Therapy for low self-esteem

Self-help is a good place to start. But sometimes low self-esteem runs deep, has lasted for years, or comes with depression, anxiety or an eating disorder. Then talking with a trained therapist can make a real difference.

The main treatments are talk therapies. This page explains the options with the most research behind them, what to expect, and how to find help.

When to consider therapy

Think about seeing a professional if:

• Harsh beliefs about yourself have lasted for years and affect many parts of your life
• You have tried self-help for several weeks without much change
• Low self-esteem comes with low mood, anxiety, eating problems or heavy drinking
• Memories of abuse, bullying or trauma still feel raw
• You keep ending up in relationships where you are mistreated

CBT for low self-esteem

Cognitive behavioral therapy (CBT) looks at how thoughts, feelings and actions keep each other going. In 1997, Fennell described a CBT model of low self-esteem. It combines methods from cognitive therapy for depression and anxiety with work on core beliefs.²

What happens in CBT

Your therapist will usually:

• Map out your story. Together you look at how harsh beliefs formed, and at the "rules for living" you use to protect yourself.³
• Catch self-critical thoughts. You learn to spot them and weigh them against the facts.
• Test predictions. If you expect people to reject you, you plan small experiments to see what really happens. These replace avoidance and other safety habits.³
• Build up the positive. You practice noticing your strengths, so a fairer view of yourself becomes easier to reach.³
• Rewrite rules and beliefs. You develop more flexible rules and a more balanced core belief about yourself.³

A 2023 update to the model adds a few points. Therapy should also look at beliefs about how others see you, feelings of shame, and the role of discrimination and other social factors.³

How well does it work?

A 2018 review looked at CBT programs for low self-esteem based on Fennell's model. It found 7 studies with 821 adults, all in the United Kingdom.¹

• Weekly group or individual sessions, often 8 to 10 of them, led to large improvements in self-esteem. Depression dropped by a similar amount.¹
• One-day workshops of about 7 hours led to smaller, but still real, gains three months later.¹
• Only 3 of the studies were randomized trials, and those compared CBT with a waiting list. Most participants were women, some studies lost many participants, and few followed people for long.¹

The authors concluded that CBT for low self-esteem looks effective, but that it is not yet clear how different it is from CBT for depression.¹ In plain terms: the early results are encouraging, and more high-quality trials are needed.

See how we rate evidence. Our free 6-week CBT course teaches many of the same skills. Week 5: core beliefs is especially relevant.

Group programs and workshops

Some health services offer low self-esteem programs in groups. In a group, you learn the skills alongside other people who know what a harsh inner voice is like.

In Scotland, the public health service ran a group version of the CBT program "Overcoming Low Self-Esteem." In routine care, people's self-esteem, anxiety and depression improved, and the gains held three months later. There was no comparison group, so the authors called for randomized trials.⁴ For self-compassion training, group programs also tended to work better than one-on-one formats.⁸

See Support groups.

Compassion-focused therapy (CFT)

CFT was developed for people whose problems are closely tied to shame and self-criticism. It helps people build a kinder, more soothing inner voice to balance the critic.⁶

An early review in 2015 found 14 studies, including 3 randomized trials. Results mostly favored CFT, especially for people high in self-criticism. The authors said larger, better trials were needed.⁶ A 2025 review of 21 studies with 450 people in clinical care found that CFT raised self-compassion and reduced self-criticism. Results for shame were less consistent. Most programs were run in groups. Many studies were small and had no comparison group.⁵

The researchers behind the 2023 model have built programs that blend CBT for low self-esteem with compassion-focused methods. Early, uncontrolled studies with young adults found these programs acceptable, with signs of improvement.³ See Self-compassion.

Acceptance and commitment therapy (ACT)

ACT does not try to argue with harsh thoughts. Instead, it teaches you to notice them, give them less power, and keep moving toward what matters to you.

A review looked at 39 randomized trials with 1,821 people who had a range of mental and physical health problems. ACT worked better than waiting lists, usual care and placebo talk sessions. It worked about as well as CBT.⁷ Fewer studies have looked at self-esteem itself. ACT may be worth trying if challenging your thoughts has not helped. See ACT.

Treating underlying conditions

Low self-esteem is often part of another condition. When depression is the cause, successful treatment often resolves the low self-esteem too.¹⁰

• Depression. Therapies such as CBT are well tested, and most people with depression benefit from treatment.⁹ See Treatment for depression.
• Social anxiety. CBT, including gradual exposure to feared situations, is the leading talk therapy.¹¹ See Social anxiety.
• Eating disorders need specialist care. See Treatment for eating disorders.
• Trauma. See PTSD and Therapy for PTSD.

Medicines are used for conditions like depression and anxiety, not for self-esteem on its own. If you take a medicine, talk with your doctor or pharmacist before changing anything.

What to expect

• Length. Many CBT programs for low self-esteem run for 8 to 10 weekly sessions.¹ Some people need more.
• Homework. You will practice between sessions, for example with thought records or a log of your strengths.
• Measuring progress. Your therapist may ask you to fill in a short questionnaire, such as the Rosenberg scale, from time to time. You can try it with our self-esteem test.
• Discomfort. Looking at old beliefs can stir up painful feelings. That is part of the work. Tell your therapist if it feels like too much.
• Ups and downs. Progress is rarely a straight line. A bad week does not undo your work.

Finding help

• Start with your doctor, who can check for depression or other health problems and refer you.
• Search for a therapist trained in CBT or CFT. See Finding a therapist and our therapy finder.
• Check costs. See Paying for therapy.
• Try online options if travel is hard. See Online therapy and apps.

Medicare. As of October 2026, Medicare Part B covers individual and group psychotherapy. Providers can include psychologists, clinical social workers, marriage and family therapists and mental health counselors, and visits can be by telehealth. After the Part B deductible, you usually pay 20% of the Medicare-approved amount.¹² See What Medicare covers for mental health.

Later life

Low self-esteem in later life deserves care just as much as at any other age. Therapy can focus on what is happening now, such as retirement, illness, losses or ageist messages, as well as on older beliefs. A geriatric psychiatrist or a therapist who works with older adults can help sort out whether low mood is depression. See Self-esteem in later life and Geriatric psychiatry.

Common questions

Do I need a diagnosis to get therapy for low self-esteem?

Not always. Some therapists see people for low self-esteem alone. If you plan to use insurance, including Medicare, ask the therapist and your plan what is covered.

Is a self-help book as good as therapy?

Self-help can be a good start. The 2018 review did not include any self-help-only studies, so we cannot compare them directly.¹ If self-help is not enough after a few weeks, consider therapy.

When to get help right away

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.