This paper examines the relationship between constructivist theory and brief therapy, arguing that constructivist thinking provides the conceptual foundation for modern brief therapeutic approaches. The paper begins by defining constructivism as a learning theory in which individuals actively build meaning from experience, and distinguishes it from the related concept of constructionism. It then defines brief therapy as a distinct treatment modality—not merely a shortened version of long-term therapy—and surveys its major forms, including solution-focused therapy. The paper traces how managed care pressures and emerging research prompted therapists to adopt constructivist frameworks that allow rapid, focused intervention. It concludes with a personal reflection on the ethical and practical advantages of brief therapy for emerging clinicians.
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 prominent in the field is that of brief therapy, it is necessary to see how that concept was formulated from other concepts. This paper examines how constructivist perspectives underlie brief therapy, and also gives the author the opportunity to articulate a personal statement about how these findings coincide with personal constructions of therapy.
It is first necessary to understand the terms to be discussed. The two primary concepts are constructivism and brief therapy. The definition of constructivism is not necessarily difficult, but many people have studied and thought about what the concept means, and this has led to some confusion. First, there are two different words used in the literature that appear similar but are not the same. It is easy to be confused for two reasons: both words look and sound alike, and one theory is based on the precepts of the other. The concept of constructionism is actually based on constructivism; it is essentially the same except that it addresses learning through the manipulation of physical objects, which is not a component of constructivism. That distinction aside, constructivism itself still requires a clear explanation.
A straightforward 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 increasingly more complex, differentiated, and realistic as time goes on" (University, 1999).
By way of illustration, a child will witness something and, drawing on 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 the child develops comes from their own experience. As experience grows, the construction of explanations grows with it. This is why constructivism is fundamentally a learning theory: as an individual matures, their understanding of events deepens and they are able to approach a truer perception of reality.
It is also noteworthy, particularly in relation to therapy, that the construct does not have to align with what society regards as reality. The "reality" a person develops is based on their own interpretation of events — it is essentially a study of personal perception. As far as the psychotherapy community is concerned, it is important to understand the constructs an individual has built over time and how a therapist can reinforce those that are healthy or dismantle those that are not.
The idea of brief therapy is not as simple as taking the two words at face value. As Levenson, Speed, and Budman (1995) explain, "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 part of the design of brief therapies, but it is not the totality of the process. Researchers have found that although therapists reported using the technique approximately 40% of the time, they actually had little training in its proper delivery.
It is also a misconception that the practice of brief therapy arose solely from insurance company pressure to reduce the number of sessions. While that pressure is partly responsible for the current movement toward these therapies, it has little to do with the actual definition. Researchers in the field, and therapists themselves, have found evidence that brief therapy may be the best therapeutic solution for the majority of clients, and that is the real reason it has flourished.
The best way to define this type of therapy is to describe it as a combination of factors. 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 represents a departure from the historical focus of psychotherapy — guiding a client toward a solution they arrive at themselves through the therapeutic process — toward a paradigm where the therapist actively teaches the client. This shift is significant because historically it was considered more responsible to allow insights to dawn on the client rather than to instruct them directly. Teaching seemed to contradict longstanding therapeutic principles by giving the client the therapist's conclusions rather than allowing the client to reach their own understanding. Nevertheless, external forces helped constrain the number of available sessions, and studies suggested that certain brief therapy methods were actually more effective than allowing clients to arrive at solutions through extended therapeutic work.
Therapists use many different types of therapy to achieve meaningful outcomes for clients. Because there is a session limit — usually no more than 20, but often fewer — therapists typically focus on one issue per course of treatment. This means that additional sessions may be needed in the future for other concerns, but they are not necessarily part of the original treatment plan. Traditional forms such as cognitive-behavioral therapy can be adapted to a brief format, and other modalities have also proven effective. Hypnotherapy, for instance, has been shown to reduce the number of sessions required for certain problems, particularly those with a physical component such as smoking cessation and weight loss. A major type of therapy that is specifically brief in nature is solution-focused therapy, in which the client identifies the issue they want to resolve and the therapist assists them in solving it. Solution-focused therapy in particular is grounded in assumptions drawn from social construction theory.
As noted above, people gather experiences throughout their lifetimes and, from those experiences, adopt constructs. The problem is that experience can be very narrowly focused. Individuals have different levels of experience and will devise solutions to problems in different ways based on what personal experience has taught them. There is also a base of general knowledge that people accumulate over a lifetime, but this too is colored by individual experience.
Consider a simple example: a person encounters fire and experiences it in different ways as they develop. As an infant, there may be a desire to touch the bright, moving flame, which the child may act upon and thereby learn that fire is hot and can cause burns. The child also learns that it is safe to observe fire from a distance but that getting too close is painful. As that individual grows, they discover that fire can be enjoyable (fireworks), useful (cooking), and destructive. These varied encounters with fire help the person draw increasingly nuanced conclusions.
The same developmental process applies in mental health. While some mental illnesses result from physical causes, many are either exacerbated or caused by difficulties during development. Consider a child who is not closely cared for and is frequently left alone for long periods from a very young age. When the parents return, they continue to take no notice of the child. As the individual grows, reinforcing experiences deepen a sense of abandonment. As an adult, she seeks help from a counselor because of ongoing problems stemming from this early neglect. The construct she has developed is that people will not respect her and that no one pays her any attention. This has produced deep depression and self-loathing that she sometimes relieves through cutting behaviors. The original construct has become so entrenched that she views everything through the lens of her abandonment, expecting it to continue. Given the reinforcement she has received throughout her life, it is not surprising that these thoughts have taken hold.
Constructs, as mentioned, develop across the lifespan and can either move toward a truer reality or drift further from it, depending on what experiences the individual has. Because constructs can easily become faulty, many people require some means of reorganizing their beliefs to bring them closer to reality. Sometimes this can be accomplished through maturity alone — accumulating enough experiences to recognize flaws in one's earlier thinking. Education is another means of acquiring knowledge that can compensate for experiential deficits. However, sometimes an individual needs unbiased coaching to help them arrive at a truer perception of reality.
In the past, when someone needed a counseling adjustment, a therapist could delve deeply into the person's psyche and address a wide range of issues. This was possible because either health insurance or the client could and would pay for extended treatment. Ethical considerations generally kept therapists from taking advantage of this arrangement. However, healthcare companies eventually began reducing the number of sessions they were willing to fund, creating a need for new therapeutic paradigms.
Therapists turned to constructivist thinking more closely because they recognized in it a method of counseling compatible with the new time constraints they faced. Since the constructs people hold are often very narrow, it is possible for the therapist to work with the individual to broaden those perspectives. Another reason for the shift is that social constructivist thinking "may allow the profession a broad and encompassing framework for providing an array of services otherwise defined within the paradigms aligned with other professions. For example, social constructivism allows for the application of systemic-relational techniques or individual psychotherapy, depending on the consensus that emerges around a problem — is it a relationship problem, or is it primarily a concern best addressed individually? Because the choice of approach is based on the 'communities of understanding' around a problem, there is unlimited flexibility for the practitioner" (Levenson, Speed, & Budman, 1995).
This flexibility is valuable because adjacent professions have been studying the social constructivist approach for a long time, and their research holds value for the counseling profession. No profession operates in a vacuum, so it is important to recognize where new theories can be effective for clients.
Once psychotherapy researchers recognized these possibilities, they began studying the effects of constructivist approaches to counseling and found them to be efficacious, particularly given the new directives to reduce session counts. Constructivism accommodates brief therapy more fully than many other approaches previously used, because it allows counselors to set a timeline. An individual can discuss their problems indefinitely without making progress, but this new form of therapy enables counselors to work toward specific solutions within defined limits. Studies also confirmed that these techniques were effective.
In an initial session the counselor may conduct themselves much as they always did: the client provides pertinent information about themselves and helps the therapist understand what they believe the problem to be. The counselor begins forming theories as before, but acts on them more quickly. In traditional long-term therapy, a therapist might spend weeks or months allowing the client to explore all presenting issues while formulating a comprehensive theory, potentially requesting conjoint sessions or conducting additional research. Brief therapy does not allow for this. In the first session, the groundwork is laid and the counselor asks open-ended questions that move quickly to the heart of the issue.
"Brief therapy applied to substance use and goal setting"
"Ethical and practical case for brief therapy"
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