Assignment on psychotherapy

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 ( 1 st year)

2. I ntroduction 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.

4. 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.

5. 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

6. 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’

7. 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…

8. 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.

9. 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.

10. 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.

11. 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.

12. 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.

13. 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.

14. 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.

15. 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.

16. 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.

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

18. 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.

19. 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.

20. 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.

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

22. 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.

23. 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)

24. 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 .

25. 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

26. 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 )

27. 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.

28. 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.

29. 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: Group therapies. Different rehabilitative techniques. 3. Structured activities of daily living for all patients.

30. 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.

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

32. Cont….. Biofeedback Physical exercise Deep breathing exercise Psycho education

33. Other psychotherapies Play therapy

34. Other psychotherapies Music therapy

35. Other psychotherapies Dance therapy

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

37. Major psychiatric disorders and related complimentary and alternative therapies

38. 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.

39. 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.

40. 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.

41. 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.

42. 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. 6 th edition. Publisher, nursing: Robert G. Marton , 2009. page no. 195-199, 292, 583-586.

43. References… www.slideshare.com www.psychiatry.org www.medicalcalnewstody.com www.webmd.com