THERAPEUTIC
APPRORACHES
CHAPTER 5
Nazneen Banu
A video
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Nature of
Psychotherapy
Psychotherapy is defined as a voluntary
relationship between the one seeking
treatment who is known as the client and the
one who treats the client is known as the
therapist. Therapeutic Relationship aims at
resolving the psychological problems of the
client.
Goals of Psychotherapy
Modifying Facilitate
Increasing Self- Improving
Changing Decision-
Awareness Habits
Patterns Making
Unleashing the
Improving Help the client
potential of the
interpersonal in living a
client to the
relationships fulfilling life
fullest
Therapeutic Relationship
The therapeutic relationship is defined as the special relationship
between the client and therapist and this is not a long-lasting
professional relationship instead it is very professional in nature.
Two components of the therapeutic relationship are:
• Contractual nature of the relationship in which two willing
individuals, the client, and the therapist, enter into a partnership
that is propelled by the aim of resolving the problems of the
client
• Limited duration of the psychotherapy
Types of Therapies
There are various types of therapies like psychodynamic therapy, behavioral therapy,
cognitive therapy, and the factors which determine the classification of kinds of therapies
are mentioned below:
• What is the cause of the problem?
• How did the cause come into existence?
• What is the chief method of treatment?
• What is the nature of the therapeutic relationship between the client and the therapist?
• What is the chief benefit to the client?
• What is the duration of treatment?
Behavior Therapy
Behavior Therapies lay focus on the fact that
Psychological distress arises because of
faulty thinking or behavioral patterns.
The ultimate focus is laid on present thinking
patterns and thoughts and the past is just
relevant for understanding the cause of
clients’ maladaptive behavior.
The past is not relived, unlike Psychodynamic
Therapy.
Method of
Treatment
• Behavioral Analysis is conducted to find
maladaptive behaviors, antecedent, and
maintaining factors of the maladaptive behavior
• Antecedent factors are the causal factors behind the
malfunctioning Behaviour and maintaining factors
are those factors that maintain the maladaptive
Behaviour
• Once the above-mentioned factors are identified,
the way of treatment is identified and that can be
either antecedent operations in which the
antecedent factors are controlled by the therapist
and in establishing operations the reinforcing value
of the consequence is increased or decreased
Aversive Conditioning – Here an
association is made between an
undesirable response and an
unfavorable consequence and this
T e c h n iq u e s o fB e h a v io ra lT h e ra p y
Technique is used in rehabilitation
centers
Positive Reinforcement- When the
adaptive Behaviour occurs rarely,
positive reinforcement is used to cover
up the deficit
Negative Reinforcement- It is provided
Various techniques of behavioral
in order to escape the painful stimulus
therapy are discussed below:
in the environment.
Modeling – In order to bring the
desired change in the behavior, the
client will try to imitate or shadow the
movements of the person whom they
consider as their role model
Other techniques of behavioural
therapy are token economy,
differential reinforcement, principle of
reciprocal inhibition, and systematic
desensitisation
Cognitive
Therapy
The first step in this
therapy is ABC
(Antecedent-
Irrational beliefs in this
Behaviour-
An example of an therapy are assessed
Consequence) analysis
Irrational belief is that by non-directive
As per cognitive where Antecedent
one should be loved questioning which is
Therapies, the events are the causal
by everyone all the subtle and gentle in
underlying cause of Albert Ellis formulated factors of
Rational Emotive time. Irrational beliefs nature. The client
our psychological rational-emotive Psychological distress,
Therapy about the Antecedent overcomes their
distress lies in our therapy. Irrational beliefs are
event lead to psychological distress
irrational beliefs and found out by
consequences which by replacing their
thoughts. interviewing the client
negative emotions and irrational belief system
and these beliefs
Behaviours. with a rational belief
distort the reality.
system.
Irrational Beliefs are
characterized by
‘musts’ and ‘shoulds’.
Cognitive Therapy
by Aaron Beck
Society, peers, and parents shape up the Beliefs of an individual
and as per the cognitive therapy given by Aaron Beck, these
beliefs are known as core schemas.
For example- If a child didn’t have any friends in childhood then
he may develop a belief that “I am worthless” which leads to the
development of automatic negative thoughts called cognitive
distortions which distort reality in a negative way. The Therapist
in this case uses a way of questioning which is gentle and subtle
in nature.
Cognitive Behaviour Therapy
CBT is considered as a short and efficacious treatment for a plethora of
Psychological Disorders like anxiety, panic attacks, borderline personality,
etc. It combines Techniques of Behaviour Therapy along with Cognitive
Therapy and it is based on the BioPsychosocial approach.
CBT addresses Biological aspects through relaxation procedures,
Psychological problems through Behaviour Therapy and cognitive therapy
techniques, and social problems through changing environments.
Humanistic-Existential Therapy
The main cause of Psychological distress is feelings of loneliness, alienation, and
inability to find meaning and responsibility in life. The main features of existential
therapy are explained as follows-
• Humans are propelled by the notion of personal growth and attaining a state of
self-actualization which is defined as the tendency of humans to become more
integrated and achieve a state of balance in life
• Free emotional expression is a prerequisite for self-actualization but it is curbed
by society as complete emotional expression releases negative emotions like
anger, sadness, etc
Cont...
• In humanistic therapy, a non-judgemental and permissive atmosphere is
given to the client where the client completely expresses his/her
emotions
• In this therapy, the therapist is a mere facilitator and success mainly
depends upon the client
• Existential Therapy was proposed by a famous psychiatrist and
neurologist Victor Frankl and this therapy is also known as Logotherapy
• The main motive of the therapist is to help the client find meaning and
purpose in his/her life irrespective of life circumstances and this process
is called the process the process of meaning-making
Client-Centered Therapy
This Therapy was given by Carl Rogers. The main focus is to
provide a warm relationship so that the client can reconnect
and understand his/her disintegrated feelings.
In client-centered therapy, the Therapist provides
unconditional positive regard which means total acceptance
of what the client actually is, empathy which means
understanding the client’s problems from their perspective,
and that helps clients feel secure.
Alternative therapies
They are mainly categorized under two heads – Yoga and
Meditation. alternative therapies as well which are explained
as follows:
• Yoga has gained immense importance in the last 25 years
and it includes either practice of Asanas or Breathing
practices or both
• The two most popular yoga techniques are Sudarshan Kriya
Yoga and Kundalini Yoga
• Sudarshan Kriya Yoga is a beneficial, low-cost treatment of
stress, anxiety, post-traumatic stress disorder. Research
conducted at the National Institute of Mental Health and
Neurosciences, India has arrived at a conclusion that
Cont...
• Kundalini Yoga is considered to be effective in the treatment of
mental disorders
• Institute of Nonlinear Sciences, University Of California, San
Diego, USA has found that kundalini yoga to be an effective
treatment of OCD. Kundalini Yoga includes Pranayama and
Chanting Of Mantras
• Meditation is a set of techniques that helps in enhancing focus,
attention and altering the state of consciousness by focussing on
the inner self. Mindfulness meditation helps in improving focus,
treatment of depression, and proper processing of stimuli
Ethics in Psychotherapy
Just like every job role, psychotherapy also has some ethics to be followed
by every individual. Ethical standards that need to be adhered to by
psychologists are mentioned below:
• Informed Consent needs to be taken
• Respect for human rights and dignity
• Confidentiality of the client’s problem must be maintained
• Professional competence and skills are musts
• Alleviating the personal distress of the client must be the goal of therapy
• The integrity of the practitioner-client relationship must be there
Rehabilitation of Mentally Ill
Treatment of psychological disorders have two components
• Reduction Of Symptoms
• Improvement In Quality Of Life
• Above mentioned points are applicable in mild problems like
Generalised Anxiety Disorders(GAD), but in case of severe disorders like
schizophrenia it is not applicable
• Rehabilitation is propelled by the purpose to empower clients to become
productive members of society
Cont
• In rehabilitation, patients are given occupational therapy, social skills
training, vocational therapy, and cognitive training and they are described
below:
• Occupational Therapy- Clients are taught work therapy and they are
taught skills like weaving, paper making, etc
• Social skills training- Clients are taught interpersonal skills like empathy,
communication skills, cooperation, etc
• Vocational therapy-employability skills are taught to clients in vocational
therapy
• Cognitive training-patients are taught cognitive skills like decision-
making, memory, etc
