The power of brief therapies in mental health

Last year, a survey by the American Psychological Association found demand for psychotherapy had increased dramatically since the start of the Covid pandemic, with 68% of therapists saying their waiting lists had grown longer and more than 40% saying they were unable to keep up with the request. But help does not necessarily mean long years of traditional psychotherapy. Research has shown that even brief interventions—targeted, time-limited programs to improve thinking and behavior at critical times—can have significant benefits.

These interventions, which can be as brief as 30 minutes of online training, do not replace psychotherapy. But given the increased rates of anxiety, depression, stress, substance abuse, and suicide among American adults and teens, they can be powerful ways to prevent challenges from escalating.

After just one encounter, people have reported that their feelings of hopelessness and anxiety have improved significantly.

A study published on the online preprint library PsyArXiv in July by Jenna Sung, a doctoral student in psychology at Stony Brook University, and her colleagues found that even a telehealth session with a counselor can be beneficial for people enrolled on psychotherapy waiting lists. During the sessions, 65 participants were asked to think about their most important goal, the steps they could take to achieve it, and the potential obstacles they might face. After just one encounter, people have reported that their feelings of hopelessness and anxiety have improved significantly.

Brief interventions can also reduce the risk of suicide, says David Jobes, a psychologist at Catholic University who developed the Collaborative Assessment and Management of Suicidality (CAMS) program, an evidence-based clinical intervention to help people avoid suicide. get stuck in suicidal thoughts. Over the course of six to eight sessions, the therapist helps the patient identify the struggles that are causing suicidal feelings and generate a coping plan.

Dr. Jobes conducted a study published in the journal Psychiatry in 2017 involving 148 members of the US military who had reported suicidal thoughts. They were divided into two groups, one receiving CAMS and the other the usual treatment. The study found that CAMS participants were “significantly less likely” to have suicidal thoughts after three months. “People are really good at improving themselves if you give them the right tools,” Dr. Jobes said.

Chronic pain is another problem that responds well to brief interventions. A study published in the journal JAMA Open Network in 2021, led by Beth Darnall, director of the Pain Relief Innovations Lab at Stanford University, showed that for people with chronic low back pain, a single two-hour session teaching the skills pain self-management was as effective as eight weeks of conventional cognitive behavioral therapy. Dr. Darnall’s “Self-Relief” program teaches people to notice distressing thoughts and feelings, then practice accepting their symptoms rather than catastrophizing them. Three months later, participants reported significant improvement in managing their pain and sleep disturbances.

Brief interventions hold particular promise as a means of helping children and adolescents.

Brief interventions hold particular promise as a means of helping children and adolescents. A report released by the Centers for Disease Control and Prevention in March found that the Covid pandemic had accelerated an increase in mental health problems among adolescents, with 37% reporting experiencing poor mental health in 2021.

During the first months of the pandemic in 2020, Jessica Schleider, a psychologist and assistant professor at Stony Brook University, and her colleagues launched Project YES!, offering free half-hour online interventions to adolescents with symptoms of stress, depression and anxiety.

In addition to learning skills to build resilience, participants answered questions about their own experiences and were asked to write down their takeaways to share with other young people. In a study published in the journal Nature in 2021, Dr. Schleider looked at more than 2,400 teens who participated, finding that the interventions helped reduce depression and eating disorders, with the benefits persisting after three months.

Dr Schleider, a former elementary school teacher, points out that “children, in particular, don’t really have options to choose when, where and how they get help”. Brief, easily accessible interventions can contribute to long-term improvements in mental health: “Long-term change is a series of small changes, and every small change matters,” she says.

Another former elementary school teacher, psychologist David Yeager of the University of Texas at Austin, and his collaborators have developed a 30-minute online training session for freshmen. Participants also heard stories from older students, who pointed out that college can seem difficult at first, but gets better with time. Then the first years were invited to write their own letters offering hope to future students.

“You can get people to internalize big, powerful ideas in a short time by inviting them to process the information and share it with others,” says Dr. Yeager. In a study published in the journal Nature in 2021 involving more than 4,000 students, he and his colleagues found that online training was correlated with fewer mental health symptoms, even during Covid shutdowns.

Research by Jeremy Jamieson of the University of Rochester found that a brief training session on “stress reassessment” can also help students cope with anxiety. In a study of 339 community college students published in the Journal of Experimental Psychology in July, those who were taught to view anxiety symptoms like racing heartbeat and sweaty palms as normal responses to stress performed better on academic exams. Dr. Jamieson explains that his interventions aim to serve as a scaffolding to prevent stress from escalating into depression.

Dozens of studies also point to the potential of single-session interventions to reduce problematic drinking. A study led by Felicia Chi, senior research analyst at Kaiser Permanente, published in the journal Drug and Alcohol Dependence in 2022, looked at a sample of over 300,000 adults and found that a brief intervention reduced the average number of days during which participants were engaged in heavy drinking by 26%.

Geoffrey Cohen, a professor at Stanford University’s Graduate School of Education and author of ‘Belonging’, a new book on brief interventions to improve social inclusion, describes them as opportunities for people to realize their full potential , which is much more effective than trying to convince them of something.

“It’s almost like walking into a party where you don’t know anyone, but the host gives you a warm welcome, relieving your nerves so that you feel more able to socialize,” says Dr. Cohen. The growing body of evidence for the success of brief interventions shows that mental health and psychological treatment should not be thought of in terms of all or nothing.

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