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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Psychotherapy
What is psychotherapy?
Psychotherapy refers to ways of treating mental and
emotional disorders by talking to a therapist about yourself
and your problems. The therapist helps you to understand
yourself more and to cope better. Being in therapy does not
mean you are crazy. Everyone has problems. Psychotherapy
is one way to help yourself with your problems.
The goals of psychotherapy are to:
- change harmful behavior patterns
- improve relationships
- improve self-esteem and help you be content with who you
are
- resolve conflicts
- reduce or eliminate symptoms of a psychiatric disorder.
Depression, anxiety, suicidal feelings, drug or alcohol
abuse, eating disorders, sexual problems, sleep problems,
anger, grief, and phobias are just some of the problems that
can be helped with therapy. Family, couple, or relationship
problems can also be worked out in therapy.
Psychotherapy helps you learn about yourself. In some
cases you learn by coming to understand your past and how it
relates to your present. In other cases you become aware of
and learn to change responses that cause problems in your
life.
How do I choose a therapist?
Your therapist should be someone with whom you are
comfortable. Therapists include:
- psychiatrists
- psychologists
- psychiatric nurses
- psychiatric social workers
- trained counselors.
Many people get names of therapists from others whose
judgment they trust:
- friends
- family members
- doctors
- church leaders.
Even with this help from others, finding the right therapist
for you is a very personal thing. Be careful. There are
many therapies and therapists outside the mainstream. Be
sure the person you use as a therapist is licensed and well
regarded.
You may want to interview several therapists before you
choose one. When you first meet with a therapist, ask
about:
- fees
- the kind of therapy he or she practices
- the therapist's credentials.
Some health plans cover, or help cover, the cost of therapy.
Many universities have clinics for students getting degrees
in mental health fields. These clinics charge very low fees
and provide good therapists. Rape crisis centers can often
give you information on getting therapy after a sexual
assault, even if it occurred years before. Many county
health departments offer mental health counseling.
As you reveal some of the personal issues you will wish to
discuss, pay careful attention to:
- how the therapist relates to you
- what kind of a listener he or she is
- your comfort level with the therapist.
It is common to feel a little nervous in your first session.
However, if you notice traits in the therapist that you
think may prevent you from revealing your feelings and
trusting him or her, another therapist may be better for
you. Trust your feelings during your first sessions. Use
them as a guide to decide whether to continue to work with
that therapist or to try a different one.
Once you have found someone with whom you are comfortable,
keep an open mind and allow yourself to develop trust in the
therapist. It is very important to be able to be open and
honest in therapy.
What types of psychotherapy are used?
Many types of therapy are used today. Among the more common
types are the following.
Behavior therapy: This type of therapy focuses on changing
what you do. It supports positive behaviors and reduces
negative ones. This type of therapy works well for problems
such as phobias, anxiety disorders, obsessive-compulsive
disorders, drug and alcohol problems, and eating disorders.
Cognitive-behavior therapy: The therapist helps you
identify views you have of yourself, the world, and the
future that are not realistic. This therapy helps you
recognize unhealthy ways of thinking. You will learn new
thought and behavior patterns that lead to healthier living.
Client-centered therapy: The therapist listens to you and
helps you understand your feelings.
Dynamic psychotherapy: The therapist brings to light and
interprets your unconscious feelings without using formal
psychoanalysis. This type of therapy often involves your
saying whatever comes into your mind (free association).
Family therapy: This form of therapy treats the family as a
whole rather than focusing on each member. It is based on
the idea that a troubled person cannot be understood apart
from his or her home environment. The therapist encourages
open expression of feelings among family members. Family
therapy is often used for families with children who have
behavior problems and families dealing with sexual abuse,
serious diseases, or other traumatic events.
Group therapy: A group is usually made up of about 8
people with similar problems who meet regularly with a
therapist. They discuss their problems with one another and
with the therapist. Group therapy is most effective for
dealing with issues such as personality problems, alcohol
and drug problems, eating disorders, and certain types of
depression.
Interpersonal therapy: This type of therapy centers around
relationships. It focuses on the here and now and specific
problems that you are having. The therapist works with you
to improve your skills and self-concept. You are taught new
interpersonal and communication skills. Treatment can be
either short-term or long-term.
Marital counseling: The therapist encourages improved
communication between a husband and wife and helps them
focus on the problems in their relationship. Both partners
work to learn new behavior patterns. Sometimes the couple
writes a contract or agreement that spells out how behavior
will change.
Psychoanalysis: The therapist listens as you explore deep,
unconscious feelings and experiences from childhood. You
will usually meet with your therapist 4 or more times a
week for a number of years.
Psychodrama: This type of therapy is used to express hidden
feelings. You are asked to play the parts of different
people in your life by acting as if you were those people.
Psychodrama can be done with a partner or in a group. It
sometimes uses music or dance.
How long does psychotherapy take?
Psychotherapy can take a few sessions or many years,
depending on your treatment goals and the extent of the
problem. Both you and your therapist will assess your
progress from time to time. You should be actively involved
in deciding how long you stay in therapy. You, not the
therapist, are in control of the decisions that affect your
life.
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