2. What is psychotherapy?
Interpersonal, relational
intervention by trained
therapists to aid in life
problems
Psychotherapy is the process
of examining thoughts,
feelings, bodily experiences
and relationships as well as
looking at personal or family
patterns to gain greater
understanding about oneself.
3. Goal
Increase sense of well-being, reduce discomfort
Changing maladaptive behavior
Modifying environment causing maladaptive
behavior
Improving I.P.R skills
Helping the patient to overcome a feeling of
handicap
Helping him to make an accurate assessment of
himself and self- identity .
4. Who seeks therapy…and why?
• Children: behavioral, school, family issues
• Adolescents: as above and issues of separation
and peer relationships
• Young adults: all of above plus career issues
• Mature adults: all of above plus issues of
changing relationships, family alignments, health,
work and social status
• Older adults: all of above plus end of life issues
5. How does therapy work?
• Research: quality of therapist/client relationship
effects outcome more than specific therapy
• Lambert (1992) estimates 40% client changes due
to motivation or severity of problem; 30% to
quality of therapeutic relationship; 15% to
expectancy (placebo) effects, and 15% to specific
techniques.
6. Introduction to individual therapy
• Individual psychotherapy involves regularly
scheduled talks between the client and a mental
health professional such as psychiatrist ,
psychologist, psychiatric social worker or nurse.
– Client : Patient; the one who participates in
psychotherapy
– Rogers used “client” to equalize therapist-client
relationship and de-emphasize doctor-patient
concept
7. What is individual therapy?
• Individual therapy is a
psychotherapy implemented by a
trained professional, usually
a therapist or psychologist,
– to help a client come out from a
problem.
– The ways that individual therapy is
implemented varies widely depending
upon the psychological problem
– experienced by the client, the
personal beliefs and practices of the
therapist, and the individual needs of
the client.
8. Organization of individual therapy?
• Individual therapy Usually have minimum 7-8 of sessions are needed to
make sure all aspects of the illness .
• However, therapist may recommend more or less sessions depending on
client’s progress.
• An important part of therapy is making sure that you come back for follow
up sessions after one month, six months and 12 months so psychologist can
monitor condition and make sure it is under control.
• The first session will usually involve client and psychologist “getting to
know” one another.
• psychologist will ask questions about :
– client and his past experiences, current situation, family, job and friends.
– psychologist will not push client to delve into private matters, but does need to obtain
enough information about your individual needs in order to determine a course of
treatment.
9. • It will help the psychologist to :
– assess the problem and
– decide the best plan of action.
• Remember that, although psychologist may be directing
the sessions.
• If you feel that the therapy should take a different
direction, discuss this with psychologist.
• However, keep in mind that psychologists are highly trained
professionals that have a lot of experience in their field.
• By trusting that client’s psychologist has best intentions in
mind, you will benefit more from the therapy.
10. Therapist-client relationship
Ingredients of success in psychotherapy is the strength and stability of
the relationship between the client and the therapist. Therefore it is
very important that client feels comfortable and happy with his
psychologist.
Therapists that are rigid, critical and uninvolved are less effective. Client
will not share his views ,opinions openly.
Qualities in a psychologist include :
• warmth
• empathy
• patience
• genuineness
• Honesty
• Politeness
11. These qualities help the client to achieve
the important goal of self efficacy.
self efficacy means clients believe in themselves, the
therapy and the psychologist.
When client make trust that the therapy is helping,
psychologist are more likely to actively work
on therapy goals, and are therefore more likely to
experience the benefits of the treatment.
One of the most important aspects of psychotherapy
is communication.
12. Therapy goals
therapist will also help the client to :
• Identify coping strategies: psychologist will teach you
to adapt these strategies to your current situation.
• If your coping strategies have been unsuccessful in the
past, therapist will guide you in the development of
new ones.
• Rearrange life priorities: Sometimes people have
psychological problems because they have an irrational
expectation of themselves and others.
– This increases the pressure on everyone and can lead to
stress, anxiety and depression.
– By rearranging your expectations and priorities you may
be able to avoid unnecessary stress.
13. • Focus on meaningful pursuits.
• Identify personal strengths:
– Sometimes during times of psychological crisis it
is easy to focus on their weaknesses and what you
do not have, instead of your strengths and the
wonderful things you do have.
– Psychologists will draw client’s attention to
positive aspects about yourself, and help them to
rediscover and bring them out again. This will help
the client to believe in yourself.
14. The principles of achieving goals of individual
psychotherapy are described by Shives L.R, as follows
a) Establishing 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 in to the
problem
d) Providing an opportunity to practice new skills.
e) Reinforcing an appropriate behavior as it occurs.
f) Providing consistent support.
16. Psychoanalysis
• Psychoanalysis is the body of ideas developed by
Sigmund Freud
• Devoted to the study of human psychological
functioning and behavior
• Therapeutic techniques focuses :
– on the influence of unconscious forces such as
repressed impulses and memories , internal conflicts
and childhood traumas on mental health
– And adjustment of individuals.
17. Foundation is based on early psychosexual development.
The system of personality : Id , Ego , Superego.
Psychoanalysis is a form of therapy is used primarily by
bringing about basic modification in personality.
Freudian’s psychoanalysis refers to a specific type of
treatment in which ‘’analysand ‘’ verbalizes thoughts ,
including :
Free associations
Fantasies
And dreams from which the analyst formulates unconscious conflicts
causing the patient symptoms and character problem and interpret
them for the patient to create insight for resolution of problem.
18. a) Free association
• Free association is a technique
used in psychoanalysis which was
originally devised by Sigmund
Freud
• The importance of free
association is that the patients
spoke for themselves, rather than
repeating the ideas of the analyst;
- they work through their own
material, rather than parroting
another's suggestions'.
• James Strachey considered
free association as 'the first
instrument for the scientific
examination of the human mind'.
19. Characteristics
• In free association, psychoanalytic patients are
invited to relate whatever comes into their mind
during the analytic session, and not to censor
their thoughts.
• Technique is intended to help the patient learn
more about what he or she thinks and feels
• Psychoanalysis assumes that people are often
conflicted between their need to learn about
themselves, and their (conscious or unconscious)
fears of and defenses against change and self-
exposure.
20. Freudian approach
• the use of free association was intended to help
discover notions that a patient had developed,
initially, at an unconscious level, including:
• Transference - unwittingly transferring feelings about
one person to become applied to another person;
• Projection - projecting internal feelings or motives,
instead ascribing them to other things or people;
• Resistance - holding a mental block against
remembering or accepting some events or ideas.
21. b) Fantasy
• Fantasy is a genre of fiction that commonly
uses magic and
other supernatural phenomena a
primary plot element, theme, or setting.
22.
23. • A fantasy is a situation
imagined by an individual
or group , which doesn‘t
corresponds with reality
but express certain desires
or aims of its creators.
• Involves typically situations
which are impossible
• Fantasies can also be
sexual in nature
• In other words fantasy is
something which is not real
,or can not be real.
24. c) Dreams analysis
• Dreaming is a part of life.
• Everyone dreams.
• Even unborn babies dream in their
mother's womb.
• Dream is an event that takes place in the
world of mind when the whole physical
body has gone to rest.
• Dreams are the gateway to an inner
world, a world just as real as the one
outside .
• Dreams analysis inform us in a visual
language about repressed experiences
and other process of the unconscious.
• Dream analysis images and activities,
however strange and even meaningless
they may seem, show symbolic
structures.
• Dreams became psychotherapy's most
important aid in exploration of the
25. • Dreams are historically
used for healing as well
as for guidance or divine
inspiration.
• Dreams as an interaction
between the
unconscious and
conscious .
• unconscious is the
dominant force of the
dreams it conveys its
own mental activity.
26. 2.Hypnosis
• Hypnotherapy is a therapy that is undertaken
with a subject in hypnosis.
• The word "hypnosis" (from the Greek Hypnos,
"sleep") is an abbreviation of James Braid's
(1841) term "neuro-hypnotism", meaning
"sleep of the nervous system".
• A person who is hypnotized displays certain
unusual characteristics and propensities,
27. • Hypnosis is "a special
psychological state with
certain physiological
attributes, resembling sleep
only superficially and marked
by a functioning of the
individual at a level of
awareness other than the
ordinary conscious state.“
• According to "state theory",
it is a mental state, while,
according to "non-state
theory", it is
imaginative role-enactment.
28. Characteristics
• heightened suggestibility and focus accompanied by a sense
of tranquility.
• the hypnotized individual appears to heed only the
communications of the hypnotist.
• He seems to respond in an uncritical, automatic fashion,
ignoring all aspects of the environment .
• He sees, feels, smells, and otherwise perceives in accordance
with the hypnotist's suggestion.
• An example of this would be "your eyes are slowly starting to
close". Even the subject's memory and awareness of self may
be altered by suggestion.
• A characteristic of hypnosis is that it possesses age-regression
which is it allows one to be in the conscious state of returning
to a specific age.
29. • Modern hypnotherapy has been used in a variety
of forms with varying success, such as :
• Addictions
• Habit control
• Pain management
• Psychological therapy
• Relaxation
• Skin disease
• Soothing anxious surgical patients
• Sports performance
• Weight loss
30. Definition of a hypnotherapist
• Induces hypnotic state in client, using
individualized methods and techniques of
hypnosis based on interpretation of test
results and analysis of client's problem. May
train client in self-hypnosis conditioning.
31. Traditional hypnotherapy
• This form of hypnotherapy practiced by most Victorian
hypnotists, including James Braid and Hippolyte Bergheim,
mainly employed direct suggestion of symptom removal, with
some use of therapeutic relaxation and
occasionally aversion to alcohol, drugs,
Hypnoanalysis
• In 1895 Sigmund Freud and Joseph Breuer published a
seminal clinical text entitled Studies in Hysteria (1895) which
promoted a new approach to psychotherapy
32. Ericksonian hypnotherapy
• In the 1950s, Milton H. Erickson developed a
radically different approach to hypnotism
,known as "Ericksonian hypnotherapy" or
"Neo-Ericksonian hypnotherapy."
• Erickson made use of an informal
conversational approach with many clients
and complex language patterns, and
therapeutic strategies.
33. Uses
a) Hypnosis in childbirth
• Hypnotherapy has long been used in relation
to childbirth. It is sometimes used during
pregnancy to prepare a mother for birth, and
during childbirth to reduce anxiety, discomfort
and pain.
b) Psychotherapy
c) Research
34. 3.Abreaction
• Abreaction therapy is a form
of psychotherapy in which abreaction is used
to assist a patient suffering from post-
traumatic stress disorder by relieving the
experience in a controlled environment.
35. • Therapeutic technique
in which the patient
talks about repressed
emotions by reviving
and relieving painful
experiences that have
been buried in the
unconscious mind.
• IV injection –Pentothal.
36. 4.Reality therapy
• Reality therapy (RT) is an approach
to psychotherapy and counseling.
• Developed by William Glasser in the 1960s, it
is considered a form of cognitive behavioral
therapy.
• it focuses on what Glaser calls psychiatry's
three R's: realism, responsibility, and right-
and-wrong, rather than symptoms of mental
disorders.
37. Reality therapy maintains that the individual is
suffering from a socially universal human
condition rather than a mental illness.
It is in the unsuccessful attainment of basic
needs that a person's behavior moves away from
the norm.
Since fulfilling essential needs is part of a
person's present life, In these ways reality therapy
is very different from other forms of
psychotherapy.
38.
39. • The reality therapy approach to counseling
and problem-solving focuses on the here-and-
now actions of the client and the ability to
create and choose a better future.
• Focuses on the present behavior and
development of patient’s ability to cope with
the stresses of reality and take a greater
responsibility for the fulfillment of his needs.
40. Principles
- Be patient and supportive
– Focus on the present and avoid discussing the
past .
– Avoid discussing symptoms and complaints
– Understand the concept of total behavior
– Remain non-judgmental and non-coercive
– Teach counselees
_ Avoid criticizing, blaming and/or complaining
41. Process
• Involvement
• Evaluating current behavior
• Planning possible behavior
• Implementation to the plan
• No Excuses, No Punishment, Never Give Up
43. • goal of insight therapy is to help a person
become more self-aware and understand their
own feelings to help them better function in
everyday life.
• There are three main ways that this type of
therapy is used:
Psychoanalysis
client centered therapy,
and gestalt therapy
44. a) Psychoanalysis
• Psychoanalysis tries to help a patient to find his
feelings and emotions so that they can deal with
them. The therapist tries to uncover unconscious
thoughts that a person has so they can better
understand themselves
b) Client centered therapy
• focuses on the patient's problem,
• but the psychologist helping the patient offers
unconditional positive opinions for him or her.
• Using this method, the patient often feels more
comfortable about him or herself, and is more willing
to open up and discuss his or her flaws
45. • After discovering the problems of the person seems to have,
both the patient and the psychologist work together to try to
change negative thoughts and behaviors.
c) Gestalt therapy :
• emphasizes current day life in the wholeness of the
personality
• Most people have conflicting feelings, if this is a problem for a
person, this method of psychotherapy tries to help balance
these conflictions.
• By doing this, the psychologist tries to help the patient
function better in everyday life
• If a persons belief are in constant confliction, then the person
can find themselves overwhelmed and confused and will
often tend to seek out the negative, which is only harmful and
damaging to a person's well-being.
48. Techniques
• SHOW INTEREST
– ask follow-up questions to clarify
– Remember what pt has told you (e.g. their
likes / dislikes / attitudes)
– Body language – attentive posture, eye
contact, head nods
49. 2.ALLIANCE – Pay attention to
language
- Avoid arguing
– Avoid denigration
• E.g. INSTEAD OF: “What are you trying to say?”
• SAY: “I don’t understand.”
– Avoid attacking questions
• E.g. INSTEAD OF: “Why?” Or “Why didn’t you…?”
• SAY: “What happen?” or “What was the reason
that…?”
50. – Avoid criticism
• E.g. INSTEAD OF: “Didn’t they tell you to take it
every day?”
• SAY: “A lot of the effect is lost if you don’t take
it every day. If the dose is too large, we should
discuss it. A smaller dose might be the
answer.”
– Avoid abrupt, dismissive response:
• E.g. Pt: “I think this medication is making me
sleepy.”
INSTEAD OF - “It hasn’t been a problem for
most people. How’s your appetite?”
SAY: “In what way?” or “What have you
noticed?”
51. • PRAISE
– Reinforce positive behavior
– Must be genuine
– Get feedback to ensure is accepted by pt.
• REASSURANCE
– NOT just saying what pt wants to hear
– Pt must believe is based on understanding
their unique situation (~praise)
• Example
– Normalizing
52. • ENCOURAGEMENT
– Help engage in adaptive behaviors
• Maintain hygiene, get exercise, interact with
others, be more independent, accept caring
– Help identify ‘small steps’ for rehabilitation
• E.g. attainable tasks, activities
• GOAL-SETTING
• E.g. ‘SMART’ goal
• Improve physical health: – Walk for 20 min on
M,W, F at 4pm
53. Ventilation
• Free expression of feelings
• Talk freely whatever comes in his mind
• Also described as mental ventilation
• Helps the client to unburden his feelings by sharing and
revealing himself which makes him less tense.
Environmental modification or manipulation
-Improving well being of patients
Persuasion :
- therapist attempts to induce the patient to change his faulty
behavior
- By using his power of reasoning , will ,self criticism
54. • Reeducation : learns more effective way of
dealing with problems and relationship
through therapist – patient relationship
• Reassurance :
– Encourages the patient to believe that there are
possibilities of improvement.
– Used to diminish anxiety.
55. Basic rules
• Listen and say little.
• Do not interrogate .Encourage patient to be at ease.
• Be empathic , accept patient non- judgmentally
• Define aims clearly and the nature of help offered.
• Set clearly mutually agreed goals , frequency and
duration of treatment
• Review progress regularly
• Respect confidentiality and avoid gossips.
56. REFERENCES:
• en.wikipedia.org/wiki/psychotherapy/viewed on
10/6/2013
• www.simplypsychology.org/psycoanalysis/ viewed on
/10/2013
• www.mayoclinic.coim/.../hypnosis/MY01/viewed
on10/6/2013
• Campbel JE-1985,Perspect psychiatric care.1985;
23(3):85-90
• En.wikipedia.org/wiki/Reality_therapy/viewed on
9/6/2013
• Voices.yahoo.com/insight –therapy-treatment/viewed
on 9/6/2013
• En.wikipedia.org/wiki/hypnosis/viewed on 10/6/2013