If you’ve started looking for a psychologist, two approaches to therapy will likely come up again and again: cognitive behavioural therapy (CBT) and psychodynamic therapy.
They’re two well-established approaches to psychological therapy, both supported by research, but they have quite different ideas about what psychological difficulties are and what helps people change. If you’re already feeling stretched, being asked to choose between them can feel like one more thing you’re somehow meant to understand.
CBT tends to focus on patterns in the present, particularly the connections between thoughts, feelings and behaviours. It often offers practical strategies for changing patterns that are contributing to distress.
Psychodynamic therapy also begins with what is happening in the present, but takes a broader view of the person experiencing it. It is interested in how you have come to understand yourself and other people, how you experience emotions and relationships, and why certain patterns can continue even when you consciously want something to be different.
This difference matters to me. I believe that psychological difficulties are rarely just problems to be solved. They are experiences that have developed within a particular person’s life, relationships and way of making sense of the world. Understanding that complexity can be an important part of creating meaningful change.
I can speak to both approaches because I trained in both. My training at Victoria University took an integrative approach spanning the cognitive behavioural and psychodynamic traditions, and I have training in several forms of CBT, including Acceptance and Commitment Therapy (ACT). In my current practice, I work exclusively within a psychodynamic framework because it is the approach that best fits how I understand people and psychological change.
What Is CBT (Cognitive Behavioural Therapy)?
CBT is based on the idea that thoughts, feelings and behaviours are interconnected, and that changing patterns in one area can influence the others.
It tends to be structured and goal-oriented, with a focus on the difficulties you’re facing in the present. In therapy, you might identify patterns of thinking that contribute to distress, experiment with different behaviours, develop coping strategies, or practise new skills between sessions.
CBT is collaborative, and the work often involves agreeing on specific goals and working towards them together. For someone who wants practical strategies for addressing a particular difficulty, this structure can be very useful.
Acceptance and Commitment Therapy (ACT) is one approach within the broader CBT tradition. CBT also has a large and well-established evidence base across many common psychological difficulties, which is one reason it is so widely offered.
What Is Psychodynamic Therapy?
Psychodynamic therapy starts from the idea that our psychological lives are more complicated than what we are immediately aware of. We can know something about ourselves intellectually and still find ourselves responding in ways we don’t fully understand or feel able to change.
Rather than approaching a difficulty as a problem to be isolated and fixed, psychodynamic therapy is interested in the person as a whole. How do you experience yourself? What do you expect from other people? What happens for you when you feel rejected, disappointed, dependent, angry or vulnerable? What patterns do you find yourself repeating, even when you would prefer not to?
These questions are not about looking for someone or something to blame. They are about developing a more complete understanding of your experience.
For example, someone might know that they regularly withdraw when they feel criticised, become anxious when someone is disappointed with them, or take on more responsibility than they can manage. Knowing that pattern exists is useful, but it doesn’t necessarily explain why it feels so difficult to respond differently.
Psychodynamic therapy creates space to become curious about those patterns and what they mean for you. Sometimes the most important parts of a pattern are not immediately obvious, and they can become clearer through the process of talking and reflecting together.
A few things tend to characterise this way of working.
It is non-directive, meaning I’m less focused on providing solutions or strategies and more interested in helping you develop your own understanding of your experience and consider what might need to change.
It pays close attention to relationships, including the therapeutic relationship itself. The ways we experience and relate to other people can also emerge in therapy, where they can be noticed and explored as they happen rather than only discussed in the abstract.
It also tends to be medium- to long-term. Developing a fuller understanding of yourself and working through longstanding patterns can take time. The aim is not simply to help you cope better with the problem in front of you, but to understand the person experiencing it and create the possibility for change that extends beyond that immediate difficulty.
Key Differences Between Psychodynamic Therapy and CBT
The difference between CBT and psychodynamic therapy is not simply that one looks at the present and the other looks at the past. Both can consider your history, and both are concerned with what is happening in your life now.
The more important difference is what each approach considers important to understand in order for change to occur.
- The focus of therapy: CBT tends to work directly with thoughts, feelings and behaviours that are contributing to difficulties in the present. Psychodynamic therapy takes a broader view of how you experience yourself, other people and emotions, including patterns that may be difficult to recognise from the inside.
- How sessions are structured: CBT tends to be more structured, with agreed goals and sometimes exercises or tasks between sessions. Psychodynamic sessions are more open, allowing the direction of the conversation to be shaped by what feels important as it emerges.
- The approach to change: CBT often aims to identify and change patterns that are maintaining distress. Psychodynamic therapy is interested in helping you understand patterns more fully, including why particular responses can feel so compelling or difficult to change. I value this because I don’t think meaningful change always comes from simply learning a different response. Sometimes it comes from understanding yourself differently.
- The therapeutic relationship: In CBT, the relationship provides a collaborative foundation for working towards agreed goals. In psychodynamic therapy, the relationship is also something we pay attention to in its own right. How you experience me and how we relate to one another can offer useful information about how you experience closeness, trust, conflict and other relationships.
- Time: CBT is often shorter-term, while psychodynamic therapy can unfold over a longer period. The length of therapy depends on the person, the difficulties they are experiencing and what they want from treatment.
CBT can be an excellent fit for someone who wants a structured, practical approach to a particular difficulty. I also understand why many people find that appealing.
My own preference for psychodynamic therapy comes from believing that, for many people, there is value in having somewhere to explore more than the immediate problem. Sometimes the patterns causing us the most difficulty are not the ones we consciously chose, and changing them requires more than knowing what we should do differently.
CBT vs Psychodynamic Therapy for Anxiety
When people search for CBT vs psychodynamic therapy for anxiety, they are often looking for one approach that will work better than the other. A more useful question may be what you want therapy to help you understand and change about your anxiety.
CBT tends to work directly with the thoughts, feelings and behaviours involved in anxiety. This might include identifying patterns of thinking, gradually approaching situations that have become difficult, or developing different ways of responding when anxiety arises.
Psychodynamic therapy is interested in anxiety as part of the person’s broader emotional and relational life. Rather than focusing only on what happens when anxiety appears, we might become curious about what particular situations or relationships bring it out, what the anxiety feels like, and how you have learned to respond to difficult emotions.
For example, someone might understand that they become anxious when they think another person is disappointed with them, but still feel unable to stop trying to prevent anyone from being disappointed. Understanding that pattern can involve looking at what being disappointing to someone has come to mean, how the person experiences other people’s expectations, and what happens when they begin to respond differently.
For some people, practical strategies for managing anxiety are exactly what they are looking for. For others, managing the anxiety is only part of the picture. They may want to understand why particular situations or relationships have such a strong emotional impact, or why similar patterns keep returning.
This is one of the reasons I value psychodynamic therapy for anxiety. It gives us room to ask not only how to reduce the anxiety, but what the anxiety means within the person’s wider emotional life and what might need to change so that it no longer has quite the same hold.
If anxiety is what’s bringing you here, you can read more on my anxiety treatment page.
CBT vs Psychodynamic Therapy for Depression
When considering CBT vs psychodynamic therapy for depression, both approaches can be helpful, but they offer different ways of understanding and responding to the experience of depression.
CBT tends to focus on the thoughts, feelings and behaviours that can maintain depression in the present. Therapy may involve identifying patterns of thinking, addressing withdrawal and inactivity, and developing practical ways of responding differently.
Psychodynamic therapy is interested in depression within the context of the person’s broader emotional life. Depression can involve much more than feeling sad. It can affect how you experience yourself, your relationships, your sense of worth and your connection to things that once felt meaningful.
Therapy might therefore involve becoming curious about what happens in your relationships, how you respond to loss or disappointment, what you expect from yourself, or why certain experiences seem to leave you feeling particularly defeated or disconnected.
For some people, practical strategies for addressing low mood and withdrawal are exactly what they need. For others, depression may feel longstanding or recurring, or connected to difficulties that extend beyond the current episode. They may want to understand why certain patterns keep returning and what might allow something to change more fundamentally.
This is where I see particular value in psychodynamic work. Rather than treating depression only as a collection of symptoms to reduce, it allows us to consider what the depression means in the context of your life, relationships and sense of self. That does not mean ignoring symptoms. It means being interested in the person experiencing them.
You can read more about how I approach this on my depression treatment page.
How to Choose the Right Therapy for You
Choosing between CBT and psychodynamic therapy does not have to mean deciding which approach is objectively better. It is more about considering what you want from therapy.
You might ask yourself:
- Are you looking for practical strategies to address a specific difficulty, or space to understand yourself and your patterns more fully?
- Would you prefer more structure and guidance, or open, reflective exploration?
- Is there a particular problem you want to address now, or are you also interested in patterns that have developed over time?
- Do you feel that you mainly need different ways of responding, or that you want to understand why certain responses feel so difficult to change?
If you are drawn towards structure, practical strategies and working towards specific goals, CBT may be a good fit. If you are interested in exploring recurring patterns, relationships and the ways you have come to experience yourself and other people, psychodynamic therapy may offer something valuable.
You don’t need to work all of this out before starting therapy. A short conversation with a psychologist can help you think through what you’re looking for and whether their approach is likely to be a good fit.
Why Alicia Chooses Psychodynamic Therapy
As I mentioned, I trained across both the cognitive behavioural and psychodynamic traditions, and I have training in several forms of CBT, including ACT. In my current practice, I work exclusively within a psychodynamic framework.
I made that choice because psychodynamic therapy best reflects how I understand psychological change.
I don’t think people are simply collections of symptoms, thoughts and behaviours that can be modified one by one. I think our difficulties make sense in the context of who we are, what we have experienced, how we have learned to relate to other people, and what we have come to expect from ourselves and the world around us.
People can experience very similar difficulties for very different reasons. Two people might both experience anxiety in relationships, for example, while having very different experiences of closeness, conflict, rejection or dependence. Two people might both describe themselves as perfectionistic, while one is driven primarily by fear of failure and another by a deep sense that being useful is how they earn their place with other people.
I don’t want to assume that the same explanation or solution will fit both people.
I also value the fact that psychodynamic therapy can help with patterns that someone already understands intellectually but still finds difficult to change. Knowing that you always say yes when you want to say no is different from understanding what makes saying no feel so difficult, what you imagine might happen if you did, and how that pattern has come to feel necessary.
That distinction is important to me. Insight is not the same thing as change, but meaningful change often requires more than simply knowing what to do differently. It can require developing a different relationship with yourself, your emotions and other people.
The therapeutic relationship is part of this work. How we relate to one another in therapy can provide another opportunity to notice how you experience trust, closeness, disappointment, dependence or conflict. These patterns do not need to be forced or searched for. They can emerge naturally through the work and become something we can think about together.
I also work in a non-pathologising way. I’m trained to diagnose and will offer a diagnosis where it is genuinely useful, but I place less emphasis on labels and more on understanding you as an individual. That includes considering your relationships, life circumstances, sexuality, class and broader social environment, rather than treating psychological distress as something that exists entirely within the individual.
Ultimately, psychodynamic therapy is the approach I have chosen because I value having the time and space to understand not only what someone is struggling with, but how they have come to experience themselves and their world in the way they do. For me, that is where some of the most meaningful possibilities for change begin.
You can learn more about my approach on my psychodynamic therapy page.
Online Psychodynamic Therapy in Australia
I work entirely via telehealth, with sessions held over Zoom. For some people, online therapy is simply the most practical way to access psychological support, particularly when there are limited options nearby or travelling to appointments is difficult.
Telehealth means:
- No commute or parking
- No waiting room
- Less time away from work or other responsibilities
- The option to attend from a private, familiar space
- The ability to choose a psychologist based on fit rather than location
For some people, attending from home can also make it easier to maintain regular appointments around work, childcare or other commitments. Telehealth can be particularly useful for people living in regional or rural areas, people for whom travel is difficult, parents working around childcare, and shift workers.
My sessions are held over Zoom and are available on weekday mornings. Appointments are scheduled in Australian Eastern Standard Time, or AEDT during Victorian daylight saving.
This generally makes my current availability most workable for people in:
- Victoria
- New South Wales
- Queensland
- South Australia
- Australian Capital Territory
- Northern Territory
Enquiries from Western Australia are welcome too, although the early-morning appointment times will only suit some people.
You can read more about how telehealth appointments work on my telehealth psychology page.
Conditions Alicia Helps With
I work with adults aged 18 and over on a wide range of concerns, including:
- Anxiety: Persistent worry, social anxiety, panic, OCD and health anxiety
- Depression: Low mood, exhaustion, loss of interest, and depression that keeps returning
- Trauma: Both single-incident and complex trauma, worked with at a pace that feels manageable
- Stress and burnout: Chronic stress and feeling overwhelmed by ongoing demands
- Grief, loss and life transitions: Including the psychological impact of chronic illness, disability and complex medical conditions, an area of particular interest for me
- Relationship patterns: Recurring dynamics, and difficulty with closeness or conflict (I work with individuals, not couples)
- Sexual concerns and pornography use: Explored without judgement
- Body image, eating disorders, addiction or problematic substance use, anger, and identity-related concerns
Frequently Asked Questions
Is Psychoanalytic Therapy The Same As Psychodynamic Therapy?
They’re closely related. Psychodynamic therapy grew out of the psychoanalytic tradition and shares its interest in the unconscious and in early experience. In practice, modern psychodynamic therapy is typically less intensive than classical psychoanalysis.
How Long Does Each Type Of Therapy Take?
CBT is often shorter-term and structured around specific goals. Psychodynamic therapy is generally medium- to long-term, because understanding longstanding patterns in depth takes time. I usually suggest beginning with weekly or fortnightly sessions where possible, and frequency can be reviewed as things progress.
Is Psychodynamic Therapy Available Online In Australia?
Yes. Psychodynamic therapy can be delivered effectively via telehealth for many people. I work entirely online over Zoom with adults across Australia, on weekday mornings in AEST — most workable for people in Victoria, New South Wales, Queensland, South Australia, the ACT and the Northern Territory.
Do I Need A Referral Or Mental Health Treatment Plan?
No. You can book directly without a referral or a Mental Health Treatment Plan. A referral from your GP or psychiatrist is only needed if you’d like to claim a Medicare rebate; without one, sessions are privately billed. You’re welcome to arrange a plan later if you choose to. See my rates and fees.
If you’re weighing up your options, you don’t have to settle the CBT vs psychodynamic question before you begin. I offer a free 15-minute phone call to talk through what’s bringing you to therapy and whether my way of working feels like a good fit — and if a different approach would serve you better, I’ll say so and can point you toward it.
