WHAT IS BRIEF PSYCHOTHERAPY AND HOW DOES IT WORK? - ECONOMÍA - 2024

Brief psychotherapy is a term used for a variety of solution-focused and short-term psychological therapies.

It differs from other therapeutic schools in that it emphasizes: 1) focusing on a specific problem and 2) direct intervention. In brief psychotherapy the therapist takes responsibility to work more proactively with the client to deal with the clinical problem more quickly.

All the psychological currents (behavioral, cognitive, psychoanalytic, systemic…) have developed a brief therapy model, each one with objectives and assumptions specific to its particular model.

This general interest in developing shorter models of therapy responds to the need to find faster solutions for people who suffer and suffer from their symptoms, so that they can be resolved in the shortest possible time.

From brief psychotherapy we can talk about the birth of two great models that have been gaining strength and that currently represent the two great pillars of this form of therapy:

Solution-focused brief therapy.

Brief strategic therapy.

Solution-focused brief therapy

origins

Solution-Focused Brief Therapy (TCS) was developed by Steve de Shazer and his collaborators in the late 1970s.

This model has its background in brief therapy at the Mental Research Institute (MRI) in Palo Alto, CA. Thus, traditional MRI brief therapy has had a major influence on the development of solution-focused brief therapy.

Similarly, IRM brief therapy draws its influences from Bateson's systems theory, social constructivism, and the work of psychiatrist Milton Erickson.

The major difference between brief MRI therapy and solution-focused therapy is that, while the former focuses on intervention on what sustains the problem, CTS focuses on building solutions.

As we can see, CTS does not come from nowhere but is the result of a whole theoretical and practical arsenal of great influence in psychotherapy.

The practical and goal-directed nature of TCS has made it not only one of the most important schools of brief therapy, but it has exerted enormous influence in other fields such as the education system, services of criminal justice, in the field of companies, social policy, etc.

Key concepts

Steve de Shazer and his wife, Insoo Kim Berg, emphasized that solution-focused therapy is not simply a set of therapeutic techniques, but beyond the techniques it represents a way of thinking.

Knowing the techniques well and applying them is not enough for clients to change, but they must be subject to solid concepts and beliefs (de Shazer, 1985).

The TCS assumptions are as follows:

Focus on solutions, strengths, and healthy behaviors

TCS assumes that all clients have the knowledge and resources to make their lives improve and that, therefore, they have the solutions to their problems.

So instead of focusing on what you can't do, you focus on what you can do. They do not focus on defining and diagnosing the problem but on the resources that the person has to solve the problem.

For a brief therapist focused on solutions, it is not so important to explore and investigate in depth the problem and its cause, but to rescue the person's resources, their strengths and the healthy behaviors that they carry out, which can be of great help when it comes to finding solutions to the problem.

Find the exceptions

TCS starts from the idea that if the problem is not present at all times and in all situations, it means that in the moments that it does not occur, it is because the person has carried out a series of strategies that makes the problem does not appear. This leads us to the concussion that the same person has the key so that the problem does not arise.

It then focuses on the exceptions, that is, when the symptoms are not present, and what the person does so that they are not present in order to enhance it.

For example, a couple who goes to therapy because they are in continuous conflict. Instead of focusing on what is causing them to conflict, they focus on the moments when they are not in conflict.

As we can see, the questions are always positive and in search of solutions.

It is therefore about developing positive thinking in customers. It is about helping them develop a constant mental dynamic of building solutions.

Tools and techniques

Question Miracle

It is a very powerful technique to generate the first steps that lead to the solution of the problem. It helps clients to describe in a very precise and detailed way each of the steps they must take to generate change.

For example, the case of a husband who has lost his wife and because of it falls into alcoholism. Excessive alcohol consumption leads him to maintain aggressive and conflictive behavior with his children.

The miracle question is posed as follows:

These types of questions make the client leave his circle of negativity and mentally place himself on the possibility of starting to do positive things. They build in their minds the detailed sequence of what they can do to solve their problem. This leads them to see a way out and motivate themselves for change.

Questions about scale

It is also a technique very focused on achieving the objectives. It consists of negotiating, for example, with the family and the adolescent what each of the parties would have to do to decrease half, one… points each week.

In the case of a mother who complains about her daughter's misconduct, they are asked:

Handling the problem situation

This technique is designed for those very pessimistic families who do not respond effectively to the previous two techniques.

It consists of validating the client to ensure that things are not worse than they could be. For this, questions such as:

Brief strategic therapy

origins

Paul Watzlawick and Giorgio Nardone are the promoters of strategic brief therapy that has its ancestral origins in Hellenic traditions, the rhetoric of the Sophists and the art of Chinese stratagems.

Strategic Brief Therapy is descended from Brief Therapy at the Mental Research Institute (MRI) in Palo Alto, CA.

It is a model of therapy that has shown surprising efficacy and efficiency in many pathologies (panic, phobias, obsessions and compulsions, eating disorders, etc.).

The collaboration of Paul Watzlawick and Giorgio Nardone led to the founding of the Center for Strategic Therapy (CTS) in Arezzo.

This collaboration has led to numerous publications such as The Art of Change (1992); Fear, panic, phobias (1995) in which Nardone presents protocols for phobias, compulsions, obsessions, panic attacks and hypochondria, which turned out to be the most effective and rapid therapy for these pathologies.

Another publication of great therapeutic interest was Food prisons (2002) for the intervention of anorexia and bulimia.

In summary, the research and clinical practice carried out at the CTS in Arezzo have produced a significant increase in the efficacy and efficiency of therapeutic interventions. In the CTS of Arezzo, 86% of the cases have been resolved and an average duration of treatment of 7 sessions.

Key concepts

Work on how the problem works

The first goal of strategic therapy is to break the vicious cycle. For this, a strategic therapist is interested in understanding how the problem works rather than why it exists, working on solutions instead of causes.

As Nardone expresses: “I

usually explain to my clients that the TBE is like a chess game, where all the possible moves are known in advance, it is only necessary to observe which of them the other player carries out to know his strategy (in our case, how the problem works) and thus be able to win the game to the problem ”.

Promote the search and finding of attempted solutions

The solutions that the client has carried out are analyzed to try to solve their problem without success.

He is then made to see that all these tried solutions have not served him well and that, therefore, he must carry out behaviors different from those carried out so far that can solve the problem.

Use suggestive language and strategic interventions

The objective is that the client begins to perceive reality in a different and more functional way. With a new perception of reality it is possible to change behaviors and unlock mechanisms and reactions.

Tools and techniques

In strategic brief therapy the techniques and tools used are not as specific as in solution-focused brief therapy.

In this type of therapy, creativity and flexibility of the therapist are of great importance.

The techniques and tools used for TBE are:

Communication techniques

Very persuasive language is used to convince the client about the interventions that are going to be carried out, however strange they may seem.

There is a great use of paradox and stories of anecdotes and metaphors.

Displacement

It is not an attempt at an immediate suppression, but a temporary displacement of the symptom, which provides the patient with a first glimpse of a possible power over the symptom.

For example:

A woman who every time her husband does not please her gives her a headache, tachycardia and her legs swell, is asked that when she is upset with her husband she will concentrate all her pain only on her arms on even-numbered days. and in odd numbers the right leg.

Symptom prescriptions

It consists of assigning a task to the patient where he will emphasize the frequency, the intensity of the symptom, the situations in which it occurs, so that he can identify and regain control over the symptom.

For example, a person with review and order compulsions that he cannot control, creating a high degree of anxiety, is prescribed to force himself to perform the compulsions for 60 minutes, not one minute more, not one minute less.

Paradoxes

They are behavioral interventions where a behavior different from the symptomatic one is not proposed, but its continuity is prescribed at a fixed time. And the mandate is more of the same.

For example, in the case of a person suffering from insomnia, they are prescribed to force themselves not to sleep the next night.

References

1. http://www.solutionfocused.net/what-is-solution-focused-therapy/.
2. http://www.brieftherapysolutions.com.au/article1.html.
3. http://socialwork.oxfordre.com/view/10.1093/
4. http://www.centroditerapiastrategica.org/en/
5. http://welldoing.org/article/what-brief-strategic-psychotherapy.