Individual therapy is an intensely personal experience. How often in this busy, multi-tasking world, is there space for a real sit-down, paying attention just to oneself? Not often, but individual therapy provides this space by designating a specific time, place, and person to help. The time is regularly scheduled appointments, usually weekly; the place is the quiet safety of the therapist's office; and the helper is the psychotherapist, whose sole purpose is to support the individual's self-centering. Staying centered on what is needed to improve the quality of life is the overarching goal of individual therapy. The particulars evolve through the collaboration of client and psychotherapist.
ROLE OF PATIENT
The patient brings the issues, which may be one or many, narrow or wide in scope. There may be a once in a lifetime crisis or a set of problems that have been going on for as long as can be remembered. Illustrative of some specific concerns would be the decision about whether or not to divorce, panic attacks, loss of a loved one, a life transition, and job stress. Having chronic depression or being a worrier whose anxieties are overwhelming are broader-based problems. Even more complex would be the need to understand and remedy the effects of the past upon the present and future. Or the goals may be to know oneself better through self-examination and also to get to know others better through developing better communication skills.
Whatever issues are brought to the table, the patient needs more than problem definition to take part fully in the experience of individual psychotherapy. Personal pain that makes the status quo unacceptable fuels motivation and commitment to change, both of which are necessary to a successful course of treatment. The belief that introspection and understanding are worthwhile is almost a prerequisite. Openness is facilitative, as is the willingness to look at oneself squarely. The capacity to cooperate makes the therapist-patient coalition possible. Taking the work seriously by continuing to do it outside the sessions, either by reflecting upon what has been brought up or by doing any agreed upon homework, intensifies the experience and makes progress more likely.
ROLE OF THERAPIST
Most therapists are people who want to help others, but caring is not enough. The therapeutic role has to be learned and put into practice. It is enacted by making knowledgeable and disciplined interventions based on theory, clinical experience, and scientific evidence. Such interventions are necessary to a successful individual therapy.
The process by which a Ph. D. clinical psychologist develops expertise is long and demanding. It begins in a university's doctoral program with rigorous courses covering a variety of theoretical approaches, research methodology, standards of practice, and diagnostic methods, including psychological testing. In addition, there is clinical practice in a variety of settings under the supervision of master psychologists. After obtaining the degree and after formal supervision is no longer required, further professional development comes through work experience, continuing education through coursework and workshops, and peer consultation.
ROLE OF THEORY
Individual psychotherapy is best rendered when based on well documented theories and the techniques that are derived from them. Of the 400 available theoretical approaches, the two most frequently adopted by mental health professionals are Cognitive Behavioral Therapy and Psychodynamic Psychotherapy.
Psychodynamic Psychotherapy grew out of Sigmund Freud's psychoanalytic theory, the first modern western system of psychological investigation and treatment. Since Freud's seminal writings, there have been many other contributors to its ongoing evolution over the last hundred years or so. At this point, it is the most comprehensive of all approaches with the richest clinical hertitage represented by a wide array of articulated perspectives. Its scope encompasses both the internal and interpersonal worlds of its clients. Its goal is to go beyond symptom reduction to deeper personality changes.
Cognitive Behavioral Therapy is based on behavioral, learning, and cognitive theories. Its main goal is symptom reduction by replacing maladaptive thoughts and behaviors with adaptive ones. It focuses on specific techniques for specific problems. A focus on the present and practical solutions are its strengths.
To date, Cognitive Behavioral Therapy is the most heavily researched approach and has the most proponents. However, Psychodynamic Psychotherapy is also evidenced -based and some research has shown it to be superior. Psychodynamic Psychotherapy, although second in popularity, has not only been shown to be effective during treatment but also afterwards as its clients maintain their gains and even continue to improve after treatment has ended.
By combining Cognitive Behavioral Therapy and Psychodynamic Psychotherapy, the individual therapist can have the advantage of drawing upon two complementary but differently focused approaches. The blending creates a very versatile repertory with many available choices grounded in two solid, evidence-based theories. This therapeutic versatility in combination with an active, invested client makes individual psychotherapy a likely path to positive outcomes. Neuropsychology, although in its infancy as a discipline, is showing that psychotherapy changes the brain in important ways that increase adaptation.