The end phase of psychoanalytical oriented psychotherapy constitutes the following, EXCEPT?

AIIMS Raipur - 2017 (shift-2)

Psychiatric Nursing

Medium

Appeared in: AIIMS Raipur - 2017 (shift-2)

Explanation

The application of core therapeutic techniques, such as interpretation, analysis of transference, and dream analysis, is the central task of the middle or 'working phase' of psychotherapy.
The primary goal of the working phase is to actively explore the patient's unconscious conflicts and defense mechanisms to produce new insights.
The end phase, or termination phase, shifts focus away from applying new techniques and toward consolidating the progress that has already been achieved.

Option A: This is incorrect because the termination phase is a crucial time to review, consolidate, and strengthen the insights gained during the working phase. The goal is to ensure the patient can internalize and use these insights independently after therapy ends.
Option B: This is incorrect because reinforcing the patient's improvement is a key task of termination. The therapist actively reviews the progress made, highlighting the patient's strengths and new coping skills to build their confidence for the future.
Option D: This is incorrect because preparing the patient for the end of treatment is the defining characteristic of the termination phase. This involves discussing the end date, exploring feelings about separation and loss, and planning for the future.

Visual 1: Flowchart - A flowchart illustrating the three main phases of psychotherapy (Initial, Working, Termination) and listing the key tasks associated with each phase. This would visually separate the 'Application of techniques' (Working Phase) from the tasks of the 'Termination Phase'.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Phases of Psychoanalytic Psychotherapy as background academic context rather than a clinical decision trigger.
A well-managed termination phase is critical for long-term patient success. It helps prevent feelings of abandonment, reduces the risk of relapse, and empowers the patient to maintain their progress independently.
Nurses often support patients undergoing therapy. Understanding the different phases helps the nurse reinforce the therapeutic work, recognize normal reactions (like anxiety during termination), and support the patient appropriately.
What if? If a therapist abruptly ends therapy without a proper termination phase, the patient may feel abandoned, their symptoms may worsen, and the therapeutic gains may be lost. This highlights the ethical and clinical importance of this final phase.

How to Approach the Question

First, identify the core subject of the question, which is the phases of psychotherapy, specifically the 'end phase'.
Second, note the critical keyword 'EXCEPT'. This signals that you must find the option that does NOT belong to the end phase.
Third, mentally review the purpose of each phase of therapy. The beginning is for building rapport, the middle is for active work, and the end is for concluding and consolidating.
Fourth, evaluate each option against the purpose of the 'end phase'. 'Application of therapeutic techniques' is the active 'work' of therapy, which fits better in the middle phase.
Finally, confirm that the other three options (strengthening insight, reinforcing improvement, preparing for termination) are all logical tasks for wrapping up a course of treatment, making them part of the end phase.

Concept Tested & Keywords

Concept Tested: Phases of Psychoanalytic Psychotherapy
Stem keywords: psychoanalytical oriented psychotherapy, end phase
Lead-in keywords: EXCEPT
Negative lead-in flag: This is a negative-lead question requiring you to identify the option that does NOT fit.

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