Very Brief Psychotherapy

James P. Gustafson9780415950589, 0-415-95058-9

As the fields of psychiatry and clinical psychology are increasingly driven by the economics of the HMO or Mental Health Center, practitioners in any setting, whether it be private practice or university clinic, are now forced to develop more concrete procedures and models in order to practice more efficiently. This book presents a set of procedures for brief therapy that are based entirely on the four common dynamics of psychiatry. By following the model set forth in this book, psychiatrists, psychologists, social workers, psychiatric nurses, and mental health workers will be able to build an entire brief therapy program based upon the initial conditions for each patient. The first of the four procedures is to block and contain either the eruption of anxiety or collapse of depression in a patient, usually through pharmacological intervention. Once the anxiety and/or depression has been temporarily contained, the patient will be able to function through the rest of the therapeutic process. The second procedure is to identify and isolate the step that leads up to the eruption of anxiety or collapse of depression, thus allowing the patient to avoid walking into similar situations that lead to catastrophe. Thirdly, the practitioner works with the patient to help her realize that there is always a step in the opposite direction from the old step, one that used to be suppressed by the oncoming anxiety or depression. The identity of this new step will release the patient from the traps of the old patterns, and will free her to enter into a new trajectory. The fourth procedure is to notice that the old step had locked the patient into a (seemingly) inescapable trap, but that any new step(s) taken will also carry with them the potential for further anxiety and depression. The completion of this final procedure should allow the patient to see that mental health comes from the combined ability to avoid the pitfalls of old steps, while accepting the inherent risks in taking new steps. The success of this brief therapy model is fully realized when a recovered patient begins to fall into a new trap, and can duplicate this process on her own.