Chapter 14  Individual Psychotherapy

1. Chapter 14Individual Psychotherapy

2. The goal of individual therapy is to alleviate patients’ emotional difficulties in living and the elimination of symptomatology. Fromm-Reichmann, 1960

3. Learning Objectives • After studying this chapter, you should be able to • Recognize the terms transference, countertransference,resistance, and parataxis • Compare and contrast the principles of individual psychotherapy for children, adolescents, and adults • Explain the qualifications of a nurse–therapist • Articulate the role of the nurse as counselor • Formulate a list of some alternate approaches to conventional psychotherapy

4. An important factor common to all of the psychotherapeutic approaches is the client–therapist relationship with its interpersonal experiences. (Kolb, 1982)

5. Individual Psychotherapy • Establish a therapeutic relationship with the client. • Provide an opportunity for the client to release tension as problems are discussed. • Assist the client in gaining insight about the problem. • Provide the opportunity to practice new skills. • Reinforce appropriate behavior as it occurs. • Provide consistent emotional support.

6. Modes of Individual Psychotherapy • Brief cognitive therapy • Behavior therapy • Cognitive–behavioral therapy • Brief interpersonal psychotherapy • Split-treatment psychotherapy

7. Brief Cognitive Therapy • This therapy uses a time-limited, goal-oriented, problem-solving, here-and-now approach. • The therapist helps individuals solve present-day problems by identifying distorted thinking that causes emotional discomfort, exploring alternate behaviors, and creating change.

8. Behavior Therapy • This therapy focuses on modifying overt symptoms without regard to the client’s private experience or inner conflicts. • It is based on the assumption that behaviors or responses are learned and may be relearned. • The therapist helps the client analyze behavior, define problems, and select goals.

9. Cognitive–Behavioral Therapy • CBT is a structured, collaborative, goal-oriented psychotherapy that focuses on current symptoms and teaches specific skills and strategies for managing them. • The therapist works with the client to identify both the thoughts and the behaviors that are causing distress and to change those thoughts in order to readjust the behavior.

10. Brief Interpersonal Psychotherapy (BIPT) • BIPT is a semistructured, psychodynamically time-limited model of psychotherapy. • It focuses on the overall relationship competency of the client and the client’s level of satisfaction with his or her environment. • The therapist reinforces the client’s self-esteem; employs a conversational, goal-focused approach; reinforces and supports the positive use of defense mechanisms or coping skills; and avoids the use of transference and countertransference.

11. Split-Treatment Psychotherapy • It is also referred to as dual treatment, triangulated treatment, or medication backup. • It combines a protocol between a nurse–therapist who provides psychotherapy and a psychiatrist or nurse practitioner who provides pharmacotherapy for the client.

12. Counseling • Counseling interventions may occur in a variety of settings and may include the following: • Communication and interviewing techniques • Problem-solving skills • Crisis intervention • Stress management • Relaxation techniques • Assertiveness training • Conflict resolution • Behavior modification

13. Alternate Approaches to Psychotherapy • Online psychotherapy or e-therapy –Cyberspace therapy –Telepsychiatry –Videophone psychotherapy • Dialectic behavioral therapy (DBT) • Cross-cultural therapy

14. Key Terms • Behavior therapy • Brief cognitive therapy • Brief interpersonal psychotherapy • Cognitive–behavioral therapy • Counseling • Countertransference • Dialectic behavioral therapy • e-therapy • Individual psychotherapy • Parataxis • Psychoanalysis • Psychotherapy • Resistance • Split-treatment psychotherapy • Transference

15. ? Reflection • How does the nurse use the therapeutic relationship to achieve the goals of individual psychotherapy? • Consider the benefits and limitations of the five modes of individual psychotherapy presented in this chapter. • Identify clients who might benefit from the different modes of psychotherapy, and explain the rationales for your selections.