ALL INDIA INSTITUTE OF MEDICAL SCIENCES,

JODHPUR
COLLEGE OF NURSING
Classroom Presentation
SUBJECT- CLINICAL SPECIALITY 1st
(PSYCHTRIC NURSING)
UNIT-X (Psycho social and physical therapies)
TOPIC- Individual Therapy

SUBMITTED TO: SUBMITTED BY:

Mr. Aashish Parihar Ganesh Kumar Bhambu
Assistant Professor M.Sc. Nursing
College Of Nursing 1st YEAR
AIIMS, JODHPUR AIIMS, JODHPUR

DATE OF SUBMISSION:-31/03/2023

1
INTRODUCTION-

Individual psychotherapy is a method of bringing about change in a person by exploring his

or her feelings, attitudes, thinking and behavior.
Therapy is conducted on a one-to-one basis that is the therapist treats one patient at a time.
Individual therapy is a psychotherapy implemented by a trained professional, usually a
therapist or psychologist, to help a client work through a problem. The ways that individual
therapy is implemented varies widely depending upon the psychological problem
experienced by the client, the personal beliefs and practices of the therapist, and the
individual needs of the client.

DEFINITION – Individual therapy is a process through which clients work one-on-one with
a trained therapist- in a safe, caring, and confidential environment to explore their feelings,
beliefs, or behaviours, identify aspects of their lives that they would like to change, better
understand themselves and others, & set personal goals of their life.
PURPOSE OF INDIVIDUAL THERAPY

Therapy is conducted on one-to-one basis, i.e. the therapist treats one patient at a time.
Such therapy helps to:-

 Understand themselves and their behavior.

 Make personal changes.

 Improve interpersonal relationships.

 Get relief from emotional pain or unhappiness.

INDICATIONS-

 Stress related disorders.

 ADHD (Attention deficit hyperactivity disorder)
 Alcohol and drug dependency.
 Sexual Disorders
 Marital disharmony.
 Mild to moderate major depression
 Mild to moderate anxiety disorder
 Crisis, acute distress or acute adjustment disorder.
 Eating disorders.

TYPES OF INDIVIDUAL PSYCHOTHERAPY

1.Psychoanalysis- Psychoanalytical therapy was developed by Sigmund Freud. It focus on

unconscious forces such as repressed emotions & memories, internal conflicts & childhood
trauma on mental life & adjustment of the individual.
The aim of therapy is to bring all repressed emotions and experiences to conscious
awareness, so that the patient can work towards a healthy resolution of his problems, which
are causing the symptoms.

2
Psychotherapy is used primarily in bringing about basic modification in the personality. This
is done by establishing a constructive therapeutic relationship.

2.Hypnosis- The induction of a state of consciousness in which a person apparently loses the
power of voluntary action and is highly responsive to suggestion or direction. Its use in
therapy, typically to recover suppressed memories or to allow modification of behaviour.

It induced in a patient by suggestions of relaxation & concentrating attention on a single

object. The client becomes highly suggestible, submissive & response to therapist influence.
He can be induced to recall forgotten events, becomes insensitive to pain, gain relief from
tension, anxiety & other psychological symptoms. It affects behavioural change & control of
attitude.

Changes that occur during hypnosis: The person becomes highly suggestible to the
commands of the therapist. There is an ability to produce or remove symptoms or
perceptions. Amnesia for the events that occurred during the hypnotic state.

3.Abreaction- Abreaction is a process by which repressed material, particularly a painful

experience or conflict is brought back to consciousness. Abreaction, the dramatic reliving of
traumatic events under hypnosis, is a powerful therapeutic intervention useful in the
treatment of victims of trauma. It is most useful in acute neurotic conditions caused by
extreme stress (Posttraumatic Stress Disorder (PTSD) like terrorist incidents, serious
accidents, or physical or sexual assault in adult or childhood, etc).

METHODS:- Abreaction can be brought about by strong encouragement to relieve the

stressful events. The procedure is begun with neutral topics at first, & gradually approaches
area of conflict. Abreaction can be done with or without the use of medication.

4.Reality therapy-
Reality therapy (RT) is an approach to psychotherapy and counseling, Developed by William
Glasser in the 1960s. This is a psycho therapeutic technique which focuses on the present
behaviour & development of patient’s ability to cope with the stress of reality & take a
greater responsibility for the fulfillment of his needs.
To achieve these purposes the therapist becomes involved in an active relationship with
patient, rejects his unrealistic behaviour & teaches better ways to meet his need in the real
world. The patient need to be stressed on that the past cannot be changed, so he must take
responsibility of right or wrong actions of present.

5.Supportive Psychotherapy (Surface Psychotherapy) - The therapist helps the patient to

relieve emotional distress. It is a form of “surface therapy”. The therapist reinforces the
existing defenses used by the client symptoms without probing in to past or attempting to
change or alter the basic personality of the individual.

APPROACH OR TECHNIQUES: There are four main approaches to individual therapy

which include psychodynamics therapy, humanistic therapy, behavioral therapy and cognitive
therapy.
A. PSYCHODYNAMICS THERAPY:- is primarily based on psychoanalytic theory, the
assumption that when a patient has insight into early relationships and experiences as the
source of his or her problems they can be resolved.

3
B. HUMANISTIC THERAPY:- centres on the patients view of the world and his or her
problems. The goal is to help patients realize their full potential through the therapist’s
genuineness, unconditional positive regard, which fosters the patient’s sense of self worth and
empathetic understanding of the patient’s point of view. This therapy is nondirective but
focuses on helping the patient to explore and clarify his or her own feelings and choices.

C. BEHAVIOUR THERAPY does not foster awareness but emphasizes the principles of
learning with positive and negative reinforcement and observational modelling.
Behavior Techniques –
Systematic desensitization-It is developed by Joseph Wolpe.
Relaxation training: Relaxation produces physiological effects opposite to those of anxiety

Hierarchy construction: 10 - 12 condition in order or increasing anxiety

Desensitization to stimulus; Gradually exposure of individual from least to most anxiety

provoking situation in a deeply relaxed state.

It is suitable for -
 Anxiety disorder
 Phobic anxiety disorder
 Obsessive Compulsive disorder
 Certain sexual disorder

Flooding
Exposing the individual directly with the Situation
Based on the principles that escaping from anxiety reinforces the anxiety through
conditioning Prematurely withdrawing from the situation may reinforce the phobia.
Not suitable for the client with the heart diseases and fragile psychological adaptation.
Aversion Therapy
When a noxious stimulus (punishment) is presented immediately after a specific behavioral
response. theoretically, the response is eventually, the response is eventually inhibited and
extinguished.

Time out-
Time put is a aversion stimulus or punishment during which the client is removed from the
environment where the unacceptable behaviour is being exhibited.

The client is usually isolated so that reinforcement from attention of others

is absent.

D. COGNITIVE THERAPY focuses on identifying and correcting distorted thinking

patterns that can lead to emotional distress and problem behaviours. Cognitive therapists
believe that patients change their behaviours by changing their maladaptive thinking about
themselves and their experiences. Patients are taught problem solving skills and stress
reducing methods. They learn that their psychological difficulties or problems can be solved
through cognitive processing.

4
GOAL OF INDIVIDUAL THERAPY: In every type of psychotherapy, the psychologist
will help you develop specific goals for the therapy. This will include a broad overall goal as
well as more focused goals that may change from session to session. The therapist will also
help you to:
A. Identify coping strategies :- These may be coping strategies that have helped in the past.
The psychologist will teach to adapt these strategies to the current situation. If the coping
strategies have been unsuccessful in the past, the therapist will guide in the development of
new ones.

B. Rearrange life priorities:- Sometimes people have psychological problems because they
have an irrational expectation of themselves and others. This increases the pressure on
everyone and can lead to stress, anxiety and depression. By rearranging the expectations and
priorities you may be able to avoid unnecessary stress.

C. Identify personal strengths: Sometimes during times of psychological crisis it is easy to

focus on the weaknesses and what you do not have, instead of the strengths and the
wonderful things one do have. Psychologists will draw the attention to positive aspects about
oneself, and help you rediscover and bring them out again. This will help to believe in
oneself.

Advantages and disadvantages of individual therapy:

ADVANTAGES DISADVANTAGES
1. Can be set up quickly. 1.Client can talk but not make any real changes.
2. Patient with a trained professional 2.Some clients don't have interest in talking about
to talk to. their problems.
3. Helps define the problem the client 3.May not provide enough help for the severity Of
is having. problems.
4. Improves communication skills 4.It is costly in form of time, money and energy.
5. Teaches better way to cope.
5.It is not useful in uncooperative patient.
6. Therapy given without medicine
6.Increase dependency.
and ECT.
7. Very useful in cooperative and
motivated patient.

ROLE OF NURSE

 Reinforce positive behavior.

 Co-ordinate with other team members.
 Allow patient to take decision.
 Explain about the treatment.

5
  Develop a trusting relationship.
 Set limits on unexpectable behavior.

Research article:
Randomized comparative study of group versus individual cognitive behavioural therapy
for obsessive compulsive disorder1
H Jónsson  et.al.

Objective: The primary aim of the study was to compare the effectiveness of group and
individual cognitive behaviour therapy (CBT) for obsessive compulsive disorder (OCD).

Method: One hundred and ten out-patients with OCD were randomly assigned to 15 sessions
of either group CBT or individual CBT. Outcome measures were administered before and
after treatment, as well as at 6- and 12-month follow-ups. The study was supplemented by a
meta-analysis of accomplished comparative studies of group vs. individual CBT for OCD.

Results: Large and stable pre-post effect sizes were found for both treatment conditions in
the study (d = 1.06-1.24 on the Yale-Brown Obsessive Compulsive Scale). There were no
significant between-group differences in outcome at any data point (ds= -0.13 to 0.15). The
meta-analysis of four accomplished comparative studies (including the present one) found a
between-group mean effect size of (d= 0.15 favouring individual over group CBT at
posttreatment (95% confidence interval, -0.12, 0.42).

Conclusion: The results of this study suggest that OCD can be treated effectively with a
group format of CBT, thus sparing some therapist resources, although the four accomplished
comparative studies do not rule out the possibility of a small superiority of individually
conducted CBT.

SUMMARY

We have discussed about definition, purpose, indication, types of individual therapy,

advantage and disadvantage of individual therapy.

CONCLUSION
Individual psychotherapy is a method of bringing about change in a person by exploring his
or her feelings, attitudes, thinking and behavior. lt is a form of therapy that deals with
conscious conflicts and current problems.

Goals are to remove or modify existing symptoms. Promote positive personality & growth
and development.

6
Reference

1. R Shreevani A guide to mental health& psychiatric nursing 3 rd edition Jaypee

publishers Page no 144.
2. Stuart Gail W,Laraia Michele T.Principles and practice of Psychiatric
nursing.8th edition Elsevi Elizabeth M .Varcarolis; Foundations Of Psychiatric Mental
Health Nursing; Saunders Publications ;6th Edition
3. Dr Bimla Kapoor, Textbook Of Psychiatric Nursing Volume-II, Kumar Publishing
House, First Edition, Page no 114
4. Mary C.Townsend, Essentials Of Psychiatric Mental Health Nursing" F.DA. Davis
Company, Fourth Edition, Page no-112
5. Jónsson H, Hougaard E, Bennedsen BE. Randomized comparative study of group
versus individual cognitive behavioural therapy for obsessive compulsive disorder.
Acta Psychiatr Scand. 2011 May;123(5):387–97.