The goals and techniques of psychotherapy were first discussed by the psychodynamic theorists who originated the modern practice of psychotherapy. Sigmund Freud and Josef Breuer are generally credited with describing the first modern case treated with psychotherapy, and Freud went on to develop the basis for psychodynamic psychotherapy in his writings between 1895 and his death in 1939. Freud sat behind his patients while they lay upon a couch, so that they could concentrate on saying anything that came to mind in order to reveal themselves to the psychotherapist. This also prevented the patients from seeing the psychotherapist's reaction, in case they expected the psychotherapist to react to them as their parents had reacted. This transference relationship provided Freud with information about the patient's relationship with parents, which Freud considered to be the root of the problems that his patients had. Later psychodynamic psychotherapists sat facing their patients and conversing with them in a more conventional fashion, but they still attended to the transference.
Carl Rogers is usually described as the first humanistic psychotherapist, and he published descriptions of his techniques in 1942 and 1951. Rogers concentrated on establishing a warm, accepting, honest relationship with his patients. He established this relationship by attempting to understand the patient from the patient's point of view. By communicating this "accurate empathy," patients would feel accepted and therefore would accept themselves and be more confident in living according to their wishes without fear.
Behavioral psychotherapists began to play a major role in this field after Joseph Wolpe developed systematic desensitization in the 1950's. In the 1960's and 1970's, Albert Bandura applied his findings on how children learn to be aggressive through observation to the development of modeling techniques for reducing fears and teaching new behaviors. Bandura focused on how people attend to, remember, and decide to perform behavior they observe in others. These thought processes, or "cognitions," came to be addressed in cognitive psychotherapy by Aaron T. Beck and others in the 1970's and 1980's. Cognitive behavioral therapy became a popular hybrid that included emphasis on how thinking and behavior influence each other.
In surveys of practicing psychotherapists beginning in the late 1970's, Sol Garfield showed that the majority of therapists practice some hybrid therapy or eclectic approach. As it became apparent that no one model produced the desired effects in a variety of patients, psychotherapists used techniques from various approaches. An example is Arnold Lazarus's multimodal behavior therapy, introduced in 1971. It appears that such trends will continue and that, in addition to combining existing psychotherapeutic techniques, new eclectic models will produce additional ways of understanding psychotherapy as well as different techniques for practice.
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