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Block 1 Unit 3 Short Term Psychotherapies

1) What is the difference between brief, very brief and time-limited therapies?

Brief, very brief, and time-limited therapies are distinguished by the number of sessions they involve:

• Very brief therapy consists of one to five sessions, and lasts less than two months.
• Brief therapy usually consists of six to 16 sessions and lasts two to six months.
• Time-limited therapy involves 17 to 30 sessions, lasting six to nine months.

2) What are the general working assumptions of brief therapies?

General working assumptions of brief therapies include:

• Therapy is a catalyst for change in a complex system rather than a ‘one-shot’ curative method.
• Therapists aim to maximise the therapeutic alliance and avoid regression.

3) What are triangles of insight?

Triangles of insight, used in psychodynamic therapy, offer a framework for understanding psychological distress.

• The Triangle of Conflict connects anxiety (presenting symptoms) to hidden feelings/impulses (e.g., anger) and the defenses used to repress them (e.g., denial). 
• The Triangle of Person links current relationships to past significant relationships and the therapeutic relationship (transference), revealing recurring relational patterns. 

By exploring these connections, patients gain insight into how past experiences and internal conflicts contribute to present difficulties, facilitating deeper self-understanding and healthier coping mechanisms.

4) What is the selection criteria for Short term anxiety provoking psychotherapy?

The selection criteria for short-term anxiety provoking psychotherapy include:

• People of above-average intelligence.
• Having had at least one meaningful relationship.
• Ability to express emotion in the assessment.
• Having a specific chief complaint.
• Motivation to work hard.
• Realistic expectations of treatment.
• Able to participate actively in treatment and curiosity.
• A willingness to make ‘the necessary sacrifices’

5) What is Problem-solving therapy?

Problem-solving therapy (PST) is a brief psychological treatment for depression based on cognitive-behavioural principles. It has also been used as a form of crisis intervention following deliberate self-harm or attempted suicide.

6) What is the aim of motivational interviewing?

The aim of motivational interviewing is to help those reluctant to change problematic behaviours move from the pre-contemplation stage, or ambivalent contemplation, to preparation where change options can be explored, and then action and maintenance of change. The method is nondirective and avoids any confrontation with resistance or lack of motivation.

7) Describe in detail the defining features of brief or short term psychotherapies?

Defining features of brief or short-term psychotherapies include:

• Time limits: Brief therapies work within set time limits, which can be managed in different ways. Some therapies emphasize the time limit, using the frustration it can arouse to facilitate change, while others minimize it, making further therapy available if needed.
• Therapeutic focus: The therapy can focus on manifest symptoms or a presenting problem, or on intrapsychic or interpersonal issues, such as a core conflict or an issue in personal development.
• Therapist activity: The therapist is generally more active in short-term therapy, in contrast to some long term approaches where the therapist is more passive. In brief psychodynamic therapies, for example, the therapist is more active in interpreting transference, unconscious conflicts and in confronting resistance.

8) Discuss the different models of brief therapies using psychodynamic approaches?

Different models of brief therapies using psychodynamic approaches include:

• Early psychoanalytic therapies, some of which were very brief.
• Modern brief psychodynamic therapies that have roots in the work of Ferenczi (1920) and Alexander and French (1946).
• Short Term Anxiety Provoking Psychotherapy where treatment is seen as ‘anxiety-provoking’ because it confronts the patient’s defences directly. This therapy has a maximum of 20 sessions, and mostly lasts between 12 and 16 sessions.
• Anxiety suppressive therapy, which is aimed at less-healthy patients who might be discomforted by the confrontational stance of anxiety provoking therapy.

9) Write about the short term therapies under cognitive behavioural approaches?

Short term therapies under cognitive behavioural approaches include:

• Brief therapies based on behavioural, CBT, and cognitive theories that arose from a research-based tradition.
• Cognitive Behaviour Therapy (CBT) and Cognitive Therapy, which were designed to be brief.
  • These therapies originally focused on depression, anxiety disorders, and obsessive-compulsive disorders, all without comorbid personality disorders. Since then, the range of mental health problems addressed has grown.
• Problem Solving Therapy (PST), which is a brief psychological treatment for depression based on cognitive behavioural principles.
• Computerised CBT and guided self-help approaches to anxiety and depression, to reduce time spent in therapist contact.

10) Write about cognitive analytic therapy (CAT)?

Cognitive analytic therapy (CAT) is a modern integration of analytic (object relations theory) and cognitive psychotherapy traditions. It provides a brief, structured and collaborative therapeutic journey from past trauma into reconnection with dialogue and meaning. CAT emphasizes shared meaning in the context of the client’s life story, and gives importance to ‘dialogue’ in the therapeutic relationship.

11) What are very brief therapies and discuss motivational interviewing and solution-focused brief therapy?