Future-oriented therapy (FOT) and future-directed therapy (FDT) are approaches to psychotherapy that place greater emphasis on the future than on the past or present.
The term future-oriented therapy was first used in an article by psychologist Walter O'Connell in 1964, [1] and then the term was used as the title of an article by psychiatrist Stanley Lesse in 1971. [2] Psychiatrist Frederick T. Melges also used the term in his writings in the 1970s and 1980s. [3] [4] [5] In the 2000s, psychiatrist Bernard Beitman, inspired in part by Melges, [6] wrote about future-oriented formulation and about how emphasis on the future is a common factor among different approaches to psychotherapy and is a basis for integrating psychotherapies. [6] [7] [8] Future-directed therapy, an intervention with a similar emphasis on the future (developed independently of the previous future-oriented therapies), was first tested by psychologist Jennice Vilhauer and colleagues in 2011, [9] [10] and in 2014 was the subject of a self-help book that aimed to help readers "overcome negative emotions, identify what you want in life, transform limiting beliefs, take action, live ready for success". [11]
Stanley Lesse's approach, published in 1971, stressed the need for all future psychiatrists, psychologists, social scientists, and political scientists to understand the relationships between sociodynamics and individual psychodynamics. [2] Lesse viewed discussion of the future as a prophylactic (preventative) technique and guided patients over a relatively brief number of sessions to consider their role in the future in order to prepare for the impending stresses and challenges. [2] [12]
In 1972, Frederick T. Melges published a paper about a future-oriented intervention, which he referred to as FOT. [3] A decade later he wrote a book chapter describing the intervention. [4] Melges's FOT is based on a psychodynamic model and was intended to be an adjunctive intervention, not a treatment for psychiatric disorders. Melges described it a "useful adjunct to past- and present-oriented therapies" [3] to help patients with issues such as low self-esteem and identity diffusion. According to Melges:
The general thesis is that time distortions disrupt anticipatory control and lead to psychopathological spirals. That is, problems with time, such as distortions of sequence, rate, and temporal perspective, disrupt the normal interplay between future images, plans of action, and emotions, thereby leading to lack of anticipatory control and vicious cycles (spirals). [4] : 43
Melges proposed that the harmonization of future images, plans of action, and emotions restore a person's sense of hope and control over the future: "Thus, with hope, the personal future is not certain and fixed, but is viewed as being open, unfrozen, and full of opportunities." [4] : 178 There were five stages to Melges's FOT treatment:
In a 1983 review of Melges's book, psychiatrist Lenore Terr said that "the author must be commended for his very ambitious attempt to characterize broadly what happens to time sense in the major mental disorders", but she also noted: "Some of the author's theoretical proposals are clear and seem to be right, but unfortunately some go too far." [13]
Philip Zimbardo and John Boyd have described how "psychologist Susan Nolen-Hoeksema extended Melges's work on time and depression in studying the ways in which preoccupation with the past reinforces depression." [14] : 200 Zimbardo and Boyd explained that an obsession with the past makes people less able to think about the future, according to Nolen-Hoeksema and her colleagues. "The key to relieving depression lies not in untangling the Gordian knot of the past but in accepting and planning for the uncertain future." [14] : 202
A wide range of approaches, such as future-oriented group training, [15] future-oriented writing therapy, [16] [17] future-directed therapy, [10] [18] and others, have been developed to help people to confront the future and the uncertainties, complexities, and discontinuities implied by the future.
Zimbardo and Boyd's time perspective theory, which differentiates between several future time perspectives (general or basic, future transcendental, future negative, and future positive), [19] has been applied in time perspective coaching [20] and time perspective therapy. [21] [22]
Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. Cognitive behavioral therapy is one of the most effective means of treatment for substance abuse and co-occurring mental health disorders. CBT focuses on challenging and changing cognitive distortions and their associated behaviors to improve emotional regulation and develop personal coping strategies that target solving current problems. Though it was originally designed to treat depression, its uses have been expanded to include many issues and the treatment of many mental health conditions, including anxiety, substance use disorders, marital problems, ADHD, and eating disorders. CBT includes a number of cognitive or behavioral psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies.
Psychotherapy is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome problems. Psychotherapy aims to improve an individual's well-being and mental health, to resolve or mitigate troublesome behaviors, beliefs, compulsions, thoughts, or emotions, and to improve relationships and social skills. Numerous types of psychotherapy have been designed either for individual adults, families, or children and adolescents. Certain types of psychotherapy are considered evidence-based for treating some diagnosed mental disorders; other types have been criticized as pseudoscience.
Clinical psychology is an integration of human science, behavioral science, theory, and clinical knowledge for the purpose of understanding, preventing, and relieving psychologically-based distress or dysfunction and to promote subjective well-being and personal development. Central to its practice are psychological assessment, clinical formulation, and psychotherapy, although clinical psychologists also engage in research, teaching, consultation, forensic testimony, and program development and administration. In many countries, clinical psychology is a regulated mental health profession.
Aaron Temkin Beck was an American psychiatrist who was a professor in the department of psychiatry at the University of Pennsylvania. He is regarded as the father of cognitive therapy and cognitive behavioral therapy (CBT). His pioneering methods are widely used in the treatment of clinical depression and various anxiety disorders. Beck also developed self-report measures for depression and anxiety, notably the Beck Depression Inventory (BDI), which became one of the most widely used instruments for measuring the severity of depression. In 1994 he and his daughter, psychologist Judith S. Beck, founded the nonprofit Beck Institute for Cognitive Behavior Therapy, which provides CBT treatment and training, as well as research. Beck served as President Emeritus of the organization up until his death.
Person-centered therapy, also known as person-centered psychotherapy, person-centered counseling, client-centered therapy and Rogerian psychotherapy, is a form of psychotherapy developed by psychologist Carl Rogers beginning in the 1940s and extending into the 1980s. Person-centered therapy seeks to facilitate a client's self-actualizing tendency, "an inbuilt proclivity toward growth and fulfillment", via acceptance, therapist congruence (genuineness), and empathic understanding.
Solution-focused (brief) therapy (SFBT) is a goal-directed collaborative approach to psychotherapeutic change that is conducted through direct observation of clients' responses to a series of precisely constructed questions. Based upon social constructivist thinking and Wittgensteinian philosophy, SFBT focuses on addressing what clients want to achieve without exploring the history and provenance of problem(s). SF therapy sessions typically focus on the present and future, focusing on the past only to the degree necessary for communicating empathy and accurate understanding of the client's concerns.
Psychodynamic psychotherapy and psychoanalytic psychotherapy are two categories of psychological therapies. Their main purpose is revealing the unconscious content of a client's psyche in an effort to alleviate psychic tension, which is inner conflict within the mind that was created in a situation of extreme stress or emotional hardship, often in the state of distress. The terms "psychoanalytic psychotherapy" and "psychodynamic psychotherapy" are often used interchangeably, but a distinction can be made in practice: though psychodynamic psychotherapy largely relies on psychoanalytical theory, it employs substantially shorter treatment periods than traditional psychoanalytical therapies. Psychodynamic psychotherapy is evidence-based; the effectiveness of psychoanalysis and its relationship to facts is disputed.
The Internal Family Systems Model (IFS) is an integrative approach to individual psychotherapy developed by Richard C. Schwartz in the 1980s. It combines systems thinking with the view that the mind is made up of relatively discrete subpersonalities, each with its own unique viewpoint and qualities. IFS uses systems psychology, particularly as developed for family therapy, to understand how these collections of subpersonalities are organized.
Acceptance and commitment therapy is a form of psychotherapy, as well as a branch of clinical behavior analysis. It is an empirically based psychological intervention that uses acceptance and mindfulness strategies along with commitment and behavior-change strategies to increase psychological flexibility.
Coherence therapy is a system of psychotherapy based in the theory that symptoms of mood, thought and behavior are produced coherently according to the person's current mental models of reality, most of which are implicit and unconscious. It was founded by Bruce Ecker and Laurel Hulley in the 1990s. It has been considered among the most well respected postmodern/constructivist therapies.
Interpersonal psychotherapy (IPT) is a brief, attachment-focused psychotherapy that centers on resolving interpersonal problems and symptomatic recovery. It is an empirically supported treatment (EST) that follows a highly structured and time-limited approach and is intended to be completed within 12–16 weeks. IPT is based on the principle that relationships and life events impact mood and that the reverse is also true. It was developed by Gerald Klerman and Myrna Weissman for major depression in the 1970s and has since been adapted for other mental disorders. IPT is an empirically validated intervention for depressive disorders, and is more effective when used in combination with psychiatric medications. Along with cognitive behavioral therapy (CBT), IPT is recommended in treatment guidelines as a psychosocial treatment of choice for depression.
Leslie Samuel Greenberg is a Canadian psychologist born in Johannesburg, South Africa, and is one of the originators and primary developers of Emotion-Focused Therapy for individuals and couples. He is a professor emeritus of psychology at York University in Toronto, and also director of the Emotion-Focused Therapy Clinic in Toronto. His research has addressed questions regarding empathy, psychotherapy process, the therapeutic alliance, and emotion in human functioning.
Although modern, scientific psychology is often dated from the 1879 opening of the first psychological clinic by Wilhelm Wundt, attempts to create methods for assessing and treating mental distress existed long before. The earliest recorded approaches were a combination of religious, magical and/or medical perspectives. Early examples of such psychological thinkers included Patañjali, Padmasambhava, Rhazes, Avicenna and Rumi.
Emotionally focused therapy and emotion-focused therapy (EFT) are a family of related approaches to psychotherapy with individuals, couples, or families. EFT approaches include elements of experiential therapy, systemic therapy, and attachment theory. EFT is usually a short-term treatment. EFT approaches are based on the premise that human emotions are connected to human needs, and therefore emotions have an innately adaptive potential that, if activated and worked through, can help people change problematic emotional states and interpersonal relationships. Emotion-focused therapy for individuals was originally known as process-experiential therapy, and it is still sometimes called by that name.
Behavioral theories of depression explain the etiology of depression based on the behavioural sciences, and they form the basis for behavioral therapies for depression.
A clinical formulation, also known as case formulation and problem formulation, is a theoretically-based explanation or conceptualisation of the information obtained from a clinical assessment. It offers a hypothesis about the cause and nature of the presenting problems and is considered an adjunct or alternative approach to the more categorical approach of psychiatric diagnosis. In clinical practice, formulations are used to communicate a hypothesis and provide framework for developing the most suitable treatment approach. It is most commonly used by clinical psychologists and is deemed to be a core component of that profession. Mental health nurses, social workers, and some psychiatrists may also use formulations.
Common factors theory, a theory guiding some research in clinical psychology and counseling psychology, proposes that different approaches and evidence-based practices in psychotherapy and counseling share common factors that account for much of the effectiveness of a psychological treatment. This is in contrast to the view that the effectiveness of psychotherapy and counseling is best explained by specific or unique factors that are suited to treatment of particular problems.
Frederick T. Melges was an American psychiatrist and professor of psychiatry at Stanford University School of Medicine, notable for his interest in time and for his pioneering work on the role of distortions of time in various psychiatric disorders.
Metacognitive therapy (MCT) is a psychotherapy focused on modifying metacognitive beliefs that perpetuate states of worry, rumination and attention fixation. It was created by Adrian Wells based on an information processing model by Wells and Gerald Matthews. It is supported by scientific evidence from a large number of studies.
Vittorio Filippo Guidano was an Italian neuropsychiatrist, creator of the cognitive procedural systemic model and contributor to constructivist post-rationalist cognitive therapy. His cognitive post-rationalist model was influenced by attachment theory, evolutionary epistemology, complex systems theory, and the prevalence of abstract mental processes proposed by Friedrich Hayek. Guidano conceived the personal system as a self-organized entity, in constant development.
A measure of harmony might be introduced into the relationship between the social sciences and religion by emphasizing a future oriented psychotherapy based on outsight.
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