'''心理治療''' (Psychotherapy) 是由經過專業訓練的人員以建立一種特定人際關係的方法來協助患者(或稱案主、個案)處理心理問題、減輕主觀痛苦經驗、醫治精神疾病及促進心理健康、個人成長。心理治療一般是基於心理學理論及研究(主要是臨床心理學和精神病學) 而建立的治療系統，以建立關係、對話、溝通、行為改變等的技巧來達到治療目的，例如改善受助者的心理健康或減輕精神疾病徵狀等。

== 主要派別 ==

心理治療有多個不同學派，而且不斷發展中。不同學派之間對學派之劃分也有歧異，即使有經驗的治療師也無法熟捻所有學派的治療方式。美國著名的精神科經典教材Synopsis of Psychiatry和英國牛津出版的精神科教科書也沒有一致的分類法。在此引用英國系統的分類方式<ref> Anthony Bateman等著  陳登義譯  心理治療入門(Introduction to Psychotherapy)</ref>

* 精神分析 - 由弗洛依德創立，主要目標為揭示潛意識的焦慮，主要技巧包括自由連結 (free association)、移情和反移情 (transference and counter-transference)、夢分析 (dream analysis)等.

* 容格的精神分析學派 - 由容格創立，主要技巧如沙箱 (sandplay)，多種藝術治療均以容格的理論為基礎。

* 阿德勒精神分析學派 - 由阿德勒所創立，主要目標為減少自卑 (inferiority)，主要技巧包括：分析家庭星座 (family constellation)，生活風格等。

* 動力取向心理治療: 儘管精神分析學者不認為精神分析是精神動力學派其中一支，但大多數治療師仍同意精神分析是動力取向的始祖。

* 團體心理治療

* 家庭治療與夫妻治療

* 完形治療

* 會心治療

'''Psychotherapy''' is an clients in problems of living. This usually includes increasing individual sense of well-being and reducing subjective discomforting experience. Psychotherapists employ a range of techniques based on experiential relationship building, dialogue, communication and behavior change and that are designed to improve the mental health of a client or patient, or to improve group relationships (such as in a family).  Psychotherapy may be performed by practitioners with a number of different qualifications, including psychologists, marriage and family therapists, licensed clinical social workers, psychiatric nurses, and psychiatrists.  Only psychiatrists may administer medical treatments outside of the scope of psychotherapy such as psychosurgery, prescribe medications or give electroshock treatments.

==Etymology==
The word psychotherapy comes from the Ancient Greek words ''psychē'', meaning breath, spirit, or soul and ''therapeia'' or ''therapeuein'', to nurse or cure. <ref>[http://www.yourdictionary.com/psychotherapy Your dictionary definition]</ref> Its use was first noted around 1890. <ref>[http://www.merriam-webster.com/dictionary/psychotherapy Merriam-Webster dictionary definition]</ref>

==Forms==
Most forms of psychotherapy use spoken artwork, drama, narrative story, music, or therapeutic touch. Psychotherapy occurs within a structured encounter between a trained therapist and client(s). Purposeful, theoretically based psychotherapy began in the 19th century with psychoanalysis; since then, scores of other approaches have been developed and continue to be created.

Therapy is generally employed in response to a variety of specific or non-specific manifestations of clinically diagnosable and/or existential crises. Treatment of everyday problems is more often referred to as counseling (a distinction originally adopted by Carl Rogers). However, the term counseling is sometimes used interchangeably with "psychotherapy".

Whilst some psychotherapeutic interventions are designed to treat the patient employing the medical model, many psychotherapeutic approaches do not adhere to the symptom-based model of "illness/cure". Some practitioners, such as humanistic therapists, see themselves more in a facilitative/helper role. As sensitive and deeply personal topics are often discussed during psychotherapy, therapists are expected, and usually legally bound, to respect client or patient confidentiality. The critical importance of confidentiality in enshrined in the regulatory psychotherapeutic organisations codes of ethical practise.

==Systems of Psychotherapy==

There are several main broad systems of psychotherapy: 
* Psychoanalysis - the first practice to be called a psychotherapy. It encourages the verbalization of all the patient's thoughts, including free associations, fantasies, and dreams, from which the analyst formulates the nature of the unconscious conflicts which are causing the patient's symptoms and character problems. 
*Cognitive behavioral - is based on cognitions, assumptions, beliefs, and behaviors, with the aim of influencing negative emotions that relate to inaccurate appraisal of events.
*Psychodynamic - is a form of depth psychology, the primary focus of which is to reveal the unconscious content of a client's psyche in an effort to alleviate psychic tension. Although it has its roots in psychoanalysis, psychodynamic therapy tends to be briefer and less intensive than traditional psychoanalysis.
*Existential - is based on the existential belief that human beings are alone in the world. This aloneness leads to feelings of meaninglessness which can be overcome only by creating one's own values and meanings. 
*Humanistic -  emerged in reaction to both behaviorism and psychoanalysis and is therefore known as the Third Force in the development of psychology. It is explicitly concerned with the human context of the development of the individual with an emphasis on subjective meaning, a rejection of determinism, and a concern for positive growth rather than pathology. It posits an inherent human capacity to maximise potential, 'the self-actualing tendency'. The task of Humanistic therapy is to create a relational environment where this tendency might flourish.
*Brief therapy - is an umbrella term for a variety of approaches to psychotherapy. It differs from other schools of therapy in that it emphasizes (1) a focus on a specific problem and (2) direct intervention. It is solution-based rather than problem-oriented. It is less concerned with how a problem arose than with the current factors sustaining it and preventing change.
*Systemic Therapy - seeks to address people not at an individual level, as is often the focus of other forms of therapy, but as people in relationship, dealing with the interactions of groups, their patterns and dynamics.(includes family therapy & marriage counseling)
* Somatic Psychotherapy - also referred to as body psychotherapy, is a field in which the therapist uses touch in some way as part of therapy process.  
* Transpersonal Psychotherapy is a school that studies the transpersonal, the transcendent or spiritual aspects of the human experience. 
*Hypno-Psychotherapy - is undertaken with a subject in hypnosis.
*Psychodrama/Dramatherapy - explores, through dramatic action in groups , the problems, issues, concerns, dreams and highest aspirations of people.

:''See the list of psychotherapies for an extended list of all individual psychotherapies''.

==History==
<!--  Commented out because image was deleted: thumb|130px|[[Victor Frankl, founder of  -->
<!-- Image with inadequate rationale removed: thumb|130px|[[Carl Rogers, advocate for Person-centered psychotherapy]] -->

thumb|right|150px|The Persian physician, [[al-Razi (Rhazes), who probably first developed purposeful, theoretically-based psychotherapy in the 9th century]]
In an informal sense, psychotherapy can be said to have been practiced through the ages, as individuals received psychological counsel and reassurance from others. Purposeful, theoretically-based psychotherapy was probably first developed in the Persian physician and psychological thinker, Rhazes, who was at one time the chief physician of the Baghdad psychiatric hospital. In the West, however, serious mental disorders were generally treated as demonic or medical conditions requiring punishment and confinement until the advent of moral treatment approaches in the 18th Century. This brought about a focus on the possibility of psychosocial intervention - including reasoning, moral encouragement and group activities - to rehabilitate the "insane". 

Psychoanalysis was perhaps the first specific school of psychotherapy, developed by Sigmund Freud and others through the early 1900s. Trained as a neurologist, Freud began focusing on problems that appeared to have no discernible organic basis, and theorized that they had psychological causes originating in childhood experiences and the unconscious mind. Techniques such as dream interpretation, free association, transference and analysis of the id, ego and superego were developed.

thumb|right|150px|[[Sigmund Freud developed Psychoanalysis in the early 1900s which was perhaps the first specific school of psychotherapy]]
thumb|right|150px|Starting in the 1950s [[Carl Rogers brought Person-centered psychotherapy into mainstream focus.]]
 
Many theorists, including psyche's unconscious influence on external relationships and the self. Sessions tended to number into the hundreds over several years. 

Behaviorism developed in the 1920s, and behavior modification as a therapy became popularized in the 1950s and 1960s. Notable contributors were Joseph Wolpe in South Africa, M.B. Shipiro and Hans Eysenck in Britain, and John B. Watson and B.F. Skinner in the United States. Behavioral therapy approaches relied on principles of operant conditioning, classical conditioning and social learning theory to bring about therapeutic change in observable symptoms. The approach became commonly used for phobias, as well as other disorders.  

Some therapeutic approaches developed out of the European school of R.D.Laing, Emmy van Deurzen) attempted to create therapies sensitive to common 'life crises' springing from the essential bleakness of human self-awareness, previously accessible only through the complex writings of existential philosophers (e.g., Søren Kierkegaard, Jean-Paul Sartre, Gabriel Marcel, Martin Heidegger, Friedrich Nietzsche). The uniqueness of the patient-therapist relationship thus also forms a vehicle for therapeutic enquiry. 

A related body of thought in psychotherapy started in the 1950s with counselor; empathic understanding. The aim is to create a non-directive relationship conducive to enhancing the client's psychological well being, by enabling the client fully to experience and express themselves.  Others developed the approach, like Fritz and humanistic psychotherapy today. Self-help groups and books became widespread. 

thumb|150px|[[Albert Ellis, founder of Rational Emotive Behavior Therapy developed in the mid-1950s.]]
During the 1950s, Rational Emotive Behavior Therapy (REBT). A few years later, psychiatrist distorted thinking, by contrast with the long-lasting insight-based approach of psychodynamic or humanistic therapies.  Cognitive and behavioral therapy approaches were combined during the 1970s, resulting in Cognitive behavioral therapy (CBT). CBT was oriented towards symptom-relief, collaborative empiricism, and modifying one's core beliefs. This approach gained widespread acceptance as a primary treatment for numerous disorders. A "third wave" of cognitive and behavioral therapies developed, including Acceptance and Commitment Therapy and Dialectical behavior therapy, which expanded the concepts to other disorders and/or added novel components. 

solution-focused therapy and Systems Therapy also developed, which focuses on family and group dynamics—and Transpersonal psychology, which focuses on the spiritual facet of human experience. Other important orientations developed in the last three decades include Feminist therapy, Brief therapy, Somatic Psychology, Expressive therapy, and applied Positive psychology.

A survey of over 2,500 US therapists in 2006 revealed the most utilised models of therapy and the ten most influential therapists of the previous quarter-century.<ref>[http://www.psychotherapynetworker.org/index.php?category=magazine&sub_cat=articles&page=1&type=article&id=The%20Top%2010 The Top 10: The Most Influential Therapists of the Past Quarter-Century.] (2007). ''Psychotherapy Networker.'' (retrieved 11 Sept 2007)</ref>

==General Concerns==

Psychotherapy can be seen as an interpersonal invitation offered by (often trained and regulated) psychotherapists to aid clients in reaching their full potential or to cope better with problems of life. Psychotherapists usually receive remuneration in some form in return for their time and skills. This is one way in which the relationship can be distinguished from an altruistic offer of assistance.  	

Psychotherapy often includes techniques to increase awareness, for example, or to enable other choices of thought, feeling or action; to increase the sense of well-being and to better manage subjective discomfort or distress. Psychotherapy can be provided on a one-to-one basis or in Internet. Its time frame may be a matter of weeks or many years. Therapy may address specific forms of diagnosable mental illness, or everyday problems in managing or maintaining person relationships or meeting personal goals. Treatment of everyday problems is more often referred to as '''counseling''' (a distinction originally adopted by Carl Rogers) but the term is sometimes used interchangeably with "psychotherapy".

Psychotherapists employ a range of techniques to influence or persuade the client to adapt or change in the direction the client has chosen. These can be based on clear thinking about their options; experiential relationship building; dialogue, communication and adoption of behavior change strategies. Each is designed to improve the client or patient confidentiality. 	 

Psychotherapists are often trained, certified, and licensed, with a range of different certifications and licensing requirements depending on the jurisdiction. Psychotherapy may be undertaken by marriage-family therapists, expressive therapists, trained mental health counselors, Psychiatrists have medical qualifications and may also administer prescription medication.  The primary training of a psychiatrist focuses on the biological aspects of mental health conditions, with some training in psychotherapy. school, or rehabilitation counseling to include evaluation and assessments as well as psychotherapy. Many of the wide variety of training programs are multiprofessional, that is, psychiatrists, psychologists, mental health nurses, and social workers may be found in the same training group. Consequently, specialized psychotherapeutic training in most countries requires a program of continuing education after the basic degree, or involves multiple certifications attached to one specific degree.

==Specific schools and approaches==

In practices of experienced psychotherapists, therapy will not represent pure types, but will draw aspects from a number of perspectives and schools.<ref>Hans Strupp and Jeffrey Binder, Psychotherapy in a New Key. New York, Basic Books, 1984, ISBN 9780465067473</ref><ref>Anthony Roth and Peter Fonagy, What Works for Whom? A Critical Review of Psychotherapy Research, Guilford Press, 2005, ISBN 572306505</ref>

===Psychoanalysis===

thumb|200px|right|Freud , seated left of picture with Jung seated at right of picture. 1909
dynamic workings of a mind understood to consist of three parts: the hedonistic ''id'' (German: ''das Es'', "the it"), the rational ''ego'' (''das Ich'', "the I"), and the moral ''superego'' (''das Überich'', "the above-I"). Because the majority of these dynamics are said to occur outside people's awareness, Freudian psychoanalysis seeks to probe the fixations and other issues by probing deeply into clients' youth.

Other psychodynamic theories and techniques have been developed and used by psychotherapists, psychologists, psychiatrists, personal growth facilitators,  occupational therapists and social workers. Techniques for group therapy have also been developed. While behaviour is often a target of the work, many approaches value working with feelings and thoughts. This is especially true of the psychodynamic schools of psychotherapy, which today include Jungian therapy and Psychodrama as well as the psychoanalytic schools. Other approaches focus on the link between the mind and body and try to access deeper levels of the psyche through manipulation of the physical body. Examples  are Rolfing, Bioenergetic analysis and postural integration.

===Gestalt Therapy===

Gestalt Therapy is a major overhaul of psychoanalysis.  In its early development it was called "concentration therapy" by its founders, Frederick and Laura Perls.  However, its mix of theoretical influences became most organized around the work of the gestalt psychologists; thus, by the time Gestalt Therapy, Excitement and Growth in the Human Personality (Perls, Hefferline, and Goodman) was written, the approach became known as "Gestalt Therapy."

Gestalt Therapy stands on top of essentially four load bearing theoretical walls:  phenomenological method, dialogical relationship, field-theoretical strategies, and experimental freedom.  Some have considered it an existential phenomenology while others have described it as a phenomenological behaviorism.  Gestalt therapy is a humanistic, holistic, and experiential approach that does not rely on talking alone, but facilitates awareness in the various contexts of life by moving from talking about situations relatively remote to action and direct, current experience.

===Group Psychotherapy===

The therapeutic use of groups in modern clinical practice can be traced to the early years of the 20th century, when the American chest physician Pratt, working in Boston, described forming 'classes' of fifteen to twenty patients with tuberculosis who had been rejected for sanatorium treatment. The term group therapy, however, was first used around 1920 by Jacob L. Moreno, whose main contribution was the development of psychodrama, in which groups were used as both cast and audience for the exploration of individual problems by reenactment under the direction of the leader. The more analytic and exploratory use of groups in both hospital and out-patient settings was pioneered by a few European psychoanalysts who emigrated to the USA, such as Paul Schilder, who treated severely neurotic and mildly psychotic out-patients in small groups at Bellevue Hospital, New York. The power of groups was most influentially demonstrated in Britain during the Second World War, when several psychoanalysts and psychiatrists proved the value of group methods for officer selection in the War Office Selection Boards. A chance to run an Army psychiatric unit on group lines was then given to several of these pioneers, notably Wilfred Bion and Rickman, followed by S. H. Foulkes, Main, and Bridger. The Northfield Hospital in Birmingham gave its name to what came to be called the two 'Northfield Experiments', which provided the impetus for the development since the war of both social therapy, that is, the therapeutic community movement, and the use of small groups for the treatment of neurotic and personality disorders.

===Medical and non-medical models===

A distinction can also be made between those psychotherapies that employ a humanistic model. In the medical model the client is seen as unwell and the therapist employs their skill to help the client back to health.  The extensive use of the DSM-IV, the diagnostic and statistical manual of mental disorders in the United States, is an example of a medically-exclusive model. 

The humanistic model in contrast strives to depathologise the human condition. The therapist attempts to create a relational environment conducive to experiential learning and help build the client's confidence in their own natural process resulting in a deeper understanding of themselves.  An example would be gestalt therapy.

Some psychodynamic practitioners distinguish between more uncovering and more supportive psychotherapy.  Uncovering psychotherapy emphasizes facilitating the client's insight into the roots of their difficulties.  The best-known example of an uncovering psychotherapy is classical psychoanalysis.  Supportive psychotherapy by contrast stresses strengthening the client's defenses and often providing encouragement and advice.  Depending on the client's personality, a more supportive or more uncovering approach may be optimal.  Most psychotherapists use a combination of uncovering and supportive approaches.

===Cognitive behavioral therapy===

Cognitive behavioral therapy focuses on modifying everyday thoughts and behaviors, with the aim of positively influencing emotions.  The therapist helps clients recognise distorted thinking and learn to replace unhealthy thoughts with more realistic substitute ideas.  This approach includes Dialectical behavior therapy.

===Behavior Therapy and Behavioral Counseling===

Behavior Therapy focuses on modifying overt behavior and helping clients to achieve goals. This approach is built on the principles of learning theory including operant and respondent conditioning, which makes up the area of applied behavior analysis or behavior modification. This approach includes Acceptance and Commitment Therapy, Functional Analytic Psychotherapy, and Dialectical behavior therapy. Sometimes it is integrated with cognitive therapy to make cognitive behavior therapy

===Expressive therapy===

Expressive therapy is a form of therapy that utilizes artistic expression as its core means of treating clients.  Expressive therapists use the different disciplines of the creative arts as therapeutic interventions.  This includes the modalities dance therapy, drama therapy,  art therapy, music therapy, writing therapy, among others.  Expressive therapists believe that often the most effective way of treating a client is through the expression of imagination in a creative work and integrating and processing what issues are raised in the act.

===Narrative Therapy===

Narrative therapy gives attention to each person's "dominant story" by means of therapeutic conversations, which also may involve exploring unhelpful ideas and how they came to prominence. Possible social and cultural influences may be explored if the client deems it helpful

=== Integrative Psychotherapy ===