Definition
Therapy, more precisely psychotherapy or talk therapy, is the treatment of psychological conditions through structured, evidence-based methods delivered by a licensed mental health clinician. The clinician may be a psychologist (PhD or PsyD), a master's-level therapist (LCSW, LPC, MFT), a psychiatric nurse practitioner, or a psychiatrist. "Therapy" in this clinical sense isn't the same as a supportive conversation with a friend, a coach, a pastor, or an unlicensed practitioner; while those relationships can be valuable, they aren't psychotherapy and the term shouldn't be used interchangeably. There are many distinct psychotherapy approaches; the choice matters because the evidence base differs significantly between them.
What it can feel like
Sessions are typically 45 to 50 minutes, weekly at the start, with practice between sessions in the more structured approaches. Good therapy involves agreement at the outset about what the work is trying to change, regular check-ins on progress, and concrete tools the patient can use outside the room. It isn't the same as being listened to, although that's part of it.
What the evidence supports
For anxiety disorders specifically, cognitive behavioral therapy and its variants, including exposure therapy and acceptance and commitment therapy, have the strongest evidence. For trauma, prolonged exposure, cognitive processing therapy, and EMDR have the strongest evidence. Less structured supportive therapy can be useful for life issues but tends to move anxiety symptoms less than the structured protocols. When choosing a therapist, asking what approach they use and what evidence supports it for the specific problem is reasonable and welcomed by most clinicians.
Mechanism in brief
Different therapies work through different mechanisms. CBT changes the cognitive and behavioral patterns that maintain a symptom. Exposure-based therapies retrain the brain's threat associations through structured experience. Acceptance and commitment therapy changes the relationship between thoughts and action rather than the content of the thoughts. Psychodynamic therapy examines patterns from earlier relationships that are shaping current ones. The choice of modality is matched to the presenting issue; most evidence-based treatments for anxiety include exposure as a core element.
When to see a clinician
Therapy is appropriate when symptoms are interfering with daily life, when patterns in relationships or self-evaluation feel stuck, or when life events have outpaced the person's capacity to process them. Choice of modality (CBT, ERP, ACT, psychodynamic) depends on the presenting issue.