MRI brief therapy

Domain V · Systemic, relational, group & community · Richard Fisch, John Weakland, Paul Watzlawick · 1966 · Palo Alto, USA

What it is

Richard Fisch, John Weakland and Paul Watzlawick founded the BTC at MRI in 1966 to study rapid problem resolution. The model is also called the Palo Alto model, brief problem-focused therapy or brief strategic therapy. Its roots are Bateson's communication project (1952–62) and Milton Erickson's…

Format

• Format. BTC cases were unselected and capped at 10 sessions. Sessions ran weekly, and one review describes them as one-hour sessions. Over 24 years the mean was about six sessions. A trial of a five-session cap gave worse results than the ten-session cap and was dropped. The team met weekly: one…
• It is used with individuals, couples and families, often seeing only one motivated member. It is listed under family therapy schools because its theory is interactional, not because whole families must attend.

Who practises it, and how they are trained or regulated

• The core idea of change is that a problem persists because of what people currently do to solve it. A difficulty is met with an attempted solution that keeps or worsens it, which prompts "more of the same" solution, and so on in a self-reinforcing loop. The origin and duration of the problem do not matter. Interrupting the loop, usually by getting the most concerned person to do "less of the same" or the reverse,…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• consent to observation and recording.
• non-compliance. Never push, which is the mine field; see section 5.
• recognition, or a smile. Do not prescribe worsening of anything risky.
• the client calmly handling a slip without going back to the old solution.
• clients describing the follow-up call as itself helpful. Keep it neutral.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.