What is psychotherapy, and how is it different from psychiatry and counselling?

Psychotherapy is the use of psychological methods, usually built on regular conversation between two people, to help someone change behaviour, overcome problems and feel better. People call it "talk therapy". The name itself comes from two Greek words, psyche (breath, spirit, soul) and therapeia (healing).

The surprising part is who does it. A psychotherapist can be a psychiatrist, a psychologist, a mental health nurse, a social worker, a family therapist or a counsellor, and depending on the country the work may be tightly regulated, lightly regulated or not regulated at all; in some places the word itself is not even protected.

Psychiatry is the best-known neighbour. Psychiatrists are trained as physicians first and specialise afterwards, so they can prescribe medication. Clinical psychologists instead hold specialist doctorates in psychology. A psychiatrist may train in talk therapy too, but it is the medical training that sets psychiatrists apart. Over time many psychiatrists have moved toward prescribing: since the early 1980s, Wikipedia notes, insurers that limited payment for therapy sessions pushed the 50-minute talk hour toward shorter medication visits.

Counselling sits alongside. Some definitions overlap with psychotherapy, while others describe guidance on everyday problems, usually shorter and less medical. Counselling psychology's own society describes helping people improve well-being, ease distress and resolve crises.

Psychotherapy is not one thing. There are hundreds of techniques, some of which have been tested and judged evidence-based for diagnosed conditions, while others have been criticised as pseudoscience. That is why the rest of this path looks at how the main schools work and how researchers check whether they do.