Very Brief Therapeutic Conversations

Windy Dryden

• Publisher: Routledge
• Year: 2018
• ISBN:
  9781351104982
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

In Very Brief Therapeutic Conversations, Windy Dryden demonstrates the therapeutic value of very brief interventions in counselling, psychotherapy and coaching, using a wide range of techniques and skills to bring this novel approach to life.

The book provides an informative and innovative guideon 'how to do' very brief therapy in 30 minutes or less. The often fascinating and universal problems the volunteers discuss, as well as the goal and guiding principles of this novel therapy, are explored in the first half of this book. Inspired by Ellis's therapeutic 'Friday Night Workshops', transcripts from Dryden's own therapeutic conversations at his 'live sessions' with volunteers form the second half of the book.

Very Brief Therapeutic Conversations is an accessible and entertaining read for all therapists, whether in training or practice, who want to see very clear examples of theory being put into practice.

Part 1

Principles and practice

Chapter 1

The principles that guide my work in very brief therapeutic conversations

Introduction

The focus of this book is on very brief therapeutic conversations (VBTCs) that I have had with people who volunteered to participate in such conversations in front of an audience. In this chapter, I will review, in brief, the principles that guide my work while conducting VBTCs, but before I do so, let me say something about the context of such conversations.

The context of VBTCs

The events that provide the context for such conversations are ones where people have come to see me either: (i) demonstrate the way I practise cognitive behaviour therapy (CBT),¹ or (ii) lecture on a particular psychological topic followed by me carrying out VBTCs with volunteers from the audience who are seeking help from me for a problem relevant to the topic.

When I call for a volunteer from the audience, I ask that the person volunteers only if they meet the following criteria:

1.They have a genuine, current problem for which they want help. It is important that the person does not (a) manufacture a problem, (b) roleplay someone else who has the problem (e.g. one of their clients if they are a helping professional) or (c) present a problem that they had in the past that is no longer current. In my view, unless the person has a genuine, current problem and wants help with that problem, then the ensuing conversation is a sham and cannot be described as a VBTC.

2.They are willing to discuss the problem in front of an audience. Normally, the audience is exclusively made up of helping professionals, or it comprises a mix of such professionals and members of the general public who have an interest in CBT/rational emotive behaviour therapy (REBT) or the specific topic on which I am lecturing. At the outset, I ask members of the audience to observe the confidentiality principle of ‘what is said here, stays here’ and ask anyone who will not observe it to make themselves known. In the 12 years in which I have conducted VBTCs, nobody has objected to this principle.² I then quip that I don’t mind them going away and telling people what a lousy therapist I am, but I do mind if they disclose the content of my conversation with the person. I also make it clear that audience members are not allowed to make recordings of the ensuing conversation. I point out that I will make such a recording, which I will send to the volunteer so that they may have a copy of our conversation for later review (see Chapter 5).

Before I begin a conversation, I ask members of the audience to remain very quiet during the interview and to refrain from even whispering to their neighbour, as in the kind of rooms I do this work, even whispers can be heard and be distracting. I remind them that they will have the opportunity to ask questions of the volunteer and me after the conversation has been concluded. With that done, I commence the conversation.

Guiding principles: an overview

In this chapter, I will provide a summary of the principles that guide my work in conducting VBTCs before discussing each of them in greater detail later. The purpose of this chapter is to provide you with an idea of the foundations that underpin this work. Let me stress at the outset that while I make use of some principles in carrying out VBTCs, I certainly do not make use of them all in every VBTC. I utilise certain principles with some volunteers and other principles with others. For example, while I often draw upon certain key REBT principles, sometimes I don’t use these principles at all. This is because perhaps the most important principle that guides my work is as follows.

The person is more important than any principle

As I will soon make clear, my goal in these conversations is to help the person take away at least one thing that they can use in their life going forward that will make a difference to them. I will use any idea at my disposal to help them to do this. In doing so, I prioritise the person’s interest over any allegiance I have to a valued principle.

One thing

When I began engaging in VBTCs in front of a public audience, I was much more concerned to show members of that audience what a fine therapist I was than I am now. This led me to make a routine error in that I gave volunteers too much to digest in a short period. I call this ‘Jewish mother’ syndrome. When I used to visit my dear late mother, she would always make sure that I would not go hungry. She would offer me too much food when I was there and gave me more food to take away with me, “just in case.” By contrast, my goal is to offer the volunteer one thing that they can digest and act on in their life to make a difference to that life. In VBTCs, ‘less is more’ (Talmon, 1990).

The effectiveness of VBTCs depends on a fusion between what I bring to the process as therapist and what the volunteer brings to the process

The predominant therapeutic tradition in single-session work is known as the ‘constructive therapies’ (Hoyt, 1998). This tradition is composed of therapeutic approaches such as narrative therapy (e.g. McLeod, 1997), solution-focused therapy (e.g. Ratner, George & Iveson, 2012), systemic therapy (Hedges, 2005) and strengths-based therapy (Jones-Smith, 2014). The goal of the therapist in these approaches in single-session work is largely facilitative. It is to help the client draw upon and use resources and strengths that they already have and are not using. The expertise of the therapist is in the mobilisation of client resourcefulness and not in offering a particular content-based view of how clients develop problems and how they can best approach these problems.

Hoyt et al. (2018) contrast this ‘constructive’ approach with an active-directive approach to single-session work. They would say that my approach to VBTC was active-directive “in which change, even if informed by the client’s goals, is primarily brought about through the application of therapist techniques…It is the therapist who forms an opinion about what is wrong (e.g. ‘How is the client stuck?’), and then it is the therapist who proceeds to provide what the therapist discerns to be the needed remedy – be it insight, explanation and instruction, specific skill training, paradoxical behavioral directives to obviate interpersonal problems, etc.” While I agree that my approach to VBTCs is ‘active-directive’, I disagree with Hoyt et al.’s apparent view that the volunteer is the passive recipient of the therapist’s wisdom. My view is that I do have expertise as a therapist that I am willing to share, but the volunteer is an active participant in the process and brings their view of what might be helpful to them, which also informs my work. That is why I say that my approach to VBTC is a fusion of what I bring to the process and what the volunteer brings to the process.

Helping the volunteer to get the most out of our conversation

As noted above, I see one of my tasks as to help the volunteer to get the most out of the VBTC. I do this in three ways. First, I want to discover what the person has already tried to solve their problem. In doing so, I strive to find out what the person has done that has been helpful and what they have tried that has been unhelpful. During our conversation, my goal is to help the person to capitalise on the former and to refrain from using the latter. Second, I want to discover and make use of the volunteer’s internal strengths and access to external resources where appropriate during the conversation. Finally, I want to discover and make use of the volunteer’s core values to promote emotional problem-solving.

Principles from REBT

I am most closely associated with the approach to CBT known as REBT, and I do draw from this approach some principles that guide my work in VBTCs. This is part of my expertise as a therapist in VBCT, which I discussed above. Amongst others, I am particularly guided by the following principles:

•It is important to face and deal with adversity rather than to avoid it or skirt around it.

•Flexible attitudes tend to promote psychological health, while rigid attitudes tend to promote psychological disturbance.

•The person’s response to their initial response to adversity is more important than that initial response.

•Knowing why an attitude is problematic is not an end in itself. It is the beginning of a process.

•Unless a person repeatedly acts on a new healthy attitude, it will remain theoretical, but won’t influence emotion or behaviour.

The importance of understanding, emotion and action

Whether I am using an idea that comes from REBT or from some other source, it is important that the volunteer understands the idea, agrees with it and can see its relevance. If not, then the idea will have no value for the person. Having said that, no matter how valuable such an idea is for the person, if they do not have an emotional response to it, then the idea will probably not stay with them for very long. Even if the idea does have emotional resonance for the person, unless they act on the idea, then it will not help them to solve their problem. So, in a relatively short period, I try to promote affect-based understanding in the volunteer and encourage then to make a commitment to act on that understanding. That for me is the g...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Contents
• Foreword
• Preface
• Acknowledgements
• Part 1 Principles and practice
• Part 2 Conversations
• Afterword
• Appendix 1 Behaviours and action tendencies associated with unhealthy negative emotions and healthy negative emotions
• References
• Index