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Group psychotherapy is effective and appeals to many patients and doctors. The same number of doctors can treat more patients, and it may be combined with individual psychotherapy. In some countries, the group psychotherapeutic approach has exceeded the individual approach. As the nuclear family and religion has become diverse, and in some instances, fragmented, the psychotherapy group may meet the strong need to belong, affiliate and assist others. Many doctors see a group size of 8 to 10 patients as optimal, but groups may vary in size from 3 to 15. Weekly or twice monthly sessions of 1-2 (1½ most common) hours seems to be the average. Groups of differing ("heterogeneous") patient needs may be helpful, but there are some group psychotherapy where all share the same expressed need or disorder. In some instances the group is thought of as a doctor who is expressed through other group members: as each group member grows stronger, he/she provides assistance in interpretation, insight and decision making to other group members.

Clinical biofeedback instrumentation provides information (data) to a patient about normally involuntary physical processes that are below threshold (outside of awareness). The patient, with these data, can adjust behavioral, cognitive (mental) and affective (emotional) processes and learn to control these physical processes. The term was first employed during WWII and the term behavioral medicine was first utilized in 1973 to describe integration of behavioral and biomedical sciences for the diagnosis, treatment, rehabilitation and prevention of illness as well as promotion of health. Not only can bio-behavioral methods be effective in the management of specific symptoms and rehabilitation, but these approaches are often useful for patients who are resistant to other forms of treatment.

Dialectical behavior therapy (DBT) is a longer term cognitive behavioral treatment devised for borderline personality disorder which teaches patients skills for regulating and accepting emotions and increasing interpersonal effectiveness.

Eclectic therapies Many NHS therapists formulate the patient's difficulties using more than one theoretical framework and choose a mix of techniques from more than one therapy approach. The resulting therapy is pragmatic, tailored to the individual. These generic therapies often emphasize important non-specific factors (such as building the therapeutic alliance and engendering hope). By their nature, they are more idiosyncratic and difficult to standardize for the purposed of randomized controlled trials research.

Eye movement desensitization and reprocessing (EMDR) is a form of imaginable exposure treatment for post-traumatic conditions where the traumatic event is recalled whilst the client makes specific voluntary eye movements.

Focal psychodynamic therapy identifies a central conflict arising from early experience that is being re-enacted in adult life producing mental health problems. It aims to resolve this through the vehicle of the relationship with the therapist giving new opportunities for emotional assimilation and insight. This form of therapy may be offered in a time-limited format, with anxiety aroused by the ending of therapy being used to illustrate how re-awakened feelings about earlier losses, separations and disappointments may be experienced differently.

Psychopharmacotherapies are based upon the realization that the brain is not chemically responding in a functional fashion. This has to do with chemicals within the brain and central nervous system called neurotransmitters which must not only exist but exist in balance for thought, emotion and behavior to have regulation. Vigorous research on these chemical agents have existed since the mid 1950s. As a result of this research, we better understand how the brain's function is regulated and how best to assist those who suffer from dysregulation of these neurotransmitters. Acetylcholine and norepinephrine were among the first investigated followed by dopamine (dihydoxyphenylethylamine) and indoleamine serotonin. Quantitatively, these are only minor transmitters in the brian but they serve major roles in emotional behavior. The anticonvulsants, neuroleptics, antidepressants and anxiolytic agents are ever being refined. They are not addictive agents although some patients become dependent upon the anti-anxiety (anxiolytic agents) when they are not prescribed in an appropriate schedule. Non-medical abuse of the anti-anxiety drugs is actually uncommon. These anxiolytic agents were excessively prescribed in the past, and some clinicians became hesitant to prescribe them. Appropriately used, the drugs are both safe and beneficial.

Marital and Sexual Psychotherapies deal with not only environmental, situational and phase of life problems which confront relationships but deal with concurrent problems in communication and conflict. Problems that occur within a relationship often emerge from interactional problems, the nature of feedback which couples provide each other, the difficulties in maintaining functional balance within the relationship, and the struggles for power and control which emerge. While interactional problems within a marital system may result in, and sometimes from, sexual conflicts, these are not the sole causes, nor even necessarily the primary causes. It is quite possible for a couple to have a functional sexual relationship and a dysfunctional emotional relationship. Relationship problems may emerge or worsen as a result of sexual dysfunction. By the time the couple consults a doctors, it is questionable as to whether sole resolution of the sexual problem, via medication for example, will make the marriage again functional unless other intervention (e.g. marital psychotherapy) is concurrently provided.

continue: Short-term Dynamic Psychotherapies (STDP)

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Reviewed: 04/2006