Psychotherapy

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Psychotherapy
Psychotherapy has been referred to as a systemic treatment primarily employing verbal communication as the
means of treatment aimed at relieving the patient’s symptoms and helping him to understand and modify his
conduct so as to lead a well-adjusted life.
Who can be a psychotherapist?
 Adequately trained and certified
 Psychiatrist
 Psychologist
 Social worker
 Nurse practitioner
 Physician assistant
 Minister
 Priest etc
Who seeks therapy and why?
 Children – behavioural, school, family issues
 Adolescents – as above and issues of separation and peer relationships
 Young adults – all above plus career issues
 Marital adults – all above plus issues of changing relationships, family alignments, health work and
social status
 Older adults – all above plus end-of-life issues
Types of psychotherapy
I. Individual psychotherapy
1. Psychoanalysis
2. Hypnosis
3. Abreaction
4. Reality therapy
5. Uncovering
II. Behavioural psychotherapy
1. Behavioural modification
2. Systemic desensitization
3. Aversion therapy
4. Assertiveness training
5. Cognitive behavioural therapy
6. Implosive (flooding ) therapy
7. Positive reinforcement
8. Response shaping
9. Modelling
10. Token economy
III. Interpersonal therapy
1. Marital therapy
2. Family therapy
3. Transactional therapy
IV. Group psychotherapy
V. Other psychosocial therapy
1. Therapeutic community
2. Milieu therapy

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3. Occupational therapy
4. Play therapy
5. Recreational therapy
6. Music therapy
7. Dance therapy
8. Attitude therapy
I. Individual psychotherapy
Individual therapy is one type of psychotherapy in which a trained professional helps a single person work
through personal issues they have been facing. It is an effective treatment for a variety of emotional difficulties
and mental illnesses. Also known as talk therapy, it can help improve or control symptoms that influence an
individual’s well-being.
Indications
 Extreme emotions, like sadness or anger
 Recent trauma, such as death of a loved one or divorce
 Substance abuse
 Problems at work
 Loss of enjoyment of activities
 Strained family and/or personal relationships
 Concern from friends or family
1. Psychoanalysis
Psychoanalysis is defined as a set of psychological theories and therapeutic methods which have their origin
in the work and theories of Sigmund Freud. The primary assumption of psychoanalysis is the belief that all
people possess unconscious thoughts, feelings, desires, and memories.
2. Hypnosis
Hypnotherapy, also referred to as guided hypnosis, is a form of psychotherapy that uses relaxation, extreme
concentration, and intense attention to achieve a heightened state of consciousness or mindfulness. In other
words, it places the individual into a “trance” or altered state of awareness.
Indication
 Phobias, Anxiety, Depression, Post-Traumatic Stress Disorder (PTSD), Sleep Disorders
 Addiction, Cessation of Smoking, Weight Loss
 Relationship/Family/Work Conflicts, Grief and Loss of a Loved One
Hypnotic Induction- methods
 Close eyes and concentrate on breathing
 Fix attention on object/voice
 Instant Induction
Self-hypnosis
 Choose a quiet place and be the best that you're on your own Then choose a comfortable position
for you and would prefer to be sitting on a comfortable chair.
 Start looking to a higher level than the level of our its called) third eye
 We begin by focusing on breathing through the entry of air at normal speed and extricate longest
possible period of time With the closure of the eye slowly
 We begin to relax and feeling fully relaxed body from head to foot with the attempt to focus on
breathing and relaxation only
 Take your time in this position until it reaches the total relaxation.

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 Then imagine you are handed down from the 10 stairs and start counting backwards from 10 to 1
you descend Increase the state of relaxation
 Then imagine you in a place that you love to imagine with everything around you as
 In this case, the brain is in a stable condition It serves as a rest for the brain Because the brain
starts to stop sending nerve signals to the body in terms of the conscious mind At the same time
opens its doors to the subconscious mind to receive suggestions and saved
3. Abreaction
Abreaction Therapy focuses on reliving a traumatic event and going through the emotions associated with
them to heal and move forward. Originally created by Sigmund Freud. Therapists who work as Abreaction
counsellors use catharsis or the cleansing of emotions to get rid of the spirit and thoughts associated with the
experience.
4. Reality therapy
Reality therapy is a form of counselling that views behaviours as choices. It states that psychological
symptoms occur not because of mental illness, but due to people irresponsibly choosing behaviours to fulfil
their needs.
5. Uncovering
the process of peeling away an individual’s defences and passing beyond a focus on symptoms to get to the
underlying roots of a problem. Uncovering techniques are used particularly in psychoanalysis and other
psychodynamic or depth therapies.
II. Behavioural psychotherapy
Behavioural therapy is a term used to describe a broad range of techniques used to change maladaptive
behaviours. The goal is to reinforce desirable behaviours and eliminate unwanted ones. Behavioural therapy
is rooted in the principles of behaviourism, a school of thought focused on the idea that we learn from our
environment.
Unlike some other types of therapy that are rooted in insight (such as psychoanalytic therapy and
humanistic therapies), behavioural therapy is action-based. Because of this, behavioural therapy tends to be
highly focused. The behaviour itself is the problem and the goal is to teach people new behaviours to minimize
or eliminate the issue.
1. Behavioural modification
Behavior modification is a means of changing behavior through various techniques used to replace undesirable
behaviors with desirable ones. Behavior modification techniques have been used to treat both adults and
children for various problems, such as enuresis (bedwetting), separation and general anxiety, various phobias,
obsessive-compulsive disorder (OCD), etc. The methods use vary, but usually involve some form of positive
or negative reinforcement. This concept had its beginning in 1938, when B. F. Skinner
 Positive Reinforcement
 Negative Reinforcement
 Positive Punishment
 Negative Punishment
2. Systemic desensitization
Systematic desensitization, also known as graduated exposure therapy, is a type of behaviour therapy. The
process of systematic desensitization occurs in three steps. The first step of systematic desensitization is the
identification of an anxiety inducing stimulus hierarchy. The second step is the learning of relaxation or coping
techniques. When the individual has been taught these skills, he or she must use them in the third step to react
towards and overcome situations in the established hierarchy of fears. The goal of this process is for the
individual to learn how to cope with, and overcome the fear in each step of the hierarchy.
3. Aversion therapy

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Aversion therapy is a form of psychological treatment in which the patient is exposed to a stimulus while
simultaneously being subjected to some form of discomfort. This conditioning is intended to cause the patient
to associate the stimulus with unpleasant sensations with the intention of quelling the targeted (sometimes
compulsive) behaviour. Aversion therapies can take many forms, for example: placing unpleasant-tasting
substances on the fingernails to discourage nail-chewing; pairing the use of an emetic with the experience of
alcohol; or pairing behaviour with electric shocks of mild to higher intensities.
4. Assertiveness training
Assertiveness is a skill regularly referred to in social and communication skills training. Being assertive means
being able to stand up for your own or other people’s rights in a calm and positive way, without being either
aggressive, or passively accepting ‘wrong’.
Assertive individuals are able to get their point across without upsetting others, or becoming upset themselves.
Although everyone acts in passive and aggressive ways from time to time, such ways of responding often
result from a lack of self-confidence and are, therefore, inappropriate ways of interacting with others.
5. Cognitive behavioural therapy
CBT focuses on challenging and changing cognitive distortions (e.g. thoughts, beliefs, and attitudes) and
behaviors, improving emotional regulation, and the development of personal coping strategies that target
solving current problems. CBT is a "problem-focused" and "action-oriented" form of therapy, meaning it is
used to treat specific problems related to a diagnosed mental disorder.
CBT is based on several core principles, including:
 Psychological problems are based, in part, on faulty or unhelpful ways of thinking.
 Psychological problems are based, in part, on learned patterns of unhelpful behavior.
 People suffering from psychological problems can learn better ways of coping with them, thereby
relieving their symptoms and becoming more effective in their lives.
6. Implosive (flooding ) therapy
Flooding, sometimes referred to as in vivo exposure therapy, is a form of behavior therapy and
desensitization—or exposure therapy—based on the principles of respondent conditioning. As a
psychotherapeutic technique, it is used to treat phobia and anxiety disorders including post-traumatic stress
disorder. Flooding is a psychotherapeutic method for overcoming phobias. In order to demonstrate the
irrationality of the fear, a psychologist would put a person in a situation where they would face their phobia.
Under controlled conditions and using psychologically proven relaxation techniques, the subject attempts to
replace their fear with relaxation. The experience can often be traumatic for a person but may be necessary if
the phobia is causing them significant life disturbances. The advantage to flooding is that it is quick and usually
effective.
7. Positive reinforcement
In operant conditioning, positive reinforcement involves the addition of a reinforcing stimulus following a
behaviour that makes it more likely that the behaviour will occur again in the future. When a favourable
outcome, event, or reward occurs after an action, that particular response or behaviour will be strengthened.
Eg - After you execute a turn during a skiing lesson, your instructor shouts out, "Great job!"
8. Response shaping
The process of establishing a behavior that is not learned or performed by an individual at present is referred
to as Shaping. Shaping can also be defined as the procedure that involves reinforcing behaviors that are closer
to the target behavior, also known as successive approximations. The concept was first developed and used
by B.F Skinner, who is known for his theories that involve learning behaviors through reinforcement.
9. Modelling
Modelling is:

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 a method used in certain cognitive-behavioural techniques of psychotherapy whereby the client learns
by imitation alone, without any specific verbal direction by the therapist, and
 a general process in which persons serve as models for others, exhibiting the behaviour to be imitated
by the others. This process is most commonly discussed with respect to children in developmental
psychology.
The word modelling refers both to the behaviour of the learner and the teacher.
10. Token economy
A token economy system is one of the fastest and most effective ways to get kids to follow the rules. Similar
to a traditional reward system, kids earn tokens throughout the day. Then, tokens can be exchanged for bigger
rewards.
III. Interpersonal therapy
Is a brief, attachment-focused psychotherapy that centres on resolving interpersonal problems and
symptomatic recovery. It is an empirically supported treatment (EST) that follows a highly structured and
time-limited approach and is intended to be completed within 12–16 weeks. IPT is based on the principle that
relationships and life events impact mood and that the reverse is also true.
1. Marital therapy
Couple’s therapy (also couples' counselling, marriage counselling, or marriage therapy) attempts to improve
romantic relationships and resolve interpersonal conflicts. Marriage counselling helps couples of all types
recognize and resolve conflicts and improve their relationships. Through marriage counselling, you can make
thoughtful decisions about rebuilding and strengthening your relationship or going your separate ways.
2. Family therapy
Family therapy is a type of psychological counseling (psychotherapy) that can help family members improve
communication and resolve conflicts.
3. Transactional therapy
Transactional analysis (TA) is a psychoanalytic theory and method of therapy wherein social transactions are
analyzed to determine the ego state of the communicator (whether parent-like, childlike, or adult-like) as a
basis for understanding behavior. In transactional analysis, the communicator is taught to alter the ego state
as a way to solve emotional problems. The method deviates from Freudian psychoanalysis which focuses on
increasing awareness of the contents of subconsciously held ideas.
IV. Group psychotherapy
Group psychotherapy is a special form of therapy in which a small number of people meet together under the
guidance of a professionally trained therapist to help themselves and one another.
An optimal therapy group size is about six to fifteen participants, with one or two therapists. The smaller and
more intimate the group, the easier it is to notice when someone is missing. If the group is larger, it is much
easier for an absence to go unnoticed.
V. Other psychosocial therapy
1. Therapeutic community
Therapeutic community is a participative, group-based approach to long-term mental illness, personality
disorders and drug addiction. The approach was usually residential, with the clients and therapists living
together, but increasingly residential units have been superseded by day units. It is based on milieu therapy
principles, and includes group psychotherapy as well as practical activities.
2. Milieu therapy
Milieu therapy is a form of psychotherapy that involves the use of therapeutic communities. Patients join a
group of around 30, for between 9 and 18 months. During their stay, patients are encouraged to take
responsibility for themselves and the others within the unit, based upon a hierarchy of collective consequences.
3. Occupational therapy

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Occupational therapy is a type of health care that helps to solve the problems that interfere with a person’s
ability to do the things that are important to them – everyday things like:
 Self-care - getting dressed, eating, moving around the house,
 Being productive - going to work or school, participating in the community, and
 Leisure activities - sports, gardening, social activities.
4. Play therapy
Play therapy is a form of therapy primarily geared toward children. In this form of therapy, a therapist
encourages a child to explore life events that may have an effect on current circumstances, in a manner and
pace of the child's choosing, primarily through play but also through language. Play therapy, can help
individuals communicate, explore repressed thoughts and emotions, address unresolved trauma, and
experience personal growth and is widely viewed as an important, effective, and developmentally appropriate
mental health treatment.
5. Recreational therapy
Recreational therapy is a therapeutic treatment process, typically practiced in a group setting, that is designed
to restore, remediate and enhance a person’s functioning while fostering independence in life activities.
Through the use of leisure activities and education, recreation therapy promotes stress management, healthy
coping skills, healthy social skills, and increased self-esteem. Examples of intervention modalities include
creative arts (e.g., crafts, music, dance, drama, among others), games, sports like adventure programming,
exercises like dance/movement, and skill enhancement activities (Motor, locomotion, sensory, cognition,
communication, and behavior).
6. Music therapy
Music therapy is the use of music to address the physical, emotional, cognitive, and social needs of a group
or individual. It employs a variety of activities, such as listening to melodies, playing an instrument,
drumming, writing songs, and guided imagery. Music therapy is appropriate for people of all ages, whether
they are virtuosos or tone deaf, struggling with illnesses or totally healthy.
7. Dance therapy
Dance/movement therapy (DMT) is defined by the American Dance Therapy Association (ADTA) as the
psychotherapeutic use of movement to promote emotional, social, cognitive, and physical integration of the
individual, for the purpose of improving health and well-being.
8. Attitude therapy
Attitude indicate set of feelings, faith and behavior at individual or incident. There are four types of attitude
like Positive, Neutral, Sicken and Negative. The Main aim of Attitude therapy is convert person negative
attitude to Positive attitude through change of behavior and beliefs by different techniques.
Chandni Narayan
18.4.2021