NCERT Textbook - Therapeutic Approaches Humanities/Arts Notes | EduRev

 Page 1


Chapter 5 • Therapeutic Approaches
89
THER THER
THER THER THERAPEUTIC APPROACHES APEUTIC APPROACHES
APEUTIC APPROACHES APEUTIC APPROACHES APEUTIC APPROACHES
Nature and Process of Psychotherapy
Therapeutic Relationship
Type of Therapies
Steps in the Formulation of a Client’s Problem (Box 5.1)
Psychodynamic Therapy
Behaviour Therapy
Relaxation Procedures (Box 5.2)
Cognitive Therapy
Humanistic-existential Therapy
Biomedical Therapy
Alternative Therapies
Rehabilitation of the Mentally Ill
CONTENTS
Key Terms
Summary
Review Questions
Project Ideas
Weblinks
Pedagogical Hints
After reading this chapter, you would be able to:
familiarise yourself with the basic nature and process of psychotherapy,
appreciate that there are different types of therapies for helping people,
understand the use of psychological forms of intervention, and
know how people with mental disorders can be rehabilitated.
Page 2


Chapter 5 • Therapeutic Approaches
89
THER THER
THER THER THERAPEUTIC APPROACHES APEUTIC APPROACHES
APEUTIC APPROACHES APEUTIC APPROACHES APEUTIC APPROACHES
Nature and Process of Psychotherapy
Therapeutic Relationship
Type of Therapies
Steps in the Formulation of a Client’s Problem (Box 5.1)
Psychodynamic Therapy
Behaviour Therapy
Relaxation Procedures (Box 5.2)
Cognitive Therapy
Humanistic-existential Therapy
Biomedical Therapy
Alternative Therapies
Rehabilitation of the Mentally Ill
CONTENTS
Key Terms
Summary
Review Questions
Project Ideas
Weblinks
Pedagogical Hints
After reading this chapter, you would be able to:
familiarise yourself with the basic nature and process of psychotherapy,
appreciate that there are different types of therapies for helping people,
understand the use of psychological forms of intervention, and
know how people with mental disorders can be rehabilitated.
Psychology
90
NATURE AND PROCESS OF PSYCHOTHERAPY
Psychotherapy is a voluntary relationship
between the one seeking treatment or the
client and the one who treats or the
therapist. The purpose of the relationship
is to help the client to solve the
psychological problems being faced by her
or him. The relationship is conducive for
building the trust of the client so that
problems may be freely discussed.
Psychotherapies aim at changing the
maladaptive behaviours, decreasing the
sense of personal distress, and helping the
client to adapt better to her/his
environment. Inadequate marital,
occupational and social adjustment also
requires that major changes be made in an
individual’s personal environment.
All psychotherapeutic approaches have
the following characteristics : (i) there is
systematic application of principles
underlying the different theories of
therapy, (ii) persons who have received
practical training under expert supervision
can practice psychotherapy, and not
In the preceding chapter, you have studied about major psychological
disorders and the distress caused by them to the patient and others. In this
chapter , you will learn about the various therapeutic methods that are used
by psychotherapists to help their patients. There are various types of
psychotherapy. Some of them focus on acquiring self-understanding; other
therapies are more action-oriented. All approaches hinge on the basic issue
of helping the patient overcome her/his debilitating condition. The
effectiveness of a therapeutic approach for a patient depends on a number
of factors such as severity of the disorder , degree of distress faced by others,
and the availability of time, effort and money, among others.
All therapeutic approaches are corrective and helping in nature. All of
them involve an interpersonal relationship between the therapist and the
client or patient. Some of them are directive in nature, such as
psychodynamic, while some are non-directive such as person-centred. In
this chapter, we will briefly discuss some of the major forms of
psychotherapy.
Introduction
everybody. An untrained person may
unintentionally cause more harm than any
good, (iii) the therapeutic situation involves
a therapist and a client who seeks and
receives help for her/his emotional
problems (this person is the focus of
attention in the therapeutic process), and
(iv) the interaction of these two persons —
the therapist and the client — results in
the consolidation/formation of the
therapeutic relationship. This is a
confidential, interpersonal, and dynamic
relationship. This human relationship is
central to any sort of psychological therapy
and is the vehicle for change.
All psychotherapies aim at a few or all
of the following goals :
(i) Reinforcing client’s resolve for
betterment.
(ii) Lessening emotional pressure.
(iii) Unfolding the potential for positive
growth.
(iv) Modifying habits.
(v) Changing thinking patterns.
(vi) Increasing self-awareness.
(vii) Improving interpersonal relations and
communication.
Page 3


Chapter 5 • Therapeutic Approaches
89
THER THER
THER THER THERAPEUTIC APPROACHES APEUTIC APPROACHES
APEUTIC APPROACHES APEUTIC APPROACHES APEUTIC APPROACHES
Nature and Process of Psychotherapy
Therapeutic Relationship
Type of Therapies
Steps in the Formulation of a Client’s Problem (Box 5.1)
Psychodynamic Therapy
Behaviour Therapy
Relaxation Procedures (Box 5.2)
Cognitive Therapy
Humanistic-existential Therapy
Biomedical Therapy
Alternative Therapies
Rehabilitation of the Mentally Ill
CONTENTS
Key Terms
Summary
Review Questions
Project Ideas
Weblinks
Pedagogical Hints
After reading this chapter, you would be able to:
familiarise yourself with the basic nature and process of psychotherapy,
appreciate that there are different types of therapies for helping people,
understand the use of psychological forms of intervention, and
know how people with mental disorders can be rehabilitated.
Psychology
90
NATURE AND PROCESS OF PSYCHOTHERAPY
Psychotherapy is a voluntary relationship
between the one seeking treatment or the
client and the one who treats or the
therapist. The purpose of the relationship
is to help the client to solve the
psychological problems being faced by her
or him. The relationship is conducive for
building the trust of the client so that
problems may be freely discussed.
Psychotherapies aim at changing the
maladaptive behaviours, decreasing the
sense of personal distress, and helping the
client to adapt better to her/his
environment. Inadequate marital,
occupational and social adjustment also
requires that major changes be made in an
individual’s personal environment.
All psychotherapeutic approaches have
the following characteristics : (i) there is
systematic application of principles
underlying the different theories of
therapy, (ii) persons who have received
practical training under expert supervision
can practice psychotherapy, and not
In the preceding chapter, you have studied about major psychological
disorders and the distress caused by them to the patient and others. In this
chapter , you will learn about the various therapeutic methods that are used
by psychotherapists to help their patients. There are various types of
psychotherapy. Some of them focus on acquiring self-understanding; other
therapies are more action-oriented. All approaches hinge on the basic issue
of helping the patient overcome her/his debilitating condition. The
effectiveness of a therapeutic approach for a patient depends on a number
of factors such as severity of the disorder , degree of distress faced by others,
and the availability of time, effort and money, among others.
All therapeutic approaches are corrective and helping in nature. All of
them involve an interpersonal relationship between the therapist and the
client or patient. Some of them are directive in nature, such as
psychodynamic, while some are non-directive such as person-centred. In
this chapter, we will briefly discuss some of the major forms of
psychotherapy.
Introduction
everybody. An untrained person may
unintentionally cause more harm than any
good, (iii) the therapeutic situation involves
a therapist and a client who seeks and
receives help for her/his emotional
problems (this person is the focus of
attention in the therapeutic process), and
(iv) the interaction of these two persons —
the therapist and the client — results in
the consolidation/formation of the
therapeutic relationship. This is a
confidential, interpersonal, and dynamic
relationship. This human relationship is
central to any sort of psychological therapy
and is the vehicle for change.
All psychotherapies aim at a few or all
of the following goals :
(i) Reinforcing client’s resolve for
betterment.
(ii) Lessening emotional pressure.
(iii) Unfolding the potential for positive
growth.
(iv) Modifying habits.
(v) Changing thinking patterns.
(vi) Increasing self-awareness.
(vii) Improving interpersonal relations and
communication.
Chapter 5 ? Therapeutic Approaches
91
(viii)Facilitating decision-making.
(ix) Becoming aware of one’s choices in
life.
(x) Relating to one’s social environment in
a more creative and self-aware
manner.
Therapeutic Relationship
The special relationship between the client
and the therapist is known as the
therapeutic relationship or alliance. It is
neither a passing acquaintance, nor a
permanent and lasting relationship. There
are two major components of a therapeutic
alliance. The first component is the
contractual nature of the relationship in
which two willing individuals, the client
and the therapist, enter into a partnership
which aims at helping the client overcome
her/his problems. The second component
of therapeutic alliance is the limited
duration of the therapy. This alliance lasts
until the client becomes able to deal with
her/his problems and take control of her/
his life. This relationship has several
unique properties. It is a trusting and
confiding relationship.  The high level of
trust enables the client to unburden
herself/himself to the therapist and confide
her/his psychological and personal
problems to the latter. The therapist
encourages this by being accepting,
empathic, genuine and warm to the client.
The therapist conveys by her/his words
and behaviours that s/he is not judging
the client and will continue to show the
same positive feelings towards the client
even if the client is rude or confides all the
‘wrong’ things that s/he may have done or
thought about. This is the unconditional
positive regard which the therapist has for
the client. The therapist has empathy for
the client. Empathy is different from
sympathy and intellectual understanding
of another person’s situation. In sympathy,
one has compassion and pity towards the
suffering of another but is not able to feel
like the other person. Intellectual
understanding is cold in the sense that the
person is unable to feel like the other
person and does not feel sympathy either.
On the other hand, empathy is present
when one is able to understand the plight
of another person, and feel like the other
person. It means understanding things
from the other person’s perspective, i.e.
putting oneself in the other person’s shoes.
Empathy enriches the therapeutic
relationship and transforms it into a
healing relationship.
The therapeutic alliance also requires
that the therapist must keep strict
confidentiality of the experiences, events,
feelings or thoughts disclosed by the client.
The therapist must not exploit the trust
and the confidence of the client in anyway.
Finally, it is a professional relationship,
and must remain so.
Activity
5.1
A classmate or friend of yours or your
favourite character in a TV serial may
have recently experienced a negative
or a traumatic life event (e.g., death
of a loved one, break-up of an
important friendship or relationship)
of which you are aware. Try to put
yourself in the other person’s shoes,
try to experience how that person is
feeling, what s/he is thinking and try
to take her/his perspective of the
entire situation. This will help you to
understand better how that person is
feeling.
(Note : This exercise may be done in
class, so that teachers can help
students in overcoming any distress
experienced).
TYPE OF THERAPIES
Though all psychotherapies aim at
removing human distress and fostering
effective behaviour, they differ greatly in
Page 4


Chapter 5 • Therapeutic Approaches
89
THER THER
THER THER THERAPEUTIC APPROACHES APEUTIC APPROACHES
APEUTIC APPROACHES APEUTIC APPROACHES APEUTIC APPROACHES
Nature and Process of Psychotherapy
Therapeutic Relationship
Type of Therapies
Steps in the Formulation of a Client’s Problem (Box 5.1)
Psychodynamic Therapy
Behaviour Therapy
Relaxation Procedures (Box 5.2)
Cognitive Therapy
Humanistic-existential Therapy
Biomedical Therapy
Alternative Therapies
Rehabilitation of the Mentally Ill
CONTENTS
Key Terms
Summary
Review Questions
Project Ideas
Weblinks
Pedagogical Hints
After reading this chapter, you would be able to:
familiarise yourself with the basic nature and process of psychotherapy,
appreciate that there are different types of therapies for helping people,
understand the use of psychological forms of intervention, and
know how people with mental disorders can be rehabilitated.
Psychology
90
NATURE AND PROCESS OF PSYCHOTHERAPY
Psychotherapy is a voluntary relationship
between the one seeking treatment or the
client and the one who treats or the
therapist. The purpose of the relationship
is to help the client to solve the
psychological problems being faced by her
or him. The relationship is conducive for
building the trust of the client so that
problems may be freely discussed.
Psychotherapies aim at changing the
maladaptive behaviours, decreasing the
sense of personal distress, and helping the
client to adapt better to her/his
environment. Inadequate marital,
occupational and social adjustment also
requires that major changes be made in an
individual’s personal environment.
All psychotherapeutic approaches have
the following characteristics : (i) there is
systematic application of principles
underlying the different theories of
therapy, (ii) persons who have received
practical training under expert supervision
can practice psychotherapy, and not
In the preceding chapter, you have studied about major psychological
disorders and the distress caused by them to the patient and others. In this
chapter , you will learn about the various therapeutic methods that are used
by psychotherapists to help their patients. There are various types of
psychotherapy. Some of them focus on acquiring self-understanding; other
therapies are more action-oriented. All approaches hinge on the basic issue
of helping the patient overcome her/his debilitating condition. The
effectiveness of a therapeutic approach for a patient depends on a number
of factors such as severity of the disorder , degree of distress faced by others,
and the availability of time, effort and money, among others.
All therapeutic approaches are corrective and helping in nature. All of
them involve an interpersonal relationship between the therapist and the
client or patient. Some of them are directive in nature, such as
psychodynamic, while some are non-directive such as person-centred. In
this chapter, we will briefly discuss some of the major forms of
psychotherapy.
Introduction
everybody. An untrained person may
unintentionally cause more harm than any
good, (iii) the therapeutic situation involves
a therapist and a client who seeks and
receives help for her/his emotional
problems (this person is the focus of
attention in the therapeutic process), and
(iv) the interaction of these two persons —
the therapist and the client — results in
the consolidation/formation of the
therapeutic relationship. This is a
confidential, interpersonal, and dynamic
relationship. This human relationship is
central to any sort of psychological therapy
and is the vehicle for change.
All psychotherapies aim at a few or all
of the following goals :
(i) Reinforcing client’s resolve for
betterment.
(ii) Lessening emotional pressure.
(iii) Unfolding the potential for positive
growth.
(iv) Modifying habits.
(v) Changing thinking patterns.
(vi) Increasing self-awareness.
(vii) Improving interpersonal relations and
communication.
Chapter 5 ? Therapeutic Approaches
91
(viii)Facilitating decision-making.
(ix) Becoming aware of one’s choices in
life.
(x) Relating to one’s social environment in
a more creative and self-aware
manner.
Therapeutic Relationship
The special relationship between the client
and the therapist is known as the
therapeutic relationship or alliance. It is
neither a passing acquaintance, nor a
permanent and lasting relationship. There
are two major components of a therapeutic
alliance. The first component is the
contractual nature of the relationship in
which two willing individuals, the client
and the therapist, enter into a partnership
which aims at helping the client overcome
her/his problems. The second component
of therapeutic alliance is the limited
duration of the therapy. This alliance lasts
until the client becomes able to deal with
her/his problems and take control of her/
his life. This relationship has several
unique properties. It is a trusting and
confiding relationship.  The high level of
trust enables the client to unburden
herself/himself to the therapist and confide
her/his psychological and personal
problems to the latter. The therapist
encourages this by being accepting,
empathic, genuine and warm to the client.
The therapist conveys by her/his words
and behaviours that s/he is not judging
the client and will continue to show the
same positive feelings towards the client
even if the client is rude or confides all the
‘wrong’ things that s/he may have done or
thought about. This is the unconditional
positive regard which the therapist has for
the client. The therapist has empathy for
the client. Empathy is different from
sympathy and intellectual understanding
of another person’s situation. In sympathy,
one has compassion and pity towards the
suffering of another but is not able to feel
like the other person. Intellectual
understanding is cold in the sense that the
person is unable to feel like the other
person and does not feel sympathy either.
On the other hand, empathy is present
when one is able to understand the plight
of another person, and feel like the other
person. It means understanding things
from the other person’s perspective, i.e.
putting oneself in the other person’s shoes.
Empathy enriches the therapeutic
relationship and transforms it into a
healing relationship.
The therapeutic alliance also requires
that the therapist must keep strict
confidentiality of the experiences, events,
feelings or thoughts disclosed by the client.
The therapist must not exploit the trust
and the confidence of the client in anyway.
Finally, it is a professional relationship,
and must remain so.
Activity
5.1
A classmate or friend of yours or your
favourite character in a TV serial may
have recently experienced a negative
or a traumatic life event (e.g., death
of a loved one, break-up of an
important friendship or relationship)
of which you are aware. Try to put
yourself in the other person’s shoes,
try to experience how that person is
feeling, what s/he is thinking and try
to take her/his perspective of the
entire situation. This will help you to
understand better how that person is
feeling.
(Note : This exercise may be done in
class, so that teachers can help
students in overcoming any distress
experienced).
TYPE OF THERAPIES
Though all psychotherapies aim at
removing human distress and fostering
effective behaviour, they differ greatly in
Psychology
92
concepts, methods, and techniques.
Psychotherapies may be classified into
three broad groups, viz. the
psychodynamic, behaviour, and existential
psychotherapies. In terms of the
chronological order, psychodynamic
therapy emerged first followed by
behaviour therapy while the existential
therapies which are also called the third
force, emerged last. The classification of
psychotherapies is based on the following
parameters:
1. What is the cause, which has led to the
problem?
Psychodynamic therapy is of the view
that intrapsychic conflicts, i.e. the
conflicts that are present within the
psyche of the person, are the source of
psychological problems. According to
behaviour therapies, psychological
problems arise due to faulty learning of
behaviours and cognitions. The
existential therapies postulate that the
questions about the meaning of one’s
life and existence are the cause of
psychological problems.
2. How did the cause come into existence?
In the psychodynamic therapy,
unfulfilled desires of childhood and
unresolved childhood fears lead to
intrapsychic conflicts. The behaviour
therapy postulates that faulty
conditioning patterns, faulty learning,
and faulty thinking and beliefs lead to
maladaptive behaviours that, in turn,
lead to psychological problems. The
existential therapy places importance
on the present. It is the current feelings
of loneliness, alienation, sense of futility
of one’s existence, etc., which cause
psychological problems.
3. What is the chief method of treatment?
Psychodynamic therapy uses the
methods of free association and
reporting of dreams to elicit the
thoughts and feelings of the client. This
material is interpreted to the client to
help her/him to confront and resolve
the conflicts and thus overcome
problems. Behaviour therapy identifies
the faulty conditioning patterns and
sets up alternate behavioural
contingencies to improve behaviour.
The cognitive methods employed in this
type of therapy challenge the faulty
thinking patterns of the client to help
her/him overcome psychological
distress. The existential therapy
provides a therapeutic environment
which is positive, accepting, and non-
judgmental. The client is able to talk
about the problems and the therapist
acts as a facilitator. The client arrives
at the solutions through a process of
personal growth.
4. What is the nature of the therapeutic
relationship between the client and the
therapist?
Psychodynamic therapy assumes that
the therapist understands the client’s
intrapsychic conflicts better than the
client and hence it is the therapist who
interprets the thoughts and feelings of
the client to her/him so that s/he gains
an understanding of the same. The
behaviour therapy assumes that the
therapist is able to discern the faulty
behaviour and thought patterns of the
client. It further assumes that the
therapist is capable of finding out the
correct behaviour and thought
patterns, which would be adaptive for
the client. Both the psychodynamic and
the behaviour therapies assume that
the therapist is capable of arriving at
solutions to the client’s problems. In
contrast to these therapies, the
existential therapies emphasise that the
therapist merely provides a warm,
empathic relationship in which the
client feels secure to explore the nature
Page 5


Chapter 5 • Therapeutic Approaches
89
THER THER
THER THER THERAPEUTIC APPROACHES APEUTIC APPROACHES
APEUTIC APPROACHES APEUTIC APPROACHES APEUTIC APPROACHES
Nature and Process of Psychotherapy
Therapeutic Relationship
Type of Therapies
Steps in the Formulation of a Client’s Problem (Box 5.1)
Psychodynamic Therapy
Behaviour Therapy
Relaxation Procedures (Box 5.2)
Cognitive Therapy
Humanistic-existential Therapy
Biomedical Therapy
Alternative Therapies
Rehabilitation of the Mentally Ill
CONTENTS
Key Terms
Summary
Review Questions
Project Ideas
Weblinks
Pedagogical Hints
After reading this chapter, you would be able to:
familiarise yourself with the basic nature and process of psychotherapy,
appreciate that there are different types of therapies for helping people,
understand the use of psychological forms of intervention, and
know how people with mental disorders can be rehabilitated.
Psychology
90
NATURE AND PROCESS OF PSYCHOTHERAPY
Psychotherapy is a voluntary relationship
between the one seeking treatment or the
client and the one who treats or the
therapist. The purpose of the relationship
is to help the client to solve the
psychological problems being faced by her
or him. The relationship is conducive for
building the trust of the client so that
problems may be freely discussed.
Psychotherapies aim at changing the
maladaptive behaviours, decreasing the
sense of personal distress, and helping the
client to adapt better to her/his
environment. Inadequate marital,
occupational and social adjustment also
requires that major changes be made in an
individual’s personal environment.
All psychotherapeutic approaches have
the following characteristics : (i) there is
systematic application of principles
underlying the different theories of
therapy, (ii) persons who have received
practical training under expert supervision
can practice psychotherapy, and not
In the preceding chapter, you have studied about major psychological
disorders and the distress caused by them to the patient and others. In this
chapter , you will learn about the various therapeutic methods that are used
by psychotherapists to help their patients. There are various types of
psychotherapy. Some of them focus on acquiring self-understanding; other
therapies are more action-oriented. All approaches hinge on the basic issue
of helping the patient overcome her/his debilitating condition. The
effectiveness of a therapeutic approach for a patient depends on a number
of factors such as severity of the disorder , degree of distress faced by others,
and the availability of time, effort and money, among others.
All therapeutic approaches are corrective and helping in nature. All of
them involve an interpersonal relationship between the therapist and the
client or patient. Some of them are directive in nature, such as
psychodynamic, while some are non-directive such as person-centred. In
this chapter, we will briefly discuss some of the major forms of
psychotherapy.
Introduction
everybody. An untrained person may
unintentionally cause more harm than any
good, (iii) the therapeutic situation involves
a therapist and a client who seeks and
receives help for her/his emotional
problems (this person is the focus of
attention in the therapeutic process), and
(iv) the interaction of these two persons —
the therapist and the client — results in
the consolidation/formation of the
therapeutic relationship. This is a
confidential, interpersonal, and dynamic
relationship. This human relationship is
central to any sort of psychological therapy
and is the vehicle for change.
All psychotherapies aim at a few or all
of the following goals :
(i) Reinforcing client’s resolve for
betterment.
(ii) Lessening emotional pressure.
(iii) Unfolding the potential for positive
growth.
(iv) Modifying habits.
(v) Changing thinking patterns.
(vi) Increasing self-awareness.
(vii) Improving interpersonal relations and
communication.
Chapter 5 ? Therapeutic Approaches
91
(viii)Facilitating decision-making.
(ix) Becoming aware of one’s choices in
life.
(x) Relating to one’s social environment in
a more creative and self-aware
manner.
Therapeutic Relationship
The special relationship between the client
and the therapist is known as the
therapeutic relationship or alliance. It is
neither a passing acquaintance, nor a
permanent and lasting relationship. There
are two major components of a therapeutic
alliance. The first component is the
contractual nature of the relationship in
which two willing individuals, the client
and the therapist, enter into a partnership
which aims at helping the client overcome
her/his problems. The second component
of therapeutic alliance is the limited
duration of the therapy. This alliance lasts
until the client becomes able to deal with
her/his problems and take control of her/
his life. This relationship has several
unique properties. It is a trusting and
confiding relationship.  The high level of
trust enables the client to unburden
herself/himself to the therapist and confide
her/his psychological and personal
problems to the latter. The therapist
encourages this by being accepting,
empathic, genuine and warm to the client.
The therapist conveys by her/his words
and behaviours that s/he is not judging
the client and will continue to show the
same positive feelings towards the client
even if the client is rude or confides all the
‘wrong’ things that s/he may have done or
thought about. This is the unconditional
positive regard which the therapist has for
the client. The therapist has empathy for
the client. Empathy is different from
sympathy and intellectual understanding
of another person’s situation. In sympathy,
one has compassion and pity towards the
suffering of another but is not able to feel
like the other person. Intellectual
understanding is cold in the sense that the
person is unable to feel like the other
person and does not feel sympathy either.
On the other hand, empathy is present
when one is able to understand the plight
of another person, and feel like the other
person. It means understanding things
from the other person’s perspective, i.e.
putting oneself in the other person’s shoes.
Empathy enriches the therapeutic
relationship and transforms it into a
healing relationship.
The therapeutic alliance also requires
that the therapist must keep strict
confidentiality of the experiences, events,
feelings or thoughts disclosed by the client.
The therapist must not exploit the trust
and the confidence of the client in anyway.
Finally, it is a professional relationship,
and must remain so.
Activity
5.1
A classmate or friend of yours or your
favourite character in a TV serial may
have recently experienced a negative
or a traumatic life event (e.g., death
of a loved one, break-up of an
important friendship or relationship)
of which you are aware. Try to put
yourself in the other person’s shoes,
try to experience how that person is
feeling, what s/he is thinking and try
to take her/his perspective of the
entire situation. This will help you to
understand better how that person is
feeling.
(Note : This exercise may be done in
class, so that teachers can help
students in overcoming any distress
experienced).
TYPE OF THERAPIES
Though all psychotherapies aim at
removing human distress and fostering
effective behaviour, they differ greatly in
Psychology
92
concepts, methods, and techniques.
Psychotherapies may be classified into
three broad groups, viz. the
psychodynamic, behaviour, and existential
psychotherapies. In terms of the
chronological order, psychodynamic
therapy emerged first followed by
behaviour therapy while the existential
therapies which are also called the third
force, emerged last. The classification of
psychotherapies is based on the following
parameters:
1. What is the cause, which has led to the
problem?
Psychodynamic therapy is of the view
that intrapsychic conflicts, i.e. the
conflicts that are present within the
psyche of the person, are the source of
psychological problems. According to
behaviour therapies, psychological
problems arise due to faulty learning of
behaviours and cognitions. The
existential therapies postulate that the
questions about the meaning of one’s
life and existence are the cause of
psychological problems.
2. How did the cause come into existence?
In the psychodynamic therapy,
unfulfilled desires of childhood and
unresolved childhood fears lead to
intrapsychic conflicts. The behaviour
therapy postulates that faulty
conditioning patterns, faulty learning,
and faulty thinking and beliefs lead to
maladaptive behaviours that, in turn,
lead to psychological problems. The
existential therapy places importance
on the present. It is the current feelings
of loneliness, alienation, sense of futility
of one’s existence, etc., which cause
psychological problems.
3. What is the chief method of treatment?
Psychodynamic therapy uses the
methods of free association and
reporting of dreams to elicit the
thoughts and feelings of the client. This
material is interpreted to the client to
help her/him to confront and resolve
the conflicts and thus overcome
problems. Behaviour therapy identifies
the faulty conditioning patterns and
sets up alternate behavioural
contingencies to improve behaviour.
The cognitive methods employed in this
type of therapy challenge the faulty
thinking patterns of the client to help
her/him overcome psychological
distress. The existential therapy
provides a therapeutic environment
which is positive, accepting, and non-
judgmental. The client is able to talk
about the problems and the therapist
acts as a facilitator. The client arrives
at the solutions through a process of
personal growth.
4. What is the nature of the therapeutic
relationship between the client and the
therapist?
Psychodynamic therapy assumes that
the therapist understands the client’s
intrapsychic conflicts better than the
client and hence it is the therapist who
interprets the thoughts and feelings of
the client to her/him so that s/he gains
an understanding of the same. The
behaviour therapy assumes that the
therapist is able to discern the faulty
behaviour and thought patterns of the
client. It further assumes that the
therapist is capable of finding out the
correct behaviour and thought
patterns, which would be adaptive for
the client. Both the psychodynamic and
the behaviour therapies assume that
the therapist is capable of arriving at
solutions to the client’s problems. In
contrast to these therapies, the
existential therapies emphasise that the
therapist merely provides a warm,
empathic relationship in which the
client feels secure to explore the nature
Chapter 5 ? Therapeutic Approaches
93
and causes of her/his problems by
herself/himself.
5. What is the chief benefit to the client?
Psychodynamic therapy values
emotional insight as the important
benefit that the client derives from the
treatment. Emotional insight is present
when the client understands her/his
conflicts intellectually; is able to accept
the same emotionally; and is able to
change her/his emotions towards the
conflicts. The client’s symptoms and
distresses reduce as a consequence of
this emotional insight. The behaviour
therapy considers changing faulty
behaviour and thought patterns to
adaptive ones as the chief benefit of the
treatment. Instituting adaptive or
healthy behaviour and thought
patterns ensures reduction of distress
and removal of symptoms. The
humanistic therapy values personal
growth as the chief benefit. Personal
growth is the process of gaining
increasing understanding of oneself,
and one’s aspirations, emotions and
motives.
6. What is the duration of treatment?
The duration of classical psycho-
analysis may continue for several years.
However, several recent versions of
psychodynamic therapies are completed
in 10–15 sessions. Behaviour and
cognitive behaviour therapies as well as
existential therapies are shorter and are
completed in a few months.
Thus, different types of psycho-
therapies differ on multiple parameters.
However, they all share the common
method of providing treatment for
psychological distress through psycho-
logical means. The therapist, the
therapeutic relationship, and the process
of therapy become the agents of change in
the client leading to the alleviation of
psychological distress. The process of
psychotherapy begins by formulating the
client’s problem. Steps involved in the
formulation of a client’s problem are given
in Box 5.1.
Box
5.1
Steps in the Formulation of a Client’s Problem
Clinical formulation refers to formulating the problem of the client in the therapeutic model
being used for the treatment. The clinical formulation has the following advantages:
1. Understanding of the problem : The therapist is able to understand the full implications
of the distress being experienced by the client.
2. Identification of the areas to be targetted for treatment in psychotherapy : The theoretical
formulation clearly identifies the problem areas to be targetted for therapy.  Thus, if a
client seeks help for inability to hold a job and reports inability to face superiors, the
clinical formulation in behaviour therapy would state it as lack of assertiveness skills
and anxiety.  The target areas have thus been identified as inability to assert oneself
and heightened anxiety.
3. Choice of techniques for treatment : The choice of techniques for treatment depends on
the therapeutic system in which the therapist has been trained. However, even within
this broad domain, the choice of techniques, timing of the techniques, and expectations
of outcome of the therapy depend upon the clinical formulation.
The clinical formulation is an ongoing process. Formulations may require reformulations
as clinical insights are gained in the process of therapy. Usually the first one or two sessions
yield enough clinical material for the initial clinical formulation.  It is not advisable to start
psychotherapy without a clinical formulation.