What Is Psychotherapy and How Exactly Does It Help?
Most people have heard the term “psychotherapy”, but don’t have an accurate concept of what it really is. Their ideas about it are formed by television shows instead of facts.
So what exactly is psychotherapy?
Psychotherapy aims to enable patients, or clients, to recognize both positive and negative feelings, and what triggers or situations can make them feel good, nervous, or depressed. This allows them to cope with difficulties in a more constructive way.
Most courses of therapy last less than a year, and clients who are excited to change and willing to work often report great outcomes.
Psychotherapy helps with a diverse set of problems, including depression and low self-esteem, addiction and family quarrels. Anyone overwhelmed by daily problems and an inability to cope can benefit from psychotherapy. Learn more about psychotherapy careers.
Types of Psychotherapy
At least 500 different types of psychotherapy exist, according to one estimate by University of Scranton psychologist John Norcross. Given the vast number, researchers can’t dedicate the time to investigate whether they are beneficial, so they focus on the most frequently used types.
As Scientific American noted:
These include behavior therapy (altering unhealthy behaviors), cognitive-behavior therapy (altering maladaptive ways of thinking), psychodynamic therapy (resolving unconscious conflicts and adverse childhood experiences), interpersonal therapy (remedying unhealthy ways of interacting with others), and person-centered therapy (helping clients to find their own solutions to life problems).
Let’s look at each of these in a bit more detail:
Behavioral therapy shows clients how changes in their behavior will create changes in their feelings. BT focuses on growing a person's engagement with positive activities.
The main goal is to replace undesirable behaviors with desirable behaviors, and the therapy is very useful for clients whose emotional distress comes from behaviors that repeatedly engage in.
Cognitive therapy is based on the notion that what and how we think influences how we feel. One example of a condition that cognitive therapy addresses is depression.
Depression is a disorder that may come from thoughts or beliefs not based on evidence, like, "I am useless," or, "Everything goes wrong because of me." This is often called negative self-talk.
Changing or eliminating negative self-talk can change a person's perspective of everyday living and their ongoing emotional well-being. Cognitive therapy can also be used to treat conditions such as post-traumatic stress disorder (PTSD).
Cognitive behavioral therapy (CBT) joins cognitive and behavioral therapy to help with both negative feelings and negative behaviors.
Interpersonal therapy focuses on the client’s interpersonal relationships.
Depression, in some cases, may be the result of a person's negative or toxic relationships with others. Learning to improve communication patterns may help a person manage and even move past their depression.
For example, if a client can learn to express their pain and anxiety calmly to another person, this can increase the chances of the other person reacting well. When the client learns to adjust the way they handle interpersonal problems, understand them, and manage them, he or she will see improvement in their relationships.
Some conditions may require treatment of the entire family - a couple with marital problems, for example. Recognizing family patterns that contribute to behavior problems or mental disorders can help members of a family to change negative patterns or habits.
Family therapy most frequently focuses on better communication between family members. Clients learn more constructive ways of listening and how to avoid being defensive during discussions or arguments. Learn more about MFT careers.
Group therapy sessions usually bring together half a dozen to a dozen clients and one therapist. The participants usually face similar challenges, and they benefit interacting with the therapist and by seeing how others in the group handle the same issues.
Gathering comments from other people with the same issues can give clients a new perspective and help them improve. Group therapy is also useful for those who may feel isolated because of their issue.
Psychodynamic therapy is focused on the deep-rooted causes of behavior. For example, behaviors based in a person's upbringing or earlier life experiences that keep impacting present-day behavior.
The goal is to find and embrace self-awareness and understanding of how past events affect present behavior. This can help people to understand the source of their emotional distress, usually by exploring motives, needs, and defenses that they are not aware of.
How Talk Therapy Usually Works
Psychotherapy is often called a "talking treatment" because it uses talking exclusive of medication.
While psychotherapy can take up to a year for a course of treatment, some clients only need a few sessions to address a specific issue. Sessions last from forty-five minutes to an hour, once weekly, and they follow a carefully structured process.
Sessions can be one-on-one, with couples, or with groups. Techniques vary and may include other forms of communication, like dramatization, narrative story-telling, or music and dance.
In long-term psychotherapy, there is a of getting-to-know-you process with the psychologist, and the treatment specialist may want to do some general assessment. These assessments may help them identify general problems, which can then guide treatment.
You and your psychologist explore your issues through talking. For some clients, just talking freely about an issue is relief itself. As you begin treatment, the psychologist will help you understand what’s upsetting you.
After assessment is the problem-solving phase. You will work with your therapist to find different ways of behaving, thinking and managing your feelings. A therapist might encourage role-playing new behaviors during sessions and assign homework to practice new skills.
It is possible that your psychologist might suggest bringing in others. If you’re having relationship problems, having a spouse or friend join you can be helpful. Similarly, an person with parenting struggles might want to bring his or her child in.
Slow resolution of the problem is the goal of psychotherapy. Part of this resolution is learning coping skills. You’ll learn to distinguish between situations you can’t change and those you can. You will use this to focus on fixing things only within your control.
Benefits of Psychotherapy
Every patient or client will derive different benefits from psychotherapy based on their individual diagnoses and treatment plans.
One of the primary benefits of psychotherapy is giving clients a person to talk to. Working with someone can help you find a new way of looking at issues, and help you work for a solution.
Clients gain a better understanding of themselves, their goals and values, and helps them develop skills to improve relationships.
Short-term or long-term therapy can help individuals overcome specific problems, such as a phobia or an eating disorder.
But, if psychotherapy is going to work, the client must be engaged and work hard during the session as well as between sessions.
Hundreds of studies have found that psychotherapy helps people make positive changes in their lives.
These studies show that about 75 percent of people who engage in psychotherapy receive at least some benefit.
Psychotherapy can help you handle emotions from problems or triggers, even if they aren’t traumatic or life-altering.
It can also offer unique problem-solving methods that can help you cope with depression, anxiety and addiction.
A person doesn’t have to go through something life-altering to gain the benefits of therapy. Meeting with a therapist allows you to see how you seem to other people, gets you feedback on your feelings and offers awareness of how negative emotions are affecting your life.
Therapy can help you create a strategy to handle hardships. Talking with a therapist lets you look at any issue from a different angle.
When Psychotherapy Can be Ineffective
Although research exists in the benefits of psychotherapy, there is not enough evidence to confirm that any and all psychotherapy is helpful.
In fact, there are some professionals who suggest that certain types of psychotherapy can be harmful. Scott Lilienfeld, professor of psychology at Emory University, wrote in the journal Perspectives on Psychological Science, “...it should be possible for the field to agree that treatments that potentially cause harm ‘should be avoided, or in the case of treatments that yield both positive and negative effects, implemented only with caution’.”
Among these potentially harmful treatments are facilitated communication, critical incident stress debriefing, boot camps for conduct disorder, recovered-memory techniques, dissociative identity disorder-oriented psychotherapy, attachment therapy, grief counselling during normal bereavement and expressive-experiential psychotherapies.
However, how much evidence is necessary before a treatment approach is listed as harmful?
Peter Fonagy, professor of clinical psychology at UCLA and a practicing psychoanalyst, says this is a, “complex problem”, and he cautions that while the idea of banning harmful treatments is welcome in principle, “...you’ve got to be very, very careful that you specify in what groups a treatment is causing harm, and that the trial this is based on was as rigorously carried out as it would be for evidence-based treatments’.”
While there are some who say that there are certainly some harmful types of psychotherapy, the general consensus is that mainstream psychotherapy treatments do offer hope to those with issues or disorders.
If you’re struggling with depression, anxiety, addiction, grief, PTSD, or any other struggle, psychotherapy can be an effective tool in helping you cope and move forward.