Psychotherapy( updated Oct 2006)

Psychotherapy is a general term to describe treatment that tries to eliminate or control mental symptoms through talking. It involves a relationship between a therapist and a client. Different types of therapy are used. Each is based on different principles, structure, and methods. The therapist may be a psychiatrist, GP, psychologist, social worker, nurse, or other counsellor.

There are several types of psychotherapy. Some focus on the present, others on the past. The therapist decides the type of therapy based on the nature of the problem. The person's personality, culture, and experience are also used to help choose the type of therapy. Sometimes, more than one type is used. Examples of types of therapy include:

• psychodynamic therapy, to help people better understand themselves
• interpersonal therapy, to improve the quality of the person's relationships
• cognitive therapy, to help a person recognise and change his or her ways of thinking that are harmful or not useful
• psychoanalysis, to examine a person's childhood and conscience to help figure out current problems

Each of these types of therapy may be done one-on-one or in a family, couple, or group setting. People with a wide range of problems can be helped with psychotherapy. The common reasons a person might seek therapy include:

• severe emotional pain such as sadness, depression, anxiety, and grief
• problems in relationships with a spouse, parent, child, co-worker, or other persons
• problems with communication skills
• problems with controlling anger
• sexual problems
• a recent loss, such as a death or separation
• being a victim of trauma or abuse.
• needing help with a clinical disorder or condition
• needing help with problems that have kept a person from reaching their goals

Finding the "right" therapist is very important. The right therapist is different for different people. Good places to start looking include one's family physician, community mental health centre, and family and friends.

The relationship between a therapist and a client is unique. Mutual trust, respect, and confidentiality are important. Both the client and the therapist have clear roles. The client must be honest and willing to reveal uncomfortable feelings and thoughts. He or she needs to be able to address problems and be open to new insights. In some cases, the person may be given "homework" activities.

The therapist's role is to listen carefully. He or she must also help to interpret a person's thoughts and actions. The therapist helps point out problems that may not be obvious. He or she helps guide the client to see problems and solutions. The therapist also needs to help the client change unhealthy patterns of thought or behaviour.

The relationship is strictly professional. Clear boundaries need to exist to maintain a therapeutic relationship between the therapist and client. The purpose of the therapy is to help the client. The therapist is there for the client and expects only payment for the time.

The amount of time a person spends in therapy depends on many factors. These include the nature of the illness or problem being treated and the ability of the person to pay for the therapy in some cases. Most people get some benefit after three to six months of therapy but others may need to have psychotherapy for many years for more complex problems.

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