Psychotherapy

1. PSYCHOTHERAPY
MS SHARIKA RATISH
ASSISTANT PROFESSOR (PSYCHIATRIC NURSING)
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2. Introduction
 Interpersonal, relational intervention by trained therapists to aid in life problems
 Goal: increase sense of well-being, reduce discomfort
 Employs range of techniques based on relationship building, dialogue, communication and behavior
change designed to improve the mental wellbeing of individual patient or group
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3. DEFINITION
 A form of treatment for problems of an emotional nature in which a trained individual
deliberately establishes a professional relation ship with the objective of removing,
modifying or retarding existing symptoms, of mediating disturbed patterns of behaviour
and of promoting positive personality growth and development. (Wolberg in Longman
dictionary of psychology and psychiatry)
 A method of treatment based on the development of intimate therapeutic relationship
between client/patient and therapist for the purpose of exploring and modifying the
client/patients behaviour in a satisfying direction. (Lego S)
 A process in which a person who wishes to relive symptoms or resolve problems in living or
is seeking personal growth enters in implicit or explicit contract to interact in a prescribed
way with a psychotherapist. (Psychiatric Glossary 1980)
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4. Goals of Psychotherapy
 Changing maladaptive behaviour pattern.
 Reducing or eliminating environmental conditions that may be causing such
behaviour.
 Improving interpersonal and other competencies i.e. communication skills.
 Helping the patient to resolve inner conflicts and overcome feelings of handicap.
 Modyfying an individuals accurate assessment of himself and the world around
him.
 Helping him to develop a sense of self identity.
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5. TYPES OF PSYCHOTHERAPY
Individual
-Psychoanalysis
-Hypnosis
Abreaction
Reality therapy
Uncovering
• Supportive therapy
• Ventilation
• Environmental
modification
• Persuasion
• Re-education
• reassurance
Behavioural
Behavioural
modification
Systematic
desensitization
Implosive therapy
Aversion therapy
Assertiveness training
Cognitive behaviour
therapy
Positive reinforcement
Response shaping
Modelling
Token economy
Interpersonal
Marital
Family
transactional
Group Other
Milieu Therapy
Attitude therapy
Play therapy
Dance therapy
Occupational therapy
Recreational therapy
Music therapy
Colour therapy
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6. Individual Psychotherapy
 Psychotherapy conducted on a one to one basis.
The therapist treats one person at a time. The
effectiveness of such therapy depends on the
patient-therapist relationship.
 By this therapist helps the patient to come to a
greater understanding of himself & to find a way
of dealing with his problem.
 Indication: stress-related disorder, alcohol & drug
dependence, sexual disorder & marital
disharmony.
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7. Types of individual Psychotherapy
 Psychoanalysis
 Hypnosis
 Abreaction
 Reality therapy
 Uncovering
 Supportive therapy
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8. Psychoanalysis
 Psychoanalytical therapy was developed by Freud.
 It focus on unconscious forces such as repressed impulses & memories, internal
 conflicts & childhood trauma on mental life & adjustment of the individual.
 The most important indication for psychoanalytical therapy is the presence of longstanding
mental conflicts, which may be unconscious but produce symptoms.
 The aim of therapy is to bring all repressed material to unconscious awareness so that the
patient can work towards a healthy resolution of his problems, which are causing the
symptoms.
 Psychotherapy as a form of therapy is used primarily in psychoneuroses by bringing about
basic modification in the personality. This is done by establishing a constructive therapeutic
relationship.
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9. Psychoanalysis
 The specific methods used to achieve the effect of therapy are; free association, dream
interpretation analysis of resistances & defences used by the patient, working through the
feelings & experiences revealed by the patient during transferring.
 Every interaction lasts for 45 minutes. 4- 5 days a week for approximately 3-5 years.
 Transference: unconscious redirection of feelings for one person to another (including the therapist)
 Countertransference: redirection of therapist’s feelings for the patient
 Therapeutic alliance: therapist and patient trust
 Resistance: ideas unacceptable to conscious; prevents therapy from proceeding
 Free association: patient says what comes to mind uncensored. Clues to unconscious
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10. Hypnosis
 Hypnosis is a superficial or deep trance (a somnolent state/sleep like) resembling sleep.
 It induced in a patient by suggestions of relaxation & concentrating attention on a single
object.
 The client becomes highly suggestible, submissive & abandons control & response to
therapist influence.
 He can be induced to recall forgotten events, becomes insensitive to pain, gain relief from
tension, anxiety & other psychological symptoms.
 It affects behavioural change & control of attitude
 This therapy is used in; obesity, hypertension, asthma, smoking, peptic ulcer, overeating,
abreaction of past experiences, psychosomatic disorders, conversion & dissociative disorders,
habit disorder & anxiety disorder or other addiction disorder.
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11. Hypnosis
 Changes that occur during hypnosis:
 The person becomes highly suggestible to the
commands of the therapist.
 There is an ability to produce or remove
symptoms or perceptions.
 Dissociation of a part of the body or emotions.
 Amnesia for the events that occurred during
the hypnotic state.
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12. Abreaction therapy
 Abreaction is a process by which repressed material, particularly a
painful experience or conflict is brought back to consciousness.
 The person not only recalls but also relieves the material, which is
accompanied by the appropriate emotional response.
 It is most useful in acute neurotic conditions caused by extreme
stress (PTSD, hysteria etc).
 Abreaction can be brought about by strong encouragement to
relieve the stressful events.
 The procedure is begun with neutral topics at first, & gradually
approaches area of conflict.
 Abreaction can be done with or without the use of medication.
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13. Reality Therapy
 This is a psychotherapeutic technique which focuses on the present behaviour &
development of patient’s ability to cope with the stress of reality & take a greater
responsibility for the fulfilment of his needs.
 To achieve these purposes the therapist becomes involved in an active
relationship with patient, rejects his unrealistic behaviour & teaches better ways
to meet his need in the real world
 The patient need to be stressed on that the past cannot be changed, so he must
take responsibility of right or wrong actions of present.
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14. Uncovering or Insight Therapy
 This technique is used to break through the patient’s repressed conflict &
traumatic experience to the surface.
 It helps the patient in gaining an insight.
 The patient explores different methods to cope with problem, once he gain an
insight into his conflict or problem.
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15. Supportive therapy
 It is a form of “surface therapy”.
 The therapist helps the patient to relieve emotional distress & symptoms without probing in to past
or attempting to change or alter the basic personality of the individual.
 The therapist reinforce the existing defences used by the client & utilizes various techniques such as:
Ventilation
 Environmental Modification or Manipulation
 Persuasion
 Re education
 Reassurance
 Explanation
 Suggestion
 Reinforcement
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16. Principles to achieve goals of individual
psychotherapy(Shives L.R.)
 Establishing a therapeutic relationship with the client
 Providing opportunity for the patient to release tension as problems are
discussed.
 Assisting the patient in gaining insight into the problem.
 Providing an opportunity to practice new skills.
 Reinforcing an appropriate behaviour as it occurs.
 Providing consistent emotional support.
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17. THANK YOU
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