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The best psychotherapies for patients with cognitive limitations
What are the major types of psychotherapies and which types may be better for patients with cognitive limitations?
Supportive therapy aims to bolster existing adaptive (healthy) coping skills and is well suited for nearly all patients, even those with cognitive limitations.
Psychoeducation—teaching patients about brain function and the relevant aspects of their psychiatric disorder and treatments—is also appropriate for nearly all patients and can be empowering and facilitate adaptive coping.
Psychotherapies that require higher levels of cognitive input on the part of the patient (as well as extensive training on the part of the therapist) include psychoanalysis, psychodynamic psychotherapy, interpersonal psychotherapy, cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and group and couples therapy.
Select Supportive Therapy Techniques
| Aim to enhance the patient’s self-esteem; praise and encourage use of strengths. |
| Keep the therapy focused in a constructive direction rather than encouraging the patient to say whatever comes to mind. |
| Aim to allay any anxiety generated by the therapy itself. |
| Respond to the patient’s questions with appropriate answers. |
| Make suggestions and give advice. |
| Use clarification and confrontation but generally avoid interpretation. |
Adapted from Abernethy R, Schlozman S. An overview of the psychotherapies. In Stern TA, Fava M, Wilens TE, Rosenbaum JF, editors. Massachusetts General Hospital Comprehensive Clinical Psychiatry. London, Elsevier, p. 104
Sources
- Gerstenblith T, Kontos N: Somatic symptom disorders. In Stern TA, Fava M, Wilens TE, Rosenbaum JF (eds): Massachusetts General Hospital comprehensive clinical psychiatry. London: Elsevier, 2016, pp 255-264.
- Miller WR, Rollnick S: Motivational interviewing: preparing people for change, 2nd ed. New York: Guilford Press, 2002.
- Flashman LA, McAllister TW: Environmental and behavioral interventions. In Arciniegas DB, Anderson CA, Filley CM (eds): Behavioral neurology & neuropsychiatry. New York: Cambridge University Press, 2013, p 612.
- Littell JH, Girvin H: Stages of change: a critique. Behav Modif 26:223-273, 2002.
