(c) treesftf, Flickr

Introduction to Short-term, “brief” Psychodynamic Counselling.

In addition to open-ended counselling, Dean Richardson can offer short-term psychodynamic psychotherapeutic counselling to individuals where an assessment & both client & counsellor deem it appropriate to do so.

Short-term psychodynamic psychotherapeutic counselling is where the client and counsellor meet weekly for an agreed set number of sessions.  Each session lasts for fifty minutes, occurs once a week, and the whole therapy is limited to an agreed number of sessions (which may be between four to twelve sessions, to give an example).  The actual number will be agreed by mutual consent between counsellor and client.  The brief-therapy work concentrates upon a specific (and agreed) matter in the life of the client(s) and the therapy aims not to expand into other subject matters.  Expanding into other matters is more in the realm of open-ended counselling.

A Summary of Brief Counselling.

• Short-term psychodynamic counselling takes place within an agreed fixed number of sessions.
• The client and counsellor must agree a focus for the counselling work at the beginning (ie during the assessment).
• Although other matters may come up during counselling, these matters may need to be put aside (at least for now).
• The client must be motivated and focussed to do this form of therapy.
• The relationship between counsellor and client must be good to achieve this focussed work.

Benefits of Brief Counselling.

Some benefits of short-term, brief psychodynamic counselling work can include:-

• …the therapy lasts for a certain “known” amount of time,
• …the end date of the therapy is known at the start (which can be helpful on the focus of the counselling),
• …the client is aware of how much money the counselling will cost,
• …only a specific matter is worked with,
• …it can be useful to be able to measure the outcome of the counselling, although this is in no way essential or compulsory,
• …the rapport between client and counsellor is good, and therapeutically reliable (the client having had at least one beneficial relationship in their life)
• …uses client’s own insight into their problem,
• …works if the area of conflict can be agreed upon.

This approach (and, possibly, these limitations) can be beneficial to some clients. It is important, however, to realise that this approach is not suitable for everyone, and an initial assessment will be helpful in evaluating if this form of therapy could be helpful and in the client’s best interests.

Counter-indications for Brief Counselling.

The counsellor is responsible for judging during the assessment if the client is suitable for brief therapy or if such therapy may cause harm to the client (eg based upon the client’s level of functioning) when, instead, the counsellor may offer other forms of therapy (such as open-ended counselling).

Other counter-indications for brief counselling may include:

• The client is unable to focus adequately on one matter, instead requiring the time and space to make use of free association.
• The client is unmotivated to focus on a particular matter within the limited amount of time.
• It is felt by the client and/or counsellor that the client’s needs would not be adequately met by focussing upon just one matter.
• When setting a deadline to a psychological or emotional matter would be inappropriate (eg the client is motivated to select short-term work only because of costs or due to an EAP offering only of a fixed number of sessions, when the client’s needs are greater than that offered & beyond the therapeutic interventions available).
• The client’s ability or potential for insight is limited (insight = a kind of self-realization or self-knowledge).
• The client may be dependant on the counsellor for providing solutions, rather than be motivated to be an active participant  in their own therapy.
• From a psychodynamic point of view, the client’s defense mechanisms and resistance are too high/too ingrained to invite self-change during brief therapy.

The  assessment session will allow client and counsellor to discuss what is and what is not possible, and to reach a decision together as to whether short-term, brief therapy would be suitable as opposed to open-ended therapy.

See also “How long can counselling take”.

Introduction.

Dean combines systemic counselling with psychodynamic counselling to provide couples counselling.

Mara Aelvini Palazzoli

Overview of Systemic Therapy.

Everyone involved in a relationship has their own personality, ways of seeing things, sets of values and history.  Systemic therapy aims to help people in a relationship by addressing their their interactional patterns and dynamics … addressing the relationship rather than addressing the individuals within the relationship.

Background to Development of Systemic Therapy

Mara Selvini Palazzoli (1916-1999) was an Italian psychiatrist and founder in 1971, with Gianfranco Cecchin, Luigi Boscolo and Giuliana Prata, of the systemic and constructivist approach to family therapy which became known as the Milan systems approach.

Early forms of systemic therapy were based on cybernetics – the study of computer systems.  For example, a computer system is programmed to perform tasks one after the other, and choose different tasks depending on decisions that judge previous events in the system.  In a human relationship, a couple might say that an argument began “when he says this”.  If we begin by addressing this systemically, we can begin to understand not just that “he said that” but what prompted him to say it, what was going on in his process to say it, how did he experience something that happened just before he said it,  was this in response to something his partner had said or done previously … and so on.  It can be a complicated process – but in therapy we have time and can slow things down in order to understand how this relationship system works.

Systemic therapy helps us address complex systems – and hence complicated relationships within an intimate, human relationship. Systemic therapy focuses on practically addressing current relationship patterns, and it is limited in that it does not analysing in detail where the patterns came from (however, by adding psychodynamic therapy, we add the necessary process to also begin to understand where the patterns came from).

Use of Systemic Therapy in Couple Counselling.

When combined with psychodynamic counselling, Dean provides couple counselling that follows a “Milan” style of therapy – commonly used by Relate-trained therapists.  This helps a couple to discover what’s going on in their relationship … and once understanding begins to take place, a couple can then become more free to make conscious choices about what they wish to change and, of course, what they wish to leave the same.

Recommended Reading Material.

Introduction.

Sigmund Freud

Dean practices primarily as a psychodynamic counsellor.

Overview.

Psychodynamic counselling is derived from psychoanalysis and the work of Freud and subsequent psychoanalytic theorists. It is a way to understand how a person’s past has had an affect upon present day problems. It is also a way to understand human growth and development, which are major factors upon people’s lives. This, plus understanding unconscious matters such as defences (behaviours that are intended to protect us, but can end up getting in the way of ours lives), leads to a form of therapy that is accepting, empathic, understanding and helpful.

Use of Psychodynamic Counselling.

The counsellor respects how the client sees his/her real world, including the affect of any trauma, any differences in culture, sexuality, disability and any social context. In such a therapeutic containment, the therapist and client work together in their relationship to help the client build a better life for him/herself.

When combined with systemic counselling, Dean provides couple counselling that follows a “Milan” style of therapy.  This helps a couple to discover what’s going on in their relationship.  Once understanding begins to show, a couple becomes more free to make conscious choices about whether (or not) to change their relationship.

Recommended Reading Material.