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Brief therapy vs counselling? Though the question may make it sound like a contest, there isn’t one. There are so many approaches to therapy that it can be confusing trying to decide which is right for you. Such a wide variety of approaches produces a lot of debate, not least among therapists themselves who get into some pretty hot discussions about the right way to go about things.

Which is best for me?

Choosing between longer-term and brief therapy is more about what you want to achieve, than how you go about it.

If you are trying to find a counsellor you may well be a little confused by the range of counselling services on offer and the titles and terminology used for the different kinds of counselling. Just what isc ounselling? What is the difference between counselling and therapy? Long-term or short-term? And where does brief therapy fit in, is it the same as brief counselling?

First off, the word ‘therapy’, as it generally gets used in the UK, is shorthand for any talk-based approach aimed at psychological and emotional wellbeing. The same goes for counselling. And the different approaches are just as diverse as the reasons people seek a therapist (or counsellor) in the first place.

There are over 400 approaches to therapy (Duncan et al 2004), so it can be confusing and trying to decide which is for you can be daunting. As you can imagine, such a wide variety of approaches produces a lot of debate, not least among therapists themselves who get into some pretty hot discussions about the right way to go about things.

The popular idea of therapy is the classic model of talk therapy where the counsellor sits passively listening while the client speaks. There are many approaches that are based on this method, but there are many others that are more interactive and even lively. First, and most importantly, no approach has shown itself to be better than others at helping clients achieve their outcomes (Duncan et al. 1999; Frank and Frank?). Second, the different therapies have more in common than separates them; experienced therapists are by nature caring, empathetic and insightful and work to help clients improve something in their lives. In all cases therapy should provide a non-judgmental environment in which client and therapist work together towards an agreed set of outcomes.

Two categories

Rather than struggling to understand the terminology and jargon of the different models, choosing the type of that is best for you is really a question of deciding what you want out of it, and the time (and money) you are prepared to commit to. Briefly, let’s put therapy into two categories as a starting point; traditional and brief. While both groups do many of the same things (listening, reflecting back, questioning…), it is the therapists’ underlying beliefs and attitudes that separate them. A key distinction here is that traditional therapy assumes an illness orientation and brief therapies, a healthy one.

But choosing between a longer-term or brief approach to therapy is more about client preferences than it is about therapists’ models. Traditional therapy is generally thought of as involving regular sessions over an extended period. This may last from just a few weeks to several years. Counselling, typically, comes under this heading (though there are plenty of counsellors that do brief therapy!). The focus is on exploration, understanding and insight, with the therapist seen as the expert and the client as in need of help to bring about change.

Brief therapies tend to be shorter, three to six sessions is common, and rather than a weekly format, sessions are often spread out, at a pace agreed by client and therapist. Here the focus is on problem solving, client strengths and resources, and visible change. The client is seen as expert on their own life, and change is seen as inevitable. You might say that brief therapy is about action whereas traditional therapy is about reflection and insight.

Both of these are valuable and its important to point out that you can’t have personal growth without reflection and insight, or self-understanding. The big question is, must you have insight before change can happen, or is it possible that once someone has begun to change, insight might happen as a result? But that’s a philosophical point and not helping clarity here, so it’ll will have to be continued elsewhere. Studies have shown that both types of approach get the same satisfaction-rating from clients, so when asking “Counselling or brief therapy?” we are back to “What do you want to achieve?”

The Choice

Like most things it is a question of personal preference which approach you choose. Traditional counselling allows more time to engage in a journey of self-discovery that can lead you to developing a fuller life over time. It provides an opportunity to work on issues that might be deeply rooted in upbringing and experience. Some people want to better understand their emotional lives, to gain more insight into what leads them feel or act in a certain way, but that causes problems or leaves them unfulfilled.

Brief therapy, on the other hand, is a time limited, collaborative process between client and therapist. It has clear, focused goals from the outset, and often includes specific assignments for the client between sessions. It aims to address the client’s complaint or problem in a purposeful way, it is forward looking and unconcerned with diagnosis or interpretation. Since sessions are arranged ‘on demand’, it also suits people whose lifestyle won’t allow the regular commitment of the traditional approach.

Reading

Article: Therapists Say a Single Session May Be Enough

Footnote:

‘Counselling’ is an umbrella term which in real life gets used generally to mean include all forms of therapy. I have used counselling here to mean traditional forms of therapy

References

Duncan BL, Miller SD, Sparks JA. (2004) The heroic client: a revolutionary way to improve effectiveness through client-directed, outcome-informed therapy. San Fransisco: Jossey-Bass..

Duncan BL, Hubble MA, Miller SD, (1999), The Heart and Soul of Change: What Works in Therapy, American Psychological Association, Washington, DC.

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