Types of therapies

Therapy is not a mode of treatment restricted to people living with a chronic mental illness; anyone can benefit from it.
Types of therapies

Medication is used to treat both physical and mental illnesses. Like treatment for physical illness is complemented by diet, exercise and rest, mental illness too is managed with more than just medicationpsychotherapy forms an integral part of treatment for mental illness.

What is psychotherapy?

Psychotherapy makes use of scientifically tested methods to help a person manage their thoughts and feelings, and develop healthier habits. It offers a supportive, non-judgmental environment where a person can speak openly about their problems, and talk about how they feel. A psychotherapist teaches the client skills like effective communication, problem-solving, decision-making, and relaxation techniques to help them cope with difficulties they’re facing in their daily life. The goals of psychotherapy are wide-ranging, but some instances of it involve helping, or guiding the client to figure out how to:

  • Resolve conflicts with past or present relationships

  • Relieve anxiety or stress due to work or other life situations

  • Cope with major life changes such as divorce, bereavement, or loss of a job

  • Reduce negative and unhealthy behavior patterns that impair social and interpersonal relationship, such as anger, aggressiveness

  • Cope with the mental health fallout of a chronic medical condition or illness that the client or their relative has been diagnosed with, such as diabetes, hypertension, cancer, AIDS

  • Modify unhealthy lifestyle habits and replace them with healthy onesfor instance, changes required due to lifestyle disorders like diabetes, hypertension, or to follow the steps towards de-addiction

  • Process trauma caused by incidents of violence that are sexual or domestic in nature, and develop healthy coping mechanisms to deal with it

Psychotherapy can be as effective as medication in reducing emotional distress. That said, depending on the severity of the condition the psychiatrist in charge will decide what is the best course of treatment. In some cases psychotherapy can be more effective than medication in addressing long-term recovery from the symptoms of the illness.

Who is a psychotherapist?

A mental health professional trained in psychotherapy and other forms of psychological treatment. Additionally, they may have expertise in mental health assessment, diagnosis and treatment. To practice psychotherapy in India, a bachelor’s or doctorate degree in psychology is necessary.

What are the different types of psychotherapy?

There are different types of therapies and a mental health professional decides which type of therapy is best for the client depending on the nature of their problem. For example, behavior therapy may be used to treat obsessive compulsive disorder (OCD), while cognitive behavior therapy (CBT) may be more effective to treat depression. Here is a brief description of different types of therapies:

Behavior therapy: Behavior therapy uses a structured approach to help the person improve their behavioral patterns, and respond to situations in more adaptive ways. It focuses on helping the client understand their thoughts and behavior, identify negative patterns and replace them with positive ones.

It is used in the treatment of:

  • Anger management

  • Anxiety and related disorders

  • Attention deficit/hyperactivity disorder (ADD/ADHD)

  • Bipolar disorder

  • Depression

  • Eating disorders

  • Obsessive-compulsive disorder (OCD)

  • Phobias

  • Post-traumatic stress disorder (PTSD)

  • Self-harm

  • Substance abuse

Cognitive therapy: Cognitive therapy aims at changing unhealthy beliefs and thoughts that result in maladaptive behaviors. It uses specific principles of learning like reinforcement through rewards and punishments; planning change through behavior control; relaxation training; and assertiveness skills trainingto deal with emotions and thoughts which in turn lead to a change in actions.

It is used in the treatment of:

  • Anxiety and related disorders

  • Bipolar disorder

  • Low self-esteem

  • Schizophrenia

  • Substance abuse

  • Suicidal ideation

Cognitive-behavioral therapy (CBT): CBT is a short-term, structured, goal oriented form of psychotherapy that combines cognitive and behavior therapy. It aims to change the person’s attitude and behavior by changing their thought and belief patterns, and how they regulate their emotions. It is widely used to treat mental illness.

It is used to treat:

  • Addiction (for example, to the internet, nicotine, gambling, alcohol)

  • Anxiety and related disorders

  • Bipolar disorder

  • Depression

  • Eating disorders

  • Psychosis

  • Schizophrenia

  • Substance abuse

Interpersonal therapy (IPT): IPT is a structured therapy that focuses on helping the person improve their interpersonal relationships. It is a time-limited treatment offered in three phases.

In the initial phase the therapist completes a standard clinical interview to determine the suitability of the treatment for the personthe person’s relationship patterns, capacity for bonding, and current relationships are evaluated. The middle phase consists of sessions used to address the problem areas using IPT techniques. In the final phase the therapist and person review progress made in the problem areas, and form a plan for the future.

IPT treatment also includes working on problems related to grief or bereavement, role dispute (such as struggle between spouses or with a relative), and role transition (important life changes like deciding to have a child).

It is used to treat:

  • Bipolar disorder

  • Borderline personality disorder (BPD)

  • Depression

  • Eating disorders

  • Family and marital disputes

  • Panic disorder

  • Substance abuse

Psychodynamic therapy: Also known as insight-oriented therapy, psychodynamic therapy focuses on subconscious thought processes that manifest in a person's behavior. It aims to help the person gain self-awareness and insight into how their experience of certain events influences their present behavior. While it may not work with severe mental disorders such as OCD and schizophrenia, this form of therapy works well for resolving emotional conflicts, relationship issues, etc. It is effective especially in case of persons who feel like they have lost meaning in their lives, and who have trouble maintaining relationships.

Family therapy: Family therapy helps people overcome issues they’re having within familial relationships. The therapist evaluates the relationship at present; events that have caused emotional problems; and identifies patterns of dysfunctional communication. The family is then taught how to listen with empathy, ask questions, and respond in a rational way without getting angry or defensive.

This therapy is also effective in cases where families have to be involved in the patient's treatment, or in the case of a dysfunctional family which may be contributing to the patient's current condition.

Dialectical behavior therapy (DBT): DBT is a modified form of behavior therapy. It aims to help a person live a ‘life worth living’ by teaching them how to regulate their emotions. It encourages them to solve their problems, and focuses on skills training to effectively cope with their issues. DBT also helps the client create long-term goals, and work towards it.

It is used in the treatment of

  • Anger management

  • ADD/ADHD

  • BPD

  • Depression

  • Eating disorders

  • PTSD

Mentalization-based therapy (MBT): Mentalization is being able to look at an event from different perspectives without personalizing or generalizing the situation and going into a cycle of unhealthy thoughts and patterns.

MBT is a form of talk therapy where the therapist helps the client validate their thoughts and feelings, see events from different perspectives, and identify non-mentalizing modes, like thinking in negative extremes (always, never, only). The person can then engage in seeing the event from a different perspective, and regulate their own emotions. The more this exercise is performed the more it becomes second nature for the client to apply the strategy to interpersonal interactions outside of the therapy space. This results in fewer outbursts which improves their relationships and social functioning. MBT is offered in both individual and group sessions.

It is used to treat:

  • Addiction

  • Eating disorders

  • Personality disorders

  • Recurrent depression

  • Self-harm

Psychotherapy plays a crucial role in treating mental illness. It can address issues that medication can’t and have a long-lasting impact on the person’s life.

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