Course Review by Consultant Psychiatrist

As the waiting-list for psychotherapeutic intervention relentlessly grows and at the same time many patients are reluctant to accept pharmacotherapy, the psychiatrist in out-patients is often faced with a dilemma as to what kind of brief and effective help could be offered to these patients. It was therefore not a very difficult decision for me to make when one of my colleagues drew my attention to Brief Strategic Therapy Course offered in London.

The six day "Saturdays" course promises to introduce the participants to the method and technique of psychotherapeutic intervention suitable for a brief treatment in a wide range of psychiatric problems such as generalised anxiety, phobias, adjustment depressive disorders and problems associated with stress, post-traumatic stress, sleep disorders, etc.

The protocol is based on a brief three-stage approach using specific approaches for each stage. The underlying principles are well understood to anyone who is involved in management of psychiatric disorders: it accepts patient's experience as valid and uses the symptoms as a vehicle of change, aims at achieving psychological balance and not at unrealistic aspirations to eliminate the symptoms. Since the intervention is brief, the emphasis in later stage is put on technique which can maintain the favourable changes into the future.

The first stage is focused on careful history of the problem which is, however, structured in a specific BST Way. The emphasis is also put on psycho education and re-framing the presenting symptoms in a positive way.

In the second stage the state dependent memory and learned behaviour (often a very important factor at the core of the problem) and then deconstructed (re-processed) using variety of methods ranging from deep relaxation to eye movement desensitisation and reprocessing.

The third stage is primarily focused on therapeutic procedures suitable for maintaining gains of therapy in future. These techniques use methods based on recent evelopment in neurophysiology, dynamic neuroanatomy, nueropsychology and neurochemistry, and include even some elements of chaos theory and quantum physics. Practical use of group theory and paradox is included in the programme.

The course is aimed at a wide variety of professionals and covers subjects which some of the participants will be more familiar with than others but it is my opinion that the lectures struck the appropriate balance.

I believe that I have benefited from the course which helped me to improve my therapeutic efficacy. I would recommend it to all professionals working with psychiatric patients who want to improve their range of psychotherapeutic skills. The BST approach differs from usual orthodox treatment and since it is one to one therapy it does not require any extra resources beyond initial outlay on cost of training.