Psychotherapy

Psychotherapy describes the way specially skilled people called psychotherapists help people who have problems and unhappiness in their lives or who want to improve the quality of their lives and relationships with others.

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A session with a psychotherapist (751707089)

Psychotherapy means treatment of the mind. It aims to help the person feel better, be braver, happier and more in control of their lives. The main way they do this is by talking to the person who has the problems in a way that they begin to be able to understand themselves better. Some psychotherapists may work with a group of people such as a family who have problems and are unhappy.

Training

Psychotherapists usually complete their training at the doctoral level through doctor of philosophy programs or medical school, although, some are trained at the master's level. Psychotherapists do not use surgery, or give drugs or electric shocks to the people they help. These methods are used by special medical doctors called psychiatrists, who may also sometimes give psychotherapy.

How it started

Psychotherapy was started in the west in 1886 by Sigmund Freud, the first modern psychotherapist. Freud was a medical doctor who was trained in neurology. He became certain that hidden thoughts in the brain (which he called the Unconscious) could cause physical symptoms and strange behavior in some people. He believed that human behavior was not all caused by the brain, but by things that happened to people when they were babies and young children. His research of this theory -the idea he had- led him to create "talking therapy" , where he tried to figure out what could cause the mind to do things like this. Freud thought that his figuring things out and telling the patients what had caused the behavior would cure the patient. Unfortunately, it usually made no lasting changes.

Types

There are many different types of psychotherapy. Different therapies are often variations on an established approach, such as cognitive behavioral therapy. There is no formal approval process for psychotherapies as there is for the use of medications in medicine. For many therapies, however, research involving large numbers of patients has provided evidence that treatment is effective for specific disorders. These “evidence-based therapies” have been shown in research to reduce symptoms of depression, anxiety, and other disorders.  

The particular approach a therapist uses depends on the condition being treated and the training and experience of the therapist. Also, therapists may combine and adapt elements of different approaches. The health information pages for specific disorders on the NIMH website list some of the evidence based therapies for those disorders.

Evidence based psychotherapy

One goal of establishing an evidence base for psychotherapies is to prevent situations in which a person receives therapy for months or years with no benefit. If you have been in therapy and feel you are not getting better, talk to your therapist, or look into other practitioners or approaches. The object of therapy is to gain relief from symptoms and improve quality of life.

Elements of Psychotherapy

A variety of different kinds of psychotherapies and interventions have been shown to be effective for specific disorders. Psychotherapists may use one primary approach, or incorporate different elements depending on their training, the condition being treated, and the needs of the person receiving treatment.

Here are examples of the elements that psychotherapies can include:

Helping a person become aware of ways of thinking that may be automatic but are inaccurate and harmful. (An example might be someone who has a low opinion of his or her own abilities.) The therapist helps the person find ways to question these thoughts, understand how they affect emotions and behavior, and try ways to change self-defeating patterns. This approach is central to cognitive behavioral therapy (CBT).

• Identifying ways to cope with stress.
• Examining in depth a person’s interactions with others and offering guidance with social and communication skills, if needed.
• Relaxation and mindfulness techniques.
• Exposure therapy for people with anxiety disorders. In exposure therapy, a person spends brief periods, in a supportive environment, learning to tolerate the distress certain items, ideas, or imagined scenes cause. Over time the fear associated with these things dissipates.
• Tracking emotions and activities and the impact of each on the other.
• Safety planning can include helping a person recognize warning signs, and thinking about coping strategies, such as contacting friends, family, or emergency personnel.
• Supportive counseling to help a person explore troubling issues and provide emotional support.

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