
As the fields of psychiatry and clinical psychology are increasingly
driven by the economics of the HMO or Mental Health Center,
practitioners in any setting, whether it be private practice or
university clinic, are now forced to develop more concrete procedures
and models in order to practice more efficiently. This book presents a
set of procedures for brief therapy that are based entirely on the four
common dynamics of psychiatry. By following the model set forth in this
book, psychiatrists, psychologists, social workers, psychiatric nurses,
and mental health workers will be able to build an entire brief therapy
program based upon the initial conditions for each patient.
The first of the four procedures is to block and contain either the
eruption of anxiety or collapse of depression in a patient, usually
through pharmacological intervention. Once the anxiety and/or
depression has been temporarily contained, the patient will be able to
function through the rest of the therapeutic process. The second
procedure is to identify and isolate the step that leads up to the
eruption of anxiety or collapse of depression, thus allowing the
patient to avoid walking into similar situations that lead to
catastrophe. Thirdly, the practitioner works with the patient to help
her realize that there is always a step in the opposite direction from
the old step, one that used to be suppressed by the oncoming anxiety or
depression. The identity of this new step will release the patient from
the traps of the old patterns, and will free her to enter into a new
trajectory. The fourth procedure is to notice that the old step had
locked the patient into a (seemingly) inescapable trap, but that any
new step(s) taken will also carry with them the potential for further
anxiety and depression. The completion of this final procedure should
allow the patient to see that mental health comes from the combined
ability to avoid the pitfalls of old steps, while accepting the
inherent risks in taking new steps. The success of this brief therapy
model is fully realized when a recovered patient begins to fall into a
new trap, and can duplicate this process on her own.
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