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BRIEF THERAPY RESOURCE AND INFORMATION PAGE
A Web Page Project Completed by Jill Aubuchon & Candace Crosby
5/99
Over the last decade, therapy research has placed an emphasis on evaluating the effectiveness of brief therapy. Brief therapy, once used only in crisis situations until long-term therapy could begin, is now considered the treatment of choice for most patients (Wells & Phelps, 1990). In addition, therapists are now looking to briefer models of therapy due to an increasing demand for services, diminishing budget in the clinics, diminishing staff availability, and trends toward managed care. Furthermore, research indicates that clients' attitudes have changed in the last decade regarding their expectations of length of therapy. According to Garfield (1978), clients now believe that their mental health issues will be resolved in a few sessions at most. In addition, Lambert, Shapiro, & Bergin (1986) found that 75% of clients who benefit from therapy do so within the first six months.
Generally, there is the assumption that brief therapy is twenty sessions or less. However, it would be more accurate to assume that brief therapy is not so much about the number of sessions, but the establishment of a clear focus for the treatment. There are various orientations to brief therapy: psychodynamic; behavioral, cognitive, and cognitive-behavioral; eclectic; crisis-oriented; and verbal approaches. In addition, when considering types of brief therapy, one may include group treatment, family therapy, marital therapy, telephonic crisis interventions, and inpatient programs (Koss & Shiang, 1994).
Several common techniques are required for the brief therapist to bring about change in the most efficient manner. These techniques include the maintenance of focus, high therapist activity, therapist flexibility, promptness of intervention, and addressing the termination. There are specific variations of these techniques, according to the particular orientation of the therapist.
Garfield, S. L. (1978). Research on client variables in psychotherapy. In S.L. Garfield and A.E. Bergen (Eds.), Handbook of psychotherapy and behavior change (2nd ed., pp. 191-232). New York: Wiley.
Koss, M. P. & Shiang, J. (1994). Research on brief psychotherapy. In S.L. Garfield and A.E. Bergen (Eds.), Handbook of psychotherapy and behavior change (4th ed., pp.664-700). New York: Wiley.
Lambert, M. J., Shapiro, D. A., & Bergin, A.E. (1986). The effectiveness of psychotherapy. In S.L. Garfield and A.E. Bergen (Eds.), Handbook of psychotherapy and behavior change (3rd ed., pp. 157-212). New York: Wiley.
Wells, R. A., & Phelps, P. A. (1990). The brief psychotherapies: A selective overview. In R.A. Wells & V.J. Giannetti (Eds.), Handbook of the brief psychotherapies (pp.3-26). New York: Plenum.
BRIEF THERAPY: CLARIFICATION OF MYTHS
Myth 1: Brief therapy doesn't treat the "real" problems. Brief therapy is a style of therapy that searches for clients' resources and strengths. A brief therapist will help clients recognize how to use their own resources to deal more effectively with the problems. By focusing on strengths, not pathologies, clients feel more hopeful and begin to make changes more quickly. This style differs in that it places more emphasis on strengths than the "real" problem.
Myth 2: Brief therapy is only for "minor" problems. Brief therapy has been effectively used with depression, eating disorders, substance abuse, dissociative disorders and other major psychiatric conditions. It has been used in hospitals, community mental health centers, and outpatient centers.
Myth 3: Brief therapy is concerned about limiting number of sessions or time with a therapist. The term "brief" was coined as a side effect of this treatment. With a client and therapist focusing on strengths, resources, solutions and strategies to deal with the problems, frequency of therapy sessions decreases. Hence, the term brief. A good brief therapist will not focus on limiting sessions or time, but rather helping clients set goals and develop strategies to reach those goals.
Myth 4: Brief therapy doesn't have long lasting effects. To state that any therapy has long lasting effects would be a falsehood. Too little long term research (3-10 year follow ups) has been conducted to clearly understand what long-lasting effects there are from any style of therapy. Brief therapists tend to view therapy in "doses" or "episodes." By teaching clients when to recognize help is needed and how to set goals, the next "episode" will be preventative in nature, not corrective. Think of when you see a doctor for a sore throat. After being treated do you believe you will never need to see a doctor for a sore throat the rest of your life?
Myth 5: Brief therapy was only developed in response to limited money. Actually, some of Sigmund Freud's most famous cases were one or two sessions. Brief therapy has existed as long as any other form of therapy, but it wasn't used as often as other forms. Mostly, because it was difficult for clinicians to keep getting clients to support their practices. Now that psychotherapy is more widely accepted, and less stigmatized, people are seeing psychotherapists more frequently. Yes, companies such as insurance and managed care are using brief therapists because they don't need to spend as much money, but only because it already existed and there were clinicians practicing brief therapy successfully.
HELPFUL LINKS
Solution Focused Brief Therapy Research and Writings
Good Resource Page with Publication Listings and Clinicians
An Example of a Brief Therapy Clinic (used by Employee Assistance Programs)
Depth-Oriented Brief Therapy Page
SOME BOOKS TO TRY:
Mental Research Institute (MRI)
Richard Fisch, John Weakland, & Lynn Segal (1982) The Tactics of Change.
William J. Lederer & Don D. Jackson (1990). The Mirages of Marriage.
Giorgio Nardone (1976). Brief strategic solution-oriented therapy of phobic and obsessive disorders
Ellen Quick (1996). Doing What Works in Brief Therapy.
Paul Watzlawick (1983). The Situation is hopless but not serious: The pursuit of unhappiness.
Paul Watzlawick (1983). Ultra-solutions: How to fail most successfully.
Paul Watzlawick (1976). How real is real? Confusion, disinformation, communication.
Paul Watzlawick, Janet Beavin & Don D. Jackson (1967). Pragmatics of human communication.
Watzlawick, P., Weakland, J. & Fisch, R.(1974). Change: Principles of problem formation and problem resolution.
John Weakland & Wendel A. Ray (1995). Propagations: Thirty years of influence from the Mental Research Institute.
John Weakland and J. J. Herr (1984) Beratung Alterer Menschen Und Ihrer Familien.
Solution Focused Therapy
Insoo Kim Berg (1994). Family-based Services: A Solution-Focused Approach.
Insoo Kim Berg and Scott Miller (1992). Working with the Problem Drinker.
Brian Cade & William H. O'Hanlon (1993). A Brief Guide to Brief Therapy
Steve de Shazer (1988). Clues: Investigating solutions in brief therapy.
Steve deShazer (1985). Keys to Solutions in Brief Therapy.
Steve de Shazer (1991). Putting Difference to Work.
Yvonne Dolan (1985) A Path with a Heart: Ericksonian utilisation with resistant and chronic clients.
Yvonne Dolan (1991). Resolving Sexual Abuse: Solution-focused therapy and Ericksonian hypnosis for adult survivors.
Michael Durrant. Creative Stategies For School Problems: Solutions For Psychologists and Teachers.
Michael Durrant (1993) Residential Treatment: A Cooperative Competency-based Approach.
Ben Furman & Tapani Ahola (1992). Solution Talk: Hosting theraputic conversations.
Pat Hudson & Bill O'Hanlon. (1991). Rewriting Love Stories.
Barbara McFarland (1995). Brief Therapy and Eating Disorders : A practical guide to solution-focused work with clients.
Linda Metcalf (1995) Counseling Towards Solutions: A practical solution-focused program for working with students, teachers and parents.
Linda Metcalf (1996). Parenting Toward Solutions: How parents can use skills they already have to raise responsible, loving kids.
Linda Metcalf (1998). Solution Focused Group Therapy: Ideas for Groups in Private Practice, Schools Agencies and Treatment Programs.
Alex Molnar & Barbara Lindquist (1989). Changing Problem Behavior in Schools.
John J. Murphy & Barry Duncan (1997) Brief Intervention for School Problems: Collaborating for Practical Solutions.
Giorgio Nardone (1976). Brief Strategic Solution-Oriented Therapy of Phobic and Obsessive Disorders.
William H. O'Hanlon. & Michelle Weiner-Davis (1989). In search of Solutions: A new direction in psychotherapy.
William H. O'Hanlon & Bertolino, B. (1998). Even From a Broken Web: Brief, respectful solution-oriented therapy for sexual abuse and trauma.
Ellen Quick (1996). Doing What Works in Brief Therapy.
Matthew D. Selekman (1993) Pathways to Change: Brief therapy solutions with difficult adolescents.
Matthew D. Selekman (1997). Solution Focused Therapy with Children: Harnessing family strentghs for systemic change.
Gerald B. Sklare (1997). Brief counseling that works: A solution focused approach for school counselors (Practical skills for counselors).