How to succeed at limited interventions

The reality faced by many mental health practitioners is that the time spent with the client is often limited. We may have 20 therapy sessions at our disposal but many of us are working with a limit of 3-5 for counseling sessions or even a single session that we try to make the most of. Here are some key success factors for making an impact within a limited time frame.

1. Trust requires honesty

The first and maybe most important one is the ability to establish a strong therapeutic alliance that is built on trust and mutual respect. This involves being non-judgmental, empathetic, and compassionate with our clients. Trust also requires honesty about the scope of the therapy or counseling process. This involves setting clear expectations, being honest about the limitations of a brief process and tracking the progress and providing regular feedback to clients during each session.

2. Structures and flexibility

The second key success factor for a brief or limited intervention is to take an active role in the process by both asking open-ended questions, and providing guidance, viewpoints and support when needed. The challenge here is to balance between a structured and goal-oriented approach and flexibility or responsiveness to the clients needs. While it is important to start off with clear goals in mind, one often needs to provide additional support or guidance and revise these goals during even a brief process.

3. Reframing the issues

The third key success factor is the ability to effectively identify, verbalize and challenge the client’s negative conceptions and repeating patterns in their interactions with others. This involves helping clients reframe their thoughts, ways of relating to others and suggesting or guiding towards new coping strategies.

Meaningful change in the making

In conclusion, creating a safe and supportive therapeutic environment, facilitating active collaboration, effectively identifying and challenging negative patterns of thinking  are essential skills. But so is the ability to adjust one’ own approach to suit the client’s needs and the management of the expectations about the possible outcomes of the process.

If we have to spend a lot of time identifying the harmful or distressing situation, there may not be sufficient time for facilitating a meaningful change or even help the client identify what they need to start working with. With a case formulation at hand at the beginning of the process we can focus on both building a good alliance and get started with addressing those issues the client already knows to be meaningful.