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Appraisal of the Psychodynamic Psychotherapy |
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Introduction According to Kessler and associates (1994), anxiety disorders are one of the common psychiatric problems in the United States. This poses a major health matter as untreated anxiety problems can greatly affect the quality of life of the affected individuals. Physiologically speaking, people with anxiety disorders undergo an increased reaction of the autonomic nervous system (ANS) when threatened. This on the other hand results to their typical feeling of wanting to escape from the source of their anxiety.
The symptoms of anxiety disorders are usually divided into somatic and emotional symptoms. The somatic signs are manifested by abnormal bodily reactions such as rapid heart rate, numbness, muscle tension and excessive sweating. The emotional signs on the other hand are often represented by various negative feelings such as fear, nervousness, agitation and irritability. In most cases, people with anxiety disorder usually over-predict the outcomes of certain events. Moreover, the symptoms of this disorder are often misinterpreted by more serious ailments (Shear, 2003).
Leaving anxiety disorders untreated can result to other psychological and health problems. Moreover, as these involve the people’s life, the affected individual usually has trouble handling normal life activities. It is also a common reaction that people with anxiety disorders to limit themselves to routines where less or no risks can be encountered. Opportunities for these individuals become limited as well. It is then necessary that individuals with anxiety disorders are given the right treatment or therapy in order to overcome their fears or hesitations.
For this purpose, several therapeutic approaches without the use of pharmacological treatment had been developed and applied for anxiety management. Among these treatment approaches include the cognitive behavior therapy (CBT) and the psychodynamic psychotherapy. Thus, in this research, the roles of these approaches for anxiety management will be defined. In particular, focus will be on the goals of psychodynamic psychotherapy and its relation to the CBT theory. The efficacy of this treatment approach will also be highlighted through clinical trials and various researches.
Cognitive Behavior Therapy Cognitive behavior theory (CBT) is a therapeutic approach that involves talks and conferences. In this therapy, the patients will have to discuss and express their feelings, behaviors and thoughts to a mental health professional. The focus of CBT is to determine these feelings and identify how these are affecting the patients, in terms of their actions. This focus of the CBT makes it a problem-solving therapeutic approach. The main aim of this therapy is to teach individuals how to properly think and react to certain stressful situations. CBT can actually be used for a number of reasons. These include anxiety disorders, phobias, depression, eating disorders, schizophrenia and relationship difficulties (Kassel, 2005).
This psychosocial therapy is based on a non-medication approach, which believes that maladaptive thinking patterns are the ones causing negative emotions. Maladaptive thinking patterns basically pertain to the behavior that leads to an individual’s unproductiveness; thus, this behavior is often used to explain how anxiety problems can interfere with the individual’s normal life activities (Ford-Martin, n.d). Cognitive behavior therapy (CBT) is a general term used to describe the different therapies that combine both behavioral and cognitive interventions in handling psychological disorders.
The aim of the behavioral intervention is to lessen the individuals’ problematic behavior and emotions by means of behavioral modification. The cognitive intervention on the other hand also aims to reduce the persons dysfunctional behavioral and emotional; however, in this case, the process is through the alteration of the individual’s thinking pattern. These two approaches were used based on the theory behind CBT theory. The theory states that people who have psychological troubles like anxiety disorders undergo problems on these two aspects as maladaptive consequences of previous learning. It is then the aim of CBT to reduce the person’s unwanted behavior or distress; this can be done by means of providing a new and more adaptive learning experience (Brewin, 1996). CBT was developed by two psychologists Albert Ellis and Aaron Beck during the 1960s. The psychologists believed that disturbed emotions and maladaptive behaviors are caused by inappropriate automatic thoughts or irrational thinking pattern. An example of a distorted viewpoint is when the person feels useless when scolded by a superior or when he or she does not please a particular person. A therapist applying CBT will then attempt to make the patient realize this distorted view and change it through cognitive restructuring. Behavioral therapy is also part of the CBT. In this case, the therapist tries to train the person to remove all undesirable behaviors and replace them with good ones. This approach is not after the identification of why the patients behave in certain ways; rather, it is more after teaching the affected individuals how to modify their behaviors (Ford-Martin, n.d).
Basically, CBT is given to the affected patient in order to identify the causes of the negative behavior as well as show the patient how he or she can bring about changes to these behaviors. From other case observations, patients who undergo CBT often have schemas or core beliefs about their self or their surroundings; these schemas are then the ones that must be identified and changed. This can perhaps be explained further through an actual situation. For example, a patient with anxiety disorder has this fear about being with people. Thus, in order to avoid this fear, the person tries to isolate himself or herself from others.
Upon questioning, the patient will state that it is best to avoid people than face rejection. Eventually, the therapist will find out that it is the patient’s inferiority complex that is drawing him or her from others. The lack of love and belief for oneself is the main schema of this case; this then will be the focus of the CBT. The therapist helps the individual the level of reality behind this schema and convinces him or her to realize the truth and what is possible.
The aim of CBT is then to make the patient feel important and loved. This can be done by asking the patient to name his or her family members, relatives and close friends. The purpose of this approach is to make the patient realize that there are people who appreciate hi or her for who he or she is. This in turn will make the patient realize the irrationality of his or her distorted schema. As CBT is applied, the patient will start to think that he or she is an interesting person and fun to be with. By teaching the patient to become more appreciative of himself or herself, the maladaptive behavior and thinking pattern is replaced with a more positive schema.
There had been a number of empirical supports that confirm the efficacy of CBT in reducing both short and long term anxiety disorders (Chambless et al., 1996). Similar to how CBT is applied to other psychological conditions, CBT is given to patients with anxiety disorders in order to make the patients aware of the sources of their anxiety. The therapy is also after the learning of the different skills that will help the patients restructure their cognitive and behavioral aspects. This will help the patients to reduce the level of their anxiety or fear.
The treatment approach for patients with anxiety disorders usually take about ten to fifteen individual or group sessions, utilizing different activities such as psychoeducation, relation training, systematic exposure to causes of anxiety, cognitive restructuring and self-monitoring. The duration of the treatment however, depends significantly on the severity of the patient’s condition. In addition, the outcome and length of the treatment period is based on how the patient can master the concepts of the CBT approach as well as his or her willingness to get better. The skill of the health provider is also an important determinant of the treatment outcome (Demertzis & Craske, 2005).
Treatment Modalities of CBT There are a number of specific approaches on how CBT can be administered to an individual. One way is through psychoeducation. As the name implies, this approach aims to educate the patients about different feeling related to anxiety as well as various behavioral symptoms. This modality also objects to relay the rationale of the treatment plan to the patient and explain how the process will be able to address his or her psychological condition. Among patients with anxiety disorder, psychoeducation is a useful CBT approach that helps patients to understand physical sensations with the different possible sources of harm. In other words, this approach is helpful in teaching the affected individuals the right feeling or emotion as the situation requires it.
Another CBT technique used for handling psychological disorders is through the self-monitoring strategy. In this case, the aim is to pinpoint the exact cause of anxiety or fear in the individual and identify how the person reacts to this stimulus. This strategy is not only helpful for patients in recognizing their fears, but it also serves as a useful gauge for individuals to recognize their psychological progress. Though this CBT tool may initially show the level of distress the patient is currently in, it is a very helpful approach in motivating the patient to work on their disorder especially if therapeutic success is gradually becoming evident.
In other cases, exposing the individuals to their sources of anxiety repetitively can also help in cognitive and behavioral modification. This is also known as exposure therapy, wherein the resulting effect of this approach is the significant emotional reaction to a certain stimulus. One more specific approach with this type of strategy is called the imagery exposure. In this case, the patients are encouraged to increase their tolerance over an imagined situation.
The deliberate initiation of the physical sensation that patient fear is also used in reducing heightened negative reactions to a particular situation. Examples of these deliberate physical sensations are panic, nausea and increased heart rate. Patients for example will be spun around to initiate a feeling of panic or hyperventilation; the patient will then be taught how to handle these sensations. Redundant exposure will help affected individuals to get accustomed to these used to be overly negative sensations. Eventually, they will be able to handle different stress factors by responding to them appropriately.
Psychodynamic Psychotherapy A related approach for handling anxiety disorders and related health problems is through psychodynamic psychotherapy. At times, this non-pharmacological approach is also referred to as psychoanalytic psychotherapy. According to Scholten (2005), this treatment approach is a general term for therapies that help patients to bring out their hidden feelings out. Similar to the theory of CBT, psychodynamic psychotherapy believes that by realizing the sources of their fears, patients will be able to understand how these unconscious feelings are affecting them as well as how these can be managed more effectively.
Without the proper attention and help, people tend to leave unconscious feelings unrecognized; psychodynamic psychotherapy believes that such feeling are often left unacknowledged due to the pain or negative things associated with them. People put up certain defenses to protect from recalling such negative feelings. Some of the common ways on how one defends himself from negative thought include denial, made up explanations and venting bottled up feelings through anger or other extreme negative reactions. This therapeutic approach presumes that these defenses are not actually protecting the person (Scholten, 2005).
Psychoanalysis is a subsidiary of the psychodynamic therapy; this derivative actually makes this therapy quite different from the concepts of the CBT theory and anxiety management. The main objective of psychoanalysis is to track down the possible causes of the person’s psychological disorder based on his or her background. Typically, this background analysis includes an individual’s childhood or adult experiences; by analyzing the person’s upbringing, possible conflicts encountered by the individual that could have resulted to his or her mental state, can be identified.
The process of administering the psychodynamic psychotherapy is largely dependent on the good relations between the patient and the therapist. The procedure is commonly divided into three stages. These include transference, counter transference and interpretation. The first step, transference, commonly involves the transfer of an important relationship to the health therapist. During the discussion of the patient’s relationship to the therapist, the patient tries to relay related thoughts, emotions and defenses. In this initial stage of psychodynamic therapy, the patient sorts through issues and become more aware of the causes of his or her anxiety.
It is essential that the therapist fully understands the feelings of the patient. Thus, in counter transference, the therapist tries to use his or her feelings in order to understand the patient’s situation. This is an important step as this will allow the therapist to develop an intervention suitable for the patient’s case. After this, the therapist will gain the relevant insights about the patient’s problem.
In the interpretation stage, the patient tries to assess how much the patient is attached to these feelings as well as what feelings are left unrecognized. At this final phase of the therapeutic procedure, the therapist also tries to identify the ability of the patient to tolerate the negative things associated with those feelings. These interpretations will then be used by the therapist to explain the patient’s situation. Eventually, this realization will allow unconscious feelings to surface and be addressed.
Theoretical Comparison: CBT and Psychotherapy As initially discussed, CBT theory states that the recognition of ones source of anxiety is caused by dual factors: cognitive and behavioral. Thus, it is important that these causes of stress should be addressed by cognitive and behavioral medication. Similarly, psychodynamic psychotherapy is based on the concept that a stress factor, referred to as unconscious or hidden feelings, is the primary cause for an individual’s psychological problem. This therapy is patterned after the CBT theory as it also stands by the belief that these causative factors must be realized for proper treatment. Despite the similarity of the treatment approaches, psychodynamic therapy also has some features different from CBT. For instance, it was mentioned that the aim of CBT is to address the patient’s psychological disorder through the administration of cognitive and behavioral modification. The psychodynamic approach on the other hand, is more focused on identifying the roots of the patient’s condition based on his or her background. Childhood experiences or adult encounters that could have brought about the patient’s anxiety disorder are recognized by both the patient and the therapist. Through this, the therapist is able to design a treatment approach that will help the patient face the identified unconscious feeling. In other words, psychodynamic psychotherapy is not after the patient’s maladaptive behavior but on exact personal experiences.
There appears to be a distinction between a CBT and psychodynamic therapist as well. Although the relation between the patient and the therapist are important in both treatment approaches, psychodynamic therapeutic procedures suggest a stronger relationship treatment relationship. In CBT, the therapist’s role is to help the patient change cognitively and behaviorally through different CBT approaches. In psychodynamic however, the aim is for the therapist to feel what the patient is feeling; this helps the therapist to understand the patient’s situation and develop individual treatment approaches. As psychodynamic psychotherapy requires a deeper sharing and understanding of the patient’s feelings, it can be said that patient-therapist relation in this treatment approach is stronger and more established.
Clinical Trials and Psychodynamic Psychotherapy From the description of this treatment approach, psychodynamic psychotherapy primarily aims in allowing the patient to recall significant experiences, events or relationships. This in turn helps the patient to identify unconscious feelings, while the therapist can develop appropriate interventions that will help the affected individual to address his or her sources of anxiety. It is then the purpose of psychodynamic psychotherapy to reduce the anxiety levels of the patients and help them live a life with improved quality. The treatment approach was able to fulfill this purpose as confirmed by a number of clinical trials and researches.
One example of clinical trial done using psychodynamic psychotherapy was conducted by Franke, Hoffmann & Frommer (2005). In this research, the aim was to identify whether psychodynamic inpatient psychotherapy can lead to significant mental health outcomes after a year of administration. For the participants, a total of sixty-four patients were selected from a single hospital. In order to determine the impact of the treatment approach, the researchers used two checklist tools called SCL-90-R and IIP-D. These assessment tools were utilized for four times during the duration of the research process. The observations were conducted at the start of the treatment, after four weeks, at the end of the treatment and a year after the treatment was given. The results of the assessment tools showed that giving psychodynamic psychotherapy to patients after four weeks resulted to significant progress of reduced psychological distress as compared to the assessment result during the start of the treatment.
However, the researchers also concluded that as the treatment approach is continuously used, the impact of treatment decreases. Still, the findings of the assessment tools used by the researchers indicated that problems such as depression, obsessive/compulsive behavior, dominance and anxiety were addressed significantly through the treatment approach. The researchers concluded that although significant signs of improvement were detected on the first four week of treatment, this is still not enough to achieve optimum reduction of psychological distress or change in behavior. During the course of treatment, changes are still observed during the different period of assessment, indicating that long-term outcomes can be achieved through long treatment plans (Franke, Hoffmann & Frommer, 2005).
Other researches verified the fulfillment of the treatment’s purpose to mental health patients by concentrating on specific disorders. Kronmuller and associates (2005) for example focused on identifying the efficacy of psychodynamic psychotherapy among children and adolescents suffering from various anxiety disorders. Aside from the observed prevalence of this psychological condition among children, the researchers opted to focus on this disorder considering that limited researches had been done to correlate the treatment’s efficacy to anxiety disorders. The major objective of the study was to assess whether PSTP or short-term psychotherapy can result to significant progress in addressing anxiety disorders among children and adolescents.
In order to determine the efficacy of the treatment approach, two participant groups were formed: the treatment group and the control group. The treatment group was composed of patients with anxiety disorders who were subjected to twenty five therapy sessions. The outcomes of the treatment will then be compared to the children and adolescents found on the waiting list who then served as the control group; this group did not receive any treatment yet. For data-gathering, the researchers made use of the IS-CA or the Impairment-Score for Children and Adolescents, the CBCL or Child Behavior Checklist as well as the PSCFS-CA or the Psychic and Social Communicative Findings Sheet for Children and Adolescents. Both the CBCL and PSCFS-CA assessment tools were also used by the researchers during the start of the treatment. Significant clinical changes and statistical findings were then evaluated through these measures (Kronmuller et al., 2005).
Based from the gathered findings of the IS-CA, the group who were subjected to psychodynamic psychotherapy was able to obtain significant advantages as compared to the participants in the control group. Majority of the participants in the treatment group, or sixty-two percent, exhibited significant improvements after the twenty-five treatment sessions. This finding also applied to the data gathered using the CBCL and PSCFS-CA. From these results, the researchers concluded that PSTP is an efficient treatment approach for addressing anxiety disorder among children and adolescents. However, considering that not all patients were able to show significant treatment outcomes, the researchers suggested that the impact of psychodynamic psychotherapy is also related to the severity of the patients’ disorder (Kronmuller et al., 2005).
Panic disorder, a form of anxiety disorder, is also among the psychological conditions used to test the efficacy of psychodynamic therapy for anxiety management. Originally, this disorder is termed as anxiety neurosis wherein patients typically have a hard time in upholding themselves. This disorder is also characterized by the anxious expectation of the individual for frightening things to occur either to him or to the people he cares about. This is also observed when affected individuals feel great anxiety when separated from people or things that are closest to them.
There had been a multitude of previous researches confirming that psychodynamic psychotherapy is efficient in addressing panic disorders. One example is the research of Mildrod and Shear (1991) where the researchers were able to collate thirty-five case studies of panic disorders, which had been treated successfully through psychodynamic psychotherapy. From this research finding, other researches had also been introduced, confirming the efficacy of the treatment approach for panic disorders (Mildrod et al., 1996; Busch et al., 1996). In general, these subsequent studies concluded that psychodynamic psychotherapy is an efficient treatment approach for psychological disorders. It was also considered to be as fast-effecting as pharmacological and cognitive-behavioral interventions. In a randomized controlled trial done by Wiborg and Dahl (1996), the researchers tried to compare the outcome of clomipramine treatment with psychodynamic psychotherapy with an approach using clomipramine alone. The researchers found out that significant reduction of relapse rate was observed among patients using the integrated treatment approach.
A more recent research also confirmed that psychodynamic psychotherapy is effective in treating panic disorders (Mildrod et al., 2001). In this open trial, the researchers utilized the Panic-focused psychodynamic psychotherapy (PFPP) to twenty-one patients with panic disorder. The selected patients underwent a total of twenty-four treatment sessions. The selected treatment modality is administered to the patients twice every week. Each session lasts for about forty-five minutes. The PFPP is actually a modified version of the psychodynamic psychotherapy, which is still based on the same principles particularly on the significance of unconscious mental emotions and imaginations. The process is still centered on transference where the patient relays his or her experiences of panic to the therapist.
The PFPP is a treatment approach that is also divided into three stages. The first stage of the approach is centered on the treatment of the patient’s acute panic. Here, the main objective is to reduce panic symptoms as well as reveal the unconscious meanings behind these symptoms. Under this stage, the therapist conducts three procedures. Initially, the therapist and the patient will try to explore what triggers panic as well as the symptoms and feelings related to it. After which, the unconscious reasons of panic such as anger or separation will be determined. From this recognition phase, it is expected that the patient will have reduced panic symptoms (Mildrod et al., 2001).
On the second stage, the main objective is to resolve the unconscious cause or reason behind the patients’ feelings of panic. The purpose of this stage is to lessen the patient’s vulnerability to these unconscious causes. For instance, if the patient feels panic when separated from an important person or object, the therapist works on helping the patient handle separation. This can be done by citing the rationale of separation. This is also applies when anger is the factor that causes panic. Here, the aim to help patient handle anger or similar strong emotions. Thus, in the second stage, the expected outcome is the development of the ability to handle unconscious dynamisms among affected individuals (Mildrod et al., 2001). As the patient is now able to recognize and handle his or her unconscious dynamism, it is then the goal of the third stage of PFPP to totally terminate the patient’s difficulty in overcoming these causes of panic. In this stage, the patient is allowed to experience this conflict like separation or anger repeatedly. Through this procedure, the patient is able to understand his or her condition as well as the factors that cause it. This does not only improve the patient’s psychological response to these unconscious dynamisms, but it also helps in maintaining the expression of more appropriate reactions. In this final treatment stage, the expected outcome is likely to be the total termination of the panic symptoms or the development of a new ability for the patient to handle his or her unconscious dynamisms of panic (Mildrod et al., 2001).
As this treatment approach is administered to the patients, the researchers also made use several assessment tools to evaluate the outcome of the PFPP. One of these assessment tools is called ADIS or Anxiety Disorders Interview Schedule-IV-L. A tool that measures anticipatory anxiety known as ASI or Anxiety Sensitivity Inventory as well as the Marks and Matthews Fear Questionnaire that roughly measures phobic severity and avoidance were also used in the trial. Other measures like the Social Adjustment Scales (SAS), which measures the patients’ functional impairments; Panic Disorder Severity Scale (PDSS), which measures panic severity; the Hamilton Rating Scale for Anxiety (Ham-A) that measures anxiety factors that are not related to panic; and the Sheehan Disability Scale (SDS), which was found to be a sensitive tool for assessing panic patients and measures impairments in family, social and vocational aspects (Mildrod et al., 2001).
After the clinical trial, the researchers found out that sixteen of the participants had experienced significant reduction of agoraphobia and panic. Participants who had depression problems also encountered remissions of the disorder. The measures used in this clinical trial also showed substantial improvements in the patients’ symptoms and quality of life. From this finding, the researchers concluded that psychodynamic psychotherapy can be a useful treatment approach for patients with panic disorder.
Other researches had also verified the usefulness of psychodynamic psychotherapy in addressing cases of panic disorders. Ablon and associates (n.d.) stated that the focus of most clinical trials on various psychological conditions was centered on the use of cognitive-behavioral therapy or pharmacologic interventions. However, follow up researches revealed that the discontinuation of these treatment approaches result to relapse or recurrence of the disorder. Thus, the researchers attempted to identify whether psychodynamic treatment may be used as a more effective alternative for handling patients with psychological problems, particularly those with panic disorders. In order to carry out this research objective, the researchers opted to assess the effect of brief psychodynamic psychotherapy to sixteen patients with panic disorder. The treatment involved twenty-four sessions administered once every week. The sessions were all audiotaped for data gathering purposes. The responses of the therapists, patients and observers to the treatment process were all evaluated every month through various assessment measures.
The summary of the findings revealed that significant reduction in the patients’ total anxiety symptoms was observed. In addition, the overall functioning improvement of the patients was also evident after the treatment procedure. Specifically, sixty-eight to seventy-five percent of the total participants showed significant clinical changes after the treatment was administered. Based from these research outcomes, the researchers concluded that psychodynamic psychotherapy is indeed an effective alternative for treating patients with panic disorders. Aside from its efficacy, using psychodynamic psychotherapy is also a good treatment approach for patients who are resistant to pharmacological or CBT interventions (Ablon, et al., n.d.).
Other clinical trials and researches had also been conducted to determine the ability of psychodynamic psychotherapy to treat anxiety disorders. Most of the researches concluded that this treatment is effective as it was able to reduce psychological symptoms, which is the main purpose of psychodynamic psychotherapy. An example is the research of Doige and associates (2002). In this study, the researchers conducted a survey of five hundred and ten psychoanalysts from Canada, US and Australia. The respondents were to describe the development of their patients after undergoing psychoanalysis. From the responses given by the participants, it was revealed that majority (82%) of the patients had been subjected to other medications or treatment approaches before going through psychoanalysis. The responses also showed that most of the patients (72%) cited in the study had been diagnosed with significant psychopathology, indicating that past treatment strategies may not have resulted to considerable clinical developments. The responding psychoanalysts noted in the survey that patients had greatly progressed after going through psychoanalysis, which on the average, lasted for five to six years (Doige et al., 2002).
Sandell and colleagues (2000) reported reduction of symptoms in a longitudinal study where hundreds of patients from Stockholm were selected. In order to determine the efficacy of the treatment approach, an assessment tool, Symptom Check List-90, was used to assess the effects of psychotherapy before, during and after the treatment procedure. In another research, Beutel and associates (2004) found out that long term psychodynamic psychotherapy is not only effective in reducing symptoms, but it is also significant in reducing work absenteeism as well as health care expenses.
German studies had also been published, confirming the efficacy of psychodynamic psychotherapy in reducing symptoms of anxiety and other related disorders. For instance, a total of 401 patients were used by Leuzinger-Bohleber (2002) in order to test the effectiveness of psychoanalysis. This was done through an effectiveness follow up for six years using either a questionnaire or interview method. The study concluded that patients were more satisfied with the outcome of the treatment approach than the psychoanalysts themselves. This is perhaps attributable to their cautiousness in measuring the outcomes of the therapy. A total of 111 patients were used in another similar research (Keller et al., 2002). The selected participants were subjected to a 100 treatment session of psychotherapy. Using SCL-90, the researchers also concluded that psychiatric symptoms were significantly reduced after psychoanalysis.
Factors Affecting Treatment Efficacy From these clinical trials and researches, it has been indicated that although psychodynamic psychotherapy is effective in reducing psychiatric symptoms, certain factors appear to affect its efficacy. For instance, some patients with severe cases of anxiety disorders were not able to respond positively to this treatment approach as they require more extensive treatments. Treatment duration and continuity were also some identified factors that enhances psychotherapy’s efficacy. Although brief psychotherapy was found to be effective in reducing symptoms of anxiety, other researchers suggest that continuity of treatment is important in maintaining gained benefits and preventing recurrence.
There are some factors however which has been considered as determinants of psychotherapy effectiveness. For instance, therapy outcomes based on the gender factor had been raised. Researchers were able to provide multiple inconclusive findings in this aspect; hence, the relation of the gender factor to psychotherapy remains inadequately understood. Most of the researches were focused on determining whether the gender of the patient or the therapist has any effect on treatment outcome. The study of Jones and Zoppell (1982) for example, indicated that female patient gain more benefits from psychiatric therapy as compared to male patients. In the same study, the researchers also found out that both female and male patients gain more psychiatric benefits from therapy when a female therapist is involved in the treatment process. Most studies however, claim that the relation between patient/therapist genders to the outcome of treatment is weak (Zlotnick et al., 1996; Beutler, Machado & Neufeldt, 1994).
Ogrodniczuk and associates (2001) on the other hand, attempted to determine the relation of the patients’ gender to two different types of short term individual psychotherapy. Through random sampling, a total of 89 male and female patients were assigned in random either in the interpretative approach or supportive approach. Psychiatric aspects including anxiety, depression as well as symptomatic distress were measured in order to determine the effects of the treatments to the patients. The results showed that significant relations between gender and treatment type can be observed with the depression and distress measures. The findings indicated that female patients respond more positively in supportive psychotherapy that in the interpretative type. On the contrary, interpretative therapy appears to result to better treatment outcomes among male patients. The results then imply that gender factors may have a stronger correlation to the type of treatment approach given to the patients.
The researchers explained these findings based on the explanations of other researches. These previous literatures had suggested that female patients tend to prefer the establishment of more personal and collaborative relations with their therapists. As supportive psychotherapy is mainly characterized by these features, female patients tend to respond well to this treatment. In addition, the female patients gained better treatment outcomes from this approach than their male counterparts. On the other hand, literature suggested that male patients generally prefer the establishment of neutral relations with their therapists. The interpretive therapy fosters this feature, resulting to better treatment outcomes among male patients (Ogrodniczuk et al., 2001).
Usefulness in Psychology and Mental Health Psychodynamic psychotherapy may be supported by a different theoretical framework as compared to a more popular CBT approach. Nonetheless, the studies and clinical trials cited in this discussion emphasize that psychotherapy can also serve as an effective treatment approach not only for anxiety disorders but in other psychiatric problems as well. One of the most important factors that make psychotherapy useful for both psychology and mental health is its ability to reduce psychiatric symptoms among affected individuals.
It was mentioned that anxiety disorders tend to affect the quality of the person’s life. Through psychodynamic psychotherapy, patients are able to realize the roots of their fear or anxiety. The therapists on the other hand, are able to develop suitable treatment plans that will help patient behave and think more appropriately. This ability of psychotherapy helps psychologists and mental health professionals in achieving their goal of treating affected individuals and giving them better quality lives.
Among patients, the use of psychodynamic therapy is also useful not only in reducing the symptoms of their disorders but also in helping them enjoy life more. As they are gradually treated by psychotherapy, they are able to access greater opportunities, perform more activities and produce better work output. In addition, this treatment approach is useful for them in dealing with people and in other actual life situations. Overall, the administration of this treatment approach is useful for patients, especially in giving them the chance to experience and enjoy things that life has to offer.
Patients tend to have different responses to psychiatric treatment approaches. Although pharmacologic treatment may be a tried and tested strategy for anxiety problems and other similar disorders, some patients are hesitant to take in medications. The compliance of patients to pharmacologic treatments is also difficult to ensure; for some, this intervention can also be costly that non-pharmacologic interventions. Hence, another usefulness of psychotherapy to mental health and psychology is the provision of treatment options based on the patients’ individual cases. Therapists are also given more treatment alternatives depending on the needs of their patients. In other words, the addition of psychotherapy improves flexibility in addressing various mental health concerns.
Conclusion Managing anxiety disorders and other psychiatric disorders is essential as this will allow patients to gain a life with better quality. Addressing these disorders will also help them in performing various activities. This then led to the introduction of various treatment approaches like CBT and psychodynamic psychotherapy. Both of these approaches have certain differences; however, the principle of both approaches has a single objective, and that is to help patients recover from their ailments. From this research, the efficacy of psychotherapy has been stressed through a number of clinical trials and relevant researches. In addition, the usefulness of this approach to the patients as well as to the mental health field had also been stressed though these studies. In conclusion, both CBT and psychodynamic therapy had been confirmed as effective by a number of authors. Therapists and mental health professionals should then consider the distinct features of these treatment approaches and apply them according to the preferences and needs of individual patients.
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