The ultimate therapeutic approach varies according to the type of the psychiatric disorder, duration that the patient suffers or shows symptoms and the severity of symptoms (to what extent the patient is independent and can do or perform certain cognitive tasks without help).

Even though empathy toward cases who suffer from certain disorders such as GAD, PTSD or domestic violence can alleviate stress, fear or feeling of insecurity, long-term or unwarranted empathy may result in manifestation of unreliable signals, a mild doctor dependence, and sometimes core vulnerability.

Most often the psychologist cannot find the context personally to empathize with the patient. For instance, a patient is referred to you with the case of feeling overly insecure in particular when someone yells at somebody. But you you think that there is nothing to fear about someone who yells. That might be a reaction that many of us do under stress and nobody is insecure. But it can be a manifestation that is related to a violent or physical action for that person a context for conditioning.

Empathizing with patients or leaving them on their own to resolve their issue can both be futile and aggravate the situations and symptoms. A suitable approach should be flexible enough to be corrected or adjusted in the midst of a therapy if a counselor observes signs of no progress with the client neither with empathizing frequently nor leaving the client to resolve their own problem gradually.

There are a lot of papers regarding the effects of empathy on psychiatric disorders. But I have found a general text that could be interesting for everyone:

https://ct.counseling.org/2013/02/the-paradox-of-empathy-when-empathy-hurts/

A part of this article is very interesting and relate the feeling of vulnerability and empathy as well:

"The client’s increasing contact with “forbidden” thoughts and feelings through the counselor’s empathic efforts can also evoke an anxious sense of vulnerability. The counselor is becoming important to the client as a new attachment figure, and the client fears that the counselor will in some way reject, punish or abandon the client as others have done in the past. Some clients may even fear that the expression of their prohibited and “dangerous” affects or thoughts will injure the counselor. Caught between his or her longing for validation and the fear of rejection or interpersonal injury, the client sometimes takes evasive measures before these new traumas can happen. The counselor is naturally confused when, in response to the counselor’s sensitive attunement, the client suddenly begins creating conflict, criticizing the counseling process as unproductive, assigning to the counselor feelings and thoughts that confirm the client’s expectations of rejection, or refusing to allow the counselor to become an important attachment figure. When these dynamics happen, the counselor may conclude that the client is being “resistant.” "

" which therapeutic relationship is more effective while dealing with patients suffering from psychological problems? ".

Context is everything thus the question is highly context dependent especially in regards to the general psychological profile of any particular patient. However, Empathy (in the context of forming trust not specifically sympathy ) in combination with useful information (evidenced based therapeutic information) that can contribute towards the patient self mitigating their psychological problems is the best method to increase the chance of helping the patient mitigate their own psychological stresses .

For example: Some people experience higher levels of anxiety within similar environmental situations than others due to the genetic differences between individuals. People on the high percentile of conscientiousness may find an environment high in cruelty (e.g. Non human animal cruelty) far more disturbing (Anxious) than those on the lower-mid levels for conscientiousness.

Building Therapist to Patient trust. e.g. People build trust more quickly with people whom display similar genetic traits (‘Inclusive fitness’ see Hamilton et al) & cultural backgrounds (e.g. Research has shown that Black males living in certain regions of Africa are more likely to take their prescribed medication if the Doctor was also a Black male. The same research showed that Black Doctors from the same cultural backgrounds as their patients discussed more relevant social context with their patients, thus gained trust).

Once that trust is established (Therapy in of it's self) there will be a measurable positive correlation between the quality of the Therapeutic information (inc medication) provided to the patient and the mitigation of psychological conditions. And of course in any decent Therapeutic method these outcomes should be quantified & compared to alternatives ( e.g. Evolutionary psychology) to avoid the practice of quackery (Therapy that has not been proven to work & is based on false presumptions about the mind). e.g. “Lets examine your childhood & bring up all those painful memories”. Memories that the patient would be better off forgetting rather than “reliving”. i.e. People can learn methods ‘how to forget’ disturbing memories. Essentially because the more or less a persons brain goes over certain neurological pathways the more these pathways become embedded in thought (memory). That’s why certain psychedelic drug therapy has shown to be successful (compared to other methods) in alleviating the suffering of patients whom have certain psychological conditions associated with repetitive thoughts. e.g. Depression. Furthermore, Therapists must also take the patients environment into account when assessing any condition. e.g. A patient may only be displaying signs of depression or insomnia due to the fact that other peoples behavior in there environment are triggering a psychological phenotypical response. e.g. genes develop a mind that expresses certain traits or not due to environmental triggers .e.g. The average local levels of Air/Noise/Light Pollution will have a negative correlation with the overall psychological health of that culture as psychology is ultimately biology & all biological systems are evolved systems including thoughts and the behaviors that thought evolved to mitigate.

As is quite often the case in any medical practice a medical practitioner tries mitigating the symptoms a patient displays. Biological conditions that have been caused over time due to a phenotypic response to the environment (e.g. A poor Diet can lead to Low self esteem/depression ) or/and a genetic disposition for any particular disease (e.g.A poor diet can lead to heart disease ) . The answer to mitigating much of human psychological suffering & disease* (including people with a genetic deposition for extreme psychological conditions under certain environmental stimuli) is to first understand where, when & why that psychology evolved & what form of environments are more beneficial for human health inc psychological well being. Evolution isn’t a hypothesis it’s a working scientific theory. Any comparably effective psychologist (Therapist) can not ignore such a large body of evidence without it seriously reducing their capacity to provide effective treatment.

*Predetermined genetic disease aside.

بستگی به نوع اختلال ،رویکرد درمانی و همچنین تجربه درمانگر که در ارتباط با بیماران به دست می آورد متفاوت است.

Thought provoking reflective talk by Evolutionary psychologists G. Miller.

https://www.youtube.com/watch?v=OhqNWGg0miI

I think, no matter if you personally believe in your patient believes or not. You have to deal it with professionally according to the situation. BUT gaining the trust of your patient is the first step (I am not talking about psychytric point of view , I am talking about literally psychologist point of view) let's suppose , a women is sexual assault , a child was abondend , abusive husband or parents , bullying at school , some past trauma. So when patient trust the doctor they open themselves and then it's easy to find out where the problem lies. So as a future psychologist I will show sympathy if I see my patient needed it , I will show acceptance if the patient needed it or a hard front.. it depends of patient needs.