7.5 Psychotherapy

Psychotherapy is a term used for specific treatment techniques provided by trained mental health professionals that help an individual identify and change their troubling emotions, thoughts, and behaviors. Trained professionals who provide psychotherapy include psychologists, psychiatrists, counselors, social workers, or psychiatric-mental health nurse specialists who are licensed to treat mental, emotional, and behavioral disorders. Psychotherapy may be provided to individuals, couples, families, or groups. There are many types of psychotherapy, with common types being cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and group therapy.^[1],[2]

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a form of psychotherapy that is effective for a range of problems, including depression, anxiety disorders, alcohol and drug misuse, marital conflict, eating disorders, and severe mental illness. CBT helps a person to recognize distorted and negative thinking with the goal of changing thoughts and behaviors to respond to changes in a more positive manner. Numerous research studies suggest that CBT leads to significant improvement in functioning and quality of life.

CBT is based on these core principles:

• Psychological problems are based, in part, on faulty or unhelpful ways of thinking.
• Psychological problems are based, in part, on learned patterns of unhelpful behavior.
• People suffering from psychological problems can learn better ways of coping, thereby relieving their symptoms and increasing quality of life.

CBT treatment involves efforts to change thinking patterns. These strategies might include the following:

• Learning to recognize one’s distortions in thinking that are creating problems, and then reevaluating them in light of reality.
• Gaining a better understanding of the behavior and motivation of others.
• Using problem-solving skills to cope with difficult situations.
• Learning to develop a greater sense of confidence in one’s own abilities.

CBT treatment also usually involves efforts to change behavioral patterns. These strategies might include facing one’s fears instead of avoiding them, using role-playing to prepare for potentially problematic interactions with others, and learning to calm one’s mind and relax one’s body.

CBT aims to help clients develop skills to manage their feelings in healthy ways. Through in-session exercises and “homework” between sessions, clients develop coping skills, whereby they learn ways to change their own thinking and behavior, ultimately changing how they feel. CBT therapists focus on current situations, thought patterns, and behaviors rather than past events. A certain amount of information about one’s history is needed, but the focus is primarily on developing more effective ways of coping with life moving forward.

Dialectical Behavior Therapy

Dialectical behavior therapy (DBT) is a type of cognitive behavioral therapy that provides clients with new skills to manage painful emotions and decrease conflict in relationships. It has been used successfully to treat people experiencing depression, bulimia, binge-eating, bipolar disorder, post-traumatic stress disorder, borderline personality disorder, and substance abuse. DBT focuses on providing therapeutic skills in four key areas:

• Mindfulness focuses on improving an individual’s ability to accept and be present in the current moment.
• Distress tolerance is geared toward increasing a person’s tolerance of negative emotion, rather than trying to escape from it.
• Emotion-regulation strategies are used to manage and change intense emotions that are causing problems in a person’s life.
• Interpersonal effectiveness techniques allow a person to communicate with others in a way that is assertive, maintains self-respect, and strengthens relationships.

Group Therapy

Group therapy refers to a group of five to 15 individuals led by a trained mental health professional who meet weekly for an hour or two. Groups are designed to treat a specific condition or improve a specific skill. For example, problem-focused groups may focus on coping with conditions like depression, anxiety, eating disorders, or substance use disorder. Other groups may focus on coping with issues like anger management or grief.^[3]

There are many potential benefits of group therapy compared to individual therapy. Talking and listening to others with similar concerns can help develop a social support network. It helps an individual realize they are not alone in dealing with a difficult life circumstance and often suggests ideas for improving a specific concern or situation.^[4]