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Brief psychotherapy

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Brief therapy is an umbrella term for a variety of approaches to psychotherapy that look to bring about therapeutic change within a limited timeframe and or a limited number of sessions, say under 16 sessions.

The approaches emphasise (1) a focus on a specific problem and (2) direct intervention.

In brief therapy, the therapist takes responsibility for working more pro-actively with the client in order to treat clinical and subjective conditions faster. It also emphasizes precise observation, utilization of natural resources, and temporary suspension of disbelief to consider new perspectives and multiple viewpoints.

Rather than the formal analysis of historical causes of distress, the primary approach of brief therapy is to help the client to view the present from a wider context and to utilize more functional understandings (not necessarily at a conscious level). By becoming aware of these new understandings, successful clients will de facto undergo spontaneous and generative change.

Brief therapy is often highly strategic, exploratory, and solution-based rather than problem-oriented. It is less concerned with how a problem arose than with the current factors sustaining it and preventing change. Brief therapists do not adhere to one "correct" approach, but rather accept that there being many paths, any of which may or may not in combination turn out to be ultimately beneficial.

Factors in the development of brief therapy

One of the limiting factors in traditional psychoanalysis was the need for analysands to commit considerable resources to the enterprise, both in terms of time and money. With the development in the 1960 of firstly behaviour therapy and gestalt therapy then cognitive behaviour therapy with their claims of more efficient procedures and the promise of more widely available treatment there was pressure within psychotherapy traditions to respond. The development of various counselling approaches, offering services to a wider audience, often with less severe problems showed how people could be helped with only limited input. Gradually it become clear that different levels of difficulty could be treated by different approaches. Indeed, that a broad spectrum of problems are amenable to a focused short term intervention and that only a limited proportion of complex cases require longterm therapy. These developments in practice were reinforced by the development of managed care policies, particularly in the US where insurers set limits on treatment contracts. More recently the development of stepped care pathways has made explicit the principle of providing the least amount of resources required to bring about improvement.

The emphasis on more efficient and more economical therapy has lead to developments within the main brands of therapy (eg Davanloo')s Intensive short-term dynamic psychotherapy, as well as spawning new stand alone approaches (eg Cognitive Analytic Therapy)

Founding proponents of brief therapy

Milton Erickson was a master of brief therapy, using clinical hypnosis as his primary tool. To a great extent he developed this himself. His approach was popularized by Jay Haley, in the book "Uncommon therapy: The psychiatric techniques of Milton Erickson M.D."

"The analogy Erickson uses is that of a person who wants to change the course of a river. if he opposes the river by trying to block it, the river will merely go over and around him. But if he accepts the force of the river and diverts it in a new direction, the force of the river will cut a new channel." (Haley, "Uncommon therapy", p.24, emphasis in original)

Richard Bandler, the co-founder of neuro-linguistic programming, is another firm proponent of brief therapy. After many years of studying Erickson's therapeutic work, he wrote:

"It's easier to cure a phobia in ten minutes than in five years... I didn't realize that the speed with which you do things makes them last... I taught people the phobia cure. They'd do part of it one week, part of it the next, and part of it the week after. Then they'd come to me and say "It doesn't work!" If, however, you do it in five minutes, and repeat it till it happens very fast, the brain understands. That's part of how the brain learns... I discovered that the human mind does not learn slowly. It learns quickly. I didn't know that." (Time for a change, 1993, p.20)

The limits of brief therapy

Brief dynamic psychotherapy

Brief Dynamic Psychotherapy is an approach developed by David Malan

Very brief dynamic psychotherapy

Main article: Very brief dynamic psychotherapy

Very brief dynamic psychotherapy (VBDP) has been an approach explored by a number of investigators. Here the time frame is reduced to fewer than 10 sessions, sometimes just a single session. This framework puts a premium on the knowledge, skill and sensitivity of the therapist.The main models and proponents have been:

Notable therapists


Journals

See also

References & Bibliography

Key texts

Books

  • Berg, I.K., (1991). Family Preservation:A Brief Therapy Workbook. Ed. George, E. Brief Therapy Press.
  • De Shazer, S., (1988). Clues:Investigating Solutions in Brief Therapy. Norton.
  • George, E., Iveson, C., and Ratner, H., (1999)

Problem to Solution: brief therapy with individuals and families. 2nd ed. Brief Therapy Press, London.

  • Hoyt, M.F., (1995). Brief Therapy and Managed Care. Jossey-Bass.
  • Walter, J.L. & Peller, J.E., (2000). Recreating Brief Therapy: preferences and possibilities. Norton.
  • Wolberg, L.R. (1965). Short-term Psychotherapy. New York. Basic books
  • Wolberg, L.R. (1980). Handbook of Short-term Psychotherapy. New York.Thieme-Stratton.

Papers

  • Cade, B., 1987:Brief/Strategic Approaches to Therapy: A Commentary. A.N.Z.J. Family Therapy, 8:1, pp. 37-44
  • Davanloo, H. (1995) "Intensive Short-Term Dynamic Psychotherapy: Spectrum of Psychoneurotic Disorders",

International Journal of Intensive Short-Term Dynamic Psychotherapy, Vol. 10, 3-4, 121-155,

  • Gingerich, W., and Weiner-Davis, M. Brief Therapy: Focused Solution Development. Family Process 25, pp.207-222.

Additional material

Books

Papers


External links

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