Brief Psychotherapies: Potent Approaches to Treatment

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Original release date 02/09. Approved for CME credit through April 2009.

Educational Objectives

After reading this article, you will be familiar with:

• The history of brief psychotherapy • Why there is a need for brief psychotherapy • The approaches of the various psychotherapies • The type of patient most suitable for brief psychotherapy.

Who will benefit from reading this article?
Psychiatrists, psychologists, primary care physicians, nurse practitioners, and other health care professionals. To determine whether this article meets the continuing education requirements of your specialty, please contact your state licensing and certification boards.

Brief psychotherapy is not the name of a specific model or theory of treatment. Rather, it describes an approach that attempts to make psychotherapy as efficient and practically helpful as possible within a limited time frame. The aim of brief therapy is to speed up the process of change, amplify patient involvement, and foster more focused psychotherapy sessions. Over the years, several approaches to brief psychotherapy have evolved. Some advocate a handful of sessions; others involve more than 20 sessions (eg, psychodynamic therapy).

A growing body of empirical evidence highlights not only the fact that short-term psycho­therapy produces positive outcomes but also that the likelihood of success can be linked to certain patient and therapist characteristics. The value of brief psychotherapies for a variety of conditions has been well documented.^1-3

A brief history of short-term approaches Some may be surprised to learn that treatments of brief duration have roots in psychoanalysis, which is often portrayed as the model that requires the longest time in treatment. In Studies on Hysteria, Freud4 described 3 of his cases that only lasted between 1 and 9 weeks. Furthermore, his successful treatment of famed composer Gustav Mahler’s impotence in a single, 4-hour session is a demonstration of the value of focus and brevity.⁵ Other psychoanalysts, such as Ferenczi and Rank,⁶ also made deliberate attempts to abbreviate the length of psychotherapy. However, it was Alexander and French7 who most systematically moved analysts toward briefer therapies in their classic work Psychoanalytic Therapy: Principles and Applications.