Doing Therapy Briefly

If you’re not familiar with — or even wary of — brief or time-limited approaches to counselling, this book provides a comprehensive introduction that could challenge your way of thinking. The whole theory behind brief therapy is in fact an incentive to be present, to check everything out with the client, not to let things slide, hoping that they will come up later. The time is now!

Rating: 4

Doing Therapy Briefly

By , 2004. ISBN 0333947622. Palgrave Macmillan. 202 pages.

Written by two systemic therapists, a clinical psychologist and a counselling psychologist, this book is a comprehensive introduction to what they refer to as time-sensitive (rather than “time-limited”) counselling aimed mainly at counsellors not familiar with, or wary of, such ways of working.

The book explores the background of brief therapy and how it relates to, and challenges, therapists’ core beliefs about what they do, in a considered and theoretical way. It goes on to introduce the vital elements of brief therapy: a collaborative working relationship, rather than an hierarchical relationship of expert and “person with something wrong with them” (an element which I see as essential to therapy however long it lasts); therapy as conversation, requiring active engagement (which will be hard for some clients); and an emphasis on finding the resources, coping strategies and competences the client has.

The authors then deal with assessment of suitability for brief therapy, engagement with the client in the first session, the phases of each session and the relationship as a whole, and finally with the ending process, not forgetting to address stuckness by considering it as an opportunity, and as a place for the counsellor to move forward rather than blaming it on the client. There are numerous illustrative examples and one full case study. The last chapter, “Evidence-based and Time-limited Therapy” deals with the effect of managed care on therapeutic practice and engaging with the NHS system in the UK.

As someone who works in private practice without time limits I found this book quite inspiring; I found the idea very motivating that every session can be a whole counselling relationship in itself, and should be gone into in just that way.

“The competent brief therapist…actively chooses to impose time constraints for the positive contribution that this can make to the therapeutic process, in terms of creating an intensity of purpose, clarity of focus, and a heightened awareness of interactional process”. (p. 26)

The whole theory behind brief therapy is in fact an incentive to be present, to check everything out with the client, not to let things slide, hoping that they will come up later. The time is now! Apart from this, however, the empowering elements, the teamwork relationship, the emphasis on looking at how the client copes, and finding and using their resources, are in no way exclusive to brief counselling.

The theory is empowering, but in practice for those working within a health care system with finite resources and a particular theoretical bias toward quick treatments that show measurable, if not always long lasting, results, further sessions may simply not be an option. So many counsellors may be making the best of a bad job by learning how to work briefly, while their hearts are really in a more open ended arrangement.

I was struck by the emphasis on the “positive” in the theory expressed in the book. Of course every counsellor goes into a therapeutic relationship hoping for a positive outcome, but most know from experience that it often gets worse before it gets better, and that these “negative” emotions are not just a block to be swiftly removed, but a vital part of the person’s experience, also having something important to say. On the other hand, the normalising of distress, as suggested in the book, in helping clients not to berate themselves for being “mad or bad” often speeds up healing significantly.

This “positive” emphasis is maybe a helpful redressing of the balance from some kind of “traditional”, or “psychoanalytical” (or maybe just stereotypical?) therapy with its tendency to get bogged down in every single painful feeling and wallow in it for years while overlooking the client’s resources, support systems, dreams, and good things in their life. But personally, I would like to proceed with caution, making space for positive factors, desires and possibilities in the client’s life without laying too much of an expectation on them that they have to “be positive” and achieve specific goals, fast.

This book is a careful and thorough account of the therapeutic process undertaken by client and counsellor with a co-created map in their hands and their eyes, from the very start, on the end of the journey.

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