Psychodynamic Psychotherapy

We’re going to start by examining each form of therapy individually before comparing the two

As you know, Psychodynamic  psychotherapy, like CBT, has been proven to work through research. It makes use of the psychoanalytical theory of Sigmund Freud and uses free association and the understanding of transference and counter-transference to help clients recognize why they’re having psychological issues and lead them down a cathartic path where they can then improve their status after realizing the root of their problem.

This therapy method tends to work well because it focuses on getting to root of the client’s problems and allows for a free range of corrections that account for the various idiosyncrasies you may notice during your sessions.

The challenge with psychodynamic  psychotherapy – especially in today’s fast-paced society – is that it takes quite a while and is rather costly in order to be truly effective. Getting sensitive, helpful information from clients by getting them to talk about their childhood can be like pulling teeth. It’s also hard to test the therapy empirically since results are intrinsic to each particular individual, which makes its effectiveness a hotly debated topic.

CBT (Cognitive Behavioral Therapy)

CBT is seemingly the opposite of psychodynamic  psychotherapy.  It is goal-oriented, has a set time frame, and tends to be more structured – all pros in its corner. It also has a bit more scientific support and is much more cost effective than the former therapy type, which are big pluses in today’s economy.

CBT isn’t all roses and unicorns though. It can miss issues that are brought to light in more in-depth therapies like psychotherapy, which can greatly limited the overall effectiveness of CBT if those issues are left unaddressed. It tends not to be as effective for people with complex mental disorders or learning disabilities – limiting the population range CBT can benefit and causing you to have to turn away more clients if you choose to use only CBT.

The Final Comparison

CBT simply works better in today’s insurance reimbursement driven world. People are more skeptical of the psychodynamic approach than ever before and many simply aren’t willing to spend the money required to see real results from psychodynamic psychotherapy. You may it best to start with CBT, especially if there’s a specific issue the client wants addressed, and then ease into psychodynamic psychotherapy once the client has become acclimated with you and a working relationship and trust has been established.

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During our weekly session, Allan stated, “I don’t know what went wrong. I was in my session with Betty, and she was mentioning her new boyfriend, and I just got really in sync with the discrepancies between her verbal and nonverbal communications. So, I brought them up, just like we learned how to do. All of a sudden, she’s hostile and defensive… she just shut down on me!”  Track 6 will outline four ways in which a therapist can respond to a client’s nonverbal behavior using Gestalt therapy.

I stated to Allan, “Well, your perceptions of her behaviors certainly seem accurate.  But there seem to be two factors that contributed to Betty’s being defensive.
— First, you had never responded to her nonverbal behavior in a session before. 
— Second, you didn’t introduce the approach you were using, so Betty did not know what to expect.
In the future, you might want to consider carefully introducing the ideas of Gestalt therapy, and starting by implementing only one or two approaches at a time.  Implementing complicated or multiple approaches early on might overload Betty.”

For Guideline #2, #3 and #4 go to Gestalt Course

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While each drawing is individually configured and unique in meaning, common pictorial symbols and metaphors of human figures and animals, place and weather, and toys and games usually convey fairly general meanings-albeit at times with wide variance from one culture to another (Oster and Gould, 1987). For example, alligators and other big mouth animals may be used to reflect nurturant needs or oral aggression; dogs and other cuddly animals, companionship and transitional objects; or birds, flight and freedom. Caves may hide and protect or, conversely, trap. Mountains may be attainments, obstacles, or something else entirely. Rain may reflect crying or be cleansing. Snow seems cold, the sun warm. How then, with these and the myriads of other possible meanings, does the clinical social worker figure out what a particular child has in mind? In part, the answer lies in asking the child directly (Timberlake, 1978a; Webb, 1991). In addition, the representational ways in which individual children condense multiple metaphors, details, and memories into one picture and their action style in doing so provide indirect clues to the more individualized meaning in their drawings. To make educated decisions about which of these polar opposite or nuanced generic meanings most accurately represents a nonverbal child’s intended meaning, clinicians draw on their understanding of this child gained during psychosocial assessment and other interviews, comment on the observable, and await the child’s own nonverbal or verbal confirmation that the observation is accurate or not.

To continue reading go to Play Therapy Course

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