CBT vs psychodynamic therapy: what's the difference?

If you've started looking into therapy, you've probably come across CBT and psychodynamic therapy. Both involve talking, so it isn't always clear what the difference is.

CBT (cognitive behavioural therapy) is structured and focused on the present. It looks at the thoughts and behaviours keeping a problem going now, and gives you practical ways to change them, often with exercises to try between sessions. It's usually shorter-term, with clear goals.

Psychodynamic therapy is more open and exploratory. It looks at how earlier experiences, especially early relationships, still shape how you feel and relate to people today, often without you realising. It's usually longer-term, because this kind of understanding builds gradually.

Neither is better than the other. They suit different people and different problems. If you have a specific problem, such as panic attacks, a phobia or anxious thoughts, and want practical tools fairly quickly, CBT is often a good place to start. If you sense that a pattern in your life has deeper roots and you want to understand it, not just manage it, psychodynamic work may suit you better.

Many therapists, including me, work integratively. That means drawing on both approaches, and others, depending on what you need, rather than using one method for everyone.