Psychotherapy

“Such is the force of Happiness–
The Least can lift a ton
Assisted by its stimulus.”

—Emily Dickinson

Definition

Psychotherapy is a general term for a process of treating mental and emotional disorders by talking about your condition and related issues with a mental health provider.

During psychotherapy, you learn about your condition and your mood, feelings, thoughts and behavior. Using the insights and knowledge you gain in psychotherapy, you pick up healthy coping skills and stress management. Psychotherapy often can be successfully completed in just a few months, but in the case of a severe mental illness, long-term treatment may be helpful.

There are many specific types of psychotherapy, each with its own approach to improving your mental well-being. The type of psychotherapy that’s right for you depends on your individual situation. Psychotherapy is also known as talk therapy, counseling, psychosocial therapy or, simply, therapy.

Why it’s done

Psychotherapy is one of many effective ways to treat a wide range of mental illnesses and life stressors.

When to consider psychotherapy

Psychotherapy may be used because:

• It’s your preferred treatment choice
• You don’t want to take psychiatric medications
• You’ve tried other treatments and they haven’t worked
• Other treatments aren’t appropriate for your situation — for instance, you can’t tolerate the side effects from antidepressants
• You want to experience emotional growth and healing
• You’re having a hard time overcoming negative moods and self-destructive behavior
• You want to prevent a relapse of your condition after stopping other treatment

Conditions and issues psychotherapy may help

Conditions and problems that may benefit from psychotherapy include, but aren’t limited to:

• Grief
• Anger
• Abuse
• Medical illnesses, such as diabetes
• Relationship problems
• Sleep disorders
• Work problems
• Sexual disorders
• Depression
• Bipolar disorder
• Anxiety disorders
• Phobias
• Eating disorders
• Substance abuse disorders
• Personality disorders

In severe cases, psychotherapy may be more effective when it’s combined with other treatments, such as psychiatric medications.

Risks

In general, there’s little risk in using psychotherapy. Because psychotherapy can explore painful feelings and experiences, though, you may feel emotionally uncomfortable at times. Some forms of psychotherapy, such as exposure therapy, may require you to confront situations you’d rather avoid — such as airplanes if you have a fear of flying. This can lead to temporary distress or anxiety. But the coping skills you learn should help you later on to manage and conquer distressful feelings and thoughts.

How you prepare

You might decide on your own that you want to try psychotherapy, or a doctor, relative, friend, employer or someone else may suggest psychotherapy to you. In any case, consider these points to prepare for starting psychotherapy:

• Find a therapist. You can find a therapist on your own — looking through the phonebook, for instance — or you can get a referral from a doctor, health insurance plan, friend or other trusted source.
• Understand the costs. If you have health insurance, contact your health plan to be sure you understand what coverage it offers for psychotherapy treatment. Some health plans cover only a certain number of psychotherapy sessions per year. Also, talk to your therapist about fees and payment options.
• Review your issues. Before your first appointment, spend some time thinking about what issues you’d like to work on. While you also can sort this out with your therapist, having some sense in advance may provide a starting point.

What you can expect

Starting psychotherapy

Usually you’ll go to a therapist’s office for psychotherapy sessions. A therapist may have an office in a medical clinic, an office building or even a private home. Psychotherapy also can take place in a hospital, if you’ve been admitted for treatment. You usually meet with your therapist once a week for a session that lasts about 45 to 60 minutes.

Your first psychotherapy session is usually a time for the therapist to gather information about your situation. The therapist may ask you to fill out forms about your current and past physical and emotional health. All of this information helps the therapist gain a deeper understanding of your situation and whether you might benefit from combination treatment, such as medications. It might take a few sessions for a full evaluation of your situation and issues.

At any time during therapy, especially in the beginning, feel free to ask the therapist questions about his or her approach, the goals of your treatment, how long therapy may last, when and how to contact your therapist during a crisis, and other details about your therapeutic relationship. Know that in general, conversations with your therapist are confidential. However, there are certain situations in which a therapist may be required by law to report any concerns to authorities. Talk to your therapist about any worries you might have about confidentiality.

Types of psychotherapy

Some therapists are trained to provide several types of psychotherapy. Your therapist evaluates your situation to determine which may be best for you, along with any preferences you may have.

Common types of psychotherapy include:

• Art therapy, also called creative art therapy, uses the creative process to help express thoughts and feelings and may include music, dance and movement, drama, drawing, painting, and poetry.
• Behavior therapy focuses on changing unwanted or unhealthy behaviors, typically using a system of rewards, reinforcements of positive behavior and desensitization.
• Cognitive therapy is designed to help you identify and change distorted thought (cognitive) patterns that can lead to feelings and behaviors that are troublesome, self-defeating or self-destructive.
• Cognitive behavioral therapy combines features of both cognitive and behavior therapies to help you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones.
• Dialectical behavior therapy is a type of cognitive behavioral therapy whose primary objective is to teach behavioral skills to help you tolerate stress, regulate your emotions and improve your relationships with others.
• Exposure therapy is a form of behavior therapy that deliberately exposes you to the very thing that you find upsetting or disturbing to help you learn to cope effectively with it.
• Family therapy helps families or individuals within a family understand and improve the way family members interact with each other and resolve conflicts.
• Group therapy brings together a small group of people facing a similar illness or situation for discussion facilitated by a qualified leader or mental health provider.
• Interpersonal therapy focuses on your current relationships with other people to improve your interpersonal skills — how you relate to others, including family, friends and colleagues.
• Marriage counseling, also called couples therapy, gives partners — married or not — the tools to communicate better, negotiate differences, problem solve and even argue in a healthier way.
• Play therapy, geared mainly for young children at specific developmental levels, uses a variety of play techniques to encourage children to more easily express emotions and feelings if they’re unable to do so with words.
• Psychoanalysis is an in-depth, Freudian-based therapy that guides you to examine memories, events and feelings from the past to understand current feelings and behavior.
• Psychodynamic psychotherapy, based on the theories of psychoanalysis, focuses on increasing your awareness of unconscious thoughts and behaviors, developing new insights into your motivations, and resolving conflicts to live a happier life.
• Psychoeducation teaches you — and sometimes family and friends — about your illness, including treatments, coping strategies and problem-solving skills.

During psychotherapy

For most types of psychotherapy, you and your therapist generally sit facing each other during sessions. Your therapist encourages you to talk about your thoughts and feelings and what’s troubling you. Don’t worry if you find it hard to open up about your feelings. Your therapist can help you gain more confidence and comfort.

Sometimes a therapist may ask you to do “homework” — activities or practices that build on what you learn during your regular therapy sessions. Over time, discussing your issues can help improve your mood, change the way you think and feel about yourself, and improve your ability to cope with problems.

Because psychotherapy sometimes involves intense emotional discussions, you may find yourself crying, upset or having an angry outburst during a session. You may also feel physically exhausted after a session. Your therapist is there to help you cope with such feelings and emotions.

How long you have psychotherapy depends on your situation. In some cases, you may need therapy for only a few months. In other cases, you may continue therapy for a year or even more.

Length of psychotherapy

The number of psychotherapy sessions needed per week and the length of therapy depend on such factors as:

• The type of disorder or situation
• How severe your symptoms are
• How long you have had your symptoms or have been dealing with your situation
• How quickly you make progress
• How much stress you’re experiencing
• How much support you receive from family members and others

Results

Psychotherapy may not cure your condition or make an unpleasant situation go away. But it can give you the power to cope in a healthy way and to feel better about yourself and your life.

Benefits of psychotherapy

Psychotherapy can help you:

• Gain better understanding of your condition or situation
• Identify and change behaviors or thoughts that negatively affect your life
• Explore relationships and experiences
• Find better ways to cope and solve problems
• Learn to set realistic goals for your life
• Feel better about yourself

Getting the most out of psychotherapy

Psychotherapy isn’t effective for everyone. But you can take steps to get the most out of your therapy and help make it a success, including:

• Approach therapy as a partnership. Therapy is most effective when you’re an active participant and share in decision making. Make sure you and your therapist agree about the major issues and how to tackle them. Together, you can re-evaluate progress and goals over time.
• Be open and honest. Success with psychotherapy depends on your willingness to share your thoughts, feelings and experiences, and on being open to new insights and ways of doing things. If you’re reluctant to talk about certain things because of painful emotions, embarrassment or fears about your therapist’s reaction, let your therapist know.
• Stick to your treatment plan. If you feel down or lack motivation, it may be tempting to skip psychotherapy sessions. Doing so can disrupt your progress. Try to attend all sessions and to give some thought to what you want to discuss. Be honest with your therapist if you have reservations about therapy.
• Don’t expect instant results. Working on emotional issues can be painful and may require hard work. It’s not uncommon to feel worse during the initial part of therapy as you begin to confront past and current conflicts. You may need several sessions before you begin to see improvement.
• Do your homework between sessions. If your therapist gives you work outside of your regular therapy sessions, be sure to do it. Doing these homework assignments is important because they help you apply what you’ve learned in the psychotherapy sessions.
• Make sure you feel comfortable with your therapist. Successful psychotherapy depends on a good relationship between you and a therapist you trust. Talk to your therapist if any part of your therapy troubles you. If you’re still uncomfortable, consider finding another therapist with whom you feel more at ease.

Source: www.mayoclinic.com