psychotherapy, treatment of mental and emotional disorders using psychological methods. Psychotherapy, thus, does not include physiological interventions, such as drug therapy or electroconvulsive therapy, although it may be used in combination with such methods. This type of treatment has been used in one form or another through the ages in many societies, but it was not until the late 19th cent. that it received scientific impetus, primarily under the leadership of Sigmund Freud. Although Freud's theoretical formulations have come sharply into question, his treatment method involving individualized client-psychologist sessions has been used in modified forms for years (see psychoanalysis).

Behavior therapy aims to help the patient eliminate undesirable habits or irrational fears through conditioning. Techniques include systematic desensitization, particularly for the treatment of clients with irrational anxieties or fears, and aversive conditioning, which uses negative stimuli to end bad habits. Humanistic therapy tends to be more optimistic, basing its treatment on the theory that individuals have a natural inclination to strive toward self-fulfillment. Therapists such as Carl Rogers and Abraham Maslow used a highly interactive client-therapist relationship, compelling clients to realize exactly what they are saying or how they are behaving, in order to foster a sense of self-awareness. Cognitive therapies try to show the client that certain, usually negative, thoughts are irrational, with the goal of restructuring such thoughts into positive, constructive ideas. Such methods include Albert Ellis's rational-emotive therapy, where the therapist argues with the client about his negative ideas; and Aaron Beck's cognitive restructuring therapy, in which the therapist works with the client to set attainable goals. Other forms of therapy stress helping patients to examine their own ideas about themselves.

Psychotherapy may be brief, lasting just a few sessions, or it may extend over many years. More than one client may be involved, as in marriage or family counseling, or a number of individuals, as in group psychotherapy.

group psychotherapy, a means of changing behavior and emotional patterns, based on the premise that much of human behavior and feeling involves the individual's adaptation and response to other people. It is a process carried out in formally organized groups of three or more individuals who seek change, whether their problem is alcoholism, overeating, or poor social skills. The composition of a group may be heterogenous or homogeneous with reference to the age of the members or the type of problem. The therapist may be directive or nondirective, allowing the group to set their own agenda for discussion. The group becomes a "sample" of the outside world, reproducing conditions of interpersonal relationships; its members jointly participate in observing personal motivation and styles of interaction. They also participate in attempting new behaviors and dealing with the consequences of such behaviors, with the intended result that they will eventually be able to employ these behavior patterns outside the group. In observing the totality of the events that take place in group therapy, the process by which elements of personality are developed in each member is also studied.

Origins of Group Therapy

The technique of formally organized group therapy is said to have been devised by J. H. Pratt in 1905. Pratt was holding general-care instruction classes for recently discharged tuberculosis patients when he noticed the impact of this experience on their emotional states. In 1925 psychoanalyst Trigant Burrow became dissatisfied with individual psychoanalysis, and began experimenting with group techniques. Burrow hoped to decrease the authoritarian position of the therapist, and to more thoroughly examine interpersonal interactions. The application of group therapy methods to prison inmates and discharged mental hospital patients was pioneered by Paul Schilder and Louis Wender in the 1930s. At that time group therapy was found to be particularly useful in the treatment of children and adolescents. The development of group therapy was given impetus during World War II, as a result of the large number of soldiers requiring treatment.

Types of Group Therapy

There are various types of group therapy; approaches include behavior therapy, psychoanalytic therapy, sensitivity training, or Gestalt psychology (see psychotherapy). The composition of groups varies as well, with family therapy and marriage counseling common forms in recent years. Peer group therapy usually consists of a group of individuals who have similar problems, and can be mediated by a psychoanalyst or by the members themselves. Many people seeking help prefer this sort of group therapy over individual therapy, largely because of the comfort derived from knowing that others share their problems. The approach is nondirective, and in some cases, the individual can continue attending sessions whenever they are needed. Alcoholics Anonymous (AA) is a well-known peer support group, run entirely by members. AA has been influential in the formation of similar groups, particularly support groups centered on addictions.

Treatment of psychological, emotional, or behaviour disorders through interpersonal communications between the patient and a trained counselor or therapist. The goal of many modern individual and group therapies is to establish a central relationship of trust in which the client or patient can feel free to express personal thoughts and emotions and thus gain insight into his condition and generally share in the healing power of words. Such therapies include psychoanalysis and its variants (see Alfred Adler; Carl Gustav Jung), client-centred or nondirective psychotherapy, Gestalt therapy (see Gestalt psychology), play and art therapy, and general counseling. In contrast, behaviour therapy focuses on modifying behaviour by reinforcement techniques without concerning itself with internal states.

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or client-centered therapy

Type of psychotherapy in which the counselor refrains from interpretation or explanation but encourages the client to establish a person-to-person relationship with him or her and to talk freely. It originated with Carl R. Rogers and influenced later individual and group therapies. The goal is to enable the client to see him- or herself more clearly and react more openly with the therapist and others. The client determines the course, speed, and duration of treatment.

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Form of psychotherapy in which several patients or clients discuss their personal problems, usually in the presence of a therapist or counselor. In one approach to group therapy, the chief aim is to raise members' awareness and morale and combat feelings of isolation by cultivating a sense of belonging to the group; a notable example is Alcoholics Anonymous. The other principal approach strives to foster free discussion and uninhibited self-revelation; members are helped to self-understanding and more successful behaviour through mutual examination of their reactions to people in their lives, including one another.

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