Components and techniques of supportive psychotherapy
Rather than only considering the theoretical frame work behind supportive psychotherapy it may be helpful to look at what actually done in such psychotherapy. Bloch in 1979 gives a useful analysis of the key components of supportive psychotherapy.
Reassurance is critical. It is necessary to remove doubts and misconceptions, and focus on assets. If reassurance is to be effective it must be realistic. The aim is to create a climate of hope and positive expectation.
A thorough and detailed explanation of the illness should be given, focused on the here and now. The emphasis is very much on the external reality the patient faces. The overriding aim is to improve the individual’s coping ability rather than enhance self-awareness. Repeated reality-testing is the key.
Direct advice is acceptable and indeed desirable. The ultimate aim is to produce transferable skills. The individual should not only develop improved coping skills but also know when to seek help.
Suggestion by the clinician can result in change by influencing the patient both implicitly and explicitly.
Encouragement can promote self-esteem, prevent feelings of inferiority and facilitate more appropriate patterns of behaviour.
Environmental change may often be necessary in order to effect significant change.
Sympathetic active listening, unconditional acceptance and allowing catharsis ensure the patient a safe and secure environment, thereby facilitating full and frank disclosure.
Techniques of Supportive Therapy
Basic interview skills such as history taking, listening, clarifying, empathy and responding to verbal and non- verbal cues, are important in supportive therapy. The following techniques are used in supportive therapy.
1. Holding and containment
It is a technique in supportive therapy which means the ability of the therapist to be there for the person provides a point of stability and security in his or her otherwise disorganized world. The comfort these people have in knowing that you are there for them can calm them when they are under stress. Often in therapy, the best intervention is to listen and do nothing rather than to do something that is ineffective or even destructive.
Genuineness has a major emphasis in supportive therapy. Therapists who are genuine are open, honest and sincere, and the relationship which they involve is not simply mirrors or blank screens. Therapists are real people in real encounters. So in supportive therapy some minimal self- disclosure is appropriate, by doing that therapist acknowledges that his or her life is not as perfect as the client assumes. At the same time therapist should be careful about the fact that, it is inappropriate to discuss specific aspects in their life and should not break the professional boundary between the therapist and the client.
In supportive therapy explanation means educating the client and the family about the illness, symptoms and components of treatment, which gives a better idea to the clients as well as family about the nature of illness, prognosis and role of family in the management of illness.
People approach for supportive therapy usually has limited coping skills so therapist uses the technique, advice more frequently in supportive therapy then in other forms of psychotherapy. In supportive therapy therapist usually gives advice about the treatment, how to seek help, how to deal with everyday problems, and also about social and interpersonal skills.
It is another technique in supportive therapy. In therapy therapist makes encouraging statements about the client’s actions thus enhance the selfesteem of the client, reduce client’s sense of ineffectiveness and promote further positive actions.
6. Improving Social Supports
This technique is used in supportive therapy to improve the client’s prognosis by reducing high expressed emotions in the family. Thus ensure a strong social support or improve the social support which helps to limit the disability of the client.
Catharsis means emotional release and it is a main technique in supportive therapy. To develop a trusting therapeutic relationship is the core of supportive therapy. Only within a trusting relationship, client may be able to disclose events in their lives that they have been unable to discuss with anyone else.
8. Positive Reframing
Positive reframing is a technique uses in supportive therapy. In positive reframing therapist help the client to give a new positive meaning to a given behaviour, interactions or some other feature in the current situation which helps the client to approach everyday situations more confidently than earlier.