A Brief Guide to Brief Therapy

Often, less is enough when it comes to talk therapy.

Reviewed by Tyler Woods

You feel you could benefit from therapy, but you know upfront that you can’t do any long-term treatment—your insurance won’t cover it, you’re moving out-of-state in two months, or you simply are looking for advice on a specific problem you’re having right now and don’t want to get bogged down on talking about your childhood. It’s time for brief therapy.

Actually, most therapy clients do exactly that. Despite our stereotypical, cultural image of therapy going on for months or even years, most therapy is brief. Brief therapy is defined as 1-20 sessions, but research shows that most clients go once, and 90 percent stop before the 20 sessions, with the average treatment being five to eight sessions.

While brief therapy works for many—from one-session therapy to several sessions—it’s not appropriate for some: those who need ongoing supportive treatment or have a chronic mental health condition that requires regular monitoring, those working through trauma, or those who simply prefer a therapy model that focuses on unraveling their past. Therapy that is shorter and more fast-paced requires you to step up and take an active role. Here are some tips to make the most of your brief therapy experience:

Have a specific problem/goal in mind. When you show up in your primary care physician's office, you have a specific medical problem you want to resolve—a muscle ache or cough, a rash on your arm, or three days of headaches—the same is often true in therapy. Maybe you want to help sort through the pros and cons of changing jobs, or you and your partner had a terrible argument last week and need to find a way to resolve the problem and move beyond it, or you are giving a major presentation at work in two months, are freaking out, and need techniques to help you manage your anxiety. The more specific you can be, the better.

Look for therapists with a brief approach. Because brief therapy is not just less time but has a different focus from traditional therapy, look for therapists who mention "problem-solving" and "solution-focused" in their profiles. Once you've narrowed down your list, screen potential therapists on the phone or by email, and look carefully at their websites. State your needs and expectations upfront to save time and be sure you are both on the same page before you start.

Have an agenda for every session. You’re the consumer; it’s not time to slip into being the passenger on the train. Treat each session as if it were a meeting with your work supervisor: have an agenda, decide what you most want to get out of each session, ask questions, and get your topics on the table at the start of the hour. Don’t waste time chattering about the weather or last night’s football game.

Get and do homework. Your doctor gives you medication, your physical therapist gives you exercises, and then they check your progress. The same is true about brief therapy. Just as you want to be proactive before sessions by preparing an agenda, you want to be proactive about asking for and doing homework. Brief therapy is about changing your everyday life, not having a comfortable place to complain while someone nods her head. Because most change happens outside the session, homework helps you put your new skills and perspectives into real-world practice.

Track your reactions, behaviors, and emotions between sessions. The homework is as much diagnostic as prescriptive. The aim often is to have you break out of your patterns and do something different. While you do this, try and step back and observe your internal process: How did you feel and what were you thinking when you did a certain activity? You want to uncover where you get stuck, what is difficult, where anxiety comes up, and how your behaviors, thoughts, and emotions change, and pass these observations on to your therapist. It will save time in the sessions and help the therapist fine-tune the next steps. Think of you and your therapist as a team working against your problems.

Bring in others for problem-solving and support. If you are struggling with your mother, ask if you can invite her in when she visits. If you need to have a serious conversation with your boyfriend about his drinking or because he doesn’t understand how your depression affects you, your therapist can provide the support and guidance you need. And if you’re anxious about what will unfold, talk to your therapist beforehand so you can lay out a game plan and quell your concerns.

The theme here is clear: Be specific, clear, and proactive. This is your therapy; make sure you get what you need.

To find a therapist near you, visit the Psychology Today Therapy Directory.