Psychosocial therapy

1. PSYCHOSOCIAL THERAPY
1.INTRODUCTION
In treatment modalities of psychiatric patients the approaches
used are; psychopharmacology, psychotherapies or psychological
treatments and physical treatment . Psychotheraoy is a the treatment
used for a patient with emotional and personality problems.The basic
principal in psychotherapy is the therapist-patient relationship.Use
psychotherapy by nursing personnel is an indioendant role where nurse
use an appropriate psychotherapy approach to help her patient.
2.DEFINITION
Wolberg define psychotherapy as, “ a form of treatment for
problems of an emotional nature in which a traines person
deliberately establishes a professional relationship with the
objective of removing, modifying or retarding existing symptoms,
of mediating disturbed patterns of behavior and of promoting
positive personality growth and development.
Lego S. defines psychotherapy as , “A method of treatment based
on the development of intimate relationship between patient and
therapisfor the purpose of exploring and modifying the patient
behavior in a satisfying direction.

2. 3.GOALS OF PSYCHOSOCIAL THERAPY
1. Changing maladaptive behaviour patterns.
2. Reducing or eliminating envioronmenal conditions that may be
causing such a behaviour.
3. Improving interpersonal and other competencies.
4. Helping the patient to resolve inner conflict and overcome
fellings of handicap(such as the patients feels he cannot
socialize or take decision or communicate effectively.)
5. Helping him to develop a sence of selfidentity.

3. TYPES 0F
PSYCHOSOCIAL
THERAPY
INDIVIDUAL
PSYCHOTHERAPY
•PSYCHOANALYSIS
•HYPNOSIS
•ABREACTION
•REALITY THERAPY
•UNCOVERING
•SUPPORTIVE
THERAPY
BEHAVIOURAL
THERAPY
•BEHAVIOUR
MODIFICATION
•SYSTEMETIC
DESENTRALIZATION
•AVERSION THERAPY
•ASSERTIVENESS
TRAINING
•COGNITIVEBEHAVIOUR
THERAPY
•IMPLOSIVETHERAPY
•POSITIIVE
REENFORCEMENT
INTERPERSONAL
PSYCHO THERAPY
•MARITAL THERAPY
•FAMILYTHERAPY
•TRANACTIONAL
THERAPY
GROUP
PSYCHOTHERAPY
OTHER
PSYCHOSOCIAL
THERAPY
THERAPEUTIC
COMMUNITY
MILIEU THERAPY
ATTITUDE THERAPY
OCCUPATIONAL
THERAPY
RECERATIONAL
THERAPY
PLAY THERAPY
MUSIC THERAPY
LIGHT THERAPY
COLOR THERAPY
AROMA THERAPY

4. INDIVIDUAL PSYCHOTHERAPY
Psychotherapy conducted on a one to one basis.The therapist
treats one person at a time, The effectiveness of such a therapy
depends on the patient-therapist relationship.
Types :
 Psychoanalysis
 Hypnosis
 Abreaction
 Reality therapy
 Uncovering
 Supportive therapy
 Psychoanalysis
Psychoanalytical therapy was developed by freud.the
therapeutic technique focuses primarialy on the influence of
unconscious forces such as repressed impulses and memories,
internal conflicts and childhood traumas on the mental life and
adjustment of the individual.
Psychoanalysis as a form of therapy is used primarily in
psychoneurosis by briniging modification in the personality.This is
done by establishing a constructive therapeutic relationship.
The specificmethods used to achive the effect on therapy
are: free association , dream interpretation, analysis of resistance
and defences used by the patient , working through the fellings
and experiences releved by the patient during transference.

5. Every interaction lasts for 45 minutes, four to five days a
week for approximately three or five years . It is ana expensive
form of therapy in term of money and time.
 Hypnosis and Hypnotherapy
Hypnosis is a superficial or deep trance resembling sleep. It is
induced in a patient by suggestions of relaxation and
concentrationtrsting attention on a singal object.
The client becomes highly suggestible submissive and
abandos control and response to therapist influence.
He can be induced to recall forgotten events becomes
intenssitive to pain, gains relief from tention, anxity and other
psychological symptoms.It affects behavioural change and control
of attitudes.
Hypnosis is considered effective in obesity, hypertention,
asthama, smoking , peptic ulcer, over eating and other addictive
disorders.
 Abreaction
It is a therapeutic technique in which the patient talks about
repressed emotion by reviving and reliving painful experiences
that have been buried in the unconscious.When the psychiatrist
that it could be helpful, he may use an intravenous injection of a
drug such as pentothal.

6.  Reality Therapy
This is a psychotherapeutic technique which focouses on the
present behaviour and development of a patients ability to cope
with the stresses of reality and take a greater responsibility fpor
the fulfillment of his needs.
To achieve these purposes the therapist becomes involved in
an active relationship with the patient, rejects his unrealistic
behaviour and teaches better ways to meet his needs in real
worls.
The patients need to be stressed on, that the past cannot be
changed;so he must take responsibility of right or wrong action of
present.
 Uncovering
This technique is used to break the patient repressed conflict
and traumatic experience to the surface. It helps te patient in
gaining an insight. The patient explores different methods to cope
with the problem,once he gains an insight into his conflict or
problem.
4. Supportive therapy
It is form of “surface therapy”. The therapist helps client or
patient to relive emotional distress and symptoms without probing
into the past or attemoting to change the basic personalityof the
individual.

7. 5. Technique of supportive therapy:
1. Ventilation
2. Environmental modification
3. Persuasion
4. Reeducation
5. Reassurance
 Ventilation
It is free expression of feeling emotions. The patient is allowed
to talk frerely whatever comes to his mind. It is also described as
mental ventilation.
The therapist will note that during free talking the patient
avoids certain events or mentions them superficially.
The client is encouraged to talk about them more freely until
they no longer cause emotional disturbance in patient.It helps the
client to unburden his feeling by sharing and revealing himself
which makes the patient less tense.
 Environmental modification
A method of improving the wellbeing of mental patients by
changing their leaving condition. If there is a restless patient in
the ward due to whom the other patient is not able to sleep, the
former may be transferred to cubicle where no other patient is
allowed for a day or two.
 Persuasion
Persuasion psychotherapy used in which the therapist
attempts to induce the patient to modify his faculty behaviour by
using his power of reasoning will and self criticism.

8.  Reeducation
The patient learns more effective ways of dealing with
problems and relationship through therapist-patient relationship.
 Reassurance
It is supportive approach that encourages the patient to
believe that there are possibilities of improvement.
It is also used to diminish anxity.
 Goals of individual pasychotherapy
A. Establish a therapeutic therapist-patient relationship.
B. Providing an opportunity for the patient to release tension
as problems are discussed.
C. Assisting the patient in gaining an insight into the problem.
D. Providing an opportunity to practice new skills.
E. Reinforcing an appropriate

9. BEHAVIOURAL THERAPY
Definition
It is form of psychotherapy which focuses on modifying
faulty behaviour rather than basic changes in personality.
Behaviour therapist tries to eliminate the symptoms and
modify ineffective or maladaptive patterns by applying basic
learning techniques.
 It is used in followed condition:
i. For behaviour modification
ii. Any anxiety disorders related to behaviour disorders
iii. To control any unwanted impulses
 Behaviour therapy is more useful in :
 Anxiety disorders
 Phobia
 Nocturnal enuresis
 Tics
 Anorexia nervosa
 Tension headache
 Obesity
Techniques of behaviour therapy:
1. Behaviour modification
2. Systematic decentralization
3. Aversion therapy
4. Assertiveness therapy
5. Implosive therapy
6. Positive reinforcement therapy

10. Behaviour modification
It is also called “simple extinction”. To eliminate a
maladaptive behaviour one has to remove the reinforcement for
it. It is effective when reinforcement is being used without the
knowledge of the affected individual.
Systemic decentralization
Systemic decentralization is a form of behaviour therapy
developed by j.wolpe and others.
The objective of the therapy is to reduce or eliminate fear
or anxiety in which:
1) The patient is trained in deep muscle relaxation ,
2)He has various anxity provoking situation or special phobia such
as fear of death , fear of animal. These problems are placed from
the strongest to the weakest order.i.e the client is anxious about
which one is causing anxiety the least.
3) Each of these situations is presented in imagination or in reality
beginning with the weakest. Once the patient relaxes while
imagining that means the anxiety is getting reduced gradually.
Therapy is very useful in for patient who have developed certain
fears specially to domestic animal like dog.
Aversion therapy
It is a form of behaviour therapy in which the patient is
conditioned to avoid an undesirable behaviour or symptoms by
associating them with painful or unpleasant experience.such as
putting a bitter taste on nails or toungue for nail biting.

11. Aversion therapy has been used for alcoholism and
coumpulsive unacceptable social behaviour like homosexuality.
Asservativeness training
It is behaviour therapy technique in which the patients is
given training to bring about changes in emotional and other
behaviour pattern by assessing himself.
In other words , one is encouraged not