Questions & Answers
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What is short term or brief psychotherapy?
Short-term or brief psychotherapy is problem focused and time-limited. It can be anywhere from one to twelve sessions. Brief therapy includes, but is not limited to, (1) crisis intervention for dealing with situational crises that occur in ones life (e.g., marriage, divorce, death, disability, losses and other tragedies); (2) developing coping strategies for dealing with life transitions, career issues, dilemmas, situational stresses; (3) problem centered work for dealing with specific issues, habits, fears, and phobias. Once it is established that the concerns are amenable to brief-psychotherapy, specific goals will be determined and a treatment plan will be developed, including the length of treatment. Specific techniques, including homework, are employed depending upon the problem.
Is brief psychotherapy helpful?
Brief psychotherapy can often prevent the need for more extensive treatment later on. Frequently simply making the decision to visit a psychologist can help you formulate your thinking and begin the process of gaining a fresh perspective. Psychological problems do not develop all of a sudden. They usually develop similarly to putting one grain of sand in a sack over your shoulder. One grain of sand placed in a sack one at a time will yield a mighty heavy sack over a period of years. When this happens it often takes a considerable amount of time to undo the damage. Early detection is the key to a rapid solution and can prevent a relatively minor concern from developing into a chronic issue.
What is Group Therapy and how is it different from Individual Psychotherapy?
Group therapy is different from individual therapy. Individual psychotherapy focuses on your inner psychological life. It deals with your emotional reactions to events, your unconscious conflicts, and it attends to causes of behavior and personality development. It focuses on internal, individual processes assisting people in becoming aware of their inner life, their beliefs, and emotional reactions. Past traumas, current struggles, as well as dreams, are analyzed in to gain resolution and mastery.
The primary focus of group therapy is interpersonal and interactional rather than intrapersonal and intrapsychic. We focus on the nature of the interactions and the how and why of each person's reaction. The focus is on the group and between members, not between members and the therapist. It is not individual therapy in a group, although there is time for each member to work on his or her issues. The group rather than the individual is the primary focus. Group therapy focuses on interpersonal interactions. It becomes the laboratory for practicing new behaviors. You can become aware of many struggles through your interaction with others. The group is a microcosm of the world in which you live. People stimulate each other in various ways. Because there are different personalities in the group you have the opportunity to examine your reactions to other people. Frequently the people you meet in group therapy represent others in your past or present life with whom you have difficulty. In group therapy you have the opportunity to worth through these situations, where in your ordinary life you might avoid these people or have difficulty. You have the opportunity to learn ways of dealing with these situations rather than avoiding them. The group can offer you valuable feedback and help you discover alternative ways of thinking, feelings, and behaving. In group therapy you learn that you are not alone in your reactions to events and people. You will find support from others who will share their concerns and how they are approaching problems of living. The combined effort of the group becomes the healing agent.
What causes addictions?
Most people do not intend to become addicts. Many addictions start with experimentation. Social pressure, as with cigarettes or marijuana, may influence us to experiment. The human need to be accepted, to be part of the crowd, is very powerful. Some people are more prone to become addicted than others as a function of genetic predisposition. Others are more emotionally needy than others and thus more prone to become addicts. And still others are seeking a way to stop emotional pain; for some it becomes a form of self-medication. Cigarette and alcohol addictions, for example, begin within a social context. Once we have experimented some people find that the substance gives immediate pleasure and offers an escape from current psychological pain and/or loneliness. Addicts do not think of the long-term consequences of their behavior. They live in the moment. Once addicted, these individuals need more of the substance to maintain themselves. At this point there is both the physical and psychological addiction. Without help it is very difficult to break this cycle. A combination of psychological intervention and social support offers the best chance for recovery from addiction.
What is your theoretical orientation?
This is a question that I often asked. Are you Freudian, Jungian, transactional, cognitive, behavioral, or humanistic? Though I was classically trained in clinical psychology and psychoanalytic theory, after so many years in practice, I have stopped allying myself with one particular school. Each school has something to contribute. I found that strict adherence to one particular school of thought was intellectually stifling and practically inappropriate. Orthodoxy and parochialism were too confining. I have been exposed to most theoretical orientations and trained in several. I have found it more helpful to focus on the individual seated before me than to focus on any one theory. I prefer to design the course of treatment to suit this unique person without adhering to only one approach, one orthodoxy. And I have found that frequently I have to shift approaches in midstream depending on the circumstances. Thus in practice I may utilize a variety of approaches to understanding an individual and treating a problem. In my own thinking, however, I tend to conceptualize along existential-humanistic and psychoanalytic lines. I view people as a product of their internalizations of family interactions and experiences, their social interactions in the world, and the factors that make people essentially human, i.e., the human condition. These three sets of variables interact resulting in unique personalities.
What is the difference between a Clinical Psychologist, Marriage, Family, Child Therapist, Psychiatrist, and Social Worker?
Clinical Psychologists hold a Bachelors degree in Psychology and after attending graduate school for 4 - 6 years obtain either a Doctor of Philosophy (Ph.D.) or Doctor of Psychology (Psy.D.) degree specializing in clinical psychology studying the psychological basis of behavior. Subsequently they complete a one-year internship in a clinical setting. On completion of this training they ate then ready to sit for the licensing examination in Psychology. The practice of Clinical Psychology includes psychodiagnosis, psychological testing, neuropsychological evaluations, and psychotherapy with individuals, groups, and couples either in private practice or in a clinical setting.
Marriage and Family Therapists (MFT) hold a Bachelor's degree in a social science and after two years of graduate school obtain a Master's of Arts (MA) degree in a behavioral science. Subsequent to their educational training, they must obtain 3000 (about one and one-half years) supervised hours of clinical experience learning skills in family therapy and individual psychotherapy. MFTs are primarily trained to deal with families and individuals within the context of the family. After receiving their license MFTs can practice in both private and clinical settings.
Psychiatrists hold a Bachelor's degree usually with pre-medical studies as a major. They then spend four years attending medical school and obtain a Doctor of Medicine (M.D.) degree after which they complete a three-year residency in psychiatry studying the biological basis of behavior. They study psychopathology and psychopharmacology and learn to administer psychotherapy, electro-convulsive therapy, and prescribe medication.
Social Workers hold a Bachelor's degree in a social science and after three years of graduate school studying the role of culture, society, and the environment on human development obtain a Master of Social Work (M.S.W.) degree. After interning for two years Social Workers can sit for a license as a Licensed Clinical Social Worker (LCSW) and practice in either a clinical or private setting.
Each of the disciplines has a decidedly different base as its foundation: Clinical Psychology studies the developmental, behavioral, and psychological aspects of human behavior; Marriage and Family Therapy emphasizes the role of the family in human behavior; Psychiatry studies the medical-biological basis of human behavior; and Social Work emphasizes the role of society in human development.
What is a sex therapist?
A sex therapist is a licensed mental health professional (psychologist, psychiatrist, social worker, or marriage, family, child therapist) who has had additional training and experience in treating sexual dysfunctions. In addition to their professional license, the sex therapist is certified by the American Association of Sex Educators, Counselors, & Therapists as a Certified Sex Therapist or holds a Diplomate from the American Board of Sexology.
Dr. Dreyfus' blog with additional information
