Brief Psychodynamic Therapy focuses on a dynamic unconscious. It focuses on the large parts of people’s psychological lives that they are unaware of as well as centers on dynamic activities in these unconscious processes, which essentially contribute to people’s emotional and behavioral lives (Carlyle, 2007). Brief Psychodynamic Therapy is informed and influenced by psychoanalytic approaches, namely by four main schools of psychoanalytic theory: Freudian, Self Psychology, Ego Psychology, as well as Object Relations (Center for Substance Abuse Treatment. Brief Interventions and Brief Therapies for Substance Abuse, 1999).
Freudian psychology revolves around Freud’s theory of aggressive and sexual energies arising from the unconscious (the id) and modulated by the ego; there is also a superego, which controls the drives of the id. Ego Psychology focuses on the need to enhance the ego function. Self Psychology focuses on promoting a person’s acceptance of the self. Finally, Object Relations focuses on the individuals’ attempts to replay old object relationships (in families) in order to master them and get free from them. This paper discusses the goals and techniques of Brief Psychodynamic Therapy, examines the roles of a counselor and a client, and provides a personal reflection of the author on the use of this brief therapy.
The goals of Brief Psychodynamic Therapy are promoting clients’ self-awareness and understanding of how the past influences their present behaviors. Sharpless & Barber (2009) also say that clients’ needs are the goals of BPT. Still, the overarching goal of Brief Psychodynamic Therapy is similar to Psychodynamic Therapy – to change some aspect of a client’s personality or identity or, alternatively, integrate major developmental learning that has been missed during the period when the client got stuck at some earlier stage of his or her emotional development (Sharpless & Barber, 2009). Yet, Brief Psychodynamic Therapy specialists’ goal is to start an ongoing process of the client’s change and provide him or her with short-term interventions (25-40 sessions) without such long involvement as long-term psychodynamic therapy uses (2 years of sessions at least).
Depending on the selected model, BPT aims at fostering positive changes in clients’ interpersonal functioning, diminishing clients’ negative self-images, ameliorate clients’ symptoms and support them through fostering adaptive skills, improving self-esteem and ego function. Additionally, BPT aims at helping clients examine their unresolved conflicts and, respectively, symptoms arising from dysfunctional relationships in the past and manifesting themselves in clients’ substance abuse desires (Sharpless & Barber, 2009). In this context, BPT aims at contributing to the treatment for disorders of substance abuse, when the severity of substance abuse is moderate.
Based on its foundations in psychoanalysis, BPT uses many psychoanalytic techniques including clarification, interpretation, and confrontation of defenses, motives, impulses, and interpersonal patterns. Yet, the use of this or that technique depends on the choice of a BPT model, the focus and the goals of the therapy. In particular, time-limited psychotherapy (Mann) employs such techniques as formulating, presenting, and interpreting the focal issue, interpreting the issue around earlier losses, and termination. Next, short-term anxiety-provoking psychotherapy (Nielsen & Barth) employs such techniques as interpretation of early transference, confrontations along with previously mentioned interpretation and clarification (Ursano, Sonnenberg, & Lazar, 2008). Further, SE therapy (Luborsky & Mark) uses such techniques as creating therapeutic alliance through sympathetic listening, formulating and interpreting the core conflictual relationship theme, relating the existing symptoms to it and explaining them as attempts to cope (Ursano, Sonnenberg, & Lazar, 2008). Additionally, dynamic supportive psychotherapy uses self-esteem boosters such as praise, encouragement, and reassurance; employs rationalizations, advice, and reframing; uses the techniques of anxiety reduction and reflections among others (Ursano, Sonnenberg, & Lazar, 2008).
The roles of a counselor and a client in BPT are defined by the understanding of the specifics of the brief therapy in contrast to long-term therapy. According to Budman & Gurman (1988 in Levenson et al., 2008), the value system of a short-term therapist defines the manner in which he or she practices therapy. Based on Levenson et al. (2009), short-term therapists should keep a limited focus and pursue a limited set of goals (having identified them from the client’s needs); should base their therapeutical intervention taking into consideration the existing time constraints and engage in effective time management; should do rapid assessment; need to quickly develop therapeutical alliances; should consider using treatment contracts; ought to express optimism with regard to the success of therapy; should engage in greater activity and highly intense alertness; and should be able to determine what a successful termination is in every case while also being able to leave the therapy open-ended.
The role of the client is to engage in psychotherapeutic interventions and remain “suffering, curious about his or her problems, motivated to change, willing and able to think psychologically, capable of understanding metaphor, and able to acknowledge his or her emotional experiences” (Sharpless & Barber, 2009). Also, the client should be responsive to the counselor’s efforts to establish a productive (i.e. authentic) therapeutic alliance and willing to work through various insights that may arise in the process of BPT. Additionally, the role of the client is to pay money for the sessions and regularly attend them (i.e. spend his or her time) (Sharpless & Barber, 2009).
Even though in the light of the current dominance of evidence-based practices psychoanalytic approaches have not fared well, there are cases when they can demonstrate their effectiveness. If to reflect from the position of a counselor, BPT can be truly effective when treating depression in adults and adolescents, and can even be effective with patients who resist treatment. In particular, adolescents can benefit from BPT because it suggests flexibility and freedom as well as because it provides young patients with space within which they can express their negative emotions, in other words, their destructiveness. It can help then realize that these negative emotions in reality are not able to destroy anything, externally or internally. As adolescent patients find themselves in a secure environment created by the psychotherapist, they allow they psychic world to unfold. In this way, their past experiences and developmental deficits might be relived. In line with this, adolescent patients may experience modifications and development by way of transference and interpretation. Overall, BPT is an effective short-term intervention that can benefit patients given adequate training and invested efforts of the therapist.
