Brief psychotherapy is a term used for a variety of solution-focused, 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 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 (TCS) was developed by Steve de Shazer and his collaborators in the late 1970s..
This model has its antecedents in brief therapy in 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 biggest difference between brief MRI therapy and solution-focused therapy is that, while the former focuses on intervention on what maintains 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 has exerted enormous influence in other fields such as the education system, services criminal justice, in the field of companies, social policy, etc..
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 they can't do, they focus on what they can. 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.
Look for 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 leads to conflict, it focuses on the moments when they are not in conflict..
(T: Therapist, P: Couple)
T- When you are not in conflict, how are you?
P- Well, with our things
T- What things are those?
Q- Well we like to go to the mountains on Sundays or watch monologues on the internet
T- And how are you with each other when you go to the mountains or when you see monologues?
P- Well we had a good time
T- And what do you do to have fun?
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.
Question Miracle
It is a very powerful technique to generate the first steps that lead to the solution of the problem. Helps clients 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 you to maintain aggressive and conflictive behavior with your children.
The miracle question is posed as follows:
T: Tonight you come home and go to bed with all the worries and problems you have in your head. In the middle of the night, unexpectedly, a miracle happens; all your problems and worries have disappeared. You wake up little by little, what would be the first sign that would make you realize that a miracle has occurred and that your problems have disappeared?
C: I guess I would get out of bed and face the day with strength and courage instead of staying in bed letting the hours go by.
T: So getting out of bed and going into the day with strength would be the first sign that you feel fine??
C: Yes, I guess I would greet my children with a smile and ask them how they slept, instead of being ogre-faced and yelling at them.
T: How do you think your children would respond?
C: They would be surprised. I guess they would be happy to see me well after such a long time ...
These types of questions make the client leave his circle of negativity and mentally place himself in 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 the change..
Questions about the 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 misbehavior, they are asked:
On a scale of 1 to 10 where 1 is the worst and 10 is the best:
What number on the scale is your daughter's behavior right now??
What number would correspond to you two weeks ago?
What would you have to do so that next week instead of being a 3 it would be a 3.5 or a 4?
(To the daughter) What would you have to do so that next week instead of being a 3 it would be a 3.4 or a 4?
Is there something different that both can do so that next week instead of being a 3 it is a 3.5 or even a 4?
Handling the problem situation
This technique is designed for those very pessimistic families who do not respond effectively to the two previous techniques..
It consists of validating the client to ensure that things are not worse than they could be. For this, questions such as:
Why are things not worse?
What have you done so that the situation does not get worse?
Fantastic! How did you come up with such an idea? What would you have to do to keep this happening?
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..
The strategic brief therapy descends from the brief therapy of the Mental Research Institute (MRI) in Palo Alto, CA.
It is a therapy model 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 (C.T.S.) of 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 C.T.S. of 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.
Work on how the problem works
The first goal of strategic therapy is to break the vicious circle. For this, a strategic therapist is interested in understanding how the problem works instead of why it exists, working on solutions instead of causes.
As Nardone expresses: "
I usually explain to my clients that TBE is like a game of chess, where all the possible moves are known beforehand, it is only necessary to observe which of them the other player carries out to know his strategy (in our case, how the problem) 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, the creativity and flexibility of the therapist is 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 to be carried out, no matter how strange they may seem.
There is 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. odd right leg.
Symptom prescriptions
It consists of giving the patient a task where he will accentuate the frequency, intensity of the symptom, the situations in which it occurs, so that he or she identifies and regains control over the symptom.
For example, a person with revision 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 during the following night.
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