What is psychotherapy?
Psychotherapy is the treatment of mental and emotional disorders through the use of psychological techniques designed to encourage communication of conflicts and to deliver insight into problems. The ultimate goal is the relief of symptoms and changes in behaviour leading to improved social and vocational functioning and personality growth.
What is Integrative psychotherapy ?
Integrative psychotherapy is an approach that emphasises the value of all individuals. Practitioners attempt to integrate all aspects of the personality such as feelings, perceptions and unresolved conflicts into a cohesive whole, that can encourage their client to approach life more positively, without prejudice, pre-formed opinions or attitudes.
The Integrative psychotherapeutic model recognises the use of other therapeutic approaches such as humanistic, cognitive, gestalt and psychodynamic and attempts to fuse them into a approach that is of benefit to the individual. The facilitation of a person's 'wholeness', to improve their quality of life, is one of the most important features of Integrative therapy.
Does psychotherapy work?
Many people feel a great deal of benefit from psychotherapy, even after comparatively few meetings. When you comes to a turning point in your life, help from someone who has experience of such difficulties and an understanding of the processes you need to go through, can be invaluable.
Much research has been carried out into the effectiveness of psychotherapy. Significant improvements have been demonstrated in a number of areas, including symptoms, social and occupational functioning, family and other relationship patterns, personality change and reduction in the relapse rate of severe mental illness.
Like any other treatment or life experience, psychotherapy may not be suitable for everyone. Each individual has to make up their own mind about whether psychotherapy is helpful for them. One aim of the initial consultation is to help you think about whether psychotherapy might be useful for you.
Is there a difference between therapy, counselling and psychotherapy?
Psychotherapy is the most specific term referring to the process of therapy on psychological issues as defined above. 'Therapy' is often used interchangeably, when referring to psychotherapy but in reality it is the more general term referring to the treatment of any illness or disability by any means e.g. physical therapy or aromatherapy. Counselling is also a more generic term, and is often used to describe an exchange of ideas or advice giving, e.g. pastoral counseling, career counselling.
Usually psychotherapy trainings are longer and more in-depth than counselling training, although not all therapy or counselling trainings are equivalent so some care should be taken when comparing one counsellor or therapist with another.
Who can be helped by psychotherapy?
People suffering from a wide range of psychological and emotional problems can be helped.
People with quite clear-cut symptoms such as phobias, obsessions, compulsions or panic attacks often find much relief in behavioural approaches that target the specific symptom.
Cognitive therapies extend these approaches, and pay particular attention to recurring, self-defeating patterns of thought in conditions such as depression and anxiety.
Family therapy may be sought by a family where they have relationship difficulties. It may be suggested to a family where, for example, children have behavioural disturbances, or when one or more family members develop symptoms. It may also help with difficulties at a time of change in the family, such as a bereavement, a birth, or when children are about to leave home.
The psychodynamic therapies are used mostly with difficulties arising from problems of living with oneself, or in relation to others. People vary in their susceptibility to emotional distress, often through a combination of temperament, family relationships in childhood, and possibly experiences of trauma, loss, neglect, and abuse. Circumstances may then trigger psychiatric symptoms or disturbed behaviour, including self-harm.
Where the source of the problem concerns a particular event such as a bereavement or unexpected trauma in a person with an otherwise healthy personality, the therapy may only need to be brief. Where such events touch on deeper problems, the issues are more complex, and the person may need longer term therapy. Sometimes there is a need to combine medication and psychotherapy over a longer period of time.
In all cases, the choice of approach should be based upon individual need.
How long does psychotherapy take?
This depends. Psychotherapy is a collaborative process between you and your therapist. The initial consultation should help you to decide if this is the right person for you to work with. Over the first few months, one should not ask the question, "Am I fixed?" Rather ask, "Am I moving in the right direction?" Spinning off of the old adage, "Psychotherapy is a journey, not a destination."
Psychotherapy often requires a deeper examination of core issues, childhood events or past traumas. Akin to an archeological dig, this excavation of old material can unsettle thoughts which have been dormant for many years. When this happen, you may actually feel worse. Know that this too can be part of the process which will ultimately promote healing.
How do I choose a psychotherapist?
There is no one way to find the right psychotherapist. The most common method is word of mouth. Friends, family, or other trusted individuals often are the best referral source because they know you and/or the therapist personally. While there is much research about the best type of therapy, the most consistent finding is this: the relationship between therapist and client is the most important factor in determining outcome. Finding someone that you can trust and feel comfortable with is the best criteria to use.
It is encouraged that you phone a potential psychotherapist. Ask your questions and see if he/she is the right fit for you. It is also important to ask if he/she can work with the particular problem that you want addressed, e.g., couples therapy, coping with depression, etc. I welcome and encourage such phone calls in my practice.
What should I be prepared for in the process of therapy?
All effective treatments are challenging. During psychotherapy there may be spells of being in touch with painful emotions, sometimes for the first time, which may temporarily lead to feeling worse. This is part of the process of facing, and learning to live with your feelings.
The process of psychotherapy can make people question the way they live their lives and make relationships. It is important that people try not to make major life decisions whilst they are in a period of upheaval, because the decisions may be impulsive, before the underlying issues have been understood. Sometimes, however, important decisions have to be made, and therapy should then provide a place for reflection and considering the options.
On occasions, a person drops out of therapy, feeling disappointed or angry with their psychotherapist. As with any relationship, the reasons for this may be simple or complex - and there may be great benefit, even if the relationship ends, from understanding what went wrong, and why. Ideally this understanding can be worked out in collaboration with the therapist.
If a therapy does break down, sometimes the person will later come back to treatment with someone else, to tackle problems that were not able to be dealt with the first time round.
These challenges and difficulties are aspects of therapy that are known and understood by an experienced and properly qualified psychotherapist.
Is it confidential?
Yes, all information is regarded as confidential. There are some exceptional circumstances where this might not apply, for example if I felt you were a risk to yourself or to others, then I might be ethically required to inform your GP - but I would try to agree this step with you first. In practice, breaking confidentiality is an extremely rare event.
Sources of further information
There are two national registers of psychotherapists, and one for counsellors. These are maintained by the UK Council for Psychotherapy (UKCP), the British Psychoanalytic Council and the British Association for Counselling & Psychotherapy (BACP). These organisations will be able to send general information and let you know the names and addresses of any of their therapists or counsellors working in the area. With the UKCP you will have to specify the type of therapy you are looking for, since they have a number of different sub-groups. The BACP maintains a list of counsellors accredited by the organisation. None of these bodies are part of the NHS, but are responsible for setting standards and trainings for all professionals working in these fields, within the NHS or outside it.
Various reports on psychological treatments and the arrangements needed to provide them have been issued in recent years by the Royal College of Psychiatrists.
Local NHS services will be able to give information about what is provided in their area.