Learning supportive psychotherapy an illustrated guide

Mastering the art of supportive psychotherapy demands years of training and experience–and Learning Supportive Psychotherapy: An Illustrated Guide paves the way. This book, along with the accompanying DVD, serves as a trustworthy guide to mastering the rudiments of supportive psychotherapy from the initial interview through the therapeutic progression to the very last ses

Mastering the art of supportive psychotherapy demands years of training and experience–and Learning Supportive Psychotherapy: An Illustrated Guide paves the way. This book, along with the accompanying DVD, serves as a trustworthy guide to mastering the rudiments of supportive psychotherapy from the initial interview through the therapeutic progression to the very last session.

The authors, preeminent figures in psychiatry, describe the basic principles and objectives of supportive psychotherapy, with emphasis on the critical importance of the therapeutic relationship and how to develop a positive therapeutic alliance. They have written an extremely accessible text that provides practical hands-on instruction to beginning psychotherapists, social workers, psychiatric nurses, and others who require the fundamentals of psychotherapeutic patient care.

Supportive psychotherapy has been recognized as a core competency, and readers seeking the requisite skills will find an advantage in this volume’s beneficial features: – Insightful perspective on the origins and development of supportive psychotherapy, locating it on the psychodynamic therapy spectrum, and distinguishing it from the expressive psychotherapies in terms of objectives, process, and outcomes- Expert instruction on conducting a thorough assessment and evaluation of a patient, with emphasis on techniques for conducting a comprehensive initial interview, exploring the patient’s manifesting problems, taking an accurate patient history, eliciting useful information, and identifying supportive measures–all of which are crucial to establishing a therapeutic relationship- Specialized focus on useful techniques, including alliance building, esteem building, encouragement, promoting adaptive behaviors, anticipatory guidance, reducing and preventing anxiety, naming the problem, rationalizing and reframing, expanding awareness, clarification, interpretation, and much more- Critical information on how to intervene in a crisis to facilitate the patient’s personal growth rather than physical and psychological deterioration- Significant clinical illustrations, vignettes, and case studies to help the reader make connections between theoretical concepts and real-world applications.

This text follows one of the three formats now required for psychiatry residency training by the Accreditation Council for Graduate Medical Education (ACGME) and provides newly credentialed psychiatrists with the basic tools needed to treat the broad range of patients they encounter. Like the other books in the Core Competencies series, it is a valuable adjunct to the traditional methods of psychotherapy education and an indispensable resource for the profession.

…more SUPPORTIVE PSYCHOTHERAPY

Supportive psychotherapy is by far the most commonly used method of psychotherapy around the world. It is one of the most commonly trained forms of psychotherapy, training or residency programs in Europe, US, Canada and Australia include supportive psychotherapy – or at least its techiques.

Supportive psychotherapy actually takes place in almost every psychiatric clinical setting to a degree. Therefore it is advisable to start deepening your therapeutic skills and practical experience with supportive psychotherapy.

Description & Brief Historic Overview

As the author of one of the founding books in the field and the owner of the most cited definition, Pinsker defines it as a “dyadic treatment and use direct measures to ameliorate symptoms and maintain, restore or improve self-esteem, ego functions and adaptive skills”. The empirical utilization of supportive techniques in treatment has been present for at least two centuries now – but the developent of what we today call as supportive psychotherapy can be traced through the approaches of Freud’s successsors in the second half of 20th century and their differences from his original psychoanalytical technique. Once called as the “Cinderella of Psychotherapies”, there has always been a debate if it is a form of psychotherapy in its own right or a compilation of techniques. A great review on the history (spoiler: dates back to ancient Greeks!) and development of supportive psychotherapy can be found in the book “Clinical Manual of Supportive Psychotherapy” by Novalis and colleagues.

Indications & Efficacy

Supportive techniques can be employed in a spectrum of therapies ranging from counseling to rather expressive approaches. The advantage is you could move through the spectrum depending on the needs and capacity of the patient. It can be implemented in hospital settings, for chronically ill patients to restore daily functioning or to help patients resolve crises. The techniques may change over the course of the therapy – depending on patient’s progress.

Although it is implemented in various settings, research spesifically investigating the effect of supportive psychotherapy is scarce. What is researched is mainly supportive techniques. Yet, one inspiring research that you would benefit from taking a look is the Psychotherapy Research Project of the Menninger Foundation.

How you can train for it?

Theoretical and technical aspects carry influences from psychodynamic, interpersonal and cognitive behavioral therapy approaches – this can allow you to have a broader perspective. It is even mentioned that supportive psychotherapy provides effective treatment for broadest range of clinical problems. If you are curious, then you can enjoy many valuable works in both fields and find out about different techniques. In their illustrated guide, Winston and colleagues say that beginner therapists, who cannot yet attempt expressive psychotherapy, can provide good supportive-expressive treatment.

It will require long hours of theoretical learning and following patients with a supervisor. In more structured training programs, theoretical training generally lasts for one year, simultaneously with or followed by another year of practical training. The reward is – it allows you to work with a wide range of patients and problems.

It is not only about knowing the techniques, but also having the correct attitude. You’ll need regular supervisions, group supervisions are also helpful. It is not strictly required for you to have your own psychotherapy, but as this form of psychortherapy contains psychodynamic elements and in general, sitting on the other chair is recommended.

Essential Textbooks on Supportive Psychotherapy:

1. Learning Supportive Psychotherapy: An Illustrated Guide, by Winston, Rosenthal and Pinsker: This is a book and DVD in which you can find very useful examples of interviews with the patient.

2. A Primer of Supportive Psychotherapy, by Pinsker: Quite old, but provides essential, easy to understand information on the technique.

3. Dynamic Supportive Psychotherapy: A fifty-pages handbook with basics. Of course, only a handbook will never be enough, but good for daily use, eg. Reading from your tablet

4. Instruction to Supportive Psychotherapy, by Winston, Rosenthal and Pinsker: Patient-therapist dialogues and case-vignettes, on course and interventions of supportive psychotherapy

5. Of course, theoretical psychodynamic literature, different approaches (drive theory, object relations theory, ego psychology, attachment, etc.) are all worth reading to increase your competence. Try to read some of the classical books during your training, which would introduce you the context and the historical development of therapies- but keep in mind most of them may not be taken as an updated source of knowledge.

Don’t miss these articles:

1. The Nuts and Bolts of Supportive Psychotherapy

2. 5 keys to good results with supportive psychotherapy

Course 2. Principles of Supportive Psychotherapy

Thank you for attending the WPA Principles of Supportive Psychotherapy Course delivered as part of the World Congress of Psychiatry (WCP) Online Learning Program. Below you will find the readings and resources recommended by the Course presenters, Dr. César A. Alfonso, Dr. Erin Crocker, Dr. David Teo Choon Liang and Assoc. Prof. Rasmon Kalayasiri. Together with the course, these will be made available in coming weeks on WPA’s Education Portal.

Resources recommended by César A. Alfonso, M.D. || Common Factors in Psychotherapy

Wampold BE (2015). How important are the common factors in psychotherapy? An update. World Psychiatry 14(3):270-277.

Tschacher W, Haken H, Kyseloz M. Alliance: a common factor of psychotherapy modeled by structural theory. Front Psychol 6:421.

Sullivan HS (1954) The Psychiatric Interview. WW Norton & Company: New York.

Preston SD, Hofelich AJ (2012). The many faces of empathy: Parsing empathic phenomena through a proximate, dynamic-systems view of representing the other in the self. Emotion Review 4:24–33.

Nahum, D., Tasman A., Alfonso, CA, Sonmez E (2017) Common factors in Psychotherapy, In K Fountoulakis and A Javed: Advances in Psychiatry, 4th Edition, Springer Nature.

Lietaer, G. (1993). Authenticity, congruence and transparency. In Brazier, D. (Ed..), Beyond Carl Rogers. London: Constable.

Laska KM, Gurman AS,Wampold BE (2014). Expanding the lens of evidence-based practice in psychotherapy: a common factors perspective. Psychotherapy 51(4):467-481.

Hofmann SG, Barlow DH (2014) Evidence-based psychological interventions and the common factors approach: the beginnings of a rapprochement? Psychotherapy 51(4):510-3.

Horvath, AO, Del Re AC, Flückiger C, Symonds D (2011) Alliance in individual psychotherapy, Psychotherapy 48(1):9-16.

Fisher H, Atzil-Slonim D, Bar-Kalifa E, Rafaeli E, Peri T (2016). Emotional experience and alliance contribute to therapeutic change in psychodynamic therapy. Psychotherapy (Chic) 53(1):105-116

Feinstein R, Heiman N, Yager J. (2015) Common factors affecting psychotherapy outcomes: some implications for teaching psychotherapy. J Psychiatr Pract 21(3):180-9

Resources recommended by Erin Crocker, M.D. || Fundamentals of Supportive Psychotherapy

‘Learning Specific Psychotherapies’ an extract from ‘Psychotherapy: A Practical Introduction’ can be downloaded from WPA’s Educational Portal (Module 2 of the Psychotherapy Course: Supportive Psychotherapy) https://wpa.learnbook.com.au/course/view.php?id=161

​

Crocker, E.M. (2017). Supportive Psychotherapy. In D.W. Black (Ed.), Psychotherapy. Scientific American Psychiatry.

 

Winston, A., Rosenthal, R. N., & Pinsker, H. (2012). Learning supportive psychotherapy: An illustrated guide. American Psychiatric Publishing.

           

Bloch, S. (2006).  An introduction to the psychotherapies. Oxford University Press.

           

Novalis, P. N., Virginia Singer, D. N. P., & Peele, R. (2019). Clinical manual of supportive psychotherapy. American Psychiatric Publishing.

           

Piper, W. E., Joyce, A. S., McCallum, M., Azim, H. F., & Ogrodniczuk, J. S. (2002). Interpretive and supportive psychotherapies: Matching therapy and patient personality. American Psychological Association.

           

Welton, R.S., & Crocker, E.M. (2020).  Supportive Psychotherapy.  In A. M. Brenner & L. S. Howe-Martin (Eds.)., Psychotherapy: A Practical Introduction. Wolters Kluwer.

           

Frank, J. D., & Frank, J. B. (1993). Persuasion and healing: A comparative study of psychotherapy. JHU Press.

           

Plakun, E. M., Sudak, D. M., & Goldberg, D. (2009). The Y model: an integrated, evidence-based approach to teaching psychotherapy competencies. Journal of Psychiatric Practice, 15(1), 5-11.

           

Cuijpers, P., Driessen, E., Hollon, S. D., van Oppen, P., Barth, J., & Andersson, G. (2012). The efficacy of non-directive supportive therapy for adult depression: a meta-analysis. Clinical psychology review, 32(4), 280-291.

 

Zitrin, C. M., Klein, D. F., & Woerner, M. G. (1978). Behavior therapy, supportive psychotherapy, imipramine, and phobias. Archives of General Psychiatry, 35(3), 307-316.

 

Klein, D. F., Zitrin, C. M., Woerner, M. G., & Ross, D. C. (1983). Treatment of phobias: II. Behavior therapy and supportive psychotherapy: Are there any specific ingredients?. Archives of General Psychiatry, 40(2), 139-145.

 

Lipsitz, J. D., Gur, M., Vermes, D., Petkova, E., Cheng, J., Miller, N.,Laino, J., Liebowitz, M.R., & Fyer, A. J. (2008). A randomized trial of interpersonal therapy versus supportive therapy for social anxiety disorder. Depression and Anxiety, 25(6), 542-553.

 

Gunderson, J. G., Frank, A. F., Katz, H. M., Vannicelli, M. L., Frosch, J. P., & Knapp, P. H. (1984). Effects of psychotherapy in schizophrenia: II. Comparative outcome of two forms of treatment. Schizophrenia bulletin, 10(4), 564-598.

 

Rosenbaum, B., Harder, S., Knudsen, P., et al. (2012). Supportive psychodynamic psychotherapy versus treatment as usual for first-episode psychosis: two-year outcome. Psychiatry: Interpersonal & Biological Processes, 75(4), 331-341.

 

Hellerstein, D. J., Rosenthal, R. N., Pinsker, H., Samstag, L. W., Muran, J. C., & Winston, A. (1998). A randomized prospective study comparing supportive and dynamic therapies: Outcome and alliance. The Journal of Psychotherapy Practice and Research, 7(4), 261.

 

Clarkin, J. F., Levy, K. N., Lenzenweger, M. F., & Kernberg, O. F. (2007). Evaluating three treatments for borderline personality disorder: A multiwave study. American journal of psychiatry, 164(6), 922-928.

 

Jørgensen, C. R., Freund, C., Bøye, R., Jordet, H., Andersen, D., & Kjølbye, M. (2013). Outcome of mentalization‐based and supportive psychotherapy in patients with borderline personality disorder: a randomized trial. Acta Psychiatrica Scandinavica, 127(4), 305-317.

​

McIntosh, V. V., Jordan, J., Carter, F. A., et al. (2005). Three psychotherapies for anorexia nervosa: a randomized, controlled trial. American Journal of Psychiatry, 162(4), 741-747.

 

O‘Malley, S. S., Jaffe, A. J., Chang, G., Schottenfeld, R. S., Meyer, R. E., & Rounsaville, B. (1992). Naltrexone and coping skills therapy for alcohol dependence: a controlled study. Archives of general psychiatry, 49(11), 881-887.

 

Schindler, B. A., Shook, J., & Schwartz, G. M. (1989). Beneficial effects of psychiatric intervention on recovery after coronary artery bypass graft surgery. General hospital psychiatry, 11(5), 358-364.

 

Salzmann, S., Euteneuer, F., Laferton, J. A., et al. (2017). Effects of preoperative psychological interventions on catecholamine and cortisol levels after surgery in coronary artery bypass graft patients: The randomized controlled PSY-HEART trial. Psychosomatic medicine, 79(7), 806-814.

 

Sjödin, I., Svedlund, J., Ottosson, J. O., & Dotevall, G. (1986). Controlled study of psychotherapy in chronic peptic ulcer disease. Psychosomatics, 27(3), 187-200.

 

Svedlund, J. (1983). Psychotherapy in irritable bowel syndrome: a controlled outcome study. Acta Psychiatrica Scandinavica, 67, 1-86.

 

Taylor, C. B., Zlutnick, S. I., Corley, M. J., & Flora, J. (1980). The effects of detoxification, relaxation, and brief supportive therapy on chronic pain. Pain, 8(3), 319-329.

 

Rutledge, T., Atkinson, J. H., Chircop-Rollick, T., et al. (2018). Randomized controlled trial of telephone-delivered cognitive behavioral therapy versus supportive care for chronic back pain. The Clinical journal of pain, 34(4), 322.

 

Spiegel, D., Bloom, J. R., & Yalom, I. (1981). Group support for patients with metastatic cancer: A randomized prospective outcome study. Archives of general psychiatry, 38(5), 527-533.

 

Mukherjee, A., Mazumder, K., Kaushal, V., & Ghoshal, S. (2017). Effect of supportive psychotherapy on mental health status and quality of life of female cancer patients receiving chemotherapy for recurrent disease. Indian Journal of Palliative Care, 23(4), 399.

 

Blanco, C., Markowitz, J. C., Hellerstein, D. J., et al. (2019). A randomized trial of interpersonal psychotherapy, problem solving therapy, and supportive therapy for major depressive disorder in women with breast cancer. Breast cancer research and treatment, 173(2), 353-364.

 

Naccarato, A. M. E. P., Reis, L. O., Ferreira, U., & Denardi, F. (2016). Psychotherapy and phosphodiesterase‐5 inhibitor in early rehabilitation after radical prostatectomy: a prospective randomised controlled trial. Andrologia, 48(10), 1183-1187.

 

Cabaniss, D.L. 3-Step Supportive Psychotherapy Manual. 2015; Available from: http://www.aadprt.org/training-directors/virtual-training-office.

 

Rockland, L. H. (1993). A review of supportive psychotherapy, 1986-1992. Psychiatric Services, 44(11), 1053-1060.