<p>Chalquist.com</p><p>Time-Limited Therapy: A “Crisis to Ceremony” Model</p><p>Craig Chalquist, MS PhD</p><p>By the very nature of the object of our professional work, we cannot separate mental health from the social order. For this reason, I believe there is an extremely urgent task for education for mental health. And this task consists not so much in teaching relaxation techniques or new ways of communicating, however important these objectives may be, as in training and socializing so that people’s desires truly conform to their needs. – Ignacio Martin-Baro</p><p>The following brief therapy model, which includes a crisis intervention phase, reimagines brief therapy as a tool for cultural awareness and social change. In a historical period like ours, where the dominant culture can no longer meet human needs or desires and even employs the social sciences to manufacture artificial ones, a prime task of the therapist is to turn psychology back on itself to empower clients to discover what they truly want.</p><p>INITIAL STAGE</p><p> Identify and manage crisis and safety issues, including suicidality, domestic violence and substance abuse.  Explore trigger event/presenting problem. 1. How has client tried to solve it. 2. What behaviors and relational interactions worsen it. 3. Expression of feelings about it.  Assess IDEA*: interpersonal, developmental (individual and family system), existential, and archetypally storied dimensions of the problem. 1. What is changing in the client’s key relationships? 2. What are the client’s pockets of immaturity? Developmental tasks? Family life cycle stage? 3. Why did they come for therapy just now? Look for upcoming or recent life event milestones, decisions, challenges, losses, expected gains. 4. What mythic-archetypal themes (Death, Rebirth, Hostile Brothers, Inanna’s descent into the underworld, etc.) shine through the client’s struggle?  Assess client strengths, weaknesses, and needs.  Assess support system.  Referrals and resources.  Help clients develop an action plan of 3-4 immediate problem-solving goals.  Explore client beliefs about therapy, including how long it will take.  Role induction: explain how therapy works. Chalquist.com</p><p> Mutually agreed-upon goals for therapy.  Agree on criteria for termination.</p><p>* Adapted from the IDE model of Budman and Gurman. </p><p>MIDDLE STAGE</p><p> Multileveled interventions--cognitive, family, behavioral, narrative, etc.—around a central theme.  Transference work.  Countertransference as a tool for opening up the therapy.  Resistance management.  Training the client to be their own therapist.  Utopic imagining: encouraging the dreaming of better futures.  Problematizing: seeing through cultural illusions that promote the problem.  Homework: practicing in-session gains out of session.</p><p>TERMINATION</p><p> Deal with issues of loss and grief.  Recap client strengths and areas of growth.  Make sure client connects with people who support new perceptions.  Ceremonialize the transition negotiated by the client.  For clients who need it, go over options for longer-term therapy.  Plan a tentative followup.  If appropriate, frame the brief therapy as an introduction to lifelong learning.</p><p>Checklist of frequent client issues to look for:</p><p> Developmental injury, with a resulting structural deficit.  A need to heal some unhealed trauma.  Pockets of immaturity.  Issues of control and power.  Ethnic, sexual, age, cultural dimensions.  Inner critic.  A present symbolic trigger, obstacle or stress/confusion.  Self-alienation.  Relational problems.  Issues around grief and loss.</p><p>Reminder: A symptom (crisis, outbreak of pathology) is where past and future collide with a rupture in the present. The rupture has an initiatory dimension. Overall goal: assist with the client’s rite of passage forward.</p>