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Topics :
 Psychotherapy is a voluntary relationship between
the one seeking treatment or the client and the one

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who treats or the therapist.

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 It aims at changing maladaptive behaviour, to solve

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their problems etc.
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 There are several characteristics of
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psychotherapeutic approaches:
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Systematic application of principles

Only trained person can practice therapy
It involves a therapist and a client who seeks and receives
help.
 Therapeutic relationship
 Interaction between client and therapist form

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therapeutic relationship

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 Special relationship between client and therapist is

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known as therapeutic relationship. It has two

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components :
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- Contractual nature of relationship
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- Limited duration of therapy

Unique properties of relationships :

 Trusting & confiding relation

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 Unconditional positive regard

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 Empathy
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 Strict & confidential
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 Professional relationship
Types of therapies :
 PSYCHODYNAMIC THERAPY

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 BEHAVIOUR THERAPY

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 COGNITIVE THERAPY

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 Humanistic-Existential Therapy
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 BIOMEDICAL THERAPY
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 ALTERNATIVE THERAPIES
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 Psychodynamic therapy
 It is pioneered by Sigmund Freud. It is oldest form of

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psychotherapy.

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 It has conceptualized the structure of psyche, dynamics

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between different components of psyche and source of
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psychological distress.
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 Intrapsychic conflicts leads to disorder.
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 First step is to elicit this Intrapsychic conflict by the

method of free association & dream analysis invented
by psychoanalysis.
 Modality of Treatment:
 (a) Transference: The client starts identifying the
therapist with the authority figures of the past, usually
childhood.

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 (i) The therapist maintains a non-judgmental and

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permissive attitude and allows the client to continue with

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this process of emotional identification.
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(ii) Transference Neurosis
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 • Positive Transference
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 • Negative Transference
 (b) Resistance
 (i) Conscious Resistance.
 (ii) Unconscious Resistance.
 (c) Interpretation
 (i) Subtle process, the pinnacle of psychoanalysis.
 (ii) Two analytical techniques:

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 Confrontation

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 Clarification

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 Working Through: confrontation, clarification and
interpretation.
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 Insight
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 (i) End-point of psychoanalysis

 (ii) Intellectual Insight
 (iii) Emotional Insight
Intense treatment, three phases.
 (i) Initial Phase: Client becomes familiar with the
routines, establishes a therapeutic relationship, and

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recollects the superficial material from the

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consciousness about the past and present.
 (ii) Middle Phase: Characterised by transference,

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resistance on the part of the client, and confrontation,
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clarification and working through on the therapist’s
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part; all these processes finally lead to insight.
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 (iii) Third Phase: Termination; the relationship with

the analyst is dissolved and the client prepares to leave
the therapy.
Behaviour therapy :
 Behaviourists believes that distress arises due to faulty
learning.

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 The clint unlearn the faulty behaviour and relearn a

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new one by various techniques.

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 Mode of treatment :

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- clint is interviewed and analysed
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 - identification of malfunctioning behaviour

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antecedent factors and maintaining factors.

 -antecedent operation and consequent operations
are used.
 Behavioral Techniques :

 - Positive reinforcement

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 - Token economy

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 - Negative reinforcement

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 - Aversion conditioning
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 - Systematic desensitisation (fears)
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 - Principle of reciprocal inhibition

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 - Modelling
 Cognitive therapy
1). Rational Emotive Therapy (RET) (Albert Ellis)
• Irrational beliefs mediate between the antecedent events
and their consequences.

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• The first step in RET is the antecedent-belief-

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consequence (ABC) analysis.

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• Antecedent events, which caused the psychological
distress, are noted. yc
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• Client is interviewed to find irraltional believes which
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distorting the reality.

• Unconditional positive regard
• Non-directive questioning ( gentle, make the client
think deeper, change philosophy, rational belief system
replaces the irrational belief system.)
2. Aaron Beck’s Cognitive Therapy:
 As per him, childhood experience create core

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schemas which include beliefs and action patterns.

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 They create negative thoughts which are characterized

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by cognitive distortions.

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 These patterns of thoughts are called dysfunctional
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cognitive structures. Repeated occurrence can cause
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anxiety & Depression.
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 The aim is to achieve cognitive restructuring.

COGNITIVE BEHAVIOUR THERAPY (CBT)
 Short & efficacious treatment

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 Adopts bio psychosocial approach.

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 Combines cognitive and behavioural techniques.

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 Origins in biological, psychological and social realms.
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 Comprehensive technique
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HUMANISTIC THERAPY
 Distress arises due to inability to find meaning of life.

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 Motivation by desires of self actualization

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 Healing occurs at a stage

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 It requires free emotional expression which is curbed
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and leads to destructive behaviour etc.
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 Therapy creates permissive and non judgmental
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atmosphere
 Therapist is facilitator & guide
 Aim is to expand the client’s awareness.
EXISTENTIAL THERAPY
 Victor frankl gave logo therapy i.e treatment for the

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soul.

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 Neurotic anxiety arises

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 Frankl emphasised to the role of spiritual anxieties
leading to meaninglessness and hence may be called
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existential anxiety.
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 The goal is to facilitate the client to find the meaning

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of his/her being.
CLIENT CENTRED THERAPY
 Given by Carl Rogers.

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 He brought into psychotherapy the concept of self.

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 It provides warm relationship.

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 Empathy, unconditional positive regard, non
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 The reflection us achieved by rephrasing client’s
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statements.
 Personal relationships improves with increase in
adjustments.
GESTALT THERAPY
 Given by Freiderick perls with his wife Laura perls.

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 Goal is to increase self awareness and acceptance

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 Can be done in group settings

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 Therapist encourages client.
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BIOMEDICAL THERAPY
 Medicines can be prescribed given by psychiatrist.

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 Nature of medicine depends on disorder

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 Anti psychotic drugs, milder drugs

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 Medication should be under supervision
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 Electro convulsive therapy (ECT)
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 Mild shocks given via electrodes
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 Not a routine treatment

Factors Contributing to Healing:
 Techniques adopted by the therapist and the
implementation of the same with the client.

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 The therapeutic alliance.

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 Catharsis: A process of emotional unburdening by a

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client.
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4. Non-specific Factors:
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 (i) Patient Variables (motivation for change,
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expectation of improvement).
 (ii) Therapist Variables (positive nature, good mental
health, absence of unresolved emotional conflicts).
Ethics in Psychotherapy:
 Informed consent needs to be taken.

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 Confidentiality of the client should be maintained.

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 Alleviating personal distress should be the goal of all

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attempts of the therapist.
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 Integrity of the practitioner-client relationship is
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important.
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 Respect for human rights and dignity.

 Professional competence and skills are essential.
ALTERNATIVE THERAPIES Yoga:
 A. Sudarshana Kriya Yoga (SKY)

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( Rapid breathing, PTSD, Reduces stress)

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 B. Kundalini Yoga

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(breathing techniques, OCD)
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 C. Vipasana Meditation
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(Mindfulness-based meditation)
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Rehabilitation of the Mentally :
 In rehabilitation, the patients are given:
(i) Occupational Therapy: teaches skills such as candle

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making, paper bag making and weaving to help them to

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form a work discipline

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(ii) Social Skills Training: Develops interpersonal skills
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through role play, imitation and instruction; objective is
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to teach the patient to function in a social group.
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(iii) Cognitive Retraining: Improves the basic cognitive

functions of attention, memory and executive function.
(iv) Vocational Therapy: Once the patient improves
sufficiently, gains skills necessary to undertake
productive employment.
Topics Covered :
 Psychotherapy meaning.
 Therapeutic relationship.

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 Classification of therapies.

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 PSYCHODYNAMIC THERAPY.

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 Behaviour therapy.
 Cognitive therapies.
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 Humanistic-Existential therapy.
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 Biomedical therapy.
 Factors contributing to healing.
 Alternative therapies.
 Rehabilitation of mentally ill.