The use of dreams in brief therapy.

Suggests a general clinical framework for listening to dreams and interacting with the patient's dreams in brief therapy. Dreams may aid in assessing the quality of object relations and transference, facilitating expression of repressed affect, setting a therapeutic focus, placing dream material in reality, determining resistances, locating meaning, and implementing insight. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Resistance to brief therapy.

Comments that N. A. Cummings's (see record 1986-22651-001) discussion on dismantling the health system should be required reading for all psychological health-care providers. Types of resistance are discussed that must be overcome by therapists learning and practicing short-term therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A brief history of practice— expanded.

Psychology can trace its origins from philosophy, through experiential introspection and behaviorism, to a major branch in the evolution of the discipline called practice. This article presents a history of practice, with emphasis on major events that altered the direction and focus of practice. The history begins with the "first" patient of Lightner Witmer and traces the movement into assessment, psychotherapy, and primary health care. It examines the impact of the federal government, the Veterans Administration system, and World Wars I and II on the evolution of practice. The expansion of the availability of services along with the movement to credential-qualified professionals are delineated within the context of licensure laws, freedom of choice acts, and third-party reimbursement Finally, the impact of health reform on psychological practice is described. These events are viewed as an integral part of the history of psychology as well as the evolution of practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrating play therapy techniques into solution-focused brief therapy.

Solution-focused brief therapy is a recognized therapeutic approach proven effective in time-limited circumstances. This article describes the solution-focused process and presents a framework for integrating the expressive play therapy techniques of art, sandtray, and puppets into the solution-focused model. Three case studies are used to demonstrate this process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Strategic brief therapy in a clinic setting.

Strategic brief therapy involves defining the problem, exploring the attempted solutions, developing new solutions, and convincing the client to try them. Three cases from an outpatient clinic are presented to illustrate the use of this therapy in a clinic practice. Advantages of the approach are discussed, and modifications arising from the application of research-derived techniques in a clinical setting are described. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Constructing managed care, constructing brief therapy.

Comments on the article by P. Cushman and P. Gilford (see record 2000-05933-002). The author appreciates the questioning of managed care's use of positivism and "objective scientism" as well as a recognition of its focus on "instrumentality, efficiency, and conformity", but argues that brief therapy and managed care are not synonymous. The author sees many problems with managed care, but also sees the need for fiscally viable and clinically sound ways to provide broad services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The practice and ethics of sexual orientation conversion therapy.

Sexual orientation conversion therapy was the treatment of choice when homosexuality was thought to be an illness. Despite the declassification of homosexuality as a mental illness, efforts to sexually reorient lesbians and gay men continue. The construct of sexual orientation is examined, as well as what constitutes its change. The literature in psychotherapeutic and religious conversion therapies is reviewed, showing no evidence indicating that such treatments are effective in their intended purpose. A need for empirical data on the potentially harmful effects of such treatments is established. Ethical considerations relative to the ongoing stigmatizing effects of conversion therapies are presented. The need to develop more complex models for conceptualizing sexual orientation is discussed, as well as the need to provide treatments to gay men and lesbians that are consonant with psychology's stance on homosexuality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Theory and practice of brief psychotherapy.

Reviews the book, Theory and practice of brief psychotherapy by Simon H. Budman and Alan S. Gurman (1988). This book provides an excellent view into the theory and practice of effective brief therapy. In this comprehensive and well-written joint effort, the authors present and richly illustrate a brief treatment model that integrates the intrapsychic with the interpersonal, showing how skillful and motivated therapists who value pragmatism and flexibility can formulate and conduct therapies in a parsimonious, cost-effective manner. The authors emphasize that brief (or "time-sensitive") therapy is defined not by a certain number of treatment sessions but rather by the quest to be efficient and to get the job done as quickly as possible. Each chapter is full of basic principles, cogent research findings, and good clinical examples that will help the reader to be a more efficient therapist. This book should become basic reading for all therapists, in training or continuing their education, who want to learn more about how to get the job done efficiently. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An evaluation of a brief group therapy for depression.

Evaluated a brief group therapy for treating 20 depressed outpatients. As an adjunct to group therapy, clients used written self-instructional materials to guide them in monitoring and increasing their frequency of pleasurable activities. Ss were randomly assigned to an immediate (IT) or delayed treatment (DT) group. Results did not support the effectiveness of IT. However, after receiving treatment, DT clients successfully increased activities and decreased depression relative to IT. (2 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Time-limited brief therapy has gone too far: The result is invisible rationing.

Proponents of managed care endorse time-limited brief treatment on the belief that time limits result in little or no harm to psychotherapy outcome. However, the research findings cited as favorable to time limits are based on erroneously classified research, and the related research is incorrectly interpreted. Properly classified and interpreted, the research indicates that time-limited therapy is in fact inferior to clinically determined treatment. Both research and reason indicate that time-limited therapy is not an equally effective alternative treatment but merely a form of rationing. Although rationing may be necessary, when time-limited therapy is promoted as equivalent to clinically determined treatment, the consumer is often unaware of the rationing. The result is the ethically questionable practice of invisible rationing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Managed care, brief therapy, and therapeutic integrity.

A major cost-containment strategy of managed mental health care is the mandating of short-term psychotherapy via session limits, dollar caps on mental health benefits, and utilization review mechanisms. It is argued that while brief therapy is a widely useful treatment modality, when it is mandated by a 3rd party it violates the fundamental integrity of the therapeutic relationship. The construct of therapeutic integrity is defined, and the parameters vulnerable to managed care intrusions are identified. The author examines the implications of this analysis for (1) the practice of brief therapy, (2) training in brief therapy, (3) managed care, and (4) organized psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Inhalation therapy in children younger than 2 years. II. The practice

Effective inhalation of drugs, even by small children under 2 years, is often faster, simpler, cheaper and better with metered dose inhalers with small antistatic (metal) inhalation chambers than with nebulisation. This is also true during considerable bronchial obstruction. It is mandatory that the inhalation chamber has a small dead space and well functioning valves opening at low flows. Effective dosing in small children is enhanced by more doses, given separately, while choosing the highest dose per spray available. Important factors determining bronchial deposition in small children are breathing frequency, tidal volume and the degree of bronchial obstruction and nasal obstruction, since inhalation goes primarily through the nose. If well-performed medication with a small inhalation chamber is clinically ineffective, it is better to start systemic medication, e.g. a corticosteroid, or even to consider artificial ventilation, rather than to try nebulisation. Better effective deposition is possible with inhalation of drugs in hydrofluoroalkane (HFA) aerosols, which will replace chlorofluorocarbon (CFC) aerosols in the near future.     

Three sessions of brief couples therapy: A clinical trial.

The effects of positive reframing and restraining in the context of time limited brief couples therapy were investigated. Forty couples were randomly assigned to either an immediate treatment group or to a waiting-list control group that received delayed treatment. The interventions had a positive impact on dyadic adjustment target complaints and conflict resolution of treated couples compared to couples in the waiting-list control group. There were no significant differences observed in the relationship belief and spousal attributions between the treated and untreated couples. Thirty-nine percent of couples met L. Christensen and J. Mendoza's (1986) definition of clinically meaningful improvement. Treatment gains observed at the termination of the 3-session treatments appear to have been maintained at 6-weeks follow-up. A positive relation was observed between couples improvement and compliance with treatment directives. Implications for time-limited brief therapy are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Person-centered therapy and solution-focused brief therapy: An integration of present and future awareness.

The authors propose an integration of person-centered therapy, with its focus on the here and now of client awareness of self, and solution-focused therapy, with its future-oriented techniques that also raise awareness of client potentials. Although the two theories hold different assumptions regarding the therapist's role in facilitating client change, it is suggested that solution-focused techniques are often compatible for use within a person-centered approach. Further, solution-focused activities may facilitate the journey of becoming self-aware within the person-centered tradition. This article reviews the two theories, clarifying the similarities and differences. To illustrate the potential integration of the approaches, several types of solution-focused strategies are offered through a clinical example. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The current state of brief therapy training in American Psychological Association-accredited graduate and internship programs.

Did your graduate education include training in the types of therapy most in demand today? The present study surveyed training directors at graduate and internship sites accredited by the American Psychological Association to ascertain if their programs offered training in brief therapy. With response rates of 87% and 78%, respectively, the authors found that almost all internship sites and a simple majority of graduate schools provide some brief therapy training. The brief therapy teachers and supervisors in these settings were also surveyed with regard to course content, educational methods, amount of supervision, and problematic training issues. It is the authors' position that given the nature of the emerging marketplace, clinical training programs should include brief therapy as part of their curricula. Specific recommendations for increasing trainees' and professionals' knowledge base in this area are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The intensive analysis of recurring events from the practice of Gestalt therapy.

Presents an intensive analysis of 9 events in which 3 clients were working on resolving "splits" by means of the Gestalt "2 chair method." These events had previously been shown to contain good therapeutic process as measured by the Experiencing Scale, and the purpose of this analysis was to discover performance patterns associated with resolution. A model of "split" resolution, constructed from Voice Quality and Depth of Experiencing data (indices of productive therapeutic process), shows that resolution occurs by integration. The softening of the internal critic emerges as a key factor in resolving intrapsychic splits. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist adherence in brief strategic family therapy for adolescent drug abusers.

Objective: Therapist adherence has been shown to predict clinical outcomes in family therapy. In prior studies, adherence has been represented broadly by core principles and a consistent family (vs. individual) focus. To date, these studies have not captured the range of clinical skills that are represented in complex family-based approaches or examined how variations in these skills predict different clinically relevant outcomes over the course of treatment. In this study, the authors examined the reliability and validity of an observational adherence measure and the relationship between adherence and outcome in a sample of drug-using adolescents who received brief strategic family therapy within a multisite effectiveness study. Method: Participants were 480 adolescents (age 12–17) and their family members, who were randomized to the Brief Strategic Family Therapist treatment condition (J. Szapocznik, U. Hervis, & S. Schwartz, 2003) or treatment as usual. The adolescents were mostly male (377 vs. 103 female) and Hispanic (213), whereas 148 were White, and 110 were Black. Therapists were also randomly assigned to treatment condition within agencies. Results: Results supported the proposed factor structure of the adherence measure, providing evidence that it is possible to capture and discriminate between distinct dimensions of family therapy. Analyses demonstrated that the mean levels of the factors varied over time in theoretically and clinically relevant ways and that therapist adherence was associated with engagement and retention in treatment, improvements in family functioning, and reductions in adolescent drug use. Conclusions: Clinical implications and future research directions are discussed, including the relevance of these findings on training therapists and studies focusing on mechanisms of action in family therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Investigation of what clients and counselors do not say in brief therapy.

After each session in 24 cases of 6-session therapy, clients and counselors reported thoughts or feelings that they did not say, and counselors tried to guess what clients left unsaid. Results indicated that most things left unsaid were negative. Clients did not reveal behaviors/cognitions and emotions, whereas counselors did not reveal emotions and clinical conjectures. For clients, there was a positive correlation between (1) the proportion of things with emotional content left unsaid and (2) client-rated satisfaction with therapy and change, but there was a negative correlation between (1) the proportion of things left unsaid with behavioral/cognitive content and (2) client-rated satisfaction with change. Finally, counselors were aware of only 17% of the things clients left unsaid. When counselors accurately guessed what clients left unsaid, counselors rated the sessions as being rougher, and clients were less satisfied with treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief couples therapy: Lessons from the history of brief individual treatment.

In the author's attempt to grasp the controversies facing brief couples therapy it was useful to apply the principles of brief individual psychotherapy, learned earlier by such pioneers as D. H. Malan, H. Davanloo, and J. P. Gustafson, to major, contemporary, couples treatment models: emotionally focused treatment, integrative behavioral couple treatment, nontraditional egoanalytic couples therapy, and the narrative, solution-focused, and strategic schools. This exercise illustrates that present-day couples therapy faces important theoretical and technical dilemmas that impede its development toward a mature system of brief treatment. When some resolution to these dilemmas can be gained, brief couples therapy can progress into a consolidation phase. (PsycINFO Database Record (c) 2010 APA, all rights reserved)