Key Health Care Concepts: Tracing the Evolution of Psychotherapy

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A psychotherapist discusses issues with a patient while sitting in his chair.

Since its inception in the late 19th century, the concept of psychotherapy and the value of this practice in treating mental illness continues to evolve. With the American Psychiatric Association reporting that almost one in five Americans will experience some form of mental illness each year, this important medical practice is receiving more attention than ever.

In fact, the demand for mental health treatment and care is outpacing the number of qualified professionals, particularly in psychiatry. A 2017 study by Merritt Hawkins described the shortage of qualified psychiatrists as an “escalating crisis.”

Registered nurses who want to advance their careers and provide elevated patient care can benefit from pursuing a psychiatric-mental health nurse practitioner (PMHNP) specialization in a Bachelor of Science in Nursing to Doctor of Nursing Practice (DNP) degree program. This program provides students with a deep understanding of the psychotherapeutic concepts required to be successful in various mental health and psychiatric roles. Read on to learn more about psychotherapy and the skills gained by pursuing a DNP.

The Evolution of Psychotherapy

Sigmund Freud played a critical role in the mainstream practice of psychotherapy, starting with his 1895 publication Studies on Hysteria, written with fellow physician Josef Breuer. As a result, psychological disorders were increasingly studied during the 20th century, eventuating in an influx of new psychology-based treatment methods, including new behavioral theories and cognitive models.

The concept of psychotherapy continues to evolve in the 21st century, and the increasing attention given to mental illnesses is demonstrated by the demand for professionals in this field. According to the U.S. Bureau of Labor Statistics (BLS), there were 181,700 practicing psychologists in 2018, and demand for professionals in this field is expected to grow by 14% between 2018 and 2028.

What Is Psychotherapy?

Psychotherapy refers to psychologically based practices and techniques used to treat a range of mental health issues. Commonly called talk therapy, psychotherapy involves therapy sessions that use communication techniques, such as conversation, storytelling, and music, to help patients heal and manage their symptoms. Therapy session length and duration of treatment are dependent on patients’ circumstances.

Psychotherapy is used to treat emotional difficulties, such as recovering from trauma or the loss of a loved one, and various mental disorders, such as depression. Medical treatment, often referred to as pharmacology, can be combined with psychotherapy to further support a patient’s needs, particularly with specific conditions. Psychologists, social workers, therapists, and PMHNPs may work as psychotherapists.

Here are some key psychotherapy concepts and treatment types.


Since Freud’s theory is that the unconscious mind dramatically affects human behavior and well-being, psychoanalysis techniques help patients uncover repressed memories and emotions. Essentially, it helps patients become aware of the unconscious processes that may be impacting their present life, such as traumatic childhood experiences or post-traumatic stress disorder. Psychoanalysis typically requires a long-term treatment plan, which can involve multiple sessions per week over a long period of time.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) strays from more traditional Freudian psychoanalysis by focusing on a patient’s current behaviors, thoughts, and feelings. CBT is a solution-oriented therapy that helps patients identify and recognize harmful thought patterns and then provides the tools to change those behaviors and thoughts. This type of treatment is commonly used for disorders that involve negative thought patterns, such as anxiety, obsessive compulsive disorders, and eating disorders.

Supportive Therapy

Developed in the early 20th century, supportive therapy provides patients with the tools to manage and cope with life stressors. Compared with psychoanalysis and CBT, supportive therapy is a more simplistic therapeutic practice. Supportive therapy is used to treat patients who are living with a painful chronic illness or dealing with a personal crisis. In some situations, supportive therapy is used to help individuals without the resources or support to deal with a life challenge. This type of therapy helps patients improve their self-esteem and develop coping skills so that they’re prepared for future stress- and anxiety-inducing situations.

A Look at the Psychiatric-Mental Health Nurse Practitioner Role

PMHNP is a specialized advanced nursing practice designation. A PMHNP may diagnose, treat, and assess patients — including individuals, families, and groups — with psychiatric and mental health needs. PMHNPs require extensive knowledge of both modern psychotherapy and pharmacology practices to develop effective care strategies.

For PMHNPs, developing personal, collaborative relationships with their patients is critical to gaining patient cooperation and achieving successful treatment results. The article “Therapeutic Alliance, Relationship Building, and Communication Strategies for the Schizophrenia Population: An Integrative Review,” recently published in the journal Archives of Psychiatric Nursing, discusses strategies that PMHNPs can use to improve patient care by developing therapeutic relationships. The findings presented in this article suggest that PMHNPs give specific attention to how symptoms may impact a patient’s willingness to be open. PMHNPs should also focus on being present during their interactions with each patient, developing a common understanding about the illness and treatment options to ensure a positive patient relationship.

Developing the Skills of a PMHNP

Regis College’s online BSN to Doctor of Nursing Practice degree with a PMHNP specialization provides students with both the soft skills and the technical competencies required to be successful in this role, including the following:

  • Advanced communication and interpersonal skills. Building trust and positive relationships with patients is a critical aspect of a PMHNP’s daily responsibilities. Courses in nursing theory and concepts in nursing leadership help students enhance their skills in these areas so they can build rapport and create collaborative relationships with their patients.
  • Analytical skills. PMHNPs rely on their analytical skills when diagnosing and assessing patients. The decisions made by a PMHNP can greatly impact the patient experience and treatment outcome. Courses in advanced health assessment and roles and issues for advanced practice nurses help students refine their analytical and decision-making skills.
  • Technical competence. To provide top patient care, PMHNPs require an extensive understanding of mental health disorders, psychotherapy practices, and psychopharmacology. The coursework in the PMHNP track is designed to provide this specialized knowledge with courses in psychopharmacology and the theory and practice of contemporary psychotherapies.

Learn More About Regis College’s BSN to DNP

For registered nurses looking to acquire these specialized skills, the PMHNP track from Regis’ online Bachelor of Science in Nursing to Doctor of Nursing Practice program delivers a comprehensive curriculum that equips graduates with the knowledge to be successful. Learn more about how Regis can help you reach your career goals.
Recommended readings

What Are Some Doctor of Nursing Practice Specialties?
Is Being a Nurse Practitioner Worth It? Exploring an Advanced Career
What Degree Does a Nurse Practitioner Need? Why Advanced Programs Are Critical


American Psychiatric Association, What Is Psychotherapy?
American Psychological Association, “Why the History of Psychotherapy Matters”
American Psychiatric Nurses Association, Psychiatric-Mental Health Nurses
Archives of Psychiatric Nursing, “Therapeutic Alliance, Relationship Building and Communication
Strategies for the Schizophrenia Population: An Integrative Review”
Association of American Medical Colleges, “Addressing the Escalating Psychiatrist Shortage”
Exploring Your Mind, A Brief History of Psychotherapy
Medical News Today, “What Is Psychotherapy?”, Timeline of Psychotherapy Psychiatric Times, “Supportive Therapy in Everyday Clinical Practice: It’s Like Riding a Bike”
Psychology Today, Cognitive Behavioral Therapy
Regis College, Online BSN to Doctor of Nursing Practice
Simple Psychology, “Psychoanalysis”
U.S. Bureau of Labor Statistics, Psychologists
U.S. National Library of Medicine, “Psychotherapy in Historical Perspective”