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Brief psychotherapy is here to stay. Even before the revolution in health insurance, large surveys of both private and clinic practice showed that the average length of psychotherapy was 10-12 sessions (Budman and Gurman, 1988). And brief therapies are relatively effective: 60% of patients are greatly improved according to a variety of outcome measurements by the end of 13 sessions (Messer and Warren, 1995). A recent overview of this field summarizes: “Brief therapy is what most clients receive, … constitutes a significant part of clinician's work… and is likely to increase in the current climate” (Messer and Warren, 1995, p. 63).
But most of these are still unplanned brief therapies, which Budman and Gurman (1988) have called “brief therapy by default” instead of “brief therapy by design.” Especially among psychoanalytically oriented therapists, the practice of planned, time-limited, and focused psychotherapy has not met with wide acceptance. Psychodynamic therapists feel less skilled in brief therapy than psychotherapists of any other orientation and have a less positive view of brief therapy. They overwhelmingly favor a long-term time-unlimited model even though most of their patients in fact come for relatively short-term encounters. They rarely plan to conduct brief treatments unless mandated to do so by a job in a clinic setting or other external requirements like insurance (Messer and Warren, 1995).
This remains true despite the very substantial contributions over the last 30 years by Malan (1976), Davanloo (1980), Sifneos (1972), Mann (1973), Luborsky , Horowitz et al. (1986), Strupp and Binder (1984), and others who have taught us how to conduct brief psychodynamic treatments, and despite the research evidence that brief dynamic psychotherapy (BDP) can produce good results including both symptomatic