Ancaster Psychotherapy

---

Psychotherapy involves communication between patients and psychotherapists that is intended to help people:

• Find relief from emotional distress (becoming less anxious, fearful or depressed).
• Seek solutions to problems in their lives ( with grief, family issues, and job or career dissatisfaction).
• Modify ways of thinking and acting that are preventing them from working productively and enjoying personal relationships.

Regardless of the treatment modality, 

all psychotherapies take place within a frame that is agreed upon between patient and psychotherapist.

This frame includes such elements as the time, place and meeting frequency, payment , contact outside sessions and the role and responsibilities for both.   

Source: APA Div. 12 (Society of Clinical Psychology)

 Psychotherapist generally draw on one or more theories of psychotherapy.

A theory acts as a roadmap through the process of understanding clients and their problems and developing solutions.

Approaches to psychotherapy fall into five broad categories:

1) Psychoanalysis and psychodynamic therapies: 

This approach focuses on changing problematic behaviors, feelings, and thoughts by discovering their unconscious meanings and motivations. 

 Patients learn about themselves by exploring their interactions in the therapeutic relationship. While psychoanalysis is closely identified with Sigmund Freud, it has been extended and modified since his early formulations.

2)  Behavior therapy:

 This approach focuses on learning's role in developing both normal and abnormal behaviors. Ivan Pavlov made important contributions to behavior therapy by discovering classical conditioning. (Pavlov's famous dogs began drooling when they heard their dinner bell, because they associated the sound with food). 

"Desensitizing" is classical conditioning in action: A therapist might help a client with a phobia through repeated exposure to whatever it is that causes anxiety. 

Thorndike discovered operant conditioning. This type of learning relies on rewards and punishments to shape people's behavior.

One variation is cognitive-behavioral therapy, which focuses on both thoughts and behaviors.

3) Cognitive therapy:

 Cognitive therapy emphasizes what people think rather than what they do.

Cognitive therapists believe that it's dysfunctional thinking that leads to dysfunctional emotions or behaviors.

Major figures in cognitive therapy include Albert Ellis and Aaron Beck.

4) Humanistic therapy:

 This approach emphasizes people's capacity to make rational choices and develop to their maximum potential. Concern and respect for others are also important themes.

Humanistic philosophers like Jean-Paul Sartre, Martin Buber and Søren Kierkegaard influenced this type of therapy.

Three types of humanistic therapy are especially influential: 

A) Client-centered therapy rejects the idea of therapists as authorities on their clients' inner experiences. Instead, therapists help clients change by emphasizing their concern, care and interest.

B)  Gestalt therapy emphasizes what it calls "organismic holism," the importance of being aware of the here and now and accepting responsibility for yourself.

 C) Existential therapy focuses on free will, self-determination and the search for meaning.

5) Integrative or holistic therapy. Many therapists don't tie themselves to any one approach. Instead, they blend elements from different approaches and tailor their treatment according to each client's needs.

Adapted from the Encyclopedia of Psychology

Date created: 2009

American Psychological Association
 

The assessment of a patient for psychotherapy has two major goals: establishing a therapeutic relationship and obtaining a careful history. The history should explore the nature, duration and severity of the presenting problem, past psychiatric history and treatment, significant interpersonal relationships, level of  and changes in functioning, and basic psychological structure. 

Psychological Factors in assessment for psychotherapy

Psychological mindedness: refers to the capacity of insight and to understand problems in psychological terms.

Motivation for insight and change:             Requires a degree of introspectiveness and verbal fluency. 

Adequate ego strength:  Includes the ability to sustain feelings and fantasies without impulsively acting upon them , being overwhelmed by anxiety or losing the capacity to continue the dialogue.   

Ability to form and sustain relationships: where there is inability to enter into trusting relationships or where there is inability to maintain relationship boundaries. This may preclude exploratory methods. 

Ability to tolerate change and degree of frustration: Psychotherapy (especially exploratory methods) has the potential to exacerbate symptoms, particularly as maladaptive coping mechanism are examined and changed.      

Selection of psychotherapeutic method                      

Local availability: one determinant of therapy choice is often the availability of skilled therapist in a particular modality.

Practitioner experience:     Where the psychotherapist area of expertise may determine choice of psychotherapeutic method.

Illness factors: While the exact suitability of the various therapeutics modalities to specific illness has yet to be clearly established, research shows that therapies are beneficial for particular disorders.

Patient choice: Patient may express a preference for a particular therapeutic model because of previous positive experience or having read or been told about the approach. A method that makes sense to the patient given their understanding of their symptoms is preferred. 

Reference: David kupfer et all. Oxford American Handbook of Psychiatry.