Psychotherapy might be termed "a conversation with a therapeutic purpose". Extending the definition of an interview, Anna O- called it "the talking cure" (Breuer and Freud, 1895). Psychotherapy is a more than a talk between two people regarding some problem. At it's core is a unique relationship between the clinician and the patient with in which there is communication which can relieve distress and set condition for learning and personal growth.
Over the years, the field of psychotherapy has expanded greatly not only in the number of contending approaches and theories but also in the range of people treated. Originally psychotherapy is conceived as method of treatment of patient with symptom neuroses- hysteria in the first instance- it has come to be used with people who are both more or less disturbed, by now forms of psychotherapy has been used with patients with brain damage of psychosomatic problems, with psychotics, drug addicts, alcoholics, the aged and the very young, and with patients formerly believed to have too little ego strength to collaborate in self- exploration. On the other hand, people seek help in coping with the distressing but less devastating problems of living.
People seek psychotherapy because of painful dependence or inferiority feelings, inability to work effectively, identity crisis, a sense of futility, guilt or inadequacy or spiritual malaise.
Definitions of Psychotherapy
It is difficult to arrive at an acceptable definition of psychotherapy. Dorlands- defines it as "the treatment of emotional and mental problems."
Webster's and Noyes- described it as "the treatment of emotional and mental problems by psychological means."
Perhaps the most acceptable definition is the one given by Wolberg (1967), which is as follows:
"Psychotherapy is the treatment by psychological means, of problems of an emotional nature, in which a trained person deliberately establishes professional relationship with the patient, with the object of:
1. Removing, modifying or retarding existing symptoms.
2. Mediating disturbed patterns of behavior and
3. Promoting positive personality growth and development."
How does Child Psychotherapy differ from Adult Psychotherapy?
- Child therapy is different from adult therapy and possesses certain special challenges(Kazdin, 2003).
- Most of the problems encountered in the children are present in the normal course of development in lesser levels (like aggression, hyperactivity, anxiety) and it is special challenge to decide whether and when to intervene.
- Unlike adults, children rarely refer themselves for treatment or themselves as experiencing stress/symptom. Problems most commonly referred for treatment are disruptive behaviors.
- Retaining the child in treatment provides its own challenges (Weirzbicki & Pekarik, 1993), as 40% to 60% of children, adolescents and adults who begin treatment drop out early. Children are not particularly motivated to come for treatment.
- The assessment of child is in itself very difficult and different from that of an adult. Young children can not give clear accounts of their life histories.
- Usually mental health practitioner sees a client individually in treatment session in psychotherapy, while in child therapy accompanying parents, teachers, siblings and peers play an important role.
Varieties of Psychotherapies commonly used:
- Psychodynamic Psychotherapy
- Behavior Therapy
- Cognitive Behavior Therapy
- Play Therapy
- Group Psychotherapy
- Family Therapy
How is Psychotherapy different from Counseling?
Counseling and Psychotherapy are often considered to be
interchangeable therapies that overlap in a number of ways. Counseling, in
specific situations, is offered as part of the psychotherapy process; whereas a
counsellor may work with clients in a psychotherapeutic manner. The key difference between the two courses of therapeutic
communication treatment lies in the recommended time required to see benefits.
Counseling usually refers to a brief treatment that centres around behaviour
patterns. Psychotherapy focuses on working with clients for a longer-term and
draws from insight into emotional problems and difficulties.
- Helps people identify problems and crises and encourages them to take positive steps to resolve these issues.
- It is the best course of therapeutic treatment for anyone who already has an understanding of wellbeing, and who is also able to resolve problems.
- Counselling is a short-term process that encourages the change of behavior.
- Helps people with psychological problems that have built up over the course of a long period of time.
- It will help you understand your feelings, thoughts and actions more clearly.
- Psychotherapy is a longer-term process of treatment that identifies emotional issues and the background to problems and difficulties.
Limited number of researches have been done in the areas of assessment of extent and dimensions of psychopathology in Indians as well as effectiveness of psychotherapeutic methods in treatment of psychopathology. Although limited a number, researches have been done in India to evaluate the efficacy of different types of psychotherapies in treating psychological problems among Indians. Psychodynamic oriented supportive psychotherapy has been found to be effective in reducing adjustment and interpersonal problems as well as the perceived severity of stress and problems in children suffering from emotional problems .Play therapy as compared to behavioral modalities in treatment of emotionally disturbed children has been found to be equally effective.
What needs to be done ?
Since researches have highlighted large scale need for psychotherapy in Indian Population, certain measures can be taken. For instance,
1. Large scale screening can identify individuals with psychological problems and address their needs.
2. There are indications for school mental health practice and researches in India.
3. Time limited brief therapies are effective and should be practice at wider level.
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