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Brief psychotherapy is predicated upon a thorough knowledge of psychodynamics and careful conceptualization of each individual's psychopathology. Areas and methods of intervention must be concisely selected and clearly goal-related. As a modality, I see brief therapy relating to traditional therapy the way a short story relates to a novel. It takes special skill and expertise.
Structured brief psychotherapy is a method of organizing treatment along problem-solving lines. The features of this method are the selection of problem areas, the translation of insight into specific activity, the structuring of psychodynamics and a concentration on termination events. The method is illustrated by clinical examples.
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26 non-selected out-patients of a psychiatric and psychotherapeutic clinic with psychoneurotic personality disorders and psychosomatic complaints were treated with the Guidive Affective Imagery (GAI) during 20 sessions. Analysis of the psychodiagnostic tests prior to treatment showed that 7 patients had insignificant psychopathological profiles although they felt bad and had diffuse psychosomatic complaints whereas 12 suffered from neurotical symptoms and severe psychosomatic disorders. The rate of improvement was assessed by standardized tests. The GAI proved to be an effective short term treatment of depressive and inhibited patients. A significant rate of improvement of less neurotic and psychosomatic disorders was found. These results are still to be confirmed by katamnestic questionnaires in order to assure that the therapeutic changes are long lasting.
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The advance of industrialization in Mexico and elsewhere has brought about psychosocial problems of aging similar to those encountered in the United States. A case study is presented of a 64-year-old Mexican widow who had suicidal thoughts and feeling of uselessness. External constraints on the therapist dictated that psychotherapy be completed within 15 days. A strategy of brief psychotherapy was adopted. The focus was not on establishing transference, probing the unconscious or reconstructing the patient's personality, but on identifying problems and formulating practical solutions promptly. Four hour-long sessions were sufficient to gather information and to counsel the patient and her family. The diagnosis was depression. Treatment centered around increasing the quality of the patient's activity. The initial success of these measure made for a good prognosis. Both patient and family were advised of the availability of antidepressant drugs, and advised against relocating the patient.
How do patients who had brief behavior therapy evaluate change in themselves as compared to those who had brief psychoanalytically oriented psychotherapy a year following termination of their treatment? Restults of the follow-up study reveal that over-all, patients rated themselves at one-year follow-up as improved over their status at three months after therapy but less so than at the time of termination of therapy. The form of therapy did not make a difference in the patients' evaluation of change.
The six-month psychotherapeutic treatment of a 29-year-old woman with a hysterical personality is described. Criteria for selection of patients suitable for brief psychotherapy and the various applications of this technique are discussed. Aspects of the psychopathology of the hysterical personality are described and related to that of the patient presented, whose sexualized transference exemplifies the important task of 'focusing' this form of treatment.
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The need for a focus for brief interpretive psychotherapy is considered and a new approach is suggested. In this method, the ways in which the patient's construction of himself and his relationships are related to his problems are identified and expressed in the form of dilemmas, traps and snags. It is suggested that these formulations represent an appropriate level of abstraction, allowing patient and therapist to share provisional hypotheses about the goals of therapy and offering the basis for a method of measuring how far these goals are achieved.