The Gaskell House Psychotherapy Centre

Structured Brief Therapy
Information leaflet produced for patients by Gaskell House

Timing

You will see your therapist for a set number of sessions, usually between 8 to 12, at a mutually convenient time. The frequency of the sessions will be arranged with your therapist but they may be weekly, fortnightly or monthly.

What Does It Involve?

It involves you and your therapist describing your difficulties and how you deal with situations in a new way which links these with patterns of thinking and reacting which may be making things worse for you. These can be patterns of thinking and acting which do not achieve what you want, being constantly pushed into making false choices or being caught up in ways of behaving that stop you changing for the better.

This will result in you and your therapist making a list of Target Problems to work on. Your therapist will then help you to work out new ways of thinking and acting to deal with these.

The First Sessions

The first two or three sessions are spent finding unhelpful but recurring interpersonal patterns in your life, usually involving other people, which can be identified, clarified and (hopefully) changed during the course of therapy. In the first session, your therapist will go over your history, and will try to identify such recurring maladaptive patterns. At the end of the first session you will be given the psychotherapy file to read and complete, and this should be reviewed in the second session. The aim of this is to provide examples of maladaptive patterns which can be identified during the session.

Recurring unhelpful problems include:

(a) Target problems

These are the general areas that you might wish to look at in therapy, and which cause you most pain and dissatisfaction in your life. These can be things like "difficulty asserting my own needs in relationships", or "difficulty expressing powerful feelings such as anger or neediness". Target Problem Procedures and Reciprocal Role Procedures (see below) form part of these general target problems.

(b) Target Problem Procedures

These are patterns of thought, feeling or behaviour which are typical of you. They are divided up into dilemmas, traps or snags. They are explained in more detail in the Psychotherapy File which your therapist will give you to read.

(c) Reciprocal Role Procedures

The target problem procedures identified in '(b)' above are usual ways of responding to difficulties in relationships. These responses lead to a pattern of mutual behaviour involving the other person which form a "vicious circle", leading back to the starting point. These will be identified and clarified by exploring particular examples with your therapist and you will be able to recognise that they apply in other situations. Your therapist will ask you for examples of typical situations when you experience the dilemmas, traps or snags they have ticked in the Psychotherapy File.

Your therapist will tend to describe reciprocal role procedures in the form of a diagram, which they can draw during the session with your co-operation. An example might be:

Once these vicious circles have been identified you can start to look for exit points, or ways of getting out of these self defeating loops.

The Structure of Therapy

(i) Reformulation Letter

In the third, or at the latest fourth, session your therapist will give you a letter which puts forward your problems in the way you have understood them, usually in terms of target problems and reciprocal role procedures.

(ii) The Main Part of Therapy

After the reformulation, most of the subsequent sessions are concerned with recognising RRPs when they occur, clarifying the repetitive maladaptive patterns and practising alternatives (especially looking for exit points). It is this concentration on patterns of thought, feeling and behaviour identified as problems by the patient which give the therapy a clear focus.

(iii) The Goodbye Letter

At the end of therapy, your therapist will usually give you a letter which summarises the problems the patient presented with, repeats the aims of therapy, and reviews the progress of therapy. You may also wish to write a goodbye letter to your therapist.

(iv) Follow Up

You will usually be offered a single follow up appointment approximately 3 months after the end of therapy. This is partly to get a sense of progress you have made and partly to help apply what yu have gained to any new problems that mnight arise.

Holidays And Absences

The therapist will give the you good notice of planned breaks, and you are asked to do likewise if you plan to be away. If you have to be absent at short notice, you can leave a telephone message between 9.00am and 4.45pm at Gaskell House reception on (0161) 273-2762.

Child care

Unfortunately we do not have creche facilities at Gaskell House and so if you have a baby or small child you will have to arrange for someone to look after him/her. In this form of psychotherapy it is not usually possible to have your child in the therapy room during sessions.

Confidentiality

The proceedings of the session are confidential. This is essential if people are to trust each other. Your therapist will also respect confidentiality, with the proviso that he/she will discuss events from time to time with a small group of colleagues for the purpose of supervision. Your therapist, however, has a duty to inform your family doctor that you are receiving treatment at Gaskell House.

There are uncommon limited situations when the therapist must disclose therapy material elsewhere; the therapist will discuss this with you first. This may be when someone's safety is at risk, or to comply with the Children's Act.

Medication

The use of medication for psychological difficulties is not a bar to psychotherapy treatment, though we discourage the use of minor tranquillisers, such as valium. It is important that you do not stop any medication without discussing this with the G.P. or psychiatrist supervising it. Your therapist will not supervise your medication.

Gaskell House Psychotherapy Center
Swinton Grove
Manchester M13 0EU
England
Tel: 0161 273 2762            Fax: 0161 273 4876
email: gmcgrath@psy.cmht.nwest.nhs.uk

   
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North West Institute
of Dynamic Psychotherapy