In observance of May being Mental Health Month, this is one of my Dirty Dozen lectures. It’s on the elements that are shared among some of the important psychotherapy methods.
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Dirty Dozen on Common Elements of Psychotherapy by Jim Amos, MD
What is Psychotherapy?
-Change facilitation
-Self awareness development
-Doesn’t necessarily have to occur in formal therapy encounters
-Can happen between patients and a wide range of professionals
Patient Variables and Relationship Factors
-Ability to relate, psychological mindedness
-Therapeutic alliance
-Readiness to change
-Respect, listening for understanding
Placebo, Hope, and Expectancy Effects
-Power of providing a “treatment experience”
-An emotionally charged relationship in which therapy instills hope for change
-A particular set of procedures that enhance belief in the therapist’s competency
-A therapeutic explanation of the problems that fits the patient’s belief system
Motivational Interviewing
-Intended to raise patient’s awareness of ambivalence between opposing thoughts and behaviors
-Accepts the “yes, but” responses without confrontation
-Emphasizes validation, reflection, reframing
-Source: Miller, W. R. and S. Rollnick (1991). Motivational interviewing : preparing people to change addictive behavior. New York, Guilford Press.
Motivational Interviewing cont. Stages of Readiness to Change
-Precontemplation
-Contemplation
-Preparation
-Action
-Maintenance
-Termination
Cognitive Behavioral Therapy (CBT)
-Foci of treatment are internally based cognitions and challenging, unhelpful or harmful thoughts and behaviors.
-Time limited
Interpersonal Therapy (IPT)
-Focus on interpersonal communications with others
-Focus on helping improve communication and social support in the present
-Time limited
Psychodynamic Psychotherapy
-Focus of treatment is on understanding contributions of early life experiences to psychological functioning and unhelpful or harmful behaviors
-Can be lengthy or open-ended
Essential Operations of Psychodynamic Psychotherapy
-Accepting: Therapist affirms the patient’s past and present subjective experience
-Understanding: Therapist appreciates both the conscious and unconscious contributions to the patient’s emotional problems
-Explaining: Therapist expresses, through interpretations, his or her understanding to the patient
Integrating Therapies
-Skillfully staged combinations of approaches may be more successful than one used alone
-Cognitive behavioral or interpersonal approaches first for more immediate symptom relief
-Psychodynamic approaches first for increasing self-awareness and exploring the need for change
References
-Dewan, M. J., MD,, B. N. Steenbarger, PhD,, et al., Eds. (2004). The Art and Science of Brief Psychotherapies: A Practitioner’s Guide. Core Competencies in Psychotherapy. Washington, DC, American Psychiatric Publishing, Inc.
-Miller, W. R. and S. Rollnick (1991). Motivational interviewing : preparing people to change addictive behavior. New York, Guilford Press.
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