What is a therapy session
Psychotherapy - Mayo Clinic
Overview
Psychotherapy is a general term for treating mental health problems by talking with a psychiatrist, psychologist or other mental health provider.
During psychotherapy, you learn about your condition and your moods, feelings, thoughts and behaviors. Psychotherapy helps you learn how to take control of your life and respond to challenging situations with healthy coping skills.
There are many types of psychotherapy, each with its own approach. The type of psychotherapy that's right for you depends on your individual situation. Psychotherapy is also known as talk therapy, counseling, psychosocial therapy or, simply, therapy.
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Why it's done
Psychotherapy can be helpful in treating most mental health problems, including:
- Anxiety disorders, such as obsessive-compulsive disorder (OCD), phobias, panic disorder or post-traumatic stress disorder (PTSD)
- Mood disorders, such as depression or bipolar disorder
- Addictions, such as alcoholism, drug dependence or compulsive gambling
- Eating disorders, such as anorexia or bulimia
- Personality disorders, such as borderline personality disorder or dependent personality disorder
- Schizophrenia or other disorders that cause detachment from reality (psychotic disorders)
Not everyone who benefits from psychotherapy is diagnosed with a mental illness. Psychotherapy can help with a number of life's stresses and conflicts that can affect anyone. For example, it may help you:
- Resolve conflicts with your partner or someone else in your life
- Relieve anxiety or stress due to work or other situations
- Cope with major life changes, such as divorce, the death of a loved one or the loss of a job
- Learn to manage unhealthy reactions, such as road rage or passive-aggressive behavior
- Come to terms with an ongoing or serious physical health problem, such as diabetes, cancer or long-term (chronic) pain
- Recover from physical or sexual abuse or witnessing violence
- Cope with sexual problems, whether they're due to a physical or psychological cause
- Sleep better, if you have trouble getting to sleep or staying asleep (insomnia)
In some cases, psychotherapy can be as effective as medications, such as antidepressants.
However, depending on your specific situation, psychotherapy alone may not be enough to ease the symptoms of a mental health condition. You may also need medications or other treatments.
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Risks
Generally, there's little risk in having psychotherapy. But because it can explore painful feelings and experiences, you may feel emotionally uncomfortable at times. However, any risks are minimized by working with a skilled therapist who can match the type and intensity of therapy with your needs.
The coping skills that you learn can help you manage and conquer negative feelings and fears.
How you prepare
Here's how to get started:
- Find a therapist. Get a referral from a doctor, health insurance plan, friend or other trusted source. Many employers offer counseling services or referrals through employee assistance programs (EAPs). Or you can find a therapist on your own, for instance, by looking for a professional association on the Internet.
- Understand the costs. If you have health insurance, find out what coverage it offers for psychotherapy. Some health plans cover only a certain number of psychotherapy sessions a year. Also, talk to your therapist about fees and payment options.
- Review your concerns. Before your first appointment, think about what issues you'd like to work on. While you also can sort this out with your therapist, having some sense in advance may provide a good starting point.
Check qualifications
Before seeing a psychotherapist, check his or her background, education, certification, and licensing. Psychotherapist is a general term rather than a job title or indication of education, training or licensure.
Trained psychotherapists can have a number of different job titles, depending on their education and role. Most have a master's or doctoral degree with specific training in psychological counseling. Medical doctors who specialize in mental health (psychiatrists) can prescribe medications as well as provide psychotherapy.
Examples of psychotherapists include psychiatrists, psychologists, licensed professional counselors, licensed social workers, licensed marriage and family therapists, psychiatric nurses, or other licensed professionals with mental health training.
Make sure that the therapist you choose meets state certification and licensing requirements for his or her particular discipline. The key is to find a skilled therapist who can match the type and intensity of therapy with your needs.
What you can expect
Your first therapy session
At the first psychotherapy session, the therapist typically gathers information about you and your needs. You may be asked to fill out forms about your current and past physical and emotional health. It might take a few sessions for your therapist to fully understand your situation and concerns and to determine the best approach or course of action.
The first session is also an opportunity for you to interview your therapist to see if his or her approach and personality are going to work for you.
Make sure you understand:
- What type of therapy will be used
- The goals of your treatment
- The length of each session
- How many therapy sessions you may need
Don't hesitate to ask questions anytime during your appointment. If you don't feel comfortable with the first psychotherapist you see, try someone else. Having a good fit with your therapist is critical for psychotherapy to be effective.
Starting psychotherapy
You'll likely meet in your therapist's office or a clinic once a week or every other week for a session that lasts about 45 to 60 minutes. Psychotherapy, usually in a group session with a focus on safety and stabilization, also can take place in a hospital if you've been admitted for treatment.
Types of psychotherapy
There are a number of effective types of psychotherapy. Some work better than others in treating certain disorders and conditions. In many cases, therapists use a combination of techniques.
Your therapist will consider your particular situation and preferences to determine which approach may be best for you.
Although many types of therapies exist, some psychotherapy techniques proven to be effective include:
- Cognitive behavioral therapy (CBT), which helps you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones
- Dialectical behavior therapy, a type of CBT that teaches behavioral skills to help you handle stress, manage your emotions and improve your relationships with others
- Acceptance and commitment therapy, which helps you become aware of and accept your thoughts and feelings and commit to making changes, increasing your ability to cope with and adjust to situations
- Psychodynamic and psychoanalysis therapies, which focus on increasing your awareness of unconscious thoughts and behaviors, developing new insights into your motivations, and resolving conflicts
- Interpersonal psychotherapy, which focuses on addressing problems with your current relationships with other people to improve your interpersonal skills — how you relate to others, such as family, friends and colleagues
- Supportive psychotherapy, which reinforces your ability to cope with stress and difficult situations
Psychotherapy is offered in different formats, including individual, couple, family or group therapy sessions, and it can be effective for all age groups.
During psychotherapy
For most types of psychotherapy, your therapist encourages you to talk about your thoughts and feelings and what's troubling you. Don't worry if you find it hard to open up about your feelings. Your therapist can help you gain more confidence and comfort as time goes on.
Because psychotherapy sometimes involves intense emotional discussions, you may find yourself crying, upset or even having an angry outburst during a session. Some people may feel physically exhausted after a session. Your therapist is there to help you cope with such feelings and emotions.
Your therapist may ask you to do "homework" — activities or practices that build on what you learn during your regular therapy sessions. Over time, discussing your concerns can help improve your mood, change the way you think and feel about yourself, and improve your ability to cope with problems.
Confidentiality
Except in rare and specific circumstances, conversations with your therapist are confidential.
However, a therapist may break confidentiality if there is an immediate threat to safety (yours or someone else's) or when required by state or federal law to report concerns to authorities. Your therapist can answer questions about confidentiality.
Length of psychotherapy
The number of psychotherapy sessions you need — as well as how frequently you need to see your therapist — depends on such factors as:
- Your particular mental illness or situation
- Severity of your symptoms
- How long you've had symptoms or have been dealing with your situation
- How quickly you make progress
- How much stress you're experiencing
- How much your mental health concerns interfere with day-to-day life
- How much support you receive from family members and others
- Cost and insurance limitations
It may take only weeks to help you cope with a short-term situation. Or, treatment may last a year or longer if you have a long-term mental illness or other long-term concerns.
Results
Psychotherapy may not cure your condition or make an unpleasant situation go away. But it can give you the power to cope in a healthy way and to feel better about yourself and your life.
Getting the most out of psychotherapy
Take steps to get the most out of your therapy and help make it a success.
- Make sure you feel comfortable with your therapist. If you don't, look for another therapist with whom you feel more at ease.
- Approach therapy as a partnership. Therapy is most effective when you're an active participant and share in decision-making. Make sure you and your therapist agree about the major issues and how to tackle them. Together, you can set goals and measure progress over time.
- Be open and honest. Success depends on willingness to share your thoughts, feelings and experiences, and to consider new insights, ideas and ways of doing things. If you're reluctant to talk about certain issues because of painful emotions, embarrassment or fears about your therapist's reaction, let your therapist know.
- Stick to your treatment plan. If you feel down or lack motivation, it may be tempting to skip psychotherapy sessions. Doing so can disrupt your progress. Try to attend all sessions and to give some thought to what you want to discuss.
- Don't expect instant results. Working on emotional issues can be painful and may require hard work. You may need several sessions before you begin to see improvement.
- Do your homework between sessions. If your therapist asks you to document your thoughts in a journal or do other activities outside of your therapy sessions, follow through. These homework assignments can help you apply what you've learned in the therapy sessions to your life.
- If psychotherapy isn't helping, talk to your therapist. If you don't feel that you're benefiting from therapy after several sessions, talk to your therapist about it. You and your therapist may decide to make some changes or try a different approach that may be more effective.
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What Really Happens in a Therapy Session
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When you take your car to the car mechanic, you know what’s going to happen: Your car will get repaired.
When you break a bone and visit your doctor, you know what’s going to happen: Your bone will be set in a splint or cast and eventually heal.
But when you make an appointment to see a therapist, do you know what’s going to happen? Many people aren’t quite certain. Will you just talk? Will you have to discuss your childhood? Will you be “hypnotized?" And what’s the “point” of seeing a therapist, anyway? Why not just talk to a friend?
There is a great deal of uncertainty in our society about what actually happens during a therapy session, what types of issues and problems are suitable for therapy, and what benefits a therapy session can provide.
I’d like to address a few typical questions—and misconceptions—about what therapy is, what it isn’t, and how it really works.
Q: Do I have to be “sick” or “disturbed” to go see a therapist?
A: No. Thinking that one has to be “seriously disturbed” in order to see a therapist is a myth.
While some therapists do specialize in severe emotional disturbances—including schizophrenia or suicidal thoughts—many focus on simply helping clients work through far more typical, everyday challenges like mapping out a career change, improving parenting skills, strengthening stress management skills, or navigating a divorce. Just as some physicians specialize in curing life-threatening illnesses, while others treat “everyday” illnesses like flus, coughs, and colds, psychotherapists can serve a wide range of clients with a range of needs and goals, too.
In fact, most of my clients are successful, high-achieving people who are quite healthy, overall. Most are challenged by a specific, personal goal—like losing weight, creating more work-life balance, finding ways to parent more effectively, or feeling anxious about dating again after a rough break up.
Q: How can I choose the right therapist for my goal/situation?
A: Choosing a therapist is like choosing any other service provider—it’s a good idea to visit the practitioner’s website, and read client testimonials or reviews (if they have any—many do not, for confidentiality reasons). It's also good to ask friends and family members, or your physician, for referrals (and of course, check to see who is covered in your health insurance network).
If you are hoping to work on a specific issue—overeating, smoking, making a career change—try to find a therapist with expertise in that area. Many list their specialties or areas of focus on their websites. There are therapists who specialize in relationship issues, parenting issues, anger management, weight issues, or sexuality—pretty much any issue, goal, or situation you can imagine. If you’re not sure about someone’s expertise, just call them and ask. If they can’t be of assistance with your issue, they may be able to refer you to someone who can.
Q: What actually happens during a therapy session?
A: Each session is, essentially, a problem-solving session. You describe your current situation, and your feelings about it, and then the therapist uses their expertise to assist you in trying to resolve that problem so you can move closer to having the life you wish to have.
At the beginning of a session, the therapist typically invites you to share what’s been going on in your life, what’s on your mind, what’s bothering you, or whether there are any goals you’d like to discuss. You’ll be invited to speak openly. The therapist will listen and may take notes as you speak; some, like myself, take notes after a session. You won’t be criticized, interrupted or judged as you speak. Your conversation will be kept in the strictest confidentiality. This is a special, unique type of conversation in which you can say exactly what you feel—total honesty—without worrying that you’re going to hurt someone’s feelings, damage a relationship, or be penalized in any way.
Anything you want—or need—to say is OK.
Some therapists (like myself) may give clients some homework to complete after a session. That homework might be to set up an online dating profile and reach out for a first date, or to exercise three times a week. It may be to spend some time each day pounding a pillow to safely release pent-up emotions, make a nightly journal entry, or any number of “steps” and “challenges” relevant to your goals. During your next session, you might share your progress and address any areas where you got frustrated, stuck, or off-track.
Of course, every therapist is different, every client is unique, and every therapist-client relationship is distinct as well—which means that there is no universal description of a therapy session. Some therapists employ dream interpretation in their work. Others bring music or art therapy into their work. Others incorporate hypnotherapy, life coaching, meditation, visualization, or role-playing exercises to “rehearse” challenging conversations.
The list goes on and on. Ultimately, regardless of their approach, a therapist will listen without judgment and help clients try to find solutions to the challenges they face.
Q: Will I have to talk about my childhood?
A: Not necessarily. Many people think that visiting a therapist means digging up old skeletons from your childhood, or talking about how awful your mother was, etc. That is a myth. What you talk about during a therapy session will largely depend on your unique situation and goals. And depending on your goals, you may not actually talk about your past that much. The focus of your therapy is as likely to be your present-day reality and the future that you wish to create.
That being said, if you really do not want to discuss your childhood, the intensity of your desire not to talk about it might suggest that you should! When people have strong negative emotions—about their childhood or any other topic—it’s typically worth doing some excavating to figure out why that is.
Whatever is causing them to feel such strong emotions about the past is more than likely impacting their present-day life in some way, too.
Q: How long will I have to go to therapy?
A: This varies from person to person. I’ve had clients who booked one session, we worked out their issue(s), and they were all set: They marched out and didn’t need a follow-up session. Sometimes, one brave, honest conversation is really all you need.
Other clients have booked sessions with me over a period of several weeks or months, focusing on one issue, resolving that issue, then perhaps moving on to a different challenge. Then there are other clients who I’ve been working with for some time—they appreciate having a weekly, bi-weekly, or monthly “check-in.” They may share their feelings, sharpen their life skills as needed, or perhaps enjoy a deeply nourishing guided meditation or hypnotherapy experience to de-stress. As one client put it, “Every two weeks when I meet with you, I leave your office feeling like you pressed my reset button.
”
Therapy is really about whatever a client needs—a one-time conversation, a temporary source of support during a life transition, or an ongoing experience to optimize health physically, mentally, emotionally and spiritually.
Q: Is meeting with a therapist over the phone—or through video chat—just as effective as meeting in person?
A: That depends on your personality and preferences. In the state of Hawaii, where I live, at least one insurer that I know of covers doing therapy virtually via video chat (like Skype or Facetime). This makes it a convenient option for people. Many of my clients do enjoy having some, or all, of their sessions via video chat because it means they don’t have to take time out of their busy schedules to drive, park, and so on. They can just close their bedroom or office door, pick up the phone or log in, and away we go—very convenient.
Where feasible, I suggest trying out both ways—do a traditional, in-person therapy session and then try a video session—and see which format is the best fit for you.
Q: Why see a therapist? Why not just talk to a friend or someone in my family?
A: If you are blessed with caring, supportive family members and friends, by all means, share your feelings, goals, and dreams with those people. They are a big part of your support network, and their insights and encouragement can be very helpful. However, people who already know you might not always be completely objective when listening to you. For example, you may want to change your career, and you confess this dream to your wife. She may want to support you 100%, and try her very best to do so, but she may also be dealing with emotions of her own—such as anxiety about how a career shift will change your lives, not to mention your income. These emotions could make it difficult for her to listen and support you objectively.
This is why working with a therapist can be so valuable. It's a unique opportunity to share everything you’re feeling, and everything you want to create, without anyone interrupting you, imposing his or her own anxieties onto the conversation, or telling you that you’re “wrong” or that you “can’t.
”
A therapy session is a space where you don’t have to worry about hurting anyone else’s feelings—you can be totally honest. It also means you have the potential to solve problems faster and with greater success. In the long run, that’s better for you and everyone else involved in your life, too.
To sum it up:
Therapy is a valuable tool that can help you to solve problems, set and achieve goals, improve your communication skills, or teach you new ways to track your emotions and keep your stress levels in check. It can help you to build the life, career, and relationship that you want. Does everybody need it? No. But if you are curious about working with a therapist, that curiosity is worth pursuing. Consider setting up one or two sessions, keep an open mind, and see how things unfold. You have very little to lose and, potentially, a lot of clarity, self-understanding, and long-lasting happiness to gain.
Step into my virtual office or sign up to receive a free meditation.
Check Psychology Today's directory of therapists for a professional near you.
Disclaimer: This post is for informational purposes only. It is not a substitute for professional or psychological advice, diagnosis, or treatment. Always contact your qualified health provider before implementing any new personal growth or wellness technique and with any questions about your well-being.
Copyright © 2015 Suzanne Gelb. All rights reserved.
LinkedIn Image Credit: Syda Productions/Shutterstock
what it is, how it goes, methods and principles
According to the WHO, every fourth person in the European Region has experienced mental health problems at least once in their lives. Careful work on oneself and full awareness of the causes of the situation allows a person to cope with them. For this, psychotherapy sessions are held. Today, such treatment is considered a truly profitable investment in one's health.
Who is a psychotherapist?
A psychotherapist is a specialist who helps to restore a person's psycho-emotional balance. To do this, he uses various non-drug techniques, which are based on a conversation with the patient.
To conduct individual sessions, a specialist must have a higher medical or psychological education, as well as undergo special training in the relevant profile. These are not short-term courses, but an annual program that allows you to study in detail all areas of this area.
A psychotherapist can conduct consultations only if he has a license that confirms the right to such activities. At the request of the patient, the specialist must provide all documents on specialized education.
Unlike a psychologist, a psychotherapist has the right to diagnose diseases of the psycho-emotional sphere and prescribe treatment, including medication.
What problems does a psychotherapist help solve?
Contacting this specialist will help:
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Cope with mild to moderate psycho-emotional problems.
These include depression, obsessive-compulsive disorder, neurosis, panic attacks. -
Cope with addiction. A course of psychotherapy can be prescribed after undergoing treatment for alcoholism, drug addiction, gambling.
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Recover from severe mental disorders (schizophrenia, bipolar disorder, incipient dementia). You can stop an acute condition only with the help of a psychiatrist. After undergoing the necessary treatment, such patients are sent for psychotherapeutic sessions. With their help, it is possible to reduce the level of anxiety, increase self-esteem and stress resistance of a person, convince him of the need to take psychotropic drugs, and reduce manifestations of fear. In this case, psychotherapeutic treatment is most often prescribed by a psychiatrist.
When should I visit a psychotherapist?
Consultation with this specialist is indicated for the following symptoms and conditions:
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apathy, manifested in the absence of a desire for any vigorous activity - people who are faced with such a problem hardly get out of bed in the morning and even perform ordinary household activities with great difficulty;
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decrease in the level of working capacity on the background of chronic fatigue;
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sudden deterioration in mood - a person becomes not interested in things and activities that previously attracted him, he becomes less sociable, withdraws into himself, tries to leave the house less often;
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abrupt change of emotional background;
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low self-esteem;
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the appearance of bodily sensations unusual for a person;
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constant emotional outbursts from tearfulness to aggression;
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sleep disorders;
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difficulty concentrating;
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panic attacks that start for no apparent reason at any time of the day;
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the appearance of suicidal thoughts;
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uncontrolled eating and absolute lack of appetite;
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obsession with thoughts and actions.
Psychotherapist consultation may be required for people without any diagnosis, if they are faced with difficult life circumstances. A specialist helps a person get out of an emotional impasse and find peace of mind.
Which specialist to contact with various problems?
| Psychologist | Psychiatrist or psychotherapist |
| Difficulty finding a common language with children | Impairment of sleep |
| Loss of job, difficulty finding employment | Emergence of uncontrolled attacks of aggression |
| Appearance of addiction to gadgets | Depression due to the death of a loved one |
| Moving to another city or country and experiencing related emotional problems | The occurrence of panic attacks, during which the person may lose a sense of reality and the ability to think |
| Increased emotionality and tearfulness | Depression after childbirth |
Types of psychotherapy
Today there are several classifications of types of psychotherapy.
The following option is most in demand:
| By number of people involved | |
| According to the tasks that are performed in the course of treatment | |
| According to the goals set by the specialist | |
| According to the level of theoretical generalization | |
| According to the role played by the psychotherapist in the treatment process | |
| According to the degree of involvement of medical (including psychiatric) methods | |
| Additional activities used in therapy |
The choice of the most effective technique is carried out by a specialist after studying a specific problem. Different areas of psychotherapy can be combined with each other to achieve the desired result.
How can I get the help I need?
In most cases, psychotherapy sessions are paid. When applying for such help in a polyclinic, a referral to a psychiatrist is most often issued.
Free consultations of a psychotherapist are assigned to patients in psychiatric departments. The decision on the need for such sessions is made by the attending physician.
You can also get qualified help from a psychotherapist by contacting the appropriate institute. Institutions that train professionals in this field often run incentive programs. At the same time, it should be borne in mind that at such sessions, psychotherapists talk with a person not alone, but in the presence of students of an educational institution. Despite the large number of participants, the privacy policy in this case is fully preserved.
Currently, in many cities of our country, psychological assistance centers have been established for various categories of citizens: families, women, children in difficult life situations.
Such institutions are funded by the state. The help they need is provided free of charge.
If a person plans to see a specialist on his own, the fastest and most convenient way to do this is in psychotherapy clinics or relevant departments of private centers.
Peculiarities of the work of a psychotherapist
In order for the session to bring the desired result, it is important to get to a specialist who knows and loves his work well. A trusting relationship between him and the patient is an important component of successful treatment. The person who asked for help should feel that he is respected and understood.
Please note that a psychotherapy session cannot take place unilaterally. The receptionist is not a psychic. With a passive position of the patient, it is difficult to talk about a successful outcome of therapy. He needs to make some efforts and work on himself.
There are cases when a person gets to an unqualified specialist. Most often, it can be recognized by the following features:
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the presence of the phrases “it happens”, “time heals” and similar ones;
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the promise of a quick solution to the problem at the first session;
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providing clear advice to help get out of the current situation;
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criticism of the patient.
A psychotherapist cannot give advice, push a person to a certain decision, much less evaluate his actions. His main task is to help the patient to realize his problems, to analyze and find a way out of the situation in which he finds himself at the moment.
The sessions themselves are held according to a specific plan. If necessary, the specialist can give the patient homework. This may be a request to keep a daily diary, to present and describe in detail a specific situation.
The frequency of sessions is determined individually. Depending on the complexity of the situation, at least one appointment per week is prescribed. The average duration of a session is 1 hour.
The course of psychotherapy does not always involve many visits to a specialist. Some problems can be solved in 2-3 sessions. The consequences of serious emotional upheavals require a longer study.
What techniques does the therapist use?
There are many effective methods of psychotherapy.
Let's talk about the main ones. | Art Therapy | The methodology is based on a combination of classical conversation and creativity. It can be modeling, drawing, playing music. Specialists who use such therapy are sure that creative activity expresses the inner emotions of a person in the best way. The technique has practically no contraindications. Art Therapy Suitable:
|
Client-centered psychotherapy | Psychotherapists using this technique seek to help a person become a better version of himself and independently find the cause of his own problems and a way out of this situation. Method suitable:
|
| Cognitive behavioral therapy | The methodology is based on the theory of the influence of past experience on the current behavior of a person. The main task of the specialist is to help the patient change the habitual reaction to emerging stressful situations. Special exercises allow you to develop a new algorithm of actions. Thus, a person learns to respond to stressful events more calmly. Method suitable:
|
| Psychoanalysis | Method developed by Z. Freud. The task of the psychotherapist is to identify unconscious processes by analyzing the words and thoughts of a person, to find internal contradictions and help to cope with them. Psychoanalysis can help people who:
|
| Movement therapy | The method is based on the relationship between the body and thoughts. During the conversation, the specialist can turn on the music and ask the person to make a few movements or even perform an entire dance. This therapy promotes self-expression and improves the emotional state of the patient. The technique has practically no contraindications.
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| Family therapy | The main goals of the specialist are to help family members establish relationships, cope with conflicts and learn how to calmly interact with each other in any situation. During therapy, a conversation is held with adults and children. Both group and individual sessions are available. Method suitable:
|
| Gestalt therapy | The technique is based on the assertion that stereotyped behavior patterns interfere with the achievement of mental balance. Gestalt therapy will be especially effective for people who:
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| Hypnosis | The technique allows you to achieve a state of complete relaxation, in which the mind begins to perceive new behavioral attitudes. To obtain the desired result, the psychotherapist uses special language techniques. The technique is suitable for people who:
|
| Jungian analysis | The creator of the methodology is K.Jung. It is based on the analysis of personality archetypes. The technique allows you to expand consciousness and stabilize the emotional state. The session is based on a confidential conversation between the psychotherapist and the patient. During the reception, a person can talk about all the thoughts that visit him. If he has difficulty verbally expressing emotions, the specialist suggests doing this through a drawing or other creative activity. The technique allows:
|
| Psychodrama | Group technique involving several people in a role play. It is based on a real story from the life of one of those present. The technique allows you to look at the experienced problem from the outside and find the best ways to solve it. |
| Desensitization | The technique helps to cope with traumatic and negative memories. At the reception, the specialist asks the person to remember the most vivid situations that have caused emotional problems. At the same time, the information processing mechanism is launched. After a course of therapy, memories of negative events persist, but the person no longer reacts to them very sharply. Method suitable:
|
During the conversation, the specialist guides the patient and points out points that are worth paying attention to. 
She fits: 
With the help of certain exercises, the psychotherapist helps to work through unfinished life situations. As a result, a person learns to live in the present and plan his future without looking back at past stories. 
He and other participants are trying to feel this situation and answer all the exciting questions. Ethics
Psychotherapist guarantees 100% confidentiality.
He does not have the right to discuss with anyone the information received during the reception.
Despite the fact that the ethical aspects of psychotherapy are not regulated at the legislative level, their violation can negatively affect the future work of a specialist. If the privacy policy is not observed, he may lose the right to engage in professional activities.
Common myths about psychotherapy
This is not true. The help of a specialist is required not only for people with psychiatric diseases, but also for those who are faced with psychological problems. The course of therapy helps to better understand the situation and come to emotional harmony.
Listening to a person is one of the tasks of a specialist. During therapy, he also studies the patient's attitude to the problem situation and helps to better understand it and find a way out.
Depending on the complexity of the case, treatment can last from 1-2 weeks to several months. If after some time the problem returns, the course is repeated.
The optimal therapy is selected individually during the first consultation. The specialist combines various techniques that make the treatment as effective as possible.
Cost of consultations
The average price of a psychotherapist session consists of several parameters:
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specialist qualifications;
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the complexity of the problem with which the person applied;
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types of therapy (group methods will have a better cost for each participant).
Author
Adams Antonina Leonidovna
psychiatrist, psychotherapist
Doctor of the highest category
Experience 21 years
+7 (495) 032-15-21
Manual therapy session with a manual therapist: how to properly prepare for an appointment, features of manual therapy and methods of conducting
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Manual therapy is a system of manual techniques, the purpose of which is to correct or eliminate disorders in the spine, joints and muscles. At the same time, the field of application of manual therapy methods is much wider, and the impact is carried out on internal organs and soft tissues.
The goal of manual therapy is the normalization of function in the marks of existing structural features. It is important to understand that the chiropractor ignores structural changes to a certain extent. Its main task is to identify the reserve of movement with the existing structural changes. That is why it cannot be said that the goal of manual therapy is the treatment of pathologies of the organs of movement. What does this mean? For example, in case of osteochondrosis, arthrosis, a specialist does not eliminate the restructuring of bone and cartilage elements, he eliminates muscle-fascial spasm, restores the motor reserve within the framework of existing structural changes.
How is the reception?
The session consists of diagnostic and therapeutic parts. The diagnosis is established on the basis of an assessment of general and local functional changes.
It is characteristic that the solution of problems is carried out from "private" to "general": first, local influence is carried out, and then - general. That is, first of all, local functional disorders are corrected, then regional ones, and after that, the disturbed dynamic stereotype is corrected.
First pretreatment preparation . The doctor informs the patient about the tasks, teaches certain postures to work with the doctor, etc. The next step is manual testing. Then - manual therapy: relaxation, mobilization, manipulation.
The procedure is carried out exclusively by a specialist who has undergone appropriate training, with in-depth knowledge in the field of vertebroneurology.
Indications for manual therapy
First of all, these are osteochondrosis, spondylarthrosis.
Various functional visceral disorders, myofascial pain, various spondylogenic syndromes.
Techniques used in manual therapy
Manual influence has several effects: reduces muscle tone, interrupts nociceptive reactions, leads to the elimination of excessive sympathetic activity. These processes are put into action by the following manual methods: soft tissue techniques, mobilization, manipulation. Each method has its own characteristics that allow you to achieve certain goals. The task of soft tissue techniques is to prepare pathologically altered vertebral motor segments for mobilization and manipulation. These techniques allow you to reduce tension in individual muscle groups. For this, various relaxation options are used to reduce muscle spasm, eliminate hypertonicity, and inactivate trigger points. Soft tissue techniques include the following techniques:
- ischemic compression;
- acupressure;
- voltage and counter-voltage technique;
- release;
- post-isometric relaxation.
At the next stage of manual therapy, mobilization and manipulation techniques are used. Mobilization is a manual action that helps to restore the range of motion in the vertebral motor segments due to the elimination of the functional block. Recovery can be achieved instantly or gradually, it can be partial or complete. Mobilization is based on biomechanical displacement, which allows restoring physiological relationships in the spinal motion segment. Mobilization techniques improve the coordination of the nervous structures of the ligamentous-muscular apparatus. They are carried out with the help of flexion, extension, rotation, tilts to the sides in combination with breathing. Mobilization is preceded by a study of the volume of passive and active movements. The procedure for performing mobilization is as follows: first, prestressing is achieved, then jerky movements are performed rhythmically with a gradual increase in amplitude, and the functional block is eliminated.
Another variation of manual techniques is manipulation. When they are performed, small power impulses and a small amplitude of movements are used. The doctor makes passive movements in the joints, making sure that the volume of these movements is below the limit, after which the development of injury is possible. This so-called paraphysiological volume is used for therapeutic purposes, and osteopathic manipulations are performed within it, accompanied by crunching. In the course of manipulations in the paraphysiological gap, impulses arise from the receptors of muscles, tendons, and joints. This impulsation allows you to influence the pathological mechanisms that caused the restriction of mobility. As a result of exposure, the activity of trigger points is eliminated, movements are normalized, and pain sensations are reduced.
Manipulation provides significantly higher stimulation compared to other manual therapy methods. A stronger response is caused by forced rotation and lateral tilts, traction techniques have less force.
Dosed load is especially important during manipulations in the cervical region and avoids injury. To work with this zone, the gentle isometry method is used.
Basic principles of mobilization and manipulation techniques
The effectiveness and safety of the procedure is ensured by following the rules developed on the basis of many years of practical experience. Basic principles of manipulation:
- The body weight of the doctor and the patient must be taken into account. If the mass is large, the impact force increases and the rhythm of movement slows down. With a small mass, the rhythm accelerates, but the strength decreases.
- Manipulations are carried out only during movement.
- When performing manual therapy, the vertebral curves are taken into account.
- The main manipulation is performed on the segment that is directly related to the development or exacerbation of a specific disease of the spine. In order to consolidate the achieved motor stereotype, in addition to the main manipulation, additional manipulations are carried out in other spinal segments.
- Frequency of manual therapy sessions - daily, less often - 2-3 times a week. With severe pain syndrome, drug blockades are used. If, due to tissue microtraumatization, pain intensifies or hyperemia occurs, rest, analgesics, and drugs that reduce the permeability of the vascular wall are recommended. At this time, manual techniques of muscle relaxation are used.
- Treatment should be complex and include drug therapy, in severe cases - blockade, acupuncture and other methods to reduce pain.
Contraindications to manual therapy
Presence of osteochondrosis of the spine above stage 4, scoliosis above stage 2, gross atrophy of the muscles of the extremities, occlusion, thrombosis of the vertebral arteries, sequestration of disc herniation, various syndromes associated with compression of the spinal arteries.
There are absolute and relative contraindications to manual therapy. Strictly speaking, this type of treatment is effective only for functional disorders of the joints.
