What psychotherapy does depends in large part on the patient’s reasons for seeking treatment. Psychotherapy can help with symptom reduction, but psychotherapy can also help patients develop more effective coping skills; gain a more solid sense of self; and learn to connect with others more meaningfully. The treatment approach depends in large part on the patient’s goals.
Psychotherapy is an interpersonal treatment process between therapist and patient. In graduate school, psychotherapists learn about treatment approaches and practice psychotherapy techniques in training clinics under the supervision of senior clinicians. When the “talking cure” was still establishing itself as a form of treatment, the relationship of doctor and patient was more rigid: the patient would tell the doctor what ails him or her, and the doctor would listen and make occasional, brief interpretations. The relationship of doctor and patient has evolved since those earlier years. It is now more fluid, but the focus remains on healing the patient.
Psychotherapy treatments were all originally insight oriented: one of the principal contributions of early psychologists to the social sciences was the notion that people do and say many things for reasons of which they are not fully aware. Psychotherapy can help patients identify, clarify and articulate the reasons for which they say and do certain things; with this understanding and insight emerges the opportunity to say and do things differently. In insight oriented therapy, therapists function like informed guides who help patients discern the nature of the landscape they are traveling and clarify their rationale for choosing one path over other possible ones.
Insight oriented therapies comprise effective, evidence based treatment modalities, but they are not the only forms of effective, evidence based treatments currently available. In addition to insight oriented therapies, some treatment modalities, such as Cognitive Behavior Therapy (CBT), can help patients identify and change cognitive distortions. Others treatment modalities, such as Dialectical Behavior Therapy (DBT), can help patients improve their coping skills and responses. Still others treatments, such as Exposure Therapy, can help patients target and eliminate specific symptoms like phobias.