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Many of my patients are baffled about all the different kinds of psychotherapy which are available, and which kind might be most helpful for them.

This is a complex question, and cannot be answered with some knowledge of your diagnosis and your personal situation.

Basically, I believe some patients benefit from medications, some from psychotherapy, and some from both forms of treatment.

Psychotherapy is a subject with a rich history and many therapists have thought deeply about how to help people, so trying to summarize anything about it on one page is bound be superficial. However, I have listed two sources below which are representative of the way that I understand the theory behind psychotherapy.

The first book is a classic, written by one of my teachers and clinical supervisors. Although the research described in the book is now dated, I think that the primary claims that Dr. Frank made are still correct and relevant:

  • Most of the effectiveness of different forms of psychotherapy are due to features that they all have in common rather than to those that distinguish them from one another.
  • A major source of the distress and disability of persons who seek psychotherapeutic help is demoralization, a sense of failure or powerlessness to affect oneself and one's environment.
  • Common to all types of psychotherapy are features that combat demoralization by alleviating specific symptoms of distress and disordered behavior, and more importantly, restoring self-confidence and promoting a sense of mastery through successful experiences.
  • All psychotherapies involve a particular setting and a conceptual framework that specifies a relationship between healer and patient.
  • Psychotherapy is more akin to rhetoric than applied behavioral science, a position fraught with implications for how the subjects should be practiced, studied and taught.

In the second book, there is an essay by another teacher of mine, Dr. Paul McHugh, entitled 'The "conflict" and the "deficit" psychotherapies." In this essay,Dr. McHugh divides psychotherapies into two types. In the "conflict" psychotherapies, exemplified by therapies such psychoanalysis or "dynamic" psychotherapies, the mental model used by the therapist in guiding psychotherapy involves the concept of conflict between conscious and unconscious factors within the patient as being the cause of painful symptoms. "Conflict" oriented psychotherapists often try to help people get better by trying to understand how past events may be influencing them now. In the "deficit" psychotherapies, exemplified by therapies such as cognitive behavioral therapy, the mental model used by the therapist in guiding psychotherapy involves the concept of cognitive distortions. "Deficit" oriented psychotherapists usually try to help people get better by helping people change these cognitive distortions.

I have had some training in both types of psychotherapy and combine features from both, but my primary focus tends to be oriented towards correcting cognitive distortions.