The theory of Freudian psychoanalysis is a psychological current and a pseudoscience founded by Sigmund Freud, an Austrian neurologist, at the end of the 19th century. As a result, new currents and therapies emerged. Here we will know one of them, the support psychotherapy .

Supportive psychotherapy is based on psychoanalysis, although it is aimed at treating a great diversity of patients and clinical pictures. One of its central elements is the therapeutic alliance. We will know in detail what this type of intervention consists of.

Origin of supportive psychotherapy

The therapy initially proposed by Sigmund Freud was the psychoanalytic type of cure, a therapy where the patient would lie down on an armchair or couch and express mental images and ideas that would pass through his mind under the indications of the psychoanalyst. The sessions took place between 4 and 5 times a week. It was a therapy that lasted several years (practically “all my life”).

Later, new forms of therapy emerged, the so-called psychoanalytic psychotherapies, which are three in number:

  • Psychoanalytic psychotherapy proper.
  • Brief dynamic psychotherapy.
  • Supportive psychotherapy.

In the next few lines we will see how the latter was conceived.

Characteristics

Supportive psychotherapy, as we have seen, has its roots in psychoanalysis. However, it is currently used by many schools of psychotherapy, approaches and techniques.

Its area of intervention is broader than that of the other two psychoanalytic psychotherapies mentioned (as well as that of the psychoanalytic type of cure). It focuses on seeking the relief of the patient’s suffering and on restructuring his or her personality.

The sessions are held face to face, with a variable frequency and duration of sessions between 30 and 60 minutes.

Applications

This is a type of intervention focused on three fundamental objectives: to enable the expression of feelings, strengthen defences and contain anxiety . More specifically, it is aimed at maintaining or reinforcing the patient’s adaptive defences, so that these allow them to cope as best as possible with their day-to-day life or their situation.

Supportive psychotherapy emphasizes mobilizing the patient’s strengths to increase their self-esteem . It uses the patient’s adaptive defences and coping strategies in a positive way, so that the patient can better cope with their life situation or crisis.

Indications

As for the indications of brief psychotherapy, the patient is not required to have special psychological qualities. This differentiates it from the other two psychoanalytic psychotherapies, as well as from the psychoanalytic type of cure, which require insight on the part of the patient and good tolerance to frustration.

Supportive psychotherapy is often used for a wide range of disorders and patient types. The indication depends on the specific clinical situation, rather than the type of psychopathology.

It is generally considered that the more severe the crisis and the greater the fragility of the patient, the more support he will require ; likewise, he will also need more support the more his psychic structure is deteriorated or damaged.

Supportive Psychotherapy Techniques

The techniques in supportive psychotherapy are aimed at forming an enabling environment in therapy. It tries to provide a climate where the patient feels comfortable to freely express their concerns and worries.

Thus, the most used techniques in this type of psychotherapy are: case formulation, framing, active listening and therapeutic alliance.

1. Formulation of the case

Once the patient has been listened to in detail in various interviews, his case is formulated. The formulation of the case consists of a set of hypotheses about the causes, precipitants and influences that maintain the patient’s problems . It is therefore a conceptualization of your case, beyond the diagnosis or psychopathology.

2. Framing

It is the conscious expression (with unconscious elements), voluntary and propositional of the time, place and end of the therapy. The frame defines who, why or for what, when, where, how and at what price will be the patient and the therapist; that is to say, they would be the “conditions” of the therapy.

The frame structure and gives a sense of reliability to the psychotherapy and the therapist .

3. Active listening

As obvious as it may seem, it’s all about listening, but doing it with quality. Respecting the silences, providing elements that allow the patient to know that he/she is being heard , maintaining eye contact, etc. In short, to listen to the patient with respect and in an attentive manner. It is an element present in any type of psychotherapy.

With proper active listening, the patient will feel free to express his or her feelings, emotions, fears and conflicts in his or her own way.

4. Therapeutic alliance

According to Sigmund Freud, the first duty of every therapist is “to bring the patient as much into the therapy itself as into the person of the therapist”. The therapeutic alliance is about the degree to which the patient experiences the relationship with the therapist as solid and useful in order to achieve his therapeutic goals .

Bordin (1979) breaks down the therapeutic alliance into three elements:

  • Agreement between patient and therapist regarding psychotherapy goals.
  • Agreement between patient and therapist about the tasks involved in the psychotherapy being performed.
  • Link between patient and therapist and perception that there is a common commitment and reciprocal understanding of psychotherapeutic activities

Bibliographic references:

  • Avila, A; Rojí, B; Saúl, L.A. (2004). Introduction to psychodynamic treatments. UNED. Madrid.
  • Alarcón, A. (2008). Technical foundations of supportive psychotherapy. Rev. Colomb. Psychiatry, 37(1), 114-126.