Brief psychotherapy Is a term that is used for a variety of psychological therapies focused on the solution and that are given in the short term.
It differs from other therapeutic schools in that it emphasizes: 1) focus on a specific problem and 2) direct intervention. In brief psychotherapy the therapist takes responsibility for working more proactively with the client to deal with the clinical problem more quickly.
All the psychological currents (behavioral, cognitive, psychoanalysis, systemic...) have developed a model of brief therapy each of them with Objectives and assumptions of 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 their symptoms, so that they can be resolved in the shortest possible time.
From brief psychotherapy we can speak of the birth of two great models that have been gaining strength and which currently represent the two great Pillars of this form of therapy:
Brief solution-focused therapy.
Strategic brief therapy.
Brief solution-focused therapy
origins
Brief solution-focused therapy (TCS) was developed by Steve de Shazer And his collaborators at the end of the 70 '.
This model has its antecedents in brief therapy in the Mental Research Institute (MRI) In Palo Alto, CA. Thus brief therapy Traditional MRI has had a major influence on the development of brief solutions-focused therapy.
Similarly, brief MRI therapy derives its influences from Bateson's systems theory, social constructivism, and the work of the psychiatrist Milton Erickson.
The major difference between brief MRI therapy and solution-focused therapy is that, while the former focuses on intervention over Which maintains the problem, the CTS focuses on building solutions.
As we see, CTS does not come from nothing but is the result of a whole theoretical and practical arsenal of great influence in psychotherapy.
The practical and goal-oriented nature of TCS has made it not only one of the most important schools of therapy Rather, it has exerted an enormous influence in other fields such as the educational system, in criminal justice services, 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 That beyond the techniques represents a way of thinking.
Knowing the techniques well and applying them, is not enough for the change to take place in the clients, but these must be subject to a solid Concepts and beliefs (de Shazer, 1985).
The assumptions of the TCS are as follows:
Focus on healthy solutions, strengths and behaviors
From the TCS it is assumed that all clients have the knowledge and resources to make their lives better and that, therefore, they have the Solutions to their problems.
So, instead of focusing on what you can not do, focus on what you can. They do not focus on defining and diagnosing the problem but Resources that the person has to solve the problem.
For a brief solution-focused therapist, it is not so important to explore and investigate the problem and its cause thoroughly, but to Resources, and the healthy behaviors it performs, and that can be a great help in finding problem.
Look for exceptions
The 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 do not happen, It is because the person has carried out a series of strategies that makes the problem not appear. This leads us to the concussion that the same person Has the key so that the problem does not occur.
It focuses on the exceptions, that is, when the symptoms are not present, and what the person does so they are not present in order to Strengthen it.
For example, A couple that goes to therapy for being in continuous conflict. Instead of focusing on what drives them to conflict, it focuses on times when they are not in conflict.
(T: Therapist, P: Couple)
When you are not in conflict, how are you?
P- Well, with our things
What are these things?
Q- Well, we like going to the mountains on Sundays or watching monologues on the internet.
And how are you among you when you go to the mountain or when you see monologues?
P- Well, we had a good time
What are you doing to have fun?
As we see, the questions are always positive and in search of solutions.
It is therefore a question of developing in clients the positive thinking . It is a question of helping them to develop a constant mental dynamics 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. Helps clients describe in a very accurate way And detailed each of the steps they must take to generate the change.
For example, The case of a husband who has lost his wife and because of it falls into alcoholism. Excessive alcohol consumption leads to aggressive and conflicting behavior with your children.
The miracle question is posed as follows:
T: Tonight you come home and go to bed with all the worry and problems that you have in your head. In the middle of the night, unexpectedly, a miracle occurs; All your problems and worries are gone. You wake up little by little, what would be the first sign that would make you realize that there has been a miracle and that your problems have disappeared?
C: I suppose I would get out of bed and face the day with strength and encouragement instead of staying in bed letting the hours go by.
T: So, getting out of bed and facing the day would be the first sign that would indicate that you feel good?
C: Yes, I suppose I would greet my children with a smile and ask them how they have slept, instead of looking like an ogre and shouting 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 all this time..
These kinds of questions lead the client out of his circle of negativity and mentally stand on the possibility of starting to do positive things. They themselves are building in their minds the detailed sequence of what they can do to solve their problem. This leads them to see an exit and to Motivate yourself for change.
Questions about the scale
It is also a very focused technique in achieving the goals. It consists of negotiating, for example, with the family and the adolescent what it would have to do Each of the parts to decrease average, 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 is the scale of your child's behavior at the moment?
What number would correspond to you two weeks ago?
What would you have to do next week instead of being a 3 out a 3.5 or a 4?
(To the daughter) What would you have to do so that next week instead of being a 3 out a 3.4 or a 4?
Is there something different that both can do so next week instead of being a 3 is a 3.5 or even a 4?
Handling the problem situation
This technique is designed for those very pessimistic families that do not respond effectively in the two previous techniques.
It consists of validating the client by getting things not worse than they could be. For this you must ask questions like:
Why are not things worse?
What has done to make the situation not worse?
Fantastic! How did you come up with such an idea? What would you have to do to keep this going?
Strategic brief therapy
origins
Paul Watzlawick Y Giorgio Nardone Are the promoters of the brief strategic therapy that has its ancestral origins in the Hellenic traditions, of the Rhetoric of the sophists and the art of Chinese stratagems.
Strategic brief therapy descends from brief therapy of Mental Research Institute (MRI) In Palo Alto, CA.
It is a model of therapy that has demonstrated 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.) 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 hypochondriasis, which proved to be the most effective and fast therapy for these Pathologies
Another publication of great therapeutic interest was The Prisons of Food (2002) for the intervention of anorexia and bulimia.
In summary, the research and clinical practice performed in the C.T.S. Of Arezzo have led to a significant increase in efficiency and Efficiency of therapeutic interventions. In the CTS of Arezzo, 86% of the cases and an average treatment duration of 7 sessions were resolved.
Key concepts
Work on how the problem works
The first objective of a strategic therapy is to provoke a rupture of 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 on causes.
As expressed by Nardone: "
I usually explain to my clients that TBE is like a game of chess, where all possible movements are known in advance, it is only necessary to observe which one of them is carried out by the other player to know his strategy (in our case, Problem) and thus be able to win the game to the problem".
Promote the search and encounter of tried solutions
We analyze the solutions that the client has carried out to try to solve his problem without success.
It is made clear to him that all these tried solutions have not served him and that, therefore, he must carry out behaviors different from those realized Until now they can solve the problem.
Using suggestive language and strategic interventions
The goal is for the customer to begin to perceive reality in a different and more functional way. With a new perception of reality it is possible Change behaviors and unlock mechanisms and reactions.
Tools and techniques
In brief strategic therapy the techniques and tools used are not as specific as in brief solution-focused therapy.
In this type of therapy the creativity and flexibility of the therapist is of great importance.
The techniques and tools that are used for TBE are:
Communicative techniques
A very persuasive language is used to convince the client about the interventions that are going to take place, however strange they may seem.
There is a great use of paradox and stories of anecdotes and metaphors.
Displacement
It is not a question of an immediate suppression, but of a provisional displacement of the symptom, which gives the patient a first glimpse of A possible power over the symptom.
For example:
A lady who whenever her husband does not please her gives her headache, tachycardia and her legs are swollen, she is asked to disagree with her husband to concentrate all her pain only on the arms on even days and in the Odd right leg.
Symptom prescriptions
It consists in assigning a task to the patient where the frequency, the intensity of the symptom, the situations in which it is presented will be accentuated, Identify and regain control over the symptom.
For example, A person with compulsions of review and order that can not control creating a high degree of anxiety, is required to force compulsions for 60 minutes, not one minute or one minute less.
Paradoxes
They are behavioral interventions where a behavior different from the symptomatic one is not proposed, but the continuity of the behavior is prescribed in a time set. And the mandate is more of the same.
For example, In the case of a person who suffers from insomnia he is prescribed that during the following night he is forced not to sleep.