psychotherapy-definition- objectives and types of psychotherapies used in psychiatry to treat or to help the client with their problems.

1. ASSIGNMENT ON
PSYCHOTHERAPY…
presented by : Sonali Katoch
M.Sc. Nursing
(1st year)

2. Introduction
A process which attempts to help the patient relieve
symptoms, resolve problems or seek personal
growth through a structured relation ( i.e. specified
goals and methods) with a trained professional
therapist .
The therapist may be a psychiatrist, a psychologist, a
nurse etc.

3. Definition...
• Psychotherapy has been referred to as a
systemic treatment primarily employing verbal
communication as the means of treatment
aimed at relieving the patients symptoms and
helping him to understand and modify his
conduct so as to lead a well adjusted life.

8. Individual psychotherapy
• Individual psychotherapy is a method of
bringing about change in a person by
exploring his or her feelings, attitudes,
thinking and behavior.
• Such therapy helps to:
• Understand themselves and their behavior.
• Make personal changes.
• Improve interpersonal relationships.

9. Individual psychotherapy
• Indications…
Stress related disorders, alcohol and
drug dependence , sexual disorders and marital
disharmony.
Approaches…
4 main approaches are:
Psychodynamic therapy
Humanistic therapy
Behavior therapy
Cognitive therapy

10. Psychodynamic(Expressive) therapy
• A group of deep therapies that aim at
symptom resolution as well as producing
positive fundamental changes in the patients
character or personality’

11. Types of psychodynamic therapy
• Psychodynamic psychotherapy includes a
variety of models , e.g.
• Classical psychoanalysis
• Psychoanalytic oriented models
• Short term models
• Object relation
• Self psychology models etc…

14. Supportive psychotherapy
• In this therapy , the therapist helps the patient to
relive emotional distress and symptoms without
probing into the past and changing the personality
.
• Aims..
• Relive symptoms and resolve problems.
• Regain equilibrium and maintain stability.
• Achieve better adaptation, coping and functioning.

15. Supportive psychotherapy
• Indication…
Crisis, acute distress or acute adjustment
disorders.
Chronic or handicapped patients (e.g. chronic
schizophrenia, mood or personality disorders).
Patients who do not need (not motivated) or not
fit (lacking ego strength or intellectual ability)
for deeper expressive therapy.

16. Techniques of supportive
psychotherapy
• Establishing an emphatic understanding relation
(therapeutic alliance).
• Active listening (empathic).
• Reassurance and encouragement.
• Suggestion, advice and persuasion.
• Clarification and explanation (education), e.g., as regards
symptoms, interpersonal problems and ways of coping.
• Strengthening useful defenses.
• Suppression of unwanted conflicts.
• Environmental manipulation and modification.
• Help in improving insight.

17. Supportive psychotherapy
• Duration
According to the patient need, it could be a
single session or prolonged to many years.
• Format
It is usually individual but can be used in all
formats.
• Complication
Mainly dependency on therapist.

19. Cognitive therapy
• Cognitive therapy is a psychotherapeutic
approach based on the idea that behavior is
secondary to thinking . It focuses on how
patients think about themselves and their
world , make change in current ways of
thinking and behavior.

20. Cognitive therapy
• Techniques
Techniques for stopping intrusive cognition.
Techniques to counterbalance faulty cognition.
Techniques for altering cognitions.
Techniques to resolve problems directly.
• Indications
Anxiety , eating disorders.
Personality disorders.
Suicidal thoughts or attempts.
Sexual disorders.

21. Cognitive behavioral therapy
• Based on the theory that a person’s affect and
behavior are largely determined by the way in
which he cognitively structures and interprets the
world ( cognitive schemata developed from
previous experience).
• Aim
To identify and correct cognitive distortions
and the result from them.
through a combination of verbal and behavior
modification techniques.

23. Family and marital therapy
• Family therapy is that branch of psychiatry
which seems an individual’s psychiatric
symptoms as inseparably related to the family
in which he lives.
• Thus, the focus of treatment is not the
individual , but the family.
• Marital therapy is focused on the relationship
rather then any of the individual partners.

24. Family and marital therapy
• Indications…
relational problems within a family or
marital unit, which can occur in almost all types
of psychiatric problems, including psychosis,
reactive depression, anxiety disorders,
psychosomatic disorders, substance abuse and
various childhood psychiatric problems.

25. Family and marital therapy
• Types of therapy…
Individual family therapy
Conjoint family therapy
Couple therapy multiple family group therapy
Multiple impact therapy
Network therapy

27. Group psychotherapy
• A form of therapy in which therapeutic
changes occur as a result of the interactions of
patients with other patients and at least one
trained professional therapist in a group
setting.

28. Group psychotherapy
• Selection
• Homogeneous groups
• Adolescents and patients with personality
disorders
• Families and couple where the system needs
change.
• Group size
optimal size for group therapy is 8 to 10
members.

29. Group psychotherapy
– Indications
• All most all diagnoses except:
Acute manic or
Acute psychotic episodes and
Antisocial personality disorder
• Frequency and length of sessions:
Most group psychotherapists conduct group
sessions once week; each session may last foe
45 min to 1 hr.

30. Group psychotherapy
• Therapeutic factors involved :
• Sharing experience
• Support to and from group members
• Socialization
• Imitation
• Interpersonal learning

31. Behavior therapy
• It is the form of treatment for problems in
which a trained person deliberately establish a
professional relationship with patient, with
the objective of removing or modifying
existing symptoms and promoting positive
personality , growth and development.

32. Behavior therapy
Behavior therapy involves identifying
maladaptive behavior and seeking to correct
these by applying the principle of learning
derived from the following theories:
• Classical conditioning model by Ivan
pavlov(1936)
• Operant conditioning model by BF
Skinner(1953)

33. Behavior therapy
• Behavior therapy is a short duration therapy,
therapists are easy to train and it is cost
effective. The total duration of therapy is
usually 6-8 weeks.
• Initial session are given daily, but the later
session are space out .

34. Behavior therapy techniques
1.Systematic desensitization
2.Graded exposure
3.Flooding
( the above techniques are useful in phobic, and obsessive compulsive
disorders and some sexual disorders)
4. Aversive conditioning
e.g. in treating alcoholism ( disulfiram)
5. Positive reinforcement
( chronic patient e.g. schizophrenia , autistic disorder and M.R.)
6. Participant modeling
7. Shaping
8. Chaining
9. Timeout
10. Assertiveness and social skill training

36. Rehabilitation therapy
• It is management of disability and handicaps
resulting from psychiatric disorder conducted
by trained therapists.
• It is particularly important in chronic
psychiatric disorders (such as chronic schizophrenia
and mood disorders)

37. Rehabilitation therapy
• Aiming to improve the patient’s performance
in different domains including:
• personal hygiene and self care skills.
• Interpersonal and social skills.
• Vocational (work) and educational skills
(occupational therapy).
• Recreation and activity therapies, e.g., art,
music, sports, celebration of social events, etc.

38. Milieu therapy
• An environment that is structured to assist
patients to:
• Control and modify maladaptive behaviors.
• Promoting adaptive psychosocial skills in
coping with the self, others and the
environment.

39. Milieu therapy
• The focus is on social relationship as well as
occupational and recreational activities.
• To achieve its goal it uses different
therapeutic modalities particularly:
1. Group therapies.
2. Different rehabilitative techniques.
3. Structured activities of daily living for all
patients.

41. Relaxation therapies
• Relaxation produces physiological effects
opposite those of anxiety:
slowed heart rate , increased
peripheral blood flow and neuromuscular
stability. There are many methods which can
be used to induce relaxation.

42. Relaxation therapies
• Therapies are:
• Progressive muscular relaxation
• Mental imagery
• Yoga
• Meditation

43. Cont…..
• Biofeedback
• Physical exercise
• Deep breathing exercise
• Psycho education

44. Other psychotherapies
• Play therapy

45. Other psychotherapies
• Music therapy

46. Other psychotherapies
• Dance therapy

47. Other psychotherapies
• Recreational therapy etc….
These therapies are suggested for :
• Anxiety disorder
• Depressive disorder
• Manic disorder
• Schizophrenia
• Dementia
• Childhood and adolescent disorders
• Mental retardation

48. Major psychiatric disorders and related
complimentary and alternative
therapies

49. Role of nurse in psychological
therapies
• The nurse has an important role in enhancing the
therapeutic effects of activity therapies. Some
points to be keep in mind are:
• Close co-ordination between the nursing staff
and the activity therapy department is essential
• By engaging in these activities, the nurse not only
has an opportunity to support the therapeutic
efforts of the recreational therapist but also has
an invaluable opportunity to observe the patient
in different settings.

50. Role of nurse in psychological
therapies
• Through her observation of the patient’s
behavior during these activities, the nurse
gains valuable information that she can
subsequently utilize to therapeutic advantage
in the working phase of the nurse patient
relationship.

51. Conclusion
• Psychotherapy is a collaborative treatment
based on the relationship between an individual
and psychologist. Grounded in dialogue, it
provides a supportive environment that allows
you to talk openly with someone who’s
objective, neutral and non judgmental. You and
your psychologist work together to identify and
change the thought and behavior pattern that
are keeping you from feeling your best.

52. Conclusion
• Psychotherapy is also called as talk therapy,
therapy or counseling … is a process focused on
helping you heal and learn more constructive
way to deal with the problems or issues within
your life.

53. Bibliography
• Sreevani R. A guide to mental health and
psychiatric nursing. 4th edition new delhi:
jaypee brothers medical publishers(P) ltd.
Page no. 141-163 .
• Townsend C. Mary. psychiatric mental health
nursing. 6th edition. Publisher, nursing: Robert
G. Marton , 2009. page no. 195-199, 292, 583-
586.

54. References…
• www.slideshare.com
• www.psychiatry.org
• www.medicalcalnewstody.com
• www.webmd.com