Therapy Approaches Explained: CBT, ACT, DBT, EMDR and More
There are many types of therapy, but most evidence-based approaches fall into a few families. Cognitive behavioural therapy (CBT) works on thoughts and behaviours. Acceptance and commitment therapy (ACT) changes your relationship with difficult thoughts and feelings. Dialectical behaviour therapy (DBT) teaches skills for intense emotions. Schema therapy and psychodynamic therapy explore deeper patterns from earlier life. EMDR is a specialised trauma therapy. In practice, most psychologists draw on several approaches, and the quality of the relationship with your therapist matters as much as the model.
This guide explains each approach in plain language, what it's used for, and how to think about which might suit you.
Quick comparison
CBT — Core idea: Thoughts, feelings and behaviours affect each other; changing thoughts and behaviours changes how you feel; Often used for: Anxiety, depression, panic, OCD, insomnia; Style: Structured, practical, homework-based
ACT — Core idea: Struggling against difficult thoughts and feelings keeps you stuck; making room for them frees you to act on your values; Often used for: Anxiety, depression, chronic pain, stress, burnout; Style: Experiential, uses metaphors and mindfulness
DBT — Core idea: Balancing acceptance and change; building skills for managing intense emotions; Often used for: Emotional dysregulation, self-harm, borderline personality disorder, impulsivity; Style: Skills-based, often includes group work
Schema therapy — Core idea: Early unmet needs create deep patterns (schemas) that repeat in adulthood; Often used for: Long-standing patterns, personality difficulties, complex trauma, chronic depression; Style: Integrative, longer-term, emotionally focused
Psychodynamic — Core idea: Past experiences and unconscious patterns shape present relationships and feelings; Often used for: Relationship patterns, recurring difficulties, self-understanding; Style: Exploratory, less structured
EMDR — Core idea: Processing traumatic memories while doing bilateral stimulation reduces their emotional charge; Often used for: PTSD and trauma; Style: Structured eight-phase protocol
Mindfulness-based approaches — Core idea: Paying attention to the present moment without judgement changes how you relate to experience; Often used for: Stress, recurrent depression, anxiety; Style: Practice-based
Somatic approaches — Core idea: Trauma and stress are held in the body; working with sensations helps regulate the nervous system; Often used for: Trauma, anxiety, chronic stress; Style: Body-focused
Cognitive behavioural therapy (CBT)
CBT is the most researched form of psychological therapy. It's based on the idea that how we interpret situations shapes how we feel and act, and that unhelpful patterns of thinking and behaviour keep problems going.
What it involves: identifying unhelpful thoughts, testing them against evidence, gradually facing avoided situations, and building practical skills. Sessions are structured and goal-focused, with tasks between sessions.
Good fit if: you like structure and practical strategies, and you're dealing with a specific problem such as panic, social anxiety or insomnia.
Acceptance and commitment therapy (ACT)
ACT is part of the "third wave" of behavioural therapies. Rather than challenging thoughts, it teaches you to notice them and hold them lightly, while moving toward what matters to you.
What it involves: mindfulness, "defusion" techniques that create distance from thoughts, clarifying values, and taking committed action. See our beginner's guide to ACT.
Good fit if: you've tried to think your way out of problems without success, or you're dealing with things that can't simply be fixed, such as chronic pain, grief or uncertainty.
Dialectical behaviour therapy (DBT)
DBT was developed by psychologist Marsha Linehan, originally for people with chronic suicidality and borderline personality disorder. "Dialectical" refers to holding two things at once: accepting yourself as you are, and working to change.
What it involves: full DBT programs include individual therapy, skills groups, phone coaching and a therapist consultation team. Many psychologists use DBT skills without delivering the full program. The four skill areas are mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. See DBT Skills That Can Help in Everyday Life.
Good fit if: emotions feel intense and hard to manage, or you act impulsively when distressed.
Schema therapy
Schema therapy was developed by Jeffrey Young to help people with long-standing patterns that didn't respond fully to standard CBT. It combines elements of CBT, attachment theory, psychodynamic ideas and experiential techniques.
What it involves: identifying schemas (such as abandonment, defectiveness or unrelenting standards) and "modes" (the emotional states that get triggered), understanding their origins, and meeting unmet needs through the therapy relationship and techniques such as imagery rescripting and chair work. See Schema Therapy Explained.
Good fit if: you recognise patterns that have followed you for years, especially in relationships or self-worth.
Psychodynamic therapy
Psychodynamic therapy has its roots in psychoanalysis but has since developed into several contemporary forms. It focuses on how past experiences, particularly early relationships, shape present feelings and patterns, often outside conscious awareness.
What it involves: open, exploratory conversation, attention to recurring themes, and exploring the therapy relationship itself. Short-term psychodynamic therapy has research support for depression and some anxiety presentations.
Good fit if: you want to understand why you keep ending up in the same place, not just change behaviour.
EMDR (Eye Movement Desensitisation and Reprocessing)
EMDR is a structured trauma therapy in which you briefly focus on a traumatic memory while following bilateral stimulation, usually eye movements. It's recommended for PTSD in the Australian PTSD Guidelines and must be delivered by a practitioner with specific EMDR training. See What Is EMDR Therapy and How Does It Work?
Mindfulness-based approaches
Mindfulness means paying attention to the present moment, on purpose and without judgement. It's a core element of ACT and DBT, and structured programs such as mindfulness-based cognitive therapy (MBCT) have good evidence for preventing relapse in recurrent depression. See Mindfulness in Therapy: More Than Just Meditation.
Somatic and body-based approaches
Somatic approaches focus on physical sensations, posture, breath and movement to help regulate the nervous system, particularly after trauma or chronic stress. They're usually integrated with other therapies. The research base is smaller than for CBT or EMDR, so they work best as part of a broader treatment plan.
Attachment-based and relational approaches
These focus on how early relationships shape the way we connect with others as adults, and use the therapy relationship as a place for new, more secure experiences. See Attachment Styles Explained.
Couples approaches
Gottman Method couples therapy and Emotionally Focused Therapy (EFT) are two well-known evidence-informed approaches for relationships. Read more in our couples therapy guide.
Which approach is right for me?
Research consistently shows that the therapeutic relationship, meaning trust, collaboration and agreement on goals, is one of the strongest predictors of good outcomes across all types of therapy. So while it's useful to know about approaches, it's equally important to find a psychologist you feel comfortable with.
Most psychologists are integrative, drawing on different approaches depending on the person and the problem. Some questions to consider:
Do you want practical tools, deeper understanding, or both?
Is there a specific problem you want to target, or broader patterns?
How do you feel about structure and homework?
Is there a history of trauma that needs a trauma-informed approach?
Our article on how to choose the right psychologist has a list of questions to ask.
Our approaches at Satya Psychology
Our team integrates several evidence-based approaches:
Mirinda Smith, Founder and Psychologist: ACT, CBT, DBT, Gottman Level 1 for relationships, with a psychodynamic lens
Natalie Luxford, Provisional Psychologist: CBT, ACT and mindfulness
Maddison Weinert, Provisional Psychologist: CBT, ACT, person-centred and strengths-based, neurodiversity-affirming
Isabelle Bucher, Counsellor: person-centred, CBT, ACT and mindfulness, with a strong focus on values (currently on parental leave)
We also draw on somatic, attachment-based and trauma-informed approaches, and offer therapy in person, by telehealth and through Walk and Talk sessions on the Gold Coast.
Meet our team to find the right fit, or book a session.
This article is general information and isn't a substitute for individual advice.