Psychotherapy
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The document defines psychotherapy as a treatment for emotional problems through a professional relationship aimed at modifying symptoms and promoting personal growth. It emphasizes the necessity of proper training for therapists and addresses common misconceptions about psychotherapy. Additionally, it outlines guidelines for practice, therapist qualities, patient responsibilities, and the importance of self-awareness and monitoring in the therapeutic process.
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Psychotherapy
- 1. PSYCHOTHERAPY Dr. S. Krishnan MBBS, MD, DPM, DIP.NB,MNAMS Associate Professor of Psychiatry Mo-IN-Charge, Holistic and Stress Research Clinic Department of Psychiatry Medical College, Thiruvananthapuram
- 2. Definition… • "Psychotherapy is the treatment, by psychological means, • Of problems of an emotional nature in which a trained person deliberately establishes a professional relationship with the patient • With the object of • (1) Removing, modifying, or retarding existing symptoms • (2) Mediating disturbed patterns of behavior, and • (3) Promoting positive personality growth and development." Woolberg L, The Technique of Psychotherapy, 1977.
- 4. Psychotherapy • Should be a regular part of Psychiatrist’s treatment schedule • Very few budding psychiatrists get training • Most training programs end up as dramas or theoretical sessions
- 5. Misconceptions • Psychotherapy is THE treatment • Psychotherapy is not a treatment at all • Psychotherapy does not need training • With the understanding of the neurobiology of psychotherapy, psychotherapy has become a valid treatment • Psychotherapy produces the same changes in the brain as pharmacotherapy • And many more…
- 6. Psychotherapy • Have a diagnosis • Is there an indication for psychotherapy • Does the patient fits well into the paradigm?
- 7. Following steps • General introduction to psychotherapy • Guideline to initiate practice • Guideline to what you should be prepared to face and do To open or to close the door?
- 8. Seating
- 9. Time
- 10. Place
- 11. Qualities of a Psychotherapist
- 12. Who can really be a psychotherapist? Adequately trained and certified • Psychiatrist • Psychologist • Social worker • Nurse practitioner • Physician assistant • Minister, priest Untrained persons not tested for competence! • Anyone can call themselves a “therapist!”
- 13. Being Monitored
- 14. Psychotherapy • Fellow travelers • Engage in personal therapy • Be supportive • Have and teach empathy (Hyperempathy!!!) • Let the patient matter to you • Acknowledge your limitations and errors • Have a new therapy for each patient
- 15. The therapist has many patients. The patient, one therapist
- 16. Which Therapy is the Best
- 17. The present – use it, use it, use it • Hear with eyes and see with ears • Working through issues in present • Frame ‘present’ comments carefully • What lies have you exchanged • Be real
- 18. Therapist disclosures – 3 kinds • Be transparent • Use discretion • Use caution
- 19. Revealing your personal life Why What How
- 20. Do patients want to hear your life story
- 21. On being helped by your patient
- 22. Encourage patient self disclosure
- 23. Feedback – Johari Window
- 24. How to talk about God Death Sex Meaning of life
- 25. Helping patients to assume responsibility
- 26. Never make decisions for the patient
- 27. Blocks in therapy Forms of transference Types of resistance
- 28. Facilitate awareness • Encourage self monitoring
- 29. Should advices be given?
- 30. Notes on each session
- 31. What to do if patient… • Weeps • Gets irritated
- 32. Taking care of yourself
- 33. Express your dilemmas openly
- 35. Should everything have a psychological explanation
- 36. Should you touch the patient? • Where • When • How
- 37. Your feelings for the patient… Sexual Love Compassion Involvement
- 38. Promises given to patients
- 39. Interview with significant others
- 41. Freud was not always Right Freud was not always Wrong
- 42. CBT is not everything
- 43. Dreams – Use them First Last Recurring Distressing
- 45. Thanks…