Psychological Treatments: Healing the Mind Through Interaction

• Throughout this paper, the word “difficulty,” “condition,” or “challenge” has been used as a substitute for “problem.”
• The majority of the content of this paper is original to the source and will be tagged as copyrighted if used without being paraphrased!

Psychotherapy:

• Def: Psychotherapy is an interaction between a socially sanctioned clinician and someone suffering from a psychological condition, intending to provide support or relief from the difficulty.

Psychodynamics:

• Def: psycho dynamic psychotherapies explore childhood events and encourage individuals to use this understanding to develop insight into their psychological difficulties.
• Interpersonal Psychotherapy (IPT): Interpersonal Psychotherapy is among the most common psychodynamic treatments, with a focus on helping clients improve their current relationships (Weissman, Markowitz, & Klerman, 2000).
  • Frequency of the sessions: Once a week
  • Treatment duration: Minimum of few months
    • In the movie, Good Will Hunting, the psychotherapist uses IPT (psychodynamics).
  • Studies have found that IPT and CBT are among the most effective psychological treatments for depressive and anxiety disorders (Tolin 2010; Watzke et al. 2012; Zhou et al. 2015).

Humanistic and Existential Therapies:

• Humanistic and Existential therapies assume that human nature is generally positive, and they emphasize the natural tendency for each individual to strive for personal improvement. They share the assumption that psychological challenges stem from feelings of alienation and loneliness and that those feelings can be traced to failures to reach one’s potential (in the humanistic approach) or from failures to find meaning in life (in the existential approach). 
• Person-Centred Therapy (or client-centred therapy): It assumes that all individuals have a tendency toward growth and that this growth can be facilitated by acceptance and genuine reactions from the therapist.
  • Person-centred therapy assumes that every individual is qualified to determine their own goals for therapy, such as feeling more confident or making a career decision, and even the frequency of therapy.
  • Percen-centred is a type of nondirective treatment in which the tharpist tends not to provide advice or suggestions about what the client should be doing, but instead paraphrases the client’s words, mirroring client’s thoughts and sentiments.
  • Person-centred therapists believe that with adequate support, the client will recognize the right things to do.
  • Person-centred therapists demonstrate three basic qualities:
    • Congruence: Congruence means openness and honesty in the therapeutic relationship and ensuring that the therapist communicates the same message at all levels.
    • Empathy: Empathy is the continuous process of trying to understand the client by getting inside their way of feeling, thinking, and understanding the world.
    • Unconditional positive regard: The therapist treats the client with a nonjudmental, warm, and accepting environment in which the client can feel safe expressing their thoughts and feelings.
  • The goal is not to uncover the repressed conflicts, as in psychodynamic therapy.

• Gestalt therapy: It has the goal of helping the client become aware of their thought, behaviours, experiences, and feelings and to “own” or take responsibility for them.
  • To help facilitate the client’s awareness, gestalt therapists reflect back to the client their impressions of the client.

Behavioural and Cognitive therapies:

• Behavioural and cognitive treatments emphasize actively changing a person’s current thoughts and behaviours as a way to mitigate or eliminate their psychopathology.
• Behaviour Therapy: Changing maladaptive behaviour patterns
  Def: Behaviour therapy assumes that disordered behaviour is learned and that symptom relief is achieved through changing overt, maladaptive behaviours into more constructive behaviours.

• Cognitive therapy: Changing distorted thoughts
• Def: Cognitive therapy focuses on helping a client identify and correct any distorted thinking about self, others, or the world.
  • Cognitive therapies use a principal technique called cognitive restructuring, which involves teaching clients to question the automatic beliefs, assumptions, and predictions that often lead to negative emotions and to replace negative thinking with more realistic and positive beliefs.
  • Another technique called Mindfulness Meditation teaches an individual to be fully present in each moment; to be aware of their thought, feelings, and sensations; and to detect symptoms before they become a problem.

• Cognitive Behavioural Therapy (CBT) combines cognitive and behavioural therapeutic strategies.
  • CBT is problem-focused, meaning that it is undertaken for specific problems (e.g., returning to work after a period of depression), and action-oriented, meaning that the therapist tries to assist the client in selecting specific strategies to help address those problems.
  • Clients are expected to do things, practice behaviour change skills, or use a diary to monitor relevant symptoms.
  • Studies have found that IPT and CBT are among the most effective psychological treatments for depressive and anxiety disorders (Tolin 2010; Watzke et al. 2012; Zhou et al. 2015). Significant effects of CBT have been found for unipolar depression, generalized anxiety disorder, panic disorder, social phobia, posttraumatic stress disorder (PTSD), and childhood depressive and anxiety disorders (Butler et al., 2006).
  • In contrast to Psychodynamic approaches, CBT is transparent in that nothing is withheld from the client. By the end of the course of therapy, most clients have a good understanding of the treatment they have received and the specific techniques used to make the desired changes.

Group Treatments: Healing Multiple Individuals at the Same Time

• Couples Therapy Def: In couples therapy, a married, co-habiting, or dating couple is seen together in therapy to work on problems usually arising within the relationship.
  • When a couple is “having problems,” neither individual may be suffering from any psychopathology. Rather, it may be the relationship itself that is disordered.
  • Treatment strategies would target changes in both parties, focusing on ways to break the repetitive dysfunctional pattern.
• Family Therapy Def: Psychotherapy involving members of a family.
• Group Therapy Def: A type of therapy in which multiple participants (often do not know one another at the outset) work on their individual challenges in a group atmosphere.
  • The therapist in group therapy serves more as a group facilitator than a personal therapist, conducting the sessions by talking to individuals and encouraging them to talk with each other.
  • It is important to note that group therapy is not an approach in itself but a mode of delivering treatment.
  • Why choose Group Therapy?
    • Attending a group with others who have similar challenges shows clients that they are not alone in their suffering.
    • Group members model appropriate behaviour for each other and share their insights about how to deal with their challenges.
  • Group therapy is often shown to be as effective as one-on-one therapy (Jonsson and Hougaard, 2008).
• Self-Help and Support Groups Def (Collectives):
  Self-help groups and support groups are discussion groups that focus on a particular disorder or difficult life experience and are often run by peers (rather than a clinician) who have themselves struggled with the same issues.
  • A great advantage of self-help groups is that they are cost-effective. 

Photo Therapy:

• Def: A therapy that involves repeated exposure to bright light. This is a natural treatment that may be helpful to people who have a seasonal pattern of depression (SAD).
  • Typically people are exposed to bright light in the morning, using a lamp designed for this purpose.

→ Specific Treatment Strategies for the Disorder (excluding biological treatments like medication or surgical approaches):

• Unipolar Depression → CBT
• Seasonal Affective Disorder (SAD) → Photo Therapy
• Preventing Depression Relapse → Cognitive Therapy (Mindfulness Meditation), CBT
• Depressive and Anxiety Disorders → IPT, CBT
• Childhood Depressive and Anxiety Disorders → CBT
• Generalized Anxiety Disorder (GAD) → CBT
• Posttraumatic Stress Disorder (PTSD) → CBT
• Panic Disorder → CBT
• Intergenerational Trauma → Family Therapy
• Insomnia → CBT
• Social Phobia → CBT

References:

Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26, 17-31.

Jonsson, H., & Hougaard, E. (2008). Group cognitive behavioural therapy for obsessive-compulsive disorder: A systematic review and meta-analysis. Acta Psychiatrica Scandinavica, 117, 1-9.

Tolin, D. F. (2010). Is cognitive-behavioral therapy more effective than other therapies? A meta-analytic review. Clinical Psychology Review, 30, 710-720.

Watzke, B., Rüddel, H., Jürgensen, R., Koch, U., Kristen, L., Grothgar, B., & Schulz, H. (2012). Longer term outcome of cognitive-behavioural and psychodynamic psychotherapy in routine mental health care: Randomised controlled trial. Behaviour Research and Therapy, 50, 580-387.

Weissman, M. M., Markowitz, J. C., & Klerman, G. L. (2000). Comprehensive guide to interpersonal psychotherapy. New York: Basic Books.

Zhou, X., Hetrick, S. E., Cuijpers, P., Qin, B., Barth, J., Whittington, C. J., . . . Xie, P. (2015). Comparative efficacy and acceptability of psychotherapies for depression in children and adolescents: A systematic review and network analysis. World Psychiatry, 14, 207-222.