Psychotherapy

The treatment of mental or emotional disorders and adjustment problems through the use of psychological techniques rather than through physical or biological means.

Psychoanalysis, the first modern form of psychotherapy, was called the "talking cure," and the many varieties of therapy practiced today are still characterized by their common dependence on a verbal exchange between the counselor or therapist and the person seeking help. The therapeutic interaction is characterized by mutual trust, with the goal of helping individuals change destructive or unhealthy behaviors, thoughts, and emotions. It is common for experienced therapists to combine several different approaches or techniques. The most common approaches are discussed below.

Psychodynamic approach

Freudian psychoanalysis places emphasis on uncovering unconscious motivations and breaking down defenses. Therapy sessions may be scheduled once or even twice a week for a year or more. This type of therapy is appropriate when internal conflicts contribute significantly to a personís problems. (For more information, see entry on Psychoanalysis).

Behavioral techniques

In contrast to the psychodynamic approach, behavior-oriented therapy is geared toward helping people see their problems as learned behaviors that can be modified, without looking for unconscious motivations or hidden meanings. According to the theory behind this approach, once behavior is changed, feelings will change as well. Probably the best-known type of behavioral therapy is behavior modification, which focuses on eliminating undesirable habits by providing positive reinforcement for the more desirable behaviors.

Another behavioral technique is systematic desensitization, in which people are deliberately and gradually exposed to a feared object or experience to help them overcome their fears. A person who is afraid of dogs may first be given a stuffed toy dog, then be exposed to a real dog seen at a distance, and eventually forced to interact with a dog at close range. Relaxation training is another popular form of behavior therapy. Through such techniques as deep breathing, visualization, and progressive muscle relaxation, clients learn to control fear and anxiety.

Cognitive methods

Some behavior-oriented therapy methods are used to alter not only overt behavior, but also the thought patterns that drive it. This type of treatment is known as cognitive-behavior therapy (or just cognitive therapy). Its goal is to help people break out of distorted, harmful patterns of thinking and replace them with healthier ones. Common examples of negative thought patterns include magnifying or minimizing the extent of a problem; "all or nothing" thinking (i.e., a person regards himself as either perfect or worthless); overgeneralization (arriving at broad conclusions based on one incident, for example); and personalization (continually seeing oneself as the cause or focus of events).

In cognitive-behavioral therapy, a therapist may talk to the client, pointing out illogical thought patterns, or use a variety of techniques, such as thought substitution, in which a frightening or otherwise negative thought is driven out by substituting a pleasant thought in its place. Clients may also be taught to use positive self-talk, a repetition of positive affirmations. Cognitive therapy is usually provided on a short-term basis (generally 10-20 sessions).

Family and group therapy

Family therapy has proven effective in treating a number of emotional and adjustment problems. While the clientís immediate complaint is the initial focus of attention, the ultimate goal of family therapy is to improve the interaction between all family members and enhance communication and coping skills on a long-term basis (although therapy itself need not cover an extended time period). Group therapy, which is often combined with individual therapy, offers the support and companionship of other people experiencing the same problems and issues.

Therapy is terminated when the treatment goals have been met or if the client and/or therapist conclude that it isn't working. It can be effective to phase out treatment by gradually reducing the frequency of therapy sessions. Even after regular therapy has ended, the client may return for periodic follow-up and reassessment sessions.