BRIEF PSYCHOTHERAPY Introduction Messer's tex

Messer's textbook, Models of Brief Psychodynamic Therapy (1995), is critically discussed relative to its merits as a comprehensive review and evaluation of brief treatment. Focus will include theory, research, and practice of brief psychotherapy. Discussion will also encompass how brief treatment models differ from long-term models, and an evaluation of the textbook.

Messer reports that brief psychodynamic psychotherapy theories include drive/structural, relational and cognitive, integrative/analytic, and eclectic. The drive/structural model encompasses brief psychodynamic therapy which began with Malan's brief intensive psychotherapy (BIP), Davanloo's intensive short-term dynamic psychotherapy (ISTDP), and Sifneos's short-term anxiety-provoking psychotherapy (STAPP). An intersystemic conflict model of the mind starts with the concept of drive or wish. Freud stated that motor driving behavior consists of sexual and aggressive energies (id) and their derivatives (wishes, impulses); ego modulates drives by instituting defenses that help to keep the drive in check. Superego manipulates with guilt. Failure of a defense may result in anxiety.

Davanloo and Malan refer to the triangle of conflict (impulse or feeling leads to defense, if unsuccessful results in anxiety). Brenner expanded the defense motive to include any unpleasurable affect, particularly depressive affect. Thus the structural (id, ego, superego) and dynamic (conflict) of the drive/structura

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(Wachtel and others). Gustafson's brief therapy is viewed as assimilative integration that includes systems understanding. Messer offers a comprehensive and clear presentation of the different theories found regarding brief therapy. Research The author reports that empirical research attempts to determine if brief therapy is helpful compared to long-term therapy, whether one form is more helpful than another, if depressed or anxious patients improve faster than borderlines, if well-being and symptom reductions occur sooner than measures of life functioning, if results depend on the outcome measure, if patients maintain gains, and if outcome measures are pertinent to psychoanalytic therapy. Studies compare time-limited and time-unlimited therapy. A comparison of eight studies showed that time-limited therapy was superior in two studies and time-unlimited was superior in one; no differences were found int the other five. Another study compared seven studies and found that three time-limited were superior, one time-unlimited was superior, and three showed no difference. It appears there is a lack of empirical evidence regarding differences in overall effectiveness. Studies fail to show differences comparing brief thera

Category: Psychology - B