BRIEF APPROACHES: AN OVERVIEW
Tracing the exact beginnings of brief approaches to counseling and therapy is not an easy task. Did they become part of the therapeutic world during World War II, as suggested by Herman (1995), who stated that military clinicians devised a "menu of creative psychotherapeutic alternatives and shortcuts" (p. 112) to ensure that the maximum number of soldiers could be returned to active duty in a minimum of time? Was it the pioneering work at the Mental Research Institute, in the 1950s and 1960s, under the direchon of Don Jackson and Gregory Bateson, with consultation and collaboration with Richard Fisch, John Weakland, Jay Haley, William Fry Jr., Virginia Satir, and Milton Erickson, that provided the real thrust in the development of brief approaches to counseling and psychotherapy? Regardless of where one places the responsibility, brief approaches are today a major part of the therapeutic picture.
According to R. Lewis (2005), approximately 50 brief approaches exist in the literature. Many of these are tied into existing theoretical systems, for example, rational emotive behavior therapy, reality therapy, psychodrama, and Adlerian therapy. A few stand alone as developing theoretical and therapeutic approaches, for example, brief problem-focused therapy, brief solution-focused therapy, and solution-oriented (possibility) therapy (Palmatier, 1996; Shulman, 1989). Brief approaches are a rapidly developing area, and the development has been encouraged by the response from managed care and its attraction to brief approaches because of their focus on symptom relief and increased function as pragmatic and cost effective (Battino, 2007; Hoyt, 1995; Seidel & Hedley, 2008).
R. Lewis (2005) stated that "the overemphasis on length of treatment may take those interested in brief counseling approaches down the wrong path" (p. 176). In the discussion of brief approaches to counseling and psychotherapy, the emphasis should not be on "brief" but on the concepts of counseling and therapy. Mahoney (1997) stated that "indeed, the actual number of hours logged in psychotherapy is much less important... than is the significance of the experiences that transpire during that time" (p. 141). There appears to be no hard-and-fast rule regarding how long brief counseling and psychotherapy should take. Sharf (1996) stated that 3 to 40 sessions could be the range. This of course is debatable, and in general brief counseling and therapy ranges from 1 to 25 sessions, with 25 generally considered the maximum number of sessions. Hoyt (1995), perhaps, best captured the essence of this number debate when he stated that brief counseling and psychotherapy are not defined by "a particular number of sessions but rather the intention of helping clients make changes in thoughts, feelings, actions in order to move toward or reach a particular goal as time-efficiently as possible" (p. 1).
Based on the existence of many different brief approaches, it is important to look at certain factors that seem to be common across these approaches. Cooper (1995) offered the following eight technical features found in various forms of brief counseling:
1. Keep a clear and specific treatment focus.
2. Use time conscientiously.
3. Limit goals and clearly define outcomes.
4. Place emphasis on the present and here and now.
5. Assess rapidly and integrate this into treatment.
6. Review progress frequently and discard ineffective interventions.
7. Maintain a high level of therapist-client collaboration.
8. Be pragmatic and flexible in technique use.
Addressing this issue further, Fisch (1994) provided counselors or therapists with the following four principles common across brief approaches: (a) Narrow the database regarding counselor-client focus, (b) use interactional rather than intrapsychic concepts, (c) develop a task orientation rather than an insight orientation, and (d) define goals to know when to stop therapy.
These common factors are further supported by Bertolino and O'Hanlon (2002) and Hoyt (2000) when they suggested that brief counselors or therapists (a) embrace pragmatism and parsimony, (b) see human change as inevitable, (c) build on client resources and competence, (d) focus on work outside of counseling and psychotherapy, (e) recognize that sometimes counseling and therapy do not help, and (f) view counseling and psychotherapy as more effective when based on specific contexts and problem areas. R. Lewis (2005) stated that brief counselors or therapists shift their efforts from concentrating on deficits to looking for strengths, from exploring problems to creating solutions, and from fixation on the past to active construction of a preferred future.
Building on these common factors, we provide in the following paragraphs brief comparative discussions of the three brief approaches mentioned previously, namely, brief problem-focused therapy, brief solution-focused therapy, and solution-oriented (possibility) therapy. These three brief approaches have developed from a common theme rooted in client competence and strengths (Dejong & Berg, 2002; Fisch, 1994). Each draws upon client strengths in solving problems, finding solutions, or discovering possibilities. According to R. Lewis (2005), these strength based approaches do not embrace a normative model that prescribes which is normal and healthy or abnormal and deviant, the approaches move away from viewing the client as pathological and resistant, and concentrate on working with clients to find out what works in their own lives, (p. 178)
These were selected as they seem to be representative of the current brief counseling and psychotherapy movement.