Within the field of counselling and psychotherapy, ‘brief therapy’ – or time-limited/short-term therapy – has become a loaded term provoking both support and disdain amongst practitioners. In Psychosynthesis, particularly, the concept of short-term work continues to be regarded as novel, unlikely or even impossible. Whilst a student at the Trust, I recall that my peers and I often thought almost exclusively in terms of working with long-term clients, and even today, I speak to many current trainees who subscribe to the view that Psychosynthesis works best over a considerable period of time.
Whatever the reasons for this perspective, the marketplace reality indicates that brief therapy is the norm –counselling departments in educational institutions, Employee Assistance Programme providers and especially the NHS, have made brief therapy very popular, even though there continues to be some disagreement about whether it is effective enough for most clients. With this in mind, I spoke with Dragana Djukic, who teaches Brief Therapy using Psychosynthesis, for her thoughts and insights on this topic:
What led you to start using Psychosynthesis in brief therapy?
In 1996, when brief therapy was not so well known in the UK, I came across a book on the subject written by an American psychotherapist, which sparked my interest. However, I really started using Psychosynthesis in a short-term context only when I was offered a job as a therapist for a charity organisation in 2006. Then, I moved to work in NHS practices, where I still work in a short-term context as a Psychosynthesis psychotherapist and integrative/transpersonal supervisor. Based on this very rich experience, by working one-to-one with clients and by supervising honorary counsellors in placement, I have developed an even stronger belief in the value of brief therapy.
In your experience, how effective is the Psychosynthesis model in short-term work?
The Psychosynthesis model is very effective in short-term work. I find particularly useful the concepts of bi-focal vision and the will. By holding a bi-focal vision we see the client as a unique human being who has a purpose in life, and challenges and obstacles to meet in order to fulfil that purpose. The client ultimately has all the answers needed within and our task is to evoke this inner knowing.
Change is fundamental to all psychotherapies. In Psychosynthesis, we place the will at the centre of our work. Our aim is to encourage the client to become aware of their hidden potential and to evoke the client’s will so that they make their own choice and take positive steps forward.
How important is brief therapy in today’s therapeutic landscape?
Nowadays, brief therapy is recognised by the NHS, universities, schools and providers of EAPs, and for many people who seek therapy it is becoming a personal choice. I believe that both approaches, the long-term and the short-term, have a place in today’s therapeutic landscape. I like to use the metaphor of a novel for long-term work and a short story for brief therapy. Similar to the two literary genres, the two therapeutic modalities have different goals. In long-term therapy, the goal usually involves the restructuring of the whole personality. In short-term therapy, the goal is more specific, and related to an emotional difficulty which the client has brought in and is unable to deal with on his or her own.
The on-going debate among therapists and in the media regarding which approach is ‘better’ is quite unhelpful. We have to look at which approach would best serve the individual client and their need for therapy. I believe that psychotherapy has to be as short as possible and as long as the client really needs it. There are clients who need long-term work and are ready to engage in it. On the other hand, many clients come to therapy to resolve a particular issue and are not ready to go deeper.
What have you personally gained from working this way with Psychosynthesis?
My experience in short-term work has definitely helped me to improve in my long-term work. I see on average 30 NHS clients per year, each for 6 sessions. The diversity of the client group can be seen with regards to age, gender, ethnicity, social background, family and cultural issues, and the wide spectrum of symptomology. I always learn something new from each of them.
It has helped me to become more creative; I’ve developed the capacity to stay with uncertainty and to let go of the tendency to be a perfectionist. I am much better in assessing clients, formulating a working hypothesis and strategy, finding the therapeutic focus and goal related to the client’s presenting issue, and being able to be mindful of the ending straight away from the beginning.
How long have you taught the seminar on Brief Therapy for? What improvements have you made to the seminar over time?
Psychosynthesis, as an open system, provides us space to integrate other forms and practices of psychotherapy. I have been teaching the Brief Therapy seminar since 2010 and over time I have been bringing into the seminar the concepts and techniques from Psychodynamic brief therapy, CBT, Solution-Focused therapy and Mindfulness practice. The whole seminar is skill-orientated with theoretical input. It is structured into three main parts, which address the three phases of the 12-session brief therapy model – the beginning phase, the middle phase and the ending.
What are the main aims of your seminar?
My aims are to make clear to students the goals of brief therapy, as well as our role as a therapist.
Clients usually seek therapy at critical moments in their life journey, when they feel stuck, in pain or crisis. Our role as therapists is to help them deal with the crisis by giving it a meaning, finding a resolution and aiding them to move on their path. It is useful to look at brief therapy as a ‘chapter’ in the narrative of the client’s life, which ends when brief therapy comes to an end. This means that the client may have other experiences of brief or long-term therapy on their life journey, if needed.
In brief therapy there is a specific focus and goal, and our aim is to facilitate change. The change can be very small but it has to be significant, meaningful and positive, which is different from just removing the symptoms. It means helping the client to gain a new way of seeing things, a new perspective, a new learning or to have a new experience. From the systemic perspective, the part represents a whole in some way, and a small, positive change in one selected area of the client’s life or their inner world will lead to other positive changes in the overall picture.
What feedback do you have from students when teaching the seminar?
In recent years there have been increasingly more students who have worked in the short-term context at their placements. They say that the Brief Therapy seminar gives them a structure for their work. The students who work with long-term clients get a deeper understanding on how important the therapeutic focus is, and how easily it can be lost in long-term work.
All of them find it useful to see all the principles, maps, concepts and techniques of Psychosynthesis – including the stages of the act of will – listed on the board; and also that all the concepts are related to each other and held within the larger context of the Egg diagram.
Would you consider running workshops at the Psychosynthesis Trust for practitioners (as CPD) on this subject?
All major schools of therapy already offer their own approach to brief therapy. I see huge potential in Psychosynthesis and I am in the process of writing a book on the Psychosynthesis approach to brief therapy, based on my clinical experience, theoretical knowledge and the research I’ve done. I hope that the book will be useful for therapists from all modalities and above all for our students, because most of the placements, which is where they start to practice with ‘real’ clients, offer only brief therapy.
I am also planning to run various workshops on brief therapy open to therapists from all modalities and students in training. Brief therapy requires effective training in the specific skills and attitudes that promote meaningful change when time is limited. It can be seen as an area of specialisation and it is important for all of us who are practising brief therapy to take continuing education so as to sharpen our skills and keep up-to-date with clinical and research advances.
Edwin Tan interviewing Dragana Djukic
Edwin Tan is a graduate of the Psychosynthesis Trust in private practice – www.edwintantherapy.com
Dragana Djukic is a Psychosynthesis psychotherapist, supervisor, trainer and Mindfulness teacher. She works in private practice and with the NHS. She teaches on Counselling Diploma courses at the Psychosynthesis Trust and Mary Ward Centre – www.quantumkoan.com.