Contemporary Theories and Therapies

Gestalt Therapy

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Founders

German Psychotherapist Frederick "Fritz" Perls and Laura Perls.

 Definition

Phenomenological method of awareness, in which perceiving, feeling, and acting are distinguished from interpreting and reshuffling preexisting attitudes.

Description

The theory of Gestalt Therapy takes as its centerpiece two ideas. The first is that the proper focus of psychology is the experiential present moment.  In contrast to approaches which look at the unknown and even unknowable, the Gestalt Therapy perspective is the here and now of living. The second idea is that peopel are inextricably caught in a web of relationship with all things. It is only possible to truly know ourselves as we exist in relation to other things.

These twin lenses, here-and-now awareness and the interactive field, define the subject matter of Gestalt therapy.  Its theory provides a system of concepts describing the structure and organization of living in terms of aware relations.  Its methodology, techniques, and applications … link this outlook to the practice of Gestalt therapy. The result is a psychology and method with a rich and unique view of everyday life, the depths and difficulties which life encompasses, and "the high side of normal," the ennobling and most creative heights of which we are capable. Gestalt therapists believe their approach is uniquely capable of responding to the difficulties and challenges of living, both in its ability to relieve us of some measure of our misery and by showing the way to some of the best we can achieve.

Therapeutic Goals

Gestalt therapy integrates the body and mind factors, by stressing awareness and integration. Integration of behaving, feelings, and thinking is the main goal in Gestalt therapy. Clients are viewed as having the ability to recognize how earlier life influences may have changed their lives.The client is made aware of personal responsibility, how to avoid problems, to finish unfinished matters, to experience things in a positive light, and in the awareness of now. It is up to the therapist to help lead the client to awareness of moment-by-moment experiencing of life. Then to challenge the client to accept the responsibility of taking care of themselves rather then expecting others to do it.
Therapists may use confrontation, dream analysis, dialogue with polarities, or role-playing to reach their goals.

Martin Kantor in his book 'Distancing'(1993, Praeger Publishing) suggests it is important to move away from individual components of avoidance, such as fear of rejection or low self-esteem, and to study and treat the avoidant "gestalt" for which the proper treatment is avoidance reduction. Components of the psychoanalytic, cognitive behavioral, interpersonal, and supportive approaches that involve "doing" or action, are emphasized.

 
The ultimate goal for Gestalt Therapy is increased life enjoyment and experience of peace through greater awareness, acceptance of personal responsibility, and integration of fragmented parts of the self.
 
Treatment Techniques
 
Gestalt therapy begins with the first contact. Ordinarily, assessment and screening are done as a part of the ongoing relationship rather than in a separate period of diagnostic testing and social history taking. The data for the assessment are obtained by beginning the work, for example, by therapeutic encounter. This assessment includes the patient's willingness and support for work within the Gestalt therapy framework, the match of patient and therapist, the usual professional diagnostic and characterological discriminations, decisions on frequency of sessions, the need for adjunctive treatment and the need for medical consultation.

An average frequency for sessions is once per week. Using the Gestalt methodology, an intensity equivalent to psychoanalysis can often be achieved at this frequency. Often individual therapy is combined with group therapy, workshops, conjoint or family therapy, movement therapy, meditation, or biofeedback training. Sometimes patients can utilize more frequent sessions, but often they need the interval to digest material and more frequent sessions may result in overreliance on the therapist. Frequency of sessions depends on how long the patient can go between sessions without loss of continuity, decompensation, or lesser forms of relapse. Frequency of sessions varies from five times per week to every other week. Meeting less frequently than every week obviously diminishes intensity unless the patient attends a weekly group with the same therapist. More than twice a week is ordinarily not indicated, except with psychotics, and is definitely contraindicated with borderline personality disorders.

All through the therapy patients are encouraged and aided in doing the decision making for themselves. When to start and stop, whether to do an exercise, what adjunctive therapies to use, and the like are all discussed with the therapist, but the competence and ultimate necessity for the patient to make these choices is supported.

Analysis
 
In Social Work practice given that psychotherapy is a kind of treatment restricted mostly to verbal exchanges, practitioners do not have to be medically qualified. In most countries, however, psychotherapists must be trained, certified and licensed with a range of different licensing schemes and qualification requirements in place around the world. Psychotherapists may be psychologists, social workers, trained nurses, psychiatrists, psychoanalysts, or professionals of other mental health disciplines. Social workers have special training in mental health assessment and treatment as well as linking patients to community and institutional resources.
 
References
 
Mental Health Matters
 
Aviodant Personality Disorder
 
Conitive Therapy Associates
 
Wikipedia
 
Gestalt Therapy
 
Kohler, Wolfgang. Gestalt Psychology. New York: NAL Books, 1975.

Gestalt Therapy Verbatim. Lafayette, California: Real People Press, 1969; Highland, New York: The Center for Gestalt Development, Inc., 1988.
 R. Hefferline, P. Goodman. Gestalt Therapy: Excitement and Growth in the Human Personality. New York: The Julian Press, 1951.
 
Polster, Erving, and M. Polster. Gestalt Therapy Integrated. New York: Brunner/Mazel, 1973.