Supportive Psychotherapy

About

Supportive Psychotherapy

What is supportive psychotherapy?

Supportive psychotherapy is a client-oriented approach to therapy that uses a positive relationship between therapist and patient as the primary means of change and healing. It is the type of psychotherapy that’s provided to the vast majority of patients who are seen in psychiatric clinics and mental health centers. Supportive psychotherapy can provide the patient with comfort, advice, encouragement, reassurance, and attentive and sympathetic listening. It helps patients avoid ineffective and inappropriate behaviors that are common with many emotional illnesses.

Supportive psychotherapy can be provided by anyone in a patient’s life, as long as they want to help the patient learn to deal with their emotional distress and problems in living. Besides psychoanalysts and therapists, others who may provide supportive therapy include family, friends, ministers or rabbis, social workers, doctors and nurses, probation officers, drug counselors, school counselors, even first responders. 

Anyone who lives with, works with, or provides medical care to an emotionally disturbed person will inevitably find themselves in the role of therapist. Anyone who cares about the patient and actively provides advice, comfort, encouragement, reassurance, or sympathetic listening is providing supportive psychotherapy. It can be as simple as providing an emotional outlet, the chance to express themselves and be themselves. 

An important part of supportive psychotherapy is that it exists solely to meet the needs of the patient. It addresses only problems and conflicts that the patient is aware of. Treatment planning considers what the patient wants to accomplish. The therapist remains in a supportive role offering guidance and interpretation, when needed.

Supportive psychotherapy focuses on improving symptoms and maintaining, restoring or improving self-esteem and coping skills. In formal therapy sessions, supportive psychotherapy may involve examining the patient’s relationships and their patterns of emotional response or behavior. In less formal settings, supportive psychotherapy may mean an expression of interest, attentive listening, encouragement and optimism. 

Is supportive psychotherapy evidence based?

Yes. The most beneficial aspects of therapy come from a strong and supportive relationship between therapist and patient. Supportive psychotherapy excels at creating this kind of relationship. 

Who developed supportive psychotherapy?

Supportive psychotherapy is an offshoot of psychoanalytic therapy, and was developed by Franz Alexander. It has been widely practiced for many decades and is considered a standard therapeutic approach. 

When is supportive psychotherapy used?

Supportive psychotherapy is used to treat a wide range of mental health challenges related to depression, anxiety, eating disorders, schizophrenia, and personality disorders. In the initial phases of treatment of severe personality disorders, supportive therapy can be especially effective. Patients with personality disorders often resent and/or fear the power of their therapist because they have been subjected to power abuses in early life.

Supportive psychotherapy targets the patient’s issues with self-esteem, relationships, dealing with change, relapse prevention and other psychological issues. Relapse prevention is important for patients with a history of substance misuse. The therapist helps the patient identify high-risk situations, strategies for dealing with those situations, ways to cope with negative emotions or interpersonal conflict, and identifying and planning for a relapse. 

Supportive psychotherapy focuses closely on developing adaptive or coping capacity that is sensitive to the patient’s limitations. Limitations can include:

  • Personality issues
  • Sensory limitations 
  • Low IQ or learning disabilities
  • Low education level
  • Not speaking the native language (immigrants)
  • Poverty
  • Social oppression or isolation
  • Limited social-support system
  • Subjected to the abuse of power in relationships

Many patients have multiple limitations that can overwhelm their coping capacity. For these patients, supportive therapy is the treatment of choice. It can be the first step away from social isolation and marginalization.

What are supportive psychotherapy techniques?

Supportive therapy conveys to the patient acceptance, interest, respect, and admiration for his or her accomplishments, thus supporting their self-esteem. Conscious problems are addressed, and defenses are questioned only if they are maladaptive. The patient is treated with honesty and respect.

Supportive therapy uses these techniques:

  • Praise and positive reinforcement targets accomplishments and positive changes in behavior, especially praise of progress toward achieving his or her goals.
  • Encouragement can be powerful. Patients want to believe that small efforts will lead to something larger. The therapist identifies tasks and activities that support behavior change in small steps. Encouragement and attention to the patient’s strengths can empower him or her to take small steps.
  • Setting behavior goals. For example, developing the capacity to control anxiety can prevent defensive distortions of reality.
  • Teaching adaptive and coping skills gives the patient the ability to find their own way toward making good decisions. 
  • Advice can be helpful when the patient sees it as connected to his or her goals and needs. 
  • The therapist models the behaviors the patient wants to adopt. This can provide a more stable sense of self, and some of the first fundamental building blocks for change.
  • Normalizing, a form of reassurance, lets the patient know that their experiences, thoughts, and feelings are not unusual or pathological. 
  • Reframing a patient’s understanding of problems, by looking at it in a different light, can provide reassurance.
  • Reassuring the patient that hope and healing can be achieved. 

How long does supportive psychotherapy last?

It depends on the patient’s main challenges, if they completed therapy, and if they’re able to transfer what they’ve learned to their current and future problems. If the patient successfully copes with subsequent problems, the therapy has provided lasting skills. 

One of the strongest predictors of successful supportive psychotherapy and positive outcomes for the patient is their relationship with their therapist. This relationship can be supportive if the patient believes the therapist is aligned with the patient's goals, respects the patient, and holds him or her in a positive regard. 

How does supportive psychotherapy compare to cognitive behavioral therapy?

Supportive psychotherapy emphasizes the relationship and its use of support and coping skills to provide healing. Cognitive behavioral therapy places more of an emphasis on changing patterns of thinking to improve functioning. 

How does supportive psychotherapy compare to interpersonal therapy?

Supportive psychotherapy and interpersonal therapy share many similar techniques. Supportive psychotherapy is not as time-limited and structured as interpersonal therapy. 

How does supportive psychotherapy compare to insight therapy?

Insight psychotherapy is a prolonged and expensive process. It’s conducted by a very few highly trained professional psychoanalysts. It uses dreams, defense mechanisms, interpretation of patient resistances, and transference reactions to the therapist. In contrast, supportive therapy focuses on the immediate events in the patient’s life, and appeals to the patient’s conscious mind. A supportive psychotherapist listens to what the patient tells him, as well as what the patient’s family and friends say about the patient. It may be used at irregular intervals and is usually over a shorter period of time than insight therapy.

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References

Neuman, F. (2013, June) Supportive Psychotherapy. Psychology Today. Retrieved 2-22-22, {https://www.psychologytoday.com/us/blog/fighting-fear/201306/supportive-psychotherapy}
University of Nevada School of Medicine. (n.d.). What is Supportive Psychotherapy? Retrieved 2-22-22, {https://med.unr.edu/psychiatry/resources/supportive-psychotherapy}
Rothe, E.M. (2017, May) Supportive Psychotherapy in Everyday Clinical Practice: It’s Like Riding a Bicycle. Psychiatric Times Vol. 34 No. 5, Issue 5. Retrieved 2-22-22, {https://www.psychiatrictimes.com/view/supportive-psychotherapy-everyday-clinical-practice-its-riding-bicycle}
Misch, D.A. (2000, Fall) Basic Strategies of Dynamic Supportive Therapy. The Journal of Psychotherapy Practice and Research. Retrieved, 2-22-22, {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3330607/}

Information

Medically reviewed by:

Dr Roy Kedem, MD

Dr Roy Kedem started his premedical studies at Harvard, and research in genetics and gene sequencing at Harvard, Beth Israel. He attended medical school in the UK at the Cambridge Overseas Medical Program in 1998. Dr Kedem then completed his residency in Internal Medicine at Columbia College of Physicians and Surgeons in Stamford, Connecticut and his fellowship in Hospital Medicine at the Cleveland Clinic in Cleveland, Ohio.

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Affordable –
with or without insurance

With Insurance

Therapy

Your copay
Depending on insurance

Without Insurance

Therapy

$99

Initial Visit

$99

Follow Up