Psychotherapy

By Dr Tony Fiore, Ph.D.

Millions of Americans have found relief from depression and other emotional difficulties through psychotherapy.

What does research show about the effectiveness of psychotherapy?

How can I evaluate whether therapy is working well?

What Is Therapy?
Psychotherapy is a partnership between an individual and a professional such as a psychologist who is licensed and trained to help people understand their feelings and assist them with changing their behavior.

According to the National Institute of Mental Health, one-third of adults in the United States experience an emotional or substance abuse problem.

Research suggests that therapy effectively decreases patients' depression and anxiety and related symptoms -- such as pain, fatigue and nausea.

Psychotherapy has also been found to increase survival time for heart surgery and cancer patients, and it can have a positive effect on the body's immune system.

Research increasingly supports the idea that emotional and physical health are very closely linked and that therapy can improve a person's overall health status.

There is convincing evidence that most people who have at least several sessions of psychotherapy are far better off than untreated individuals with emotional difficulties.

You may need to adjust your goals depending on how long you plan to be in psychotherapy.

Patients often feel a wide range of emotions during psychotherapy.

Some qualms about psychotherapy that people may have result from the difficulty of discussing painful and troubling experiences.

Explanations of Some Therapy Styles and Theoretical Orientations:

Behavior Therapy: Founded on the belief that true change and movement towards goals is accomplished through action and that disorders are learned ways of behaving that are maladaptive. If we can learn to change our behavior, then our thoughts, feelings, and attitudes will also change. Common behavioral techniques include systematic desensitization (gradual exposure to an anxiety-provoking situation paired with relaxation), using reinforcements for desired behaviors, and aversion therapy to extinguish unwanted behaviors. It is often used also to teach parents how to manage behavior of their children by a system of rewards and consequences for behavior.

Biofeedback: Use of electronic systems to monitor internal processes such as heart rate, brain waves, or perspiration to help an individual become aware of their physiological responses and learn to have more control over them. It is often used to treat stress-related conditions. A variant, called neurofeedback teaches patients to control brain wave patterns which is sometimes useful in treating ADHD and other conditions.

Cognitive Therapy. The word "cognitive" or "cognition" means "to know" or "to think". Therefore, cognitive therapy is viewed as a "psychological treatment of thoughts." Simply, cognitive therapy operates under the assumption that thoughts, beliefs, attitudes and perceptual biases influence what emotions will be experienced and also the intensity of those emotions. Cognitive Therapy was pioneered by Aaron Beck, M.D. for the treatment of depression. Dr. Beck and other researchers have developed methods for applying cognitive therapy to other psychiatric problems, such as panic, anger control problems and substance abuse.

A variant is "Rational Emotive Therapy" which is based on the belief that our emotions result from our beliefs, interpretations and reactions to life events. Founder: Albert Ellis is known as the father of RET and the grandfather of cognitive-behavioral therapy.

EMDR (Eye Movement Desensitization & Reprocessing) Technique of restructuring thought patterns and associations related to traumatic events and memories and other sources of emotional distress. Method was developed by Francine Shapiro when she discovered that rapid-eye movements combined with focusing on disturbing thoughts and memories produced a calming effect.

Existential: A philosophy of life, rather than a specific therapy, which focuses on free will, responsibility for choices, and search for meaning and purpose through suffering, love, and work. People are seen as constantly changing and becoming their true selves. Searching within and finding one's own answers is encouraged. Emphasis is on the present and future, not the past. See works by Viktor Frankl (b.1905), Rollo May (b.1909), and Irvin Yalom.

Family Systems: Therapy which looks at the entire family as a complex system having its own language, roles, rules, beliefs, needs, and patterns. Each family member plays a part in the system and family systems therapy helps an individual discover how their family operated, their role in the system, and how it affects them in their current family and in relationships outside the family.

Gestalt: Experiential therapy emphasizing what is happening in the here and now to help individuals become more self-aware and learn responsibility for and integration of thoughts, feelings, and actions. A goal is to develop more internal vs. external support. Techniques include confrontation, role playing, and the empty-chair or dialogue between two parts of a personality. Founder: Frederick S. (Fritz) Perls (1893-1970) who believed that people must find their own way in life and accept responsibility for who they are to reach maturity.

Solution-Focused Treatment begins from the observation that most psychological problems are present only intermittently.: begins from the observation that most psychological problems are present only intermittently. People with panic disorder obviously do not spend every minute of every day in a panic; even depression fluctuates in severity. Solution-focused therapy tries to help the patient notice when symptoms are diminished or absent and use this knowledge as a foundation for recovery. If a patient insists that the symptoms are constant and unrelieved, the therapist works with him or her to find exceptions and make the exceptions more frequent, predictable, and controllable. In other words, therapy builds on working solutions already available to the patient.