Baltimore Psychotherapist

What is psychotherapy and how does it work?

The term psychotherapy covers a broad range of personal encounters where a community-sanctioned helper (the therapist) meets with a person or persons to provide relief through spoken words or actions. At Via Clinic, this encounter is between a clinician and patient. Therapy works through the formation of a relationship whereby the therapist skillfully influences change in a manner that relieves the individual.

For many people, psychotherapy is the driving force behind lasting change. While medications may quickly provide symptomatic relief, research has shown that psychotherapy provides a gradual and sustainable improvement that continues well beyond completion of therapy.

Our style of psychotherapy is eclectic and individualized to the patient. It draws from training in several evidence-based disciplines:

Psychodynamic Psychotherapy

Psychodynamic psychotherapy, broadly speaking, provides relief through self-exploration and better self-understanding. The patient and therapist work together to identify chronic and problematic styles of relating to one’s self and others. These patterns are discovered through taking a detailed history and through examining the exchanges between patient and therapist.

People with a variety of symptoms – including depression, anxiety and interpersonal struggles – can be good candidates for this therapy. Psychodynamic psychotherapy requires frequent contact, generally ranging from twice per week to every other week, and is not time-limited. Also note, psychodynamic psychotherapy differs from psychoanalysis, which refers to a more intensive (almost daily) form of therapy.

Cognitive-Behavioral Therapy (CBT)

Cognitive-Behavioral Therapy, as the name implies, has two components. The first is cognitive restructuring, which provides relief through changing the way we think about ourselves and the world around us. We are often not aware of these reflexive thoughts that can both create and exacerbate our symptoms.

The second component of CBT refers to direct behavioral changes. This is accomplished by gradually challenging the status quo at a pace that is comfortable and acceptable to both patient and therapist.

Conditions prominently featuring anxiety – such as panic disorder, social anxiety disorder or obsessive-compulsive disorder (OCD) – often respond best to CBT. For more information, visit the National Association for Cognitive-Behavioral Therapists (NACBT).

Supportive Therapy

Supportive therapy refers to direction or intervention by the therapist for the purpose of providing short-term symptomatic relief. In this case, the therapist assumes a more prominent role. Relief is provided through addressing the patient’s functioning or safety. It is often conceptualized as being on the opposite end of the spectrum compared to psychodynamic psychotherapy, where the patient is comparably more active. Patients who experience a severe exacerbation of a mental illness often respond best to this approach.

The path to change is not easily traveled alone. Dedicated work with a skilled therapist helps drive the lasting growth individuals seek. After the initial evaluation, Dr. Andrews will make recommendations regarding the need for, and direction of, psychotherapy. Therapy sessions are 50 minutes in length. Patients in psychotherapy often follow-up every one to two weeks.

Dialectical Behavior Therapy (DBT) Skills

Instead of fighting the wave of emotion, learn to surf.

DBT is among the most highly researched, evidence-based interventions for the management of intense, overwhelming emotions. Formal DBT often requires committing to weekly individual and group therapies over six months. While we highly value and encourage this approach, we also recognize that for some individuals this is not always practical.

Kerry O’Brien, our psychiatric nurse practitioner and clinical counselor, is certified in DBT skills training. As part of her treatment approach, Ms. O’Brien may incorporate these skills, which consist of the following:

Distress Tolerance

Sometimes we attempt to cope with emotions in ways that are ultimately hurtful or unproductive, such as through isolation, obsession, over-eating, self-injury or rage.
Distress tolerance teaches us to build resiliency and soften the impact of emotional events.

Mindfulness

We might get too “in our own head.” Typically this results in feeling overly internalized, with our thoughts stuck in the past or the future.
Mindfulness teaches us to be present and non-judgmental in a given moment. Through this practice, we can learn to overcome habitual negative thoughts about ourselves or others.

Emotion Regulation

Emotions get complex. Sometimes we feel two different ways at the same time (ambivalence). Sometimes we feel emotions about our emotions (e.g., feeling guilty about getting angry).
Emotion regulation involves recognizing and observing how we feel. We can learn to restructure our thoughts and behaviors, so as to not get overwhelmed or engage in unhealthy coping.

Interpersonal Effectiveness

We are all connected. The people in our lives can bring both joy and pain. Our skill with navigating the dynamics of relationships can set us on a more fulfilling path.
Interpersonal effectiveness sharpens the tools needed to actively listen, be assertive, create healthy boundaries, and negotiate solutions to shared problems.

Individual Psychotherapy