A randomized trial of brief interventions for problem and pathological gamblers.

Limited research exists regarding methods for reducing problem gambling. Problem gamblers (N = 180) were randomly assigned to assessment only control, 10 min of brief advice, 1 session of motivational enhancement therapy (MET), or 1 session of MET plus 3 sessions of cognitive-behavioral therapy. Gambling was assessed at baseline, at 6 weeks, and at a 9-month follow-up. Relative to assessment only, brief advice was the only condition that significantly decreased gambling between baseline and Week 6, and it was associated with clinically significant reductions in gambling at Month 9. Between Week 6 and Month 9, MET plus cognitive-behavioral therapy evidenced significantly reduced gambling on 1 index compared with the control condition. These results suggest the efficacy of a very brief intervention for reduction of gambling among problem and pathological gamblers who are not actively seeking gambling treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief Treatments for Cannabis Dependence: Findings From a Randomized Multisite Trial.

This study evaluated the efficacy of 2 brief interventions for cannabis-dependent adults. A multisite randomized controlled trial compared cannabis use outcomes across 3 study conditions: (a) 2 sessions of motivational enhancement therapy (MET); (b) 9 sessions of multicomponent therapy that included MET, cognitive-behavioral therapy, and case management; and (c) a delayed treatment control (DTC) condition. Participants were 450 adult marijuana smokers with a Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) diagnosis of cannabis dependence. Assessments were conducted at baseline, and at 4, 9, and 15 months postrandomization. The 9-session treatment reduced marijuana smoking and associated consequences significantly more than the 2-session treatment, which also reduced marijuana use relative to the DTC condition. Most differences between treatments were maintained over the follow-up period. Discussion focuses on the relative efficacy of these brief treatments and the clinical significance of the observed changes in marijuana use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluating alliance-focused intervention for potential treatment failures: A feasibility study and descriptive analysis.

This article describes a pilot study evaluating the feasibility of an approach developed to test the efficacy of a therapeutic intervention (brief relational therapy) for patients with whom it is difficult to establish a therapeutic alliance. In the first phase of the study, 60 patients were randomly assigned to either short-term dynamic therapy (STDP) or short-term cognitive therapy (CBT), and their progress in the first eight sessions of treatment was monitored. On the basis of a number of empirically derived criteria, 18 potential treatment failures were identified. In the second phase of the study, these identified patients were offered the option of being reassigned to another treatment. The 10 patients who agreed to switch treatments were reassigned either to the alliance-focused treatment, referred to as brief relational therapy (BRT), or a control condition. For patients coming from CBT, the control condition was STDP. For patients coming from STDP, the control condition was CBT. The results provide preliminary evidence supporting the potential value of BRT as an intervention that is useful in the context of alliance ruptures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief psychodynamic and cognitive therapy regarding acute treatment.

Cognitive–behavioral therapy (CBT) and psychodynamic psychotherapy either in their pure forms or possibly synthesized as a form of eclectic therapy appear to be the 2 most commonly utilized forms of psychotherapy, both having levels of empirical support. As the majority of outpatient therapy in America appears to be very brief, 1 reasonable assumption is that treatment is often sought for resolution of acute episodes. A relevant question for practice and clinical training is what are the potential implications with brief psychodynamic and cognitive therapy for this type of treatment? This brief commentary will address the following: (a) the current general differential empirical status of each approach; (b) distinctions between acute treatment and traditional brief therapy and current common treatment patterns; and (c) the general clinical mechanisms for change for each approach and their potential implications regarding acute treatment and clinical supervision. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Strike while the iron is hot: Can stepped-care treatments resurrect relapsing smokers?

The efficacies of 2 group counseling step-up treatments for smoking cessation, cognitive-behavioral/skill training therapy (CBT) and motivational interviewing/supportive (MIS) therapy, were compared with brief intervention (BI) treatment in a sample of 677 smokers. Differential efficacy of the 2 step-up treatments was also tested in smokers at low and high risk for relapse (no smoking vs. any smoking during the first postquit week, respectively). All participants received 8 weeks of nicotine patch therapy. BI consisted of 3 brief individual cessation counseling sessions; CBT and MIS participants received BI treatment and 6 group counseling sessions. Neither CBT nor MIS treatment improved long-term abstinence rates relative to BI. Limited support was found for the hypothesis that high-risk smokers would benefit more from MIS than CBT. Other hypotheses were not supported. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-Behavioral Therapy for Insomnia: Comparison of Individual Therapy, Group Therapy, and Telephone Consultations.

Forty-five adults with primary insomnia received cognitive-behavioral therapy (CBT) implemented in a group therapy format, in individual face-to-face therapy or through brief individual telephone consultations. The results indicate that CBT was effective in improving sleep parameters with all 3 methods of treatment implementation, and there was no significant difference across methods of implementation. All 3 treatment modalities produced improvements in sleep that were maintained for 6 months after treatment completion. These results suggest that group therapy and telephone consultations represent cost-effective alternatives to individual therapy for the management of insomnia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Brief therapy with couples.

Reviews the book, Brief therapy with couples by Maria Gilbert and Diana Shmukler (see record 1997-08432-000). As every clinician knows, couples' problems rank at or near the top of the stress hierarchy. These problems are the direct focus of, or at least indirectly related to, much of our work. Gilbert and Shmukler have waded in, worked hard, and yielded up a straightforward, serviceably slim volume that marches toward its goal with nary a misstep. From the outset they establish a refreshingly realistic parameter: for them, "brief" means six to eight sessions. Although the often-cited maximum of 25 sessions has the appeal of a nice round number, the brutal realities of the managed-care world lead us all more frequently into the realm of single digits. Refreshing also is the authors' candid assessment of brief therapy's strengths and limitations. They rightly point out how brief formats tend to minimize such problems as triangulation of, dependence on, and transference toward, the therapist, but they do not hesitate to explore the inevitable downside. A treatment with this time frame, they note, simply does not allow for the consolidation of new behavior patterns during the course of the therapy itself; instead, it is hoped that the ego strength of the clients will allow for continuing consolidation in the months following termination. Furthermore, they are candid about the sometimes insurmountable wall of personal pathology: "The main limitation of brief therapy with couples is that it simply may not reach deepseated, personal issues that are confounding the relationship." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Narrative solutions in brief therapy.

Reviews the book, Narrative solutions in brief therapy by Joseph B. Eron and Thomas W. Lund (see record 1996-98412-000). The narrative solutions approach developed in this volume is an attempt to integrate several existing psychotherapies. Most fundamentally, however, this new approach is a variant of brief interactional therapy, which was developed at the Mental Research Institute (MRI) in Palo Alto, CA, beginning in the 1960s. The MRI approach posited that (1) a client's problems originated "from the mishandling of ordinary life difficulties" (p. 18), (2) "The well-intentioned attempts of family members to solve problems actually maintained problems" (p. 18), and (3) "Problems were resolved simply by interrupting problem-maintaining behaviors and getting people back on course" (p. 19). Eron and Lund agree with each of these tenets, but they contend that MRI therapists focused too narrowly on the client's overt behaviors. Though the authors maintain that it is important to deal with the client's actions, they do so within the context of the narrative meaning that the client ascribes to these actions. The authors' primary intent in this book is to answer the question, "What are the key ingredients of a helpful [therapeutic] conversation?" (p. 265). By presenting a coherent framework that they consistently apply to a variety of clinical cases, they provide a compelling answer about how therapists can more effectively talk with their clients. For therapists interested in learning about a solution-focused therapy that emphasizes the client's concrete actions as well as the meanings behind these actions, this book will serve as a useful guide. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Models of brief psychodynamic therapy.

Reviews the book, Models of brief psychodynamic therapy by Stanley B. Messer and C. Seth Warren. This book is suitable for supplementary reading in a graduate psychotherapy course, and is intended for graduate students in the field of clinical and counseling psychology. It is also intended as a concise reference work on brief psychodynamic therapies for clinicians who are or wish to practice in the newer mode of limited goals and limited sessions. The authors consider drive theory based psychotherapy treatment, as well as integrative and eclectic models of brief psychodynamic therapy. In consideration of each of the various approaches, Messer and Warren have primarily concerned themselves with four issues as a focal point of their analysis: (a) the theory of pathology involved; (b) the development of a clinical focus; (c) patient selection considerations, including indications and contraindications; and (d) typical techniques associated with the treatment involved. This text is an excellent addition to the literature, primarily for adjunct reading in graduate courses on psychotherapy. It also affords the opportunity for psychodynamically oriented clinicians to address a need for an overview and grounding in brief treatment models. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist immediacy in brief psychotherapy: Case study II.

Immediacy was examined in a 17-session case of brief therapy with a bright, articulate, inner-city, African American female client seeing an interpersonally oriented, White, male therapist. The main types of therapist immediacy were reinforcing the client for in-session behavior, inviting the client to collaborate, inquiring about client reactions to therapy, and reminding the client that it was okay to disagree with him. An in-depth qualitative examination of the seven most extensive/salient immediacy events revealed that therapist immediacy enabled the therapist and client to negotiate the relationship, helped the client express her immediate feelings to the therapist, helped the client open up to deeper exploration of concerns, and provided the client with a corrective relational experience. Implications for practice and research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The first session in brief therapy.

Reviews the book, The first session in brief therapy edited by Simon H. Budman, Michael F. Hoyt, and Steven Friedman (see record 1992-98543-000). This book provides an overview of the models of brief psychotherapeutic intervention. A major focus is how brief therapists structure and manage their initial contact with the patient. The editors intend this volume to be a casebook in which the reader can learn what therapists actually do in their clinical practice and offers the reader opportunities to further develop and sharpen his/her thinking regarding brief therapy. According to the reviewer, this book provides a fine survey of the current diversity of approaches to brief therapy. Taken as a whole, the book stimulates considerable thought on the most efficacious use of time in psychotherapy and will appeal to a wide audience including graduate students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reflective-functioning during the process in brief psychotherapies.

Reflective-functioning (RF) is the ability to recognize the existence and nature of mental processes taking place in the self and in others (e.g., intentions and wishes). RF was investigated here as a patient variable during the process in two studies of brief psychotherapy. The first study investigated cognitive-behavioral therapy (CBT) and interpersonal psychotherapy (IPT) in the TDCRP sample. The second study investigated psychodynamic psychotherapy (BPDT). The Psychotherapy Process Q-set (PQS) was implemented to identify process correlates associated with high and low RF in order to distinguish which specific components in the psychotherapeutic process are related to RF. Process correlates defining high RF had good outcome, and process correlates defining low RF had poor outcome. RF remained stable or decreased during treatments and was linked with personality characteristics in the patients. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Review of Becoming solution-focused in brief therapy.

Reviews the book, Becoming solution-focused in brief therapy by John L. Walter and Jane E. Peller (see record 1992-97355-000). With this book, the authors' goal was to produce a manual to aid therapists in learning the model of constructing solutions in brief therapy. Theoretical assumptions about personality development and psychotherapy technique which are crucial to implementing the model are presented. Walters and Peller work within a framework which assumes that problems are maintained by individuals functioning in family and organizational systems and that these individuals have the resources to change personal behavior. Interactional patterns between individuals in various systems are the focus of attention. The book is a clear and consistent portrayal of a therapy approach which is growing in application. It is readable and practical. In summary, this is an effective book which demonstrates alternate theories (exceptions) which could provide an almost miraculous solution to some troubled clients. Advanced graduate students and active practitioners will find this a helpful book in learning the model of constructing solutions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An evaluation of the efficacy of brief-contact therapy with hospitalized psychiatric patients.

In 2 experiments, brief-contact therapy—a series of very brief, friendly, casual conversations between a staff member and a patient—was shown to have a beneficial effect upon the psychological status of newly admitted psychiatric patients. In the 1st study, conducted with 44 recently admitted patients, a 2-wk regimen of brief contacts produced a reduction in subjective anxiety, an increase in self-esteem, and a reduction in length of hospitalization. More frequent contacts (6 each wk) appeared to be more effective than fewer contacts (3 each wk). A 2nd study with 74 Ss provided further confirmation of the effectiveness of brief-contact therapy, and demonstrated that the content discussed during the contacts has a bearing on their efficacy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment outcomes for adolescent substance abuse at 4- and 7-month assessments.

This randomized clinical trial evaluated individual cognitive-behavioral therapy (CBT), family therapy, combined individual and family therapy, and a group intervention for 114 substance-abusing adolescents. Outcomes were percentage of days marijuana was used and percentage of youths achieving minimal use. Each intervention demonstrated some efficacy, although differences occurred for outcome measured, speed of change, and maintenance of change. From pretreatment to 4 months, significantly fewer days of use were found for the family therapy alone and the combined interventions. Significantly more youths had achieved minimal use levels in the family and combined conditions and in CBT. From pretreatment to 7 months, reductions in percentage of days of use were significant for the combined and group interventions, and changes in minimal use levels were significant for the family, combined, and group interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Needs ABC: Needs acquisition and behavior change--An integrative model for couples therapy.

This article addresses the application of the needs acquisition and behavior change (Needs ABC) approach to providing therapy for couples. The Needs ABC model was originally developed at the McGill Domestic Violence Clinic. It uses an integrated therapeutic approach combining observation and elucidation of client and group process, using concepts also described in cognitive-behavioral, motivational, narrative, and emotion-focused models. The Needs ABC model is distinguished by its emphasis on the relational needs behind maladaptive behaviors rather than on the behaviors themselves and by its flexibility in terms of application to clients in a range of personal and therapeutic settings. In the context of providing therapy for couples, it provides a unique approach that helps clients to understand the origins of their behavior individually and in the context of their dyad and to formulate more constructive ways to react to stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

We Don't Train in Vain: A Dissemination Trial of Three Strategies of Training Clinicians in Cognitive-Behavioral Therapy.

There has been little research on the effectiveness of different training strategies or the impact of exposure to treatment manuals alone on clinicians' ability to effectively implement empirically supported therapies. Seventy-eight community-based clinicians were assigned to 1 of 3 training conditions: review of a cognitive-behavioral therapy (CBT) manual only, review of the manual plus access to a CBT training Web site, or review of the manual plus a didactic seminar followed by supervised casework. The primary outcome measure was the clinicians' ability to demonstrate key CBT interventions, as assessed by independent ratings of structured role plays. Statistically significant differences favoring the seminar plus supervision over the manual only condition were found for adherence and skill ratings for 2 of the 3 role plays, with intermediate scores for the Web condition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Change in attachment anxiety is associated with improved depression among women with binge eating disorder.

The study examined if the relationship between change in attachment insecurity and target symptom outcomes was moderated by treatment type. Women (N = 66) with binge eating disorder (BED) were randomly assigned to two treatment types: group cognitive-behavioral therapy (GCBT) or group psychodynamic-interpersonal psychotherapy (GPIP). Results indicated significant positive pre- to posttreatment changes in all attachment insecurity scales, but no difference between GCBT and GPIP on these changes. Change in attachment anxiety was related to improved depression for women completing GPIP, but not for women completing GCBT. This indicated a moderating effect of treatment type in explaining the relationship between change in attachment anxiety and improved depression. Changes in attachment anxiety may be important for symptom outcomes related to psychodynamic-interpersonal therapies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Models of brief psychodynamic therapy.

Reviews the book, Models of brief psychodynamic therapy by Stanley B. Messer and C. Seth Warren (see record 1995-98730-000), stating that the book organizes the prevailing models of brief psychodynamic therapy (BPT) into a clear and easily comprehended framework. The opening chapter sets the stage for the remainder of the book through a general overview of the current and historical contexts in which brief psychodynamic therapies have been performed and developed. Current views of brief psychotherapy are reviewed from the perspectives of the patient, the therapist, and managed care. This is followed by a review of the historical background of BPT, in which credit is given to Freud, Rank, Ferenczi, Alexander, and Reich for their relevant technical and theoretical contributions. Next, the authors survey some of the research relevant to BPT. The chapter concludes with a comprehensive discussion on the learning and teaching of BPT. Once this groundwork is laid, the authors delve into a discussion of the major models of BPT currently practiced and researched. The authors group the BPTs along theoretical lines. (PsycINFO Database Record (c) 2010 APA, all rights reserved)