Watching Psychotherapy

by Ed Meidenbauer

Two people talking: picture this activity, and you will easily come up with an image of psychotherapy. Conversation between two people is a basic human activity. Psychotherapy, to the casual observer, looks like two people talking.  It’s been nicknamed “talk therapy” with good reason, but is talk all there is to it?

Whether or not they have actually been to a therapist, most people have a mental image of psychotherapy due in large part to its portrayal in movies and TV shows. Examples of therapy in popular media tend to heighten the drama of therapy for the sake of the plot. This may be done by stressing the personal dilemmas of the therapists themselves or by featuring clients with extraordinarily memorable presenting problems. Is this truly what psychotherapy is about?

APA Books publishes therapy demonstrations on video—hundreds of hours of demonstrations that are used for training mental health professionals. After watching a number of these (or all of them, as I have), a broad overarching pattern emerges that, on the surface, seems simple but, in actuality, is quite profound. Most of these demonstrations show two people talking and include some fairly typical social questions (“How was your week?” “How are things going at work?” “So, can you tell me more about this project you are so excited about?”). These seem like parts of conversation you might hear every day until you realize that all of the questions are coming from one person 99% of the time, the therapist. Even when the therapist is not asking questions, his or her comments or statements always directly apply to the client. This is a major distinguishing feature of the psychotherapy interaction: The client is doing most of the talking, all of it is about him or herself, usually with hardly a question for the therapist. The strangely imbalanced way these two people are talking is at the core of psychotherapy. In no other type of relationship is one person attending another so closely, so consistently, and for such a length of time.

Watching psychotherapy 2
A scene from a psychotherapy training video featuring Dr. Candice M. Monson and a client (portrayed by an actor).

Being listened to, and more important, feeling listened to, is a great experience, one that we can usually only expect regularly from significant others. In the non-therapeutic relationships we have–whether with a spouse, a best friend, girlfriend, or boyfriend–there is hopefully some give and take. Each person in a relationship has to do some of the listening sometimes and show caring and support to the other. In psychotherapy, such mutuality is not expected, and is even—by design—discouraged. The therapist generally maintains strict boundaries, and the psychotherapy relationship is built for the client’s benefit.

If this one-sided listening were the only feature of a psychotherapy interaction that made it differ from your average conversation, it would be unusual enough and would alone have a powerful effect on the client. But behind this one-sided interaction there is something else going on. Psychotherapists are educated in the intricacies of human relationships, the way the mind works, and how emotion, behavior, and general stressors of life can tangle up a person’s thinking. They have also been educated and trained to use a host of solutions to help the client. To the observer, these solutions may look simple—a question posed at just the right time, or a suggestion to try doing something differently—but they are usually the result of much training and research.

How do therapists learn to do this? It comes not just from years of study—learning the theories and interventions involved in psychotherapy—but also from hours of observing therapy before actually sitting down to talk with a client. In past years, student therapists would sit in on therapy sessions to learn how it is done. This is tricky: The dynamics of the delicate interactions I am describing would be affected by someone silently observing. However, over the past several decades, another way to watch and learn therapy has developed: Watching psychotherapy demonstration videos.

The APA Psychotherapy Video Series has more than 200 DVDs, and PsycTHERAPY® , a database product available for streaming, holds 400 psychotherapy training videos. Whereas the video series is available title-by-title and is ideal for individual training, PsycTHERAPY® is a subscription database, accessible through the APA PsycNET® platform.  It was developed to allow clinical students and faculty to observe how therapists use different approaches and techniques and to share clips of therapeutic interactions with one another.

To help students get the most from PsycTHERAPY, all subscribers are given access to a free book, The PsycTHERAPY® Teaching Guide, that features different ways to use the videos in everything from courses on psychopathology or personality theories to providing empathy training to teaching researchers to code psychotherapy sessions. Faculty at institutions with access to PsycTHERAPY® can download the book from the PsycTHERAPY® landing page. In January 2016, in addition to getting the download, faculty can also request a print version of the book, available for free to faculty at subscribing institutions; otherwise, available for sale.

Psychotherapy can be seen as a unique type of conversation between two people. APA Books produces videos and books to aid psychotherapists as they continue to have these healing interactions, so that they may help people lead happier, healthier lives.


One Reply to “Watching Psychotherapy”

  1. I have never responded to aninhytg written on a blog but this is the best piece of advice that I have ever read on the subject. I agree 100% that solely having a therapist or belonging to a therapy group or depending on a spouse is not enough. We need different people in our lives to build that sense of community. It is refreshing to hear it from a therapist because many professionals would lead one to believe that therapy alone is enough support. Thank you for this article. It has given me the jolt that I need to start working on my trust issues so that I can strive toward building my own community.

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