EFPT Psychotherapy Guidebook chapter on Supportive Psychotherapy
Supportive psychotherapy is by far the most commonly used method of psychotherapy around the world. It is one of the most commonly trained forms of psychotherapy, training or residency programs in Europe, US, Canada and Australia include supportive psychotherapy – or at least its techiques.
Supportive psychotherapy actually takes place in almost every psychiatric clinical setting to a degree. Therefore it is advisable to start deepening your therapeutic skills and practical experience with supportive psychotherapy.
As the author of one of the founding books in the field and the owner of the most cited definition, Pinsker defines it as a “dyadic treatment and use direct measures to ameliorate symptoms and maintain, restore or improve self-esteem, ego functions and adaptive skills”. The empirical utilization of supportive techniques in treatment has been present for at least two centuries now – but the developent of what we today call as supportive psychotherapy can be traced through the approaches of Freud’s successsors in the second half of 20th century and their differences from his original psychoanalytical technique. Once called as the “Cinderella of Psychotherapies”, there has always been a debate if it is a form of psychotherapy in its own right or a compilation of techniques. A great review on the history (spoiler: dates back to ancient Greeks!) and development of supportive psychotherapy can be found in the book “Clinical Manual of Supportive Psychotherapy” by Novalis and colleagues.
Supportive techniques can be employed in a spectrum of therapies ranging from counseling to rather expressive approaches. The advantage is you could move through the spectrum depending on the needs and capacity of the patient. It can be implemented in hospital settings, for chronically ill patients to restore daily functioning or to help patients resolve crises. The techniques may change over the course of the therapy – depending on patient’s progress.
Although it is implemented in various settings, research spesifically investigating the effect of supportive psychotherapy is scarce. What is researched is mainly supportive techniques. Yet, one inspiring research that you would benefit from taking a look is the Psychotherapy Research Project of the Menninger Foundation.
Theoretical and technical aspects carry influences from psychodynamic, interpersonal and cognitive behavioral therapy approaches – this can allow you to have a broader perspective. It is even mentioned that supportive psychotherapy provides effective treatment for broadest range of clinical problems. If you are curious, then you can enjoy many valuable works in both fields and find out about different techniques. In their illustrated guide, Winston and colleagues say that beginner therapists, who cannot yet attempt expressive psychotherapy, can provide good supportive-expressive treatment.
It will require long hours of theoretical learning and following patients with a supervisor. In more structured training programs, theoretical training generally lasts for one year, simultaneously with or followed by another year of practical training. The reward is - it allows you to work with a wide range of patients and problems.
It is not only about knowing the techniques, but also having the correct attitude. You’ll need regular supervisions, group supervisions are also helpful. It is not strictly required for you to have your own psychotherapy, but as this form of psychortherapy contains psychodynamic elements and in general, sitting on the other chair is recommended.
Learning Supportive Psychotherapy: An Illustrated Guide, by Winston, Rosenthal and Pinsker: This is a book and DVD in which you can find very useful examples of interviews with the patient.
A Primer of Supportive Psychotherapy, by Pinsker: Quite old, but provides essential, easy to understand information on the technique.
Dynamic Supportive Psychotherapy: A fifty-pages handbook with basics. Of course, only a handbook will never be enough, but good for daily use, eg. Reading from your tablet
Instruction to Supportive Psychotherapy, by Winston, Rosenthal and Pinsker: Patient-therapist dialogues and case-vignettes, on course and interventions of supportive psychotherapy
Of course, theoretical psychodynamic literature, different approaches (drive theory, object relations theory, ego psychology, attachment, etc.) are all worth reading to increase your competence. Try to read some of the classical books during your training, which would introduce you the context and the historical development of therapies- but keep in mind most of them may not be taken as an updated source of knowledge.
The Nuts and Bolts of Supportive Psychotherapy
5 keys to good results with supportive psychotherapy