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Psychotherapy

Psychotherapy is an interpersonal, relational intervention used by trained psychotherapists to aid patients in problems of living. This usually includes increasing individual sense of well-being and reducing subjective discomforting experience. Psychotherapists employ a range of techniques based on experiential relationship building, dialogue, communication and behavior change and that are designed to improve the mental health of a client or patient, or to improve group relationships (such as in a family).

Client confidentiality is the legal principle that a psychiatric, psychologist, social worker, or counselor cannot not reveal information about their patients to a third party without the consent of the patient or a clear legal obligation such as in the case of imminent suicide, homicide, child abuse, elder abuse, abuse of a disabled individual, inappropriate sexual relationship with a healthcare worker, or a court order signed by a judge.

PSYCHOTHERAPY MODALITIES (available at CMPS)

Individual Psychotherapy: Individual psychotherapy involves one-on-one interaction between a therapist and a patient. The therapist may be a psychiatrist, psychologist, licensed social worker, or licensed therapist. During psychotherapy, efforts are made to understand a patient’s thoughts and feelings that are involved in behaviors and decision making. The psychotherapy also involves helping the patient develop more effective strategies to manage stress and emotions, and to make more effective decisions about behaviors.

Family Psychotherapy: Family psychotherapy involves a therapist meeting with two or more members of a family. Family psychotherapy helps individual family members better understand the thoughts, motivations, feelings, and behaviors of other family members. Communication improves and family members make more effective behavior choices.

Couples Therapy: This is a modality of choice when communication problems between two individuals involved in an intimate relationship are causing stress and disharmony. The client and focus of treatment, in this case, is on the relationship, not the individuals. Without “taking sides”, the therapist focuses on how the individuals involved in the relationship can better understand and express their needs within the context of better understanding the emotional needs and messages of the other. Development of problem resolution strategies is the goal so that the relationship, as a whole, is healthier and able to withstand the stresses of everyday life as well as crises.

Group Psychotherapy: Group psychotherapy involves a therapist meeting with a group of people with similar types of emotional issues. During group psychotherapy, patients learn how other people react and cope. Together each individual in the group learns ways of presenting themselves, reacting, and coping which they may never have in the past realized or considered were possible. The group members learn and grow together by sharing their feelings and reactions in a safe, confidential environment led by a psychotherapist who is experienced in this type of treatment.

PSYCHOTHERAPY TECHNIQUES / MODELS / SCHOOLS / SYSTEMS (which may be utilized at CMPS)

Psychodynamic psychotherapy is a form of insight-oriented “talk therapy” the primary focus of which is to explore underlying conscious or unconscious causes of how a patient may be feeling or acting. The interpersonal relationship between the patient and the therapist is crucial to allowing for trust to occur and for reactions that occur within the therapeutic relationship to be explored in terms of how those reactions may impact the patient in his/her everyday life and relationships. This form of therapy tends to be more eclectic than others, taking techniques from a variety of sources, rather than relying on a single system of intervention.

Humanistic psychology is a school of psychology that is explicitly concerned with the human dimension of psychology. The meaning of behavior in the context of the nature of healthy growth is primary. The postulates of Humanistic Psychology include:

      • Human beings cannot be reduced to components.
      • Human beings have in them a uniquely human context.
      • Human consciousness includes an awareness of oneself in the context of other people.
      • Human beings have choices and non desired responsibilities.
      • Human beings are intentional, they seek meaning, value and creativity.

Behavior Therapy: Specific strategies are used to help encourage acceptable behaviors and discourage unacceptable behaviors. These strategies may include the use of positive and negative reinforcers which increase or decrease the likelihood of a behavior occurring.

Interactive Psychotherapy/Play Therapy: Interactive psychotherapy involves interaction between a therapist and a patient who cannot understand language sufficiently for a verbal psychotherapy to be completely helpful. Play therapy is a type of interactive psychotherapy used with children. There are also specialized interactive psychotherapy techniques to help clients with impairments of language, including autistic individuals.

Cognitive-Behavioral Therapy (CBT) is a form of psychotherapy that emphasizes the important role of thinking in how we feel and what we do. It is focused on modifying everyday thoughts and behaviors, with the aim of positively influencing emotions. The therapist helps clients recognize distorted thinking and learn to replace unhealthy thoughts with more realistic substitute ideas. It does not exist as a distinct therapeutic technique. There are several approaches to cognitive-behavioral therapy, including Rational Emotive Behavior Therapy, Rational Behavior Therapy, Rational Living Therapy, Cognitive Therapy, and Dialectic Behavior Therapy. However, most cognitive-behavioral therapies have the following characteristics:

CBT is based on the Cognitive Model of Emotional Response.
CBT is briefer and time-limited.
A sound therapeutic relationship is necessary for effective therapy, but not the focus.
CBT is a collaborative effort between the therapist and the client.
CBT is structured and directive.
CBT is based on an educational model.
CBT theory and techniques rely on the Inductive Method.
Homework is a central feature of CBT.

For more information, see: http://www.nacbt.org/whatiscbt.htm

Dialectical behavioral therapy (DBT) is a psychological method developed by Marsha M. Linehan to treat patients with prominent difficulties with emotional reactivity, particularly in terms of anger/rage, anxiety, and extreme emotional mood swings. DBT also directly addresses issues related to self-injury and impaired interpersonal relationships.

A key component of DBT is the therapist and patient working together towards improving emotional and behavioral coping skills (core mindfulness skills, emotional regulation skills, interpersonal effectiveness skills, and distress tolerance skills). This is accomplished by discussing issues that come up during the week, and developing charts and lists to use as a diary to facilitate such discussions. Self-injurious and suicidal behaviors take first priority, followed by episodes of destructive emotional over-reactivity experienced during the week. The approach is practical and oriented toward behavior change as opposed to insight oriented understanding of the origin of symptoms. The emphasis in on “radical acceptance” of one’s symptoms and simultaneously of the need to change behavior.

Psychoanalysis is a treatment approach, refined over 100 years, that has been enhanced by contributions from Freud, neuro-science, sociology and linguistics for drawing inferences about unconscious processes.  There is a wide range of empirical data that supports the theory and application.

This approach has evolved over the years to help develop a deeper understanding and eventual working through of internal systems that contribute to destructive and repetitive patterns that can be passed on from generation to generation.  Psychoanalysis focuses on the relationship between the client and the analyst and the function of resistance and defenses. It is not an intellectual approach but an emotional one which the therapist has been trained to experience the process called countertransference.  It no longer entails years of therapy.

Psychoanalysis has much to offer to both individuals seeking to address emotional concerns and to modern day culture and society.

Dr. Raymond Roitman is a Certified Psychoanalyst with a Doctorate in Psychoanalysis.  He has been involved in the mental health field in a variety of settings.  He is a mature, seasoned, caring professional whose  approach is both supportive, practical and evolving.  He has been working for C.M.P.S. for over 9 years.

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