Brief Therapy

History

Brief therapy began to gain attention in the 1950s, following the increase in popularity of behavior therapy and family therapy. Behavior therapy emphasizes the correction of immediate problem behaviors and employs numerous behavioral techniques to facilitate change in the individual. Family therapy emphasizes the individual in the context of the family. In both therapies, the therapist is direct and active. These two therapies differ from earlier dominant therapies rooted in psychoanalytic thought that focus on the individual's insight and past, and in which the therapist is nondirective and passive. Thus behavior therapy and family therapy set the stage for the acceptance of active short-term therapeutic approaches.

The popularity of brief therapy increased in the 1980s, following empirical research on the process [Page 480]and outcomes of psychotherapy. Researchers used meta-analysis, a statistical method allowing the results of many studies to be compared, to make the following conclusions about psychotherapy: (a) most clients stayed in therapy for six to eight sessions, (b) 75% of clients who reported improvement experienced benefits within the first 6 months of therapy, and (c) time-limited psychotherapy had outcomes similar to those of long-term therapy.

In addition to these research findings, societal changes increased the need and demand for brief therapy. Insurance companies, Health Maintenance Organizations (HMOs), and Preferred Provider Organization (PPOs) routinely place restrictions on the number of sessions an individual can attend. Some people, unwilling to go through insurance, elect to pay outright for their psychotherapy. Many individuals do not have the time or personal income for long-term therapy. Finally, the demand for therapy has increased while the supply of therapists (in the face of reduced fees and increased workloads) has decreased. Therefore, in many community and university counseling centers, there are not enough therapists to see clients for long-term courses of therapy. Brief therapy has become an attractive method for meeting the increased demand for counseling services in a way that is timely and cost-efficient.

Types

There are many approaches to brief therapy. Typically, existing long-term therapies have been adapted to a short-term context. Table 1 below provides a list of the most popular approaches followed by key concepts and suggested readings for each type of therapy.