What Is Psychotherapy? How It Works | Özgün Emre Yaylacı

Psychotherapy is a structured psychological support process in which a person addresses the emotional, cognitive, behavioral and relational difficulties they experience together with a mental health professional. It is also known as talk therapy and is usually carried out through regular sessions, either individually or in a group. This article covers, in general terms, what psychotherapy is and is not, how sessions work, how it relates to medication and the framework of confidentiality; links to related articles are provided for more detail.

What is psychotherapy?

In this process, not only the visible symptoms but also the person’s life story, ways of thinking, ways of regulating emotions, behavioral cycles and recurring patterns in relationships are considered together. The US National Institute of Mental Health (NIMH) describes psychotherapy as a general term for a variety of treatment approaches that aim to help a person change troubling emotions, thoughts and behaviors. The Turkish Psychiatric Association likewise notes that special techniques in psychotherapy are used within a positive relationship with the patient or client.

What is done in psychotherapy?

In therapeutic sessions, the aim is to create a space for the person to understand the difficulty they are experiencing better, to notice the cycles that challenge them, and to cope with these difficulties in more functional ways. The process is shaped by the client’s needs, reason for seeking support, life circumstances and therapy goals; the methods used vary with the psychotherapy approach followed.

What psychotherapy is not

Knowing what psychotherapy is not can help build realistic expectations of the process:

It is not an everyday conversation. It has a planned framework, a principle of confidentiality and a defined purpose, and it is carried out with a professional trained in this field.
It is not a process of giving advice or making decisions on a person’s behalf. The focus is on the person understanding their own patterns of thought, feeling and behavior.
It is not a process in which medication is prescribed. Matters concerning medication belong to the evaluation of a psychiatrist.
It is not a process that promises outcomes. Progress varies with the person, the difficulty and participation in the process.

Which topics can be addressed in psychotherapy?

Different topics can be addressed in psychotherapy, such as anxiety, stress, difficulties with emotion regulation, difficulties in interpersonal relationships, life transitions, experiences of loss and grief, burnout, difficulties related to self-worth, or the need to understand oneself more closely. Every psychotherapy process is unique to the person; for this reason, the content, pace and focus of the sessions are evaluated in line with the client’s needs. For detailed information, see Which Topics Can Be Addressed in Sessions? and When Can Psychological Support Be Considered?.

What types of psychotherapy are there?

Psychotherapy is not a single method; there are different theoretical approaches and ways of delivering it. The NHS and the Royal College of Psychiatrists (RCPsych) list many approaches, such as cognitive behavioral therapy, interpersonal therapy, counseling, and couples and family therapy; according to NIMH, a therapist may use one primary approach or bring together elements of more than one. The related articles on this site are:

What Is Cognitive Behavioral Therapy (CBT)? A structured approach that focuses on the cycles that maintain present-day difficulties.
What Is Psychodynamic Psychotherapy? An approach aimed at understanding relationship patterns and the effect of the past on the present.
What Is the Difference Between CBT and Psychodynamic Psychotherapy? A comparison of the two approaches.
Which Approaches Can Be Used in the Psychotherapy Process? Criteria for types and short definitions.
How Is the Suitable Way of Working Assessed? Points that can be considered when choosing.
What Is Individual Psychotherapy for Adults? How individual work differs from group, couples and family therapy.

How is the psychotherapy process conducted?

The psychotherapy process is conducted on the basis of confidentiality, ethical principles and mutual collaboration. The main points about how it works are summarized below.

What can be expected in the first session?

The first session is usually an introductory and assessment meeting: the person’s reason for seeking support, how long the difficulties have been going on, their effects on daily life and the person’s expectations are discussed, along with the general way the process works and its limits. NIMH notes that such a preliminary conversation can help show how the work would proceed and whether the person feels comfortable, and that rapport and trust with the professional are essential. The person can also ask about the professional’s training, the approach used, the recommended number of sessions and the limits of confidentiality. For detailed information, see What Is Covered in the First Session? and How Is the Process Planned After the First Session?.

How long do sessions last and how often are they held?

According to RCPsych, psychotherapy usually consists of regular meetings at the same time and place every week or two, and the length of the process is most often agreed with the professional within about a month of starting. Duration varies with the nature of the difficulty, how long it has lasted and the approach followed: some topics can be addressed in a shorter-term piece of work, while others may call for a longer process. Sessions can be held in person or online. For details, see How Are Session Frequency and Length Determined? and What Is Online Psychotherapy and How Do Sessions Proceed?.

What are the limits of confidentiality in psychotherapy?

Personal information shared in sessions is not passed on to third parties without the person’s explicit consent, and the scope and limits of confidentiality are discussed openly at the start of the process. RCPsych also states that sessions are confidential, but adds that the professional may discuss sessions with a supervisor for supervision purposes and may have to tell others when a person becomes a danger to themselves or to others, in which case the matter is usually discussed with the person first.

What is the relationship between psychotherapy and medication?

NIMH states that psychotherapy can be used as an alternative to medication and other treatment options or alongside them, that the right plan depends on the individual, and that it should be guided by a mental health professional. Decisions about medication belong to a psychiatrist; a psychologist does not prescribe or recommend medication.

How can a person benefit from psychotherapy?

Psychotherapy is not limited to what is discussed during session hours; it is a process of making sense of one’s own experience and working on it, so the client’s active participation is important. The general points that stand out in the sources can be summarized as follows:

Keeping sessions regular (RCPsych).
Talking with the professional about goals, expectations and how progress will be evaluated (NIMH).
Sharing doubts about the process with the professional; NIMH advises talking with the therapist if there is no improvement after a reasonable period.
Paying attention to fit with the professional; RCPsych notes that personal factors are very important and that a person should not hesitate to look for someone who suits them.

For the general framework of psychology, see What Is Psychology?; for the roles of psychologists and psychiatrists, see What Is the Difference Between a Psychologist and a Psychiatrist?.

Expert note

In clinical work, psychotherapy is approached not as the application of a ready-made list of methods but as a collaboration that moves forward in the context of a person’s life story, relationships and recurring patterns. Two people who seek support for the same topic may therefore move toward different goals and at a different pace.

From a perspective that draws on both cognitive behavioral and psychodynamic theory, thoughts, feelings, behavior and relationship patterns are considered together. How suitable the process is for a person usually becomes clear only after an assessment meeting; the information in this article does not replace that assessment.

Clinical Psychologist Özgün Emre Yaylacı

Frequently asked questions

Is psychotherapy the same for everyone?

Every psychotherapy process is unique to the person; the content, pace and focus of the sessions are evaluated in line with the person’s needs. Because there are different approaches, the methods can also vary from person to person.

How long does psychotherapy take?

The duration is not the same for everyone; it varies according to the reason for seeking support, the goals and the course of the process. For detailed information, see How Long Does Psychological Support Take?.

How is confidentiality protected in psychotherapy?

The psychotherapy process is conducted on the basis of confidentiality and ethical principles. For detailed information, see How Are Confidentiality and the Ethical Framework Protected?.

Is a diagnosis needed for psychotherapy?

The NHS states that a diagnosed mental health condition is not required for talking therapies; practice may vary by country and institution. Whether a difficulty amounts to a diagnosis is understood through the assessment of the relevant professional.

Does psychotherapy replace medication?

According to NIMH, psychotherapy can be used as an alternative to medication or alongside it. Whether medication is needed is decided by a psychiatrist.

Sources

This article was prepared for general information; the following sources were used in preparing it (all in English except the one marked as Turkish):

This article was prepared by Clinical Psychologist Özgün Emre Yaylacı. Last updated: October 23, 2026. The content is for general information only and does not constitute diagnosis, treatment or personal guidance.