Understanding the basis of theories and therapy is a necessary element of the therapist's trade. Without some knowledge of why certain therapies are practiced, or where they came from, it is difficult to develop a personal theory and a personal view of how to conduct therapy. Since one of the basic concepts presently is that of brief therapy, it is necessary to see how that concept was formulated by other concepts. Thus, this paper examines how constructivist perspectives underlie brief therapy. This paper also gives the author the opportunity to voice a personal statement about how these findings coincide with personal constructions of therapy.
It is first necessary to understand the terms that are to be discussed. The two primary phrases to be discussed are constructivism and brief therapy. However, it is also necessary to grasp what brief therapies exist.
The definition here is not necessarily difficult, but there are many people who have both studied and thought about what the concept of constructivism is and that has led to some confusion. First, there are two different words used in the literature that are similar but they are not the same (it seems). It is easy to be confused for two reasons: both of the words look and sound the same, and one theory is based on the precepts of the other. The concept of constructionism is actually based on that of constructivism in that it is actually the same except for the fact that it discusses learning based on manipulation of objects which is not a part of constructivism. Thus, that part of the confusion is assuaged. However, that still does not explain what constructivism is.
A simple, and understandable, definition is that;
"Constructivism is a theory of learning based on the idea that knowledge is constructed by the knower based on mental activity. Learners are considered to be active organisms seeking meaning. Constructions of meaning may initially bear little relationship to reality (as in the naive theories of children), but will become increasing more complex, differentiated and realistic as time goes on" (University of Saskatchewan, 1999).
By way of illustration, a child will witness something and, via their limited experience, will develop an understanding of that event. It does not matter what the relative simplicity or gravity of the situation is in reality, the construct that the child develops comes from their own experience. But, as the experience grows, the construction of explanations also grows. That is why this is basically a learning theory. As an individual grows, their understanding of events increases and the person is able to get closer to actual reality than they were able to at first.
It is also noteworthy for the study of the concept in relation to therapy that the construct does not have to be based on what society views as reality. The "reality" that the person develops is based on their own interpretation of events. It can best be said then that this is a study of personal perception. As far as the psychotherapy community is concerned, it is important to understand the constructs the individual has built over time and how they can either reinforce those that are healthy or defeat those that are unhealthy.
The idea of brief therapy is not as simple as just taking the two words at face value and constructing a definition from that knowledge. As Levenson, Speed and Budman (1995) relate, "brief therapy, although it is customarily defined in terms of limited sessions, is not simply a shorter version of long-term therapy, but a different treatment modality requiring specialized training in its theory and techniques." Having fewer sessions is a part of the design of brief therapies, but it is not the totality of the process. Unfortunately, researchers have found that although therapists said that they were using the technique approximately 40% of the time, they actually had little training in the actual delivery of proper brief therapy.
It is also false to think that the entire practice of brief therapy comes from a need, due to insurance company imposition, that therapy take fewer sessions, again this is partly true for the current movement to these types of therapies, but it has little to do with the actual definition. The fact that researchers in the field, and therapists themselves have found evidence that this may be the best therapeutic solution for the majority of clients is the reason brief therapies have flourished.
The best way to define this type of therapy is to say that it is a combination of factors. Lisa Fritscher (2009) defines it as "A collection of therapy options that are focused on fixing the presenting problem in only a few sessions. Many brief therapy practitioners see their role as largely one of "educator," teaching the client strategies to manage their own conditions. Brief therapy has become popular due to the limitations of managed care." Thus, brief therapy is primarily a departure from the historical focus of psychotherapy from leading a consumer towards a solution that they devise themselves through therapeutic techniques, to a paradigm where the therapist actually teaches the consumer. This is a departure because it has seemed in the past that it was more responsible to allow discoveries to dawn on the client rather than have the therapist actually teach them. Teaching seems to go against some of the historical principles because it is akin to giving the consumer the knowledge that the therapist thinks they need rather than allowing the client to reach an understanding for themselves. However, forces outside of the therapeutic interaction fist helped determine the number of sessions, and there were studies that suggested that certain methods of brief therapy were actually more effective than allowing the client to arrive at a solution through a greater length of therapy.
Types of Brief Therapy
Therapists use many different types of therapy to achieve a meaningful outcome for a client. Usually, because there is a session limit (usually no more than 20, but often fewer), therapists will only work on one issue with a client. This means that there may be more sessions in the future, but they are not necessarily a part of the original issue. Traditional forms of therapy such as cognitive and behavioral types can be used but there are others that have proven affective as well. Hypnotherapy has been shown to limit the number of sessions that are needed for some problems (especially those such as smoking cessation and weight loss that have a physical component). A major type of therapy that is specifically brief in nature is solution-focused therapy. The client tells the therapist the issue that they are trying to solve and therapist assists the client in solving it. Solution-focused therapy in particular is based on assumptions made is social construction theory
How Constructivist Thinking led an Emphasis on Brief Therapy
As mentioned above, people are prone to gather experiences throughout their lifetimes and with the experiences they have had adopt a construct. The problem with this is that experience can be very narrowly focused. Individuals have different levels of experience, of course, and they will devise the solution to a problem in different ways based on what personal experience has taught them. Of course there is a base of knowledge that people gain throughout their lives also, but this is also flavored with the experiences gained.
For example, a person sees fire and they experience it in different ways as they develop. When that individual is an infant, there is probably a desire to touch the bright, moving flame which they may fulfill. Thus, the individual learns that the fire is hot and that it can burn them. The individual also learns that it is okay to look at fire, but that getting too close is painful. As that individual grows they learn that fire can be fun (fireworks), useful (cooking food), and that it can also be destructive. The person probably experiences variations of the utility, fun and danger of fire which helps to draw conclusions.
In the case of mental health, the same development can occur. Of course, there are mental illnesses that are the result of actual physical causes, but many are either exacerbated or caused by flaws during development. A child is not closely cared for, and is often left by herself. The parents go out of the house, sometimes for hours from the time the child is very young, and when they return they continue to take no notice of the child. As the individual grows, they have reinforcing experiences that deepen a sense of abandonment. As an adult, she seeks assistance from a counselor because of continuing problems as a result of the abandonment which started when she was a child. The construct she developed was that people will not respect her, and that no one pays any attention to her. This has caused a deep depression and a…