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Psychotherapy, treatment of individuals with emotional problems, behavioral problems, or mental illness primarily through verbal communication. In most types of psychotherapy, a person discusses his or her problems one-on-one with a therapist. The therapist tries to understand the person’s problems and to help the individual change distressing thoughts, feelings, or behaviors.
People often seek psychotherapy when they have tried other approaches to solving a personal problem. For example, people who are depressed, anxious, or have drug or alcohol problems may find that talking to friends or family members is not enough to resolve their problems. Sometimes people may want to talk to a therapist about problems they would feel uncomfortable discussing with friends or family, such as being sexually abused as a child. Finding a therapist to talk to who is knowledgeable about emotional problems, has patients’ best interests at heart, and is relatively objective can be extremely helpful.
Psychotherapy differs in two ways from the informal help or advice that one person may give another. First, psychotherapy is conducted by a trained, certified, or licensed therapist. In addition, treatment methods in psychotherapy are guided by well-developed theories about the sources of personal problems.
DIFFERENCE BETWEEN PSYCHOTHERAPISTS AND COUNSELORS
At one time the term psychotherapy referred to a form of psychiatric treatment used with severely disturbed individuals, whereas counseling referred to the treatment of people with milder psychological problems or to advice given on vocational and educational matters. Today the distinction between psychotherapy and counseling is quite blurred, and many mental health professionals use the terms interchangeably. Psychotherapists and counselors often treat the same kinds of problems and use the same set of techniques.
PROBLEMS TREATED WITH PSYCHOTHERAPY
Psychotherapy is an important form of treatment for many kinds of psychological problems. Two of the most common problems for which people seek help from a therapist are depression and persistent anxiety. People with depression may have low self-esteem, a sense of hopelessness about the future, and a lack of interest in people and activities once found pleasurable. People with anxiety disorders may feel anxious all the time or suffer from phobias, a fear of specific objects or situations. Psychotherapy, by itself or in combination with natural supplements treatment, can often help people overcome or manage these problems.
People experiencing an emotional crisis due to marital problems, family disputes, problems at work, loneliness, or troubled social relationships may benefit from psychotherapy. Other problems often treated with psychotherapy include obsessive-compulsive disorder, personality disorders, alcoholism and other forms of drug dependence, problems stemming from child abuse, and behavioral problems, such as eating disorders and juvenile delinquency.
TYPES OF THERAPY
FAMILY THERAPY
Family therapy involves the participation of one or more members of the same family who seek help for troubled family relationships or the problems of individual family members. Typical problems that bring families into family therapy are delinquent behavior by a child or adolescent, a child’s poor performance in school, hostilities between a parent and child or between siblings, and severe psychological disturbance or mental illness in a parent or child.
One of the most influential forms of family therapy, family systems therapy, views the family as a single, complex system or unit. Individual members are interdependent parts of the system. Rather than treating one person’s symptoms in isolation, therapists try to understand the symptoms in the larger context of the family. For example, a boy who begins picking fights with classmates might do so to get more attention from his busy parents. Therapists work from the rationale that current family relationships profoundly affect, and are affected by, an individual family member’s psychological problems. For this reason, most family therapists prefer to work with the entire family during a session, rather than meeting with family members individually.
In most family therapy sessions, the therapist encourages family members to air their feelings, frustrations, and hostilities. By observing how they interact, the therapist can help them recognize their roles and relationships with each other. The therapist tries to avoid assigning blame to any particular family member. Instead, the therapist makes suggestions about how family members might adjust their roles and prevent future conflict.
MARITAL OR COUPLE THERAPY
Couples therapy, also called marital therapy or marriage counseling, is designed to help intimate partners improve their relationship. Therapists treat married couples as well as unmarried couples of the opposite or same sex. Therapists normally hold sessions with both partners present. At certain times during therapy, however, the therapist may choose to see the partners individually.
Couples may seek therapy for a variety of problems, many of which concern a breakdown of communication or trust between the partners. For example, an extramarital affair by one partner may cause the other partner to feel emotional pain, anger, and distrust. Some partners may feel distant from one another or experience sexual problems. In other cases, one or both partners may have psychological problems or alcohol or drug problems that negatively affect their relationship.
The techniques used in therapy vary depending on the theoretical orientation of the therapist and the nature of the couple’s problem. Most often, therapists focus on improving communication between partners and on helping them learn to manage conflict. By observing the partners as they talk to each other, the therapist can learn about their communication patterns and the roles they assume in their relationship. The therapist may then teach the partners new ways of expressing their feelings verbally, how to listen to each other, and how to work together to solve problems. The therapist may also suggest that they try out new roles. For example, if one partner makes all of the decisions in the relationship, the therapist may encourage the couple to try sharing decision-making power.
Because most couples therapists also have training in family therapy, they often examine the influence of the couple’s relationships with parents, children, and siblings. Psychoanalytically oriented therapists may focus on how the partners’ childhood experiences affect their current relationship with each other. For couples who cannot work through their differences or reestablish trust and intimacy, separation or divorce may be the best choice. Therapists can help such partners separate in constructive ways.
EFFECTIVENESS OF PSYCHOTHERAPY
Almost since the inception of psychotherapy, therapists and their clients have asked, “Does it work? Does psychotherapy help people resolve their problems, feel better, and change the way they deal with other people?” Therapists and clients are not the only ones asking these questions. In recent years, the agencies that fund mental health services—health insurance companies, health maintenance organizations, and government organizations—have increased their scrutiny of the effectiveness of various psychotherapies in an effort to contain costs.
Measuring the effectiveness of psychotherapy is an extremely complex task. Asking psychotherapists or their clients, “How helpful has therapy been?” is only a start. The answer does provide some information about how therapists and their clients perceive therapy. However, it does not answer the question of whether psychotherapy is effective because both therapists and clients have vested interests in believing that therapy succeeded. Therapists want to uphold their professional reputation and sense of competence, and clients want to feel that their investment of time and money has been worthwhile. Because of these biases, most studies of effectiveness rely on other evaluations of a client’s improvement: psychological tests given before and after treatment, reports from the client’s friends and family, and reports from impartial interviewers who do not know the client or whether the client received any therapy.
For questions, email hypnotherapy@ctawellness.com
Dr Zaitun Sulaiman, Practising Psychotherapist
CTA Wellness & Longevity Center
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