NCERT Textbook: Therapeutic Approaches | Psychology for UPSC Optional (Notes) PDF Download

 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)
Behaviour Therapy
Relaxation Procedures (Box 5.2)
Cognitive Therapy
Humanistic-existential 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.
Rationalised 2023-24
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)
Behaviour Therapy
Relaxation Procedures (Box 5.2)
Cognitive Therapy
Humanistic-existential 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.
Rationalised 2023-24
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 everybody.
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
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.
Rationalised 2023-24
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)
Behaviour Therapy
Relaxation Procedures (Box 5.2)
Cognitive Therapy
Humanistic-existential 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.
Rationalised 2023-24
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 everybody.
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
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.
Rationalised 2023-24
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
Rationalised 2023-24
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)
Behaviour Therapy
Relaxation Procedures (Box 5.2)
Cognitive Therapy
Humanistic-existential 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.
Rationalised 2023-24
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 everybody.
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
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.
Rationalised 2023-24
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
Rationalised 2023-24
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
Rationalised 2023-24
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)
Behaviour Therapy
Relaxation Procedures (Box 5.2)
Cognitive Therapy
Humanistic-existential 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.
Rationalised 2023-24
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 everybody.
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
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.
Rationalised 2023-24
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
Rationalised 2023-24
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
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Chapter 5 • Therapeutic Approaches
93
explore the nature 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.
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