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Cognitive Behavioral Psychotherapy
is based upon a theory of psychopathology, set of psychotherapeutic
principles, and empirical investigation. It is based upon
information-processing theory and social psychology. Aside from
being effective with a wide range of disorders, it appears to
enhance the impact of medications used to treat such disorders and
has appeal in that it is active, structured and time-limited. Pain,
phobias, and mood disorders as well as psychophysiologic
(psychosomatic) disorders have been treated successfully with this
approach. Errors in thinking leading to self-defeating assumptions,
incorrect interpretation of information, and lack of adequate
problem solving or planning are often at the heart of problems.
Treatment assists the patient in identifying, testing the reality
of, and correcting dysfunctional beliefs, and in modifying the
thoughts and behaviors that emerge. In systematic desensitization,
the patient can overcome disabling anxiety evoked by situations or
objects by approaching the feared situations gradually and in a
psychophysiologic state that inhibits the experience of anxiety.
Deep muscle relaxation procedures and advanced EMDR induces a
psychophysiological state that counterconditions the anxiety
response. The patient approaches the deconditioning of anxiety by
beginning, in fantasy (mental imagery), with the least
anxiety-provoking scene and progressing up the hierarchy. The goal
is to imagine the previously anxiety-evoking scene with equanimity.
This capacity translates to real life situations but is most
successful when real life situations are incorporated into the
course of resolving each scene in the hierarchy.
Clinical biofeedback
instrumentation provides information (data) to a patient about
normally involuntary physical processes that are below threshold
(outside of awareness). The patient adjusts behavioral, cognitive
(mental) and affective (emotional) processes and learn to control
these physical processes. (The term was first employed during WWII
and the term behavioral medicine was first utilized in 1973 to
describe integration of behavioral and biomedical sciences for the
diagnosis, treatment, rehabilitation and prevention of illness as
well as promotion of health. Not only can biobehavioral methods be
effective in the management of specific symptoms and rehabilitation,
but also these approaches are often useful for patients who are
resistant to other forms of treatment.)
Marital and Sexual Psychotherapies
deal with not only environmental, situational and phase of life
problems that confront relationships but deal with concurrent
problems in communication and conflict. Problems that occur within a
relationship often emerge from interactional problems, the nature of
feedback that couples provide each other, the difficulties in
maintaining functional balance within the relationship, and the
struggles for power and control that emerge. While interactional
problems within a marital system may result in, and sometimes from,
sexual conflicts, these are not the sole cause, nor even necessarily
the primary cause. It is quite possible for a couple to have a
functional sexual relationship and a dysfunctional emotional
relationship. Relationship problems may emerge or worsen because of
sexual dysfunction. By the time the couple consults a doctors, it is
questionable as to whether sole resolution of the sexual problem,
via medication for example, will make the marriage again functional
unless other intervention (e.g. marital psychotherapy) also
occurs.
Short-term dynamic psychotherapies
(STDP) work well for nonresistant patients whose resolution of
problems do not become steeped in long term transferential problems
relating to the doctor and for whom problems are significant but not
overwhelmingly complex. Such patients often have some beginning
insight or awareness of potential causes of their problems.
Treatment begins with a comprehensive diagnostic examination that
determines whether a particular psychotherapeutic technique will
address the problem. The doctor also determines whether the patient
has the strength to confront the underlying causes for their
problems and if there is the potential for positive response to
short-term intervention. |