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Psychodynamic
therapy is based on psychoanalytic ways of
understanding personal and emotional development. The way we see
and relate to the world develops through relationships made in
infancy, childhood, and later life. Disturbances in these
relationships can produce continuing vulnerabilities, and symptoms
and relationship problems in later life. Symptoms have a meaning in
the context of our lives, and difficulties in relationships often
follow patterns laid down in earlier life.
The therapist offers a reliable and professional relationship,
where old patterns may be repeated, but can be thought about and
understood in a way that frees people to change.
- Individual psychodynamic therapy in the NHS is usually offered
weekly. The duration can range from a few months to considerably
longer, although NHS resources for long-term treatments are not
always available.
- Couple therapy may be suggested where problems seem to centre
in the relationship between partners.
- In group therapy a small group of people meets weekly, with a
therapist, over a substantial period of time. The group becomes a
reliable setting within which members can come to a new
understanding of themselves and others, in a way that allows change
to take place. Most groups involve men and women with a variety of
problems and backgrounds. Some groups consist of people with
similar experiences coming together to share these. This can
relieve feelings of isolation - such as in groups for those
recovering from child sexual abuse, young people, or those facing
old age.
- For more intensive group therapy, the therapeutic community
approach can be used, where people meet together for a therapeutic
programme lasting several hours a day. This treatment is sometimes
offered on a residential basis.
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Cognitive behavioural
therapy has been developed from learning theory and is
less concerned with development of personality, or with the nature
of the relationship with the therapist. A less intense, but
supportive relationship is encouraged instead.
The focus is often on the practical effects of a problem, rather
than its meaning and the reasons behind it.
The aim is to treat difficulties by problem solving, finding
better strategies for coping, and overcoming irrational fears.
Treatment is usually on a weekly one-to-one basis, lasting for up
to a few months.
Cognitive analytic therapy, or CAT, is a therapy that
incorporates both cognitive and psychodynamic insights. It has a
relatively brief, but intense, format.
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Systemic therapy
sees a symptom or problem in one individual as arising from
unhealthy interactions within a network of people. In NHS practice,
this usually means the person’s family, but the understanding can
be applied to other groups, such as a work setting. The approach
does not label one single person as "ill", or as "the patient".
Treatment consists of meeting with the whole family, and
exploring the network of views and relationships, to throw new
light on the problems the family is having. This can help family
members discover new and more helpful ways of communicating with
each other. Appointments are usually several weeks apart, with
meetings spaced over a period of months.
Counselling is a
general term for exploring emotional problems by talking them
through with a trained counsellor or therapist. The term covers a
considerable range of approaches. In its simplest form, this can be
supportive and sympathetic listening in the form of weekly sessions
over a small number of weeks. This sort of counselling is suited to
people with fundamentally healthy personalities who need help in
addressing a current crisis in their life or relationships.
Some more experienced counsellors, who have had further training
in any of a large range of theoretical approaches, work in a deeper
way, and are able to help people with more complex problems.
Counsellors are sometimes attached to Health Centres and able to
see patients directly at the request of the GP.
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