The Power of Brief Mental Health Therapies

Last year, a survey by the American Psychological Association found that the demand for psychotherapy has increased dramatically since the start of the Covid pandemic, with 68% of therapists reporting that their waiting lists have increased and more than 40% saying they are unable to keep up. with the request. But help doesn’t have to mean years of traditional psychotherapy. Research has shown that even short interventions — targeted, time-limited programs to improve thinking and behavior at critical moments — can have significant benefits.

These interventions, which can be as short as 30 minutes of online training, are not a substitute for psychotherapy. But given the rising rates of anxiety, depression, stress, substance abuse and suicide among American adults and teens, they can be powerful ways to prevent challenges from escalating.

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After one meeting, people reported that their feelings of hopelessness and anxiety improved significantly.

A study published in the online preprint library PsyArXiv in July by Gina Song, a doctoral student in psychology at Stony Brook University, and colleagues found that even one healthcare session with a counselor can be beneficial for people on psychological treatment waiting lists. In the sessions, 65 participants were asked to think about their most important goals, steps they could take to achieve them, and potential obstacles they might have to overcome. After one meeting, people reported that their feelings of hopelessness and anxiety improved significantly.

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Brief interventions can also reduce suicide risk, explains David Jobs, a psychologist at Catholic University who developed the Collaborative Assessment and Suicide Management (CAMS) Program, an evidence-based clinical intervention to help people avoid falling into suicidal thoughts. Over the course of six to eight sessions, the therapist helps the patient identify the difficulties that trigger suicidal feelings and develop a coping plan.

Dr. Jobs led a study published in the Journal of Psychiatry in 2017 that included 148 US military personnel who reported suicidal thoughts. They were divided into two groups, one receiving CAMS and the other receiving treatment as usual. The study found that CAM participants were “significantly less likely” to have suicidal thoughts after three months. “People are really good at getting better if you give them the right tools,” Dr. Jobes said.

Chronic pain is another problem that has been shown to respond well to short interventions. A study published in 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 teaches pain self-management skills. It was as effective as eight weeks of conventional cognitive behavioral therapy. Dr. Darnall’s Empowered Relief program teaches people to notice distressing thoughts and emotions, then practice accepting their symptoms rather than blowing them up. After three months, participants reported significant improvement in pain management and sleep disturbances.

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Brief interventions are particularly promising as a way to help children and adolescents.

Brief interventions are particularly promising as a way to help children and adolescents. A report published by the Centers for Disease Control and Prevention in March found that the Covid pandemic has accelerated the rise in mental health problems among teens, with 37% reporting they experienced poor mental health during 2021.

In the early months of the pandemic in 2020, Jessica Schleider, a psychologist and assistant professor at Stony Brook University, and her colleagues launched the YES! Which offers free online half-hour interventions for teens with symptoms of stress, depression and anxiety.

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

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

Another elementary teacher, psychologist David Yeager of the University of Texas, Austin, and his collaborators developed a 30-minute online training session for first-year college students. Participants also heard stories from older students, who emphasized that college can feel challenging at first but improve over time. Then the early years were asked to write their own letters offering hope to future students.

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

Research led by Jeremy Jamison of the University of Rochester found that a short training session on “stress reassessment” can also help students deal with anxiety. In a study of 339 community college students published in the Journal of Experimental Psychology in July, those who were taught to think about symptoms of anxiety such as increased heart rate and sweaty palms as a natural response to stress performed better on academic exams. Dr. Jamieson explains that his interventions are meant to act as a prop to prevent stress from escalating into depression.

Dozens of studies also highlight the potential for single-session interventions to reduce drinking problems. 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 more than 300,000 adults and found that a brief intervention reduced the average number of days participants participated in. Excessive drinking by 26%.

Jeffrey Cohen, a professor at Stanford Graduate School of Education and author of Belonging, a new book about brief interventions to improve social inclusion, describes those interventions as literal opportunities for people to perform to their full potential, which is far 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 greets you warmly, calming your nerves so you feel more able to socialize,” says Dr. Cohen. The growing body of evidence for success with short interventions shows that mental health and psychotherapy should not be considered in terms of all or nothing.

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