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Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Psychotherapy, Individual


Text Only Home | Graphic-Rich Site | Overview | Reason for Procedure | How Procedure is Performed | Prognosis | Specialists | Complications | Factors Influencing Duration | Length of Disability | Ability to Work | Medical Codes | References

Medical Codes

ICD-9-CM:
94.31 - Psychoanalysis
94.33 - Behavior Therapy; Aversion Therapy; Behavior Modification; Desensitization Therapy; Extinction Therapy; Relaxation Training; Token Economy
94.34 - Individual Therapy for Psychosexual Dysfunction
94.35 - Crisis Intervention
94.36 - Play Psychotherapy
94.37 - Exploratory Verbal Psychotherapy
94.38 - Supportive Verbal Psychotherapy
94.39 - Other Individual Psychotherapy; Biofeedback

Related Terms

  • Analytical Therapy
  • Behavior Therapy
  • Cognitive Therapy
  • Cognitive-behavioral Therapy
  • Freudian Therapy
  • Gestalt Theoretical Psychotherapy
  • Interpersonal Therapy
  • Jungian Therapy
  • Person-centered Therapy
  • Psychoanalytic (Freudian) Therapy
  • Psychoanalytic Therapy
  • Rational-emotive Therapy
  • Solution-focused Brief Therapy
  • Talk Therapy

Overview

Psychotherapy is a general term covering many psychological treatment methods, all taking place primarily through interaction with a trained therapist. With individual psychotherapy, the verbal interaction is between two individuals: the therapist, and the individual seeking help. These two work together to identify and address the individual's problems with the expectation of making a positive change. The change is directed at characteristically fixed patterns of thought, feeling, or behavior that are causing difficulties.

The psychotherapist listens to what the individual has to say and tries to understand its meaning. A therapeutic alliance is developed with the two working together in a cooperative manner. The therapist has specific expertise in using communication and relationship in a helpful way, usually based on a particular theory of personality and human behavior. These theories form the basis, goals, and techniques used in therapy. An individual's problem and treatment are usually linked to a particular theory as seen in cognitive therapy, cognitive-behavioral therapy, rational-emotive therapy, behavior therapy, person-centered therapy, interpersonal therapy, psychodynamic therapy, and others. Unfortunately, it is difficult to predict which kind of therapy will be most helpful for a particular individual experiencing a particular disorder.

All forms of psychotherapy have some common therapeutic factors. The individual should view the therapist as someone who can help and can be trusted. Psychotherapy also provides a safe place for experiencing any and all emotions, provides new information and new meanings for seemingly unrelated symptoms and events, and creates the conditions to maximize success. In the process, symptoms may be relieved and unproductive patterns of behavior changed.

Source: Medical Disability Advisor



Reason for Procedure

The purpose of individual psychotherapy is to treat emotional, behavioral, or mental dysfunction; remove negative symptoms such as anxiety or depression; modify or reverse problem behaviors; help the individual cope with situational crises such as bereavement, pain, or prolonged medical illnesses; improve the individual's relationships; manage conflict; or enhance positive personality growth and development. There are a number of therapeutic approaches and techniques but all of them try to establish a relationship between the therapist and the individual who seeks to unlearn old or maladaptive patterns, gain insight, and learn more effective patterns of thinking and behavior.

Some approaches, such as psychodynamic psychotherapy, attempt to remove underlying personality conflicts. Others, such as cognitive or behavior therapy, focus more on direct removal of negative symptoms including depression, anxiety, obsessive-compulsive behavior, low self-esteem, marital conflicts, chronic pain or substance abuse. Solution-focused brief therapy focuses on helping individuals construct solutions rather than solve problems.

Source: Medical Disability Advisor



How Procedure is Performed

Individual psychotherapy is usually performed by a psychiatrist, psychoanalyst, clinical psychologist, or licensed mental health professional. The goals of therapy may include simple emotional support; insight into sources of thoughts, feelings, perceptions, or behaviors; relief of symptoms such as anxiety or depression; stress management; behavioral changes; or crisis intervention. Psychotherapy sessions can be short-term (4 to 6 sessions), intermediate (up to 6 months), or long-term (6 months to several years); and can occur several times a week, weekly, bi-weekly, or on an as-needed basis. Each session lasts about 50 minutes and is conducted by the therapist with a single individual.

During the initial period (usually the first session), the therapist attempts to establish rapport, assess the individual's needs, and determine therapeutic goals in cooperation with the individual. In an accepting, non-judgmental atmosphere, the individual is encouraged to talk about feelings, fears and anxieties, relationship issues, problematic behaviors, or disturbing thoughts. The therapist listens and provides comment and feedback based on training and experience. The therapist guides the individual to a deeper insight and understanding of his or her thoughts, feelings, and behaviors, and explores methods of self-acceptance or ways to make needed and desired changes.

There are a variety of therapeutic techniques under an umbrella of several major categories that include psychoanalysis, psychodynamic psychotherapy, cognitive psychotherapy, behavioral psychotherapy, marital or family psychotherapy, and brief psychotherapy. Psychoanalysis is derived from the works of Sigmund Freud and is a long-term approach taking several years where the goal is to help an individual recall, understand, and re-experience childhood conflicts in a way that allows insight and modification of destructive thoughts, feelings, or behaviors.

The psychodynamic psychotherapies draw on principles of psychoanalysis, but focus on helping an individual modulate negative emotions. Rather than focusing on deep insight and change, they help maintain an acceptable level of functioning in a climate of unconditional acceptance and support. Cognitive psychotherapy focuses on the direct removal of negative symptoms such as anxiety and depression. By promoting discovery of irrational beliefs or thinking patterns related to negative feelings or behaviors, cognitive psychotherapy helps the individual develop methods to alter these negative patterns of thought or behavior.

The behavioral therapies are derived from learning theory. Through a variety of techniques such as desensitization and biofeedback, they focus on eliminating disruptive behavior patterns and substituting appropriate behaviors. Desensitization gradually exposes individuals to anxiety-provoking situations (phobias) until their anxiety decreases or disappears. A biofeedback session uses specialized equipment to help the individual realize how negative thoughts and feelings affect body processes such as heart rate or skin temperature.

In marital/family therapy, psychological symptoms of individual family members are thought to be expressions of disturbances in the social system of the family. Family therapy is particularly helpful in schizophrenic patients. The therapeutic goal is to focus on current issues and achieve improvement in relationship conflicts, communication patterns, emotional boundary management, and role-relationships. Brief psychotherapy is any type of therapeutic approach designed to bring about change in a short period of time, usually less than 20 therapy sessions.

Source: Medical Disability Advisor



Prognosis

Most individuals experience some decrease in symptoms or a change in fixed patterns of thought, feeling, or behavior that are causing difficulties. A number of studies have shown psychotherapy to be as effective as pharmacotherapy in many conditions; for example, major depression and panic disorder. Behavioral therapy for obsessive compulsive disorder is more effective than medication. The ability of the individual and therapist to form a close therapeutic alliance is associated with better outcome, particularly in depression. A combination of psychotherapy and psychopharmacology has been documented as having the greatest effect for treating certain illnesses. With psychoanalysis, self-rating measures of symptom distress and morale are more likely to improve than self-rating measures of social relations.

Source: Medical Disability Advisor



Specialists

  • Clinical Psychologist
  • Psychiatrist

Source: Medical Disability Advisor



Complications

Some individuals may not respond positively to a particular type of therapy or may be unable to develop an effective therapeutic relationship with the therapist.

Source: Medical Disability Advisor



Factors Influencing Duration

Length of disability is influenced by the duration and severity of any underlying mental illness, substance abuse or dependency, the individual's social support system, motivation to change, and compliance with scheduled psychotherapy sessions.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Work restrictions and accommodations are related to the specific disorders. A flexible work schedule may be helpful, but most psychoanalysis sessions should be scheduled during the individual's personal time.

Source: Medical Disability Advisor



References

General

Craighead, Edward W., and Linda Wilcoxon Craighead. "The Role of Psychotherapy in Treating Psychiatric Disorders." Medical Clinics of North America 85 3 (2001): 617-629.

Kerns, Robert. "Cognitive-Behavioral Therapy for Chronic Pain in the Elderly." Clinics in Geriatric Medicine 17 3 (2001): 503-523.

Lauriello, John, et al. "Maximizing the Synergy Between Pharmacotherapy and Psychosocial Therapies for Schizophrenia." Psychiatric Clinics of North America 26 1 (2003): 191-211.

Muratori, Filippo, et al. "A Two-Year Follow-Up of Psychodynamic Psychotherapy for Internalizing Disorders in Children." Journal of American Academy of Child and Adolescent Psychiatry 42 3 (2003): 331-339.

Source: Medical Disability Advisor