METHODS OF TREATMENT
Dennis B. Kottler, MD
Westlake Village, CA
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See Also LIFE NAVIGATION vs. Psychotherapy
There are many different methods of treating psychiatric problems. The main categories include:
Psychotherapy - This includes dynamic and supportive, as well as cognitive-behavioral and interpersonal psychotherapy. These therapies can be either brief or long-term, depending on the individual's needs. They can also be combined.
Dynamic psychotherapy is insight-oriented and attempts to help the individual understand the psychological (and often unconscious) roots of the current pattern of behavior and feelings. Tools used include free association, dream analysis, transference analysis, and interpretation (by the therapist) of the patient's thoughts and fantasies.
Supportive psychotherapy generally does not focus on the unconscious. Rather the goal is to help the individual explore feelings in an empathic setting and to experience emotional support from the therapist.
Cognitive-behavioral therapy has as its goal helping the individual modify his thinking about a situation. For example, the depressed patient tends to unduly focus on negative thoughts, as well as fall prey to such cognitive pitfalls as "over-generalization," "catastrophizing," "black and white thinking," "drawing various inappropriate conclusions," and other forms of destructive thinking. Such thinking leads to negative emotions, such as sadness. Modify the thinking and the emotions and behavior will change.. This is the basis of cognitive-behavioral therapy.
Interpersonal therapy emphasizes the relationship between individuals as well as with the therapist to help bring about a therapeutic result.
Problem-solving Therapy - This modality emphasizes a pragmatic approach to helping the individual think though significant areas of conflict. For example, a person may not "see" an alternative way of looking at something. In problem-solving therapy the goal is to assist resolution of rather specific problems; in cognitive-behavioral therapy, the emphasis is more general and looks at erroneous thought patterns and how they impact on feelings and behavior.
Psychopharmacology - This involves the use of various medications to help the individual resolve a psychiatric disorder. Medication is most effective when it is used in combination with psychotherapy. Please click on the following link for additional information on the currently available medications: MEDICATION.
Family and Relationship Therapy - There are many different approaches to family and relationship therapy. Most therapies aim at improving communication and understanding the sources of interpersonal conflict.
Biofeedback-Relaxation Therapy - Biofeedback uses electronic equipment to detect and feed back to the individual physiologic information which is then used to help the patient learn to relax or gain control over both voluntary and autonomic functions. This form of therapy is very useful in treating various anxiety disorders, including generalized anxiety disorder, panic disorder, and phobic disorders. It is also quite helpful in treating various sleep disorders and somatoform disorders, situations that involve physical reactions to stress. Finally, problems such as over-eating, smoking, and pain can also be helped by this treatment modality.
Hypnotherapy - Hypnotherapy is helpful in situations similar to those addressed with biofeedback-relaxation therapy. Hypnotherapy has also been used to help indviduals remember suppressed or repressed memories. There is some controversy, however, about the reliability of these memories, since memories are often highly distorted.
Group - There are many modalities of group therapy including support groups, process groups, 12-step groups, and groups focussed on specific problem areas (includes most 12-step groups).
The different modalities of treatment are frequently applied in various combinations. Thus, for many psychiatric problems, such as various forms of depression and anxiety, a combination of psychotherapy and psychopharmacology can be more effective than either modality used alone. Even the various psychotherapies work well when elements of each are combined. For example, a psychotherapy can have supportive elements and still be dynamic in nature, or involve problem-solving aspects. Some purists might argue that psychodynamic psychotherapy does not mix well with other forms of therapy, however, this does not seem to be the case.
Perhaps most important is the requirement that the mode of treatment fit the individual as well as the psychiatric problem. Thus, someone, who for whatever reason, is extremely resistant to hypnotherapy, most likely will not benefit from this form of treatment. The same can be said for any of the treatments described above.
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