Type of psychological therapy

sychodynamic therapies
Historically, psychoanalysiscreated by Sigmund Freudhas played an important role in the growth and development of psychotherapy. Central to Freud's theories was the importance of unconscious conflicts in producing the symptoms and defenses of the patient. The goal of therapy is to help the patient attain insight into the repressed conflicts which are the source of difficulty. Since patients resist these attempts bring to consciousness the painful repressed material, therapy must proceed slowly. Consequently, psychoanalysis is a long-term therapy requiring several years for completion and almost daily visits. Since Freud's time, there have been important modifications associated with former disciples such as Alfred Adler and Carl Jung. Self psychology and ego psychology are among more recent emphases. However, the popularity of psychoanalysis has waned. See also Psychoanalysis.

Experiential therapies
A number of related therapies are included in this group. Probably best known was the patientcentered therapy of Carl Rogers appearing in the 1940s. In Rogers' therapy, a major emphasis is placed on the ability of the patient to change when the therapist is empathic and genuine and conveys nonpossessive warmth. The therapist isnondirective in the interaction with the patient and attempts to facilitate the growth potential of the patient. Other therapeutic approaches considered as experiential include Gestalt therapy, existential approaches, and transpersonal approaches. The facilitation of experiencing is emphasized as the basic therapeutic task, and the therapeutic relationship is viewed as a significant potentially curative factor.

Cognitive, behavioral, and interpersonal therapies

In behavioral therapies, therapists play a more directive role. The emphasis is on changing the patient's behavior, using positive reinforcement, and increasing self-efficacy. More recently, cognitive therapies such as those of A. T. Beck have tended to be combined with behavioral emphases. The cognitive-behavioral therapies have focused on changing dysfunctional attitudes into more realistic and positive ones and providing new information-processing skills. See also Cognition. Most of the developments in interpersonal therapy have occurred in work with depressed patients. The goal of interpersonal therapy (a brief form of therapy) is centered on increasing the quality of the patient's interpersonal interactions. Emphasis is placed on enhancing the patient's ability to cope with stresses, improving interpersonal communications, increasing morale, and helping the patient deal with the effects of the depressive disorder. See also Personality theory.

Eclectic and integrative therapies

The largest number of psychotherapists consider themselves to be eclectics. They do not adhere strictly to one theoretical orientation or school but use any procedures that they believe will be helpful for the individual patient. Eclecticism has been linked with the development of a movement for integration in psychotherapy. The emphasis in this new development is on openness to the views of other approaches, a less doctrinaire approach to psychotherapy, and an attempt to integrate two or more different theoretical views or systems of psychotherapy.

Group, family, and marital therapy

Most psychotherapy is conducted on a one-to-one basisone therapist for one patientand the confidentiality of these sessions is extremely important. However, there are other instances where more than one patient is involved because of particular goals. These include marital, family, and group therapy. Outpatient groups have been used for smoking cessation, weight loss, binge eating, and similar problems as well as for what were traditionally viewed as psychoneurotic problems. Inpatient group therapy was frequently employed in mental hospital settings. There has been research on the combined use of medication and psychotherapy. In general, where two highly successful treatments are combined in cases with depressive or anxiety disorders, there appears to be little gain in effectiveness. However, in several studies of hospitalized patients with schizophrenia where individual psychotherapy has been ineffective, a combination of psychotherapy and medication has produced better results than medication alone

Summary
This is an introductory chapter to the psychological therapies for eating disorders (EDs) section, which aims to provide a state-of-the-art review of current psychological treatments for EDs; with a particular focus on the NICE (2004) treatment of choice, namely, cognitive behavioural therapy (CBT), as well as the other traditionally used psychotherapeutic approaches, such as psychodynamic psychotherapy and family therapy. However, since the NICE guideline was published a number of authors have developed new treatment approaches, many of which appear to offer promising provisional data or have face validity for clients and professionals. These therapies are yet to be subjected to the rigours of large-scale randomized control trials (RCTs), but will hopefully inspire the next generation of clinicians and researchers to explore their usefulness in the treatment of ED, or to develop and evaluate alternative approaches.

Definition of Cognitive Therapy

Cognitive therapy is a kind of psychotherapy that treats mental, emotional, and psychological problems by identifying errors in a patient's thought processes; it is one form of cognitive-behavioral therapy. Originated by Aaron Beck in the 1960s, cognitive therapy depends on the view that mental errors (not, as psychoanalysts claim, childhood events) cause problematic behavior and feelings. For example, someone's belief that making a mistake proves that one is a failure may induce an anxiety disorder. Treatment of this disorder, then, would involve helping that person to identify that thought and recognize it as irrational. Cognitive therapy typically occurs for a relatively brief period of time and involves specific goals and a close patient-therapist relationship. Research suggests it effectively treats conditions such as depression.

In group therapy approximately 6-10 individuals meet face-to-face with a trained

group therapist. During the group meeting time, members decide what they want to talk about. Members are encouraged to give feedback to others. Feedback includes expressing your own feelings about what someone says or does. Interaction between group members are highly encouraged and provides each person with an opportunity to try out new ways of behaving; it also provides members with an opportunity for learning more about the way they interact with others. It is a safe environment in which members work to establish a level of trust that allows them to talk personally and honestly. Group members make a commitment to the group and are instructed that the content of the group sessions are confidential. It is not appropriate for group members to disclose events of the group to an outside person.

Why is group therapy helpful? 1. When people come into a group and interact freely with other group members, they usually recreate those difficulties that brought them to group therapy in the the first place. Under the direction of the group therapist, the group is able to give support, offer alternatives, and comfort members in such a way that these difficulties become resolved and alternative behaviors are learned.

2. The group also allows a person to develop new ways of relating to people. 3. During group therapy, people begin to see that they are not alone and that there is hope and help. It is comforting to hear that other people have a similar difficulty, or have already worked through a problem that deeply disturbs another group member. 4. Another reason for the success of group therapy is that people feel free to care about each other because of the climate of trust in a group. As the group members begin to feel more comfortable, you will be able to speak freely. The psychological safety of the group will allow the expression of those feelings which are often difficult to express outside of group. You will begin to ask for the support you need. You will be encouraged tell people what you expect of them. In a group, you probably will be most helped and satisfied if you talk about your feelings. It is important to keep in mind that you are the one who determines how much you disclose in a group. You will not be forced to tell you deepest and innermost thoughts.

f you have a phobia, including a social phobia, where you feel anxious about blushing, public speaking or eating in public behaviour therapy can be most helpful. It will not delve into your past, or concern itself much with your thoughts; instead it will concentrate on eradicating the difficulty in a practical way. To do this, the therapist will first help you develop appropriate skills to deal with difficult situations and then adopt a step-by-step approach to help you conquer your fears. For example, if you're afraid of eating and drinking in public, the therapist will give you little techniques to help you reduce your anxiety, but will then encourage you to face your problems. Sometimes the therapist may suggest things you think are impossible or weird, but it's done with your mental health in mind.

How behaviour therapy works

Let's suppose you are someone who's so terrified of knocking over a glass of wine in a posh restaurant that you never go out to eat. Your therapist will teach you breathing techniques to help reduce your panic, and they might then ask you to go, or may even go with you, to a cheap and cheerful caf and encourage you to knock over your cup of tea. Terrifying though this will feel to you, you'll quickly see that nothing awful happens. Step-by-step, you'll be encouraged to go to more upmarket cafs, then restaurants until eventually you may well be asked to knock over a glass of red wine in some really swanky place. Once you've faced up to your fear, it will cease to have any hold over you. Then you'll be able to go out to restaurants, happy in the knowledge that though it's most unlikely you'll knock anything over, if you do, it won't be the cataclysmic event you once thought. Obviously, I'm simplifying what happens in this treatment. But I hope you get the picture. This is usually a short-term form of therapy. It can feel tough, but it's also lively and often quite funny.

Other types of therapy

Psychotherapy Coaching Cognitive analytic therapy Cognitive therapy Gestalt therapy Person-centred therapy Psychodynamic therapy Rational emotive behaviour thera