Because very many patients are asking: what is psychotherapy, how to do psychotherapy, professional books may explain in more detail, but not necessarily conducive to public understanding and acceptance. In order to give the patients and their families a general understanding of psychotherapy and to better maintain the doctor-patient relationship and therapeutic alliance, we would like to briefly explain the operation process of the general model of psychotherapy.
1. Entering the treatment phase: the doctor and the helper and his family, establish a positive cooperative relationship. Xu Fushan, Mental Health Center, Harbin First Specialized Hospital
Preparation: This includes the communication and explanation work before the treatment starts, so that the affected person understands the origin of his or her problem and is generally clear about the proportion of biological factors of the disorder and the proportion of psychological and sociological factors. In order to facilitate the design of the treatment plan. and the determination of the treatment model.
Working alliance relationship: psychotherapy is not a process where the doctor is pie in the sky and does whatever he wants, it may be magical, but it should never be godz, especially to play the initiative of the affected party and mobilize all available resources to serve the treatment goal. So the treatment plan must be developed together, including time, place, content, assignments, etc. should be rigidly defined, ideally with the existence of a mutually agreed agreement.
2. Identification phase of the problem.
Spend a certain amount of time and effort to gain an in-depth understanding of the thinking patterns, emotional characteristics, types of behavioral responses, personality traits, and coping styles of the helper and his or her family, and finally to depict the family structure. Fully understand the factors that interact in this family environment and analyze the composition and proportion of the pathogenic disturbance quality and recovery maintenance quality components. In simple terms, the influence of the family environment is almost decisive if the patient is not mentally ill, not mentally ill due to other physical problems such as trauma or encephalopathy, and then it can be concluded that psychosocial factors are more likely to cause the illness. Treatment of a sick member must be accompanied by treatment of an unhealthy family pattern. Otherwise, even if the treatment is effective and the client feels well, the probability of relapse or aggravation is almost 100%.
If possible, the identification and recognition of poor coping styles is carried out at this stage.
3. Habit change stage.
As I have mentioned in many previous articles, psychotherapy is painful because it involves changing something fundamental about a person. Although to an outsider the patient adopts an incomprehensible approach, it is never the same for the patient himself, who has relied on this unhealthy way of living for a long time, and the two parties are closer than we can imagine. It’s like a poor woman who has a man who drinks, and everyone thinks she should leave, but she always finds reasons to stay with him, and even if she leaves, the next man she finds is still a drinker. I hope my statement can be understood.
This is a moment for the doctor to use a variety of psychological and sociological skills to help guide the helper and family to let go of the past, to try to be creative, and to believe that the approach and hope are ultimately in their own hands. And support and encourage them to constantly practice and maintain new life patterns, new life concepts, and new interpersonal attitudes. Finally, the scope of positive power influence is continuously expanded.
4. End of treatment phase.
There is no such thing as a banquet that does not end, and there will not be relationships that never part. Perhaps for the helper and the family, the cooperation with a good psychologist is the best interpersonal relationship that they can hardly find in their life, but this is not the goal that therapy should have. We want to give the initiative of life back to them, to see them move forward in the midst of difficulties on their own, to rush up to help them up when they fall, but after a few steps we should let go of our hands and gaze with expectation at people who are bravely moving forward in this suffering world.
So, the end of the therapeutic relationship may take a greater effort, and getting the helper and family to accept this view is sometimes difficult. But to be clear, we are not leaving completely, and they can communicate with the doctor as necessary at any time they feel the need. And in most cases, the necessary follow up and return visits are very necessary.
The above is as generalized as possible. I am limited in my ability, so I hope the group will take more shots.