Psychotherapy - Medical Experts

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

Psychotherapy is a process between therapist and patient designed to treat behavioral disorders, states of distress, and mental health conditions.

This is achieved through:

• Verbal communication (talk therapy)
• Nonverbal communication (art therapy, body therapy, or music therapy)
• Setting a goal (minimizing symptoms or changing behavior)
• Specific techniques

There are different schools of psychotherapy. Experts also refer to them as basic orientations. Each school of psychotherapy has different basic assumptions and different treatment approaches:

The psychotherapy approaches are:

• The behaviorist model
• The psychoanalytic model
• Humanistic psychology

When applied to psychotherapeutic practice, these give rise to various therapeutic methods that are fundamentally standardized.

These are:

• Behavioral therapy
• Psychoanalytic psychotherapy
• Client-Centered Psychotherapy

Depending on the approach, different treatment settings are possible:

• Individual therapy
• Group therapy
• Couples and family therapy
• Inpatient, outpatient, or day treatment

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

Inpatient psychotherapy is a distinct form of therapy in which the patient, the facility, and the payer jointly plan admission and treatment. Inpatient psychotherapy takes place in a specialized clinic.

Various coordinated therapeutic methods are used. The goal is the recovery and healing of patients suffering from psychosomatic and psychoneurotic disorders.

In inpatient psychotherapy, the hospital serves as the setting where the patient and therapist address and treat the following issues:

• Conflicts
• Deficits in personality structure
• Relationship problems
• Multimodal and multiprofessional therapy

Inpatient psychotherapy encompasses various types of therapy in which experts from different disciplines work together.

The team plays a central role in the patient’s successful recovery. Therapists work not only with the patient but also with family members, physicians, and nursing staff.

This collaboration among experts includes:

• Daily discussions between the therapist, physician, and nursing staff
• Meetings with all staff members involved
• Collaboration with experienced psychosomatic specialists
• Consultations with family members as needed

The specialized staff uses a variety of methods:

• Individual therapy
• Group therapy
• Creative therapies
• Movement and body therapies
• Music therapy
• Group courses that provide theoretical knowledge about the condition
• Trauma-Focused Psychotherapies
• Behavioral therapy groups
• Relaxation techniques
• Pharmacotherapy and psychopharmacotherapy

Inpatient psychotherapy generally consists of short-term therapy and group therapy. The specialized departments are Internal Medicine and Neurology.

In outpatient treatment, psychotherapy guidelines govern the procedures. The framework conditions are different for inpatient psychotherapy. Nevertheless, it is fundamentally based on the methods of the various therapeutic approaches.

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

Basic Approaches in Inpatient Psychotherapy

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

• Psychoanalytic psychotherapy
• Behavioral therapy
• Person-centered psychotherapy

Key elements of the basic psychoanalytic orientation are:

• Analysis of transference and countertransference
• Establishing a helpful therapeutic relationship
• Establishing a therapeutic working alliance
• Taking social and real-life relationships into account
• Analysis of resistance 
• Uncovering Unconscious Psychological Conflicts

Coming to terms with the past plays a less important role in inpatient psychotherapy. 

Psychoanalytic psychotherapy is characterized by two essential attitudes:

1. Neutrality: The psychotherapist should neither judge what the patient says nor take a personal stance.
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 one-on-one setting or in group psychotherapy. However, nonverbal techniques such as art and music therapy are also possible.

Cognitive-behavioral approaches 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 techniques usually take place in individual or group sessions. Examples include: training groups for skills and competencies, and problem-solving groups.

Another fundamental approach is client-centered psychotherapy, which is rarely found in inpatient psychotherapy.

The central element of client-centered psychotherapy is the tendency toward actualization. This refers to the fact that every person strives to develop their full potential and fully realize their own individual possibilities for growth.

A failed tendency toward self-actualization is considered the basis of a (neurotic) disorder.

The therapeutic relationship is structured according to the principles of empathy, warmth, and authenticity. In this way, the therapist can help the patient. Client-centered psychotherapy takes place in both individual and group therapy settings.