How Does the Psychotherapy Theory Work?
What Makes It Therapeutic?
The client achieves insight (awareness) about how the past influences present. The client’s insight is believed to generate emotional and behavioral change. The therapist guides the client by interpreting the meaning of feelings and actions based on the client’s past. The therapist also addresses and explores how the client reacts to the therapist in ways that are based on the client’s past reactions to significant relationships in the past. The client’s process of relating to the therapist as if the therapist was someone in the client’s past is called “transference. The therapist makes interpretations so that the client gains insight, and the therapist “processes” transference so the client gains emotional and cognitive understanding of how he/she relates to the therapist is related to how he/she relates to others in their world. The theory involves a lot of exploration of the client’s past. This is the first theory of psychotherapy and evolves out of the work of Freud.
The client identifies faulty assumptions and mistaken goals. This awareness leads to emotional and behavioral change. The client establishes goals and with clear goals is motivated to move toward them. The therapist guides client to an understanding of his/her perception of the world and to establish goals. This theory offers basically no specific interventions and assumes that the awareness of faulty assumptions and goals will lead to change.
The client embraces an existential philosophy. This means that the client accepts that life is finite and understands that emotions and behaviors are generated out of meaning. The client learns that he/she is free and has the power to make life choices. With the experience of meaning, client makes choices to create one’s own life path. The therapist offers his/her self as an existential being. The client learns to be existential through the “being of the therapist.”
The client learns to be self-empathic, self-accepting, and self-understanding by experiencing these qualities in the relationship with the therapist. The therapist demonstrates a deep level of understanding by communicating empathy with the client. Therapist offers “core conditions” which, when experienced by the client, become integrated into the client’s way of being with oneself and with the world. The client grows by experiencing the presence of the therapist. This theory is essentially the basis for all other theories. We know that what works in psychotherapy is the therapist’s ability to create a positive “therapeutic” relationship with the client, and this theory is dedicated the that relationship.
The client experiences the moment and he/she develops awareness of the moment and learns and understands (gains insight—self-understanding from experiencing the moment) his/her presence in the world. The client becomes aware of emotion, sensation, and cognition as they are happening in the moment. The therapist is present oriented and very little attention is paid to the past or the future. Specific problems are not addressed so that the focus of the therapy can be on the process happening in the room between the therapist and the client. The therapist invites the client to be in the moment and focuses on client process (what is happening in the now) and not on client content (for example, problems).
The client learns and understands what maintains behavior and learns to use reinforcement (and or punishment) to manage behaviors. The client moves in systematic steps toward behavioral or emotional change, and sets specific achievable goals. The therapist provides a systematic and organized approach to teach what reinforces and maintains behavior. The therapist works with the client to develop an organized and structured behavioral plan.
Cognitive or Cognitive Behavioral (CBT) Psychotherapy
The client learns the relationship between feelings, behaviors, and thoughts and how they interact. The client learns to identify negative thinking that generates emotional distress and maintains negative behavior. The client learns how to change negative thinking. The therapist links feelings, behaviors, and thoughts and teaches the client 1. how negative thinking maintains emotional distress and dysfunctional behavior; and 2. how to change negative thinking to change emotional distress and negative behavior. CBT is one of the most applied therapies.
The client learns that emotional and physical reactions are essentially behaviors. The client is guided to pursue that which he/she “can” do versus attempting to do what the client claims he/she “can’t” do. Client is encouraged to understand his/her motivation as action toward fulfilling genetic needs. The therapist takes a lively and positive approach encouraging the client toward actions that the client is willing and chooses to act upon while not addressing issues the client claims he/she can’t or is unwilling to pursue. Therapist teaches the client the five genetic needs and helps the client understand how his/her motivation is toward fulfilling those genetic needs.
Which Theory is Best????
Some very good research suggests that the specific theory of the therapist does not impact outcome. What is important is the therapist’s ability to connect with the client and the therapist’s commitment and positive attitude toward his/her process in therapy. Years of experiencing of the therapist is not particularly important, and some research suggests that experience leads to a decline in client outcome.
Bottom line, find a therapist with whom you feel comfortable and connected.