Dimensions of Therapy-Let Me Count the Ways

Dimensions of Therapy-Let Me Count the Ways

Dimensions of Therapy-Let Me Count the Ways

Gateway Question 15.3: How do psychotherapies differ? In contrast to medical therapies, which are physical in nature, psychotherapy refers to any psychological technique that can bring about positive changes in personality, behavior, or personal adjustment. Psychotherapy is usually based on a dialogue between therapists and their clients, although some therapists also use learning principles to directly alter troublesome behaviors (Corsini & Wedding, 2011).

Therapists have many approaches to choose from: psycho- analysis, which we just discussed, as well as client-centered ther- apy, Gestalt therapy, cognitive therapy, and behavior therapy—to name but a few. As we will see throughout the chapter, each therapy emphasizes different concepts and methods. For this reason, the best approach for a particular person or problem may vary (Prochaska & Norcross, 2010).

Dimensions of Therapy-Let Me Count the Ways

Dimensions of Psychotherapy The terms in the list that follows describe some basic aspects of various psychotherapies (Prochaska & Norcross, 2010; Sharf, 2012). Notice that more than one term may apply to a particular therapy. For example, it is possible to have a directive, action- oriented, open-ended group therapy or a nondirective, individual, insight-oriented, time-limited therapy:

• Insight vs. action therapy: Does the therapy aim to bring clients to a deeper understanding of their thoughts, emotions, and behavior? Or is it designed to bring about direct changes in troublesome thoughts, habits, feelings, or behavior, without seeking insight into their origins or meanings?

• Directive vs. nondirective therapy: Does the therapist provide strong guidance and advice? Or does the therapist merely assist clients, who are responsible for solving their own problems?

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Dimensions of Therapy-Let Me Count the Ways

Therapies 515

Transference The tendency of patients to transfer feelings to a therapist that correspond to those the patient had for important persons in his or her past.

Brief psychodynamic therapy A modern therapy based on psychoanalytic theory but designed to produce insights more quickly.

Interpersonal psychotherapy (IPT) A brief dynamic psychotherapy designed to help people by improving their relationships with other people.

Spontaneous remission Improvement of symptoms due to the mere passage of time.

• Individual vs. group therapy: Does the therapy involve one therapist with one client? Or do several clients participate at the same time?

• Open-ended vs. time-limited therapy: Is the therapy open- ended? Or is it begun with the expectation that it will last only a limited number of sessions?

Myths Psychotherapy has often been depicted as a complete personal transformation—a sort of “major overhaul” of the psyche. But therapy is not equally effective for all problems. Chances of improvement are fairly good for phobias, low self-esteem, some sexual problems, and marital conflicts. More complex problems can be difficult to solve and may, as in Joe’s case, require medical treatment as well. The most extreme cases may not respond to psychotherapy at all, leaving a medical therapy as the only viable treatment option.

In short, it is often unrealistic to expect psychotherapy to undo a person’s entire past. For many people, the major benefit of psychotherapy is that it provides comfort, support, and a way to make constructive changes (Bloch, 2006; Burns, 2010). Yet, even when problems are severe, therapy may help a person gain a new perspective or learn behaviors to better cope with life. Psychotherapy can be hard work for both clients and therapists, but when it succeeds, few activities are more worthwhile.

It’s also a mistake to think that psychotherapy is used only to solve problems or end a crisis. Even if a person is already doing well, therapy can be a way to promote personal growth (Bloch, 2006). Therapists in the positive psychology movement are developing ways to help people make use of their personal strengths. Rather than trying to fix what is “wrong” with a person, they seek to nur- ture positive traits and actively solve problems (Compton, 2005). ? Table 15.1 lists some of the elements of positive mental health that therapists seek to restore or promote. Before we dig deeper into some of the different types of psychotherapy, let’s enhance your positive academic health with a short review.