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What is Supportive Psychotherapy?
John C. Markowitz, M.D.
FOCUS 2014;12:285-289. doi:10.1176/appi.focus.12.3.285
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Author Information and Disclosure

John C. Markowitz, M.D., Professor of Clinical Psychiatry, Columbia University College of Physicians & Surgeons; Research Psychiatrist, New York State Psychiatric Institute New York, NY

The author reports no competing interests.

Dr. Markowitz was supported in part by grant MH079078 from the National Institute of Mental Health and by New York State Psychiatric Institute.

Address correspondence to: John C. Markowitz, M.D., New York State Psychiatric Institute, 1051 Riverside Dr., Unit #129, New York, NY 10032; e-mail: jcm42@columbia.edu


This article reviews the meaning, use, and utility of supportive psychotherapy, a widespread treatment with an undeservedly malign birthright and history. This entails sorting through the historical definitions of supportive therapy and reviewing its good research track record achieved despite being the comparison condition. The author then defines brief supportive psychotherapy (BSP), a manualized, “common factors” treatment that has fared well in research settings, which may provide a model for clinical and research use in the future.

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Anchor for Jump
Table 1.“Common Factors” of Psychotherapya
Table Footer Note

a Based on Frank and Frank (6).

Anchor for Jump
Table 2. Do’s and Dont’s of Brief Supportive Psychotherapy
Anchor for Jump
Table 3.Brief Supportive Psychotherapy Adherence Items


Dangerfield  R:  It’s Not Easy Bein’ Me: A Lifetime of No Respect But Plenty of Sex and Drugs .  New York,  HarperEntertainment, 2004
Hoch  P;  Polatin  P:  Pseudoneurotic forms of schizophrenia.  Psychiatr Q 1949; 23:248–276
[CrossRef] | [PubMed]
Rogers  CR:  Client-centered Therapy .  Boston,  Houghton Mifflin, 1951
Frank  JD:  Eleventh Emil A. Gutheil memorial conference. Therapeutic factors in psychotherapy.  Am J Psychother 1971; 25:350–361
Frank  JD;  Frank  JB:  Persuasion and Healing: A Comparative Study of Psychotherapy .  Baltimore,  Johns Hopkins, 1993
Novalis  PN;  Rojcewicz  SJ;  Peele  R:  Clinical Manual of Supportive Psychotherapy .  Washington, D.C.,  American Psychiatric Press, 1993
Pinsker  H:  A Primer of Supportive Psychotherapy .  Hillsdale, NJ,  The Analytic Press, 1997
Douglas  CJ:  Teaching supportive psychotherapy to psychiatric residents.  Am J Psychiatry 2008; 165:445–452
[CrossRef] | [PubMed]
Tanielian  TL;  Marcus  SC;  Suarez  AP;  Pincus  HA:  Datapoints: trends in psychiatric practice, 1988–1998: II. Caseload and treatment characteristics.  Psychiatr Serv 2001; 52:880
[CrossRef] | [PubMed]
Hellerstein  DJ;  Markowitz  JC:  Developing supportive psychotherapy as evidence-based treatment. (letter) Am J Psychiatry 2008; 165:1355–1356, author reply 1356
[CrossRef] | [PubMed]
Falkenström  F;  Markowitz  JC;  Jonker  H;  Philips  B;  Holmqvist  R:  Can psychotherapists function as their own controls? Meta-analysis of the crossed therapist design in comparative psychotherapy trials.  J Clin Psychiatry 2013; 74:482–491
[CrossRef] | [PubMed]
Gaffan  EA;  Tsaousis  I;  Kemp-Wheeler  SM:  Researcher allegiance and meta-analysis: the case of cognitive therapy for depression.  J Consult Clin Psychol 1995; 63:966–980
[CrossRef] | [PubMed]
Luborsky  L;  Diguer  L;  Seligman  DA;  Rosenthal  R;  Krause  ED;  Johnson  S  et al:  The researcher’s own therapy allegiances: a “wild card” in comparisons of treatment efficacy.  Clin Psychol (New York) 1999; 6:95–106
Clarkin  JF;  Levy  KN;  Lenzenweger  MF;  Kernberg  OF:  Evaluating three treatments for borderline personality disorder: a multiwave study.  Am J Psychiatry 2007; 164:922–928
[CrossRef] | [PubMed]
Kocsis  JH;  Gelenberg  AJ;  Rothbaum  BO;  Klein  DN;  Trivedi  MH;  Manber  R;  Keller  MB;  Leon  AC;  Wisniewski  SR;  Arnow  BA;  Markowitz  JC;  Thase  ME; REVAMP Investigators:  Cognitive behavioral analysis system of psychotherapy and brief supportive psychotherapy for augmentation of antidepressant nonresponse in chronic depression: the REVAMP Trial.  Arch Gen Psychiatry 2009; 66:1178–1188
[CrossRef] | [PubMed]
Markowitz  JC;  Kocsis  JH;  Bleiberg  KL;  Christos  PJ;  Sacks  MH:  A comparative trial of psychotherapy and pharmacotherapy for “pure” dysthymic patients.  J Affect Disord 2005; 89:167–175
[CrossRef] | [PubMed]
Markowitz  JC;  Kocsis  JH;  Fishman  B;  Spielman  LA;  Jacobsberg  LB;  Frances  AJ;  Klerman  GL;  Perry  SW:  Treatment of depressive symptoms in human immunodeficiency virus-positive patients.  Archives of General Psychiatry 1998; 55:452–457
[CrossRef] | [PubMed]
Hellerstein  DJ;  Rosenthal  RN;  Pinsker  H;  Samstag  LW;  Muran  JC;  Winston  A:  A randomized prospective study comparing supportive and dynamic therapies. Outcome and alliance.  J Psychother Pract Res 1998; 7:261–271
Hembree  EA;  Foa  EB;  Dorfan  NM;  Street  GP;  Kowalski  J;  Tu  X:  Do patients drop out prematurely from exposure therapy for PTSD? J Trauma Stress 2003; 16:555–562
[CrossRef] | [PubMed]
Hellerstein  DJ;  Pinsker  H;  Rosenthal  RN;  Klee  S:  Supportive therapy as the treatment model of choice.  J Psychother Pract Res 1994; 3:300–306
Cuijpers  P;  Driessen  E;  Hollon  SD;  van Oppen  P;  Barth  J;  Andersson  G:  The efficacy of non-directive supportive therapy for adult depression: a meta-analysis.  Clin Psychol Rev 2012; 32:280–291
[CrossRef] | [PubMed]
Wampold  BE:  The Great Psychotherapy Debate: Models, Methods, and Findings .  Mahwah, NJ,  Lawrence Erlbaum Associates, 2001
Markowitz  JC;  Kocsis  JH;  Christos  P;  Bleiberg  K;  Carlin  A:  Pilot study of interpersonal psychotherapy versus supportive psychotherapy for dysthymic patients with secondary alcohol abuse or dependence.  J Nerv Ment Dis 2008; 196:468–474
[CrossRef] | [PubMed]
Schramm  E;  Hautzinger  M;  Zobel  I;  Kriston  L;  Berger  M;  Härter  M:  Comparative efficacy of the Cognitive Behavioral Analysis System of Psychotherapy versus supportive psychotherapy for early onset chronic depression: design and rationale of a multisite randomized controlled trial.  BMC Psychiatry 2011; 11:134
[CrossRef] | [PubMed]
Crits-Christoph  P;  Gibbons  MB;  Hamilton  J;  Ring-Kurtz  S;  Gallop  R:  The dependability of alliance assessments: the alliance-outcome correlation is larger than you might think.  J Consult Clin Psychol 2011; 79:267–278
[CrossRef] | [PubMed]
Markowitz  JC;  Milrod  BL:  The importance of responding to negative affect in psychotherapies.  Am J Psychiatry 2011; 168:124–128
[CrossRef] | [PubMed]
Markowitz  JC;  Spielman  LA;  Scarvalone  PA;  Perry  SW:  Psychotherapy adherence of therapists treating HIV-positive patients with depressive symptoms.  J Psychother Pract Res 2000; 9:75–80
Krupnick  JL;  Sotsky  SM;  Simmens  S;  Moyer  J;  Elkin  I;  Watkins  J;  Pilkonis  PA:  The role of the therapeutic alliance in psychotherapy and pharmacotherapy outcome: findings in the National Institute of Mental Health Treatment of Depression Collaborative Research Program.  J Consult Clin Psychol 1996; 64:532–539
[CrossRef] | [PubMed]
Markowitz  JC;  Manber  R;  Rosen  P:  Therapists’ responses to training in brief supportive psychotherapy.  Am J Psychother 2008; 62:67–81
Plakun  EM;  Sudak  DM;  Goldberg  D:  The Y model: an integrated, evidence-based approach to teaching psychotherapy competencies.  J Psychiatr Pract 2009; 15:5–11
[CrossRef] | [PubMed]
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Sample questions:
Which of the following best represents the role of psychotherapy in the treatment of bipolar disorder?

See Swartz and Swanson; Results, p 252
An evidence-based psychotherapy that has not been tested as treatment for individuals with bipolar disorder is which of the following:

See Swartz and Swanson; Table 2: Description of Evidence-Based, Bipolar Specific Psychotherapies, p 259
How does psychopathology develop within the framework of metacognitive theory?

See Mundy and Hofmann; Meta-Cognitive Therapy, p 267
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