New Trends in Psychotherapy Offer Shorter Stays and Focused Problem Solving Techniques by Julie Cohen/Marriage and Family Therapist: at DailyStrength Doctors and Advisors

Julie Cohen is a licensed Marriage and Family Therapist MFT and a Child Mental Health Specialist with a private practice in Los Angeles. Her areas of focus include: depression, anxiety, panic, post-traumatic stress, bipolar…

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New Trends in Psychotherapy Offer Shorter Stays and Focused Problem Solving Techniques

Posted in ADHD / ADD by Julie Cohen on Jun 05, 2008

With mental health benefits being slashed or all together disappearing, consumers & insurance companies are looking for ways to get in and out of therapy quickly by strategically targeting specific problems. As an old school psychodynamic, existential and humanistic therapist I am impressed with emerging theories of psychological thought called "Post Modern Therapy."

Post Modern includes theoretical orientations such as Solution Focused and Narrative. New lingo includes "externalizing the problem," "strength based" and "resiliency." Most of this work focuses on identifying the problem in a non-judgmental supportive forum, helping the client become aware of their inner resources and strategize solutions to the problem. Although post modern therapy lends well to long-term work it tends to be short-term and highly focused. Insurance companies and clients like these therapies because less sessions mean less out of pocket expense as well as a quicker return to wellness.

Stephanie Gregory, a Beverly Hills Marriage and Family Therapist who specializes in Narrative Therapy describes why she likes this modality; "[The therapist] takes a non-pathologizing stance and a collaborative stance with the client. Both the client and the therapist are viewed as experts in the process." This strength-based approach makes it easier to solve problems.

When a client comes into therapy with a problem such as depression, a narrative therapist will immediately separate the person from the problem. This is called externalizing the problem. Ms. Gregory stated, ". . . When you separate the person from the problem it allows you to look at the problem as a separate entity which protects the person from feeling deficient." For instance she says it's very different to say: "depression has a hold over you vs. you're depressed."

This slight change of phrasing has a big impact on clients as it helps them stop blaming themselves for the problem and connect to their inner sense of self. It also empowers them to challenge or fight the problem. "The problem clouds . . . your whole sense of self; who you are, how you see yourself and how you want to be in the world. So we try to get back to the glory of you by finding ways to fight the problem. Narrative therapy is a two-fold approach; first realizing that the glory [your sense of self] is still there and second, [developing] tools to fight the problem."

One of the tools Ms Gregory uses in her practice is called interviewing the problem. This technique helps a client learn about the problem and how it impacts their life. It also helps a client gain self-awareness of their inner resources that will ultimately defeat the problem. Ms Gregory will work with a client to answer questions such as:

What does depression get you to do or think about yourself?

Does depression follow you to work or other activities?

Can you identify anytime during the day that you can keep depression away from you?

What does depression want you to do?

Post Modern modalities such as Narrative therapy offer consumers a fresh approach to resolving problems and reclaiming their sense of self. Some of these techniques can be easily applied to your daily life. Try externalizing the problem. If you find yourself making statements that are self blaming or make you feel stuck, empower yourself by changing your phrasing. Remember you are strong! It's the problem that clouds your view of your inner strengths.

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Displaying comments 13-1 of 13

Trying minimize therapy treatments to maximize insurance company profits. Why have national health care when private insurance can already ,,stick it to the man''? I have BP and Aspergers Syndrome. Don't see the day would end that I would not pay my own expenses to see a Pdoc and therapist of my choosing. And number of visits of choice. Thank you very much! And do so on $8.50/hour salary. Received church funding for full cost of therapy. Pdoc at full expense.

By freakyg Jan 11, 2009

My therapist talks about my finances and asks in depth details about
wha t money I have- my will advice regarding money- also
asks about will- gets family names mixied up
Iam being abused and she said on phone-"nothing I can do"
I have seen her four years- I have severe stress in life
I work and cope but I don't understand her,what do others think

By Kellie30 Nov 11, 2008

the biggest fear of those with any sickness, is 'the bill'.
i worked for a collection agency years ago as its full-charge
bookkeeper. most people owed medical bills, and credit unions
and others till the end of time itself. interest upon interest.
i had to quit, it was too much like being Uncle Scrooge. having
bob cratchit fired, and tiny tim told to 'get real' and 'get a job'.
take his wheelchair to work. i was too nice of a guy. the owner
was an expert. he could get money, even blood out of a turnip.
pay, and pay and pay. debtors prisons. child support prisons.
alimony prisons. enjoy!!! ah yes, the dreaded, day of reckoning.
and don't forget taxes. and taxes on taxes. all due and payable.

By jeanlafitte Jul 21, 2008

I called my insurance company and told them my family practice doctor thought biofeedback would be helpful. I told her my blood pressure went off the chart because I was angry because I was in unnecessary pain. My VA doctor cut my MS medication in half because he was concerned it would cause me to be confused. My insurance company gave me the name and phone number of a network psychologist who specialized in biofeedback. I learned it in six sessions. Now I see him on as needed basis.
In the interim my doctor slowly increased the dosage of the Gabapentin and I have not been confused yet.

By SuzanneCol Jun 29, 2008

Can I help my gay husband to become a straight man? Will therapy change a gay man to become straight? Please give me the right answer. He loves me a lot and does not want to leave me.

By aduhsakit76 Jun 20, 2008

hmmm... very interesting

By Ark01 Jun 19, 2008

I am seeking someone who can assist me in overcoming the fear of Claustrophobia. I think I have had it since I was 12 and I really want to be able to get into an airplane and just go somewhere. The older I get (58) the harder it gets to overcome. Is there anyone in the Los Angeles Area that specializes in this...L

By lalalinle Jun 16, 2008

I guess my biggest fear of insurance payment driven therapy in any form is that it treats symptoms and not the disease. I may well be able to "interview the issue" and get a handle on a specific symptom of my C-PTSD but I can't help but believe that fewer sessions with a therapist is not going to help me truly deal with the multitude of issues and deep seated self defeating beliefs that makes up C-PTSD. A strength based approach is only going to work if the patient truly feels empowered and someone emerging from an abusive relationship does not feel that way.

By queenvalerie Jun 16, 2008

Any changes in the current trends are greatly needed. Progress is especially needed in therapy modalities and services regarding mental health. Too many people are getting victimized when they need supportive care.

Yay for progress!

By Samadian Jun 12, 2008

Interesting

By Sinatra47 Jun 08, 2008

Whenever I hear phrases like 'Trends in Therapy' I cringe. A lot of these trends (remember Primal Scream therapy anyone?) end up being pop psychology fads that end up doing more harm than good. Inreading this article I see all kinds of trouble. Any mode of therapy coming out of Beverly Hills should be immediatly considered suspect. Any therapist who talks about 'modalities' ditto. These big words (what the hell is 'Interviewing thr Problem' anyway? Are you going to ask someone to bring the suspected problem person in for an interview too?. If the problem is your boss or your dead father, how's THAT going to help?) are as meaningful as a hot air baloon, but not as useful. It all sounds like pretensious garbage to me and all it'll do is end up further confusing the people it's supposed to help. That's NEVER a good thing. I'm not anti-therapy.....I'm anti-garbage (which is a euphemism for what I think but won't say in a place like this.)

By ALC67 Jun 08, 2008

I feel depressed because of the treatment of bully boss
She tells me I cannot have days off and I am hard worker.
I need to stop this- letting her define me- she swears and
wears beach clothes to work.
I think she drinks too much and plan to try to ask to communicate
with someone else at work about requests for time off

By Kellie30 Jun 06, 2008

hmmm, not sure if i like this, i do understand how it separates the illness from the self and now thinking of the questions you posted, it does take the 'blame' off me, but for me personally Narrative therapy feels like like minimising what is going on inside me because of the depression, even healing from depression or taking it away, i'll have issues that will be left with me and affect my quality of life, some issues may go over time, some will be with me forever.
I use my guide daily to help me cope, to deal with issues, to calm the voices, it is a useful tool.
Change is never easy, maybe it is a good thing, not sure really.
thank you for this informative blog.

By OOBIT Jun 06, 2008

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