mental health disorders
Treatment of Mental Illness
Psychotherapy
In recent years, significant advances have been made in the field of psychotherapy, which is sometimes referred to as talk therapy. By creating an empathetic and accepting atmosphere, the therapist often is able to help the person identify the source of the problems and consider alternatives for dealing with them. The emotional awareness and insight that the person gains through psychotherapy often results in a change in attitude and behavior that allows the person to live a fuller and more satisfying life. Psychotherapy is appropriate and effective in a wide range of conditions. Even people who do not have a mental health disorder may find psychotherapy helpful in coping with such problems as employment difficulties, bereavement, or chronic illness in the family. Group psychotherapy, couples therapy, and family therapy are also widely used. Most mental health practitioners practice one of six types of psychotherapy: Behavioral therapy Cognitive therapy Interpersonal therapy Psychoanalysis Psychodynamic psychotherapy Supportive psychotherapy Behavioral therapy involves a number of interventions that are designed to help the person unlearn maladaptive behaviors (for example, dependency and inability to tolerate frustration) while learning adaptive behaviors (openness to experience and conscientiousness). Treatment , often used to treat phobias, is one example of a behavioral therapy. In exposure therapy, people are exposed to feared objects, activities, or situations in a safe environment. The purpose is to reduce fear and help people stop avoiding the things they fear. Behavioral therapy is related to cognitive therapy. Sometimes a combination of the two, known as cognitive-behavioral therapy, is used. The theoretical basis of behavioral therapy is learning theory, which says that abnormal behaviors are due to faulty learning. Cognitive therapy helps people identify distortions in thinking and understand how these distortions lead to problems in their lives. For example, people may think in an all-or-nothing way ("if I am not a total success, I am a complete failure"). The premise is that how people feel and behave is determined by how they interpret experiences. Through the identification of core beliefs and assumptions, people learn to think in different ways about their experiences, reducing symptoms and resulting in improvement in behavior and feelings. Interpersonal therapy was initially conceived as a brief psychologic treatment for depression and is designed to improve the quality of a depressed person’s relationships. It focuses on the following: Unresolved grief Conflicts that arise when people have to fill roles that differ from their expectations (such as when a woman enters a relationship expecting to be a stay-at-home mother and finds that she must also be the major provider for the family) Transitions in social roles (such as going from being an active worker to being retired) Difficulty communicating with others The therapist teaches the person to improve aspects of interpersonal relationships, such as overcoming social isolation and responding in a less habitual way to others. Psychoanalysis is the oldest form of psychotherapy and was developed by Sigmund Freud in the first part of the 20th century. The person typically lies on a couch in the therapist’s office 4 or 5 times a week and attempts to say whatever comes to mind—a practice called free association. Much of the focus is on helping the person understand how past patterns of relationships repeat themselves in the present. The relationship between the person and the therapist is a key part of this focus. An understanding of how the past affects the present helps the person develop new and more adaptive ways of functioning in relationships and in work settings. Psychodynamic psychotherapy, like psychoanalysis, emphasizes the identification of unconscious patterns in current thoughts, feelings, and behaviors. However, the person is usually sitting instead of lying on a couch and attends only 1 to 3 sessions per week. In addition, less emphasis is placed on the relationship between the person and therapist. Supportive psychotherapy, which is most commonly used, relies on the empathetic and supportive relationship between the person and the therapist. It encourages expression of feelings, and the therapist provides help with problem solving. Problem-focused psychotherapy, a form of supportive therapy, may be used successfully by primary care doctors. 