Casebook of the Brief Psychotherapies

APPLIED CLINICAL PSYCHOLOGY

Series Editors: Alan S. Bellack, Medical College of Pennsylvania at EPPI, Philadelphia, Pennsylvania, and Michel Hersen, Nova University School of Psychology, Fort Lauderdale, Florida

Current Volumes in This Series

ACTIVITY MEASUREMENT IN PSYCHOLOGY AND MEDICINE Warren W. Tryon

BEHAVIOR ANALYSIS AND TREATMENT Edited by Ron Van Houten and Saul Axelrod

CASEBOOK OF THE BRIEF PSYCHOTHERAPIES Edited by Richard A. Wells and Vincent J. Giannetti

CLINICAL PSYCHOLOGY Historical and Research Foundations

Edited by C. Eugene Walker

CLINICAL PSYCHOLOGY SINCE 1917 Science, Practice, and Organization

Donald K. Routh

ETHNIC VALIDITY, ECOLOGY, AND PSYCHOTHERAPY A Psychosocial Competence Model Forrest B. Tyler, Deborah Ridley Brome, and Janice E. Williams

PERSPECTIVES AND PROMISES OF CLINICAL PSYCHOLOGY Edited by Anke Ehlers, Wolfgang Fiegenbaum, Irmela Florin, and

Jürgen Margraf

SEXUAL BEHAVIOR Problems and Management

Nathaniel McConaghy

THERAPEUTIC CHANGE An Object Relations Perspective Sidney J. Blatt and Richard Q. Ford

USING RATIONAL-EMOTIVE THERAPY EFFECTIVELY A Practitioner's Guide Edited by Michael E. Bernard

A Continuation Order Plan is available for this series. A continuation order will bring delivery of each new volume immediately upon publication. Volumes are billed only upon actual shipment. For further information please contact the publisher.

Casebook of the Brief Psychotherapies

Edited by RICHARD A . WELLS University of Pittsburgh Pittsburgh, Pennsylvania

and

VINCENT J. GIANNETTI Duquesne University Pittsburgh, Pennsylvania

SPRINGER SCIENCE+BUSINESS MEDIA, LLC

L ib ra r y o f Congress CatalogIng-1n-Pub1 1 cat 1 on Dat a

Casebook o f t h e b r i e f p s y c h o t h e r a p 1 e s / e d i t e d b y R i c h a r d A . W e l l s an d

V i n c e n t J . G l a n n e t t 1 .

p. era . — ( A p p l i e d c l i n i c a l p s y c h o l o g y )

I n c l u d e s b i b l i o g r a p h i c a l r e f e r e n c e s an d I n d e x .

ISBN 978-0-306-44393-0 ISBN 978-1-4615-2880-7 (eBook) DOI 10.1007/978-1-4615-2880-7 1. B r i e f p s y c h o t h e r a p y — C a s e s t u d i e s . I . W e l l s , R i c h a r d A .

I I . G l a n n e t t l , V i n c e n t J . I I I . S e r i e s .

[DNLM: 1 . P s y c h o t h e r a p y , B r i e f - c a s e s t u d i e s . W M 4 0 C337 5 1993 ]

RC480.55.C36 199 3

616 .89' 14—dc2 0

DNLM/DLC

f o r L i b r a r y o f C o n g r e s s 93-2885 7

C I P

ISBN 978-0-306-44393-0

© 1993 Springer Science+Business Media New York Originally published by Plenum Press New York in 1993 Softcover reprint of the hardcover 1st edition 1993

A l l rights reserved

No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, nÜCTofflming, recording, or otherwise, without written permission from the Publisher

To our parents,

Frank and Angela -V.G.

Charles and Myrtle -R.w.

Contributors

BRAD A. ALFORD, Department of Psychology, University of Scranton, Scranton, Pennsylvania 18510

HAROLD S. BERNARD, Department of Psychiatry and Group Psycho­therapy Program, Psychology Service, New York University Medi­cal Center, New York, New York 10016

LAURA BLACK, State Hospital, Lanark, Scotland ML11 8RP

SIMON H. BUDMAN, Harvard Community Health Plan, Harvard Medical School, and Innovative Training Systems, 24 Loring Street, New­ton, Massachusetts 02159

WILLIAM I. COHEN, Child Development Unit, Children's Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, Pennsylvania 15213

CLEON CORNES, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, Pennsylvania 15213

BARRY L. DUNCAN, Dayton Institute for Family Therapy, 65 West Frank­lin Street, Centerville, Ohio 45459

STUART FINE, Division of Child Psychiatry, University of British Colum­bia, Vancouver, British Columbia, Canada V5Z 1M9

STUART G. FISHER, Worcester Youth Guidance Center, 275 Belmont Ave­nue, Worcester, Massachusetts 01609

VINCENT J. GIANNETTI, School of Pharmacy, Duquesne University, Pitts­burgh, Pennsylvania 15282

vii

viii CONTRIBUTORS

MERVYN GILBERT, Department of Psychology, Vancouver General Hospi­tal, Vancouver, British Columbia, Canada V5Z IM9

CAROL J. GOLDEN-SCADUTO, Department of Psychiatry, New York Uni­versity Medical Center and Bellevue Hospital Center, New York, New York 10016

CARLOS J. GONSALVES, Institute for the Study of Psychopolitical Trauma, and Kaiser-Permanente Medical Center, Santa Clara, California 95120

MICHAEL A. GREENWALD, Program in Counseling Psychology, Depart­ment of Psychology in Education, University of Pittsburgh, Pitts­burgh, Pennsylvania 15213

BERNARD G. GUERNEY, JR., Individual and Family Consultation Center, Department of Human Development and Family Studies, Pennsyl­vania State University, University Park, Pennsylvania 16802

MICHAEL F. HoYT, Department of Psychiatry, Kaiser-Permanente Medi­cal Center, 27400 Hesperian Boulevard, Hayward, California 94545-4299

DANIEL J. HURLEY, Worcester Youth Guidance Center, 275 Belmont Ave­nue, Worcester, Massachusetts 01609

JOEL KATZ, Department of Psychology, Toronto Hospital, 200 Elizabeth Street, Toronto, Ontario, Canada M5G 2C4

JOSEPH LOPICCOLO, Department of Psychology, University of Missouri, Columbia, Missouri 65211

LAMBERT MAGUIRE, School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania 15260

ALVIN R. MAHRER, School of Psychology, University of Ottawa, Ottawa, Ontario, Canada KIN 6N5

RAYMOND W. NOVACO, School of Social Ecology, University of California at Irvine, Irvine, California 92717

CONTRIBUTORS ix

ELAM NUNNALLY, School of Social Welfare, University of Wisconsin­Milwaukee, Milwaukee, Wisconsin 53201

LARRY V. PACOE, Departments of Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania 15213

PHILLIP A. PHELPS, Child Development Unit, Children's Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, Pennsylvania 15213

GREGORY K. POPCHAK, Family and Personal Consultation Network, 117 Opal Boulevard, Steubenville, Ohio 43952

CATHRYN G. PRIDAL, Department of Psychology, University of Missouri-Columbia, Columbia, Missouri 65211

KATHLEEN REED, Pittsburgh Action Against Rape, 81 South 19th Street, Pittsburgh, Pensylvania 15203

MARTINE ROBERGE, School of Psychology, University of Ottawa, Ottawa, Ontario, Canada KIN 6N5

ROBERT ROSENBAUM, California Institute for Integral Studies, 765 Ash­bury St., San Francisco, California 94117

JAIME Ross, Institute for the Study of Psychopolitical Trauma, and Mira­monte Mental Health Services, Palo Alto, California 94301

BRIAN F. SHAW, Department of Psychology, Toronto Hospital, 200 Eliz­abeth Street, Toronto, Ontario, Canada M5G 2C4

ELIZABETH SIEGEL, New Directions, 837 South Fair Oaks, Suite 201, Pas­adena, California 91105

IRENE SIOTIS, Department of Psychiatry, McMaster University, Ham­ilton, Ontario, Canada L8N 3Z5

MARYHELEN SNYDER, New Mexico Relationship Enhancement Institute, 422 Camino del Bosque, Albuquerque, New Mexico 87114

KAREN SUBRAMANIAN, School of Social Work, University of Southern California, Los Angeles, California 90089-0411

x CONTRIBUTORS

RICHARD A. WELLS, School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania 15260

JASON WORCHEL, 1020 East Jefferson Street, Charlottesville, Virginia 21901

Preface

Following the publication of the Handbook of the Brief Psychotherapies (Wells & Giannetti, 1990), the editors began to conceptualize the idea of a collection of case studies encompassing a number of the commonly en­countered clinical problems that have been treated with such ap­proaches. The Casebook of the Brief Psychotherapies is the result. The Case­book details clinical interventions with client populations as diverse as substance abusers, torture victims, the physically handicapped and other exceptional groups, and the economically disadvantaged with emotional and behavioral problems, as well as individuals experiencing sexual dysfunction or eating disorders. In addition, topics such as be­reavement, depression, anger, and many crucial aspects of marital and family therapy are discussed by eminent clinical practitioners. Although the cases draw heavily upon cognitive behavioral and strategic structural formulations, psychodynamic, interpersonal, and experiential ap­proaches are also included.

The Casebook is clinically oriented, with a minimum of theory. Am­ple case material and commentary allow the reader to experience direct­ly the application of brief therapy to specific client problems. What emerges from this compendium of approaches and problems is a tap­estry of action-oriented, problem-solving, skill-building, rational ap­proaches to therapy that balance the client's ability to change with the demands and limits of time. The result is a bringing together of a variety of parsimonious, pragmatic, and effective methods for delivering psycho­therapeutic services to diverse clients in this era of declining resources and cost-containment pressure on administrators and policymakers in the mental health field.

We agree with Garfield's (1989) summation and forecast:

Most of the psychotherapy that is conducted in the United States, at least, is brief therapy, and there is no basis for expecting any change in the

xi

xii PREFACE

future. There are still opportunities for those individuals who want to enter psychoanalysis or receive some other type of long-term psychotherapy as a means of personal self-exploration in terms of a specific theory of personality. However, such therapy is clearly for the very few who desire such an experi­ence and can afford to pay for it. For the rest of the population, brief psycho­therapy remains the treatment of choice. (p. 156)

Thus, in the spirit of Garfield's injunction, the Casebook is devoted to clear explication of how time-limited interventions are actually carried out by expert practitioners. In addition, the editors hope that the volume will stimulate further interest and experimentation with brief psycho­therapy for the purpose of benefiting clients and contributing to the continued development of efficacious and cost-effective psychothera­peutic services.

REFERENCES

Garfield, S. L. (1989). The practice of brief psychotherapy. New York: Pergamon Press. Wells, R. A., & Giannetti, V. J. (Eds.). (1990). Handbook of the brief psychotherapies. New York:

Plenum Press.

Contents

I. INTRODUCTION

1. Clinical Strategies in Brief Psychotherapy .,. . . . . . . . . . . . . 3

RICHARD A. WELLS

II. INDIVIDUAL INTERVENTION

2. Active Interventions in Brief Therapy and Control Mastery Theory: A Case Study ........................ 21

SIMON H. BUDMAN AND MICHAEL F. HoYT

3. Brief Treatment of a Torture Survivor .................. 27

JAIME Ross AND CARLOS J . GONSALVES

4. Interpersonal Psychotherapy of Depression: A Case Study ........................................ 53

CLEON CORNES

5. Brief Cognitive Psychotherapy of Panic Disorder

BRAD A. ALFORD

6. Cognitive Therapy of Unipolar Depression

BRIAN F. SHAW, JOEL KATZ, AND IRENE SIOTIS

xiii

65

77

xiv

7. Brief Social Support Interventions with Adolescents

LAMBERT MAGUIRE

CONTENTS

91

8. Heavy Ideals: Strategic Single-Session Hypnotherapy . . . . 109

ROBERT ROSENBAUM

9. Brief Treatment of Anxiety Disorders 129

LARRY V. PACOE AND MICHAEL A. GREENWALD

10. Treatment of Anger with a Developmentally Handicapped Man ................................... 143

11.

LAURA BLACK AND RAYMOND W. NOVACO

Brief Relapse Prevention with Substance Abusers

VINCENT J. GIANNETTI

12. Single-Session Experiential Therapy with Any Person

159

Whatsoever........... ..... .. . . .. ... .. ......... ..... . 179

ALVIN R. MAHRER AND MARTINE ROBERGE

13. Pathological Mourning in Short-Term Dynamic Psychotherapy ....................................... 197

JASON WORCHEL

III. COUPLE AND FAMILY INTERVENTIONS

14. Brief Couple/Family Therapy: The Relationship Enhancement Approach .............................. 221

MARYHELEN SNYDER AND BERNARD G. GUERNEY, JR.

15. Two Cases of Brief Therapy in an HMO

MICHAEL F. HoYT

235

CONTENTS xv

16. She'll Cook It Herself: Brief Family Therapy with an Elderly Couple ....................................... 249

WILLIAM I. COHEN AND KATHLEEN REED

17. A Brief Family Therapy Model for Child Guidance Clinics .............................................. 259

DANIEL J. HURLEY AND STUART G. FISHER

18. Solution Focused Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271

ELAM NUNNALLY

19. The Case of Oppositional Cooperation

PHILLIP A. PHELPS

20. Brief Family Therapy with a Low-Socioeconomic

287

Family .............................................. 303

GREGORY K. POPCHAK AND RICHARD A. WELLS

21. Creating Opportunities for Rapid Change in Marital Therapy. . . . . . . . ........ .. .. ... .......... ............ 315

BARRY L. DUNCAN

22. Brief Treatment of Vaginismus. . . . . . . . . . .. . . . . . . . . . . . . . 329

CATHRYN G. PRIDAL AND JOSEPH LOPICCOLO

IV. GROUP TREATMENT

23. Short-Term Group Therapy with a Chronic Pain Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 349

KAREN SUBRAMANIAN AND ELIZABETH SIEGEL

xvi CONTENTS

24. A Short-Term Group Intervention in the Context of Ongoing Individual Psychotherapy .................. 363

CAROL J. GOLDEN-SCADUTO AND HAROLD S. BERNARD

25. Short-Term Group Therapy with Depressed Adolescents 375

STUART FINE AND MERVYN GILBERT

Index.................................................... 389