One of the most common questions I hear from new clients is some version of: "What kind of therapy is best for me?" It is a fair question, and also a difficult one to answer briefly. Different approaches ask different questions, work at different depths, and suit different moments in a person's life. In this article, I want to give you a plain-English feel for three of the most established traditions, cognitive behavioural, psychodynamic and existential, and explain how integrative practice weaves them together.
Cognitive behavioural therapy (CBT)
CBT is probably the most widely known form of talking therapy in the UK. It is grounded in the idea that our thoughts, feelings, bodily responses and behaviours are constantly influencing one another. If our thinking is dominated by patterns like "I always fail", "people will judge me" or "if I relax, something bad will happen", our feelings and actions tend to follow.
CBT is usually structured and focused. You and your therapist agree what you want to work on, then look closely at the specific thoughts, situations and behaviours involved. There is often homework between sessions, noticing thoughts, trying small behavioural experiments, gradually facing avoided situations. It has a strong evidence base for anxiety disorders, low mood, panic, phobias, OCD and PTSD.
Its strengths are clarity, structure and practical change. Its limitation is that it does not always reach the deeper roots of why certain patterns became so entrenched in the first place, which is where other approaches come in.
Psychodynamic therapy
Psychodynamic therapy takes the view that much of what shapes us is not fully in our awareness. Early relationships, unprocessed feelings, and coping strategies formed long ago continue to influence how we love, work and react as adults, often outside our conscious control.
In practice, sessions are usually less structured than CBT. You are invited to speak more freely, about your week, your relationships, your dreams, your memories, and we notice together the patterns that emerge. Particular attention is paid to the therapeutic relationship itself, because the way we relate to a therapist often mirrors the way we relate to others. Insight builds gradually, and change comes as much through the experience of being deeply understood as through anything specific we "do".
Psychodynamic work can be especially helpful when difficulties are long-standing, when the same painful patterns keep repeating in relationships or at work, or when a person feels stuck in a way they cannot fully explain. It tends to be longer-term and more open-ended.
Existential therapy
Existential therapy sits within a philosophical tradition that takes seriously the "big" questions of being human, meaning, choice, freedom, responsibility, isolation, mortality. Rather than treating these as abstract ideas, it asks how they show up in your particular life: What matters to you? What are you avoiding? What would it mean to live more honestly?
Practically, existential sessions look a lot like other in-depth talking therapies, thoughtful, open, exploratory. What is distinctive is the willingness to sit with difficult truths rather than solve them away: the reality that we cannot control everything, that important choices carry loss, that some anxieties are part of being alive, not symptoms to be eliminated. Clients often turn to existential work at moments of transition, loss, midlife re-evaluation, questions of identity or purpose, or after events that have shaken their sense of who they are.
So which one is "right" for you?
There is rarely a single correct answer, and the research is clearer than many people expect: across many conditions, the specific brand of therapy matters less than the quality of the relationship and how well the approach fits the person. A few gentle guidelines can still help.
- If you have a clearly defined problem, a phobia, panic attacks, sleep issues, a specific anxiety, and want a focused, practical piece of work, CBT is often a strong starting point.
- If you keep noticing the same painful patterns in your relationships, work or self-image, and want to understand where they come from, psychodynamic work can offer real depth.
- If you are wrestling with meaning, change, identity, loss or how you want to live, existential therapy may speak to what you are actually asking.
Personal preference matters too. Some people feel steadied by structure; others feel freer with more open exploration. Neither is better, they are different ways in.
How integrative work brings them together
In my own practice I work integratively, drawing on all three traditions. In real life, people rarely arrive with only one kind of difficulty. A client might begin with a very concrete anxiety, flying, presentations, sleep, where practical, CBT-informed work makes a real difference. As things settle, deeper themes often emerge: an old belief that they must always perform to be loved, a grief that was never fully mourned, a question about what kind of life they actually want.
An integrative approach means being able to move flexibly with you, offering structure when it helps, depth when it is needed, and space to reflect on the bigger questions when they arise. It also means the work stays anchored in you as a whole person, not in a technique.
A soft next step
If you are trying to decide whether therapy, and this kind of therapy, might be right for you, the most useful thing is usually a conversation. You are warmly welcome to book a free introductory call so we can talk through what you are looking for and which way of working might suit you best, without any pressure to commit.