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J. Connor Barnhart, MD

Psychotherapy in San Francisco

Also known as: Talk Therapy, Counseling, Therapy

5 min readLast updated: 2026-02-20
Reviewed by J. Connor Barnhart, MD

Psychotherapy, also called talk therapy, refers to a variety of treatment approaches that aim to help a person identify and change troubling emotions, thoughts, and behaviors. Conducted by licensed mental health professionals, psychotherapy encompasses multiple modalities – including cognitive behavioral therapy, psychodynamic therapy, dialectical behavior therapy, and others – each is supported by research for treating conditions such as depression, anxiety disorders, PTSD, and personality disorders.

At a Glance

  • A comprehensive meta-analysis of 409 randomized controlled trials found that CBT produced clinically meaningful improvements in depression, with 42% of patients responding versus 19% in control groups[4]
  • The American Psychological Association recognizes psychotherapy as effective for a wide range of mental health conditions based on extensive research evidence[2]
  • EMDR therapy is supported by more than 30 published randomized controlled trials and is recommended as a first-line treatment for PTSD by multiple international clinical practice guidelines[6]
  • Evidence-based psychotherapies have been shown to reduce symptoms of depression, anxiety, and other mental health conditions, with benefits often persisting after treatment ends[1]

Overview

Psychotherapy is a broad term encompassing multiple evidence-based treatment approaches that involve intentional conversations between a trained mental health professional and a patient. Treatment may occur individually, with couples, families, or in group settings, and can be delivered in person or via telehealth.

Several distinct styles of therapy fall under the psychotherapy umbrella, including cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), psychodynamic therapy, psychoanalysis, interpersonal therapy (IPT), acceptance and commitment therapy (ACT), eye movement desensitization and reprocessing (EMDR), and exposure and response prevention therapy. Each modality draws on different theoretical frameworks and techniques, though all share the goal of reducing psychological distress and improving functioning.

Research supports psychotherapy as an effective treatment for a wide range of mental health conditions. The clinical relationship and alignment on goals is often an important, shared determinant of positive outcomes.

Psychotherapy can be used as a standalone treatment or in combination with medication. For many conditions, the combination of psychotherapy and pharmacotherapy has been shown to produce outcomes that are comparable to or better than either approach alone.

What to Expect During Treatment

  1. 1Initial assessment involves a comprehensive evaluation of symptoms, mental health history, medical history, current stressors, and treatment goals to determine the most appropriate therapeutic approach.
  2. 2The therapist and patient collaboratively develop a treatment plan, including the modality to be used, frequency of sessions, and specific goals for therapy.
  3. 3Early sessions typically focus on building the therapeutic alliance, establishing safety, and psychoeducation about the patient's condition and the treatment approach.
  4. 4Active treatment sessions involve modality-specific interventions such as cognitive restructuring, behavioral experiments, exposure exercises, skill building, or free exploratory dialogue, depending on the approach.
  5. 5Between-session work may be assigned, including thought records, behavioral activation tasks, mindfulness exercises, or journaling, to reinforce skills learned in therapy.
  6. 6Regular progress monitoring occurs through clinical assessment, standardized measures, and collaborative review of treatment goals to determine whether the approach is helping.
  7. 7As symptoms improve, sessions may shift focus to relapse prevention, consolidating gains, developing long-term coping strategies, and planning for future challenges.
  8. 8Termination is a planned process that involves reviewing progress, addressing remaining concerns, and bringing the treatment to a satisfactory conclusion.

How does Psychotherapy work?

  • Psychotherapy helps individuals identify and examine patterns of thinking, feeling, and behaving that contribute to psychological distress, and create healthy change
  • Cognitive behavioral approaches work by helping patients recognize automatic negative thought patterns and cognitive distortions, then test and restructure those thoughts to reduce their impact on emotions and behavior
  • Psychodynamic approaches explore how unconscious processes, past experiences, and interpersonal patterns influence current emotional difficulties, aiming to increase self-awareness and insight in service of change
  • Dialectical behavior therapy teaches specific skills in mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness, particularly for individuals with intense emotional responses or self-destructive behaviors
  • Exposure-based therapies work by systematically confronting feared stimuli in a structured, thoughtful manner, allowing for habituation and new learning that reduces anxiety responses over time
  • EMDR uses bilateral stimulation (typically eye movements) during recall of traumatic memories to facilitate adaptive processing and reduce the emotional intensity of those memories
  • The therapeutic relationship itself serves as a mechanism of change, providing a safe, nonjudgmental space for emotional exploration, corrective interpersonal experiences, and development of trust

When It's Recommended

  • Major depressive disorder and persistent depressive disorder
  • Generalized anxiety disorder, social anxiety disorder, and panic disorder
  • Post-traumatic stress disorder (PTSD)
  • Obsessive-compulsive disorder (OCD)
  • Borderline personality disorder and other personality disorders
  • Eating disorders such as bulimia nervosa and binge eating disorder
  • Substance use disorders
  • Bipolar disorder (adjunctive to medication)
  • Phobias and phobia-related disorders
  • Grief, adjustment disorders, and life transitions
  • Insomnia and sleep disturbances
  • Chronic pain management (psychological component)

Conditions I Treat

Anxiety

Anxiety is a mental health condition that can involve persistent worry, nervousness, or unease about events with uncertain outcomes. Anxiety disorders...

Depression

Depression is a common and serious mental health condition involving persistent feelings of sadness, hopelessness, and loss of interest in activities....

Bipolar Disorder

Bipolar disorder is a mental health condition that causes significant shifts in mood, energy, activity levels, and thinking. People with bipolar disor...

Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after exposure to a traumatic event involving actual or threatened...

ADHD (Attention-Deficit/Hyperactivity Disorder)

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition marked by persistent patterns of inattention, hyperactivity, and imp...

OCD (Obsessive-Compulsive Disorder)

Obsessive-compulsive disorder (OCD) is a mental health condition in which a person experiences intrusive and recurring thoughts known as obsessions, e...

Recovery & Aftercare

  • Most individuals can continue their normal daily activities during the course of psychotherapy, as sessions are typically scheduled weekly or biweekly
  • Some emotional processing may continue between sessions, and patients may experience heightened emotional awareness as they develop new insights
  • Skills learned in therapy – such as cognitive restructuring, mindfulness, and distress tolerance – typically become more natural with practice over time
  • Treatment duration varies by condition and modality, with some structured approaches (such as CBT for specific phobias) lasting 8 to 12 sessions and others (such as psychodynamic therapy) continuing for months or years
  • Research suggests that therapeutic gains often persist after treatment ends, with some studies showing continued improvement even after therapy is completed

Alternative Treatments

  • Psychiatric medication (antidepressants, anxiolytics, mood stabilizers)
  • Support groups and peer support programs
  • Exercise and physical activity programs
  • Bibliotherapy and guided self-help resources

Related Treatments

Psychodynamic TherapyCognitive Behavioral TherapyMedication Management

Frequently Asked Questions

Psychotherapy, also called talk therapy, refers to a variety of different treatments that involve working with a trained mental health professional to identify and change troubling emotions, thoughts, and behaviors. Multiple modalities exist, including cognitive behavioral therapy, psychodynamic therapy, and dialectical behavior therapy, each suited to different conditions and goals.
Psychotherapy can involve discussing painful experiences, emotions, or memories, which may cause temporary emotional discomfort. This is a normal and often necessary part of the therapeutic process. Most people find that this short-term discomfort leads to meaningful long-term improvement in how they feel and function.
Psychotherapy is generally considered safe when conducted by a licensed mental health professional. Short-term emotional distress when processing difficult material is common. See the safety section above for specific risks and contraindications.
The number of sessions depends on the condition, its severity, and the modality used. Some structured approaches like CBT for insomnia may be relatively brief and resolve the presenting problem after 6 to 10 sessions, while treatment for complex conditions may continue for several months or longer. Your therapist will collaborate with you on a treatment plan based on your progress.
During a typical session, you meet with your therapist in a private setting for 45 to 60 minutes. The therapist may guide you through exploratory conversation, skill-building activities, or a combination, depending on the style of therapy that they practice and your particular goals. Sessions are confidential and you set the pace of what you are comfortable discussing.
Individuals experiencing active psychosis without pharmacological stabilization, severe cognitive impairment that prevents meaningful engagement in therapy, or active substance intoxication may not benefit from standard psychotherapy. Those in crisis may need a higher level of care before outpatient therapy can begin safely.
For current session rates and payment options, please visit my Services page or contact my office directly. Fees are prorated based on time spent on patient care.
Dr. Barnhart is out-of-network with all commercial insurance and Medicare Advantage plans. He is enrolled as a non-participating physician with Original Medicare Part B (limited slots for therapy). Superbills are provided for out-of-network reimbursement. HSA and FSA payments are accepted.
Dr. Barnhart specializes in psychodynamic therapy, which explores how past experiences and unconscious patterns shape current problems in living. He sometimes also incorporates techniques from cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), mindfulness-based approaches, and motivational techniques, depending on the particular goals of each patient.
Dr. Barnhart's office is at 35 Vicente Street, in the West Portal neighborhood of San Francisco. In-person sessions are available on select days of the week (contact the office to learn more). Telehealth sessions are available throughout California, when appropriate, following an initial in-person session.

Your Practitioner

J. Connor Barnhart

J. Connor Barnhart, MD

Dr. J. Connor Barnhart is a board-certified psychiatrist and psychotherapist practicing in San Francisco. He completed his psychiatry residency at UCSF, where he trained in the Bipolar, LGBT, and Women's Mental Health specialty clinics and developed focused expertise in integrative psychiatry through a year-long rotation at the UCSF Osher Center. He attended medical school at the University of Pennsylvania's Perelman School of Medicine and graduated from Brown University with honors in Human Biology. His practice combines insight-oriented therapy, medication management, supplements, and lifestyle optimization to holistically address the root causes of mental health challenges including depression, anxiety, and difficulties with focus.

Medically reviewed by J. Connor Barnhart, MD · Last reviewed: 2026-06-03