Tag Archives: brief therapy

How to devise a treatment model for brief therapy or short term counselling

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Last week we broke into groups to devise a strategy for a short term course of treatment for a brief course of therapy. We had been tasked as a group to tackle the philosophical question of whether we worked in a person centred approach or a more structured way when seeing clients within a short framework. 

Essentially my group were agreed that we would first check that the client was happy that a short course of treatment was appropriate for them. We also agreed on the need for goals setting and to keep the sessions tight so that we kept sight of the outcomes of the sessions. This was in keeping with CBT techniques with daily and weekly tasks, thought monitoring and goals setting and reviews. We would set a formal review at session 3.

This is a summation of what we discussed as a wider group.

The initial meeting

The initial meeting with the client could comprise of the following questions:

1. What do they want from the sessions that would really change their lives?

2. What changes were needed to be made in order to accomplish this?

3. If they agree to change, what would they will be willing to do?

4. How much do they sabotage themselves?

5. How would the counsellor know if they were getting better?  

Following a discussion based around these discussions you would then agree the contract of when, where, how much and the cancellation arrangements. 

The next step would be to discuss the presenting problems.  Here your aim is to gather as much of the background information as possible, the back story. 

Ways of working

You could ask the client at the end of each session how they thought the session went. You could also mention how many sessions are remaining each week.  This will provide a tight containing space.

During sessions it can be a good idea to reflect back to the client what is holding them back from making changes. But your job is not to open pandora’s box in short term counselling, merely to undertake some modest digging. Try to track dreams during the sessions too.

Avoid psychobabble.  Plain English is always best.

The review

At the midpoint of the intended number of sessions you could ask for views about how it is going.  We were here, now we’re here. What were their views?

It is also important to have a formal ending and to offer the client the option of coming back.  

What is important is to devise your own model for short term counselling.

Next week:  TA and EMDR

Resources:

Do I need short or long term counselling?
Short term counselling books
A six session model for short term counselling
  


 

Brief therapy: All you need is now

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Well, I have started my second year on the course.  The marking of the passage of time, a new calender year, a new academic year, a new supervision group and a new year tutor was a bit unsettling but such is the nature of change.  My new year tutor started the new academic year off with an exercise on brief therapy, essentially how we would structure a course of short term therapy with a client, supposing that short term therapy was the only option. His preamble to the session was that there is only “now”.  For him, he marvels every day he wakes up. Very existential.

Applying this to psychotherapy, he reminded us that all the theory and all the knowledge can lose its importance when you close the door and sit with a client.  Whilst the theory can give us confidence as a therapist there is also the danger that we can mistakenly try to fit square pegs into round holes. Not knowing is best, or being in the mystery. Indeed, Erickson apparently said that a new psychology was needed every time one meets with a new client.

It was a useful exercise in group work to devise a strategy for a short term course of treatment as it challenged us to think creatively about strategies and options.  We were tasked as a group to tackle the philosophical question of whether we worked in a person centred approach or a more structured way. Essentially my group were agreed on the need for goals setting and to keep the sessions tight so that there was little opportunity for wandering. This was in keeping with CBT techniques with daily and weekly tasks, thought monitoring and goals setting and reviews.

My year tutor made a few other interesting statements.  He said that there is no guarantee there will be another session if you are contracted to a long term client.  Every session should be treated as if it might be the last session. He also stated that there is no evidence that suggests the more you invest the more benefit you get from therapy.

We will discuss the findings next week as a group.

Resources
Existentialism 
CBT
Brief therapy provider
Short term psychotherapy