Academic journal article
By Cameron, Christopher L.
American Journal of Psychotherapy , Vol. 60, No. 2
During the last several decades, brief psychotherapeutic approaches to mental health treatment have become increasingly prevalent. This paper describes brief psychotherapy and provides a brief review of the relevant empirical literature. Therapists who are unfamiliar with brief psychotherapy will find that this paper provides a concise introduction to the essential processes and outcomes of this therapeutic approach.
Since the advent of psychotherapy, one of the most common questions has been, "how much psychotherapy is enough?" (Shapiro et al., 2003). The answer to this important question is far from clear and has been shaped by a wide variety of economic, political, clinical, and scientific considerations. However, during contemporary times, the delivery of all mental health care services, including psychotherapy, is heavily influenced by economic considerations. Limited financial resources often dictate that treatment be administered using the most cost-effective, short-term strategies available (Macdonald, 1994). Consequently, in many countries a large number of the individuals who need mental health treatment receive brief psychotherapy.
The term "brief psychotherapy" often refers to mental health treatment that typically ends after no more than 25 sessions (Shapiro et al., 2003). It should be acknowledged that this definition tends to vary depending on the theoretical orientation of the therapist. However, for the most part therapists believe that 12 to 25 sessions of psychotherapy usually are enough to stimulate positive, enduring change in clients with a wide range of mental health issues (Garfield; 1994; Shapiro et al., 2003). While it is important to note that the duration of sessions tends to make a large impact on the psychotherapeutic outcome (Goldenberg, 2002), the duration-outcome relationship in psychotherapy is mediated by a complex interplay of client, practitioner, and contextual factors that, under certain conditions, allow change to proceed quickly and under others, necessitate allocation of more time for treatment (Freedman, Hoffenberg, Vorus, & Frosch, 1999; Steenbarger, 1994).
Brief psychotherapy is the form of mental health treatment that most closely corresponds with what many clients expect when they voluntarily seek mental health care. Voluntary clients rarely expect prolonged treatment and often are only seeking assistance to resolve specific, temporal problems (Cooper, 1995; Hoyt, 2001; Koss, Butcher, & Strupp, 1986; Shapiro et al., 2003). Even when therapists see utility in pursuing treatment until habitual problems are addressed and rectified, clients are generally unwilling to engage in lengthy treatment (Hoyt, 2001). Most clients who seek brief psychotherapy do so periodically throughout their lifetimes when difficult challenges or unexpected traumas present themselves (Cooper, 1995). However, deep exploration of the past and dramatic overhauls seldom are desired (Anchin, 2003; Cooper, 1995).
Several forms of brief psychotherapy exist, and each has its own unique features (see Steenbarger, 1992). Despite these unique features, each form of brief psychotherapy uses similar concepts and principles in a focused and purposeful way to stimulate client change (Cooper, 1995). However, not every form of psychotherapy that is short in duration can be classified as brief psychotherapy. In order to be classified as brief psychotherapy, certain therapeutic characteristics must be present (Koss, Butcher, & Strupp, 1986). Five therapeutic characteristics that must be present are as follows (Cooper, 1995; Koss, Butcher, & Strupp, 1986; Shapiro et al., 2003):
1. Maintenance of a clear and specific treatment focus. This is often referred to as the hallmark of brief psychotherapy. The therapist helps the client select problems on which to focus. The therapist helps the client stay focused on what they are trying to accomplish from session to session over the course of treatment. …