Psych Vivas · Psychotherapy
Supportive psychotherapy techniques — structured clinical viva
Supportive psychotherapy techniques — structured clinical viva
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Study tools
Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
You are the psychiatry registrar in a community clinic. A 46-year-old with recurrent depression after job loss is demoralised, on sertraline, and faces a long CBT wait. The consultant asks you to: define supportive psychotherapy and the expressive–supportive continuum; demonstrate six techniques with this case; structure a 20-minute medication visit; summarise Winston/Pinsker, Hellerstein, Misch, Markowitz BSP, and alliance/rupture evidence; and state when support-first care replaces exploratory work.
Opening (definition and continuum)
Supportive psychotherapy is a skilled, ego-strengthening, present-focused modality that builds adaptive functioning, alliance, and coping rather than deep uncovering.[1][2] Expressive–supportive continuum: interpretation/clarification at one pole; validation, praise, advice, problem-solving, reality testing, limit-setting, and environmental help at the other. Technique tracks ego strength and risk.[1][7]
References10ShowHide
- [1]Winston A, Pinsker H, McCullough L A review of supportive psychotherapy Hosp Community Psychiatry, 1986.PMID 3781499
- [2]Hellerstein DJ, Pinsker H, Rosenthal RN, et al. Supportive therapy as the treatment model of choice J Psychother Pract Res, 1994.PMID 22700197
- [3]Hellerstein DJ, Rosenthal RN, Pinsker H, et al. A randomized prospective study comparing supportive and dynamic therapies. Outcome and alliance J Psychother Pract Res, 1998.PMID 9752637
- [5]Markowitz JC Supportive Evidence: Brief Supportive Psychotherapy as Active Control and Clinical Intervention Am J Psychother, 2022.PMID 35232221
- [6]Dotson S, Markowitz JC Planting the Tree Right-Side Up: Supportive Psychotherapy as a Priority in Residency Training Acad Psychiatry, 2025.PMID 40921918
- [7]Misch DA Basic strategies of dynamic supportive therapy J Psychother Pract Res, 2000.PMID 11069130
- [9]Martin DJ, Garske JP, Davis MK Relation of the therapeutic alliance with outcome and other variables: a meta-analytic review J Consult Clin Psychol, 2000.PMID 10883561
- [11]Flückiger C, Del Re AC, Wampold BE, Horvath AO The alliance in adult psychotherapy: A meta-analytic synthesis Psychotherapy (Chic), 2018.PMID 29792475
- [12]Safran JD, Muran JC, Eubanks-Carter C Repairing alliance ruptures Psychotherapy (Chic), 2011.PMID 21401278
- [14]Gutheil TG, Gabbard GO The concept of boundaries in clinical practice: theoretical and risk-management dimensions Am J Psychiatry, 1993.PMID 8422069