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Psychological treatments

What is a psychological treatment?

Psychological treatment is sometimes called ‘psychotherapy’ or ‘talking therapy’.

They involve talking about your thoughts with a professional to:

  • better understand your own thinking and behaviour
  • understand and resolve your problems
  • recognise symptoms of mental illness in yourself
  • reduce your symptoms
  • change your behaviour
  • improve your quality of life.

Evidence shows that psychological treatments work well for emotional, mental and behavioural issues.

Psychological treatments are useful for people of all ages, including children.

They can help people from different cultural, social and language backgrounds.

You can have psychological treatment in an individual session, as part of a group, or online.

Why get psychological treatment?

Psychological treatments are proven to help with mental illnesses such as:

  • depression
  • anxiety
  • addiction
  • eating disorders
  • post-traumatic stress disorder
  • obsessive-compulsive disorder
  • personality disorders.

They are also used successfully to help people deal with:

  • stress
  • emotional problems
  • grief and trauma
  • relationship problems.

It may take a number of weeks for you to see results from most psychological treatments. Some types of treatment can take a year or more for you to get the full benefit.

They are not a quick fix, but the positive effects are often long-lasting.

Who can provide psychological treatments?

Psychiatrists can provide psychological treatments to people with mental illness.

Psychologists, some GPs, social workers, mental health nurses, counsellors and other therapists also offer psychological treatments.

Not all people who offer psychological treatments have professional training or experience in that therapy. Ask your therapist about their qualifications before your first appointment.

Types of psychological treatment

There are different types of psychological treatments designed to help with different issues.

Some of the most common treatments are listed below (in alphabetical order):

Acceptance and commitment therapy

Acceptance and commitment therapy (ACT) is based on mindfulness (being aware of the present moment). You are encouraged to accept negative thoughts and emotions and to think of them as passing through, and not defining you. It is used in different ways to treat stress, anxiety, personality disorders and schizophrenia.

Cognitive analytic therapy

Cognitive analytic therapy (CAT) is where you are asked to review your childhood and look at how you have learnt to cope with different situations. With your therapist, you work towards changing the way you view situations and how you respond to them.

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) is based on the idea that our emotions are produced by our thoughts. It asks you to challenge unhelpful ‘head-talk’– the things we tell ourselves every day.

For example, you might think, ‘the presentation I’m doing tomorrow will be a disaster’. This causes you to feel anxious and depressed.

In CBT, your therapist asks you to provide the evidence for this thought, and the evidence against it. You are then asked to suggest a more balanced view of the situation by seeing both sides.

CBT is often used to treat depression and anxiety.

Dialectical behaviour therapy

Dialectical behaviour therapy (DBT) focuses on controlling problem emotions (especially anger) and behaviours (such as cutting). It is often used to help people with personality disorders.

Family therapy

Family therapy involves family members talking to each other under the guidance of a therapist. It aims to get everyone in the family working together to get you well again.

Group therapy

Group therapy involves a group of people with the same types of issues talking under the guidance of a therapist. Group therapy gives you the opportunity to hear from others who are struggling with similar issues to you, to hear their perspectives and to gain an understanding of your own illness.

Interpersonal therapy

Interpersonal therapy is a brief treatment for depression. It asks you to think about and discuss your relationships with other people, and how they affect your mood and emotions.

Mentalisation-based therapy

Mentalisation-based therapy (MBT) is used to treat people with personality disorders. The focus is on helping you to understand the mental states of other people and yourself.

Mindfulness

Mindfulness is where you are encouraged to focus on the present moment, rather than worrying about past or future events. Mindfulness is an activity you can do by yourself in a quiet moment, or you can be guided by a therapist or even a phone app. Mindfulness may be used to help with depression and anxiety.

Motivational interviewing

Motivational interviewing is a way of encouraging you to make changes in your life, without being judgemental or telling you what to do. It is often used help people who are trying to cut down their drug, alcohol, smoking or gambling habits.

Psychodynamic psychotherapy

Psychodynamic psychotherapy can help you to see your behaviour patterns, defences, and inner struggles. The idea is that once your inner struggles are brought to light, your behaviour and feelings will improve. Any issues that arise in treatment with your therapist may reflect some of the issues in your life.

Psychoanalysis is a specialised, more intensive form of psychodynamic psychotherapy, which usually involves several sessions per week.

Supportive psychotherapy

Supportive psychotherapy is a conversational-style therapy that aims to make you feel comfortable and less anxious, while helping you to come up with practical ways to cope with stressful situations.

Your first appointment

In a first appointment you will probably be asked to tell your story – what’s happened in your life and the thoughts and feelings you’ve been having.

You may also discuss what your goals are for treatment.

This is a good time to ask your psychiatrist or other therapist questions such as:

  • Why do you think this therapy will suit me?
  • What are the outcomes?
  • How often do I need to see you?
  • How long will the therapy last?
  • What should I do if there’s a crisis, or I need urgent help?
  • How much will it cost?

After a session you might feel relief, or your emotions might be stirred up. Exercise is a good way to release tension.

Get the most out of psychological treatment

You have to be actively involved for psychological treatment to work.

You can do this by:

  • speaking honestly about what’s going on in your life, and in your mind
  • giving your therapist feedback on how you’re doing
  • asking questions
  • attending all your appointments
  • completing any ‘homework’ you are asked to do.

Your psychiatrist or other therapist will:

  • offer a safe, trusting relationship
  • provide a treatment plan that is created with your input
  • adjust the treatment to your life stage and circumstances
  • keep what you say in an appointment confidential (although sometimes legal processes will require that some information is shared)
  • offer a positive and non-judgemental approach with a view to your recovery.

If you don’t feel comfortable with your therapist, consider trying someone else.

Online therapy

There are a number of websites that offer online treatments for mild depression and anxiety.

Web-based programs that have evidence to show that they work are:

  • Mood Gym (depression and anxiety, free)
  • This Way Up (depression, anxiety, stress, some courses are free, some are paid)
  • Brave (anxiety in children and young people, free)

Remember

✔ Make sure you feel comfortable with your therapist.

✔ You need to be active in contributing to and being part of the therapy.

✔ It takes time for psychological treatments to work, but the effects last.

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What’s it like to have cognitive behavioural therapy?

 ‘The skills I learned were invaluable to put things in perspective during an anxiety attack. For example, simple skills such as asking, 'will this matter in 5 days, 5 weeks, 5 years?' was a simple question that I often apply when I feel worry creeping in. I learned a lot about challenging the script in my mind, so that negative thoughts weren't as dominant. ‘

Leanne, Melbourne