chapter  9
Importance of the First Two Sessions
Pages 6

Chapters Five through Seven illustrate that most of the critical techniques and strategies of treatment abbreviation-rapid assess­ ment and case conceptualization, focus identification, and goal es­ tablishment-are typically accomplished during the first two ses­ sions of brief therapy. The last chapter (eight) showed that important treatment, that is, direct assistance for the client, also occurs in those initial sessions. Research that has examined the degree of clinical improvement associated with different stages of therapy provides empirical support for this latter assertion. As re­ viewed in Chapter Two, several studies have found that there is substantial improvement associated with one to two sessions of therapy; this is supported by experimental studies of random as­ signment to one to two sessions vs. time-unlimited treatment (e.g., Edwards et al., 1977; Miller & Hester, 1986) as well as a much larger number of studies that have addressed improvement at differ­ ent stages of therapy (e.g., Howard et al., 1986; Howard et al., 1993; Gottschalk, Mayerson, & Gottlieb, 1967; Pekarik, 1983a). Howard et al.’s 1993 work illustrates the improvement associated with the initial two sessions very clearly. Figure 9.1 shows the amount of improvement achieved on three different outcome mea­ sures at the second, fourth, and seventeenth sessions.