Approaches / Compare
CBT and psychodynamic therapy
Both approaches are widely offered for common difficulties such as depression, yet they draw on different accounts of how distress persists and how sessions are organised. This page compares emphasis, not outcomes.
| Aspect | Cognitive behavioural therapy (CBT) | Psychodynamic therapy |
|---|---|---|
| Main focus | How present interpretations of events and the behaviours that follow maintain distress. | How recurring feelings, defences and relationship patterns, including those outside full awareness, shape present life. |
| Attention to the past | Usually focuses mainly on current patterns, exploring earlier history when it helps make sense of present beliefs. | Places sustained weight on earlier relationships and developmental experience alongside present difficulties. |
| Session structure | Typically begins with an agreed agenda, focuses on one or two items, and agrees between-session tasks. | Usually open-ended conversation in which the person speaks freely and the therapist listens for recurring themes. |
| Role of the therapeutic relationship | A collaborative working partnership that supports shared formulation and active testing of ideas. | Both a working alliance and a live setting in which feelings from other relationships (transference) can be noticed and explored. |
| Usual duration | Commonly time-limited (for example, 5 to 15 sessions in NHS talking therapies, depending on the problem). | Ranges from time-limited short-term models with an agreed focus to open-ended weekly or more frequent work. |
| Origins | Behaviour therapy from the mid twentieth century combined with cognitive therapy developed by Albert Ellis and Aaron Beck. | Psychoanalytic traditions beginning with Sigmund Freud and later diversified through ego, object relations, self and relational schools. |
This comparison describes emphasis. It does not say which approach is more effective, and it is not advice on treatment.
Sources are listed on the CBT and Psychodynamic entries. Back to all comparisons.
Educational draft · Subject review pending