Psychotherapy - Medical specialists

What is psychotherapy?

Psychosomatic medicine deals with mental disorders. The preferred treatment method is psychotherapy.

Psychotherapy is a process between therapist and patient to treat behavioral disorders, states of suffering and mental illness.

This is done through:

• Verbal communication (talk therapy)
• Non-verbal communication (creative, body or music therapy)
• Setting a goal (minimizing symptoms or changing behaviour)
• Certain techniques

Basic orientations of psychotherapy

There are different psychotherapy orientations. Experts also call them basic orientations. Each psychotherapy orientation has different basic assumptions and different treatment approaches:

The psychotherapy orientations are:

• The behaviorist model
• The psychoanalytical model
• The humanistic psychology model

Applied to psychotherapeutic treatment practice, this results in various therapy methods that are fundamentally standardized.

These are

• Behavioral therapy
• Psychoanalytical psychotherapy
• Conversational psychotherapy

Depending on the method, different framework conditions are possible:

• Individual therapy
• group therapy
• Couple and family therapy
• Inpatient, outpatient or partial inpatient therapy

In outpatient psychotherapy, specialists, psychotherapists or alternative practitioners offer their services in their own private practice @ Meow Creations /AdobeStock

Inpatient psychotherapy

Inpatient psychotherapy is an independent form of therapy in which the patient, facility and payer plan the admission and treatment together. Inpatient psychotherapy takes place in a specialist clinic.

Various coordinated therapeutic methods are used. The aim is to improve and heal patients suffering from psychosomatic and psychoneurotic illnesses.

In inpatient psychotherapy, the hospital is the place where the patient and therapist work on and treat the following issues:

• Conflicts
• Deficits in the personality structure
• Relationship disorders
• Multimodal and multiprofessional therapy

Inpatient psychotherapy includes various types of therapy in which experts from different specialist areas work together.

The team plays a central role in the patient's successful recovery. Therapists work not only with the patient, but also with relatives, doctors and nursing staff.

The collaboration between the experts includes

• Daily discussions between the therapist, doctor and nursing staff
• Meetings with all staff involved
• Cooperation with experienced psychosomatic specialists
• Discussions with relatives if necessary

The specialist staff use different methods:

• Individual therapies
• Group therapies
• creative therapies
• Movement and body therapies
• music therapies
• Group courses that impart theoretical knowledge about the illness
• Trauma-oriented psychotherapies
• Behavioral therapy groups
• Relaxation methods
• Pharmacotherapy and psychopharmacotherapy

As a rule, inpatient psychotherapy consists of short-term therapies and group therapies. The specialist departments are Internal Medicine and Neurology.

In outpatient treatment, the psychotherapy guidelines regulate the applications. The framework conditions for inpatient psychotherapy are different. Nevertheless, it is fundamentally based on the methods of the individual therapeutic directions.

Inpatient psychotherapy takes place in clinics or hospitals @ rh2010 /AdobeStock

Basic orientations in inpatient psychotherapy

As with outpatient care, the following types of therapy play a central role in inpatient psychotherapy:

• Psychoanalytic psychotherapy
• Behavioral therapy
• Conversational psychotherapy

The basic psychoanalytic orientation

Central elements of the basic psychoanalytic orientation are

• Analysis of transference and countertransference
• Creation of a helpful therapeutic relationship
• Establishing a therapeutic working alliance
• Consideration of the social and real relationship
• The analysis of resistances
• Uncovering unconscious psychological conflicts

Dealing with the past plays a less important role in inpatient psychotherapy.

Psychoanalytical-therapeutic psychotherapy is characterized by two essential attitudes:

1. Neutrality: the psychotherapist should neither evaluate things the patient tells nor take a position of their own.
2. Abstinence: Psychotherapists must not use the relationship of trust with the patient to satisfy their own needs.

Psychodynamic psychotherapy usually takes place in a two-person setting or in group psychotherapy. However, non-verbal techniques such as art and music therapy are also possible.

Cognitive-behavioral methods

Cognitive-behavioral methods focus on the following processes:

• Information processing
• Perception and attention
• Knowledge representation and memory
• Problem solving and logical thinking
• Language and language comprehension

Cognitive-behavioral procedures usually take place in individual or group discussions. Examples are Skills and competence training groups, problem-solving groups.

Talking psychotherapy

Another basic orientation is conversational psychotherapy, which is rarely found in inpatient psychotherapy.

The central element of conversational psychotherapy is the updating tendency. This means that every person strives to develop and fully exploit their own individual development potential.

An unsuccessful actualization tendency is regarded as the basis of a (neurotic) disorder.

The therapeutic relationship isbased on theprinciples of empathy, warmth and authenticity. This enables the therapist to help the patient. Talking psychotherapy takes place in both individual and group therapy.