What is brief therapy?
Brief therapy is a form of psychotherapy that uses short-term treatment methods to help people handle current life problems and crises. The distinctive features of brief therapy include a time limit and a focus on specific problems and topics. During brief therapy, the therapist takes an active role in directing the participant to specific issues and limiting the exploration of other aspects of the person’s life. This approach contrasts with traditional open-ended therapy, which seeks to explore numerous topics as they are uncovered during psychotherapy.
Although brief therapy is time limited, there is no consensus concerning the ideal number of therapy sessions for this form of treatment. It may last anywhere from a single session to twenty or more. Brief therapy is also known as time-limited psychotherapy or short-term psychotherapy. Consensus is also lacking regarding the type of person who benefits most from this form of therapy. Sometimes focusing on a particular problem may bring forth additional problems that cannot be addressed in the time-limited format.
Because of the time-limited nature of brief therapy, the costs associated with psychotherapy are less than with traditional forms. Brief therapy has become popular with managed-care organizations, as it helps to contain treatment costs.
The foundations for brief therapy were laid by Franz Alexander and Thomas French in 1946, when they identified the critical elements for a time-limited form of psychotherapy. They suggested that new ways of thinking, acting, and feeling could be promoted in individuals through the establishment of a corrective emotional experience during treatment. If the individuals being treated were highly motivated and worked effectively with a therapist, they could achieve change in a short time.
In the 1950s, while working in London, David Malan developed brief focal psychotherapy as a time-limited treatment. In this type of therapy, the patient and therapist formulate a focus for the treatment and set a termination date before the therapy begins. The average number of sessions for this treatment is twenty meetings. To be selected for this therapy, a person must be able to think in feeling terms, have a high motivation level, and respond to the trial interpretations from the therapist. Trial interpretations are explanations provided by the therapist about why a person is behaving in a certain manner.
Also developed during the 1950s was short-term anxiety-provoking psychotherapy. Peter Sifneos identified individuals who could select a specific problem in their lives and had the motivation to solve the problem in therapy. For those persons, Sifneos confronted their problems using forced-choice questions, which do not permit a person to avoid problems or ideas that may be upsetting. The focus of this form of brief therapy is on anything related to the identified problem that provokes worry and anxiety.
James Mann developed time-limited psychotherapy in the 1970s while working at Boston University. Mann selected individuals who had an easily identifiable central conflict in their lives and limited treatment to only twelve sessions. The conflicts usually related to problems with maturation and psychological development. For example, a young man may be having difficulty moving away from his parents and be afraid of living alone. This conflict of independence versus dependence would become the central focus of the time-limited psychotherapy. The treatment would then focus on possible solutions to this conflict.
One of the major similarities among all brief therapies is the importance of the therapist’s behavior during the sessions. In brief therapy, the therapist is very active in the process of focusing on specific problems and confronting the patient to solve his or her problem. Because the therapist is very direct with the patient, there is a dynamic interaction between them that is designed to obtain solutions in the least amount of time. Modern brief therapy uses many cognitive and behavioral techniques to facilitate the changes sought from the person seeking treatment. Cognitive techniques focus on modifying how a person thinks about the surrounding environment. Behavioral techniques attempt to reinforce desired behaviors and remove actions that are causing problems in a person’s life. Specific exercises are performed to solve problems and improve interpersonal skills. Research investigations of brief therapy have shown that it is effective for a specific range of mental-health problems, but controversy has emerged over its extensive use.
Brief therapy is frequently the treatment of choice for managed-care organizations, which often discourage long-term treatments. Outpatient psychotherapy is usually approved for six to eight sessions of brief therapy. Critics charge that the mental-health profession is being driven by economic considerations rather than the needs of its patients. The support that brief therapy receives from managed-care organizations has created a conflict with those providing psychotherapy that may take years to resolve.
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