Approaches to psychotherapy


Know least about 450 types of psychotherapy. Unified systematization of such a wide and still growing list of almost unreal, and classification of types of psychotherapy varies considerably from author to author. But nevertheless most forms of psychotherapy can be correlated with major approaches. Consider the basic approaches in psychotherapy .

The psychodynamic approach.

Originates with the principles and techniques of psychoanalysis. coming from a dynamic understanding of psychic phenomena «… as a manifestation of the struggle of spiritual forces, as targeted expression of tendencies that operate in accordance with each other or against each other» (Z. Freud. 1915). The goal of psychotherapy — the understanding and resolution of inner emotional conflicts . arisen in the earliest relationships that determine the subjective value of subsequent experience and reproduced in later life.

The therapeutic relationship is used to identify, explain, and change these subjective values. Relationship «therapist-patient» considered as a reflection of ascending to the early experience of subjective values, emotional conflicts . During the therapeutic relationship, the patient unconsciously transfers to the therapist developed in the early experience of the values and feelings that thus become available to awareness. In turn, the therapist may also unconsciously transferred to the patient’s own subjective values and feelings. The realization of the system of transfers and contrariness. emerging resistances and forms the main fabric of the psychodynamic approach .

Behavioural (behavioural) approach.

The essence of this approach ascending to the theories of Ivan Pavlov and B. Skinner . this consists of modifying behaviours through the use of the principles of the theory of learning . Behavioral and emotional problems are understood as fixed as a result of encouragement and reinforcement disadaptive responses to stimuli in the environment. The task of psychotherapy is to eliminate or modification. Behavioral therapist answers the questions:

1. What behavior is targeted for change, and that the observed behavior to be increased, decreased, support?

2. What events have been supporting this behavior?

3. What changes in the environment and systematic intervention can change this behavior?

4. How can one steady-state behavior to be maintained and/or extended to new situations within a limited time?

The therapist does not seek to penetrate into the origins of the conflict (the symptom of the problem) — it modifies the observed behavioral patterns. Psychotherapy begins with a detailed analysis of behavior. The purpose of the analysis — to get a more detailed scenario of the occurrence of the symptom described in observable and measurable terms what, when, where, under what circumstances, in response to what, how often, how much, etc. and Then together with the patient are analyzed launching and supporting the symptom factors. Then prepared and implemented in collaborative and independent work detailed step by step plan of action. Compared to this psychodynamic approach is clearly prescriptive.

Cognitive approach.

Goes back to the works of A. Beck and draws on ideas about the crucial role of thinking, cognitive (cognitive) processes in the origin of disorders. Like the psychodynamic approach he refers to the implicit, hidden causes of the violations and similar behavioural — to disadaptive behavioral stereotypes. But the focus of this approach is not focused on the dynamics of the main psychic powers and experiences and not to the stimulus-reactive chains, and the patterns of thought: any response to external circumstances mediated internal organization of mental processes, thought patterns. The failure of these patterns triggers «negative cognitive schemas» what is essentially comparable to programming errors and malicious distortions of computer programs.

Various schools within the framework of this approach stress the importance of individual cognitive styles, cognitive complexity, cognitive balance, cognitive dissonance, etc. Goals and objectives of psychotherapy is focused on «reprogramming» thinking and cognitive processes as a mechanism of occurrence of problems and the formation of symptoms. The range of methods is very wide — from rational psychotherapy according to claim Dubois to rational-emotive psychotherapy A. Ellis . Like behavioral, cognitive approach is based on the policy position of the therapist.

A systemic approach.

Determined not focus on theoretical models, and a focus on partnership, family, marriage, groups as independent organisms, holistic systems with its history, the internal laws and dynamics, stages of development, value orientations, etc. Therapy within the framework of this approach comes from the fact that dysfunctional relationship determines the deadaptation of its participants. The therapist takes the position of an involved observer or player-coach. System therapist sufficiently prescriptive: he asks questions, observes and controls, structures communication participants, dramatizes relationships and models the conflict, gives homework, etc.

Humanitarian (existential-humanistic) approach.

Originates in humanistic psychology and the work of its founders — K. Rogers, R. may, A. Maslow and others. The essential core of this approach — in the understanding of man as fundamentally indivisible and holistic unity of body, psyche and spirit, and therefore — in an address to the integrated experiences (happiness, grief, guilt, loss, etc.) and not to a specific isolated aspects, processes and manifestations. Categorical apparatus humanitarian approach includes ideas about «», identity, authenticity, self-realization and self-actualization, personal growth, existence, the meaning of life, etc.

Methodological apparatus is associated with humanistic-existential reinterpretation of the life experience and the psychotherapeutic process. With this approach, linked to a range of methods: a non-Directive client-centered psychotherapy (Rogers), psychological counseling (R. may), bioenergy (V. Raich), sensory awareness (S. silver, C. Brooks), structural integration (Rolf I.), psychosynthesis (R. Assagioli), Logotherapy (Viktor Frankl), existential analysis R. may and J. Bugental, etc. this may also include the art therapy, poetry therapy, therapy creative expression (M. E. Rapidly), music therapy (P. Nordoff and C. Robbins), etc.

Integrative approach.

Becomes more dominant trend, within which we distinguish methodological eclecticism, psychotherapeutic polypharmacy, theoretical integration. In practical terms, integration is directed by the principle Paul G. (1967): what is psychotherapy conducted and by whom is most effective for this individual with his specific problems in his circumstances and surroundings, or — according to the expression of M. Erickson (1975): for each patient — its psychotherapy. The blending of different factors and styles of integration creates a «wild psychotherapy» fraught, as stressed by A. Lazarus (1995), unpredictable effects.

These are the major approaches in psychotherapy .