Psychotherapy

Ralph Kairupan

INTRODUCTION

The field of psychotherapy is fragmenting from future shock.

New therapies are placed on the market. 1976 (Parloff): 130 therapies; 1979 (Time

Magazine): > 200 therapies. Best answer to treatment: claming 80 – 100%

succes. Students, practitioners, and patients are faced

with the dilemma of too many choices.James O. Proschaska: SYSTEM OF PSYCHOTHERAPY - A Transtheoretical Analysis,

1984

Definition (1)

Dorland’s Illustrated Medical Dictionary, 30th Ed. 2003: treatment of mental disorders and behavioral disturbances using verbal and non-verbal communication, including such psychological techniques as support, suggestion, persuasion, reeducation, reassurance, and insight, in order to alter maladaptive pattern of coping, relieve emotional disturbance, and encourage personality growth.

Definition (1b)

Dorland’s Illustrated Medical Dictionary, 30th Ed. 2003: treatment of mental disorders and

behavioral disturbances using verbal and non-verbal

communication, in order to alter maladaptive pattern of

coping, relieve emotional disturbance, and encourage personality growth.

Definition (2)

Kaplan & Sadock’s Pocket Handbook of Clinical Psychiatry. 4th, Ed. 2005: Psychotherapy is the treatment for mental illness and behavioral disturbances in which a trained person establishes a professional contract with the patient and through definite therapeutic communication, both verbal and non-verbal, attempt to alleviate the emotional disturbance, reverse or change maladaptive pattern of behavior, and encourage personality growth and development.

Definition (2b)

Kaplan & Sadock’s Pocket Handbook of Clinical Psychiatry. 4th, Ed. 2005: the treatment for mental illness and

behavioral disturbances in which a trained person establishes a professional contract with the

patient and through definite therapeutic

communication, both verbal and non-verbal, attempt to alleviate the emotional disturbance,

reverse or change maladaptive pattern of behavior, and encourage personality growth and development.

Definition (3)

W.F. Maramis – (Catatan Ilmu Kedokteran Jiwa, 1980): Psikoterapi ialah suatu cara pengobatan terhadap masalah emosional seorang pasien yang dilakukan oleh seorang yang terlatih dalam hubungan profesional secara sukarela, dengan maksud hendak menghilangkan, mengubah atau menghambat gejala-gejala yang ada, mengoreksi perilaku yang terganggu, dan mengembangkan pertumbuhan kepribadian secara positif.

Definition (4)

Noyes & Kolb – Modern Clinical Psychiatry, 5th Ed., 1958: as the treatment of emotional and personality problems and behaviors by psychological means. Therapist-patient relationship (with its interpersonal experiences) is the important therapeutic factor

Noyes & Kolb’s highlight: Through this relationship the patient knows

that: he/she can share his/her feelings, attitudes,

and experiences with the physician and that the latter with his/her warmth,

understanding empathy, acceptance and support will not depreciate, censure or judge him/her no matter what he/she may reveal, but will respect his/her dignity and worth.

This desired, positive, patient-therapist relationship with its psychotherapeutic value is often known as ‘positive’ transference (not transference situation).

Improvements’ Factors

PRECONDITION FOR THERAPY: NONSPECIFIC VARIABLES Expectation (patient expect the treatment to

be effective) The Hawthorne Effect (people can improve

just by having special attention paid to them) Classic Hawthorne studies: on the effect of

improve lighting on productivity in a factory, it was discovered that participants increase their output as a result of just being in a study and having special attention paid to them

Improvements’ Factors

PROCESS OF CHANGE Consciousness Raising (patient’s awareness)

Freud’s assumption: therapeutic cure is “to make the unconscious conscious”

Catharsis (Gr. katharsis – a cleansing; evoking emotions was one of the best means of providing personal relief and improvement) Psychiatry: released of thought, ideas, and

repressed material from the unconscious, accompanied by an emotional response and relief.

Improvements’ Factors

PROCESS OF CHANGE Choosing (an increase in choosing involves

the individual becoming aware of new alternatives, including the conscious creation of new alternatives for living)

Conditional Stimuli (and counter conditioning approach; people change by making critical changes in the conditional stimuli that control their response)

Contingency Control (behavior is under the control of the consequences to which it leads – punish & reward).

James O. Proschaska:

Psychoanalysis Existential Analysis Client-Centered Therapy Gestalt Therapy Alderian Therapy Rational Emotive Therapy Transactional Analysis Emotional Flooding Therapies Behavior Therapy System Therapies

BAHAN AJAR KULIAH PSIKIATRI

Psikoterapi

Analisis Transaksional, Terapi Rasional Emotif, Terapi Tingkah Laku

Kaplan & Sadock(Pocket Handbook of Clinical Psychiatry. 4th, Ed. 2005)

Psychoanalysis & Psychoanalytic Psychotherapy

Brief Dynamic Psychotherapy Behavior Therapy Cognitive-Behavioral Therapy Family Therapy Interpersonal Therapy Group Therapy

Kaplan & Sadock(Pocket Handbook of Clinical Psychiatry. 4th, Ed. 2005)

Couple & Marital Therapy Dialectical Behavior Therapy Hypnosis Guided Imagery Biofeedback Paradoxical Therapy Sex Therapy

Task:

Describe (shortly but clearly) the characteristics of Kaplan & Sadock’s classification of psychotherapies