Steps 4 and 5: How Do Couples Change in Brief Therapy?

Since graduate school in the late ‘60s, I've been struck by an odd asymmetry in the study of psychotherapy. We teach and learn much about evaluating clients: What are the presenting symptoms? Biological, psychological, or both, in cause? Core relationship themes? Contributing family history? Most mental health professionals also seem skilled in crisis intervention and medication referral (at last count, over 50% of the clients in our large HMO psychiatry system used psychotropic medicine as part of their treatment). So we know a lot about how to start with our treatments.