psychology for today, How is your Psychotherapy Sessions Enjoyable? How is your psychology today
Examples of questions from psychotherapists Have you ever had psychotherapy before? How did you decide to come to psychotherapy? What are the problems that brought you here?
1) What is psychotherapy? different definitions
“Psychotherapy is talking therapy.” –Sigmund Freud
How is your Psychotherapy Sessions Enjoyable? How is your psychology today
By calling it talk therapy, Freud distinguished psychotherapy from biologically based treatments (drug, electroconvulsive -electroshock-…).
Anna O., one of Freud's patients, was one of the first people to receive psychotherapy. She compared the effect of the treatment applied to him to "sweeping a chimney" (Breuer & Freud, 2000, p. 30). She observed that as she talked, she relaxed, like cleaning the dirt from the chimney, and that talking had a healing effect.
How is your Psychotherapy Sessions Enjoyable? How is your psychology today
Psychotherapy is the art and knowledge of establishing a positive patient-physician relationship. – M. Orhan Öztürk (Psychoanalysis and Psychotherapy)
Thus, Öztürk emphasized the healing effect of the relationship in the psychotherapy process.
“Therapy is a dress rehearsal for life.” – Irvin Yalom
Psychotherapy examines a person's emotions, thoughts, attitudes, relevant personal history, behavior and relationships with other people in a structured way.
Psychotherapy is a social practice where the psychological well-being of the other is aimed. It is the development of the ability to cope with life's difficulties and troubles with the help of an expert therapist. – Kemal Sayar,
It is an intervention made by therapists trained in psychotherapy using different therapy methods. –EAP
2) Therapy types / services
individual therapy
marriage therapy
family therapy
child therapy
Group therapy (Self-help groups)
online therapy
3) Therapy methods / approaches
Psychodynamic approach
The main therapy methods of this approach are:
Individual Psychology – Alfred Adler
Analytical Psychology – Carl Jung
Psychology of the Self – Heinz Kohut
Lacan's Psychoanalysis – Jacques Lacan
Interpersonal Psychoanalysis – Harry Stack Sulliven
…
Cognitive behavioral therapy
behavioral therapy
Cognitive Behavioral Therapy
Rational Emotive Behavior Therapy
Acceptance and Commitment Therapy
Mindfulness-Focused Cognitive Therapy
Schema Therapy
…
Existential/Humanistic approach
Person-Centered Therapy – Carl Rogers
Gestalt Therapy – Fritz Perls
Psychodrama – Jacob L. Moreno
Existential therapies
Transpersonal Psychotherapy
…
Systemic family therapy
Experiential family therapy / Transformational family therapy – Virgia Satir
Structural family therapy – Salvador Minuchin
Strategic family therapy – Jay Haley and Selvini Palazzo
System constellation method (Intergenerational family therapy) – Bert Hellinger
Narrative Therapy – Michael White – David Epson
Brief solution focused therapy – Steve De Shazer
…
* There is a large degree of consensus regarding the first three therapy approaches. However, you may encounter very different classifications, especially when it comes to categorizing post-modern therapy methods.
4) Situations where psychotherapy can help
Reasons that lead adults to psychotherapy
anxiety, worries
Life crises: Immigration, divorce, suicidal tendencies, separation, accident, mourning
Depression
Psychosomatic disorders
substance addictions
Obsession diseases
Aggression
Intimacy and sexuality
feeling of alienation
existential crises
self discovery
Spousal and family disputes
Questions about child education and child development
Problems with parenting
Aging
Difficulties adapting to society
Reasons that direct children to psychotherapy
Children are often referred to psychotherapy by social security experts, school psychological counselors, pedagogues and teachers.
Difficulty, anxiety, failure at school
behavioral problems
developmental delay
teenage crises
Psychological disorders in children: Attention deficit and hyperactivity disorder, ADHD, autism…
socially insecure
!!! Sometimes, even if psychotherapy is started for a certain reason, the focus may change during the process.
You may be interested in: Psychological diseases
5) Purposes of Psychotherapy
Psychotherapy aims to overcome psychological diseases, psychosocial and psychosomatic complaints. Psychotherapy can provide behavioral and attitude changes, self-awareness, development and maturation in the individual.
Elimination or reduction of psychological disease symptoms and psychosomatic reactions
Emotional relief, overcoming emotional confusion
Correcting behavioral disorders
change of attitude
Individual maturity acquisition, self-awareness, self-discovery
Reconsidering relationships
Obtaining psychological resources, developing coping methods
Being able to decide. For example; divorce process, career choice…
Many clients are happy to embark on a journey of getting to know themselves, their inner world, and their relationships better with their psychotherapists.
The purpose of psychotherapy is to liberate people. – Rollo May
!!! The therapy method applied also affects the therapy goals.
In the psychodynamic approach, one of the goals is to "reveal" (unconscious conflicts). The repressed material that is revealed is worked with and overcome.
The aim of cognitive behavioral therapy may be to make the individual's maladaptive behaviors and thoughts more compatible.
humanist approach
This approach aims for the individual to be "harmonious" (sincere, authentic). Becoming more aware of and experiencing one's emotions. Rather than overcoming his findings, he develops, grows, and realizes himself.
Systemic family therapy aims to help family members help each other. It aims to give people different perspectives on their problems. One of the goals is for people to gain new psychological resources and become good problem solvers in life.
Major prejudices about psychotherapy
Psychotherapists give advice.
Psychotherapists try to change your minds.
It is necessary to explain everything to psychotherapists.
6) Benefits of psychotherapy
Psychotherapy gives people hope for recovery and happiness.
It has been observed that patients who received psychotherapy were in a better situation than patients who received no treatment and received a placebo. (Smith, Glass & Miller, 1980).
Therapy improves work functions. Provides cost effectiveness.
Thanks to psychotherapy, the time spent in psychiatry is reduced. Dependence on psychiatric drugs and unnecessary surgical treatments are reduced. (Dixon-Gordon, Turner, & Chapman, 2011; Lazar & Gabbard, 1997).
It has been observed that mental health studies, including psychotherapy practices, reduce general health expenditures. (Alexander, Arnkoff, & Glass, 2010; Felker, et al., 2004; Roy-Byrne, et al, 2003).
The effectiveness of psychotherapy has been observed on people in different age groups, socio-economic status and cultures.
People often come to psychotherapy to change others. However, they can only change themselves.
Everything said in psychotherapy may not have any support for solving the problem in a short time. However, some ideas instilled in psychotherapy can build over time and have long-lasting effects.
7) Psychotherapy or medication?
Medicine
Some patients are satisfied with just taking medication. They cannot access psychotherapy. Or they do not prefer therapy.
Especially in the treatment of psychotic diseases, only medication is often used. However, these patients and their families also need psychological support to cope with the difficulties they experience.
We are gradually observing a significant increase in the use of anti-depressant drugs. There may be patients whose eyes cannot see anything other than the medicine.
People now worry about the troubles and concerns of daily life; Instead of seeing it as an opportunity for personality development and maturation, they act with the desire to get rid of it as soon as possible. Out of intolerance and intolerance, they say, "Let's go with the summer antidepressant." However, those who do not have the power to tolerate cannot have the power to change. – Cengiz Güleç, from the book There is No Happiness with Metaphor
It is not realistic for an individual to change nothing in his life and rely only on medications. Medicines that may be effective on the symptoms cannot eliminate the source of the individual's problems. Relationship problems are incapable of affecting conflict problems. Even if the client experiences temporary relief, he should review his life for the long-term effect.
Today, the development of drug treatments that literally make up the soul reduces the importance of the psychotherapeutic process. – Kemal Sayar, from the book A Cultural Criticism
Psychotherapy
Some prefer psychotherapy to psychiatric medications because of their side effects (Deacon & Abramowitz, 2005; Paris, 2008).
Psychotherapy can bring changes in people's behavior, relationships, outlook on life, and personality development. Thus, it may be more beneficial in the long term than patients treated with medication.
On the other hand, some clients may be biologically prone to psychological disorders, no matter how much therapy they receive. Additionally, for some diseases, psychotherapy alone may not be sufficient.
Medication and psychotherapy simultaneously
Many clients use medication and receive psychotherapy at the same time.
Taking medication can also make psychotherapy possible. Because it is very difficult or impossible to do therapy with some patients, such as clients with extreme anxiety, without taking medication.
Mental health professionals prefer the drug during periods when the patient is acute. Once stabilized with medications, the client becomes ready for psychotherapy. It's like walking with a cast on your feet for a while.
Studies have shown that clients who receive medication and psychotherapy treatment at the same time make progress in a shorter time.
⇒ There have also been findings that psychotherapy is more effective than psychiatric medications in the long term. (Cuijpers, et al., 2010; Pyne, et al., 2005).
Psychotherapy only, medication alone, or both. There is no consensus on which of these choices is best for which patient. Some experts believe that both together will be more effective. Some may find medications unnecessary or harmful. Some experts are also skeptical about the effectiveness of psychotherapy.
Alternatives and complements to medication and psychotherapy
Of course, this article will only focus on the use of psychotherapy and medication in the treatment of psychological disorders.
We cannot claim that he is laughing.
The patient's treatment can be made more effective in many different ways, such as meditation, social and spiritual support.
The effects of different efforts have also been observed in scientific studies. For example; The positive effect of regular daily walks in the treatment of depression has been demonstrated.
The best thing for people is social support, the effect of which has been seen in psychological studies. Short-term and self-selected solitude can be constructive in some cases. However, it often invites psychological diseases.
8) Who is a psychotherapist?
Psychotherapy is performed safely by psychotherapists trained in this field.
In our country, some psychiatrists, psychologists and psychological counselors improve themselves in the field of psychotherapy and provide psychotherapy services to their clients.
Saying that a psychiatrist applies drug treatment and a psychologist provides talking therapy is a very reductionist approach. Because, whether they are psychologists or psychiatrists, although they have foundations in the field of psychotherapy, they also provide psychotherapy services by improving themselves with psychotherapy training. As a matter of fact, many psychiatrists have made great contributions to this field. We cannot ignore these.
Similarly, the view that a psychologist is an expert who cannot prescribe medication is a different, rather reductionist, perspective. Psychologists are scientists trained in the field of human behavior.
Psychotherapy services in Turkey are generally provided by experts with university education in fields such as psychiatry, psychology and psychological counseling. Different practices can be seen in different countries. The longed-for practice is to work in harmony with our colleagues who specialize in different fields of mental health.
You may be interested in: How to become a psychotherapist?
How is psychotherapy done?
9) First psychotherapy session
Information about the psychotherapy process
Many clients need to be enlightened about what psychotherapy is.
Protecting the privacy of the conversation
Frequency of psychotherapy sessions and ultimately duration of therapy
Fee and payment method for psychotherapy
How to cancel psychotherapy sessions when necessary
Goal setting in psychotherapy
The focus of the first psychotherapy session is to determine the client's goals and create a road map for future sessions.
Reasons that bring the client to psychotherapy; psychological illnesses, crises, family conflicts, etc.
Expectations of the client and his/her relatives from psychotherapy.
Which type of therapy will be applied; individual therapy, marriage therapy, family therapy, etc.
Many clients decide after their first psychotherapy session whether they would like to work with a particular psychotherapist.
What you can take with you: referral notes, names of psychiatric medications you use, note paper and agenda.
You may be interested in: Questions asked in the first psychotherapy session
10) Themes discussed in psychotherapy
In therapy, there is essentially no subject that cannot be discussed. The therapy session will vary depending on the individual's age group, goals, and personal differences.
Current issues that concern you are discussed. Your relevant personal history is also taken into account. The self-awareness (insights) you gained from the previous psychotherapy session and your subsequent development are evaluated together.
Psychotherapeutic work with some clients can be started immediately by talking about the problems that worry them. This is especially the case in crisis interventions.
Examples of questions from psychotherapists
Have you ever had psychotherapy before?
How did you decide to come to psychotherapy?
What are the problems that brought you here?
How would you describe these problems from your perspective? (or from others' point of view)
What is your personal history and current life situation?
What do you expect from psychotherapy?
What kind of picture do you see in your life when your problems are solved?
What have you done to overcome the difficulties you have experienced so far?
What has worked so far when it comes to dealing with your problems? What didn't help you?
If you are wondering how exactly psychotherapy works, I have prepared a transcription of a session (a written conversation between the client and the therapist). Gloria with Carl Rogers: Transcription of the session – Turkish translation
11) Who participates in the psychotherapy process?
You can invite your family or friends for certain sessions.
What begins as individual therapy may turn into family or couple therapy.
In particular, families, teachers and friends may be involved in the child therapy process. The psychotherapist may meet with the teacher or caregiver face to face or by phone. Such collaboration can make the therapy process more effective.
In addition to the client's needs, the therapist's preferences and the therapy method he applies are also effective in determining who will participate in therapy. While the psychodynamic approach usually takes place individually, marriage and family therapies are often applied in systemic family therapy.
12)P
How long does psychotherapy last?
Length of psychotherapy sessions
Individual therapy sessions usually last fifty minutes.
Marriage therapy, family therapy, and group therapy often take two sessions. Double sessions can last an hour and a half or an hour and forty minutes.
The first therapy session may be a double session. It takes time for the client to meet the psychotherapist, to be informed about the therapy process, and to determine the goals.
Psychotherapy session intervals
Individual therapy, child therapy and group therapy often occur once a week.
Marriage therapy and family therapy usually occur every two weeks.
My application is this. I start therapy once a week during the client's crisis periods. Gradually, after the client stabilizes, I continue the process every two weeks. Of course, clients' needs may vary from time to time.
Total number of psychotherapy sessions
Psychotherapy continues as needed and until the therapy goals determined together are achieved. Many therapists recommend 8 to 20 sessions for this. A study conducted in America revealed that more than half of the patients quit psychotherapy after 8 sessions. According to the same research, the average number of sessions is 4. This suggests that many clients leave therapy early.
Psychological diseases occur over a long period of time. Likewise, their treatment may take a long time. For some, this may take a few sessions, for others it may take months.
Therapy methods also determine the length of psychotherapy.
The psychodynamic approach, which aims to eliminate internal conflicts and develop personality, requires a long time. Nowadays, short-term psychodynamic psychotherapy is also applied.
Psychotherapy methods that are solution-oriented and target behavioral changes are shorter. For example, systemic family therapy rarely exceeds twenty sessions.
13) Ending the psychotherapy process
Volunteerism is essential in psychotherapy. Clients can end therapy whenever they want.
It would be ideal for the therapist and the client to decide together to end therapy. This may not always be possible.
The psychotherapy process, its impact on your life, and your other ideas and feedback about the therapy are the determining factors in ending psychotherapy.
The ethics of psychotherapy do not allow relationships between therapists and their patients outside of psychotherapy. Still, many clients want to be friends with their therapist after therapy. This is not true. Final psychotherapy sessions should prepare clients for this separation.
Themes of recent psychotherapy sessions
What can the client do if the findings recur?
Gained psychological resources. What are the things that give strength to the client and are good for him when he feels bad? How can these resources be protected and developed?
Building new life goals after psychotherapy.
Clients give feedback.
During the psychotherapy session, they express which questions and interventions were helpful or not helpful.
In this way, the client becomes active. He/she gets the chance to indirectly help people experiencing similar problems.
Feedback also provides guidance for the professional development of the psychotherapist.
14) Increasing the effectiveness of psychotherapy sessions
The purpose of psychotherapy is to be able to apply the gains of the session to your daily life. It is very important to be active both during psychotherapy sessions and between sessions.
Clients think about the topics discussed between sessions.
They observe themselves and gain insights.
They make small experiments and take steps.
They can talk about these issues with their relatives and include them in the therapy process.
15) Ethical principles
Professional organizations and the laws of the country decide which ethical rules will apply in psychotherapy. Although they vary in each country, the basic ethical principles in psychotherapy are as follows:
Psychotherapists cannot have different relationships with their patients outside of the psychotherapy relationship. For example, emotional closeness or business relationships.
Psychotherapists are prohibited from having any sexual intercourse with their clients. Even if the patient consents, it is considered abuse. Clients may not be able to make healthy decisions on this issue due to the trauma they have experienced, especially sexual trauma.
Information cannot be exchanged with third parties and institutions without the patient's knowledge and permission.
The psychotherapist informs the patient about going to a health institution when deemed necessary.
When the psychotherapist realizes that the client no longer needs it, he informs the patient. He tries to end the therapy before the patient's psychotherapy addiction emerges.
They cannot discriminate between psychotherapists and their patients in any way (due to sexual orientation, race, age, political opinion, etc.).