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Common Therapies

While each patient is unique, and his/her circumstances different, individuals do exhibit symptom patterns that help us decide which treatments are likely to be most effective. Diagnoses – broad classifications of symptoms and behaviors – are expressed in terms of these patterns. Psychologists use models to describe and understand human behavior, but many of these theories are not approachable by the average patient. An alternate framework is called Descriptive Psychology (http://www.sdp.org/), in which problems are understood as a function of three aspects of personality: Actor, Observer, and Critic (AOC). All three components of the personality are essential, but an over-emphasis or under-emphasis of any of these three roles can result in dysfunction.


Actor

Problems of Acting refer to a person's engaging in behaviors without full consideration of consequences. Thus, problems of the Actor might manifest in a number of different ways, such as addictive behavior, problems with impulsivity, overeating, smoking, or difficulty regulating or managing one's emotions.


Observer

The Observer is the part of our personality that pays attention, describes situations in objective terms, and regulates our behavior. While the Observer role is critical to living an adaptive life, it too can become problematic when out of proportion. Problems such as having obsessive thoughts could be conceptualized as a problem of Observing.


Critic

Finally, some problems can be attributed to the Critic function of our personality. The Critic serves as a judge - either towards self or others. When out of proportion, this often leads to problems commonly referred to as depression. When directed externally towards others, the Critic role often also contributes to problems and dissatisfaction in relationships.


After conceptualizing a patient's problem as one of Acting, Observing, or Criticizing, or via traditional diagnostic classifications, psychologists can understand which therapeutic paradigms will be most helpful to the patient.


When possible, at WellStar we use evidence-based and empirically supported psychological therapies whose efficacy has been identified and thoroughly demonstrated through scientific study. While staying at the cutting edge of psychological research and evaluation, we avoid faddish, unproven psychotherapies, which may be ineffective or even dangerous to patients. Although some problems require ongoing or longer-term therapy, others can be resolved via these brief, evidence-based and empirically-supported treatments. Patients should have confidence that treatment duration hinges on medical necessity, and that the frequency and duration of sessions are determined on the basis of individualized need. Many problems can be resolved in six or fewer sessions. Others, however, require more extensive work.


Treatment Approaches

Acceptance and Commitment Therapy (ACT) teaches patients to observe, accept, and embrace events in their lives, even those that are unpleasant. Inherent in ACT is the concept that pain avoidance is normal, but also problematic. Via ACT, patients learn to increase their psychological flexibility – their ability to manage unforeseen events – by strengthening their values and acting in accordance with them. Rather than relying on "willpower" to change behavior, when a person tethers their daily actions to their core values, behavioral change becomes more probable.


Unlike some traditional psychological models, which assume that people are naturally psychologically healthy, ACT assumes that a “normal” mind can sometimes be self-destructive. Its central insight is that habit, comfort, and risk-aversion lead to a rigidity that leads to discord between values and behavior. ACT is well-suited to treat problems of Acting, Observing, and Criticizing, such as addictive behaviors depression, phobia, and post-traumatic stress disorder. In many cases, ACT is effective by bringing to light the patient's behavioral avoidance, which further intensifies the patient's problem.


Cognitive Behavioral Therapy (CBT) assumes that, during times of mental distress, people's minds begin working differently, producing extreme and destructive thoughts and emotions. Extreme thoughts can elicit unpleasant emotions, which may then contribute to maladaptive and unhealthy behaviors. This process can result in a vicious cycle, as an individual’s behavioral choices may prolong and deepen his/her distress.


CBT involves a process of patient and therapist engagement, which includes collaborative development of a shared view of the patient's problem, and identification and achievement of personalized therapy goals. The strategies employed vary according to the problems being addressed, but they include evaluation and questioning beliefs and assumptions that may be unrealistic, facing unpleasant activities and obligations, and consciously adjusting behavior.


Compared to many other treatment approaches, CBT is typically brief and time-limited. It has been shown to be highly effective in treating anxiety disorders (e.g. phobias), mood disorders, insomnia, stress-related problems, and various other conditions. It has been shown to be effective with children and adolescents as well as adults.


Interpersonal Psychotherapy (IPT) emphasizes personal relationships as they contribute to psychological problems, and attempts to alleviate these issues by adjusting the ways in which individuals relate to other people. It is often helpful to adolescents as well as adults.


IPT begins with diagnosis and development of a treatment plan for the problems identified. Interpersonal problems that are often identified and treated via an IPT approach include:


  • Grief – a distorted reaction to a lost relationship. The patient is helped to accept his/her grief, and move on to replacement of the loss.
  • Role Dispute – expecting something from a relationship that the other person is unwilling or unable to provide. Usually treated by analyzing the dispute and fostering communication.
  • Role Transition – difficulties in moving from one role in life to another (e.g. retirement). The patient's loss is explored, and he/she is equipped with tools and skills to succeed in the new role.
  • Interpersonal Deficits – problems establishing and cultivating relationships. Communication problems are identified and corrected, often through role-playing exercises with the therapist.