Psychotherapy and Psychological Treatments
What the exam tests
Psychotherapy items test indications, mechanisms, structure, boundaries and common factors. You must match the therapy to the problem and know when therapy alone is unsafe.
Core rules
- CBT targets unhelpful thoughts and behaviours through psychoeducation, cognitive restructuring and exposure; it is structured and present-focused.
- Psychodynamic therapy explores unconscious conflict, transference and early relationships; it is less directive and longer-term.
- Supportive therapy provides empathy, advice and stabilisation; it is useful in crisis and severe illness.
- Interpersonal therapy targets role transitions, grief, disputes and social deficits.
- DBT combines skills training, mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness; it reduces self-harm in borderline personality disorder.
- Informed consent, confidentiality and its limits, boundaries and termination are part of safe practice.
Worked example
A young woman with borderline personality disorder repeatedly self-harms after minor rejections. DBT is indicated because it targets emotional dysregulation and teaches distress tolerance and interpersonal skills. The reasoning is that insight-oriented therapy alone may intensify affect without skills. Therapy should be structured, coordinated with risk management and not used as a substitute for emergency medical care.
Traps that cost marks
Do not offer exploratory therapy as the sole treatment in acute psychosis or severe depression. Do not promise absolute confidentiality. Do not ignore transference and countertransference. Do not continue therapy without review when risk escalates.