Psychotherapy is the use of psychological techniques to change behaviors, feelings, thoughts, or habits. It is generally employed to relieve symptoms of emotional or behavioral dysfunction or distress, however it is also used to help people achieve greater levels of self-awareness and to actualize latent potential.
There are a wide variety of psychotherapeutic modalities (e.g. individual, group, family) and theoretical approaches (e.g. psychodynamic, behavioral, cognitive).
When should one go for psychotherapy?
Psychotherapy is recommended for individuals experiencing symptoms of psychological distress. If you are depressed, anxious fearful, angry or don’t feel in control of your life psychotherapy might help you. If you are unhappy, having relationship problems, or feel you are not living up to your potential, psychotherapy can give help develop greater self -awareness and support your efforts in improving your life.
If you are unsure about starting psychotherapy, consult a mental health professional for an assessment and evaluation to help in making the decision about whether to engage in psychotherapy and what kind.
Psychotherapy is used for treating many different problems. Some alone, and some in combination with drugs. The most commons ones are listed below:
- Post-traumatic stress disorder
- Low self-esteem
- Anxiety disorder, including phobias
- Emotional crises
- Marital problems
- Family disputes
- Obsessive-compulsive disorder
- Personality disorders
- Problems stemming from child abuse
- Behavioral problems
- Bipolar disorder (in combination with drugs)
- Schizophrenia (in combination with drugs)
Who does psychotherapy?
Psychotherapy is practiced by a number of different mental health professionals. Although they have similarities in their approach to treatment, their varied training backgrounds sometimes lead them to choose different approaches and/or orientations. below is a table that summarizes some of the characteristics of different practitioners. The special orientations listed are generalizations and individuals may differ.
Discipline Training Special Orientation
Psychologist Ph.D.(Doctor of Philosophy in psychology) or Psy.D. (Doctor of Psychology) and one year Internship. Psychotherapy: All modalities and orientations. Psychological Testing.
Masters Level Psychologist M.A.(Master of Arts) or M.S. (Master of Science) or M.Ed.(Master of Education) Psychotherapy: Some modalities and orientations. Psychological Testing.
Social Worker M.S.W.(Master of Social Work) Psychotherapy: Interpersonal, family, group, milieu orientation.
Psychiatrist M.D.(Medical Doctor) or D.O.(Doctor of Osteopathy) and Three year Psychiatric Residency
Biological Treatment, Psychopharmacology. Some Psychotherapeutic modalities and orientations.
Counselor M.A.(Master of Arts in counseling) or M.Ed.(Master of Education in counseling) Counseling. Vocational and Educational Testing.
Psychiatric Nurse Specialist M.S.N.(Master of Science in Nursing) Counseling and Psychotherapy: Some modalities and orientations.
How do I select a psychotherapist?
The decision on who to choose as a psychotherapist is complicated by many variables. Here are some of the important points to consider.
- Reputation. Does the therapist come recommended by a friend, family member or professional? Have I read or heard about their work? If they are a member of local or national professional organizations you can call and ask about them. You can verify their licensure with your state and inquire about any complaints against them. Do they practice at an organization with a good reputation?
- Theoretical Orientation. Does their approach sound compatible with your needs? If you feel relatively intact but want to change a habit now you might choose a behavioral approach over psychoanalysis.
- Personal Characteristics. Does the therapist seem compatible? The age, sex and cultural background of the therapist can be important in establishing rapport. If you are a fifty five year old woman struggling with woman’s issues a 27-year-old male therapist might not be your first choice.
- Cost. What is the fee? Do they accept my insurance plan? What are the alternatives in my area?
- Location. Can I conveniently get there? Remember psychotherapy might take many months or even longer.
Theoretical Approaches to Psychotherapy
There are a wide variety of theoretical approaches or orientations to psychotherapy. The choice of approach is usually determined by the training and experience of the therapist as well as the needs and desires of the patient. Some of the more widely used approaches are briefly described below.
Behavioral Therapy employs learning theory to effect changes in behavior. It is usually symptom focused as opposed to working on unconscious material. Unlearning unwanted behaviors (even thoughts and feelings can be viewed as behaviors) and learning desired behaviors is the work of behavior therapy.
Maladaptive habits are weakened and eliminated (extinguished) and adaptive habits developed and strengthened in very small steps (successive approximations). These changes are consolidated through reinforcements (rewards, either intrinsic or extrinsic) until stable behavior change is established.
Cognitive Therapy seeks to alter habitual maladaptive thought patterns. Unrealistic expectations, wishful thinking, living in the past (or future) and over generalizing can all lead to disappointment and frustration. Cognitive therapy emphasizes a rational and positive world view. It has proven to be especially effective with anxiety and depression.
Eclectic Therapy although not a formal school of thought, is the use of a combination of approaches or theoretical orientations. It is used by most therapists. There are many different blends. It is a recognition that individuals may benefit from a variety of techniques. The eclectic approach can be flexible and adaptive and avoid forcing treatment into one size fits all limitations. It is necessary that the therapist be well grounded in several of the more orthodox approaches to treatment rather than using bits and pieces through a lack of familiarity.
Existential Therapy is an approach that examines some of the major issues in our existence such as the meaning of life, loneliness, mortality, and the challenge of free will. It focuses on taking responsibility for ones choices and creating our own meaning and purpose. It is especially useful with the elderly and in working on issues of death and dying. Though it emphasizes needs of the individual it usually helps patients find new meaning in their relationships.
Psychoanalysis is the personality theory and psychotherapeutic approach pioneered by Sigmund Freud. Freud is known as the father of psychoanalysis. The approach emphasizes making the unconscious conscious and thereby giving the individual choices in life rather than being at the whim of unknown forces within themselves. Psychoanalysis frequently uses dreams and free associations (spontaneous uncensored communications) as the subject matter for treatment. . The therapist (analyst) says little but guides the patient in interpreting the meaning of the intrusion of unconscious material into everyday life. Sessions are frequent, up to five times per week, and treatment usually lasts for years.
Psychodynamic Psychotherapy is the term used to describe treatment approaches based on psychoanalytic principals, but which are conducted less frequently, over a shorter duration and allow a small amount of eclecticism. Psychodynamic therapists are more active (communicative) than psychoanalysts.
Various Modalities of Psychotherapy
There are a variety of treatment modalities or forms available to meet each patient’s individual needs. The modality chosen will depend on factors such as diagnosis, age of the patient, family support, financial constraints and patient preference. There is a full discussion of psychotherapy in Psychology 101.
Individual Psychotherapy is the modality with one patient and one therapist. This form offers the most attention to the patient’s individual concerns however it can be limited in that it cannot directly study family or social relationships. There are many different styles or theoretical orientations of therapists such as psychodynamic, cognitive and behavioral.
Family Psychotherapy is conducted with all or as many members as possible of a family. The work may all be done with the entire group or involve various combinations of family members. The process helps identify and modify maladaptive or destructive interaction patterns as well as foster group communication and problem solving skills.
Group Psychotherapy is conducted with at least three and up to fifteen patients together. This modality offers the patient the opportunity to interact with others and learn from them as well as study their own relationship style. Patients usually encounter some social anxiety in beginning group therapy; however it offers an ideal environment in which to challenge such anxieties.
Homogeneous groups are made up of individuals with similar concerns such as chemical dependency or women’s issues. These groups offer support and understanding and the feeling that one is not the only one struggling with a given set of concerns. Heterogeneous groups have a more varied membership and more closely approximate the world at large.
Marital/Relationship Therapy is conducted with couples in a marital or “significant other” relationship. Its purpose is to assist the couple to work together as partners to communicate, love and solve the problems of daily life. The establishment of realistic, adult expectations is usually an important goal.
Stress Management training is a process of identifying stressors, learning ones physiological and cognitive responses to stress and developing techniques to manage those responses. Common stress management techniques are systematic desensitization, relaxation training, and cognitive therapy.
Medication Management is the use of psychotropic medications to manage emotional, cognitive, and behavioral symptoms. The medication is prescribed by psychiatrists after thorough evaluation and with ongoing monitoring. Medication management is usually implemented in conjunction with other therapies aimed at treating the underlying causes of the condition.
What are the benefits of psychotherapy?
Participating in psychotherapy offers a number of benefits for the client. It is usually helpful to have somebody who really does understand you. Therapy may give the client a fresh perspective on a difficult problem and direct the client towards a solution. Most patients will say that the benefits of psychotherapy include:
- Being able to understand yourself and your personal goals and values better.
- Developing skills for improving relationships.
- It helps the client overcome certain problems, such as an eating disorder, depression, or anxiety.
- Obtaining a solution to the problems or concerns that made the client seek therapy.
What are the disadvantages of psychotherapy?
- Some clients may find that the treatment results in changes they had not expected, or did not want.
- Some people do not like to have to relive unpleasant events (not all psychotherapy techniques make the client do this).
Bahareh Talei, Psy.D.
Diagnostic & Counseling Center, Inc.
Phone: (818) 324-6594
Dr. Bahareh Talei received her Doctorate of Psychology (Psy.D.) from Pepperdine University, Graduate School of Education and Psychology. Dr. Talei is a licensed psychologist and is co-founder of Diagnostic & Counseling Center (DCC). Her experience has primarily been in working with children and adolescents with various disabilities such as autism and difficulties with learning and attention. Throughout her career, Dr. Talei has been actively engaged in the assessment of a diverse population (e.g., pervasive developmental disorder, learning disorders, central nervous system damage) and training of other professionals. Her experience and interests also includes conducting individual and group psychotherapy with family members of children with developmental disabilities and other populations (e.g., depression, anxiety disorders, and infertility).