current psychotherapy

CURRENT PSYCHOTHERAPIES: THEORY AND PRACTICE : 

CURRENT PSYCHOTHERAPIES: THEORY AND PRACTICE

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There is a story about a philosopher and a psychologist having a drink. The philosopher asks: why did the chicken really cross the road? The psychologist replied: well as the chicken lacks any formal reasoning or decision making capabilities, it seems unlikely that its action was spurred by any conscious motivation. I’d say it was instinct. The example brings out some salient points for the present discussion on clinical making in social work practice. Firstly, we generally assume that all human behavior with the exception of reflexes is driven by some motivating influence. Motives In turn lead to decision making which characterizes human behavior. The first decision of the day, getting out of bed, arises from a complex of motivators which may include, vocation, making a living, hunger, and sense of duty, threat, guilt and others. Once that first decision is made the rest the rest of the day consists of a series of decisions and actions, one after the other, some in parallel of lesser or greater complexity. If the environment is predictable and routine, some decision and actions can be relegated to an automatic level, such as driving.

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Contrast, when there is uncertainty a sustained level of vigilance and attention may be required. At the highest level of cognitive function we can make a decision to monitor our decision making—this is metacognition. Good problem solving, sound judgment and effective clinical decision making are considered among the highest attributes of social workers. QUESTION: How many social workers does it take to change a light bulb? ANSWER: Only one, but the bulb must really want to be changed………… This joke reflects a fundamental point about clinical social work practice. Any change that happens in your life must come from you and your own efforts. Although a social worker can quite you, no one can do the work for you. Social work is not about “getting rid” of symptoms. Unlike politics, and even unlike medicine, social work is not about waging war or getting control of anything. Instead it’s about making peace with—by listening to and understanding—your symptoms.

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And curiously enough, once you listen to, rather than fear, your symptoms you might be enlightened by a profound wisdom that will become a great blessing to your life. The light of truth—or insight in psychological terms –however is not sufficient in itself to bring about behavioral change. For a psychological change to occur, a person must react to insight with shock. A hardened, blind heart must feel sorrow—sorrow for all the injury and pain that it has inflicted on others while stuck in its own blindness. It will no longer Blame others for its own misery. Instead, it will see the ugliness of its own behavior for what it is. Shocked by the past, it will be motivated to change the present.

  DIFFERENT THEORIES: 

DIFFERENT THEORIES Theories of personal change differ from each other according to the assumptions made about the nature of the individual, the relationship between the person and the social, and the nature of causality. Three different concepts of the individual person are distinguished, namely, the autonomous, the expressivist , and the social individual. Each of these implies different relationships between the individual and the social worker and different theories of causality.

ADLERIAN PSYCHOTHERAPY: : 

ADLERIAN PSYCHOTHERAPY: Also known as individual psychotherapy, Adlerian Psychotherapists believes that an individual’s self-image can be self-defeating and that those with “psychopathology” are discouraged rather than sick. Thus, the therapeutic approach is to encourage, to activate social interest, and to develop a new life style through relationship, analysis, and action methods.

ANALYTICAL PSYCHOTHERAPY: : 

ANALYTICAL PSYCHOTHERAPY : Analytical Psychotherapy attempts to create, using a symbolic approach, a dialectical relationship between consciousness and the unconscious. The therapist encourages and guides communication between the two systems via an imagining process using “symbolic language”, as in dreams, fantasies, etc. Increased awareness and thus symptomatic relief is brought about by the translation ad interpretation of this “symbolic language”.

BEHAVIORAL THERAPY: : 

BEHAVIORAL THERAPY: Behavioral is composed of cognitive (thought), motor (reflexes), and most importantly, emotional responses. Behavior is seen as responses to stimulation, internal and external, therefore the goal of therapy is to modify unadaptive stimulus-response (S-R) connections (automatic responses). Behavioral therapy methods, insofar as possible, parallel those of experimental psychology. Behavior therapy includes systematic desensitization, assertiveness training, and aversion techniques, as well as several others

CLIENT-CENTERED THERAPY: : 

CLIENT-CENTERED THERAPY: In Client-Centered Therapy, the central hypotheses is that the growth potential of any patient will tend to be released in a relationship in which the therapist communicates realness, caring, and a deeply sensitive, non-judgmental understanding. Thus, the therapist practices participative and empathic listening, while allowing the client to freely vent his/her feelings.

ECLECTIC PSYCHOTHERAPY: : 

ECLECTIC PSYCHOTHERAPY: Eclectic Psychotherapy selects what is valid or useful from all available theories, methods, and practices. The eclectic approach rejects adherence to any one school or system, and instead utilizes what is most valid or relevant from the whole therapeutic spectrum. It is composed of contributions from many different sources, used according to whether they are valid, applicable, and indicated. The eclectic method thereby becomes a basic scientific approach to the problem of matching suitable clinical methods to the needs of specific cases.

ENCOUNTER PSYCHOTHERAPY: : 

ENCOUNTER PSYCHOTHERAPY: Encounter is a method of human relating based on openness and honesty, self-awareness, self-responsibility, awareness of the body, attention to feelings, and an emphasis on the here-and-now. As a therapeutic method, it usually occurs in a group setting. Encounter therapy focuses on removing blocks to better functioning. Encounter is also educational and recreational in that it attempts to create conditions leading to a more satisfying use of personal capacities.

EXPERIENTIAL PSYCHOTHERAPY: : 

EXPERIENTIAL PSYCHOTHERAPY: Experiential psychotherapy works with immediate concreteness. Linked to existential psychotherapy, which holds that one makes and changes oneself in present living, experiential psychotherapy and “focusing” gets into direct touch with the concrete level, where troubles are said to actually exist. Therapists try to establish a “felt sense” within their patients in order to create a more holistic sense of a problem or unresolved situation.

EXISTENTIAL PSYCHOTHERAPY: 

EXISTENTIAL PSYCHOTHERAPY Existential Psychotherapy is a form of psychotherapy which allows clients to be the author of their own lives through self-knowledge. It’s believed that the client's suffering stems from how the they relate to the four ultimate human concerns of death, freedom, isolation, and eaninglessness. By understanding the underlying conflict the client is able to identify their poor ways of dealing with the conflict and develop better ways of coping with the reality of basic existence.

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A mutually-open and honest relationship is essential to the therapeutic process because it’s through this relationship that the client learns his or her potential for feelings that have lain dormant. The existential psychotherapist tries to establish and maintain this relationship by striving for an authentic encounter with the client in the therapeutic setting. The therapist is not an impassive participant in the therapy process, but a fully active, open human being, modeling the process for the client.

EMDR (Eye Movement Desensitization & Reprocessing): : 

EMDR (Eye Movement Desensitization & Reprocessing): EMDR is a process developed by Francine Shapiro to help clients process through traumatic memories and events more quickly. These events can include anything from losing a job or divorce or low self-esteem to sexual/physical/emotional abuse or abandonment as a child. The intense feelings that result from these types of events can become locked in the nervous system and later produce symptoms of fear, anxiety, sadness, and rage long after the event has passed. It is a profound tool for rapid and deep personal healing and change.

GESTALT THERAPY: : 

GESTALT THERAPY: Gestalt therapy consists of bringing discordant elements into a mutual, self-disclosing confrontation. This approach is historic, focuses attention on immediate behavior, and calls for the personal participation of the therapist. Individuals often feel fragmented, with at least some perceptions, feelings, behaviors, or thoughts that are puzzling, unrelated, or troubling because they are not integrated with the whole. The task of therapy is to discover the relatedness of these alienated aspects through awareness.

HUMANISTIC THERAPY: 

HUMANISTIC THERAPY Humanistic therapy overlaps considerably with existential approaches and emphasizes the growth and fulfillment of the self (self-actualization) through self mastery, self-examination and creative expression. Although the influences of the unconscious and society are taken into account, freedom of choice In creating one’s own experience is at the core; and is referred to as self determination and creative expression. Although the influences of the unconscious and society are taken into account , freedom of choice in creating one’s experience is at the core, and is referred as self-determination.

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Humanistic psychotherapy emerged in the 1950s in reaction to both behaviorism and psychoanalysis. It is concerned with the subjective experience of human beings and views using qualitative methods in the study of the human mind and behavior as misguided. This is in direct contrast to cognitivism (which aims to apply the scientific study of psychology), an approach of which humanistic psychology has been strongly critical. Instead, the discipline stressed a phenomenological view of human experience, seeking to understand human beings and their behavior by conducting qualitative research.

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The focus of the humanistic perspective is on the self, which translates into “you” and “your” perception of “your” experiences. This views argues That you are free to choose your own behavior, rather than reacting to environmental stimuli and reinforcers . Issues dealing with self-esteem, self-fulfillment, and needs are paramount. The major focus is to facilitate personal development. Humanistic therapy holds a hopeful, constructive view of human beings and the individual’s Substantial capacity to be self-determining. The ideal description of humanistic therapist is genuine, non-judgmental, and empathetic and uses-open ended responses, reflective listening and tentative interpretation to promote client self understanding, acceptance and actualization.

HYPNOTHERAPY: : 

HYPNOTHERAPY: Hypnotherapy is a mechanism that effectively lifts depressions, uncovers memories, encourages abreactions (the re-experiencing of a previous emotional event) and dreaming (in terms of affective experiencing), enhances both motivation and a working alliance, and is also effective in activating a rapid transference reaction. Hypnotherapy can also be defined as a deepening of a normal psycho physiological phenomenon through an intense focusing of attention upon a specific inner or outer stimulus.

NARRATIVE THERAPY: 

NARRATIVE THERAPY Narrative therapy with individuals, couples, and families focuses on the stories through which people interpret and record their experiences. Based on a social constructionist view of discourse as power, narrative retellings and subtle editing help people reject negative stories of shame, isolation, and powerlessness and create integrated stories of growth, shared struggle, and purpose.

NON_DIRECTIVE THERAPY: 

NON_DIRECTIVE THERAPY Non-directive Counseling emphasizes the importance of getting the individual to share his problems. The individual may need to unload and air his problems, and it is important the counselor affirms the worth of the client by listening. However, just sharing doesn't bring resolution to the problems. It is also important to allow the individual come to a conclusion; however, it is more important to direct the individual to the correct conclusion. Furthermore, if the individual had the answer within himself he wouldn't really need a counselor. Furthermore, so called "common knowledge" is not always true knowledge and is, in fact, often wrong.

PSYCHOANALYSIS: : 

PSYCHOANALYSIS: As a system of psychology derived from Sigmund Freud, Psychoanalysis stresses the importance of the unconscious and dynamic forces in psychic functioning. It is a form of therapy which uses “free association”, in which the patient is encouraged to speak openly and freely, and relies on the analysis of transferences and resistance. Psychoanalysis strives on making the unconscious more conscious. As a system of psychology derived from Sigmund Freud, Psychoanalysis stresses the importance of the unconscious and dynamic forces in psychic functioning. It is a form of therapy which uses “free association”, in which the patient is encouraged to speak openly and freely, and relies on the analysis of transferences and resistance. Psychoanalysis strives on making the unconscious more conscious.

REALITY THERAPY: : 

REALITY THERAPY: Reality therapy consists of a series of theoretical principles. It is applicable to individuals with behavioral and emotional problems, as well as those experiencing identity crisis. Focusing on the present and behavior, the therapist guides the individual towards enabling him/her to see him/herself accurately, to face reality, and to fulfill his/her own needs without harming him/herself or others. The crux of this theory is personal responsibility for one’s own behavior.

RATIONAL-EMOTIVE THERAPY: : 

RATIONAL-EMOTIVE THERAPY: RET is based on the hypothesis that an individual’s irrational beliefs result in erroneous and damaging self-appraisals. RET attempts to change these faulty beliefs by emphasizing cognitive restructuring, using the “ABC” theory of emotional disturbance and of personality change. Albert Ellis states “...when a highly charged emotional consequence (C) follows a significant activating (A) event (A) may contribute to, but only partially causes (C). RET hypothesizes that the emotional consequences (C) are more likely caused by someone’s belief system (B) about (A), rather than (A) alone”. Rational-Emotive therapists utilize many cognitive, affective, and behavioral methods to reorient the patient’s belief system.

SOMATIC PSYCHOTHERAPY: : 

SOMATIC PSYCHOTHERAPY: Somatic Psychotherapy works with attention to the bodily experience. It makes use of breath, sensory awareness, movement, and one's spatial sense and boundaries. Exploring how we form our experience and making use of body metaphors can play a powerful role in this therapy approach.

TRANSACTIONAL ANALYSIS: : 

TRANSACTIONAL ANALYSIS: Transactional analysis is an approach to interactional psychotherapy. This style focuses on gaining the greatest possible benefit from the group environment. The therapist’s ultimate objective is to provide the client with a level of awareness which enables him/her to make new decisions regarding future behavior and the future course of his life.

TRANSPERSONAL PSYCHOTHERAPY: 

TRANSPERSONAL PSYCHOTHERAPY Four major viewpoints have emerged in psychology: psychoanalytic, the behaviorist, the humanistic, and the transpersonal. The “fourth force” or transpersonal includes the wisdom and methods of the preceding orientations and expands psychology to include the spiritual aspects of human experience. The transpersonal therapist uses an eclectic approach. There is an emphasis on the counselor’s own presence, openness, and authenticity as central to the therapeutic process; a respect for the client’s self-healing capacities and on methods evoking those capacities; a view of dysfunction as a growth opportunity rather than “illness,” and an emphasis on the counselor as expert facilitator rather than “physician.”

Neuro Linguistic Psychotherapy: 

Neuro Linguistic Psychotherapy NEURO-LINGUISTIC PSYCHOTHERAPY Imagine you're in a room, with a group of people, perhaps chatting away and suddenly in walks a lion. An African, hair, teeth and claws, fully paid up member of the National Union of Carnivores and Allied Beasts, pads into the room and it's a bit peckish... Now I don't know about you but I suspect that me and most of the room would be out the nearest window throwing other people behind them, but suddenly, the lion turns and spots him. There, stood in the middle of the room is a small sandy-haired man rubbing his hands together. Now this man is different because he's always dreamed about being a Lion-Tamer.

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He's been practicing on the cat for years and finally he has got his chance with a real live lion and he's determined not to lose his opportunity. So, what's the difference? It's the same lion, one-person jumps out the nearest window and another person rubs his hands. How is it that they both see the same thing differently? And what happens when instead of a lion an awkward customer comes into the shop or the boss comes into the office, what do you do, run and hide or rub your hands together? Next imagine you went to the pictures with your best friend. You went to the same cinema, saw the same film and sat in the same row next to each other and when you came out your friend said it was a really funny film but you said it was a really sad film. Which one is real, funny or sad?

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The fact is that each is real to the individual. We each take in the information from the outside world, we Delete, Distort and Generalise it according to our model of the world and create our own reality based on what's inside our head. Neuro Linguistic Psychotherapy (NLPt) uses the idea that we work from and react to the world as we each make it inside our own head. We build our own unique map, which we believe to be reality and it genuinely is to us, although it might be different to someone else.As a model of Psychotherapy, NLPt has several distinct differences from other forms of therapy. Firstly, it is very solution focussed in that an NLPt therapist will always want to know what your outcome is from the therapy or even from each session. It may seem like a dumb question to ask, “What do you want from therapy?”

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Isn't it obvious, but is it? Stop and think, what do you want from therapy? Many people know what they don't want, they don't want this problem, or they don't want to feel like that or even be in this relationship but if I were to say to you “Don't think of a jumping blue kangaroo” how many of you are thinking of exactly that? A lot of people focus on the problem, spending a terrific amount of energy striving to defeat it whereas if you can simply think about a solution, you can start your path towards it. Secondly NLPt is very interested in the structure and process of how you run your life, rather than the tiny detail. A prospective client will come in with what is termed a presenting problem, maybe they have low self-esteem, or they can't lose weight or even they cry every time they see a movie.

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Often when you talk to them there are other issues in their life they are unhappy with, maybe they drink too much, or can't sleep properly or kick the dog. The question I always ask is “Do all the issues form a pattern and does that pattern repeat in other areas of your life?” How does that pattern indicate what is the root problem such that if you were able to deal with that one, all the others would melt away. In addition, because I am interested in the pattern often I don't need the story behind the pattern. I don't need to know all the horrible details of what happened during the horrible incident. Maybe they want to talk about what happened because that would help, and some clients are glad that it can be done content free and it isn't essential to tell.

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Thirdly, NLPt can be a relatively quick form of therapy. Since it is outcome focussed and looks at pattern, structure and process rather all the content of a person's life, sometimes it can appear to be very brief. Some may be suspicious that a client can complete in under 12 hours of therapy when they may quote 30 or 50 hours or even several years for change. I would counter that by saying who said suffering had to be prolonged? If a client tries a few hours of outcome focussed therapy and it doesn't work then they can still go on to do something else without much wasted. If instead they tried several years of another therapy then decide it's not for them that's a lot wasted.

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For some, however, NLPt is not for them. Some clients will want the stability that long-term therapy brings with it. They need to know that they have the support because they genuinely believe that therapy is a long process and every journey is composed of a series of small steps. Others will not take to the idea that the answer is inside their own head because of what that means for their life so far. Personally, I believe we are who we are because of everything that has happened to us rather than despite it. Its about understanding what has gone before in order to be different, if we go around blaming it how can we be truly free. If an alcoholic comes for therapy because he believes alcohol has control over him and

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seeks therapy and cuts down to zero and never drinks again, has he really changed? His consumption of alcohol may have changed but has he really changed his relationship with alcohol? What's different in the dynamic between that carbon based life form and the simple organic molecule known as ethanol? Do you feel you are driving the bus of your life, or are you a passenger on the back seat being driven

COGNITIVE THERAPY: 

COGNITIVE THERAPY How Cognitive Therapy Works Cognitive behavioral therapies are based on the premise that cognitive (mental) events are very important; that people actively interpret and appraise events that happen to them, even though they are not commonly aware that they are doing this. Their appraisal process – their process of making sense of stimulus events – essentially determines how they will react to those stimulus events. In other words, people do not passively response to events in predetermined ways, but rather add their own 'spin' to events which helps to determine how they will ultimately respond to those events.

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Cognitive behavioral therapies are sometimes referred to as "SOR" approaches, with the "O" standing for organism in recognition that there is a thinking person who interprets the meaning of stimulus events (the "S"), before acting out a response. According to cognitive behavioral theory, cognitive (thoughtful) appraisal drives emotional responding. What you think about what is happening to you influences how sad or worried you will feel in response, even when you are not especially aware of having interpreted those events. Problematic mood disorders involving anxiety & depression can occur when people's appraisal processes get messed up and they come to the wrong conclusions about the meaning of various stimulus events they are confronted with.

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The way to fix such problem moods is thus to help the people experiencing those problem moods to become better, more accurate appraisers. The basic technique that is taught in cognitive behavioral psychotherapy is something that could be called the "Analysis of Appraisal", although it is usually called "cognitive restructuring" or sometimes "cognitive reframing" instead. In essence, cognitive therapists teach their patients to become conscious of the fact that they are unconsciously appraising and judging all the various stimulus events that come their way, and then teach them to consciously take charge of that appraisal process so as to make sure that their conclusions are accurate and free of biases and mistakes.

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Thinking Influences Behavior An example will help make this brief and fairly abstract description of cognitive therapy more understandable. Let's say that you're depressed, and as part of your treatment for depression you visit a cognitive behavioral psychotherapist. After orienting you, answering questions and getting you comfortable, the therapist is going to provide an explanation of how it is that depression occurs which will go something like this:

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"People think that depression just occurs randomly, but it really isn't like that most of the time. Usually, depression occurs in response to certain depressing events. Are events themselves actually depressing, though? No; Events them-selves are neutral. It is our interpretation of those events that makes them take on depressing, or uplifting qualities." The point of this explanation is to teach this basic and all important sequence: that events which occur, trigger an appraisal process which interprets the meaning of those events, resulting in a behavioral consequence, which could be depression, or any number of other outcomes.

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Schematically, the sequence is sometimes taught as "ABC", where "A" stands for activating events, "B" stands for beliefs (which drive inter- pretation and appraisal), and "C", standing for consequences. Teaching the sequence involved in how a depressed mood occurs is important for several reasons. It sets the stage for what occurs next, which is a set of interventions designed to help patients identify and alter their interpretation process. It is also empowering in of itself, because it may be the first time that a patient has considered that he or she can have control over how he or she feels.

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Core Beliefs and Cognitive Biases After teaching the sequence of events behind the onset of depressed feelings, the therapist will introduce other important concepts, such as Core Beliefs, Cognitive Biases, and Automatic Thoughts. The reason that one person gets depressed when faced with a given event, while another person shrugs it off has to do with how those two people interpret the meaning of the event. Each person has a different set of core beliefs about themselves, their relationships and their world, and these different core beliefs act like filters, causing them to draw different conclusions about the meaning of an event that has occurred.

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The depressed person's beliefs are negatively biased (loaded, weighted, bent, etc.) in such a way as to all but insure that most any event that occurs will be further cause for depression. Conversely, the non-depressed person's belief set is either not biased very much, or biased in a more positive direction, so that events will invariably be seen in a positive light; a quality generally described as optimism. "The process of interpreting the meaning of events happens very quickly", the therapist will tell you, "and you may very well not be all that aware that you are interpreting events at all".

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Core beliefs are invisible sorts of things whose existence and shape can only be pieced together by paying attention to the thoughts that naturally and spontaneously flow through each person's mind. Such thoughts are often referred to as "Automatic Thoughts" to reflect their continuous, unbidden quality. A depressed person's automatic thoughts contain the stamp of their negatively biased core beliefs. They will spontaneously conclude, "I'm a loser, I never had a chance at that job in the first place" , when faced with a rejection letter because they deeply believe at some level that they are not worthy and not capable of influencing their circumstances. Non-depressed people's automatic thoughts would reflect their own neutral or positive biases.

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"There is a lot of competition out there for jobs, but I will ultimately find one if I keep at it" , they might conclude, because their core beliefs support a self view as worthy, and as capable of positively influencing their lives for the better through hard work. "If the difference between depressed and non-depressed responses to life events reduces to the presence or absence of depressing core-beliefs and automatic thoughts, then the best way for a depressed person to learn to feel better is to learn how to think more like a non-depressed person does" , your therapist might say.

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What he has in mind for you, however, is not a simple "put on a happy face" sort of thought substitution exercise. Superficial fixes won't work, because they won't touch you where you live, in the core beliefs that cause you to develop biased conclusions in the first place. Instead, your therapist is proposing to teach you how to carefully examine and critique your automatic thoughts and core beliefs themselves so as to root out the source of bias that cause you to interpret things negatively. You will root out the negative bias by identifying and rejecting automatic thoughts that you know are biased, and by attempting to replace them with more honest and objectively accurate thoughts.

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With repeated practice doing this, the exercise will become a habit, and the core beliefs will start to shift so as to become less biased. As the negative bias is rooted out, you will naturally begin to feel better, because you will perceive fewer circumstances that merit being depressed about.

Common Cognitive Biases : 

Common Cognitive Biases Your therapist will then proceed to teach you about the common ways that core beliefs and the automatic thoughts that spring from them can be biased. Here are a few examples, drawn from a much larger list of biases that creative people have invented for themselves:

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Overgeneralization is a common cognitive bias that causes people to mistakenly conclude that things are worse than they really are. Overgeneralization occurs when a person takes something that is true for one domain of life and applies it to another domain of life where it doesn't fit. "I failed to get a second interview", says the overgeneralizing depressed person, "so that must mean that I am a failure as a person".

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Selective Attention is another sort of common cognitive bias or error that many people make. In selective attention, a depressed person pays attention to one or two bits of bad news contained within a complex message that also contains many bits of positive news. "Our vacation is ruined because of this rain!" says the depressed person, failing to pay attention to the fact that he is on vacation in the first place. "I got a C in that subject on the report card and that is terrible" says the depressed person, failing to give proper credence to the fact that As and Bs have been earned in other subjects.

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Catastrophization is yet another form of cognitive bias. In catastrophization a small negative event which in reality is merely inconvenient or uncomfortable is magnified into something "terrible, awful, and unbearable". Cognitive errors like these are fairly easy to identify and correct when they're written down on paper, but they are quite difficult to spot in the wild, as they flit through your head automatically without your even noticing them. The trick to cognitive therapy then is to take the time to write down the thoughts that occur to you in the wake of a troubling event, and then to examine those thought records for the presence of cognitive errors.

The Thought Record & Cognitive Restructuring : 

The Thought Record & Cognitive Restructuring If he hasn't done so already, your therapist will now give you a paper form called a thought record, which is a tool for recording your automatic thoughts and fixing them when you know they are biased. The thought record is commonly broken into columns. In the first column, you write down something depressing that has happened (e.g., the Activating Event). In the second column, you write down verbatim some of the thoughts that are flying through your head while you think about the activating event.

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In the third column, you record how you are feeling as a result of those thoughts in the second column. In the fourth column you can identify what sorts of cognitive errors are present in your (second column) thoughts. In the fifth column, you can write down a "fixed" version of your (second column) thoughts with the biases you identified in the fourth column all stripped out. Finally, in a sixth column, you can record how you feel after contemplating the fixed thoughts from column five.

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Cognitive errors like these are fairly easy to identify and correct when they're written down on paper, but they are quite difficult to spot in the wild, as they flit through your head automatically without your even noticing them. The trick to cognitive therapy then is to take the time to write down the thoughts that occur to you in the wake of a troubling event, and then to examine those thought records for the presence of cognitive errors.

The Thought Record & Cognitive Restructuring : 

The Thought Record & Cognitive Restructuring If he hasn't done so already, your therapist will now give you a paper form called a thought record, which is a tool for recording your automatic thoughts and fixing them when you know they are biased. The thought record is commonly broken into columns. In the first column, you write down something depressing that has happened (e.g., the Activating Event). In the second column, you write down verbatim some of the thoughts that are flying through your head while you think about the activating event.

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In the third column, you record how you are feeling as a result of those thoughts in the second column. In the fourth column you can identify what sorts of cognitive errors are present in your (second column) thoughts. In the fifth column, you can write down a "fixed" version of your (second column) thoughts with the biases you identified in the fourth column all stripped out. Finally, in a sixth column, you can record how you feel after contemplating the fixed thoughts from column five.

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This exercise, often called cognitive reframing or restructuring, is the very heart of cognitive behavioral therapy. Repetitive practice with this exercise trains you to become aware of and reject cognitive errors that creep into your thoughts, causing you to become depressed. As you learn to make fewer cognitive errors, you will naturally start to feel better. Though simple in structure, the thought record exercise can be tricky to actually implement. People have a hard time learning to identify their automatic thoughts in the first place, or to know what cognitive errors they may be making, or how to rewrite their thoughts with the biases removed.

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The exercise is difficult precisely because people are very embedded in their unconsciously biased mode of interpreting events and have difficultly gaining the perspective on their own thought process necessary to see the automatic thoughts happening there in the background of the mind. The therapists' main purpose, in cognitive therapy, is thus to help you (the patient) gain the perspective and practice you need in order to get good at the thought record restructuring task. It takes most people a few months of regular practice, complete with homework consisting of filling out thought record after thought record, and consideration of depressing event after depressing event, to gain these skills.

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At the end of the process, however, you have gained the ability to see (perhaps for the first time) how your own mind creates your emotional experience, and you have gained the tools necessary to influence your thought process for the better. So – that is cognitive therapy in a nutshell. The therapy empowers people to grab hold of their own thought process and fix the mental mistakes they make that lead them to make themselves depressed. We should mention that this therapy is useful far beyond just helping people overcome depression.

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It has also been shown to be helpful for helping people overcome anxiety disorders (including obsessive compulsive disorder, panic disorder, and phobias), substance abuse issues, and even (as a secondary treatment, after medical assistance has been rendered) psychotic disorders (including schizophrenia and bipolar disorder) when patients are high functioning. With regards to depression, studies have shown that cognitive therapy is often as effective a treatment for depression as anti-depressant medication. What's more, its anti-depressant effect lasts longer than medication's anti-depressant effect when both therapies are stopped.

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This is probably because anti-depressant medications act directly on the brain's structure and chemistry to suppress the likely that depressive interpretations will be made, while cognitive therapy teaches you how to avoid taking seriously the depressive interpretations that otherwise do get made. When anti-depressant medications are no longer taken, the brain tends to go back to its pre-drug structure and chemistry, making it more likely that depressive interpretations will become common again. No such suppressive-rebound will occur in the wake of cognitive therapy, because nothing was ever suppressed.

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Though cognitive therapy's focus on mental events would have been considered heretical by the early behaviorists, the therapy has remained true to its behavioral roots. It is, I think, quite durably here to stay (although it will certainly continue to evolve) for simple solid reasons: scientific studies show it works, it is short term in duration, it is focused, it offers accountability, and it is cheap to implement relative to other forms of psychotherapy. Cognitive therapy fits our health care culture's needs like no other current therapy. It will likely take a cultural shift before some other therapy rises to take its current dominant place.

FAMILY THERAPY: 

FAMILY THERAPY What is Family or Couples Therapy? (also sometimes called systemic therapy) Family therapy is offered to whole families, parts of families, and even individuals when relationships seem central to the difficulties. Families and couples who are struggling in their relationships are usually aware that they each have an impact on the other(s) but may need help sorting out how this works and finding new, less conflictual ways of relating.

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The family therapist does not take sides, blame people, or provide simple answers but tries to understand how the difficulty arises, and assist the family in discovering its own resources for new ways of relating. This may involve doing family trees or genograms because these help the therapist and family to see how expectations and patterns of thinking and feeling may carry from one generation to another. Family therapy sees the problems people bring to therapy in the context of their relationships. The therapist is not only interested in the relationship between the family members in the room but also in the wider economic, social, cultural, political, and religious context in which the family lives.

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The therapists each have their own backgrounds but do not assume that they know about other cultures; in other words the therapist is curious and respectful of differences between families. Family therapist often work in teams so that the different perspectives of each team member can be offered to the family. At the first session the family meets the therapist (or sometimes a pair of therapists). The therapist and the family are observed by the rest of the team (usually 2-4 people) via a one way screen.

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After about 45 minutes the family and the team swap over and the family has the chance to observe the team discussion for 5-10 minutes. Then the family have the opportunity to say what ideas they found useful or if they disagree with any of the comments. If the family feel that another session could be useful, a further appointment is made. What sort of problems can family therapy help with? Serious mental illness in a family member inevitably has a major impact on the rest of the family, and the way the family reacts can help or hinder the patient ’ s recovery.

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Depression, bipolar illness, schizophrenia and personality difficulties are all challenging for individuals and their families and family therapy can be a useful part of the care plan, cooperating with other professionals. Family therapy is also important in managing eating disorders, addictions, and emotional and behavioural problems in children. Is there research evidence that it works? Yes, there is good evidence of efficacy and some of the evidence is for particular conditions such as anorexia, depression, opiate use, and psychosis.

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Overview : Asen, E (2002) Outcome research in Family Therapy. Advances in Psychiatric Treatment, 8. 230-238 Psychosis: Stanbridge,RI ,Burbach,FR,Lucas,AS and Carter,K (2003) A Study of families ’ satisfaction with a family interventions in psychosis service in Somerset. Journal of Family Therapy 25. 181-204

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Depression: Leff et al (2000) The London Depression Intervention Trial: Randomised controlled trial of antidepressants vs couple therapy in the treatment and maintenance of people with depression living with a partner; clinical outcome and costs. British Journal of Psychiatry 177. 95-100 How long does therapy last? Therapy lasts while the family and the therapist think it is useful. This decision is made collaboratively, and each appointment and the interval between appointments is negotiated.

Thanks……….: 

Thanks………. Shine Vayala