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Even if you informally commit to never moving certain Git tags, a consumer of your GitHub repository has no way to be sure about it. Price Machine — Experts on Price. They differ from other therapists in that they can prescribe medications, such as antidepressants and antianxiety drugs. Clinical psychologists and counseling psychologists have a Ph.

They work in settings such as businesses, schools, mental health centers, and hospitals. Licensing requirements vary in the United States, but most states require psychologists to have postdoctoral training. Psychiatric social workers have a master's degree in social work M.

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They may work in mental health agencies or medical settings practicing individual therapy or family and marital therapy. Psychiatric social workers make up the single largest group of mental health professionals. Licensing requirements vary in the United States.

Psychiatric nurses are registered nurses who usually have a master's degree in psychiatric nursing. They often work in a hospital setting conducting individual or group therapy with patients under the supervision of a psychiatrist. Psychoanalysts specialize in psychoanalysis. Although anyone may use the title of psychoanalyst, those accredited by the International Psychoanalytic Association are usually psychiatrists, psychologists, or social workers who have completed six to ten years of psychoanalytic training.

They are also required to undergo a personal analysis themselves. All but a few states license professional counselors, usually under the title of licensed professional counselor or licensed mental health counselor.

The National Board for Certified Counselors offers certification for counselors who have a minimum of a master's degree and who meet the organization's professional standards. Members of the clergypriests, ministers, and rabbisusually take courses in counseling and psychology as part of their seminary training. Some ministers specialize in pastoral counseling, working with members of a congregation who are in distress.

Any person, even one with no training, can legally use the title of therapist, psychotherapist, or other titles not covered under licensing and certification laws. Therefore, clients should ask therapists who practice under such titles about their academic and professional training.

Types of Therapy Print section Psychotherapy encompasses a large number of treatment methods, each developed from different theories about the causes of psychological problems and mental illnesses. There are more than kinds of psychotherapy, but only a fraction of these have found mainstream acceptance. Many kinds of psychotherapy are offshoots of well-known approaches or build upon the work of earlier theorists. In individual therapy, a patient or client meets regularly with a therapist, typically over a period of weeks or months.

The methods of therapists vary depending on their theory of personality, or way of understanding another individual. Most therapies can be classified as 1 psychodynamic, 2 humanistic, 3 behavioral, 4 cognitive, or 5 eclectic. In the United States, about 40 percent of therapists consider their approach eclectic, which means they combine techniques from a number of theoretical approaches and often tailor their treatment to the particular psychological problem of a client.

Forms of therapy that treat more than one person at a time include group therapy, family therapy, and couples therapy. These therapies may use techniques from any theoretical approach. Other forms of therapy specialize in treating children or adolescents with psychological problems. People seeking help for their problems most often select individual therapy over group therapy and other forms of therapy. People may prefer individual therapy because it allows the therapist to focus exclusively on their problems, without distractions from others.

Also, individuals may desire more privacy and confidentiality than is possible in a group setting. Sometimes people combine individual therapy and group therapy. Psychodynamic Therapies Print section Psychodynamic therapies are those therapies in some way derived from the work of Austrian physician Sigmund Freud, the founder of psychoanalysis.

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In general, psychodynamic therapists emphasize the importance of discovering and resolving internal, unconscious conflicts, often through an exploration of one's childhood and past experiences. Although psychoanalysis is the best-known form of psychodynamic therapy, theorists have developed many other psychodynamic therapies, some very different from Freud's original techniques. Classical Psychoanalysis Print section Freud developed the theory and techniques of psychoanalysis in the s.

He believed that much of an individual's personality develops before the age of six. He also proposed that children pass through a series of psychosexual stages, during which they express sexual energy in different ways. For example, during the phallic stage, from about age three to age five, children focus on feelings of pleasure in their genital organs. At this time, according to Freud, boys become sexually attracted to their mothers and feel hostility and jealousy toward their fathers.

Similarly, girls develop sexual feelings toward their fathers and feel rage toward their mothers. In Freud's view, such innate sexual and aggressive drives cause feelings and thoughts that the person regards as unacceptable. In response, the individual represses these feelings, driving them into the unconscious mind. In the process, three basic personality structures are formed: The id represents unchecked, instinctual drives; the superego is the voice of social conscience; and the ego is the rational thinking that mediates between the id and superego and deals with reality.

These three systems function as a whole, not separately. Id forces are unconscious and often emerge without an individual's awareness, causing fear, anxiety, depression, or other distressing symptoms.

Freud used the term neurosis to refer to such symptoms. In psychoanalysis, Freud sought to eliminate neurotic symptoms by bringing the individual's repressed fantasies, memories, and emotions into consciousness. He placed particular emphasis on helping patients uncover memories about early childhood trauma and conflict, which he regarded as the source of emotional problems in adults. At first, he used hypnosis as a way to gain access to a person's unconscious.

Later he developed free association, a method in which patients say whatever thoughts come to their minds about dreams, fantasies, and memories. The analyst's interpretations of this material, Freud believed, could provide patients with insight into their unconsciousinsight that would help them become less anxious, less depressed, or better in other ways.

Freud also placed great value on what could be learned from transference, the patient's emotional response to the therapist. Freud believed that during therapy, patients transfer repressed feelings toward their family members to their relationship with the therapist.

Transference exposes these repressed feelings and allows the patient to work through them. Free association and transference are still central features of Freudian psychoanalysis. In traditional or classical psychoanalysis, the patient lies on a couch and the therapist sits out of sight of the patient. This practice is intended to minimize the presence of the therapist and allow the patient to engage in free association more easily.

Classical psychoanalysis requires three to four sessions of therapy each week for several years. Classical psychoanalysis is not typically covered by insurance plans with managed mental health care.

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Therefore, relatively few individuals choose this intensive and long-term therapy. Contemporary Psychoanalysis Print section In contemporary forms of psychoanalysis, the duration of therapy is often shorterbetween one and four yearsand meetings may take place one or two times a week.

Other psychoanalytically oriented therapists work in a brief format of 30 sessions or less. The patient sits on a chair across from the therapist rather than lying on a couch. Modern psychoanalysts tend to focus more on current functioning and make less use of free association techniques.

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Neo-Freudian Therapies Print section Several of Freud's followers developed new theories about the causes of psychological disorders. Three important neo-Freudians were Erich Fromm, Karen Horney, and Erik Erikson, who emphasized the role of social and cultural influences in the formation of personality.

All three emigrated from Germany to the United States in the s. Their theories have influenced modern psychodynamic therapists. Fromm believed that the fundamental problem people confront is a sense of isolation deriving from their own separateness. According to Fromm, the goal of therapy is to orient oneself, establish roots, and find security by uniting with other people while remaining a separate individual.

Horney departed from Freud in her belief in the importance of social forces in personality formation. She asserted that people develop anxiety and other psychological problems because of feelings of isolation during childhood and unmet needs for love and respect from their parents.

The goal of therapy, in her view, is to help patients overcome anxiety-driven neurotic needs and move toward a more realistic image of themselves. Erikson extended Freud's emphasis on childhood development to cover the entire lifespan.

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Referred to as an ego psychologist, he emphasized the importance of the ego in helping individuals develop healthy ways to deal with their environment. Often working with children, Erikson helped individuals develop the basic trust and confidence needed for the development of a healthy ego.

Other psychoanalytic therapists focused on how relationships develop between the child and others, especially the mother. British pediatrician Donald Winnicott and Austrian-American pediatrician Margaret Mahler were known as object-relations analysts because of their emphasis on the child's love object such as the mother or father. They and other object-relations therapists, such as Austrian-born British psychoanalyst Melanie Klein, helped patients deal with problems that arose from being separated inappropriately or at too early an age or from their mothers.

Jungian Therapy Print section Unlike the psychoanalytic therapists, Swiss psychiatrist Carl Jung developed a very different system of therapy. He had worked closely with Freud, but broke away totally from Freud in his own work. Jung created a school of psychology that he called analytical psychology. He felt that Freud focused too much on sexual drives and not enough on all of the creative instincts and impulses that motivate individuals.

Whereas Freud had described the personal unconscious, which reflected the sum of one person's experience, Jung added the concept of the collective unconscious, which he defined as the reservoir of the experience of the entire human race. The collective unconscious contains images called archetypes that are common to all individuals.

They are often expressed in mythological concepts such as good and evil spirits, fairies, dragons, and gods. In general, Jungian therapists see psychological problems as arising from unconscious conflicts that create disturbances in psychic energy. They treat psychological problems by helping their patients bring material from their personal and collective unconscious into conscious awareness. The therapists do this through a knowledge of symbolismnot only symbols from mythology and folk culture, but also current cultural symbols.

By interpreting dreams and other materials, Jungian therapists help their patients become more aware of unconscious processes and become stronger individuals. Adlerian Therapy Print section Like Jung, Austrian physician Alfred Adler believed that Freud overemphasized the importance of sexual and aggressive drives.

Adler was particularly interested in sibling relationships, birth order, and relationships with parents. He would ask patients about their early memories and use this information to analyze their attitudes, beliefs, and behaviors. He helped his patients by encouraging them to meet important life goals: For Adler and modern therapists who draw from his work, interest in others and participation in society are important goals of therapy.

Adlerian therapists see therapy in part as educational, and they use a number of innovative action techniques to help patients change mistaken beliefs and interact more fully with family members and others. Humanistic Therapies Print section Humanistic therapies focus on the client's present rather than past experiences, and on conscious feelings rather than unconscious thoughts. Therapists try to create a caring, supportive atmosphere and to guide clients toward personal realizations and insights.

Clients are encouraged to take responsibility for their lives, to accept themselves, and to recognize their own potential for growth and change. The length of therapy depends on the severity of the problem and on a client's ability to change and try new behaviors.

Because humanistic therapies emphasize the relationship between client and therapist and a gradual development of increased responsibility by the client, these therapies typically take a year or two of weekly sessions. Three of the most influential forms of humanistic therapy are existential therapy, person-centered therapy, and Gestalt therapy. Existential Therapy Print section Based on a philosophical approach to people and their existence, existential therapy deals with important life themes.

These themes include living and dying, freedom, responsibility to self and others, finding meaning in life, and dealing with a sense of meaninglessness.

More than other kinds of therapists, existential therapists examine individuals' awareness of themselves and their ability to look beyond their immediate problems and daily events to problems of human existence. The first existential therapists were European psychiatrists trained in psychoanalysis who were dissatisfied with Freud's emphasis on biological drives and unconscious processes.

Existential therapists help their clients confront and explore anxiety, loneliness, despair, fear of death, and the feeling that life is meaningless. There are few techniques specific to existential therapy. Therapists normally draw on techniques from a variety of therapies.

One well-known existential therapy is logotherapy, developed by Austrian psychiatrist Viktor E. Frankl in the s logos is Greek for meaning. Person-Centered Therapy Print section Person-centered therapy, originally called client-centered therapy, is perhaps the best-known form of humanistic therapy.

American psychologist Carl Rogers developed this type of therapy in the s and s. Rogers believed that people, like other living organisms, are driven by an innate tendency to maintain and enhance themselves, which in turn moves them toward growth, maturity, and life enrichment. Within each person, Rogers believed, is the capacity for self-understanding and constructive change. Person-centered therapy emphasizes understanding and caring rather than diagnosis, advice, and persuasion.

Rogers strongly believed that the quality of the therapist-client relationship influences the success of therapy.

He felt that effective therapists must be genuine, accepting, and empathic. A genuine therapist expresses true interest in the client and is open and honest. An accepting therapist cares for the client unconditionally, even if the therapist does not always agree with him or her.

An empathic therapist demonstrates a deep understanding of the client's thoughts, ideas, experiences, and feelings and communicates this empathic understanding to the client. Rogers believed that when clients feel unconditional positive regard from a genuine therapist and feel empathically understood, they will be less anxious and more willing to reveal themselves and their weaknesses.

By doing so, clients gain a better understanding of their own lives, move toward self-acceptance, and can make progress in resolving a wide variety of personal problems. Person-centered therapists use an approach called active listening to demonstrate empathyletting clients know that they are being fully listened to and understood.

First, therapists must show through their body position and facial expression that they are paying attentionfor example, by directly facing the client and making good eye contact. During the therapy session, the therapist tries to restate what the client has said and seeks clarification of the client's feelings.

The therapist may use such phrases as "What I hear you saying is I always felt my husband loved me. I just don't understand why this happened. You feel surprised by the fact that he left you, because you thought he loved you.

It comes as a real surprise. I guess I haven't really accepted that he could do this to me. A big part of me still loves him. You seem to still be hurting from what he did. The love you have for him is so strong. Many therapists, not just those of humanistic orientation, have adopted elements of Rogers's approach. Gestalt Therapy Print section Gestalt is a German word referring to wholeness and the concept that a whole unit is more than the sum of its parts.

Gestalt therapy was developed in the s and s by Frederick Fritz Perls, a German-born psychiatrist who immigrated to the United States.


Like person-centered therapy, Gestalt therapy tries to make individuals take responsibility for their own lives and personal growth and to recognize their capacity for healing themselves. However, Gestalt therapists are willing to use confrontational questions and techniques to help clients express their true feelings.

In the following example, the therapist helps the client become more aware of her own behavior and her responsibility for it: You know, you just can't do anything right in today's world. Please repeat that phrase using the word I instead of you. I can't do anything right, it seems. Would you change the word can't to won't? I won't do anything right.

What won't you do that you want to do? The general goal of Gestalt therapy is awareness of self, others, and the environment that brings about growth, wholeness, and integration of one's thoughts, feelings, and actions. Gestalt therapists use a wide variety of techniques to make clients more aware of themselves, and they often invent or experiment with techniques that might help to accomplish this goal.

One of the best-known Gestalt techniques is the empty-chair technique, in which an empty chair represents another person or another part of the client's self.

For example, if a client is angry at herself for not being kinder to her mother, the client may pretend her mother is sitting in an empty chair. The client may then express her feelings by speaking in the direction of the chair. Alternatively, the client might play the role of the understanding daughter while sitting in one chair and the angry daughter while sitting in another.

As she talks to different parts of herself, differences may be resolved. The empty-chair technique reflects Gestalt therapy's strong emphasis on dealing with problems in the present. Behavioral Therapies Print section Behavioral therapies differ dramatically from psychodynamic and humanistic therapies.

Behavioral therapists do not explore an individual's thoughts, feelings, dreams, or past experiences. Rather, they focus on the behavior that is causing distress for their clients. They believe that behavior of all kinds, both normal and abnormal, is the product of learning.

By applying the principles of learning, they help individuals replace distressing behaviors with more appropriate ones. Typical problems treated with behavioral therapy include alcohol or drug addiction, phobias such as a fear of heightsand anxiety.

Modern behavioral therapists work with other problems, such as depression, by having clients develop specific behavioral goalssuch as returning to work, talking with others, or cooking a meal. Because behavioral therapy can work through nonverbal means, it can also help people who would not respond to other forms of therapy. For example, behavioral therapists can teach social and self-care skills to children with severe learning disabilities and to individuals with schizophrenia who are out of touch with reality.

Behavioral therapists begin treatment by finding out as much as they can about the client's problem and the circumstances surrounding it. They do not infer causes or look for hidden meanings, but rather focus on observable and measurable behaviors. Therapists may use a number of specific techniques to alter behavior. These techniques include relaxation training, systematic desensitization, exposure and response prevention, aversive conditioning, and social skills training.

Relaxation Training Print section Relaxation training is a method of helping people with high levels of anxiety and stress. It also serves as an important component of some other behavioral treatments. In one type of relaxation exercise, people learn to tighten and then relax one muscle group at a time.

This method, called progressive relaxation, was developed in the s by American physiologist and psychologist Edmund Jacobson. At first, the therapist gives spoken instructions to the client. Later the client can practice the relaxation exercise at home using a tape recording of the therapist's voice. The following example, adapted from Jacobson's work, illustrates a brief relaxation procedure: Just settle back as comfortably as you can, close your eyes, and let yourself relax to the best of your ability Now clench up both fists tighter and tighter and study the tension as you do so.

Keep them clenched and feel the tension in your fists, hands, forearms Let the fingers of your hands become loose and observe the contrast in your feelings Now let yourself go and try to become more relaxed all over. Take a deep breath Just let your whole body become more and more relaxed.

Another relaxation technique is meditation. In meditation, people try to relax both the mind and the body.

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In many forms of meditation, people begin by sitting comfortably on a cushion or chair. Then they gradually relax their body, begin to breathe slowly, and concentrate on a sensationsuch as the inhaling and exhaling of breathor on an image or object. In Transcendental Meditation, a person does not try to concentrate on anything, but merely sits in a quiet atmosphere and repeats a mantra a specially chosen word to try to achieve a state of restful alertness.

Systematic Densensitization Print section Systematic desensitization, a procedure developed by South African psychiatrist Joseph Wolpe in the s, gradually teaches people to be relaxed in a situation that would otherwise frighten them.

It is often used to treat phobias and other anxiety disorders. The word desensitization refers to making people less sensitive to or frightened of certain situations. In the first step of desensitization, the therapist and client establish an anxiety hierarchya list of fear-provoking situations arranged in order of how much fear they provoke in the client.

For a man afraid of spiders, for example, holding a spider may rank at the top of his anxiety hierarchy, whereas seeing a small picture of a spider may rank at the bottom.

In the second step, the therapist has the client relax using one of the relaxation techniques described above. Then the therapist asks the client to imagine each situation on the anxiety hierarchy, beginning with the least-feared situation and moving upward. For example, the man may first imagine seeing a picture of a spider, then imagine seeing a real spider from far away, then from a short distance, and so forth. If the client feels anxiety at any stage, he or she is instructed to stop thinking about the situation and to return to a state of deep relaxation.

The relaxation and the imagined scene are paired until the client feels no further anxiety. Eventually the client can remain free of anxiety while imagining the most-feared situation. Asking a client to encounter the feared situation is a technique called in vivo exposure. For the man who is afraid of spiders, a therapist might arrange to go to a park or zoo where visitors can touch large spiders.

The therapist would model for the client how to approach a spider and how to handle it. The therapist may also encourage the man to walk gradually closer to the spider, reinforcing his progress with praise and reassurance as he does so. The goal for the therapist and patient would be for the man to pick up the spider.

Problems are rarely as clear and simple as fear of spiders. Therapists may spend considerable time deciding on appropriate goals, which ones to pursue first, and then reevaluating or changing goals as therapy progresses. Systematic desensitization typically takes from 10 to 30 sessions, depending on the severity of the problem. In vivo therapies are more direct and may take less time. Exposure and Response Prevention Print section Exposure and response prevention is a behavioral technique often used to treat people with obsessive-compulsive disorder.

In this technique, the therapist exposes the client to the situation that causes obsessive thoughts, but then prevents the client from acting on these thoughts.

For example, to treat people who compulsively wash their hands because they fear contamination from germs, a therapist might have them handle something dirty and then prevent them from washing their hands. Therapists have also experimented with exposure and response prevention to treat people with bulimia nervosa, an eating disorder in which people engage in binge eating and afterward force themselves to vomit or, more occasionally, take laxatives see Bulimia.

The therapist feeds the bulimic patients small amounts of food but prevents them from binging, taking laxatives, or vomiting. Aversive Conditioning Print section Behavioral therapists occasionally use a technique called aversive conditioning or aversion therapy.

In this method, clients receive an unpleasant stimulus, such as an electric shock, whenever they perform an undesirable behavior. For example, therapists treating patients with alcoholism may have them ingest the drug disulfiram Antabuse.

The drug makes the patients violently sick if they drink alcohol. Many therapists have found that aversive conditioning is not as effective as other behavioral techniques, and as a result, they use this technique very infrequently.

For some problems, however, aversive conditioning can work when all other techniques have failed. For example, therapists have found that immediate application of an unpleasant stimulus can eliminate self-mutilation and other self-destructive behaviors in children with autism.

Social Skills Training Print section Social skills training is a method of helping people who have problems interacting with others. Clients learn basic social skills such as initiating conversations, making eye contact, standing at the appropriate distance, controlling voice volume and pitch, and responding to questions. The therapist first describes and models the behavior.

Then the patient or client practices the behavior in skits or role-playing exercises. The therapist watches the exercises and provides constructive criticism and further modeling. Therapists often conduct this kind of training with groups of people with similar problems. Social skills training often can help people with schizophrenia function more easily in public situations and reduce their risk of relapse or rehospitalization.

One popular form of social skills training is assertiveness training, another technique pioneered by Joseph Wolpe. This technique teaches people, often those who are shy, to make appropriate responses when someone does something to them that seems inappropriate or offensive or violates their rights. For example, if a woman has trouble saying no to a coworker who inappropriately asks her to handle some of his job responsibilities, she may benefit from learning how to become more assertive.

In this example, the therapist would model assertive behavior for the client, who would then role-play and rehearse appropriate responses to her coworker. Cognitive Therapies Print section Cognitive therapies are similar to behavioral therapies in that they focus on specific problems. However, they emphasize changing beliefs and thoughts, rather than observable behaviors. Cognitive therapists believe that irrational beliefs or distorted thinking patterns can cause a variety of serious problems, including depression and chronic anxiety.

They try to teach people to think in more rational, constructive ways. Rational-Emotive Behavior Therapy Print section In the mids American psychologist Albert Ellis developed one of the first cognitive approaches to therapy, rational-emotive therapy, now commonly called rational-emotive behavior therapy. Trained in psychoanalysis in the s, Ellis quickly became disillusioned with psychoanalytic methods, viewing them as slow and inefficient.

Influenced by Alfred Adler's work, Ellis came to regard irrational beliefs and illogical thinking as the major cause of most emotional disturbances. In his view, negative events such as losing a job or breaking up with a lover do not by themselves cause depression or anxiety. Rather, emotional disorders result when a person perceives the events in an irrational way, such as by thinking, "I'm a worthless human being.

First the therapist identifies irrational beliefs by talking with the client about his or her problems. Examples of irrational beliefs, according to Ellis, include the idea that unhappiness is caused by external events, the idea that one must be accepted and loved by everyone, and the idea that one must always be competent and successful to be a worthwhile person.

To dispute the client's irrational beliefs and longstanding assumptions, rational-emotive behavior therapists often use confrontational techniques. For example, if a student tells the therapist, "I must get an A on this test or I will be a failure in life," the therapist might say, "Why must you? Do you think your entire career as a student will be through if you get a B? Beck became disenchanted with psychoanalysis, finding that it often did not help relieve depression for his patients.

In the s Beck developed his own form of cognitive therapy for treating depression, and later applied it to other disorders.

In Beck's view, depressed people tend to have negative views of themselves, interpret their experiences negatively, and feel hopeless about their future. He sees these tendencies as a problem of faulty thinking. Like rational-emotive behavior therapists, practitioners of Beck's technique challenge the client's absolute, extreme statements.

They try to help the client identify distorted thinking, such as thinking about negative events in catastrophic terms, and then suggest ways to change this thinking. The following example illustrates how a cognitive therapist might challenge a client's absolute statement.

Everyone at work is smarter than me. Every single person at work is smarter than you?

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There are a lot of people at work I don't know well at all. But my boss seems smarter; she seems to really know what's going on. Notice how we went from everyone at work being smarter than you to just your boss. Cognitive therapists often give their clients homework assignments designed to help them identify their own irrational patterns of thinking and to reinforce what they learn in therapy. For example, clients often keep a daily log in which they write down distressing emotions, the situation that caused the emotions, their thoughts at the time, whether the thoughts were distorted or not, and alternative ways of thinking about the situation.

Other Therapies Print section Helping individuals change problematic behaviors, thoughts, or feelings is not an easy task. Therapists have tried many creative approaches to help patients, some of which do not fall neatly into the major categories of psychodynamic, humanistic, behavioral, or cognitive.

Two such therapies still in use today are transactional analysis and reality therapy. Transactional Analysis Print section In the s and s Canadian-American psychiatrist Eric Berne developed a form of therapy he called transactional analysis. Although trained in psychoanalysis, Berne felt that the complexity of psychoanalytic terminology excluded patients from full participation in their own treatment.

He developed a theory of personality based on the view that when people interact with each other, they function either as a parent, adult, or child. For example, he would characterize social interactions between two people as parent-adult, parent-child, adult-child, adult-adult, and so forth depending on the situation. He referred to social interactions as transactions and to analysis of these interactions as transactional analysis.

In therapy, which is often conducted in groups, patients learn to recognize when they are assuming one of these roles and to understand when being an authoritarian parent or an impulsive child is appropriate or inappropriate.

In addition to identifying these roles, clients learn how to change roles in order to behave in more desirable ways. Reality Therapy Print section American psychiatrist William Glasser developed reality therapy in the s, after working with teenage girls in a correctional institution and observing work with severely disturbed schizophrenic patients in a mental hospital.

He observed that psychoanalysis did not help many of his patients change their behavior, even when they understood the sources of it. Glasser felt it was important to help individuals take responsibility for their own lives and to blame others less. Largely because of this emphasis on personal responsibility, his approach has found widespread acceptance among drug- and alcohol-abuse counselors, corrections workers, school counselors, and those working with clients who may be disruptive to others.

Reality therapy is based on the premise that all human behavior is motivated by fundamental needs and specific wants. The reality therapist first seeks to establish a friendly, trusting relationship with clients in which they can express their needs and wants. Then the therapist helps clients explore the behaviors that created problems for them. Clients are encouraged to examine the consequences of their behavior and to evaluate how well their behavior helped them fulfill their wants.

The therapist does not accept excuses from clients. Finally, the therapist helps the client formulate a concrete plan of action to change certain behaviors, based on the client's own goals and ability to make choices. Eclectic Therapy Print section Currently, many therapists describe their approach as eclectic or integrative, meaning that they use ideas and techniques from a variety of therapies.

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Many therapists like the opportunity to draw from many theories and not limit themselves to one or two. Most therapists who adopt an eclectic approach have a rationale for which techniques they use with specific clients, rather than just choosing an approach randomly or because it suits them at the time. One of the most influential eclectic approaches is cognitive-behavioral therapy.

Other eclectic approaches use other combinations of therapies. Cognitive-Behavioral Therapy Print section There are almost no pure cognitive or behavioral therapists. Usually therapists combine cognitive and behavioral techniques in an approach known as cognitive-behavioral therapy. For example, to treat a woman with depression, a therapist may help her identify irrational thinking patterns that cause the distressing feelings and to replace these irrational thoughts with new ways of thinking.

The therapist may also train her in relaxation techniques and have her try new behaviors that help her become more active and less depressed. The client then reports the results back to the therapist. Cognitive-behavioral therapy has rapidly become one of the most popular and influential forms of psychotherapy, in part because it takes a relatively short period of time compared to humanistic and psychoanalytic therapies, and also because of its ability to treat a wide range of problems.

Sometimes cognitive-behavioral therapy takes only a few sessions, but more often it extends for 20 or 30 sessions over four to six months. The length of therapy usually depends on the severity and number of the client's problems.

Other Eclectic Approaches Print section Some therapists have one particular way of understanding clientsthat is, they adhere to one theory of personalitybut use many techniques from a variety of theories.

Other therapists may understand clients using two or three theories of personality and only use techniques to bring about change that are consistent with those theories. Some therapists have combined psychodynamic and behavioral therapies in ways to help their clients deal with fears and anxieties but also understand their causes. Therapists may use different approaches to treat different problems.

For example, a therapist might find that clients who are grieving over the loss of a spouse may respond best to a humanistic approach, in which they can share their grieving and their hurts with the therapist. However, the same therapist may use a cognitive-behavioral approach with a person who reports being anxious most of the time.