In a discussion of the ideal definition of psychotherapy on Monday (4.1.10), we had read Wolberg’s (1995) definition, being one of the most accepted ones. According to Lewis Wolberg "Psychotherapy is the treatment, by psychological means, of problems of an emotional nature in which a trained person deliberately establishes a professional relationship with the patient with the object of (1) removing, modifying, or retarding existing symptoms, (2) mediating disturbed patterns of behaviour, and (3) promoting positive personality growth and development."
A request to react to this definition brought forth several interesting comments from the class:
• We see that point (3) (“promoting positive…”) is not always the average psychotherapist’s primary concern. Perhaps this is not so strange: focusing on the immediate problems (symptoms) seems to do be a way to do away with the “road blocks” in the process of positive personality growth.
• Some may not be comfortable with the term “treatment” because it rings rather medical and dominant. We tried to understand why, by exploring the etymological roots of the term and found that, as a term used in medicine, it only meant “behaviour or conduct”. The term “therapy” was used much later, and in medicine, meant to “heal or to cure”. However, some of us in class felt that to discuss etymology did not seem so relevant to a discussion of the word’s present-day usage. Language is a tool. The fact remains that sometimes it may take on some borrowed power from its usage (sir used the example of “gay”).
• Most of us preferred the term “assistance” instead, which Ninad had mentioned in his definition in Monday’s class. Interestingly, we seemed to find Ninad’s definition more satisfactory than Wolberg’s one: Psychotherapy is defined as the process in which an expert viz. the psychotherapist assesses the client or patient in reviewing, reinterpreting and reconstructing his/her concerns, consistent with the psychological school of thought in which (s)he has received training. [Perhaps we will hold sir to his promise to grant us full marks for writing Ninad’s definition of psychotherapy in the exam. ;) ]
• It lays rather too much stress on the emotional side of problems than others.
• “Psychological means” is an ambiguous term, and has no mention of theoretical backing-up.
• Positive personality growth is something that may differ from culture to culture.
Another definition we finally found satisfactory was the one given by Sommers-Flanagan and Sommers-Flanagan (2004): Psychotherapy is a process that involves a trained person who practices the artful application of scientifically derived principles for establishing professional helping relationships with persons who seek assistance in resolving large or small psychological or relational problems. This is accomplished through ethically defined means and involves, in the broadest sense, some form of learning or human development.
Moving on to the differentiation of psychotherapy from psychotherapeutics (a term coined by Tuke), we agreed that psychotherapy is ideally supposed to be generally helpful to anyone, whereas psychotherapeutics aids psychotherapy but may work for some and not for others (e.g. psychodrama, dance, music, etc).
The “ideal” patient/client for psychotherapy has the following characteristics (remembered by the mnemonic YAVIS): Young, Attractive, Vital/verbose, Intelligent and SuccessfulIn fact, it has been jocularly suggested that the most ideal client for psychotherapy is the one who doesn’t need it at all! Incidentally, there also exists an acronym for those qualities that make a “bad” client: HOUND, which stands for Homely, Old, Unsuccessful, Non-verbal and Dumb.
The primary stakeholders of psychotherapy are the therapist and the client. Several intervening factors that affect psychotherapy are qualities around these stakeholders, i.e client variables, therapist variables (like age, sex, etc) and the relationship between the two (which can sometimes be dictated by the school of thought the therapist belongs to).
The class was wound down with an interesting study by Farber et al (2005) who listed out 12 themes in finding out the reasons for why people become psychotherapists, most of which we could identify with. These reasons have implications for practice, which will be discussed next class.
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