Supportive Psychotherapy

Markos Tesfaye, MD PhD

Professor of Psychiatry
Department of Psychiatry, SPHMMC
 Definition
• A form of psychological treatment provided to
a patient over extended period in order to
sustain him/her psychologically
• Given patients with chronic and disabling
psychiatric conditions for whom fundamental
change is not a realistic goal
• A form of treatment in which therapist
support is a core component
 Goals of Therapy
• To promote patient’s adaptation to cope with
challenges in life
• To bolster patient’s self-esteem & self-
confidence
• To make the patient aware of the reality of
his/her life situation
• To prevent relapse and re-hospitalization
 Basic supportive procedures

Listening to patient’s concern

Expression of emotions, to relieve distress

Information, explanation, and advice

Improving morale

Installation of hope

Encourage self-help / action

“Here and now”

 Steps in general supportive treatment

1. Establish rapport
2. Facilitate expression (anger – grief, sadness)
3. Reflection / clarification / reassurance
4. Encouragement of problem solving behavior
(action) (homework)
 Two Distinct Phases in Supportive
Psychotherapy

1. Exploration of feelings and experiences

2. Instruction for change in the behavior

 Explorations of feeling & experiences

• Stand by; available

• Involved
• Sound board
• Empathy
• Reducing resistance
• Paraphrasing
• Following
• Preference questioning-sentences with you as
subject
 Instruction for change in behavior
• Obvious present
• Active
• Trainer
• Challenging
• Advice
• Negotiating
• Checking the results
• Preference advisory-sentences with I as subject
 Indications for supportive treatment

Indications: basically any patient is suitable

◦ Out-patients on medication

◦ Admitted patients

◦ Patients with long standing chronic illnesses,

where basic change is not a realistic goal
15 minutes weekly
 Case
• A 20 year old lady complains of headache. She
feels lonely and inferior. She is failing in her
academic achievements. She trust you as
therapist and tells you about her unhappy
childhood and her parents who always
quarrel.
 Practicing (1)
Role-play the two approaches
1. Are the two approaches recognizable?
2. Which approach do you like the most?
3. Can you explain why you have that
preference?