Coping.org:
Tools for Coping
with Life's
Stressors
|
|
|
|
|
|
Search WWW Search www.coping.org |
The
clients have experienced "faulty learning at some point in early life.
The
clients and their environment interact and influence each other reciprocally.
The
interpersonal environment of the clients is never neutral. It influences the
clients positively or negatively.
Although
personality, character, social supports etc. are all very important in
people’s life patterns, chance encounters and chance events are also
prominent factors in shaping life's course.
People
understand experience, at least in part, on the basis of their stage of
development.
There
will be little to no therapy achieved until the clients are ready to change
(Light Bulbs wanting to be changed ).
Critical
factors concerning therapists in ESBT are:
The
therapist must maintain a clear, specific focus and structure in the
therapeutic process.
The
therapist must maintain an active therapeutic role by suggesting activities
or insights, collaborating and problem solving with the clients, using tasks
and homework assignments and by
asking questions.
The
therapist must remain aware of the value of "time" in the process
and that each session be valued as vital to the desired outcomes.
The
therapist must make sure that the time between sessions is spent in carrying
on the therapeutic process. This is done by liberal use of homework
assignments. These assignments include readings, journal writing, practice
of new behaviors such as exercise, joining self-help groups, public
speaking, volunteering and trying new interactional patterns in the family,
marriage and work or school setting if applicable.
The
therapist must be willing to try new strategies and do something different
and novel in order to move the clients to be motivated and challenged to
deal with the presenting problems
successfully.
The
therapist must be willing to be flexible and eclectic in using a variety of
treatment modalities for individual, couple, family and group therapies.
The
therapist must be willing to use innovative session duration and
re-scheduling.
The
therapist must see end of treatment as interrupting vs. terminating and
encourage the clients to recognize that therapy is a process over the whole
life cycle and that they can return in the future on an as needed basis.
The
therapist must be clear with the clients that relapse is a part of recovery
and that to return to therapy is not failure but rather good common sense.
The
therapist must be clear what the disincentives for brief therapy such as
ESBT are so that they do not fall into the trap of unnecessarily lengthing
therapy. Some disincentives are the bias of training programs against
training therapists in the brief model, the current over supply of
therapists competing for the same clients population and the financial
survival need for the fees for
services as basis for private practice.
Although
there is a common belief that 85% to 90% of all clients are appropriate for
brief therapy Koss and Shiang (1994) indicate that individuals who appear to
benefit most from brief therapy are those whose problems had a sudden or acute
onset, were previously reasonably well-adjusted, could relate well with others
and had high initial motivation when entering the therapeutic process.
They went on to suggest that brief therapy may be inappropriate for
individuals whose personal characteristics are in contrast to those noted above
and for some types of psychological disturbances such as substance abuse,
psychosis, and personality disorders. This being said, the factors, which seem
to make clients good candidates for ESBT, are:
The
clients must have an average intellectual ability and capable of
understanding the issues in involved. They must be able to read and write in
order to many of the assignments given.
The
clients must be psychologically minded and open to psychologically oriented
insight, interpretations and suggestions.
The
clients must have some social support system in place where they can turn
for support and understanding during their time in the therapeutic process.
The
clients must be motivated for change. They need to be the light bulbs that
are ready.
The
clients must have a social orientation and be able to relate their problems
in a social context.
The
clients must have a clear present problem or principle complaint, which can
be identified in therapy.
The
clients must have an ability to collaborate with the therapists in the
process.
The
clients in their past must have been able to have established at least one
meaningful relationship in their lives.
The
clients must have the capacity for rapid emotional involvement and equally
rapid emotional separation.
The
clients must have good ego strength.
The
clients must have the ability to express feelings.
The
clients must have the expectation that ESBT therapy will be successful. This is possible by having family and friends who have experienced
successful similar brief therapy, their own successful experience in
previous similar therapy, if they are in a helping profession and if they
have heard in the media the benefits of such brief therapies.
Those people who are not candidates for any psychotherapy and considered untreatable are excluded from ESBT based on the belief that therapists do not try to treat the untreatable.
In
order to determine if this is so, therapists need to think of all therapy
as "trial therapy" for 3 sessions and then they either: transfer
inappropriate clients, use an alternative or adjunctive modality of
treatment, or offer no treatment at all.
|
|
The Tools for Coping
Coping.org
is a Public Service of James J. Messina, Ph.D. & Constance M. Messina, Ph.D.,
Email: