CHAPTER 22

Psychological
Treatment

Zhong-Lin Tan Ph.D. M.M.

Hangzhou Mental Health Center
Department of psychiatry, School of
Medicine Hangzhou Normal
University
zlintan@yahoo.com.cn

Aim

Grasp classification of
psychological treatments

Be familiar with different

counseling approaches

Preface

Psychological treatment is not given in

isolation, often combined with medication.
Appropriate ways of doing this are
considered in the chapters concerned with
the relevant disorders.
This chapter contains advice on the
general value of various treatments.
Although outline descriptions of technique
are given in several places, supervised
experience is essential before any of these
treatments can be used with patients.
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Psychological treatments
considered in this chapter

Counseling
Crisis intervention
Supportive
psychotherapy
CBT
Individual dynamic
psychotherapies
Historical
treatments
Meditation and
traditional healing

Small-group
psychotherapy
Large-group
psychotherapy
Psychotherapy
with couples
Family therapy
Psychotherapy
for children and
older people
4

How psychological
treatments developed

Hypnosis and free

association:1895,1923
Classical dynamic psychotherapy
The neo-Freudians:1930s
Object relation theory
Attachment theory
Interpersonal therapy

Behaviour therapy:1920s
Cognitive therapy:
Cognitive-behaviour therapy

Classification of
psychological treatments

Technique
Eclectic
Psychodynamic
Cognitive behavioral
other: systems theory

Number of patients
Individual therapy
Couple therapy
Family therapy
Small and large group therapy

Common factors in
psychological treatment
Therapeutic relationship
II.
Listening
III. Release of emotion
IV. Restoration of morale
V.
Providing information
VI. Providing a rationale
VII. Advice and guidance
VIII. Suggestion
I.

Counselling and crisis

intervention

Counselling

Counselling incorporates the nonspecific factors shared by all kinds of

psychotherapy

Crisis intervention

Helps patients cope with a crisis in

their lives, and to learn effective ways
of dealing with future difficulties.
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Counselling 1

Approaches to counselling
Problem-solving counselling
Interpersonal counselling

Loss, interpersonal disputes, role

transitions, and interpersonal deficits.

Psychodynamic counselling

Counselling 2

Counselling for specific purposes

Debriefing
Relationship problems
Late effects of trauma
Risks
Students
In primary care

10

Crisis intervention 1

Problems leading to crisis

Loss problems
Role changes
Relationship problems
Conflict problems

Indications:

well-motivated people with stabel

personalities who are facing major but
transitory difficulties.
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Crisis intervention 2:
methods

Stage :
reduce arousal;
focus on current problems;
encourage self-help

Stage:
assess problems;
consider solutions;
test solutions

Stage:

consider future coping methods

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Supportive
psychotherapy

Table22.3

13

Interpersonal
psychotherapy

Interpersonal problems under

four headings
1.
2.
3.
4.

Bereavement and other loss

Role disputes
Role transitions
Interpersonal deficits such as
loneliness

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Cognitive behaviour
therapy 1

General features: 8 types

Assessment
Topics to be consided
Source of information for the
assessment
The formulation

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Cognitive behaviour
therapy 2

Behavioural techniques: 16 types

; relaxation training, exposure,
desensitization, flooding,
exposure in everyday practice,
exposure with response
prevention

Cognitive techniques
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CBT for different mental

disorders
Anxiety disorders
II.
Panic disorder
III. Post-traumatic stress disorder
(PTSD)
IV. Depressive disorders
V.
Hypochondriasis
VI. Schizophrenis
VII. Personality disorder
VIII. Dialectic behaviour therapy for
borderline personality disorder
I.

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Individual dynamic
psychotherapies

Brief insight-oriented
psychotherapy
Cognitive-analytical therapy
Psychodynamic interpersonal
therapy
Long-term individual dynamic
psychotherapy

19

Treatment in groups

Small group psychotherapy

Types of small group
psychotherapy
Therapeutic groups
Large-group therapy

20

Treatment in groups

21

Psychotherapy with couples

and families

Couple therapy
Psychodynamic
Systems approaches
Cognitive behvioural
Behavioural-systems

Family therapy
Psychodynamic family therapy
Structural family therapy
Systemic family therapy
Eclectic family therapy

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Psychotherapy for
children

Play therapy

23

Psychotherapy for older

people

24

Other psychological
treatments

Hypnosis
Autogenic training
Abreaction
Meditation

25

Ethical problems in
psychological treatment

Autonomy
Confidentiality
Exploitation

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