Support psychotherapy: what it is and what are its characteristics

The theory of Freudian psychoanalysis is a psychological current and a pseudoscience founded by Sigmund Freud, an Austrian neurologist, at the end of the 19th century. As a result of it, new currents and therapies arose. Here we will know one of them, supportive psychotherapy.

Supportive psychotherapy is based on psychoanalysis, although it is aimed at treating a wide variety of patients and clinical conditions. One of its central elements is the therapeutic alliance. We are going to know in detail what this type of intervention consists of.

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Origin of supportive psychotherapy

The therapy that Sigmund Freud initially proposed was the psychoanalytic type of cure, a therapy where the patient would lie down in an armchair or couch and express mental images and ideas that passed through his mind under the instructions of the psychoanalyst. The sessions took place between 4 and 5 times a week. It was a therapy that lasted several years (practically "all life").

Subsequently, new forms of therapy arose, the so-called psychoanalytic psychotherapies, which are three:

• Psychoanalytic psychotherapy proper.
• Brief dynamic psychotherapy.
• Support psychotherapy.

In the next lines we will see how the latter was conceived.

Characteristics

Supportive psychotherapy, as we have seen, has its roots in psychoanalysis. However, currently many psychotherapeutic schools, approaches and techniques use it.

Its area of ​​intervention is broader than that of the other two psychoanalytic psychotherapies mentioned. (as well as that of the psychoanalytic type cure). It focuses on seeking relief from the patient's suffering and on restructuring her personality.

As regards its setting, the sessions are held face to face, with a variable periodicity and a session duration of between 30 and 60 minutes.

Applications

It is a type of intervention focused on three fundamental objectives: enable the expression of feelings, strengthen defenses and contain anxiety. More specifically, it is aimed at maintaining or reinforcing the adaptive defenses of the patient, so that they allow him to cope with his day-to-day life or her situation as best as possible.

Supportive psychotherapy emphasizes mobilize the patient's strengths to increase their self-esteem. Use the patient's adaptive defenses and coping strategies in a positive way, so that he can better cope with her situation or life crisis.

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Indications

As for the indications for brief psychotherapy, the patient is not required to have special psychological qualities. This differentiates it from the other two psychoanalytic psychotherapies, as well as from the cure type psychoanalytic, which require insight capacity on the part of the patient and good tolerance to frustration.

Supportive psychotherapy is usually used in a very wide series of disorders and types of patients. The indication depends on the specific clinical situation, rather than the type of psychopathology.

It is usually considered that the more serious the crisis and the greater the fragility of the patient, the more support the patient will require; in the same way, you will also need more support the more deteriorated or damaged your psychic structure is.

Supportive psychotherapy techniques

Techniques in supportive psychotherapy are aimed at forming a facilitating environment in therapy. This tries to provide a climate where the patient feels comfortable to freely express her worries and concerns.

Thus, the most used techniques in this type of psychotherapy are: case formulation, framing, active listening and therapeutic alliance.

1. Case formulation

Once the patient has been listened to in detail in various interviews, her case is formulated. The case formulation consists of a set of hypotheses about the causes, precipitants, and influences that maintain the patient's problems. It is therefore a conceptualization of your case, beyond diagnosis or psychopathology.

2. framing

It is about the conscious expression (with unconscious elements), voluntary and purposeful of the moment, place and end of the therapy. The frame defines who, why or for what, when, where, how and at what price the patient and therapist will meet; that is, they would be the “conditions” of the therapy.

The frame structure and gives a sense of reliability to psychotherapy and the therapist.

3. Active listening

Although it may seem obvious, it is about listening, but doing it with quality. Respect silences, provide elements that allow the patient to know that he is being listened to, maintain eye contact, etc. In short, listen respectfully and attentively to the patient. It is an element present in any type of psychotherapy.

If adequate active listening is carried out, the patient will feel free to express his feelings, emotions, fears and conflicts in her own way.

4. therapeutic alliance

According to Sigmund Freud, the first duty of every therapist is "to bring the patient closer to the therapy itself as well as to the person of the therapist." The therapeutic alliance is about the degree to which the patient experiences the relationship with the therapist as solid and useful. to achieve your therapeutic goals.

Bordin (1979) breaks down the therapeutic alliance into three elements:

• Agreement between patient and therapist regarding the goals of psychotherapy.
• Agreement between patient and therapist about the tasks of the psychotherapy that is being carried out.
• relationship between patient and therapist and perception that there is a common commitment and mutual understanding of psychotherapeutic activities.