Supportive psychotherapy: what is it and what are its characteristics?

A type of psychological intervention of the psychodynamic current initiated by Sigmund Freud.

The theory of Freudian psychoanalysis is a psychological current and a pseudoscience founded by Sigmund Freud, Austrian neurologist, in the late nineteenth century. As a result, new currents and therapies emerged. Here we will know one of them, the supportive psychotherapy..

Supportive psychotherapy is based on psychoanalysis, although it is oriented to treat a great diversity of patients and clinical pictures. One of its central elements is the therapeutic alliance. We are going to know in detail what this type of intervention consists of.

Origin of supportive psychotherapy

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

Later, new forms of therapy emerged, the so-called psychoanalytic psychotherapies, of which there are three:

• Psychoanalytic psychotherapy proper.
• Brief dynamic psychotherapy.
• Supportive psychotherapy.

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

Characteristics

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

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

As for its setting, the sessions are conducted face to face, with a variable frequency and a session duration of between 30 and 60 minutes.

Applications

It is a type of intervention focused on three main objectives: enabling the expression of feelings, reinforcing defenses and containing anxiety.. More specifically, it is aimed at maintaining or reinforcing the patient's adaptive defenses, so that they allow him or her to cope as well as possible with his or her daily life or situation.

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

Indications

As for the indications of 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 psychoanalytic type of cure, which require insight capacity on the part of the patient and good tolerance to frustration.

Supportive psychotherapy is usually used in a very Wide range of disorders and patient typologies. The indication depends on the specific clinical situation rather than the type of psychopathology.

It is generally considered that the more severe the crisis and the more fragile the patient, the more support he/she will require; similarly, he/she will also need more support.Similarly, the more deteriorated or damaged the psychic structure of the patient, the more support he/she will need.

Techniques of supportive psychotherapy

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

Thus, the most commonly 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 several interviews, his or 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 the case, beyond the diagnosis or psychopathology.

2. Framing

This is the conscious expression (with unconscious elements), voluntary and purposeful of the time, place and purpose of the therapy. The frame defines who, why or what for, when, where, how and at what cost the patient and therapist will meet; that is, it would be the "conditions" of the therapy.

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

3. Active listening

Although it may seem obvious, it is about listening, but doing it with quality. Respecting silences, providing elements that allow the patient to know that he/she is being listened to, maintaining eye contact, etc., etc., etc.maintaining eye contact, etc. In short, listening respectfully and attentively to the patient. This is an element present in any type of psychotherapy.

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

4. Therapeutic alliance

According to Sigmund Freud, the first duty of every therapist is "to bring the patient both to the therapy itself and to the person of the therapist". Therapeutic alliance is about the degree to which the patient experiences the relationship with the therapist as solid and useful to achieve their 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 being carried out.
• Patient-therapist bonding and and the perception that there is a common commitment and mutual understanding of the psychotherapeutic of the psychotherapeutic activities.