This document provides an overview of supportive therapy. Supportive therapy helps patients relieve emotional distress and symptoms without delving into past issues or personality changes. It is used to treat conditions like schizophrenia, personality disorders, anxiety, PTSD, eating disorders, substance abuse, and psychosis. The therapist establishes a relationship with the patient and uses techniques like ventilation, environmental manipulation, persuasion, and reassurance. Supportive therapy involves assessment, relationship building, working through problems, and preparing the patient to end treatment. Family and marital therapy views individual symptoms as related to family issues and aims to treat the family system. It uses assessment, skills training, and various models like individual, conjoint, couples, group, and network therapy.

1. SUPPORTIVE THERAPY
PREPARED BY
Mrs. Divya Pancholi
M.Sc. (Psychiatric Nursing)
Assistant Professor
SSRCN, Vapi

2. INTRODUCTION
Lawrence Rockland described ‘supportive
therapy. It is widely used in hospital and in
community setting.
In this therapist, helps the patient to relieve
emotional distress and symptoms without
probing into past and changing the personality.

3. INDICATION
Schizophrenia
Borderline personality
disorders
Anxiety
Post-traumatic stress
Eating disorders
Substance abuse
Psychosis
Crisis situations


4. PRINCIPLES
Patient therapist relationship has to be established
The setting from supportive therapy has to allow for activity
This therapy will be used as adjunct to other therapies
Involvement of family and social support systems
It focuses on present problems of the patient and immediate help has
to be provided
Supportive measures and problem solving approaches in the
therapeutic sessions has to be provided like, advice, limit setting,
environmental manipulation and counselling.

5. TECHNIQUES
Ventilation: It is a free expression of feelings or emotions.
Patientis encouraged to talk freely whatever comes to his mind.
Environmental modification/manipulation: improving the well-
being of mental patients by changing their living condition.
Persuasion: Here the therapist attempts to modify the patient’s
behavior by reasoning.
Reeducation: Education to the patient regarding his problems,
ways of coping, etc.
.

6. CONTI….
Reassurance: Reassurance is used to dispel apprehension and restore
confidence and to promote hope. However care should be taken against
offering false reassurance and providing it prematurely even before the
patient has fully opened up.
Explanation: the explanation of the nature of symptoms and their causes is
done by the therapist during the therapy. The choice of treatment and the
likely outcome are explained to the patient.
Guidance: guidance involves offering direct advice on handling particularly
difficult situation in the real life of the patient. He may be advised on how
and when he should seek help in future. Suggestion involves advising in an
indirect manner

7. PHASES OF THERAPY
Initial phase:
It focused on assessment and relationship formation. Assessment
encompasses full physical and psychiatric evaluation including level of
motivation, the patient’s strengths and weaknesses. The therapist should
be able to empathize with the patient in order to understand him better.
Working phase
It involves intense therapeutic activity and there is a further exploration of
the patient’s problems and life situations. The various therapeutic
techniques are applied and attempts are made to give the patient an
insight into his problems.

8. Terminal phase
This phase is intended to strengthen the
patient’s improvement and to prepare him to
end his treatment.

9. ROLE OF THERAPIST
The therapist has to possess specific qualities like empathy,
concern, non-judgmental, acceptance, willingness, genuine
interest, respect
Therapist will play an active directive and supportive role,
helps the client to improve social functioning and coping
skills
Therapist will promote two way communication process by
encouraging the client to talk more about his life events

10. CONTI…
Motivates the client autonomy to opt treatment modality
and life decisions.
Identifies the patient’s strength, abilities and coping skills
Helps them to utilize bio psychosocial coping resources to
achieve independent living skills
Tries to reduce the client’s subjective feelings, distress and
maladaptive coping responses.

11. FAMILY AND MARITAL THERAPY
DEFINITION
Family therapy is the branch of psychiatry which sees
an individual’s psychiatric symptoms as inseparably
related to the family in which he lives.
AIM:
Main aim of the treatment is not the individual, but
the family.

12. INDICATIONS
Whenever there are relational problems within a family or marital unit,
which can occur in almost all types of psychiatric problems including
Psychosis
Depression
Anxiety disorders
Psychosomatic disorders
Substance abuse
Various childhood psychiatric problems.

13. PATIENT SELECTION
Families may be referred for treatment by private
physicians, and agencies such as the school system, welfare
board, parole officers, and judges
Some families are referred for therapy from emergency
room psychiatric services after a visit caused by a crisis in
the family, such as drug overdose.
On discharge form a psychiatric hospital, a patient and his
family may be referred for family therapy, as part of follow
up services.

14. CONTI….
Family therapy is the treatment of choice when there is a
marital problem or sibling conflict, family therapy may also
be indicated when problems are caused by using one child
as a scapegoat.
Situational crisis, such as the sudden death of a family
member, and malnutritional crisis such as birth of a first
child, may cause sufficient stress to warrant family therapy.

15. COMPONENTS OF THERAPY
Assessment of family structure, roles, boundaries,
resources, communication patterns and problem solving
skills
Teaching communication skills
Teaching problem solving skills
Writing a behavioral marital contract
Homework assignments

16. TYPES OF FAMILY THERAPY
Individual family therapy
Conjoint family therapy
Couples therapy
Multiple family group therapy
Multiple impact therapy
Network therapy

17. Individual family therapy:
In individual family therapy each family
member has a single therapist. The whole
family may meet occasionally with one or
two of the therapists to see how the
members are relating to one another and
work out specific issues that have been
defined by individual members.

18. Conjoint family therapy:
The most common type of family therapy is the
single-family group, or conjoint family therapy. The
nuclear family is seen, and the issues and problems
raised by the family are the ones addressed by the
therapist. The way in which the family interacts is
observed and becomes the focus of therapy. The
therapist helps the family deal more effectively with
problems as they arise and are defined.

19. Couples therapy:
Couples are often seen by the therapist together. The
couple may be experiencing difficulties in their marriage,
and in therapy they are helped to work together to seek a
resolution for their problems. Family patterns, interaction
and communication styles, and each partner’s goals, hopes
and expectations are examined in therapy. This examination
enables the couple to find a common ground for resolving
conflicts by recognizing and respecting each other’s
similarities and differences.

20. Multiple family group therapy:
In this therapy, four or five families meet weekly to confront and
deal with problems or issues they have in common. Ability or
inability to function well in the home and community, fear of
talking to or relating to others, abuse, neglect, the development
of social skills, and responsibility for oneself are some the issues
on which these groups focus.
The multiple family group becomes the support for all the
families. The network also encourages each person to reach out
a form new relationships outside the group.

21. Multiple impact therapy:
In this therapy, several therapists come together with the
families in a community setting. They live together and deal
with pertinent issues for each family member within the
context of the group.
Multiple impact therapy is similar to multiple family group
therapy except that it is more intense and time limited. Like
multiple family group therapy, it focuses on developing skills
or working together as a family and with other families.

22. Network therapy:
Network therapy is conducted in people’s homes. All individuals
interested or invested in a problem or crisis that a particular person
or persons in a family are experiencing take part.
This gathering includes family, friends, neighbors, professional
groups and anyone in the community who has and investment in the
outcome of the current crisis. The rewards are great when all the
people involved mobilize energy for management of the problem.
The power is in the network itself. The answers to each problem
come from the network and how people in the network decide to
manage each issue as it rises.