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Supportive psychotherapy is widely practiced and may in fact be the treatment provided to most psychiatric patients. In the early years of psychoanalysis, it was generally assumed that anyone who studied psychoanalysis could automatically do psychotherapy. Since the 1950s it has been recognized that psychotherapy should be systematically taught as a modality apart from analysis and that it should be conceptualized on its own terms, not as a lesser form of analysis. However, supportive psychotherapy has seldom been taught.
It seems to be assumed that if one masters psychodynamic therapy, one is able to do supportive therapy, which has generally been seen as a therapy that requires less skill and is appropriate primarily for patients who are less intelligent, less well motivated, or less interesting (Winston, Pinsker, & McCullough, 1986).
The consequence of this assumption has been that supportive psychotherapy is often conducted with the objectives and techniques of expressive therapy as the model. Paul Dewald (1971) described expressive therapy and supportive therapy as the poles of the continuum of dynamic psychotherapies.
Most patients receive a therapy that incorporates both supportive and expressive elements.