My Takeaway ([[27-03-2024]]) - I was initially intrigued by the title of this book, which suggested that brevity was the key to success. However, I found myself disagreeing with the notion that everything should be faster and shorter. In a world that is already moving too quickly, people need to take a moment to slow down and reconnect with themselves. Instead of speeding up, we should focus on slowing down. - The author of the book suggests that healthcare providers should be able to gather all necessary information and build a therapeutic relationship with their patients within just 10-20 minutes. However, I believe that this expectation is unrealistic and puts a lot of pressure on clinicians. Rushing through assessments and therapy sessions can lead to burnout and negatively impact patient care quality. I wonder whether this approach is solely designed to increase the number of patients seen in a clinic. - In my opinion, this book does not contain anything new that we do not already know. It seems to be repackaging already-known practices and approaches. While it may be a handy tool, it is important to acknowledge that real "second-order change" requires deeper work that cannot be achieved through surface-level interventions alone. [[Books Index]] [[psychotherapy]] ---- # Introduction 1. Healthcare professional competency - It takes a long time to train a therapist with all the needed certifications. 2. Billing systems based on 15-minute billing units - implication to psychotherapy durations 3. Complex bio-psycho-social (mental and physical is it due to increase demand of shorter format of therapy? Therefore need to train more people to give brief therapy? Sure, but is it applicable for all conditions/problems? Look like ultra-brief interventions can be use in depression, anxiety, acute distress, pain, sleep problems and weight problems. # Chapter 1 Ultra-Brief Interventions in Mental Health and Intergrated Care Practice - (Norcross, Et al, 2013) Four themes were responsible for driving these trends: technology, economy, evidence-based treatment, and innovative ideas and practices. - The trend moving towards more mindfulness CBT, integrative, multicultural, internet and telephone format. Use of technology, self-change, skill building and relationship fostering interventions. - Instead of 12-20 psychotherapy sessions as norm, more likely 4-6. - Ultra-brief interventions 10-20 mins. Clinicians to assess, diagnose, treat clients within 15mins!? - Behavioural Health Consultant. Equipped with the following tools - *(1)Assertive communication is a method of expressing emotions, opinions, and needs clearly and appropriately.* - *(2)Behavioral activation is a method for breaking cycles of inactivity and avoidance by substituting activating behaviors. Used with depression and other avoidance conditions.* - *(3)Behavioral self-analysis is a model for analyzing a situation in ABC terms: A is the antecedent or activating event that precedes behavior, B, and is followed by a consequence, C, or effect.* - *(4)Controlled breathing is a method to slow breathing and restore regulated breathing rhythms to reduce stress-related symptoms.* - *(5)Emotional first aid is a method to treat emotional wounds as they arise, without the direct aid of a mental health professional.* - *(6)Habit reversal is a method to reduce tics, stuttering, hair-pulling, and skin-picking by engaging in a competing response that suppresses the unwanted behavior* - *“(7)Mindfulness is a method of focusing on the present without judgment, which results in reduced stress, anxiety, mood symptoms, and mindless action.* - *(8)Motivational interviewing is a method of resolving ambivalent feelings and insecurities in order to find the internal motivation needed to change one’s behavior.* - *(9)Self-monitoring is a method of recording one’s behavior as the basis for changing or regulating it.* - *(10)Stimulus control is a method for identifying factors (stimuli) that precede a behavior to be changed and then taking steps to alter the factors to bring about the desired result.* - *(11)Strategies for improving treatment adherence include motivational interviewing, self-monitoring, and behavioral self-analysis.* - *(12)Thought stopping is a method to interrupt and replace distressing, ruminative thoughts.”* # Chapter 2 - 20 Key Ultra-brief interventions in mental health and integrated care practice - 20 common ultra-brief interventions ![[Screenshot 2024-03-27 at 2.28.39 PM.png]] When to use the interventions ![[Screenshot 2024-03-27 at 2.29.01 PM.png]] *I am wondering why we do not see the implementation of helpful interventions or techniques at our workplace to address issues such as attachment, trauma, sense of self, and motivation.* # Chapter 3 - Brief Assessment in Mental Health and Integrated Care Practice 1. Functional assessment 2. ![[Screenshot 2024-03-27 at 2.35.42 PM.png]] 3. Medication Misuse assessment 4. Risk assessment 5. Cultural assessment 6. Goals assessment # Chapter 4 - Pattern-Focused Therapy in Mental Health and Integrated Care Practice Pattern-focused therapy is a brief therapeutic approach for easily and effectively identifying and changing an individual’s maladaptive pattern of thinking, feeling, and behaving to a healthier and more adaptive pattern” - Looking for patterns, both adaptive or maladaptive patterns. (Sure, no disagreement there, but what's the next step after identifying a pattern?) Pattern shifting - *Sure, I think most therapeutic approaches aim to increase the patient's awareness of maladaptive behavior or patterns. But how can this be achieved in a very short time?* # Chapter 5 - Ultra-Brief Interventions with Depression - Behavioural Activation - Psychoeducation - Medication - Identifying factors/triggers (Author call it "Pattern-Focused Therapy") # Chapter 6 - Ultra Brief Interventions with Anxiety and Trauma - Distress tolerance training - Controlled breathing - Thought stopping - Psychoeducation - Identifying factors/triggers (Author call it "Pattern-Focused Therapy") - Medication # Chapter 7 - Ultra Brief Interventions with Chronic Pain and Medication Misuse - Psychoeducation - Gate Control Theory of Pain (Melzack & Wall, 1965): Pain can be affected by thoughts, mood, attention - Identifying factors/triggers (Author call it "Pattern-Focused Therapy") - Medication # Chapter 8 - Ultra Brief Interventions with Sleep Problems - Psychoeducation - Sleep hygiene - Progressive muscle relaxation - Medication - Identifying factors/triggers (Author call it "Pattern-Focused Therapy")