Psychotherapy is the clinical process of treating mental and emotional health problems by utilizing numerous and diverse psychological techniques and approaches. The practice of psychotherapy is a dialogic process between a client, i.e., the person seeking assistance for problems, and the psychotherapist, who is a trained helping professional, whose explicit intention is to improve the mental health and social functioning of the client who is seeking treatment. Clients are sometimes referred to as patients or consumers, and psychotherapists are often simply called therapists.

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General Psychotherapy Concepts

Psychotherapy is a general term and can be used by anyone involved in therapeutic helping relationships, although it most commonly refers to professionally trained and licensed psychologists, psychiatrists, and social workers. Additionally, other types of counselors and helping professionals, including nurses and educators, are often referred to as psychotherapists.

Counseling, a term often used synonymously with psychotherapy, refers to a less intensive helping relationship, whereby the counselor offers advice in very specialized areas (e. g., career counseling).

The practice of psychotherapy usually entails a long-term, in-depth dialogue, involving therapeutic transference and the revelation of unconscious material. The process of psychotherapy depends on the compassionate therapeutic rapport between the therapist and client, and is therefore best practiced by a professional with training and skill who adheres to ethical guidelines for client confidentiality. Professional organizations clearly outline ethical expectations as well as licensure requirements.

Psychotherapy encourages an intimate dialogue wherein the client reveals his or her fears, conflicts, and behavioral difficulties, and the psychotherapist responds with empathetic listening, advice, and interpretations. The goals of psychotherapy for the client include enhanced insight, improved behavior, increased coping skills, lessening of symptoms, heightened self-esteem, and emotional and psychological growth. Psychotherapeutic tools include a wide assortment of techniques focusing on assisting clients in having a healthier, more aware, and better contented life.

Most psychotherapy involves a thorough psychosocial assessment and history-taking. Problems, conflicts, and interpersonal dynamics are assessed, including a complete evaluation of the client's medical, social, familial, educational, and work-related problems, as well as his or her strengths and weaknesses in coping with life's challenges. Psychotherapy often involves only one person, but Group Therapy involves many similar processes but practiced within a group setting. Group Therapy may be considered a specialized branch of psychotherapy, although many practitioners see it as a distinct therapeutic method.

There are three general branches of psychotherapy: those established from traditional Freudian psychoanalysis, those based in behavioral models, and those rooted in humanistic schools.

All psychotherapy has its roots in Freud's original "talking cure," but psychoanalysis, which is expensive and enormously time-consuming, has branched off into smaller psychodynamic-based schools. Under the influence of Carl Rogers, therapies have developed that are based in client-centered, reflective, therapist-client communication. Other psychodynamic schools include Transactional Analysis and Object Relations Therapy.

Behaviorally-based theories, originally developed to treat obsessive habits and irrational fears, have become the foundation for various schools of cognitive-behavioral therapies, including the ground breaking work of Aaron Beck and Albert Ellis.

Beginning in the 1960s, humanist and transpersonal schools of psychotherapy developed. These approaches focus on client self-actualization and the lessening of the traditionally all-powerful role of the psychotherapist. Some of these alternative schools include Gestalt and Existential Therapies, and Art, Music and Somatic Therapies. Over two hundred different acknowledged theories of psychotherapy are practiced.

Psychotherapeutic Treatment of GLBTQ People

Early psychotherapeutic theory assumed that people with alternative sexual and gender identities were expressing severe psychopathologies. Freud, never as in his philosophy or treatment as his followers, did base his psychosexual theories in the belief that male/female pair-bonding was the developmental norm for adult sexual behavior.

This supposition became the foundation for various psychotherapeutic treatments aimed at treating and attempting to "cure" homosexual and gender-variant behaviors. These "reparative therapies" have included psychoanalysis and behavioral modalities, such as aversion therapy, and have also worked in conjunction with medical interventions such as lobotomies, castrations, sterilizations, and electroshock treatments.

In the 1960s, political activism and social science research converged to challenge the belief system that homosexuals were inherently mentally ill and that their relationships were plagued with psychological problems. Researchers such as Alfred Kinsey, Clellan Ford, Frank Beach, Evelyn Hooker, George Weinberg, and Stephen Morin began to promulgate the then controversial theory that homosexual behavior was a normal variation of human sexual behavior. At the same historical juncture, the gay liberation movement began gaining momentum.