Advantages of Brief Therapy
Though I don't practice brief therapy, I have great respect for this approach to therapy. It serves an extremely important role in the life's of many people and can be an extremely effective approach to therapy. However, just like long-term therapy, it has its limitations, as well as its advantages.
General Characteristics
Length of Treatment: Generally 8 to 20 sessions, though some are now as short-term as 5 sessions. This depends partially on the type of brief therapy and partially on managed care.
Setting: This type of therapy can be found in many different settings including private practice, community clinics, medical clinics, and hospital settings.
Misconceptions
Brief therapy doesn't get to the root of the problem. This is not necessarily true. It depends upon the problem. Sometimes depth therapists can make more out of an issue than is necessary. For example, a fear of cats could be due to a deeper symbolic issues or it could just be due to a bad experience with cats!
The problem always returns with brief therapy, so therapy just becomes a revolving door. Sometimes this is true; however, often it is not. It depends upon the issue. Some people go through many different periods of brief therapy over the years so that it ends up being just as long as a long-term therapy process. However, others may just need one or two shots to work through the problem. It depends upon the problem and the resolution the individual desires.
How Brief Therapy Works
Any brief overview like this is going to be a little over-simplistic, but I will try to summarize some of the ways that brief therapy works.
Skill Development. Brief therapy helps people learn various skills which help them function better. These may be coping skills, communication skills or ways to ways to change thoughts and behaviors.
Changing Thought Patterns. Most brief therapies help people identify problematic thoughts and then challenge them. This is sometimes called "cognitive restructuring" and can be very effective in making quick changes.
Changing Behaviors: Similar to changing thoughts, brief therapists will help clients identify destructive behavior patterns and then make changes in them.
Promoting Physical Health: Brief therapists will often encourage clients to eat healthier, exercise, and engage in other behaviors shown to improve psychological health.
Supporting Healthy Behaviors: Brief therapists will help clients identify what is already working well in their life and increase reliance on these behaviors and support systems.
Advantages
Brief or solution-focused therapy fits very well with our fast-paced culture. In the 60's and 70's, the depth therapy approaches were very popular because they fit with the pop culture ideas of "finding oneself" and "becoming one's own person." However, today's culture is more interested in quick fixes. Brief therapy is often quite effective at bring about quick change to many types of problems.
Brief therapy is much more cost effective than long-term therapy and more likely to be covered by insurance. Insurance companies don't want to make a long-term investment in your mental health. They want to help you get through your crisis and get back to a more productive level of functioning. Because of this, they often will only pay for brief therapy. If they do pay for depth therapy, they are likely to only pay for a certain number of sessions a year leaving you to pay for the rest.
Brief therapy is less psychologically painful. I say this somewhat tongue in cheek, but there is some truth to it. Making the more significant life changes often involves going into more of your past and current pain, which can cause temporary periods of feeling worse or less stable. While this is part of a healthy process, some people are concerned this can cause complications in their life, work, and family. Brief therapy is often less disruptive.
Brief therapists are generally easier to find. In contemporary times, brief therapy is more popular so there are more therapists who practice from this approach.
Disadvantages:
Many depth therapists believe that brief therapy does not get to the underlying problem as well as the longer term therapies. While some brief therapists would disagree, more and more brief therapists are acknowledging this. Often, people don't realize or voice the real reason they are coming to therapy until 12-20 sessions into therapy, when brief therapists are just wrapping up.
Brief therapy does not promote the same degree of self-awareness and self-understanding as depth psychotherapy. Long-term therapy or depth therapy is more effective at promoting greater self-awareness. Because a deeper understanding and resolution of the problem is not sought, it is more likely that the person may replace on pattern with another pattern driven by the same underlying cause. While the new pattern might be healthier, it sill doesn't fully resolve the issue. If problems just keep being replaced with different types of problems, then it may be time to consider a depth therapy approach.
Brief therapy also is not as effective at making changes the more significant life changes. If you have been establishing a pattern for 25-30 years or more, it makes sense that it will take time to make these changes. While brief therapy is very effective at making certain types of change, some behaviors and patterns are more resistant to change, especially if the person does not fully understand what is driving the pattern.
Brief therapy may not be as effective at working through past traumas. Issues which people have been carrying with them for some time need to be explored in depth. The traumatic event not only created pain which has been carrying around for a long time, but it also impacted many areas of the person's psyche or self. Working through all this takes time.
Here's an Example of Some Types of Brief Therapy :
- Cognitive Therapy
- Cognitive-Behavioral Therapy
- Rational-Emotive Therapy
- Behavioral Therapy
- Interpersonal Therapy
- Solution-Focused Therapy (often a variant of one of the above listed approaches)