Praxical.Psych
Unit 1 of 20

Defining psychotherapy, and comparing the psychotherapies

Establish what is being studied, and the framework by which systems will be compared.

Chapter 1Sessions 9/9–9/14

What you should be able to do afterwards

  • 1Give a defensible definition of psychotherapy and say what it excludes
  • 2Describe the transtheoretical framework: processes of change and levels of content
  • 3Explain why the number of named therapies is not the number of distinct treatments
  • 4State the difference between a theory of pathology, a theory of change, and a technique

The reading

A serviceable definition: psychotherapy is the informed and intentional application of clinical methods and interpersonal stances, derived from established psychological principles, for the purpose of assisting people to modify behaviours, cognitions, emotions and other personal characteristics in directions that the participants deem desirable.

Every clause is doing work. "Informed and intentional" excludes accidental help. "Derived from established psychological principles" excludes practices with no theoretical grounding. "Directions the participants deem desirable" is the clause that keeps psychotherapy from being social control — and it is the clause that conversion practices violate.

Why comparison is hard

Estimates of the number of named psychotherapies run past four hundred. Most are minor variations, rebrandings, or the personal synthesis of one clinician. The transtheoretical solution is to ask two questions of every system rather than accepting its own self-description: which processes of change does it use, and at what level of content does it aim them?

QuestionWhat it reveals
Theory of personalityWhat the system thinks a person is
Theory of psychopathologyWhat it thinks goes wrong
Theory of changeWhat it thinks fixes it — the load-bearing claim
Therapeutic relationshipVehicle, or active ingredient, or both
Processes of changeWhich of the ten it actually uses
Content levelSymptom, cognition, interpersonal, family, or intrapersonal
PracticalitiesHow long, how often, how structured
EvidenceWhat is supported, and by comparison with what

What belongs to this unit

Questions to take away

For a seminar, a supervisor, or an argument with yourself.

  1. 1Is a self-help book psychotherapy? Is a good conversation with a friend? What exactly is missing?
  2. 2If two systems produce the same outcome by different mechanisms, in what sense are they different treatments?
  3. 3What would have to be true for a psychotherapy to be considered harmful rather than merely ineffective?

Your notes

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Before you begin

What Praxical.Psych is, and is not

Praxical.Psych is an educational tool. It teaches the theory, evidence base and clinical method of psychotherapy at the level of an advanced survey course, and it lets you rehearse a complete session in a simulator.

It is not medical, clinical, psychological or legal advice. It cannot diagnose or treat anyone, and it does not state the law where you practise — requirements differ by jurisdiction and change. Nothing here creates a clinician–patient or solicitor–client relationship.

  • Every patient, transcript and case in this app is fictional — a composite written for teaching. None depicts a real person.
  • Praxical.Psych is not therapy, not a substitute for supervision, and not a credential. Competence to practise comes from training, supervised hours and licensure.
  • Scores from the instruments here are for learning how they behave. They are not a diagnosis and not a risk assessment, and must not inform a decision about a real person.
  • Do not enter real patient information. Everything you type stays in this browser, but that is not the same as a compliant clinical record system.
If you are in crisis

In the US and Canada, call or text 988. In the UK and Ireland, call 116 123 (Samaritans). Elsewhere, find a local line at findahelpline.com. In immediate danger, use your local emergency number.

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