA, board-certified psychiatrist and the reviewer of this article.

Reviewed by Shariq Refai, MD, MBA·Updated March 15, 2026·About 3 minutes

About this term

Quick definition
A structured form of treatment in which a person works with a trained clinician to address mental health concerns. Includes many specific approaches.
Full clinical definition
Psychotherapy, sometimes called talk therapy, is a category of treatments delivered by trained clinicians (psychiatrists, psychologists, licensed clinical social workers, licensed mental health counselors, marriage and family therapists). Several specific psychotherapies have strong evidence in depression: cognitive behavioral therapy (CBT), behavioral activation, interpersonal therapy (IPT), problem-solving therapy, mindfulness-based cognitive therapy (MBCT), and the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) for chronic depression. Each has its own structure, duration, and target.
Epidemiology
In a given year, about 17 percent of U.S. adults receive any mental health treatment, with about 9 percent receiving psychotherapy (SAMHSA, 2022). Psychotherapy is recommended as first-line for mild to moderate depression in APA and NICE guidelines, alone or in combination with medication.
What it can feel like
Most evidence-based psychotherapies for depression are time-limited (often 12 to 20 sessions) and structured. Sessions usually last 45 to 60 minutes. Patients often complete between-session work (activity scheduling, thought records, behavioral experiments). Early sessions focus on assessment and on building a shared formulation. Later sessions focus on practice and consolidation.
Why it matters
Psychotherapy with strong evidence has effect sizes comparable to antidepressants for mild to moderate depression and has lower rates of relapse than medication alone in some long-term studies. It also addresses skills, patterns, and contexts that medication cannot reach. The combination of psychotherapy plus medication is generally more effective than either alone for moderate to severe depression.
How clinicians assess fit
An intake visit reviews symptoms, history, prior treatment, and goals. The clinician and patient agree on a treatment approach, expected duration, and what success looks like. Symptom tracking with PHQ-9 or a similar tool is standard in measurement-based care.
Treatment implications
For mild to moderate depression, evidence-based psychotherapy alone is a reasonable first-line treatment. For moderate to severe depression, combined therapy and medication is often preferred. Choice of approach (CBT, behavioral activation, IPT) is guided by symptom pattern, patient preference, and clinician training. Access barriers (cost, waitlists, insurance coverage) are common and worth raising directly.
Related terms
CBT. Behavioral activation. Medication management. Psychiatric evaluation.
Related articles
Treatment.

Sources

  • American Psychiatric Association. Practice Guideline for the Treatment of Patients with Major Depressive Disorder.
  • NICE Guideline NG222. Depression in adults: treatment and management. 2022.
  • Cuijpers P, et al. Psychotherapies for depression in adults: a network meta-analysis. World Psychiatry. 2021.
  • SAMHSA. Key Substance Use and Mental Health Indicators. 2022.

Frequently asked questions

What is psychotherapy?
Psychotherapy, often called talk therapy, is a structured treatment delivered by a trained clinician that uses conversation to address mental health conditions. For depression, the forms with the strongest evidence are cognitive behavioral therapy (CBT), behavioral activation, interpersonal therapy (IPT), and problem-solving therapy.
Which type of therapy is best for depression?
CBT, behavioral activation, and interpersonal therapy have the strongest research evidence for depression and are recommended as first-line by APA and NICE. Choice between them depends on what is driving the episode, patient preference, and clinician training. The fit with the therapist is one of the strongest predictors of outcome.
How long does psychotherapy take to work?
For evidence-based therapies, most people see meaningful change in 12 to 20 sessions. Some people benefit from longer, especially with chronic patterns or trauma. If there is no change at all by the eighth session, it is reasonable to discuss the plan with the therapist or seek a second opinion.
Is therapy as effective as medication?
For mild to moderate depression, psychotherapy and antidepressants have similar response rates. For moderate to severe depression, the combination usually outperforms either alone. Therapy also has evidence for relapse prevention after recovery, especially mindfulness-based cognitive therapy (MBCT).
Does telehealth therapy work as well as in-person?
For most people with depression, telehealth therapy is comparable in effectiveness to in-person care. Telehealth widens access. In-person care can help when the home environment is a barrier or when telehealth is not a fit for technical or comfort reasons.

Last reviewed March 15, 2026.

Every clinical page on DepressionResource.org is written in plain language, dated, and reviewed by a board-certified psychiatrist against current clinical guidelines. See our editorial standards and medical review process.