Very Brief Psychotherapy

Very Brief Psychotherapy

Very Brief Psychotherapy

Very Brief Psychotherapy


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.

In Very Brief Psychotherapy,Dr. James Gustafson provides the reader with the tools and techniques to make a discernable difference in a patient's life in only a few moments. The majority of people seeking help from mental health professionals are not pathological, but are most often stuck in self-imposed cyclical patterns of behavior from which they cannot escape. It is the first step in any situation that leads to the iteration of the familiar circle, and it is in this single step that the clinician can effect decisive change. Given a window of only five or ten minutes, the practitioner armed with this approach can help a patient break out of the repeating pattern, move around the impasse, and take the first step onto a new trajectory. Very Brief Psychotherapycan help the practitioner make meaningful interventions in real world time, and in less than ideal circumstances, will radically change the reader's concepts of what can be accomplished in a day, in a clinical hour, or even in a single moment.


… the laws of nature appear simple when expressed in higher
dimensional space (Kaku, 1994, p. 37).

In the mental health professions, we all have some kind of niche with some kind of procedure that is useful. I am thinking of psychology and psychiatric social work and nursing and mental health workers, with procedures of cognitive-behavior therapy and solution-focused therapy and psychodynamic therapy, and I am thinking of psychiatry with psychopharmacology. If we had a chance to add one step to what we already do, what would this step look like?

It has been my job to give this chance to trainees and staff in psychiatry, psychology, and social work at the University of Wisconsin, Department of Psychiatry for over 30 years. Since the mid-1990s, the medical school has required every patient seen by a trainee to be seen also by an attending, and I have had to practice giving this chance, most of the time, in 10 minutes. This is the time frame, the window of opportunity, for either the patient or the trainee to ask me one question. Additionally I can take 20 minutes if the question is about a dream, and once a week I can take an hour in my brief psychotherapy clinic to do a videotaped interview about a case of particular interest that is stuck and needs my opinion about how to get unstuck. But the usual chance is taken in 10 minutes, and that is very brief psychotherapy.

Many colleagues have been loud in their sympathy for me that I get so little time to be of help. Surely, I must only have time to write a little note and sign it. I tell them that this is quite enough time, and they are amazed, or disbelieve me. There is a simple reason why this is enough time: human beings are astoundingly repetitive or redundant. If they take a single step . . .

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