In tribal societies the remedies to combat disease mental health not only involved the patient but the social group as a whole. There was a belief that the soul could leave the body (animism) and that people could reincarnate into other beings (metempsychopsis). Therefore, there were different techniques to alleviate these alleged ailments, such as ceremonies for restoration, in which the "lost soul" is found, exorcist practices, confessions, incubation cures, etc. Little by little these tribal thoughts became part of other paths such as organized religions in China, or Greek rational thought. Both of them thoughts they try to distance themselves from the immediacy of the present situation.
Psychotherapy has its roots in Greece, where rational thought arises, with thinkers like Aristotle and Plato (know yourself). This tradition provides a rational conception and methods for the rational part to triumph over the animal (Stoic and Aristotelian tradition). In the Middle Ages the Church regarded mental disorders as a product of the devil, and methods that ranged from prayer, bonfire, torture or exorcism.
Although the ecclesiastical tradition provides relevant aspects for psychotherapy such as confession or the resources to avoid sin (the "Treatise on victory over oneself" or exercises spiritual). In the Renaissance, exorcisms were performed according to Father J.Gassner due to two types of diseases: natural and pre-natural. The moral treatment introduced by Pinel constituted an important step towards the humanization of the mental illness, with its reform of psychiatric care and an optimistic conception of illnesses mental. Psychotherapy appears in the last quarter of the 19th century. Hypnosis marks a bridge between prepsychological attitudes and the aspect of psychoanalysis. Mesmer was a key impetus for psychotherapy with his theory of body fluid and its distribution.
He obtained therapeutic successes (group therapy, "rooms in crisis") There was a split among his followers. The fluidists who followed Mesmer (healing powers of the fluid) and the animists who followed the Marques de Puysegur (healing had to do with faith). Braid coined the term hypnosis and attempted to provide a scientific explanation using the neurophysiology of his time. Liebault began treating his patients with hypnosis and Bernheim, his admirer, developed a research program on the therapeutic potential of hypnosis. Charcot studied hysteria and hypnotism, and Janet tries the first cathartic cure with "the Lucile case" trying that by concentration through hypnosis to treat subconscious ideas.
At the end of the 19th century psychotherapy it referred to treatment by suggestion, and to methods of healing through the mind. The cathartic method was described by Breuer and from it Freud developed his psychoanalytic method. It is a step from the old methods of hypnotic suggestion to the new psychoanalytic method (Breuer left of insisting on hypnotic suggestion and merely hypnotizing her to relive emotional memories traumatic. Freud started from the cathartic method because he could cure symptoms but could not prevent them from reappearing. He highlighted the importance of defense, of the therapeutic relationship and proposed the method of free association.
In the twentieth century, some experimental academic psychologists began to be interested in practical social problems, but academic-experimental psychology developed in Germany and represented mainly by Wundt and Tichener, so there is a clear disconnect between academic psychology with practice or applied to problems social.
Psychoanalysis develops autonomously and parallel to all this controversy. Lightmer Witner appears as the first clinical psychologist, although at that time clinical psychologists were mere test-takers in hospitals, and psychoanalytic postulates were adopted for the treatment of patients. Many projective tests emerge and psychoanalysis and experimental psychology are approached through the Institute of Human Relations at Yale University by psychologists neo-behaviorists led by Hull, in the 1940s (Dollard, Miller, Mower, Sears, Spence) As a result of the Second World War and due to the recruitment efforts, a greater therapeutic awareness. There is a very important event for the passage of the application of academic postulates to applied psychology to take place and it is the Boulder Conference in 1949.
In this conference it is stated that the clinical psychologist must be trained in a scientific and applied way, that they must be trained in diagnosis, research and therapy. Therefore, the appearance of behavior therapy is due to several main reasons: The cataclysm of the Second World War, which contributed to change the spirit of the time (the zeigeist) making consider data from experimental psychology due to the great social demand The break with the methods of psychoanalysis as they are considered little related to the experimental method The confrontation with psychiatry that claimed psychotherapy as an exclusive competence of its discipline Therefore, alternative therapeutic approaches began to be developed to psychoanalysis.
Rogers begins to record therapeutic interviews to subject them to systematic analysis Behaviorism emerges strongly after the hegemony of psychoanalysis and emerges behavior therapy, with representatives such as Eysenck (studies on the efficacy of psychotherapy), Skinner ("Science and human behavior") Wolpe (systematic desensitization) In the 50s therefore fundamentally, psychotherapy was reduced to two options: psychoanalytically oriented psychotherapies and behavior modification (inspired by psychology scientific). But these two alternatives were insufficient: a somewhat dehumanized image of man, difficulty in understanding complex human phenomena, and an effectiveness that was not devastating.
Therefore, other important psychotherapeutic approaches emerge: Humanistic psychology or third force, as a philosophical and social movement rather than as a therapeutic approach. Techniques and therapies that seek to achieve self-realization and the development of human potential (gostatic therapy, transactional analysis) Systemic model: That understands the family as an open system, as a nucleus of conceptualization and treatment (Bateson, Weakland, Haley) Cognitive models: They propose cognitions and other mental processes as the main object of study. Very significant impact on psychotherapy. Cognitive approach (Ellis, Beck) and cognitive-behavioral approach (Mahoney, Meichenbaum).
There is a conceptual, methodological and technical dispersion, or "several" modifications of behavior due to parallel developments rather than due to paradigm breaks or overcoming. We mainly find the following paradigms:
- Applied Behavioral Analysis (Skinner)
- Radical neobehaviorism (Hull-Spencer, Eysenck, Wolpe.
- Social learning theory (Bandura)
- Cognitive behavior modification
- Cognitive approach
- Behavioral-cognitive approach (Mahoney, Meichenbaum)
Mahoney precisely summarizes the most notable trends and their changes Increase in eclecticism in 60 with a moderate decrease in the 80's Decrease in the psychoanalytic tendency with an increase in the late 80. Consolidation of humanistic therapy in the 60s that declined in the 80s Moderate but constant role of behaviorism, and constant but more moderate evolution of systemic orientation.
In practice, eclecticism is the most widely used option: Intuitive and atheoric eclecticism:
They choose techniques based on their subjective attraction
- Technical eclecticism: They choose the techniques according to systematic criteria without having to pass the theoretical framework to which they belong
- Synthetic Eclecticism: Assimilative Integration (reformulation of the concepts of one theory as a function of another) and Accommodative Integration (articulation of compatible theoretical elements)
Eysenck's studies on the effectiveness of psychotherapy have profoundly influenced current trends, because it takes into account that: The therapeutic model that each one defends is not definitive, but limited It is necessary to achieve a deeper understanding of the mechanisms of change, which encourages openness towards new approaches in the investigation
Development of an inclusive movement.
In recent years, there has also been a trend towards the adoption of brief therapy, considering that fewer than 25 sessions are. This is due to the fact that the longer duration of the experimental studies did not yield clear differential efficacy effects.
MOMENTS OF THE THERAPEUTIC PROCESS
- Answer: Reduction of symptoms in at least 50% of those presented at the beginning of treatment
- Remission: Total disappearance of symptoms with return to a normal level of functioning
- Recovery: Remission maintained for at least a period of 6 months
- Relapse: Appearance of symptoms during remission or recovery
- Recurrence: Appearance of symptoms after recovery. This phenomenon appears frequently in chronic diseases
- Efficacy: Achievement of therapeutic objectives in optimal and ideal conditions (laboratory)
- Effectiveness: Degree to which a treatment achieves its therapeutic objectives in routine clinical practice.
Therapeutic efficiency: Achievement of clinical objectives at the lowest possible cost. In 1986 Lambert identifies that a total of change experienced by the patient in psychotherapy: 40% due to extra-therapeutic effects 30% to common factors 15% techniques applied in therapy 15% Effect placebo. THE TASK FORCE REPORT aims to evaluate psychotherapeutic treatments. The report distinguishes 2 categories of treatments:
- Well established or effective treatments
- Probably effective or experimental treatments
For a treatment to be well established, three conditions must be met:
- That there are at least 2 experimental studies where the treatment has been shown to be superior to placebo
- That the treatment is manualized.
- That the characteristics of the sample are well specified.
Criticism Manualization only occurs in behavioral therapies Different therapies show the same efficacy Patient variability is inevitable
This article is merely informative, in Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.
