Psychotherapies: Models, Indications, and Mechanisms
Core concepts
Understand the theoretical basis and typical indications of the main modalities: cognitive behavioural therapy (identifying and testing maladaptive thoughts and behaviours), psychodynamic psychotherapy (unconscious conflict, transference, defence mechanisms), interpersonal therapy (role transitions, grief, disputes, deficits), dialectical behaviour therapy (emotion regulation and distress tolerance for borderline presentations), and systemic/family therapy (interactional patterns). Know concepts such as transference, countertransference, resistance, and the therapeutic alliance.
Traps
Questions often ask which therapy is first-line for a given presentation, or test the difference between supportive and exploratory approaches. Do not assume that all therapies are equivalent across disorders; evidence-based indications differ. Be careful with terms: transference is the patient's projection onto the therapist; countertransference is the therapist's emotional response.
Worked example
A patient with recurrent self-harm and unstable relationships is offered a structured, skills-based therapy targeting emotion regulation. The rule of thumb: match the therapy to the target problem (skills for emotion dysregulation, exposure for anxiety, interpersonal work for role transitions), and confirm that the patient can engage with the format.
Key points for revision
Know the mechanism, target, and typical indication of each modality.