SUPPORTIVE THERAPY

A general form of psychological treatment aimed at reinforcing existing defenses and alleviating distress through techniques that operate on a conscious level. It consists of “relieving symptoms by the use of motivation, suppression, ego-strengthening and re-education without the altering of the basic personality structure” .The most frequently employed supportive measures are reassurance, encouragement and approval of desirable behavior. In some cases a more “repressive” approach is used—that is, the therapist attempts to eliminate symptoms by command, persuasion or hypnotic suggestion. In either case supportive measures are usually classified as a form of surface therapy, since their object is to help the patient handle his overt difficulties without attempting to explore their unconscious sources or bring about profound personality change.In general, supportive measures of one kind or another are applied (1) to patients who are faced with relatively minor, limited or external problems, and who appear to have sufficient inner strength to meet them; (2) patients who are hospitalized for serious functional disorders, such as schizophrenia, and need emotional and social support to preserve morale, prevent deterioration, and stimulate socialization; (3) patients who are hospitalized for brain disorders, such as senile brain disease or lead poisoning, in order to make them feel more comfortable and minimize the effects of their distressing symptoms; and (4) patients who are engaged in longterm depth therapy, since the creation of a reassuring, accepting atmosphere helps to establish rapport between therapist and patient, to allay the patient’s anxieties, and to encourage him to give voice to his innermost feelings.A comprehensive enumeration of supportive approaches is found in Watkins, General Psychotherapy (1960). He lists the following twenty-eight techniques as “primarily supportive,” though some may be partially reconstructive, since they may help to modify the personality of the patient: reassurance, suggestion (including autosuggestion), advice, reasoning and persuasion, motivation procedures (rewards, punishments), desensitization, ventilation and verbal catharsis (talking it out, expressive writing), ab- reaction, counseling (directive and nondirective; educational, vocational, personal, marital), rest, progressive relaxation, hypnotherapy, re-education (conditioned reflex and aversion therapy), environmental manipulation, social service, chemotherapies (when used as psychotherapy), placebos, physiotherapy (rehabilitation), occupational therapy, food therapy, recreational therapy, dance therapy, music therapy, art therapy, bibliotherapy, group therapy (supportive types), religious therapy (confession, pastoral counseling, participation in church activities), dynamic-supportive approach (helping the patient to become aware of the unconscious significance of various supportive procedures). See the Index and Category Index under Treatment Techniques and Facilities.