The therapy alphabet soup.

What sessions can feel like: Often structured as weekly individual sessions plus a weekly skills group, typically run over about 6 months to a year for a full skills cycle, though shorter and ongoing formats exist.

What the evidence says: DBT has strong research support for borderline personality disorder, chronic suicidal and self-harming behavior, and is also used for emotional dysregulation more broadly. It's one of the most well-studied therapies for BPD specifically, though it takes real time and practice to see benefits.

Questions to ask a therapist

• Is this standard DBT with a skills group, or an individual-only adaptation?
• How long is a typical course of treatment?
• What happens if I'm in crisis between sessions?
• Which skills modules will we focus on first?

What sessions can feel like: Commonly delivered weekly for about 8–20 sessions for a specific issue, though it can run longer for more complex or chronic concerns.

What the evidence says: CBT has one of the largest evidence bases of any psychotherapy, with strong support for depression, generalized anxiety, panic disorder, social anxiety, insomnia, and as part of treatment for many other conditions. It tends to work best as an active, between-session-practice approach rather than talk alone.

Questions to ask a therapist

• What between-session practice or homework should I expect?
• How will we track whether this is working?
• Is this a general CBT approach or one tailored to a specific condition?
• How many sessions do you typically recommend before reassessing?

What sessions can feel like: Often weekly, sometimes more intensive (several sessions a week) for more severe OCD, typically over roughly 12–20 sessions, with ongoing practice between them.

What the evidence says: ERP is considered a first-line, strongly evidence-supported treatment for OCD and is also used for some related conditions like body dysmorphic disorder. It can be uncomfortable, especially early on, since it deliberately involves facing anxiety rather than avoiding it — a trained ERP therapist paces this carefully.

Questions to ask a therapist

• How will exposures be chosen and paced?
• What if an exposure feels like too much, too soon?
• How is response prevention actually practiced day to day?
• Have you specifically been trained in ERP for OCD?

What sessions can feel like: Varies widely — brief formats exist (a handful of sessions), while longer-term work for chronic conditions may run for months.

What the evidence says: ACT has a growing evidence base supporting its use for anxiety, depression, chronic pain, and stress-related concerns, with effectiveness broadly comparable to CBT for several of these, though the research base is somewhat smaller overall.

Questions to ask a therapist

• How does this differ from CBT in practice?
• What does "values work" actually look like in sessions?
• How will we know this approach fits my goals?

What sessions can feel like: Typically weekly, often over roughly 6–12 sessions for a single trauma, though more complex or repeated trauma can take longer.

What the evidence says: EMDR has solid research support for PTSD and is recommended as an effective treatment option by major guidelines (alongside trauma-focused CBT-type approaches). Researchers still debate exactly why it works — the eye movements themselves versus the structured exposure to the memory — but outcome studies for PTSD are generally positive.

Questions to ask a therapist

• What should I expect physically and emotionally during a session?
• How do we decide which memories to target first?
• Are you certified in EMDR specifically, and how much experience do you have with it?

What sessions can feel like: Usually a defined course, often around 12 weekly sessions for CPT; TF-CBT (often used with children/adolescents and caregivers) is similarly structured over a set number of sessions.

What the evidence says: Both are considered first-line, strongly evidence-supported treatments for PTSD by major clinical guidelines, with substantial research behind their effectiveness, including for trauma related to abuse, combat, and disaster.

Questions to ask a therapist

• What will a typical session structure look like?
• How much detail about the trauma will I need to share, and when?
• What if a session brings up more distress than I expect?

What sessions can feel like: Varies by purpose and format — can be short-term and focused (a handful of sessions) or longer-term, depending on what it's addressing.

What the evidence says: Family-based approaches have strong evidence specifically for adolescent eating disorders (family-based treatment, or FBT, is a leading approach for anorexia in younger patients), and are commonly used to support treatment of adolescent mental health concerns and improve family communication more broadly, though evidence quality varies by the specific approach and condition.

Questions to ask a therapist

• Who is expected to attend sessions?
• How is confidentiality handled within the family context?
• Is this a structured, evidence-based family model (like FBT) or a more general approach?