General Principles of Psychotherapy

Psychotherapy is an effective treatment for a variety of conditions, whether alone or in combination with medications. The therapeutic alliance is a feature common to all effective psychotherapies and is correlated with clinical outcomes. Most psychotherapies utilize the principle that symptoms reflect enduring maladaptive patterns in cognitions, emotions, behaviors, and relationships, and that each of these areas is intimately connected with the others. A goal of all psychotherapies is to increase the range of behaviors available to the patient for the purpose of modifying maladaptive patterns. While multiple forms of psychotherapy have been developed to treat the wide spectrum of psychopathology, the two largest families are cognitive behavioral therapy (CBT) and psychodynamic psychotherapy. This chapter describes some concepts and assumptions underlying each modality, highlighting features which may be similar across psychotherapies.