PSYCHOTHERAPY

UNDERSTANDING PSYCHOTHERAPY AND HOW IT WORKS

Presented By

Priyanka Pandey

Clinical Psychologist(RCI)

BBRFI, New Delhi

 PSYCHOTHERAPY

• DEFINITION

• A process which attempts to help the patient relieves symptoms, resolve problems or
seek personal growth through a structured relation(I.e. specified goals and methods)
with the trained professional therapist.

• A method of treatment based on the development of intimate(Therapeutic) relationship

between client and therapist for the purpose of exploring and modifying the client
behavior in a satisfying direction.
 TYPES OF PSYCHOTHERAPY
• Individual psychotherapy(This therapy involves • Interpersonal psychotherapy
only the patient & the therapist)
• Marital therapy(This type of therapy helps spouses
• Psychoanalysis and partners understand there problems, what
changes in communication & behavior can help
• Hypnosis and what they can do to cope. It also help a
couple those who are struggling with the aspects
• Abreaction of their relationship)
• Reality therapy • Family therapy(It helps family members to
understand what their loved one is going through,
• Uncovering
hoe they themselves can cope and what they can
do to help)
• Transactional therapy
 TYPES OF PSYCHOTHERAPY
• BEHAVIORAL PSYCHOTHERAPY • GROUP PSYCHOTHERAPY(Two or more patient
may participate at same time. Patients are able to
• Behavior modification share experiences & learn that other feels the same
way and have had the same experiences)
• Systematic desensitization.
• OTHER PSYCHOSOCIAL THERAPY
• Cognitive behavior therapy
• Therapeutic community.
• Positive reinforcement.
• Play therapy
• Modelling
• Recreational therapy
• Token economy
• Music therapy
• Flooding therapy.
• Dance therapy.
• Assertiveness training.
TECHNIQUES OF PSYCHOTHERAPY

VENTILATION:

It is the process of allowing the release of bottled emotions. It helps to express the
suppressed emotions.

Patient is allowed to talk whatever comes to his mind.

ABREACTION:

It is a process of exploring a repressed emotions e.g "OK" Than what happened?

 TECHNIQUES

• REASSURANCE:
• Supportive approach e.g. "you do not have a serious problem. I am confident that you will get
well".
• EXPLANATION:
• Explanation are provided to remove misconceptions and to provide proper understanding of
the problem
• SUGESSTION:
• Suggestion is a process by which symptoms relief is achieved through positive statements
made with a degree of firmness and authority.
 TECHNIQUES

• PERSUASION:

• Persuasion is a procedure in which therapist urges the patient repeatedly to change his
behavior or to try new methods of dealing with his problem.
 WORK AS THERAPY

• When a person engages in a work his preoccupation with

emotional problems decreases.
• It enhances self-esteem and helps to resolve conflicts in
many circumstances
 REINFORCEMENT

• Reinforcement of rewards are potent methods to enhance

the desired behavior.
• They can be verbal or material in nature.
 RECREATION

• It helps to break the monotony of work.

• It is essentially required for the patients who have
developed emotional problems as a result of having to
perform monotonous and hard work.
 RELAXATION

• It is especially used for the anxious individual.

• It is an effective intervention for many psychosomatic
problems like HT, PUD AND MIGRAINE.
• EXAMPLE:Yoga and Asanas.
 SIGN THAT NEED THERAPY

• It include:
• A person feels an overwhelming, prolonged sense of helplessness and sadness.
• A person's problems don’t seem to get better despite your efforts and help from family and
friends.
• A person finds it difficult to concentrate on work assignments or to carry out other every day
activities.
• A person worries excessively, expect the worst or are constantly on edge.
• A person's actions, such as drinking too much alcohol, using drugs or being aggressive, are
harming you or others.
 PSYCHODYNAMIC THERAPY

• A group of deep therapies that aim at symptom resolution as well as producing positive
fundamental changes in the patients.
• Character or Personality
• This is achieved through: Uncovering unconscious conflicts and shift them to the
conscious awareness of the patient.
• Help the patient resolve the conflicts and correct deficits through understanding and
insight.
• Induce change motivated by insight.
ESSENTIAL OPERATIONS OF PSYCHODYNAMIC PSYCHOTHERAPY

1. Accepting • The therapist affirms the patient's past and present

subjective experience.

• The therapist appreciates both the conscious and the

2. Understanding
unconscious contributions to the patients emotional
problems.

3. Explaining • The therapist expresses, through interpretations, his/her

understanding to the patient.
 PSYCHODYNAMIC THERAPY

• Time-limited: Weekly sessions

• for 3-6 months
• Problem focused: Focused on
• limited key aspects of the
• patients psychopathology.

•
 PSYCHOANALYSIS
• Psychoanalysis approach was developed
by Freud .

• The task of Psychoanalysis is to make the

person aware of the repressed material,
recognize that it is a harmless residue of
childhood fears and confusion and thus
accept the feelings and end the defensive
process.

• Primary tool of psychoanalysis is pre-

association: The person is told to talk about
whatever comes to mind. He/she can follow
any train of thought, discuss an experience,
person or feeling.
 PSYCHOANALYSIS

• Interpretation: The goal of both free association and interpretation is to promote insight,
understanding and acceptance of unconscious material.
• Transference: Is the technical term used to describe an unconscious transferring
of experiences from one interpersonal situation to other.
• It is a theoretical phenomenon characterized by unconscious redirection(projection) of the
feelings a person has about their parents, as one example, on to the therapist. It usually concern
feelings from a primary relationship during childhood.
• Transference is often manifested as an erotic attraction towards the therapist, but can be seen
in many other forms such as hatred, mistrust, parentification, extreme dependence or even
placing the therapist in a God like or Guru status.
 PSYCHOANALYSIS

• Countertransference:

• It is the redirection of a therapist" feeling towards a patient, or more generally, as a

therapist emotional entanglement with the patient.

• For example: A therapist who is sexually attracted to a patient must understand the
countertransference(if any) of the attraction, and look at how the patient might
be eliciting this attraction. Once any countertransference aspect has been identified, the
therapist can ask the patient what his/her feelings are towards the therapist and can
explore how those feelings relate to unconscious motivations, desires or fears.
 SUPPORTIVE PSYCHOTHERAPY

• DEFINITION & AIMS:

• It is the form of therapy that deals with conscious conflicts &
current problems.
• It aims at supporting the patient & helping him to:
• Relieve symptoms & resolve problems.
Achieve better adaptation, coping and functioning.
DURATION: According to patient needs it could be a single
session or prolonged to many years.
INDICATIONS: Crisis, acute distress, chronic schizophrenia,
demotivated patients, lacking ego strength, personality disorder.
 BEHAVIORAL THERAPIES

• Behavioral therapy is based on the theory that

symptoms are persistent maladaptive behaviors
acquired by conditioning or learning.

• TECHNIQUES OF BEHAVIORAL THERAPY:

• 1 Systematic desensitization

• 2 Graded exposure

• 3 Flooding

• All above techniques are useful in Phobia,

OCD, and some sexual disorders.
TECHNIQUES OF
BEHAVIORAL
THERAPY
Aversive conditioning e.g. in treating
Alcoholism(Disulfiram)

Positive reinforcement(Reward)
chronic patients e.g. Schizophrenia,
autistic disorder, M.R

Participant Modelling
 COGNITIVE-BEHAVIORAL
THERAPY
Based on the theory tnhat a persons
affect and behavior are largely
determined by the way in which he
cognitively structures and interprets
the world(Cognitive schema developed
from previous experience)

When faced with any situation, we

respond with certain immediate
interpretations(called automatic
thoughts) which are highly influenced
by our underlying or hidden beliefs or
assumptions.
 AIM OF CBT

• TO identify and correct cognitive distortions(automatic thoughts and underlying believes) and
maladaptive behaviors that result from them
• Through a combination of verbal and behavior modification techniques
• DURATION: Short term and time limited, usually 15-20 sessions, over three months.
• Focused on conscious aspect of experience and behavior.
• Current here and now problems
• Structured: problems and goals are operationally defined
• Agenda prepared for each session
 DIALECTICAL BEHAVIORAL
THERAPY
• DBT is a type of cognitive behavioral therapy used for high risk, tough to treat patients .
The term "dialectical" comes from the idea that bringing together two opposites in
therapy- acceptance & change.

• DBT helps a person change unheathy behaviors such as lying and self injury through
keeping daily diaries, individual, group therapy and phone coaching.

• DBT was initially designed to treat people with sucidal behavior & BPD but it has been
adapted for other mental health problems that threaten a person's safety, relationship,
work and emotional well-being.
 DBT
Comprehensive DBT focuses on four ways
to enhance life skills:

DISTRESS TOLERANCE : feeling intense

emotions like anger without reacting
impulsively or using self-injury or substance
abuse to dampen distress

EMOTION REGULATION: recognizing

,labeling, and adjusting emotions.

MINDFULNESS: Becoming more aware of

self and others and attentive to the present
moment

INTERPERSONAL EFFECTIVENESS:
Navigating conflict and interacting
assertively
THANKYOU