Supportive psychotherapy

Supportive psychotherapy is a psychotherapeutic approach that integrates various schools to provide therapeutic support. It includes components from therapeutic schools such as psychodynamic, cognitive-behavioral, and interpersonal conceptual models and techniques.[1] The aim of supportive psychotherapy is to reduce or to relieve the intensity of manifested or presenting symptoms, distress or disability. It also reduces the extent of behavioral disruptions caused by the patient's psychic conflicts or disturbances.[2] The objective of the therapist is to reinforce the patient's healthy and adaptive patterns of thought behaviors in order to reduce the intrapsychic conflicts that produce symptoms of mental disorders. Unlike in psychoanalysis, in which the analyst works to maintain a neutral demeanor as a "blank canvas" for transference, in supportive therapy the therapist engages in a fully emotional, encouraging, and supportive relationship with the patient as a method of furthering healthy defense mechanisms, especially in the context of interpersonal relationships.

Uses

This therapy has been used for patients suffering from severe cases of addiction as well as bulimia nervosa, stress and other mental illnesses.[3]

Supportive psychotherapy is used as an initial therapy, to be reduced and not to be prolonged, in situations or periods where there is a lack of means for a systematic approach or behaviorism. Examples of such situations include:

• critical negotiations
• volatile but unavoidable everyday life or decisive situations
• compromises (to introduce at least minimal operational, efficient relationship conditions) in long term, engaged relationships, based on lasting agreements

A systematic review examined the effectiveness of supportive therapy for people with schizophrenia:

Supportive therapy versus any other psychological or psychosocial treatment[4]

Summary
There are few data to identify clear differences in a series of outcomes between supportive therapy and more sophisticated therapies for people with schizophrenia.[4]
Outcome Findings in words Findings in numbers Quality of evidence Global state Relapse. Follow-up: 2 to 3 years Supportive therapy is not better - or worse - for making a difference to the risk of relapse when compared with other psychological treatments, but, at present it is not possible to be confident about the difference between the two treatments and data supporting this finding are very limited. RR 1.19 (0.66 to 2.16) Very low Service outcomes Hospitalization. Follow-up: 12 weeks to 2 years Supportive therapy may increase the chance of being hospitalized, but, at present there are only very limited data supporting this finding. RR 1.82 (1.11 to 2.99) Very low Mental state No clinically important improvement. Follow-up: 1 to 2 years Supportive therapy may increase the chance of experiencing 'no improvement' in mental state, but, at present there is only very limited data supporting this finding. RR 1.27 (1.04 to 1.54) Very low Leaving the study early Follow-up: 10 weeks to 3 years Supportive therapy probably causes little or no increase to the chance of being lost to follow-up or finding treatment unacceptable or being withdrawn from treatment, but the difference between the two treatments is not clear. Data supporting this finding are based on moderate quality evidence. RR 1.03 (0.87 to 1.21) Moderate General functioning Average score (GAF and GAS) Follow-up: 12 to 18 months This outcome measure was used in studies but no data are clearly reported. Very low Satisfaction with treatment Recipient of care not satisfied with treatment. Follow-up: 1 years Compared with other therapies, supportive therapy may increase the chance of be unsatisfied with treatment, but, at present there are only very limited data supporting this finding. RR 3.19 (1.01 to 10.07) Very low Quality of life Average score (QLS) On average, people receiving supportive therapy scored a little lower than people treated with any other psychological or psycho-social treatment but there was no clear difference between the groups. The meaning of this in day-to-day care is unclear and data supporting this finding are very limited. MD 0.07 lower (21.11 lower to 20.97 higher) Very low

Internet-based

Internet-based supportive psychotherapy is a type of supportive psychotherapy that is characterized by having a two-hour initial meeting between the client and therapist, and then periodic and occasional study conducted by therapist through email and telephone.[5]

Research directions

Some studies suggest that genetics, animal studies and neuroscience may have an impact or play a role in supportive psychotherapy.[6]

See also

• Phenomenology

References

1. Winston, Arnold; Richard N. Rosenthal; & Henry Pinsker. Introduction to Supportive Psychotherapy. Washington, D.C., American Psychiatric Publishing, 2004.
2. Dewald, P. A. (1994). "Principles of supportive psychotherapy". American Journal of Psychotherapy. 48 (4): 505–518. doi:10.1176/appi.psychotherapy.1994.48.4.505. ISSN 0002-9564. PMID 7872414.
3. Werman, David S. The Practice of Supportive Psychotherapy. New York, New York, Psychology Press, 1984.
4. Buckley, L; Maayan, N; Soares-Weiser, K (2015). "Supportive therapy for schizophrenia". Cochrane Database of Systematic Reviews. 4 (4): CD004716.pub4. doi:10.1002/14651858.CD004716.pub4. PMC 6486211. PMID 25871462.
5. Litz, Brett T.; Engel, Charles C.; Bryant, Richard A.; Papa, Anthony (2007). "A Randomized, Controlled Proof-of-Concept Trial of an Internet-Based, Therapist-Assisted Self-Management Treatment for Posttraumatic Stress Disorder". American Journal of Psychiatry. 164 (11): 1676–1684. doi:10.1176/appi.ajp.2007.06122057. PMID 17974932.
6. Appelbaum, Ann (2008). "Supportive Psychotherapy for Borderline Patients". Social Work in Mental Health. 6: 145–155. doi:10.1300/j200v06n01_12.