Psychotherapy is a range of techniques based on dialogue, communication and behavior change and which are designed to improve the mental health of a client or patient, or to improve group relationships (such as in a family). Most forms of psychotherapy use only spoken conversation, though some also use various other forms of communication such as the written word, artwork or touch. Commonly psychotherapy involves a therapist and patient/client(s) — and in family therapy several family members or even other members from their social network — who discuss emotionally difficult situations in an effort to discover underlying problems and to find constructive solutions. Therapy may address specific forms of diagnosable mental illness, or everyday problems in relationships or meeting personal goals. Treatment of everyday problems is more often referred to as counseling. The term patient is generally used for those who are undergoing psychotherapy or involved in a medical model of treatment. Client is used for those who are undergoing counseling for more simple, everyday problems. There are many different types of psychotherapy, too numerous to discuss here, but a basic guide to the main schools of thought are summarized below to help gain a basic understanding of what psychotherapy is all about.
Cognitive Behavioral Therapy (CBT) is based on the idea that how we think (cognition), how we feel (emotion) and how we act (behavior) all interact together. Specifically, our thoughts determine our feelings and our behavior. Therefore, negative - and unrealistic - thoughts can cause us distress and result in problems.
Psychodynamic therapy is centered around the idea of a maladapted function developed early in life (usually childhood) which are at least in part unconscious. This maladapted function (a.k.a. defense mechanism) does not do well as it formed instead of a normal/healthy one. Later on the client will feel discomfort when they notice (or do not notice) that this function causes problems day to day. The psychodynamic therapist will first treat the discomfort associated with the poorly formed function, reveal to the client that such a function exists, then change, remove or replace it with a proper one.
Existential psychotherapy is partly based on the existential belief that human beings are alone in the world. This aloneness leads to feelings of meaninglessness which can be overcome only by creating one’s own values and meanings. We have the power to create because we have the freedom to choose. In making our own choices we assume full responsibility for the results and blame no one but ourselves if the result is less than what was desired. The psychotherapist helps his or her patients/clients along this path: to discover why the patient/client is overburdened by the anxieties of aloneness and meaninglessness, to find new and better ways to manage these anxieties, to make new and healthy choices, and to emerge from therapy as a free and sound human being.
Humanistic psychology is a school of psychology that emerged in the 1950s in reaction to both behaviorism and psychoanalysis. It is explicitly concerned with the human dimension of psychology and the human context for the development of psychological theory. These matters are often summarized by the five postulates of Humanistic Psychology given by James Bugental (1964), mainly that:
- Human beings cannot be reduced to components.
- Human beings have in them a uniquely human context.
- Human consciousness includes an awareness of oneself in the context of other people.
- Human beings have choices and responsibilities.
- Human beings are intentional, they seek meaning, value and creativity.
Brief therapy is an umbrella term for a variety of approaches to psychotherapy. It differs from other schools of therapy in that it emphasises (1) a focus on a specific problem and (2) direct intervention. In brief therapy, the therapist takes responsibility for working more pro-actively with the client in order to treat clinical and subjective conditions faster. It also emphasizes precise observation, utilization of natural resources, and temporary suspension of disbelief to consider new perspectives and multiple viewpoints. Brief therapy is often highly strategic, exploratory, and solution-based rather than problem-oriented. It is less concerned with how a problem arose than with the current factors sustaining it and preventing change. Brief therapists do not adhere to one "correct" approach, but rather accept that there being many paths, any of which may or may not in combination turn out to be ultimately beneficial.
Systemic Therapy, or Marriage and Family therapy, is a professional and conscious attempt and method to study, understand and cure disorders of the interactional whole of a family and its individual members as family members. The aim of Family therapy is that the interactional patterns which prevent individual growth will change. This is achieved especially emphasizing and trying to find the hidden positive resources in family’s interactional whole. In Family therapy the therapist or a family therapy team meets in the session those family members willing to participate in discussion about the topic they have or some of family members has defined as a disorder or problem. The number of sessions depends on the disorder, but the average is 5-20 sessions. The basic theory of family therapy is derived mainly from object relations theory, cognitive psychotherapy, systems theoryand narrative approaches. According to the main theoretical perspectives, family therapy can be classifies as follows: Psychodynamic; structural; behavioral or cognitive; strategic; reflective and narrative models. The main indications of family therapy are as follows:
- Serious psychic disorders (e.g. schizophrenia, addictions and eating disorders);
- Interactional and transitional crises in a family’s life cycle (e.g. different separation and individuation crises or divorce crises)
- As a support of all other psychotherapies and other psychological and psychiatric therapies (even medication).
Group psychotherapy is a special form of therapy in which a small number of people meet together under the guidance of a professionally trained therapist to help themselves and one another. The therapy has been widely used and has been a standard treatment option for over 50 years.