Psychotherapy: Encyclopedia II - Psychotherapy - History

Psychotherapy - History

Most psychotherapies are either direct descendants of psychoanalysis, or their founders started out in areas of psychoanalysis before developing their own theories. Therefore, when describing the history of psychotherapy, most traditionally start with Freud.

Psychotherapy - Psychoanalysis

Although there are some bodies of thought in psychology without Sigmund Freud in their legacy, most can be traced back to his work starting in the 1880s in Vienna. Trained as a neurologist, Freud began noticing neurological problems in patients that had no discernible biological basis. Seeing blindness, paralysis and anorexia with no apparent physical cause, he looked towards the mind for answers. Finding some evidence that those who were mentally ill could exhibit physical symptoms, he discovered colleagues and teachers who were equally perplexed and interested in such matters like Josef Breuer and Jean-Martin Charcot.

Freud opened up a private practice in 1886 until 1896 that mostly treated women who showed symptoms of hysteria (which, at that time, was very loosely defined). Using such techniques as dream interpretation, free association, transference and analysis of the id, ego and superego, his colleagues developed a system of psychotherapy termed 'psychoanalysis'. Students and colleagues of his such as Alfred Adler, Otto Rank and Carl Jung became psychoanalysts themselves, and formed their own differentiating systems of psychotherapy. These were all later termed under a more broad label of 'psychodynamic', meaning anything that involved the psyche's conscious/unconscious influence on external relationships and the self. Psychodynamic psychotherapy and psychoanalysis are considered to be particularly effective at treating certain mental disorders, such as personality disorders and mood disorders.

Current psychodynamic approaches continue to develop and change. Contemporary Freudian approaches usually retain Freud's emphasis on sexuality, aggression, and mental conflict, and often prefer insight-oriented, uncovering psychotherapy to more supportive techniques. Contemporary Freudians, for the most part, continue to believe that psychotherapy is most effective when it leads to increased self-knowledge on the part of the patient. Other current psychodynamic approaches -such as object-relational and self-psychological approaches- prefer techniques designed to change the patient's habitual patterns of living by building an especially authentic or supportive relationship with the analyst that is believed to help the patient learn new ways of relating to others and to life in general.

The psychoanalytic community has recently begun to put extensive effort into researching the efficacy and process of psychoanalytic treatment.

Psychotherapy - Cognitive

As psychoanalysis and its influence spread throughout the world in the early 1900s, other ideas were brewing. Aaron T. Beck, following schooling at Brown University and Yale Medical School developed his own form of psychotherapy known as cognitive therapy in the 1940s. Similarly Albert Ellis, a student at Columbia University developed Rational Emotive Behavior Therapy (REBT). The spectrum that soon became cognitive therapy involves some common features. These included short, structured and present focused therapy aimed at changing a person's distorted thinking. Being oriented towards symptom-relief, collaborative empiricism and modifying peoples core beliefs, this is often the preferred method of treatment for depression, substance abuse, anxiety disorders, eating disorders and phobias. This method of treatment is known for having been more extensively researched than most other types of psychotherapy.

Psychotherapy - Humanistic

Another body of thought in psychotherapy started in the 1950s with Carl Rogers. Rogers, who went to Columbia University just like Albert Ellis, earned a PhD while simultaneously becoming interested in existentialism, the works of Abraham Maslow and his hierarchy of human needs. By the early 1930s he had finished his doctoral work and had brought Person centered psychotherapy into mainstream focus. Rogers' basic tenets were unconditional positive regard, genuineness, and empathic understanding, with each demonstrated by the counselor. According to Rogers, these tenets were both necessary and sufficient to create a relationship conducive to enhancing the client's psychological well being, by enabling the client to fully experience themselves. Inspired by Rogers, others followed his mode of thinking like Fritz and Laura Perls in the creation of Gestalt therapy. Later these fields of psychotherapy would become what is known as humanistic psychotherapy today.

Psychotherapy - Behavioral

The rudiments of behavioral counseling begin in the 1920's, however it's comprehensive form did not emerge until the 1950's and 1960's. The primary contributors were Joseph Wolpe in South Africa, M.B. Shipiro and Hans Eyseneck in Britain, and B.F. Skinner in the United States.

Behavioral counseling approaches rely on principles of operant conditioning, classical conditioning and social learning theory. Behaviorism is often based on the philosophy of behaviorism. According to behaviorism, counseling should only focus on behaviors that are observable and measurable, rather than cognitions. Note that B. F. Skinner was awarded Humanist of the Year Award in 1972 by the American Humanist Association, indicating that behavioral counseling is considered compatible with humanistic philosophy as well (Epstein, 1997).

The behavioral counselor may use operant conditioning techniques contingency contracts, self-management, shaping, behavioral momentum, token economies, response cost, and biofeedback. For social learning theory techniques, counselors may use modeling, behavior practice groups, and role playing. Often classical conditioning techniques are the treatment of choice for phobias and fetishes, and include techniques of systematic desensitization, flooding, counterconditioning, and aversive conditioning. Sometimes hypnosis is used to achieve relaxation as well.

Additionally, behavioral counseling has been effective in treating eating disorders. Behavioral counseling is the most scientifically validated approach because of its emphasis measurable and observable results. Increasingly, counselors and researchers are incorporating behavior modification techniques with other approaches (eclectic or multimodal approaches), and develop behavioral definitions to measure psychological constructs such as depression, anxiety or anger (Thompson, Rudolph, & Henderson, 2004).

Psychotherapy - Brief counseling

Also see: Brief therapy

Brief Counseling can make use of any of the above psychotherapeutic approaches, but it also may involve specific techniques that have been shown to provide rapid relief for large numbers of people. Among these approaches are Narrative Therapy and Solution-focused Therapy. These practices help clients to identify those occasions when their stated problem(s) are less dominant in their lives.

Typically brief counseling can take from one to five sessions. Employee Assistance Programs are geared to provide brief assessments and interventions that often fulfill the clients' needs in just a few sessions. It is also not unusual for a community mental health center to offer Brief Counseling to all new clients in order to encourage greater self-reliance and to discourage dependence on a therapist. In such a context, self-help groups also play a role in aiding ongoing improvements in functioning.

Well-known writers/practitioners of brief counseling techniques are Bill O'Hanlon, Insoo Kim Berg, Michael White, Jeffrey Guterman, and Steve de Shazer.

Adapted from the Wikipedia article "History", under the G.N U Free Docmentation License. Please also see http://en.wikipedia.org/wiki