Understanding Psychotherapy

• Psychotherapy is a treatment for psychological distress
• Aims to help individuals facing psychological problems
• Effectiveness depends on disorder severity, distress, and availability of resources like time and money
• Therapeutic approaches assist and correct issues, involving a relationship between therapist and client
• Approaches can be directive (psychodynamic) or non-directive (person-centered)

Nature and Process of Psychotherapy

• Psychotherapy relies on a voluntary therapeutic relationship to help clients resolve psychological challenges
• The relationship fosters trust, encouraging clients to openly discuss issues
• Goals: to change maladaptive behaviors, reduce distress, and enhance environmental adaptation
• Involves applying therapy principles, practiced only by trained and supervised individuals
• A confidential, interpersonal, and dynamic interaction between therapist and client
• Key objectives of psychotherapy: bolster client resolve, alleviate emotional strain, unlock positive growth, modify habits and thought patterns, improve self-awareness, and enhance interpersonal skills and communication

Therapeutic Relationship

• This relationship between client and therapist aims at partnership to aid the client in resolving problems
• Limited duration, lasting until the client can manage their issues independently
• Characterized by trust, encouraging clients to share personal and psychological issues
• Therapists show acceptance, empathy, genuineness, and warmth, offering unconditional positive regard
• Empathy means understanding another's feelings and perspective, enriching the therapeutic bond
• Therapists maintain confidentiality and professional boundaries, not exploiting the client's trust

Types of Therapies

• Therapies can be categorized into psychodynamic, behavior, and existential approaches
• Differing in their concepts, methods, and techniques, with psychodynamic therapy emerging first
• Classification is based on the causes of problems, their origins, treatment methods, therapeutic relationship, benefits, and duration.

Causes of Problems:

• Psychodynamic: Intrapsychic conflicts
• Behavioral: Faulty learning and cognitions
• Existential: Questions about life's meaning

Origin of Causes:

• Psychodynamic: Unfulfilled childhood desires
• Behavioral: Faulty conditioning and thinking
• Existential: Present feelings of loneliness and futility

Chief Method of Treatment:

• Psychodynamic: Free association and dream analysis
• Behavioral: Modifying conditioning patterns
• Existential: Facilitation of personal growth in a positive environment

Therapeutic Relationship:

• Psychodynamic: Therapist interprets client's thoughts
• Behavioral: Therapist discerns faulty behaviors
• Existential: Therapist provides a warm, empathic relationship.

Chief Benefit to the Client:

• Psychodynamic: Emotional insight
• Behavioral: Adaptive behavior
• Humanistic: Personal growth

Duration of Treatment:

• Psychodynamic: Several years to 10–15 sessions
• Behavioral and Existential: A few months

Formulation of a Client's Problem

• Clinical formulation helps the therapist understand the distress, identify treatment areas, and choose techniques
• The formulation identifies inability to assert oneself and heightened anxiety as target areas
• The choice of techniques depends on the therapist's training and the clinical formulation

Behaviour Therapy

• Psychological distress comes from faulty behavior or thought patterns
• Focuses on present behavior, correcting faulty patterns rather than reliving the past
• Learning theory principles guide the therapy, employing techniques based on clinical diagnosis
• Treats phobias differently than anger or depression
• Foundation is on formulating dysfunctional behaviors, reinforcing factors, and devising methods for altering them

Method of Treatment:

• Aims to analyze behavior patterns and antecedents/maintaining factors
• Malfunctioning behaviors cause distress and are predisposed by antecedent factors and are sustained by maintaining factors
• Antecedent operations manage behavior through changes preceding it
• Consequent operations involve methods for changing behavior

Behavioural Techniques:

• Reduce client arousal, alter behavior through conditioning, and use vicarious learning
• Negative reinforcement helps avoid painful stimuli
• Aversive conditioning pairs undesired responses with aversive consequences
• Positive reinforcement encourages adaptive behavior
• Token economy rewards wanted behaviour

Relaxation Procedures

• Anxiety increases arousal, triggering faulty behavior (e.g., smoking, overeating)
• Used to lower anxiety levels
• Progressive muscular relaxation involves tensing, then releasing muscle groups to induce relaxation

Differential Reinforcement

• This can decrease unwanted behavior and increase desired behavior together
• Positive reinforcement for wanted actions combined with negative reinforcement for unwanted ones
• Ignore unwanted behavior

Systematic Desensitization

• Technique to treat phobias involving eliciting fear-provoking situations
• Clients learn to manage anxiety by starting with the least anxiety-provoking stimulus

Reciprocal Inhibition

• Relaxation response is built up and a scary scene is imagined which causes anxiety
• Anxiety is overcome by the relaxation

Modelling

• Client can behave by observing behavior of a role model

Cognitive Therapy

• Locates the cause of psychological distress in irrational thoughts and beliefs
• Antecedent-Belief-Consequence (ABC) analysis involves noting antecedent events and irrational beliefs
• Therapist refutes irrational beliefs through non-directive questioning, changing the client's philosophy

Cognitive Distortions

• Childhood experiences shape core schemas
• Negative automatic thoughts and cognitive distortions result in anxiety and depression development
• These thoughts are characterised by negative automatic thoughts

Dysfunctional Cognitive Structures

• Cognitive restructuring reduces anxiety and depression
• Focuses on specific client problems

Cognitive Behaviour Therapy (CBT)

• Short, effective treatment for anxiety, depression, and panic
• Combines cognitive and behavioral techniques, addresses biological, psychological, and social factors

Humanistic-Existential Therapy

• Psychological distress arises from loneliness, alienation, and inability to find meaning
• Focuses on personal growth and emotional expression
• The therapist creates accepting environment
• The client initiates process of self-growth
• Fundamental assumption is that client has freedom to control their own behaviour

Existential Therapy

• Logotherapy is treatment for the soul

Logotherapy

• Meaning comes from finding life-affirming meanings and finding the spiritual truth of existence
• Helps patients find meaning and responsibility regardless of circumstances

Client-Centered Therapy

• A warm relationship where clients reconnect with feelings, with empathy from therapist
• Aim: to help clients become their real self

Gestalt Therapy

• Aims to increase self-awareness and acceptance
• Clients learn to recognize bodily processes and emotions

Factors Contributing to Healing in Psychotherapy

• Techniques and implementation
• Therapeutic alliance
• Catharsis, or emotional unburdening
• Non-specific factors related to patient and therapist variables

Ethics in Psychotherapy

• Informed consent, confidentiality, alleviating distress, integrity, and respect for rights/dignity

Alternative Therapies

• Treatment possibilities to conventional drug treatment or psychotherapy
• Yoga and meditation
• Ancient Indian Yoga details asanas, breathing and meditation practices
• Vipasana meditation involves observing bodily sensations and thoughts

Influence of SKY

• Breathing techniques induce hyperventilation
• Reduce depression of alcoholic patients
• Treats Insomnia

Kundalini Yoga

• Combines breathing techniques and mantra chanting
• Effective on patients with obsessive-compulsive disorder

Rehabilitation of the Mentally Ill

• Reduces symptoms
• Improves level of functioning or quality of life
• Helps patients become self-sufficient by occupational and social and vocational therapy
• Occupational therapy teaches candle making
• Social skills develops interpersonal skills
• Cognitive retraining improves attention and memory