Monday, March 28, 2011

re: psychotherapy. . . some differentiations - Part One

Last week en blog  we were talking a bit about the need for therapy and about the "true Aussie [as elsewhere also, not just in the Land DownUnder] reluctance to ask for help, the "fix it myself", etc.

Gary [a greater OZ-Man than whom there is no other. . lol ]responded to Greg and to all of us about sometimes an outsider can be more objective about a situation than those of us actually involved.

I'd like to add a bit more about directive and nondirective therapies, maybe some about cognitive thereapy, and then go on from there. 
Nondirective therapy:
(psychology) Type of psychotherapy in which the patient is in the dominant position and is given complete freedom to express herself or himself.

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Directive therapy:
(psychology) A method of psychiatric treatment by which the therapist, assuming complete understanding of the patient's needs, endeavors to change the patient's attitudes, behavior, or mode of living.

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Difference between the two. .. 
Directive therapy is where the therapist leads the therapeutic process. For example, if you are providing cognitive behavioral therapy, you are giving the client instructions for dealing with the problem, helping them practice specific techniques, assigning homework etc.

Non-directive therapy allows the client to take the lead. The therapist may reflect back the information the client is providing, offer possible interpretations, or seek clarification, but it is the client who initiates the content of the therapy session. 

Cognitive therapy. . .
Cognitive therapy seeks to help the patient overcome difficulties by identifying and changing dysfunctional thinking, behavior, and emotional responses. This involves helping patients develop skills for modifying beliefs, identifying distorted thinking, relating to others in different ways, and changing behaviors.[1] Treatment is based on collaboration between patient and therapist and on testing beliefs. Therapy may consist of testing the assumptions which one makes and identifying how certain of one's usually-unquestioned thoughts are distorted, unrealistic and unhelpful. Once those thoughts have been challenged, one's feelings about the subject matter of those thoughts are more easily subject to change. Beck initially focused on depression and developed a list of "errors" in thinking that he proposed could maintain depression, including arbitrary inference, selective abstraction, over-generalization, and magnification (of negatives) and minimization (of positives).
A simple example may illustrate the principle of how CT works: having made a mistake at work, a person may believe, "I'm useless and can't do anything right at work." Strongly believing this then tends to worsen their mood. The problem may be worsened further if the individual reacts by avoiding activities and then behaviorally confirming the negative belief to themself. As a result, any adaptive response and further constructive consequences become unlikely, which reinforces the original belief of being "useless". In therapy, the latter example could be identified as a self-fulfilling prophecy or "problem cycle", and the efforts of the therapist and client would be directed at working together to change it. This is done by addressing the way the client thinks and behaves in response to similar situations and by developing more flexible ways to think and respond, including reducing the avoidance of activities. If, as a result, the patient escapes the negative thought patterns and dysfunctional behaviors, the negative feelings may be relieved over time.

for a more comprehensive presentation. . .

End of Part One . . . .check for continued Part Two in the next  post.

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