In the United States, a mental health crisis is being dealt with, one that has implications for individuals seeking help, families, and, therefore, their communities. In recent years, the prevalence of mental health issues has increased to alarming levels, posing a significant challenge to the nation’s well-being and stability. Based on international observations from colleagues we have been working with, this crisis seems to exist in other countries as well, especially expressed in the lack of psychiatrists and psychologists available to take on new clients. One of the many causes we suggest in this writing is that prevalent approaches to treatment might not be as effective.
According to the National Institute of Mental Health (NIMH), approximately one in five adults experiences a mental illness in a given year. From anxiety and depression to more “severe” disorders like schizophrenia and bipolar disorder, the spectrum of issues is vast and complex.
The crisis appears to have worsened with isolation during the intense years of COVID-19, but technology, which leads to constant connectivity (Facebook, Instagram, TikTok), has also brought about a new set of challenges, such as digital addiction and cyberbullying, especially among adolescents, which significantly affects the well-being of the bullied child or teenager, as well as their families. We are interested in highlighting the insufficiency of available mental health services.
Needless to say, the consequences of the crisis are profound and far-reaching. People who are burdened by mental health issues often face a deteriorating quality of life, strained relationships both at home and in the workplace, and thus lower productivity. Without treatment, these conditions lead to more severe outcomes. These situations do not happen overnight: if someone feels “down” and seeks help at that moment instead of being placed on a waiting list, more severe consequences, such as suicidal threats, could be avoided. We suggest that a positive change could come from the professional who is able to see anxiety, depression, and other diagnoses as shades of gray rather than black or white, or like a switch that turns on or off, because it would allow for more effective help to be offered. This approach would also reduce the enormous financial burden on social services, Health Maintenance Organizations (HMOs), and private professionals, as well as the time available to open spaces for new clients.
In our experience, therapists, social workers, and counselors are taught in school that treatments must address the root of the problem. Exploring the origins in-depth and over a long period of time, and hopefully, through clarity, the person will stop suffering. Psychotherapy, like other sciences, has evolved; therefore, getting stuck in the past might make some people more aware of their problems, but it does not guarantee that it will promote positive change. People come to see us because something hurts, and we can be more helpful if we can stop that pain as quickly as possible. Similarly, when you go to see a doctor with stomach pain, the “why” should be somewhat secondary to the stomach pain stopping. Since humans are all unique and different from one another, Cognitive-Behavioral approaches are not much better because, ultimately, and with the best intentions, the protocols used are always the same, and when they do not produce the desired/expected changes for the clients they do not work for, more protocols are applied or the patient is blamed for it not working.
At the Brief Therapy Center, we have been addressing people’s pain since 1966. From the beginning, we focused treatment on what the client — we refer to clients instead of patients — is requesting, rather than adopting the “tip of the iceberg” approach, which inevitably leads the therapist to inadvertently steer therapy toward something that generally takes more time to resolve. If a client is asking for help with a sad teenager, most therapists will try to talk about the relationship with the parents or family dynamics instead of “entering the system where we are invited.” Sometimes a cigarette is just a cigarette, as Sigmund Freud once said.
Our approach is a goal-centered, time-limited therapy designed to address specific challenges and promote movement and change effectively. Pragmatic solutions are emphasized instead of prolonged exploration of underlying problems. The central premise is that people possess the resources and skills necessary to overcome their difficulties, and PSBT aims to activate these strengths with the help of the therapist who looks toward the future. The therapeutic process begins with a clear and collaborative identification of the problem and the desired outcome. Therapists and clients work together to establish clear and achievable goals without delving into past experiences, primarily focusing on practical strategies to effect change in the present and future. The premise is that once change begins to occur, a positive cycle is established that brings a new perspective on what caused the pain in the first place. The process is adapted to each person’s particular situation, carefully listening to what clients bring in their language and specific frame of reference. This is the key to offering help because we see the request for help as a small hill rather than turning it into a high, unattainable mountain. Our approach is not a quick fix. It allows both the therapist and the clients to see their situation differently and opens doors to resilience in individuals, families, and society in general.
