Brief and Narrative Therapy - Journal 1

          For my "Brief and Narrative " Therapy class we have been reading "The Tactics of Change:  Doing Therapy Briefly" by Fisch, Weakland, and Segal.  I enrolled in the class because I thought it would have a very practical application.  For starters, the idea of doing therapy "briefly" is often presssure that is put on therapists and counselors by their organizatinos, employers, and insurance companies.  Those groups wnat to see results and they don't wnat to spend too muchmoney.  I'll get back to this in a bit.  I also wanted to enroll in the course because of the appeal of "narrative" therapy.  For instance, when we think of the word "narrative" we think of a story.  But when the etymology of the word is broekn down, we find that it comes from the Lating word "narrare" (to relate) and Sanskrit work meaning "to know."  This of course plays nicely with my existential-phenomenological view of psychology in regards to "relating what we know" and / or "knowing how to relate."

          Now, back to the book.  What I like about the book is that the authors' style of therapy is very outcome oriented.  Now, this is both good and bad.  First, the good.  Some of the tactics explained are very specific, practical, and insightful.  When a client comes to see a therapist of their own accord it is usually because they have a problem..The goal, as the authors see it, is to resolve the problem.  This book does a very good job of explaining and detailing action-oriented outcome generation.  There is some staunch reality to this methodology.  Firstly, there is the matter of salary.  If you, as a therapist, are accpeting insurance payments or are working for an organization who is being paid by insurance companies then you foten will have a limeited (maybe less than 10) number of sessions to work with.  I'd love to spend "as much time as needed" with every clint who walks in the door and let them work at thier own pace; but the fact of the matter is that in instances above, if you want to get paid, you have to work within certain constraints.  Your personal preference may be to go steadily and deeply with a client, but here is another idea to sit on.  Perhaps, your supervisor asks you if you asked the client if he had ever had suicidal / homicidal tendancies and you reply; "No, we hadn't gotten to that yet."  Your supervisor returns; "Really?  Because he was court appointed to meet with you after trying to stab his mother to death and trying to overdose on sleeping pills."  [Exagerated for emphasis]
          Here are some issues I take with the book.  There seems to be, for me, some ethical concerns in being process oriented.  Whether it is cognitive-behavioral therapy or brief therapy, action-based outcomes have always seemed tongue-and-cheek to me.  My personal opinion is that, while they are effective, they may only be so ona superficial leve.  The issue at hand has only been pruned and the client has learned nothing about actually dealing and existing with the problem.  Coping and closure are freuitless idealizations in many cases.  They are sentiments of giving up and giving in as if somehting tragically psychologically devastating can simply be "fixed" by sending it back to the factory, applying mechanical remedies, and polishing the surface.




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