Psychotherapy

G

2

Psychodrama

Psychodrama, the first form of group therapy, was developed in the 1920s by Jacob L. Moreno, an Austrian psychiatrist. Moreno brought his method to the United States in 1925, and its use spread to other parts of the world. Participants in psychodrama act out their problems—often on a real stage and with props—as a means of heightening their awareness of them. The therapist serves as the director, suggesting how participants might act out problems and assigning roles to other group members. For example, a woman might reenact a scene from her childhood with other group members playing her father, mother, brother, or sister. Groups who use psychodrama may do so weekly or simply as a one-time demonstration.

G

3

Self-Help Groups

A self-help group or support group involves people with a common problem who meet regularly to share their experiences, support each other emotionally, and encourage change or recovery. They are usually free of charge to interested participants. Self-help groups are not strictly considered psychotherapy because they are not led by a licensed mental health professional. However, they can serve as an important source of help for people in emotional distress.

There are thousands of self-help and support groups in the United States and Canada. The oldest and best known is Alcoholics Anonymous, which uses a 12-step program to treat alcoholism. Other groups have formed for cancer patients, parents whose children have been murdered, compulsive gamblers, battered women, obese people, and many other types of people.

H

Family Therapy

Family therapy involves the participation of one or more members of the same family who seek help for troubled family relationships or the problems of individual family members. Typical problems that bring families into family therapy are delinquent behavior by a child or adolescent, a child’s poor performance in school, hostilities between a parent and child or between siblings, and severe psychological disturbance or mental illness in a parent or child.

---

---

One of the most influential forms of family therapy, family systems therapy, views the family as a single, complex system or unit. Individual members are interdependent parts of the system. Rather than treating one person’s symptoms in isolation, therapists try to understand the symptoms in the larger context of the family. For example, a boy who begins picking fights with classmates might do so to get more attention from his busy parents. Therapists work from the rationale that current family relationships profoundly affect, and are affected by, an individual family member’s psychological problems. For this reason, most family therapists prefer to work with the entire family during a session, rather than meeting with family members individually.

In most family therapy sessions, the therapist encourages family members to air their feelings, frustrations, and hostilities. By observing how they interact, the therapist can help them recognize their roles and relationships with each other. The therapist tries to avoid assigning blame to any particular family member. Instead, the therapist makes suggestions about how family members might adjust their roles and prevent future conflict.

I

Couples Therapy

Couples therapy, also called marital therapy or marriage counseling, is designed to help intimate partners improve their relationship. Therapists treat married couples as well as unmarried couples of the opposite or same sex. Therapists normally hold sessions with both partners present. At certain times during therapy, however, the therapist may choose to see the partners individually.

Couples may seek therapy for a variety of problems, many of which concern a breakdown of communication or trust between the partners. For example, an extramarital affair by one partner may cause the other partner to feel emotional pain, anger, and distrust. Some partners may feel distant from one another or experience sexual problems. In other cases, one or both partners may have psychological problems or alcohol or drug problems that negatively affect their relationship.

The techniques used in therapy vary depending on the theoretical orientation of the therapist and the nature of the couple’s problem. Most often, therapists focus on improving communication between partners and on helping them learn to manage conflict. By observing the partners as they talk to each other, the therapist can learn about their communication patterns and the roles they assume in their relationship. The therapist may then teach the partners new ways of expressing their feelings verbally, how to listen to each other, and how to work together to solve problems. The therapist may also suggest that they try out new roles. For example, if one partner makes all of the decisions in the relationship, the therapist may encourage the couple to try sharing decision-making power.

Because most couples therapists also have training in family therapy, they often examine the influence of the couple’s relationships with parents, children, and siblings. Psychoanalytically oriented therapists may focus on how the partners’ childhood experiences affect their current relationship with each other. For couples who cannot work through their differences or reestablish trust and intimacy, separation or divorce may be the best choice. Therapists can help such partners separate in constructive ways.

J

Child Therapy

Some psychotherapists specialize in working with children. Therapists deal with children who are anxious, depressed, or have difficulty getting along with others at home or school. Some children have psychological problems resulting from family issues such as divorce, new stepparents, single-parent homes, death of a parent or sibling, being homeless, or being raised in an alcoholic family. Other children have emotional problems related to physical disabilities, learning disabilities, or attention-deficit hyperactivity disorder.

Play therapy is a special technique that therapists often use with children aged 2 to 12. For children, play is a natural way of learning and relating to others. Play therapy can help therapists both to understand children's problems and to help children deal with their feelings, behaviors, and thoughts. Therapists may use playhouses, puppets, a toy telephone, dolls, sandboxes, food, finger paints, and other toys or objects to help children express their thoughts and feelings. In addition to projecting a caring and gentle manner, therapists who work with children are trained to understand and interpret children’s nonverbal and verbal expressions.