Download System Individual Couple Group Family Organisation

Psychological Therapies
Dr Mark O Evans
Consultant Psychiatrist in
Psychotherapy
Gaskell House Psychotherapy Centre
Manchester Royal Infirmary
Psychotherapy is:
“…essentially a conversation which involves listening to
and talking with those in trouble with the aim of
helping them understand and resolve their
predicament.” - Brown and Pedder.
“…an interpersonal process designed to bring about a
modification of feelings, cognitions, attitudes and
behaviour which have proven troublesome to the
person seeking help.” Hans Strupp
“…the art of alleviating personal difficulties through the
agency of words and a personal, professional
relationship”. - Anthony Storr
Who does psychotherapy?
(All mental health workers)
Counsellors
Clinical /Counselling Psychologists
Adult Psychotherapists
Child Psychotherapists
Medical Psychotherapists
Forensic Psychotherapists
Setting
GP surgeries
Out-patient – PCMHT, CMHT, Psychology
and Psychotherapy departments
In-patient
Day Hospital
At home of patient
Prison (Grendon Underwood)
System
Individual/Couple/Group/Family/
Organisation
Three main groupings of Psychotherapy
Psychoanalytic/Psychodynamic
Behavioural/Cognitive-Behavioural
Humanistic Movement
Common Features of Psychotherapies
(Jerome Frank)
1.
a
2.
3.
4.
5.
6.
7.
An intense, emotionally charged relationship with
person or group.
A rationale or myth explaining the distress and
methods of dealing with it.
Provision of new information about the future,
the
source of the problem and possible
alternatives which hold a hope of relief.
Non-specific methods of boosting self-esteem.
Provision of success experiences.
Facilitation of emotional arousal.
Takes place in a locale designated as a place of
healing
Common types of therapy:
Cognitive Behavioural Therapy
Psychodynamic psychotherapy
Cognitive Analytic Therapy
Psychodynamic Interpersonal Therapy
Systemic/Family Therapy
Group analytic therapy
Psychodrama
Counselling
Other types of therapy
Specific family interventions with schizophrenia
patients
Supportive Therapy
Therapeutic Communities
Dialectical Behavioural Therapy
Gestalt Therapy
Solution Focused Therapy
Transactional Analysis
Classifications of psychotherapy (NHSE, 1996)
Type A
Psychological treatment as an integral component of
Mental Health care. Refers to the psychotherapeutic skills required
by all mental health and social care professionals.
Type B
Eclectic Psychological therapy and Counselling.
Type C
Formal Psychotherapies: Refers to the specialist
Refers to the psychotherapeutic skills needed by a broadly trained
mental health/social care professional (nurse, occupational
therapist, social worker, clinical psychologist or psychiatrist with a
special interest in psychotherapy who treats patients but does not
act in a senior consultative or training capacity.
therapeutic skills required by a professional working for the majority
of his/her time in the speciality ie. Consultant Psychotherapist level
with a significant responsibility for teaching and supervising others.
Available evidence for efficacy in specific
conditions (Roth and Fonagy, 1996):
Depression
CBT, IPT, PDP
Anxiety
CBT, Applied relaxation
Phobias
CT, Exposure therapy
Panic
CBT, Panic control therapy
Alcoholism
Behavioural treatments, social skills
training, motivational interviewing
Schizophrenia
Family intervention programmes,
CBT
Anorexia
(younger)
CT, Eclectic therapy, Family therapy
Available evidence for efficacy in specific
conditions (Roth and Fonagy, 1996)
Bulimia
CT, IPT
Psychosomatic
? IPT
Personality
disorders
DBT, ?PDP day hosp, ?CAT,
TCs
OCD
Exposure and response prevention
PTSD
Stress inoculation with CT and exposure
Sex dysfunctions
Behavioural and CBT
Why is psychotherapy
important?
Consumer choice
Efficacy (equivalent to antidepressants)
Cost effective
Reduces relapse
Additive effects to medication (SZ + FT)
Few side effects
Works with treatment resistant cases